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Exam (elaborations)

NSG 122 FUNDAMENTAL CONCEPTS HESI FINAL EXAM QUESTIONS AND VERIFIED ANSWERS

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NSG 122 FUNDAMENTAL CONCEPTS HESI FINAL EXAM QUESTIONS AND VERIFIED ANSWERS

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Correct Walker Use


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Wear nonskid shoes or slippers.
When rising from a seated position, use the chair arms for support. Once
standing, place one hand at a time on the walker and move forward into it.
Begin by pushing the walker forward, keeping the back upright. Place one
leg inside the walker, keeping the walker in place. Then, step forward with
the remaining leg into the walker, keeping the walker still. Repeat the

, process by moving the walker forward again.
Caution the patient to avoid pushing the walker out too far in front and
leaning over it. Patients should always step into the walker, rather than
walking behind it, staying upright as they move.
Never attempt to use a walker on stairs.




Hypocalcemia Assessment


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Hypocalcemia refers to a calcium deficit in ECF (serum calcium <8.9 mg/dL,
ionized calcium <4.5 mg/dL). Common causes related to a calcium deficit
involve inadequate calcium intake, impaired calcium absorption, and
excessive calcium loss. Manifestations of hypocalcemia include numbness
and tingling of fingers, mouth, or feet; tetany; muscle cramps; and seizures.




Functional assessment


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-Functional assessment is a continuous collaborative process that
combines observing, asking meaningful questions, listening to family
stories, and analyzing individual child skills and behaviors within naturally
occurring everyday routines and activities across multiple situations and
settings. -The subgroup that worked on the definition established a priority
to describe what functional assessment looks like throughout the early
intervention process.




Catheter Insertion Steps Female


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, Hand Hygiene
Assist patient in to dorsal recumbent position with knees flexed
Open cath tray with sterile technique
With thumb and finger of nondominant hand, spread the labia and identify
the meatus.
Using the dominant hand, clean the labial fold from top to bottom.
With the dominant hand, hold a lubricated catheter 2 to 3 inches from the
tip and insert slowly into the urethra.
Advance the catheter another 2 to 3 inches after the initial return of urine.
Inflate catheter balloon
Secure to patient's leg




NP‐evaluation


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In the fifth step of the nursing process, evaluating, the nurse and patient
together measure how well the patient has achieved the outcomes
specified in the care plan. When evaluating patient outcome achievement,
the nurse identifies factors that contribute to the patient's ability to achieve
expected outcomes and, when necessary, modifies the care plan. The
purpose of evaluation is to allow the patient's achievement of expected
outcomes to direct future nurse-patient interactions. Based on the patient's
responses to the care plan, the nurse decides to:
Terminate the care plan when each expected outcome is achieved
Modify the care plan if there are difficulties achieving the outcomes
Continue the care plan if more time is needed to achieve the outcomes
When evaluation points to the need to modify nursing care, the nurse
reviews each preceding step of the nursing process (assessing,
diagnosing, planning, andimplementing). Successful evaluation helps
ensure that valued patient outcomes are attained. In the nursing process,
evaluative criteria are the patient outcomes developed during the planning
step.
The five classic elements of evaluation are:
Identifying evaluative criteria and standards (what you are looking for
when you evaluate—i.e., expected patient outcomes)
Collecting data to determine whether these criteria and standards are met
Interpreting and summarizing findings

, Documenting your judgment\
Terminating, continuing, or modifying the plan




Medication Error - Action


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-Taking ownership of the error and doing the right thing by putting the
patient first is the only realistic course of action.
-Take immediate corrective measures.
-Inform the patient's doctor of the mistake so that action can be taken as
soon as possible to counteract the effects of the incorrect medication.




End‐of‐life ‐pain


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Pharmacological approach to EOL pain
-Non opioids, opioids, and adjuvant
-continue to give pain meds - although higher doses are not necessary
-Routes: oral, rectal, transdermal, topical, parenteral
-discontinue all nonessential meds
-treatment for excessive secretions: atropine




Body Mechanics


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Coordinated effort of musculoskeletal and nervous systems, maintain
balance, posture, and body alignment, during bending, lifting, moving, and

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