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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid
Rheumatoid Arthritis Assessment
- Mechanism
- Destruction of Connective Tissue and Synovial Membrane
- Signs and Symptoms
- Inflammation of Joints
- Morning Stiffness
- Nodules
- Joint Deformities
1 min
Rheumatoid Arthritis Interventions
- Lifestyle Modifications
- Heat and Cold Applications
- Therapeutic Exercise
- Balance Rest and Activity
- Drug Therapy
- NSAIDs
- DMARDs
- Glucocorticoids
- Considerations
- PT/OT
- Reconstructive Joint Surgery
2 mins
ROM Assessment
- Types of ROM
- Active ROM (AROM)
- Active Assisted ROM (AAROM)
- Passive ROM (PROM)
- Upper Extremity
- Neck Flexion, Extension and Rotation
- Shoulder Flexion, Extension and Rotation
- Elbow Flexion and Extension
- Fingers and Wrist Flexion and Extension
- Lower Extremity
- Hip and Knee Flexion
- Hip Abduction and Rotation
- Ankle Rotation
- Toe Flexion and Extension
- Lumbar Rotation and Spine Inspection
4 mins
Strength Assessment
- Inspection
- Assess Patient Appearance for Abnormalities
- Observe ROM of Upper and Lower Extremities
- Assess Motor Power
- Hand Grips
- Dorsiflexion and Plantarflexion
- Hip and Knee Flexion Against Resistance
- Manual Muscle Test (MMT) Grading System
2 mins
Immobility
- Assessment
- Mobility Continuum
- Complications
- Cardiovascular
- Respiratory
- Musculoskeletal
- Integumentary
- Gastrointestinal
- Urinary
- Considerations
- Turn, Cough, Deep Breathe (TCDB)
- Range of Motion (ROM)
- Skin Care
- Fluids
- Balanced Diet
2 mins
NSAIDs
- Indications
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Mechanism of Action
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Side Effects
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
1 min
Aspirin (Acetylsalicylic Acid)
- Mechanism
- Inhibits Platelet Aggregation
- NSAID
- Indications
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Side Effects
- Pancytopenia
- GI Ulcers
- Bleeding
- Considerations
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
2 mins
Ibuprofen (Advil, Motrin)
- Mechanisms
- NSAID
- COX Inhibitor
- Indications
- General Pain
- Fever
- Inflammatory Conditions
- Side Effects
- GI Ulcers
- Nephrotoxicity
- Rash
- Considerations
- Avoid with Alcohol
- Risk of Thrombotic Event
2 mins
Celecoxib
- Indications
- Rheumatoid Arthritis
- Osteoarthritis
- Pain
- Mechanism of Action
- NSAID
- Selectively Inhibits COX-2
- Side Effects
- Sulfa Allergy
- Increased Risk of Thrombosis
- GI Bleed
- Contraindication
- Pregnancy > 30 Weeks
1 min
Aspirin Poisoning (Salicylism) Assessment
- Early Symptoms
- Nausea and Vomiting
- Tinnitus
- Confusion
- Hyperventilation
- Respiratory Alkalosis
- Late Symptoms
- Metabolic Acidosis
- Coma
- Hyperthermia
1 min
Cane
- COAL
- Sizing a Cane
- Quad Cane
- Rubber Tips for Safety
1 min
Walker
- Walker with Affected Leg
- Sizing a Walker
- Rubber Tips for Safety
55 secs
Wheelchair Fitting
- Basic Measurements
- Seat Width
- Seat Depth
- Seat Height
- Armrest Height
- Backrest Height
- Footrest Length
- Types of Wheelchairs
- 16” x 18” x 20”
- Recline Wheelchair
- Tilt in Space Wheelchair
- Provision of Proper Fitting
- ADA Wheelchair Regulations
- Skin Integrity Protection
- Contracture Prevention
- Proper Posture
- Functional Tasks, Mobility and Transitions
5 mins
ADA Wheelchair Standards for Accessible Design Guidelines
- Legislation
- General Building Standards
- Turning Radius
- Doorways and Corridors
- Workplace Standards
- Checklist
- Ramps
- Ramp Handrails
- Ramp Slope
- Model
- PEO (Person-Environment-Occupation Model)
- Home Evaluations
- Assessments
3 mins
Systemic Lupus Erythematosus (SLE) Assessment
- Mechanism
- Multisystem Inflammatory Disorder
- Assessment
- Malar Rash
- Discoid Rash
- Arrhythmias
- Arthritis
- Hemolytic Anemia
- Seizures
- Glomerulonephritis
- Considerations
- Periods of Exacerbation and Remission
- Diagnosed by ANA (Anti-nuclear antibody assay)
2 mins
Systemic Lupus Erythematosus (SLE) Interventions
- Avoid Sunlight
- Drug Therapy
- Glucocorticoids
- Methotrexate
- NSAIDs
- Hydroxychloroquine
- Azathioprine
- Considerations
- Monitor for Renal Failure (ARF)
- Manage Pain
2 mins
Osteoarthritis
- Mechanism
- Articular Cartilage Destruction
- Biomechanical Stress
- Aging
- Signs and Symptoms
- Asymmetric
- Pain Decreases with Rest
- Morning Stiffness Under 30 Minutes
- Crepitus
- DIP and PIP Joints
- Treatment
- Lifestyle Changes
- Acetaminophen or NSAIDs
2 mins
Osteoarthritis Assessment
- Mechanism
- Aging
- Articular Cartilage Destruction
- Biomechanical Stress
- Signs and Symptoms
- Asymmetric
- Pain Decreases with Rest
- Morning Stiffness under 30 Minutes
- Crepitus
- DIP and PIP Joints
1 min
Osteoarthritis Interventions
- Lifestyle Modifications
- Balance Rest and Activity
- Therapeutic Exercise
- Heat and Cold Applications
- Drug Therapy
- Intra-articular Injection
- NSAIDs
- Considerations
- Reconstructive Joint Surgery
1 min
Osteoporosis Assessment
- Highest Risk
- Postmenopausal Women
- Long Term Corticosteroids
- Assessment
- Kyphosis
- Dowager's Hump
- Loss of Height
- Back Pain
- Pathologic Fractures
- Spinal Compression Fracture
1 min
Osteoporosis Interventions
- Increased Calcium Intake
- Vitamin D Supplements
- Bisphosphonates
- Raloxifene
- Denosumab
- Calcitonin
- Teriparatide
- Bone Densitometry (DEXA) Scan
- Weight Bearing Exercises
2 mins
Prevention of Falls
- Risk Factors
- Physical Aging
- Polypharmacy
- Environmental
- Hospital / Facility Prevention
- Call Light within Reach
- Assistive Devices Available
- Bed Alarms
- Home Prevention
- Improve Lighting
- Remove Home Hazards
- Priority Nursing Interventions
- Promote Exercise
- Fall Risk Assessment
2 mins
Alendronate (Fosamax)
- Mechanism
- Inhibits Osteoclasts
- Indications
- Osteoporosis
- Paget's Disease
- Side Effects
- Esophageal Ulcers
- Musculoskeletal Pain
- Vision Changes
- Atrial Fibrillation
- Osteonecrosis of the Jaw
- Considerations
- Take on Empty Stomach
- Remain Upright
2 mins
Raloxifene
- Mechanism of Action
- Selective Estrogen Receptor Modulator (SERM)
- Agonist in Bone
- Antagonist in Breast and Uterus
- Indications
- Osteoporosis
- Breast Cancer Prophylaxis
- Uterine Fibroids
- Side Effects
- Hot Flashes
- Thromboembolism
2 mins
Vitamin D Deficiency
- Signs & Symptoms
- Rickets in children
- Bending bones
- Rachitic rosary
- Breast milk has decreased vitamin D
- Osteomalacia in adults
- Tetany from Hypocalcemia
2 mins
Ergocalciferol (Vitamin D2)
- Mechanism
- Vitamin D2
- Indications
- Hypoparathyroidism
- Rickets
- Hypophosphatemia
- Side Effects
- Fatigue
- Constipation
- Hypercalcemia
- Kidney Stones
2 mins
Cholecalciferol (Vitamin D3)
- Mechanism
- Vitamin D3
- Indications
- Dietary Supplement
- Vitamin D Deficiency
- Side Effects
- Fatigue
- Constipation
- Hypercalcemia
- Kidney Stones
- Considerations
- More Effective Than Ergocalciferol
- Hypervitaminosis D
2 mins
Vitamin C (Ascorbic Acid)
- Mechanism
- Antioxidant
- Collagen Formation
- Steroid Synthesis
- Indications
- Dietary Deficiency
- Scurvy
- Side Effects
- GI Distress
- Considerations
- Citrus Fruits
- May Improve Healing
2 mins
Types of Fractures
- Nondisplaced
- Displaced
- Incomplete
- Complete
- Closed
- Open
- Direction of Fracture Line
2 mins
Venous Thromboembolism (DVT) Assessment
- Mechanism
- Venous Wall Inflammation caused by Thrombus
- Assessment
- Tenderness
- Edema
- Warmth
- Asymmetry
- Considerations
- Could be Asymptomatic
- Monitor for Pulmonary Embolism
58 secs
Venous Thromboembolism (DVT) Interventions
- Anticoagulants
- Prevention Education
- Frequent Ambulation
- Leg Exercises
- Compression Stockings or SCD's
- Avoid Nicotine and Oral Contraceptives
- Surgery
1 min
Neurovascular Assessment 6 P's
- Pain
- Paresthesia
- Pulse
- Pallor
- Pressure
- Paralysis
1 min
Sizing Crutches
- 3 Finger Widths
- 6 Inches Lateral From Heel
- 30 Degree Flexion
- Tripod Position
1 min
Total Knee Replacement (TKR)
- Indications
- Joint Pain (Uncontrolled)
- Impaired Mobility
- Considerations
- Compression Dressing
- Frequent Neurovascular Assessments
- Continuous Passive Motion (CPM) Devices
- Early Ambulation
- Venous Thromboembolism (VTE) Prophylaxis
- Limit Flexion Positions
- Monitor for Infection
2 mins
Hip Fracture
- Assessment
- External Rotation
- Muscle Spasms
- Shortened Leg
- Pain
- Interventions
- Buck's Traction
- Analgesics
- Surgery
- Considerations
- Avascular Necrosis
1 min
Hip Surgery
- Neurovascular Assessment
- No 90 Degree Hip Flexion
- No Adduction
- No Internal Rotation
- Avoid Turning on Affected Side
- Considerations
- Thromboembolism Prevention
2 mins
Anterior Shoulder Dislocation
- Axillary Nerve Damage
- Axillary Artery
- Rotator Cuff Injury
- Supraspinatus Tendon
- Anterior Glenohumeral Ligament
- Anatomic Lesions
- Bankart's Lesion
- Hill-Sachs Lesion
1 min
Interventions for Impaired Skin Integrity
- Assessment
- Signs of Skin Breakdown
- Pain
- Redness
- Decreased Skin Turgor
- Bleeding
- Bony Prominences
- Intervention
- Reposition Q2H
- Pressure Relief
- Maintain Clean and Dry Skin
- Adequate Nutrition and Hydration
2 mins
Amputation
- Indications
- Trauma
- Peripheral Vascular Disease
- Diabetes Complications
- Considerations
- Gentle Handling
- Surgical Tourniquet at Bedside
- Prevent Contractures
- Frequent Inspection
- Compression Bandages
- Phantom Pain
- Mirror Therapy
2 mins
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