NUR 2356 / NUR2356 Multidimensional
Care I Final exam Review / MDC I
Final Exam | Rated A Complete Guide
| Latest | Rasmussen
College
1. Psoriasis
- Silvery scales
- large patches of red, flaky skin
2. Nursing Process
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluate
3. Priorities ABC (ALWAYS ASSESSED FIRST)
- Airway
- Breathing
- Circulation
4. Maslow's Hierarchy of Needs
, - Physiological Needs (food, rest, water)
- Safety(security)
- Love/Belonging(intimate relationships, friends)
- Esteem(feeling of accomplishment)
- Self-Actualization(achieving one's full potential)
5. normal b/p
- 90/60 to 120/80
- Systolic: 90-120
- Diastolic: 60-80
6. Normal temperature
- 96.4F-99.5F
- Rectal is +1 to oral
- Axillae is -1 to oral
7. regular Pulse
- 60-100
8. Pulse Oximetry (SpO2)
- 95%-100%
9. respirations
- 12-20 per minutes
10. nurses can’t delegate?
, - Evaluation
- Assessment
- Teaching/Education
11. Fall Prevention in Homes:
- Remove items that could cause the client to trip(throw rugs and loose carpets)
- Place electrical cords and extension cords against a wall behind furniture
- Monitor gait and balance, and provide aids as needed
- Make sure that steps and sidewalks are in good repair
- Place grab bars near the toilet and in the tub or shower and install a stool riser
12. Fall Prevention in Hospitals
- Fall bracelets and yellow socks
- Bed alarm
- Remove clutter
- Keep items within reach (call light, personal items)
- Gait Belts
- "Call, don't fall"
o Orient them to the call light and educate them to use call light to get help
rather than getting up without assistance. Nurses should respond to call
light in a timely manner
- Put them in room close to nurses station
- Have good lighting (especially at night)
- BEDS:
- Put in low position
- Lock wheels
- Use side rails appropriately
, 13. Cast Care
- Handle with the palms of your hands
- Have patient report painful "hot spots" under the cast which might indicate area of
pressure necrosis
- Instruct the patient to never put anything down into the cast i.e. pencil.
- Don't get it wet
- Encourage the patient/family to smell the area for mustiness or unpleasant odor. If
ignored the patient may develop a fever
14. If the cast or patient is immobilized for a long period of time may suffer from
complications of
- immobility.
15. If patient's hand start to swell
- Elevate
16. After cast removal
- Remove dry skin carefully use lotion
- Expect decreased size and range of motion
- Support the extremity with pillows until strength returns
- Exercise slowly and according to rehabilitation instruction
- Wear support hose for lower extremity injury to prevent edema
17. Compartment Syndrome
- Most common in the tibia and forearm but has other causes
Care I Final exam Review / MDC I
Final Exam | Rated A Complete Guide
| Latest | Rasmussen
College
1. Psoriasis
- Silvery scales
- large patches of red, flaky skin
2. Nursing Process
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluate
3. Priorities ABC (ALWAYS ASSESSED FIRST)
- Airway
- Breathing
- Circulation
4. Maslow's Hierarchy of Needs
, - Physiological Needs (food, rest, water)
- Safety(security)
- Love/Belonging(intimate relationships, friends)
- Esteem(feeling of accomplishment)
- Self-Actualization(achieving one's full potential)
5. normal b/p
- 90/60 to 120/80
- Systolic: 90-120
- Diastolic: 60-80
6. Normal temperature
- 96.4F-99.5F
- Rectal is +1 to oral
- Axillae is -1 to oral
7. regular Pulse
- 60-100
8. Pulse Oximetry (SpO2)
- 95%-100%
9. respirations
- 12-20 per minutes
10. nurses can’t delegate?
, - Evaluation
- Assessment
- Teaching/Education
11. Fall Prevention in Homes:
- Remove items that could cause the client to trip(throw rugs and loose carpets)
- Place electrical cords and extension cords against a wall behind furniture
- Monitor gait and balance, and provide aids as needed
- Make sure that steps and sidewalks are in good repair
- Place grab bars near the toilet and in the tub or shower and install a stool riser
12. Fall Prevention in Hospitals
- Fall bracelets and yellow socks
- Bed alarm
- Remove clutter
- Keep items within reach (call light, personal items)
- Gait Belts
- "Call, don't fall"
o Orient them to the call light and educate them to use call light to get help
rather than getting up without assistance. Nurses should respond to call
light in a timely manner
- Put them in room close to nurses station
- Have good lighting (especially at night)
- BEDS:
- Put in low position
- Lock wheels
- Use side rails appropriately
, 13. Cast Care
- Handle with the palms of your hands
- Have patient report painful "hot spots" under the cast which might indicate area of
pressure necrosis
- Instruct the patient to never put anything down into the cast i.e. pencil.
- Don't get it wet
- Encourage the patient/family to smell the area for mustiness or unpleasant odor. If
ignored the patient may develop a fever
14. If the cast or patient is immobilized for a long period of time may suffer from
complications of
- immobility.
15. If patient's hand start to swell
- Elevate
16. After cast removal
- Remove dry skin carefully use lotion
- Expect decreased size and range of motion
- Support the extremity with pillows until strength returns
- Exercise slowly and according to rehabilitation instruction
- Wear support hose for lower extremity injury to prevent edema
17. Compartment Syndrome
- Most common in the tibia and forearm but has other causes
