CRNE June 2012 - page 5

Anyone started to prepare for CRNE June 2012?... Read More

  1. Visit  Christoph profile page
    0
    clap clap clap!!!
  2. Visit  Christoph profile page
    0
    I may have to agree with kheemoy because we just have to answer what is being asked. For that question, "Which of the following independent nursing actions should the nurse implement to limit spread of Mr. Del Ray's ankle edema?", Let me just justify the cues that we have. First, We have the word Independent nursing action (nurse initiative) which means autonomous actions of the nurse, and based on the nursing diagnoses and client-centered goals that we us a nurse acts on our own intiative, without instructions from other persons/disciplines(physicians). Second, How do we intervene if a patient has a ankle edema? Based on what i know, one of the intervention for ankle edema (swollen legs or ankle) is to Raise your legs above your heart while lying down.

    Although #1 restricting his fluid is a good answer. We need an order from the doctor before we can implement that. So it will not be a independent nursing action. It will be Interdependent intervention.

    So I therefore conclude that my answer to that question is #4 Elevating his legs


    Cheer guys,,
  3. Visit  allicandoispray profile page
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    just to be clear the question and answer did not come from the CNA, it was in mosby's. the question was just a poor question overall. throughout my readings i was under the impression elevation of legs to relieve edema is completely contraindicated in patient's with CHF so this question is off base in my humble opinion.
  4. Visit  kheemooy profile page
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    @ allicandoispray --- can you provide us any readings that elevation of leg is contraindicated in CHF, mosby's doesn't say that and i searched for answer i didn't find anything that says it's contraindicated in CHF.

    @ christoph --- we have the same thoughts about this question. i agree with everything you said. you definitely got my point.
    Last edit by NotReady4PrimeTime on Jun 4, '12 : Reason: enabled multiple quote reply
  5. Visit  NotReady4PrimeTime profile page
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    Elevation of the legs is not contraindicated in CHF.
  6. Visit  jvre888 profile page
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    so that answered the question. Thanks janfrn.
  7. Visit  allicandoispray profile page
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    thank you for the clarification janfrn!

    kheemooy, i apologize, not contraindicated. it is just mentioned in mosby's (with Lewis reference) that elevation of extremities should be avoided in patient's with heart failure as it increases venous return, placing an increased workload on the heart.

    thank you for sharing why you believe the answer was correct. i still feel that this question was strange.
  8. Visit  jvre888 profile page
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    i never encountered any med-surg book that said elevation of leg is completely contraindicated in chf. or i just don't read med-surg book that much. lol..
  9. Visit  kheemooy profile page
    1
    @allicandoispray ---i know, the options were really tricky. there are always two answers which are correct, you just have to choose the best one. i just used test taking strategy, since the question gave cue and specifically asked for "independent" nursing action and intervention for edema. and if it seems that there's no correct answer from the option, just go for the closest answer and the best option that can somehow suffice what the question is asking. lol.
    petethecanuck likes this.
  10. Visit  jvre888 profile page
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    @kheemooy- You already!!! haahaha...

    can you teach us more about your test taking strategy? It sounds interesting... would you mind to share???
  11. Visit  NotReady4PrimeTime profile page
    3
    it's not contraindicated, but it does increase venous return to the heart as you say - which may increase perfusion to the kidneys and allow better diuresis. since peripheral edema is associated with right-sided heart failure, it would be expected in mr del ray. the dyspnea and pulmonary edema that accompanies left-sided heart failure would suggest a contraindication for elevating the legs, but these are not present in right-sided failure. check this out: www.nursing.umich.edu/.../congestive%20heart%20failure.ppt i would say that the university of michigan could be considered a reliable source.
  12. Visit  louise1821 profile page
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    Hi Kheemooy
    Sorry for the late reply, I found the course really good. I did the 10 week Prep course. How did it go for yoy.

    Olga

    Good luck to all tomorrow at 08:30
  13. Visit  kheemooy profile page
    0
    Quote from janfrn
    It's not contraindicated, but it does increase venous return to the heart as you say - which may increase perfusion to the kidneys and allow better diuresis. Since peripheral edema is associated with right-sided heart failure, it would be expected in Mr Del Ray. The dyspnea and pulmonary edema that accompanies left-sided heart failure would suggest a contraindication for elevating the legs, but these are not present in right-sided failure. Check this out: http://www.nursing.umich.edu/.../Con...%20Failure.ppt I would say that the University of Michigan could be considered a reliable source.
    AGREE!

    thanks janfrn! that answered it all.


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