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Semester 3 Finals > 203D Beth's Final > Flashcards

203D Beth's Final Flashcards

1
Q

Clinical manifestations of acromegaly

A

coarse facial features and a thick tongue (may occlude airway)

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2
Q

transsphenoidal hypophysectomy for pituitary adenoma teaching

A

you will not be able to brush your teeth for several days after surgery

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3
Q

Intervention for fluid volume excess r/t SIADH

A

maintain fluid restriction as ordered

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4
Q

Nurse suspects DI upon finding

A

urine specific gravity 1.003 (low)

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5
Q

Hyperparathyroid, Ca+ 14 (high), phos 1.7 (low). Include which nursing action?

A

Increase oral fluids

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6
Q

Hypoparathyroid for 20 years, assess for?

A

Tetany

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7
Q

Hypoparathyroid teaching, calcium levels altered because role of parathyroid is to?

A

stimulate bone resorption, increasing calcium when levels fall

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8
Q

Assess for tetany by

A

tapping facial nerve proximal to ear

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9
Q

SIADH assessment findings

A

ADH increased (urine volume decreased), serum osmolality decreased, urine sp. gr. increased

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10
Q

34 yo female, constipation, cold all the time, can’t get anything done, hair falling out. What does she have?

A

Myxedema (severe hypothyroid)

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11
Q

Post-op hypophysectomy, monitor for?

A

Hypopituitaryism

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12
Q

Pt. with untreated hypothyroidism, nurse should question which order?

A

Sedatives

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13
Q

Hyperthyroid symptoms

A

nervousness, irritability, tachycardia, heat intolerance

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14
Q

Exophthalmos (bug eyes) nursing interventions

A

lubricating eye drops, instruct patient to blink often

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15
Q

Hypothyroid pt. with new Synthroid prescribed, assess what?

A

blood pressure and heart rate

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16
Q

Assessment findings for DI

A

ADH decreased (urine volume increased), serum osmolality increased, urine sp. gr. decreased

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17
Q

Early manifestation associated with hypo-pituitary

A

headache, visual changes, loss of smell

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18
Q

Parathyroidectomy complications

A

hematoma at surgical site, vocal cord paralysis, increased bleeding with coughing

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19
Q

Thyroid storm s/sx

A

severe tachycardia, hyperthermia, agitation/delirium/psychosis

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20
Q

Cushing’s patient teaching: dexamethasone test involves

A

administered dexamethasone orally at 11PM, take plasma cortisol at 8AM next morning

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21
Q

Pheochromocytoma complains of sweating, palpitations, and HA. Nurse should assess what first?

A

blood pressure (hallmark sign is severe HTN)

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22
Q

Pheochromocytoma patients have

A

excessive catecholamine

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23
Q

Addison’s pt. should consult MD if they experience this side effect of Florinef

A

rapid weight gain and dependent edema

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24
Q

Clinical manifestations of Addison’s include

A

hyper K, hyperpigmentation, decreased resistance to stress

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25
Q

Addison’s crisis priority

A

prevent shock

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26
Q

Receiving too much glocucorticoid replacement s/sx

A

moon face

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27
Q

SIADH, what should be reported to physician

A

serum sodium 112 and headache

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28
Q

Vomiting for 2 days, unable to take glucocorticoids. Anticipate that the patient may

A

develop adrenal insufficiency

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29
Q

Corticosteroid therapy teaching

A

don’t stop taking abruptly, taper off dosages as prescribed

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30
Q

To measure effectiveness of steroid therapy, cortisol levels should be measured when?

A

8AM and 4PM

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31
Q

Cushing’s syndrome assessment reveals truncal obesity, thin arms/legs, what is another expected assessment finding?

A

purple/red striae on abdomen

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32
Q

Idiopathic Cushing’s disease rationale

A

taking steroids for another disease process

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33
Q

Teach pt with hyper-cortisol to avoid consuming what?

A

caffeine

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34
Q

Why is IV hydrocortisone ordered prior to bilateral adrenalectomy?

A

to compensate for the sudden lack of hormones following surgery

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35
Q

Priority assessment post-op bilateral adrenalectomy?

A

vital signs

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36
Q

Bilateral adrenalectomy pt teaching

A

wear a medical alert bracelet or necklace at all times

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37
Q

Assess this pt. first

A

72 yo pt. that just started taking levothyroxine, pulse irregular, 134

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38
Q

Flexion of arms, wrists, and fingers in comatose pt. is called what?

A

decorticate posturing

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39
Q

Increased ICP pt should not receive what?

A

enemas

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40
Q

midline tongue cranial nerve

A

12

41
Q

GCS 7, include which interventions

A

decrease noxious stimuli, HOB 30-45*, monitor VS

42
Q

When physician obtains spinal fluid from lumbar puncture, the nurse should?

A

obtain FSBG for comaprison

43
Q

Early sign of increased ICP

A

change in LoC

44
Q

Nursing diagnosis of ineffective breathing/airway for?

A

loss of cough/gag reflexes

45
Q

Most significant observation to report when monitoring a pt with increased ICP is?

A

decreasing pulse, Cheynne-Stokes respirations, widening pulse pressure

46
Q

For increased ICP pt, elevating HoB and straight alignment positioning are effective because they?

A

promote venous drainage

47
Q

Pt with inserted ICP monitor, the nurse should intervene when?

A

intervene when CPP > 15

48
Q

Craniotomy family teaching, purpose of bone flap is to?

A

accommodate for post-op brain swelling

49
Q

Post-op craniotomy pt, which action by the inexperienced nurse requires the charge nurse to intervene?

A

the staff nurse suctions pt. every 2 hours (may increase ICP)

50
Q

sub-arachnoid hemorrhage, nursing diagnosis of pain related to

A

blood causing irritation to the meninges

51
Q

Glasgow Coma Scale

A 
Eye:                        Verbal:
4. spontaneous     5. oriented
3. speech               4. confused
2. pain                    3. inappropriate
1. none                    2. incomprehensible
                                1. none
Motor:
6. obeys
5. localizes
4. withdrawals
3. flexion
2. extension
1. none
52
Q

Left frontal lobe tumor expected findings

A

personality and judgement changes

53
Q

Most malignant type of brain tumor

A

glioblastoma multiforme

54
Q

Most accurate way to measure compliance and monitor toxicity

A

blood tests for levels

55
Q

Flashing lights, spots, numbness/tingling in the arms are examples of?

A

aura experiences

56
Q

Effective seizure teaching when father states:

A

stay with the child during and after the seizure

57
Q

CNA trying to insert an oral airway lol

A

is this really a question? stop that SHIT!

58
Q

Status epilecticus pt precautions

A

placing oxygen and suction equipment at the bedside

59
Q

MVA pt w/ open femur fracture, given Vanco in OR, Cr/BUN now high, what type of renal injury is this?

A

intra-renal

60
Q

Pt has BP 100/42, ICP 24, CPP indicates?

A

MAP - ICP = CPP, impaired blood flow to the brain

61
Q

MRI pre-procedure questions

A

metal in the body?

62
Q

Spinal fusion teaching plan, discuss what?

A

pt typically experiences more pain at the donor site than the fusion site

63
Q

Classic assessment for meningitis is called?

A

Brudzinski’s sign: severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed

64
Q

Report this finding immediately in meningitis pt

A

BP 80/42

65
Q

exploding HA, photophobia, N/V

A

subarachnoid hemorrhage

66
Q

Risk for hemorrhagic stroke

A

HTN, BP 220/110

67
Q

Most frequent cause of stroke in pt with atherosclerosis

A

thrombus

68
Q

Right visual field deficit, during rehab phase, nurse should?

A

stay with pt, draw attention to food on right side of tray

69
Q

Appropriate action when assessing therapeutic effect of heparin drip (PTT low)

A

continue infusion and notify physician

70
Q

hyperparathyroidism can result in this renal disorder

A

increased Ca results in renal calculi

71
Q

Polycystic kidney disease, question which order?

A

Lovenox 60mg

72
Q

Possible cervical SCI action

A

immobilize and align the head/spine

73
Q

S2-S4 stab wound, lower motor neuron lesion, pt will experience

A

flaccid bladder

74
Q

T4 SCI, which activity indicates effective learning

A

check for bladder distension frequently

75
Q

Auscultate abdomen because pts with SCI often develop?

A

paralytic ileus

76
Q

T2 SCI, throbbing HA, nauseated

A

check BP (may be autonomic dysreflexia)

77
Q

Pt with ileoconduit, mucous in urine

A

normal for this pt

78
Q

Teach to empty ileoconduit frequently to prevent what?

A

separation of the appliance from the skin

79
Q

Nephrectomy tube placement order

A
  1. call physician if tube dislodged
  2. VS
  3. bleeding
  4. assure the tube in unobstructed
  5. I/O
80
Q

Neurogenic bladder major complication

A

infection

81
Q

Corticoids regulate a lot of stuff EXCEPT potassium, T/F?

A

False

82
Q

New bladder CA diagnosis discharge education

A

smoking is the highest risk factor

83
Q

Hemodialysis access site assessment complications SATA

A

local bleeding, thrombus, yellow/green fluid

normal: thrill, some numbeness/tingling d/t reduced blood flow to extremities

84
Q

Impaired renal perfusion, secondary HTN results from

A

increased RAAS production

85
Q

Urinary system disorder, frequent use of what nephrotoxic drugs?

A

frequent use of NSAIDs

86
Q

Hx renal calculi hospitalization highest priority?

A

pain from stone

87
Q

UA high protein indicates

A

damage to glomerulus

88
Q

Cr. clearance test

A

obtain supplies for and instruct patient about 24hr urine collection

89
Q

24hr urine collection missed sample

A

start over

90
Q

Pre-renal kidney injury causes

A

hypovolemia and cardiac pump failure

91
Q

Root cause of glomerulonephritis

A

group A strep throat infection

92
Q

High UO (oliguric) with acute renal failure

A

control of fluids

93
Q

N/V 5 days, BP low, BUN/Cr high, what caused acute renal failure?

A

pre-renal dehydration

94
Q

Assess patency of fistula

A

auscultate for bruit

95
Q

During inflow phase of peritoneal dialysis, pt reports abdominal cramping, nurse should?

A

decrease rate of dialysate

96
Q

Manage phosphate levels in renal pt by?

A

taking phosphate binding medication with all meals

97
Q

Prevent peritonitis by?

A

maintaining aseptic technique throughout procedure

98
Q

Spouse wants to divorce, nursing diagnosis?

A

altered family processes

99
Q

Post-op renal transplant management

A

hourly UO, protective isolation, aseptic technique (all of the above)

Semester 3 Finals (3 decks)

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