Milestone 2 Version B Latest Update with Verified Solutions

Milestone 2 Version B Latest Update with Verified Solutions Continuous bladder irrigation -Peri and Foley care will need to be done twice a day - Will be on this for 24 hrs and then after 24hrs need to be on a lot of fluids -Use only sterile saline with bladder irrigation ( prevents fluid and electrolyte imbalance) - Increase fluids to 3000mL/day - Sometimes give anti-spasmatic bc they have lots of bladder spasms - Make sure pt is on stool softener -Pt needs to urinate q2-3hr -Will have sensation of full bladder -Advise the patient to not attempt to void as it will cause bladder spasms urethritis - Urethritis: Inflammation of the urethra (Lower UTI) - S&S: Burning on urination, urinary frequency (voiding more than every 3 hours), urgency, nocturia, incontinence, suprapubic or pelvic pain - RISK: Female, diabetes, pregnancy, neurologic disorder, gout, incomplete emptying of bladder - Prevention: Hand hygiene, careful perineal care, and frequent toileting may decrease UTIs TX: Antibiotics when bacteriuria present, monitor kidney function, monitor I&O, increase fluid intake if cardiac status does not contraindicate Renal calculi risk Risk factors: - Family history, dehydration, certain diets (high in protein, sodium, and sugar increase risk), strictures, neoplasms, prostatic hypertrophy, medications/supplements (Vit C, laxatives, calcium-based antacids) Risks (emergency): - Can lead to infection with fever and chills à this is an emergency and can be life-threatening - Calcium and oxalate -Risk for developing kidney stone pt with gout (middle age) -Strain all urine -Avoid supine position -regularly scheduled pain medication rather then PRN to prevent spasm and promote comfort Calculi pain - Opioid are given to prevent shock and syncope that may result from the excruciating pain - NSAIDS - Once stone is passed the pain the relieved - Hot baths or moist heat to the flank area may also be helpful - S&S nausea, vomiting, diarrhea, and abdominal distention Severity and location of pain are determine, along with any radiation of pain Imitrex contraindications Imitrex (Sumatriptan) is used for migraine headaches with or without an aura (also used to treat cluster headaches) - Contraindications 1. Older adults should not take 2. Caution when administering to renal impaired patients because elimination takes place in the renal system 3. Caution with hepatic impaired patients because metabolism takes place in liver 4. History of hypersensitivity reactions to the drug 5. Cerebrovascular or peripheral vascular systems - Important to ask patient about recent administration ergot alkaloids, should not be given within 24 hours of administration (causes cardiac ischemia) - Administration of MAO inhibitors lead to increased serum levels of sumatriptan and sumatriptan toxicity - 2 weeks after MAO inhibitor has been discontinued, it is permissible to give sumatriptan in combination with MAO inhibitor - Administration of St. John's wort with triptans results in triptan toxicity. Seizures -Patient bed in the lowest position with side rails padded -Suction -Oxygen equipment must be available at the patient's bedside -Document -Airway patency turn patient head to side Hyperthyroidism signs/symptoms - Exophthalmos (bulging eyes) - Enlarger thyroid gland - Weight loss - T3 elevated and T4 elevated - Diarrhea - Tachycardic, palpitation, inc BP - Bruit over thyroid - Increased appetite - Heat intolerance - Diaphoresis - Nervous, insomnia - Monitor EKG, heart rate, and blood pressure Exophthalmos-POC - Wear