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NSG 221 HESI Blueprint

Course

NSG med surg (NSG 223)

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West Coast University

Academic year: 2023/2024

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NSG 221 HESI Blueprint

Pre-test Items Not Graded  Abuse- question  Addiction- motivation to change  Addiction- relapse  Alcohol withdrawal- action  Heroin- history  Anxiety- panic  OCD- referral  PTSD- document  Antipsychotic- POC  Aggression- communication Module 1  Counter transference- Countertransference occurs when the therapist displaces onto the client attitudes or feelings from his or her past. For example, a female nurse who has teenage children and who is experiencing extreme frustration with an adolescent client may respond by adopting a parental or chastising tone. The nurse is countertransfering her own attitudes and feelings toward her children onto the client.  Defense Mechanism- Freud believed that the self, or ego, uses ego defense mechanisms, which are methods of attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings, or events.  Therapeutic Milieu- planning- The concept of milieu therapy, originally developed by Sullivan, involved clients’ interactions with one another, including practicing interpersonal relationship skills, giving one another feedback about behavior, and working cooperatively as a group to solve day-to-day problems.  Sleep Deprivation- Maslow (1954) formulated the hierarchy of needs, in which he used a pyramid to arrange and illustrate the basic drives or needs that motivate people. The most basic needs—the physiologic needs of food, water, sleep, shelter, sexual expression, and freedom from pain—must be met first.  Tardive Dyskinesia- severe, late side effect of antipsychotic medication- permanent involuntary movement  Neuroleptic Malignant Syndrome- med- dantrolene (muscle relaxant), bromocriptine (dopamine stimulator), diazepam (benzo depressant) Module 2  Civil rights- psychiatric patients- Clients receiving mental health care retain all civil rights afforded to all people except the right to leave the hospital in the case of involuntary commitment. They have the right to refuse treatment, to send and receive sealed mail, and to have or refuse visitors. Any restrictions (e., mail, visitors, clothing) must be made for a verifiable, documented reason. These decisions can be made by a court or a designated decision-making person or persons, for example, a primary nurse or treatment team, depending on local laws or regulations.  Refusal of treatment- Clients admitted to the hospital voluntarily have the right to leave, provided they do not represent a danger to themselves or others. They can sign a written request for discharge and can be released from the hospital against medical

advice. If a voluntary client who is dangerous to him or herself or to others signs a request for discharge, the psychiatrist may file for a civil commitment to detain the client against his or her will until a hearing can take place to decide the matter.  Group treatment- A group is a number of persons who gather in a face-to-face setting to accomplish tasks that require cooperation, collaboration, or working together. Each person in a group is in a position to influence and to be influenced by other group members. Group content refers to what is said in the context of the group, including educational material, feelings, and emotions or discussions of the project to be completed. Group process refers to the behavior of the group and its individual members, including seating arrangements, tone of voice, who speaks to whom, who is quiet, and so forth. Content and process occur continuously throughout the life of the group. In group therapy, clients participate in sessions with a group of people. The members share a common purpose and are expected to contribute to the group to benefit others and receive benefit from others in return. Group rules are established, which all members must observe. These rules vary according to the type of group. Being a member of a group allows the client to learn new ways of looking at a problem or ways of coping with or solving problems and also helps him or her learn important interpersonal skills. Module 3  Depression adolescents- rapport- Self-Disclosure. Self-disclosure means revealing personal information such as biographical information and personal ideas, thoughts, and feelings about oneself to clients. Traditionally, conventional wisdom held that nurses should share only their name and give a general idea about their residence, such as “I live in Ocean County.” Now, however, it is believed that some purposeful, well-planned self-disclosure can improve rapport between the nurse and the client. The nurse can use self-disclosure to convey support, educate clients, and demonstrate that a client’s anxiety is normal and that many people deal with stress and problems in their lives.  Crisis intervention- empathy- In therapeutic communication, the nurse must ask specific questions to get the entire story from the client’s perspective, clarify assumptions, and develop empathy with the client. Empathy is the ability to place oneself into the experience of another for a moment in time. Nurses develop empathy by gathering as much information about an issue as possible directly from the client to avoid interjecting their personal experiences and interpretations of the situation. The nurse asks as many questions as needed to gain a clear understanding of the client’s perceptions of an event or issue.  Clarification- communication- Understanding the context of a situation gives the nurse more information and reduces the risk for assumptions. To clarify context, the nurse must gather information from verbal and nonverbal sources and validate findings with the client. For example, if a client says, “I collapsed,” she may mean she fainted or felt weak and had to sit down, or she could mean she was tired and went to bed.  Stress and anger- therapeutic response  Anxiety communication- Anxious people lose cognitive processing skills—the higher the anxiety, the less the ability to process concepts—so concrete messages are important for accurate information exchange. Techniques such as exploring, focusing, restating, and

pressure, and relieves nausea. Cannabis and hallucinogen overdoses do not occur. Opioid overdoses have increased dramatically in the United States; many first responders now carry naloxone in autoinjector form (Evzio).  IV bolus- mL- a volume of 250mL defines a fluid bolus, with a range from 100-1000mL and a speed of delivery from stat to 60 minutes  Alcohol abuse- codependent behaviors- Codependence is a maladaptive coping pattern on the part of family members or others resulting from a prolonged relationship with the person who uses substances. Characteristics of codependence are poor relationship skills, excessive anxiety and worry, compulsive behaviors, and resistance to change.  Alcohol detox- Alcohol detoxification through pharmacologic means generally takes place in a hospital setting but may occur in the home.  Sleeping medications- benzos short term, anti-histamines, non-benzo sedative hypnotics (eszopiclone, ramelteon, tasimelteon, zaleplon, zolpidem)  Catapress- alcohol withdrawal- Clonidine (Catapres) is an alpha-2-adrenergic agonist used to treat hypertension. It is given to clients with opiate dependence to suppress some effects of withdrawal or abstinence. It is most effective against nausea, vomiting, and diarrhea, but produces modest relief from muscle aches, anxiety, and restlessness  Disulfiram- Disulfiram is a sensitizing agent that causes an adverse reaction when mixed with alcohol in the body. This agent’s only use is as a deterrent to drinking alcohol in persons receiving treatment for alcoholism. It is useful for persons who are motivated to abstain from drinking and who are not impulsive. Five to 10 minutes after a person taking disulfiram ingests alcohol, symptoms begin to appear: facial and body flushing from vasodilation, a throbbing headache, sweating, dry mouth, nausea, vomiting, dizziness, and weakness.  Alcohol detoxification action- Detoxification is the process of safely withdrawing from a substance. Clients needing medically supervised detoxification are often treated on medical units in the hospital setting and then referred to an appropriate outpatient treatment setting when they are medically stable.  Caffeine addiction withdrawal- POC- taper off  Antabuse- avoid all products with alcohol Module 7  Anxiety intervention- meds, CBT  Anxiety cognitive behavioral techniques- decatastrophizing, thought-stopping, assertiveness training  Stress behavior Module 9  Lithium creatinine- lithium can increase serum creatinine (0.7-1 men normal level)  Bipolar coping  Coping- past success- talk with the client about coping strategies they used in the past. Explore which strategies have been successful and which may have led to negative consequences  Depression activity- symptoms = decreased interest in activities  Depression- increased energy- risk for suicide increases as the client’s energy level is increased by medication, time is unstructured, and observation decreases

 Depression- plans for harm- It is important to assess suicidal ideation by asking about it directly. The nurse may ask, “Are you thinking about suicide?” or “What suicidal thoughts are you having?” Most clients readily admit to suicidal thinking.  Depression- structured lifestyle- leaves less time for suicide attempts  Tricyclic med schedule- take at bedtime  Depakote monitoring lab- monitor CBC, liver function tests, pregnancy test. Depakote levels should be 50-125. Module 10  IV mL remaining  IV mL/hour  IV volume to be infused  Anorexia- Anorexia nervosa is a life-threatening eating disorder characterized by the client’s restriction of nutritional intake necessary to maintain a minimally normal bodyweight, intense fear of gaining weight or becoming fat, significantly disturbed perception of the shape or size of the body, and steadfast inability or refusal to acknowledge the seriousness of the problem or even that one exists. Clients with anorexia have a body weight that is less than the minimum expected weight considering age, height, and overall physical health  Bulimia priority- safety is a priority, ask about thoughts of suicide or self-harm  OCD action- observe patterns, encourage decreased frequency of compulsions, talk about thoughts and behaviors, convey honest interest and concern  Eating disorder assess- eating attitude test, family relationships, behavior, mood, appearance, usually low energy, loose clothing, people pleasing, limited eye contact, labile mood  Anorexia fainting female adolescent  Depress- bulimia and K- bulimia causes hypokalemia which can result in dysrhythmias, cardiomyopathy, muscle weakness, tetany Module 11  Self-mutilation assess- encourage client to identify feelings that are related to self- mutilation. Mutilation is deliberate physical damage not intended to be fatal. Risk factors: impulsive temper, inability to express feelings verbally, physically self-damaging acts, attention-seeking behavior, ineffective coping. Most seen in borderline personality disorder  Antisocial personality disorder- disregard for the rights of others, rules, and laws. Interventions: limit setting, confrontation, teach client to solve problems effectively and manage emotions of anger and frustration  Paranoia assessment- Forming an effective working relationship with paranoid or suspicious clients is difficult. The nurse must remember that these clients take everything seriously and are particularly sensitive to the reactions and motivations of others. Therefore, the nurse must approach these clients in a formal, businesslike manner and refrain from social chit-chat or jokes. Being on time, keeping commitments, and being especially straightforward are essential to the success of the nurse–client relationship. Module 12

 Child abuse- action- The first part of treatment for child abuse or neglect is to ensure the child’s safety and well-being. This may involve removing the child from the home, which also can be traumatic.  Recording

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NSG 221 HESI Blueprint

Course: NSG med surg (NSG 223)

9 Documents

Students shared 9 documents in this course

University: West Coast University

Was this document helpful?

NSG 221 HESI Blueprint

Pre-test Items Not Graded

Abuse- question

Addiction- motivation to change

Addiction- relapse

Alcohol withdrawal- action

Heroin- history

Anxiety- panic

OCD- referral

PTSD- document

Antipsychotic- POC

Aggression- communication

Module 1

Counter transference- Countertransference occurs when the therapist displaces onto

the client attitudes or feelings from his or her past. For example, a female nurse who has

teenage children and who is experiencing extreme frustration with an adolescent client

may respond by adopting a parental or chastising tone. The nurse is countertransfering

her own attitudes and feelings toward her children onto the client.

Defense Mechanism- Freud believed that the self, or ego, uses ego defense

mechanisms, which are methods of attempting to protect the self and cope with basic

drives or emotionally painful thoughts, feelings, or events.

Therapeutic Milieu- planning- The concept of milieu therapy, originally developed by

Sullivan, involved clients’ interactions with one another, including practicing

interpersonal relationship skills, giving one another feedback about behavior, and

working cooperatively as a group to solve day-to-day problems.

Sleep Deprivation- Maslow (1954) formulated the hierarchy of needs, in which he used a

pyramid to arrange and illustrate the basic drives or needs that motivate people. The

most basic needs—the physiologic needs of food, water, sleep, shelter, sexual

expression, and freedom from pain—must be met first.

Tardive Dyskinesia- severe, late side effect of antipsychotic medication- permanent

involuntary movement

Neuroleptic Malignant Syndrome- med- dantrolene (muscle relaxant), bromocriptine

(dopamine stimulator), diazepam (benzo depressant)

Module 2

Civil rights- psychiatric patients- Clients receiving mental health care retain all civil rights

afforded to all people except the right to leave the hospital in the case of involuntary

commitment. They have the right to refuse treatment, to send and receive sealed mail,

and to have or refuse visitors. Any restrictions (e.g., mail, visitors, clothing) must be

made for a verifiable, documented reason. These decisions can be made by a court or a

designated decision-making person or persons, for example, a primary nurse or

treatment team, depending on local laws or regulations.

Refusal of treatment- Clients admitted to the hospital voluntarily have the right to leave,

provided they do not represent a danger to themselves or others. They can sign a

written request for discharge and can be released from the hospital against medical

NSG 221 HESI Blueprint

NSG med surg (NSG 223)

West Coast University

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NSG 221 HESI Blueprint

NSG 221 HESI Blueprint

Course: NSG med surg (NSG 223)

University: West Coast University

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