NUR2200 WK6 Green Bankonly!

Key Vital Signs to Track: Blood Pressure (BP), Oxygen Saturation ( $SpO_2$ ), Temperature ( $Temp$ ), Heart Rate ( $HR$ ), Respiratory Rate ( $RR$ ), and Pain level.
Prioritization Framework:
* Health care providers must prioritize vitals based on the hierarchy of Airway, Breathing, and Cardiac (ABC) status.
* Priority vital signs include Temperature, Pulse, Respiratory Rate, Blood Pressure, and Oxygen levels.
Normal Reference Ranges:
    * Normal Blood Pressure: $120/80\,mmHg$
    * Normal Heart Rate: $60 - 100\,bpm$
    * Normal Respiratory Rate: $12 - 20\,breaths\,per\,minute$
Temperature Clinical Significance:
* Low Temperature: Severe condition; has the potential to cause seizures.
* Moderate Elevation: A temperature of $100^{\circ}F$ is not considered severe.
Blood Pressure Extremes:
* Hypotension (Low BP): Can lead to death due to insufficient perfusion to the brain or heart.
* Severe Hypertension (High BP): A reading of $200/100\,mmHg$ can cause a stroke, heart attack, or a terminal cardiac event.
Oxygen Saturation ( $SpO_2$ ) Thresholds:
* Below $95\%\,O_2$ : Initiate oxygen administration.
* $80\%\,O_2$ : Classified as a medical emergency.

Clinical Presentation of Vital Signs:
    * Heart Rate: Low (Bradycardia).
    * Blood Pressure: Low (Hypotension).
    * Temperature: Low (Hypothermia).
    * Respiratory Rate: Low (Bradypnea).
    * Activity Level: High (Hyperactive behaviors despite being lethargic due to lack of energy).
Diagnostic Findings and Action Plans:
* In a clinical scenario where BP, RR, and Temperature are normal but the HR is abnormal, the Heart Rate is the finding that requires an immediate action plan.
Laboratory Concerns:
* Potassium: Low potassium (Hypokalemia) is a critical lab finding that causes cardiac dysrhythmias.
Physical and Behavioral Indicators:
    * Amenorrhea: Anorexia Nervosa causes a lack of menstruation, irregularity, or complete cessation of the menstrual cycle.
    * Attire: Patients often wear loose-fitting clothing to hide their body shape.
    * Relationship with Food: The patient is often obsessed with food. They will research it and know how to prepare/make it, but they will refuse to eat it. They consistently perceive themselves as overweight regardless of actual weight.
High-Risk Populations (Professions):
    * Figure Skaters
    * Dancers
    * Athletes
    * Models

Bulimia Nervosa Characteristics:
    * Physical Appearance: Patients typically maintain a normal or regular Body Mass Index (BMI).
    * Social Masking: People close to the patient often do not know they have the condition because their physical appearance does not obviously change.
    * Behavioral Cycle: Patients engage in eating large quantities of food followed by the use of laxatives or self-induced vomiting.
Binge-Eating Disorder vs. Bulimia Nervosa:
* The primary difference is the absence of compensatory behaviors; in Binge-eating, the individual does not throw up (purge) after eating.
* Dietary Habits: Binge-eaters consume large amounts of digestible food, which allows them to consume even more over time.

General Nursing Interventions:
    * Provide small, frequent meals.
    * Behavioral Modeling: Nurses should eat with the patient so the patient understands what normal eating behavior looks like.
    * Post-Meal Observation: Stay with the patient for $1 - 2$ hours after eating to ensure they do not engage in purging (throwing up).
    * Visitor Monitoring: Check the bags of friends and visitors for laxatives.
Refeeding Syndrome:
* Definition: A fatal condition that occurs when a patient who is adapted to starvation is suddenly given a large amount of food.
* Mechanism: Severe electrolyte imbalances occur, which can lead to seizures and death.

Risk Factors for Alzheimer’s:
    * Age: $65\,years+$ (primary risk factor).
    * Gender: Women are at higher risk.
    * Genetic Profile: Familial history and specific genetic markers.
    * Physical Health: Cardiovascular risk factors.
Symptomatology:
* Agnosia: The inability to recognize objects or stimuli despite intact sensory organs. For example, a patient can smell something but cannot recognize it as perfume or identify that food is spoiled.
Safety Implementation:
* Nurses must ensure food safety by throwing away spoiled food, as patients with agnosia cannot identify spoilage.
Terminal (End-Stage) Symptoms:
    * Loss of facial expression (cannot smile).
    * Incontinence.
    * Positioning: Primarily found in the fetal position.
    * Loss of motor function: Cannot sit up straight or swallow.

Reminiscent Therapy:
    * Description: Utilizing familiar items, such as family pictures, in the patient's room to promote memory and provide comfort through familiarity.
    * Focus: Incorporating activities the patient used to enjoy.
    * Purpose and Benefits:
        * Reflecting on significant life memories (both positive and negative).
        * Promoting resolution: Helping the patient make peace with unresolved life issues.
        * Implementation: Can be performed one-on-one or in a group setting.
        * Goal: Promote self-esteem.
Elderly Group Therapy:
* Family Education: Families may not see the benefit; nurses must educate them that group therapy provides sensory stimulation and reality orientation.
* Social Benefits: Patients orient each other and experience reduced depression through social interaction and making friends.

Memory Consolidation:
    * Short-term memory: Worsens with age.
    * Long-term memory: Remains stable as we age.
    * Learning: Learning is a lifelong ability; however, the ability to solve day-to-day problems becomes increasingly difficult with age.
Nursing Care Priorities for Dementia:
    * Physical Needs: Patients often become disheveled, stop brushing teeth, and lack Activities of Daily Living (ADLs).
    * Immediate Priority: Assisting with toileting and showering.
    * Environmental Management: Maintain a consistent daily routine schedule.
    * Sequencing Care: Reality reorientation is performed later, after physical ADL needs are met.

Delirium:
    * Context: Delirium is not a normal part of aging.
    * Classification: It is a medical emergency.
    * Etiology (Causes): Infections, medications, withdrawal, substance abuse, alcohol, and advanced age.
Safety Interventions for Self-Harm/Suicidality:
    * Implementation: Move the patient closer to the nurse's station.
    * Staffing: Utilize a sitter for constant observation.
    * Contraindication: Never use restraints; they can exacerbate the condition or cause death.
Sundowning:
* Definition: A clinical phenomenon where the patient becomes increasingly agitated or restless past the afternoon and into the evening.
Medication Side Effects:
* Donepezil: Can cause side effects of lightheadedness and fainting.