ADULT HEALTH HESI STUDY GUIDE ALL ANSWERS 100% CORRECT SPRING FALL-2022 LATEST SOLUTION GUARANTEED GRADE +

• Asthma attack- ABgs a. Respiratory alkalosis (fast breathing) • ALS- living will a. Progressive muscle weakness b. Patient should create their living will (health care decisions) because they can expire at any given time.. There is no cure for ALS c. ALS – Progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. • Handwashing home teach a. Friction b. 5ml soap c. Prevents infection d. Before and after care to patients • Parkinson’s home care a. Home Care i. Soft Diet ii. Encourage activities and exercise iii. Eliminate environmental noise and encourage client to speak slowly and clearly iv. Schedule activities later in the day to allow sufficient time to perform self-care activities. v. Administer antiparkinsons drugs b. Imbalance between acetylcholine and dopamine -- Symptoms can be controlled by administering a dopamine precursor (Levodopa) c. Nursing Assessment i. Rigidity of extremities ii. Masklike facial extremities iii. Drooling iv. Tremors v. Stooped posture vi. Hypertonicity • Alzheimer’s predictable a. Progressive decline in the patients cognitive function b. Predictable i. Patients will get worse ii. Memory loss iii. Function loss c. Needs an alert bracelet • Toe amputation a. Changes your gait/Balance b. Phamptom lymph pain • MI- home care • HIV CD4 count pathology • Research study design • TB Mantoux test negative a. Are they in the 5mm category or 10mm category? Healthy or immunocompromised b. 5 and above is positive c. Healthy 10mm induration – Positive d. Healthy 10mm redness – Negative e. Skin Test i. Only shows if you have been exposed to TB f. Checking for : Induration and diameter i. Remember REDNESS is not a sign of induration.. REDNESS is negative ii. Hardening or swelling and less then 5mm – negative and more than 10mm is positive 1. 3mm & no diameter– Negative 2. 10mm & no redness – positive 3. 6mm Swelling & hardening – Positive iii. Healthy individual with redness 10 mm- negative iv. Transplant with hardening of 6mm – positive v. Cancer with induration of 3mm induration – negative g. Positive TB Skin test on a Healthy Client – Induration 10mm or greater in diameter 48-72 hours later h. Induration 5mm immunocompromised i. Someone who has been in close contact with someone with TB i. Chest XRAY i. Confirms if you have active TB • Herpes zoster vaccine a. Do not give to Immunocompromised patients i. HIV/AIDS ii. Radiation/Chemo/Cancer iii. Transplants b. Gives around age 60-65 c. Decreases long term pain associated with shingles • Healthy People 2020 a. A list of initiatives to implement by 2020 to help decrease disparities. • Evidence based research- quality improvement project- delirium a. What can I do improve delirium? / Quality improvement / Safety b. Delirium – Sudden change in patients behavior / Acute & Reversible i. Delirium is associated with increased length of hospital stay and hospital readmissions, increased services after discharge, and increased morbidity, mortality, and institutionalization, independent of age, co-existing illnesses, or illness severity ii. Screening all older adults before they leave the hospital may help to identify those in need of specific transitional care with more frequent follow up after hospitalization iii. Occurs in response to 1. Infection 2. Drug reaction 3. Withdrawal 4. Electrolyte imbalance (Sodium) 5. Head trauma 6. Sleep deprivation c. Sodium(brain) , Calcium Mag (heart) • Chest tube seal break a. Can be pulled by a confused patient b. If patient flipped over tube machine.. insert saline c. Chest wall – Vaseline gauze with regular gauze on top.. tape down on 3 sides( so air can go out but prevent air from going in) so air doesn’t not go into the lungs • Transfusion reaction process a. Febrile transfusion reactions occur most often in the patient with anti-WBC antibodies, a situation that can develop after multiple transfusions. b. Hemolytic transfusion reactions are caused by blood type or Rh incompatibility. c. Stop transfusion d. New line e. Hang and flush with normal saline f. Then call the doctor • Transfusion process a. 15 minutes with the patient once the blood hits the line and starts b. Vital signs should be done pre-transfusion, during transfusion, post-transfusion • Hypoglycemia- altered LOC a. Slurred speech b. Confusion • Pneumonia- action a. Standard precautions b. Steroids , IV hydration, Cough suppressants c. Sputum culture in the AM… and before the antibiotics • Restraint a. May only be used in an emergency, for a limited time or for the purpose of protecting the client or other from injury/harm b. Nurse must notify the health care provider c. Nurse must document the facts and the clients behavior leading to restraints. d. Only use restraints when all alternatives have been tried. e. Chemical restraints • Pain symptoms- geriatrics • Wheezing- assess breathing patterns a. Monitor carefully for increasing respiratory distress b. Bronchodilators then steroids c. Inflammation in the bronchioles creates the wheezing sound d. Respiratory acidosis – Airway is closing • Braden scale- reassess a. Rates the patient for their risk of developing pressure ulcers.. Age is not a risk factor i. Sensory perception ; Can they feel pain? ii. Activity/Mobility ; Can they walk? Are they paraplegic? iii. Moisture ; Incontinent? iv. Nutrition ; Pre-albumin , Albumin levels , Weight , BMI v. Friction & Shear ; Turn every 2 hrs. , Sliding and gliding techniques needed? b. Prevention for a patient with a LOW Braden score i. Turn every 2 hrs ii. Heel boots / Pillows on bony prominences iii. Supplements iv. Mepilex on sacrum area • Oral hygiene NG tube a. Oral Swabs • GERD-lifestyle modifications a. Lose weight b. Encourage small frequent meals c. Eliminate food that are determined to aggravate symptoms (spicy foods, chocolate , caffeine , alcohol , strawberries d. Encourage client to sit up while eating and remain upright for 1 hr. after eating. e. Do not eat 3 hrs. before bedtime i. HESI Hint : A fowler or semi-fowler position is beneficial in reducing the amount of regurgitation as well as in preventing the encroachment of the stomach tissue upward through the opening in the diaphragm. f. Pyrosis : Heartburn g. Medications: Reduce acid i. h2 antagonist “dines” 1. Famotidine (Pepcid as a prescription, Pepcid-AC as an OTC medication) 2. Cimetidine (Tagamet and Tagamet-HB) 3. Nizatidine (Axid and Axid AR) 4. Ranitidine (Zantac and Zantac 75)