Hesi Exit Version 3
Study online at https://quizlet.com/_4trilx
1. Myocardial Infarction EKG Changes
(MI) ST Elevation
T inversion
Wider Q Wave
2. Hyperglycemia in el- Greater than 110 if fasting
derly Greater than 140 for 2 hour test
normal is 80-125
Excessive urine output
Have pt. administer their own insulin
Sliding scale insulin
3. Colorectal cancer - Sur- Monitor vital signs, stoma, Q 4 hours
gical Care and care of Should be Beefy Red (normal)
Colostomy Dusky appearance (necrotic)
Small amount of bleeding is normal
NG suctioning until bowel sounds are present
No lifting greater than 10 lbs or pulling for 6 weeks
wash with mild soap, warm H20, pat dry
do not wash off markings
KNOW! Low fat, high fiber cruciferous diet (Brussel Sprouts, cauliflower,
broccoli, cabbage )
4. Osteoporosis plan of RISK IS LOW CALCIUM INTAKE
care Watch for stairs, waxed floor, rugs,
medicate for pain
High Protein, High calcium, High iron diet
Weight bearing and strengthening exercises
fall prevention: Non-skid socks
encourage activity of D.L.
Side rails in bathrooms
, Hesi Exit Version 3
Study online at https://quizlet.com/_4trilx
5. Burn Neck Contrac- Neck stabilized and aligned
tures Airway management
Splinting, neck collars
6. Pedicuosis (head lice) Direct contact
No sharing personal items
Nits (whitish sacs)
Keeping staff separate
SCHOOL NURSE - send note home to parents
7. DKA Labs ANION GAP
Metabolic Acidosis - PH < 7.15
8. Advance Directive Living Will
Prepared when person is still alive competent, able to make decisions
about life sustaining measures
9. Pavlik Harness used for hip dysplasia in infants
Remove only to take baths
10. UAP Can pick up blood from lab
11. Alcoholism Hypo magnesium
Detox
12. Unna Boot Treats Venous Stasis Ulcers
Layers of Gauze and Unna Paste
13. Near Drowning Can cause PTSD
14. Pyelonephritis - Chron- Psychosocial part - how they deal with it.
ic
15.
, Hesi Exit Version 3
Study online at https://quizlet.com/_4trilx
Disaster Training - Nurses own safety first
Safety/priority Red - first priority - immediate treatment
Yellow - 2nd - systemic injury - treat within 30-6- minutes
Green - minor injury - can wait several hours
Black - NO HOPE
16. How to avoid Medica- Six Rights
tion Errors ID Check
17. Ventilated / Intubated Check for necrosis / erosion from bleeding and trauma related to tube
Patient insertion or balloon overinflated
18. Medications delayed Give when PT comes back an reschedule next dose accordingly
due to Procedure
19. Hearing Aid Make sure accurate fit
If it's whistling, take it out and re-insert
20. Femur Fracture Monitor for Compartment syndrome and bleeding
21. Pneumothorax Monitor for presence of breath sounds
Chest X- Ray
O2 stats improved
remove air to fix collapsed lung
priority is ABC/s
check insertion site for redness, swelling, warmth, drainage
semi-fowlers
change position Q 2 hours
22. Thyroid Tumor - re- Monitor for
moved Thyroid storm
Airway
Bleeding
Study online at https://quizlet.com/_4trilx
1. Myocardial Infarction EKG Changes
(MI) ST Elevation
T inversion
Wider Q Wave
2. Hyperglycemia in el- Greater than 110 if fasting
derly Greater than 140 for 2 hour test
normal is 80-125
Excessive urine output
Have pt. administer their own insulin
Sliding scale insulin
3. Colorectal cancer - Sur- Monitor vital signs, stoma, Q 4 hours
gical Care and care of Should be Beefy Red (normal)
Colostomy Dusky appearance (necrotic)
Small amount of bleeding is normal
NG suctioning until bowel sounds are present
No lifting greater than 10 lbs or pulling for 6 weeks
wash with mild soap, warm H20, pat dry
do not wash off markings
KNOW! Low fat, high fiber cruciferous diet (Brussel Sprouts, cauliflower,
broccoli, cabbage )
4. Osteoporosis plan of RISK IS LOW CALCIUM INTAKE
care Watch for stairs, waxed floor, rugs,
medicate for pain
High Protein, High calcium, High iron diet
Weight bearing and strengthening exercises
fall prevention: Non-skid socks
encourage activity of D.L.
Side rails in bathrooms
, Hesi Exit Version 3
Study online at https://quizlet.com/_4trilx
5. Burn Neck Contrac- Neck stabilized and aligned
tures Airway management
Splinting, neck collars
6. Pedicuosis (head lice) Direct contact
No sharing personal items
Nits (whitish sacs)
Keeping staff separate
SCHOOL NURSE - send note home to parents
7. DKA Labs ANION GAP
Metabolic Acidosis - PH < 7.15
8. Advance Directive Living Will
Prepared when person is still alive competent, able to make decisions
about life sustaining measures
9. Pavlik Harness used for hip dysplasia in infants
Remove only to take baths
10. UAP Can pick up blood from lab
11. Alcoholism Hypo magnesium
Detox
12. Unna Boot Treats Venous Stasis Ulcers
Layers of Gauze and Unna Paste
13. Near Drowning Can cause PTSD
14. Pyelonephritis - Chron- Psychosocial part - how they deal with it.
ic
15.
, Hesi Exit Version 3
Study online at https://quizlet.com/_4trilx
Disaster Training - Nurses own safety first
Safety/priority Red - first priority - immediate treatment
Yellow - 2nd - systemic injury - treat within 30-6- minutes
Green - minor injury - can wait several hours
Black - NO HOPE
16. How to avoid Medica- Six Rights
tion Errors ID Check
17. Ventilated / Intubated Check for necrosis / erosion from bleeding and trauma related to tube
Patient insertion or balloon overinflated
18. Medications delayed Give when PT comes back an reschedule next dose accordingly
due to Procedure
19. Hearing Aid Make sure accurate fit
If it's whistling, take it out and re-insert
20. Femur Fracture Monitor for Compartment syndrome and bleeding
21. Pneumothorax Monitor for presence of breath sounds
Chest X- Ray
O2 stats improved
remove air to fix collapsed lung
priority is ABC/s
check insertion site for redness, swelling, warmth, drainage
semi-fowlers
change position Q 2 hours
22. Thyroid Tumor - re- Monitor for
moved Thyroid storm
Airway
Bleeding
