GI 1
What can the nurse have the UAP do to assist with placing an IV on an obese patient?
Hold the adipose tissue back to assist with IV placement
What is the BMI for being obese?
BMI for severely(morbidly) obese?
Severe: 40 or more
What are some signs the nurse should monitor for a patient with ARF
What can be a complication from ARDS?
Other body systems shut down
How do elderly present differently when they have pneumonia?
Confusion and lethargy
What two types are Hepatitis are transmitted through fecal/oral routes
Hepatitis A and E
The nurse is caring for a patient with a hiatal hernia, the patient is lying flat and complaining of having acid reflux. What is the priority intervention the nurse should do?
Place the client in semi's Fowler's position
Why would a client with influenza be prescribed an antibiotic?
To prevent bacterial pneumonia from developing
The lung cancer patient who is receiving chemotherapy should be instructed to monitor for signs of?
Infection!
The lung cancer patient is having increased nausea and vomiting during therapy treatments. What should the nurse do?
Administer antiemetic medications as ordered
The nurse is caring for a patient who is post operatively recovering from a gastric bypass surgery. The patient is vomiting intermittently, has respiratory rate of 24, and is complaining of sudden severe abd pain with a rigid abdomen and is having to use the restroom. What requires immediate attention?
The sudden onset of abdomen pain with the rigid abdomen.
Why is the nurse concerned about obese patients post-operatively?
Adipose tissue retains the anesthetic which places the patient at risk for respiratory depression
For a patient who is reporting difficulty swallowing, what food should we have them eating?
Soft, mechanically soften foods (mashed potatoes)
What is the first thing a nurse in the ER should do for a client having an asthma exacerbation?
Assess breath sounds, respiratory status, O2 status
ABC!
What should the nurse discuss/educate for dietary to a patient who is being discharged after being treated for pulmonary embolus
Increased fluid intake (2-3L/ day)
The nurse is taking care of a patient with cirrhosis who is becoming more agitated and confused. What may be occurring for this patient, what lab will be elevated and what medication assists with this process?
Hepatic encephalopathy
Ammonia
Lactulose
What are the lifestyle changes for GERD patients?
Elevate HOB to 30 degrees, Should not go supine 2-3 hours after meal, Quit smoking, maintain a healthy weight, decrease alcohol use, increase physical activity
A patient with bacterial pneumonia is being sent home with oral antibiotics. The patient asks the nurse what they can do to assist with the increased thick secretions they are coughing up, what intervention can the nurse educate the patient to do?
Increase fluid intake, humidification, take anti-histamines (especially before bed)
What signs would we see for a patient who is experiencing a respiratory emergency?
Cyanosis, stridor, inability to speak/swallow, increased WOB, etc.
What lab value increases for worsening sepsis?
Lactate
List the diagnostic categories for metabolic syndrome
Waist circumference, HDL, triglycerides, blood pressure, fasting blood glucose
List the steps involved in stoma care and what the nurse should educate the patient on about stoma/ostomy care
Monitoring stoma color (pink, pale red), measuring the size of the stoma (for proper ostomy appliance placement), Assessing the skin
Education: dietary changes, teaching the patient to empty the bag (1/3) how to assess the skin, measure stoma, etc.
Who do you see first?
57 year old w/ COPD who is having increased SOB, O2: 89% on room air, patient states using rescue inhaler w/ no relief
OR
45 year old w/tracheostomy who is having tracheal secretions, looks to be in mild respiratory distress due to a partially blocked trach
45 year old w/tracheostomy who is having tracheal secretions, looks to be in mild respiratory distress due to a partially blocked trach
Who do you see first?
The patient who has a dislodged tracheostomy tube who's O2 is 87%
OR
The patient who has increased tracheal secretions, RR 24 and O2 is 90%
The patient who has a dislodged tracheostomy tube who's O2 is 87%
Who do you see first?
40 year old with asthma, recently diagnosed with influenza A, is experiencing increased SOB, WOB and wheezing
OR
71 year old with CAD, diagnosed with influenza A, reports chest pain with coughing and increased sneezing
40 year old with asthma, recently diagnosed with influenza A, is experiencing increased SOB, WOB and wheezing