Nutrition
Proteins, carbohydrates, and fats.
The needed macronutrients for optimal nutrition include?
Effective urine output in healthy adults is approximately 1.5 to 1.8 liters daily.
What is the approximate daily urine output for a healthy adult?
1. Epidermis
2. Dermis
3. Subcutaneous layer
What are the three main layers of the skin?
Sensory deprivation occurs when there is a reduction in or absence of stimuli to one or more of the five senses
Sensory deprivation can be defined as?
P ull pin
A im at the base of fire
S queeze
S weep
What are the four simple steps to remember when using a fire extinguisher?
The large intestine.
What part of the gastrointestinal tract removes water and electrolytes from the remaining food particles for the body’s use and converts the rest into feces?
Coughing, sneezing, laughing, or physical activity that increases pressure on the bladder, resulting in urine leakage.
How can you define stress incontinence?
Thin, watery wound drainage mixed with blood.
Serosanguineous wound exudate can be described as?
Diabetic retinopathy
What is the most common cause of impaired vision and blindness during adulthood?
ABC priority framework
What framework do you use to prioritize nursing care?
Place the tubing on the tip of or near the client’s nose (N), extend to the earlobe (E), and then measure down to the xiphoid process (X). This is referred to as the NEX measurement.
What are the three landmarks to measure the length of the nasogastric (NG) tube before placement?
-After pregnancy
-In older adults
-In clients who consume little to no fiber
-In clients who take certain medications
-In clients who have GI disorders.
Constipation can affect all age groups, but it is more prevalent in what groups?
The Braden Scale
What scale is a valid and reliable risk assessment tool used for hospitalized clients, that rates a client’s risk for alterations in tissue integrity using six categories?
-Whisper a word 2 to 3 cm away from one ear while client occludes the other ear. Check both ears.
-Observe the client’s balance as they walk.
How do you test sensory response to cranial nerve VIII (Vestibulocochlear (Auditory))?
G loves
E ye wear
R ope (gown)
M ask
What is the order for doffing PPE?
Partial parenteral nutrition supplies a client with only part of their nutritional requirements, allowing for supplemental oral intake. In contrast, total parenteral nutrition gives the client their total daily nutritional requirements
What is the difference between partial parenteral nutrition and total parenteral nutrition?
Clean the urinary meatus with a sterile antiseptic using a circular motion. Repeat at least three times, using one cotton swab or cotton ball each time.
When preparing to insert an indwelling urinary catheter in a male client, what portion has to be cleansed, what motion should be used, and how many times does that process have to be repeated?
Stage 3 Pressure Injury
A pressure injury described as a full-thickness skin loss with visible adipose tissue can be classified as?
Loss of peripheral vision
What is the first manifestation of glaucoma?
Venturi mask
Which oxygen delivery system is best for clients with chronic lung diseases?
If vomiting, which is a risk factor for aspiration, occurs during enteral feeding:
-Discontinue feeding
-Ensure airway clearance
-Notify the provider
What actions by the nurse are expected when a patient experiences vomiting during an enteral feeding?
It is the result of excess fats or pyuria (puss in urine)
What does urine with a milky appearance indicate?
Hydrogels
If a client presents with a dry wound for debridement of necrotized tissue and eschar, what type of dressing would be the most appropriate to use?
Manifestations of cerebral edema
A patient presents to the emergency room with lethargy, headache, vomiting without nausea, unilateral pupillary dilation, appropriate but slow speech, restlessness, and posturing; these manifestations are indicators of possible ________?
Two-point gait
Which type of gait requires the client to have partial weight bearing on both feet when using crutches?