PN1 Rasmussen Exam 1 Questions with complete solutions

PN1 Rasmussen Exam 1 Questions with complete solutions Immobility side effects - Muscle atrophy - joint dysfunction - contractures - atelectasis (Partially or completely collapsed lung) -Venous stasis (Blood pooling) -orthostatic hypotension -glucose intolerance -pressure ulcers - constipation - UTI - ileus (no bowel movement usually after surgery) - renal calculi (kidney stones) - depression - sleep disturbances - disorientation Prevention of skin issues hydration, proper nutrition keep skin clean q2hr rotation for bed rest patients reduce pressure points perform daily skin assessments avoid excess layers use barrier cream Decubitis / pressure ulcer localized area of damage to the skin and or underlying tissue usually over a bony prominence as a result of pressure Shearing Tissue layers of skin slide over top of each other causing blood vessels to kink or stretch which interrupts blood flow. Also a factor in developing pressure ulcer's Repositioning - avoid friction and shearing - use good body mechanics - use pillows and rolled towels to maintain position risk for falls . hip fracture a fracture of the proximal femur. progression of violence Violence typically begins with - anxiety and escalates in stages through - verbal aggression and then - physical aggression. Nurse safety precautions - back injury - needle stick - radiation injury - violence medication errors protocol To prevent making a medication error, you should develop a set routine for administering medications. Learn from your mistakes and the mistakes of others. Many errors occur as a result of interruption or distraction. It is best not to stop what you are doing when preparing or giving medication.You might even wear a bright yellow sash to alert people not to disturb you when preparing or giving medication. Three checks of drug administration Three Checks Check each medication three times: 1. BEFORE you pour, mix, or draw up medication, check its label against the entry on the MAR. Be sure that the name, route, dose, and time match the MAR entry. 2. AFTER you prepare the medication, and before returning the container to the medication cart or discarding anything, check the label against the MAR entry again. 3. AT THE BEDSIDE, check the medication again before actually administering it. Observing the "three checks" rule will help you to practice the "rights of medication." Seven rights of medication right patient right drug right dose right time right route right technique (reason) right documentation body mechanics the proper use of the body to facilitate lifting and moving and prevent injury Proper body mechanics Keep back straight, bend at knees, keep wide stance, and keep objects close to body. SAFETY: INFANT Motor vehicle accidents are the leading cause of death for children ages 1 to 3, followed by drown- ing. Falls, choking, sudden infant death syndrome (SIDS), and ingesting poisons are other critical safety concerns. - Completely dependent on others for their care. Safety Children - MVC - Leading cause of death - Falls - Sports injuries - Playground injury Fearless- ready to try any new skill without practice or training. Safety: Adolescents - MVC - leading cause of death - homicide - associated with drug and alcohol use - sports and recreational injury Peak physical, sensory and psychomotor abilities, yet lack wisdom and judgment. more prone to participate in high-risk behavior Safety in Young Adults - 35 to 54 years old, unintentional poisoning causes more deaths than motor vehicle accidents - Workplace injury may also be a significant concern. - Other injuries to adults are related to lifestyle (e.g., excessive alcohhol use), stress, carelessness, abuse, and decline in strength and stamina. _ Weekend athlete injuries Safety - Seniors falls most common cause of death physiological changes start to occur reduced muscle strength, joint mobility, slowing of reflexes, decreased ability to respond to stimuli, sensory loss (hearing, vision loss) Home safety hazards poisoning, carbon monoxide exposure, scalds and burns, fires, falls, firearm injuries, suffocation, Hospital safety hazards Falls, Never events, Fires, Equipment related accidents, Restraints, Mercury exposure, biological hazards Safety and similar drug names ... Growth and development - Infants trust vs mistrust Growth and development - children initiative vs guilt Growth and development - teenagers identity vs role confusion Growth and development - young adults intimacy vs isolation Restraints and alternatives Restraints are a last resort Provide consistency Review the patient's medications Provide relaxation and relieve anxiety Provide frequent assessment and surveillance Find ways to communicate Modify the environment Anticipate unmet needs Transfers ... antiembolism stockings - Put on before getting the client out of bed - used to stop thrombus formation by exerting pressure on lower extremity muscles and superficial leg veins. - prevents stasis and promotes venous return in lower extremities. Knee-high or thigh-high stockings that provide low compression force to prevent DVT formation. Fire Safety: RACE rescue, alarm, contain, extinguish Home safety age and developmental status; mobility and balance; knowledge of safety hazards; sensory and cognitive awareness; communcation skills; home/work environment; community Gout Condition- inflammatory response from high levels of uric acid. usually affects the big toe Treatment - low purine diet Medications = For acute gout - colchicine (Colcrys) and an NSAID such as indomethacin (Indocin, Novomethacin ) or ibuprofen (Motrin, Amersol). IV colchicine works within 12 hours. The patient takes oral medications until the inflammation subsides, usually for 4 to 7 days. Chronic gout medication = promote uric acid excretion or reduce its production. Allopurinol (Zyloprim, Purinol) or febuxostat (Uloric) is the drug of choice. SIde effects = liver dysfunction and bone marrow suppression. Fibromyalgia Chronic pain - not inflammatory disease. Pain, stiffness, and tenderness are located at specific sites in the back of the neck, upper chest, trunk, low back, and extremities. These tender points are also known as trigger points and can typically be palpated to elicit pain in a predictable, reproducible pattern. Treatment = Teach patients to limit caffeine, alcohol, or other unnecessary substances that could interfere with deep sleep Medications = anticonvulsants such as gabapentin (Neurontin) - pregabalin (Lyrica) -selective norepinephrine reuptake inhibitors (SNRIs, -a class of antidepressants) such as duloxetine HCl (Cymbalta) and milnacipran (Savella) -. Tricyclic antidepressive agents such as amitriptyline (Elavil, Apo-Amitriptyline) or nortriptyline (Pamelor) may promote sleep and reduce pain or muscle spasm. - Trazodone (Desyrel) may be preferred for this population because of its minimal side effects. - Tramadol (Ultram) Side effects = Drowsiness (avoid alcohol), confusion, orthostatic hypotension Osteoarthritis inflammation of the bone and joint - loss of cartilage in the joint Treatment -good nutrition, healthy and active lifestyle rest / surgery Medications = Tylenol, topical analgesic, NSAIDS, Ultram, Celecoxib (COX 2 inhibitor) Side effects = Toxicity, GI Bleed, black tarry stools, confusion, MI, Kidney disease. Ostiomalacia Softening of bones through a deficiency of Vitamin D or Calcium. Treatment = Vitamin D and calcium Sunlight, proper nutrition, Medications = Normalize Vit D levels to more than 12 Side effects = Osteomyelitis infection of the bone that is difficult to treat Treatment = Antibiotics, infected tissue removal Medications = Long term antibiotic therapy using PICC line IV for 4-6 weeks. Side effects = potential for CDiff, Mrsa,