ATI Comprehensive, Exit, PN
Comprehensive Predictor, Predictor, Exit
exam, Lokaineeeee
-Follow ABC post-op
-Make sure airway is clear and patient is able to breathe off of anesthesia
-Promote ambulation and anti-coags to prevent blood clots
-Monitor the surgery site to watch for infection
Post operative care
-Phases of making change:
-1st stage: unfreezing - Inform others about current issues
-2nd stage: moving - implementing change
-3rd: refreezing - solidifying change into a daily thing
Managing Client Care: Implementing Change
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-Teach about care inc caregivers if necessary
-Talk about self-esteem issues
-Often pts have a hard time accepting this change
Colostomy care
-Assess client every 15-30 minutes
-Someone must be with patient at all times
,-Check for new prescription q4 for> 18, q2 for 9-17 y, and q1 for <9 y
Restraints: Mechanical
-Rapid speech
-Irritability
-Clouding of consciousness.
-Difficulty maintaining or shifting attention.
-Disorientation.
-Illusions.
-Hallucinations.
-Fluctuating levels of consciousness.
Neurocognitive Disorders: Delirium
-Manifestations: Decrease or loss of central vision d/t bleeding into the macula, yellow spots
under retina
-Amsler grid can be used to help diagnose or test for this, grid with lines, pt with macular
degeneration may see blurred or twisted lines w/dark spots
-Lack of depth perception
-Objects appear distorted
-Blurred vision
-Loss of central vision
-Blindness
Disorders of the Eye: Macular Degeneration
-Consider how much the patient can move
-Work to their strengths
-Be considerate of their health needs
-Work on regaining strength and mobility if immobility is not related to paralysis
-Place trochanter rolls to prevent external rotation & abduction of the hips
-Encourage 2-3L consumption of water a day
-Do not massage lower extremities
Mobility and Immobility: Developing a Plan of Care for a Client Who Is Immobile
-Meds:
*Estradiol
-Adverse effects:
*htn
*HA (can cause thromboembolism which can result in stroke)
*swelling/tenderness of calf (can be indicative of DVT)
*gentinourinary candidiasis
,Medications Affecting the Reproductive Tract
-Meds Used:
*Misoprostol
-Side Effects:
*uterine contractions
*reduces gastric acid secretions
*diarrhea
-Interventions:
*Notify provider if dysmenorrhea & spotting occur.
*Report diarrhea or abd pain; reduce dose if nec
-Administration:
pregnancy test must be taken before starting
*Take AC & HS
*don't take w/Mg containing antacids
Peptic Ulcer Disease (PUD):
*Administering ear drops:
-For child < 3, pull pinna back & down
-For person > 3, pull pinna up & back
-Warm to room temp
-Cold drops can cause n/v
Medication Administration: Ear Drop Administration
-Cont. TPN can be given to pts who don't meet adequate nutrient intake
-TPN should be given thru a pump
-TPN should only be given in a central line
blood glucose checks are needed
check for egg allergy bc this can cause interaction with tpn formula
take in oral nutrients as much as possible to allow for intestines to still digest as normal and
work
Total Parenteral Nutrition (TPN) Infusion: Continuous
-encourage ambulation
-bed rest
-intermittent, continuous warm moist compress
-do not massage limb
-provide thigh high compression or stockings
-drink 2-3L per day
-place warm compresses on affected area
, -elevate the affected leg above heart level
-watch for signs of an embolism
Peripheral Vascular Diseases: Deep-Vein Thrombosis
Stroke:
*Interventions to < Risk of ^ICP
-place client no more than 25*
-> or < than 25* can cause ^ ICP
-suction only when airway isn't clear
-unneccessary suctioning ^ risk for ^ ICP
-keep in quiet environment
-avoid coughing, sneezing, or nose blowing
Hematologic Disorders: Stroke
-hematuria: can be fatal d/t renal ischemia
-visual disturbances
-Severe pain; usually in bones, joints, & abd
-swollen joints, hands, & feet d/t restricted vessels
-anorexia
-n/v
-^T
-obstructive jaundice
Hematologic Disorders: Manifestations of Vaso-Occlusive Crisis
*Risk factors:
-Immobility
-Cognitive deficit
-Chronic illness (example diabetes)
-Steroid use
-Incontinence
-Malnutrition:
**^ risk for pressure ulcer d/t < tissue integrity
**slows healing process
*Teaching home care to a family of a child who has a large wound?
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