Editing Medical-Surgical Nursing – LPN Flashcards (section)

== Chronic Disease Care ==

;Treatment of hypoglycemia in an alert patient who can swallow
:Give 15 grams of fast-acting carbohydrate such as 4 ounces of juice or regular soda or glucose tablets, recheck the blood glucose in 15 minutes, repeat if still low, then give a snack with protein if a meal is not due soon. Report the episode.

;Signs of low blood glucose versus high blood glucose
:Low glucose brings shakiness, sweating, fast heartbeat, hunger, irritability, and confusion, and comes on quickly. High glucose brings thirst, frequent urination, blurred vision, fatigue, and dry skin, and comes on gradually.

;Foot care teaching for a patient with diabetes
:Inspect the feet daily including between the toes, use a mirror or ask for help, wash with warm water tested by hand or thermometer and dry well, apply lotion but not between the toes, never go barefoot, wear well-fitting shoes, cut nails straight across, and report any sore, blister, or color change.

;Correct way to take levothyroxine
:In the morning on an empty stomach, at least 30 to 60 minutes before food, separated from calcium and iron supplements. It is taken for life and is never stopped because the patient feels better.

;Teaching for oral iron supplements
:Best absorbed on an empty stomach and with a source of vitamin C such as orange juice. Stools turn dark or black, which is expected. Increase fluids and fiber for constipation, and use a straw with liquid forms to protect the teeth.

;Rule about an arm with a dialysis fistula
:Never take blood pressure, draw blood, or start an intravenous line in that arm. Check for a thrill by touch and a bruit by listening each shift, and report immediately if either is absent.

;Normal versus abnormal stoma appearance
:Normal is beefy red and moist, with mild swelling expected right after surgery. Pale, dusky, purple, or black is abnormal and is reported immediately, because it means the blood supply is impaired.