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INP session 2-8 notes, Cheat Sheet of Nursing

City University, Vancouver locationNursing

overview and important details session 2-8

Typology: Cheat Sheet

2025/2026

Uploaded on 03/24/2026

honradoangela4
honradoangela4 🇨🇦

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INP$II$SESSION$2-8$NOTES$$
🩺
SESSION 02 – ABDOMINAL
ASSESSMENT (FULL OSCE LEVEL)
🔹
Preparation (ALWAYS FIRST)
• Perform hand hygiene
• Introduce yourself
• Verify patient (2 identifiers)
• Explain procedure
• Provide privacy (drape properly)
• Position: supine, knees slightly flexed
👉 Rationale: relaxes abdominal muscles → more accurate assessment
🔹
INSPECTION
What you LOOK for:
• Contour: flat, rounded, distended
• Symmetry
• Skin: scars, lesions, striae
• Umbilicus: midline/inverted
• Visible pulsations or peristalsis
👉 Abnormal findings:
• Distention → gas, fluid, tumor
• Visible peristalsis → obstruction
🔹
AUSCULTATION (DO FIRST BEFORE TOUCHING)
• Use diaphragm
• Listen in all 4 quadrants
• Listen 1 full minute per quadrant if needed
👉 Normal: 5–30 bowel sounds/min
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INP II SESSION 2 - 8 NOTES

🩺 SESSION 02 – ABDOMINAL

ASSESSMENT (FULL OSCE LEVEL)

🔹 Preparation (ALWAYS FIRST)

  • Perform hand hygiene
  • Introduce yourself
  • Verify patient (2 identifiers)
  • Explain procedure
  • Provide privacy (drape properly)
  • Position: supine, knees slightly flexed 👉 Rationale: relaxes abdominal muscles → more accurate assessment

🔹 INSPECTION

What you LOOK for:

  • Contour: flat, rounded, distended
  • Symmetry
  • Skin: scars, lesions, striae
  • Umbilicus: midline/inverted
  • Visible pulsations or peristalsis 👉 Abnormal findings:
  • Distention → gas, fluid, tumor
  • Visible peristalsis → obstruction

🔹 AUSCULTATION (DO FIRST BEFORE TOUCHING)

  • Use diaphragm
  • Listen in all 4 quadrants
  • Listen 1 full minute per quadrant if needed 👉 Normal: 5 – 30 bowel sounds/min

👉 Abnormal:

  • Hypoactive → post-op, ileus
  • Hyperactive → diarrhea
  • Absent → listen 5 mins → emergency 👉 ❗ EXAM TRAP: If you palpate first → FALSE bowel sounds

🔹 PERCUSSION

  • Tap lightly across abdomen 👉 Findings:
  • Tympany = normal (air)
  • Dullness = mass, fluid, organ 👉 Special:
  • Shifting dullness → ascites

🔹 PALPATION

Light (1 cm):

  • Tenderness
  • Guarding

Deep (4–5 cm):

  • Masses
  • Organ enlargement 👉 Rules:
  • Painful area = LAST
  • Watch facial expression 👉 Abnormal:
  • Guarding = inflammation
  • Rigidity = serious (peritonitis)
  • Oral fluids
  • IV fluids
  • Tube feeding Output:
  • Urine
  • Vomit
  • Drainage

🔹 Key Values:

  • Urine ≥ 30 mL/hr 👉 Low output = BAD
  • dehydration
  • kidney failure 👉 ❗ EXAM TRAP: 20 mL/hr = REPORT immediately

🧠 SESSION 03 – SAFETY & NEURO

🚨 FALL PREVENTION (VERY TESTED)

🔹 Nursing Actions:

  • Bed LOW & LOCKED
  • Call bell within reach
  • Non-slip socks
  • Adequate lighting
  • Hourly rounding
  • Assist with ambulation

🔹 DO NOT:

  • Raise all 4 side rails ❌ (counts as restraint)

👉 Rationale: prevents injury

🔒 RESTRAINTS

🔹 Use ONLY if:

  • Patient is danger to self/others
  • All alternatives failed

🔹 Requirements:

  • MD order
  • Time-limited

🔹 Nursing Care:

  • Check circulation (color, temp, pulses)
  • Skin integrity
  • Remove q2h
  • Provide ROM 👉 Complications:
  • Pressure injury
  • Nerve damage
  • Emotional distress

🧠 NEURO ASSESSMENT

🔹 LOC (Level of Consciousness):

  • Alert
  • Drowsy
  • Stupor
  • Coma

🌬 RESPIRATORY ASSESSMENT

🔹 Inspect:

  • Rate
  • Depth
  • Effort

🔹 Auscultation:

Sound Meaning Crackles Fluid Wheezes Narrow airway Absent Obstruction

🛑 SESSION 05 – RESTRAINTS (DETAILED)

🔹 Rules:

  • LAST resort
  • MD order required
  • Documentation required

🔹 Care:

  • Check circulation frequently
  • Remove q2h
  • Reposition patient
  • Offer fluids/toileting

🩹 SESSION 06 – WOUND CARE

🔹 Wound Assessment:

Measure:

  • Length × Width × Depth

Color:

  • Red = healthy
  • Yellow = slough
  • Black = necrotic

🔹 Drainage:

  • Serous = clear
  • Purulent = infection 👉 Odor = infection

🔹 Dressings:

Type Purpose Dry Protection Wet-to-dry Debridement Hydrocolloid Moist healing Foam Absorb drainage

🔹 Sterile Technique:

RULES:

  • Sterile touches sterile only
  • 1 - inch border = contaminated
  • Keep above waist
  • Do not turn back 👉 ❗ If unsure → consider contaminated

💉 SESSION 08 – INJECTIONS

🔹 Subcutaneous (SC):

  • Angle: 45–90°
  • Sites: abdomen (best) 👉 Used for insulin, heparin

🔹 Intramuscular (IM):

  • Angle: 90°
  • Sites: o Deltoid o Vastus lateralis (preferred) 👉 ❗ Avoid dorsogluteal → sciatic nerve injury

🔹 Blood Glucose:

  • Normal: 4 – 7 mmol/L fasting

Hypoglycemia:

  • Sweating
  • Confusion
  • Shaking 👉 Give glucose immediately

Hyperglycemia:

  • Thirst
  • Frequent urination

🔹 Insulin Mixing:

  • Clear → Cloudy 👉 prevents contamination

⭐ ULTRA HIGH-YIELD EXAM SUMMARY

  • Abdomen → Auscultate FIRST
  • Urine <30 mL/hr = REPORT
  • 4 side rails = restraint
  • Clear → Cloudy insulin
  • IM = 90°, SC = 45–90°
  • Aspiration → sit upright + chin tuck
  • Sterile = don’t touch, above waist