Mich UWORLD

The nurse employed in a woman's health care clinic would be most concerned about which client statement

"My right breast is red and warm with little tiny indented areas on the surface of the skin" The nurse would be most concerned about the client who describes symptoms of inflammatory breast cancer. In this aggressive form of cancer breast lymph channels are blocked by cancer cells, creating breast tissue that becomes red,warm and has orange peel, Pitting appearance on the skin surface. The nurse would be most concerned about this client and make an immediate referral to the health care provider for examination and evaluation

A client was placed in restraints appears in the hallway an hour later and states, I'm houdini.... I can get out of anything. There could be trouble now." Which of the following is best response to this client?

"What kind of trouble are you thinking?" A client at high risk for violence, self-directed or other directed, may need to be placed in restraints as a last resort. Frequent monitoring and assessment through observation and use of therapeutic communication techniques will help determine if a client is ready to have restraints removed

A client recently diagnosed with schizophrenia is brought to the mental health clinic by the identical twin siblings for the first follow up visit after hospitalization. The clients sibling says to the nurse, "I read that schrizophrenia runs in families. I guess I'm doomed." Which is the best response by the nurse?

"You are at risk for the disease. However, there are other factors that contribute to the development of schizophrenia" The best response should acknowledge the reality of the siblings concerns, provide information, and open the door to further discussion about the development of the disease

How to deal with toddlers during the stage of apetite and pickiness?

- Set and enforce a schedule for all meals and snacks -Offer the child 2 or 3 choices of food items - Do not force the child to eat. - Keep food portion smalls (1-2 teaspoons per serving) and provide an additional serving after the first serving is consumed - Expose the child repeatedly to new foods on several separate occasions - Do not allow the child to watch TV and play games during meals or snacks.

Steps for self-administration of ophthalmic ointments

- Wash Hands - Tilt the head back, pull the lower lid down, and look upward - Squeeze a thin strip of ointment onto the lower eyelid, from the inner to the outer edge - Close the eyes gently for 2-3 minutes applying the ointment

The nurse receives report on 4 clients. Which client should be seen first?

15 year old with painful right hip, fever, and limited range of motion Pain, limited range of motion and fever indicate joint infection (Septic Joint). A septic hip is a surgical emergency as impaired blood supply may lead to permanent joint destruction, sepsis, and/or death. The nurse should expect management to include cultures antibiotics and surgical debridement

The student nurse completes clinical rotation in the emergency department. The instructor knows the student is able to prioritize care appropriately when the student visits which client first?

29 year old with neck swelling and increased pain 2 days after thyroidectomy. These complication have a high priority due to potential interference with airway patency Client with possible airway obstruction, respiratory distress, or compromised circulation take priority for assessment and intervention. Neck swelling and increasing pain after a thyroidectomy can indicate hematoma formation or increased tissue inflammation that could lead to airway obstruction

Multiple clients are triaged in the emergency department at the same time. Which client should the nurse alert the health care provider to see first?

40 year old with a first degree burn and signed beard from a campfire. Signed facial hair may indicate a smoke inhalation injury from close proximity to a fire. Inhaled smoke causes injury to the airway and lung tissue, which may result in life threatening pulmonary or tracheal edema. The nurse should assess for any indication of inhalationg injury (eg, signed facial hair, hoarse voice, burned clothing around the chest and Neck) and prepare for emergent intubation to protect the airway

When no changes are made to the diet or prescribed insulin, Which client with type 1 diabetes mellitus does the nurse anticipate having the highest risk of developing hypoglycemia?

A 40 year old experience bicycle rider who add 10 extra miles to his route. Aerobic exercises typically lower blood glucose levels. Physiologically, glucose production in the liver fails to keep up with elevated glucose uptake by the muscle at work

Bowel Obstruction

A bowel obstruction happens when either your small or large intestine is partly or completely blocked. The blockage prevents food, fluids, and gas from moving through the intestines in the normal way. The blockage may cause severe pain that comes and goes.

ADHD attention deficit hyperactivity disorder

A chronic condition that starts in childhood and continue into adulthood, presents with inattention impulsivity and or hyperactivity. Medications and behavioral therapy help clients cope with and manage their symptoms, allowing for improved academic and workplace performance and relationships. Parents should minimize distraction and prevent overstimulation

What is bronchiolitis

A common viral illness of childhood that is usually caused by RSC. The focus of home care is monitoring respiratory status and periodic nasal suctioning using saline nose drops to ease breathing. Additional Fluids should be offered

Exploratory Laparotomy

A laparotomy is a large incision made into the abdomen. Exploratory laparotomy is used to visualize and examine the structures inside of the abdominal cavity.

The practical nurse is collecting data on a client with acute diverticulitis. Which finding will the nurse report immediately to the Registered Nurse?

Abdominal pain has progressed to the upper quadrant When these diverticula become inflamed (Diverticulitis), the client may experience acute pain (usually in the left lower quadrant) and systemic signs of infection (eg, fever, tachycardia, nausea, leukocytosis). Potential complication of diverticulosis include abscess formation

Dietary intervention to help prevent or minimize the symptoms of GERD include avoiding factors that decrease lower esophageal sphincter pressure

Alcohol, Caffeine, Chocolate, High fat and spicy foods) and promoting factors that decrease gastric pressure (eg, small, frequent meals; loose clothing

Myasthenia Gravis

An autoimmune disease of the neuromuscular junction causing fluctuating muscle weakness. Autoantibodies are formed against acetylcholine receptor, so fewer receptors are availablle to acetylcholine to bind.

The nurse is assisting with care of a client with blunt head injury admitted for observation, including hourly neurologic checks. At 1:00 AM, the client reports a headache; the neurologic check is normal, and the nurse administers acetaminophen PRN. at 2:00 AM, the client appears to be sleeping. What action does the nurse anticipate taking?

Arouse the client and ask what the current month is. Client must be awakened for a prescribed, necessary neurologic assessment. A neurologic assessment consist of Glasgow Coma Scale, pupillary checks, movement and strength of the extremities and vital signs

Paracentesis

Ask client to empty bladder High Fowlers position or a sitting position

The 11:00AM routine fingerstick (Glucose monitoring) test for a client was assigned to the UAP by the nurse at 11:15AM, the client tells the nurse that no one checked the blood level. The nurse should take which action first?

Ask the UAP about the situation The nurse should first verify the accuracy of the clients statement with the UAP. The client could be mistaken. It is also important to make the UAP accountable for completing the action or reporting the inability to do so WHEN THE COMPLETION OF AN ASSIGNED TASK IS QUESTIONED, THE NURSE SHOULD FIRST CONFIRM THE STATUS OF THE TASK WITH THE DESIGNATED PERSONNEL

Visual Acuity testing in children age 6 and older

Assessed by use of Snellen Letter Chart. The child is positioned 10 ft (3 m) from the chart and asked to read the letters, beginning with the lines to large text to small text. Standard testing for visual acuity is at 20ft. However, the american Academy of pediatrics recommends testing at 10ft as it is easier to maintain the childs attention and provides a more accurate results.

1 month (Fine motor Abilities)

Attempts to hold head up when prone Maintains fisted hands Cries when upset Gazes at parents face when parent speaks

A client has been hospitalized with bipolar disorder, manic episode. The nursing care plan includes the diagnosis "imbalance nutrition: Less than body requirement." Which of the following meal selection would be best for the client?

Banana Smoothie, Hamburger, French fries Client experiencing a manic episode are often undernourished and dehydrated on hospital admission. They ned more calories, protein, and fluids due to their excessive energy and psychomotor activity. Most client with mania are unable to sit still long enough to consume a meal and they would not be able, on their own to choose foods that would meet their caloric needs Clients will need frequent reminders to eat, and their intake should be monitored. Foods that are readily available and ready to consume should be provided

A nurse is talking with the parent of a 6 year old regarding sleep and rest. Which information should be included?

Bedtime hours should be established During school age years (6-12) sleep needs of a child depend on health status, activity level, and age. Children in this age group need approximately 11 hours of sleep daily at age 5 and 9 hours at age 12 It is important to establish bedtime hours and bedtime rituals. These children usually do not need daytime naps if they have slept well at night

During the one on one contact with the client, the nurse can promote therapeutic and trusting relationship with the client by...

Being honest and accepting of the client Presenting the reality condition Acknowledging the clients feeling of loss of control anger Encouraging the client to express feelings and fears

A nurse is reinforcing information on dietary management to a group of clients with newly diagnosed type 2 diabetes. Which meal represents the best adherence to the principles of and recommendations for diabetic meal planning.

Black bean chili with brown rice, mixed green salad Client with diabetes should eat food with a low glycemic index and high fiber content. Saturated fat and sodium should be restricted

The nurse is caring for an AFRICAN AMERICAN client with disseminated intravascular Coagulation. Which locations are best to monitor for the presence of petechiae?

Buccal Mucosae and conjunctivae of the eyes Petechiae are reddish and purple pinpoints on the skin that occur due to bleeding from capillaries. Petechiae usually occur due to blood vessel injury or bleeding disorders (eg, thrombocytopenia, disseminated intravascular coagulations) Petechiae and similar skin condition are often challending to detect in dark-skinned clients as dark pigmentation makes it difficult to assess skin color changes. In dark skinned clients petechiae can best be assessed in the conjunctivae of the eyes and buccal mucosae

Celiac Disease Diet

Celiac disease is an autoimmune disorder in which an individual cannot tolerate gluten, a protein found in barley, Rye, Oats and wheat (BROW). Rice, corn, and potatoes are allowed in the diet and can be used as grain substitutes. Affected individual must adhere a GLUTEN FREE DIET FOR LIFE.

The nurse receives news of a local mass shooting. Stable clients need to be discharge to make room for newly admitted clients. Which client would the nurse identify as safe to recommend for discharge.

Client with asthma exacerbation who has not required oxygen or nebulizer in 12 hours In response to a local disaster, the nurse identifies client who can be safely discharge to make room for newly admitted clients. A client with acute asthma exacerbation can be safely discharge home when respiratory status has stabilized

The practical nurse and charge nurse work together to assign a semi private room to a client with diabetes mellitus admitted for IV antibiotic therapy to treat leg cellulitis. Which of the 4 room assignments is the best option for this client?

Client with dementia and urinary incontinence wearing an external urine collection device. A client with an infection should not be assigned to a semi private room with a client who had surgery or immunocompromised and receiving immunosuppressants as such clients are highly susceptible to infection. Post splenectomy clients are also lifelong risk for rapid sepsis

What is cellulitis?

Common bacterial skin infection that is usually treated with IV antibiotics in clients with diabetes mellitus.

What is Rotavirus

Contagious infection that is easily spread via the fecal oral route by touching contaminated object, food and hands. It is not treated with antibiotics as it is viral infection vaccination is available for children less than 8 months old. Children with rotavirus are at risk for dehydration

A nurse in a pediatric clinic is collecting data on a 30 month old child. Which finding requires further evaluation?

Current weight is 6 times greater than birth weight Weight gain slows during the toddler years. By age 30 months, a toddler's weight should be approximately 4 times greater than the birth weight

What is Disseminated intravascular coagulation

Disseminated intravascular coagulation (ko-ag-u-LA-shun), or DIC, is a condition in which blood clots form throughout the body's small blood vessels. These blood clots can reduce or block blood flow through the blood vessels, which can damage the body's organs.

A client hospitalized for anorexia nervosa has a nursing diagnosis of imbalanced nutrition: Less than body requirements. Which nursing intervention should be implemented to promote weight gain in this client?

Document Daily weight Restrict privileges if weight loss occurs Set limits on physical activities Strategies to improve nutritional intake and promote weight gain in a client with anorexia nervosa include setting goals for caloric intake and weekly weight gain, allowing the client to make food choices, monitoring intake, setting limits on physically activity and exercise, basing privileges on treatment adherence, and maintaining a matter of fact, nonjudgemental approach toward weight and food related behaviors

Esophageal atresia (EA)

Esophageal atresia (EA) is a congenital defect. This means it occurs before birth. There are several types. In most cases, the upper esophagus ends and does not connect with the lower esophagus and stomach. Most infants with EA have another defect called tracheoesophageal fistula (TEF)

Delusion

False belief that have no basis in reality

2-3 Months (Fine Motor Abilities)

Gains head control when held Hold rattle when place in hand Makes Cooing sounds Smiles in response to smiling & talking

Chest Tube insertion

Has the arm raised above the head on the affected side for chest tube insertion

A client at 21 weeks gestation has intense heartburn (pyrosis). What should the nurse recommend.

High Protein, Low fat diet Six Small meals a day Heartburn (Pyrosis) is cause by the hormone progesterone, which causes the esophageal sphincter to relax. methods the pregnant client can take to reduce pyrosis include maintaining an upright position after meals, eating small meals, taking approved antacids and avoiding causative foods and beverages

Teaching points to assist a client in appropriate use of a cane

Hold Cane on the stronger side to provide maximum support and body alignment, keeping the elbow slightly flexed (20-30 degrees)

Horizontal Violence

Horizontal violence (eg, Bullying, disparaging Behaviors) is common in the health care environment and often occurs between nurses. Nurses should analyze their workplace culture, create anonymous reporting systems, and provide staff education to remediate factors contributing to horizontal violence

The nurse is caring for a client with Non-Hodgkin Lymphoma who is starting Chemotherapy. What findings alert the nurse that the client is developing the potential complication of tumor lysis syndrome?

Hyperkalemia and Hyperuricemia

Steps for administering an intermittent enteral feeding

Identifying client elevate head 30-45 degree Validating tube placement Assessing bowel function Returning aspirated residual contents to the stomach Flushing Before and after feeding w/ 30mL of water Slowly administering prescribed feeding

A client with community acquired pneumonia is receiving 0.9% normal saline at 50 mL/hr. Pulse oximetry shows 95% on nasal oxygen at 3 L/min. The registered nurse adds a nursing diagnosis of ineffective airway clearance to the care plan. Which prescription would the practical nurse expect to best facilitate secretion removal?

Increase 0.9% normal saline to 125 mL/hr A fluid intake of 2500-3000 mL/day is recommended in clients with pneumonia as additional fluids are needed to replace insensible lossess. Low-pitched wheezing indicates the presence of secretion in the airways. The best choices for this client is to increase hydration by raising the infusion rate to 125 mL/hr (eg, 3000 mL/day) as this will help thin secretion and facilitate mucus expectoration

A 7 month old infant is admitted to the unit with suspected bacterial memingitis after receiving an initial dose of antibiotics in the emergency department. Frequent monitoring of which of the following is most important

Infant with bacterial meningitis can develop hydrocephalus. Bulging/tense fontanels and increasing head circumference are important early of increase ICP in children and should be monitored to prevent long term complication

The nurse is assissting in planning care for a client experiencing an acute attack of Meniere disease. Which action is a high priority to include in the plan of care?

Initiate fall precaution Clients can have severe vertigo

A client is receiving Nasogastric tube feedings as nutritional rehabilitation for anorexia Nervosa. After a weigh-in, the client learns of gaining 2 lbs and says to the nurse, "See what your force feeding has done to me? I'm fatter and uglier that ever." What is the best action by the nurse

Initiate one on one supervision of the client during feeding Providing one on one supervision during the tube feeding will ensure that the client is actually receiving the feeding and prevent the client from stopping the feeding and/or pulling out the nasogastric tube The priority nursing care for a client with anorexia nervosa is nutritional rehabilitation and prevention of medical complication, including death. Clients who are severely ill and/or resistant to oral refeeding may require nutrition support with intense monitoring to achieve adequate caloric intake and weight gain

Thoracentesis

Involves the insertion of a large bore needle through an intercostal space to remove excess fluid.

What is ventricular septal defect?

Is an acyanotic congenital heart defect causing blood shunt from the left side of the heart to the right (left sided heart has higher pressure than right sided) An increase in pulmonary blood flow causes an increase in workload of the right heart and pulmonary arteries, resulting in pulmonary hypertension. Eventually, blood does not go to the lungs, but instead the pressure on the right side of the heart increases, resulting in shunt reversal

The nurse is floated from the obstetrical (OB) floor to the medical surgical floor. Which client is the best assignment for the OB NURSE

Male client with an open bowel resection with a foley catheter Nurses who are floated for shift to areas different that their usual client population should be assigned client who can be managed using skills to those used for their usual client population and not requiring specialized knowledge. An abdominal bowel surgery with a foley catheter is similar to the type of care require with a cesarean section. Therefore, this client should be assigned to the OB nurse

10-12 months (Fine Motor Abilities)

May Walk with help of take independent steps Crawl up stairs Uses 2 finger pincer grasp Hits 2 object together Says 3-5 words Uses non-verbal gestures (eg, waving goodbye) May have separation Anxiety Searches for hidden object

Memantine

Medication used in the treatment of moderate to severe Alzheimer disease. It slows the progression of AD symptoms, and improvement may be seen in the clients behavior, Cognitive functioning and ability to perform activities of daily living.

Nocturnal Enuresis

Nocturnal enuresis or involuntary bed wetting at night is managed with a variety of non pharmacologic measures that nurses should teach parents. These include use of positive reinforcement and bed alarms, Restricting fluids after the evening meals, avoiding scolding or ridiculing, awakening the child at a specified time to void, and keeping a log of wet and dry nights

The nurse is caring for a client who just had a total thyroidectomy. Which finding does the nurse recognize as most important to report immediately

Noisy Breathing Airway swelling is a life threatening complication of thyroid surgery. Signs of respiratory distress such as stridor dyspnea require rapid intervention

Paresthesia

Paresthesia is an abnormal sensation such as tingling, tickling, pricking, numbness or burning of a person's skin with no apparent physical cause

Petechiae

Petechiae are pinpoint, round spots that appear on the skin as a result of bleeding. The bleeding causes the petechiae to appear red, brown or purple. Petechiae (puh-TEE-kee-ee) commonly appear in clusters and may look like a rash. Usually flat to the touch, petechiae don't lose color when you press on them. Sometimes they appear on the inner surfaces of the mouth or the eyelids.

The nurse plans care for a child admitted with measles. Which instruction will the nurse anticipate to be included in the clients plan of care.

Place Child on Airborne precaution in a negative pressure room Provide a quiet and dimly lit atmosphere Measles or rubeola, is a highly contagious disease that can affect people of all ages. The disease starts with a fever, cough, runny nose, and conjunctivitis, soon after which a rash appears on the face and slowly spread downward Measles is spread through the air when infected person cough and sneeze, and the virus remains in the air up to 2 hours. Clients with measles are place on airborne precautions in a negative pressure single occupant room Clients with measles are highly contagious and should be placed on airborne precautions in a negative pressure room. Nursing care includes administering antipyretics, instating seizure precautions as needed, and providing a quit, dimly lit environment. Unvaccinated family members and those who have never had the disease are susceptible and should be advised to receive post-exposure prophylaxis

A child with Autism Spectrum Disorder is being admitted to a medical surgical unit. Which is the most appropriate nursing action

Placing the child in a private room away from nurses station Children with Autism spectrum disorder (ASD) often exhibit sensory processing problems; they may be hyper or hypo sensitive to sounds, lights, movements, touch, taste and smells. A calming environment with minimal stimulation should be provided; A private room away from the nurses station is the best location

Proper Crutch

Proper crutch fit include a 3-4 finger width space between the axillary pad and axilla and handgrip location that allows 20-30 degree of elbow flexion. Client should support their body weight on the hands and arms, not axillae. Wear and tear on crutch pads may indicate improper use or fit. Client progress from 3 point gait (no to partial weight bearing) to 2 point gait and then 4 point gait as rehabilitation continues

The nurse is caring for a 10 year old diagnosed with osteomyelitis. What is the best activity the nurse can suggest to promote age specific growth and development during hospitalization

Provide missed schoolwork According to Erikson's stages of psychosocial development, school age children deal with the conflict of industry versus inferiority. Attaining a sense of industry (competence) is the most significant developmental goal for children age 6-12. Parent should therefore be encouraged to provide a hospitalized child with missed school work on a regular basis. This will help the child keep up with school demands, learn new skills, cope with stressors of hospitalization, and avoid sense of inferiority

Loose Association

Rapid shifting from one idea to another, with little or no connection to logic or rationality

Malignant Hyperthermia

Rare life threatening inerited muscular abnormality that is triggered by specific drugs used to induce general anesthesia

During the client interview for a developmentally normal 18 month old, the parent expresses concern about the small amount of food the child consumes. What is the nurse priority intervention?

Reinforce teaching about the toddles nutritional needs During toddlerhood, it is normal for a child to have a decreased appetite as the result of reduced metabolic needs. Parents should be taught to provide multiple food option, set a schedule for meals/snacks and avoid watching TV or playing games during mealtime. Toddlers should not be forced to eat.

Needlestick injury

Remove Gloves Wash hands w/ soap and water Notify the nurse's supervisor Go to employee health clinic Take Postexposure

The experience nurse on a medical surgical unit is supervising a new nurse who is caring for a client with constipation. Which action by the new nurse would cause the experience nurse to intervene?

Request coffee to be included in breakfast trays Ambulation, fiber consumption, privacy and creation of bowel regimen (eg, avoiding delay of defecation, defecating at the same time each day) are important practices that prevent constipation. Clients should avoid caffeinated beverage which cause diuresis

Meniere Disease

Results from excess fluid accumulation inside the inner ear. Client have episodic attacks of vertigo, tinnitus, hearing loss, and aural fullness Client with Meniere disease can have severe vertigo, tinnitus, hearing loss, and aural fullness

compartment syndrome

Results from swelling and increased pressure

4-5 months (Fine motor Abilities)

Rolls front to back then back to front Sits with support Hold object with palmar grasp Put things in mouth Begins to laugh Makes some consonant sounds Becomes calmed by parents voices

(SIADH) Syndrome of inappropriate antidiuretic hormone

SIADH is an endocrine condition in which too much ADH is produced, causing water retention, increased total body water, and dilutional hyponatremia (low serum sodium). Some cancer cells particularly those of small cell lung cancer have the ability to produce and secrete ADH, leading to SIADH. Other causes include central nervous system disorder (eg, stroke, trauma,neurosurgery) and some commonly used medications (eg, desmopressin carbamazepine)

Oral Iron supplements

Should be given between meals, consumed with citrus juice to promote absorption, and administered to the back of the mouth to prevent tooth staining. No more than 1 month supply of supplement should be kept on hand to reduce the risk of accidental poisoning. Oral iron should not be taken with milk.

Parent who feed their infants commercial formula

Should closely follow the manufacturers recommendation for preparation and storage. For infant safety, formula should never be diluted, concentrated or microwaved. After preparation, unused prepared formula can be stored in the refrigerator for up to 48 hours

Lumbar Puncture

Side lying with the head back, and knees flexed for lumbar puncture.

6-9 months (Fine Motor Abilities)

Sits without help Begins to crawl May pull to a stand Moves object between hands Uses Crude Pincer grasp Babbles & imitates sounds May say "Mama" Recognizes familiar faces May have stranger anxiety

Bradypnea

Slow breathing

Sepsis

Systemic inflammatory responce to an infection that can occur as a complication of pneumonia in clients who do not repond to antibiotic therapy. It is caused by bacteria entering the bloodstream from the alveoli. Manifestation of sepsis include heart rate >90/min, Temp >100.4 F or 96.8F Systolic BP pressure <90 mm Hg, Respiratory rate >20/min Altered mental status

The home care nurse visit the house of an elderly client. Which assessment finding requires immediate intervention?

The client has new dependent edema of the feet New onset of dependent edema of the feet could represent CHF. This is an urgent medical condition that needs prompt evaluation for characteristic signs (eg, weight gain, lung crackles and treatment. The client need further assessment for characteristic signs such as lung crackles and increased body weight (Fluid retention)

Before chest tube removal

The client is given an analgesic and then asked to perform Valsalva During the procedure. The nurse should also bring sterile suture removal equipment and a sterile airtight occlusive dressing. Post procedure chest Xray is necessary within 2-24 hours

Suspected Air embolism

Trendelenburng on the left side

What is Tumor Lysis Syndrome?

Tumor lysis syndrome (TLS) is a group of metabolic abnormalities that can occur as a complication during the treatment of cancer, where large amounts of tumor cells are killed off (lysed) at the same time by the treatment, releasing their contents into the bloodstream. A condition that can occur after treatment of a fast-growing cancer, especially certain leukemias and lymphomas (cancers of the blood). As tumor cells die, they break apart and release their contents into the blood. This causes a change in certain chemicals in the blood, which may cause damage to organs, including the kidneys, heart, and liver.

Classic signs of Deep Venous Thrombosis?

Unilateral leg swelling, local warmth, erythema, and low grade fever in a client with obesity or immobility

Electroconvulsive Therapy (ECT)

Uses an electrical current applied to the scalp to induce generalized seizure in an anesthetized client. Prior to the procedure the client should be NPO and not take anticonvulsant medications. Temporary confusion and memory loss are common after the procedure ECT: induces a generalized seizure by passing an electrical current through electrodes applied to the scalp. Although the exact mechanism is unknown, 15-20 seconds seizures are proven effective in treating mood disorder (eg, major depression, Bipolar Disorder) and schizophrenia

What medication should the patient avoid during ECT?

Valporic Acid is an anticonvulsant that is also prescribed for bipolar disorder, therefore, it would prevent the therapeutic effect of ECT. Any prescribe anticonvulsant should be discontinued prior to ECT

Sentinel event

anu unanticipated event in a health care setting that results in death or serious physical psychological injury

Client with hemophilia

are at risk for permanent joint destruction due to frequent bleeds into the joint spaces. Assissting client with decreasing the incidence of bleeding episode and prompt treatment when bleeding occurs can help minimize joint destruction

What is INR

blood test used to monitor the effectiveness of warfarin therapy. The typical target INR is 2-3

After Liver Biopsy

lies on the right side for 2 hours and then supine 12-14 hours after liver biopsy