OK I know this sounds stupid but I have a friend that gets really freaked out before big tests like finals, HESI, NCLEX, and usually we get together and a few days before I start throwing out random facts at her. On 2 different tests she said the only way she got several questions was from the random facts that I threw at her that she never would have thought of!
SOOOOO..... I thought that if yall wanted to do this we could get a thread going and try to throw out 5 random facts or "things to remember". NCLEX is coming and the more I try to review content the more I realize that I have forgotten so......here are my 5 random facts for ya:
OH and BTW these came from rationales in Kaplan or Saunders no made up stuff:
1️⃣ A kid with Hepatitis A can return to school 1 week within the onset of jaundice.
2️⃣ After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine.
3️⃣ Hyperkalemia presents on an EKG as tall peaked T-waves
4️⃣ The antidote for Mag Sulfate toxicity is ---Calcium Gluconate
5️⃣ Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact.
Oh, ohh, one more...
? Vasopressin is also known as antidiuretic hormone
- trying to improve/promote o avoid/prevent something.
- what are you trying to prevent/promote?
- promoting circulation? venous, arterial… after angiogram.(supine with affected extremity extended)
- think about anatomy, physiology and pathophysiology
- what position best accomplished what you are trying to prevent or promote?
anaphylactic reaction: place in supine position with legs elevated
air/pulmonary embolism (s&s: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) --> position the client to a left trendelenburg position with the hob lower (this will trap the air in the right side of the heart
pneumonia on right side, position with the left side dependent
for a lung biopsy, position pt lying on side of bed or with arms raised up on pillows over bedside table, have pt hold breath in midexpiration, chest x-ray done immediately afterwards to check for complication of pneumothorax, sterile dressing applied
best position to improve respiration effort = left lateral, folwer & modifications of it
detached retina --> area of detachment should be in the dependent position
after cataract surgery --> pt will sleep on unaffected side with a night shield for 1-4 weeks.
eye problems do not want head in dependent position. lie on good side and have bad eye up or elevate the head of the bed to 35 degrees.
infant w/ cleft lip --> position on back or in infant seat to prevent trauma to suture line. while feeding, hold in upright position. cleft palate - on side or abdomen
meneries- position affected side
after myringotomy --> position on side of affected ear after surgery (allows drainage of secretions)
after thyroidectomy --> low or semi-fowler's, support head, neck and shoulders.
tube feeding w/ decreased loc --> position pt on right side (promotes emptying of the stomach) with the hob elevated (to prevent aspiration)
infant with laryngomalacia(congenital laryngeal stridor), place in prone position with neck hyperextended to decrease stridor
infant w/ spina bifida --> position prone (on abdomen) so that sac does not rupture
during epidural puncture --> side-lying
for a lumbar puncture, pt is positioned in lateral recumbent fetal position, keep pt flat for 2-3 hrs afterwards, sterile dressing, frequent neuro assessments
after lumbar puncture
- (and also oil-based myelogram oil based dye heavier bed flat)--> pt lies in flat supine (to prevent headache and leaking of csf).post laminectomy -flat position
- myelogram postop positions. water based dye (lighter) bed elevated.
head injury --> elevate hob 30 degrees to decrease intracranial pressure
william's position - semi fowlers with knees flexed (inc. knee gatch) to relieve lower back pain.
autonomic dysreflexia/hyperreflexia (s&s: pounding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension) --> place client in sitting position (elevate hob) first before any other implementation.
seizure position patient on his or her side in a lateral position
shock --> bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified trendelenburg)
buck's traction (skin traction) --> elevate foot of bed for counter-traction
after total hip replacement --> don't sleep on operated side, don't flex hip more than 45-60 degrees, don't elevate hob more than 45 degrees. maintain hip abduction by separating thighs with pillows.
above knee amputation --> elevate for first 24 hours on pillow, position prone daily to provide for hip extension.
below knee amputation --> foot of bed elevated for first 24 hours, position prone daily to provide for hip extension.
prolapsed cord --> knee-chest position or trendelenburg. call for help!! get that bottom off the cord! support cord with you hand
woman in labor w/ un-reassuring fhr (late decels, decreased variability, fetal bradycardia, etc) --> turn on left side (and give o2, stop pitocin, increase iv fluids)
preterm high risk: position in add & flex extremities w/ rounded shoulders
pt w/ heat stroke --> lie flat w/ legs elevated
bridiging technique ,which i had never heard of is a type os positioning of pillows used to relieve pressure on bony prominences
liver biopsy - position supine with arms raised above head. lay on right side after liver biopsy.
during continuous bladder irrigation (cbi) --> catheter is taped to thigh so leg should be kept straight. no other positioning restrictions.
nephroticsyndrome require good skin care and frequent position changes d/t edema
parkinson risk of aspiration --> upright during feeding.
to prevent dumping syndrome (post-operative ulcer/stomach surgeries) --> eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low cho and fiber diet, small frequent meals)
peritoneal dialysis when outflow is inadequate --> turn pt from side to side before checking for kinks in tubing (according to kaplan)
- when more dialysate drains than has been given, more fluid has been lost(output). if less is returned than given, a fluid gain has occured.
- peritoneal dialysis if outflow slow check tube for patency, turn pt side to side
• weight before and after treatment
• monitor bp
• monitor breath sounds
• use sterile technique
• if problem w/ outflow, reposition client
• side effects: constipation
- slow dialysate instillation- increase height of container, reposition client. poor dialysate drainage-lower the drainage, reposition.
administration of enemaà position pt in left side-lying (sim's) with knee flexed. do not elevate the head of bed
colonoscopyàleft sims position
after supratentorial surgery (incision behind hairline) --> elevate hob 30-45 degrees
after infratentorial surgery (incision at nape of neck)--> position pt flat and lateral on either side.
during internal radiation --> on bedrest while implant in place
a cholinergic blocking agent may delay the sublingual absorption of nitroglycerin because of dry mouth .
verapamil reduces afterload and with concurrent use of nitroglycerine can cause (increase) hypotension.
nitroglycerine causes vasodilation=increase iop
do not give when bp is
in empty stomach - avoid alcohol.
discard unused nitroglycerine tablets 3-6 months after bottle opened (spray nitroglycerin can last longer) & obtain new prescription. tingling or burning sensation under your tongue or flushing or warmth in your face and neck-not everyone feels these effects, some do not give that efect
avoid exposed of pills to heat, moisture, or air for long periods of time
se: throbbing ha (acetaminophen/ibuprofen can be used), flushing skin, dizziness, fainting,
viagra=no nitroglycerin
long-term nitrates, you may need to take them at uneven intervals throughout the day to prevent nitrate tolerance (lose ability to vasodilate. does not occur with fast-sublingual nitro)
nitrates can also relieve chest pain due to prinzmetal's angina and syndrome x.
I am trying to get a person taking nclex-rn just for sharing information one another ,if any body willing please post me and I will reply as soon as I can.
Hi guys, I just wanna thank this forum for being a great help on my review, I took my exam last Aug 3 and did the pearsonvue trick and got the good pop up:yeah:, I still coudn't believe that I've pass cause I'm sleepy when I took the test, I couldn't remember what hep c is, LOL,. I coudn't sleep the day before I took my exam, I think it was 4am when I slept, good thing I scheduled my exam at 1pm, I saw my name on the ca brn site and later on they sent my license. Just think positive guys, everyday face yourself in the mirror and tell to yourself I can do it, always stay focused and always pray to god.
This thread is awesome. I read every post and I took my nclex-RN the other day and because of this thread I was able to answer some questions I wouldn't have had the answer to and I passed my exam :) Thanks so much for posting this thread and those who gave great stuff to remember. :)
ex. clients who are in severe and refusing meds (needs more assessment)
- review
- nsg process/ nsg judgement use (apie= assessment,planning, implementation,evaluation)
- encourage
- develop
- use of iv meds (ex. plasma, blood products-- these and iv are done by rn only)
- consult/counsel/suggest & update
- admission .. new & post op
- teach
- educate
- discharge & admission preparation
lpn/lvn-
-certain invasive task =i-sound star cross ++
- im adm
- sq adm.
- oral meds adm
- urinary catheterization
- nitroglycerin
- dreassing of wound (changing & irrigating) very commonly seen q.
- suctioning
- tube feeding
- auscultate/listen
- routine/standard
- check(s)
- reinforce/remind
- observe
- set up (basic equipment)
- specimen collection & data colletion
+
-blood glucose readings
-monitor
-review/teach-- usually standard practices (hand washing/hygiene) or med administration (ie. eye drops) -- rn mostly teaches/educated and lpns reinforce
+
cast & toe amputation are stable clients and need on going assessment and pain mgt./la charity book(don’t know too..just dont deprive with it.. just follow the book
data collection such as listening to lung sounds & checking for peripheral edema_part of lpn scope of practice: /lacharity book
** don't assign lvn/lpn to do a task an nurse assistant can complete**
- non invasive procedure/basic care =sparrtacus groam +++
-skin care (ex. bed rest with a skin tear and hematoma from a fall 2 days ago, apply and care for a client’s rectal pouch )
-positioning-- special positioning-- requires initial education by rn -- assistant will assist not teach
-ambulation/ assisting with adl (ambulation of fractured hip only rn& pt) ( patienst with chestube ambulating the hall-lpn/lvn)
-recording & monitoring of v/s (bp,pulse, oxygen sat,)
-range of motion &exercise
-transport of client
-assist (assisting for prep for sitz bath)
-collection of
-urine &
-stool
-groam (groaming & hygiene measure, bathing & checking water temp)
+
weighting
intake & output
feeding
+
- remind/reinforce: usually reminds pt. to do something rather than how to do it (skills previously taught by other health care professional or precaution measures)***
- they can detach suction and remove a foley but not connect or insert
- gather (equipment)
+
- measurement of ankle and bracial blood pressure for ankle brachial index calculation.(calculated already)
( calculation on the ankle-brachian index is responsibility of rn)
-experienced nsg assistant should have been taught how to..
monitor apical pulse, however, the rn should observe to be sure that s/he mastered this skills.
---la charity book---
new rn
-education and hospital orientation includes.. safe administration of iv meds.
-stable patients
some key points:
patients that require teaching about drugs or need procedures done are not rn priority.
physician
-informed consent
-medical diagnosis
-prescriptions
-order procedures
avoid these assignments for new/float/lvn/lpn/traveling
-new onset/sudden/acute
-new admission
-transfer
-newly diagnosed
-discharge
-require education/teaching (beyond basic skills -- tend to be complex and specific to patients on that particular unit)
- unstable (ie. high risk of sudden respiratory failure, or requires frequent assessments and changes in therapy(like electrolyte imbalances)
give:
- chronic
- routine meds/procedures
- stable
all healthcare workers
- responsible for knowing about and implementing standard precautions + airborne/droplet/contact --> therefore all can teach about it or prepare a room for it
-can be delegated care for stable pt's with expected outcomes
cna
- delegate tasks that involve standard unchanging non sterile procedures
if a RN comes from another unit, give that RN a pt who does not need to have a RN from specific unite care for him/her. ex. --post op mastectomy needs an onco nurse to take with.
for delegating: lvn / float RN = with stable pt with predictable outcome
assessment, teaching, meds, evaluation, unstable patientcannot be delegated to an unlicensed assistive personnel.
lvn/lpn cannot handle blood.
delegation--if you are assigning pt care to lpn/na, rank order the pt as to the ones who have the least acute problems/changes to the most
uap= unlicensed assistive personnel
ask yourself:
1) are the and rules in place which support the delegation?
a) yes---go to step 2
b) no--- do not delegate
2) is the task to be delegated within the scope of practice of the RN/lpn?
a) yes---got to step 3
b) no---do not delegate
3) is the RN/lpn has the knowledge and experience to make delegation decisions?
a) yes---go to step 4
b) no---do not delegate. action to take: provideeducation and documenteducation provided
4) has there been assessment of the client's needs?
a) yes---move to step 5
b) no---assessclient's needs first, then proceed with considerations to delegations
5) is the uap competent, has the experience to accept the delegation?
a) yes---move to step 6
b) no---do not delegate. action to take: provide education and document the education given to the uap
6) does the ability of the care giver match the care needs of the client?
a) yes---go to step 7
b) no---do not delegate
7) can the task to be delegated be performed withoutrequiring nursing judgment?
a) yes---move to step 8
b) no---do not delegate
? are the results of the task reasonably predictable?
a) yes---move to step 9
b) no---do not delegate
9) can the task be safely performed according to exact, unchanging directions?
a) yes---move to step 10
b) no---do not delegate
10) can the task be safely performed without complex observations or decisions based on critical thinking?
a) yes---move to step 11
b) no---do not delegate
11) can the task be performed without repeated nursing assessments?
a) yes---move to step 12
b) no---do not delegate
12) is appropriate supervision available?
a) yes--- all other steps met, it is safe to delegate
b) no---do not delegate
delegation= transferring a selected nursing task in a situation to an individual who posses the knowledge, experience that makes the person competent to perform that specific task.
the nurse practice act and any practice limitation, such as been unfamiliar with the particular task which needs to be delegated, define which aspects of care can be delegated and which must be performed by the registered nurse.
only the task not the ultimate accountability may be delegated to another. the nurse who delegates maintains accountability for the overall nursing care of the client. the nurse must know what are her clients preferred outcomes in terms of health care delivery goals, so that the process of delegation is geared toward achieving desirable outcomes.
the RN must match the task to be delegated based on the nurse practice act and appropriate position descriptions.
task that which are the responsibility of the RN only:
a) unstable patients with the least predictable medical outcomes
b) central line care
c) any tasks involving teaching, observation, discharge of a patient, assessment and critical thinking based decisions
d) blood transfusions
e) parenteral nutrition
f) patient controlled analgesia
g) development of a plan of care
h) taking a medical history
I) taking phone doctor's orders for prescription and treatment
a) patients who are stable and with predictable outcomes and common, well-defined health problems
b) give meds, oral, topical and inhalants, can administer treatments such as sterile wound care, blood sugar testing, nasogastric tube insertion, tube feedings and charting
c) lpn/lvn can start an iv of saline and superimpose iv fluids with vitamins, nutrients and electrolytes by primary or secondary infusion lines, infuse blood and blood products with iv certification
d) give injections
e) monitor running iv
f) give enemas
g) monitor a urinary catheter
h) do simple wound dressing change
I) any task which does not require nursing judgment or complex observation, nurse can delegate to the lpn. RN must inform the parameters of what to report as abnormal
j) use sterile technique procedures such as putting a urinary catheter
k) can give intra muscular injections, subcutaneous, intradermal
l) cannot give iv push, infuse antibiotics or other medications via secondary iv line
m) can initiate teaching and a care plan
n) cannot infuse iv fluids such as tpn or other fluids via a central line and cannot do blood withdrawal via central line
o) can do blood withdrawal via venipuncture or peripheral line with blood withdrawal certification
only RN & pn can delegate to uaps. one uap cannot delegate task to another uap
uap (unlincensed assisitive personnel) should be able to perform "routine" trach care
uap
a) bathing patient
b) ambulation
c) making beds
d) routine vital signs feeding patients
e) transferring patients
reverse delegation – occurs when a person with lower rank delegates to someone with authority.
overdelegation when a delegator loses control over a situation by providing delegate with too much authority or responsibility.
underdelegation: when full authority and responsibility are not trasferable.
incomplete delegation: delegator delegates a task and then due to fear or inexperience removes the task either while its being accomplished or before ist fully accomplished.
charge nurse responsibility = make assignments for nursing staff; assess critically ill pts and bed assignments for admissions.
Private room - negative pressure with 6-12 air exchanges/hr
mask, n95 for tb
- disseminated herpes zoster is airborne precautions, as to localized herpes zoster is contact precautions. a nurse with a localized herpes zoster can care for patients as long as the patients are not immunosuppressed and the lesions must be covered!
- include all universal precautions and negative pressure single patient rooms, gown, goggles, mask on you, mask on pt. if leaving room which should only be done if absolutely necessary and wearing mask.
**always check facilities policies when following isolation precautions/procedures
Droplet
think of s3p3iderm3an!
s - sepsis
s - scarlet fever
s - streptococcal pharyngitis
p - parvovirus b19
p - pneumonia
p - pertussis
I - influenza
d - diptheria (pharyngeal)
e - epiglottitis
r - rubella
m - mumps
m - meningitis
m - mycoplasma or meningeal pneumonia
an – adenovirus (requires contact precautions in addition)
private room or cohort
mask
- include all universal precautions, gown, goggles, masks on you before you enter, on pt. if leaving room, single pt. rooms, private room unless other pt has same organism, mask when transported.
- used with: majority of infectious diseases, involves contact conjunctive or mucous membranes of nose, mouth that happens during coughing, sneezing, talking or during procedure such as suctioning and bronchoscopy
- maintain spatial separation of 3 feet between infected patient and visitors.
- door may remain open.
Contact Precaution
Mrs. Wee
m - multidrug resistant organism – mrsa, vrsa
r - respiratory infection, rsv, parainfluenza
s - skin infections * diphteria
w - wound infxn (abscesses, decubitus
e - enteric infxn - clostridium difficile, e. coli 157:h7, salmonella, shigella, hep a, rota
e - eye infxn – hemorrhagic conjunctivitis
h – viral hemorrhagic feves (ebola, lassa, marburg)
RSV - child in private room...contact precautions..not droplet or airbone. (sometimes I get this mixed up because its called respiratory synctical virus..I used to pick droplet precautions but I have down now LOL!
- use universal precautions, gown, gloves, when contact with pt., single pt. room in most situations. clean non sterile gloves when entering the room
- room needs to be private unless same organism
- avoid skin-to-skin contact (turning pt, bathe, hand contact
- used with: any colonizing infections, msrv, fifths disease, rsv, infected wounds, skin, or eyes
- wear a gown before entering the room if clothing will have contact with patient, environment surfaces, or if patient is incontinent, has diarrhea, an ileostomy, colostomy or wound drainage
- remove the gown before leaving the room
- use dedicated equipment or clean and disinfect between patients
Skin infections
vchips
v - varicella zoster
c - cutaneous diphtheria
h - herpez simplex
I - impetigo
p - pediculosis
s – scabies, staphylococcus
Private room or cohort
gloves
gown
Airborne
*keep door closed*
In addition to droplet precaution:
*maintain spatial separation of 3 feet between infected patient and visitors. door may remain open.
Standard precautions
tetorifice, hepatitis b, hiv
rubella (german measles)- airbone contact precautions, 3 day rash, no pregnancy x 3 month (I kept forgetting which was dangerous when you're pregnant; regular measles (rubeola), or german measles (rubella), so remember:
a) put the surgical mask or respirator around mouth and nose (type of mask depend on the type of isolation)
b) apply eyeware or goggles snugly around the face and eyes (when needed)
c) apply gown and make sure it covers all outer garments, pull sleeves down to wrist and tie the gown securely on the neck and waist
d) apply disposable globes to cover over the edge of the gown sleeves
e) enter the patient's room
f) equipment such as stethoscope, pressure cuff, thermometer--disposable--.
g) nondisposable equipment remains in the room... clean nondisposable equipment with alcohol before and after using it, place dedicated equipment on a clean surface
Leaving isolation room:
a) remove gloves, discard
b) untie top mask string and then bottom string pull mask away from face and do not touch the outer surface of the mask
c) untie waist and neck string of the the gown, allow the gown to fall from the shoulders
d) remove hands from sleeves without touching the outside of the gown
e) hold the gown inside at the shoulders seams and fold inside out and discard
f) remove eyeware or goggles
g) wash hands
h) leave the room and close the door if the patient is on airborne precautions
Putting gown, mask, gloves
1. wash hands
2. place mask on face
3. put on gown
4. put on clean or sterile gloves
Removing gown, glove, mask
1. remove gloves
2. remove mask
3. untie gown
4. wash hands
5. remove gown
6. fold it inside out and discard
7. wash hands again
Steps of the procedure of preparing and maintaining sterile field
equipment:
*flat work surface
*sterile drape.
*sterile supplies as needed (sterile gauze,sterile basin,solutions,scissors,foreceps),packed sterile gloves.
1.wash your hands
2.check for the integrity of the sterile package,expiration date etc.
3.during the entire procedure,never turn your back on the sterile field or lower your hands below the level of the field.
4.open the sterile drape
*start from the outer wrapper and place the inner drape in the center of the of the work surface with the outer flap facing away from you
*touching the outside of the flap only,reach around rather than over the sterile field to open the flap away from you first
*open the side flaps,in the same manner,using the right hand for the right flap and the left hand for the left flap.
5.lastly ,open the inner most flap that faces you,being careful that it does not touch your clothing or any object.
Adding sterile supplies to the the field.
General rule
*generally before opening the sterile package you want to assess the order in which supplies will be used during the procedure so that supplies used firstcan be added to the field last
1.prepackaged sterile supplies are open by peeling back the partially sealed edges with both hands or lifting up the unsealed edge,taking care not to touch the supplies with your hands.
2.hold supplies 10 to 12 inches above the field and allow them to fall to the middle of the sterile field.wrapped sterile supplies are added by grasping the sterile object with one hand and unwrapping the flaps with the other hand.
3.grasp the corners of the wrapper with the free hand and hold them against the wrists of the other hand while you carefully drop the subject onto the sterile field.
Adding sterile solutions to a sterile field1.read the solution labeland expirationdate
2.remove cap and place it within facing up on the flat surface.do not touch the inside of the cap or rim of the bottle.
3.hold bottle 6 inches above the container on the sterile field and pour slowly to avoid spills.
4.recap the solution bottle and label it with date and time of opening if the solution is to be reused.
5.add any additional supplies and don sterile gloves before starting the procedure.
fmAtoZ&backagain
135 Posts
positioning facts:
- trying to improve/promote o avoid/prevent something.
- what are you trying to prevent/promote?
- promoting circulation? venous, arterial… after angiogram.(supine with affected extremity extended)
- think about anatomy, physiology and pathophysiology
- what position best accomplished what you are trying to prevent or promote?
anaphylactic reaction: place in supine position with legs elevated
air/pulmonary embolism (s&s: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) --> position the client to a left trendelenburg position with the hob lower (this will trap the air in the right side of the heart
pneumonia on right side, position with the left side dependent
for a lung biopsy, position pt lying on side of bed or with arms raised up on pillows over bedside table, have pt hold breath in midexpiration, chest x-ray done immediately afterwards to check for complication of pneumothorax, sterile dressing applied
best position to improve respiration effort = left lateral, folwer & modifications of it
detached retina --> area of detachment should be in the dependent position
after cataract surgery --> pt will sleep on unaffected side with a night shield for 1-4 weeks.
eye problems do not want head in dependent position. lie on good side and have bad eye up or elevate the head of the bed to 35 degrees.
infant w/ cleft lip --> position on back or in infant seat to prevent trauma to suture line. while feeding, hold in upright position. cleft palate - on side or abdomen
meneries- position affected side
after myringotomy --> position on side of affected ear after surgery (allows drainage of secretions)
after thyroidectomy --> low or semi-fowler's, support head, neck and shoulders.
tube feeding w/ decreased loc --> position pt on right side (promotes emptying of the stomach) with the hob elevated (to prevent aspiration)
infant with laryngomalacia(congenital laryngeal stridor), place in prone position with neck hyperextended to decrease stridor
infant w/ spina bifida --> position prone (on abdomen) so that sac does not rupture
during epidural puncture --> side-lying
for a lumbar puncture, pt is positioned in lateral recumbent fetal position, keep pt flat for 2-3 hrs afterwards, sterile dressing, frequent neuro assessments
after lumbar puncture
- (and also oil-based myelogram oil based dye heavier bed flat)--> pt lies in flat supine (to prevent headache and leaking of csf).post laminectomy -flat position
- myelogram postop positions. water based dye (lighter) bed elevated.
head injury --> elevate hob 30 degrees to decrease intracranial pressure
william's position - semi fowlers with knees flexed (inc. knee gatch) to relieve lower back pain.
autonomic dysreflexia/hyperreflexia (s&s: pounding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension) --> place client in sitting position (elevate hob) first before any other implementation.
seizure position patient on his or her side in a lateral position
shock --> bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified trendelenburg)
buck's traction (skin traction) --> elevate foot of bed for counter-traction
after total hip replacement --> don't sleep on operated side, don't flex hip more than 45-60 degrees, don't elevate hob more than 45 degrees. maintain hip abduction by separating thighs with pillows.
above knee amputation --> elevate for first 24 hours on pillow, position prone daily to provide for hip extension.
below knee amputation --> foot of bed elevated for first 24 hours, position prone daily to provide for hip extension.
prolapsed cord --> knee-chest position or trendelenburg. call for help!! get that bottom off the cord! support cord with you hand
woman in labor w/ un-reassuring fhr (late decels, decreased variability, fetal bradycardia, etc) --> turn on left side (and give o2, stop pitocin, increase iv fluids)
preterm high risk: position in add & flex extremities w/ rounded shoulders
pt w/ heat stroke --> lie flat w/ legs elevated
bridiging technique ,which i had never heard of is a type os positioning of pillows used to relieve pressure on bony prominences
liver biopsy - position supine with arms raised above head. lay on right side after liver biopsy.
during continuous bladder irrigation (cbi) --> catheter is taped to thigh so leg should be kept straight. no other positioning restrictions.
nephrotic syndrome require good skin care and frequent position changes d/t edema
parkinson risk of aspiration --> upright during feeding.
to prevent dumping syndrome (post-operative ulcer/stomach surgeries) --> eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low cho and fiber diet, small frequent meals)
peritoneal dialysis when outflow is inadequate --> turn pt from side to side before checking for kinks in tubing (according to kaplan)
- when more dialysate drains than has been given, more fluid has been lost(output). if less is returned than given, a fluid gain has occured.
- peritoneal dialysis if outflow slow check tube for patency, turn pt side to side
• weight before and after treatment
• monitor bp
• monitor breath sounds
• use sterile technique
• if problem w/ outflow, reposition client
• side effects: constipation
- slow dialysate instillation- increase height of container, reposition client. poor dialysate drainage-lower the drainage, reposition.
administration of enemaà position pt in left side-lying (sim's) with knee flexed. do not elevate the head of bed
colonoscopyàleft sims position
after supratentorial surgery (incision behind hairline) --> elevate hob 30-45 degrees
after infratentorial surgery (incision at nape of neck)--> position pt flat and lateral on either side.
during internal radiation --> on bedrest while implant in place