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AH II Exam IV Flashcards

1
Q

Traction patient teaching

A

we expect some clear drainage around pins (but not new red drainage)
traction weight should never touch the floor
if pt has mm spasms, the weight is too heavy and they need to be realigned

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2
Q

What can you do to make a cast more comfortable?

A

petaling

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3
Q

What can you do to make a cast more comfortable?

A

petaling

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4
Q

Complication of cast care

A

compartment syndrome

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5
Q

How heavy can skin traction for hip and femur fractures be?

A

5-10 lbs

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6
Q

How heavy can skeletal traction be?

A

15-30 lbs

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7
Q

What are considerations for skeletal traction?

A

it impairs patient mobility

it involves pin care

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8
Q

What are considerations for skeletal traction?

A

it impairs patient mobility

it involves pin care

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9
Q

Rheumatiod vs Osteoarthritis labs/S&S

A 
Rheumatoid: 
women 35-45, bilateral 
Sjogren's Syndrome: dry mouth, dry eyes, dry vagina 
(+) Rheumatoid arthritis (RA) factor
(+) A/A
Increased ESR

Osteo: 
women over 65, unilateral 
joint stiffness in the morning 
pain in weight bearing joints
Heberden's nodes (DIP)
Bouchard's nodes (PIP)
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10
Q

How should you position a hip fracture patient?

A

maintain ABDuction (Buck’s traction?)

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11
Q

Pt teaching for osteoarthritis (regarding a medication)

A

Glucosamine is a medication for osteoarthritis; do NOT take if you are diabetic, pregnant or breastfeeding

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12
Q

How should you position a hip replacement patient?

A

maintain ABDuction (Buck’s traction?)

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13
Q

What is a priority for a post op hip replacement patient?

A

early ambulation

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14
Q

When are abductor pillows NOT recommended after a hip replacement?

A

if the surgery was anteriorly approached (we want to avoid hyperextension of the hip)

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15
Q

When are abductor pillows NOT recommended after a hip replacement?

A

if the surgery was anteriorly approached (we want to avoid hyperextension of the hip)

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16
Q

Should a joint replacement patient increase activity?

A

not unless prescribed

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17
Q

What precautions are particularly important for a joint replacement patient?

A

bleeding precautions

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18
Q

What tx is specific to a knee replacement?

A

Continuous passive ROM device

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19
Q

Gout hallmark sign:

A

big toe pain

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20
Q

What labs must be assessed when giving allopurinol for Gout?

A

uric acid

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21
Q

Gout dx labs

A

> 6.5 mg/dL uric acid

750 mg uric acid in a 24 hour urine

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22
Q

Gout diet recommendations:

A

reduce purine (sardines, organ meats)

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23
Q

S&S of osteoporosis:

A

height loss
back pain
fractures
kyphosis

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24
Q

Risk factors for osteoporosis:

A

postmenopausal women

steroids (reduce bone density)

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25
Osteoporosis meds
fosamax*** - reduces bone breakdown Evista Boniva - c water Reclast - check creatinine Salmon calcitonin
26
Lupus S&S
Hallmark: butterfly rash Alopecia Arthritis Anemia hematuria pleural effusion raynaud's seizures
27
What aids in the diagnosis of lupus (lab)?
ANA antibodies
28
What organs does lupus affect?
kidneys skin joints
29
Lupus patient teaching
avoid crowds, wear sunglasses/hat
30
What labs will be elevated if lupus is affecting the kidney's?
creatinine and BUN
31
S&S of Lyme Disease:
Hallmark: bullseye (erythema migrans) Stage I: fatigue H/A bullseye Stage II: neuro cx lyme carditis Stage III: arthritis memory loss
32
Pt teaching for Lyme disease:
DEET up | flush the tick if you find one and wash the area with alcohol
33
S&S of fibromyalgia:
``` weeklong pain fatigue memory loss morning stiffness depression noise sensitivity ```
34
Nursing priority for fibromyalgia:
help them sleep and reduce their pain
35
Pt teaching for fibromyalgia:
avoid caffeine
36
What levels does allopurinol affect in the body?
it reduces uric acid AND blood sugar
37
What instructions should you give with allopurinol?
drink 2-3 liters of water/day
38
What should the nurse expect to find after a tick bite (NOT Lyme disease)?
bright red rash with vesicles
39
What should someone do to avoid a tick bite?
avoid dense undergrowth when in a wooded area
40
How does someone get Lupus (SLE)?
it is an autoimmune condition from genetics/hormones
41
What is a major teaching point with SLE?
they should NOT become pregnant
42
What are some considerations for Fosamax (for osteoporosis and Paget's)
take on an empty stomach 30 minutes BEFORE eating or drinking and remain upright for 30-60 minutes after they've taken it
43
What are the 4 bacterial sin infections we should know?
Folliculitis & Furuncles | Carbuncle & Cellulitis
44
What is folliculitis? S&S?
Razor burn on the thighs, beard and scalp S&S: hair may grow through the infection NO scarring
45
What are furuncles? S&S?
boils in the hair, neck and armpit - worsening of folliculitis pus filled nodules YES scarring
46
What is a carbuncle?
an abscessed furuncle (boil) involves subcutaneous tissue
47
What is cellulitis?
red/hot/painful skin caused by staph or strep infection
48
Which skin infections are viral?
``` Herpes Simplex 1&2 Herpes Zoster (Shingles) Acne Dermatitis Psoriasis ```
49
How does someone get Herpes I? Herpes II?
I - reoccurring cold sore (kissing/shared glass) | II - genital herpes (sex)
50
S&S of Herpes I vs. Herpes II?
I - lips tingling/burning | II - painful perineum and vesicles
51
How do you detect Herpes Zoster (Shingles)?
Tzanck test
52
S&S of Shingles?
unilateral pain and itching then an eruption older patients can get postthuerpetic neuralgia (burning pain with eruption)
53
S&S of Shingles?
unilateral pain and itching then an eruption along a nerve line fever malaise
54
What can older patients with Shingles get?
postthuerpetic neuralgia (burning pain with eruption)
55
How do we treat Herpes Zoster (Shingles)?
isolate the patient and keep them away from kids give Acyclovir and a chicken pox vaccine if they've never had it
56
What are the types of pediculosis (lice)?
``` Pediculosis capitis (head) Pediculosis corporis (body) Pediculosis pubis (crabs) ```
57
Who should NOT take Kwell?
pt with hx of seizures
58
Who might take Kwell?
pt with lice (pediculosis) | pt with scabies
59
How do we manage Scabies?
a contagious mite disease Kwell Elimite WASH THOSE BEDDINGS
60
How do you manage psoriasis flare ups non pharmacologically?
UV light | Vitamin D
61
How do you know you're experiencing a psoriasis flare up?
the area becomes thick
62
How can you tell if psoriasis tx is working?
- skin is thinner | - reduced scales
63
What is the hallmark sign of a basal cell carcinoma?
pearly colored with a crater
64
What skin tumor is usually malignant?
actinic keratosis
65
What is a seborrheic keratosis?
a mole that is part of the normal aging process
66
How should you assess for a malignant melanoma?
``` A - asymmetry B - border irregularity C - color changes D - diameter > 6mm E - evolution ```
67
What are the different types of glaucoma?
Open angle - most common type, gradual onset | Angle closure - sudden onset
68
S&S of glaucoma?
Open angle - slowly reduced visual field, H/A, eye itching, blurred vision Late: halos, loss of peripheral vision, glasses do NOT help Angle closure - iris moves forward and presses on cornea, SUDDEN ONSET, pain, dilated pupils, red conjunctiva
69
surgical tx of glaucoma?
1. argon laser trabeculoplasty 2. trabeculectomy - creates new outlet for fluid outflow 3. for acute closure - iridotomy to prevent scarring of the iris/cornea
70
What IS glaucoma?
increased pressure in the eyeball
71
What should you do with a pt who punctured their eye?
do not remove object, put on a protective shield
72
What should you do with a pt who spilled chemicals in their eye?
immediate eye irrigation
73
Post op care for eye surgery
1. elevate HOB | 2. avoid straining/valsalva, sneezing, coughing, lifting weights (increased IOP)
74
Post op care for cataract surgery
antibiotics/steroids as ordered eye is NOT patched Mild itching and bloodshot eyes are normal Pain and N/V is NOT normal
75
tx for conjunctivitis
hand washing antibiotic eyedrops warm compresses
76
pt eduction for conjunctivitis
prevent cross contamination | WASH YAH HANDS
77
detached retina S&S
floaters flashing lights "shooting stars"/"lighting" blurred vision
78
detached retina priority tx
protect the eye | position to decrease IOP
79
S&S of otitis media
``` pain fever drainage (any color) bulging eardrum non-permeant hearing loss ```
80
What is a consideration for an older client with cerumen ear?
reduce the pressure
81
What is a consideration for an older client with cerumen ear?
reduce the pressure
82
What are the types of hearing loss?
Conductive - physical obstruction Sensorineural - cochlea/8th cranial nerve/brain defect Mixed - profound and total
83
Post op management for hearing loss procedures:
antiseptic soaked gauze in the ear canal | pt positioned supine with operative ear facing up for 12 hours after surgery
84
Post op care for otosclerosis :
pain and anti vertigo drugs damage to cranial nerves, vertigo N/V are common
85
What surgery is related to otosclerosis?
Stapedectomy - a prosthesis that corrects hearing loss Hearing improvement may not occur until 6 weeks after surgery
86
What cranial nerve does acoustic neuroma impact? S&S? Tx?
8th (benign tumor) tinnitus vertigo hearing loss requires surgical removal
87
S&S of Meniere's Disease:
tinnitus unilateral hearing loss vertigo for several days
88
How do we fix Meniere's Disease?
nonsurgical - slow head movements, salt and fluid restrictions, stop smoking, diuretics, nicotinic acid, allergy meds, vomiting meds, benzo . surgical - last resort; labyrinthectomy or endolymphatic decompression (Meniett device) - hearing in affected ear is sacrificed most of the time
89
How is HIV transmitted?
semen blood rectal fluid
90
What should HIV/AIDs patients not share?
razors
91
What is the only test that confirms HIV (+) status?
Western blot
92
What is the diagnostic criteria for AIDS?
T cells drop below 200
93
What is the priority tx for HIV/AIDS?
prevent opportunistic infection
94
At what levels do opportunistic infections occur?
when CD4 count is less than 200
95
What is the most effective tx for preventing opportunistic infections in patients with HIV/AIDS?
antiretrovirals
96
What is the prophylactic tx of HIV?
PrEP (Truvada) daily dose SE: N/V, dizzy, H/A goal is PREVENTION NOT TX
97
What is HIV PEP?
post-exposure prophylaxis within 72 hours month long course that is not 100% effective SE: nausea most commonly used for exposed healthcare workers

ABSN (18 decks)

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