ATI RN Fundamentals Proctored Focus Questions and Answers

ATI RN Fundamentals Proctored Focus Questions and Answers Discharge teaching for a client with diabetes mellitus: - Answer ️️ -DIET: -limit calories & decrease total fat intake to 30% of total calories/day -eat omega 3 fatty acids and fiber -low sat fats -use artificial sweetners WHEN SICK: -monitor glucose Q 3-4 hr -take DM meds as prescribed -increase fluids -test urine for ketones -encourage rest -report persistent fever above 101, confusion, rapid breathing, persistent N/V, etc. -assess support systems -assess ability to self-admin insulin -check glucose before meals and at bedtime -return demonstrations on self admin -store test strips in dry closed container -hand hygiene -continuous pump needles need to be changed Q 2-3 days -rotate injection sites -record I&Os and daily weights -hypoglycemia warrants immediate evaluation of glucose FOOT CARE: -inspect feet daily, wash w/mild soap & warm water-test temp first -avoid lotions -use mild foot powders -NO home corn/callous remedies -nail care after bath/shower -avoid open toe or open heel shoes -leather shoes better -no barefoot -cotton or wool socks -water heater should be no more than 120 Client safety: fall risk precautions - Answer ️️ --complete fall risk assessment upon admission -show client how to use call light, make sure it is within reach -ensure adequate lighting -orient the client to the setting, make sure they know how to use all assistive devices -place fall risk clients near nurses station -bedside tables, overbed tables, and frequently used items should be within reach -bed in lowest position -sedated/unconscious clients bed rails up, bed in lowest position -avoid use of full side bed rails for clients who get out of bed or attempt to w/out assistance -nonskid footwear & nonskid bathmats -keep floor free from clutter (no rugs, cords, furniture) -educate family & client on fall risk status/prevention -lock wheels on beds, wheelchairs, & cartss -use chair & bed sensors Home safety: Teaching an older adult client about home safety - Answer ️️ --remove items that could cause the client to trip (rugs, cords, carpets) -place electrical/extension cords against a wall behind furniture -monitor gait/balance, provide aids PRN -make sure steps/sidewalks are in good condition -grab bars near toilet, tub, shower -stool riser, toilet cushion -nonskid bath mats/shower mats -shower chair or bedside commode PRN -ensure adequate lighting -water heater 120 -no smoking if on oxygen, cotton stuff only, no heating oil or nail polish remover -cook meat and fish fully, handle properly Client safety: alternatives to restraints for a client who is confused - Answer ️️ --one to one care -keep close to nurse's station -low to the floor beds with mattress on the floors -bed alarms -rocking chair in the room -relaxation techniques -family stay with the patient Hygiene: Bathing a client who has dementia - Answer ️️ --assess client's ability to help -collect equipment & explain procedure, reassure, maintain their dignity -apply gloves -lock wheels on beds -wash face first -keep them covered -shave in direction of hair -brush teeth and hair often and gently -do not need to bathe daily as their skin cannot take it -reorient often thorax, heart, and abdomen: appropriate technique for abdominal assessment: - Answer ️️ -1. Inspection 2. Auscultation 3. Percussion 4. Palpation -urinate before abd assessment -supine, knees slightly bent Self-concept and sexuality: Providing client support following a mastectomy: - Answer ️️ -- monitor anger, emotions -encourage client to participate in care -arrange support group or visit from someone in similar situation -counseling -discuss alternative means of sexual expression (hugging, cuddling) -therapeutic communication Mobility & Immobility: Appropriate use of crutches: - Answer ️️ --do not alter crutches after fitting -follow prescribed crutch gait -support body weight at the hand grips w/the elbows flexed at 30 degrees -position crutches on the unaffected side when sitting or rising from a chair -keep crutches 6 inches to the front and to the side of client when walking -don't let crutches fit under the armpit - allow some space to avoid damage to skin or nerves in axillae Urinary elimination: preventing skin breakdown - Answer ️️ --keep skin dry and clean -assess for signs of breakdown -apply protective barrier creams -implement bladder retraining programs Mobility & Immobility: Preventing thrombus formation: - Answer ️️ --avoid pillows under knees or lower extremities -avoid crossing legs -avoid wearing tight clothes -avoid sitting for long periods of time -avoid massaging the legs -use elastic stockings -use compression devices (SCD, IPC) -increase fluid intake -avoid valsalva maneuver -change positions often -encourage ROM & leg exercises Fluid imbalances: hypersomolar imbalance - Answer ️️ --aka dehydration -fluids: isotonic solutions such as LR or 0.9% sodium chloride NaCl -blood transfusions -encourage oral rehydration as tol