Inflamm.
What is the difference between Ulcerative Colitis and Crohn's Disease?
What are they both at risk for? 2 things specifically
UC: Multiple BMs daily with mucous and blood within the stools
Crohns: Multiply BMs daily
infx and electrolyte imbalance
What are the 5 rights of delegation?
1. Right Task
2. Right circumstance
3. Right person
4. Right direction
5. Right supervision
What are some diagnostic tests that we may do if a patient is coming in with trauma? (rape, Child abuse, etc)
Blood Alcohol level
urinalysis (infx, sti)
Pregnancy test
Ct scan (head trauma)
Rape kit (swabs, nail clippings, vaginal fluids)
If a mom has a bishop score of 4, what pharmacological interventions do you anticipate the doctor prescribing?
What is an is considered unripe/ripe?
When can we give pitocin/oxytocin?
Misoprostol
unripe= less than 6 ripe=greater than 6
we can give pitocin when mom reaches 6cm
What is an ESR and what is a normal range?
What is a CRP and what is the normal range?
ESR- erythrocyte sedimentation rate (how far erythrocyte settles in one hour) Men: 1-15 Women: 1-20
CRP- C reactive protein; it is produced by the liver and it is used to detect inflammation and track effectiveness of treatment; 0 (less than 1) is a normal level)
How would someone presents to the ED if they had appendicitis?
N/V
pain in upper abdomen that migrated after 4 hrs to RLQ
pain with mvmt, coughing, jumping
Mcburney's point rebound tenderness
low grade fever
What nursing functions can we NOT delegate?
Assessments (initial)
Care plans
Evaluation of care effectiveness
Initial teaching
Which types of incidences require mandatory reporting by a RN?
Child abuse
Elder abuse (not filling scrips, misuse of funds) usually report through security
Gun shot wounds
Meningitis
stab wounds
Certain Burns
What are the 2 main SE to the medication Terbutaline?
Hypoglycemia (sweaty,cold,pale skin,shakiness)
Tachycardia (if mom RR is greater than 120 we can not give this medication)
**What is a normal glucose?
What is a normal level for hemoglobin/hematocrit? (for both men and women)
Hemoglobin: M= 13.5-18 F=12-15
Hematocrit: M= 40-54 F= 36-46
What are some risk factors increases someones chance of developing gall gladder disease?
4 F's- fat, forty, female,fair (native american & Mexican americans)
obesity, hyperlipidemia, family hx,
What are some cost containment strategies?
What are some specific nursing cost containment?
walk-in clinic, NP's instead of MD's
hand hygiene, promote safety, supplies, reducing overtime costs, not drawing up too much medication
How may a child respond who is being sexually abused?
clinging behavior (to parents)
Isolate themselves
Act out sexually
Run way
Suicide
May victimize other children
Bedwetting (regression)
Tell me about Early decelerations? What causes them? As the nurse what is our role?
Early decelerations are caused by compression of the fetal head
SVE
See if mom is dilated enough to push
What is a normal WBC?
4,500-10,000
Differences between Cholelithiasis and Cholecystitis
Cholelithiasis- lasting about 30 mins to 5 hrs, N/V, Abrupt onset, may radiate to back rt scapula, and shoulder, severe onset, localized to epigastrium to RUQ
Cholecystitis- lasting 12hrs to 18 hrs, n/v, anorexia, fever, chills, tenderness, guarding, gangrene leading to perforation, generalized RUQ, may radiate to back, rt scapula, shoulder, sever onset, abrupt onset
What is the job of case management?
Who benefits the most from case managers?
Sometimes called "Discharge planners"
transportation, pt,ot,homecare, supplies, insurance
usually an older more experienced nurse; use critical pathway to which is the anticipated course of patient recovery
Pregnant at risk women, children with special needs, people with behavioral health issues, older adults
When trying to get information out of a child out the sexual abuse they experienced, what are some appropriate things we can do as nurses in order to retrieve needed information?
Build rapport; First talk about school, activities, pets
Use anatomical dolls
ask gentle questions
DO NOT TELL THEM PERP WILL NOT GET IN TROUBLE
What are reasons that we may stop the pitocin that mom has running?
1. Non-reassuring FHR
2. Tachysystole- More than 5 contractions in 10 mins
3. Hypertonic contraction- a contraction lasting longer than 2 mins; this is bad because during a contracting there is a decrease is oxygen supply that is going to the baby
**If stopping the pitocin doesn't work then what may we have to do?
What is a normal PLT?
150,000-400,000
If you have a patient coming into the ED with suspected PUD what may they display with and what may they say they are experiencing?
pain, food, relief pattern
heartburn
regurgitation; N/V
Burning, aching, gnawing,hunger-like abd. pain
pain occurs when stomach is empty (2-3 hrs after eating & in the middle of the night)
What are critical pathways?
Guides for care
expected outcomes for patient with specific dx
Developed through collab with healthcare team
cost and length of stay play a role in critical pathways
What are the components of the cycle of battering?
Phase1: Tension (Waiting for something to happen); tension can be so unbearable some victims will trigger the battering just to get to the honeymoon phase
Phase2: Acute Battering Incident (short period of time)
Phase3: Calm,Loving,Respite (Honeymoon phase; sorry, gifts, "never do it again")
Go through All of the stages of labor (include all components for each stage)
Stage 1 Labor: Dilation and effacement Phase1 Latent or early labor 0-6 cm Phase 2 Active labor 6-8 cm Phase 3 Transition 8-10 cm
Stage 2 Pushing: Delivery of the fetus•Passive descent Uterine contractions facilitate descent of fetus through pelvis•Active descentMaternal pushing efforts assist fetus through pelvis
Stage 3 Birth of fetus to delivery of the placenta; 5-30 mins
Stage 4 Immediate postpartum recovery period; first 1-4 hours after delivery
What can cause Metabolic Alkalosis?
Which one of the topics that we talked about has a complication that deals with metabolic alkalosis, explain?
N/V, low potassium
Complications of PUD; obstruction from the pyloric region the pt will experience epigastric fullness, n/v and electrolyte issues due to the n/v. This can lead to metabolic alkalosis