Metered dose inhalers (MDI) are commonly used for asthma treatment. An MDI should never be put in the mouth but held two fingerwidths in FRONT of the mouth. However, if the MDI has a spacer, it can be placed in between the lips.
Take a deep breath before use
Breathe for 5 seconds with the inhaler activated
Hold breath for 10-15 seconds before slowly breathing out
If second dose is needed, wait 1-2 minutes before repeating
MDI medications can include Albuterol, Theophylline, Salmeterol, Advair, Fluticasone, Montelukast. These are a few of the more commonly used medications, be sure to look up side effects and contraindications.
Theophylline: toxicity can occur when serum level is higher than 20 mcg/nl. Look for early signs such as restlessness, nervousness, tremors, palpitations, and tachycardia.
During kidney failure, peritoneal dialysis (PD) is used as a means to keep the body’s electrolyte levels in balance. A tube is entered through the stomach 3-5 cm BELOW the umbilicus. The three main steps to this type of dialysis for one infusion is fill, dwell, and drain.
Look for infection signs ( Number one complication for PD)
Abdominal Pain (Some irritation in first few infusions is normal)
leakage around the catheter site ( can indicate wrong placement)
Sample NCLEX Question
A patient newly diagnosed with renal failure has just been started on peritoneal dialysis. During the infusion of the dialysate, the client reports pain in the abdominal area. What action should the nurse take?
Stop the dialysis
Slow down the infusion rate
Immediately Report findings to the physician
Explain that the pain with subside after the first several infusions
The answer is 4. Note that the patient is … Read More »
Both cleft lip and cleft palate are congenital abnormalities that can occur in the womb. Repair surgery is usually done between 6-24 months of age. As far as nursing and NCLEX goes, prepare for assessment and interventions on caring for these types of patients.
Assessment: ability to suck, swallow, breathe, and manipulate secretions without distress.
Interventions: Hold infant in upright position to prevent aspiration. When feeding through bottle, position it into the side and back of the mouth and burp frequently.
After Repair: NO suctioning, thermometer, forks, spoons, pacifiers, straws in the mouth. A soft elbow restraint may be put on the child to prevent site being touched. (Removing the restraints every 2 hours)