Tissue/Peri-op
When a pt is on bedrest, what are your concerns regarding tissue integrity?
Pressure injuries
Risks for developing osteoporosis include:
female, older adult, overweight, smokes, low exercise
After a seizure, a patient may report feeling:
Post-ictal: tired, sleepy, weak, slight headache
Examples of negative symptoms:
Alogia, asociality, social withdrawal, anhedonia, avolition, poor self-care, poor judgment, poor insight, blunted affect
Decels during active labor are expected - T or F
True
Tell me about early, late and variable decels
What is important to check in the "Golden Hour"
VS, physical (uterus) and psychological assessment
What is normal and abnormal cyanosis in a pt?
circumoral cyanosis normal, central core cyanosis is not
If a wound has white drainage and a strong order, what do you anticipate the MD or order?
wound culture
Someone with PD may take levodopa/carbidopa to help with which neurotransmitter?
Dopamine - ↓ muscle stiffness, ↓ tremors, ↓ spasms, ↑ muscle control
Early signs of increased ICP:
change in LOC
Examples of positive symptoms:
Agitation, paranoia, delusions, hallucinations, catatonia, disorganized thinking, disorganized motor behavior
Tell me 3 things Oxytocin do during/post labor:
increases uterine contractions, milk let-down reflex, helps to control post-partum bleeding
Lochia post partum that is concerning
dark red blood with large clots a week after 3 days
How should a baby be put to sleep? And why?
On their back to decrease SIDS
A pt is worried about their upcoming surgery, what should your priority action be?
assess pt worry and education as needed
What are some non-pharm interventions for PD:
Improving bowel elimination (fiber), Improving nutrition (small frequent meals), Enhancing swallowing (thick liquids), Encouraging use of assistive devices, Improving communication (speak slow), Supporting coping abilities, Daily exercise
If a patient s/p concussion has a headache, which of the following meds are ok to give: ASA, Tylenol, Narcotics, NSAIDS
Tylenol
How do you know antipsychotic medications are effective?
pt self-care habits improve
Tell me about true labor vs false labor
True labor: regular contractions that increase in intensity and result in cervical dilation.
False labor: irregular contractions NO cervical changes.
What are 3 post-partum concerns to review with moms before discharge?
lochia review, PPD, newborn care
What 3 medications do newborns receive at birth?
Erythromycin, Vit K and Hep B
A pt with back spasms is prescribed baclofen (Gablofen), what should they avoid when taking this medication?
Alcohol
Medications to decrease muscle spasms like cyclobenzaprine and baclofen have this effect on the CNS:
lower BP, may decrease LOC, cause weakness, dizziness
N/V is an expected complication of a TBI so no intervention is necessary T/F
False, vomiting can increase ICP and should be avoided
Which scoring tool tells you a pt's cognitive status?
mini-mental status exam
What are 4 things you want to ask a mom when she states her membranes ruptured.
fluid appearance - TACO Time, amount, color, odor
Post partum hemorrhage is defined as... and what do you do about it?
>500ml blood loss for vag delivery
>1000ml blood loss for c-sec delivery
fundal massage, prepare for oxytocin
If a baby has tachypnea and breathing pauses, I should immediately notify the OB doc.
Transient Tachypnea of the Newborn or TTN is normal and resolves within hrs after birth
Who's responsibility is it to obtain a consent for surgery?
MD, RN assess to assure pt understands the procedure and their questions were answered
Which PD medication can cause dry mouth, blurred vision: carbidopa/levodopa (dopamine replacement) or benztropine (anticholinergic) or pramipexole (dopamine agonist) or selegiline (MAO-B inhibitor)
Benztropine (Cogentin)
If your pt's ICP is not resolved, the end result will be:
herniation - brain tissue thru spinal cord skull opening (foramen magnum)
A pt believes their food is poisoned. What is the best way encourage pt to eat?
validate their concerns, ask open ended questions.
Explain 4 stages of labor
1 - latent start regular contraction, Active dilation 6-8 cm, transition short, 8-10cm
2 - push and baby out
3 - placenta delivered
4 - first few hrs post delivery
If a mother chooses not to breastfeed, how long til milk production stops?
2 weeks
Tell me about baby weight loss and gain after birth.
babies lose 5-10% wt and regains by 3-4 weeks