week 1 Flashcards
7 Tasks of a person with a chronic illness
- preventing and managing crisis
- carrying out prescribed tx regimen
- controlling symptoms
- reordering time
- adjusting to changes in the course of the disease
- preventing isolation
- attempting to normalize interactions with others
ADL
bathing
dressing
eating
IADL
shopping
paying bills
housework
meal prep
SCALES
assesses risk factors for poor nutrition
Sadness or mood change
Cholesterol high
Albumin low
Loss or gain of weight
Eating problems (swallowing, poor dentition)
Shopping or food preparation problems
Types of elder mistreatments in an institution
- failure to follow plan of care
- use of physical or chemical restraints
- over or under medicating
- punishment by isolation
Main goals in nursing for chronic care
identify strengths and abilities
include caregivers
Priority goals: gain a sense of control, feel safe, reduce stress
overall: functional independence and improve quality of life
How to manage anemia from blood loss
management in blood transfusion
How is anemia diagnosed
CBC
reticulocyte count
peripheral blood smear
What to eat to help anemia
red meat
grains
greens (folic acid)
stool in anemia
black stool is a late sign so test stool even if it looks normal to test for GI bleed
Iron administration
PO or parenteral
all iron have special instructions for administration
Albumin administration
FFP
good for third spacing because it collects fluid
FFP has no platelets but used to control bleeding
Febrile in transfusions (Allergic Febrile Hemolytic)
leukocyte incompatibility
give acetaminophen or diphenhydramine 30 min. prior to prevent reaction
occurs in the first 10-15 minutes or first 50 mL
Transfusion reactions
reaction to plasma proteins:
antihistamines can be used
epinephrine or corticosteroids can be used to treat
circulatory overload: people with cardiac or renal disorders are at risk. GIve it slow and give lasix
sepsis
TRALI (transfusion-reaction acute lung injury)
sudden dev. of non cardiogenic pulmonary edema
usually 2-6 hrs after transfusion begins but can occur 72 hrs after
*** leader in transfusion-related deaths
Delayed Transfusion reactions
delayed hemolytic reaction
- infections such as: HIV, cytomegalovirus, human t-cell leukemia type 1, EBV, malaria
- iron overload
- hep B or hep C
Assessment signs of bleeding
weakness
malaise
fever
petechiae
pallor
purpura
tachycardia
hypotension
tachypnea
hemoptysis
orthopnea
bloody stools
hematuria
vision changes
headache
change in mental status
bone/ joint pain
DIC signs of thrombotic
cyanosis
ischemic tissue necrosis
tachypnea
pulmonary embolus
paralytic ileus
kidney damage
DIC lab findings
- low platelet and fibrinogen
- prolonged clotting times by all measures (PT, PTT, TT)
- elevated fibrin split products (fibrin degradation products)
- D-dimer elevated -tells us if there’s a high breakdown of fibrin-
Care for DIC
supplement with oxygen
resolve underlying cause
- if bleeding, support with necessary blood products; cryo, fibrinogen, factor 7, platelets, and FFP
- manifestation of thrombosis- administer heparin and low-molecular-weight heparin BUT NOT GIVEN if platelet < 30,000
