Hot Topics Recording
First exam
Second exam
Third Exam
● Rules of delegation
● LPN: give them patients who have the most straight forward patho/stable and least complicated surgical
patients (stable post op patients)
● UAP: tasks (right task, right person, right circumstance (they can not feed a patient who is post stroke with
dysphagia), they can empt drains, I&O, VS after RN gets first set (post op liver biopsy has increased risk for
bleeding UAP can get VS after RN get first set)
● Treat a floated RN as an LPN (no first assessments, stable patients, no admission/discharge teaching) (post
op appy patient is the most stable patient with expected outcome)
● Which client questions
● If you’re doing something for someone FIRST you are looking for the LEAST stable patient
● When you are looking for which client to send home you want the MOST stable patient
● Three As for priority
● ABC (Airway/breathing)
● Acute vs chronic (acute is more unstable)
● Actual vs potential issues
● Therapeutic responses: Three Fs
● Feeling/tone presented in the stem (read the room)
● Focus doesn’t need to be on you as the nurse “I think” “I feel”, it needs to be on the patient/person
● Facts
● DABDA (Grief and loss process)
● Denial
● Anger
● Bargaining
● Depression
● Acceptance
● Ethical dilemma (Management of care slides)
● Autonomy: patients right to self determination. *Jehovah's witness not getting blood products*
● Justice: treat all peoples equally
● Veracity: to tell the truth
● Benefalience: duty to “do good”
● Fidelity: remain truthful
● Negligence vs malpractice (you can be negligent without malpractice but you can’t have malpractice without
negligence)
● Negligence: practice falls below the standard of care, and injury could occur
● Malpractice: practice falls below the standard of care and injury did occur
● Assault vs Battery
● Assault: threatening someone
● Battery: actually hitting a patient
● False imprisonment = restraint
● Clients rights:
● Right to refuse treatment/meds
● Right to their records
● Right to privacy
● Right to help with billing and claims
● Right to autonomy: make decisions and be involved with their own care
● ABG values
● PH 7.35-7.45
● Paco2 35-45
● HCO3 22-28 (Acid/base reversed)
● Comp: PH normal
● Uncomp: all 3 are abnormal
● Partial Comp: Ph + one other is abnormal
, ● ROME: Respiratory opposite, metabolic equal
A. Health Promotion and Maintenance
-Immunizations
● Nurse needs to question a polio and DTAP vaccine in older adult
●Flu vaccine contraindications: immunocompromised (low WBC 5-10), under 6M
●Newborn/infant immunization schedule:
● Birth = Hep B
● 2M = B DR HIP = Hep B, DTAP ,RV, Hib, Ipv (inactive polio), Pcv (PNA)
● 4M = DR HIP = DTAP, RV, HIB, Ipv, Pcv
● 6M = B DR HIP = Hep B, DTAP, RV, Hib, Ipv, Pcv, + start annual flu vaccine
● Vital Signs across the lifespan (galen lab sheet)
● FHR: 110-160
● Newborn: HR 110-170, BP 60-85/40-55, RR 30-60, axillary 97.6-99.3
● Infant: HR 90-160, 65-100/55-65, RR 30-53
● Toddler: HR 80-140, 90-105/55-70, RR 22-37
● Preschooler: HR 75-120, 95-110/60-75, RR 20-28
● School age: HR 70-100, 100-120/60-75, RR 18-25 Follow up if 6 yr old has HR 130 while snacking
● Adolescents: HR 60-100, 110-125/65-85, RR 12-20
● Adults: HR 60-100, <120/80, RR 12-20
● Temp infant-Adult: axillary 97.6-99.5
● Growth and Development
● 1-2 M: Posterior fontanelle closes
●2M : social smile
●6M : Sits up without support, rolls from back to front, birth weight doubles, holds bottle
●8M : Pincer grasp
●14M: Walks alone without support
●24M : 300 words
●3 yr: 900 words
●Follow up if birth weight triples by 6 months
●Follow up if 17M can’t hold a cup
●Follow up if they can’t walk alone by 24 M
● Follow up if 6M old can’t drop things at will
● Appropriate toys for 5 year old: coloring book and dolls
● Diet examples:
● High Fiber: lentils, apples, pears, almond, Brussels sprouts, avocados
● Low fiber: milk cheese, yogurt, fish, eggs, meat
● Low cholesterol: avoid egg yolks
● High potassium: Potatoes, oranges, tomatoes, avocados, strawberries, spinach, fish, mushroom, mush melon
(cantaloupe)
● Low sodium: salmon, broccoli
● Primary, secondary, tertiary
● Primary (prevention): stress management
● Secondary (screening): breast exams, colonoscopy (start at 45 years old every 10 years), self testicular exams
(in/after shower with warm soapy hands), mammograms (begins at 40 years old)
● Tertiary (teaching): diabetic foot care
● Normal Aging Process:
● Decreased muscle tone
● Decreased HR
● Thinning Skin (place towel between tourniquet and patient)
● Decreased peristalsis
● Decreased body temp
● Cancer risks
● Breast cancer: smoking, family hx, early period/late menopause
● Cervical: HPV, smoking, multiple sexual partners
● Colorectal: UC, Crohns, genetics, smoking
First exam
Second exam
Third Exam
● Rules of delegation
● LPN: give them patients who have the most straight forward patho/stable and least complicated surgical
patients (stable post op patients)
● UAP: tasks (right task, right person, right circumstance (they can not feed a patient who is post stroke with
dysphagia), they can empt drains, I&O, VS after RN gets first set (post op liver biopsy has increased risk for
bleeding UAP can get VS after RN get first set)
● Treat a floated RN as an LPN (no first assessments, stable patients, no admission/discharge teaching) (post
op appy patient is the most stable patient with expected outcome)
● Which client questions
● If you’re doing something for someone FIRST you are looking for the LEAST stable patient
● When you are looking for which client to send home you want the MOST stable patient
● Three As for priority
● ABC (Airway/breathing)
● Acute vs chronic (acute is more unstable)
● Actual vs potential issues
● Therapeutic responses: Three Fs
● Feeling/tone presented in the stem (read the room)
● Focus doesn’t need to be on you as the nurse “I think” “I feel”, it needs to be on the patient/person
● Facts
● DABDA (Grief and loss process)
● Denial
● Anger
● Bargaining
● Depression
● Acceptance
● Ethical dilemma (Management of care slides)
● Autonomy: patients right to self determination. *Jehovah's witness not getting blood products*
● Justice: treat all peoples equally
● Veracity: to tell the truth
● Benefalience: duty to “do good”
● Fidelity: remain truthful
● Negligence vs malpractice (you can be negligent without malpractice but you can’t have malpractice without
negligence)
● Negligence: practice falls below the standard of care, and injury could occur
● Malpractice: practice falls below the standard of care and injury did occur
● Assault vs Battery
● Assault: threatening someone
● Battery: actually hitting a patient
● False imprisonment = restraint
● Clients rights:
● Right to refuse treatment/meds
● Right to their records
● Right to privacy
● Right to help with billing and claims
● Right to autonomy: make decisions and be involved with their own care
● ABG values
● PH 7.35-7.45
● Paco2 35-45
● HCO3 22-28 (Acid/base reversed)
● Comp: PH normal
● Uncomp: all 3 are abnormal
● Partial Comp: Ph + one other is abnormal
, ● ROME: Respiratory opposite, metabolic equal
A. Health Promotion and Maintenance
-Immunizations
● Nurse needs to question a polio and DTAP vaccine in older adult
●Flu vaccine contraindications: immunocompromised (low WBC 5-10), under 6M
●Newborn/infant immunization schedule:
● Birth = Hep B
● 2M = B DR HIP = Hep B, DTAP ,RV, Hib, Ipv (inactive polio), Pcv (PNA)
● 4M = DR HIP = DTAP, RV, HIB, Ipv, Pcv
● 6M = B DR HIP = Hep B, DTAP, RV, Hib, Ipv, Pcv, + start annual flu vaccine
● Vital Signs across the lifespan (galen lab sheet)
● FHR: 110-160
● Newborn: HR 110-170, BP 60-85/40-55, RR 30-60, axillary 97.6-99.3
● Infant: HR 90-160, 65-100/55-65, RR 30-53
● Toddler: HR 80-140, 90-105/55-70, RR 22-37
● Preschooler: HR 75-120, 95-110/60-75, RR 20-28
● School age: HR 70-100, 100-120/60-75, RR 18-25 Follow up if 6 yr old has HR 130 while snacking
● Adolescents: HR 60-100, 110-125/65-85, RR 12-20
● Adults: HR 60-100, <120/80, RR 12-20
● Temp infant-Adult: axillary 97.6-99.5
● Growth and Development
● 1-2 M: Posterior fontanelle closes
●2M : social smile
●6M : Sits up without support, rolls from back to front, birth weight doubles, holds bottle
●8M : Pincer grasp
●14M: Walks alone without support
●24M : 300 words
●3 yr: 900 words
●Follow up if birth weight triples by 6 months
●Follow up if 17M can’t hold a cup
●Follow up if they can’t walk alone by 24 M
● Follow up if 6M old can’t drop things at will
● Appropriate toys for 5 year old: coloring book and dolls
● Diet examples:
● High Fiber: lentils, apples, pears, almond, Brussels sprouts, avocados
● Low fiber: milk cheese, yogurt, fish, eggs, meat
● Low cholesterol: avoid egg yolks
● High potassium: Potatoes, oranges, tomatoes, avocados, strawberries, spinach, fish, mushroom, mush melon
(cantaloupe)
● Low sodium: salmon, broccoli
● Primary, secondary, tertiary
● Primary (prevention): stress management
● Secondary (screening): breast exams, colonoscopy (start at 45 years old every 10 years), self testicular exams
(in/after shower with warm soapy hands), mammograms (begins at 40 years old)
● Tertiary (teaching): diabetic foot care
● Normal Aging Process:
● Decreased muscle tone
● Decreased HR
● Thinning Skin (place towel between tourniquet and patient)
● Decreased peristalsis
● Decreased body temp
● Cancer risks
● Breast cancer: smoking, family hx, early period/late menopause
● Cervical: HPV, smoking, multiple sexual partners
● Colorectal: UC, Crohns, genetics, smoking
