Soap Notes: Asthma dx age 2.5 yrs old, Diabetes dx at 24yrs old,Denies surgical history, last hospital admission at 16 yrs old for asthma exacerbation. Reports all Immunization are current at this visit, Last Flu vaccine: declines at this time Last Tetanus booster: last year
Parents are nervous about how their 3-year-old will act when newborn arrives. What can they do = Provide gift from the infant to the
sibling
Methylprednisolone sodium succinate lab to watch for? Serum glucose (because glucocorticoids cause hyperglycemia)
At 14 weeks' gestation, what should the patient report to the MD = Swelling of the face (sign of preeclampsia)
A patient is 14 weeks pregnant, where do you check to find the FHR = below the pubs symphysis area.
Change of shift report should include = The blood lost
Patient teaching for colostomy care = patient doesn't need to change the bag every day (only needs to be changed every 4-7 days)
Scoliosis manifestation = Lateral curvature of the spin & asymmetrical hips/ribs
Lab values that are elevated for Cushing's disease = ↑ Cortisol, ↑sodium, ↑ glucose
Cushing disease Sx: Moon face
Administering medications through an NG tube =
* Administer meds separately
* DO NOT mix with enteral feedings
* Dissolve crushed tablets in 15-30mL of water
* Flush tubing before & after each medication with 10-30mL of water
Tobramycin adverse reaction = Ototoxicity (hearing damage & loss of balance) & Cloudy/bloody urine (nephrotoxicity
Anorexia expected finding = pre-albumin 10 (normal is 3.5-5)
Amniocentesis patient teaching = empty bladder before the procedure (S/E: can cause contractions)
Expected finding during cardiac catheterization = Patient will feel warmth and flushed when dye is inserted
Retinoblastoma = white eye reflex
What action should you instruct the patient to do prior to postural drainage? Administer a bronchodilator or nebulizer prior to
treatment, postural drainage should be done 1 hour before meals or two hours after meals (perform twice daily)
IV phlebitis =Discontinue IV & apply a warm/moist compress
, 2
IV is infiltrated = Discontinue IV & apply a cool compress
Female is to undergo an NST = Doppler transducer placed around abdomen
When a patient is receiving mannitol, what should the nurse monitor for = Hypovolemia
Co-worker is impaired, what do you do = Report it to the charge nurse
Fine hair is a result of this disease = HYPERthyroidism
How do you draw blood out of a PICC line = Draw 10mL of blood and discard it, then draw another 10mL of blood for sample, and
then flush with 10mL of 0.9% sodium chloride
Crohn’s disease = LOW fiber diet
latex allergy if they have a sensitivity to what food = Bananas
Buddhist patient = vegetarians
Food Label = greatest weight is listed first.
Child with positional plagiocephaly = Child will wear a molded helmet for 23 hours a day
Pregnant women should eat more of what to prevent neural defects = Folate/folic acid
A caregiver states they are becoming tired when caring for their parent with Alzheimer's disease, what can the nurse suggest =
Respite care (care to give caregivers a break)
Cleft palate teaching for feeding = don’t use a spoon, Position infant upright while cradling head & burp them frequently
A wound that would heal by primary intention = A surgical incision
Sign of glaucoma is loss of = Peripheral vision loss
Baby w/reflux = small frequent meals, thicken formula with rice cereal, HOB 30
Radiation implant precautions =
* Private room with radiation sign
* Wear dosimeter film badge
* Limit visitors to 30 min and to remain 6ft away from the patient
* Keep lead container in room and tongs
* No pregnant ladies or anyone under the age of 16 should come into contact with the patient
Discharge teaching for a patient who is going home with HIV/AIDS =
* Good hygiene & frequent hand washing
* Avoid crowds
* Avoid cleaning litter boxes
* Avoid raw foods such as veggies or meats
Adolescent nutrition = 1300mg of calcium
Priority nursing care for a patient who has been sexually assaulted = Assess their anxiety
Identifying a need for hearing evaluation =
* Absence of talking by 7 months
* Uses gestures rather than talking by 15 months
* Speaks in monotone
* Speaks loudly for the situation
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