Fundamentals ATI RN 2019, Over 300 Questions And Correct Answers With Verified Solutions 100%
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Fundamentals ATI RN
Institution
Fundamentals ATI RN
Fundamentals ATI RN 2019, Over 300 Questions And Correct Answers With Verified Solutions 100%
Telephone orders: best practice
-have a second RN listen in
-repeat the prescription back
-make sure the provider signs the prescription within 24 hr
Information Security
-HIPPA: ensures confidenti...
Fundamentals ATI RN 2019, Over 300
Questions And Correct Answers With Verified
Solutions 100%
Telephone orders: best practice
-have a second RN listen in
-repeat the prescription back
-make sure the provider signs the prescription within 24 hr
Information Security
-HIPPA: ensures confidentiality of health info
-Only those responsible for patient's care may access the medical record.
-Do not use patient names on display boards
-communication about the pt should happen in a private place or at the nurse's station
-password protect electronic records. Do not share passwords.
-Do not share pt information with unauthorized people.
code system can be used.
living will
communicates patient's wishes regarding medical treatment if patient becomes
incapacitated.
DPOA
durable power of attorney
patient designates health care proxy to make medical decisions for them if they become
incapacitated.
Provider's orders
Prescription for DNR and/or AND
Mandatory reporting for RN
-suspicion of abuse (child, elderly, domestic violence)
-communicable diseases to local/state health department (mandated by state)
informed consent: Provider responsibility
-communicate purpose of procedure, and complete description of procedure in the
patient's primary language (use medical interpreter if needed)
-explain risks vs. benefits
-describe other options to treat the condition
informed consent: RN responsibility
-ensure the provider gave the pt the above information
-ensure pt is competent to give informed consent (adult, emancipated minor, not
impaired)
-have patient sign consent document
-notify provider if pt has more questions or doesn't understand any information provided.
nonspecific immunity
defense mechanisms (barriers) in the body that respond immediately to all antigens.
Barriers include: skin, stomach acid, mucus, inflammatory response, phagocytic cells.
specific adaptive immunity
,body produces antibodies in response to a specific antigen through action of B and T
lymphocytes. Requires more time, but the immune response against that antigen in the
future is more efficient.
incubation
time from when the pathogen enters the body until the first symptom appears.
prodromal stage
time from the onset of general symptoms (malaise, fatigue) to specific symptoms.
illness stage
time when specific symptoms occur
convalescence
time from when symptoms disappear to complete recovery (can take months)
primary prevention
prevents initial occurrence of disease
ex: education, immunizations, prenatal classes
secondary prevention
focuses on early detection of disease, limiting severity of disease.
ex: screenings, control of outbreaks
tertiary prevention
maximize recovery after injury /illness
ex: rehab, PT/OT, support groups
active natural immunity
body produces antibodies in response to exposure to live pathogen
active artificial immunity
body produces antibodies in response to vaccine
passive natural immunity
antibodies are passed from the mom to her baby through the placenta or breast milk
passive artificial immunity
immunoglobulins are administered to an individual after they have been exposed to a
pathogen
ABCDE Principle
A (airway): ensure pt airway. Stabilize cervical spine if neck/head trauma is suspected
B (breathing): assess for respirations
C (circulation): check heart rate, blood pressure, and capillary refill
D (disability): assess the patient's level of consciousness
E (exposure): assess the patient's body for trauma, exposure to heat/cold
Using an interpreter
-DO NOT use patient's family or friends
-use certified medical interpreter
-explain purpose of meeting to interpreter prior to approaching the patient
-direct questions at family, not interpreter
-use layman's terms (NOT medical jargon)
-DO NOT supplement words with gestures or nonverbal reinforcement
nursing care: Hearing loss
-face the pt and avoid covering your mouth
-speak slowly and clearly; use brief sentences
-try lowering vocal pitch
,-do not shout
-use sign-language interpreter, or write down communication
nursing care: aphasia
-speak clearly and slowly, using short sentences
-make sure only one person speaks at a time
-give patient plenty of time to respond
-tell patients if you do not understand them
preventing pressure injuries and skin damage
-turn patient Q2
-limit chair/wheelchair sitting to one hour, advise pt to shift weight every 15 minutes, use
pressure-relieving device
-ensure proper hydration and nutrition (especially protein)
-keep HOB <=30 degrees. rise heels off of bed.
-lift (vs pull) patients up in bed
-DO NOT massage bony prominences
DO NOT use powder or cornstarch
Components of pain assessment
-location of pain
-quality (how it feels: burning)
-intensity (pain scale from 0-10)
-timing (onset, duration, frequency)
-setting ( how it affects patient's ADLs)
-associated symptoms (nausea, fatigue)
-aggravating/ relieving factors (what makes it better or worse)
Wound Healing: Primary Intention
wound edges approximated (sutures/staples). Heals quickly, minimal scarring
Wound Healing: Secondary Intention
wound edges widely separated. Longer healing time, scarring, increased infection risk.
Wound Healing: Tertiary Intention
wound left open to address infection and then close at a later time
Factors that delay wound healing
old age, decreased immune function, impaired nutrition (especially protein!), decreased
perfusion, smoking
Denture Care
-remove upper dentures by pulling down and out
-remove lower dentures by pulling up and out
-brush w/ toothbrush and denture cleaner
- store in cup (labeled) with water to keep moist
oral hygiene for unconscious patients
-have suction available
-do not put fingers in patients mouth
-position patient on side, with head turned towards you. allows
oral secretions to drain out, and prevents aspiration
nursing care for a patient with dysphagia
-place patient in Fowler's or high-fowlers position
-give one med at a time
, -lightly stroke chin/throat to promote swallowing
-thicken thin liquids
-check for food pockets in mouth before feeding
-encourage pt to tuck their chin when swallowing
-monitor pt during meals, have suction set up
-avoid straws
key conversions for dosage calculations
1mg = 1,000 mcg
1 g = 1,000 mg
1 oz = 30 ml
1 tsp = 5 ml
1 tbsp= 15 ml
1 tbsp = 3 tsp
1 kg = 2.2 kg
1 gr = 60 mg
Tracheostomy care
-give oral care every 2 hours, tracheostomy care every every 8 hours
-suction tracheostomy PRN (not routinely)
-apply oxygen loosely if patient's spo2 decreases during procedure
-use split gauze dressing under tracheostomy plate ( do not cut gauze)
-replace trach ties as needed. secure new ties before removing soiled ones
home care: cleanse w/ NS using medical asepsis, cover tract when outside
pulses
normal range for adults: 60-100 (120-160 bpm for infants)
rhythm: regular/irregular
equality: right vs. left side pulses
strength:
0 (absent)
1 + (diminishes)
2 + (normal)
3 + (strong)
4 + (bounding)
Tachycardia
heart rate greater than 100 bpm
causes:
fever, exercise, meds, pain, stress, hypovolemia, hyperthyroidism
Bradycardia
heart rate less than 60 bpm
causes:
meds, athletes, hypothyroidism, hypothermia
changes in older adults
eyes: decreased vision, yellowing of lens, issues w/ glare and darkness
ears: hearing loss, thickening of tympanic membrane
mouth: decreased sense of taste, gum disease, tooth loss, decreased salivation, pale
gums
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