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30 Cards in this Set
- Front
- Back
addisons= down, down down UP down
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addisons=
hyponatremia, hypotension, decreased blood vol, HYPERKALEMIA hypoglycemia |
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cushings= up up up DOWN up
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cushings=
hypernatremia, hypertension, increased blood vol, HYPOKALEMIA, hyperglycemia |
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No Pee, no K
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(do not give potassium without adequate urine output)
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EleVate Veins; dAngle Arteries
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for better perfusion
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APGAR Scoring
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A= appearance (color all pink, pink and blue, blue [pale])
P= pulse (>100, < 100, absent) G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent) |
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Air/Pulmonary Embolism
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(S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom)
--> turn pt to left side and lower the head of the bed. |
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Woman in Labor w/ Un-reassuring FHR
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(late decels, decreased variability, fetal bradycardia, etc)
--> turn on left side (and give O2, stop Pitocin, increase IV fluids) STOP |
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Tube Feeding w/ Decreased LOC
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--> position pt on right side
(promotes emptying of the stomach) with the HOB elevated (to prevent aspiration) |
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During Epidural Puncture
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--> side-lying
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After Lumbar Puncture (Spinal Tap)
(and also oil-based Myelogram) |
--> pt lies in flat supine
(to prevent headache and leaking of CSF) |
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Pt w/ Heat Stroke
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--> lie flat w/ legs elevated
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During Continuous Bladder Irrigation (CBI)
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--> catheter is taped to thigh so leg should be kept straight. No other positioning restrictions
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After Myringotomy
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--> position on side of AFFECTED ear after surgery (allows drainage of secretions)
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After Cataract Surgery
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--> pt will sleep on UNaffected side with a night shield for 1-4 weeks.
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After Thyroidectomy
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--> low or semi-Fowler's, support head, neck and shoulders.
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Infant w/ Spina Bifida
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--> position prone (on abdomen) so that sac does not rupture
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Buck's Traction (skin traction)
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--> elevate foot of bed for counter-traction
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After Total Hip Replacement
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--> don't sleep on operated side, don't flex hip more than 45-60 degrees, don't elevate HOB more than 45 degrees. Maintain hip abduction by separating thighs with pillows.
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Prolapsed Cord
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--> knee-chest position or Trendelenburg
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Infant w/ Cleft Lip
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--> position on back or in infant seat to prevent trauma to suture line. While feeding, hold in upright position.
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To Prevent Dumping Syndrome
(after Gastric Bypass Surgery) |
--> eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low CHO and fiber diet, small frequent meals)
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Above Knee Amputation
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--> elevate for first 24 hours on pillow, position prone daily to provide for hip extension.
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Below Knee Amputation
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--> foot of bed elevated for first 24 hours, position prone daily to provide for hip extension.
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Detached Retina
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--> area of detachment should be in the dependent position
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Administration of Enema
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--> position pt in left side-lying (Sim's) with knee flexed
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After Supratentorial Surgery (incision behind hairline)
*brain herniation |
--> elevate HOB 30-45 degrees
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After Infratentorial Surgery (incision at nape of neck)
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--> position pt flat and lateral on either side
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During Internal Radiation
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--> on bedrest while implant in place
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Autonomic Dysreflexia/Hyperreflexia
(S&S: pounding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension) |
--> place client in sitting position (elevate HOB) first before any other implementation.
*life-threatening |
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Shock
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--> bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified Trendelenburg)
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