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7 Cards in this Set
- Front
- Back
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What are the 3 categories of intervention activities for the patient with hypothyroidism?
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respiratory monitoring
shock prevention hypothermia treatment |
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When monitoring respiratory system, it is important to?
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collect and analyze client data to ensure airway patency and adequate gas exchange
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When monitoring for shock, it is important to?
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detect and treat a patient at risk for impending shock
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When monitoring for hypothermia, it is important to?
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rewarm and observe a patient whose core body temperature is below 35 degrees Celcius
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What 7 respiratory interventions should nurse monitor for?
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rate, rhythm, depth, and effort of respirations
chest movement, watching for symmetry, use of accessory muscles, and supraclavicular and intercostal muscle refractions breathing patterns for bradypnea diaphragmatic muscle fatigue (paradoxical motion) changes in SaO2 and Svo2, end tidal CO2 and ABG values, as appropriate client's ability to cough effectively dyspnea and events that decrease and worsen it |
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What 7 shock interventions should nurse monitor for?
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temperature and respiratory status
circulatory status: BP, skin color, skin temperature, heart sounds, heart rate and rhythm, presence and quality of peripheral pulses, and capillary refill signs of inadequate tissue oxygenation apprehension, increased anxiety, and changes in mental status intake and output administer oxygen and/or mechanical ventilation, as appropriate administer antiarrhythmic agents, as appropriate |
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What 11 hypothermia interventions should nurse monitor for?
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client's temperature, using a low-recording thermometer if necessary
place on a cardiac monitor, as appropriate cover with warmed blankets, as appropirate administer heated oxygen, as appropriate VS, as appropriate skin color and temperature intake and output avoid giving IM or subcutaneous medications during hypothermic state give client warm oral fluids, if alert and able to swallow teach client to consume a caloric intake sufficient to maintain a normal body temperature emphasize the importance of wearing warm, protective clothing when going into a cold environment |
