TALK TO ME GOOSE
How to get a history on a patient that does not speak English
obtain an interpreter
Nutrient needed to maintain tissue integrity and promote healing
protein
type of wound healing seen with a burn patient
secondary intention (wound edges not approximated, scarring, scar tissue)
Burning with urination
dysuria
Ways to prevent constipation
Exercising or walking
Increase fruits, vegetables, fiber, water
One way to facilitate communication during teaching with a patient who wears a hearing aid
turn off the television
How do you assess a patient's legs when they are wearing TED/compression/antiembolic stockings?
Take them off
Lab data most indicative of a wound infection?
low protein level
positive wound culture for gram negative bacteria
red blood cell count 5.2 million mm3
blood glucose 12 mg/dL
positive wound culture for gram negative bacteria
A treatment for stress urinary incontinence
pelvic floor exercises
How to position your patient on the bedpan
high fowlers/raise the head of the bed
The purpose in using SBAR when providing report
to standardize communication
Wound healing stage expected to see 1 week after hip replacement
proliferative phase of healing (granulation tissue; 6-21 days after)
Tissue seen with full thickness wound that is healing without complication
granulation
It's a good time, after your patient voids, to perform a bladder scan.
10 minutes after the patient voids
Patient has black stool and fecal occult (guaiac) test is negative. What could you ask your patient?
Are you taking iron supplements?
ISBARR
Introduction, Situation, Background, Assessment, Recommendation/Request, Repeat back
Risk categories associated with the Braden scale?
activity
friction and shear
moisture
sensory perception
inadequate nutrition
Describe serosanguineous drainage
watery, pale, red drainage
Bacteria
Which of these assessments will you expect to find on a patient who has not had a bowel movement in 3 days?
hypoactive bowel sounds
increased fluid intake
soft, tender abd
jaundice in sclera
hypoactive bowel sounds
A confused older patient is wearing thick glasses and a hearing aid. Which intervention is the priority to facilitate communication?
Focus on tasks to be completed
Allow time for the patient to respond
Limit conversations with the patient
Use gestures and other nonverbal cues
Allow time for the patient to respond
Stage pressure ulcer seen with full thickness skin loss, extensive damage to underlying tendons, muscles, bone, extensive tunneling, slough or eschar present?
Stage 4
What would be documented as a Stage II pressure ulcer?
3cm area on left elbow; reddened and an abrasion is noted with partial thickness skin loss
The first action, when assisting a male patient with urinary retention, to assist with voiding
Assist to a standing position
What will you expect to see in a patient with diarrhea x1 week?
Signs of dehydration (decreased skin turger)