Here is what I took away from the review session with Mrs. Semillo today.
There were a few things that she mentioned more than once or that she mentioned out of the blue.
- The majority of the questions will be about the assessment of and rationale for the cardiopulmonary system.
- When checking circulation, note 'mottled' skin (red/blue/purple blotches)
- When checking circulation, note the oral mucosa (tongue: shiny and beefy)
- Meds that can effect circulation are Coumadin (Warfarin) and Aspirin (most commonly)
- Do NOT use MRI if pt has metal, pacemaker, old lead based tatoo
- Do NOT do a CT if pt is allergic to iodine or shellfish
- If doing a bronchoscopy, check gag reflex (aspiration)
- If Left Ventricle enlarged, you may see edema or hear crackles (lung sounds)
- With apnea, crackles indicate secretions, fluid
- #4: Know that subjective is symptoms, objective is signs
Nurses treat signs/symptoms
Outcomes need to be specific and measureable (when, how much, how many, etc)
Be able to identify a good outcome statement
Be able to prioritize (ABC's, then safety)
Interventions need to address the signs and symptoms (the 'as manifested by')
- #5: Hypoxemia is measureable
The common diagnoses for oxygenation are:
- Ineffective tissue perfusion
- Impaired gas exchange
- Ineffective airway clearance
- #6: Know that you ask OPEN-ENDED questions.
- #10: If someone is having difficulty breathing, sit them up, use purse-lipped technique.
- When someone has a trach, air always needs to be humidified
- #11: Hyperoxygenate before suctioning (3-5 x's; 750mL (1 1/2 x's normal Tidal Volume (500mL))
- Check cannulas and masks for pressure sores
If anyone has anything else, please comment.
Tuesday, September 18, 2007
Exam #2 review
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4 comments:
Trina, you did a pretty good job of summing it all up. Thanks for posting that, I missed the 1st half of the study session yesterday and your input is very helpful.
I second that!
I just noticed you asked if anyone had anything else to add. Hmmm... some of this might be redundant, but here goes:
1. know difference between primary and secondary data (such as chart, client's spouse).
2. Related to diagnoses/the nursing process: Be aware of Gordons' 11 functional health patterns (see box 11-4 on p. 190). All refer to patterns to signify a sequence of recurring behavior. Gordons' health patterns appears in the front of our Diagnoses handbook.
3. The three categories that fall under a cardiopulmonary system assessment are: 1) circulation (blood/vascular) 2) perfusion (cardio), and 3) ventilation (respiratory)
Assessing circulation, look at skin, eyes, oral mucosa, cap refill, and objective data, such as labs (hg/hct), VS, MRIs and CT scans.
Assessing perfusion, look at heart rate/murmurs, BP, carotid/peripheral pulses (weak/absent), edema
Assessing ventilation, look at 02 sat, resp. rate, breathing pattern, patent airway, SOB, tidal volume, med. history (smoking, asthma, allergies, family history), cough (productive or non-productive, quality of sputum (color, amt., viscosity), meds (opioids depress respiratory syst), gag reflex/aspirations
4. Be able to recognize a properly worded nursing diagnostic statement, with three parts: " 1)____________ (problem/NANDA wording), 2) related to (or RT) ____________ (etiology/cause), 3) as evidenced by (or manifested by) _______________" (signs/symptoms).
thanks.
I was wondering about Gordon's. I will take a look at it just in case.
thanks for the information about the perfusion/vent/circ chart. There was so much information from that, I didn't put much of it up.
Very helpful.
Oh, which elicited a cough? Opioids? Morphine was it?
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