Topics To Review
Safety and Infection Control
Home Safety
Musculoskeletal Trauma: Discharge Teaching About an External Fixation Device (RN QSEN - Safety,
Active Learning
Template - Basic Concept, RM AMS RN 10.0 Chp 71)
External fixation involves fracture immobilization using percutaneous pins and wires that are
attached to a rigid external frame.
Care of fixation device is to clean the external fixation pins one to two times each day to remove
exudate that can harbor bacteria. Use separate cotton swabs on each pin to decrease risk of pin
site infection.
Advise client to report redness, heat, drainage at pin site. These can indicate infection leading to
osteomyelitis. Talk about clothing options, activity restriction, dep breathing exercises, leg
exercises to prevent risk of pneumonia and thrombus formation.
Health Promotion and Maintenance
Health Promotion/Disease Prevention
Health, Wellness, and Illness: Identifying Risk Factors for Atherosclerosis (Active Learning Template -
System Disorder,
RM AMS RN 10.0 Chp 1)
Atherosclerosis is caused by gradual thickening of the arteries, results in progressive narrowing
of the lumen.
Plaques form on walls of arteries causing the structure to be rough and fragile.
Family history is a predisposing factor, high blood pressure, smoking, diabetes, obesity,
unhealthy cholesterol levels are all major risk factors for atherosclerosis.
Basic Care and Comfort
Elimination
Postoperative Nursing Care: Urinary Retention (Active Learning Template - System Disorder, RM AMS
RN 10.0 Chp 96)
Monitor fluid and electrolyte balance following surgery. Monitoring mat help determine an issue
of urinary retention.
Nursing care related to I&O include palpate bladder for distention, monitor urinary catheter
patency, observe urine color, consistency, odor, and amount. Less than 30 mL/hr may indicate
dehydration or hypovolemia.
Urine output of at least 30 mL/hr is crucial before discharge.
Pharmacological an
d Parenteral Therapies
Blood and Blood Products
Blood and Blood Product Transfusions: Steps in the Administration Process (RN QSEN - Safety, Active
Learning
Template - Nursing Skill, RM AMS RN 10.0 Chp 40)
Client can receive transfusions of whole blood or components of whole blood for replacement
due to blood loss or blood disease.
Explain the procedure to the client. Assess vitals including temperature prior to transfusion.
Remain with client for 15-30 minutes of infusion. Reaction usually occurs within the first 15
minutes.
Assess lab values including platelet count and hemoglobin. Verify prescription for blood product.
Obtain consent for procedure. And obtain blood samples for compatibility determination.
Rheumatoid Arthritis: Caring for a Client Receiving Plasmapheresis (RN QSEN - Safety, Active Learning
Template -
Therapeutic Procedure, RM AMS RN 10.0 Chp 88)
Chronic, progressive inflammatory disease that can affect tissues and organs as well as joints
producing inflammatory synovitis. Can affect several joints at a time. Typically affects upper
joints first.
