Comprehensive Predictor Retake Review
- ADLs
- Bathing
- Grooming
- Dressing
- Tioleting
- Ambulating
- Feeding (without swallowing precau-
Delegation to Assistive Personal
tions)
- Positioning
- Rountine Tasks
- Bed making
- Specimen collection
- I&O
- Vital Signs ( for stable clients )
- Monitor for low Bp & bradycardia
- Monitor for chest pain & peripheral ede-
ma
- Monitor clients weight
- reorient the client if confusion occurs
- provide frequent rest periods to avoid
fatigue & decrease myocardial oxygen
demands
- Monitor respiratory status
- encourage client to cough and breathe
deeply to prevent pulmonary complica-
tions
Planning Care for a Client Who Has Hy-
- low calorie, high fiber diet , & encourage
pothyroidism
fluids to prevent constipation and pro-
mote weight loss
- Administer cathartics and stool soften-
ers as needed. (Avoid fiber laxatives, in-
terfere with absorption of levothyroxine)
- Provide extra clothing and blankets for
clients who have decreased cold intoler-
ance
- caution use of electric blankets
- Encourage verbalization of feelings and
fears about body changes
- Reassure client that most physical man
, Comprehensive Predictor Retake Review
ifestations are reversible
- use caution with CNS depressants (bar-
biturates or sedatives)
- Fatigue/ lethargy
- irritability
- intolerance to cold
- constipation
- weight gain
- pallor
- think brittle fingernails
- depression & apathy
- joint or muscle pain
- bradycardia, hypotension, dysrhyth-
mias
Signs of hypothyroidism - slow thought process & speech
- hypoventilation & pleural effusion
- thickening of the skin
- hair loss
- thickening of hair on eyebrows
- dry flaky skin
- decreased acuity of taste
- impotence
- abnormal menstrual periods (menor-
rhagia/ amenorrhea)
- delayed physical and mental growth in
children
levothyroxin (synthetic thyroid hormone
Medication for hypothyroidism
replacement)
- females 30 to 60 years of age
- use of lithium & amiodarone medica-
Risk factors for hypothyroidism tions
- Inadequate intake of iodine
- Radiation Therapy the head and neck
What is hypothyroidism underactive thyroid
- Graves' disease
Hyperthyroidism risk factors - Thyroiditis
- Toxic adenoma
, Comprehensive Predictor Retake Review
- Toxic nodular goiter
- Exogenous hyperthyroidism
What is hyperthyroidism? overactive thyroid
- nervousness/ irritability
- muscle weakness
- heat intolerance
- weight loss
- insomnia
- irregular menstrual flow
- frequent stools and diarrhea
- decreased libido
Signs of hyperthyroidism
- Tremor, hyperkinesia, hyperreflexia
- Exophthalmos
- blurry vision or changes
- bloodshot appearance of eyes
- Goiter
- Tachycardia, palpitations, dysthymia
- Elevated blood pressure
- dyspnea
- minimize clients energy
- promote calm environment
- monitor mental status
- monitor nutritional status
- monitor I&O / weight
- provide eye protection (patches, eye
lubricant, tape to close eyelids)
Nursing care for hyperthyroidism
- monitor vital signs and hemodynamic
parameters
- reduce room temp
- provide cool shower/ sponge bath
- Report a increased temp of 1*F imme-
diately
- Avoid excessive palpation of the thyroid
Medication for hyperthyroidism - Methimazole
Reinforcing Teaching About Ostomy
Care
, Comprehensive Predictor Retake Review
stoma should be moist , shinny, and pink.
The peristomal area should be intact -
use mild soap and water to cleanse the
skin, then dry it gently and completely (
moisturizing soaps interfere with
adherence of the pouch) - Apply paste
if necessary
- measure and mark the desired size for
the skin barrier
- cut the opening 0.15 cm to 0.3 cm (
1/18 to 1/8) in larger, allowing the
stoma
to appear through the opening
- apply barrier paste to creases
- performance should reflect the staff
member's job and description
- various sources of data should be
collected
- data should be collected over time and
not just represent isolated incidents
Developing a Improvement Plan for As-
- actual observed behavior should be
sistive Personnel
documented
- peers can be a valuable source of data
- the employee should be given the
opportunity to provide input
- the unit manager to host a private
meeting with the staff member
Monitoring the Performance of Assistive - have ap demonstrate the tasks before
Personnel doing it
- only health care team members
directly responsible for a clients care
can access that client record. Nurses
cannot share info with other clients or
staff not caring for the client
- Client have the right to read and obtain
a copy of their medical record
- ADLs
- Bathing
- Grooming
- Dressing
- Tioleting
- Ambulating
- Feeding (without swallowing precau-
Delegation to Assistive Personal
tions)
- Positioning
- Rountine Tasks
- Bed making
- Specimen collection
- I&O
- Vital Signs ( for stable clients )
- Monitor for low Bp & bradycardia
- Monitor for chest pain & peripheral ede-
ma
- Monitor clients weight
- reorient the client if confusion occurs
- provide frequent rest periods to avoid
fatigue & decrease myocardial oxygen
demands
- Monitor respiratory status
- encourage client to cough and breathe
deeply to prevent pulmonary complica-
tions
Planning Care for a Client Who Has Hy-
- low calorie, high fiber diet , & encourage
pothyroidism
fluids to prevent constipation and pro-
mote weight loss
- Administer cathartics and stool soften-
ers as needed. (Avoid fiber laxatives, in-
terfere with absorption of levothyroxine)
- Provide extra clothing and blankets for
clients who have decreased cold intoler-
ance
- caution use of electric blankets
- Encourage verbalization of feelings and
fears about body changes
- Reassure client that most physical man
, Comprehensive Predictor Retake Review
ifestations are reversible
- use caution with CNS depressants (bar-
biturates or sedatives)
- Fatigue/ lethargy
- irritability
- intolerance to cold
- constipation
- weight gain
- pallor
- think brittle fingernails
- depression & apathy
- joint or muscle pain
- bradycardia, hypotension, dysrhyth-
mias
Signs of hypothyroidism - slow thought process & speech
- hypoventilation & pleural effusion
- thickening of the skin
- hair loss
- thickening of hair on eyebrows
- dry flaky skin
- decreased acuity of taste
- impotence
- abnormal menstrual periods (menor-
rhagia/ amenorrhea)
- delayed physical and mental growth in
children
levothyroxin (synthetic thyroid hormone
Medication for hypothyroidism
replacement)
- females 30 to 60 years of age
- use of lithium & amiodarone medica-
Risk factors for hypothyroidism tions
- Inadequate intake of iodine
- Radiation Therapy the head and neck
What is hypothyroidism underactive thyroid
- Graves' disease
Hyperthyroidism risk factors - Thyroiditis
- Toxic adenoma
, Comprehensive Predictor Retake Review
- Toxic nodular goiter
- Exogenous hyperthyroidism
What is hyperthyroidism? overactive thyroid
- nervousness/ irritability
- muscle weakness
- heat intolerance
- weight loss
- insomnia
- irregular menstrual flow
- frequent stools and diarrhea
- decreased libido
Signs of hyperthyroidism
- Tremor, hyperkinesia, hyperreflexia
- Exophthalmos
- blurry vision or changes
- bloodshot appearance of eyes
- Goiter
- Tachycardia, palpitations, dysthymia
- Elevated blood pressure
- dyspnea
- minimize clients energy
- promote calm environment
- monitor mental status
- monitor nutritional status
- monitor I&O / weight
- provide eye protection (patches, eye
lubricant, tape to close eyelids)
Nursing care for hyperthyroidism
- monitor vital signs and hemodynamic
parameters
- reduce room temp
- provide cool shower/ sponge bath
- Report a increased temp of 1*F imme-
diately
- Avoid excessive palpation of the thyroid
Medication for hyperthyroidism - Methimazole
Reinforcing Teaching About Ostomy
Care
, Comprehensive Predictor Retake Review
stoma should be moist , shinny, and pink.
The peristomal area should be intact -
use mild soap and water to cleanse the
skin, then dry it gently and completely (
moisturizing soaps interfere with
adherence of the pouch) - Apply paste
if necessary
- measure and mark the desired size for
the skin barrier
- cut the opening 0.15 cm to 0.3 cm (
1/18 to 1/8) in larger, allowing the
stoma
to appear through the opening
- apply barrier paste to creases
- performance should reflect the staff
member's job and description
- various sources of data should be
collected
- data should be collected over time and
not just represent isolated incidents
Developing a Improvement Plan for As-
- actual observed behavior should be
sistive Personnel
documented
- peers can be a valuable source of data
- the employee should be given the
opportunity to provide input
- the unit manager to host a private
meeting with the staff member
Monitoring the Performance of Assistive - have ap demonstrate the tasks before
Personnel doing it
- only health care team members
directly responsible for a clients care
can access that client record. Nurses
cannot share info with other clients or
staff not caring for the client
- Client have the right to read and obtain
a copy of their medical record
