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Incentive Spirometer Use
- Sit up
- Exhale
- Insert Mouthpiece
- Inhale for 3 seconds
- Hold for 10 seconds
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VRSA Precautions?
Contact & Airborne, private room, doors closed, negative pressure.
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Blood Transfusion Reaction Sx
- Flank pain
- Freq swallowing
- Rash
- Fever
- Chills
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Thrombocytopenia Precautions
- BLEEDING:
- Soft bristled toothbrush
- No insertion (suppositories, douche)
- No IM injections
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Iron should be given how?
P.O. with O.J. on an empty stomach.
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Burn Degrees:
- 1st: Red/Painful
- 2nd: Blisters
- 3rd: No pain/blocked nerves.
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Pernicious Anemia Sx:
Red, beefy tongue, will take B12 for the rest of their life.
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Meniere's Disease Sx & Tx
- Sx: Vertigo, Tinnitus, N/V.
- Tx: Diuretics, lay on affected ear.
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Gastric Ulcer Pain:
Occurs 30-90 mins after eating (not at night) doesn't go away with food.
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Sickle Cell Crisis Interventions?
Fluids and Pain management
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Glomerulonephritis: Monitor/Restrict?
- Mon: BP
- Rest: Dietary: higher fluids, protien, sodium.
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Labs show high hematocrit, high hemoglobin, high RBC's. Indication?
Hypoxia due to congenital heart defect.
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Meningitis CSF Labs:
High protein, low glucose.
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Head/Skull Injury-precautions?
No nasogastral suctioning.
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How to avoid Otitis Media in babies?
Feed in upright position.
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Ribavirin is being administered. Precautions?
No contact lenses, no pregnant staff.
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Neutropenic Precautions?
No milk, fresh fruit/veggies.
- What does Neutropenic mean?
- Low WBC's
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Ideal IM site for adults & infants?
Ventrogluteal (Hip)
-
Vastus Lateralus
IM injection site (thigh)
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Z-Track technique
Used for irritating drugs, pull skin to the side before performing injection.
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How many mL in 1 TBSP?
15 mL
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How many mL in 1 tsp?
5 mL
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How many oz in 1 cup?
8 oz
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How many oz in 1 lb?
16 oz.
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HTN Sx
Headache, dizziness, nosebleed.
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Theophylline causes?
GI upset. Give with food.
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Pursed lipped breathing promotes?
CO2 elimination.
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Emphysema precautions:
High fluids, high fowlers, leaning forward, pursed lipped breathing.
*What is emphysema? Pt has trouble breathing, stimulus to breathe is low PO2, not build up of CO2.
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GERD positioning for adult
lay on left side with HOB elevated 30 degrees.
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Reflux Diet:
Nonfat milk increases lower esophageal sphincter pressure, reducing reflux.
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Steroids can cause?
- Increased glucose.
- Diabetic Pt may need more insulin than normal.
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Synthroid should be given...
on an empty stomach.
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Lugol Solution
Used to treat hyperthyroid, may cause burning sensation in the mouth and brassy taste.
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Vasopressin
- "press-in"
- Used as a vasoconstrictor.
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Hyperparathyroidism can cause? Which can cause?
Hypercalcemia, and Polyuria.
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Crutches/Stairs
- Up: good leg, then crutches.
- Down: crutches, then good leg.
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Reportable STD?
Gonorrhea.
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Nitrazine paper:
- Turned blue by amniotic fluid, which is alkaline.
- Turned pink by urine/normal discharge which is acidic.
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If you found another nurse made a mistake?
Speak to that nurse, your manager, then agency.
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Wheelchair placement when moving Pt to bed?
Wheelchair should be parallel to the bed on the side of weakness.
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HbA1c test
Assesses how well BS has been controlled over the last 90-120 days. Score can be 4-7, 7 being ideal (BS of 130).
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TB positives:
- 5 mm in an immunocompromised Pt
- 10 mm in normal Pt
- 15 mm in Pt who lives in area where Tb is very rare.
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Precaution with newly diagnosed HTN Pt
BP should be taken in both arms.
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What could cause bounding pulses? How?
Coarctation (narrowing) of the aorta-through inc blood flow.
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Depressed Pt Priorities?
Safety over nutrition.
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Pancreatitis Priorities:
- Pain relief
- Cough/deep breathe to avoid fluid pushing up in diaphragm.
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Addison's precautions:
Reduce stress! Addison's can cause hypotension, check BP.
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How to mobilize edema?
Have Pt ambulate then sit with legs elevated.
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IVP precaution?
Give laxative the night before to better visualize organs.
- *What is IVP?
- Intravenous Pyelogram
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Dark stools? Lab values?
Indicate bleeding. Lab values would show low hemoglobin and/or hematocrit.
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