A Flashcards
In Abruptio Placenta, the placenta ____ from the uterine wall ____.
Separates, prematurely
Abruptio Placenta usually occurs in (prima/multi) gravida over the age of ___.
Multigravida, 35 (HTN, trauma, cocaine are risk factors)
How is the bleeding of Abruptio Placenta different from that in Placenta Previa?
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
If you are the nurse starting the IV on the client with Abruptio Placenta, what gauge needle should you use?
18 gauge – to give blood if necessary
How often should you measure the vital signs, vaginal bleeding, fetal heart rate during Abruptio Placenta?
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)
How is an infant delivered when Abruptio Placenta is present?
Usually C-section
Is there a higher or lower incidence of fetal death with Abruptio Placenta compared to Placenta Previa?
Higher
In what trimester does Abruptio Placenta most commonly occur?
Third
Should vomiting be induced after ingestion of cleaning product?
No (when the product comes back up, it will damage the esophagus again)
At what age are accidental poisonings most common?
2 years old
If a child swallows a potentially poisonous substance, what should be done first?
Call medical help
Should vomiting be induced after ingestion of gasoline?
No – not for gas or any other petroleum products
When taking a child to the ER after accidental poisoning has occurred what must accompany the child to the ER?
The suspected poison
An elderly client is a (high/low) risk for accidental poisoning?
High – due to poor eyesight
What types of chemicals cause burns to oral mucosa when ingested?
Lye, caustic cleaners
Children at highest risk for seizure activity after ingestion are those who have swallowed ______ and _____.
Drugs & insecticides
Can impaired skin integrity ever be an appropriate nursing diagnosis when poisoning has occurred?
Yes, when lye or caustic agents have been ingested.
School age children are (high/low) risk for accidental poisoning.
High
What is the causative organism of acne?
P. acnes (propionibacterium acnes)
What structures are involved in Acne Vulgaris?
The sebaceous glands
Name 3 drugs given for acne
Vitamin A,
Antibiotics,
Retinoids- Isotretinoin (accutane)
Dietary indiscretions are a cause of acne (T/F)
False
What are the 3 causative factors in Acne Vulgaris?
Heredity, Bacterial, Hormonal
Uncleanliness is a cause of acne (T/F)
False
What is the most common retinoid given to people with acne?
Accutane
Accutane is an analog of which vitamin?
Vitamin A
What is the most common side effect of accutane?
Inflammation of the lips
What side effect is MOST important in health teaching in accutane administration?
It can cause birth defects
What is the antibiotic most commonly given to clients with acne?
Tetracycline
How long will it take for the person to see results when acne is being treated?
4 to 6 weeks
Does stress make acne worse?
Yes
How often should the client with acne wash his face each day?
Twice a day
What instructions do you give to a client taking tetracycline?
Take in on an empty stomach and avoid the sunlight (photosensitivity)
What are comedones?
Blackheads & whiteheads
What virus causes AIDS?
HIV – human immunodeficiency virus
The AIDS virus invades helper _____ ______.
T-lymphocytes (CD4 cells)
AIDS is transmissible through what four routes?
- Blood,
- sexual contact,
- breast feeding,
- across placenta in utero.
HIV is present in all body fluids (T/F)
True, BUT NOT TRANSMITTED BY ALL – ONLY BLOOD, SEMEN, AND BREAST MILK.
Name the five risk groups for AIDS
- Homosexual/bisexual men,
- IV drug users,
- hemophiliacs,
- heterosexual partners of infected people,
- newborn children of infected women.
What is the first test for HIV antibodies?
HIV-1/2 Ag/Ab combination immuno assay
The rapid HIV test available in clincs and doctor’s offices tests what body fluid?
Saliva
What tests confirm the ELISA?
Western Blot, IFA, PCR
Which test is the best indicator of the progress of HIV disease?
The CD4 count
A CD4 count of under ___ is associated with the onset of AIDS-related symptoms.
500
Give 6 symptoms of HIV disease.
- Anorexia,
- fatigue,
- weakness,
- night sweats,
- fever,
- diarrhea
Which two classes of drugs are given in combination for HIV sero-positivity?
NRTI’s (nucleoside reverse transcriptease inhibitors) and PI’s (protease inhibitors)
What do these drugs do?
They prevent viral replication
What does the physician hope to achieve with these drugs?
A delayed onset of AIDS for as long as possible (usually can delay onset for 10-15 years).
What is the most challenging aspect of combination of drug therapy for HIV disease?
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.
Clients with AIDS (gain/lose) weight?
Lose
The typical pneumonia of AIDS is caused by ______ ______.
Pneumocystic carinii
What type of oral/esophageal infections do AIDS patients get?
Candida
What is the #1 cancer that AIDS patients get?
Kaposi’s sarcoma
Kaposi’s sarcoma is a cancer of the ____.
Skin
Can AIDS patients get lymphomas?
YES
What lab findings are present in AIDS?
Decreased RBC, WBC, platelets
If the AIDS patient has leukopenia they will be on ________ __________.
Protective (reverse) isolation
Without leukopenia the AIDS patient will be on ________ precautions.
Standard precautions or blood and body fluid precautions
When the AIDS patient has a low platelet count, what is indicated?
Bleeding precautions: No IM’s, no rectal temperatures, other bleeding precautions.
When the AIDS patient has a low platelet count, what is indicated?
Bleeding precautions: No IM’s, no rectal temperatures, other bleeding precautions.
Does AIDS require a single room?
Yes – if WBC counts are low
When do you need a gown with AIDS?
If you are going to get contaminated with secretions.
When do you need a mask with AIDS?
Not usually unless they have an infection caused by an airborne bug.
When do you need goggles with AIDS?
Suctioning, central line start, arterial procedures
If an AIDS patient’s blood contaminates a counter top, with what do you clean?
1:10 solution of bleach and water
Are all articles used by AIDS patients double-bagged?
No – only those contaminated with secretions.
Can AIDS patients leave the floor?
Yes, unless WBC’s are very low.
Acute Glomerular nephritis is an_________ of the ________ most often due to ______.
Inflammation, Basement membrane of the kidney, antigen/antibody reaction.
What is the typical description of urine with AGN?
Dark tea colored urine.
What happens to the kidney in AGN?
It becomes clogged with antigen-antibody complexes which then cause inflammation and loss of function.
What are the first signs of AGN?
Puffiness of face, dark urine
Is dietary protein limited in AGN?
Not usually – however if there is severe azotemia then it may be restricted – azotemia means nitrogenous wastes in the blood – increased creatinine, BUN.
What is the best indicator of renal function?
The serum creatinine (the GFR, glomerular filtration rate is actually better, but way more expensive).
AGN has a poor prognosis (T/F)
False, the vast majority of all clients recover completely from it.
How can AGN be prevented?
By having all sore throats cultured for strep and treating any strep infections.
What is the most important intervention in treating AGN?
Bedrest – they can walk if hematuria, edema, hypertension are gone
What is the most common dietary restriction for AGN?
Moderate sodium restriction. Fluid restriction is #2 if edema is severe
What are the urinalysis findings in AGN?
Hematuria, usually found only in deseases ending in –itis
Proteinuria +3 to +4
Specific gravity up
How long after strep infection does AGN develop?
2 to 3 weeks after initial infection
How do you assess fluid excess in the child with AGN?
Daily weight
What organism causes acute glomerular nephritis?
Group A beta hemolytic strep
How often are vital sign measurements taken in AGN?
Q 4 hours with blood pressure
Will the client have hypo or hyper tension with AGN? Why?
Hypertension, because of fluid retention
