HESI HINTS MEDSURG NEW BOOK COMPLETE GUIDEHESI HINTS MEDSURG NEW BOOK COMPLETE GUIDEHESI HINTS MEDSURG NEW BOOK COMPLETE GUIDEHESI HINTS MEDSURG NEW BOOK COMPLETE GUIDE
HESI Hint • HIV clients with tuberculosis require respiratory isolation. Tuberculosis is the only
real risk to nonpregnant caregivers that is not related to a break in standard precautions (e.g.,
needle sticks).
HESI Hint • An individual exposed to HIV may remain asymptomatic for many years dependent
on various factors and if he or she is actively under a medical regimen of antiretroviral therapy
(ART). The stages of HIV infection are presented in Figure 3-9.
Clients usually are not admitted to the hospital for treatment until their HIV status has
progressed to an “AIDS” diagnosis.
HESI Hint • Standard Precautions
• Wash hands, even if gloves have been worn to give care.
• Wear examination gloves for touching blood or body fluids or any nonintact body surface.
• Wear gowns during any procedure that might generate splashes (e.g., changing clients with
diarrhea).
• Use masks and eye protection during activity that might disperse droplets (e.g., suctioning).
• Do not recap needles; dispose of in punctureresistant containers.
• Use mouthpiece for resuscitation efforts.
HESI Hint • It is recommended that caregivers who are pregnant not provide care for a client
with cytomegalovirus (CMV) because fetal exposure to CMV can be detrimental to a developing
fetus.
HESI Hint • Pediatric HIV is often evidenced by lymphoid interstitial pneumonitis, pulmonary
lymphoid hyperplasia, and opportunistic infections.
HESI Hint • The focus of NCLEX-RN questions is likely to be assessment of early signs of the
disease and management of complications associated with HIV.
HESI Hint • For narcotic-induced respiratory depression, naloxone may be administered as
prescribed by the health care provider.
HESI Hint • Use noninvasive methods for pain management when possible:
Relaxation exercises Distraction Imagery Biofeedback Interpersonal skills Physical care: altering
positions, touch, hot and cold applications
,HESI Hint • Narcotic analgesics are preferred for pain relief because they bind to the various
opiate receptor sites in the CNS. Morphine is often thepreferred narcotic (remember, it causes
respiratory depression).
Another agonist is methadone. Narcotic antagonists block the attachment of narcotics such as
naloxone to the receptors. Once naloxone has been given, additional narcotics cannot be given
until the naloxone effects have passed.
MEDICAL SURGICAL HESI HINTS
HESI Hint • Safety is a priority with all clients. Ascertain the use of complementary therapies by
addressing contraindications and side effects. Safety includes safe handoff, interprofessional
communication, fall prevention, assessing, and reporting changes in condition, as well as
responses to treatments and medications.
HESI Hint • Therapeutic communication is necessary to elicit important information from clients
and their families in all nursing interventions and settings. It is important in crisis intervention
to ascertain cultural awareness/cultural influences on health; to note and address religious and
spiritual influences on health; to assess family dynamics; and to detect sensory alterations, such
as hearing loss or speech deficits.
HESI Hint • Nonverbal communication may be more important than verbal communication.
Body language, use of personal space, and verbal/oral messages should be congruent. Tone of
voice and facial expression are part of body language. An example of positive body language is
leaning in toward a client while talking. Recognition of cultural differences regarding personal
space is an important component of communication. Most Americans maintain half a meter
(1.7 or 1½ feet) distance between people when talking. Body language and verbal/oral
communication should be congruent; state messages in a positive manner even when providing
negative feedback.
HESI Hint • Clear verbal communication and accurate written records are critical during care
transitions. Care transitions include such times as changes of shift, when the client moves from
unit to unit, or when the client moves to a new care setting.
HESI Hint • The SBAR format is used in many institutions during communication processes with
other nurses, physicians, physician assistants, physical therapists, social workers, pharmacists,
laboratory technicians, etc. SBAR stands for Situation, Background, Assessment, and
Recommendations.
HESI Hint • Therapeutic communication is necessary in eliciting important information from
clients and their families in all nursing interventions and settings, including crisis intervention,
cultural awareness/cultural influences on health, religious and spiritual influences on health,
family dynamics, and sensory alterations.
HESI Hint • Changing unhealthy behaviors can modify or even prevent some chronic illnesses.
Nurses play a major role in helping clients manage their chronic illnesses and disabilities
, through behavioral changes. Health teaching and counseling often are the role of the nurse in
helping the client focus on improving health habits.
Areas of behavioral change include:
1. Physical activity
2. Nutrition
3. Stress
4. Use of tobacco or marijuana
5. Use of alcohol
6. Spiritual perspective
7. Coping skills
8. Support systems
HESI Hint • To develop a collaborative learning environment between the nurse and the client,
nurses must be acutely aware of their own beliefs and values about the teaching–learning
process, including client empowerment.
HESI Hint • Obtain a cultural and spiritual assessment and include cultural and spiritual
preferences in the plan of care when appropriate and feasible. Nurses are expected to provide
care for all clients. It is important to note that clients are culturally diverse, regardless of their
ethnicity, race, or socioeconomic status and to note that in every culture subgroups may form.
However, culturally diverse clients may be distinguished from mainstream culture by ethnicity,
social class, and/or language. Since the 2000 census there has been a notable change in the
cultural, ethnic, and racial alignment of the United States.
Culture influences how clients seek medical attention or treat themselves.
HESI Hint • Reasons why clients use herbal medications:
• Cultural influence
• Perception that supplements are safer and “healthier” than conventional drugs
• Sense of control over one’s care
• Emotional comfort from taking action
• Limited access to professional care
• Lack of health insurance
• Convenience
• Media hype and aggressive marketing
• Recommendation from family and friends
PMEUMONIA
HESI Hint • Pneumonia affects people of all ages, especially those 65 or older or infants under
age 2 (because their immune systems are still developing).
HESI Hint • Increased temperature also increases metabolism and the demand for O 2 . Fever
can also cause dehydration because of excessive fluid loss due to diaphoresis.
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