jAti comprehensive predictor retake Exam
Questions Answers. Complete Verified Solution
2023/2024
clinical findings of malnutrition
poor wound healing
dry hair
irregular blood pressure
weak hand
impaired coordination
how is BMI classified
healthy weight= 18.5-24.9
over weight= 25-29.9
obese= greater than or equal to 30
negative nitrogen balance
using protein faster than protein is being synthesized example starvation or catabolic
State Post injury or disease
risk factors for developing osteoporosis
family history
inactivity
cigarette smoking
to avoid complications of enteral feeding such as diarrhea cramping abdominal
distension dumping syndrome nausea or vomiting what are your nursing actions
diarrhea=decrease the flow rate or total volume of the infusion
abdominal distention/bloating= instill lower fat formula consider changing the formula
instill lactose free formula= nausea&vomitting administer enteral nutrition at room
temperature
to avoid complications of enteral feeding such as misplacement dislodgement
aspiration irritation and leakage irritation of the nose esophagus and clogging of
the feeding tube what are your nursing actions
confirm to placement prior to feedings
Elevate head of bed 30 degrees maintain position up for 60 mins
flush tubing with 15-30 of warm water Q 4 hours
unclog tubing with gentle pressure 32 -50 ml warm water and piston syringe
to avoid complications of enteral feeding such as dehydration hyperglycemia
electrolyte imbalance fluid overload refeeding syndrome or rapid weight gain
what are your nursing actionsh
restrict fluids if fluid overload
monitor electrolytes serum glucose and weights
, monitor respiratory cardiovascular and neurological status
provide water
change formula to isotonic
phenytoin carbamazepine valproic acid Gabapentin
meds used for seizures
if a client is taking phenytoin what should a nurse include in the teaching
taking medication at the same time everyday to enhance effectiveness
nursing care for phenytoin
good oral hygiene side effect gingival hyperplasia schedule routine Dental visits avoid
oral contraceptives they decrease effectiveness when administer does Warfarin and can
cause decrease in effectiveness
notify provider patient over-the-counter meds use
vagul nerve stimulatorj
implanted left chest program to administer instrument that stimulation of the brain via
vagal nerve
patient teaching for vagal nerve stimulator
can cause temporary hoarseness cough dyspnea and change your voice
nursing care assist with safe feeding for a patient who has a stroke
consult speech language pathologist assess swallowing and gag reflex before feeding
upright position swallow with head and neck flex slightly forward food is placed in the
back of the mouth on the unaffected side have suction on standby collaborate with a
dietician to ensure appropriate caloric intake weight loss is common following stroke
nursing actions for patient who had a stroke or has dysphagia
cheap and patient NPO position upright High Fowler's position prior to food fluid or Med
Administration
patient teaching for dysphagia and aspiration
set up right in Flex head forward when swallowing sit upright for 45 to 60 Minutes
following a meal
what type of precaution should a patient with tuberculosis be on
airborne precautions negative air-flow room patient wear surgical masks if being
transported
what is mantoux test
diagnostic procedure for tuberculosis read within 48 to 72 hours palpable Rays Harden
area of 10 mm or greater is positive skin test means patient has developed immune
response to TB does not confirm active disease is present
what are the nursing actions for isoniazid
monitor for hepatotoxicity jaundice anorexia malaise fatigue nausea and neurotoxicity
tingling of hands and feet vitamin B6 prevents neurotoxicity monitor liver function lab
tests before and monthly after
what is the patient teaching for taking isoniazid
take on an empty stomach do not drink alcohol it can increase pepper toxicity report any
manifestations of hepatotoxicity
what is the nursing action for rifampim
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