NCLEX PART 1

CH 04. Fundamentals of Nursing
(Positioning & Electrolytes)

"Fundamentals" is the foundation of nursing practice.

The NCLEX loves to ask: "How do you position this patient?"
Putting a patient in the wrong position can cause aspiration, bleeding, or increased pressure.
Let's master the positions and the confusing world of electrolytes!

1. Therapeutic Positioning

Positioning is a cheap and effective intervention. Memorize these specific post-procedure positions.

Condition / Procedure	Position	Rationale
Paracentesis (Removing fluid from abdomen)	High-Fowler’s (Sitting upright)	Allows fluid to settle to the bottom of the abdominal cavity for easier drainage.
Liver Biopsy (Post-procedure)	Right Side-Lying	Apply pressure to the liver (which is on the right) to prevent hemorrhage.
Lumbar Puncture (Post-procedure)	Supine / Flat (4-12 hours)	Prevents CSF leakage and spinal headaches.
Enema Administration	Sims' Position (Left side-lying with right knee up)	Follows the natural curve of the sigmoid colon for gravity flow.
Shock (Hypovolemic)	Modified Trendelenburg (Supine with legs elevated)	Increases venous return to the heart and brain.

2. Electrolyte Imbalances

You must recognize the signs of high/low Potassium, Calcium, and Sodium.

① Potassium (K+) : The Heart

Hyperkalemia (> 5.0):
- ECG: Peaked T waves, Wide QRS.
- Risk: Cardiac Arrest.
- Tx: Calcium Gluconate (protect heart), Insulin + Dextrose (move K+ into cells), Kayexalate (excrete K+).
Hypokalemia (< 3.5):
- ECG: U waves, Inverted T waves.
- Symptoms: Muscle cramps, weakness.
- Tx: Potassium supplements (NEVER IV Push!).

② Calcium (Ca++) : The Muscles

Hypocalcemia (< 8.5):
- Tetany: Muscle spasms, tingling lips/fingers.
- Chvostek’s Sign: Facial twitch when cheek is tapped.
- Trousseau’s Sign: Hand spasm when BP cuff is inflated.
- Risk: Thyroidectomy patients (parathyroid damage).

3. Tube Management Safety

Nasogastric (NG) Tube:
- Placement Check: X-ray is the only 100% reliable method. Bedside? Check pH (< 5.5).
- Never lay flat while feeding (Aspiration risk). Keep HOB > 30°.
Foley Catheter:
- Keep the drainage bag below the level of the bladder (Gravity).
- Never let the bag touch the floor (Infection).
- Sterile technique upon insertion.

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CH 04. Fundamentals of Nursing
(Positioning & Electrolytes)

1. Therapeutic Positioning

2. Electrolyte Imbalances

① Potassium (K+) : The Heart

② Calcium (Ca++) : The Muscles

3. Tube Management Safety

오늘의 열정을 계속 이어가세요!

제안하기

컨텐츠 수정하기

CH 04. Fundamentals of Nursing(Positioning & Electrolytes)

1. Therapeutic Positioning

2. Electrolyte Imbalances

① Potassium (K+) : The Heart

② Calcium (Ca++) : The Muscles

3. Tube Management Safety

CH 04. Fundamentals of Nursing
(Positioning & Electrolytes)