Med Surg
RN is required to report
Suspected abuse of vulnerable clients to appropriate authorities, regardless of what other pract's think
enjoy associative play
Magical thinking is present in this stage of development and commonly includes make-believe play
Unlesss otherwise specified, assume that PPE includes
gloves, gowns, goggles, and masks
Preschoolers need toys that work on:
- fine motor skills (fingers)
- balance (dance, ice skating, tumbling)
What is the terapeutic range for PO2
78-100
Clients with SLE
Be advised to avoid harsh sunlight and ultraviolet light exposure as well as harsh soaps and chemicals. These clients often receieve corticosteroids and are susceptible to infection; therefore, annual flu vacs are important
The second trimester
clients should expect quickening at 16-20 weeks, gain approx 1 lb per week if prepregnancy BMI was normal, consume iron-rich foods, and anticipate screening/diagnostic tests
The proper order for donning PPE is
1. Gown
2. Mask
3. Goggles
4. Gloves
(start low to high)
School age (7-11 years) aka ___ are characterized by the 3 C's
Concrete
1. created/creative
2. competitive
3. collective
What do you do if O2 saturation is less than 93?
assess respirations and give oxygen
The varicella vaccine
May cause mild adverse reactions, including low-grade fevers, swelling and erythema at the injection site, irritability, and a reash that may appear up to 1 month after the injection. A second dose of the vaccine is required to reach optimal immunity
Normal newborn respiratory
30-60bpm
The proper order for removing PPE is
1. Gloves
2. Goggles (from behind)
3. Gown (from behind)
4. Mask (from behind - outside room)
What type of toys should be avoided with toddlers?
toys that require good finger control/dexterity
What do you do if BNP is elevated?
Be concerned and continue to monitor patient
Warfarin
Must be taken at the same time daily to maintain a therapeutic INR. Many ntibiotics will increase INR by causing vitamin K deficiency. A diet high in vitamin K may decrease the anticoagulant effect of warfarin
Neonatal Sepsis
May be hyperthermic or hypothermic.
Subtle changes such as irritability, increased sleepiness or lethargy, and poor feeding
Blood, urine, and cerebrospinal fluid cultures should be obtained immediately and broad-spectrum antibiotics started
What is the droplet precaution used for?
Influenza, meningitis, diphtheria, pertussis, mumps
Avoid answeres with the following words in them for children 9 months and younger
build, sort, stack, make, construct
When should you call a rapid response team?
When lab values are critical or deadly dangerous or if bad symptoms during assessment
The priority intervention for tricyclic antridepressant OD
Administration of IV fluids and IV sodium bicarbonate. Sodium bicarbonate narrows the widened QRS complex and reduces the risk of fatal arrhythmias
Poorly controlled maternal diabetes mellitus
the fetus experiences hyperglycemia and hyperinsulinemia in utero during the second and third trimesters
In response, the fetus increases metabolic activity and oxygen consumption
Fetal erthropitein production subsequently increases to produce additional RBCs
This increased production of RBCs leads to polycythemia (hematocrit >65%) and increased circulatory viscosity
Contact Precautions (select all that apply)
- Private room
- Mask
- Gloves
- Mask
- Handwashing
-eye/face shield
- Disposable supplies
- Negative air flow
-gown
- Pt wear mask when leaving
- Private room
Gloves
-gown
- Handwashing
- Disposable supplies
-Stethoscope can be taken as long sterile
Adolescents (12-18 years) their "play" is ____ ____ _______. Allow adolescents to be in each others' room unless one of them is:
peer group association
1. Fresh post-op
2. immunosuppressed
3. contagious
What is the bleeding precaution?
Private room
Limit number of staff entering
Limit visitors to healthy adults
No fresh flowers or plants
Low bacteria diet
Do not drink water that has been standing for longer than 15 mins
Vital signs every 4 hours
Check WBC (ANC) daily
Avoid use of indwelling catheter
Do not re-use cups
Use disposables plates, cups, straws, utensils
Dedicated items in room: stethy, BP cuff, Thermometer, gloves