HESI REMEDIATION TIME LOG 1

Marshall University College of Health Professions, School of Nursing HESI Remediation Time Log Student Name______Seth Parsons_____________901-502-833______________________ Instructor Name___Turner______________ Semester_____Spring__________Nursing Course________222___________ Name of HESI Exam___Seth Parsons__________HESI Conversion Score_____81.2_____________ Date and Time 5/2/11 9:15-9:25 Topic and Subtopic Fundamentals/ Mouth Care Key Points Oral care for unconscious patients takes special care because they are unresponsive and do not have the gag reflex. Good oral hygiene requires keeping the mucosa wet and removing secretions that can lead to infection. The unconscious client needs their head turned towards the mattress to prevent aspiration and choking. You should perform oral care for an unconscious client every 2 hours. Time Spent 10 min. Author(s), year, p. or pp. Potter: Basic Nursing: Essent for Practice, 6th ed. Pg 744

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Q: What position do you turn your unconscious patient when giving oral hygiene? A: Supine with head turned. I now know that the client needs to be turned on side. 9:25-9:35 Fundamentals/Impa ction Fecal impaction results from prolonged constipation. It is a collection of hardened feces, stuck in the rectum that cannot be passed. Clients who are debiliatated, confused, or unconscious are most at risk for impaction. An obvious sign of impaction is the inability to pass a stool for several days. Loss of hunger, N/V, stomach pain, and rectal pain are symptoms of impaction. Q: : what kind of enema is given for a fecal impaction. My answer liquid 1000ml. 10 min. Potter: Fundamentals of Nursing, 6th ed. Pg. 1379

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9:35-9:45

Fundamentals/Resid ual Urine

For residual urine, you ask the client to void normally. Record the amount, rate, and time of voiding. Then you would enter a catheter into the client attached to a cystometer. A set amount of fluid would be instilled from the cystometer to the bladder. The client then would be asked to void. The amount of fluid voided would be recorded. Then the nurses could determine the amount of residual urine. Q: what type of patient would lead the nurse to believe they have residual urine. My answer distended bladder. I now know that a client with abdominal pain, and hard time voiding are the patients that would have residual urine.

10 min.

Ignatavicius Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 5th ed. Pg. 1674

9:45-9:55

Fundamentals/Risk for infection

Clients that are most at risk for infection are those with immune system diseases like Leukemia, AIDS, lymphoma, and aplastic anemia. Clients with chronic diseases such as Diabetes are more susceptible to infection because of nutrition impairment. Diseases that weaken the body systems lead to infection. Burn clients have a

Potter: Fundamentals of Nursing, 6th ed. Pg. 781

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very high susceptibility to infection because of the damage to skin surfaces. The more the extent of the burn, the higher the risk for infection. Q: A client with leukemia is most at risk for what My answer fatigue. I now know that a client with leukemia or any disease that affects the clients ability to fight infection is at higher risk for infections. 9:55-10:05 Fundamentals/Urine Backup The client should not be catheterized unless urine amounts by bladder scan are greater than 300 ml or the client complains of discomfort. For clients with persistent urinary retention, a straight or retention catheter may be inserted through the external meatus, into the urethra beyond the internal sphincter, and into the bladder. A straight catheter is removed after the bladder drains. An indwelling (Foley) catheter is usually inserted after two straight catheterizations. Q: When watching nurse pour warm water over periniem you should. 10 min. Ignatavicius Medical-Surgical Nursing, 7th ed. Pg. 893

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My answer tell her she is doing the correct job. I now know that the client should be catheterized to relieve the client of backup urine.

10:0510:15

Fundamentals/walke r correct use

10 A walker is most often used by the older min. client who needs additional support for balance. The physical therapist assesses the strength of the upper extremities and the unaffected leg. Strength is improved with exercise as needed. Q: A client is walking on a walker with wheels you should My answer tell client to remove wheels to reduce risk of fall. I now that different types of clients have different types of walkers. Therefore this particular client should be using the wheels.

Ignatavicius Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 5th ed. Pg. 1204

10:1510:25

Fundamentals/ Residual equal to feed.

Administration of enteral tube feeding through nasogenteric tube is a procedure that can be given to assistive personnel (AP) after the tube placement is verified by the nurse. The nurse is also responsible for client assessment. Make sure that the client is sitting upright in, and instruct assistive personnel to

Potter Fundamentals of Nursing, 6th ed. Ch. 43.

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infuse the feeding slowly. Assistive personnel should be instructed to report any difficulty infusing the feeding or any discomfort voiced by the client. Q: If aspirating a NG tube and get residual what do you do My answer flush the tube with water. I now know you make sure the client is sitting upright and return the residual back to the stomach before doing anything else to the client.

Developed 10/20/09; Approved by SON 10/26/09