QT4 Flashcards
What is necessary to implement a behavior modification plan successfully?
Confirm that all staff members understand and comply with the treatment plan
all staff members need to be included in program development, and time must be allowed for discussion of concerns from each nursing staff member; consistency and follow-through is important to prevent or diminish the level of manipulation by the staff or client during implementation of this program
preoperative medication given before a cesarean section compared to general surgery
- decreased so that less narcotic crosses the placental barrier, causing respiratory depression in the infant
- dosages of sedatives and hypnotics will be similar
How is consent for procedure obtained from divorced parents?
parent or legal guardian required to give informed consent prior to surgical procedure
Prochlorperazine maleate (Compazine)
antipsychotic for schizophrenia
Compazine should be considered incompatible in a syringe with all other medications
butorphanol (Stadol)
Pain medication
What is important teaching for a pt postgastrectomy surgery?
measures to prevent dumping syndrome,
- lying down for 30 minutes after meals,
- drinking fluids between meals (not with meal)
- reducing intake of carbohydrates
- avoid sugar, salt, milk, and highly spiced foods
- Avoid eating large meals that are high in simple sugars and liquids
- Eat small meals with no fluids
- Eat high-protein, high-fat, low-carb diet
What influences use of restraints for an agitated/aggressive patient?
- restraints/seclusion policies set forth by the institution
- patient’s competence (must get written permission from the patient for restraints; if patient has been judged incompetent, permission is obtained from the legal guardian)
- patient’s nursing care plan (must first try less restrictive means to control patient before using restraints)
**the need for restraints is based on patient’s behavioral status and condition, not the patient’s voluntary/involuntary status
What is in Oxycodone terephthalate (Percodan) that is contraindicated for persons with bleeding disorder?
aspirin
What are the s/e of terbutaline (Brethine)?
maternal side effects include:
- tachycardia,
- nervousness,
- tremors,
- headache, and
- possible pulmonary edema;
fetal side effects include tachycardia and hypoglycemia;
Brethine is usually preferred over ritodrine (Yutopar) because it has minimal effects on blood pressure
Transmission precautions for Hep A
Contact precautions
contact precautions required for diapered or incontinent clients
Need private room
Administration of haloperidol decanoate (Haldol D)
2 inch 21 gauge needle
Give deep IM in a large muscle mass
very irritating to subcutaneous tissue
What is drug of choice for PVCs?
lidocaine is the drug of choice for frequent premature ventricular contractions (PVC) occurring in excess of 6 to 10 per minute; for coupled PVCs or for a consecutive series of PVCs that may result in ventricular tachycardia
What is Isoproterenol (Isuprel) given for?
Lidocaine hydrochloride (Xylocaine) IV
lidocaine is the drug of choice for frequent premature ventricular contractions (PVC) occurring in excess of 6 to 10 per minute; for coupled PVCs or for a consecutive series of PVCs that may result in ventricular tachycardia
The nurse’s INITIAL priority when managing a physically assaultive client?
most important priority in the nursing management of an assaultive client is to maintain milieu safety by restoring the client’s self-control; a quick assessment of situation, psychological intervention, chemical intervention, and possibly physical control are important when managing the physically assaultive client
**Clearing the immediate area of other clients to prevent harm is not realistic if situation escalates quickly.
When a pt is experiencing EPS, what medication is given?
antiparkisonian drug
Biperiden (Akineton)
hypernaetremia
Sticky mucous membranes; decreased urinary output; and firm, rubbery tissues
restlessness, weakness, coma, tachycardia, flushed skin, oliguria, fever
Headache, apprehension, and lethargy
muscle twitching, convulsions, diarrhea, fingerprinting of skin
most effective way of deep breathing and coughing
“Take three deep breaths, hold your incision, and then cough.”
This dilates airway and expands lung surface area.
how many words can a 12mo speak?
3-5 in addition to mama and dada
at what age can infant pull self up?
8 months (and can say a few words)
gemfibrozil (Lopid)
lipid-lowering agent
used with patients with high serum triglyceride levels
side effects include: abdominal pain, cholelithiasis (gall stones)
take 30 minutes before breakfast and supper
check liver function before admin
ranitidine hydrochloride (Zantac)
Treats and prevents heartburn with acid indigestion. Also treats stomach ulcers, gastroesophageal reflux disease (GERD), and conditions that cause your stomach to make too much acid
best results when taking once a day, at night.
not affected by food.
side effect of haloperidol (Haldol)
includes galactorrhea (excessive or spontaneous flow of milk), lactation, gynecomastia (excessive growth of male mammary glands)
When should antiembolism stockings be worn?
the entire time that client is in the hospital; should be removed for baths and replaced after the skin is dry, and before the client gets out of bed
stockings should be worn during the day and when client is nonambulatory
Pts with multiple sclerosis (MS) have decreased perception of _________?
pain
Need less pain medications.
diet teaching for an older client with acute gout
should be on low-purine diet, should avoid red and organ meats, shellfish, oily fish with bones
How long does coumadin last in system?
duration of Coumadin 2 to 5 days, client at risk for a repeat CVA if not taken for 2 days because medication ran out
NANDA for right-sided hemiparesis
Alteration in communication related to decrease in thought processes
What cranial nerve is facial?
VII
positive response to fluoxetine HCl (Prozac)
This medicine is an SSRI that treats depression, obsessive-compulsive disorder (OCD), and other disorders.
fluoxetine HC (Prozac) is an “energizing” antidepressant; as client begins to demonstrate a positive response, he has an increased energy level, is able to participate more in milieu
Four reactions to blood transfusion and the S/S
(1) febrile reaction;
- symptoms include fever, chills, nausea, headache;
- treatment is to stop blood and administer aspirin
(2) hemolytic reaction; most dangerous type of transfusion reaction,
- symptoms include nausea, vomiting, pain in lower back, hematuria;
- treatment is to stop blood, obtain urine specimen, and maintain blood volume and renal perfusion
(3) allergic reaction;
- symptoms include urticaria, pruritus, fever;
- treatment is to stop blood, give Benadryl, and administer oxygen
(4) circulatory overload;
- neck vein distention
- treatment is to stop blood, position in an upright position, and administer oxygen
What may precipitate a mid–life crisis?
The client starts to measure life accomplishments against goals.
What type of pt is MOST at risk for developing herpes zoster?
clients with compromised immune system at risk for reactivation of the varicella zoster virus
myxedema
there is a slowing of all body functions, (b/c no metabolism?)
hypotenstion
bradycardia
hypothermia
hyponaetremia
hypoglycemia
generalized edema
respiratory failure
coma
post renal transplant and visitors
Remind family and friends that there is restricted visiting for at least 72 hours postoperatively.
esophageal speech following a total laryngectomy
The client swallows air and then eructates it while forming words with his mouth.
one of the first signs of an increase in the intracranial pressure in infants
High-pitched cry.
patient has become very hard of hearing may exhibit?
suspicious of strangers results from interference with communication
client has pulled out the nasogastric tube and is picking at the bed covers. The client’s BP is 150/90 and pulse is 90.
Indicates what?
decreased oxygen levels
Ewald tube is a large, orogastric tube designed for rapid lavage; insertion often causes gagging and vomiting, suction equipment must be immediately available to reduce the risk of aspiration
Have suction equipment at bedside.
what happens to blood glucose during illness?
increases, so insulin should still be given though not eating
signs of narcotic withdrawal
very much like the symptoms of the flu
Runny nose, yawning, fever, muscle and joint pain, diarrhea
signs of barbiturate withdrawal
Nausea and vomiting, tachycardia, coarse tremors, seizures
signs of amphetamine withdrawal
Depression, disturbed sleep, restlessness, disorientation
sign of cocaine withdrawal
Severe cravings, depression, fatigue, hypersomnia
MOST important initial goal for the pt dx of rape trauma syndrome, acute phase?
nurse’s initial priority to encourage client to begin dealing with what happened by verbalizing her feelings and gaining some acceptance and
