Day 3 study Who are you going to see first questions are evaluation questions.

ons. You are looking for the MOST unstable patient. Documentation should be descriptive and objective. Dont pass the buck! Delegation o RN- Assessment, Teaching, Eval o LVN- Stable with predictable outcomes Recognize abnormal vs normal Know sterile procedure o NAP- Standard unchanging procedures. VS, O2 Sats, assist w/ ADLs, BS, etc. Light assignment- doesnt mean most stable. Bc they could be in ICU and need Assess/eval. Transfer or float nurses get LVN-like work. RN are the only ones allowed to delegate- Advise that it should not be done. Insisting is not therapeutic communication. NAP- no Myesthenia gravis pt- requires assessment. Enteral fee in NCLEX is a standard, unchanging procedure. Cannot perform a dilation and effacement test if pt has bright red discharge.-NEVER Therapeutic Communication o Respond with feeling tone o Provide information o Dont ask- WHY o Dont ask- YES/NO questions o Dont focus on Nurse o Dont explore o Dont say -Dont worry! Airway beats cardiac! Restless, agitated, and Sweating- Hypoxia! Seizures- Oxygen and suctioning. No Crash cart nor intubation needed. Meningitis- full PPE Mononucleosis- large liver, large spleen- No contact!!! Mantoux test for TB- induration >5MM--- negative unless patient is immunocompromised (AIDS, etc) Salmonellosis- you can carry the disease up to 1 yr and pass the acute phase of the illness to your family members. Stool sample is only way to verify pt is no longer contagious. PROM for >24 hrs has high potential for infection. Kaposi sarcoma!Significant lead poisoning causes constipation and growth stunting! Go over Play typeso Infant o Toddler o Pre-school

o School age o Adolescent o Adults Amniocentesis- worried about leaking (unexpected). o Worried about infection VEAL> CHOP o Late decelsHypoxia!! o Variable, Early, adequate, late Variable decels = Cord compression Early decels = Head compression Acceleration = OK Late decels = Placental insufficieny FLOP for late decels Fluids Lateral position O2 On Pitocin off Complications of Neonatal hyperbilirubinemia o Suppression of CNS. First responders are the ones who identify hazardous material. o Nurses- determine if decontamination has occurred. Risk Factors for Breast CA: o Abdominal fat increasing after menopause has increased risk for Breast CA o First degree relative (Not aunt!) You will see bright red blood loss before Vital sign changes for Postpartum!!!! - hemorrhage! Insulin---Nancy Reagan, R Nair into Nph, Air into R, then draw up R, then draw up NPH. Symptoms of heroin withdrawal occur between 12-24 hours after birth/last dose!! o Assess respiratory and cry Temp, jaundice, and vomiting--- Neonatal sepsis o Get checked right away! o Baby is cold bc immature immune system cannot respond to infection 1 saturated peri pad = 100 mL of blood -> so, 1 peri pad soaked every hour for 2 hours may indicate post-partum hemorrhage Key word--- Saturated! Smoking---- number one for issues with arthritis! Immunizations pg 5 All People Eat Tasty Meat-- Cardiac auscultation o APE TO MAN o Erbs -3rd ICS

Manic patient- provide finger food and liquids. OCD- distract. Dont focus on ritual. Risk factor for Testicular cancer o Undescended testicle/ Cryptoorchidism 3 lbs in 24hrs is dangerous for Pregnant or cardiac pt. Neuroleptic Malignant syndrome- Dangerous! Place client in dimly lit room to reduce environmental stimuli Depressed pts: try to develop a therapeutic relationship! Pt of SSRI receiving Paxil- early signs of antidepressant toxicity: o Confusion, memory loss, and disorientation not good! Lithium toxo Antagonizes ADH- dehydration o Fine tremor expected- Coarse tremor-> toxicity! o Do not restrict NA+ o Feeling faint, fast heart rate o Instruct the client to drink 8-12 glass of water daily Psychiatric- restate and reorient Ziprasidone (Geodon)- atypical antipsychotic. Used for bipolar o Potential for neuroleptic o Pt has flight of ideas- so this med helps for them to talk coherently. o Attention span is NOT a deficit with psychotic pt. Paranoia vs delusion- my neighbors dont like me can be harmful