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A patient needs a dressing change and the LPN under an RN has only observed a similar change. What should the RN do?
Complete the dressing change while the LPN observes.
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Several days postoperatively, a patient complainsof pain, tenderness and redness of the right calf. What critical S&S should the nurse assess for next?
Chest pain and shortness of breath. The pain is an indication of a deep vein thrombosis. Leg needs to be elevated and antibiotics given.
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During the first 24hrs after surgery with an order of morphine IV q 3-4 hrs prn, what is the best way to administer pain medication?
Administer pain medication every 3 hrs. Need to control pain before it becomes severe, especially after surgery.
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If you note a reddened area on the coccyx of an elderly patient, what should you do next?
Reposition the patient every 1-2 hrs
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What is a really good source of vitamin C?
Oranges/oj
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An at home elderly pt with a diet mostly of carbs needs to increase her intake of what?
Protein
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What would be a lab finding that reflects the S&S of infection?
A white blood cell count of 16,000/mm^3
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The nurse is most concerned about the psychological adjustment of a 26yr old man scheduled for the Whipple procedure due to cancer of the pancreas because?
The patient has a life-threatening illness with poor outcome. The nurse will need to help the pt deal with physical changes due to the surgery and the threat of dying
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What is the most reliable indication that a nasogastric tube is in the correct place in a postoperative pt?
pH of the aspirate of 3
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A pt in the ER with a rusty nail puncture in his foot had his last Td shot 6 yrs ago. What should the nurse do first?
She should determine how many Td shots the pt has received
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A pt with T of 101 and WBC count of 3000/mm^3 needs what precautions?
Neutropenic precautions.
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What is a characteristic of chronic pain?
Weight loss or gain, fatigue
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What is an important fact about Coumadin?
It is an anticoagulant with a prolonged action. Also called warfarin.
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What is the description for a pt with a BMI of 38 kg/m^2?
Obese. 30-39.9 BMI.
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Give an example of when a nurse should consider withholding morphine until further assessment.
Pt level of consciousness fluctuating from alert to lethargic
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To promote evening rest and sleep for immobilized/in bed pt, what should a nurse provide?
daytime activities
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What should you do after administering preop meds to a pt?
Raise the side rails
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When teaching a pt a good exercise program, what statement would indicate the need for further teaching?
I should start by running 5 miles a day
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Aspirin in high, prolonged does may cause?
GI bleeding
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A pt with a fractured humerus due to a home fall, needs immediate intervention to which observation?
Bathroom with grab bar
Throw rugs removed
Pt ambulation with socks
Stairs well lighted
Pt ambulation with socks, need shoes or non skid slippers
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A pt with multiple wounds needs a diet that includes what?
- High Vit C
- High Protein
- High Carbs
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When preparing to leave a pt room with droplet precautions, what should you not do?
Hold onto the outer surface of the facemask and pull it away from your face.
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On postop day 1, pt develops fever. Crackles auscultated bilaterally in lower lobes. What complication of surgery is most likely developing?
Atelectasis
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A protective respiratory device is appropriate care for which kind of pt?
pt diagnosed with varicella
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Which behavior is helpful to facilitate pt bowel elimination?
Increased dietary bulk
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What is the purpose of a drain in a wound?
To keep the tissues close together so that healing can occur
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Teaching a pt discharge info bout Warfarin, what would indicate that the pt needs more teaching?
pt states: I should look for yellow-tinged complexion.
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If a pt asks for pain meds at bedtime and they have an order for 8mg morphine IV q3-4 hrs prn, what should you do first?
Assess location, character, and intensity of pain.
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What is the best position for a pt to cough and breathe after surgery?
High Fowler's: sitting straight up or leaning back slightly
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Orange juice and white toast are examples of foods with an inadequate serving of what food group?
Protein.
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