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What are the FIVE rights of teaching?
- Right time: pain free willing to learn, sufficient time for learning
- Right context: environment free of distractions: quiet private, soothing or stimulatingRight goal: client readiness and commitment to behavioral change, all necessary parties are present, objectives realistic and valued
- Right content: appropriate for needs, new or reinforced info, level of learner, related to other life experiences
- Right method: teaching strategies match learning style, learning ability, use of varied strategies integral to learning
What are the THREE learning domains?
How would you teach toddlers?
parallel play and imitation
How do you teach preschoolers?
role play and imitation
What are a few things to keep in mind when teaching the elderly?
- Use verbal and oral means, accounting for sensory deprivation due to possible visual and hearing impairments
- Labeled categories increase focus and recall
- Allow client to have maximum control
- Don’t talk to them like they’re idiots, babies, or crazy
What do you document re: patient education?
- Learning needs
- topics covered
- resources provided
- outcomes…always measure!
What types of patient need a foley?
- Critically ill
- Not good for incontinent patient unless has pressure ulcer
- Don’t put in for convenience
- Women who have had an epideral
What are some interventions you can take to help with incontinence?
- Bladder retraining – this is critical!
- Pelvic muscle exercise such as Kegel – for women.
- Scheduled toileting – this is critical!
- Drug Therapy
What is normal specific gravity?
What is normal urine pH?
What are some possible nursing diagnoses related to bladder health?
- Altered urinary elimination
- Urinary retention
- Incontinence (urge, stress, functional)
- Body image disturbance
- Anxiety or pain r/t to GU exam
- Health seeking behaviors r/t deficit of knowledge
What do you need to do to prepare for a foley insertion?
- Same sex chaperone
- Provide privacy, privacy, privacy
- Expose only parts that are to be examined
What are you looking for in the female when inserting a foley?
- hair growth and distribution
- size and shape of labia
- inflammation or excoriation
- genital piercing
What do you need to look for in a male when inserting a foley?
- skin color
- edema and inflammation
- genital piercing
What is standard protocol with changing a foley and emptying the bag?
- Most facilities say take out every 72 hours
- Empty bag every 8 hours
- Keep foley in for 5 days with statlock
What are the SEVEN components of a drug order?
- Name of the client
- Date the drug was ordered
- Name of the drug
- Route of administration and any rules of administration
- Time and frequency drug should be given
- Person who ordered medication
What are the SIX rights of drug administration?
- Right drug/medication
- Right patient
- Right dose
- Right route
- Right time
- Right documentation
What's the difference between STAT, Standard written, and NOW?
- Standard Written: These are carried out as written or until the prescriber alters or discontinues an order.
- STAT…emergent…high priority…obtain and administer
- NOW…slightly lower priority…complete within an hour.
What is the gauge and size of a subQ needle.
25-27 Gauge needle; ¼ - 5/8 inch in length
What is the gauge and size of an IM needle?
21-25 gauge needle Needle ½ - 3 inches in length, dependent on amount of adipose tissue and patient size
What is nociceptive?
receptor that responds to potential pain, sends to spinal cord
What is neuroopathic pain?
Neuropathic pain-i.e. shingles (from nerves)
What are the FOUR phases of therapeutic communication?
- Stage 1: Preinteraction Phase
- Stage 2: Orientation Phase
- Meeting the client; introductions; establishing rapport and trust
- Stage 3: Working Phase
- Use of techniques germane to therapeutic communication
- Active part of the relationship
- Client clarifies feelings and concerns through verbal and nonverbal communication
- Stage 4: Termination Phase
- Conclusion of the relationship
What is urge incontinence?
Involuntary loss of urine with a strong sensation of urgency, even when the bladder is not full
What is stress incontinence?
Involuntarybloss of urine during routine physical stress
What is mixed incontinence?
Stress & Urge incontinence
What is overflow incontinence?
- Due to acontractile or contractility impaired detrusor which causes bladder overdistention
- Frequent or constant dribbling of urine
Where can you insert an IM injection?
deltoid, vastus lateralis or ventral gluteal