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Nov 6-12 post conference

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1 Nov 6-12 post conference on Tue Nov 15, 2011 12:54 am

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5 questions:
1. Which of the following factors place a client at increased risk for a MI? select all that apply
a. Smoking
b. Obesity
c. High protein diet
d. Hypertension
Answer: a,b,d

2. Which assessment finding is of highest priority for a client diagnosed with left sided heart failure?
a. Increased BP
b. Peripheral edema
c. Dyspnea
d. Crackles in lungs
Answer: D

3. Common nursing diagnoses for the patient with CAD include: select all that apply
a. Activity intolerance
b. Ineffective tissue perfusion
c. Acute pain
d. Risk for electrolyte imbalance
Answer: A, B, C

4. A nurse is caring for patient who has just been administered t-PA. Which orders should be questioned?
a. Neuro assessments q 30 min for 6 hours
b. Administer antihypertensives as prescribed
c. Placement of foley catheter
Answer: C

5. Which of the following interventions are contraindicated in a client with increased ICP?
a. HOB elevated to 45 degrees
b. Avoid clustering of nursing procedures
c. Hyperoxygenating before suctioning
d. Maintain quiet environment
Answer: A


3 interventions/rationales related to ineffective tissue perfusion:

1. Change from supine to upright position slowly
- prevents orthostatic hypotension
2. Assist with ROM exercises 3x per day
- prevents blood from pooling, and reduces venous stasis.
3. Administer anticoagulants as ordered
- auticoagulants are used to prevent or treat clots that prevent blood flow

3 interventions/rationales related to cellular regulation (impaired gas exchange):

1. Turn, cough, deep breathe or incentive spirometry q 1-2 hours
- improves lung expansion and decreases stasis of secretions
2. Avoid intake of gas producing foods
- prevents gastric distention and an increase in pressure on the diaphragm
3. Place client in a semi to high fowlers position
- improves lung expansion and decreases stasis of secretions

A patient with an INR of 4 would be placed on Coumadin.
1. Assess for signs of bleeding and hemorrhage
- these are signs that patient is not clotting effectively and dosage could be too high
2. Monitor stool and urine for occult blood before and periodically during therapy
- signs that patient is bleeding
3. Avoid foods high in vitamin K
- Vitamin K is the antidote for warfarin and could decrease effectiveness of therapy

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