ATI DOSAGE CALCULATION PN ADULT MEDICAL
SURGICAL PROCTORED ASSESSMENT 3.1 LATEST
COMPLETE 200+ QUESTIONS AND CORRECT
DETAILED ANSWERS ALREADY GRADED A+
Seizures and Epilepsy: Seizure precautions - ANSWER- During a seizure: Position client on the floor and provide a patent airway, turn client to side and loosen restrictive clothing
Cancer treatment options: Protective Isolation (999) - ANSWER- If WBC drops below 1,000, place the client in a private room and initiate neutropenic precautions. - Have client remain in his room unless be needs to leave for a diagnostic procedure, in case of transport place a mask on him
- Protect from possible sources of infection (plants, change water in equipment daily) - Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors - Avoid invasive procedures (rectal temps, injections)
- Administer (neupogen, neulasta) to stimulate WBC production
Infection control: Appropriate room assignment - ANSWER- Standard Precautions:
1. applies to all patients
2. Hand washing
a. alcohol based preferred unless hands visually soiled
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or spraying of body fluids
Droplet:
1. private room or with someone with same illness
2. masks
Airborne:
1. private room
2. masks or respiratory protection devices
a. use an N95 respirator for tuberculosis
3. Negative pressure airflow
4. full face protection if splashing or spraying is possible
Contact:
1. private room or room with same illness
2. gloves & gowns
3. disposal of infections dressing materials into a single, nonporous bag without touching the outside of the bag
TB: Priority action for a client in the emergency department (249) - ANSWER- -Wear an N95 or HEPA respirator -Place client in negative airflow room and implement airborne precautions -use barrier protection when the risk of hand or clothing contamination exists
Immunizations: Recommended vaccinations for older adult clients (943) - ANSWER- Adults age 50 or older: -Pneumococcal Vaccine (PPSV)
- Influenza vaccine - Herpes Zoster Vaccine -Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
Pulmonary Embolism: Risk factors for DVT (258) - ANSWER- -Long term immobility - Oral contraceptives
- Pregnancy
- Tobacco use
- Hypercoagulabilty - Obesity - Surgery
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
-Long bone fractures
-Advanced age
Disorders of the male reproductive system: Complications of continuous irrigation following Trans-urethral Resection (743) - ANSWER- -Urethral trauma
-Urinary retention
- Bleeding - Infection
Stroke: Caring for a client who has left sided hemiplegia (155) - ANSWER- - Observe extremities for injury
- Apply an arm sling if client is unable to care for the affected extremity
- Ensure foot rest is on wheel chair and ankle brace is on the affected foot - Instruct client to dress the affected side first
Fractures and immobilization devices: Prevent complications (787) - ANSWER- -Assess neurovascular status of the affected body part for every hour for 24 hours and Q4 hours after that
- Maintain body alignment - avoid lifting or removing weights -Monitor pain level
- Monitor for signs of infection - Support nutrition
Pain Management: use of non pharmacological methods of pain relief - ANSWER- - Cutaneous (skin) stimulation- TENS, heat, cold, therapeutic touch and massage - Distraction (deep breathing, ambulation, visitors, TV and music)
- Relaxation (meditation, yoga and progressive muscle relaxation
-Imagery (focus on pleasant thoughts)
- Elevation of extremities to promote venous return
Acute Kidney injury and chronic kidney disease: Evaluating teaching about nutrition - ANSWER- -Restrict dietary intake of potassium, phosphate and magnesium during oliguric phase
-K and Na is regulated according to stage of kidney injury - high protein diet to replace the high rate of protein breakdown due to the stress from the illness.
Possible TPN
Heart failure and pulmonary edema: Dietary teaching about sodium restriction - ANSWER- Maintain fluid and sodium restriction Increase dietary intake of potassium
Pulmonary Embolism: Planning care for a client who is receiving enoxaparin - ANSWER- -
Assess for contraindications (active bleeding, peptic ulcer disease, history of stroke, recent trauma) -Monitor bleeding times (PT, aPTT and INR)
-Monitor for side effects such as thrombocytopenia, anemia and hemmorhage
Rheumatoid Arthritis: Reviewing Laboratory Values - ANSWER- -Positive Anti- cyclic citrullinated peptide -RF Antibody (Diagnostic level for RA is 1:40-1:60) expected reference range 1:20
- Elevated ESR 20-40 mild inflammation
40-70 moderate 70-150 severe
- Positive C-reactive protein
- Positive ANA titier - Elevated WBC's
Medications affecting coagulation: Heparin Contraindications - ANSWER- Avoid NSAIDS while on heparin
Antibiotics affecting protein synthesis: Adverse effects of gentamicin - ANSWER- -Ototoxicity:
cochlear damage (hearing loss) and vestibular damage (loss of balance). -Nephrotoxicity (proteinuria, elevated BUN, creatinine levels). -Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and urticaria).
Electrolyte imbalance: manifestations of hypokalemia - ANSWER- Weak, irregular pulse, hypotension, respiratory distress
Premature ventricular contractions, bradycardia, inverted T waves, ST depression Decreased GI motility, abdominal distension, constipation, n/v, anorexia, polyuria Decreased K (<3.5)
ABG: Metabolic alkalosis (pH > 7.45)
Electrolyte imbalance: Priority assessment for hypokalemia - ANSWER- Assessing for a patent and open airway
Blood and blood product transfusions: Administering Fresh Frozen Plasma - ANSWER- Initiate a large bore IV access: 20 gauge needle
Complete transfusion withing 2-4 hours time frame If reaction occurs:
-Stop transfusion immediately
- Initiate 0.9% NaCl in a separate line - Save blood bag and blood tubing
Cardiovascular Diagnostic and Therapeutic Procedures: Caring for a client who has a PICC - ANSWER- -Assessing site every 8 hours. Note redness, swelling, drainage, tenderness and condition of dressing -Change tube and positive pressure cap per facility protocol
-Using 10mL or larger syringe to flush the line -Cleanse with alcohol for 3 seconds before accessing it -Use transparent dressing
Cardiovascular Diagnostic and Therapeutic Procedures: Teaching about a PICC - ANSWER- -
Advise client not to immerse arm in water, to cover dressing site to avoid water exposure
-Avoid BP in the arm with PICC
Cardiovascular Diagnostic and Therapeutic Procedures: PICC care - ANSWER- - Apply an initial dressing of gauze and replace with transparent dressing within 24 hours
- An initial x-ray should be taken to ensure proper placement
Cardiovascular and Hematologic Disorders: teaching client about food interaction with Warfarin - ANSWER- -Kale, spinach
-Brussels sprouts
-collard greens, mustard greens
-green tea
-grapefruit juice, alcohol
Angina and MI: Client teaching about nitroglycerin - ANSWER- Nitrogylcerin prevents coronary artery vasospasm and reduces preload and afterload. Used to treat angina and help with BP.
- Place nitro under tongue to dissolve
- Take up to two more doses of nitro at 5-min intervals
