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1
Q

In Abruptio Placenta, the placenta ____ from the uterine wall ____.

A

Separates, prematurely

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2
Q

Abruptio Placenta usually occurs in (prima/multi) gravida over the age of ___.

A

Multigravida, 35 (HTN, trauma, cocaine are risk factors)

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3
Q

How is the bleeding of Abruptio Placenta different from that in Placenta Previa?

A

Usually with pain in Abruptio but not in Placenta Previa, bleeding more voluminous in Previa (the one that bleeds more has less pain; the one that bleeds less has more pain)

Abruptio- bleed less, more pain

Previa -bleeding more, less pain

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4
Q

If you are the nurse starting the IV on the client with Abruptio Placenta, what gauge needle should you use?

A

18 gauge – to give blood if necessary

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5
Q

How often should you measure the vital signs, vaginal bleeding, fetal heart rate during Abruptio Placenta?

A

q 5-15 minutes for bleeding and maternal VS

continuous fetal monitoring, deliver at earliest sign of fetal distress (vital signs every 15 minutes is standard for unstable patients)

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6
Q

How is an infant delivered when Abruptio Placenta is present?

A

Usually C-section

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7
Q

Is there a higher or lower incidence of fetal death with Abruptio Placenta compared to Placenta Previa?

A

Higher

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8
Q

In what trimester does Abruptio Placenta most commonly occur?

A

Third

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9
Q

Should vomiting be induced after ingestion of cleaning product?

A

No (when the product comes back up, it will damage the esophagus again)

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10
Q

At what age are accidental poisonings most common?

A

2 years old

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11
Q

If a child swallows a potentially poisonous substance, what should be done first?

A

Call medical help

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12
Q

Should vomiting be induced after ingestion of gasoline?

A

No – not for gas or any other petroleum products

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13
Q

When taking a child to the ER after accidental poisoning has occurred what must accompany the child to the ER?

A

The suspected poison

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14
Q

An elderly client is a (high/low) risk for accidental poisoning?

A

High – due to poor eyesight

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15
Q

What types of chemicals cause burns to oral mucosa when ingested?

A

Lye, caustic cleaners

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16
Q

Children at highest risk for seizure activity after ingestion are those who have swallowed ______ and _____.

A

Drugs & insecticides

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17
Q

Can impaired skin integrity ever be an appropriate nursing diagnosis when poisoning has occurred?

A

Yes, when lye or caustic agents have been ingested.

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18
Q

School age children are (high/low) risk for accidental poisoning.

A

High

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19
Q

What is the causative organism of acne?

A

P. acnes (propionibacterium acnes)

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20
Q

What structures are involved in Acne Vulgaris?

A

The sebaceous glands

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21
Q

Name 3 drugs given for acne

A

Vitamin A,

Antibiotics,

Retinoids- Isotretinoin (accutane)

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22
Q

Dietary indiscretions are a cause of acne (T/F)

A

False

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23
Q

What are the 3 causative factors in Acne Vulgaris?

A

Heredity, Bacterial, Hormonal

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24
Q

Uncleanliness is a cause of acne (T/F)

A

False

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25
Q

What is the most common retinoid given to people with acne?

A

Accutane

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26
Q

Accutane is an analog of which vitamin?

A

Vitamin A

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27
Q

What is the most common side effect of accutane?

A

Inflammation of the lips

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28
Q

What side effect is MOST important in health teaching in accutane administration?

A

It can cause birth defects

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29
Q

What is the antibiotic most commonly given to clients with acne?

A

Tetracycline

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30
Q

How long will it take for the person to see results when acne is being treated?

A

4 to 6 weeks

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31
Q

Does stress make acne worse?

A

Yes

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32
Q

How often should the client with acne wash his face each day?

A

Twice a day

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33
Q

What instructions do you give to a client taking tetracycline?

A

Take in on an empty stomach and avoid the sunlight (photosensitivity)

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34
Q

What are comedones?

A

Blackheads & whiteheads

35
Q

What virus causes AIDS?

A

HIV – human immunodeficiency virus

36
Q

The AIDS virus invades helper _____ ______.

A

T-lymphocytes (CD4 cells)

37
Q

AIDS is transmissible through what four routes?

A
  1. Blood,
  2. sexual contact,
  3. breast feeding,
  4. across placenta in utero.
38
Q

HIV is present in all body fluids (T/F)

A

True, BUT NOT TRANSMITTED BY ALL – ONLY BLOOD, SEMEN, AND BREAST MILK.

39
Q

Name the five risk groups for AIDS

A
  1. Homosexual/bisexual men,
  2. IV drug users,
  3. hemophiliacs,
  4. heterosexual partners of infected people,
  5. newborn children of infected women.
40
Q

What is the first test for HIV antibodies?

A

HIV-1/2 Ag/Ab combination immuno assay

41
Q

The rapid HIV test available in clincs and doctor’s offices tests what body fluid?

A

Saliva

42
Q

What tests confirm the ELISA?

A

Western Blot, IFA, PCR

43
Q

Which test is the best indicator of the progress of HIV disease?

A

The CD4 count

44
Q

A CD4 count of under ___ is associated with the onset of AIDS-related symptoms.

A

500

45
Q

Give 6 symptoms of HIV disease.

A
  1. Anorexia,
  2. fatigue,
  3. weakness,
  4. night sweats,
  5. fever,
  6. diarrhea
46
Q

Which two classes of drugs are given in combination for HIV sero-positivity?

A

NRTI’s (nucleoside reverse transcriptease inhibitors) and PI’s (protease inhibitors)

47
Q

What do these drugs do?

A

They prevent viral replication

48
Q

What does the physician hope to achieve with these drugs?

A

A delayed onset of AIDS for as long as possible (usually can delay onset for 10-15 years).

49
Q

What is the most challenging aspect of combination of drug therapy for HIV disease?

A

The number of pills that must be taken in 24 hours can be overwhelming. The frequency also makes it hard to remember – an alarm wristwatch is used.

50
Q

Clients with AIDS (gain/lose) weight?

A

Lose

51
Q

The typical pneumonia of AIDS is caused by ______ ______.

A

Pneumocystic carinii

52
Q

What type of oral/esophageal infections do AIDS patients get?

A

Candida

53
Q

What is the #1 cancer that AIDS patients get?

A

Kaposi’s sarcoma

54
Q

Kaposi’s sarcoma is a cancer of the ____.

A

Skin

55
Q

Can AIDS patients get lymphomas?

A

YES

56
Q

What lab findings are present in AIDS?

A

Decreased RBC, WBC, platelets

57
Q

If the AIDS patient has leukopenia they will be on ________ __________.

A

Protective (reverse) isolation

58
Q

Without leukopenia the AIDS patient will be on ________ precautions.

A

Standard precautions or blood and body fluid precautions

59
Q

When the AIDS patient has a low platelet count, what is indicated?

A

Bleeding precautions: No IM’s, no rectal temperatures, other bleeding precautions.

60
Q

When the AIDS patient has a low platelet count, what is indicated?

A

Bleeding precautions: No IM’s, no rectal temperatures, other bleeding precautions.

61
Q

Does AIDS require a single room?

A

Yes – if WBC counts are low

62
Q

When do you need a gown with AIDS?

A

If you are going to get contaminated with secretions.

63
Q

When do you need a mask with AIDS?

A

Not usually unless they have an infection caused by an airborne bug.

64
Q

When do you need goggles with AIDS?

A

Suctioning, central line start, arterial procedures

65
Q

If an AIDS patient’s blood contaminates a counter top, with what do you clean?

A

1:10 solution of bleach and water

66
Q

Are all articles used by AIDS patients double-bagged?

A

No – only those contaminated with secretions.

67
Q

Can AIDS patients leave the floor?

A

Yes, unless WBC’s are very low.

68
Q

Acute Glomerular nephritis is an_________ of the ________ most often due to ______.

A

Inflammation, Basement membrane of the kidney, antigen/antibody reaction.

69
Q

What is the typical description of urine with AGN?

A

Dark tea colored urine.

70
Q

What happens to the kidney in AGN?

A

It becomes clogged with antigen-antibody complexes which then cause inflammation and loss of function.

71
Q

What are the first signs of AGN?

A

Puffiness of face, dark urine

72
Q

Is dietary protein limited in AGN?

A

Not usually – however if there is severe azotemia then it may be restricted – azotemia means nitrogenous wastes in the blood – increased creatinine, BUN.

73
Q

What is the best indicator of renal function?

A

The serum creatinine (the GFR, glomerular filtration rate is actually better, but way more expensive).

74
Q

AGN has a poor prognosis (T/F)

A

False, the vast majority of all clients recover completely from it.

75
Q

How can AGN be prevented?

A

By having all sore throats cultured for strep and treating any strep infections.

76
Q

What is the most important intervention in treating AGN?

A

Bedrest – they can walk if hematuria, edema, hypertension are gone

77
Q

What is the most common dietary restriction for AGN?

A

Moderate sodium restriction. Fluid restriction is #2 if edema is severe

78
Q

What are the urinalysis findings in AGN?

A

Hematuria, usually found only in deseases ending in –itis
Proteinuria +3 to +4
Specific gravity up

79
Q

How long after strep infection does AGN develop?

A

2 to 3 weeks after initial infection

80
Q

How do you assess fluid excess in the child with AGN?

A

Daily weight

81
Q

What organism causes acute glomerular nephritis?

A

Group A beta hemolytic strep

82
Q

How often are vital sign measurements taken in AGN?

A

Q 4 hours with blood pressure

83
Q

Will the client have hypo or hyper tension with AGN? Why?

A

Hypertension, because of fluid retention

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