Standardized Care Plans: Disadvantages:
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~ may not be able to include UNIQUE therapy that some patients need
~do NOT replace your professional judgment/decision making
~ need to be updated regularly
,know how to remove intermittent sutures.
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Remove intermittent sutures:
o place gauze few inches from line.
o Hold scissors in dominant hand and forceps in non-dominant hand.
o Grasp not of suture with forceps and gently pull up know while slipping
tip of scissors under suture near skin.
o Snip suture as close to skin as possible at end distal to knot.
o Grasp knotted end with forceps and in one continuous smooth action
pull suture through from the other side.
o Place removed suture on gauze.
o Repeat steps until all removed
know how to remove staples.
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Remove staples:
o place lower tips of staple extractor under first staple.
o As you close handles, upper tip of extractor depresses.
o Carefully control extractor.
o As soon as both ends are visible, move it away from skin surface and
continue until staple is over refuse bag.
o Release handles of staple extractor allowing staple to drop into bag.
o Repeat steps until all removed
Different Charting Systems: Problem-Oreinted Medical Records
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, ~ structured format
~ emphasizes a patient's problems
~ ordered by problem or diagnosis
Know the Effects of Cold Therapy.
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o Decrease of:
pain. muscle spasm, metabolism, blood flow, inflammation, edema, and
extensibility
Diagnostic Label
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found in the nursing pocket guide (235 choices)
Know how to assess for pressure wounds on dark skinned patients.
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feel for warmth & look for purplish color to the skin
Assessment Techniques for Staging Pressure Ulcers: Stage 4
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full thickness skin loss with tissue necrosis or damage to muscle, bone, or
supporting structures
Be familiar with Common Record-Keeping Forms: Flow & Graphic Sheets
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~ permit concise documentation over time.
~ use a format or system for entry of information (usually every 24 hours)
~ CAN be assigned to a nurse assistant for data entry.
Type of Dressings: Alginate Dressing:
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~ dressing may come as a sheet or rope that can be packed into a sound.
~ You can safely pack deep tracking wounds with calcium-sodium alginate
preparation, which allows easy removal with little risk for retained dressing
deep in the wound cavity.
- Promote autolysis, granulation, epithelization
- Calcium alginate material (seaweed)
- Form a gel over the wound to contain exudate
Understanding Application of Assessment: Types of Data:
Give this one a try later!
~ may not be able to include UNIQUE therapy that some patients need
~do NOT replace your professional judgment/decision making
~ need to be updated regularly
,know how to remove intermittent sutures.
Give this one a try later!
Remove intermittent sutures:
o place gauze few inches from line.
o Hold scissors in dominant hand and forceps in non-dominant hand.
o Grasp not of suture with forceps and gently pull up know while slipping
tip of scissors under suture near skin.
o Snip suture as close to skin as possible at end distal to knot.
o Grasp knotted end with forceps and in one continuous smooth action
pull suture through from the other side.
o Place removed suture on gauze.
o Repeat steps until all removed
know how to remove staples.
Give this one a try later!
Remove staples:
o place lower tips of staple extractor under first staple.
o As you close handles, upper tip of extractor depresses.
o Carefully control extractor.
o As soon as both ends are visible, move it away from skin surface and
continue until staple is over refuse bag.
o Release handles of staple extractor allowing staple to drop into bag.
o Repeat steps until all removed
Different Charting Systems: Problem-Oreinted Medical Records
Give this one a try later!
, ~ structured format
~ emphasizes a patient's problems
~ ordered by problem or diagnosis
Know the Effects of Cold Therapy.
Give this one a try later!
o Decrease of:
pain. muscle spasm, metabolism, blood flow, inflammation, edema, and
extensibility
Diagnostic Label
Give this one a try later!
found in the nursing pocket guide (235 choices)
Know how to assess for pressure wounds on dark skinned patients.
Give this one a try later!
feel for warmth & look for purplish color to the skin
Assessment Techniques for Staging Pressure Ulcers: Stage 4
, Give this one a try later!
full thickness skin loss with tissue necrosis or damage to muscle, bone, or
supporting structures
Be familiar with Common Record-Keeping Forms: Flow & Graphic Sheets
Give this one a try later!
~ permit concise documentation over time.
~ use a format or system for entry of information (usually every 24 hours)
~ CAN be assigned to a nurse assistant for data entry.
Type of Dressings: Alginate Dressing:
Give this one a try later!
~ dressing may come as a sheet or rope that can be packed into a sound.
~ You can safely pack deep tracking wounds with calcium-sodium alginate
preparation, which allows easy removal with little risk for retained dressing
deep in the wound cavity.
- Promote autolysis, granulation, epithelization
- Calcium alginate material (seaweed)
- Form a gel over the wound to contain exudate
Understanding Application of Assessment: Types of Data: