14 Medication Helps & Hints: Piaget: Psych.pdf

Medication HELPS & HINTS Humulin 70/30: ○ An insulin that combines the short action of regular human insulin ( Humulin R) and the intermediate action of Humulin N. N = 70% & R = 30% Drawing up insulin: ○ CLEAR before CLOUDY... “RN”; wha...

Medication HELPS & HINTS Humulin 70/30: ○ An insulin that combines the short action of regular human insulin ( Humulin R) and the intermediate action of Humulin N. N = 70% & R = 30% Drawing up insulin: ○ CLEAR before CLOUDY... “RN”; what we all want to be!!! ☺ clear = R, cloudy = N ○ Steps to draw up insulin: Draw up the total dose in air Put air in the “N” vial Put air in the “R” vial Draw up the “R” dose Draw up the “N” dose Injections: ○ What size needle are you using? The clue is in the abbreviation! Look at the first letter & then go find that number! IM: 21 gauge/1 inch (1M- always pick the gauge/inch with the 1 in it) Subcutaneous: 25 gauge/ 5/8ths (S looks like 5) Heparin vs Coumadin: ○ *Heparin -given IV or subQ Works immediately Can NOT be given for longer than 3 weeks (except for lovenox)  Antidote = protamine sulfate Lab test that monitors: PTT (heparin = 7 letters; count on hand; 3 fingers left) CAN be given to pregnant women ○ *Coumadin -given only PO Takes a few days to a week to work Can be given for the rest of your life Antidote = vitamin K Lab test that monitors: PT (INR) (coumadin = 8 letters; count on hand; 2 fingers left) - CAN NOT be given to pregnant women K wasting / K sparing Diuretics ○ Any diuretic ending in X = X’s out K (waste) + Direril ○ All others spare K! Muscle Relaxers ○ Baclofen and Flexeril are most tested** When you’re on your Baclofen you are your “back loafin” Flexeril, you flex your muscles ○ Side Effects: Fatigue/Drowsiness Muscle weakness ○ Teach: When taking these: Don’t drink Don’t drive Don’t operate heavy machinery Piaget’s Theory of Cognitive Development (4 stages for children’s thinking) Sensorimotor (0-2 y/o): totally present oriented; only think about what they are doing right now ○ Teaching Guidelines When it is happening What you are doing now Tell them what you are doing as you are doing it Pre-teach parents not the child Pre-operational (3-6 y/o): fantasy oriented, illogical, no rules ○ Teaching Guidelines When: future tense ; slightly ahead of time (“the morning/day of” or “two hours before”) What: you will do  How: play, toys. stories Concrete operational (7-11 y/o): rule oriented, live and die by the rules, cannot abstract think ○ Teaching Guidelines When: days ahead of time What: you’re going to do and skills How: age appropriate reading and A/V material; role play is OK Formal Operational (12+ y/o): able to think abstractly, understand cause/effect, think like adults emotionally but physically not there but they can think like an adult. Can manage their own care ○ Teaching Guidelines When: like an adult What: like an adult How: like an adult Treat like an adult M/S patient FYI: What is the first age that a child can manage their own care? 12. HOW to take PSYCH Tests!! (7 principles) Make sure you know what phase of the relationship you are in ○ Pre-interaction Phase: Purpose: for the nurse to explore his/her feelings and to prevent judgemental, intolerant reactions  Length: it begins when you learn you are going to be caring for someone and it ends when you meet them Correct answer: “the nurse will explore their feelings about…” ○ Introductory Phase (Orientation): Purpose: to establish and explore/assess Length: it begins when you first meet the patient and it ends when a mutually agreed-upon plan of care is in place Correct answer: should be very tolerant, accepting, explorative, probing (nosy). Be warm and fuzzy ○ Working Phase: Purpose: to implement the plan of care Length: from the finished care plan until discharge Correct answer: should be focused, directive and “tough”. In some ways, the answers will seem stern and slightly unfriendly. Set limits. Enforce proper communication. ○ Termination Phase: It begins on admission It begins when the problems are resolved, and it ends when the relationship is ended Gift giving: Do not give/accept gifts from patients Don’t give advice- “What do you think you should do” Don’t guarantee anything- “If you talk to me I can help you/don’t cry you’ll feel better” Best answer is the one that keeps them talking (open ended), ○ It’s never wrong to get a patient to talk in any instance. Concreteness- Don’t use slang because psych patients take things literally. ○ Don’t ask them what their neologisms are *Empathy- acknowledge feeling, always be empathetic. Never choose answers like this “don’t feel...” “don’t worry”, read the feeling in the question ○ BAD answers for empathy: “don’t worry, don’t feel, you shouldn’t feel, I would feel, anybody would feel, most people feel”... DON’T SAY THESE!!  ○ 4 Step Process for Answering EMPATHY Questions: Recognize that it’s an empathy question Always have a quote in the question & each answer is a quote Put yourself in the pt’s shoes! Ask yourself “if I said those words and really meant them; how would I be feeling?” Choose the answer that reflects that feeling or anything close! Do NOT choose the answer that reflects their words! *Empathy ignores what is said and goes with what is felt*