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rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
rationale - june 2004
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rationale - june 2004

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rationale for june 2004 PNLE

rationale for june 2004 PNLE

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  • 1. RATIONALE<br />by: Randel C. Dalauta, RN<br />www.nursendoutfield.blogspot.com<br />
  • 2. Diagnosis<br />(breakdown and putting together)<br />Analysis (breakdown)<br />Synthesis (putting together)<br />Problem identification<br />formulation of nursing diagnosis<br />Assessment <br />(gathering)<br />Observation <br />Interview & Interaction<br />Examination & measurement<br />Planning<br />(laying out)<br />Setting priorities<br />Establishing goals and objective<br />Planning intervention<br />Implementation<br />(execution)<br />Executing the planned intervention<br />Validating care plan<br />giving/ documenting care<br />Continuing data collection<br />Evaluation<br />(measuring and re-assessment)<br />Comparison of clients status with expected outcomes<br />
  • 3. IPPA<br />Inspection<br />- cephalocaudal: adults<br /> - proximo-distal: child<br />Palpation<br />- light: 1-2 cm<br /> - deep: 4-6 cm, not beyond 10 cm<br />Percussion<br />- direct: plexor<br /> - indirect: pleximeter and plexor<br /> - blunt: wider (kidney punch)<br />Auscultation<br />
  • 4. Progesterone- hormone of pregnancy<br />Estrogen- hormone of menstruation<br />FSH- ripening and maturation of Ovary<br />LH- hormone of ovulation<br />HCG- sustain pregnancy <br />
  • 5.
  • 6. Secondary Sex Characteristics in Order of Onset<br />Male<br /><ul><li>increase weight
  • 7. growth of testes
  • 8. growth of hair face, axilliary & pubic hair
  • 9. voice changes
  • 10. penile growth
  • 11. increase in height
  • 12. spermatogenesis</li></ul>Female<br /><ul><li>growth spurt
  • 13. Increase transvers diameter of pelvis
  • 14. Breast development
  • 15. Growth of pubic hair
  • 16. Onset of mens
  • 17. Growth axilliary hair
  • 18. Vaginal secretions</li></li></ul><li>Progesterone- hormone of pregnancy<br />Estrogen- hormone of menstruation<br />FSH- ripening and maturation of Ovary<br />LH- hormone of ovulation<br />HCG- sustain pregnancy <br />
  • 19. Personality Disorders<br />Borderline-chronic fear of emptiness,self mutilation <br />Anti Social - habitual break of law, no guilt <br />Dependent- demand for attention,low confidence <br />Schizoid – withdrawn, “baduy”, introvert, aloof <br />Schizotypal- low social skills, odd, eccentric <br />Histrionic – “KSP”, attention seeker, extrovert<br />Avoidant – fear of criticism, fear of rejection<br />Paranoid– mistrust is high, suspicious<br />Passive-Aggressive <br />Emphatic Narcissistic – self-love, believe he’s special<br />Obsessive compulsive- high devotion to work<br />
  • 20. PHOSPHORUS<br /><ul><li>MILK
  • 21. CHEESE
  • 22. MEAT
  • 23. NUTS
  • 24. LEGUMES
  • 25. GREEN LEAFY VEGETABLES
  • 26. WHOLE GRAIN CEREALS</li></li></ul><li>Recommended Weight Gain during Pregnancy<br />Ist trimester – 2 to 4 lbs.<br /> 2nd trimester – 11 – 14 lbs.<br /> 3rd trimester – 8 – 11 lbs. /<br /> 0.5 lb weekly<br />
  • 27. Danger Signs of Pregnancy<br /> S welling of face,finger,legs<br /> Headache, continous & severe<br />Abdominal/chest pain<br />Vaginal bleeding<br />Vomiting, persistent<br />Visual changes<br />E scape of vaginal fluids<br />
  • 28.
  • 29. VITAMINS<br />
  • 30.
  • 31.
  • 32. TETANUS TOXOID VACCINE<br />
  • 33. Post-Partum Phase<br />Taking-In = focus on “SELF” <br /> = PASSIVE & Talkative<br /> = Dependency<br /> ( 1 – 2 days after delivery )<br />Taking-Hold = focus on the “NEONATE”<br /> = ACTIVE -show interest in caring for the baby<br /> ( 3 days)<br />Letting-Go = redefines her new role<br /> = assuming new role<br /> (5 – 6 weeks)<br />
  • 34. TETANUS TOXOID VACCINE<br />
  • 35.
  • 36.
  • 37. Acute Pancreatitis<br />
  • 38. Hip Replacement <br />
  • 39. Compartment Syndrome<br />
  • 40. Pinpoint Hemorrhage<br />
  • 41. Laryngeal Diphtheria<br />
  • 42.
  • 43. Pregnancy Induced Hypertension<br />
  • 44. Lithotripsy<br />
  • 45.
  • 46. Personality Disorders<br />Borderline-chronic fear of emptiness,self mutilation <br />Anti Social - habitual break of law, no guilt <br />Dependent- demand for attention,low confidence <br />Schizoid – withdrawn, “baduy”, introvert, aloof <br />Schizotypal- low social skills, odd, eccentric <br />Histrionic – “KSP”, attention seeker, extrovert<br />Avoidant – fear of criticism, fear of rejection<br />Paranoid– mistrust is high, suspicious<br />Passive-Aggressive <br />Emphatic Narcissistic – self-love, believe he’s special<br />Obsessive compulsive- high devotion to work<br />
  • 47. Prioritization<br />SAFETY NUTRITIONCIRCULATIONSocial initiation<br />ADHDCatatonicRestraintRape Victim<br />Suicidal Depressed Catatonic Battered Wife<br />ManicAlcoholic Abused Child<br />AlzheimersAnorexia <br />Crisis Manic<br />Dementia<br />Delirium<br />
  • 48. Lithium (anti-manic)<br /><ul><li>Level: .5-1.5
  • 49. Antedote: Mannitol(diamox)
  • 50. Toxicity: NAVDA – early s/sx + Tremors – late sign
  • 51. 2-3 - intake of Na/day</li></ul> - OFI/day (liters)<br /> - Onset of effect(weeks)<br /> - Checking – admission-2-3x/week<br /> - discharge – 1x/mos. <br />
  • 52.
  • 53. Disulfiram (Antabuse)<br /><ul><li> given 8 -12 hrs after last alcohol intake
  • 54. AVERSION therapy
  • 55. Avoid:</li></ul>Mouth Wash<br />OTC<br />Food suaces made of wine<br />Fuit flavored extracts<br />Aftershave lotions<br />Vinegar<br />Skin products<br />
  • 56.
  • 57. CHF<br />
  • 58.
  • 59. The Incident Report<br />Identify the client by name, hospital or id number<br />Give the date, time, and place of the incident.<br />Describe the incident as one saw it, avoid blame or conclusion.<br />Incorporate the client’s account of the accident, use direct qoutes.<br />Identify all witnesses to the incident.<br />Identify any equipment by number and any meds by name and dosage. <br />
  • 60. Rule of 9<br />
  • 61. HEMOVAC<br />
  • 62.
  • 63. Blood Transfusion<br />Use gauge 18<br />Normal saline to be used (the only compatible)<br />Vital signs prior a must (temperature)<br />Two nurses to verify client identification<br />KVO rate for first fifteen minutes <br /> (prevent abrupt hypersentivity reaction)<br />Stay with the client for the first 15 minutes (usual onset of reaction)<br />STOP if with reaction<br />Four hours to infuse (risk for hyperkalemia)<br />
  • 64. www.nursendoutfield.blogspot.com<br />
  • 65. The END<br />

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