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Assessing the Care Environment for a Client Who is Experiencing Suicidal Ideations
-search the client's belonging with the client present. Remove all glass, metal silverware,
electrical cords, vases, belts, shoelaces, metal nail files, tweezers, matches, razors, perfume,
shampoo, plastic bags, and other potentially harmful items from the client's room and vicinity
-allow the client to use only plastic eating utensils. Count utensils when brought into and out of
the client's room
-check the environment for possible hazards (windows that open, overhead pipes that are easily
accessible, non-breakaway shower rods, non-recessed shower nozzles)
-ensure that the client's hands are always visible, even when sleeping
Caring for a Client Who Has Immunosuppression
monitor skin and mucous membranes for infection (breakdown, fissures, and abscess)
Developing an Emergency Preparedness Plan
The Hospital Incident Command System (HICS) for disaster management offers a clear structure
for disaster management at the facility level
Identifying Reportable Diseases
-Nurses are also mandated to report to the proper agency (local health department, state health
department) when a client is diagnosed with a communicable disease
-a complete list of reportable diseases and a description of the reporting system are available
through the Centers for Disease Control and Prevent Web site. Each state mandates which
diseases must be reported in that state. There are more than 60 communicable diseases that must
be reported to public health departments to allow officials to do the following: ensure appropriate
medical treatment of diseases (tuberculosis), monitor for common-source outbreaks (foodborne:
hepatitis A), plan and evaluate control and prevention plans (immunizations for preventable
, diseases), identify outbreaks and epidemics, determine public health priorities based on trends,
educate the community on prevention and treatment of these diseases
Nationally notifiable diseases: identified at the CDC website and include the following
-anthrax, botulism, cholera, congenital rubella syndrome (CRS), diphtheria, giardiasis, gonorrhea,
hepatitis A, B, C, HIV, influenza-associated pediatric mortality, legionellosis/legionnaires' disease,
lyme disease, malaria, meningococcal disease, mumps, pertussis (whooping cough),
poliomyelitis, paralytic, poliovirus infection, nonparalytic, rabies (human or animal), rubella
(german measles), salmonellosis, severe acute respiratory syndrome-associated coronavirus
disease (SARS-CoV), shigellosis, smallpox, syphilis, tetanus/C. tetani, toxic shock syndrome
(TSS) (other than streptococcal), tuberculosis (TB), typhoid fever, vancomycin-intermediate and
vancomycin-resistant, viral hemorrhagic fever, staphylococcus aureus (VISA/VRSA)
Identifying a Prescription to Clarify With the Provider
-caused by damage to sensory nerve fibers resulting in numbness and pain
**peripheral neuropathy includes focal neuropathies, caused by acute ischemic damage or diffuse
neuropathies, which are more widespread and involve slow, progressive loss. This can lead to
complications (foot deformities, ulcers).
**autonomic neuropathy can affect nerve conduction of the heart (exercise intolerance, painless
myocardial infarction, altered left ventricular function, syncope), gastrointestinal system
(gastroparesis, reflux, early satiety), and urinary tract (decreased bladder sensation, urinary
retention). It affects the autonomic nervous system, which minimizes manifestations of
hypoglycemia (diaphoresis, tremors, palpitations), which can be dangerous for the client
-clients who have impaired sensory perception might not feel numbness, pain, or burning
managing adverse effects of risperidone
orthostatic hypotension
-nursing actions: monitor blood pressure and heart rate for orthostatic changes
-client education: change position slowly
placing a client in side-lying position
-position clients, especially those who are unable to move themselves, so that they maintain good
body alignment. Frequent position changes prevent discomfort, contractures, pressure on
tissues, and nerve and circulatory damage, and they stimulate postural reflexes and muscle tone