Comp exam #1

Term
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Battery
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Terms in this set (66)
Battery
physical harm
Assault
verbal threat
Defamation
demeaning someone's character
Slander
spoken defamation
libel
written defamation
Urgent
Open fracture level
Non-urgent
closed fracture level
Emergent
elephant on chest, sweaty, pain level
Hospice
less than 6 months to live. no treatment
palliative care
Comfortable and out of pain, No time limit
Sickle cell crisiso Fever, pain, signs of infection, dehydration, chills, don't live in low O2 states o Red blood cells are sickling/clumping; Vaso-occlusive crisis which causes painLPNDelegation- who? § Stable patients § Cannot assess patient right out of surgery (initial assessment/change of status)PCT- patient care techDelegation- who? § Can't take pt to bathroom on first time out of bed (need the initial assessment)Public health departmentReporting to who? o STIs o Highly contagious/Rare- anthrax, botulism o covidglomerulonephritis· Signs and symptoms of what? o Caused by strep o High BP, generalized edema, s/s of fluid overloadKidney transplanto Main concern is rejection § s/s- pain over the site, feverSubjective/objective data (as evidenced by)Developing plan of care- what is importantIncident reportWhat do you do for this? o Med errors o Patient has injury o Patient harm or patient propertydate and timeCorrect documentationinfectious/contagiouso Which patient do you remove from an outpatient clinica? Anyone that is showing ? symptomsRestraintso Try distraction first, least invasive, music, TV o Make sure they are safe- check circulation and make sure your fingers can fit under o Make sure they are retied correctlyCircumcision/belly cord careo Wash with warm water o Don't put diaper over belly button o Cord take 7-10 days to fall off o Circumcision- wash with warm water o No Vaseline if vastabell?Lung soundso Adult- vesicular breath sounds heard over most lung fields Newborn baby- Bronchial sounds over the trachea6 monthsInfant skills o Baby sits with support2-3 monthsInfant skills- smiling4-5 monthsInfant skills- grab stuff20· blood transfusions o ?G IVtransfusion reactionso fever o back/flank pain, fever, restlessness o stop, run normal saline, sent a tube of blood and bag to lab and call the doctor o start infusion within 30 minutes of getting it o return the bag if there are cryoprecipitate in it o secondary check with another nurse stay with the patient for 15 minutes from when the blood hits the veinRhogamo Mother gets the shot o Antibodies can form that could potentially attack the fetus or future pregnanciesvictimo Characteristics of ? § Powerless, helplessness, takes blame, dependent, needs someone to validate themselvesabusero Characteristics of ? § Narcissist, impaired self esteemstay with patientAbused patient comes in. what do you do?suicideDanger in terms of ? o Giving away stuff, writing out a living will, act like they are getting better (eps after starting an anti-depressant) § Do they have a plan, do they have a way to carry it out, have they done it in the past, do they live aloneManicFlight of ideas, sexually active, wreck-less, spending a lot of moneyDepressionDecreased activity, lethargy, social isolation, weight lossStrokeFAST- facial droop, arms (stick out palms up), slurred speech, timeExpressive aphasiaknow what you are saying but can't respond/express; with strokeReceptive aphasiathey can't understand what you are saying; with strokeAnti-embolism stockingso Measure- circumference of calf, widest part of the calf o Don't fold down if too long o Lack of circulation, pain in the toes o Leave off 3-4 hours a day or at bedtimeskin breakdownthese help with ? with incontinence -Turn every 2 hours, barrier cream, keep them dry, don't keep them in diapersTransurethral resection of the prostate (TURP)o Expect- § 3 way foley with continuous bladder irrigation (CBI) § pink tinged urine o output stops- clotting § irrigate the foley manually o no fluid restrictionSeizure medicationsside effects- nose bleeds, bleeding gums, low platelet count and WBC count, sleepy, take with food to decrease GI upsetHypoglycemiaGive simple sugar now give amp of D50 (one time shot)Digoxino Heart failure o Increase contractions o Check HR, watch potassium o S/S of toxicity- GI disturbances, visual disturbances § Patient exhibits these things- take vital signsPenicillin drugsAvoid cephalosporin'sHeparino APTT o Therapeutic range 60-80 o Heparin + warfarin = Bridge therapy § Trying to get person off heparin, stop heparin when they are in therapeutic range for warfarin -> INR · INR should be 2-3 o Don't have monitor APTT with lovenoxHypovolemiao S/S- tachycardia (trying to get more fluid through the body bc cardiac output has dropped)Ace inhibitorso Block angiotensin converting enzyme from 1-2 § Angiotensin 2 is vasoconstrictor § Aldosterone- conserves salt, naturally makes you retain sodium and water, excrete potassium o Inhibit aldosterone release § Release sodium and water which causes BP decrease § Hold onto potassium o Hyperkalemia- read abovenaloxoneoverdose: Morphineflucanoziloverdose: BenzoDiabetes/Insulino 15g of simple sugar, check sugar again in 15 minutes, if still low, give 15g more of simple sure and if that doesn't work give amp of D50 o preventative foot care, check feet all the time o Exercise- decreases the BG level § Check blood sugar before you, during and after exercise and keep a simple sugar on you o Don't massage site after giving, Rotate the sites o Can stay at room temp for 28 daysdiabetic neuropathyelevate glucose damages the nerves so they don't feel stuffHypoglycemiao Cold and clammy, eat some candy o Lethargy, headache, sweaty o Beta-blockers reduce the HR, can mask signs of ?External radiation§ patient does not omit radiation · Can hold your baby · Avoid sun in the area where you are getting radiationinternal radiation§ can omit radiation, radioactive · IV chemoThrombocytopeniao platelets Bleeding precautions, use electric razorNeutropeniao neutrophils § High risk for infection § Avoid large crowds, no fresh fruits or flowers, wear a mask, wash your handsPeritoneal dialysiso Biggest risk- infection, peritonitis (s/s- cloudy output) § Brown output- bowel perforation § Urine color- bladder perforation § Red output- vascular compromise o Normal output is clearBurnso First things we want to do § Airway, fluid resuscitation § Find out what kind of burn it is (fluid, chemical, electrical) · Fire- airway, lungs o Monitor fluid resuscitation efforts § Output § Need a foleyFHR monitoringo Cord compression- variable o Late deceleration- placental problems o Early deceleration- head compressionNon-maleficenceno harm to the patientFidelitydoing what you sayVeracitytelling the truthJusticetreating everybody equallyBeneficencedoing good, benefits the patientadvanced directiveCan witness a consent but not an ?