ATI - Predictor Study Notes (updated 2020) – Rasmussen
College
ATI – NCLEX Predictor Remediation Study Notes
Renal Calculi - Pain: Flank pain →
... [Show More] Kidney or Ureter (if pain radiates → stones in
ureter or bladder)
Performing Ear Irrigation: Sterile technique, warm meds, pull up & back, tilt
toward affected ear
Thrombolytic Therapy (Stroke): Reteplase recombinant (rTPA – clot buster)
w/ in 4.5 hours of initial symptoms
Trach care: Dressing ∆, inner cannula ½ hydrogen peroxide, & stoma □ knot
Head injury (changes in LOC): Length of time unconscious & GCS
General anesthesia (post-op): ABC’s – full body assessment, Vitals every 15
minutes, Lateral position (if unresponsive or unconscious - monitor LOC),
Fluids/Electrolytes
Superficial Burns: Painful, pink, red, mild edema (3-6 day healing), damage to
epidermis
2
Dialysis (reporting unexpected findings): Temp of 100 degrees, ↓ BP, bleeding,
1 L of fluid = 1Kg, clotting, H/A, Nausea, Disequilibrium syndrome (rapid ↓ BUN &
Fluid volume), anemia, peritonitis, ↑ BG, ↑ cholesterol
Pacemaker (complications): Infection, hematoma, pneumothorax, hemo-thorax,
arrhythmias, pacer spikes before P or QRS, hiccups / muscle twitching
Magnesium (Mg) Sulfate → Increase Mg+ > 1.3 Mg/dL
↑ Mg foods = (Dairy, dark leafy greens veges)
↓ Mg causes → Hyperactive deep tendon reflexes
* Paresthesia’s, muscle tetany, positive chvostek’s & Trousseau’s sign,
hypoactive bowels, constipation, abdominal distention, paralytic Ileus.
TPN Admin: (Total parenteral nutrition) -feeding that bypasses the GI tract.
Fluids are given into a vein to provide most of the nutrients the body needs. Given
when person cannot/ should not receive feedings or fluids by mouth.
Hypertonic (20-50% dextrose), Used in chronic pain, peritonitis, burns,
Infection, etc
No more than 10% hourly, ↑ in rate for body adjustment, check BG
Hyperglycemia, hypoglycemia, vitamin deficiencies, air embolism (clamp, place
in Trendelenburg pos., O2)
Fluid imbalance → Fluid volume excess
Wound Culture specimen: Sterile field, press / rotate over wound surface inside
the wound (center) in drainage
3
Diabetes Mellitus (Nephropathy): Kidney damage d/t prolonged ↑ BG &
dehydration
Monitor I & O, Creatinine, BP
Avoid Soda, alcohol, acetaminophen/NSAIDS / 2 – 3 L fluid from food /
beverages
Kidney Biopsy (Post op):
Monitor VS → Client receives sedation
Assess dressings & urinary output (hematuria-blood in urine)
Labs: HgB & Hct values, Admin PRN pain meds, Complications hemorrhage /
infection
Thyroidectomy (Post Op): Needs Thyroid hormone replacement
Client in high fowler’s position, Respiratory (trach supplies) present, Check for
laryngeal nerve damage
Pain management, Hypocalcemia / Tetany can occur
Prioritization: Apply knowledge to Standards to determine priority action
Systemic before Local – “Life before Limb”
Acute before Chronic
Actual Problems before Potential Future
Listen carefully to clients & Don’t Assume
Recognize & Respond - Trends vs. Transient findings
Recognize indications - Emergencies vs. Expected
Delegate to LPN: Monitoring Findings, Reinforcing teaching, performing trach care,
suctioning, checking NG tube patency, administer tube feedings, inserting urinary
catheter, administering meds (No IV)
4
Delegate to AP: ADLs, Bathing, Grooming, Dressing, toileting, Ambulating, feeding
w/out swallowing precautions, positioning, routine tasks, bed making, specimen
collection, I & O, VS for stable clients, monitoring clinical manifestations after initial
RN assess/eval.
Paracentesis (prep) - take out fluid from belly (peritoneal fluid) Have client VOID
Bariatric Surgery: (weight loss surgery) – Semi fowlers, 6 small meals/day,
liquid/pureed fo [Show Less]