ATI COMPREHENSIVE PREDICTOR 2019 MED-SURG: 38 Questions

ATI COMPREHENSIVE PREDICTOR 2019 MED-SURG: 38 Questions MS Priority Referral for a ALS • OT, PT, Speech Therapy • Home care • Hospice when needed Lupus, Gout, Fibro Identifying a Client Requires a Referral to Dietitian • Gout ▪ Keep diary of food triggers ▪ Low-purine diet NO!!! organ meats or shellfish, yeast, sardines, spinach ▪ Avoid/Limit alcohol intake ▪ Avoid starvation diets, aspirin, diuretics ▪ Increase fluid intake 3L/day • Lupus ▪ Limit salt intake for fluid retention secondary to steroid therapy ▪ High-vitamin, high iron diet ▪ If anorexia, • provide small, freq. meals…offer between-meal supplements • take folic acid ▪ High-protein diet, if no evidence of kidney disease • Fibro ▪ Limit intake of caffeine, alcohol, & other substances interfere w/ sleep Parkinson’s DiseaseAssessing Client’s Need for Physical Therapy • If unable to, ▪ Walking and balance difficult ▪ Physical movements slow down affecting moving ▪ Unilateral shaking or tremor of one lime ▪ Stand or walk, dependent for ▪ Do exercise, yoga, ROM ▪ Use of assistive devices, as disease progresses ▪ Walking to slow down (can reduce injury) Renal Disorder Dietary Teaching for Chronic Kidney Disease • LOW protein, LOW-potassium, HIGH-carb, vitamins & calcium supplements, LOW sodium, LOW phosphorous • Restrict magnesium • Strict I&O; fluid replacement –500 to 600 mL more than previous 24hr urine output • Limit alcohol intake • Don’t give antacids w/ Mg or enemas w/ phosphorous • Use diet & exercise to manage weight & prevent or control diabetes & HTN • Test albumin yearly Dietary Teaching About Heme Iron for pt w/ Anemia • Nutritional deficiencies  iron, B12, folic acid, intrinsic factor • Encourage increase intake of deficient nutrient  iron (meats, poultry, fish), vitamin B12, folic acid • iron-fortified cereal & breads, fish, poultry, & dried peas and beans (NOT red meat or organ meats) • should reg. consume high folate (spinach, lentils, bananas) &folic acid fortified grains & juices Stroke Assisting pt w/ Dysphagia • Monitor for aspiration, assess swallowing and gag reflexes before eating • Liquid consistencies ▪ Thinwater, juice ▪ Nectar-likecream soups, nectars ▪ Honey-likehoney, yogurt ▪ Spoon-thickpudding, cooked cereals • Food levels: ▪ Pureed ▪ Mechanically altered ▪ Advanced/mechanically soft ▪ Regular ▪ Use appropriate consistency & food type as recommended by SLP to minimize choking • Position pt sitting in chair or sitting up in bed, w/ the head & neck positioned slightly forward & flexed • Feed pt slowly, placing food in the back of the mouth and to unaffected side • Provide sips of fluids & slowly advance diet foods easy to chew & swallow • Have suction on standby • Maintain a distraction-free environment during meals • Weight loss is common collaborate w/ dietitian for caloric intake • COMPLICATIONS NI: ▪ if gag reflexes are present, give sip of water to determine if choking occurs ▪ keep NPO until evaluated by SLP ▪ Begin w/ prescribed liquid-consistency regimen from NDD & closely observe for choking ▪ Have suction equipment available, feed w/ care bc nasotracheal suctioning increases ICP ▪ RN should initial feeding