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PN EXIT HESI / RATIONALES
A fully oriented person is
o Oriented to person, place, time, & situation (oriented x4).
A person who is only oriented to one of these elements is at risk for injury. The PN
should provide instructions to the UAP about additional support to the client.
Orthostatic falls
o The PN should obtain standing blood pressure measurements to evaluate the
orthostatic falls in the blood pressure that can cause lightheaded or faint feeling
when rising from a lying position.
Atopic dermatitis (Eczema)
o Heat and humidity can cause perspiration, which intensifies itching with atopic
dermatitis (Eczema), so a client should be encouraged to shower, using non perfume
scented soaps.
Rotating injection sites
o The PN should reteach the client to rotate the noon site to a site other than the same
one used for the AM dose.. Rotation is recommended for the dose used during the
one specific time of the day.
Pain scale
o A rating scale should be used by the client to evaluate current pain. The PN should
also determine when the last pain medication was administered and the
effectiveness of that last dose.
Nystatin administration to an infant
o Nystatin is the most commonly used antifungal agent for oral candidiasis. When
administering nystatin to an infant, the medication needs to be applied topically by
using a gloved finger to rub the suspension over the infected area.
How do you prevent tissue loss in a client with hyperemia?
o The presence of reactive hyperemia occurs from pressure causing dilation of
superficial capillaries, and resolves without tissue loss if the pressure if relieved.
The UAP should be instructed in the need to turn the client every 2 hours.
PNs role during a fire alarm
o The PN has the expertise to determine how to safely transport and evacuate
residents with varying medical problems during a fire alarm.
Intention of droplet precaution
o Droplet precautions are intended to prevent transmission of pathogens spread
through close respiratory or mucous membrane contact with respiratory secretions
and include keeping the door to the client's room closed.
How should the PN respond to an RN who requested the PN to administer unlabeled
medication that the PN did not draw?
o The PN can respond in an assertive manner by refusing to administer the
medication but offering to assist the RN with another task. An aggressive response is
refusing to administer the drug while not offering to help in another way.
Slight bleeding during stoma care
o While providing stoma care with a client, it is a normal occurrence to see a little
blood on a washcloth due to the stoma being a very vascular site.
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