Summary ATI TEST TAKING STRATEGIES

ATI Strategy ATI TEST TAKING STRATEGIES • Asthma Meds – Contraindicated in BETA BLOCKERS • Inhalers – can cause hoarseness, dry mouth o Candidiasis  S/sx: white patches, soreness, redness  This should be reported PVD PAD Painless Edema Discoloration of the skin and it will be thick Most common in diabetes patient RAISE UP THE EXTREMITY To bring the fluid back to the organs Painful Decreased/pulseless Shiny leg Clubbing nails, loose hair Skin will be thin LOWER EXTREMITY Gravity will help bring the blood to the lower half • Difference between PVD/PAD • Know the Difference b/w drug reaction vs. blood product reaction vs. IV site reaction o Know nursing intervention for each • Know Maslow’s and Erickson’s theory • ABCs • Vital Signs o 9/10 it will not be pain and it will not be temperature (you can live with these for a little bit)  PAIN - Kidney stones can cause cardiac arrest  TEMP - neutropenic, chemo and HIV • 1 in 3 older adults will fall o Look over fall risk reduction precautions • Change in LOC is #1 indicator that something is wrong o Ex: hypoxia - confusion first symptom o FAT EMBOLI is an emergency!!!!!!  First thing to change is levels of consciousness • Priority Strategy o RED - ABC, hemorrhage, choking, impaired airway o YELLOW - Hypoglycemia, fracture o GREEN - PTSD , bruises and cuts o BLACK - DC to JC o Survival Potential o Least Restrictive/Invasive o Acute over Chronic o Stable vs. Unstable  Acute, unstable - Only RN  Stable, Chronic - can delegate to LPN • Default strategies o Time Elapsed o Pre, Intra, Post o Early vs. Late S/Sx • Phenytoin is an anticonvulsant o If pt is undergoing an ETC you don’t want them to take this  We want to see the pt have a seizure • Blood thinners must be tapered down • Monitor Blood Glucose every 4-6 hr for a patient undergoing TPN o This is highly concentrated o Hyperglycemia will cause metabolic acidosis - this is burning you from the inside out which causes dehydration in patient • Know about CHEST TUBE Nursing Leadership and Management UAP LPN RN Basic I’s and O’s (NUMERICAL) Vitals (stable clients) - No v/s on blood products ADL’s Ambulation NO MEDS NO ASSESSMENT No therapeutic communication Stable client Data collection Reinforce teaching NO initial/first time Chronic, stable, predictable long term Can do anything IM, SUBCUT, vaccination as long as it’s not rhogam NO Blood products NO primary bags NO PCA’s NO insulin drips NO heparin drips NO IV push OK to do IVPB Insert IV catheter Remove IV Change dressing Unstable client Assess Teach Plan care Initial/new/first time Unstable Unpredictable Acute, sudden change Initiate, D/C, POC Anything IV other than prescribe NP - ORIENTATION NURSE o Unless they have been checked off/ in question and they had the training they CAN’T do it - FLOAT NURSE o Whatever they are “used” likely to have seen in their original nurse ETHICAL AND LEGAL ISSUES - Types of CONSENT o General o Implied – not conscious, not able to give their consent. Needed for lifesaving procedure o Informed – given prior to procedure  A 16 y/o can sign a consent once they have given birth - Negligence o Duty o Breach of duty o Harm - Take the most mobile client out first during an evacuation Disaster Preparedness Plan for pandemics Perform triage Disaster Plan Chain of command Cultural and Religious Considerations - Health achieved by restoring balance - Asian American - Soup and herbal teas used to speed healing - Hispanic - Alcohol, coffee and tea not permitted - Church of Jesus, Christ of latter - Milk and meat not served same meal - Judaism PHARMACOLOGY Lithium, Potassium Sparing, Warfarin - Diet considerations o You DON’T Decrease or increase what you normally eat o Diet stays the same Digoxin and Lithium s/sx of toxicity - Same GI effects (N/V/D) - Difference o Lithium  Fine Tremors, confusion, slurred speech  Sodium - think seizures, tremors • If it’s too high or too low o Digoxin  Yellow tinge, halos, visual disturb JEAPORDY GAME - Herbal and Supplements o Supplements that pregnant women should not take  Saw Palmetto o This supplement has an additive effect when used with barbiturates and benzodiazepines  Valerian Root (has an additive effect with benzodiazepines) o A client taking this supplement may experience vivid dreams  Melatonin o This herbal supplement blocks the LDL cholesterol, raises HDL cholesterol and lowers triglycerides. This supplement increases the risk of bleeding in clients taking NSAID’s, warfarin and heparin  Garlic o St. Johns Wort  Interacts with everything  Can cause serotonin syndrome when combined with antidepressants o 4 supplements that interefere with anticoagulants  Garlic, Ginger, gingko and ginseng - Religious and Cultural Practices o A quite, peaceful environment allows the client to rest and practice mediation and prayer  Buddhism o Halal foods are allowed, Haram foods (such as pork, alcohol, gelatin and animals with fans) are prohibited. This religious group practices a period of fasting called Ramadan during the ninth lunar month  Islam o Catholicism – food and beverages are avoided 1 hr prior to communion o Native Americans  Modern medicine and traditional medicine man/woman or shaman may be consulted.  Sacred myths and legends provide spiritual guidance o Judaism  No pork and shell fish  Celebrate yom kippur  No dairy and pork together ADDison’s - hyponatremic - ADD salt Cushing’s - Hypernatremic - Water follows salt - CUSHY d/t edema MED-SURG Lab values that are elevated during dehydration - Serum Ph - Hct - Urine osmolarity - Specific gravity Potassium level that are low will have - Leg cramps - Low potassium levels Body fluid content - need 30 ml /hr