NU 311 Clinical Nursing Skills - Exam 1 Questions & Answers Already Graded A+
(P)ICOT - = Patient, population or problem (Identify your patients by age, gender, ethnicity, disease, or symptoms) 3 phases of a seizure - •Aura—the start of a partial seizure. If the aura is the only phase a patient experiences, the patient has had a simple partial seizure. If the seizure spreads and affects consciousness, it is a complex partial seizure. If the seizure spreads to the rest of the brain, it becomes a generalized seizure. •Ictus—meaning attack Ictus is another word for the physical seizure involving a series of muscle contractions, called tonic and clonic contractions. •Postictal—meaning after the attack. Postictal refers to the aftereffects of a seizure (e.g., arm numbness, altered consciousness, partial paralysis). 30-degree lateral (side-lying) position - move to: (1) Lower head of bed completely or as low as patient can tolerate. (2) Lower side rail and position patient on side of bed opposite direction toward which patient is to be turned. Move upper trunk, supporting shoulders first; then move lower trunk, supporting hips. (3) Raise side rail and go to opposite side of bed. (4) Flex patient's knee that will not be next to mattress. Keep foot on mattress. Place one hand on patient's upper bent leg near hip and other hand on patient's shoulder. (5) Roll patient onto side toward you. (6) Place pillow under patient's head and neck. (7) Place hands under patient's dependent shoulder and bring shoulder blade forward.(8) Position both arms in slightly flexed position. Support upper arm with pillow level with shoulder; other arm, by mattress. (9) Place hands under dependent hip and bring hip slightly forward so angle from hip to mattress is approximately 30 degrees. (10) Place small tuck-back pillow behind patient's back. (Make by folding pillow lengthwise. Smooth area is slightly tucked under patient's back.) (11) Place pillow under semiflexed upper leg level at hip from groin to foot (see illustration). (12) Place sandbags parallel to plantar surface of dependent foot. May use ankle-foot orthotic on feet if available. 5 P's - pain, potty, possessions, pathway, pumps accountability - -The individual delegating the task retains ____________________ for the outcome. -Can delegate responsiblity but not this advanced directive - •A document that gives a patient directions about future medical care or designates another person(s) to make medical decisions if the individual loses decision-making capacity. •Conveys the patient's choice in continuing medical care when the patient is unable to speak or make decisions. •May include a living will, power of attorney for health care, or notarized handwritten document. •A copy of the document should be available in the patient's medical record. If not available, the substance of it should be documented in the medical record, and a family member should be asked to bring it to the hospital. •The attending health care provider is notified of it. •Witnesses for one should not be medical personnel, nor should they be related to the patient or heirs to the patient's estate. A social worker often fulfills this requirement.Against Medical Advice (AMA) - Is a term used in health care institutions when a patient leaves a hospital against the advice of their doctor. Allogeneic hematopoietic stem cell transplants - Protective environment
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