RN fundamentals capstone
how to walk up stairs w/ crutches - ANS1) hold onto rail w/ one hand and crutches w/ other hand
2) push down on stair rail + crutches and step up with UNAFFECTED leg
3) if not allowed to place weight on affected leg, hop up with UNAFFECTED leg
4) bring affected leg and crutches up beside UNAFFECTED leg
5) UNAFFECTED leg goes up FIRST; CRUTCHES move with AFFECTED leg
erikson's stages - ANSTRUST v MISTRUST (infancy, 0-18 mos)
-acquaint w/ parents
AUTONOMY v SHAME/DOUBT (early childhood, 2-4 yrs)
-do things on own
INITIATIVE v GUILT (preschool, 4-5 yrs)
-what's right/wrong
INDUSTRY v INFERIORITY (school age, 5-12 yrs)
-peer groups, talents
ID v ROLE CONFUSION (adolescence, 13-19 yrs)
-body image, peer pressure
INTIMACY v ISOLATION (early adulthood 20-39 yrs)
-beliefs/ethics, close relationships, self-concept
GENERATIVITY v STAGNATION (adulthood, 40-64 yrs)
EGO INTEGRITY v DESPAIR (mature adult, 65-death)
airborne precautions - ANSWHAT:
-private room
-mask/resp protection for visitors
-N95 or HEPA respirator
-NEGATIVE pressure airflow
-at least 6 exchanges/hr
FOR:
*if droplets <5 mm*
-TB, measles, etc
contact precautions - ANSWHAT:
, -private room OR room w/ pt w/ SAME infection
-gloves/gowns worn by caregiver/visitors
FOR:
-MRSA, VRE, stomach stuff
droplet precautions - ANSWHAT:
-private room OR room w/ other pts w/ SAME infection
-masks for providers + visitors
FOR:
*when droplets > 5mm*
-pertussis, cough with visible droplets, etc.
grading pressure ulcers - ANS1) *Intact skin* with an area of persistent, nonblanchable redness,
typically over a bony prominence, that may feel warmer or cooler than the adjacent tissue. The
tissue is swollen and has congestion, with possible discomfort at the site. With darker skin
tones, the ulcer may appear blue or purple.
2) *Partial-thickness skin loss involving the epidermis and the dermis*. The ulcer is visible and
superficial and may appear as an *abrasion, blister, or shallow crater*. Edema persists, and the
ulcer may become infected, possibly with pain and scant drainage
3) The correct answer is: *Full-thickness tissue loss with damage to or necrosis of subcutaneous
tissue*. The ulcer may extend down to, but not through, underlying fascia. The ulcer appears as
a deep crater with or without undermining of adjacent tissue and *without exposed muscle or
bone*. *Drainage and infection are common*.
4) *Full-thickness tissue loss with destruction, tissue necrosis, or damage to muscle, bone, or
supporting structures*. There may be sinus tracts, deep pockets of infection, tunneling,
undermining, *eschar (black scab-like material), or slough (tan, yellow, or green scab-like
material)*.
legal documents for end-of-life decisions - ANS-DoA: says who can make decisions
-DNR: no CPR
-informed consent: RN witness
-living will: says pt wishes for life-sustaining tx (if can't make decisions for any reason)
example of HIGH calorie bu LOW protein meal - ANS-chicken breast
-mashed potatoes
-spinach
glasgow coma scale - ANSFull-thickness tissue loss with destruction, tissue necrosis, or
damage to muscle, bone, or supporting structures. There may be sinus tracts, deep pockets of
infection, tunneling, undermining, eschar (black scab-like material), or slough (tan, yellow, or
green scab-like material).
how to walk up stairs w/ crutches - ANS1) hold onto rail w/ one hand and crutches w/ other hand
2) push down on stair rail + crutches and step up with UNAFFECTED leg
3) if not allowed to place weight on affected leg, hop up with UNAFFECTED leg
4) bring affected leg and crutches up beside UNAFFECTED leg
5) UNAFFECTED leg goes up FIRST; CRUTCHES move with AFFECTED leg
erikson's stages - ANSTRUST v MISTRUST (infancy, 0-18 mos)
-acquaint w/ parents
AUTONOMY v SHAME/DOUBT (early childhood, 2-4 yrs)
-do things on own
INITIATIVE v GUILT (preschool, 4-5 yrs)
-what's right/wrong
INDUSTRY v INFERIORITY (school age, 5-12 yrs)
-peer groups, talents
ID v ROLE CONFUSION (adolescence, 13-19 yrs)
-body image, peer pressure
INTIMACY v ISOLATION (early adulthood 20-39 yrs)
-beliefs/ethics, close relationships, self-concept
GENERATIVITY v STAGNATION (adulthood, 40-64 yrs)
EGO INTEGRITY v DESPAIR (mature adult, 65-death)
airborne precautions - ANSWHAT:
-private room
-mask/resp protection for visitors
-N95 or HEPA respirator
-NEGATIVE pressure airflow
-at least 6 exchanges/hr
FOR:
*if droplets <5 mm*
-TB, measles, etc
contact precautions - ANSWHAT:
, -private room OR room w/ pt w/ SAME infection
-gloves/gowns worn by caregiver/visitors
FOR:
-MRSA, VRE, stomach stuff
droplet precautions - ANSWHAT:
-private room OR room w/ other pts w/ SAME infection
-masks for providers + visitors
FOR:
*when droplets > 5mm*
-pertussis, cough with visible droplets, etc.
grading pressure ulcers - ANS1) *Intact skin* with an area of persistent, nonblanchable redness,
typically over a bony prominence, that may feel warmer or cooler than the adjacent tissue. The
tissue is swollen and has congestion, with possible discomfort at the site. With darker skin
tones, the ulcer may appear blue or purple.
2) *Partial-thickness skin loss involving the epidermis and the dermis*. The ulcer is visible and
superficial and may appear as an *abrasion, blister, or shallow crater*. Edema persists, and the
ulcer may become infected, possibly with pain and scant drainage
3) The correct answer is: *Full-thickness tissue loss with damage to or necrosis of subcutaneous
tissue*. The ulcer may extend down to, but not through, underlying fascia. The ulcer appears as
a deep crater with or without undermining of adjacent tissue and *without exposed muscle or
bone*. *Drainage and infection are common*.
4) *Full-thickness tissue loss with destruction, tissue necrosis, or damage to muscle, bone, or
supporting structures*. There may be sinus tracts, deep pockets of infection, tunneling,
undermining, *eschar (black scab-like material), or slough (tan, yellow, or green scab-like
material)*.
legal documents for end-of-life decisions - ANS-DoA: says who can make decisions
-DNR: no CPR
-informed consent: RN witness
-living will: says pt wishes for life-sustaining tx (if can't make decisions for any reason)
example of HIGH calorie bu LOW protein meal - ANS-chicken breast
-mashed potatoes
-spinach
glasgow coma scale - ANSFull-thickness tissue loss with destruction, tissue necrosis, or
damage to muscle, bone, or supporting structures. There may be sinus tracts, deep pockets of
infection, tunneling, undermining, eschar (black scab-like material), or slough (tan, yellow, or
green scab-like material).
