ATI Practice A Remediation Templates

ACTIVE LEARNING TEMPLATE: System Disorder STUDENT NAME _____________________________________ Anorexia Nervosa DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________ Alterations in Health (Diagnosis) Anorexia Nervosa Pathophysiology Related to Client Problem Health Promotion and Disease Prevention Altered brain function and structure and deficits in neurotransmitters dopamine and serotonin. Use a health promotion approach, focusing on building self-esteem, positive body image, and a balanced approach to nutrition and physical activity. ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Occupational choices that encourage thinness. A history of obesity. Individual history of being a "picky" eater in childhood. Laboratory Tests Low blood presure. Body weight that is less then 85% of expected normal weight. Dehydration and electrolyte imbalances. Diagnostic Procedures BUN, CBC, thyroid levels, blood glucose, potassium, and sodium. Lab tests and physical assessent. PATIENT-CENTERED CARE Nursing Care Teach and encourage self-care activities. Reward the client for positive behaviors. Therapeutic Procedures In patient treatment. Dehydration, electrolyte imbalances, refeeding syndrome, and cardiac dysrhythmias. Complications Medications Selective serotonin reuptake inhibitors. Client Education Asssit the client to develop and implement a maintenance plan related to weight management. Encourage follow-up treatment in an outpatient setting. Interprofessional Care A registered dietitian should be involved to provide the client with nutritional and dietary guidance. Refeeding syndrome, cardiac dysrhythmias, severe bradycardia, and hypotention. ACTIVE LEARNING TEMPLATE: Basic Concept STUDENT NAME _____________________________________ Identifying Criteria for Hospitalization for a Client Who Has Anorexia Nervosa CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________ Related Content Underlying Principles Comorbidties of anorexia nervosa include depression, personality disorders, substance use disorder, and anxiety. Persistent energy intake restricition leading to significantly low body weight in context of age, sex, developmental path, and physical health. Fear of gaining weight or becoming fat. Disturbance in self-perceived weight or shape. Nursing Interventions WHO? WHEN? WHY? HOW? (E.G., DELEGATION, LEVELS OF PREVENTION, ADVANCE DIRECTIVES) Weight loss of 20% of ideal body weight or less than 10% body fat. Unsuccessful weight gain in outpatient treatment, failure to adhere to treatment contract. Vital signs demonstrating heart rate less than 50/min, systolic blood pressure less than 90 mm Hg, body temperature less than 96.8. ECG changes and electrolyte disturbances. Severe depression, suicidal behavior, family crisis, or psychosis. Provide a highly strucuted milieu in an acute care unit for the client requiring intensive therapy. Use a positive approach and support to promote client self-esteem and positive self-image. Establish realistic goals for weight loss or gain. Use behavioral contracts to modify client behaviors. Closely monitor the client during and after meals to prevent purging, which can necessitate accompanying the client to the bathroom. ACTIVE LEARNING TEMPLATE: System Disorder STUDENT NAME _____________________________________ Shizophrenia/Auditory Hallucinations DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________ Alterations in Health (Diagnosis) Shizophrenia Pathophysiology Related to Client Problem Dopaminergic, glutamatergic and GABAergic neurotransmitter systems are affected in schizophrenia and interactions between these receptors contribute to the pathophysiology of the disease. Health Promotion and Disease Prevention There's no sure way to prevent schizophrenia, but sticking with the treatment plan can help prevent relapses or worsening of symptoms. ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Having a family history of schizophrenia. Malnutrition or exposure to toxins or viruses that may impact brain development. Taking mind-altering (psychoactive or psychotropic) drugs during teen years and young adulthood. Laboratory Tests N/A Hallucinations, delusions, alterations in speech, and bizarre behavior. Diagnostic Procedures Abnormal involuntary movement scale (AIMS) and world health organization disability assessment schedule (WHODAS). MRI or CT scan. PATIENT-CENTERED CARE Nursing Care Establish therapeutic relationship. Do not argue with the patient delusions. Provide a structured safe enviornment. Therapeutic Procedures In patient treatment and psychotherapy. Patient is at risk for suicide and substance abuse. Complications Medications Antipsychotics Antidepressants Mood stablizers Client Education Medication can cause sedative effects. Develop social skills and frienships. Comply with medication. Interprofessional Care Psychotherapist provides individual psychotherapy. Anxiety disorders and obsessive-compuls ive disorder (OCD). Suicide and/or suicide attempts. Inability to work or attend school. Abuse of alcohol or other drugs, including nicotine. Financial problems and homelessness. ACTIVE LEARNING TEMPLATE: Medication STUDENT NAME _____________________________________ Succinylcholine MEDICATION __________________________________________________________________________ REVIEW MODULE CHAPTER ___________ Neuromuscular Blocking Agents CATEGORY CLASS ______________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action Prevents neuromuscular transmission by blocking the effect of acetylcholine at the myoneural junction. Therapeutic Use Skeletal muscle paralysis. Complications Arrhythmias, bradycardia, hypotension, hyperkalemia, muscle fasciculation, apnea, bronchospasm, malignant hyperthermia, and tachyphylaxis. Contraindications/Precautions Contraindicated in hypersensitivity to succinylcholine or parabens. Personal history of malignant hyperthermia. Use cauiously in pulmonary disease, renal impairment, major truama, and electrolyte disturbances. Interactions General anesthesia, clindamycin, lidocaine, beta blockers, lithium, digoxin, and opioid analgesics. Medication Administration Intravascular and intramsuclar. The IV route is preferred, but deep IM injection may be used in children and patients without vascular access. Nursing Interventions Assess respiratory distress. Monitor ECG, heart rate, and BP. Assess patient for history of malignant hyperthermia. Observe patient for residual muscle weakness and respiratory distress during the recovery period. Client Education Evaluation of Medication Effectiveness Adequate supression of the twitch response when tested with peripheral nerve stimulation, with subsequent muscle paralysis. Explain all procedures to patient receiving succinylcholine therapy with anesthesia, because consciousness is not affected by succinylcholine alone. Provide emotional support. Reassure patient that communication abilities will return as the medication wears off.