98%(126)123 out of 126 people found this document helpful
This preview shows page 14 - 16 out of 20 pages.
involves difficult progression through the expected stages of the grieving processgrief work is prolonged and manifestations more severeclient may develop suicidal ideation, intense feelings of guilt and lowered self-esteemsomatic complaints persist for an extended period of timedysfunctional griefSigns for meningococcemia-Vomiting, febrile, petechial rash (unstable)Levothyroxine effects-Used to restore client's metabolic rateToxic effects = heat intolerance, Tachycardia, Weight loss, HypertensionMultiple Sclerosis Patient-Mitoxantrone SE's Mitoxantrone IV every 3 months (chemo drug)* Report Sore Throat (greatest risk for client is severe infection due to myelosuppression from mitoxantrone)* Vomiting = causes dehydration* Hair Loss = emotional distress* Amenorrhea = emotional distressMalnourished COPD patients-(1) Limit liquid intake at meal times(2) Consume foods w/ protein (like eggs)(3) Maintain an upright position (High Fowler's position) to promote ventilation(4) Use milk instead of water when making soupWhich grief process is it when Client exhibits increased anxiety + may project anger toward self + others"I don't deserve to die, this isn't fair"-Anger stageWhich Grief Process when Client acknowledges the impending loss while remaining hopeful"If I could just make it through this, I'd never smoke again"-Bargaining StageHow should you respond when client wants to discontinue dialysis-"What has changed to make you decide this?" = Seek clarification from client to establish mutual understanding while staying therapeutic
What should the nurse do when one member of a support group expresses anger repeatedly?-Focus more on the group members who have a positive outlook(Speak to group member privately to uncover source of anger)What immunizations are CONTRAINDICATED for pregnant women + which SHOULD be given?-Contraindicated = Herpes Zoster + Varicella + MMR (measles, mumps, rubella)Should give = TDaP (Tetanus, Diphtheria, Pertussis)Long term effects of NSAIDS (Ibuprofen)-Gastric Ulcerations, perforations, hemorrhage,hypertensionAlcohol Use Manifestations of Withdrawal-Body burns 0.5 oz of alcohol per hour* Withdrawal appears within 4-12 hours* Irritability + Tremors + Anxiety* Nausea + Vomiting + HA * Diaphoresis * Sleep Disturbances* TACHYCARDIA + HTNUse Benzodiazepines = tx Diazepam (Valium), lorazepam (Ativan), and chlordiazepoxide (Librium)When does Discharge planning begin?-At AdmissionCase Management nursing involves:-*Decreasing cost by improving client outcomes* Providing education to optimize health participation* Advocating for services + client's rightsWhat is bipolar disorder?-Bipolar disorder is a mood disorder with recurrent episodes of depression and mania.What comorbidities may be observed with a patient who is bipolar?-Substance use disorder (experiences more rapid cycling), anxiety disorders, eating disorders, ADHD.