Health Promotion and Maintenance

  • Adults diagnosed with type 2 diabetes are recommended to have a yearly dilated eye exam to enable assessment of the blood vessels of the retina.

    • The recommendation for youth diagnosed with type 2 diabetes is a comprehensive dilated exam at the time of diagnosis and an annual dilated exam at the time of diagnosis and annual dilated exams thereafter

  • Adults between 40 and 60 years should have a glaucoma test every 2 years.

  • Formula-fed infant excretes pale yellow to light brown stools. They are firmer in consistency than those of the breastfed infant.

    • Stools of infants fed with breast milk are seedy, and the color and consistency are mustard-like with a sweet-sour smell

  • Bowel control is usually achieved before bladder control

  • Voluntary control of anal and urethral sphincters begins at about 18 to 24 months

  • The cardinal sign of impaction is continuous oozing of liquid stool, with no normal stool.

    • Oozing occurs as the liquid portion of feces higher in the intestines seeps around the mass.

  • For septic shock, administering NS at 500 ml/hr is priority to improve the client’s hemodynamic status

    • Glycemic control is important in sepsis care

  • Immunizations with live virus vaccines (Measles, mumps, rubella, varicella, and smallpox) are contraindicated during pregnancy because of possible teratogenic effects on the fetus

  • Inactivated vaccines such as (tetanus, hep B, and influenza) are safe for women who have a risk for developing these diseases.

  • Women who have not been previously vaccinated against pertussis receive the vaccine during the third or late second trimester

  • A 4 year old child should receive 4 doses of the IPV

    • The first dose at 2 months, a second at 4 months, the third dose between 6 and 18 months, and the fourth dose between 4 and 6 years of age

    • The child should receive 4 doses of PVC13. The first dose at 2 months, a second dose at 4 months, the third dose at 6 months, and the fourth dose between 12 and 15 months

    • The child should receive 4 doses of HiB. The first dose at 2 months, second dose at 4 months, and the third dose at 6 months, and the fourth dose between 12 and 15 months

    • The child should receive 2 doses of MMR, the first dose at 12 to 15 months and the second dose between 4 and 6 years of age

  • For bleeding from the circumcision site, the nurse applies gentle pressure with a sterile gauze pad to stop the bleeding in a short period of time.

  • The client diagnosed with seasonal affective disorder should use phototherapy beginning in the Fall and continue use until Spring

    • One intervention to help reduce symptoms is to increase exposure to sunlight

      • There are devices that mimic natural sunlight, which should be used until the amount of natural sunlight increases with the changing season

  • The client diagnosed with PKU lacks the enzyme necessary to convert phenylalanine to tyrosine.

    • Phenylalnine is a type of protein.

    • PKU results in phheylalnine accumulating in the tissues and that leads to mental deficiencies.

    • Clients diagnosed with PKU are fed a formula that is low in phenylalanine but contains minerals and vitamins required by the client

  • Cataract symptoms include blurred vision, photosensitivity, halos around lights, and difficulty seeing at night.

    • Vision can also seem “cloudy”

  • Macular degeneration symptoms include blurred vision and reduced central vision

  • Open angle glaucome symptoms include blurred vision, distorted vision, seeing halos around lights, and tunnel vision.

  • Nausea may being as early as 4 weeks after the last menstrual period, and usually improves by the end of the 14th week of pregnancy. Nausea is associated with an increase of hCG levels in early pregnancy.

  • Eating a dry carbohydrate upon waking up in the morning may help decrease nausea

  • Maintaining a weight within normal limits decreases insulin resistance, which may lower blood glucose levels. Women diagnosed with PCOS are predisposed to weight gain. If the client is overweight, a 10% loss in body weight can result in a more regular menstrual cycle, which can improve one’s chance of becoming pregnant. An example of a 10% weight loss would be if a 150b woman lost 15 lb.

  • Initial treatment when a DVT has occurred includes bed rest, with the affected leg elevated to decrease interstital swelling and to promote venous return from the leg

  • Explaining that the memory loss is a result of ECT.

    • The nurse should have prepared the client by explaining the procedure and associated temporary memory loss and confusion

    • Asking if the client has had memory problems is a yes/no question is non therapeutic.

  • Many twins or higher multiples are born prematurely because the uterus becomes overly distended.

    • Intermittent low back pain is a sign of labor.

  • Although the urine is dark related to the obstructive process, kidney function is usually not affected in pancreatic cancer

    • Severe anorexia and dramatic weight loss occur with pancreatic cancer

  • The nurse should make sure the bladder of the cuff is over the brachial artery in order to compress it during measurement

    • The nurse should be sure to place the cuff 2.5cm above the antecubital space

    • The nurse should position the client’s arm at the level of the heart to ensure an accurate reading

  • For clients with heavy menses, hormonal contraceptives such as birth control pills, injections, patches, and implants significantly reduce menstrual flow and associated cramping, improving the client’s quality of life.

  • If the client is not physically comfortable, the health assessment will not go as well as it could.

    • This is the priority. Remember how you conduct the client interview is just as important as the questions you ask

      • Major health problems can be assessed after physical and psychological comfort are established.