Nursing 1 Final
● What can an RN delegate to a LPN/CNA
Delegation: LPN - administering some medications (Except IV medications and some
controlled substances), starting an IV infusion and administering plain IV solutions, assisting
with identification of blood units for transfusion
CNA - bathing a stable patient, ambulating steady patients, obtaining routine
vital signs, changing linens, assisting patients with meals, clerical duties, transporting non-acute
patients and specimens
● Dehiscence and evisceration
Dehiscence - rupture (separation) of one or more layers of a wound,
Evisceration - total separation of the layers of a wound in which internal viscera protrude
through the incision
● Pre-Operative labs
CBC, BMP
Lab Values: Potassium 3.5 - 5
Calcium 8.5 - 10.5
Magnesium 1.6 - 2.6
Phosphate 1.7 - 2.6
Sodium 135-145
● Breakthrough pain
Acute flare up of pain in a patient who is on regular doses of pain medication for
persistent pain. Think cancer patients or those recovering from invasive surgeries
(i.e. tonsillectomy or ortho) .
● Somnolent
Sleepy or drowsy, difficult to arouse
● Different types of incontinence pg. 1018 Basic
Urge - the involuntary loss of large amounts of urine accompanied by a strong urge to
void. It is often referred to as overactive bladder
Stress - involuntary loss of small amounts of urine with increased intra-abdominal
pressure (factors: pregnancy, childbirth, obesity, chronic constipation, and straining at
stool)
Mixed - a combination of urge and stress
Overflow - the loss of urine in combination with distended bladder (causes - fecal
impaction, neurological disorders, and enlarged prostate)
Functional - untimely loss of urine when no urinary or neurological cause is involved
(occurs b/c of physical disability, immobility, pain, external obstacles, problems thinking
or communicating that prevent a person from reaching the toilet, dementia)
Transient - short term, expected to resolve spontaneously (causes - UTI and
medications usually diuretics)
, Unconscious (reflex) - loss of urine when the person does not realize the bladder is
full and has no urge to void (causes - central nervous system disorders, tissue damage
from radiation, cystitis, bladder inflammation, radical pelvic surgery, psychosocial
(regressing to child like behaviors), children potty training)
● What can a nurse do to maintain safety on the job: make sure that he or she
is using equipment that functions properly, proper body mechanics when moving
patients, with hostile patients make sure you are in between the door and the
patient with the door open for escape, proper precautions with all patients
especially those with PPE precautions, have another nurse assist if you are
unsure about procedure or your safety.
● Immobility and how it affects the different body systems (pg 1136-1137
Basic)
Effects on muscles and bones - atrophy, stiffness of joints, contractures, affects the
parathyroid in turn affects calcium metabolism therefore bone formation, osteoporosis,
calcium depletion in the joints and renal stones
Effects on the lungs - ventilation, depth of respirations decreases and secretions pool
in the airways, atelectasis, pneumonia
Effects on the heart and vessels - cardiac reserve lessened, force of gravity causes
blood to pool in the periphery leading to edema, DVT, orthostatic hypotension,
Effects on Metabolism - body energy reserves, metabolic rate drops, protein and
glycogen synthesis decrease, fat stores increases, causing glucose intolerance and
reduced muscle mass
Effects on the integumentary - obstruction of skin circulation, tissue ischemia,
possible necrosis
Effects in the gastrointestinal - slows peristalsis leading to constipation, gas, difficulty
evacuating stool from rectum, paralytic ileus, appetite diminishes leading to decrease
calorie intake and inability to meet the protein demands of the body, muscle broken
down causing further wasting
Effects on the genitourinary - inhibits drainage of urine from the renal pelvis and
bladder, creating ideal environment for infection and kidney stone formation
Psychological effects - depression, anxiety, hostility, sleep disturbances and changed
in their ability to perform self-care activities, lowered libeto/ self image
Risk for falls -interventions to preventions-Learn to use assistive devices such as
canes and walkers properly, exercise, take your time, move slowly to avoid orthostatic
hypotension, lighten loads, use your glasses, keep your walking area well lit, remove
throw rugs, tape up wires to the base board, ensure shoes fit properly, wear skid proof
socks & shoes, keep furniture against the wall to create large walking areas, reduce
clutter, keep items commonly use in easy to reach places, keep bed in lower position as
well as chairs (no rolling chairs), handrails in bathrooms, seats and handrails in
showers, mark steps with colored tape so they are easy to see where there is uneven
● What can an RN delegate to a LPN/CNA
Delegation: LPN - administering some medications (Except IV medications and some
controlled substances), starting an IV infusion and administering plain IV solutions, assisting
with identification of blood units for transfusion
CNA - bathing a stable patient, ambulating steady patients, obtaining routine
vital signs, changing linens, assisting patients with meals, clerical duties, transporting non-acute
patients and specimens
● Dehiscence and evisceration
Dehiscence - rupture (separation) of one or more layers of a wound,
Evisceration - total separation of the layers of a wound in which internal viscera protrude
through the incision
● Pre-Operative labs
CBC, BMP
Lab Values: Potassium 3.5 - 5
Calcium 8.5 - 10.5
Magnesium 1.6 - 2.6
Phosphate 1.7 - 2.6
Sodium 135-145
● Breakthrough pain
Acute flare up of pain in a patient who is on regular doses of pain medication for
persistent pain. Think cancer patients or those recovering from invasive surgeries
(i.e. tonsillectomy or ortho) .
● Somnolent
Sleepy or drowsy, difficult to arouse
● Different types of incontinence pg. 1018 Basic
Urge - the involuntary loss of large amounts of urine accompanied by a strong urge to
void. It is often referred to as overactive bladder
Stress - involuntary loss of small amounts of urine with increased intra-abdominal
pressure (factors: pregnancy, childbirth, obesity, chronic constipation, and straining at
stool)
Mixed - a combination of urge and stress
Overflow - the loss of urine in combination with distended bladder (causes - fecal
impaction, neurological disorders, and enlarged prostate)
Functional - untimely loss of urine when no urinary or neurological cause is involved
(occurs b/c of physical disability, immobility, pain, external obstacles, problems thinking
or communicating that prevent a person from reaching the toilet, dementia)
Transient - short term, expected to resolve spontaneously (causes - UTI and
medications usually diuretics)
, Unconscious (reflex) - loss of urine when the person does not realize the bladder is
full and has no urge to void (causes - central nervous system disorders, tissue damage
from radiation, cystitis, bladder inflammation, radical pelvic surgery, psychosocial
(regressing to child like behaviors), children potty training)
● What can a nurse do to maintain safety on the job: make sure that he or she
is using equipment that functions properly, proper body mechanics when moving
patients, with hostile patients make sure you are in between the door and the
patient with the door open for escape, proper precautions with all patients
especially those with PPE precautions, have another nurse assist if you are
unsure about procedure or your safety.
● Immobility and how it affects the different body systems (pg 1136-1137
Basic)
Effects on muscles and bones - atrophy, stiffness of joints, contractures, affects the
parathyroid in turn affects calcium metabolism therefore bone formation, osteoporosis,
calcium depletion in the joints and renal stones
Effects on the lungs - ventilation, depth of respirations decreases and secretions pool
in the airways, atelectasis, pneumonia
Effects on the heart and vessels - cardiac reserve lessened, force of gravity causes
blood to pool in the periphery leading to edema, DVT, orthostatic hypotension,
Effects on Metabolism - body energy reserves, metabolic rate drops, protein and
glycogen synthesis decrease, fat stores increases, causing glucose intolerance and
reduced muscle mass
Effects on the integumentary - obstruction of skin circulation, tissue ischemia,
possible necrosis
Effects in the gastrointestinal - slows peristalsis leading to constipation, gas, difficulty
evacuating stool from rectum, paralytic ileus, appetite diminishes leading to decrease
calorie intake and inability to meet the protein demands of the body, muscle broken
down causing further wasting
Effects on the genitourinary - inhibits drainage of urine from the renal pelvis and
bladder, creating ideal environment for infection and kidney stone formation
Psychological effects - depression, anxiety, hostility, sleep disturbances and changed
in their ability to perform self-care activities, lowered libeto/ self image
Risk for falls -interventions to preventions-Learn to use assistive devices such as
canes and walkers properly, exercise, take your time, move slowly to avoid orthostatic
hypotension, lighten loads, use your glasses, keep your walking area well lit, remove
throw rugs, tape up wires to the base board, ensure shoes fit properly, wear skid proof
socks & shoes, keep furniture against the wall to create large walking areas, reduce
clutter, keep items commonly use in easy to reach places, keep bed in lower position as
well as chairs (no rolling chairs), handrails in bathrooms, seats and handrails in
showers, mark steps with colored tape so they are easy to see where there is uneven
