Exam (elaborations)
NUR 242 EXAM 1 QUESTIONS WITH COMPLETE SOLUTIONS
- Course
- Institution
NUR 242 EXAM 1 QUESTIONS WITH COMPLETE SOLUTIONS
[Show more]
Content preview
NUR 242 EXAM 1 QUESTIONS WITHCOMPLETE SOLUTIONS
ADPIEd-dNursingdProcessd-dAssessment,dDiagnosis,dPlan,dIntervention,dEvaluation
WorlddHealthdOrganizationddefinitiondofdhealthd-
dHealthdisdadstatedofdcompletedphysical,dmentaldanddsocialdwell-
beingdanddnotdmerelydthedabsencedofddiseasedordinfirmity.
FrameworkdofdHealthydPeopled2030d-dPrinciples
OverarchingdGoals
PlandofdAction
Historyd&dContext
LeveldofdPreventiond-dPrimary-dPrevention
Secondary-dScreening
Tertiary-Rehab
RiskdFactorsd-dModifiable
Non-modifiable
PreventdConstipationdindOlderdAdultsd-
dIncreasedFiberd(35dtod50g)d&dFluiddIntaked(2L),dExercisedRegularly
CommondAdversedDrugdEventsdindolderdAdultsd-dEdema,dN/
V,dAnorexia,dconstipation,ddehydration,ddizziness,dsyncope,dacutedconfusion,ddysrhythmia
s,durinarydretention,danddhypotension
Majordpredictordofdmorbidityd&dmoralityd-dDelirium
ConfusiondAssessmentdMethodd(CAM)d-dAcutedonsetdanddfluctuatingdcourse
Inattention
Disorganizeddthinking
Altereddleveldofdconsciousness
MonitordOlderdAdultsdreceivingdAntipsychoticsdADEsd-dAnticholingericdEffects
ORTHOSTATICdHypotension
,Parkinsonism
Restlessness
Hyperglycemiad&dDM
Whenddodyoudassessdskindondptdthatdisdreddened?d-dEveryd8dhours
Immobilityd-dLongdperiodsdofdimmobility
MusculoskeletaldImmobilityd-dWasting,dOsteoporosis
IntegumentarydImmobilityd-dPressuredInjuries
GIdImmonilityd-dConstipation
CardiovasculardImmobilityd-dorthostaticdhypotension,dthrombusdformationd(DVT)
NeurologicaldImmobilityd-ddepression,dforgetfulness,danxiety,dconfusion
-pressuredondskindwilldcausednervedpain/damage
Renal/UrinarydImmobilityd-dStones
Incontinence
RespiratorydImmobilityd-datelectasisd->dpneumonia
MetabolicdFluidd&dElectrolytedImbalance-Immobilityd-dDehydrationdordFluiddOverload
OrthostaticdHypotensiond-
dAddropdofdmoredthand10dmmHgdindsystolicdord10dmmHgdinddiastolicdpressuredbetweendposit
ions
WalkerdProcedured-dLiftdWalker
Movedwalkerdaboutd2dfeetdforward
SmalldSteps
CheckdBalancedRepeat
ProperdbodydMechanicsd-dMaintaindadwide,dstabledbasedwithdyourdfeetd
Placedthedbeddatdthedcorrectdheight----
waistdleveldwhiledprovidingddirectdcaredanddhipdleveldwhendmovingdpatientsd
Keepdthedpatientdordworkddirectlydindfrontdofdyoudtodpreventdyourdspinedfromdrotatingd
Keepdthedpatientdasdclosedtodyourdbodydasdpossibledtodpreventdreachingd
Usedappropriatedsafedpatientd-handlingdequipment
CanedProcedured-dCanedindstrongdhand-dusedunaffecteddside
WelldBalanced
Cane,dWeakdLeg,dthendstrongdleg
, PhysiologicaldEffectsdImmobilityd-dChangesdindSleep/WakedCycle
ImpaireddCoping
ChangesdindBodydImage
Anxietyd
Depression
BehavioraldChanges
Assessmentdofdskind-dOncedperdshift,dupondadmission,dordnursingdinstinct
Accessdindividualsdwithdanyddevicesdassessdskindeveryd2dhoursdfordskindbreakdown
Inspectdskind-d-Beneathdanddarounddcompressiondstockings
•Bonydprominences
•Skindtodskindareas
•Anydareasdwheredthedclientdlacksdsensation
•Specialdattentiondifdthedclientdisdgettingdpaindepidurald/spinaldpaindmedications
d-depiduraldordspinaldcathsd(monitordanddensuredinfectiondfree,daccessdtoedsensation)
•dassessdperinuem
FunctionsdofdSkind-
dProtection,dHomeostatisd(WaterdBalance),dTemperaturedRegulation,dSensory,dVitamindSy
nthesis,dPsychosocial
SkindCulturaldAssessmentd-dDetectivedsubtledcolordchanges
Assess:dMucousdMembranes,dNaildBedsd&dSkindtones
SkindAssessmentdProcessd-
dSkindtemperature,dtugord(backdofdhand,dhead,dclavicle),dcolord(blanchabledtodnonblanchabl
e),dtexture,dmoistured(incontinence,dwounds,dostomy,dilesotosmy),dintegrity,dcapillarydrelief
d(hypoperfusion), dedema
SkindAlterationsd-dWhite-ddecreaseddHgbd&dblooddflow
Yellow-orange-dJaundice,dCartoenemia,dUrochromedlevel
Red-dVasodilation
Blue-dCyanosis
ReddishdBlue-ddecreaseddperipheraldcirculation
Brown-dMelanindProduction
Assessingdskindchangesdonddarkerdskindtonesd-dCyanosis-
dlipsdordtonguedaredgray,dnaildbedsdaredblue,dconjunctivadisdwhite
Inflammation-dincreaseddwarmth,dshinydordpitting,dassessmentdofdbothdextremitiesd
Jaundice-dyellowdoraldmucousdmembranedordsclera
Bleeding-dswelling,dpetechiae
Drynessd-d-scaling
d-flaking
d-lanolin,dantipruriticdagents,dtopical/doraldantihistamines
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller MASTERGRADE01. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
52355 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now