PBDS

*Acute abdomen and complications* NURSING ASSESSMENT Correct Answer: History of: -Type of pain, nature and onset, location, quality. -LBM, Change in bowel habits. -Ask about history of trauma, gynecological history, anorexia, malaise. Assess for tachycardia, HTN, fever, nausea/vomiting. *Inspect*- look for bruising (pancreatitis) listen - for bowel sounds feel - for boggy (hemorrhage) *Acute abdomen and complications* PRIORITY INTERVENTIONS Correct Answer: Administer pain medicat...

3 types of airway devices Correct Answer: OPA, NPA, ET Tube What to do with an Infiltrated IV Correct Answer: D/C IV, warm compresses, notify MD and restart IV. *Acute abdomen* NURSING ASSESSMENT Correct Answer: Should take a *history* - Type of pain, nature and onset, location, quality. Last bowel movement/Change in bowel habits Ask about history of trauma, gynecological history, anorexia, malaise. Assess for tachycardia, hypertension, fever, nausea/vomiting. *Inspect* Look - Ass...

PNEUMONIA symptoms Correct Answer: Crackles, shortness of breath, productive cough, fever, chills, loss of appetite, sharp chest pain with deep breathing, nasal congestion, decreased activity Pneumonia interventions Correct Answer: 1. Assess lung sounds for signs of crackles, Check RR, TEMP, AND O2 SAT, pulse, BP. 2. Call MD stat 3. Place patient in high fowlers 4. TCDB/Incentive spirometry 5.Collect sputum sample if ordered 6. Anticipate an order for respiratory to obtain breathing t...

Patient is experiencing increase HR, decreased B/P, thirst, tachypnea, decrease urine output, pallor, cool clammy skin, anxiety, agitation, absent bowel sounds, and decrease in SPO2, what is going on with this patient? Correct Answer: Hypovolemic shock What will you do for a patient in hypovolemic shock? Correct Answer: Make sure airway is patent, if they're not breathing begin CPR, Place patient in Trendelenburg to promote blood flow to the brain, administer high flow O2 to increase deliv...

what *nursing assessment* should be made for *acute abdomen* complications? Correct Answer: *History* -type of pain -nature & onset of pain -location -quality (sharp, dull, crampy) -changes in bowel habits -Hx of trauma -gynecological Hx -anorexia -malaise -tachycardia -hypertension -fever -nausea/vomiting *Inspect* -look -listen -feel abdomen what are the *priority nursing interventions* for *acute abdomen* complications? Correct Answer: -Give pain meds -keep patient ...

What are the signs and symptoms of stroke? Correct Answer: SUDDEN numbness or weakness of face, arm or leg - especially on one side of the body. SUDDEN confusion, trouble speaking or understanding. SUDDEN trouble seeing in one or both eyes. SUDDEN trouble walking, dizziness, loss of balance or coordination. SUDDEN severe headache with no known cause. What is the acronym commonly used for stroke symptoms? Correct Answer: FAST Facial drooping Arm drift downward Slurred speech TIME...

Hypokalemia Assessment Correct Answer: Pain, LOC changes, BP/HR/RR- rate, depth, rhythm, Breath sounds, monitor BMP, BUN/creatinine, stat EKG, I/O, AC/HS poor muscle strength/tone, slow reflexes, cardiac dysrhythmias, fatigue/weakness IV access, tele, bedrest, EKG Hypokalemia interventions/anticipated orders Correct Answer: K+ IV infusion, K+ rich diet, HOLD diuretics/digoxin, STAT EKG for critical levels, treat underlying cause- antiemetics for N/V, antidiarrheal for diarrhea, monito...

IICP priority ranking Correct Answer: must do IICP Safety Correct Answer: maintain airway maintain IV access stop fluids (could be cause) keep bed at 30 NPO IICP Assessment Correct Answer: BP,HR,RYTHM, SP02, LOC PAIN (QRST) NEURO ASSESSMENT Behavioral changes IICP Report Correct Answer: REPORT TO MD STAT BP,HR,RYTHM, SP02, LOC PAIN s/s of headache or n/v NEURO Assessment findings behavioral changes IICP Anticipated orders Correct Answer: CT or MRI of the head man...

CVA nursing diagnosis Correct Answer: inadequate tissue perfusion CVA Signs and Symptoms & RF Correct Answer: muscle weakness, facial drooping, slurred speech, vision changes, HA, arm numbness RF: HTN, previous TIA, oral contraceptive, alcohol, smoking, diabetes, older age, heart condition Nursing interventions for CVA Correct Answer: Stat vitals and neuro assessment, call rapid response, monitor BP, administer BP meds, anticipate coagulation therapy, give o2 if needed, place in semi...

Normal Sinus Correct Answer: Reg, 60-100, P(Yes, Normal, same# QRS), QRS(Normal) Sinus Brady Correct Answer: Reg, <60, P(Yes, Normal, Same# QRS), QRS(Normal) Sinus Tachy Correct Answer: Reg, 100-150, P(Yes, Normal, Same# QRS), QRS(Normal) Premature Atrial Contractions (PAC) Correct Answer: Irreg, Usually Normal Rate, P(Yes, variable morphology, Same# QRS), QRS(Normal) SVT (Supraventricular Tachycardia) Correct Answer: Reg, 150-250, P(No Visible), QRS(Normal) Atrial Flutter...