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A med-surg RN call in sick 2hrs BEFORE beginning of shift. The supervisor floats an RN from postpartum unit. Now the team consists of a RN, UAP, & 1 RN reassigned from post-partum unit. Which pt will the charge RN assign to post-partum unit RN? (Give most stable) 1.) Pt w/ lumbar spinal cord injury required assistance to transfer to bedside commode 2.) A pt w/ hx of MI 2 days ago who is having insomnia 3.) A hospice pt exhibiting gasping resps 4.) A 24-hr post-craniotomy pt who is continuous sedation - CORRECT ANSWER 2 => The float RN assigned stable pts. (cant sleep) Explanations: 1 = med-surg RN does 3 = med-surg RN 4 = pt needs alot of assessments; increase ICP A pt presented to ED w/ expiratory wheezes & dyspnea. ABGs = pH =7.31, CO2 = 50, HCO3- = 24, O2 = 51. The RN puts pt in high-fowler's position & admin 1L/min O2 via nasal cannula. After 30 mins, ABG results are pH =7.26, CO2 = 44, HCO3- = 22, O2 = 68. Which action does the RN take 1st? 1.) Bump up O2 to 2L/min 2.) Start process of admitting pt 3.) Monitor pt for another pt 4.) D/c pt home - CORRECT ANSWER 1 => Normal PaO2 = 80-100 mmHg -> pH = 7.35-7.45 -> CO2 = 35-45 -> HCO3- = 22-26 *Take action to improve hypoxia *Resp. acidosis to normal expect O2 => asthma COPD -has hypoxia --improvement Explanations: 2 = need to stabilize 1st 4 = pt still hypoxic & needs tx The RN receives report from night shift. Which does the RN see 1st? 1.) Pt 3 days post-CABG is getting AV wires removed today 2.) Pt w/ diabetes typw 2 is getting cardiac cath @ noon 3.) Pt 36 hrs post-surgery w/ PCA for pain 4.) Pt awaiting heart transplant - CORRECT ANSWER 3 => PCA for pain relief. => RN monitors for: -hypotension -resp. depression -nausea -bowel movement -urinary incontinence *on a narcotic morphine, fentanyl or both (a controlled anaglesic) Explanations: 1 = sternum open, staples & sutures; 2 wires come out of chest; come out from chest -> stitch, cut it, remove it , simple precedure 2 = have time 4 = normal pt; fatigue very quickly, moves slowly ___a.)___ is a pain medication system, in which a pt self admins pain meds through the use of a programmable pump => pt connected to a pain pump that runs thru an IV & the pt can dispense med(s) by __b.)____ - CORRECT ANSWER a.) Pt. controlled analgesia b.) Pressing a button What medication is the the following indication for? Used as an adjunct to anesthesia - CORRECT ANSWER Fentanyl What are the 4 S&S of Fentanyl? - CORRECT ANSWER 1.) Resp. depression 2.) Apnea 3.) Bradycardia 4.) Hypotension The Nursing care for Fentanyl is what ? (2 things) - CORRECT ANSWER 1.) Have resuscitation equipment readily available 2.) Do NOT mix w/ IV barbs The indication for this medications is it is the 1st choice for severe pain? - CORRECT ANSWER Morphine sulfate What are the 5 S&S of Morphine Sulfate? - CORRECT ANSWER 1.) N/V 2.) Constipation 3.) Resp. depression 4.) Depression of cough reflexes
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