NRSG261 Week 2 Worksheet PDF

Preview

Summary

weekly...

Description

NRSG2 6 1 : Cl i n i c a l I n t e g r a t i o n: Ac u t eCa r e We e k2Wor kSh e e t

St ud e nt sNa me : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I mpor t a ntnot e :I t i sapr er e qui s i t et ha t y ouc ompl e t et hi swor k s he e t pr i ora t t e ndi ngy oura l l o c a t e d c l a s s .

NRSG2 6 1Le a r ni ngout c ome s 1 . Ap p l ys p e c i fi cl e g a l a n de t h i c a l f r a me wo r k s , p o l i c i e sa n dp r o c e d u r e st ot h ec a r eo f i n d i v i d u a l su n d e r g o i n g s u r g i c a l i n t e r v e n t i o n 2 . Ap p l yac l i n i c a l d e c i s i o nma k i n gf r a me wo r kt oa s s e s st h ep o t e n t i a l i mp a c t o f a ni n d i v i d u a l ’ sc o mo r b i d i t i e s a n dc o mp l e xh e a l t hi s s u e si nr e l a t i o nt ot h e i r s u r g i c a l e x p e r i e n c e 3 . Ap p l yt h e o r e t i c a l k n o wl e d g eo f p a t h o p h y s i o l o g ya n dp h a r ma c o l o g yi nc a r i n gf o r i n d i v i d u a l su n d e r g o i n g s u r g i c a l i n t e r v e n t i o n 4 . Ad a p t c a r ea p p r o p r i a t et oa ni n d i v i d u a l ’ sa c u i t ya n dh e a l t hc o n d i t i o n Gr a dua t ea t t r i but e s GA4 Th i n kc r i t i c a l l ya n dr e fl e c t i v e l y GA5 De mo n s t r a t ev a l u e s , k n o wl e d g e , s k i l l sa n da t t i t u d e sa p p r o p r i a t et ot h ed i s c i p l i n ea n d / o r p r o f e s s i o n GA9 De mo n s t r a t ee ff e c t i v ec o mmu n i c a t i o ni no r a l a n dwr i t t e nEn g l i s hl a n g u a g ea n dv i s u a l me d i a Pr e r e a di ngs t h T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) .Pa i nMa n a g e me n t n o n p h a r ma c o l o g i c a l i n t e r v e n t i o n s . I nJ . T o l l e f s o n( 6 e d . ) , Cl i n i c a l p s y c h o mo t o r s k i l l s : a s s e s s me n t t o o l sf o r n u r s i n gs t u d e n t s( p p . 2 4 2 2 4 6 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g . t h T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) .Me d i c a t i o na d mi n i s t r a t i o n : p a r e n t e r a l . I nJ . T o l l e f s o n( 6 e d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s : a s s e s s me n t t o o l sf o r n u r s i n gs t u d e n t s( p p . 1 6 5 1 7 4 ) . So u t hMe l b o u r n e , VI C: Ce n g a g e L e a r n i n g . t h T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) .Re s p i r a t o r ya s s e s s me n t . I nJ . T o l l e f s o n( 6 e d . ) , Cl i n i c a l p s y c h o mo t o r s k i l l s : a s s e s s me n t t o o l sf o r n u r s i n gs t u d e n t s( p p . 1 6 5 1 7 4 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g .

T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) . Pa i nma n a g e me n t n o n p h a r ma c o l o g i c a l i n t e r v e n t i o n s . I nJ . T o l l e f s o n&E. t h Hi l l ma n( 6e d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s : a s s e s s me n t t o o l sf o rn u r s e s( p p . 2 2 6 2 3 0 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g . t he T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) . Re s p i r a t o r ya s s e s s me n t . I nJ . T o l l e f s o n&E. Hi l l ma n( 6 d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s : a s s e s s me n t t o o l sf o r n u r s e s( p p . 6 0 6 8 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g . t h T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) . Ne u r o l o g i c a l a s s e s s me n t a n do b s e r v a t i o n . I nJ . T o l l e f s o n&E. Hi l l ma n( 6 e d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s : a s s e s s me n t t o o l sf o rn u r s e s( p p . 4 2 4 8 ) . So u t hMe l b o u r n e , VI C: Ce n g a g e L e a r n i n g . t he T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) . Me n t a l s t a t u sa s s e s s me n t . I nJ . T o l l e f s o n&E. Hi l l ma n( 6 d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s : a s s e s s me n t t o o l sf o r n u r s e s( p p . 4 9 5 3 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g . t he T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) . Ca r d i o v a s c u l a r a s s e s s me n t . I nJ . T o l l e f s o n&E. Hi l l ma n( 6 d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s : a s s e s s me n t t o o l sf o r n u r s e s( p p . 5 4 5 9 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g .

Page 1 of 6

NRSG2 6 1 :Cl i ni c a l I nt e gr a t i o n: Ac ut eCa r e We e k2Wor kSh e e t

St ud e nt sNa me : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I mpor t a ntnot e: I t i sapr er e qui s i t et ha t y ouc ompl e t et hi swor k s he e t pr i ora t t e n di ngy oura l l oc a t e d c l a s s . t he T o l l e f s o n , J . &Hi l l ma n , E. ( 2 0 1 6 ) . Ab d o mi n a l a s s e s s me n t . I nJ . T o l l e f s o n&E. Hi l l ma n( 6 d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s : a s s e s s me n t t o o l sf o r n u r s e s( p p . 6 9 7 2 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g .

Le a r ni ngobj e c t i v e s : Co mp l e t i o no f t h ewo r k s h e e t a n dt h ep r a c t i c a l c l a s sa c t i v i t i e swi l l e n a b l ey o ut o : 1 . De mo n s t r a t et h e r a p e u t i cc o mmu n i c a t i o nwi t hp a t i e n t s . 2 . De mo n s t r a t ec o mp e t e n c ywi t hp e r f o r mi n gaf u l l s y s t e msa s s e s s me n t a n dp a i na s s e s s me n t o nt h ep o s t o p e r a t i v ep a t i e n t u s i n gt h eAt oGa l g o r i t h m. 3 .I d e n t i f yb o t hp h a r ma c o l o g i c a l a n dn o n p h a r ma c o l o g i c a l a p p r o a c h e st op a i nma n a g e me n t . 4 . De mo n s t r a t ea s s e s s me n t a n dma n a g e me n t o f Po s t Op e r a t i v eNa u s e aa n dVo mi t i n g( PONV) . 5 .I mp l e me n t , d i s c u s sa n de v a l u a t en a u s e aa n dp a i nma n a g e me n t s t r a t e g i e s . 6 . De mo n s t r a t ec o mp e t e n c ywi t ht h ea d mi n i s t r a t i o no f I Va n dI MI me d i c a t i o na d mi n i s t r a t i o n . 7 . De mo n s t r a t ei n t e r p r o f e s s i o n a l c o mmu n i c a t i o nt h r o u g hp r o g r e s sn o t ewr i t i n ga n dc l i n i c a l h a n d o v e r .

Ca s es c e na r i o: Mi c he l l eSmi t h Mi c h e l l eSmi t hh a sn o wj u s t Re t u r n e dT ot h eWa r d( RTW) p o s t h a v i n gal a p a r o s c o p i ca p p e n d e c t o my . OnRTW s h ei sd r o ws yb u t r o u s a b l ea n di sc o mp l a i n i n go f p a i n . Af t e r p r i o r i t i s i n gh e r c a r ea n dp e r f o r mi n gat h o r o u g h s y s t e msa s s e s s me n t a n dp a i na s s e s s me n t , y o ud e t e r mi n et h a t s h ei se x p e r i e n c i n gmo d e r a t ep a i nwi t har a t i n go f 5 / 1 0 . Y o ur e v i e wh e rme d i c a t i o nc h a r t t os e ewh a t s h ei so r d e r e da n dwh a t s h ec a nh a v ef o r p a i nr e l i e f . Th i n k a b o u t o t h e r n o n p h a r ma c o l o g i c a l n u r s i n gi n t e r v e n t i o n sy o uc a na l s oi mp l e me n t t oa l l e v i a t eMi c h e l l e ’ sp a i n . 4 5mi n u t e sl a t e rMi c h e l l ei sc o mp l a i n i n go f f e e l i n gn a u s e o u s . Ag a i n , y o ur e v i e wh e r me d i c a t i o nc h a r t t os e ewh a t y o uc a na d mi n i s t e r f o r h e r n a u s e a . Ast h en u r s i n gs t u d e n t c a r i n gf o r Mi c h e l l e , y o ua r et o :  Pe r f o r maf u l l s y s t e msa s s e s s me n t a n dp a i na s s e s s me n t o nMi c h e l l e .  Do c u me n t y o u r a s s e s s me n t fi n d i n g s , a n dn u r s i n gi n t e r v e n t i o n si nMi c h e l l e ’ sp r o g r e s sn o t e s .  Re v i e wt h eme d i c a t i o nc h a r t a n da d mi n i s t e r a n a l g e s i aa p p r o p r i a t ef o r Mi c h e l l e ’ sl e v e l o f p a i n , a d h e r i n g t ot h e6r i g h t so f me d i c a t i o na d mi n i s t r a t i o n , e n s u r i n ga l l d o c u me n t a t i o ni sc o mp l e t e d .  Ad mi n i s t e ra na n t i e me t i cf o r n a u s e a , a d h e r i n gt ot h e6r i g h t so f me d i c a t i o na d mi n i s t r a t i o n , e n s u r i n ga l l d o c u me n t a t i o ni sc o mp l e t e d .  Ev a l u a t en u r s i n gc a r ep r o v i s i o n ; d o c u me n t i n gt h ee ff e c t i v e n e s so f i mp l e me n t e dn u r s i n gi n t e r v e n t i o n s .

Page 2 of 6

NRSG2 6 1 :Cl i ni c a l I nt e gr a t i o n: Ac ut eCa r e We e k2Wor kSh e e t

St ud e nt sNa me : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I mpor t a ntnot e: I t i sapr er e qui s i t et ha t y ouc ompl e t et hi swor k s he e t pr i ora t t e n di ngy oura l l oc a t e d c l a s s .

T heAt oGa l gor i t hm Re a d i n g : J a c q u e s , T . , Fi s h e r , M. , Hi l l ma n , K. , Be r r y , M. , Hu g h e s , C. , L a m, D. , …Sa u l , P . ( 2 0 0 9 ) . Wh e nt owo r r y . Re t r e i v e d f r o mh t t p : / / n s wh e a l t h . mo o d l e . c o m. a u / DOH/ DETECT/ c o n t e n t / s h a r e d / d o c u me n t s / c h 1 _ wo r r y . p d f 1 . TheAt oGa l gor i t hmi saus e f ul a n dqui c ki ni t i a l a s s e s s me nt ofpa t i e nt s . I de nt i f yt he a s s e s s me nt st ha t ne e dt obedonei nt hi sa l gor i t hmi nr e l a t i ont oMi c he l l e ’ ss i t ua t i on. As s e s s me n t s A B

Ai r wa y s Br e a t h i n g

C

Ci r c u l a t i o n

D

Di s a b i l i t y

E

Ex p o s u r e

F

F u l l s e t o f v i t a l s

G

Gi v ec o mf o r t me a s u r e s

I Vt he r a pyd r ugc a l c ul a t i ons Re a d i n g : s t Br o t t o , V. &Ra ff e r t y , K. ( 2 0 1 2 ) . I n f u s i o nc a l c u l a t i o n s . I nBr o t t o&Ra ff e r t e y d ( . 1 ) , Cl i n i c a l Do s a g eCa l c u l a t i o n s f o r Au s t r a l i a&Ne wZe a l a n d( p p . 1 1 8 1 3 5 ) . So u t hMe l b o u r n e , VI C: Ce n g a g eL e a r n i n g . 2 . Wha ti st hef or mu l af orc a l c ul a t i ngi nf us i onr a t e sus i nga nI Vi nf us i onpump( ml s / he r ? Ra t e( ml / hr ) =v ol umeml / t i me a .I Vn o r ma l s a l i n e( 5 0 0 ml s ) t ob ei n f u s e do v e r4h o u r su s i n ga ni n f u s i o np u mp . Ca l c u l a t et h er a t ei n ml s / h r . 5 0 0 / 4 =1 2 5 ml s / h r b .I Vn o r ma l s a l i n e( 5 0 0 ml s ) t ob ei n f u s e do v e r3h o u r su s i n ga ni n f u s i o np u mp . Ca l c u l a t et h er a t ei n ml s / h r . 5 0 0 / 3 =1 6 7 ml s / h r Page 3 of 6

NRSG2 6 1 :Cl i ni c a l I nt e gr a t i o n: Ac ut eCa r e We e k2Wor kSh e e t

St ud e nt sNa me : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I mpor t a ntnot e: I t i sapr er e qui s i t et ha t y ouc ompl e t et hi swor k s he e t pr i ora t t e n di ngy oura l l oc a t e d c l a s s . c .I Vn o r ma l s a l i n e( 1 0 0 0 ml s ) t ob ei n f u s e do v e r 1 0h o u r su s i n ga ni n f u s i o np u mp . Ca l c u l a t et h er a t ei n ml s / h r . 1 0 0 0 / 1 0 =1 0 0 ml s / h r d .I Vn o r ma l s a l i n e( 1 0 0 0 ml s ) t ob ei n f u s e do v e r 1 2h o u r su s i n ga ni n f u s i o np u mp . Ca l c u l a t et h er a t ei n ml s / h r . 1 0 0 0 / 1 2 =8 3 ml s / h r Me di c a t i ona dmi ni s t r a t i on t h Re a d i n g : Mc Ke n n a , L . , &Mi r k o v , S. ( 2 0 1 2 ) . Au s t r a l i aNe wZ e a l a n dn u r s i n g&mi d wi f e r yd r u gh a n d b o o k( 6 e d . ) . Sy d n e y : L i p p i n c o t t Wi l l i a ms&Wi l k i n sPt yL t d .

3 . Mi c he l l ei spr e s c r i be dMe t oc l opr a mi def orhe rPos t Ope r a t i v eNa us e aa ndVomi t i ng. Pr i ort o a dmi ni s t e r i ngMe t oc l opr a mi de . I ti si mpor t a nt t ounde r s t a ndi t sba s i cpha r ma c ol ogy . Comp l e t e t het a bl ebe l o w.

I ndi c a t i onsf ori t sus e Wha ta r ei t sa dv e r s e r e a c t i ons ? Wha ta r et hev a r i ous me t hodsbywhi c hi t c a n bea dmi ni s t e r e d? Wha ta r et henur s i ng c a r ec ons i de r a t i ons whe na dmi ni s t e r i ngt he me di c a t i on?

Me t oc l opr a mi de Co n t r o l o f n a u s e aa n dv o mi t i n g Su i c i d a l i d e a t i o n , s e i z u r e s , n e u t r o p e n i a , a g r a n u l o c y t o s i s , r e s t l e s s n e s s , a n x i e t y

I n j e c t i o n , t a b l e t s Gi v ed i p h e n h y d r a mi n eh y d r o c h l o r i d et oc o u n t e r a c t e x t r ap y r a mi d a l e ff e c t s .

Re a d i n g :T o l l e f s o n ,J . ( 2 0 1 2 ) .Me d i c a t i o na d mi n i s t r a t i o n–p a r e n t a l me d i c a t i o n . I nJ . T o l l e f s o n( 5 t he d . ) , Cl i n i c a l p s y c h o mo t o rs k i l l s :a s s e s s me n tt o o l sf o rn u r s i n gs t u d e n t s( 1 4 9 1 5 6 ) .So u t hMe l b o u r n e ,VI C:Ce n g a g e L e a r n i n g 4 . Wha ts i z ene e dl ei sr e qui r e df ori nt r a mus c ul a ri nj e c t i ons ? 2 1 , a n d2 3 , g a u g e 5 . Thet a bl ebe l owpr ov i de st hedi ffe r e nts i t e swhe r ei nt r a mus c ul a ri nj e c t i onsa r ea dmi ni s t e r e d. Pl e a s ei de nt i f yt hel a ndma r k sf ort hef ol l o wi ngs i t e s:

Si t e De l t o i d

Ana t omi c a l La ndma r k s Landmarks for the deltoid muscle are the acromion process and the axillary line. Insert the needle at a point two to three finger widths (1 to 2 inches) below the acromion process, above the axillary line in the middle of the triangular-shaped deltoid muscle in the midline of the lateral aspect of the arm.

Page 4 of 6

NRSG2 6 1 :Cl i ni c a l I nt e gr a t i o n: Ac ut eCa r e We e k2Wor kSh e e t

St ud e nt sNa me : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I mpor t a ntnot e: I t i sapr er e qui s i t et ha t y ouc ompl e t et hi swor k s he e t pr i ora t t e n di ngy oura l l oc a t e d c l a s s . Va s t u sl a t e r a l i s Landmarks for the vastus lateralis muscle are the head of the greater trochanter and the knee. Insert the needle into the middle third of the muscle at least one hand width below the greater trochanter and one hand width above the knee in the anterolateral aspect of the leg. Do r s o g l u t e a l

Ve n t r o g l u t e a l

Find the trochanter. It is the knobbly top portion of the long bone in the upper leg (femur). Find the posterior iliac crest. Many people have ‘dimples’ over this bone. Draw an imaginary line between the two bones. After locating the centre of the imaginary line, find a point one inch toward the head. This is where (X) to insert the needle Landmarks for the ventrogluteal muscle are the head of the greater trochanter and the anterior superior iliac spine. Place the heel or the palm of your hand on the head of the greater trochanter with your thumb pointing toward the patient’s abdomen. Extend your index finger up to the anterior superior iliac spine then spread your other fingers back along the iliac crest. Insert the needle in the “V” formed between your index and third fingers.

6 . Mi c he l l ei spr e s c r i be dMor phi ne( I MI ) f orhe rpa i n. Pr i ort oa dmi ni s t e r i ngMor phi ne . I t i s i mpor t a nt t ounde r s t a ndi t sba s i cpha r ma c ol ogy . Comp l e t et het a bl ebe l ow. Mor phi ne I ndi c a t i onsf ori t sus e

Se v e r ep a i n

Wha ta r ei t sa dv e r s e r e a c t i ons ?

Se d a t i o n , n a u s e a , v o mi t i n g , d r ymo u t h , s e i z u r e s , b r a d y c h a r d i a , s h o c k , c a r d i a ca r r e s t , t h r o mb o c y t o p e n i a , r e s p i r a t o r yd e p r e s s i o n , a p n o e a , r e s p i r a t o r y a r r e s t , p h y s i c a l d e p e n d e n c e .

Wha ta r et hev a r i ous me t hodsbywhi c hi t c a n Or a l s o l u t i o n , c a p s u l e s , t a b l e t s , g r a n u l e sf o rs u s p e n s i o n , i n j e c t i o n , I V bea dmi ni s t e r e d? Wha ta r et henur s i ng Don o t c r u s ho r c h e wc o n t r o l l e d r e l e a s ef o r mu l a t i o n s . c a r ec ons i de r a t i ons whe na dmi ni s t e r i ngt he me di c a t i on?

Page 5 of 6

NRSG2 6 1 :Cl i ni c a l I nt e gr a t i o n: Ac ut eCa r e We e k2Wor kSh e e t

St ud e nt sNa me : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

I mpor t a ntnot e: I t i sapr er e qui s i t et ha t y ouc ompl e t et hi swor k s he e t pr i ora t t e n di ngy oura l l oc a t e d c l a s s .

Page 6 of 6...