Retake 2 ATI RN Medical Surgical

Retake 2 ATI RN Medical SurgicalGI Diagnostics Procedure: Plan of Care for a Client Who Has Gastroenteritis (Ch.46) • A positive finding for clostridium difficile is indicative of this opportunistic infection, which usually becomes established secondary to use of broad-spectrum antibiotics. • Medications: Some medications ( NSAIDs, warfarin, aspirin) place the client at risk for complications. Notify the provider if medication restrictions were not followed. • Blood Test: Interpretations of Findings • Aspartate aminotransferase/ Alanine Aminotransferase: Elevation occurs with hepatitis or cirrhosis. • Alkaline Phosphatase- Elevation indicates liver damage • Amylase/ Lipase- Elevation occurs with pancreatitis • Total Bilirubin- Elevation indicate altered liver function, bile duct obstruction, or other hepatobiliary disorder. • Albumin- Decrease can indicate hepatic disease. • Alpha-fetoprotein- Elevated in liver cancer, cirrhosis and hepatitis. • Ammonia- Elevated in liver disease. Tuberculosis: Appropriate Interventions for a Client Who Has Tuberculosis(Ch.23) • TB diagnosis should be considered for any client who has a persistent cough, chest pain, weakness, weight loss, anorexia, hemoptysis, dyspnea, fever, night sweats, or chills. • Mantoux Test • An intradermal injection of an extract of the tubercle bacillus is made. • A positive Mantoux test indicates that the client has developed an immune response to TB. • Individuals who have latent TB can retain positive MT test and can receive treatment. • Educate the client and family to continue medication therapy for its full duration of 6 to 12 months, even up to 2 years for multi-drug resistant TB. • Airborne precautions are NOT needed in the home setting because family members have already been exposed. Medical and Surgical Asepsis: Maintaining a Sterile Field ( Ch. 10) • The outer wrapping and 1-inch edge of packaging that contains sterile items are not sterile. • The inner surface of the sterile drape or kit, except for that 1-inch border around the edge the sterile field to which other sterile items may be added. • Consider any object held below the waist or above the chest contaminated. • Grasp the tip of the top flap of the package, and with arm positioned away from the sterile field, unfold the top flap away from the body. • Next, open the side flaps, using the right hand for the right flap and the left hand for the left flap. • Grasp the last flap and turn it down toward the body. Diagnostic and Therapeutic Procedures for Female Reproductive Disorders: Client Teaching about Genital Herpes ( Ch. 62) • Diagnosis of genital herpes can be based on the client history and physical. • Laboratory test • Herpes viral culture: fluid from a lesion is obtained using a swab and placed in a cup for culture. • Polymerase chain reaction: identifies genetic material of the virus. Cells from a lesion, blood, or other body fluids can be tested. • Antibody test: blood is tested for antibodies to the virus. • HerpeSelect Immunoblot, HerpeSelect ELISA, Western Blot Postoperative Nursing Care : Preventing Complications (Ch.96) • Report a blood pressure difference of 25% from baseline, a drop to 15 to 20 mmH in diastolic or systolic pressures, or a trending decrease in diastolic or systolic pressures by 5 mmHg at each 15 minute sign assessment. • Extubating of endotracheal tube is based on client’s response to commands, ability to elevate head and use of thoracic breathing. • If the client responds to verbal stimuli, gradually elevate the head of the bed to semi-fowlers position, if not contraindicated, to facilitate chest expansion. Stroke: Caring for a Client Who has Left-sided Hemiplegia(Ch.15) • Left sided hemiplegia • Right extremity hemiplegia (paralysis) or hemiparesis (weakness) • Visual changes, such as hemianopsia (loss of visual field in one or both eyes). • Right sided hemiplegia • Unilateral neglect syndrome: ignore left side of the body: cannot see, feel or move affected side, so client unaware of its existence). Can occur when left hemispheric strokes, but is more common with right hemispheric strokes. • Left hemiplegia or hemiparesis • Poor impulse control and judgement Polycystic Kidney Disease, AKI and CKI: Dietary Recommendations for a Client who Has Nephrotic Syndrome (Ch. 59) • Restrict dietary sodium, potassium, phosphorous and magnesium. • Provide a diet that is high in carbohydrates and moderate in fat. • Restrict intake of fluids (based on urinary output). • Instruct the client to monitor the daily intake of carbohydrates, proteins, sodium, and potassium according to the providers prescription. • Instruct the client to avoid antacids containing magnesium. Antibiotics Affecting the Bacterial Cell Wall: Manifestations to Report to the Provider (Pharm Ch.44) • If indications of allergy