NURSING CAPSTONE QUESTIONS WITH
COMPLETE SOLUTIONS
Dowlnotwldelegatewl-wlANS--WhatwlyouwlcanwlEATwlE-evaluatewlA-assesswlT-teach
Addison'swl&wlCushingswl-wlANS--Addison'swl=wldownwldownwldownwlupwldown
Cushings=wlupwlupwlupwldownwlup
hypo/hypernatremia,wlhypo/hypertension,wlbloodwlvolume,wlhypo/hyperkalemia,wlhypo/
hyperglycemia
Betterwlperipheralwlperfusion?wl-wlANS--EleVatewlVeins,wlDAnglewlArteries
APGARwl-wlANS--Appearancewl(allwlpink,wlpinkwlandwlblue,wlbluewl(pale)
Pulsewl(>100,wl<100,wlabsent)
Grimacewl(cough,wlgrimace,wlnowlresponse)
Activitywl(flexed,wlflaccid,wllimp)
Respirationswl(strongwlcry,wlweakwlcry,wlabsent)
Airbornewlprecautionswl-wlANS--
MTVwlorwlMywlchickenwlhezwltbwlmeasles,wlchickenpoxwl(varicella)wlHerpeswlzoster/
shingleswlTB
Airbornewlprecautionswlprotectivewlequipwl-wlANS--privatewlroom,wlnegwlpressurewlwithwl6-
12wlairwlexchanges/hrwlmaskwl&wlrespiratorwlN95wlforwlTB
Dropletwlprecautionswl-wlANS--spiderman!
wlsepsis,wlscarletwlfever,wlstreptococcalwlpharyngitis,wlparvovirus,wlpneumonia,wlpertussis
,wl
influenza,
wldiptheria,
wlepiglottitis,
wlrubella,
wlmumps,wlmeningitis,wlmycoplasmawlorwlmeningealwlpneumonia,wladeNovirus
wl(Privatewlroomwlandwlmask)
Contactwlprecautionwl-wlANS--MRSwlWHISEwl
protectwlvisitorswl&wlcaregiverswlwhenwl3wlftwlofwlthewlpt.
wlMultidrug-resistantwlorganismswl
RSV,wlShigella,wlWoundwlinfections,wlHerpeswlsimplex,wlImpetigo,wlScabies,wlEntericwldis
easeswlcausedwlbywlmicro-organismswl(Cwldiff),wl
Gloveswlandwlgownswlwornwlbywlthewlcaregiverswlandwlvisitors
,Disposalwlofwlinfectiouswldressingwlmaterialwlintowlawlsingle,wlnonporouswlbagwlwithoutwlto
uchingwlthewloutsidewlofwlthewlbag
PMGG=wlPrivatewlroom/wlsharewlsamewlillness,wlmask,wlgownwlandwlgloves
Skinwlinfectionwl-wlANS--VCHIPS
Varicellawlzoster
Cutaneouswldiptheria
Herpeswlsimplez
Impetigo
Peduculosis
Scabies
AirwlorwlPulmonarywlEmbolismwl-wlANS--S/Swlchestwlpain,wldyspnea,wltachycardia,wlpale/
cyanotic,wlsensewlofwlimpendingwldoom.wl(turnwlptwltowlLEFTwlsidewlandwlLOWERwlthewlhe
adwlofwlbed.)
Womanwlinwllaborwl(un-reassuringwlFHR)wl-wlANS--
(latewldecels,wldecreasedwlvariability,wlfetalwlbradycardia,wletc)wlTurnwlptwlonwlLeftwlside,wl
givewlO2,wlstopwlpitocin,wlIncreasewlIVwlfluids!
TubewlfeedingwlwithwldecreasedwlLOCwl-wlANS--
PtwlonwlRightwlsidewl(promoteswlemptyingwlofwlthewlstomach)wlHeadwlofwlbedwlelevatedwl(p
reventwlaspiration)
Afterwllumbarwlpuncturewlandwloilwlbasedwlmyelogramwl-wlANS--
ptwliswlflatwlSUPINEwl(preventwlheadachewlandwlleakingwlofwlCSF)
Ptwlwithwlheatwlstrokewl-wlANS--flatwlwithwllegswlelevated
duringwlContinuouswlBladderwlIrrigationwl(CBI)wl-wlANS--
catheterwliswltapedwltowlthewlthigh.wllegwlmustwlbewlkeptwlstraight.
AfterwlMyringotomywl-wlANS--
positionwlonwlthewlsidewlofwlAFFECTEDwlear,wlallowswldrainage.
AfterwlCateractwlsurgerywl-wlANS--
ptwlsleepwlonwlUNAFFECTEDwlsidewlwithwlawlnightwlshieldwlforwl1-4wlweeks
afterwlThyroidectomywl-wlANS--lowwlorwlsemi-
fowler'swlposition,wlsupportwlhead,wlneckwlandwlshoulders.
InfantwlwithwlSpinawlBifidawl-wlANS--Pronewlsowlthatwlsacwldoeswlnotwlrupture
Buck'swlTractionwl(skin)wl-wlANS--elevatewlfootwlofwlbedwlforwlcounterwltraction
, Afterwltotalwlhipwlreplacementwl-wlANS--
don'twlsleepwlonwlsidewlofwlsurgery,wldon'twlflexwlhipwlmorewlthanwl45-
60wldegress,wldon'twlelevatewlHeadwlOfwlBedwlmorewlthanwl45wldegrees.wlMaintainwlhipwla
bductionwlbywlseparatingwlthighswlwithwlpillows.
Prolapsedwlcordwl-wlANS--KneewltowlchestwlorwlTrendelenburg
oxygenwl8wltowl10wlL
CleftwlLipwl-wlANS--
positionwlonwlbackwlorwlinwlinfantwlseatwltowlpreventwltraumawltowlthewlsuturewlline.wlwhilewlf
eedingwlholdwlinwluprightwlposition.
Towlpreventwldumpingwlsyndromewl-wlANS--(postwloperativewlulcer/
stomachwlsurgeries)wleatwlinwlrecliningwlposition.wlLiewldownwlafterwlmealswlforwl20-
30wlmin.wlalsowlrestrictwlfluidswlduringwlmeals,wllowwlCHOwlandwlfiberwldiet.wlsmall,wlfreque
ntwlmeals.
AKAwl(abovewlkneewlamputation)wl-wlANS--
elevatewlforwlfirstwl24wlhourswlonwlpillow.wlpositionwlpronewldailywltowlmaintainwlhipwlextensi
on.
BKAwl(belowwlkneewlamputation)wl-wlANS--
footwlofwlbedwlelevatedwlforwlfirstwl24wlhours.wlpositionwlpronewltowlprovidewlhipwlextension.
detachedwlretinawl-wlANS--
areawlofwldetachmentwlshouldwlbewlinwlthewldependentwlposition
administrationwlofwlenemawl-wlANS--
ptwlshouldwlbewlleftwlsidewllyingwl(Sim's)wlwithwlkneewlflexed.
Afterwlsupratentorialwlsurgerywl-wlANS--
(incisionwlbehindwlhairlinewlonwlforhead)wlelevatewlHOBwl30-40wldegrees
Afterwlinfratentorialwlsurgerywl-wlANS--
(incisionwlatwlthewlnapewlofwlneck)wlpositionwlptwlflatwlandwllateralwlonwleitherwlside.
Duringwlinternalwlradiationwl-wlANS--onwlbedwlrestwlwhilewlimplantwlinwlplace
AutonomicwlDysreflexia/Hyperreflexiawl-wlANS--
S/
Swlpoundingwlheadache,wlprofusewlsweating,wlnasalwlcongestion,wlchills,wlbradycardia,wlh
ypertension.wlPlacewlclientwlinwlsittingwlpositionwl(elevatewlHOB)wlFIRST!
Shockwl-wlANS--
bedrestwlwithwlextremitieswlelevatedwl20wldegrees.wlkneeswlstraight,wlheadwlslightlywleleva
tedwl(modifiedwlTrendelenberg)
COMPLETE SOLUTIONS
Dowlnotwldelegatewl-wlANS--WhatwlyouwlcanwlEATwlE-evaluatewlA-assesswlT-teach
Addison'swl&wlCushingswl-wlANS--Addison'swl=wldownwldownwldownwlupwldown
Cushings=wlupwlupwlupwldownwlup
hypo/hypernatremia,wlhypo/hypertension,wlbloodwlvolume,wlhypo/hyperkalemia,wlhypo/
hyperglycemia
Betterwlperipheralwlperfusion?wl-wlANS--EleVatewlVeins,wlDAnglewlArteries
APGARwl-wlANS--Appearancewl(allwlpink,wlpinkwlandwlblue,wlbluewl(pale)
Pulsewl(>100,wl<100,wlabsent)
Grimacewl(cough,wlgrimace,wlnowlresponse)
Activitywl(flexed,wlflaccid,wllimp)
Respirationswl(strongwlcry,wlweakwlcry,wlabsent)
Airbornewlprecautionswl-wlANS--
MTVwlorwlMywlchickenwlhezwltbwlmeasles,wlchickenpoxwl(varicella)wlHerpeswlzoster/
shingleswlTB
Airbornewlprecautionswlprotectivewlequipwl-wlANS--privatewlroom,wlnegwlpressurewlwithwl6-
12wlairwlexchanges/hrwlmaskwl&wlrespiratorwlN95wlforwlTB
Dropletwlprecautionswl-wlANS--spiderman!
wlsepsis,wlscarletwlfever,wlstreptococcalwlpharyngitis,wlparvovirus,wlpneumonia,wlpertussis
,wl
influenza,
wldiptheria,
wlepiglottitis,
wlrubella,
wlmumps,wlmeningitis,wlmycoplasmawlorwlmeningealwlpneumonia,wladeNovirus
wl(Privatewlroomwlandwlmask)
Contactwlprecautionwl-wlANS--MRSwlWHISEwl
protectwlvisitorswl&wlcaregiverswlwhenwl3wlftwlofwlthewlpt.
wlMultidrug-resistantwlorganismswl
RSV,wlShigella,wlWoundwlinfections,wlHerpeswlsimplex,wlImpetigo,wlScabies,wlEntericwldis
easeswlcausedwlbywlmicro-organismswl(Cwldiff),wl
Gloveswlandwlgownswlwornwlbywlthewlcaregiverswlandwlvisitors
,Disposalwlofwlinfectiouswldressingwlmaterialwlintowlawlsingle,wlnonporouswlbagwlwithoutwlto
uchingwlthewloutsidewlofwlthewlbag
PMGG=wlPrivatewlroom/wlsharewlsamewlillness,wlmask,wlgownwlandwlgloves
Skinwlinfectionwl-wlANS--VCHIPS
Varicellawlzoster
Cutaneouswldiptheria
Herpeswlsimplez
Impetigo
Peduculosis
Scabies
AirwlorwlPulmonarywlEmbolismwl-wlANS--S/Swlchestwlpain,wldyspnea,wltachycardia,wlpale/
cyanotic,wlsensewlofwlimpendingwldoom.wl(turnwlptwltowlLEFTwlsidewlandwlLOWERwlthewlhe
adwlofwlbed.)
Womanwlinwllaborwl(un-reassuringwlFHR)wl-wlANS--
(latewldecels,wldecreasedwlvariability,wlfetalwlbradycardia,wletc)wlTurnwlptwlonwlLeftwlside,wl
givewlO2,wlstopwlpitocin,wlIncreasewlIVwlfluids!
TubewlfeedingwlwithwldecreasedwlLOCwl-wlANS--
PtwlonwlRightwlsidewl(promoteswlemptyingwlofwlthewlstomach)wlHeadwlofwlbedwlelevatedwl(p
reventwlaspiration)
Afterwllumbarwlpuncturewlandwloilwlbasedwlmyelogramwl-wlANS--
ptwliswlflatwlSUPINEwl(preventwlheadachewlandwlleakingwlofwlCSF)
Ptwlwithwlheatwlstrokewl-wlANS--flatwlwithwllegswlelevated
duringwlContinuouswlBladderwlIrrigationwl(CBI)wl-wlANS--
catheterwliswltapedwltowlthewlthigh.wllegwlmustwlbewlkeptwlstraight.
AfterwlMyringotomywl-wlANS--
positionwlonwlthewlsidewlofwlAFFECTEDwlear,wlallowswldrainage.
AfterwlCateractwlsurgerywl-wlANS--
ptwlsleepwlonwlUNAFFECTEDwlsidewlwithwlawlnightwlshieldwlforwl1-4wlweeks
afterwlThyroidectomywl-wlANS--lowwlorwlsemi-
fowler'swlposition,wlsupportwlhead,wlneckwlandwlshoulders.
InfantwlwithwlSpinawlBifidawl-wlANS--Pronewlsowlthatwlsacwldoeswlnotwlrupture
Buck'swlTractionwl(skin)wl-wlANS--elevatewlfootwlofwlbedwlforwlcounterwltraction
, Afterwltotalwlhipwlreplacementwl-wlANS--
don'twlsleepwlonwlsidewlofwlsurgery,wldon'twlflexwlhipwlmorewlthanwl45-
60wldegress,wldon'twlelevatewlHeadwlOfwlBedwlmorewlthanwl45wldegrees.wlMaintainwlhipwla
bductionwlbywlseparatingwlthighswlwithwlpillows.
Prolapsedwlcordwl-wlANS--KneewltowlchestwlorwlTrendelenburg
oxygenwl8wltowl10wlL
CleftwlLipwl-wlANS--
positionwlonwlbackwlorwlinwlinfantwlseatwltowlpreventwltraumawltowlthewlsuturewlline.wlwhilewlf
eedingwlholdwlinwluprightwlposition.
Towlpreventwldumpingwlsyndromewl-wlANS--(postwloperativewlulcer/
stomachwlsurgeries)wleatwlinwlrecliningwlposition.wlLiewldownwlafterwlmealswlforwl20-
30wlmin.wlalsowlrestrictwlfluidswlduringwlmeals,wllowwlCHOwlandwlfiberwldiet.wlsmall,wlfreque
ntwlmeals.
AKAwl(abovewlkneewlamputation)wl-wlANS--
elevatewlforwlfirstwl24wlhourswlonwlpillow.wlpositionwlpronewldailywltowlmaintainwlhipwlextensi
on.
BKAwl(belowwlkneewlamputation)wl-wlANS--
footwlofwlbedwlelevatedwlforwlfirstwl24wlhours.wlpositionwlpronewltowlprovidewlhipwlextension.
detachedwlretinawl-wlANS--
areawlofwldetachmentwlshouldwlbewlinwlthewldependentwlposition
administrationwlofwlenemawl-wlANS--
ptwlshouldwlbewlleftwlsidewllyingwl(Sim's)wlwithwlkneewlflexed.
Afterwlsupratentorialwlsurgerywl-wlANS--
(incisionwlbehindwlhairlinewlonwlforhead)wlelevatewlHOBwl30-40wldegrees
Afterwlinfratentorialwlsurgerywl-wlANS--
(incisionwlatwlthewlnapewlofwlneck)wlpositionwlptwlflatwlandwllateralwlonwleitherwlside.
Duringwlinternalwlradiationwl-wlANS--onwlbedwlrestwlwhilewlimplantwlinwlplace
AutonomicwlDysreflexia/Hyperreflexiawl-wlANS--
S/
Swlpoundingwlheadache,wlprofusewlsweating,wlnasalwlcongestion,wlchills,wlbradycardia,wlh
ypertension.wlPlacewlclientwlinwlsittingwlpositionwl(elevatewlHOB)wlFIRST!
Shockwl-wlANS--
bedrestwlwithwlextremitieswlelevatedwl20wldegrees.wlkneeswlstraight,wlheadwlslightlywleleva
tedwl(modifiedwlTrendelenberg)
