ACUTE LARYNGOTRACHEOBRONCHITIS LTB (Croup) ¢ Slow Onset. * Commonly Occurs Before Age 5 © Barking Cough ¢ “Crowing Sounds” © URL's Frequently Precede LTB * Restlessness * Supra-sternal © Ingpiratory Stridor © Occurs at Night in Fall and Winter Retractions ¢ TRespiratory Rate © May Progress to Hypoxic State © May Have Slight Temperature (<102")TURP (Iransurethral Resection of the Prostate) * Continuous or intermittent Bladder Irrigation (C.B.|.) (Usually DC'd after 24 houre, if No Clots). “uy Oe * Close observation of drainage system- (T Bladder Distention causes Pain & Bleeding). * Maintain Catheter Patency * Bladder Spasms * Pain Control: Analgesics & | Activity first 24 houre. * Avoid otraining with BMs. T Fiber diet & Laxatives. * Complications: + Hemorrhage - Bleeding should gradually | ta light pink in 24 hrs. * Urinary Incontinence - Kegal Exercioeo * Infections = T Fluide *# Prevertt Deep Vein Thrombosis + Sequential compression stockings * Discourage sitting for prolonged periods @Nursing Education Consultant, In.POST MASTECTOMY NURSING CARE + Elevate affected side with distal joint higher than proxima joint. * No BR, injections or venipunctures on affected side, Watch for S & & of edema on affected arm. + Lymphedema can occur any time after axillary node disection. * Flexion and extension exercises of the hand in recovery. * Abduction and external rotation arm exercises after wound has healed. * Assess dressing for drainage. * Assess wound drain for amount: and color. © Provide privacy when patient looks at incision, *c) iotherapy, Radiation therapy. * Monitor for Complications ~ hemorrhage, hematoma, lymphedema, infection, pootmastectomy pain syndrome, * Feychological concerns: Altered body image Altered sexuality ton Conauttante In Fear of disease outcome Nursing EauSUICIDE PRECAUTIONS SECURE ROOM: ~ Windows Locked - Breakproof Glass & Mirrors - Plastic Flatware - Cords - Phone - Extension - Equipment - Curtains - Belts/Shoelaces/Drawstring Pants - Matches or Cigarettes - Sharps/Razors PATIENT CARE: - Frequent Observation... Preferably1to1 - Staff Communication — Constant Risk Assessment/Documentation - Develop Therapeutic Relationship - Written Behavior Contract with Pt. - Restraints as Necessary - Medications - Monitor and Restrict Visitors OG SySCHIZOPHRENIA - Illogical Thinking - Auditory Hallucinations & Impaired Judgment - Delusions — Persecutory or Grandiose - Lows of Ego Boundaries - Hypersensitivity to Sound, Sight & Smell - Inability to Trust - Difficulty Relating to Others - Bizarre Behavior - Indifferent - Aloof - Love/Hate Feelings - Feelings of: ) - Behavior — Disorganized, Rejection (gate Motor Agitation, - Negativism - Religiosity - Lack of Social Awareness Lack of Self-Respect Catatonic Loneliness, Hopelessness - Retreat to Speech Incoherent Fantasy World & Rambling - Autiom - Disorganized Thinking BB etisrsin Education Conouleants, icRecent Difficulties / Alterations In: Relationships In Patient’s Own Words - Why le He Seeking Help? + Ueual level of functioning ee es eee eS Behavior a Ferceptions Z Cognitive abilities a tFeelings OF: Depression Anxlety Hopelessnese Being overwhelmed Suspiciousness Confusion | Name icity & Cultural lmpications = Marital Status #6 Ages Children = # &. Ages Siblings + Living Arrangements + Occupation Education Religious Affiliations Sphritual Needs 5 Previous illness / Hospitalization Education - highest grade completed Childhood Caregiver Physical Abuse ? Parents Substance Uce/ Abuset J Occupational background pation eee How long employed What joe Social patterns: Friend - importance __ Somatic Changes | Ss Constipation ‘Ageibacen Usual day bo Diarrhea ey Use OF Drugs Sowal Fatgerns E insormia pores mana te ae Lonely Etegt on family ore > Weight Lort aN a Incereste & Abilities pias Happy Family Physical eae aa srenie Rebellious Or Feychosocial Problems $Gives pleasure = Nausea Who? Substance abuse - Meds Nausea ubetance abuse - Mede mi What: problem? i [Yomiting Howitt aftccked Bare, Drug use problems meade the family Seraes coping wiethods @Nuesing Education Consutante, fo.MENTAL REWARD ATION = a Repetition Reinforcement Routine Repetition Reinforcement Routine Repetition Reinforcement R R R R R R R R Ryao ea aac) ue [oa NN oy OL REAL STIMULI MISINTERPRETED... FALSE FIXED BELIEF.EATING DISORDERS Views self as fat — regardless of weight Intenge fear of becoming fat Anxious about losing control Weight is¥85% of normal Feels powerless Associated with obsessive compulsive disorder BULIMIA Recurrent binge eating followed by self-induced vomiting, misuse oF laxatives and enemas Depressed mood following binge eating T Anxiety and compulsivity PICA Fersietent eating of non-nutritive food and non-food substances Food — cornstarch, baking powder, coffee grounds Non-food — clay, soils, laundry starch paint chips More common in children, pregnant women, individuals with autism or cognitive Impairment, patients in chronic renal failure. Influenced by cultural background. Associated with Iron and zinc deficiency. FB onursng Eavcation Constanta neDatety Precautions Remove harmful objects Clase observation Encourage expression Norejudgmental support Kind pleasant ntbresved approach Frequent contact ticipation ns ont ~ Activities Assist in decision making Westen contract = ee ieeunsir Self-Esteem Cognitive Suicidal preoccupation Crying Poverty of ideae Negative view - Self = World - Future Prevent constipation Encourage exerciee Maintain hygienic Mood Dysphoric Depressive Despair [Intereat in pleasure Feychomotor =] Agitation “Gad Persone Scale or [= (genden)t ¢ malos At Risk retardation of movement Ago 419 Adolescente & elderly Fatigue Depression Recent. crisis - stress - loos {Appetite Previous euicide attem) Slotarce sues, Canstipation Chronic or painful tiness Step veturbarees Frevious suicide attempts ETOH (alcohol) abuse Rational thinking impaired ftir i Sante pan a Ea Hallucinating @Nuroing Education Consultant, ne Sicknese (chronic)