ATI Med surg retake studying (missed ones) (2) | Summaries Nursing

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ATI Med surg retake studying (missed ones)

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ATI Med surg retake studying:

- Postoperative Nursing Care: Priority Assessment Finding Following a Total

Laryngectomy (Active Learning Template - Therapeutic RM AMS RN Procedure, 11.0 Chp

96 Postoperative Care) Nursing

o Monitor irregular respirations, decreased saturation for choking, noisy, oxygen

values, and cyanosis

§ stridor

o Implement a head-tilt/chin- maneuver to the tongue forward and lift pull open

the airway

o Keep emergency equipment at the the (resuscitation bag, bedside in PACU

suction equipment, airways)

o Notify the anesthesiologist, elevate head contraindicated, of bed if not provide

humidified oxygen, and plan reintubation with endotracheal tubefor

§ Total laryngectomy: permanent tracheostomy

- HIV/AIDS: Teaching Home Care (RM AMS RN 11.0 Chp 86 HIV/AIDS,Active Learning

Template: System Disorder)

o Keep home environment clean and avoid being exposed to family and friends

who has colds or flu viruses

o Wash dishes in hot water using a dishwasher if available

o Avoid crowded areas or traveling to countries with poor sanitation

o Avoid raw foods (fruits, vegetables) and undercooked foods (meat, fish, eggs)

o Avoid cleaning pet litter boxes to reduce the risk of toxoplasmosis

§ And gardening

o Bathe using antimicrobial soap

• Sx: persistent fever, swollen glands, diarrhea, weight loss and

fatigue

- Cancer Treatment Options: Nursing Care for a Client Who Is Receiving Internal Radiation

Therapy (RM AMS RN 11.0 Chp 91 Cancer Treatment Options,Active Learning Template:

Therapeutic Procedure)

o Put patient in private room, keep door closed as much as possible

o Place sign on door warning of the radiation source

o Wear a dosimeter film badge that records personal amount of radiation

exposure

§ Nurses and nursing staff

o Limit visitors to 30-min visits, and have visitors maintain a distance of 6 feet from

the source

o Individuals who are pregnant, trying to conceive or under the age of 16 should

not enter the clients room

o Wear a lead apron while providing care, keeping the front of the apron facing

the source of radiation

o Most linens and dressings are kept in the client’s room until the radiation source

is removed, to ensure it is not lost in the trash or laundry

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h"ps://quizlet.com/730060462/a9- rn-medical-sur gical-proctored- 2019 -flash-cards/ h"ps://quizlet.com/582159240/medical-surgical-a9-proctored-exam- 2019 -flash-cards/ ATI Med surg retake studying:

Postoperative Nursing Care: Priority Assessment Finding Following a Total Laryngectomy (Active Learning Template - Therapeutic Procedure, RM AMS RN11.0 Chp 96 Postoperative NursingCare) o Monitor for choking, noisy, irregular respirations, decreased oxygensaturation values, and cyanosis § stridor o Implement a head-tilt/chin- lift maneuver to pull the tongue forward andopen the airway o Keep emergency equipment at the bedside in the PACU(resuscitation bag, suction equipment, airways) o Notify the anesthesiologist, elevate head of bed if not contraindicated,provide humidified oxygen, and plan forreintubation with endotracheal tube § Total laryngectomy: permanent tracheostomy
HIV/AIDS: Teaching Home Care (RM AMS RN 11.0 Chp 86 HIV/AIDS,Active Learning Template: System Disorder) o Keep home environment clean and avoid being exposed to family and friends who has colds or flu viruses o Wash dishes in hot water using a dishwasher if available o Avoid crowded areas or traveling to countries with poor sanitation o Avoid raw foods (fruits, vegetables) and undercooked foods (meat, fish, eggs) o Avoid cleaning pet litter boxes to reduce the risk of toxoplasmosis § And gardening o Bathe using antimicrobial soap - Sx: persistent fever, swollen glands, diarrhea, weight loss and fatigue
Cancer Treatment Options: Nursing Care for a Client Who Is Receiving Internal Radiation Therapy (RM AMS RN 11.0 Chp 91 Cancer Treatment Options,Active Learning Template: Therapeutic Procedure) o Put patient in private room, keep door closed as much as possible o Place sign on door warning of the radiation source o Wear a dosimeter film badge that records personal amount of radiation exposure § Nurses and nursing staff o Limit visitors to 30-min visits, and have visitors maintain a distance of 6 feet from the source o Individuals who are pregnant, trying to conceive or under the age of 16 should not enter the clients room o Wear a lead apron while providing care, keeping the front of the apron facing the source of radiation o Most linens and dressings are kept in the client’s room until the radiation source is removed, to ensure it is not lost in the trash or laundry

Immunizations: Recommended Vaccinations for Older Adult Clients (RM AMS RN 11. Chp 85 Immunizations, Active Learning Template: Growth and Development) o MMR: people born before 1957 is considered immune to measles and mumps o Varicella: for adults who do not have evidence of a previous infection o Pneumococcal: for adults 65 and older who have not been immunized with PCV13 or PPSV23; don’t give at the same time (6-12 months apart) o Hep A: for high risk individuals o Hep B: high risk individuals o Flu: annually for all adults o Meningococcal conjugate polysaccharide vaccines (MPSV4): for adults older than 55 years § MCV4: under 56 years old o HPV: administered young o Zoster: age 50 and older
Pulmonary Embolism: Risk Factors for Deep-Vein Thrombosis (Active Learning Template
- System Disorder, RM AMS RN 11.0 Chp 24 PulmonaryEmbolism) o Risk factors: long-term immobility, oral contraceptive use,pregnancy, tobacco use, hypercoagulability, obesity, surgery, central venouscatheters, heart failure or chronic atrial fib, autoimmune hemolytic anemia, long bone fx,cancer, trauma, septicemia, advanced age
Coping Mechanisms - (1) o Coping: Evaluating a Client's Adaptation to a Role Change (Active Learning Template - Basic Concept, RM Fund 10.0 Chp 33 Coping) § Alarm stage § Resistance stage § Exhaustion stage
Mental Health Concepts - (1) o Alzheimer's Disease: Assessing a Client's Abstract Thinking(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp8 Alzheimer's Disease) § Mini-mental state examination,
Elimination - (1) o Disorders of the Eye: Priority ActionforEye Irrigation (Active Learning Template - Therapeutic Procedure, RM AMS RN 11.0 Chp 12 Disorders of theEye) § Determine mechanism of injury § Irrigate with 0.9% sodium chloride
Mobility/Immobility - (1) o Pressure Ulcers, Wounds, and WoundManagement: Implementing Preventive Strategies (Active Learning Template - Basic Concept, RM Fund 10.0 Chp 55 Pressure Injury, Wounds, and WoundManagement) § Prevention infection by using aseptic techniquewhen performing dressing changes § Monitor all clients regularly for skin-integrity status and for riskfactors that contribute to impaired skinintegrity § Use a riskassessment tool

§ Double check opioid doses with another nurse prior to admin

Parenteral/Intravenous Therapies - (1) o Dosage Calculation: Calculating Rate ofIV Solution (Active Learning Template - Basic Concept, RM Fund 10.0 Chp 48 Dosage Calculation)
Diagnostic Tests - (1) o Principles of Antimicrobial Therapy: Intervention forSuspected Septicemia (Active Learning Template - System Disorder) § Broad spectrum abx § After getting lab result back on what type of infection, change tospecific abx
Potential for Complications of Diagnostic Tests/Treatments/Procedures - (1) o Cancer Disorders: Monitoring a Client Who Has ChronicLymphocytic Leukemia (Active Learning Template - System Disorder, RM AMS RN11.0 Chp 92 Cancer Disorders) § Monitor for evidence ofinfection - Frequent hand hygiene - Private room - Only healthy visitors, or illvisitors have to wear a mask - Screen visitors - No fresh fruits orvegetables - Monitor WBC - Prevent transmission of bacteria and viruses, no live plantsor flowers in room § Monitor platelets/ prevent injury - Avoid IV sticks and venipunctures § Avoid trauma (electric shaver, softbristled toothbrush, avoid contact sports) § Consume energy - Rest, adequate nutrition, fluidintake - Adequate sleep - Assess clients energyresources/capability
System Specific Assessments - (2) o Cancer Disorders: Expected Findings of ColonCancer (Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 92 CancerDisorders) § Changes in stool consistency orshape § Blood in stool § Cramps and/or gas § Palpable mass § Weight loss and fatigue § Vomiting § Abdominal fullness, distention orpain § Abnormal bowel sounds indicative ofobstruction § Rectal pain

§ Sensations of bowel fullnessafter defecation o Inflammatory Disorders: Assessing a Client WhoHas a Friction Rub (Active Learning Template - Nursing Skill, RM AMS RN 11.0 Chp 34 Inflammatory Disorders) § Heard at left lower sternalborder

Therapeutic Procedures - (1) o Invasive Cardiovascular Procedures: Teaching About Left-SidedCardiac Catheterization (Active Learning Template - Diagnostic Procedure,RM AMS RN 11.0 Chp 30 Invasive Cardiovascular Procedures) § Likely be awake for theprocedure but given medicine to helpthem relax § Recovery isfast § If groin is used - pt will need to lay flat for several hoursafter the procedure to avoid seriousbleeding § Monitor VSand assess site frequently § Elevate HOB to 30 degrees or lay flat after the procedure for 2-6hours depending on the providersorders § Increase fluids after to get all the contrast dye out ofthe system § Contrast dye- hot flashfeeling § Keep leg straight after procedure
Alterations in Body Systems - (3) o Asthma: Using a Peak FlowMeter (Active Learning Template - Diagnostic Procedure, RM NCC RN 11.0 Chp 18 Asthma) § Used to measure the amount of air that can be forcefull exhaled in 1 second - Hard fast blow § Each child needs to establish personalbest § Record highestreading after 3 attempts - No average § Keep taking medicine even when attempts are in the greenzone § Measure at the same time each day o Head Injury: Responding to Change in Level of Consciousness(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 14 Head Injury) § Loss of consciousness: length of time theclient is unconsciousis significant § Even if the LOC is decreased, explain to the client the actions being taken and why (hearing is the last sense affected by a head injury) o Renal Calculi: Dietary Recommendations for a Low-Purine Diet(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 61 Renal Calculi) § Decrease intake of purine sources: organ meats, poultry, fish, gravies,red wine, and sardine - Increased uricacid
Hemodynamics - (3) o Anemias: Manifestations of Anemia (Active Learning Template - SystemDisorder, RM AMS RN 11.0 Chp 41 Anemias)

§ DVT

Encourage ambulation following initiation ofanticoag therapy o Encourage dorsiflexion/plantar exercises of thefoot when in bed o Occasionally elevate the legs above the level ofthe heart while the client is in bed (avoid using a knee gatchor pillow under the knees)
Administer intermittent or continuous warm moist compressesas prescribed
Do not massage the affected limb
Thigh - high compression oranti- embolismstockings
Prepare the client for an inferior vena cava interruptionsurgery § Venous insufficiency
Avoid crossing legs or wearing constrictive clothing orstockings
Wear elastic compression stockings. Apply them after thelegs have been elevated and when swelling is at aminimum
Analyze Cues - (1) o Hypertension: Identifying a Prescription to Clarify With the Provider(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 36 Hypertension) § Common meds
Diuretics “hydrochlorothiazide, furosemide,spironolactone”
CCB “verapamil, amlodipine, diltiazem”
ACE inhibitors “pril”
ARBs “sartan”
Aldosterone-receptor antagonists “eplerenone,spironolactone”
Beta blockers (lowers BP and HR)“lol”
Evaluate Outcomes - (1) o Meningitis: Caring for a Client WhoHas Meningitis (Active Learning Template - System Disorder, RM AMS RN 11.0 Chp5 Meningitis) § Isolation/private room § Droplet precautions (PIMP) § Cooling blanket § Report to health department § Decrease environment stimuli (quiet, dim room)
Seizure precautions § HOB elevated 30 § Monitor for increased ICP
Avoid coughing and sneezing § Replace f/e Zarahs

Preoperative Nursing Care: Identifying Allergic Cross-Reactivity (RM AMS RN 11.0 Chp 95 Preoperative Nursing Care,Active Learning Template: Basic Concept)

Latex al lergy: bananas, avo cados, strawberries
Propofol allergy: eggs, soybean oil
Povidone-iodine allergy: shellfish Preoperative Nursing Care: Priority Action for a Client Who Has Alcohol Intoxication (RM AMS RN 11.0 Chp 95 Preoperative Nursing Care,Active Learning Template: System Disorder)
ABC’s
Airway patency, O Stroke: Caring for a Client Who Has Left - Sided Hemiplegia (RM AMS RN 11.0 Chp 15 Stroke,Active Learning Template: System Disorder)
Left: language
Aphasia
Slow cautious behavior
Perception is fine
Cant recognize familiar objects o Right: reckless, poor judgement, bad perception Benign Prostatic Hyperplas 11.0 Chp 66 Disorders of the Male Reproductive Syia, Erectile Dysfunction, (^) stem,Active Learning Template: Therapeutic Procedure)and Prostatitis: Complication of Continuous Bladder Irrigation Following Tra (RM AMS RN
If obstructed, turn off CBI and irrigate with 50 mL irrigation solution using a larg e piston syringe or per facility policy Medications Affecting Coagulation: Contraindications for Heparin (RM Pharm RN 8.0 Chp 25 Medications Affecting Coagulation, RM Pharm RN 8.0 Chp 25 Medications Affecting Coagulation v2,Active Learning Template: Medication)
Bleeding (uncontrollable)
Hypersensitivity
Recent major surgery
During lumbar puncture, regional anesthesia, or surgery that involves the brain, eyes, or spinal cord
Severe thrombocytopenia (increased bleeding risk)
Peptic ulcer disease
Hx of stroke
Recent trauma Electrocardiography and Dysrhythmia Monitoring: Identifying Atrial Flutter (RM AMS RN 11.0 Chp 28 Electrocardiography and Dysrhythmia Monitoring,Active Learning Template: Diagnostic Procedure)
Flutter: normal rhythm but fast
Sawtooth!!! (fluTTer à sawTooTh) Electrolyte Imbalances: Treatment for Hypokalemia (RM AMS RN 11.0 Chp 44 Electrolyte Imbalances,Active Learning Template: Therapeutic Procedure)
Encourage foods with high potassium (avocados, broccoli, dairy products, dried fruit, cantaloupe, bananas, juices)
Oral potassium medicaitons

ATI Med surg retake studying (missed ones) (2), Summaries of Nursing

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§ DVT