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Page 1: Nursing Care and Patient Management

Patient Positionings

  • Semi-Fowler’s: Patient lies on back with upper body elevated (30-45°), used for respiratory distress and cardiac issues.

  • Trendelenburg: Patient positioned on back with legs elevated higher than head, used for hypotension and improving venous return.

  • Lithotomy: Patient lying on back with legs elevated and spread, used during gynecological examinations and procedures.

Types of Errors

  • Communication Errors: Miscommunication among healthcare providers or with patients.

  • Diagnostic Errors: Incorrect or delayed diagnosis.

  • Treatment Errors: Errors in executing medication or interventions.

  • Preventive Errors: Failure to implement measures to prevent complications.

Code of Ethics

  • Ethical principles guiding nursing practice, including autonomy, beneficence, non-maleficence, and justice.

Incidents/Adverse Events

  • Unintended events leading to harm, require reporting and analysis to enhance patient safety.

Communication

  • Types: Verbal, non-verbal, written, electronic communication.

  • Styles: Assertive, passive, aggressive, and passive-aggressive communication methods.

Falls

  • Strategies to reduce falls include patient assessments, environmental modifications, and staff education.

Specimen Collections

  • Types: Blood, urine, sputum, stool.

  • How to Do Them: Follow protocols for collection and handling.

  • Equipment: Specimen containers, gloves, swabs, etc.

Casts/Traction

  • Types: Plaster, fiberglass casts; traction can be skeletal or skin.

  • Assessments: Monitor for skin integrity and neuromuscular status.

  • Hot Spot: Areas of increased warmth indicating potential problems.

  • Compartment Syndrome: Compromise of circulation due to increased pressure in a compartment.

  • Window: A cut-out area in a cast for monitoring.

Fractures/Spinal Cord Injuries

  • Positioning: Immobilization and appropriate support.

  • Assessment: Check for deformity, swelling, movement functionality.

  • Mobility: Teach safe movement practices and the use of assistive devices.

Assistive Devices

  • Cane, Walker, Crutches, Wheelchair: Educate on proper usage and safety precautions.

Surgical Care

  • Pre-Op: Assessments, patient education, informed consent.

  • Intra-Op: Aseptic technique, monitoring vitals, support.

  • Post-Op: Assess recovery, pain management, medication administration.

Surgical Complications

  • Evisceration: Protrusion of internal organs through a wound; requires immediate care.

  • Dehiscence: Wound reopening; monitor for risk factors and interventions.

Nutrition

  • Types of Diet: Clear liquid, full liquid, soft, regular diets.

  • Consistencies: Adjust based on patient needs and swallowing ability.

Electrolyte Imbalances

  • Causes: Dehydration, renal failure.

  • Signs/Symptoms: Muscle cramps, weakness, confusion.

  • Treatment: Fluid replacement, medication.

Acid/Base Imbalances

  • Causes: Respiratory and metabolic issues.

  • Signs/Symptoms: Altered mental status, irregular breathing.

  • Treatment: Addressing underlying causes and corrective measures.

Fluid Imbalances

  • Maintenance: Hydration management and monitoring intake/output.

  • Factors Affecting Fluid Balance: Diet, activity level, environment.

Fluid Volume Deficit

  • Causes: Diarrhea, vomiting, excessive sweating.

  • Types of Volume Loss: Isotonic, hypotonic, hypertonic.

  • Signs/Symptoms: Thirst, dry mucous membranes, low blood pressure.

  • Treatment: IV fluids, oral rehydration.

Fluid Volume Excess

  • Causes: Heart failure, renal failure.

  • Signs/Symptoms: Edema, hypertension, shortness of breath.

  • Treatment: Diuretics, fluid restriction.

Informed Consent

  • Essential process ensuring patients understand risks and benefits before procedures.

Cataracts/Glaucoma

  • Cataracts: Clouding of the lens; causes include aging and UV exposure.

  • Glaucoma: Increased intraocular pressure; requires monitoring and treatment options.

  • Symptoms: Blurred vision, halos around lights, vision loss.

Hearing Aids

  • Nursing Care: Guidance for hard of hearing patients, education on device use, and maintenance.

Sensory Clinical Exemplars

  • Conditions include Otitis Media, Raynaud Syndrome, Meniere's Disease, and Nasal Polyps.

Page 2: Chronic Conditions and Management

Parkinson’s Disease

  • Manifestations: Tremors, rigidity, bradykinesia.

  • Risk Factors: Genetics, environmental factors.

  • Signs/Symptoms: Shuffling gait, difficulty with balance.

  • Medications: Levodopa, dopamine agonists.

  • Treatment: Physical therapy, lifestyle modifications.

Osteoporosis

  • Manifestations: Bone fractures, back pain, loss of height.

  • Risk Factors: Aging, gender, family history.

  • Signs/Symptoms: Often asymptomatic until a fracture occurs.

  • Medications: Bisphosphonates, calcium supplements.

  • Treatment: Weight-bearing exercises, fall prevention strategies.

Osteoarthritis/Rheumatoid Arthritis

  • Manifestations: Joint pain and stiffness.

  • Risk Factors: Age, obesity, genetic predisposition.

  • Signs/Symptoms: Swelling, decreased range of motion.

  • Medications: NSAIDs, corticosteroids.

  • Treatment: Physical therapy, joint replacements if severe.

Pelvic Inflammatory Disease

  • Infection of female reproductive organs; leads to chronic pain and fertility issues.

Pneumonia

  • Causes: Bacterial, viral, or fungal infections.

  • Prevention: Vaccination, hand hygiene.

  • Assessment: Chest X-ray, sputum culture.

  • Treatment: Antibiotics, respiratory support.

COPD

  • Causes: Smoking, environmental pollutants.

  • Signs/Symptoms: Shortness of breath, chronic cough.

  • Treatment: Bronchodilators, steroids, supplemental oxygen.

  • Oxygen Levels: Monitor SpO2 and arterial blood gases.

Gas Exchange

  • Types of breathing: diaphragmatic vs. thoracic.

  • Oxygen Administration: Methods include nasal cannula, mask, and mechanical ventilators.

Pain Management

  • Types: Acute, chronic, neuropathic.

  • Screening Tools: Numeric rating scale, visual analog scale.

  • Assessments: Physical exam, patient history, impact on daily life.

Medications

  • Refer to NUR 160 workbook for drug classifications and nursing considerations.

Health History/Sexual History

  • Essential information includes medical history, medications, STIs, reproductive health issues.

Sexuality/Reproduction

  • Topics include infertility treatments, post-operative care related to reproductive health, and considerations of sexual history.

Hormones

  • Focus on Estrogen and Progesterone roles in reproductive health.

Cancer

  • Screenings: Mammograms, colonoscopies, PSA testing.

  • Risk Factors: Genetics, lifestyle factors (smoking, diet).

  • Treatment: Chemotherapy, radiation therapy, surgery.

BPH (Benign Prostatic Hyperplasia)

  • Manifestations: Difficulty urinating, increased frequency.

  • Risk Factors: Aging, family history.

  • Signs/Symptoms: Weak urine flow, urgency.

  • Medications: Alpha-blockers, 5-alpha-reductase inhibitors.

Theories of Grief/Mourning

  • Kubler-Ross: Stages of grief (denial, anger, bargaining, depression, acceptance).

  • Bowlby’s: Attachment theory related to grief.

  • Worden’s: Tasks of mourning model.

Types of Grief

  • Anticipatory Grief: Mourning before a loss occurs.

  • Complicated Grief: Prolonged and unresolved grief reactions.

  • Unresolved Grief: Inability to process the loss adequately.

Hospice/Palliative Care

  • Concept: Focus on quality of life for terminal patients.

  • Criteria: Life expectancy of six months or less, need for symptom management.

  • Myths: Misconceptions about hospice care and patient outcomes.

Hospice Interdisciplinary Team

  • Composed of nurse, physician, social worker, chaplain, and bereavement support.

Signs of Death

  • Monitoring vital signs (decreased heart rate, changes in breathing patterns).

  • Assessment includes physical changes and patient history.

Postmortem Care

  • Care following death includes respect for the body, family support, and documentation.