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100
What are the manifestations of a fever
Flushed skin Restlessness or excessive sleepiness Irritability Poor appetite Glassy eyes & sensitive to light Increased perspiration Headache Elevated pulse & respiratory rates Disorientation or confusion Convulsions in infants & children (febrile seizures) Fever blisters around the nose or lips in clients who harbor the herpes simplex virus
100
What should the nurse encourage a patient to do before undergoing a paracentesis
When assisting a client who has to undergo a paracentesis procedure, the nurse should encourage the client to empty their bladder just before the procedure to prevent puncture of the bladder
100
What is the proper way to perform TENS and give rationale
When performing TENS, the nurse spaces the electrodes at least the width of one from the other in order to limit the potential for burning caused by close proximity of the electrodes
100
What are the ways to document pitting edema
Pitting edema has 5 categories which are differentiated by how deep the indentation is & how long indentation lasts upon pressing the thumb or finger into the skin. 1+ (2mm indtn), 2+ (4mm, lastst longer than 1+), 3+ (Deep pit, 6mm, remains several seconds), 4+ (Deep pit, 8mm, remains for prolonged time) 5+ (fluid can’t be displaced, tissue firm and hard, no pitting)
100
What should you look for if you suspect jaundice
• Yellowish or greenish-yellow discoloration of the skin and sclera (in African Americans- be sure to check the sclera and mucous membranes)
200
What are the nursing interventions for postural hypotension
• Ensure that the client remains seated after rising until dizziness passes • Restore adequate hydration if the clients fluid volume is low • Increase consumption of salty foods & those containing sodium providing the client is not hypertensive • Apply compression stockings to the lower extremities to reduce pooling of blood upon standing • Administering prescribed medications such as a synthetic mineralcorticoid that mimics aldosterone (adrenal hormone that reduces the loss of sodium in urine)
200
What are signs and symptoms of hypotension
When a blood pressure measurement is <100 systolic and <60 diastolic Low BP can be sometimes be an indicator of shock, hemorrhage or drug side effects.
200
What is the procedure for assessing skin turgor
Gently pinch clients skin over the sternum or below clavicle to lift it from underlying tissue. When released, the skin should return to its normal position quickly. Prolonged tenting indicates dehydration. Good skin turgor is documented as “elastic” or “non-elastic” if it tents.
200
What is a cordotomy (define and describe)
A cordotomy is a surgical procedure that interrupts pain pathways. Bundles of nerves that have been severed and an electrode is directed into the spinal cord . This electrode creates a lesion using radiofrequency and interrupts the sensation of pain, pressure & temperature.
200
What is phantom limb pain (define and describe - also note what type of pain this is)
Phantom limb pain is a type of neuropathic pain in which a person with an amputated limb perceives that the limb still exists and feels burning, itching, & deep pain in tissues that have been surgically removed. neuropathic
300
What are things that cause temperature change
• Food intake • Age • Climate • Gender • Exercise & activity • Circadian rhythm • Emotions • Illness & injury • Medications
300
What are nursing interventions for a fever
Being that fever is a body defense, no interventions besides fluids and rest are necessary if the temp is <102 degrees and the PT doesn’t have a chronic medical condition. If the fever is greater than 102 and baseline vitals have been taken and there is a Dr. order antipyretics can be administered
300
What education should be given to a patient who has undergone radionuclide imaging
A client who has undergone radionuclide imaging should be taught to abstain from intercourse or use an effective contraceptive method for the short period, during which radiation continues to be present
300
What are autonomic responses that can occur when pain is poorly controlled
When dealing with clients whose pain is poorly controlled, the nurse should look for autonomic nervous system responses such as tachycardia, hypertension, dilated pupils, perspiration, pallor, rapid and shallow breathing, urinary retention, reduced bowel motility, and elevated blood glucose levels.
300
How do you convert Farenheit to Celcius and how do you convert Celcius to Farenheit
C= (F-32)/1.8 F= (C x 1.8) + 32
400
What are lifestyle changes that can decrease BP
Eating a fruit/vegetable rich, low fat dairy, lean proteins, low sodium, whole grain diet • Maintain a healthy weight • Very limited alcohol intake • Manage stress
400
What is a PCA (define and describe the advantages)
PCA is patient controlled analgesia, an intervention that allows the patient to administer his own dose of opioid pain meds through an infusion device. Advantages of PCA are: • Rapid relief due to IV administration • Pain is kept at tolerable level, small doses of the drug more frequently control pain • Clients don’t have to get multiple injections • Don’t have to wait on nurse for next dose thus decreasing anxiety • Less side effects with smaller doses. • Clients tend to move more which decreases complications from being immobile • Clients participate in pain management • Frees up the nurses time
400
What is the best way to obtain a core temp in a convenient way? Who is it contraindicated for?
tympanic contraindicated for children under 2 because the ear canal is to narrow
400
What are nursing interventions when preparing a patient for an endoscopy
• Make client NPO for at least 6 hours prior to any procedure in which an endoscope is inserted into upper airway or upper GI tract • Monitor clients vital signs if conscious sedation is used. Have O2 & resuscitation ready • If topical anesthesia is used to guide the endoscope into the airway or GI tract, withhold food for at least 2 hours after the procedure to ensure that the swallow, cough & gag reflex are working properly again. • Relieve clients sore throat w/ice chips, fluids or gargles when safe to do so. • Confirm that a bowel preparation using laxatives and enemas has been completed prior to endoscopy of lower intestines. • Report difficulty of arousing a client or any sharp pain, fever, unusual bleeding , nausea, vomiting or difficulty urinating after any endoscopic procedure
400
in which direction should you pull a child's ear for optimal visualization and in what direction should you pull an adult ear for optimal visualization.
Child- pulling the ear down and back Adult- Pulling the ear up and back
500
What is the difference between the Weber test and the Rinne test? What instrument should the nurse have?
The Weber test: the nurse strikes a tuning fork on his or her palm and places the vibrating stem in the center of the client's head. (uses vibration) Rinne test: technique for comparing air versus bone conduction of sound- the nurse strikes the tuning fork and then places the stem on the client's mastoid area behind the ear? a tuning fork
500
What are the nursing interventions related to a sigmoidoscopy
• Prepares for exam by placing sigmoidoscope, gown, gloves, lube, mask, goggles, suction, and containers for tissue sample in exam room • Help client into the Sims’ position, provide draping and prepare the client for the introduction of the examiners fingers, followed by the instrument. • Keep client informed about discomfort, suction if used, when tissue sample has been obtained. • Explain to the client that there may be abdominal discomfort from air instilled during procedure. • Monitor for hemorrhaging, perforation, gas & pain. • Clarify dietary orders. • Complete any forms and see that specimen is delivered to the lab.
500
What are the different lesions that can be found during a skin assessment
• Macule (flat, round, nonpalpable) • Papule (elevated, palpable, solid) • Vesicle (elevated, round, filled w/serum) • Wheal (elevated, irregular border, no free fluid) • Pustule (elevated, raised border, filled with pus) • Nodule (elevated, solid mass, deeper and firmer than a papule) • Cyst (encapsulated, round, fluid filled or solid mass beneath the skin)
500
What are questions asked during a nutrition screening also specific objective data should a nurse get
• How many meals a day does client eat • Any unintentional weight loss/gain in the past 6 months • Food likes, dislikes, allergies, intolerances, cultural beliefs • Alcohol consumption • Any problems w/eating, digestion, elimination • Special diets • Vitamins or minerals taking • OTC meds such as antacids or laxatives height and weight
500
What are nursing interventions for pain management
• Assess clients pain & its characteristics at least every 2 hours while awake & 3o min after implementing a pain management technique • Modify or eliminate factors that contribute to pain like full bladder, uncomfortable position, pain-aggravating activity, too hot or too cold environment, noise, social isolation • Determine clients choice of pain relief techniques • Administer prescribed analgesics or alternative pain management techniques promptly • Advocate on the clients behalf for doses of prescribed analgesics or the addition of adjuvant drug therapy if pain is not satisfactorily relieved. • Administer a prescribed analgesic prior to procedure or activity that is likely to cause pain or intensify existing pain. • Plan for rest between activities
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