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ABSN > AH II Exam IV > Flashcards

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
Q

Osteoporosis meds

A

fosamax*** - reduces bone breakdown

Evista
Boniva - c water
Reclast - check creatinine
Salmon calcitonin

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26
Q

Lupus S&S

A

Hallmark: butterfly rash

Alopecia
Arthritis
Anemia

hematuria
pleural effusion
raynaud’s
seizures

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27
Q

What aids in the diagnosis of lupus (lab)?

A

ANA antibodies

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28
Q

What organs does lupus affect?

A

kidneys
skin
joints

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29
Q

Lupus patient teaching

A

avoid crowds, wear sunglasses/hat

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30
Q

What labs will be elevated if lupus is affecting the kidney’s?

A

creatinine and BUN

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31
Q

S&S of Lyme Disease:

A

Hallmark: bullseye (erythema migrans)

Stage I:
fatigue
H/A
bullseye

Stage II:
neuro cx
lyme carditis

Stage III:
arthritis
memory loss

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32
Q

Pt teaching for Lyme disease:

A

DEET up

flush the tick if you find one and wash the area with alcohol

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33
Q

S&S of fibromyalgia:

A 
weeklong pain
fatigue
memory loss
morning stiffness
depression 
noise sensitivity
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34
Q

Nursing priority for fibromyalgia:

A

help them sleep and reduce their pain

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35
Q

Pt teaching for fibromyalgia:

A

avoid caffeine

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36
Q

What levels does allopurinol affect in the body?

A

it reduces uric acid AND blood sugar

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37
Q

What instructions should you give with allopurinol?

A

drink 2-3 liters of water/day

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38
Q

What should the nurse expect to find after a tick bite (NOT Lyme disease)?

A

bright red rash with vesicles

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39
Q

What should someone do to avoid a tick bite?

A

avoid dense undergrowth when in a wooded area

40
Q

How does someone get Lupus (SLE)?

A

it is an autoimmune condition from genetics/hormones

41
Q

What is a major teaching point with SLE?

A

they should NOT become pregnant

42
Q

What are some considerations for Fosamax (for osteoporosis and Paget’s)

A

take on an empty stomach 30 minutes BEFORE eating or drinking and remain upright for 30-60 minutes after they’ve taken it

43
Q

What are the 4 bacterial sin infections we should know?

A

Folliculitis & Furuncles

Carbuncle & Cellulitis

44
Q

What is folliculitis? S&S?

A

Razor burn on the thighs, beard and scalp

S&S: hair may grow through the infection
NO scarring

45
Q

What are furuncles? S&S?

A

boils in the hair, neck and armpit - worsening of folliculitis

pus filled nodules
YES scarring

46
Q

What is a carbuncle?

A

an abscessed furuncle (boil)

involves subcutaneous tissue

47
Q

What is cellulitis?

A

red/hot/painful skin caused by staph or strep infection

48
Q

Which skin infections are viral?

A 
Herpes Simplex 1&2
Herpes Zoster (Shingles)
Acne
Dermatitis
Psoriasis
49
Q

How does someone get Herpes I? Herpes II?

A

I - reoccurring cold sore (kissing/shared glass)

II - genital herpes (sex)

50
Q

S&S of Herpes I vs. Herpes II?

A

I - lips tingling/burning

II - painful perineum and vesicles

51
Q

How do you detect Herpes Zoster (Shingles)?

A

Tzanck test

52
Q

S&S of Shingles?

A

unilateral pain and itching then an eruption

older patients can get postthuerpetic neuralgia (burning pain with eruption)

53
Q

S&S of Shingles?

A

unilateral pain and itching then an eruption along a nerve line
fever
malaise

54
Q

What can older patients with Shingles get?

A

postthuerpetic neuralgia (burning pain with eruption)

55
Q

How do we treat Herpes Zoster (Shingles)?

A

isolate the patient and keep them away from kids

give Acyclovir and a chicken pox vaccine if they’ve never had it

56
Q

What are the types of pediculosis (lice)?

A 
Pediculosis capitis (head)
Pediculosis corporis (body)
Pediculosis pubis (crabs)
57
Q

Who should NOT take Kwell?

A

pt with hx of seizures

58
Q

Who might take Kwell?

A

pt with lice (pediculosis)

pt with scabies

59
Q

How do we manage Scabies?

A

a contagious mite disease

Kwell
Elimite

WASH THOSE BEDDINGS

60
Q

How do you manage psoriasis flare ups non pharmacologically?

A

UV light

Vitamin D

61
Q

How do you know you’re experiencing a psoriasis flare up?

A

the area becomes thick

62
Q

How can you tell if psoriasis tx is working?

A
  • skin is thinner

- reduced scales

63
Q

What is the hallmark sign of a basal cell carcinoma?

A

pearly colored with a crater

64
Q

What skin tumor is usually malignant?

A

actinic keratosis

65
Q

What is a seborrheic keratosis?

A

a mole that is part of the normal aging process

66
Q

How should you assess for a malignant melanoma?

A 
A - asymmetry 
B - border irregularity 
C - color changes 
D - diameter > 6mm
E - evolution
67
Q

What are the different types of glaucoma?

A

Open angle - most common type, gradual onset

Angle closure - sudden onset

68
Q

S&S of glaucoma?

A

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
Q

surgical tx of glaucoma?

A
  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
Q

What IS glaucoma?

A

increased pressure in the eyeball

71
Q

What should you do with a pt who punctured their eye?

A

do not remove object, put on a protective shield

72
Q

What should you do with a pt who spilled chemicals in their eye?

A

immediate eye irrigation

73
Q

Post op care for eye surgery

A
  1. elevate HOB

2. avoid straining/valsalva, sneezing, coughing, lifting weights (increased IOP)

74
Q

Post op care for cataract surgery

A

antibiotics/steroids as ordered
eye is NOT patched

Mild itching and bloodshot eyes are normal

Pain and N/V is NOT normal

75
Q

tx for conjunctivitis

A

hand washing
antibiotic eyedrops
warm compresses

76
Q

pt eduction for conjunctivitis

A

prevent cross contamination

WASH YAH HANDS

77
Q

detached retina S&S

A

floaters
flashing lights “shooting stars”/”lighting”
blurred vision

78
Q

detached retina priority tx

A

protect the eye

position to decrease IOP

79
Q

S&S of otitis media

A 
pain
fever
drainage (any color)
bulging eardrum
non-permeant hearing loss
80
Q

What is a consideration for an older client with cerumen ear?

A

reduce the pressure

81
Q

What is a consideration for an older client with cerumen ear?

A

reduce the pressure

82
Q

What are the types of hearing loss?

A

Conductive - physical obstruction
Sensorineural - cochlea/8th cranial nerve/brain defect
Mixed - profound and total

83
Q

Post op management for hearing loss procedures:

A

antiseptic soaked gauze in the ear canal

pt positioned supine with operative ear facing up for 12 hours after surgery

84
Q

Post op care for otosclerosis :

A

pain and anti vertigo drugs

damage to cranial nerves, vertigo N/V are common

85
Q

What surgery is related to otosclerosis?

A

Stapedectomy - a prosthesis that corrects hearing loss

Hearing improvement may not occur until 6 weeks after surgery

86
Q

What cranial nerve does acoustic neuroma impact? S&S? Tx?

A

8th (benign tumor)

tinnitus
vertigo
hearing loss

requires surgical removal

87
Q

S&S of Meniere’s Disease:

A

tinnitus
unilateral hearing loss
vertigo for several days

88
Q

How do we fix Meniere’s Disease?

A

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
Q

How is HIV transmitted?

A

semen
blood
rectal fluid

90
Q

What should HIV/AIDs patients not share?

A

razors

91
Q

What is the only test that confirms HIV (+) status?

A

Western blot

92
Q

What is the diagnostic criteria for AIDS?

A

T cells drop below 200

93
Q

What is the priority tx for HIV/AIDS?

A

prevent opportunistic infection

94
Q

At what levels do opportunistic infections occur?

A

when CD4 count is less than 200

95
Q

What is the most effective tx for preventing opportunistic infections in patients with HIV/AIDS?

A

antiretrovirals

96
Q

What is the prophylactic tx of HIV?

A

PrEP (Truvada)
daily dose
SE: N/V, dizzy, H/A
goal is PREVENTION NOT TX

97
Q

What is HIV PEP?

A

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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