Mobility
An immobile patient needs repositioning every __ hours.
Every 2 hours
An immobilized patient may be prone to this kind of skin condition on a bony prominence?
Pressure sore/ulcer
Rule of thumb for the ‘order’ of abdominal assessment
Auscultation before palpation
Studies have shown that decreased appetite, difficulty chewing, and incidence of pneumonia have been linked to a decrease in care of this body cavity?
Oral care
Oral and IV therapy are both included in this nursing intervention for dehydration
Rehydration therapy
Generalized weakness on one half of the body
hemiparesis
This term describes a separation of wound edges
Dehiscence
30cc/hr/day for an adult, and .5cc/kg/day for children
Minimum Urine Output
Nasogastric, nasoduodenal, and nasojejunal refer to this nutritional process
Tube feeding
‘Tenting’ described by this assessment is common with dehydration
Skin turgor
Caused by damage to the Central Nervous system, this condition consists of increased muscle tone and contractures
Hypertonia
These factors contribute to skin breakdown (maceration)
Incontinence, moisture, friction, pressure, trauma
In order to advance a patient’s diet, the nurse must perform this assessment.
Bowel sounds (active)
A lung complication as a result of dysphagia
Aspiration
These 2 daily nursing assessments are indicated with both fluid volume excess and fluid volume deficit
Intake and Output, daily weights
Nursing interventions to increase lung capacity when a patient is immobile
What is Turn, Cough, Deep Breathe (TCDB), breathing exercises and positioning.
‘normal’ skin assessment descriptions included in nursing documentation
Warm, dry and intact
This medical device is a non-invasive way to determine a post-void residual.
Bladder Scanner
Vitamins and mineral are included in this nutrient term
Micronutrients
Lack of urine output, and abdominal distention are indicators of problems within this body organ/system
kidneys/renal system
Nursing assessment that includes patient’s ability to manage cooking, finances, transportation and shopping
Instrumental Activities of Daily Living
Complete the missing descriptors of melanoma screening: A=___ B= borders C=____D= diameter E= ____
Asymmetry,
Color
Evolution (changes)
This abdominal assessment if distention assists in determining if a patient has a build-up of air or fluid
Percussion
Gendered assessment tool by CDC that indicates percentages weight and stature for human development
Growth chart
Increased blood pressure, shortness of breath, lung crackles, swelling in abdomen are all symptoms of this fluid volume condition
Fluid Volume Excess