hesi case study risk for falls

• High School
• You don't have any recent items yet.
• You don't have any courses yet.
• You don't have any books yet.
• You don't have any Studylists yet.
• Information

HESI case study - Risk for Falls, Hip Fractures, and Pulmonary Embolism - Susan Weil Quizlet

Fundamentals of nursing (nur 111), university of central florida, recommended for you, students also viewed.

• Christopher postsim - vsim
• Nasogastric Tube Major Skills Check Off
• Trach Suction and Care Major Skills Check Off
• Urinary Catheterization Major Skills Check Off
• Exam 4 Review
• Study Guide for OB Exam 4

Related documents

• Answer 2 - fundamentals
• NU632 Unit 2 Discussion Case
• Study Aid Foundations chpts 18-21
• 3 - Case study
• Blood Transfusions- knowledge check
• Lipitor Med Sheet

Related Studylists

Preview text, name: score:, 20 multiple choice questions, which action should the nurse take before leaving the client's room to call the surgeon, apply oxygen 2 l via nasal cannula., the 02 saturation is low at 90%. airway is the first priority., elevated pressure within a confined myofascial section compromises neurovascular, tissue viability is compromised when compartment syndrome occurs. it can cause necrosis, of the affected extremity and lead to death. it is a life-threatening condition., determine the respiratory rate., the effects of anesthesia are often potentiated in the elderly and can cause respiratory, suppression., place the client on strict bedrest and elevate the left leg on a pillow., the client's symptoms are consistent with a deep vein thrombosis (dvt). bedrest is the, safest intervention to prevent the thrombus from breaking off and elevation may decrease, the blood bank calls with the news that ms. weil's third unit of blood (prbcs) is ready., which task(s) are required before transfusing this unit of prbcs, select all that apply, hang unit of blood and have have the charge nurse verify the orders., confirm the right client, the right blood type, and the right unit of blood with another rn., have the nurse assistant take the client's vital signs, including temperature, prior to hanging the, blood and after the transfusion is complete., ensure that the consent is signed and current., gather supplies, including new blood tubing, new normal saline to hang with the blood, and a, pump if it is required by hospital policy., client identity., a time out is a standardized procedure conducted immediately before invasive procedures, are started or before a surgical incision is made. correct client identity is an important, component of the time out process to prevent error., procedure to be done., are started or before a surgical incision is made. identification of the correct procedure is, an important component of the time out process to prevent error., surgical site., are started or before a surgical incision is made. identification of the correct surgical site is, the bubble should be closest to the plunger. it is used to clear the syringe after the, medication is injected., administer in the posteriolateral or anteriolateral abdomen., the manufacturer suggests that the drug is best absorbed when administered in either of, these sites., the nurse expects to see which manifestations of osteoarthritis in mrs. weil, joint pain., swollen nodes of the joints., asymmetrical involvement of the joints., pain typically worsens with joint use and may be relieved with rest in the early stages. in, advanced osteoarthritis, pain may worsen, causing sleep disturbances and interfering with, activities of daily living., heberden's nodes, bony bumps on finger joints closest to the fingernails, or bouchard's, nodes, bony bumps on the middle joint of the finger, can form on the joints and cause, visible disfigurement and tenderness., osteoarthritis typically affects joints asymmetrically and most commonly involves the joints, of the fingers, thumb, hips, knees, feet, and cervical and lower lumbar vertebrae., remain upright (sitting or standing) for at least 30 minutes after taking this medication., biphosphonates can cause erosion in the esophagus. lying down or reclining after, susan is scheduled for emergency surgery to relieve the compartment syndrome and repair the, right hip fracture., what is the priority action in preparation for susan's surgery, occupational therapist., occupational therapists help the client work with adaptive equipment to resume activities, of daily living., a noninflammatory condition involving formation of new joint tissue in response to, cartilage destruction., ************************, osteoarthritis results from cartilage damage that initiates a metabolic response of the, chondroyctes. it is a slowly progressive disorder of the diathrodial (synovial) joints., stop the blood transfusion and hang a new normal saline infusion., headache, tachypnea, chills, hypotension, and elevated temperature are signs and, symptoms of a blood transfusion reaction., draw blood for type and cross match., the client is scheduled for surgery, and the type and cross match must be obtained prior to, the surgical procedure., when administering enoxaparin (lovenox) in a prefilled syringe, which action(s) should the nurse, expel the bubble from the syringe prior to injecting it into the client., place a 1½ inch needle on the end of the syringe., ensure that the bubble is nearest to the plunger end of the syringe., inject the syringe into the subcutaneous tissue and aspirate prior to drug administration., two nurses should verify the unit of blood, the blood type, and the client prior to hanging, a consent for blood transfusion can be obtained in conjunction with the surgical consent;, however, a separate consent must also be obtained for a blood transfusion., gather supplies, including new blood tubing, new normal saline to hang with the blood,, and a pump if it is required by hospital policy., the blood tubing currently hanging was used for two units that were infused during the, surgery. best practice is to use tubing for either two units of blood or for 4 hours, whichever, comes first., which post-operative prescription should the nurse implement first, call for a rapid response team., the client has symptoms of dvt; therefore, it is appropriate to activate the rapid response, after the catheter is removed, susan calls the nurse with a complaint of feeling dizzy. the nurse, finds that the client's vital signs are bp 82/56 and hr 62 bpm. when the nurse inspects the, catheter site, the nurse observes a large area of blood on the sheets, and active bleeding coming, from under the groin-site dressing., holding pressure over the site and calling for help., applying continuous direct pressure to the site is the most immediate action to stop the, a white or bluish color may indicate impaired circulation., temperature., a cold temperature may indicate impaired circulation., pressure on the nerve from edema or compartment syndrome can cause changes in, "you will receive enoxaparin (lovenox) injections and warfarin (coumadin) pills until the, target anticoagulation numbers are reached.", enoxaparin (lovenox) is provided at the same time a client is starting warfarin (coumadin), therapy until the desired inr is reached. once the inr is 2-3, the enoxaparin (lovenox) may, be stopped and the client will follow-up with the monthly coagulation labs with adjustments, to warfarin (coumadin) doses controlling anticoagulation., which finding is of most concern, "i wrap the heating pad around my knee and use an extension cord so i can walk around, the house.", the use of an extension cord creates a tripping hazard for the client. this statement should, be addressed by the nurse., red, warm, and edematous area of the left calf., a red, warm, and edematous area of the calf is a possible indication of a life-threatening, complication associated with orthopedic surgeries., "it is a type of anticoagulant that is given to prevent venous blood clots.", enoxaparin (lovenox) is a low molecular weight heparin that works to prevent blood clots, from forming by blocking the action of clotting factors x and ii., musculoskeletal pain and decreased function associated with osteoarthritis heightens the, risk for falls., which statement about the use of heat and cold for osteoarthritis pain by the client is of most, concern to the nurse, black, tarry stools., nsaids can cause bleeding tendencies in addition to ulcer formation., of hip fracture., shortening., shortening of the affected extremity is a clinical manifestation of hip fracture., muscle spasms., muscle spasms caused by inflammation are a common clinical manifestation of hip fracture., are started or before a surgical incision is made. identification of allergies is an important, which symptom should mrs. weil report immediately while taking a non-steroidal anti-, inflammatory drug (nsaid), medical alert system., a medical alert system promotes autonomy by allowing the client to feel more secure that, immediate medical response is available if an injury occurs or help is needed., home healthcare referral., a homecare referral will allow for an in-home safety assessment and continuity of care, while susan continues to rehabilitate., raised toilet seat., a raised toilet seat helps alleviate discomfort associated with squatting on low toilets., when the nurse is teaching susan about medications for osteoporosis, which instruction is most, important, knowing that susan takes alendronate (fosamax), a biphosphonate, administration can allow regurgitation into the esophagus., take this medication at the same time every day., alendronate (fosamax) is given as a weekly dose., always take alendronate (fosamax) with the mid-day meal to prevent stomach upset., this drug should be taken on an empty stomach, before breakfast., throw rugs placed on hardwood floors in the home., throw rugs are a tripping hazard, and they should be removed from the home to decrease, walks with short, shuffled steps., shuffling steps indicate an abnormal gait pattern, and they increase the likelihood of, tripping or falling., uses the furniture to steady self..

• Multiple Choice

Course : fundamentals of nursing (NUR 111)

University : university of central florida, this is a preview.

Access to all documents

Get Unlimited Downloads

Improve your grades

Share your documents to unlock

Get 30 days of free Premium

Why is this page out of focus?

Written for

Document information.

• HESI Case Study
• HESI case study

HESI case study - Risk for Falls, Hip Fractures, and Pulmonary Embolism - Susan Weil

• Institution

Preview 2 out of 10  pages

•   Report Copyright Violation

Preview 2 out of 10 pages

• Uploaded on February 18, 2023
• Number of pages 10
• Written in 2022/2023
• Professor(s) .
• Grade A+
• hip fractures
• and pulmonary embolism
• hesi case study
• hesi case study risk for falls
• and pulmonary embolism susan weil
• susan visits her primary he
• Institution HESI case study
• Course HESI case study

Reviews received

The benefits of buying summaries with stuvia:.

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do i get when i buy this document.

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller StudySet. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $11.49. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

53068 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now