HESI COMP #2 REVIEW

1. BP readings Retake the BP in the same arm, deflating the cuff slowly. The nurse should first retake the BP in the right arm, deflating the cuff more slowly, because a low SBP and hig DBP measurement is often the result of deflating the cuff too rapidly. 2. Free radicals and Enzyme release from lysosomes. destruction of a cell membrane Oxidative damage to cells is thought to be a causative factor in disease and aging. If free radicals bind to polyun- saturated fatty acids found in lysosome membrane, the lysosome, nicknamed suicide bags, leaks its protein cat- alytic enzymes intracellularly and the cell is destroyed. 3. ABC airway and breathing Pain management Sleep and rest Definitive therapy First level problems are immediate priorities (airway, breathing, and circulation). Pain Management Maslows hierarchy of basic needs for rest and sleep Drug therapies 4. Vulnerable popu- lations 5. Slef administer a sub q injec- tion. Help ensure sterility of the procedure. 6. Biological prac- tices are federal- ly regulated for Survivors of violence that occurred at least 5 years ago. Vulnerable populations are those groups who have an increased risk of developing adverse health outcomes. Survivors of violence, even though the violence occurred more than 5 years ago, have an increased risk for adverse health outcomes. Method used to aspirate medication from a vial. To maintain sterility of the procedure, the most important factor to include in the teaching plan is how to manipulate the syringe parts so that the medication maintains sterility during the preparation and administration. Standard precautions N-95 tuberculosis standard Blood-borne pathogen standard healthcare work- ers. 7. High Risk for CKD secondary to DM Resource Conservation and Recovery Act - requires la- beling, storage, transportation, and disposal of biological waste according to fedral standards. Type 1 DM and retinopathy and mild vision loss. Diabetic retinopathy and nephropathy are related to pro- longed hyperglycemia and HTN which damage the mi- crovasculature of the eyes and kidneys, so a client with DM1 and retinopathy is most likely to develop nephropathy and CKD 8. H-A1c target level is below 7% 9. Metroprolol Beta adrenergic re- ceptor antago- nist Can mask signs of hypoglycemia 10. Hep A Ensure that all enrolled children have been immunized for Hep A. The CDC recommended immunization schedule for chil- dren includes Hep A (HAV), so follow up of enrolled chil- drens immunization status with HAV or human immune gamma globulin should be implemented. 11. HEP A Transmitted via fecal oral route 12. Hemoglobin Normal for males 14-18 13. O2 sat Normal 96-100 14. Med surg Start the first transfusion of blood. The hemoglobin of 6 (normal 14-18 in males) and the 82% O2 sat (normal 96-100%) indicates the client is hypoxic, so the first transfusion of blood should be started. H&H should be obtained after the client is transfused to evaluate its effectiveness 15. Med surg Defib at 200 joules. V tach converting to V fib After confirming ventricular fibrillation, rapid defibrillation is critical in reestablishing cardiac output and preserving vital organ function. After CPR is initiated and defibrillation attempted, airway intubation and IV access are indicated for successful resuscitation. 16. Post op Record these findings in the clients record. wound edges are close together, there is no sign of red- ness, and there is a slight amount of bright red blood oozing from the incision. 17. Dehiscence Seperation of surgical incision 18. Serosan- guineous Drainage Thin and red and is composed of serum and blood 19. Delusional I don't talk about things like that anymore. When the client states she doesn't want to talk about things like that anymore she is likely less delusional, be- cause when a client begins to question the delusional belief or stops talking about it, the client is becoming less delusional. 20. Comprehensive assessment for an older adult 21. Confrontation Technique 22. Use an oph- thalmoscope to watch the clients Functional abilities. The focus of a geriatric assessment is to determine the older clients functional abilities, so appropriate interven- tions can be planned and implemented to maintain and enhance independence. Sit facing the client and while look directly at the clients face, move an object inward from the periphery. Confrontation technique during a vision exam is used to determine peripheral vision, so allows the client to state when the object enters the nasal, temporal, superior, and inferior fields of vision. Pupillary reactivity pupil constrict when a strong light is shown on it. 23. Mucomyst Mucomyst is the antidote for acute Tylenol poisoning and is the treatment of choice for an overdose 24. GTPAL G= total number of times the women has been pregnant T=number carried to term 37 weeks P+ pre term birth A=abortions/miscariages L=children living 25. A client schedule for a femoro-popliteal bypass surgery An elective surgical procedure can be rescheduled for a later date