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Nursing school level 2 > 343 test 1 > Flashcards

343 test 1 Flashcards

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
spinal regional anesthesia
faster, ANS blocked, used in procedures involving lower ABD, groin, and lower extremities
26
epidural regional anesthesia
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
27
anesthetic medication classes
opioid, benzodiazepines, neuromuscular blocking agents, inhalation anesthesia
28
anesthetic complications
anaphylactic reactions from anesthesia or latex and malignant hyperthermia
29
malignant hyperthermia
problem with receptor on skeletal muscle causing major metabolic reaction. familial history important
30
malignant hyperthermia signs and symptoms
lactic acidosis, muscle contracture, hyperthermia. is important to identify early
31
malignant hyperthermia treatment
dantrolene - directly interferes with muscle contraction by inhibiting ion release from the sarcoplasmic reticulum
32
nurses job in the OR
universal protocol "time out", maintenance of sterile technique, patient monitoring, instrument and sponge count
33
important to do what when receiving a postop patient
assess!
34
things to assess on postop patients
VS, ECG, color, consciousness, fluids, comfort, position
35
common postoperative complications with GI/urinary
N/V/D and constipation
36
common postoperative complications with skin
burns and breakdown
37
common postoperative complications with respiratory
most common is atelectasis, pulmonary edema, aspiration, bronchospasm, hypoventilation, airway obstruction, pneumonia, hypoxemia
38
what interventions can the nurse implement to prevent respiratory complications
deep breathing, coughing, incentive spirometer, turning in bed, lateral "recovery" position
39
nursing diagnosis for respiratory
ineffective airway clearance, ineffective breathing pattern, impaired gas exchange
40
what interventions can the nurse implement to prevent cardio vascular complications
monitor VS, ECG monitoring, apply O2, monitory I&Os through urine output
41
intervention to prevent deep vein thrombosis
getting out of bed early and often, change positions, compression boots, prophylactic heparin
42
common postoperative complications with CV
DVT, VTE, PE, shock
43
what measures can be taken to prevent SSI
prophylactic antibiotics, hair removal, glycemic control, maintaining drainage devices
44
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?
place the pt in a lateral position
45
A nursing is caring for a patient who reports a headache following a spinal anesthetic. What is an appropriate nursing action?
increase pt's fluid intake and lie them flat
46
lower UTI
cystitis and urethritis
47
upper uti
pyelonephritis
48
urinary tract is ____ above the urethra
sterile
49
what does it mean by pathogens will enter in an ascending or descending manner during a UTI
pathogens will enter via perineal or via bloodstream
50
infections (UTI) can be ...
simple or complex and upper or lower UTI
51
risk factors for UTIs
inability to empty bladder, obstruction to flow, immunosuppression, inflammation, contributing conditions, instrumentation
52
treatment for UTI
antibiotic, increase fluid intake, and prevention
53
treatment for UTI
antibiotic, increase fluid intake, and prevention
54
symptoms of cystitis
frequency, urgency, suprapubic pain, dysuria, fever, confusion in older adults
55
pyelonephritis symptoms
flank pain, dysuria, fatigue/malaise, chills, fever, vomiting
56
dipstick urinalysis with presence of nitrates
indicated bacteriuria
57
dipstick urinalysis with blood
infection
58
dipstick urinalysis with ketones
dehydrated or DM
59
patient teaching during UTI
avoid caffeine, alcohol, and carbonation, increase fluid intake, avoid powder, sprays, and baths, cranberry juice, and urinate frequently
60
what percent of hospital acquired infections are from indwelling catheters
36%
61
prevention of UTI
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
UTI in a patient with an indwelling catheter _________ of discontinuation of catheter
within 2 days
63
indications for catheter
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
alternative to catheter
condom catheter or intermittent catheterization
65
acute pyelonephritis
upper UTI - upward or downward spread
66
what is acute pyelonephritis
inflammation of the renal parenchyma and collecting system. upward or downward spread
67
chronic pyelonephritis
repeated acute and may precipitate chronic kidney disease
68
diagnostic test of pyelonephritis
elevated WC with increase in bands, leukocytes and WBC in urine (pyuria), positive urine cultures, positive blood cultures in bacteremia
69
glomerulonephritis
inflammation of the glomerular capillaries. affects both kidneys equally. can be acute or chronic.
70
what is the third leading cause of ESRD in the US
glomerulonephritis
71
ESRD
end-stage renal disease (ESRD)
72
glomerulonephritis signs and symptoms
fever, anorexia, N/V, malaise, increased BUN and creatinine because decreased creatinine clearance, HTN, hematuria with RBC, proteinuria
73
proteinuria
protein in urine
74
hematuria
blood in urine
75
causes of acute glomerulonephritis
streptococcal infections (strep throat) group A beta hemolytic strep, viral infection, impetigo, lupus, good pastures syndrome, Wegener's disease
76
causes of chronic glomerulonephritis
familial, immune system, following an acute attack, disease that scar the glomeruli like DM, HTN, and hyperlipidemia
77
therapeutic management of glomerulonephritis
focuses on symptomatic management - antibiotics, protein and fluid restriction, bedrest, monitors I&Os, plasmapheresis, dialysis
78
plasmapheresis
removal of harmful antibodies from the plasma
79
what happens when glomerulus becomes permeable to plasma protein
proteinuria and low plasma albumen which all results in profound tissue edema
80
nephrotic syndrome
glomerulus becomes permeable to plasma protein
81
management of nephrotic syndrome
corticosteroids, control of DM, sodium restrictions and diuretics to control edema, and sure primary disease
82
risk factors to renal calculi
warm climates, sedentary occupation/lifestyle, conditions that result in increased calcium, diet high in protein, previous stones
83
renal calculi symptoms
depend on presence of obstruction, infection, and edema but minor to excruciating paining most commmon
84
common site of obstruction in renal calculi
UPJ (uretropelvic junction) where the renal pelvis narrows into the ureter or the UVJ (uretrovesical junction)
85
treatment of renal calculi
treat pain first then infection/obstruction, wait for stones to pass, climax or hytrin to relax smooth muscle
86
Lithotripsy
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
percutaneous nephrolithotomy
minimally-invasive procedure to remove stones from the kidney by a small puncture wound through the skin
88
pyelolithitomy
surgical incision of the renal pelvis of a kidney for removal of a kidney stone.
89
renal calculi teaching
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
urinary diversion
Bladder is removed or the normal structures are bypassed via an opening in the urinary system to divert urine.
91
reasons for urinary diversion
``` Bladder tumor Pelvic malignancy Trauma Birth defects Neurogenic bladder Infections ```
92
ureterostomy
creation of a stoma for a ureter or kidney. The procedure is performed to divert the flow of urine away from the bladder
93
ileal conduit
a system of urinary drainage which a surgeon creates using the small intestine after removing the bladder
94
Indiana pouch
ileal urinary reservoir in which the patient self catheterizes every 4-6 hours to empty it. no bag needed
95
Nephrostomy
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
patient teaching for urinary diversion
Changing the appliance Controlling odor Cleaning and deodorizing appliance Importance of follow up care
97
BPH
benign prostatic hyperplasia
98
signs and symptoms of BPH
FUN - frequency, urgency, and nocturia | hematuria, increased infection, decreased urinary stream, and residual urine
99
diagnostics for BPH
DRE and PSA test
100
treatment for BPH
TURP
101
prostate cancer diagnostics/screening
DRE, PSA test, and TRUS
102
cystitis
bladder UTI
103
urethritis
urethra UTI
104
normal potassium levels
3.5-5
105
normal sodium levels
135-145
106
normal calcium levels
8.6-10.2
107
ill conduit
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
stony bag needs to be changed
every 3-4 days

Nursing school level 2 (15 decks)

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