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Define urinary incontinence?
Loss or lack of bladder control.
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Signs/ symptoms of urinary incontinence?
Dribbling, leakage, & abdominal pressure.
Urinary retension increases risk for uti infection.
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Risks for incontinence?
Skin break down, and frequent uti infections.
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How is sterile specimen collected from a catheter?
Clamp, wait 5-10 min., swab port with alchol, and with draw with needle toward the bladder.
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24 hr. urine specimen pecedure?
Toss first urine, collect over 24 hr. put on ice. If one urination is miss must be started over.
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Nursing Diagnosis for urinary incontinence?
Social isolation, related to unwillingness to go out in public situations, and manifested by loss of bladder control.
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Interventions to assist voiding?
Ammonia capsule broke in urinal (for Men), shower or run water ( for sound), stand up, pore warm water over privates, give privacy, or strait catheter.
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Ausculatate bowel sounds?
No audible sounds- nursing actions?
3-5 minutes each of 4 quadrants, or 20 minutes total.
Document, and call doctor.
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Diagnostic procedures: Decrease anxiety, How?
Explain it, talk to them.
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Food pyramid: What are the food groups requirements?
Fruits, vegatables, dairy, fiber, fats, meats (protein), and fluids.
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Post colon surgery: what is accessed.
Bowel sounds, and incision.
If no farting and no bowel sounds, is very bad.
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Nursing diagnosis for diarrhea?
Fluid imbalance, related to diarrhea, manifisted by dark urine, diarrhea, skin turgor, etc.
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Colostomy: what type of stool?
Formed stool.
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Patients at risk for respitory illness?
Age, immobility, asphma, surgery, and occupation.
Pollution, and area.
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Pulse ox measures what?
Afterial Oxygen % of 02 on hemoglobin.
ABG=Arterial Blood Gas
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What position facilitates respirations?
Fowlers position.
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What is the purpose of pursed-lip breathing?
Blows off CO2, expands lungs, and reduces airway resistance.
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Bronchodilators:
How administered?
Action?
Inhilation, Nubulizer.
Dilate Bronchials.
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Define Negligence?
What is the best defence?
Failing to perform a task, that puts patient at risk.
Exp. patient falls.
Document very well.
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Define assult?
Aggresive behavior, verbal, or physical.
Exp. If you don't take those medications, I will ....!!!!
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Define damages in malpractice?
Sueing for damages to patient. Something happens or happened to patient.
Exp. Physical, monitary, or emotional.
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Dehydration and infection:
What nursing diagnosis for physical effects?
Altered mental and temperature status, related to dehydration and infection, and manifested by afebrile temperature, dry skin, dark urine, & skin turgor.
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Inhalation anesthesia:
Desired Action?
short acting and able to reverse effects faster.
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Nurse role in consent?
Witnessing their signature to consent to surgery.
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Nursing diagnosis:
Over weight, abdominal surgery?
Infection and dehissense, related to fat has less circualtion so heals at slower pace, and manifest by longer healing time.
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Low patassium: Nursing action?
Document, then call and notify doctor.
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Patient teaching to cough effectively after surgery?
Splinting.
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Purpose of Assessment in PACU?
Watch for complication from surgery, big risk for cardiac and respitory complications.
- ABC's= A=Airway
- B=Breathing
- C=Circulation
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Post surgery:
Bleeding- Nursing Action?
Where to check for bleeding?
Pressure, report finding to doctor, and document.
Underneeth them, or behind them.
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Rationale for semi-fowlers R/T respiratory?
Lung expansion.
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Post surgery: Patient teaching?
Follow up, don't drive, don't sign any legal or important documents.
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Define unintentional wound?
Jagged edges, hard to suture, and risk for infection.
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Patient teaching: Prevent infection?
Wash hands and good wound hygine.
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What are DRG's?
Diagnostic Related Groups= set amount of $ and how long you can stay.
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Long-term Care Facilities?
Have to qualify and any age.
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How can nurses shape health care reform?
Get involved and get politically active.
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HIPAA: Mandated information to patient?
How information will be shared.
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Discharge Planning rational?
Continuity of care, released to family, self-care, or long-term care setting.
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Personal space: Signs of invasion?
Backing Away from you.
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Define Empathetic?
Nonjudgemental feeling for them, and can relate to them.
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Helping relationship: Action during orientation Phase?
Introduce self, then address them, asking "whats your name?", and see what they would liked to be called if there is a preference.
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Define autocratic leadership?
One man rules, a dictatorship.
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Why give lasix and aldactone together?
They potensiate each other, and Balance Electrolites.
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Patient requests medication:
No order- nursing action?
Call doctor and get order for one.
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Examples of medications errors?
- Not doing 3 checks, and the 7 rights.
- 3 Checks: out (site), compare MAR, and back in or to patient.
- 7 Rights:Right drug, right dose, right patient, right time, right route, right reason, right documentation.
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