Gastrointestinal Alternate Format Question

A nurse is assigned to care for a child who is scheduled for an appendectomy. Select the orders that the nurse anticipates will be prescribed.

1. Initiate and IV line.
2. Maintain an NPO status.
3. Administer a Fleet enema.
4. Administer preoperative medications.
5. Administer intravenous antibiotics.
6. Place a heating pad on the abdomen to decrease pain.

Answer: 1,2,4,5


Rationale: In the preoperative period, enemas or laxatives should not be administered. Additionally, heat is not applied to the abdomen. Any of these interventions can cause rupture of the appendix and resultant peritonitis.

HESI HINT: Preeclampsia

HESI HINT: The major goal of nursing care for a client with preeclampsia is to maintain uteroplacental perfusion and prevent seizures. This requires the administration of magnesium sulfate. Withhold administration of magnesium sulfate if signs of toxicity exist: Respirations<12/min., Absence of DTR's, or urine output < 30 ml/hr.

Can an R.N. Student be a C.N.A.

As an R.N. student, some State Boards of Nursing do allow you to become a CNA (Certified Nursing Assistant)without having to take a CNA course as long as you have completed comaparable coursework in the R.N. program. This usually means that if you have completed Fundamentals of Nursing with a passing grade, you can submit your transcript and an initial application to become a CNA. Please be advised that fees and a criminal background check may also be required. Please check with your State Board of Nursing for specific requirements in your state.

Cranial Nerve Review

I-Olfactory-Smell

II-Optic-Vision acuity

III-Oculomotor – Eye function

IV-Trochlear – Eye function

V-Trigeminal – Sensory of the face, chewing

VI-Abducens – Eye function

VII-Facial – Facial expression, wrinkle forehead, taste anterior tongue

VIII-Vestibulocochlear – Auditory acuity, balance and postural responses

IX-Glossopharyngeal – Taste on posterior 33% of the scale

X-Vagus – Cardiac, respiratory reflexes

XI-Spinal Accessory - Strength of trapezius and Sternocleidomastoid muscles

Arterial Blood Gases (ABG's)

Arterial Blood Gases
An arterial blood gas (ABG) test measures the acidity and the levels of oxygen and carbon dioxide in the bloodstream from an artery. The test is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood.

As blood passes through your lungs, oxygen moves into the blood while carbon dioxide moves out of the blood into the lungs. An ABG test uses blood drawn from an artery, where the oxygen and carbon dioxide levels can be measured before they enter body tissues.

An ABG measures:

Partial pressure of oxygen (PaO2). This measures the pressure of oxygen dissolved in the blood and how well oxygen is able to move from the airspace of the lungs into the blood.
Partial pressure of carbon dioxide (PaCO2). This measures how much carbon dioxide is dissolved in the blood and how well carbon dioxide is able to move out of the body.
pH. The pH measures hydrogen ions (H+) in blood. The pH of blood is usually between 7.35 and 7.45. A pH of less than 7.0 is called acid and a pH greater than 7.0 is called basic (alkaline). So blood is slightly basic.
Bicarbonate (HCO3). Bicarbonate is a chemical (buffer) that keeps the pH of blood from becoming too acidic or too basic.
Oxygen content (O2CT) and oxygen saturation (O2Sat) values. O2 content measures the amount of oxygen in the blood. Oxygen saturation measures how much of the hemoglobin in the red blood cells is carrying oxygen (O2).
Blood for an ABG test is taken from an artery. Most other blood tests are done on a sample of blood taken from a vein, after the blood has already passed through the body's tissues where the oxygen is used up and carbon dioxide is produced.

Why It Is Done
An arterial blood gas (ABG) test is done to:

Check for severe breathing problems and lung diseases, such as asthma, cystic fibrosis, or chronic obstructive pulmonary disease (COPD).
See how well treatment for lung diseases is working.
Find out if you need extra oxygen or help with breathing (mechanical ventilation).
Find out if you are receiving the right amount of oxygen when you are using oxygen in the hospital.
Measure the acid-base level in the blood of people who have heart failure, kidney failure, uncontrolled diabetes, sleep disorders, severe infections, or after a drug overdose.

Blood Gases Normal Values
pH 7.35-7.45
PCO2 35-45 mmH
HCO3 21-28 mEq
PO2 80-100 mm
O2 Saturation 95-100%

Please learn these values as you will see them over and over for exams.