Exit HESI Version 2 Study guide.

Exit HESI Version 2 Study guide. Grave's disease signs and symptoms >>>-Enlarged thyroid -Acceleration of body process: weight loss, increased appetite, diarrhea, heat intolerance, tachycardia, palpitations, increas ...

Exit HESI Version 2 Study guide. Grave's disease signs and symptoms >>>-Enlarged thyroid -Acceleration of body process: weight loss, increased appetite, diarrhea, heat intolerance, tachycardia, palpitations, increased BP, diaphoresis, nervousness, insomnia -Exopthalamos -Increased T3 and T4 levels -Low TSH levels Grave's disease test >>>-Radioactive Iodine Uptake to detect how the thyroid is working -Ultrasound -Bloodwork -Imaging tests Grave's disease treatment >>>-Goal: inhibit production of thyroid hormones and block effect on the body -Radioactive iodine therapy: destroys overactive thyroid cells over time -Propylthiouracil, methimazole -Betablockers -Subtotal or full thyroidectomy (risk of damaging vocal cords and parathyroid glands) Nursing interventions for a pt with COPD >>>-Sit upright (positioning) -Pursed lip breathing -Diaphragmatic breathing -HOB up -Not too much O2: decreases stimulus to breathe -O2 is not first choice! Considerations when choosing an IV site >>>-Avoid restricted extremities (fistula, breast CA (mastectomy/lymphedema), cellulitis) -If no upper extremities available, can use legs -Infiltration is a problem, dont reinstill IV access; keep IV in but start a new line Pheochromocytoma >>>-Tumor on the adrenals that causes release of catecholamines (epi and norepi) -Can cause hypertensive crisis (above 240) -Monitor BP frequently -Mosly cardio sx: increased HR and BP General teaching points for pt taking meds >>>-Take the full dose of antibiotics (can build resistance) -Pay attention to timing and whether you take with food or on an empty stomach Describe post-surgical nursing assessment >>>-VITALS!! -Take VS first to give you "the lay of the land" and plan further treatment -Watch for shock and hemorrhaging -Make sure BP is above 90 -Give O2 if decreased sat -Look/ask about pain if HR increased Describe Lupus and pt education >>>-*Autoimmune disorder -Could have a decreased WBC count; increased risk for infection -Avoid crowds, avoid sick people, avoid sunlight (trigger) Explain safe insulin administration practice and how to teach another nurse >>>-Give in SubQ fat, rotate spots -Sliding scale dose is based on most recent glucose level -Check orders in the computer if forget dose/med -Clean area with alcohol -Make sure you have the right pt Assessment points for pt with constipation >>>-Assess current medications -Check measures that they're currently taking (daily enemas, laxatives, etc) -Assessment: no bowel sounds, abd distention -Make a doctors appointment -Assess current nutrition, diet, and exercise -Drink more water Osteomalacia and implications for pt teaching >>>-Focus on nutritional support -Sunlight is a good source of vitamin D -Vitamin D is important to absorb calcium and phosphorous -Check vitamin D levels Osteomyelitis >>>-Bone infection -Treat with antibiotics -Poor healing, injury entered the bone UTI >>>-Pt doesn't always report sx! -Urine sample is foul smelling and cloudy -Send sample to lab for urinalysis -Order a secondary test (culture and sensitivity) to choose the correct tx Assessment and nursing interventions for hip fx >>>-Assess for pain -Hip fracture sometimes shortens the leg/rotates it -Treat like its a hip fracture even if no testing done yet -Assess circulation (pulse, cap refill, feeling, movement, wiggle toes, color) -Don't elevate the leg -No extra motion until hip is stabilized -Assess skin and circulation if in traction Care and assessment for adrenalectomy >>>-Pt at risk for electrolyte abnormalities -Put on telemetry -Daily serum electrolytes -Monitor VS -Watch for dysrhythmias Tracheostomy pt teaching >>>-Maintain airway: suctioning -Communicate with white boards -Cough and suction on the way out -No more than 10 seconds Steps of the chain of infection >>>-Causative agent -Reservoir -Portal of exit: ex: wound, dressing change -Mode of transmission: nurse could be mode if they wear a gown in the hallway -Portal of entry -Susceptible host: decreased immune system, also have wounds (entry site) *Ways to block transmission: precautions, wash hands Aseptic handwashing >>>-Wash clean to dirty -Point arms down so dirty water runs from clean to dirty Chrones Diet >>>-Low fat -High-calorie: dried fruit increases calories and nutrients -High nutrient foods -Ex: eggs w/o yolk, lean meat, fish, seafood, chicken Heart Failure Diet >>>-No canned/processed food -No cheese or salami -Limit sodium (fluid retention) -Vegetables and fruits Mormon Diet >>>-No alcohol -No caffeine -Give milk, juice, or water -If diabetic, no juice -Church = latter day saints Muslim Diet >>>-Ramadan: fast for one month each year from dawn till after dark -Respect this -No alcohol Enema administration and nursing considerations >>>-Monitor pt for cramping and abd pain -Coach and support pt through this pain -Need to get procedure done, take break, deep breaths, then continue Trapeze bar and considerations >>>-Need upper body strength/upper extremities -Get history from pt: make sure they don't have any problems with dislocated shoulder -Allows more independence and participation with repositioning Education for splenomegaly >>>-Avoid heavy lifting/straining -Avoid contact sports -Cant go right back to the norm, unless they just sit at a desk all day -Wear a seatbelt in the car