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Nursing school level 2 > 343 test 1 > Flashcards

343 test 1 Flashcards

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1
Q

urgent vs emergent

A

urgent - you need soon, emergent - need it immediately

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2
Q

types of surgery

A

laparoscopic, open, and robotic

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3
Q

reasons for surgery

A

diagnostic, curative, palliation, prevention, exploration, cosmetic

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4
Q

three phases of a perioperative patient and what is our focus in each phase

A

preoperative- teaching and education, intraoperative- safety and sterile, and postoperative- pain management and prevention of complications

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5
Q

goals for preoperative assessment

A

identify risk factors, plan care, and ensure safety

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6
Q

identifying risk factors included

A

patient interview, physical exam, and preoperative diagnostics

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7
Q

safety during preoperative assessment includes

A

surgical consent and preoperative teaching

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8
Q

3 requirements of informed consent

A

adequate disclosure of diagnosis, purpose, and risks of treatment, understanding and comprehension, and consent given voluntarily

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9
Q

nurses role during informed consent

A

advocate, witness, appropriate person signs consent

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10
Q

consent during a medical emergency

A

necessary that 2 physicians write it

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11
Q

informed consent is a

A

active, shared decision making process between provider and recipient of care

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12
Q

consent may not be signed by a patient after

A

they have received narcotics or sedatives

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13
Q

living will vs durable power of attorney

A

living will - short period of time/more emergent. durable power of attorney - can have early in illness and covers longer period of time

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14
Q

full code during surgery

A

patient is usually a full code for 24 hours following surgery

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15
Q

why is preoperative education important

A

patient satisfaction and decreased complications

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16
Q

examples of patient education

A

pain management, deep breathing, coughing, leg exercises, turning in bed

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17
Q

pre surgical screening tests

A

chest x-ray, electrocardiography, urinalysis, and labs

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18
Q

presurgical labs

A

CBC, CMP, pregnancy test, PT/INR, PTT

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19
Q

cross over food allergies of latex

A

bananas, avocado, kiwi. If you are allergic to any of these foods you have a higher likelihood of being allergic to latex

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20
Q

nursing interventions for psychological needs of surgical patients

A

establish relationship, allow patient to verbalize fears, be prepared to response to questions about surgery

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21
Q

preoperative checklist

A

document diagnostic tests, document pre-op medication given, document VS, document safety data which includes 2 identifiers, jewelry removed, last void/meal, dentures removed, informed consent verified, patient allergies

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22
Q

SCIP protocol

A

antibiotic given 1 hour before surgery, glucose level below 200, hair removal, urinary catheter, beta blocker, VTE (anticoagulation) prophylaxis, temp management ( want temp in OR normal)

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23
Q

types of anesthesia

A

general- make the pt unconscious. pt will lose the ability to breath so they need to be intubated, regional-nerve block so can’t feel specific place, local- numbing, conscious sedation- asleep and able to breath on own

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24
Q

phases of general anesthesia

A

induction, maintenance, emergence

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25
Q

spinal regional anesthesia

A

faster, ANS blocked, used in procedures involving lower ABD, groin, and lower extremities

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26
Q

epidural regional anesthesia

A

similar level of pain relief as spinal, less incidence, minimal ANS blockage, used in procedures involving lower extremities, can be used for post op pain control

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27
Q

anesthetic medication classes

A

opioid, benzodiazepines, neuromuscular blocking agents, inhalation anesthesia

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28
Q

anesthetic complications

A

anaphylactic reactions from anesthesia or latex and malignant hyperthermia

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29
Q

malignant hyperthermia

A

problem with receptor on skeletal muscle causing major metabolic reaction. familial history important

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30
Q

malignant hyperthermia signs and symptoms

A

lactic acidosis, muscle contracture, hyperthermia. is important to identify early

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31
Q

malignant hyperthermia treatment

A

dantrolene - directly interferes with muscle contraction by inhibiting ion release from the sarcoplasmic reticulum

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32
Q

nurses job in the OR

A

universal protocol “time out”, maintenance of sterile technique, patient monitoring, instrument and sponge count

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33
Q

important to do what when receiving a postop patient

A

assess!

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34
Q

things to assess on postop patients

A

VS, ECG, color, consciousness, fluids, comfort, position

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35
Q

common postoperative complications with GI/urinary

A

N/V/D and constipation

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36
Q

common postoperative complications with skin

A

burns and breakdown

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37
Q

common postoperative complications with respiratory

A

most common is atelectasis, pulmonary edema, aspiration, bronchospasm, hypoventilation, airway obstruction, pneumonia, hypoxemia

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38
Q

what interventions can the nurse implement to prevent respiratory complications

A

deep breathing, coughing, incentive spirometer, turning in bed, lateral “recovery” position

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39
Q

nursing diagnosis for respiratory

A

ineffective airway clearance, ineffective breathing pattern, impaired gas exchange

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40
Q

what interventions can the nurse implement to prevent cardio vascular complications

A

monitor VS, ECG monitoring, apply O2, monitory I&Os through urine output

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41
Q

intervention to prevent deep vein thrombosis

A

getting out of bed early and often, change positions, compression boots, prophylactic heparin

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42
Q

common postoperative complications with CV

A

DVT, VTE, PE, shock

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43
Q

what measures can be taken to prevent SSI

A

prophylactic antibiotics, hair removal, glycemic control, maintaining drainage devices

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44
Q

A nurse is caring for a client who arrived in the PACU following a hysterectomy. The patient is not responding to verbal stimuli. Which of the following actions should the nurse perform first?

A

place the pt in a lateral position

45
Q

A nursing is caring for a patient who reports a headache following a spinal anesthetic. What is an appropriate nursing action?

A

increase pt’s fluid intake and lie them flat

46
Q

lower UTI

A

cystitis and urethritis

47
Q

upper uti

A

pyelonephritis

48
Q

urinary tract is ____ above the urethra

A

sterile

49
Q

what does it mean by pathogens will enter in an ascending or descending manner during a UTI

A

pathogens will enter via perineal or via bloodstream

50
Q

infections (UTI) can be …

A

simple or complex and upper or lower UTI

51
Q

risk factors for UTIs

A

inability to empty bladder, obstruction to flow, immunosuppression, inflammation, contributing conditions, instrumentation

52
Q

treatment for UTI

A

antibiotic, increase fluid intake, and prevention

53
Q

treatment for UTI

A

antibiotic, increase fluid intake, and prevention

54
Q

symptoms of cystitis

A

frequency, urgency, suprapubic pain, dysuria, fever, confusion in older adults

55
Q

pyelonephritis symptoms

A

flank pain, dysuria, fatigue/malaise, chills, fever, vomiting

56
Q

dipstick urinalysis with presence of nitrates

A

indicated bacteriuria

57
Q

dipstick urinalysis with blood

A

infection

58
Q

dipstick urinalysis with ketones

A

dehydrated or DM

59
Q

patient teaching during UTI

A

avoid caffeine, alcohol, and carbonation, increase fluid intake, avoid powder, sprays, and baths, cranberry juice, and urinate frequently

60
Q

what percent of hospital acquired infections are from indwelling catheters

A

36%

61
Q

prevention of UTI

A

avoid unnecessary catheters, insertion of urinary catheter using aseptic technique, maintenance of catheter, review daily need of catheter, prompt removal when not needed anymore, provide perineal care once or twice a day

62
Q

UTI in a patient with an indwelling catheter _________ of discontinuation of catheter

A

within 2 days

63
Q

indications for catheter

A

acute urinary retention obstruction, Perioperative use in selected surgeries, Assist healing of perineal and sacral wounds in incontinent patients, Hospice/palliative/comfort care, Required immobilization from trauma or surgery, Chronic indwelling catheter on admission, Accurate measurement of urine output in critically ill patients in ICU

64
Q

alternative to catheter

A

condom catheter or intermittent catheterization

65
Q

acute pyelonephritis

A

upper UTI - upward or downward spread

66
Q

what is acute pyelonephritis

A

inflammation of the renal parenchyma and collecting system. upward or downward spread

67
Q

chronic pyelonephritis

A

repeated acute and may precipitate chronic kidney disease

68
Q

diagnostic test of pyelonephritis

A

elevated WC with increase in bands, leukocytes and WBC in urine (pyuria), positive urine cultures, positive blood cultures in bacteremia

69
Q

glomerulonephritis

A

inflammation of the glomerular capillaries. affects both kidneys equally. can be acute or chronic.

70
Q

what is the third leading cause of ESRD in the US

A

glomerulonephritis

71
Q

ESRD

A

end-stage renal disease (ESRD)

72
Q

glomerulonephritis signs and symptoms

A

fever, anorexia, N/V, malaise, increased BUN and creatinine because decreased creatinine clearance, HTN, hematuria with RBC, proteinuria

73
Q

proteinuria

A

protein in urine

74
Q

hematuria

A

blood in urine

75
Q

causes of acute glomerulonephritis

A

streptococcal infections (strep throat) group A beta hemolytic strep, viral infection, impetigo, lupus, good pastures syndrome, Wegener’s disease

76
Q

causes of chronic glomerulonephritis

A

familial, immune system, following an acute attack, disease that scar the glomeruli like DM, HTN, and hyperlipidemia

77
Q

therapeutic management of glomerulonephritis

A

focuses on symptomatic management - antibiotics, protein and fluid restriction, bedrest, monitors I&Os, plasmapheresis, dialysis

78
Q

plasmapheresis

A

removal of harmful antibodies from the plasma

79
Q

what happens when glomerulus becomes permeable to plasma protein

A

proteinuria and low plasma albumen which all results in profound tissue edema

80
Q

nephrotic syndrome

A

glomerulus becomes permeable to plasma protein

81
Q

management of nephrotic syndrome

A

corticosteroids, control of DM, sodium restrictions and diuretics to control edema, and sure primary disease

82
Q

risk factors to renal calculi

A

warm climates, sedentary occupation/lifestyle, conditions that result in increased calcium, diet high in protein, previous stones

83
Q

renal calculi symptoms

A

depend on presence of obstruction, infection, and edema but minor to excruciating paining most commmon

84
Q

common site of obstruction in renal calculi

A

UPJ (uretropelvic junction) where the renal pelvis narrows into the ureter or the UVJ (uretrovesical junction)

85
Q

treatment of renal calculi

A

treat pain first then infection/obstruction, wait for stones to pass, climax or hytrin to relax smooth muscle

86
Q

Lithotripsy

A

most common treatment for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment

87
Q

percutaneous nephrolithotomy

A

minimally-invasive procedure to remove stones from the kidney by a small puncture wound through the skin

88
Q

pyelolithitomy

A

surgical incision of the renal pelvis of a kidney for removal of a kidney stone.

89
Q

renal calculi teaching

A

drink 2000-3000 mL of fluid daily, lower protein intake, limit soda, coffee, and tea, less than 2 g sodium per day, avoid sudden increase in temp, avoid oxalate/purine containing foods, strain all urine

90
Q

urinary diversion

A

Bladder is removed or the normal structures are bypassed via an opening in the urinary system to divert urine.

91
Q

reasons for urinary diversion

A 
Bladder tumor
Pelvic malignancy
Trauma 
Birth defects
Neurogenic bladder
Infections
92
Q

ureterostomy

A

creation of a stoma for a ureter or kidney. The procedure is performed to divert the flow of urine away from the bladder

93
Q

ileal conduit

A

a system of urinary drainage which a surgeon creates using the small intestine after removing the bladder

94
Q

Indiana pouch

A

ileal urinary reservoir in which the patient self catheterizes every 4-6 hours to empty it. no bag needed

95
Q

Nephrostomy

A

a small tube inserted through the skin directly into a kidney. The nephrostomy tube drains urine from the kidney into an external drainage pouch. this is only temporary

96
Q

patient teaching for urinary diversion

A

Changing the appliance
Controlling odor
Cleaning and deodorizing appliance
Importance of follow up care

97
Q

BPH

A

benign prostatic hyperplasia

98
Q

signs and symptoms of BPH

A

FUN - frequency, urgency, and nocturia

hematuria, increased infection, decreased urinary stream, and residual urine

99
Q

diagnostics for BPH

A

DRE and PSA test

100
Q

treatment for BPH

A

TURP

101
Q

prostate cancer diagnostics/screening

A

DRE, PSA test, and TRUS

102
Q

cystitis

A

bladder UTI

103
Q

urethritis

A

urethra UTI

104
Q

normal potassium levels

A

3.5-5

105
Q

normal sodium levels

A

135-145

106
Q

normal calcium levels

A

8.6-10.2

107
Q

ill conduit

A

ureters are connected to a segment of a small intestine which leads to an opening (stoma) in the abdomen and attaches to an stony bag

108
Q

stony bag needs to be changed

A

every 3-4 days

Nursing school level 2 (15 decks)

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