VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW__This document contains 17 pages of well arranged content for eam review, organised for eased readability and reference.

VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW  Management of Care – (9)  Advance Directives – (1)  Legal Responsibilities: Purpose of a Living Will (RM FUND 9.0 Chp 4) • A living will is a legal document that ex ...

VATI RN COMPREHENSIVE PREDICTOR FOCUSED REVIEW  Management of Care – (9)  Advance Directives – (1)  Legal Responsibilities: Purpose of a Living Will (RM FUND 9.0 Chp 4) • A living will is a legal document that expresses the client’s wishes regarding medical treatment in the event the client becomes incapacitated and is facing end-of-life issues. Most state laws include provisions that protect health care providers who follow a living will from liability.  Assignment, Delegation and Supervision – (2)  Delegation and Supervision: Delegating Tasks to an Assistive Personnel (RM FUND 9.0 Chp 6) • Examples of tasks nurses may delegate to Aps (provided the facility’s policy and state’s practice guidelines permit) • Activities of daily living (ADLs) – bathing, grooming, dressing, toileting, ambulating, feeding (without swallowing precautions), positioning • Routine tasks – bed making, specimen collection, intake and output, vital signs (for stable clients)  Managing Clie • Prioritizing the care of a client who has a new injury/illness (e.g. mental confusion, chest pain) or an acute exacerbation of a previous illness over the care of a client who has a long-term chronic illness • Prioritize actual problems before potential future problems • Prioritizing administration of medication to a client experiencing of  Abuse/Neglect – (1)  Family Violence: Evaluating Child Abuse (RM MH RN 10.0 Chp 32) • Infants – shaken baby syndrome: shaking can cause intracranial hemorrhage. Assess for respiratory distress, bulging fontanels, and an increase in head circumference. Retinal hemorrhage can be present. Any bruising on an infant • suspicious. Assess for human bite marks. Assess for head injuries, level of consciousness, equal and reactive pupils, and nausea or vomiting.  Mental Health Concepts – (2)  Anxiety Disorders: Expected Findings for a Client who has Social Anxiety Disorder (RM MH RN 10.0 Chp 11)  Basic Care and Comfort – (3)  Assistive Devices – (1)  Sensory Perception: Speaking to a Client Who Has a Hearing Impairment (RM FUND 9.0 Chp 45)  Mobility/Immobility – (1)  Musculoskeletal Trauma: Skeletal Traction (RM AMS RN 10.0 Chp 71)  Nutrition and Oral Hydration – (1)  Renal Disorders: Dietary Prevention of Nephrolithiasis (RM Nutrition 6.0 Chp 14) • The most common type of kidney stone is made of calcium oxalate. Contributing • Therapeutic nutrition – increasing fluid consumption is the primary intervention  Pharmacological and Parenteral Therapies – (7)  Adverse Effects/Contraindications/Side Effects/Interactions – (1)  Medications for Psychotic Disorders: Screening for Extrapyramidal Adverse Effects (RM MH RN 10.0 Chp 24) • diphenhydramine can also be beneficial. Stay with the client and monitor the airway until spasms subside (usually 5-15 min) • Pseudoparkinsonism – bradykinesia, rigidity, shuffling gait, drooling, tremors • of the tongue and face, such as lip smacking and tongue fasciculations. Involuntary movements of the arms, legs, and trunk • Nursing considerations – evaluate the client every 3 months, if TD appears, • Neuroendocrine effects – gynecomastia, weight gain, menstrual irregularities • Neuroleptic malignant syndrome – sudden high fever, blood pressure fluctuations, diaphoresis, tachycardia, muscle rigidity, drooling, decreased level of consciousness, coma, tachypnea • to the provider. The client can need dosage lowered or be switched to a high-potency agent • Skin effects – photosensitivity that can result in severe sunburn. Contact dermatitis from handling medications • Nursing considerations – Advise clients to avoid excessive exposure to sunlight, to use sunscreen, and to wear protective clothing. Advise clients to avoid direct contact with the education • Liver impairment • Nursing considerations – assess baseline liver function, and monitor  Central Venous Access Devices – (1)  Cardiovascular Diagnostic and Therapeutic Procedures: Care of the Nontunneled Expected Actions/Outcomes – (1)  Medication Administration – (4)  Bipolar Disorder: Teaching the Client About a Mood Stabilizer (RM Pharm RN 7.0 Chp 9)  Brain Stimulation Therapies: Client Education About Electroconvulsive Therapy (RM MH RN 10.0 Chp 10) • Indication • Medication Management  Any cardiac conditions, such as dysrhythmias or hypertension, should be monitored and treated before the procedure  The nurse monitors vital signs and mental status before and after the ECT procedure  The nurse assess the client’s and family’s understanding and knowledge of  Cystic Fibrosis: Client Teaching about Pancrelipase (RM NCC RN 10.0 Chp 19) • Pancrelipase treats pancreatic insufficiency associated with cystic fibrosis • Nursing considerations – monitor stools for adequate dosing (1-2 stools/day). Administer capsules with all meals and snacks. Client can swallow or sprinkle Reduction of Risk Potential – (6)  Potential for Complications of Diagnostic Tests/Treatments/Procedures – (2)  Cardiovascular Diagnostic and Therapeutic Procedures: Priority Intervention Postangiography (RM AMS RN 10.0 Chp 27) • Nursing Actions – assess vital signs every 15 min x 4, every 30 min x 2, every hour x 4, and then every 4 hr (Follow facility protocol). Assess the groin site at • Client education – instruct the client to do the following (leave the dressing in • Complications • Cardiac tamponade – can result form fluid accumulation in the pericardial sac  Nursing actions – notify the provider immediately. Administer IV fluids to • Hematoma formation – blood clots can form near the insertion site • Restenosis of treated vessel – clot reformation in the coronary artery can occur immediately or several weeks after procedure • Retroperitoneal bleeding – bleeding into retroperitoneal space (abdominal cavity behind the peritoneum) can occur due to femoral artery puncture  Disorders of the Eye: Identifying Postoperative Risk (RM AMS RN 10.0 Chp 12)  Potential for Complications from Surgical Procedures and Health Alterations – (1)  Pituitary Disorders: Clinical Findings of Diabetes Insipidus (RM AMS RN 10.0 Chp 77)  System Specific Assessments – (1)  Head Injury: Assessing Decerebrate Posturing (RM AMS RN 10.0 Chp 14)  Therapeutic Procedures – (2)  Cancer Disorders: Client Discharge Education for Ileal Conduit (RM AMS RN 10.0 Chp 92)  Skin Infections and Infestations: Home Care of Pediculosis Capitis (RM NCC RN 10.0 chp 30)  Physiological Adaptations – (5)  Alterations in Body Systems – (1)  Pituitary Disorders: Client Comfort (RM AMS RN 10.0 Chp 77) • .  Hemodynamics – (1)  Electrocardiography and Dysrhythmia Monitoring: Identifying the Need for Medical Emergencies – (1)  Emergency Nursing Principles and Management: Priority Assessment (RM AMS RN 10.0 Chp 2)  Unexpected Response to Therapies – (2) •