ANSC 520 folder questions A

1. Cystic fibrosis is a respiratory problem with lots of mucous a. Give them 6 small meals a day b. Plenty of fluids c. Monitor for clubbing of the nails i. Postural drainage (drain lower before upper) d. Cystic fibrosis patients excrete 4 times the amount of salt i. Give extra salt daily, with each meal e. Advise them not to work in the hot sun or sit in a sauna f. Cystic fibrosis affects the pancreas i. Give pancreatic enzymes with each meal g. Cystic fibrosis clients have a growth problem- failure to thrive 2. 15 month old- they are too old to BEGIN rolling over, sitting up, or teeth eruption a. They will begin trying to climb stairs i. Advise parents to place gates at top and bottom of stairs 3. Never lie a cardiac patient flat 4. Coumadin can cause bleeding a. (Melena is an upper GI bleed) (ecchymosis, petechia, epistasis, nose bleed, anything to do with bleeding) b. If client is receiving Coumadin then you monitor i. PT time (11-15) if on Coumadin it should be 1.5-2.5 times longer than normal. ii. Also do an INR (2-3) if they are on Coumadin, no INR with heparin. 5. Do not increase green leafy vegetables if client is on Coumadin, but do not completely cut out because they are full of nutrients a. Cranberry juice can increase the INR b. You are negligent if you do not advise your client to discuss OTC vitamins with physician if they are on Coumadin c. You would be negligent if you do tell the client to stay away from OTC medications 6. If client is pregnant then she cannot take Coumadin, because it crosses the placenta barrier a. However she can take Heparin because it does not cross the barrier b. You would give heparin to a pregnant client or postpartum client because they are at high risk