Test 4 CNA NOTES.pdf

Test 4 CNA NOTES Sub-acute care Patients are on: IV (Intravenous) therapy TPN (total parenteral nutrition receiving medications through PICC line (peripheral intravenous central catheter) PCA pump (receives medication such as narcotics through a mini-pump that is regulated by the patient, but has ti...

Test 4 CNA NOTES Sub-acute care Patients are on: IV (Intravenous) therapy TPN (total parenteral nutrition receiving medications through PICC line (peripheral intravenous central catheter) PCA pump (receives medication such as narcotics through a mini-pump that is regulated by the patient, but has time restraints that will prevent the patient from overdosing) The nurse manages and monitors these patients. Your job will be to report anything that just doesn't "LOOK RIGHT". Dialysis Treatments: Dialysis is a process in which the patient's blood is artificially cleansed of liquid wastes when the kidneys are unable to remove the waste. This procedure is needed when the patient is in Kidney failure. Dialysis is a temporary treatment until a donor is found and a transplant can be performed. Dialysis is performed via a shunt. Patients are usually on fluid and dietary restrictions. Never perform a blood pressure in the arm that a shunt is located. 2 types: Hemodialysis & Peritoneal Dialysis Wound Care: Caring for patients with severe pressure ulcers, burns or surgical wounds. Oncology Care: I. Types of tumors 1). Benign or nonmalignant tumors: A. Usually grow slowly B. Do not spread C. Usually encapsulated (Surrounded by a capsule) D. Do not cause death unless located in a vital area such as the brain E. Are usually named by stating the part of the body involved and adding the suffix -oma. For example, osteoma names a benign bone tumor. 2). Malignant tumors or cancerous growth A. Grow relatively rapidly B. Spread to other body parts (metastasize) C. If untreated, cause death D. May be called sarcoma or carcinoma or have special names like leukemia. Carcinomas: are spread primarily by way of the lymph system to the lymph nodes. They occur more commonly in people over 40 years of age. Sarcomas: are spread primarily by way of the blood stream. They occur more commonly in people under 40 years of age. II. Early Detection of cancer can often result in a cure. The sooner the cancer is found, the higher the rate of cure. Pain is usually a late symptom. Note: The first letters of these early signs spell CAUTION. 1).Early signs and symptoms: C = change in bowel or bladder habits A = a sore that does not heal U= unusual bleeding or discharge T= thickening or lump in breast or elsewhere I = indigestion or difficulty in swallowing O = obvious change in wart or mole N = nagging cough or hoarseness 2).Late signs and symptoms: * Fever of unknown origin * Cachexia or general wasting of the body tissues with loss of weight * Anemia * Pain due to pressure, obstruction, and ischemia. * Hormonal irregularities * Inflammation of the skin Note: Patients diagnosed with cancer, receives chemotherapy / radiation treatment. Diabetes Mellitus:Is a chronic disease that results from a deficiency of insulin, or a resistance to the effects of insulin. The problems with insulin causes the body to be unable to properly process food into energy. The glucose from the food breakdown remains in the blood, resulting in an elevated blood sugar. Types of Diabetes Mellitus IDDM-------Insulin Dependent Diabetes Mellitus (Type I) *People with type I diabetes must take daily insulin injections to stay alive. NIDDM----Non-insulin Dependent Diabetes Mellitus (Type II) *NIDDM is a metabolic disorder that occurs when the body does not make enough insulin, or does not properly use insulin. This is the most common type of diabetes. In children, Type II is the most common. Juvenile Diabetes- - -Insulin Dependent Diabetes (Type I) Gestational Diabetes- - - Diabetes during pregnancy (Those who develop are @ higher risk of developing Type 2 later in life) Treatment: Care focuses on maintaining a normal blood glucose level so that complications may be prevented, such as: 1) Eat a healthy well balanced diet as prescribed by your physician 2) Exercise regularly in a manner appropriate for age and ability 3) Check blood sugar regularly 4) Use insulin or oral antidiabetic agent correctly if ordered by physician Seven (7) Complications that can occur if Blood Sugar levels are consistently high: Write out 1) Renal Disease 5) Cardiovascular problems 2) Diabetic Coma 6) Vision Problems 3) Poor healing 7) Hypertension 4)Circulatory impairments that often lead to gangrene and amputation 9 S/S of Hyperglycemia: write out 1) Extreme thirst (polydipsia) 5) Blurred vision 9) Nausea/ vomiting 2) Dry skin 6) BS>200 3) Dizziness 7) Frequent urination (polyuria) 4) Hunger (polyphagia) 8) Sugar in the urine (glucosuria) 13 S/S of Hypoglycemia: write out 1) Cold clammy (moist) skin 2) BS>>>>>> (119/79) 2. Stage 1 Prehypertension.. ………………………..120/80139-89 3. Stage 2 (Mild)......................................................140/90 159/99 4. Stage 3 (Moderate)... ………………………..160/100-179 - 109 5. Stage 4 (Hypertensive Crisis or Severe Hypertension) 180/110 or higher III. Causes of Hypertension (write out) 1. Smoking 2. Being overweight or obese 3. Lack of physical activity 4. Too much salt in the diet 5. Too much alcohol; consumption (more than 1 to 2 drinks per day) 6. Stress 7. Older age 8. Genetics 9. Family history of high blood pressure 10. Chronic Kidney Disease 11. Adrenal and Thyroid Disorders 12. Sleep apnea Two types of Death 1. Clinical Death: Breathing and heartbeat stops. "Reversible". 2. Biological Death: Permanent damage and death of most brain cells due to the lack of O2. "Irreversible". Patients can be placed on special diets due to the following reasons: Religious Restrictions Therapeutic Diabetic Diet Low Fat/Low Cholesterol Pureed Supplements Calorie Counts Dysphagia: Is a condition when the patient has difficulty swallowing foods or liquids. Anorexia: Is a condition when the patient has a lack or loss of appetite. Bulimia Nervosa: Is a condition in which the patient usually binge eat in huge amounts, then vomit (purge) to undo the binge. The binge eating causes feelings of guilt, depression, and self condemnation. Cachexia: A state of malnutrition, emaciation, and debility, usually resulting from a prolonged illness. Alternative Nutrition: These are other ways a patient may receive nourishment. TPN-Total Parenteral Nutrition Enteral Feedings: 1) ng/Nasogastric feeding 2) gastrostomy 3) jejunostomy (J-tube) 4) percutaneous endoscopic gastrostomy tube (PEG) NPO: nothing by mouth. Make sure you read door signs. If you see a patient with food or drinks and they are not supposed to have it....REMOVE IMMEDIATELY and Notify the Patients Nurse.