Tiêu đề NCM 112 RLE MIDTERMS ✅

RD PRS The PR interval is measured from beginning of the P wave to the beginning of the QRS complex. QRS complex QRS complex represents ventricular depolarization (the time it takes for the impulse to travel through the bundle branches to the Purkinje fibers). The Q wave, when present, appears as the first negative deflection in the QRS complex; R wave appears as the first positive deflection. The S wave appears as the second negative deflection or first negative deflection after the R wave. J point and ST segment Marking the end of the QRS complex, the J point also indicates the beginning of the ST segment. The ST segment represents part of ventricular repolarization T wave and U wave The T wave usually follows the same deflection pattern as the O wave and represents ventricular repolarization. The U wave follows the T wave but isn't always seen; it is seen most frequently during bradycardia in leads V2 and V3. QT interval The QT interval represents ventricular depolarization and repolarization. It extends from the beginning of the QRS complex to the end of the T wave. 1. Exercise ECG (stress ECG) monitors HR, BP, and ECG waveforms as patient walks on a treadmill or pedals stationary bicycle. 2. Ambulatory ECG (Holter monitoring), patient wears portable Holter monitor to record heart activity continuously over 24 hours. The ECG is accomplished using a multichannel method. All of electrodes are attached to the patient and the machine prints a simultaneous view of all leads. Equipment ● ECG machine with recording paper ● Disposable pre gelled electrodes ● Soap and water ● Washcloths ● Bath blanket or sheet ● Facility-approved disinfectant ● Optional: disposable head hair clippers, single-patient-use scissors, indelible marking pen, gloves, alcohol pad, 4" × 4" (10-cm × 10-cm) gauze pads Preparation of Equipment 1. Inspect all equipment and supplies. If a product is expired, is defective, or has compromised integrity, remove it from patient use, label it as expired or defective, and report the expiration or defect as directed by your facility. 2. Place the ECG machine close to the patient's bed. 3. Check cable and wires for fraying or breakage, and replace them or obtain another machine if necessary. 4. Plug cord into the wall outlet or ensure that a battery-operated ECG machine is functioning properly. 5. Turn on machine, program or perform a self-test according to the manufacturer's instructions, and input the required patient information. Most ECG machines have automatic settings; ensure that the paper speed selector is set to standard 25mm/sec, calibration set to 10 mm/mV, and filter settings set to 0.05 to 100 Hz. If the patient is already connected to a cardiac monitor, move the electrodes to accommodate the precordial leads and to minimize electrical interference on the ECG tracing. Keep patient away from electrical fixtures and power cords. Depending on the type of pre gelled electrodes used, ensure that they are moist or sticky to promote impulse transmission. Implementation ● Verify the practitioner's order. ● Gather and prepare necessary equipment and supplies. ● Perform hand hygiene. ● Put on gloves to comply with standard precautions. ● Confirm patient's identity using at least 2 t identifiers. ● Provide privacy. ● Explain procedure according to individual communication and learning needs to increase their understanding, allay their fears, and enhance cooperation. Tell them that the test records the electrical activity of the patient's heart and that it may be repeated at certain intervals. Emphasize that no electrical current will enter the patient's body.. ● Raise the bed to waist level before providing care to prevent caregiver back strain. ● Place patient in the supine position in the center of the bed, with the arms at the patient's sides. Ensure that the patient's arms and legs remain relaxed to minimize muscle trembling, can cause electrical interference. ● Expose chest, arms, and legs and then cover patient appropriately with a bath blanket or sheet. ● Select electrode sites on the patient. Select flat, fleshy areas on which to place the limb lead electrodes. Avoid muscular and bony areas. If patient has an amputated limb, choose a site on the stump. Clinical alert: If the electrodes are placed incorrectly, the ECG tracing can be distorted sufficiently to cause a misdiagnosis. This can result in inappropriate treatment. 1

RD PRS Date and time that the ECG was performed and any significant responses by the patient. Verify the date, time, patient's name, and assigned identification number on the ECG itself. Note any appropriate clinical information, positioning changes, and calibration variations on the ECG tracing, and place it in the patient's medical record. Document teaching provided to the patient and family (if applicable), their understanding of that teaching, and any need for followup teaching. Indwelling Foley Catheter(female).mp4 - Female Indwelling urinary (Foley) catheter ● remains in bladder to provide continuous urine drainage. ● balloon inflated at catheter's distal end prevents it from slipping out of the bladder after insertion. ● Insert an indwelling urinary catheter only when absolutely NECESSARY because its use is associated with increased risk of UTI, and risk increases with each day of use. ● Catheter-associated UTI (CAUTI) accounts for 35% of health care–associated infections in the United States, making it the most common type. Hospital-acquired condition alert: Centers for Medicare and Medicaid Services considers CAUTI a hospital-acquired condition because it can be reasonably prevented using best practices. Be sure to follow CAUTI prevention practices—such as 1. Performing hand hygiene before and after any catheter manipulation; 2. Maintaining sterile, continuously closed drainage system; 3. Maintaining unobstructed urine flow; 4. Emptying the collection bag regularly; 5. Replacing catheter and collection system using sterile technique when a break in sterile technique, disconnection, or leakage occurs; 6. Discontinuing the catheter soon as it's no longer clinically indicated Consider alternatives to indwelling urinary catheterization when appropriate: external catheter application, bladder ultrasonography, intermittent catheterization, use of optimal incontinence products, prompted toileting, urinal and bedside commode use, and daily weight Indwelling only for appropriate indication: ● acute urine retention or bladder outlet obstruction ● need for accurate urine output measurements in critically ill patients ● perioperative use for patients undergoing urologic surgery or other procedures on structures of the genitourinary tract ● prolonged surgery (with removal of catheters inserted for this purpose in the postanesthesia care unit) ● surgery requiring large-volume infusions or diuretic use ● intraoperative urinary output monitoring ● assistance in the healing of open sacral or perineal wounds or skin grafts in selected patients with incontinence ● prolonged immobilization (such as for a potentially unstable thoracic or lumbar spine or multiple traumatic injuries, including pelvic fractures) ● improved comfort for end-of-life care, if needed. Indwelling urinary catheter insertion is contraindicated in a patient who has a urethral injury, which typically is associated with pelvic trauma. Relative contraindications include urethral stricture, recent urinary tract surgery (example, of the urethra or bladder), and presence of artificial sphincter. For these issues, a practitioner should be consulted to perform the procedure. Use STERILE TECHNIQUE when inserting, manipulating, and maintaining an indwelling urinary catheter. Maintain sterile, continuously closed drainage system; don't disconnect or break system unless absolutely necessary. Avoid irrigation unless necessary. If indwelling urinary catheter inserted for surgery, ensure discontinuation within 24hrs after surgery unless another indication exists. Review need for the indwelling urinary catheter daily and remove it as soon as it's no longer necessary. Equipment ● Sterile indwelling urinary catheter (smallest-bore catheter possible that will support adequate urine drainage) ● Syringe filled with 10 mL of sterile water ● Fluid-impermeable pad ● Gloves, Sterile gloves, Sterile drape ● Sterile fenestrated drape ● Sterile presaturated antiseptic swabs or antiseptic solution, sterile water, or sterile saline and sterile swabs or sterile cotton balls and plastic forceps ● Single-use packets of soap-containing wipes or soap and water and a washcloth ● Single-use packet of sterile water-soluble lubricant ● Sterile drainage collection bag ● Catheter securement device or tape ● Optional: insertion checklist, towel, examination light or flashlight, bladder ultrasonography device, gown, mask and goggles or mask with face shield Prepackaged sterile disposable kits are available that usually contain all the necessary equipment. Preparation of Equipment Inspect all equipment and supplies; if a product is expired, its integrity is compromised, or it’s defective, remove it from patient use, label it as expired or defective, and report the expiration or defect as directed by your facility. Implementation ● Verify the practitioner's order. ● Assess patient to make sure that an indwelling urinary catheter is indicated; assess for alternatives to indwelling 3