Teaching & Learning
Cognitive
Affective
Psychomotor
Right patient
Right medication
Right dose
Right route
Right time
Right reason
What are the 6 rights of medication administration?
Obtain X-ray of the abdomen to confirm placement
What is the priority intervention before starting a tube feeding?
Reason, reflection, relationships, restoration, & religion
What are the 5 R’s of spirituality?
Check the mouth for pocketing and emptying of food
Watch for drooling
What are nursing considerations for a client with dysphagia?
Be sincere and honest
Stick to the basics & use simple words
Ask if the patient has any questions
Listen to your client
Choose appropriate timing
What are some principles for effective teaching and learning?
Compare medication label with MAR before beginning to prepare medications
Compare medication label with MAR after preparing medications
Compare medication label with MAR at the patients bedside
What are the three safety checks before administering a medication?
Flush in between each medication
Give medications one at a time
Stop tube feeding during medication adminstration
What are nursing considerations when administering medications to a client via NGT?
FICA
SPIRIT
What are two assessment tools to identify spiritual needs?
Phenomenon of drug metabolism whereby the concentration of a drug is greatly reduced before it reaches the systemic circulation
What is the first pass effect?
Demonstrate blood glucose monitoring & insulin administration to the client
What is an example of a direct-care intervention for a client with diabetes?
Sudden vision changes
Green/yellow halo around lights
What are signs/symptoms of digoxin toxicity?
Placing the client supine
Flushing the tube before administering the first medication only
Gastric Residual 450mL
What are contraindications for a client with an NGT?
Valuing diversity
Having the capacity for cultural self-assessment
Being conscious of the dynamics inherent when cultures interact with one another
Having institutionalized cultural knowledge
Having developed adaptations of service delivery reflecting an understanding of cultural diversity
What are the five elements of cultural competence?
Pale skin, brittle nails, muscle wasting, weight loss, multiple pressure ulcers
What are clinical manifestations of malnutrition?
Advise the client to reduce dietary sodium intake
Instruct the client to take the medication as directed
Tell the client to avoid taking this medication right before bed
Tell the client to alert the physician about any new visible edema
What are important client teaching instructions for a client taking furosemide?
Foods high in Vit K & green leafy vegetables
What foods should the client avoid while taking Warfarin?
Stop the tube feeding immediately
Raise bed to high-fowler position
Clear airway
Notify PCP
What are nursing interventions for a client exhibiting s/s of aspiration?
Lack of knowledge
Lack of time to focus on spiritual needs
Fear that the nurse will not be able to cope with or confront issues raised
What are barriers to spiritual care?
DVT
Constipation
Atelectasis
What are some postoperative complications?
Grapefruit juice reacts with many medications
We need to make sure your medications are safe to take with grapefruit juice
What is an example of a nurse providing teaching to a client regarding food & drug interactions?
Inject the heparin without aspiration
Clean the site with alcohol before administration
Select a site on the abdomen staying two inches away from the umbilicus
What is the appropriate way to administer a SQ heparin injection?
Disconnect the tube from suction to administer meds
Clamp the tubing for 30mins after med administration
How do you administer medications through a NGT connected to continuous suction?
Consider that nonverbal cues such as eye contact may have different meanings in different cultures
Respect the clients' cultural norms & beliefs
Ask the client if they have any cultural or religious requirements that should be included in the plan of care
What are nursing considerations for caring for a client whose cultural background is different from their own?
Client with tibia-fibula fracture states her leg feels funny
Right foot is cool to touch & dusky in color
Cap refill >3 seconds
What are signs and symptoms of compartment syndrome?