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Fundamentals of Nursing BULLETS
Fundamentals of Nursing BULLETS
A blood pressure cuff thats too narrow can cause a falsely elevated blood pressure reading. When preparing a single injection for a patient who takes regular andv neutral protein Hagedorn insulin, the nurse should draw the regular insulin into the syringe first so that it does not contaminate the regular insulin. Rhonchi are the rumbling sounds heard on lung Auscultation. They arev more pronounced during expiration than during inspiration. Gavage is forced feeding, usually through a gastric tube (a tube passed into the stomach through the mouth). According to Maslows hierarchy of needs, physiologic needs (air, water, food, shelter, sex, activity, and comfort) have the highest priority. The safest and surest way to verify a patients identity is to check the identification band on his wrist. In the therapeutic environment, the patients safety is the primary concern. Fluid oscillation in the tubing of a chest drainage system indicates that the system is working properly. The nurse should place a patient who has a Sengstaken-Blakemore tube in semi-Fowler position. The nurse can elicit Trousseaus sign by occluding the brachial orv radial artery. Hand and finger spasms that occur during occlusion indicate Trousseaus sign and suggest hypocalcemia. For blood transfusion in an adult, the appropriate needle size is 16 to 20G. Intractable Pain is Pain that incapacitates a patient and cant be relieved by drugs. In an emergency, consent for treatment can be obtained by fax, telephone, or other telegraphic means. Decibel is the unit of measurement of sound. Informed consent is required for any invasive procedure. A patient who cant write his name to give consent for treatment mustv make an X in the presence of two witnesses, such as a nurse, priest, or physician. The Z-track I.M. injection technique seals the drug deep into thev muscle, thereby minimizing skin irritation and staining. It requires a needle thats 1 (2.5 cm) or longer. In the event of fire, the acronym most often used is RACE. (R) Removev the patient. (A) Activate the alarm. (C) Attempt to contain the fire by closing the door. (E) Extinguish the fire if it can be done safely. A registered nurse should assign a licensed vocational nurse orv licensed practical nurse to perform bedside care, such as suctioning and drug administration. If a patient cant void, the first Nursing action should be bladder Palpation to assess for bladder distention.
Jehovahs Witnesses believe that they shouldnt receive blood components donated by other people. To test visual acuity, the nurse should ask the patient to cover eachv eye separately and to read the eye chart with glasses and without, as appropriate. When providing oral care for an unconscious patient, to minimize thev risk of aspiration, the nurse should position the patient on the side. During assessment of distance vision, the patient should stand 20 (6.1 m) from the chart. For a geriatric patient or one who is extremely ill, the ideal room temperature is 66 to 76 F (18.8 to 24.4 C). Normal room humidity is 30% to 60%.