MEDSURGHESI-HESI
HI
NTSFOREXAM
MEDICALSURGICAL
NURSING(HOUSTON
COMMUNITYCOLLEGE)
, ME
D-SURGHE
SIp
rac
ti
cequ
est
ion
sfr
omt
heSa
und
ersb
ook
Th
enu
rsei
spr
epa
rin
gtoa
ssi
stac
li
entwi
thac
uff
edt
rac
heo
stomyt
ubet
oea
tWh
at
i
nte
rve
nti
oni
sth
epr
ior
it
ybe
for
eth
ecl
ie
nti
spe
rmi
tt
edt
odr
inkore
at?I
nfl
atet
he
c
uff
Ra
tion
ale
:Ifac
li
entwi
that
rac
heos
tomyi
sal
l
owe
dtoe
ata
ndt
het
rac
heos
tomyh
asa
c
uff
,th
enu
rses
hou
ldi
nfl
atet
hec
ufft
opr
eve
nta
spi
rat
ionoff
oodorf
lui
ds.
Thec
uff
wou
ldn
otb
ede
fla
tedb
eca
useoft
her
is
kofa
spi
rat
ion
.
Th
enu
rseh
asi
mpl
eme
nte
dab
owe
lma
int
ena
ncep
rogr
amf
ora
nun
con
sci
ousc
li
ent
.
Th
enu
rsewo
ulde
val
uat
eth
epl
ana
sbe
stme
eti
ngt
hen
eed
soft
hec
li
enti
fwh
ich
me
thodwa
ssu
cce
ssf
uli
nst
imu
lat
ingab
owe
lmov
eme
nt?Gl
yce
rins
upp
osi
tor
y
Ra
tion
ale
:Th
ele
asta
mou
ntofi
nva
siv
ene
ssn
eed
edt
opr
odu
ceab
owe
lmov
eme
nti
s
b
est
.Us
eofg
lyc
eri
nsu
ppos
it
ori
esi
sth
ele
asti
nva
siv
eme
thoda
ndu
sua
ll
yst
imu
lat
es
b
owe
lev
acu
ati
onwi
thi
nah
alf
-hou
r.
Ac
li
enti
sre
admi
tt
edt
oth
eho
spi
tal
wit
hde
hyd
rat
iona
fte
rsu
rge
ryf
orc
rea
tiono
fan
i
le
ost
omy
.Th
enu
rsea
sse
sse
sth
att
hec
li
enth
asl
ost3l
bofwe
igh
t,h
asp
oors
kin
t
urgo
r,a
ndh
asc
onc
ent
rat
edu
rin
e.Th
enu
rsei
nte
rpr
etst
hec
li
ent
'
scl
in
ica
lpi
ctu
rea
s
c
orr
ela
tin
gmos
tcl
ose
lywi
thr
ece
nti
nta
keofwh
ichme
dic
ati
on,
whi
chi
s
c
ont
rai
ndi
cat
edf
ort
hei
le
ost
omyc
li
ent
?Bi
scod
yl
Ra
tion
ale
:Th
ecl
i
entwi
tha
nil
eos
tomyi
spr
onet
ode
hydr
ati
onb
eca
useoft
hel
oca
tion
oft
heos
tomyi
nth
ega
str
oin
tes
ti
nal
tra
cta
nds
hou
ldn
ott
akel
axa
tiv
es.
Th
ecl
ie
nti
scomp
lai
nin
gofs
kini
rr
it
ati
onf
romt
hee
dge
sofac
asta
ppl
ie
dth
e
p
rev
iou
sda
y.Wh
icha
cti
ons
hou
ldt
hen
urs
eta
ke?Th
enu
rsep
eta
lst
hee
dge
soft
he
c
astwi
tht
apeRa
tion
ale
:mi
ni
miz
esk
ini
rr
it
ati
on.
Th
enu
rsei
sta
kin
gah
eal
thh
ist
oryf
orac
li
entwi
thh
ype
rpa
rat
hyr
oid
ism.Wh
ich
T
hi
sdoc
umen
ti
savai
l
abl
efr
eeofc
harg
eoo
l
nUU
OCU
.
D
ownl
oa
dedbyJ
oseCorr
al(
sp
0ki
ng.
01
@gmai
l
.
com)
, q
ues
tionwo
ulde
li
ci
tin
for
mat
iona
bou
tth
isc
li
ent
'
sco
ndi
ti
on?"
Arey
oue
xpe
rie
nci
ng
p
aini
nyo
urj
oi
nts
?"
Ra
tion
ale
:Hy
per
par
ath
yroi
di
smi
sas
soc
iat
edwi
thov
ers
ecr
eti
onofp
ara
thy
roi
d
h
ormon
e(PTH)
,wh
ichc
aus
ese
xce
ssi
veos
teob
las
tgr
owt
han
dac
ti
vi
tywi
thi
nth
e
b
one
s.Wh
enb
oner
eab
sor
pti
oni
sin
cre
ase
d,c
alc
iumi
sre
lea
sedf
romt
heb
one
sin
to
t
heb
lood
,ca
usi
ngh
ype
rca
lce
mia
.Th
ebon
ess
uff
erd
emi
ner
ali
zat
iona
sar
esu
ltof
c
alc
iuml
oss
,le
adi
ngt
obon
ean
djoi
ntp
ain
Ac
li
entwi
tht
ype2d
iab
ete
sme
ll
it
ush
asab
loodgl
ucos
ele
vel
gre
ate
rth
an600
mg/
dL(
34.
3mmo
l/L
)an
disc
omp
lai
ni
ngofp
oly
dip
sia
,po
lyu
ria
,we
igh
tlos
s,a
l
we
akn
ess
.Th
enu
rser
evi
ewst
heh
eal
thc
arep
rov
ide
r'
sdo
cume
nta
tio
nan
dex
pec
tst
o
n
otewh
ichd
iagn
osi
s?Hy
per
osmo
larh
ype
rgl
yce
mics
ynd
rome(
HHS)
Ra
tion
ale
:HHSi
sse
enp
rima
ril
yinc
li
ent
swi
tht
ype2d
iab
ete
sme
ll
it
us,
whoe
xpe
rie
nce
ar
ela
tiv
ede
fic
ien
cyofi
nsu
li
n.Th
eon
setofs
ign
san
dsy
mpt
omsma
ybeg
rad
ual
.
Ma
nif
est
ati
onsma
yin
clu
dep
oly
uri
a,p
oly
dip
sia
,de
hyd
rat
ion
,me
nta
lst
atu
sal
te
rat
ion
s,
we
igh
tlos
s,a
ndwe
akn
ess
.
Th
enu
rsei
sde
vel
opi
ngap
lanofc
aref
orac
li
entwh
owi
ll
bea
dmi
tt
edt
oth
eho
spi
tal
wi
thad
iagn
osi
sofd
eepv
eint
hro
mbo
sis(
DVT)oft
her
igh
tle
g.Th
enu
rsed
eve
lop
s
t
hep
lan
,ex
pec
tin
gth
att
heh
eal
thc
arep
rov
ide
r(HCP)wi
ll
mos
tli
kel
ypr
esc
rib
e
wh
icho
pti
on?—Ma
int
aina
cti
vi
tyl
eve
lasp
res
cri
bed
.
Ra
tion
ale
:St
and
ardma
nag
eme
ntf
ort
hec
li
entwi
thDVTi
ncl
ude
sma
int
ain
ingt
he
a
cti
vi
tyl
eve
lasp
res
cri
bedb
yth
ehe
alt
hca
rep
rov
ide
r;l
i
mbe
lev
ati
on;
rel
i
efof
di
scomf
ortwi
thwa
rm,
moi
sth
eat
;an
dan
alg
esi
csa
sne
ede
d.Re
cen
tre
sea
rchi
s
s
howi
ngt
hata
mbu
lat
ion
,asp
rev
iou
slyt
hou
ght
,doe
snotc
aus
epu
lmon
arye
mbol
i
sm
a
ndd
oesn
otc
aus
eth
eex
ist
ingDVTt
owor
sen
.Th
ere
for
e,t
hen
urs
esh
oul
dma
int
ain
t
hep
res
cri
beda
cti
vi
tyl
eve
l,wh
ichc
oul
dbeb
edr
esto
ramb
ula
tion
.Op
ioi
dan
alg
esi
cs
a
ren
otr
equ
ire
dtor
eli
evep
ain
,an
dpa
inn
orma
ll
yisr
eli
eve
dwi
tha
cet
ami
nop
hen
.re
D
own
l
oad
edb
yJo
seCo
rra
l(
sp
0ki
n
g.0
1@g
mai
l
.
com)
HI
NTSFOREXAM
MEDICALSURGICAL
NURSING(HOUSTON
COMMUNITYCOLLEGE)
, ME
D-SURGHE
SIp
rac
ti
cequ
est
ion
sfr
omt
heSa
und
ersb
ook
Th
enu
rsei
spr
epa
rin
gtoa
ssi
stac
li
entwi
thac
uff
edt
rac
heo
stomyt
ubet
oea
tWh
at
i
nte
rve
nti
oni
sth
epr
ior
it
ybe
for
eth
ecl
ie
nti
spe
rmi
tt
edt
odr
inkore
at?I
nfl
atet
he
c
uff
Ra
tion
ale
:Ifac
li
entwi
that
rac
heos
tomyi
sal
l
owe
dtoe
ata
ndt
het
rac
heos
tomyh
asa
c
uff
,th
enu
rses
hou
ldi
nfl
atet
hec
ufft
opr
eve
nta
spi
rat
ionoff
oodorf
lui
ds.
Thec
uff
wou
ldn
otb
ede
fla
tedb
eca
useoft
her
is
kofa
spi
rat
ion
.
Th
enu
rseh
asi
mpl
eme
nte
dab
owe
lma
int
ena
ncep
rogr
amf
ora
nun
con
sci
ousc
li
ent
.
Th
enu
rsewo
ulde
val
uat
eth
epl
ana
sbe
stme
eti
ngt
hen
eed
soft
hec
li
enti
fwh
ich
me
thodwa
ssu
cce
ssf
uli
nst
imu
lat
ingab
owe
lmov
eme
nt?Gl
yce
rins
upp
osi
tor
y
Ra
tion
ale
:Th
ele
asta
mou
ntofi
nva
siv
ene
ssn
eed
edt
opr
odu
ceab
owe
lmov
eme
nti
s
b
est
.Us
eofg
lyc
eri
nsu
ppos
it
ori
esi
sth
ele
asti
nva
siv
eme
thoda
ndu
sua
ll
yst
imu
lat
es
b
owe
lev
acu
ati
onwi
thi
nah
alf
-hou
r.
Ac
li
enti
sre
admi
tt
edt
oth
eho
spi
tal
wit
hde
hyd
rat
iona
fte
rsu
rge
ryf
orc
rea
tiono
fan
i
le
ost
omy
.Th
enu
rsea
sse
sse
sth
att
hec
li
enth
asl
ost3l
bofwe
igh
t,h
asp
oors
kin
t
urgo
r,a
ndh
asc
onc
ent
rat
edu
rin
e.Th
enu
rsei
nte
rpr
etst
hec
li
ent
'
scl
in
ica
lpi
ctu
rea
s
c
orr
ela
tin
gmos
tcl
ose
lywi
thr
ece
nti
nta
keofwh
ichme
dic
ati
on,
whi
chi
s
c
ont
rai
ndi
cat
edf
ort
hei
le
ost
omyc
li
ent
?Bi
scod
yl
Ra
tion
ale
:Th
ecl
i
entwi
tha
nil
eos
tomyi
spr
onet
ode
hydr
ati
onb
eca
useoft
hel
oca
tion
oft
heos
tomyi
nth
ega
str
oin
tes
ti
nal
tra
cta
nds
hou
ldn
ott
akel
axa
tiv
es.
Th
ecl
ie
nti
scomp
lai
nin
gofs
kini
rr
it
ati
onf
romt
hee
dge
sofac
asta
ppl
ie
dth
e
p
rev
iou
sda
y.Wh
icha
cti
ons
hou
ldt
hen
urs
eta
ke?Th
enu
rsep
eta
lst
hee
dge
soft
he
c
astwi
tht
apeRa
tion
ale
:mi
ni
miz
esk
ini
rr
it
ati
on.
Th
enu
rsei
sta
kin
gah
eal
thh
ist
oryf
orac
li
entwi
thh
ype
rpa
rat
hyr
oid
ism.Wh
ich
T
hi
sdoc
umen
ti
savai
l
abl
efr
eeofc
harg
eoo
l
nUU
OCU
.
D
ownl
oa
dedbyJ
oseCorr
al(
sp
0ki
ng.
01
@gmai
l
.
com)
, q
ues
tionwo
ulde
li
ci
tin
for
mat
iona
bou
tth
isc
li
ent
'
sco
ndi
ti
on?"
Arey
oue
xpe
rie
nci
ng
p
aini
nyo
urj
oi
nts
?"
Ra
tion
ale
:Hy
per
par
ath
yroi
di
smi
sas
soc
iat
edwi
thov
ers
ecr
eti
onofp
ara
thy
roi
d
h
ormon
e(PTH)
,wh
ichc
aus
ese
xce
ssi
veos
teob
las
tgr
owt
han
dac
ti
vi
tywi
thi
nth
e
b
one
s.Wh
enb
oner
eab
sor
pti
oni
sin
cre
ase
d,c
alc
iumi
sre
lea
sedf
romt
heb
one
sin
to
t
heb
lood
,ca
usi
ngh
ype
rca
lce
mia
.Th
ebon
ess
uff
erd
emi
ner
ali
zat
iona
sar
esu
ltof
c
alc
iuml
oss
,le
adi
ngt
obon
ean
djoi
ntp
ain
Ac
li
entwi
tht
ype2d
iab
ete
sme
ll
it
ush
asab
loodgl
ucos
ele
vel
gre
ate
rth
an600
mg/
dL(
34.
3mmo
l/L
)an
disc
omp
lai
ni
ngofp
oly
dip
sia
,po
lyu
ria
,we
igh
tlos
s,a
l
we
akn
ess
.Th
enu
rser
evi
ewst
heh
eal
thc
arep
rov
ide
r'
sdo
cume
nta
tio
nan
dex
pec
tst
o
n
otewh
ichd
iagn
osi
s?Hy
per
osmo
larh
ype
rgl
yce
mics
ynd
rome(
HHS)
Ra
tion
ale
:HHSi
sse
enp
rima
ril
yinc
li
ent
swi
tht
ype2d
iab
ete
sme
ll
it
us,
whoe
xpe
rie
nce
ar
ela
tiv
ede
fic
ien
cyofi
nsu
li
n.Th
eon
setofs
ign
san
dsy
mpt
omsma
ybeg
rad
ual
.
Ma
nif
est
ati
onsma
yin
clu
dep
oly
uri
a,p
oly
dip
sia
,de
hyd
rat
ion
,me
nta
lst
atu
sal
te
rat
ion
s,
we
igh
tlos
s,a
ndwe
akn
ess
.
Th
enu
rsei
sde
vel
opi
ngap
lanofc
aref
orac
li
entwh
owi
ll
bea
dmi
tt
edt
oth
eho
spi
tal
wi
thad
iagn
osi
sofd
eepv
eint
hro
mbo
sis(
DVT)oft
her
igh
tle
g.Th
enu
rsed
eve
lop
s
t
hep
lan
,ex
pec
tin
gth
att
heh
eal
thc
arep
rov
ide
r(HCP)wi
ll
mos
tli
kel
ypr
esc
rib
e
wh
icho
pti
on?—Ma
int
aina
cti
vi
tyl
eve
lasp
res
cri
bed
.
Ra
tion
ale
:St
and
ardma
nag
eme
ntf
ort
hec
li
entwi
thDVTi
ncl
ude
sma
int
ain
ingt
he
a
cti
vi
tyl
eve
lasp
res
cri
bedb
yth
ehe
alt
hca
rep
rov
ide
r;l
i
mbe
lev
ati
on;
rel
i
efof
di
scomf
ortwi
thwa
rm,
moi
sth
eat
;an
dan
alg
esi
csa
sne
ede
d.Re
cen
tre
sea
rchi
s
s
howi
ngt
hata
mbu
lat
ion
,asp
rev
iou
slyt
hou
ght
,doe
snotc
aus
epu
lmon
arye
mbol
i
sm
a
ndd
oesn
otc
aus
eth
eex
ist
ingDVTt
owor
sen
.Th
ere
for
e,t
hen
urs
esh
oul
dma
int
ain
t
hep
res
cri
beda
cti
vi
tyl
eve
l,wh
ichc
oul
dbeb
edr
esto
ramb
ula
tion
.Op
ioi
dan
alg
esi
cs
a
ren
otr
equ
ire
dtor
eli
evep
ain
,an
dpa
inn
orma
ll
yisr
eli
eve
dwi
tha
cet
ami
nop
hen
.re
D
own
l
oad
edb
yJo
seCo
rra
l(
sp
0ki
n
g.0
1@g
mai
l
.
com)
