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NRS 340 Exam 1 Questions and answers
health .history .with .children: .immunizations .- .ANS ✓✓ - the .younger .a .child .is .the .more .detail .we .need .on .this .health .history. .need .to .k now .specific .vaccine .and .date .opposed .to .adults .we .just .say ."up .to .date" when .do .we .stop .performing .head .circumference .measurement .- .ANS ✓✓ - around .the .age .of. 2 what .are .the .components .of .effective .communication .- .ANS ✓✓ -
- .Touch: .always .ask .permission .to .touch .or .hold .child, .if .parent .is .present .ask .parent .too..
- .physical .proximity .and .environment: .have .conversations .while .sitting .down .a nd .being .present .opposed .to .just .standing .in .door .way .or .don't .give .bad .news. with. 5 .children .running .around
- .listening: .be .attentive, .use .clarification .through .reflection .to .detect .meaning .i n .children's .stories, .empathy, .and .be .impartial .i.e .no .judging.
- .visual .communication: .how .is .your .body .language? .are .your .arms .crossed?
- .tone .of .voice: .use .appropriate .tone .with .age
- .body .language
- .timing: .if .baby .is .taking .a .bath, .its .not .a .good .time .to .perform .teaching .on .s omething .else what .is .family .centered .communication? .- .ANS ✓✓ --est. .rapport -availability .and .openness .to .questions. -family .edu .and .empowerment -effective .management .of .conflict -feedback .from .children .and .families.
spirituality: .be .respectful .and .observe .ways .to .incorporate .or .provide .opportuni ties .for .this how .are .way .to .establish .rapport .with .family .centered .communcation? .- .ANS ✓ ✓ - opposed .to .adults, .with .children, .parents .are .more .questionable .about .who's .ca ring .for .their .child. .you .must .establish .trust .and .a .relationship. .example .would. be .noticing .a .kid .has .basketball .pictures .hung .up, .ask .him .about .his .favorite .te am .or .about .basketball.
coining .- .ANS ✓✓ - a .form .of .relaxing, .it .doesn't .hurt, .done .by .taking .a .coin .and .scrape .across .the. back. .it .is .said .to .release .heat .and .hurt .from .the .body .i.e .with .the .flu .or .fever. therapeutic .relationship .is .done .how? .- .ANS ✓✓ -- developing .and .mantaining .trust .i.e .if .you .say .you'll .be .back .in. 5 .min .with .medi cation .then .make .sure .to .follow .through -getting .over .involved .can .occur, .fine .line what .are .the .stages .of .separation? .- .ANS ✓✓ -1. .protest
- .despair
- .detachment **these .can .occur .at .time .or .age. .if .you .get .stuck .in .a .stage .that's .when .we .star t .to .worry, .you .should .progress .through .each .stage protest .phase .- .ANS ✓✓ - when .a .child .realizes .parents .are .leaving .and .could .cry, .cling .and .act .out. .like. when .dropping .a .kid .off .for .daycare .and .they .cling .to .mom despair .phase .- .ANS ✓✓ - child .seems .to .withdraw .and .become .apathetic. .this .is .after .a .parent .leaves .and .child .is .sad .and .acts .like .everyone .hates .them, .they .feel .bad .for .themself detachment .phase .- .ANS ✓✓ - child .represses .pain .at .the .sense .of .loss .and .shows .disinterest .on .parents .retu rn. .the .child .will .start .to .interact .with .others .and .play .more. .if .parents .return .du ring .this .phase .the .child .will .ignore .them .and .play .hard .to .get. effects .of .hospitalized .child .on .parents .- .ANS ✓✓ -- feel .incapable .due .to .loss .of .control .or .inability .to .protect/help .child -behavior .may .be .anxious, .denial, .withdrawal, .guilt .or .fear ways .to .decrease .the .stress .of .hospitalization .- .ANS ✓✓ --rooming-in
encourage .child .to .bring .something .from .home, .draw .a .picture .to .hang, .watch. a .movie .or .play .a .game. -therapeutic .play -guided .imagery -role .modeling where .is .a .save .place .for .a .child .in .the .hospital? .- .ANS ✓✓ - save .place .meaning .that .no .medical .procedure .will .occur .there, .its .a .place .the. child .can .relax .and .play. .these .places .are .the .play .room .and .their .bed. what .are .the .classifications .of .play? .- .ANS ✓✓ - practice .play, .symbolic .play, .and .games
dramatic .play .- .ANS ✓✓ - act .out .roles .and .expectations. .examples .are .playing .house, .this .can .be .done .t hrough .cooperative .play familiarization .play .- .ANS ✓✓ - play .with .objects .to .become .familiar .with .them. .example .is .playing .with .medical .equipment .to .understand .and .be .comfortable functions .of .play .- .ANS ✓✓ - physical .cognitive, .emotional, .social .and .moral .development physical .development .examples .- .ANS ✓✓ - shaking .a .rattle, .dancing, .throwing .a .ball. .anything .with .physical .movement. (gross .or .fine .motor; .fine .would .be .like .drawing .and .gross .kicking) cognitive .development .- .ANS ✓✓ - games .with .colors .or .numbers .where .learning .occurs. emotional .development .- .ANS ✓✓ - example .is .finding .that .when .you .cheat .people .won't .play .with .you. what .signs .do .neonate/infants .display .when .they're .in .pain? .- .ANS ✓✓ -- facial .expressions: .frowns, .grimaces, .wrinkled .brow -increase .in .BP .and .HR .and .decrease .in .O2 .stats -high .pitched .tense, .harsh, .crying -older .infants .will .rub .painful .area, .pull .away .or .guard .area what .signs .do .toddlers .display .when .they're .in .pain? .- .ANS ✓✓ - loud .crying, .verbalizes .word .like ."ouch .or .boo- boo", .attempts .to .delay .procedures .perceived .as .painful, .generalized .restlessne ss, .guards .the .site.. **need .to .understand .what .different .families .call .pain .i.e .a .boo-boo .vs .ouchy what .signs .do .preschoolers .display .when .they're .in .pain? .- .ANS ✓✓ -- may .think .pain .is .a .punishment .for .some .action .or .thought, .so .they .may .not .w ant .to .share .that .they're .in .pain .of .fear .of .being .in .trouble -crying .kicking .and .withdrawal -denies .pain .to .avoid .injection -describes .the .location .and .intensity .of .pain -regression .to .earlier .behaviors .i.e .loss .of .bladder .control
need .to .make .sure .child .is .reliable .source .i.e .if .they .claim .pain .in .one .area .vs .a ll .over school .age .signs .when .in .pain .- .ANS ✓✓ --able .to .describe .pain .and .intensity -fears .body .harm .i.e .if .you .poke .them .all .they're .blood .might .leak .out
-has .an .awareness .of .death .because .they .can .understand .time -stiff .body .posture, .withdrawal -procrastinates .or .bargains .to .delay .procedure how .adolescents .show .pain .- .ANS ✓✓ -- perceives .pain .at .a .physical, .emotional .and .mental .level -understands .cause .and .effect -describes .pain .and .intensity -increased .muscle .tension -withdrawal .and .decreased .motor .activity -uses .words .like .sore, .ache .or .pounding how .to .determine .which .pain .scale .to .use? .- .ANS ✓✓ - it's .whatever .suits .that .child .best. .but .once .we .pick .one .we .must .stay .with .that .one .scale .and .not .interchange N-PASS .and .FLACC .pain .scales .- .ANS ✓✓ --N- pass .is .used .with .infants .and .FLACC .with .newborn .and .toddlers. .its .based .off. of .our .observations .and .parents. .its .very .subjective non-pharmacological .pain .management .- .ANS ✓✓ - distraction: .telling .a .story, .blowing .bubbles realxation: .turn .down .lights, .peaceful .music guided .imagery: .younger .the .child .the .more .concrete .the .imagery. .must .be .so mething .they've .done .or .can .understand emergency .assessments .- .ANS ✓✓ -A- .airway B- .breathing. C- .circulation D- .disability E- .exposure. F- .full .sets .of .vitals .(q. 10 .min) G- .give .comfort H- .head .to .toe. I- .inspect .the .back/neck .and .isolate S- .sugar why .do .we .give/assess .sugar .levels .in .emergency .situations .- .ANS ✓✓ - in .children .their .blood .sugar .will .spike .when .in .pain .and .then .drop .very .low .be cause .they .do .not .have .the .stores. .check .sugars .because .s/ s .can .mimic .head .injuries what .to .do .with .poison .exposure? .- .ANS ✓✓ -S- .stabilize I- .identify .the .substance R- .remove, .reverse .the .effects E- .eliminate .the .substance .from .the .body. S- .support .client/family .for .short .and .long .term .damage
hydrocarbon .poisoning .treatment .- .ANS ✓✓ - do .not .induce .vomiting, .do .not .lavage, .support .ventilation, .administer .oxygen, .I V .fluids lead .poisoning .symptoms .- .ANS ✓✓ -- vague .onset .and .gradual, .exposure .over .time. -CNS .effects .such .as .hyperactivity, .seizures, .irritability, .impulsive .action. -anemia. -anorexia, .NV, .constipation, .lead .line .on .gums -increased .bone .density, .lead .line .in .bones -glycosuria, .proteinura, .kidney .damage -kidney .function .is .important .to .check .before .giving .meds .because .need .proper .excretion treatment .of .lead .poisioning .- .ANS ✓✓ -diet: .high .in .calcium .and .iron, .low .fat drugs: .chelating .agents .like .edetat .disodium, .anticonvulsants, .iron, .calcium, .vit amin .C .and .D.. **patient .teaching .about .follow .ups .and .lead .removal what .diet .would .be .best .for .a .child .with .high .lead .levels? a. .steak .and .yogurt b. .chicken .and .corn c. .hamburger .and .ice .cream .- .ANS ✓✓ -A; .because .it .is .high .in .iron .and .calcium what .are .the .main .roles .of .a .nurse .in .terms .of .pain .management? .- .ANS ✓✓ -
- .assessment .of .pain
- .initiation .of .pain .relief .measures
- .evaluating .the .effectiveness .of .these .interventions definition .of .pain .- .ANS ✓✓ - pain .is .whatever .the .person .experiencing .the .pain .says .it .is, .existing .whenever. the .person .says .it .exists. .pain .is .personal .and .subjective acute .pain .- .ANS ✓✓ --sudden .onset, .can .identify .a .precipitating .event -less .than. 3 .mo -well .defined, .can .point .right .to .it. -mild .to .severe -increase .in .vitals .due .to .increase .in .SNS -diaphoretic, .anxiety, .NV chronic .pain .- .ANS ✓✓ -- gradual .onset, .greater .than. 3 .mo, .and .not .sure .what .caused .it -poorly .localized -mild .to .severe -can .cause .withdrawal .or .depression/destroy .quality .of .life. -slow .recovery, .can .be .continuous .or .have .flare .ups **distraction .really .helps .with .chronic .pain
nociceptive .pain .- .ANS ✓✓ -caused .by .damage .to .somatic .or .visceral .tissue somatic .pain .- .ANS ✓✓ - aching .or .throbbing .pain .that .is .well .localized. .arises .from .the .bone, .joint, .mus cle, .skin .or .connective .tissue visceral .pain .- .ANS ✓✓ -arises .from .visceral .organs .such .as .the .GI .tract, .bladder .or .liver. .tumor .pain .is .visceral .pain. .bowel .obstruction .is .visceral .pain. .other .ex amples .are .surgical .incision, .broken .bone, .or .arthritis neuropathic .pain .- .ANS ✓✓ -caused .by .damage .to .peripheral .nerves. .neuropathic .pain .is .usually .described .as .burning, .stabbing .or .shooting, .it .can .be .sudden .in tense .short .lived .or .lingering what .are .the .pain .management .principals .- .ANS ✓✓ -
- .patient .must .always .be .believed
- .every .patient .deserves .pain .management.
- .side .effects .must .be .prevented .or .managed 4.treatment .plans .should .use .a .combo .of .drug .and .non-drug .approaches
- .est .a .consistent .trusting .relationship .with .patient/family
- .evaluate .and .re-assess .often what .other .symptoms .can .pain .enhance? .- .ANS ✓✓ - pain .can .cause/enhance .diarrhea, .NV, .insomnia, .anorexia, .anxiety, .depression .or .dyspne a non-narcotic .analgesics .- .ANS ✓✓ - examples .are .aspirin, .acetaminophen, .ibuprofen, .NSAIDS -these .work .with .peripheral .analgesia .(not .CNS) .and .have .a .ceiling .effect -used .for .mild .to .moderate .pain -can .be .used .in .combo .with .narcotic narcotic .analgesics .examples .and .advantages .- .ANS ✓✓ -- morphine, .fentanyl, .hydromoprhone.
advantages: .binds .to .opiod .receptors .in .CNS, .central .analgesia, .NO .ceiling .effe ct, .and .wide .variety -disadvantages: .side .effects .especially .constipation .and .sedation morphine .- .ANS ✓✓ -"gold .standard" .of .narcotics.. -moderate .to .severe .pain -dosage .can .go .as .high .as .needed, .no .limit -short .acting .(4 .hr .duration) .or .long .(8-12) -advantage .is .it .can .be .given .orally, .rectally .or .IV fentanyl .- .ANS ✓✓ -narcotic .analgesic
what .is .the .preferred .route .of .med .administration? .- .ANS ✓✓ -orally.. advantages: .convenient, .steady .analgesic .state, .promotes .independence, .cheap er **need .to .consider .first .pass .effect .(increase .dose) transdermal .route .of .med .administration .- .ANS ✓✓ -- absorption .is .slow, .so .it .is .NOT .suitable .for .fast .relief .rather .long .term
fentanyl .patch .may .need .to .be .changed .every. 48 .hours .for .some .patients .oppo sed .to. 72 .hours parenteral .routes .for .med .administration .- .ANS ✓✓ -- IM .not .recommended .because .its .painful, .unreliable .absorption. -Subq .not .used .very .often .for .long .term.
IV .is .the .best .for .immediate .analgesia .and .rapid .titration. .it .is .continuous .and .e xcellent .steady .analgesia what .is .titration .- .ANS ✓✓ - adjusting .the .med .dosage .based .on .the .ASSESSMENT .of .the .patient. .can .be .m oved .up .or .down .and .you .MUST .have .an .order .from .a .physician .to .titrate. what .is .another .name .for .adjuvant .analgesic .therapy .and .what .is .it? .- .ANS ✓✓ - also .called .additional .therapy. .these .drugs .enhance .pain .therapy .by .enhancing. the .effect .of .opiods .and .non- opiods, .possess .analgesic .properties .of .their .own .and .counteracts .the .side .effe cts .of .other .analgesics examples .of .adjuvant .analgesics .- .ANS ✓✓ -
- .antidepressants: .TCAs .increase .the .level .of .serotonin .and .NE. .this .inhibits .p ain .transmission. .often .used .with .neuropathic .pain
- .antiseizures: .gabapentin, .clonazepam .used .for .neuropathic .pain
- .corticosteroids: .dexamethasone .or .methylprednisonlone .decrease .edema .and .inflammation .that .cause .pain what .is .the .definition .of .TPN? .- .ANS ✓✓ - TPN .is .the .administration .of .nutrients .via .the .blood .stream. .patients .can .receiv e .TPN .and .also .have .a .normal .diet .if .they .are .able. .the .goal .of .TPN .is .to .meet .n utritional .needs.. **TPN .contains .dextrose .and .protein .and .the .pharmacy .can .add .electrolytes, .vit amins .and .lipids .to .customize .to .each .patient. when .would .TPN .be .used? .- .ANS ✓✓ - nutritional .deficits .related .to .impaired .absorption. (i.e .crohns, .diarrhea, .radiation), .intestinal .obstruction, .peritonitis, .prolonged .ilue s, .hyper .metabolic .state .like .cancer .or .sepsis .or .trauma, .and .post .op .would .he aling
how .to .calculate .weight .history/weight .change .- .ANS ✓✓ - take .the .actual .weight/current .weight .and .divide .it .by .the .ideal .or .pre- sick .weight. .then .multiply .by. 100 .to .get .a .percent. .take .that .percent .and .subtra ct .from. 100 .to .get .the .weight .change basic .guidelines .regarding .when .to .initiate .TPN .- .ANS ✓✓ -
- .the. 5 .day .rule .which .is .has .not .eaten .for. 5 .days .and .is .not .expected .to .eat .w ithin .the .next. 5 .days .or .inadequate .nutritional .intake .for .7-10 .days
- .a .weight .loss .of .7% .of .body .weight .and .NPO .for. 5 .to. 7 .days
- .a .hypermetabolic .state .i.e .fever .or .cancer albumin .levels .- .ANS ✓✓ -normal: .3.5-5. mild .risk .of .malnutrition: .3.0-3. moderate .risk .of .malnutrition: .2.5-3. severe .risk .of .malnutrition: .2.5 .or .less what .other .serums .are .low .in .the .presence .of .low .albumin? .- .ANS ✓✓ - calcium .will .be .low .if .albumin .is .low .because .albumin .binds .to .calcium. total .serum .protein .(TSP) .- .ANS ✓✓ -normal .value .is .6-8.. this .lab .is .a .combo .of .albumin, .globulin .and .pre .albumin absolute .lymphocyte .count .(ABS .lymph) .- .ANS ✓✓ -- a .value .less .than. 1000 .means .malnutrition which .lab .tests .are .relevant .when .assessing .a .patient .who .has .a .diagnosis .of .a ltered .nutrition .less .than .body .requirements? .- .ANS ✓✓ - TSP, .albumin .and .ABS .lymph.. These .three .labs .tells .us .everything .about .nutrition how .are .immunity .and .nutrition .related? .- .ANS ✓✓ - good .nutrition .means .good .immunity. .i.e .ABS .lymph .is .related .to .nutrition, .and. when .it .is .low .that .means .lymphocytes .and .T .cells .are .low. what .are .the .macro .components .of .TPN? .- .ANS ✓✓ -proteins, .fats, .and .carbs. (dextrose) other .TPN .also .includes .vitamins, .minerals .and .trace .elements protein .requirements .- .ANS ✓✓ --normal .is .45-65 .g/day -ill .may .need .up .to. 150 .g/day -protein .is .essential .for .wound .healing. -TPN .protein .is .available .in .5% .to .15% .concentrations what .is .aminosyn .solution? .- .ANS ✓✓ -is .a .type .of .TPN .with .amino .acids. (protein) .and .it .provides .for .5% .to .15% .of .patients .total .calories
-monitor .catheter .site .for .phlebitis complications .of .TPN .- .ANS ✓✓ --hyperglycemia .and .hypoglycemia -problems .with .the .CVC .or .IV .administration. -sepsis -exit .site .infection older .adults .and .TPN .- .ANS ✓✓ - have .an .increased .incidence .of .glucose .intolerance .and .are .more .vulnerable .to. complications, .especially .fluid .and .electrolyte .imbalance what .is .palliative .care .- .ANS ✓✓ -- represents .a .holistic .approach .to .care .that .extends .throughout .illness -improve .quality .of .life .by .reducing .stresses .of .illness -goal .is .to .improve .peoples .live .as .much .as .possible -preventing .and .relieving .suffering .while .improving .quality .of .life where .can .patients .receive .palliative .care? .- .ANS ✓✓ -- home, .long .term .care, .acute .care .such .as .ICU .or .ER -palliative .care .can .be .used .at .any .point .in .a .disease -example, .with .heart .failure .palliative .care .would .be .to .treat .the .symptoms .such .as .dyspnea .while .curative .is .treating .heart .failure .itself what .is .the .major .difference .between .palliative .care .and .hospice? .- .ANS ✓✓ - palliative .care .allows .a .person .to .simultaneously .receive .curative .treatment .and .palliative .care. .hospice .care .is .provided .once .a .person .decides .to .stop .curative .treatments what .are .the .two .criteria .for .admission .to .hospice? .- .ANS ✓✓ -
- .understand .the .philosophy .of .hospice .i.e .if .you .get .worse .we .do .not .seek .ex tra .care .or .send .to .the .hospital .or .perform .CPR. .we .dont .intervene.
- .two .physicians .must .certify .the .prognosis .of .less .than. 6 .mo .to .live what .does .hospice .care .exemplify? .- .ANS ✓✓ --whole .person .care
skilled .healthcare .workers .who .are .able .to .care .for .a .hying .person .and .accept .t he .vulnerabilities .of .life. -coverage .is .provided .by .medicare .if .over. 65 communication .tools .used .with .palliative .care .- .ANS ✓✓ --be .honest .and .truthful, .don't .lie. -listen .as .mcuh .as .you .talk -90% .of .communication .is .nonverbal. -being .present .and .being .silent .are .valuable .tools -avoid .giving .advice. -avoid .comments .like ."everything .will .be .okay" .or ."i .know .how .you .feel"
what .is .nearing .death .awareness? .- .ANS ✓✓ - special .form .of .communication .of .dying .people. .when .you .see .or .hear .this .a .pa tient .is .approaching .death .likely .within. 48 .hours.. examples: .waving .and .reaching .out, .out .of .context .or .symbolic .language, .talkin g .of .travel .or .destinations, .or .seeing .loved .ones .that .have .already .passed what .does .the .physical .care .of .the .dying .patient .focus .on? .- .ANS ✓✓ - focuses .on .the .needs .for .oxygenation, .nutrition, .pain .relief, .elimination .and .ski n .integrity how .to .manage .dyspnea, .terminal .congestion .and .cough .- .ANS ✓✓ -- elevate .HOB -fan .or .oxygen, .cooler .room -opoids .such .as .morphine .and .anti-anxiety. -glycopyrrolate .or .atropine .used .especially .with .the .terminal .congestion. (death .rattle) how .to .manage .restless/delirium .and .agitation .of .the .dying .person .- .ANS ✓✓ - often .caused .by .infection, .med .side .effects, .hypoxemia, .unrelieved .pain .or .blad der .distention. .treatment .includes .neuroleptics .such .as .haloperidol, .reorientatio n, .relaxation .and .hydration post .mortem .care .- .ANS ✓✓ -- provide .calm .and .reassuring .presence. .create .peaceful .scene .for .family. -model .acceptance .of .the .body .by .touching .and .calling .the .person .by .name -offer .to .call .clergy -allow .family .to .be .alone .with .body .as .long .as .they .wish -notify .the .physician.
wash .body .and .put .clean .gown .on. .close .patients .eyes, .place .patient .on .their .b ack .and .straight .alignment -pillow .under .head .to .prevent .pooling/discoloration .of .the .face what .is .grief? .- .ANS ✓✓ -- it .is .a .normal .response .that .can .be .physical, .emotional, .cognitive, .behavioral, .o r .spiritual. -you .never .get .over .grief, .it .is .with .you .forever. -no .timeline .for .grief examples .of .different .domains .of .grief .- .ANS ✓✓ -physical: .insomnia, .headaches, .loss .of .appetite emotional: .numbness, .anxiety, .anger, .despair cognitive: .confusion, .dreams .of .deceased, .inability .to .concentrate behavioral: .withdrawal, .crying, .impaired .work .performance. .spiritual: .doubt .of .beliefs, .search .for .meaning, .change .in .religion culturally .competent .care .with .dying .patient .- .ANS ✓✓ -- cultural .beliefs .affect .a .persons .understanding .of .and .reaction .to .death .or .loss
-fast .access, .via .the .subclavian .vein -has .1-4 .lumens -useful .in .emergencies .or .surgical .procedures -often .used .for .short .term .TPN .and .antibiotics insertion .of .non-tunneled .CVAD .- .ANS ✓✓ --nurse .will .help .with .insertion. (strict .aseptic) -often .inserted .at .bedside -place .patient .flat .bed .with .the .head .low .and .knees .bent. -valsalva .maneuver. (hold .breath .and .bear .down) .at .the .time .the .catheter .is .open .to .air, .this .prevent s .air .embolism -14 .gauge .needle -feed .wire .through .needle. -confirm .with .xray flushing .subclavian .catheters .- .ANS ✓✓ -- need .routine .saline .flushes .to .maintain .patency.
if .you .feel .resistance .do .not .apply .force, .this .could .rupture .catheter .or .create .e mbolism.
use .push .pull .technique .when .flushing, .this .creates .turbulence .to .remove .debri s -non .tunneled .catheters .have .the .highest .infection .rate*** what .are .tunneled .catheters .- .ANS ✓✓ -- surgically .placed .CVADs .for .long .term .use, .can .remain .in .place .for .several .year s -examples .are .hickman, .broviac, .groshong -verify .surgical .placement .with .an .xray groshong .catheter .(closed .ended .catheter) .- .ANS ✓✓ -- available .as .a .PICC .line .or .implanted .port
closed .ended .with .a .slit .valve .on .the .sides .near .the .distal .end. .this .valve .opens .with .infusion, .flushing .or .aspirating .blood. .when .not .being .used .the .valve .is .cl osed .preventing .back .flow. -does .not .need .daily .flushing PICC .lines .(peripherally .inserted .central .catheter) .- .ANS ✓✓ -- central .venous .catheters .inserted .into .a .vein .in .the .arm -the .basilic .vein .is .preferred .bc .of .its .large .diameter.
can .be .placed .for .up .to. 6 .mo. .generally .used .for .short .term .IV .therapy, .giving .b lood .products .or .drugs -physician .or .specially .trained .nurse .can .perform -lower .infection .rate, .decreased .cost, .and .can .be .inserted .outpatient.
-disadvantages .include .increase .risk .of .DVT .or .phelebitis nursing .care .with .PICC .line .- .ANS ✓✓ --transparent .dressing, .not .occlusive -confirm .with .xray. -monitor .for .redness, .edema .and .tenderness. -arm .with .the .PICC .should .NOT .be .used .for .BP .or .blood .drawing implanted .ports .- .ANS ✓✓ --out .of .sight/convenient .and .cosmetically .appealing -best .used .for .cyclic .therapies .(chemo .or .antibiotics) -can .handle .bolus .injection .and .continuous .infusions
surgically .implanted. .catheter .is .placed .in .the .vein .and .other .end .is .sutured .to .t he .chest .wall .muscle .and .implanted. -good .for .long .term .therapy .and .low .risk .of .infection nursing .care .for .implanted .ports .- .ANS ✓✓ -- access .is .painful, .feels .like .pressure -sterile .procedure -cleanse .site .with .betadine, .stabilize .port .with .non-dominate .hand. -insert .huber .needle .thorugh .skin -confirm .placement .by .aspirating .blood .** complications .of .central .lines .- .ANS ✓✓ -1. .infection
- .penumothorax- .perforation .of .the .visceral .pleura .during .insertion.
- .air .embolism- .potential .danger .whenever .any .central .venous .catheter .is .open .to .air.
- .catheter .occulusion removal .of .central .lines .- .ANS ✓✓ -- have .patient .perform .valsalva .maneuver .as .the .last .5- 10 .cm .of .catheter .is .withdrawn
immediately .apply .pressure .to .site .to .prevent .air .from .entering .and .control .blee ding -inspect .the .Cather .tip .to .determine .if .its .intact. -after .bleeding .stopped .apply .an .antiseptic .ointment .and .sterile .dressing what .is .the .definition .of .family? .- .ANS ✓✓ -family .is .whatever .the .individual .says .it .is. .it .can .be .traditional. (nuclear) .i.e .mom/dad/child .or .extended .which .includes .aunts/cousins/grandparents. .blended .family .is .step .siblings .or .adoptions .and .s kip .generation .is .when .the .grandparent .is .raising .the .child what .are .some .stressors .on .families? .- .ANS ✓✓ -
- .health .care: .financial .issues/unisured/bad .prognosis.
- .homelessness
- .mental .illness .i.e .depression
- .identity .vs .role .confusion: .12- 18 .yr .forging .ahead .and .acquiring .a .clear .sense .of .self Lawrence .Kohlberg .moral .development .theory .- .ANS ✓✓ -three .levels
- .preconventional: .thinking .is .concrete .and .egocentric
- .conventional: .incorporation .of .social .and .interpersonal .relationships
- .postconventional: .social .contract .and .individual .rights .and .universal .principl es Duvalls .theory .of .family .development .- .ANS ✓✓ -- based .on .the .OLDEST .child .as .the .marker .for .transition .into .the .next .stage -marriage: .couple .is .est .as .pair -family .w/infant: .child .is .born .and .family .adjusts .to .new .structure -family .w/preschool .child: .family .functions .to .socialize .the .children
family .with .schoolchildren: .develop .friendships .and .launch .socially .outside .fam ily -family .with .adolescent: .oldest .turns .toward .Independence -family .launching .young .adult: .the .oldest .child .leaves .home what .is .temperament? .- .ANS ✓✓ - refers .to .the .characteristics .present .at .birth .that .govern .the .way .in .which .an .inf ant .responds .to .their .surroundings. .example, .some .people .are .type .A .and .other .type .B examples .of .temperament .- .ANS ✓✓ -- regularity: .needing .things .a .certain .way .daily -reaction .to .new .people: .introvert .vs .extrovert. -adaptability .to .change -sensory .sensitivity. -emotional .intensity -level .of .persistence -activity .level -distractibility -mood **person .nature, .permanently .effects .their .behavior, .like .disposition. med .administration .in .infants .- .ANS ✓✓ -- easier .to .medicate .than .toddlers .but .cannont .follow .instructions -may .need .assistance .to .medicate .if .squirming -IM .is .done .in .vastus .lateralis .(until .about .age .5) -cuddling .and .comfort .is .important .immediately .after .med med .administration .with .toddlers .- .ANS ✓✓ -- they .are .magical .thinkers .so .may .view .med .as .punishment -use .play .for .explanations -allow .child .to .see .or .play .with .instruments -ear .drops .done .by .holding .the .pinna .back .and .down
-praise, .cuddle .and .offer .reward .after .med med .administration .with .preschoolers .- .ANS ✓✓ -- continue .to .be .magical .thinkers -fear .of .unknown .and .pain -believe .a .bandage .will .make .it .better -use .therapeutic .play -allow .some .control -praise .and .cuddle .and .offer .rewards med .administration .with .school .age .- .ANS ✓✓ -- fear .loss .of .control, .pain .and .anxiety -allow .some .choice .and .control -can .cooperate .and .follow .directions -need .distraction .and .support -offer .praise .and .reward med .administration .with .adolescent .- .ANS ✓✓ -- fear .of .separation .for .peers .and .loss .of .control -understand .adult .explanations -may .be .able .to .assist .in .decisions -may .exhibit .a .hyper .response .that .may .seem .inconsistent .for .their .age -use .distraction -offer .praise .and .reward basic .med .administration .rules .- .ANS ✓✓ --calculate .drug .dosage. -five .rights -double .check .med .against .care .plan -have .another .RN .double .check -report .med .error .if .it .occurs common .questions .families .will .ask .about .medication .- .ANS ✓✓ - make .sure .to .fully .understand .medication .because .families .will .ask.. -what .is .this .drug .for? -will .there .be .any .problems .or .side .effects? -what .happens .if .a .dose .is .missed? -how .soon .will .it .start .working? -how .do .i .store .this .drug? **be .sure .to .assess .the .families .understanding .of .the .drug .and .explain .the .adm inistration .and .have .family .demonstrate .for .you what .are .the .roles .of .a .pediatric .nurse? .- .ANS ✓✓ -
- .care .provider: .provide .direct .nursing .car .to .children .and .their .families
- .teacher: .edu .children .and .their .families.
- .collaborator: .manage .the .total .care, .coordinating .with .other .team .members
- .advocate: .speak .out .for .better .care
- .researcher: .contribute .to .nursing .by .investigating .evidence .based .practice .is sues
