283 - Transition to Registered Nurse Practice -
Comp 1/ Week 1 - 4 Discussions / Dr.
Blackburn (Quizzes with Certified Solutions).
For a patient Dx w/ a Pulmonary Embolism - who may be included in the
Interdisciplinary Team? - Answer: ✦ Pulmonologist - to manage lung function
✦ Respiratory Therapist - for oxygen therapy
✦ Physical Therapist - to maintain muscle conditioning
✦ Occupational Therapist - for information and home suggesting for energy
conservation if endurance is affected
✦ Dietician - for caloric and protein needs
✦ Pastoral care/clergy - for those experiencing spiritual distress
✦ Social workers/homecare nurses - to arrange care needs at home
✦ Mental health professional - for coping support
,What are the important nursing implications to know when caring for patients
receiving enoxaparin (a low molecular weight (LMW) heparin)? - Answer: Low
molecular heparins (Enoxaparin) are often prescribed to prevent DVTs in clients
who are postoperative.
Nursing implications/teaching for patients receiving Enoxaparin:
- instruction re: self-admin
- prefilled syringes are avail in various dosages for subcutaneous injection. do not
expel the air bubble in the syringe. it's nitrous oxide and allows the client to
receive all the medication during the injection.
- for subcutaneous injections: when a prefilled syringe is not avail, use a 20- to 22-
guage needle to withdraw medication from the vial - then, change to a small
needle (25- or 26- gauge, 1/2 to 5/8 inches long). deep subcutaneous injections
should be administered in the abdomen, ensuring a distance of 2 in from the
umbilicus. do not aspirate.
- rotate sites - between left anterolateral & posterolateral abdominal walls at least
2 inches from umbilicus - pinch up an area of skin, inject at 90 degree angle, and
insert needle completely.
- do not rub the site for 1-2 min after the injection.
- avoid OTC medication unless prescribed - avoid the use of OTC NSAIDs, aspirin,
or medications containing salicylates.
- don't take enoxaparin w/: ginger, garlic, ginkgo, or feverfew. these supplements
may increase the risk of bleeding.
- monitor for indications of bleeding (bruising, gums bleeding, abdominal pain,
nose bleeds, coffee-ground emesis, tarry stools)
, - use an electric razor & soft toothbrush
- acceptable med for home use
- bloodwork monitoring of platelets is recommended
*in patients w/ renal impairment anti-Factor Xa levels may be used to monitor for
the anticoagulant effects*
Maintain tube patency (e.g. nasogastric tube for decompression, chest tubes) -
per IGGY for patients w/ NG tube, assess the following every 4 hours: - Answer: -
Assess Q4H -
✦ proper placement of tube (aspirate contents)
✦ tube patency (irrigate w/ 30 mL of NS)
✦ output (quality and quantity)
✦ nasal skin
✦ peristalsis (discontinue suction first)
✦ remember after esophageal surgery we ensure a patent NG for drainage but DO
NOT irrigate GT or reposition without provider order!
The nurse is teaching the client diagnosed with diverticulosis. Which of the
following instructions should the nurse include in the teaching session to help
prevent an exacerbation of this disorder? select all that apply.
a. Eat a high-fiber diet
b. Increase fluid intake
c. Elevate the HOB after eating
d. Walk 30 minutes per day
Comp 1/ Week 1 - 4 Discussions / Dr.
Blackburn (Quizzes with Certified Solutions).
For a patient Dx w/ a Pulmonary Embolism - who may be included in the
Interdisciplinary Team? - Answer: ✦ Pulmonologist - to manage lung function
✦ Respiratory Therapist - for oxygen therapy
✦ Physical Therapist - to maintain muscle conditioning
✦ Occupational Therapist - for information and home suggesting for energy
conservation if endurance is affected
✦ Dietician - for caloric and protein needs
✦ Pastoral care/clergy - for those experiencing spiritual distress
✦ Social workers/homecare nurses - to arrange care needs at home
✦ Mental health professional - for coping support
,What are the important nursing implications to know when caring for patients
receiving enoxaparin (a low molecular weight (LMW) heparin)? - Answer: Low
molecular heparins (Enoxaparin) are often prescribed to prevent DVTs in clients
who are postoperative.
Nursing implications/teaching for patients receiving Enoxaparin:
- instruction re: self-admin
- prefilled syringes are avail in various dosages for subcutaneous injection. do not
expel the air bubble in the syringe. it's nitrous oxide and allows the client to
receive all the medication during the injection.
- for subcutaneous injections: when a prefilled syringe is not avail, use a 20- to 22-
guage needle to withdraw medication from the vial - then, change to a small
needle (25- or 26- gauge, 1/2 to 5/8 inches long). deep subcutaneous injections
should be administered in the abdomen, ensuring a distance of 2 in from the
umbilicus. do not aspirate.
- rotate sites - between left anterolateral & posterolateral abdominal walls at least
2 inches from umbilicus - pinch up an area of skin, inject at 90 degree angle, and
insert needle completely.
- do not rub the site for 1-2 min after the injection.
- avoid OTC medication unless prescribed - avoid the use of OTC NSAIDs, aspirin,
or medications containing salicylates.
- don't take enoxaparin w/: ginger, garlic, ginkgo, or feverfew. these supplements
may increase the risk of bleeding.
- monitor for indications of bleeding (bruising, gums bleeding, abdominal pain,
nose bleeds, coffee-ground emesis, tarry stools)
, - use an electric razor & soft toothbrush
- acceptable med for home use
- bloodwork monitoring of platelets is recommended
*in patients w/ renal impairment anti-Factor Xa levels may be used to monitor for
the anticoagulant effects*
Maintain tube patency (e.g. nasogastric tube for decompression, chest tubes) -
per IGGY for patients w/ NG tube, assess the following every 4 hours: - Answer: -
Assess Q4H -
✦ proper placement of tube (aspirate contents)
✦ tube patency (irrigate w/ 30 mL of NS)
✦ output (quality and quantity)
✦ nasal skin
✦ peristalsis (discontinue suction first)
✦ remember after esophageal surgery we ensure a patent NG for drainage but DO
NOT irrigate GT or reposition without provider order!
The nurse is teaching the client diagnosed with diverticulosis. Which of the
following instructions should the nurse include in the teaching session to help
prevent an exacerbation of this disorder? select all that apply.
a. Eat a high-fiber diet
b. Increase fluid intake
c. Elevate the HOB after eating
d. Walk 30 minutes per day
