RN COMPREHENSIVE ONLINE PRACTICE 2019 A
REMEDIATION
1. DVT – heparin – elevated leg to reduce edema and further risk
2. Child safety
a. No skateboarding under 5yo
b. No sun between 1000 and 1400
c. Cut hotdogs lengthwise
3. Infection prevention when on chemo
a. No water or liquids at room temperature that have been out
for over 1 hour
b. Clean toothbrush in dishwasher once weekly
c. Take temp once weekly and notify provider if over 100
d. Ambulate short distances to prevent pulmonary stasis and
respiratory infections
4. 6m infant diet
a. 1 Tbsp/year of age (in general)
b. Under 12m – ½ to ¾ Tbsp appropriate
c. 100% juice – 120 to 180 ml d (4-6 oz) after 6m
5. Mechanical restrains
a. Don’t remove unless client calm, in control, and follows simple
commands
b. Assess physical needs, safety, comfort q 15-30 min
and document
c. New Rx q4 hr 18yo and older, q2 hr 9-17 yo, q1 hr under 9yo
d. Staff remains continuously with client or constant viewing with
audiovisual equipment
6. Umbilical cord prolapses
a. Knee-chest position
7. True labor
a. Cervix transitions to anterior position and begins to dilate in
preparation
b. Contractions primarily in lower abdomen and back
c. Contractions intensifies with increased ambulation
d. Cervix shortens and thins
8. Nurse manager changing scheduling system, action to facilitate
a. Provide information about scheduling issues to the staff
i. 1st stage of change process is unfreezing stage
1. Informing staff about issues increases
understanding of why changes
needed
9. Uric acid-based urinary calculi formation
a. Can eat citrus fruits
b. DO NOT EAT – liver & chicken (organ meats, which contain
purine) and red wine the same
, 10. Estradiol teaching
a. Headaches – indicate thromboembolic stroke
11. Multiple sclerosis
a. Speech pathologist swallow study – dysphagia is complication
b. Rest before eating – rest because of reported weakness
and easy fatigue
c. Thicken liquids before drinking – dysphagia
12. Chlorpromazine for schizophrenia – report to provider
a. Greatest risk – injury from neuroleptic malignant syndrome
i. High temp
ii. Dysrhythmia
iii. Decrease LOC
iv. Labile BP
13.Maintain sterile technique with male indwelling urinary
catheter
a. Open outer flap away from body to prevent contamination of
field by reaching over it when opening the remaining flaps
b. Clean penis with dominant hand
c. Don sterile gloves before touching any items in sterile field
d. Place catheter tray on a work surface at or above waist level
14. Cranial nerve – optic II
a. Clear objects from walking area
15. Hemolytic transfusion reaction
a. Tachycardia
b. Low back pain
c. Hypotension
16. Child tonic-conic seizure
a. Side-lying during seizure to maintain airway, decrease risk of
aspiration, facilitate drainage of oral secretions
b. Rescue breaths after seizure if child does not begin having
spontaneous respirations
c. Obtain vitals and ECG following seizure
17. Gastrostomy tube for enteral feedings – medication admin
a. Flush with at least 30ml water before and after meds to clear
residual in tube
b. Crush each medication separately from tube feeding formula
c. Change feeding bag and tubing q 24-48 hr to prevent clogs
and infection
d. Give each medication separate to prevent clogging
18. Macular degeneration
a. Decreased central vision
i. r/t bleeding int the macula or yellow spots under retina
19. Warfarin instructions understood by patient
a. Report change in color of stools
i. Red, black, tarry indicates bleeding (AE needs to be
reported)
REMEDIATION
1. DVT – heparin – elevated leg to reduce edema and further risk
2. Child safety
a. No skateboarding under 5yo
b. No sun between 1000 and 1400
c. Cut hotdogs lengthwise
3. Infection prevention when on chemo
a. No water or liquids at room temperature that have been out
for over 1 hour
b. Clean toothbrush in dishwasher once weekly
c. Take temp once weekly and notify provider if over 100
d. Ambulate short distances to prevent pulmonary stasis and
respiratory infections
4. 6m infant diet
a. 1 Tbsp/year of age (in general)
b. Under 12m – ½ to ¾ Tbsp appropriate
c. 100% juice – 120 to 180 ml d (4-6 oz) after 6m
5. Mechanical restrains
a. Don’t remove unless client calm, in control, and follows simple
commands
b. Assess physical needs, safety, comfort q 15-30 min
and document
c. New Rx q4 hr 18yo and older, q2 hr 9-17 yo, q1 hr under 9yo
d. Staff remains continuously with client or constant viewing with
audiovisual equipment
6. Umbilical cord prolapses
a. Knee-chest position
7. True labor
a. Cervix transitions to anterior position and begins to dilate in
preparation
b. Contractions primarily in lower abdomen and back
c. Contractions intensifies with increased ambulation
d. Cervix shortens and thins
8. Nurse manager changing scheduling system, action to facilitate
a. Provide information about scheduling issues to the staff
i. 1st stage of change process is unfreezing stage
1. Informing staff about issues increases
understanding of why changes
needed
9. Uric acid-based urinary calculi formation
a. Can eat citrus fruits
b. DO NOT EAT – liver & chicken (organ meats, which contain
purine) and red wine the same
, 10. Estradiol teaching
a. Headaches – indicate thromboembolic stroke
11. Multiple sclerosis
a. Speech pathologist swallow study – dysphagia is complication
b. Rest before eating – rest because of reported weakness
and easy fatigue
c. Thicken liquids before drinking – dysphagia
12. Chlorpromazine for schizophrenia – report to provider
a. Greatest risk – injury from neuroleptic malignant syndrome
i. High temp
ii. Dysrhythmia
iii. Decrease LOC
iv. Labile BP
13.Maintain sterile technique with male indwelling urinary
catheter
a. Open outer flap away from body to prevent contamination of
field by reaching over it when opening the remaining flaps
b. Clean penis with dominant hand
c. Don sterile gloves before touching any items in sterile field
d. Place catheter tray on a work surface at or above waist level
14. Cranial nerve – optic II
a. Clear objects from walking area
15. Hemolytic transfusion reaction
a. Tachycardia
b. Low back pain
c. Hypotension
16. Child tonic-conic seizure
a. Side-lying during seizure to maintain airway, decrease risk of
aspiration, facilitate drainage of oral secretions
b. Rescue breaths after seizure if child does not begin having
spontaneous respirations
c. Obtain vitals and ECG following seizure
17. Gastrostomy tube for enteral feedings – medication admin
a. Flush with at least 30ml water before and after meds to clear
residual in tube
b. Crush each medication separately from tube feeding formula
c. Change feeding bag and tubing q 24-48 hr to prevent clogs
and infection
d. Give each medication separate to prevent clogging
18. Macular degeneration
a. Decreased central vision
i. r/t bleeding int the macula or yellow spots under retina
19. Warfarin instructions understood by patient
a. Report change in color of stools
i. Red, black, tarry indicates bleeding (AE needs to be
reported)
