Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing 221-222 > 222- Test 1 !! > Flashcards

222- Test 1 !! Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

Terrorism is for…

A

bringing about Political change ! exactly.. our gov sucks, they know when this shits going to happen and let it so that they can ‘make a point’ and justify some sort of war or act they want to do… and thats my feelings… love H !lol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If a patient came in the ED with radioactive particles all over there, what is the first thing you would do?

A

Place pateint in the shower, get dust off !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Antibiotics are treament of choice for inhalation anthrax, and these are..

A

Cipro and PCN
This is SECONDARY prevention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cutaneous forms of anthrax be treated with?

A

PCN, very treatable with thi.

Pneumonic form is fatal if not caught early enough.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What kind of precautions would you use with a pt with small pox?

A

droplet, private rooms, resp protection (like TB), gown, mask and gloves.

Doesnt respond to anitbiotics !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Botulism, where it comes from, how is it treated?

A

It is caused by improperly canned foods (the dented cheap cans, DONT BUY THEM YA CHEAP ASS )

Treat with PCN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In a mass casualty situation who do you treat first?

A

Treat the less wounded first, will waste time on the ABC pts, they are dying, sorry about it !

Focus is on saving the Greatest number of salvagable people !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

You are trying to save the salvagable people, what are you going to do with bleeding and injuries?

A

wrap or tourniquet affected limb with cleanest clothing or material avaiable (may need to use your clothes)
Cleanse wounds if any clean water available (running water, water bottle, DONT use water from a pond or stream)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Random point to remember about nursing diagnosis

A

PHYSIOLOGIC ALWAYS TRUMPS PSYCHOLOGIC !!

why didnt i remmeber that on my 221 final…. lol, dumb H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Control severe hemorrage by?

A

apply pressure or truniquets. have the person put pressure on themselves if they can.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Items to include in a basic emergency supply kit

A

WATER, FOOD (non perishable we dont have a can opener silly ), FIRST AID KIT, DUST MASK.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

6 P’s ( really or Fs!!!! lmaoo just noticed i put the wrong letter !!) for whose at risk for gallballder stones..

A

Fat, Forty, Female, Fertile (whose feritle and forty? lol), Fair, Family (history), also recently dieting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sympathetic slowwws down so you will see..

A

constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Parasympathetic speeds up! so you see..

A

diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stress can be manifest as…

A

Anorexia, epigastric pain, abdominal pain, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

These two diseases are aggravated by stress

A

Peptic ucler disease (PUD) and colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fat soluable vitamins

A

Vitamins A, D, E, K

stored in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When intrinsic factor is decreased, what cant be absorbed?

A

B12 (cycobalamine) -extrinsic factor

Give IM - I mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Decrease motilitly leads to

A

constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

IF someone is going for a UGI or barium, whats important to tell them about history.

A

Having had gastric bypass, the barium will go down quicker.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Liver lab tests

A

AST/ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pancrease labs

A

amylase, lipase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

NPO when for a lower GI or barium enema

A

the day (NOT NIGHT BEFORE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Signs of hemorrage?

A

Decrease BP, increase HR, distened abdomen (GI bleed?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Nursing repsonsibilty for Esophagogastroduodenoscopy- (EGD) -upper GI endoscopy

A

Pre-op meds (Diazepam, demerol), Post-op ausculate bowel sounds and do a complete abdominal assessment (IAPP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

why is the temp checked often after EGD?

A

can be a sign theres a perforation (duoden)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

NPO when for a colonoscopy?

A

8 hours before the procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Common complication of Endoscopic retrograde cholangiopancreatography (ERCP), what to look for.

A

Pancreatitis, montior WBCs, Amylase, unresolved fever,nausea or vomitng.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What lab values will you see with pancreatitis?

A

elevared fasting BS, amylas, lipase, and WBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Normal values for Amylase

A

0-130 U/L

get during an acute attack

Pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Normal values for Lipase

A

0-160

Pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Alcoholic is a higher risk for bleeding because?

A

decreased platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Normal protein levels

A

3.5 - 5 (Albumin)

2-3.5 (globulin)

total protein is 6-8 g/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

alpha-fetoprotein, normal levels, indicative of?

A

normal < 25, indicative of liver CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

normal blood ammonia levels

A

30-70

increase can result in hepatic encephalopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Alkaline phosphatase (ALP) normal levels

A

30-120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Asparate aminotransferase(AST) normal levels

A

7-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Alanine aminortransferase (ALT) normal levels

A

5-36

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Hiatal Hernia is…

A

herniation of a portion of the stomach into the esophagus through an opening (hiatus) in the diaphram

more prevelant in males.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Factors that increase abdominal pressure (cause a hiatal hernia)

A

Obesity, pregnancy, tumors, tight corsets (SHAD better watch out ; ] ), heavy lifting, increased age, trauma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Symptoms of a hiatal hernia

A

may be asypmtomatic, Heartburn (esp after a meal or lying supinf) = chest pain and regurgitation, dysphagia, pain when being over.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what to give to decrease intraabdomnial pressure (for hernia)

A

Chewable antacids to provide relief of s/s of anitsecretory agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Meds for hiatal hernias

A

Reglan, zantac,** carafate (coats)**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Post op surgey for hernia, if thoracic approach

A

maintain chest tube, assess for resp problems.

If chest tube not bubbling, check for kinks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Body mass index (BMI)

A

weight(lbs) / height(in inches) [2] x 703

goes by gender, uses weight to height ratios

normal is 18.5 - 25

>40 you are morbidly obese !!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Cormoribity problems with obesity can be improved when…

A

you lose weight ya fat fuck !! hehe im mean !!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Causes of being a fatty (obese)

A

Sedentary lifestyle (get off your ass! ), Leptin (hereditary factor)- that really sucks for them =[

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Health people 2010 sugest what diet for overweight people..

A

low Na+, low salt, and sugar !

so bland lame foods… woo !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Dumping Syndrome !

result from gastric bypass

A

Results from rapid emptying of doos contents into the small intestine, which shifts fluids into the gut — abdominla distention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What will you experience with dumping syndrome?

A

nausea, sweating, vertigo, palpitations, lightheadedness, urge to lay down, borborygmi (loud stomach gurgles), urge to defecate, generalized weakness.

Due to advanced hyperosmolar chyme into the small indestine causing a fluid shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Pernicious anemia prevention

A

B-12 IM for life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

S/S Anemia ( we know this but reinforce)

A

Irritability, oral mucosa irriation (beefy red tongue).

These should subside with B-12 administration.

53
Q

Gastric bypass nursing maintenance

A

Prevent strain on the suture line be decompression, question any order that says replace NGT prn, irrigate gently with NS onoly if ordered !

54
Q

Why give a chewable mulitvitamin to a patient after gastric bypass?

A

The client is eating much less but the body requirements for vitamins and minerals will not change.

A chewable one will prevent a whole pill from becoming lodged in the new stomach pouch.

55
Q

what drinks should be avoided after bypass?

A

caffeniated beverages r/t the risk of dehydration. also no wine, can lead to dumping syndrome.

56
Q

What should be avoided before a decal occult blood test?

A

red meats and NSAIDs, can cause false positive.

57
Q

Coffee ground vomitus reveals..

A

that the blood has been in the stomach for some time and has been changed by the gastric secretions (UGI)

58
Q

what drugs could precipitate an acute GIB ( GI bleed)

A

ASA, motrin, prednisone

59
Q

A client bleeding that has esophageal varcies, what you do..

A

stabilize the client and manage the airway.

Question orders for NG tube

60
Q

most bleeding ulcers are r/t…

A

H. pylori

(lives in the muscosal lining of stomach)

61
Q

How will abdomen feel if there is a perforation or peritonitis?

A

tense, rigid, board-like

62
Q

drug therapy for bleeds

(goal is to decrease HCL secretion because the acidic environment can alter platelet function as well as interfere with clot stablization)

A

H2R blockers (Tagamet, Pepcid)

Proton pump inhibitors (PPI)- protonix

Given IV

63
Q

What do antacids do for bleeds?

A

Neutralize HCL, increase the pH of gastric contents above 5 (alkaline) inhibits the conversion of pepsinogen to its active form pepsin.

64
Q

s/s of shock

A

low BP, rapid weak plse, increased thirst, cold clammy skin, restlessness

65
Q

Peptic ulcer patho

A

Degradation (digestion) of proteins by cellular enzymes.

66
Q

Nursing Assessment or PUD, questions to ask.

A

Any recent stressful events of chronic illness?
What medications are you taking?
Any past medical history of PUD?
Any history of taking corticosteroids?
Rigid, boad-like abdomen? (inidicated problem-peritinitis)

67
Q

Pepcid (famotidine) works how..

A

inhibits gastric acid secretions in the stomach.

68
Q

Gastric ulcers, you see what commonly.

A

h. pylori is in 70% of cases

69
Q

duodenal ulcers

A

erosion of the GI mucous with bleeding

usually well nurished (fatty?)

H.plyori found in 95% of theses patients.

70
Q

monitor for what in duodenal ulcers..

A

active bleeding

  • nasuea
  • abdominal pain
  • *-hematemesis (blood vomit)**
71
Q

If h. plyori infection is untreated or if therapy doesnt include H2 anatgonist, what will happen?

A

many pts will have 2nd episode of bleeding

72
Q

Gastric uclers (females) s/s

A

pain preciptated by food, pain not relieved by antacids, wt loss, anorexia, less common than duodenal, age over 50, h. pylori 50-70 %

73
Q

duodenal ulcers (male) s/s

A

usually well nourished (fatty), paint relieved with antacids, pain occurs 90 min to 3 hrs after eating, wt gain (food relieves pain), age 35-45, h. pylori 90-95% of cases

74
Q

complications of PUD

A

All considered **emergency situations

  • hemmorage (assess for lightheadedness, HGB level, pallor, abdomonal distention, palpitations
  • Perforation (rigid board-like abdomen, observe for symptoms of peritonitis**- abd pain, tenderness over involved area, rebound tenderness, muscle rigidity, muscle spasm, fever
75
Q

Antibotics for H. pylori

A

7-14 days, no single agent has been effective, need multiple antibiotics !
Blaxin, amoxicillin, tetracycline, PCN

76
Q

H2 receptor antagonists

A

Pepsid - decreases acid secretion in the stomach by binding irreversibly to an enzume on the parietal cells

77
Q

Proton pump inhibitors (PPIs)

A

block the ATPase enzyme that is important for scretion of HCL acid

Priolsec, prevacid, protonix, nexium

78
Q

Cytpoprotective drug therapy

A

Carafate (COATS) - a cytoprotective agent for the esophagus, duodenum and stomach.

Give 30 min before or 30 min after an antacid

79
Q

Nutritional therap for PUD

A

Protein to neutralize, but stimulates secretion of HCL

80
Q

Surgery for PUD

A

Partial gastrectomy
- removal of the distal 2/3 of stomach and anastomosis of the gastric stump to the duodenum (billroth I), if anastomosed to jejunum is billroth II

-NGT inserted to prevent strain on the suture line by decompression (Do not irrigate without Dr order! )

81
Q

Dumping syndrome

A

A large bolus of hypertonic chyme enters the intestine and results in fluid being draw into the bowel.

Results from rapid emptying of food contents into the small intenstinem which shifts fluids into the gut – abdominal distention

82
Q

Teach elder to take NSAIDs how…

A

with food, milk or antacids, avoid ETOH and irritating substances.

83
Q

Lab criteria to evaluate if TPN is being tolerated..

A

Blood glucose ( blurred vision, dry mouth, polyurea -hyperglycemia)
ALT. AST (liver)
BUN
Hgb/Hct

84
Q

With a TPB client, how often is BS checked?

A

every 4-6 hours

85
Q

gastroesphagealreflux disease (GERD)

A

Involves relaxation of the lower esophageal sphincter allowing stomach contents to back up into the esphagus

86
Q

predisposing factors for GERD

A

hiatal hernia, incompetent lower esophageal sphincter, decreased esophageal clearance, sedentary lifestyle, obesity

87
Q

complications of GERD

A

Esophagitis, Esophageal ulcer, Esophageal stricture, Barrett’s esophagus ( precancerous lesion)

88
Q

What to ask about before a colonoscopy..

A

If they have had any recent blood in their stool. Also inform them they are going to feel the need to deficate after and they will have loud, non smelling gas, after.

89
Q

Instruct to avoid what before a fecak occult blood test?

A

red meats and NSAIDs 7 days prior to exam

90
Q

Instruct client of what before a protosigmoidscopy..

A

Enema is used the night before, urge to defecate when scope is inserted, clear liquids the day before test.

91
Q

life threatening aspects of chronic diarrhea

A

sever dehydration- water and Na+ loss, electrolyte distrubances (hypokalemia)

92
Q

Treat C-diff with..

A

Vanco and **Flagyl **

93
Q

A client with chronic diarrhea should be taught to cleanse perineal area how..

A

with warm water after each BM, rinse and dry to prevent skin breakdown and promote comfort.

94
Q

Monitoe what withdeficient fluid volume…

A

I & O, serum Na+ and K+ levels(report abnormalities to doc), VS q4 (changes indicate hypovolemia - increase HR and R, decrese BP), weigh daily

95
Q

Initial therapy for ulcerative colitis

A

Cortiocosteriods

wheen off steroids to avoid addisonian crisis

96
Q

Nursing dx for uclerative colitis

A

Altered nutrition less then body requirements r/t wt loss associated with frequent loose stools.

97
Q

clinical manifestations of ulcerative colitits

A

Unpredictable intervals over a number of years of:

10-20 liquid/bloody stools a day, abdominal pain, and in moderate cases- fever, malaise and anorexia

98
Q

Complications of ulcerartive colitits

A

Perforation (life threatening) - implement TPN therapy, observe for s/s of peritonitis - abdominal pain/tenderness, abdominal distention, fever, low urine output, nausea/vomiting.

Toxic megacolon (dilation anfd paralysis)

At greater risk for colon CA

99
Q

diagnostics for Uclerative colitis

A

may have iron deficiency, increase WBCs, decreased Na+, K+, HCO3, and Mg+

100
Q

s/e of asacol (mesalamine) - an anti-inflammatory

A

headacheand GI upset

101
Q

monitor for what post op total colectomy with rectal mucosal stripping and ileoanal reservoir?

A

bowel obstruction and electrolyte imblances (hypocalemia)

102
Q

A normal stoma appears how, when should the doc be called..

A

brick-red with moderate amout of swelling and bleeding (is viable with high vascularity)

If black/brown or purple, call doc.

103
Q

Nutritional therapy for uclerative colitis

A

increase calories, increase protein, nonspicy, caffeine-free, reduce residue (BRAT diet)

bananas, rice, applesauce, chicken, toast

104
Q

Crohns disease affects…

A

the entire GI tract (mouth to anus).

Its a chronic inflammatory disorder of segments of the GI tract (some areas not affected)

higher incidence in females

105
Q

clinical manifestations of Crohns

A

Non-bloody diarrhea, abdominal pain, cramping tenderness, and distentions, fever, fatigue, as disease progesses– wt loss, dehydration, electrolyte imbalances (Na+, K+), anemia, umbilical and RLQ pain.

106
Q

Collaborative care of Crohns..

A

maintain fluid and electrolyte balance with IV therapy, maintain activity/rest balance by pacing actitvites and taking frequent breaks, promote effective coping by encouraging the expression of feelings, high-calorie, high-vitamin, high-protein, low-residue, milk-free diet.

107
Q

How often should you check BS with TPN therapy..

A

every 4-6 hours!!! per protocol.

108
Q

Crohns nursing dx= altered nutrition less then body requirements r/t exacerbation of crohns disease AEB:

A

**weight loss of 6 pounds in 4 days ! **

NOT 1 lb in 2 days.

109
Q

DiverticuLOSIS

A

multiple noninflammed diverticula present.

110
Q

DiverticuLITIS

A

Inflammation of diverticula

most common in sigmoid colon

  • *localized abd pain (over involved area)
  • report severe abd pain-could be sign of perforation-SEE PT FIRST**!! can lead to peritonitis.

Eldery pts:
-afrbrile, normal WBCs, little (if any) abd discomfort)
Loc changes.

111
Q

Etiology of diverticular disease

A

lack of fiber in diet

112
Q

nursing managment for diverticulosis

A

High fiber diet (high roughage)- fresh fruits, veg, whole grain, low refined carbs, bulk forming laxatives (metamucil)

113
Q

Nursing management for diverticuLITIS

A

Rest the colon: clear liquid diet, low fiber diet-advance to higher fiber as s/s resolve, bed rest, TPN, NGT in more severe cases,elderly should avoid kayexalate.

114
Q

home care for diverticular disease

A

high fiber diet 25-30 g/d (fresh fruites, veggies, wheat bran, whole grain cereals), stool softeners, clear liquid diet, bulk laxaties (metamucil)

115
Q

Small bowel obstruction nursing dx

A

fluid volume deficit r/t vomiting and increased capillary permeability.

metabolic alkalois r.t loss of HCL through vomiting or NGT

  • monitor urine output
  • hypokalmeia

Projectile vomiting that relieves the abd pain

116
Q

Large bowel obstruction

A

slow onset, abd distention, pain, metabolic acidosis

117
Q

lower (large) bowel obstruction

A

slow onset, abd pain, abd distention, cramping, inability to pass gas, obstipation(extreme constipation), normal temp unless peritonitis.

low slow

118
Q

high (small) bowel obstruction

A

rapid onset, frequent, copious vomiting (orange/bronw, foul smelling r/t bacteria), once resolved will be increase in hunger.

high quick

119
Q

bowel obstruciton nursing dx

A

Fluid volume deficit r/t vomiting, increase capillary permeability, decrease intestinal fluid absorption.

120
Q
A
121
Q

what to plan to do for bowel obstruction

A

normal fluid and electrolye status- monitor their urine output, U/A output should be at least 30 ml/hr

122
Q

Colorectal CA, people present with..

A

unplanned weight loss, feeling of incomplete evacuation

123
Q

manifestations of colon CA (right side)

A

weight loss, asymptomatic, iron deficiency anemia, occult bleeding (weakness and fatigue)

124
Q

manifestations of colon CA (left side)

A

unplanned weight loss, crampy, colicky abd pain, change in stool (ribbon-like), abd fullness.

if obstuction is suspected, start anIV, maintain NPO status

125
Q

surgical therapy for Colon CA

A

Rectal drains may promote wound healing

IV antibx are given pre-op to decrease the risk of post-op infection

126
Q

Illeostomy is mosy commonly used for…

A

Crohns, ulcerative colitis, and FAP (idk what that is)

remind pt that a pouch must be worn at all times

127
Q

how to properly put appliance on stoma

A

cut the wafer 1/8 to 1/16 inch larger then to stoma pattern to prevent complications,

128
Q

Descending (sigmoid) colostomy

A

stool evacutation may be regulated meaning no applaince will be needed.

129
Q

Colostomy Irrigation

A

Irrigation set and lubricant
-lubricate tip before inserting into stoma
500-1000 mL lukewarm water
hang on IV pole 18” above stoma (or about shoulder height)
Apply irrigation sleeve and place end in toilet
Clear tubing of air before instilling fluid
insert cone
allow irrifant to flow for 10-15 mins
If cramping occurs, stop the flow for a few seconds
clamp when desired amount is infused
allow 35-40 mins for solution and feces to be expelled
close off irrigation sleeve at bottom for pt ambulation
evacutation is usually complete in 10-15 mins
cleanse, rinsem and dry stoma
replace pouch

Nursing 221-222 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions