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UWorld Nclex General Critical Thinking and Rationales/NCLEX RN MED SURG GUIDE - UWorld Nclex General Critical Thinking and Rationales$17.49
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uworld nclex general critical thinking and rationales
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Suny Orange County Community College
NCLEX RN MED SURG
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lOMoARcPSD|8981423
lOMoARcPSD|8981423
UWorld Nclex General
Critical Thinking and
Rationales
, lOMoARcPSD|8981423
Injury Patterns in Nonaccidental Trauma Signs of Abuse:
- long bone fractures in humerus or femur - Shaken baby syndrome
- linear type immersion burns - Burns in the shape of household items
- frenulum tears & gingival lesions - Repeated injuries in varied stages of healing
- subdural & epidural hematomas - lapsed time between injury and time when care is sought
- retinal hemorrhage on funduscopic exam - Inconsistency between injury & caregiver’s explanation
Room Assignments
When preparing room assignments, the nurse should not place a client who has a fresh surgical wound or is
immunocompromised in a room with a client who has an active or suspected infection.
Suicide
Clients who articulate long-term personal goals and family milestones are less likely to commit suicide.
Bone Healing
Bone healing depends on multiple factors, including nutrition, adequate circulation, and age. A client with
peripheral arterial disease has decreased perfusion to the extremities due to atherosclerotic changes in the
arteries. Without adequate perfusion, the bone is not supplied with the oxygen and nutrients required for
healing.
Pressure Injuries
• Stage 1: Intact skin with nonblanchable redness
• Stage 2: Partial-thickness skin loss (abrasion, blister, or shallow crater) involving the dermis
or epidermis; the wound bed is red or pink and may be shiny or dry
• Stage 3: Full-thickness skin loss; subcutaneous fat is visible but not tendon, muscle, or bone; tunneling
may be present
• Stage 4: Full-thickness skin loss with visible tendon, muscle, or bone; slough or eschar (scabbing, dead
tissue) may be present; undermining and tunneling may be present
• Pressure injuries are described as "unstageable" if the base is covered by necrotic tissue or eschar
Drawing Insulin
NPH insulin and regular insulin may be safely mixed and administered as a single injection. Regular insulin
should be drawn into the syringe before intermediate-acting insulin to avoid cross-contaminating multidose
vials (mnemonic – RN: Regular before NPH)
1. Inject 25 units of air into the NPH insulin vial without inverting the vial or passing the needle into
the solution.
2. Inject 12 units of air into the regular insulin vial and withdraw the dose, leaving no air bubbles.
3. Draw 25 units of NPH insulin, totaling 37 units in one syringe. Any overdraw of NPH into the syringe
will necessitate wasting the entire quantity.
Transplant
During a heart transplant, the donor heart is cut off from the autonomic nervous system (denervated), which
alters the heart rate during rest and exercise after the transplant. The transplanted heart is expected to be
tachycardic (eg, 90-110/min).
, lOMoARcPSD|8981423
Cardiac
Percutaneous coronary intervention via the femoral approach places the client at increased risk for
retroperitoneal hemorrhage, which is exacerbated by anticoagulants. Back pain, hypotension, flank ecchymosis
(Grey-Turner sign), hematoma formation, and diminished distal pulses can be early signs of bleeding into the
retroperitoneal space and require immediate intervention.
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