Side effects of corticosteroids
Mood swing, increase hair growth, hump back, hypoglycemia, puffy face
Clinical findings typically in child with nephrotic symdrome
Massive proteinuria, hypoproteinemia, hypoalbuminemia, hyperlipidemia, edema
Visicants
Chemotherapeutic agents causing severe cellular damage to tissues
Side effect of amoxicillin
N/V, diarrhea, headache. Occasionally rash
Manifestations of leukemia in child
Anemia, infection, polycythemia, bleeding, bone pain
Phimosis
Foreskin of the penis cannot retract
S/S of child with epigolitis
Drooling,restless, high fever, no spontaneous cough due to obstruction
History of child with intussusception includes
CF, gastrostomy tube, abdominal blunt force trauma, URI and gastroenteritis
Gluten-sensitive enteropathy aka
Celiac disease
Vesicouretereal reflux
Urine flows backward from bladder to ureter causing UTI
Bleeding between the cranium and the dura
epidural hematoma
Early closure of cranial sutures
Craniosynostosis
Medication to treat multifocal PVC
Lidocaine
NI for child with RSV
albuterol (airways), acetaminophen (fever), fluids (hydration)
Hemolytic reactions with blood transfusion
fever, pain at injection site, hypotention, renal failutre, tachycardia, ogliuria, shock. Allergic reactions ( rash, hives and respiratory distress)
Most common cause for emergency surgery in children
Appendicitis
NI for patient with inflammatory bowel disease prescribed TPN
1.Check glucose level
2.Daily weight
3.Assess subclavian line for infection
4.Assess bowel sounds
Indication pancreatic enzyme is effective on patient with chronic pancreatitis
Bowel movements are formed, soft, brown
Preprocedure intervention for patient scheduled for cardiac catherization
Pedal and posterial tibial pulses
Severe abdominal pain, has hard rigid abdomen, temperature of 102 F.
Notify MD immediately - signs of peritonitis (life threatening)
PTT, PT, INR levels
PTT
PT
INR 2-3
Long term use of cascara sagrada (chronic constipation)
Hypokalemia
Favorable pelvic shape for vaginal birth
Anthropoid (long, narrow, oval)
Diet for CHF patient on digoxin and furosemide
baked pollack, mash potatoes(high potassium) carrot, raisin salad(low sodium)
NI for patient postop internal rotation of fractured right hip
Pillow to keep right leg abducted during turning
Neonate response to loud noises
Moro reflex
Food high in potassium
Carrot, spinach, apricots
S/S of blunt chest wall injury
SOB, chest pain.
Larger pneumothorax - tachypnea, cyanosis, diminished breath sounds, subcutaneous emphasema
NI for child with juvenile arthritis
Isometric exercise during painful episodes.
Hot/cold packs, splinting, positioning affected joint in neutral position reduce pain.
Early sign of hypovolemic shock
Restlessness, anxiety, agitation.
Late signs: lower BP, diminished perepheral pulses, pallor, cold skin, urine < 30 mL/hr
Signs of psychomotor retarded depression
Slowed walking and talking
Priority for child with partial/full thickness burns over 35% of body
Foley catheter - accurate urine measure hourly
Therapeutic effect of nitrofuratoin sodium (Macrodantin)
Antibacterial for acute UTI or chronic suppressive treatment : absent of dysuria
Adverse effect of fluoxetine (Prozac)
N/V, cramping, diarrhea.
Side effect of isopreterenol
Bronchodilator. Tachycardia, HTN, chest pain, dyshrythmias, nervousness, restlessness, headache
Position for patient with smoke inhalation and burns to anterior trunk with diagnosis of Impaired gas exchange
Turning, humidified oxygen, IS, suctioning PRN to prevent atelectasis and pneumonia
Priority for a child with hypertonic dehydration
Urine output. Not to give potassium if < 1 mL/kg/hr
Normal labs
Creatinine 0.6-1.3
BUN 5-20
Calcium 8.6-10
WBC 4500-11000
TSH 0.2-5.4
Magnesium 1.6-2.6
S/S of dystocia with patient in labor
High level maternal fear,anxiety.
Fetal distress
Featal failed to descend
NI for patient receiving parenteral nutrition with sign of air embolism
Trendelengburg position increase intrathoracic pressure, decreases amount of blood pulled into the vena cava during inspiration
Lumbar puncture performed to obtain CSF for analysis. Negative values if CSF is normal
RBC
Adverse effect of epoetin alfa
HTN
Aluminum hydroxide prescribed for chronic renal failure, to be taken
With meal
Efavirenz - antiviral prescribed for HIV patient is best taken
HS due to side effect on the nervous system
Bronchial breath sounds can be heard at
Trachea or larynx
FSH and LH secreted by
Anterior pituitary gland
Labs values for patient with undyalized chronic renal failure
(CRF)
BUN >
Creatinine > 4.5
K > 5.9
Administration of dopanmine and nitroprusside IV drips
Dopanmine (vasopressor), nitroprusside (vasodilator) for dilation of coronary vessles. Given SEPARATE SITES
S/S if cholecystitis
Pain begin in RUQ of abdomen, radiate to right shoulder and scapula
Diet for uncomplicated hyperthyroidism patient
Increase protein + calories, no caffein
Diet for stomatitis
Soft, bland, cool food
S/S of pelvic inflammatory disease
lower abdominal pain, fever, dysuria
carbamazepine (Tegretol)
5-12 mcg/mL
digoxin (Lanoxin)
0.5-2 ng/mL
gentamicin (Garamycin)
5-10 mcg/mL
theophylline
10-20 mcg/mL
tobramycin (nebcin)
5-10 mcg/mL
Side effects of chemotherapy with doxorubicin
alopecia, cardiotoxity can occure, urine/sweat turn red, stool turn white,severe injury if extravasation occurs ( IV administration )
Side effects of phenytoin (Dilantin) - anticonvulsant
Constipation, bleeding gums, hyperglycemia, decreased platelet counts
Opisthrotonos
prolonged arching of the back with head and heels bent backward
Care plan for child with hepatitis
Low fat, well balance diet. Teach hand washing technique. Caution in giving medication due to liver inability to detoxify/excrete. Jaundice is expected.
Toxic effect of cisplatin (Platinol) given to cancer patient
otoxicity, tinnitus, hypokalemia, hyocalcemia, hypomagnesia, nephrotoxity.
Give amifostine before cisplatin to reduce potential renal toxicity
Involution of fundus 12 hrs after delivery
rise to level of umbilicus then dececends into the pelvis one fingerbreadth each succeeding day
Signs/symtoms of meningitis
Tachycardia, photophobia, red/macular rash, positive Kernig sign
Clients are high risk for metabolic acidosis
Diabetes mellitus, renal failure, malnutrion because of increase acids in the body
Increase calcium of a client who is lactose intolerant
Tofu, broccoli, sardines, mustard greens
NI for hypernatremia
Sodium level >145 . Monitor I/O, VS, reduce sodium, electrolyte levels, increase fluid
Data collection for patient with positive Chvostek sign
Indicative of hypocalcemia = tachycardia, hypotention, positive Trousseau's sign, diarrhea, seizures, hypoactive bowel sounds
S/S of child with bacterial meningitis
fever, nuchal ridgity, irritability
Adverse reaction of magnesium sulfate
flushing, depressed respiration, extreme muscle weakness,
Calcium channel blockers are use for
HTN, angina pectoris, cardiac dysrhymias
S/S of an infant with Hirshprung's disease
Fever, constipation, FTT, abdominal distention, explosive/watery diarrhea
Fetal heart developed and beating
gestational week 5
Side effects of rifabutin (Mycobutin) for client with active Mycobacterium avium complex disease and TB
Rash, gastrointestinal disturbances, neutropenia, red/orange body secretions, uvitis (blurred vision or eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea, flu-like syndrome.
cinoxacin (Cinobac) urinary antiseptic caution
client with renal impairment
Functions of amniotic fluid
Allow fetus to move freely, maintain body temperature, measure kidney function, surround+cushion+protect fetus
S/S of air embolism
Life threatening - chest pain, coughing, hypotention, cyanosis, hypoxia, churning "windmill" sound on right ventricle
S/S of client taking phenytoin (Dilantin) has serum phenytoin level of 30 mcg/mL
Phenytoin level: 10-20 mcg/mL.
CNS depression, lethargy, ataxia, nausea, nystagmus, diplopia, lack of hyperactive reflex
S/S of severe pregnancy induced hypertention (PIH)
BP 150/90, urine +3 protein
NI: Monitor renal functioning
Common symtom of nephrotic syndrome
decrease urination + appear frothy
Diet restrictions for renal failure patient
< 40 g protein daily
Medications for long term control of tonic-clonic seizures
gabapentin, ethosuximide, carbamazepine
Discharge instruction for patient taking nifedipine (Adalft) for blood pressure
Take pulse daily. Weight at the same time each day. Palpitations may occur in early morning. Be care when rising from sitting to standing
Side effects of phenytoin ( Dilantin)
Constipation, bleeding gums, hyperglycemia, blood dyscrasias = decreased platelet + WBC
Diet high in calcium for lactose intolerant patient
Tofy, mustard greens, sardines
Procedure to administer an enema to an adult patient
Standard precautions. Client in left sims' position (retention of solution). Lubricate + insert tube 4 inches. Enema solution hang 12-18 inches above client's anus. Temperature: 100-105 F. Clamp tube if client is discomfort.
NI for pulmonary edema
LV failed to eject sufficient blood = increase pressure in the lung due to accumulated blood.
Administer oxygen. High fowler position. Furosemide. Foley (measure output).IV morphine sulfate (reduces return, decrease anxiety, reduce breathing)
Instructions for a client post op total laryngectomy about caring for the stoma
Wash daily with wash cloth. Avoid soap, cotton swabs or tissues. Avoid alcohol. Thin layer of petroleum jelly to skin around stoma(prevent cracking).Protect from water.
Care of client post op lumber puncture
Monitor ability to void. Maintain supine position. Monitor ability to move extremities. Inspect puncture site for redness, drainage, swelling
S/S of skull fracture following a head injury
Drainage from ear. Bruising around eyes. Pink tinged drainage from nose
Discharge instructions for client post op tonsillectomy.
Avoid hot fluid, rough foods. Rest 24 hours
Data from client diagnosed with placenta previa
Bright red vaginal bleeding. Soft, relaxed, nontender uterus, Fundal height may be > than gestational age
Prescribed interventions for carcinoma of the lung who develops SIADH
Radiation. Chemotherapy. Serum sodieum blood level. Antagonist to ADH. Restrict fluid, increase sodium intake.
NI for seizure client on corticosteroids for arthritis. Symtoms: flushed skin, dry mucous membranes, elevated tempt, poor skin tugor. Serum sodium of 172 mEq/L
Monitor I & O. Vital signs. Sodium reduced diet. Electrolyte levels. Increase water intake.
S/S of 3 yr old suspected bacterial meningitis
Fever, irritability, nuchal rigidity
Advantage of using spinal anesthesia for delivery of a fetus
Immediate onset. Ease of administration. Absence of fetal hypoxia.
S/S of client with positive Chvostek's sign
Tetany.Diarrhea. Possible seizure. Positive Trousseau's sign
Toxic effect of cancer patient taking cisplatin (Platinol)
Tinnitus. Ototoxicity. Nephrotoxicity. Hypomagnesemia
Platelets
150,000-400,000
Prothrombin time and International normalized ratio (INR)
PT: 2 seconds.
INR: (Male) 9.6-11.8 seconds (Female) 9.5-11.3 seconds
1.5-2 lab value - oral anticoagulants
2-3 for standard warfarin therapy
Iron
Male: 65-175 Female: 50-170
Hematocrit
Male: 42-52 Female: 35-47
Cardiac markers
Troponin I: <0.6 >1.5 = MI
Troponin T: >0.1-0.2 = MI
Myoglobin > 90 = MI
Creatine kinase (CK)
26-174
RBC
Male: 4.5-6.2 million
Female: 4.0-5.5 million
Hemoglobin
Male: 14-16 g/dL Female: 12-15 g/dL
Activated partial thromboplastin time (aPTT)
1.5-2.5 times normal for heparin
WBC
4500-11000
thyroid-stimulating homrone (TSH)
0.2-5.4
magnesium
1.6-2.6
calcium
8.6-10
BUN
5-20
Serum creatinine
0.6-1.3
Medications for treatment of HF
Diuretics, cardiac glycosides, PDE inhibitors, Ace inhibitors
Respiratory Acidosis ( pH <7.35 PCO2 > 45 )
Cause: Asthma, atlectasis, brain trauma, bronchiectasis, bronchitis, CNS depression, emphasyma, hypoventilation, medications, pneumonia, PE, repiratory failure
S/S: Headache, restlessness, drowsiness, confusion, visual disturbances, diaphoresis, cyanosis, hyperkalemia, tachycardia, dysrhythmias -> V fib
Respiratory Alkalosis ( pH > 7.45 PCO2 < 35)
Cause: Anxiety, fever, hyperventilation, hypoxia, hysteria, overventilation by mechanical ventilators, pain
S/S: Headache, vertigo, lower LOC, paresthesia, hypokalemia, hypocalcemia, tetany, convulsions
Metabolic Acidosis ( pH <7.35 HCO3 <22 )
Cause: DM, ecessive acetylsalicylic acid, gastrointestinal fistulas, high fat diet, insufficient metabolism of carbohydrates, lactic acidosis, malnutrition, RF, severe diarrhea, starvation.
S/S: Headache, N/V, diarrhea, fruity smelling breath, CNS depression, hypotension, hyperkalemia
Matabolic Alkalosis ( pH > 7.45 HCO3 >27)
Cause: Diuretics, excessive vomiting or gastrointestinal suctioning, excessive intake of antacids, hyperaldosteronism, excess sodium bicarbonate, massive transfusion of whole blood
S/S: N/V, dizziness, parathesia, hypokalemia, hypocalcemia, disrhythmia, tachycardia.
Adverse effect of ergotamine (Ergostat)
HTN, parathesias, N/V
Lab results confirms meningitis
Reduce glucose level, pressure > 200, protein >15, cloudy,increase WBC
Food high in riboflavin
Milk
Indication of low protein intake
Albumin <3.5
Normal 3.5-5
ABG results of respiratory failure client
PaO2 <50 PaCO2 >50
Major adverse effects of dantrolene sodium (Dantrium)
Drowsiness, diarrhea, hepatotoxicity
Risk factor for endometrial cancer
Estrogen replacement therapy
Side effects of Rifabutin (Mycobutin) for treatment of TB and MAC disease
Rash, gastrointestinal disturbances, neutropenia, red-orange body secretions, uveitis, myositis, arthralgia, hepatitis, chest pain, dyspnea, flu-like syndrome.
Positioning for a patient with insertion of MIller Abbott tube
Right side to faciliate passage through pylorus of stomach into small intestine
Medication prescribe for a child with spina bifida
sulfisoxazole (Gantrisin)
Phallic stage of Sigmund Freud's theory of personality development
Recognition of differences between sexes
Adverse effects of scopolamine (TransdermScop)
Dry mouth, urinary retention, dilation of pupils
Diagnostic study for carcinoma of the larynx patient taking bleomycin sulfate (Blenoxane)
Pulmonary function. Monitor for dyspnea (pulmonary toxicity) - discontinue med
Neologism
Created new word by combining syllables of other words
Medication commonly use for opioid intoxication
Nalorphine (Nalline)
S/S of Meningeal irritation
Positive Brudzinski and Kernig's signs, nuchal rididity, restlessness, severe headache
S/S of otitis media
Fever (4
Plan of care for patient diagnosed with dystocia
Characteristics of contractions (prolonged labor = fetal distress)
Herbal therapies used as antispasmodic
Angelica, Chamomile, Peppermint oil
Highest priority in caring of a child with nephrotic syndrome
Dipstick the urine for protein Q 4 hrs
Lab results for a child with iron deficiency anemia
Low hemoglobin levels + microcytic/hypochronic RBC
Toxic effects related to Oxybutynin chloride (Ditropan)
nervousness, restlessness, irrability, hypo/hypertention, confusion, tachycardia, flushed face, respiratory depression
Best information for recovery from spinal shock
Reflexes
Lab values for a child with sickle cell disease
Decreased Hbg + Hmat + Platelets. Increased reticulocyte counts (short RBC life span)
S/S of spinal shock of a patient with C5 spinal cord injury
Absent B/S, distended abdomen, respiratory diminished
S/S of inhalation injury with carbon monoxide
5-10% = impaired visual
11-20% = flushing/headache
21-30% = nausea/impaired dexterity
31-40% = vomiting, dizziness, synecope
41-50% = tachypnea, tachycardia
>50% = coma/death
Therapy that involves pairing a stimulus attractive to the client with an unpleasant event
Aversion therapy (negative reinforcement)
Test which determines continuation of pyrazinamide therapy
Positive sputum culture
Adverse effect of demopressin (DDAVP)
Water intoxication + hyponatremia = drowsiness, listlessness, headache
Nervous, lethargic, memory loss
Korsakoff psychosis - result from chronic alcoholism
S/S of chronic glomerulonephritis (CGN
Fixed specific gravity of urine, increased BUN + creatinine
S/S of renal caculi of patient with multiple fractures in an auto accident
Renal calculi = imobility = decalcification of bones
NI for a child during acute phase of glomerulonephritis
Assess appearance for signs of cerebral complications
Priority NI for post op insisional cholecystectomy patient
Hypostatic pneumonia (painful to cough)
Newborn whose mother had ruptured of membranes 23 hrs before delivery is at risk for
Neonatal sepsis = infection from organisms in the vaginal tract
S/S associated with Addison's diease
Elevated Adrenalcorticotropic hormone ( ACTH) and Meloncyte-stimulating hormone (MSH) = hyperpigmentation
Client receiving furosemide IV push. Possible complication?
Tachycardia
Pt. with PE, notes petechiea on chest and abdomen. Priority?
Contact physician
Rationale for diabetic pt to use diaphragm as method of contraception instead of pills
Noninvasive that will not alter blood glucose levels
Teaching to diabetic pt with a cold regarding insulin needs
Infect = alteration/increase insulin needs. Check Q 4 hr
Complication of Grave's disease
SOB
TB patient ask how long he have to take INH
Approx. 1 year and reevaluated
MRSA pt receiving Vanomycin IV. If client experience "red man" syndrome, nurse should
Slow infusion and monitor BP
Expected finding in normal newborn
Acrocyanosis
Intervention for Pt with radical mastectomy
Arranging visit from a member of Reach for Recovery
2 medications to be given IM. Nurse should
Determine whether medications can be combined
Finding consistent with an acute inflammatory reaction of a MVA pt with 4 in laceration on left lower leg
Increased pain caused by release of histamine
Food for client lack sufficient protein
Peas and beans
Intervention for client receiving a water enema if complain of abdominal cramp
Lower height of enema container
Best method for pt with fractured femur in crutch to manipulate stairs
Start up the stairs with unaffected leg first
Assessing of a dark-skinned client with anemia
Hard palate
Patient's Bill of Rights
The right to advanced directives concerning treatment
What is the host according to agent-host model in a toxic chemical spill
Residence living in the area
Nurse first time applying dressing. Reading manual, ask another nurse, skill level of the nurse is
Novice
Foley catheter for a male client should be inserted
7-9 in
Position to move a pt up the bed with 2 care givers
Opposite side of bed at chest level
Typical finding of client with fractured hip
Disalignment of affected extremity
Pt with sudden hearing loss who just broke up with fiance. This is example of
Conversion reaction
Pt receiving Nipride D5W IV.IV fluid has light brownish tint
Expected color of solution
Best position for pt with right total hip replacement
With right hip flexed 35 degree
An overly aggressive football player who are known as quiet and brooding
Sublimation
15 mo old turns his cup upside down, shakes milk from spout
Manipulation of objects in their environment enables toddler to learn about spatial relationships
Female pt with chlamydia, before she leaves clinic, nurse should
Obtain name and addresses of client's sexual contacts
Infant in need of additional growth assessment
Baby girl 4 months, BW 7 lbs 6 oz, present weight 14 lbs 14 oz
Assess for pt on assisted ventilation developed right sided tension pneumothorax.
Left sided tracheal deviation
Post op assessment of elderly pt with total hip repair. Sign of severe discomfort
Decreased heart rate
Lab finding confirm that pt is bothered by sensory disturbance related to being in ICU.
Increased urine catecholamines
Pt with AKA of the right leg refuses to look at the operative site
...
What action by the nurse predisposes pt to hyperkalemia while administering transfusion of whole blood
Filling the drip chamber below level of the filter
Lab value indicates complication of NG suction
K 3.4 mEq/L
Correct wound healing statement
Healing by second intention results in excessive scar formation
Statement indicate needs for further teaching of bladder management of pt with paraplegia
I need to eat plenty of citrus fruits to prevent bladder infections
Assessment for jaundice in dark-skinned pt with hepatitis
Hard palate
Middle East patient
Take time for prayer during the day
Sarcoma pt being treated with Adriamycin
Nurse implements isolation precautions
Activities best tolerated with muscular dystrophy
Swimming
Appearance of area post-op of pt with basal cell carcinoma on the ear
Swollen, tender, blistered
Culture taken of a lesion suspected of being herpes
Pack on ice
Lesion < 0.5 cm in diameter on pt back
Papules
6 months old with multiple bruises, decreased ROM of right leg has fracture of right femur. Statement by mother indicate child abuse
She hurt her leg while she was crawling
Pt with pyloric obstruction has persistent vomiting, blood gases expected
pH 7.47, PCO2 40mm Hg
Acute leukemia has oral ulcerations. How to increase pt comfort
Cleanse teeth and mouth with lemon and glycerin swabs
Gastric ulcer losing significant amount of blood via NG tube, pulse weak, hypotensive.Continuous irrigation of NS ordered. Patient position
Left side lying
Pre op teaching of client scheduled for a transphenoidal hypophysectomy for removal of a pituitary tumor
You will not be able to brush your teeth for a week after surgery
Symptoms of pt diagnosed of pheochromocytoma NOT EXPECTED
Bradycardia
Teaching for pt suspected Addison's disease scheduled for rapid corticotrophin stimulation test
Need for periodic blood samples
Lab values expected in pt with Addison's
BUN 22
Position of pt with acute pelvic inflammatory disease
Semi folwer's
Pt with C6 spinal injury complaint of severe headache. BP 190/100 and diaphoretic.
Make sure Foley catheter is patent
Snacks permitted for a child with acute renal failure
Marshmallows
Activities suitable for 10 yrs old with asthma
Swimming
Musical instrument for teen with asthma
Clarinet
Post-op suprapubic prostatectomy has bright red urine with clots.
Check vital signs and notify physician
Teaching for pt taking calcium suppliments
Can use calcium based antacids to supplement diet
Pt with electrical burn, area sustained greatest degree of injury
Muscles supporting long bones
Organs most like to suffer permanent damage from shock
Kidneys
Pt to receive 8000 mL solution of Lactated Ringer begins at 7:30 am. Use Parkland formula, how much solution received by 11:30 pm
6000 mL
Drug of choice for status epilepticus
Diazepam (Valium)
Electrolyte must be maintain for pt receiving lithium
Sodium
Pt receiving colchicines for gout should report symptom
Diarrhea
Child with ventriculoperitoneal shunt has clear drainage from incision
Check dressing for presence of glucose with Dexrostik
Lung cancer pt advised to increase protein in diet
Crackers, cheese, fruit yogurt
14 months old receiving Digoxin and Lasix Q2 daily, assess for
Hypokalemia
Pt with seizure disorder to receive phenytoin and Phenobarbital. Nurse should be aware
Larger dose of Phenobarbital might be required because of increase in metabolism
If pre-op pt is allergic to shellfish
Physician need to alter type of skin preparation used
Lab value of pt in pre-op need immediate attention
PT of 1 minute 20 seconds
6 mos old pt with acute diarrhea. Rationaled for diet to include Isomil instead of Similac formula
Lactose intolerance after a diarrheal illness
Colostomy pt feel irrigation solution is not drained completely.
Massage abdomen gently
Pt with Miller-Abbot tube inserted to decompress the bowel, priority is
Advancing tube 3-4 in as ordered
Presence of Cullen's sign of pt in MVA suggestive of
Retroperitoneal bleeding
Pt with chronic pancreatitis receiving Pancreatin. Observations most indicative of drug achieved desired effect
Client's stools contain less fat + occur less frequency
Pt receiving aminophylline IV feeling nervous and shaky
CNS stimulation
Primary purpose pt with fractured hip in Buck's traction
Decrease muscle spasm
28 yr old primigravida with pregestional diabetes. Statement indicates understanding of teaching on her insulin needs
Changes in hormone levels will make my body more resistant to insulin, so I will need more as my pregnancy progress
Position best for pt with preeclampsia in labor
Left Sims
Primary physiological alteration in development of asthma is
Spasm of bronchiolar smooth muscle
Intervention to help manic pt maintain sufficient nourishment
Serve high calorie foods she can carry with her
Sign suggestive of impaired hearing in an infant
Absence of babbling by age 7 moths
Pt receiving Garamycin has order for a peak drawn. Priority
Blood draw 30 minutes after infusion
Teaching for pt receiving vincristine
Cause change in taste
Essential interventions for pt receiving cyclophosphamide
Urine output
Critical intervention for AIDS pt has lesions from herpes simplex virus, receiving acyclovir.
Fluids
First sign of graft-host disease following bone marrow transplantation
Rash
Medication orders should be questioned for client getting myelogram
Seconal 400 mg PO q 4 hours PRN for headache
Primary reason for maintain hyperventilation for MVA pt
Promote cerebral vasoconstriction + decrease cerebral blood flow
Finding consistent of stroke pt with receptive aphasia
Damage of temporal lobe
Finding considered abnormal of lumbar puncture pt
WBC 100/cu/100 mm
Interventions appropriate for pt lost function of cranial nerve V on left side
Helping client select foods easier to swallow
Priority following CT scan with contrast medium
Forcing fluids
Reddish-purple discoloration on AIDS pt eyelid
Kaposi's sarcoma
Elderly pt has difficulty with colors. Which colors often misinterpreted
Violet
Ability to remain continent depends on
Sympathetic nervous system (SNS)
Teaching for pt with history of renal calculi
Increase intake of meat, eggs, fish, plums, cranberries
Client at highest risk for Sarcodosis
30 yr old African American who is pregnant