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Clients show impaired performance on neuropsychological and cognitive tests.

Perform appropriate interventions for theunderlying cause.

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Drug therapy Antibiotics: targeted to specific infectingorganism Corticosteroid: prednisone (Deltasone)(TIN) Antipyretic: acetaminophen (Tylenol)INTERVENTIONS AND RATIONALES Monitor vital signs to detect fever andhypertension.

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NCLEX keysClient needs category: Physiological integrityClient needs subcategory: Reduction of riskpotentialCognitive level: Analysis3.

Key treatments Thoracentesis (to remove fluid) with chest tube insertion ifnecessary Thoracotomy if thoracentesis isnt effective Antibiotics for empyema: according to sensitivity of causativeorganismKey interventions Administer O2.

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Encouragingsocial interactions, attending to basic dailyneeds, and providing pharmacologic therapyare general nursing interventions that areappropriate for any psychiatric disorder.

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Acute pain Activity intolerance Ineffective tissue perfusion: Peripheral Assess cardiovascular status.

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NURSING DIAGNOSES Imbalanced nutrition: Less than bodyrequirements Impaired gas exchange Ineffective airway clearance Activity intolerance Ineffective breathing pattern AnxietyTREATMENT Bronchoscopy (to mobilize secretions) Chest physiotherapy and incentivespirometry O2 therapyDrug therapy Antibiotics: according to sensitivity of causative organism Bronchodilator: albuterol (Proventil-HFA) Mucolytic: acetylcysteineINTERVENTIONS AND RATIONALESYouve readabout your clientsbreathingnowits time to dosome breathing ofyour own.

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Key treatments Preinvasive: conization, cryosurgery Invasive: radiation therapy (internal, external, or both); radicalhysterectomyKey interventions Provide emotional support and comfort measures.

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In one of those capacities, testtakers might have been exposed to less thanoptimum clinical practice and may carry thoseexperiences over to the NCLEX.

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ASSESSMENTSClient history Clients chief complaint or concern History of the present illness Past psychiatric illness Personal or developmental history Family history Social history Cultural considerationsPhysical examination General appearance Behavior Mood Thought processes and cognitive function Coping mechanisms Potential for self-destructive behaviorKEY PSYCHOLOGICAL TESTS MiniMental Status Examinationmeasuresorientation, registration, recall, calculation, language, and motor skills313419NCLEX-RN_Chap12.

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NURSING DIAGNOSES Ineffective peripheral tissue perfusion Impaired gas exchange Acute pain Assess cardiovascular, respiratory, andneurologic status.

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NG tube feedings or TPNDrug therapy Anticonvulsants: phenytoin (Dilantin), phenobarbital Antiviral: (Zovirax), which iseffective only against herpes encephalitis andis only effective if administered before theonset of coma Analgesics and antipyretics: aspirin oracetaminophen (Tylenol) to relieve headacheand reduce fever Diuretic: furosemide (Lasix) or mannitol toreduce cerebral swelling Corticosteroid: dexamethasone to reducecerebral inflammation and edema Laxative: bisacodyl (Dulcolax) Sedative: lorazepam (Ativan) for restlessness Stool softener: docusate sodium (Colace)INTERVENTIONS AND RATIONALESDuring acute phase Monitor neurologic status often.

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NCLEX keysClient needs category: Psychosocial integrityClient needs subcategory: NoneCognitive level: Analysis NCLEX keysClient needs category: Physiological integrityClient needs subcategory: Reduction of riskpotentialCognitive level: Analysis18.

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