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Providing cost effective care using all levels Of personnel to fullest when making
assignments. Providing necessary equipment and charging the pt.
Returning uncontaminated or un used equipment to appropriate debt for credit.
Using equipment properly to prevent wastage
providing training to staff unfamiliar with
equipment,
Returning equipment to proper dept. as soon as its no longer needed.
Heart failure nutrition
recommendations Reduce sodium
intake to 2000 mg/day or less
monitor fluid intake restrict to 1.5 liters fluid a day.
Psychotic disorders assessment findings
Hallucinations, deluisons, alterations in speech, bizarre behavior are
positive signs of schizophrenia.
Negative signs-affect or flat facial expression, alogia-poverty of thought of speech,
Anergia-lack of energy, anhedonia- lack of pleasure or joy, avolition-lack of
motivation in activities and hygiene 00
Adolescent nutritional needs
2000 call for female and 4000 cal for male.
They need a adequate diet in folate, vitamin E, iron, zinc, mag,
cal and fiber. Newborn withdrawal from opioids medications
opiate withdrawl, can last 2 to 3 weeks
rapid mood changes, hypersensitivity to noise and external stimuli, dehydration,
and poor weight gain.
Alcohol withdrawl
nabdominal cramping, vomiting, tremors, restlessness, inability to sleep,
increased heart rate, hallucinations, illusions, anxiety, increased blood pressure,
respiratory rate, temp, and tonic clonic seizures.
May occur 2-3 days after cessation of alcohol, and may last for 2-3 days,
*THIS IS A MEDICAL EMERGENCY. severe disorientation, severe htn,
psychotic symptoms, cardiac dysthymias, delirium. Meds- valium, Ativan,
carbamazepine (tegretrol) seizures, clonidine (catapres) Librium
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(chlordiazepoxide)
Contraindications to oral contraceptives
Hx of blood clots, stroke, cardiac problems, breast or estrogen related cancers,
pregnancy or smoking if over 35, are advised not to take oral contraceptives.
Oral contraceptives decreases its effectiveness when taking meds that effect liver
enzymes, such as ATB's, and anticonvulsants.
Antibiotics affecting bacterial
cell wall Penicillin, cillians.
amoxicillin etc.
Magnesium signs of toxicity
Access to medical records
Clients have a right to read their on
records. Nurses may not photocopy
any part of mar.
Communication should only take place in a
private setting. Shred any printed written pt. info
after pt. care or use.
Discharge teaching regarding
circumsion A tub bath should not be
given unti healed
Notify md of redness, discharge, swelling, strong odor, tenderness, decrease in
urination, or excessive crying, will heal completely in 2 weeks.
Give Tylenol for first 24 to 48 hours.
Assess for bleeding every 15 min for the first hour, then every hour for at least 12
hour, then the 1st voiding.
Stroke priority assess findings
Expressive and receptive aphasia, agnosia, (unable to recognize objects), alexia
(difficulty to reading), a graphic (writing difficulty), hemiplegia,(paralysis), or
hemiparesis (weakness), slow behavior, depression, anger, visual
changes(hemianopsia).
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Findings of recent cocaine use
Rush of euphoria, pleasure, increased energy.
Stimulant withdrawl (cocaine)
Occurs within1 hour to several days, depression,fatigue,craving,excess
sleeping, insomnia, dramatic unpleasant dreams, psychomotor retardation,
possible suicide ideation.
Withdrawl stimulant (tobacco)
Abstinence irritability craving nervousness restlessness anxiety insomnia
increased appetite difficulty concentrating anger depressed mood,
COPD managing
nutrition High calorie
foods for energy
Encourage rest periods.
Drink plenty of fluids to liquidfy mucous, and promote hydration.
IV Therapy documenting complications.
Require notification of MD, and documentation, all IV infusions should be
restarted with new tubing and catheters.
Inflitration
Infiltration- pallor and local swelling at site, slowed rate of infusion, treatment-
stop and remove catheter, elevate extremity, encourage active ROM, apply warm
or cold compress. Restart proximal to site or another extremity.
Phlebitis
Edema, throbbing, or burning at site. Increased skin temp, erythema red line up
the arm, with a palpable band at the vein, slowed rate infusion. Treatment-
discontinue IV and remove catheter, elevate extremity, warm compresses 3x daily,
restart proximal to site, culture the site and catheter if drainage is present. Use
surgical aseptic technique. Rotate sites q 72 hours.
Ecchymosis
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Don't apply alcohol apply pressure after IV catheter removal. Use warm
compress and elevate after bleeding has subsided. Prevention- minimize
tourniquet time, remove tourniquet before starting IV infusion, maintain
pressure after removal of catheter.
Fluid overload
Distended neck veins, increased BP, tachycardia, sob, crackles in lungs, edema.
Treatment- stop infusion, raise hob, assess vs & O2 saturation, adjust the rate as
prescribed, and administer diuretics as prescribed. Prevention- monitor I&O.
Respiration assessing them
Observing the rate, depth and rhythm of chest wall movements.
Post arthroplasty
Use elevated seat, or raised
toilet seat. Use straight chairs
with arms
Use abduction pillow, or pillow if prescribed, b/w the pt. legs while in bed, and
with turning, if restless or in a altered mental state.
Externally rotate pt. toes.
Do not do, cross legs, avoid low chairs, avoid flex ion of hips at 90 degrees, do
not internally rotate the toes.
Preventing foot drop
Cane
Keep cane on stronger side of body
Support body weight on both legs, move cane forward 6-10 inches, then
move weaker leg forward, next advance the stronger leg past the cane.
Crutch walking
Do not alter after crutches after fitting
Support body weight at the hand grips, with elbows flexed at 30 degrees, position
the crutches on the unaffected side when sitting or rising from a chair.
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