NCLEX-PN CHEAT SHEETS LATEST 2023 GRADED A+

NCLEX-PN CHEAT SHEETS LATEST 2023 GRADED A+ Positioning Techniques (F) Re-position at least 1-2 hours in bed. Every 20-30 mins in a chair. • Clients who have impaired nervous or musculoskeletal systems benefit from routine therapeutic positioning. - At least every 1 to 2 hr in bed. - Every 20 to 30 min if in a chair to prevent skin breakdown over bony prominences. • Tools for repositioning clients - Pillows, foot boots. - Trochanter rolls, sandbags. - Hand rolls. - Hand-wrist splints. - Trapeze bar. - Side rails • All side rails cannot be up or they will be considered a restraint. - Bed boards. - Wedge pillow (abductor pillow). Positions (F) High Fowler's: 90 degrees Fowler's: 45-60 degrees Semi Fowler's: 30-45 degrees Supine: On back with head and shoulders on pillow. Prone: Flat on abdomen with head to the side. Allows dorsiflexion of feet. Lateral: Side-lying. Sims': On side halfway between lateral and prone. Trendelenburg: Entire bed is tilted with the head of the bed lower than the foot of the bed. Promotes venous return. Reverse Trendelenburg: Entire bed is tilted with the foot of the bed lower than the head of the bed. Promotes gastric emptying. Assistive Devices (F) Wheelchair. Walker: Take a step, move walker, take another step. Cane: Single leg or quad. Keep cane on stronger side of the body. Move cane, move weak leg, move strong leg. Crutches: 2.3.4-point gaits. When ascending stairs, good food then crutches then bad food. When descending stairs, crutches then bad foot then good foot. Splints and Braces (F) Primary Nursing Concern: Assessment and prevention of neurovascular dysfunction or compromise. Assess every hour for the first 24 hrs. Every 2-4 hours afterwards