NURSING 4601 Adult Health ATI BP/ATI COMPREHENSIVE MEDICAL SURGICAL PROCTORED EXAM BLUEPRINT

Document Content and Description Below

Foundations Health Screening 1 Aspects of health and wellness ◯ Physical – able to perform activities of daily living 
 Emotional – adapts to stress; expresses and identifies emotio... ns 
 Social – interacts successfully with others 
 Intellectual – effectively learns and disseminates information 
 Spiritual – adopts a belief that provides meaning to life 
 Occupational – balances occupational activities with leisure time 
 Environmental – creates measures to improve standards of living and quality of life 
 ● A client’s state of health and wellness is constantly changing and adapting to a continually fluctuating external and internal environment. The external environment Social – crime versus safety, poverty versus prosperity, and peace versus social unrest 
 Physical – access to health care, sanitation, availability of clean water, and geographic isolation 
 The internal environment includes cumulative life experiences, cultural and spiritual beliefs, age, developmental stage, gender, and other support systems. 
 ● The level of health and wellness is unique to each individual and relative to the individual’s usual state of functioning. 
 ◯ For example: A person with rheumatoid arthritis who has a strong support system and positive outlook may consider himself healthy while functioning at an optimal level with minimal pain. ● Variables Modifiable – may be changed, such as smoking, nutrition, health education and awareness, sexual 
practices, and exercise 
 Nonmodifiable – cannot be changed, such as gender, age, developmental level, and genetic traits 
 ● Desired outcomes are to obtain and maintain optimal state of wellness and function. 
 ◯ Can be achieved through health education and positive action (smoking cessation, weight loss, seeking health care) ● The health/wellness/illness continuum is an assessment tool that is used to measure the level of wellness to premature death. It may be useful as an assessment guide or tool to set goals and find ways to improve the client’s state of health or to have the client return to a previous state of health, which may include an illness within op Risk Factors/Causes of Acid-Base Imbalances • Respiratory Acidosis – Hypoventilation o Results from- Respiratory depression from poisons, anesthetics, trauma, or neurologicaldiseases (myasthenia gravis, o Guillain-Barré) o Inadequate chest expansion due to muscle weakness, pneumothorax/hemothorax, flail chest, obesity, tumors,or deformities o Airway obstruction that occurs in laryngospasm, asthma, and some cancers o Alveolar-capillary blockage secondary to a pulmonary embolus, thrombus, cancer, or pulmonary edema o Inadequate mechanical ventilation o Results in- Increased CO2 ›› Increased H+ concentration • Respiratory Alkalosis – Hyperventilation o Results from- Hyperventilation due to fear, anxiety, intracerebral trauma, salicylate toxicity, or excessive mechanical ventilation o Hypoxemia from asphyxiation, high altitudes, shock, or early-stage asthma or pneumonia o Results in- Decreased CO2 ›› Decreased H+ concentration • Metabolic Acidosis o Results from ›› Excess production of hydrogen ions o Diabetic ketoacidosis (DKA) o Lactic acidosis o Starvation o Heavy exercise o Seizure activity o Fever o Hypoxia o Intoxication with ethanol or salicylates o Inadequate elimination of hydrogen ions o Kidney failure o Inadequate production of bicarbonate o Kidney failure o Pancreatitis o Liver failure o Dehydration o Excess elimination of bicarbonate o Diarrhea, ileostomy o Results in- Decreased HCO3, increased H+ concentration • Metabolic Alkalosis Disorders Acute and chronic failure Prevention of acute Pg.676 • Health Promotion and Disease Prevention of Acute Kidney Injury o Encourage clients to drink at least 2 to 3 L daily. o Consult with the provider regarding prescribed fluid restriction if needed. o Promote smoking cessation, weight loss, cautious use of NSAIDs, and control of diabetes and hypertension with prescribed medication. o Instruct clients to take all antibiotics prescribed for infections. • Health Promotion and Disease Prevention of Chronic Kidney Disease o Encourage clients to drink at least 3 L of water daily. o Consult with the provider regarding any restrictions. o Promote smoking cessation. o Encourage diet and activities to control or prevent diabetes and hypertension. o Teach the client the importance of adherence to a medication regimen when prescribed. o Encourage yearly testing for albumin in the urine if the client has diabetes or hypertension. o Instruct the client to take all antibiotics until completed. o Limit over-the-counter NSAIDs. o Subjective Data  Fatigue, lethargy, involuntary movement of legs, depression, intractable hiccups o Objective Data  In most cases, findings of chronic kidney disease are related to fluid volume overload and include the following:  Neurologic – lethargy, decreased attention span, slurred speech, tremors or jerky movements, ataxia, seizures, coma  Cardiovascular – fluid overload (jugular distention; sacrum, ocular or peripheral edema), hypertension, dysrhythmias, heart failure, orthostatic hypotension  Respiratory – uremic halitosis with deep sighing, yawning, shortness of breath, tachypnea, hyperpnea, Kussmaul respirations, crackles, pleural friction rub, frothy pink sputum  Hematologic – anemia (pallor, weakness, dizziness), ecchymoses, petechiae, melena  Gastrointestinal – ulcers in mouth and throat, foul breath, blood in stools, nausea, vomiting  Musculoskeletal – osteodystrophy (thin fragile bones)  Renal – urine contains protein, blood, particles; change in the amount, color, concentration  Skin – decreased skin turgor, yellow cast to skin, dry, pruritus, urea crystal on skin (uremic frost)  Reproductive – erectile dysfunction [Show More]

Last updated: 2 years ago

Preview 1 out of 60 pages