Test Plan One PDF

TEST TEST PLAN ONE ONE TEST Plan : 1. Management of pt 's w/ parenteral nutrition Monitor pt for...

TEST TEST PLAN ONE ONE TEST Plan : 1. Management of pt 's w/ parenteral nutrition Monitor pt for hematoma phlebitis Embolus FVO.lt it's time for a - inlection , infiltration easeration, complications such as , , , , new bag of TPN t the bag is not ready hang , 101 dextrose in. water so pt doesnt experience hypoglycemia.. 2. Reason's pt. 's require infusion therapy ' tt E replacement - med admin. - blood Product admin. - Nutritional support Major N solutions crystalloid → electrolytes dissolved in water and Include dextrose solutions sodium chloride solutions balanced electrolyte solutions and - , , , alkalizing and acidifying solutions. colloidal → Large molecules usually protein or starch suspended in fluid and are not a true solution ' , l volume expander s ) , ". " used to maintain intravascular volume prevent shock after major blood loss or fluid loss Albumin Dextran f) → +. ample : , , Mannitol 3. safe + effective venipuncture 1. review the order 9 preform venipuncture 115-45 ) '. 2. prepare the pt. I check Pt Identityerst explain the procedure) 2. 10. advance Cath after flashback. 3. Gather supplies / equipment ( Cath , tube , pump, start kit, gloves towel etc , ,. ) 11 release tourniquet. 4. wash hands / 12 activate gloves apply. softly release 5. 13 attach place linen saver pad down. primed admin or extension tubing 6. apply torniquet proximal to venipuncture site 14 apply sterile dressing. 7- Select site 15 discard supplies + wash hands. 93 Alan site t allow to dry 16 asses pt 's tolerance , education t for patency... , 17 document 4. Preventing Nwmplications ( related to central lines also ) proper hand hygihl ensure pt is getting LHG baths daily central line ) '. ensure area is clean / dressed appropriately ' " " ensure you scrub the hub ' ' monitor pt for sls of inaction infiltration. , wiseration. hematoma phlebitis + Embolus , , change tubing as needed. 5. The roll of kidneys lungs , , + butters in maintaining acid-base balance kidneys excrete Wz lungs breathe out 102 , both increasing the pH. If the pH needs to be lowered the lungs , t kidneys retain We , Chemical buffers - 1. Bicarb → buffer blood + Interstitial fluid rely on chemical reactions where weak acids + bases are paired w/ stronger. ones to weaken them These chemical reactions are assisted by the kidneys +. lungs 2. phosphate → found in intracellular fluid as bicarbonate They control small fluctuations in pH + respond quickly very.. effective in renal tubules where pnos. is located greater concentrations in. 3. protein → most abundant working both inside + , outside the cells Protein works by binding. w/ acids and bases to neutralize them. 6. SIS Of FVE + FVD Huidvolumeexuss fluid volume deficit : - distended neck veins. Hypoxemia dehydration - Bounding pulse ' ( ascites ) dry skin / mucous membrane peripheral edema + third ' spacing - non elastic skin turgor - Pall , cool skin ' - ' decreased vop central venous pressure ' decreased Bp lung sounds will be net, crackles SOB, wheezing ' - ,. Increased HR poly uria - Increased temp - pulse Increases '. weight loss - BP increases - weight increases - 7. Medical Management for 1-VE + FVD fluid volume excess : fluid volume deficit : = diuretics = Bed rest = it Pt encourage fluids , it not isotonic solutions 1 LR and NS ) because - can drink they expand plasma = stop IV fluids = It 0 , wt Hull Of Consciousness, Skin color breath sound assessments containing sodium , , The rate of fluids will be determined by the amount loss = = Restriction of sodium + fluids consider usual maintain a → Heuer 1+0 wt assessments tylenol ) = = ,. , = monitor edema = treat underlying cause = Observe skin for pressure ulcers = observe thirst = elevate extremities = do not give 1M Injections in edematous areas = monitor respiratory status = daily ut. B. Nursing Interventions for FVETFVD fluid volume EXUSS : fluid volume deficit : physical assessment it pt can drink it not isotonic solutions ILR and encourage fluids NS ) because - they expand plasma = volume. ,. IV fluids give slowly ul elderly , = Ito , wt consciousness, skin color breath sound assessments level of , , - lab tests BUN , HCT, serum , osmolality : , serum Na , urine Na =ThlraHot fluids will be determined by the amount loss Chest x-ray consider Heuer tylenol ) usual maintain = → , sale + effective management torn.tt/0WWntroUrs.maklsnrefluidsarecuar,tortnerightpt 9. fluids tubes right at the time. , administered. PH 7.35 7.45 - make sure tubes are labeled w/ date and time and changed allordingly 48. - make sure pumps are set correctly ensure there are no issues ,lbeeping machine ) 3135 PCOz I 10 lntlrpert. ABG 's Norms : 2136 HC03242 pH → 7.35-7.45 paW2→ 35-45 ' ( opposite ) - HW3→ 22-26 pqoz -9930-95 A acid B base - saOz→ 795% - II. comparing / contrasting major acid-base balances , SIS , 1- treatments acidosis alkalosis respiratory acidosis Respiratory alkalosis : : - IOWPH. elevated pH " examples ' elevated Paltz. decreased pacoz pulmonary edema /early ) condition that causes alveolar pneumonia any hypoventilation hyperventilation - - examples pulmonary emboli = nervousness / anxiety - - CNS → head trauma over sedation , anesthesia , levert gram negative septicemia thyroid toxicity ' - - , high spinal cord injury - SIS ' LNSUISUNS - pulmonary WPD pneumothorax pulmonary → , , - hyperventilation - paresthesia ' hepatic failure emboli pulmonary infection lightheadedness dry month pregnancy - - , - cardiac - heart failure decreased concentration idysrhytnmias - salicylates overdose / - Autoimmune - myasthenia gravis.mu/tipiesUrosis - sweating - palpation intoxication SIS - tetanic spasms in - blurred vision extremities restlessness - - headache dyspnea - - confusion - treatment removal of causative agent adsustventtorintubatedpt 's tachycardia lethargy - - - - respiratory distress antibiotic therapy correct hyperventilation idysrnylsmias ' - - drowsiness - decreased responsiveness -02 therapy - Heat anxiety treatment Supplemental Wa treat issues underlying - improve ventilation ' antibiotic therapy metabolic acidosis : metabolic alkalosis - pH decreased - starvation pit elevated increased 11-103 diarrhea lllvatld 11-103 ' - - renal failure - salicylate intoxication - common causes vomiting + gastric suctioning DKA Intestinal fistula excessive ingestion of antacids ' - SIS hypokalemia lhypoohloremia - - headache - Kussmanlsrespirations. diuretics - contusion - NN - 9 level of aldosterone - lethargy - dysrlnythmias - lactate admin.in dialysis restlessness - seizures / thinning - SIS ' stupor / coma uarmltlnsnedskin - mnsne twitching / tramps - disorientation treatment - tetany - convulsions.lv sodium bicarb - weakness coma dizziness rapid acting insulin depressed respiration - antidiarrheals - nausea - vomiting - dialysis maybe needed ufrenalltlilnre - treatment correct underlying issue - monitor 110 ' IV fluids correct Kt disorders - 12. Identity surgical risk In Hors The pt assessment will provide the pt 's medical hx surgical / anesthesia reaction hx their. , , allergies. current meds , their v15 , last intake / Output as well as into on it the pt smokes or uses tobacco ,.. 13. post op - management Monti or Airway breathing + circulation - , ,. monitor vitals 1 remembering pain) - administer pain / nausea meds Plan for pain management plan on teaching pt.at appropriate time - 14. pre op prep - - complete the checklist complete pt assessment '. collect into t '. paperwork necessary complete pre op orders - - ensure pt Identifiers are correct. ensure there is an - N line - bowel prep / bladder prep. - skin prep - allergy bracket vis able pt educated ul return understanding. family pt questions answered ' t. Respiratory Acidosis I ventilation I Respiratory Alkalosis anxiety Asthma Hyperventilation S SX confusion sleepapnea panicAttack Dizzy headtrauma Yawedvision taltitude Drymouth postopsedative BloodTransfusion tinitis depressa q maintain Treatment tachycardia are Treatment 02therapy airway oxygen reventilate paperbag Fluids anti anxietymeds ExchangeGas Metabolic Acidosis Metabolic Alkalosis SIX fi starvation rapiddeepresp Diarrhea confusion 1111 I7ms4IIYny Hypokalemia muscletwitch warm unease say Treatment lossanti confusion NRR Treatment Gl emetics numbnessintoes fingers PKAinsulin FIE replace Diarrheaantidiarrheals fluids tkcause discontinue