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ATI LPN STEP 2011

11/17/2014

PTU- MEDICATION EFFECTIVENESS


TX HYPERTHROID
INCREASED WEIGHT RESULTS IN DECREASED THYROID HORMONE
PRODUCTION- MEDICATION EFFECTIVENESS
HEADACHE-ADVERSE EFFECT
DECREASED GI MOTILITY AND DECREASED PULSE RATEEXPECTED THERAPEUTIC EFFECT
LITHIUM CARBONATE
FINDINGS TO HOLD NEXT DOSE?
HAND TREMORS - INDICATION OF LITHIUM TOXICITY- NOTIFY MD
BEFORE GIVING NEXT DOSE
o ADVERSE EFFECTS
CONSTIPATION
HTN
URINARY RETENTION
PROPRANOLOL (INDERAL)- BETA BLOCKER
TX ANGINA PECTORIS-BY DECREASING ANGINAL PAIN BY
DECREASING CARDIAC O2 DEMAND
DECREASES ARTERIAL PRESSURE, HEART RATE AND
CONTRACTILITY
INCREASED TIME IN DIASTOLE
LIPID PANEL RESULTS-REQUIRING FURTHER EVAL
LDL CHOLESTEROL 145
o LDL LEVEL BELOW 100MG/DL
o HDL LEVEL OF AT LEAST 60 PROTECT AGAINST HEART
DISEASE

o TOTAL CHOLESTEROL LESS THAN 200


o TRIGLYCERIDE LEVEL BELOW 150
OLDER CLIENT INCONTINENT OF FECES
INTERVENTION TO INCLUDE IN PLAN OF CARE:
o APPLY PETROLEUM JELLY TO PERIANAL AREA
DO NOT PUT CORNSTARCH OR BABY POWDER- BECOME CAKED IN
SIN CREASES MAKING IT DIFFICULT FOR REMOVAL AND CAUSE
SKIN BREAKDOWN
PLACING CLIENT ON BEDPAN WILL NOT PREVENT INCONTINENCE
AND INCREASE THE RISK OF SKIN BREAKDOWN
BULIMIA NERVOSA FINDINGS ON CLIENT
AMENORHEA
DENTAL CARIES LOSS OF DENTAL ENAMEL
HYPOKALEMIA
ANOREXIA NERVOSA
LANUGO
ASA ADVERSE EFFECT
TX RHEUMATOID ARTHRITIS
RINGING IN EARS- EXPERIENCING SALICYLISM (DEVELOPMENT OF
TOXIC LEVEL OF ASA IN BODY)
BUCKS TRACTION NEVER REMOVE WTS WITHOUT A PRESCRIPTION
DONT TURN CLIENT- CAN CAUSE BONE FRAGMENTS TO SHIFT
INSPECT THE SKIN UNDER THE BOOT EVERY 8 HOUR TO CHECK
FOR INFLAMMATION OR IRRITAITON
APPLY ICE TO AFFECTED EXTREMITY TO DECREASE SWELLING

MANIFESTATION OF SCOLIOSIS FINDINGS


UNEVEN SHOULDER HT. CAUSED BY LATERAL CURVATURE OF
SPINE
CYSTIC FIBROSIS
TX PANCRELIPASE
MEDICATION EFFECTIVENESS- DECREASE STEATORRHEA
(DECREASE IN AMT OF FATTY STOOLS)
INFANT WITH HEART FAILURE
ELEVATED HEAD OF INFANT CRIB 30 TO 45 DEGREE TO INCREASE
CHEST EXPANSION
WEIGH INFANT SAME TIME DAILY ACCURATELY DETERMINE
PRESENCE OF FLUID VOLUME EXCESS
MONITOR SAO2 LEVEL EVERY 2 TO 4 HOUR AND PRN (DURING
TIME OF DISTRESS)
FEED INFANT Q. 3 HOURS PROMOTES ADEQUATE REST AND MEET
INFANTS ENERGY NEEDS
LUMBAR PUNCTURE
WILL BE PALCED IN SITTING OR FETAL POSITION WITH BACK
CURVED
AFTER PROCEDURE- LIE ON BACK (SUPINE) FOR 30 MIN TO 1 HR
TO REDUCE THE LOSS OF CEREBROSPINAL FLUID AND TO
PREVENT DEVELOPMENT OF SPINAL H/A
INCREASE FLUID INTAKE FOLLOWING LUMBAR PUNCTURE TO HELP
REPLACE THE CERBROSPINAL FLUID REMOVED AND TO PREVENT
SPINAL H/A FROM DEVELOPING
VITAMIN K (AQUAL MEPHYTON) ADMINISTERED TO NEWBORN
PREVENTS COMPLICATIONS
HEMORRHAGE
VIT K ACTIVATES THE COAGULATION FACTORS THAT ARE
SYNTHESIZED IN THE LIVER TO PREVENT HEMORRHAGE

INSPIRATORY STRIDOR- INDICATES PRESENCE OF LARYNGEAL


OBSTRUCTION
CARING FOR PT WITH INDWELLING CATHETER
KEEP DRAINAGE BAG LOWER THAN BLADDER- PREVENT BACKFLOW
OF URINE INTO THE BLADDER
PLACE CATHETER TUBING OVER THE UPPER THIGH OR LOWER
ABDOMEN FOR A MALE CILENT
COIL EXCESS TUBING IN BED NEXT TO PT- PREVENTS BACK FLOW
OF URINE AND UNNECESSARY TUGGING ON CATHETER
EVALUATION OF ABUSE
A 8 YEAR OLD WHO HAS FREQUENT UTI
o INDICATIVE OF SEXUAL ABUSE
TYPE 1 DM (BLOOD LEVEL BELOW 80)
GIVE 8OZ OF MILK
ADMINISTER GLUCAGO ONLY WHEN PT HAS SEVERE
HYPOGLYCEMIA AND IS UNCONSCIOUS OR UNABLE TO SWALLOW
AS A RESULT
BLOOD GLUOCSE BELOW 20 CAUSES SEVER HYPOGLYCEMIA
PNEUMOTHORAX AND HAS A CHEST TUBE ATTACHED TO WATER SEAL
DRAINAGE SYSTEM : INCLUDE IN TEACHING
DRAINAGE SYS PROMOTES GRADUAL RE EXPANSION OF THE LUNG
CHEST TUBE IS INSERTED TO PROMOTE NEGATIVE PRESSURE
WHICH WILL ALLOW RE EXAPNSION OF LUNG
POTENTIAL CAUSE OF ADVERSE REACTION WHILE TAKING
DISULFIRAM (ANTABUSE) FOR ALCOHOL USE DISORDER
COLOGNE REFRAIN FROM APPLYIN TO SKIN, COLOGNE CAN
CONTAIN ALCOHOL AND CAUSE AN ALCOHOL-DISULFIRAM
REACION
SIGNS OF INCRASE INTRACRAINAL PRESSURE FROM HEAD INJURY
PROJECTILE VOMITIG
LETHARGY

NUCHAL RIGIDITY INDICATES A LEAK IN CERBRAL SPINAL FLUIDCLINICAL MANIFESATION OF MENGINIGITIS


LOW SODIUM DIET (HTN CLIENT)
PROCESSED CHEESE- FOOD PROCESSING CAN INCREASE THE
SODIUM CONTENT
CLINICAL MANIFESTATIONS OF BIPOLAR DISORDER IN MANIC PHASE
FLIGHT OF IDEAS- RAPID SPEECH WITH CONSTANT CHANGES IN
TOPIC
FRACTURED FEMUR IN 90-90 TRACTION
CHECK CIRCULATION OF AFFECTED EXTREMITY AT LEAST EVERY 1
TO 4 HOUR
INSPECT PRESSURE POINTS AT LEAST DAILY
PROVIDE RANGE OF MOTION EXERCISEES FOR UNAFFECTED
EXTREMITES TO PROMOTE CIRCULATION AND PREVENT
CONTRACTURES
AFFECTED EXTREMITY SHOULD REMAIN IN TRACTION AND NOT BE
SUPPORTED ON A PILLOW
OLDER CLIENT WITH DIFFICULTY SWALLOWING
AVOID CLIENT TO USE STRAW BC IT PLACES PT AT RISK FOR
ASPIRATION
ALLOW CLIENT TO HOLD CUP OF WATER BC IT PERMITS THE PT TO
SWALLOW WATER AT APPRORIATE RATE
PLACE MEDICATION ON BACK OF PT TONGUE
2 MONTH INFANT VOMITING AND HAS DIARRHEA FOR PAST 24 HOUR:
INDICATIONS OF SEVER DEHYDRATION
SUNKEN ANTERIOR FONTANELLE
BODY WEIGHT LOSEE OF 10% OR GREATER
NO TEARS WHEN CRYING
A HR OF 130 BEATS/MIN IS WITHIN EXPECTED RANGE FOR AN
INFANT AND DOES NOT INDICATION DEHYDATION
NEW PRESCRIPTION FOR ORAL TERBUTALINE (SYSTEMIC BETA2
AGONISTS): ADVERSE EFFECTS

TREMOR
Caring for muslim pt during RAMADAN
Schedule medication administration to accommodate fastingMUSLIMS FAST IN THE DAYTIME
EAT BEEF PRODUCTS BUT NO PORK
FOODS CONTAINING POTASSIU
BAKED POTATO
ASAPARAGUS
APPLE
PINEAPPLE
DIABETIC KETOACIDOSIS- INDICATIONS OF IMPROVEMENT
SERUM PH 7.40
METHYLERGONOVINE (METHERGINE)
ADMINISTERED TO PROMOTE UTERINE CONTRATIONS AND REDUE
UTERINE BLEEDING FOLLOWING DELIVERY
BORDERLINE PERSONALITY DISORDER-MANIFESTATIONS EXPECTED
IMPULSIVNESS
REMOVAL OF PPE
GLOVES-MOST CONTAMINATED

DEVELOPMENTAL DELAY FOR 4 MONTH YEAR OLD

UNABLE TO SUPPORT HER OWN HEAD WHEN IN SITTING POSITION


o INFANT SHOULD BE ABLE TO SUPPORT HER HEAD WHEN IN A
SITTING POSITION
SOFT SPOT ON HEAD (ANTERIOR FONTANELLE- CLOSES BETWEEN
AGE 12 AND 18 MONTHS
TOES FLARE APART WHEN BOTTOM OF FOOT IS
STROKED..DISAPPEARS AFTER A YEAR.

FLUOXETINE (PROZAC)- DEPRESSION ; TO CHANGE TO MONOAMINE


OXIDASE INHIBITOR (MAOI)..DISCONTINUE FLUOXETINE FOR 5 WEEKS
BEFORE STARTING THE MAOI
TAKING FLUOXETINE WITH A MAOI CAN PRECIPITATE SEROTONIN
SYNDROME.
CONCURRENT USE OF FLUXETINE AND MAOI WILL PLACE PT AT
RISK FOR SEROTONIN SYNDROME
RISK FOR DEVELOPING HEALTH CARE ASSOCIATED INFECTION
WBC COUNT 4,000- WBC FIGHT INFECTIONS BY ATTACKING
MIRCOORGANISMS THAT CAUSE INFECTION. WBC COUNT OF 4,000
IS BELOW EXPECTED RANGE PLACING PT AT RISK
DECREASED SERUM PROTEIN LEVEL AND ALBUMIN
INDICATES MALNUTRITION AND PLACES CLIENT AT RISK
34 WEEKS OF GESTATION, FOLLOWING FINDINGS TO REPORT
VOMITING DURING 3RD TRIMESTER
EXPECTED FINDINGS
o INSOMNIA
o BRAXTON HICKS CONTRACTION
o LEUKORRHEA (WHITE DISCHARGE FROM VAGINA)

OLDER CLIENT WHO IS APHASIC AND 4 HR POSTOP, INDICATIONS OF


PAIN

DIAPHORETIC-SYMPATHETIC STIMULATION IN RESPONSE TO PAIN.


DILATED PUPILS
INCREASED HR
DECREASED GASTRO MOTILITY

EMPHYSEMA- STIMULATE THE PT BREATHING RATE WHEN DECREASED


SAO2 PT WITH EMPHYSEMA HAS CHRONIC HYPERCARBIA; LOW
ARTERIAL OXYGEN LEVEL WILL PROMPT THE BODY TO INCRASE
THE RESPIRATORY RATE TO IMPROVE OXYGENATION
PRIMARY SYPHILIS
HAVE YOU HAD PAINLESS SORES ON YOUR PENIS- PAINLESS
SORES OR CANCRES SEEN IN PRIMARY STAGE OF SYPHILLIS
SECONDARY STAGE OF SYPHILLIS
PUSTULAR SKIN LESIONS
GENERALIZED RASH
MANIC EPISODE- EARLY INDICATION OF MANIAC EPISODE IS LACK OF
SLEEP
ACTONEL (RISEDRONATE) ONCE A MONTH
CAUSES ESOPHAGITIS
o TAKE MEDICATION WITH FULL GLASS OF WATER

o SIT UPRIGHT AT LEAST 30 MIN FOLLOWING TAKING


RISEDRONATE
o TAKE 30 MIN BEFORE EATING
o DONT TAKE ANTACID FOR AT LEAST 30 MIN AFTER TAKING
RISEDRONATE
CELIAC DISEASE- GLUTEN FREE DIET
AVOID FOODS THAT CONTAIN GLUTEN
o WHEAT
o WHITE FLOUR
o BARLEY
JUVENILE IDIOPATHIC ARTHIRITIS PAIN CONTROL
APPLY MOIST HEAT TO JOINTS- PROVIDES RELIEF FROM PAIN AND
STIFFNESS FOR THE CHILD
EXERCISE ELCTROCARDIOGRAPHY STRESS TEST TEACHING
AVOID TAKING HOT SHOWER IMMEDIATELY AFTER TEST- TO
PREVENT EPISODE OF HYPOTENTION
AVOID EATING FOR 2 TO 4 HOUR BEFORE TEST
WEAR EXERCISE CLOTHES AND RUBBER SOLED SHOES DURING
TEST
PEPTIC ULCER TEACHING
SCHEUDLE SUCRALFATE PRIOR TO MEALS
o SUCRALFATE- MUCOSAL BARRIER BEOFORE MEALS TO COAT
THE LINING OF THE STOMACH AND ABSORB PEPSIN

AVOID CAFFEINATED AND DECAFFEINATED COFFEE- BOTH


INCREASE GASTRIC ACID SECRETION
TAKE CALCIUM CARBONATE 1 HR FOLOWING MEALS AND AT
BEDTIME
AVOID EATING SNACK BEFORE BEDTIME INCREASE GASTRIC
ACID SECRETION

COLOSTRUM- HIGH IN PROTEIN- FACILITATES THE BINDING AND


ELIMINATION OF BILIRUBIN
LOW IN FAT MILK THAT COMES IN AFTER COLOSTRUM IS HIGH
IN FAT
CONTAINS HIGH LEVEL OF CHOLESTROL- PROMOTES
DEVELOPMENT OF ENZYME SYS IN LATER LIFE
HIGH IN MINERALS- PROMOTE NUTRITION IN NEWBORN
DISCHARGE TEACHING FOR PT WITH RHEUMATOID ARTHRITIS
MAKE APPT WITH OCCUPATIONAL THERAPIST
o HELP PT USE ADAPTIVE DEVICES THAT AID IN
PERFORMANCES OF SELF CARE WITHIN THEIR LIMITATION
o HELP WITH REFERRAL TO OCCUPATIONAL THERAPTIST
o PERFORM PHYSICAL ACTIVITY EARLY IN THE DAY WHEN PAIN
IS AT IT LOWEST
o
Tanning
Regular: $25 (+$3) for 2 weekslevel 1
Level 2: $11 per session
MALICE- INTENTIONAL ACT OF A WRONGFUL NATURE THAT IS MEANT
TO CAUSE HARM TO ANOTHER PERSON
LIBEL- MAKING UNSUBSTANTIATED WRITTEN STATEMENT ABOUT A
CLIENT THAT CAN DAMAGE HIS REPUTATION
SLANDER- UNSUBSTANTIATED ORAL STATEMENT THAT CAN DAMAGE
REPUATION