drop of blood on strip Airway Management: Laboratory Values to Report (Active Learning Template - System Disorder, RM FUND 9.0 Ch 53) early signs: tachypnea, tachycardia, restlessness, anxiety, confusion, pale skin, mucous membranes, elevated blood pressure, use of acessoy uscles, nasal flaring, trachael tugging, adventitious lung sounds Wrap site in warm towel to enhance circulationĬleanse the site with warm water and soap or antiseptic swab Skin irritation around the tubing site Specimen Collection for Glucose Monitoring: Obtaining a Capillary Blood Glucose Sample (Active Learning Template -ĭiagnostic Procedure, RM FUND 9.0 Ch 52) most common site to draw blood: outer edge of fingertip other sites: earlobe, heel, palm, arm, thigh Gastric residual exceeds 250 ml for each of two consecutive assessmentsĭiarrhea three times or more in a 24 hour period Occlusion of the NG tube leading to distention RM FUND 9.0 Ch 54) excoriation of nares and stomach - assess the color of drainage, report dark, coffee-ground, or blood streajed immediately Results in increases in Hct, serum electrolytes, and urine specific gravityĬompensatory mechanisms include sympathetic NS responses of increased thirst, antidiuertic hormone release, and aldosterone releaseĬan lead to hypovolemic shock Nasogastric Intubation and Enteral Feedings: Unexpected Findings (Active Learning Template - Therapeutic Procedure, Loss of water from the body without the loss of electrolytes Keep crutches 6 inches to the front and to the side of client when walkingĭont let crutches fit under the armpit - allow some space to avoid damage to skin or nerves in axillae Fluid Imbalances: Hyperosmolar Imbalance (RM FUND 9.0 Ch 57, Active Learning Template - System Disorder) aka dehydration Position crutches on the unaffected side when sitting or rising from a chair Support body weight at the hand grips with elbows flexed at 30* RN QSEN - Patient-centered Care) do not alter crutches after fitting Older adults have: fewer nephrons, loss of muscle tone of the bladder leading to frequency, inefficient emptying the bladder: residual urine increasing the risk for UTIs, increase in nocturia Mobility and Immobility: Appropriate Use of Crutches (RM FUND 9.0 Ch 40, Active Learning Template - Basic Concept, Urinary Elimination: Effects of Aging on Urinary Infections (RM FUND 9.0 Ch 44, RN QSEN - Patient-centered Care,Īctive Learning Template - Growth and Development) as you age, bladder function becomes less efficient
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