MED-SURG RN Form B

MED-SURG RN Form B Cancer treatment options: Safety precautions for a sealed radiation implant ◯ Nursing Actions ■ Place the client in a private room away from other clients when possible. ■ Place appropriate sign on the door warning of the radiation source. ■ Wear a dosimeter film badge that records personal amount of radiation exposure. ■ Limit visitors to 30-min visits, and have visitors maintain a distance of 6 ft from the source. ■ Visitors and health care personnel who are pregnant or under the age of 16 should not come into contact with the client or radiation source. ■ Keep a lead container in the client's room if the delivery method could allow spontaneous loss of radioactive material. Tongs are available for placing radioactive material into this container. ■ Precautions listed above should be carried out at home if the client is discharged during therapy. ◯ Client Education ■ Inform client of the need to remain in an indicated position to prevent dislodgement of the radiation implant. ■ Instruct the client to call the nurse for assistance with elimination. ■ Instruct client and family about radiation precautions needed in the health care and home environments. Fractures and immobilization: Assessment of a new cast Neurovascular assessment is essential throughout immobilization. Assessments are performed every hour for the first 24 hr and every 1 to 4 hr thereafter following initial trauma to monitor neurovascular compromise related to edema and/or the immobilization device. Nursing Actions Monitor neurovascular status and assess pain. Apply ice for 24 to 48 hr. Handle a plaster cast with the palms, not fingertips, until the cast is dry to prevent denting the cast. Avoid setting the cast on hard surfaces or sharp edges. Prior to casting, the area is cleaned and dried. Tubular cotton web roll is placed over the affected area to maintain skin integrity. The casting material is then applied. After cast application, position the client so that warm, dry air circulates around and under the cast (support the casted area without pressure under or directly on the cast) for faster drying and to prevent pressure from changing the shape of the cast. Use gloves to touch the cast until it is completely dry. Elevate the cast above the level of the heart during the first 24 to 48 hr to prevent edema of the affected extremity. If any drainage is seen on the cast, it should be outlined, dated, and timed, so it can be monitored for any additional drainage. Older adult clients have an increased risk for impaired skin integrity due to the loss of elasticity of the skin and decreased sensation (comorbidities). Acute Kidney Injury and Chronic Kidney Disease: Over the counter medications