Describes the pathophysiology of Grave's disease and list signs and symptoms. -
ANSExophthalmos
T3 elevated above 220 ng/dL
T4 elevated above 12mcg/dL
Low TSH level
List nursing interventions for a patient with COPD. - ANSOxygen - but don't want to give too
much (not more than 2L) - not first choice***
Positioning, pursed lip breathing, deep breathing, elevate head of bed - first choices***
Explain considerations in choosing IV site. - ANSAvoid: Amputated limbs, broken limbs
Don't start in restrcited extremity - fistula, breast cancer (metastasis- lymph nodes)****
Phelbitis - fluid infiltrates, causes local irritation, don't continue use
Explain Pheochromocytoma in a few sentences and list implications for nursing care. - ANSa
benign tumor developing on adrenal gland of kidneys
release of catecholamines epinepherine and norepinepherine)
Most dangerous, immediate effect is severe HTN (above 240)
Always worry about BP
Want to monitor BP frequently and assess HR
Tachycardia, palpitations, headache***
List important general teaching points for patients taking medication. - ANSPay attention to what
you are taking med with, timing (empty stomach, food, etc)
Antibiotics - always complete the dose!!!
If you don't finish, infection could come back
Can cause resistence in that person and in the world
Describe post-surgical nursing assessment. - ANSAssess surgical site and incision***
PAIN***
Trasnfer patient to bed, vitals (plus pain), assess wound area
High HR --- pain
Temp- elevated w fever
BP- may indicate fluid volume deficit
Oxygen / RR - could be low from anesthesia
Any abnormal vital sign - assess and treat!
Describe Lupus and patient education. - ANS***AUTOIMMUNE - can have low white count, high
risk for infection
Teaching
, Vaccines
Avoid big crowds
Avoid ill people
***Avoid sunlight (triggers)
Limit exposures
Could make lupus worse or sicum to other illnesses
Avoiding triggers and exposure to things
Explain safe insulin administration practice. - ANSTEACHING ANOTHER NURSE
Subcutaneous
Rotate injection sites
If patient able - allow them to administer
Sliding scale dosage based on blood sugar
Check blood sugar
**Check insulin type in orders in EMR**
***Check the order THEN verify and check that its correct***
Clean area
Check if the right patient
Have the needle/insulin double checked with someone
List assessment points for patient with constipation. - ANSWon't have bowel sounds
Asess diet, activity, meds
Increase fluids and fiber
Exercise
Assess what they are already doing about it and their understanding
How would you assess the ongoing problem?
**Assess their diet
Describe osteomalacia and implications for pt. teaching. - ANSSoftening of the bones
Increase calcium with vitamin D***
Test vitamin D levels
Can get from the sun!!
Strengthen the bones via: Calcium (diary, supplements [Diet]) and vitamin D
Describe osteomyelitis in a sentence or two. - ANSBone infection
Poor healing and injury progresses to bone
Comorbidities- infection goes to bone via injury (DM)
Treat with antibiotics!**
List signs and symptoms and assessment of UTI. - ANSURINE SMELLS
Send to lab for urinalysis
Culture and sensitivity also