ATI COMPREHENSIVE EXIT EXAM(
t t t t
NGN ATI) t
1. Treattfirsttanytimmediatetthreatsttotatpatient'stsurvivaltortsafety.
Ex.tobstructedtairway,tlosstoftconsciousness,tpsychologicaltepisodetortanxietytattack.tAB
C's.
2. Next,ttreattactualtproblems.tEx.tnausea,tfulltboweltortbladder,tcomforttmeasures.
3. Then,ttreattrelativelyturgenttactualtortpotentialtproblemstthattthetpatienttortfamilytdoestnottrecogni
ze.tEx.tMonitoringtfortpost-
optcomplications,tanticipatingtteachingtneedstoftatpatienttthattmaytbetunawaretoftsideteffectstoftmeds.
4. Lastly,ttreattactualtortpotentialtproblemstwherethelptmaytbetneededtintthetfuture.
ExtTeachingtfortself-caretintthethome.
Heretaretsometgreattprinciplesttothelptyoutastyoutprioritize:
,Systemictbeforetlocalt
AcutetbeforetchronictA
ctualtbeforetpotentialtLi
stentdon'ttassume
Recognizetfirsttthentapplytclinicaltknowledget
Maslow'stHierarchytoftNeeds:
PrioritizetaccordingttotMaslowtwithtphysiologicaltandtsafetytissuestbeforetpsychologicaltesteemtissu
es.
Varianttanginat(Prinzmetal'stangina)
Duettotatcoronarytarterytspasm,tofteningtoccurringtduringtperiodstoftrest.
Unstabletangina
Occurstwithtexercisetortemotionaltstress,tbuttittincreasestintoccurrence,tseverity,tandtdurationtover
ttime.
Stabletangina
Occurstwithtexercisetortemotionaltstresstandtistrelievedtbytresttortnitroglycerint(Nitrostat).
electrolytetimbalancetmanifestations:th
ypocakelmia-->tflattTtwavestontECG
hypercalcemia--
>tdecreasedtdeepttendontreflexest(DTRs)thypocalcemia--
>ttetany
hyperkalemia-->ttalltpeakedtTtwavestontECG
Addison'stdisease
Decreasedtaldosteronetandtrenin
Hypothyroidism
Decreasedttriiodothyroninet(T3)tandtthyroxine
,Cushing'stdiseaset
Elevatedtcortisol
DiabetestInsipidust(DI)tDecrease
dturinetspecifictgravity
Diabetestmelitus
Elevatedtglycosylatedthemoglobint(HbA1c)
SyndrometoftInappropriatetSecretiontoftAntidiuretictHormonetIn
creasedturinetosmolality
Cataract
Progressivetandtpainlesstlosstoftvision
Angle-
closuretglaucomatRapidtons
ettoftelevatedtIOP
maculartdegenerationt
Centraltlosstoftvision
Open-
angletgalucomatLosstoftp
eripheraltvision
Retinaltdetachment
Suddentlosstoftvisiontwithouttpain
Commontdisease'stmanifestationst
Cholecystitis-->tMurphy'stsign
Pancreatitis-->tTurner'stsign
PeptictUlcertDisease-->tUppertepigastrictpaint1-
2thourstaftertmealstAppendicits-->tPaintattMcBurney'stpoint
Decorticate
, Decerebrate
Hepatitistdiseasettransmissions
HepatitistA--
>tIngestionstotcontaminatedtfood/watertHepatitistB--
>tUnprotectedtsexualtcontact
NonviraltHepatits-->tDrugttoxicity
HearttFailure
Symptoms:tShortnesstoftbreath,tfatigue,tjugulartveintdistention,tandtantS3taretsigns/symptomstofthear
ttfailuretresultingtfromtthetdecreasedtpumpingtabilitytoftthethearttandtincreasedtfluidtvolume.
Hypovolemictshock
position:tSupinetwithtlegstelevatedt(shocktposition)
Below-the-kneetamputation
Position:tThetclienttshouldtbetplacedtintthetpronetpositiontseveralttimestatdayttotpreventthiptflexi
ontcontractions.
Chestttube
-
Continuoustbublingtintthetwatertsealtchamperstindicatestantairtleak.tIftthististobserved,tthetnursetsh
ouldtattemptttotlocatedtthetsourcetoftthetairtleaktandtintervenetaccordinglyt(tightentthetconnections,t
replacetdrainagetsystem)
Compartmenttsyndrome
Symptoms:tPulselessnesst(latetsign),tIncreasedtpaintunrelievedtwithtelevationtortbytpaintme
dication
Leftthomonymousthemianopsia
hastlosttthetlefttvisualtfieldtoftbothteyes.tTheytaretunablettotvisualizetanythingttotthetlefttoftmidli
netoftthetbody.
dialysistfistula
clienttteaching:tavoidtliftingtheavytobjectstwithtaccess-
sitetarm,tavoidtcarryingtobjectstthattcompresstthetextremity,tavoidtsleepingtonttoptoftthetextremityt
withtthetaccesstdevice,tperform
t t t t
NGN ATI) t
1. Treattfirsttanytimmediatetthreatsttotatpatient'stsurvivaltortsafety.
Ex.tobstructedtairway,tlosstoftconsciousness,tpsychologicaltepisodetortanxietytattack.tAB
C's.
2. Next,ttreattactualtproblems.tEx.tnausea,tfulltboweltortbladder,tcomforttmeasures.
3. Then,ttreattrelativelyturgenttactualtortpotentialtproblemstthattthetpatienttortfamilytdoestnottrecogni
ze.tEx.tMonitoringtfortpost-
optcomplications,tanticipatingtteachingtneedstoftatpatienttthattmaytbetunawaretoftsideteffectstoftmeds.
4. Lastly,ttreattactualtortpotentialtproblemstwherethelptmaytbetneededtintthetfuture.
ExtTeachingtfortself-caretintthethome.
Heretaretsometgreattprinciplesttothelptyoutastyoutprioritize:
,Systemictbeforetlocalt
AcutetbeforetchronictA
ctualtbeforetpotentialtLi
stentdon'ttassume
Recognizetfirsttthentapplytclinicaltknowledget
Maslow'stHierarchytoftNeeds:
PrioritizetaccordingttotMaslowtwithtphysiologicaltandtsafetytissuestbeforetpsychologicaltesteemtissu
es.
Varianttanginat(Prinzmetal'stangina)
Duettotatcoronarytarterytspasm,tofteningtoccurringtduringtperiodstoftrest.
Unstabletangina
Occurstwithtexercisetortemotionaltstress,tbuttittincreasestintoccurrence,tseverity,tandtdurationtover
ttime.
Stabletangina
Occurstwithtexercisetortemotionaltstresstandtistrelievedtbytresttortnitroglycerint(Nitrostat).
electrolytetimbalancetmanifestations:th
ypocakelmia-->tflattTtwavestontECG
hypercalcemia--
>tdecreasedtdeepttendontreflexest(DTRs)thypocalcemia--
>ttetany
hyperkalemia-->ttalltpeakedtTtwavestontECG
Addison'stdisease
Decreasedtaldosteronetandtrenin
Hypothyroidism
Decreasedttriiodothyroninet(T3)tandtthyroxine
,Cushing'stdiseaset
Elevatedtcortisol
DiabetestInsipidust(DI)tDecrease
dturinetspecifictgravity
Diabetestmelitus
Elevatedtglycosylatedthemoglobint(HbA1c)
SyndrometoftInappropriatetSecretiontoftAntidiuretictHormonetIn
creasedturinetosmolality
Cataract
Progressivetandtpainlesstlosstoftvision
Angle-
closuretglaucomatRapidtons
ettoftelevatedtIOP
maculartdegenerationt
Centraltlosstoftvision
Open-
angletgalucomatLosstoftp
eripheraltvision
Retinaltdetachment
Suddentlosstoftvisiontwithouttpain
Commontdisease'stmanifestationst
Cholecystitis-->tMurphy'stsign
Pancreatitis-->tTurner'stsign
PeptictUlcertDisease-->tUppertepigastrictpaint1-
2thourstaftertmealstAppendicits-->tPaintattMcBurney'stpoint
Decorticate
, Decerebrate
Hepatitistdiseasettransmissions
HepatitistA--
>tIngestionstotcontaminatedtfood/watertHepatitistB--
>tUnprotectedtsexualtcontact
NonviraltHepatits-->tDrugttoxicity
HearttFailure
Symptoms:tShortnesstoftbreath,tfatigue,tjugulartveintdistention,tandtantS3taretsigns/symptomstofthear
ttfailuretresultingtfromtthetdecreasedtpumpingtabilitytoftthethearttandtincreasedtfluidtvolume.
Hypovolemictshock
position:tSupinetwithtlegstelevatedt(shocktposition)
Below-the-kneetamputation
Position:tThetclienttshouldtbetplacedtintthetpronetpositiontseveralttimestatdayttotpreventthiptflexi
ontcontractions.
Chestttube
-
Continuoustbublingtintthetwatertsealtchamperstindicatestantairtleak.tIftthististobserved,tthetnursetsh
ouldtattemptttotlocatedtthetsourcetoftthetairtleaktandtintervenetaccordinglyt(tightentthetconnections,t
replacetdrainagetsystem)
Compartmenttsyndrome
Symptoms:tPulselessnesst(latetsign),tIncreasedtpaintunrelievedtwithtelevationtortbytpaintme
dication
Leftthomonymousthemianopsia
hastlosttthetlefttvisualtfieldtoftbothteyes.tTheytaretunablettotvisualizetanythingttotthetlefttoftmidli
netoftthetbody.
dialysistfistula
clienttteaching:tavoidtliftingtheavytobjectstwithtaccess-
sitetarm,tavoidtcarryingtobjectstthattcompresstthetextremity,tavoidtsleepingtonttoptoftthetextremityt
withtthetaccesstdevice,tperform
