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HESI RN Specialty Study Guide 2, Study notes of Nursing

Bergen Community CollegeNursing

HESI RN Specialty Study Guide 2 Practice materials Adult Health Nursing D (NUR-291) Bergen Community College 11 pages 2023/2024

Typology: Study notes

2023/2024

Available from 03/30/2024

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HESI RN Specialty Study Guide 2
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1/11
1. Basic Nursing Skills/Safety/Legal/Ethical - OSHA mandates – Blood spill
2. Medical Surgical - Endocrine – Diabetes - patient self management
3. Professional Issues - Cultural/Spiritual – Primary prevention - Exercise
4. Professional Issues – Research Theory - Epidemiology data
5. Professional Issues - Legal/Ethical - Cultural stereotyping
6. Psychiatric –Triage disaster- Psychological needs (1 -middle age wandering,
st
2ndwoman sitting on ground, 3 -crying child, 4 -mother/father just arrived.
rd th 7.
Critical Care - Cardiovascular - IV lidocaine-VT (Infuse Lidocaine (Lidoject1) at
20-50 mg/min after airway and breathing secure)
8. Fundamentals - Blood pressure-assess (IV of Dopamine-Intropin-assessment
finding is increase blood pressure.
9. Fundamentals - Basic Nursing Skills - Sleep- Evaluate
10. Fundamentals - Basic Nursing Skills - Temperature variation
11. Fundamentals - Basic Nursing Skills/Elimination - Incontinence (Adult male
client with incontinent –provide condom Catheter)
12. Fundamentals - Elimination - Vagal response-elderly
13. Fundamentals - Basic Nursing Skills/Safety - Surgical scrub technique (1 scrape
st
under nails w/ pick, 2 - use a soapy brush to scrub the hands 3 - cleanse the
nd rd
arm w/ lathered brush 4 - Rinse from the fingertips to elbow)
th
14. Fundamentals - Basic Nursing /Safety - Wrist restraint – Physician order
15. Fundamentals - Med Administration - Ear-gtt adult (pictorial, click on pinnae,
pull upper helix of pinnae and instill drops)
16. Fundamentals - Med Administration - Therapeutic index – 1.5 –2.5
17. Fundamentals - Med Administration/Math - IV-ml STAT- Digoxin
18. /Math - PO-new dose Fundamentals - Med Administration
19. - Pressure ulcer-turning Turning the pt n noticing no Geriatrics - Mobility
pressure, redness, and pt doesn’t complain of pain)
20. - Safety – Pruritis -drug response-GERI Geriatrics/Medical Surgical
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  1. Basic Nursing Skills/Safety/Legal/Ethical - OSHA mandates – Blood spill
  2. Medical Surgical - Endocrine – Diabetes - patient self management
  3. Professional Issues - Cultural/Spiritual – Primary prevention - Exercise
  4. Professional Issues – Research Theory - Epidemiology data
  5. Professional Issues - Legal/Ethical - Cultural stereotyping
  6. Psychiatric –Triage disaster- Psychological needs (1 st-middle age wandering, 2 ndwoman sitting on ground, 3 rd-crying child, 4^ th-mother/father just arrived.^ 7. Critical Care - Cardiovascular - IV lidocaine-VT (Infuse Lidocaine (Lidoject1) at 20-50 mg/min after airway and breathing secure)
  7. Fundamentals - Blood pressure-assess (IV of Dopamine-Intropin-assessment finding is increase blood pressure.
  8. Fundamentals - Basic Nursing Skills - Sleep- Evaluate
  9. Fundamentals - Basic Nursing Skills - Temperature variation
  10. Fundamentals - Basic Nursing Skills/Elimination - Incontinence (Adult male client with incontinent –provide condom Catheter)
  11. Fundamentals - Elimination - Vagal response-elderly
  12. Fundamentals - Basic Nursing Skills/Safety - Surgical scrub technique (1 stscrape under nails w/ pick, 2 nd- use a soapy brush to scrub the hands 3^ rd- cleanse the arm w/ lathered brush 4 th- Rinse from the fingertips to elbow)
  13. Fundamentals - Basic Nursing /Safety - Wrist restraint – Physician order
  14. Fundamentals - Med Administration - Ear-gtt adult (pictorial, click on pinnae, pull upper helix of pinnae and instill drops)
  15. Fundamentals - Med Administration - Therapeutic index – 1.5 –2.
  16. Fundamentals - Med Administration/Math - IV-ml STAT- Digoxin
  17. Fundamentals - Med Administration/Math - PO-new dose
  18. Geriatrics - Mobility- Pressure ulcer-turning Turning the pt n noticing no pressure, redness, and pt doesn’t complain of pain)
  19. Geriatrics/Medical Surgical- Safety – Pruritis -drug response-GERI
  1. Pathophysiology - Parathyroid tetany –Low calcium
  2. Pathophysiology – DIC laboratory test –Fibrinogen are depleted and D-Dimer assay test measure the degree of fibrinolysis.
  3. Pathophysiology- Sensory – Ears –Inner ear - stapes & oval window 24 Pathophysiology - Acute pancreatitis Intervention- Maintain Pt on NPO status, administer NGT to suction, administer TPN, administer morphine, avoid Demerol due to sphincter of oddi spasm, administer antacids, histamine-2, PPI, anticholinergics, assist pt to position of comfort on the side with legs drawn up to chest, teach pt to avoid alcohol, caffeine, fatty and spicy foods, teach pt sitting up or leaning forward to alleviates pain located at the retroperitoneal.
  4. Pathophysiology - Leadership - Shock S&S – decrease BP, increase HR, respiratory rate, weakness, chest pain, unconsciousness, moist clammy skin, dizziness, and profuse sweating.
  5. Leadership - Assignments- UAP – Don’t delegate assessment, evaluation, and nursing judgment to LVN/UAP. 5 Rights of delegation are right task, right circumstance, right person, right direction or communication, and right supervision.
  6. Fundamentals/Nutrition - Cardiac diet – Set up for people who are at high risk of developing hear condition such as hypertension and heart attack. It is an individualized healthy eating plan tailored to pt specific needs by dietician. Fat (Monosaturated and polyunsaturated fat are allowed), restricted sodium, avoid caffeinated drinks, increase fiber,
  7. Fundamentals/Nutrition- Cholesterol low diet – fruit, vegetables, cereals, lean meat, oat meal, oat brand, high fiber food, fish, nuts, kiwi fruit, orange, watermelon, plum, broccoli, potatoes, corn, onion, tomatoes, pepper, spinach, lettuce, beans, peas, soy milk, rice milk, soy cheese, almond milk, oat milk, brown rice, noodle, wheat bread, rye bread, cornflakes, ice, flour pasta, olive oil, corn oil, canola oil, soybean oil, peanut oil, and cottonseed oil.
  8. Fundamentals/Medical Surgical - Aspirin - Assess bleeding source
  9. Fundamentals- Traction- should not be move unless health care provider prescribes its removal
  1. Maternity - Newborn -Hypoglycemia-signs (Tremors are early signs)
  2. Maternity - Postpartum- C-difficile Advise the UAP to place to box of gowns outside the clients room= C. Difficile Client and UAP
  3. Maternity - Postpartum -Perineal discomfort (Perineal care nurse notes bleeding spurts-compare current vital signs with previous vital signs)
  4. Maternity - Antepartum- Heimlich- pregnancy - using chest thrusts)
  5. Maternity/Pediatrics- Newborn - Newborn-gagging
  6. Maternity - Intrapartum/Leadership - OB client prioritization
  7. Medical Surgical - Cardiovascular - Compliance
  8. Cardiovascular - HF-hypertension (C/o SOB on exertion)
  9. Medical Surgical - Cardiovascular – Lanoxin - Yellow vision
  10. Cardiovascular - Shock- Dx -Cardiogenic shock- Ineffective Tissue Perfusion)
  11. Medical Surgical - Cardiovascular/GI/Hepatic - Transfer ICU
  12. Cardiovascular - Shock- sepsis- induced- jugular catheter is oozing blood at the insertion site)
  13. Medical Surgical - Cardiovascular/Renal - Edema cause
  14. Medical Surgical - Cardiovascular/Renal - K & Lasix (Administer the dose of Furosemide -OR- Lasix as scheduled-OR- Its not potassium sparing)
  15. Medical Surgical - Cardiovascular/Respiratory - Coreg and asthma (Coreg: contraindicated in asthma pt)
  16. Medical Surgical - Cardiovascular/Respiratory - Pleuravac®-change system
  17. Medical Surgical - Endocrine - Diabetes A1C assess (Type 2 DM and patient gained 5 pounds in six months best control indicator of diabetes- A glycosylated hemoglobin level.
  18. Medical Surgical - Endocrine - Hyperparathyroid-calcium (Calcium serum lab test needed to test for hypercalcemia)
  1. Medical Surgical - Endocrine - Insulin-sliding scale
  2. Medical Surgical - Endocrine - PTU- effective – Decrease T
  3. Medical Surgical - Endocrine/Renal - CKD – Urine output
  4. Medical Surgical - GI/Hepatic - Bariatric surgery- Preop teach
  5. Medical Surgical - GI/Hepatic - Bowel obstruction Auscultate high pitched Sounds in upper quadrant-Provides data about the location of the obstruction) OR (Measure all emesis accurately)
  6. Medical Surgical - GI/Hepatic- Kidney - Decreased K
  7. Medical Surgical - GI/Hepatic - GERD- elevate bed
  8. Medical Surgical - GI/Hepatic - Hepatitis A-preicteric phase (Initial flu-like stage, patients may experience respiratory and gastrointestinal tract symptoms, which may include malaise, fatigue, and myalgia)
  9. Medical Surgical - GI/Hepatic - Tarry stools-H&H Hint: black tarry stool, H& H low because of GI bleed, remember patient at Shake nice old lady)
  10. Medical Surgical - GI/Hepatic - Zyvox and suprainfection
  11. Medical Surgical - Immune/Hematology - Bone marrow aspiration-site (Use of a compression dressing for firm pressure to that site)-OR- (back of the hipbone, or posterior iliac crest)
  12. Medical Surgical - Integumentary - Burns-neck contractures
  13. Medical Surgical - Integumentary/Trauma/Emergency - Burns-electrical (The full thickness burn has destroyed the nerves)- OR- on a cardiac telemetry monitor)
  14. Medical Surgical - Musculoskeletal - Fat embolism-S&S
  15. Medical Surgical - Musculoskeletal - Lumbar pain relief
  16. Medical Surgical - Musculoskeletal - Osteoporosis-cigarettes

(Serum potassium level of 4.3 mEq/L, too much K+ antidote)-OR -(for increase magnesium level) 96 PICC site for vesicant – Monitor for extravasation at the IV site AEB pain, warmth tenderness and erythema. 97 Leadership Primary prevention- asthma – Avoid smoking. 98 Renal Dehydration - urine specific gravity – Increase in pt with dehydration. 99 Med Administration Inhaler use – Administer bronchodilatior. 100 Fundamentals Med Administration/Math IM-units/ml – Do it yourself!! 101 Abdominal distention and need further teaching for pt with TURP during irrigation – Obtaining 0.9% NS 1 Liter to irrigate the bladder of a patient with output @ 650ml while input was 850.

  1. Medical Surgical - Renal - Kegel exercises (pt will hold URINE for I think 10 seconds, should be able to stop and hold urine flow when going to the bathroom)
  2. Medical Surgical - Renal - Mannitol (Diuretic, Acute renal failure, oliguric phase (prophylaxis and treatment, reduce ICP, treat cerebral edema, Induces diuresis because mannitol is not reabsorbed in the renal tubule, thereby increasing the osmolality of the glomerular filtrate, measurement of glomerular filtration rate (GFR).
  3. Medical Surgical - Reproductive - Fibrocystic breast disease-treatment - Caffeine- the disease is painful, lumpy breasts Some women feel that eating chocolate, drinking caffeine, or eating a high-fat diet can cause their symptoms, but there is no clear proof of this, worse right before the menstrual period. Treatment- acetaminophen or ibuprofen, Use heat or ice on the breast, wear a well-fitting bra)
  4. Respiratory - Chest tube-disconnect - connect it back to patient.
  5. Medical Surgical - Sensory - Glaucoma-mannitol (Antiglaucoma agentIntraocular pressure, elevated (treatment) Mannitol, administered intravenously, is indicated to reduce elevated intraocular pressure after other methods have failed or in preparation for intraocular surgery). Elevates blood plasma osmolarity, resulting in enhanced flow of water from the eye into plasma and a consequent reduction in intraocular pressure
  1. Medical Surgical - Trauma/Emergency - Tylenol OD-antidote (Antidote to Tylenol is Mucomyst- Acetylycysteine)
  2. Pathophysiology - Neurological/Physical Assessment – Craniotomy -GCS
  3. Pathophysiology - Physical Assessment/Sensory - Fundoscopic-macula & fovea (Picture: there are 2 prominent spots on the eye – choose the DARK spot to the left not the spot where the light is)
  4. Pathophysiology/Medical Surgical - Cardiovascular - EKG-PRI (prolonged PRI or PR Interval reflects increased conduction time from SA node to the AV junction)-OR- (PRI interval: depolarization and repolarization
  5. Pathophysiology/Medical Surgical - Endocrine/Neurological/Operative - Hypophysectomy -Diabetes Insipidus
  6. Medical Surgical - Immune/Hematology/Renal - Epogen- Renal
  7. Pathophysiology/Medical Surgical - Musculoskeletal - Compartment Syndrome - Pain
  8. Pathophysiology - Musculoskeletal - Osteoarthritis-pathology
  9. Pathophysiology/Professional Issues/Medical Surgical - Leadership – Status epilepticus priority (Acute withdrawal from anticonvulsant medication-14 yr old brought to ED w/ status epil)
  10. Pediatrics - Cardiovascular - Aspirin overdosage Reye syndrome in kids) Overdose may happen if your kidneys do not work correctly or when you are dehydrated. Signs include ringing in ears, deafness, hyperactivity, dizziness, drowsiness, seizures, coma, Treatment-fluids, activated charcoal, laxative, IV of potassium, sodium bicarbonate.
  11. Pediatrics - Cardiovascular - Capoten-effects
  12. Pediatrics - Endocrine - Diabetes-hypoglycemic crisis (Tremors are early signs)-OR- (Mother with a 6yrs old who newly dx with DM= I put tell the mom to carry sugar with her at all times)
  13. Pediatrics - GI/Hepatic - Intussusception-hydrostatic reduction.
  1. Professional Issues - Legal/Ethical - Consent to treat – unresponsive client
  2. Professional Issues - Documentation - Lung sounds-fine crackles
  3. Professional Issues/Medical Surgical - Leadership - Assignments-PN
  4. Medical Surgical - Leadership - Client assessment -HCP call
  5. Professional Issues - Leadership - CPR- no palpable pulse
  6. Professional Issues/Medical Surgical - Leadership - Delegation-home visit
  7. Professional Issues - Leadership - Endocrine unit- priority care
  8. Professional Issues/Medical Surgical - Leadership - Lab values (charge nurse has 4 patients, need to notify provider on 29-yr old diagnosed with ulcerative colitis and potassium level of 3.1)
  9. Professional Issues - Nursing Process - Ineffective airwary clearance
  10. Professional Issues/Medical Surgical - Nursing Process - Objective data
  11. Professional Issues/Medical Surgical - Teaching - Ileostomy care-stoma
  12. Professional Issues/Medical Surgical - Teaching - Urticaria-Benadryl
  13. Psychiatric - Abuse - Alcohol detox protocol (I cannot acknowledge if a client is here or not- A man calls the hospital and asks about girlfriend)
  14. Psychiatric/Mental Hlth - Abuse – DTs - lab
  15. Psychiatric/Mental Hlth - Abuse - Safety planning
  16. Psychiatric/Mental Hlth - Abuse - Withdrawal CNS depressants
  17. Psychiatric/Mental Hlth - Anxty/Commnictns - Adolescent-insecure
  18. Psychiatric/Mental Hlth - Anxty/Commnictns - Family care
  19. Psychiatric/Mental Hlth - Depress/Grief - Depression-weekend pass
  20. Psychiatric/Mental Hlth - Depress/Grief - Suicide- determine means