BIG exam 1 topics

Question 1

Stage 1

Answer 1

skin intact

Question 2

Stage 2

Answer 2

skin not intact, no bruising, possible fluid filled blister

Question 3

Stage 3

Answer 3

positive brusing, no m/b/t exposed

Question 4

Stage 4

Answer 4

m/b/t exposed, positive brusing

Question 5

REEDA

Answer 5

Redness
Edema
Echymosis
Drainage
Approximation

Question 6

COCA

Answer 6

Color
Odor
Consistancy
Amount

Question 7

Dehiscence

Answer 7

“incision split”
Risk - above 30, steriods, diabetes, obesity, immune deficency, malnutrition

Question 8

Evisceration

Answer 8

total seperation, organs coming out
cover w sterile 4x4 guaze, call md, stay w pt

Question 9

Purulent (PROBLEM)

Answer 9

creamy yellow pus - staph
greenish/blue “fruity odor” - pseudomonas
beige “fishy” proteus
brown - fecal aerobic

Question 10

Sanguineous

Answer 10

bloody (immediate after surgery)

Question 11

Serosanguineous

Answer 11

yellowish mixed with light red, pale pink

Question 12

serous

Answer 12

serum like or yellow

Question 13

Pruitus

Answer 13

itching
avoid itching r/t breaking skin and getting another infection
tx - cooling agents (ice packs)

Question 14

Urticaria

Answer 14

hives
white/red edamatous papules/wheals
tx - antihistamine (AVOID ALCOHOL r/t CNS stimulant)

Question 15

Psoriasis

Answer 15

autoimmune, genetic
flaky/scaly plaques
avoid tanning beds
D/C biologic agents in fever/sore throat/sickness, call MD STAT

Question 16

Cellulitis

Answer 16

warn, tender, painful, swollen, red, edema, LYMPH EDEMA
warm compress

Question 17

Clubbing is r/t

Answer 17

copd, hypoxia, HD pts, lung cancer
edema/spongy when palpated

Question 18

Spoon like is r/t

Answer 18

anemia, IRON DEFICENCY, diabetes
flat/curved nail plate

Question 19

Skin Cancer

Answer 19

Asymmetry one half unlike the other
Border irregular
Color aries
Diameter (LESS THAN 6CM)
Evolving looks differernt from rest
Body mole map - monthly, complete before getting in shower

Question 20

Parasitic Disorders

Answer 20

DISINFECT WITH HOT WATER AND DETERGENT

Question 21

Informed Consent

Answer 21

Nurse gets pt to sign
Nurse can witness
SURGEON HAS TO DO TEACHING
Blind - sign, x2 witness
Cant write - “x” x2 witness
Language/hearing impairment - qualified translator, x2 witness

Question 22

PRE SURGERY

Answer 22

Shower/bath with chlorhexadine

Question 23

Decrease DVT by

Answer 23

enoxaparin day 1 post op
sequential stockings RIGHT before surgery
early ambulation

Question 24

Inflammation

Answer 24

doesnt mean there is always a POSITIVE infection
Neutrophils increased? infection process

Question 25

Hand Hygiene

Answer 25

15-30sec

Question 26

Surgical asepsis

Answer 26

3-5minutes

Question 27

CDIFF

Answer 27

contact

Question 28

MRSA/VRE

Answer 28

contact

Question 29

Pediculosis (lice)

Answer 29

contact

Question 30

RSV

Answer 30

contact

Question 31

scabies

Answer 31

contact

Question 32

diptheria

Answer 32

droplet

Question 33

streptococcyl pharngitis

Answer 33

droplet

Question 34

influenza A/B

Answer 34

droplet

Question 35

PNA

Answer 35

droplet

Question 36

rubulla

Answer 36

droplet

Question 37

mumps

Answer 37

droplet

Question 38

pertusis

Answer 38

droplet

Question 39

meningitis

Answer 39

droplet

Question 40

measles

Answer 40

airborne

Question 41

varcilla

Answer 41

airborne

Question 42

shingles

Answer 42

airborne

Question 43

Nurse role in OR

Answer 43

temp 62-64
PT ROM
sterile field
padding extrem

Question 44

general sedation

Answer 44

give benzo (versaid) intubated - always check for GAG REFLEX before giving anything/ice chips

Question 45

Malignant hyperthermia

Answer 45

LIFE THREATENING muscle disorder r/t anesthesia drugs
s/s: increased c02 level, decreased 02, tachycardia, EXTREAM temp
TX: dantrolene sodium

Question 46

Spinal anesthesia

Answer 46

fetal position, L4/L5
CHECK DISTAL PULSES TO LOCATION AND SENSATION

Question 47

POST OP to HOME
3 goals

Answer 47

1. maintain 02 saturation
2. basline b/p 20mm up or down systolic
3. pain management

Question 48

Post op bowel function?

Answer 48

minimum of 4 hrs bs should return

Question 49

High risk pts for dehiscence

Answer 49

diabetes, malnutrition, obesity, immune deficiencies, steriod use

Question 50

Possible post op hemmorrhage sign?

Answer 50

skin discoloration

Question 51

urinary retention

Answer 51

bladdder scan- does not require order
should NOT be able to palpate bladder

Question 52

hypothermia

Answer 52

beir hugger blanket, can warm IV fluids, heat packs 20 min on 20 min off

Question 53

anemia s/s

Answer 53

cold, pale, fatigue, LOW b/p, HIGH RR/HR, nails refill slowly

Question 54

sickle cell (IHOP)

Answer 54

genetic
RBC are affected, leading to LOW 02 level
IV
Hydrate NS/LR
OXYGEN
PAIN (high dose IV dilulaid (PCA pump)
keep hob 30 or higher
AVOID high altitudes, extreme temps, pregnancy
keep room at 72 (not hot/cold)
CBC to check HGB/HCT levels

Question 55

Iron deficiency

Answer 55

s/s: spoon shaped nails, persistant HA
TX: iron supplements, FOODS ( green leafy vegs, red beets, organ meats )
risk = alcoholism

Question 56

B12 Deficiency

Answer 56

s/s: parasthesia, infertility, GLOSSITIS, poor balance
TX: subQ B12 injections for life (90 angle)
FOOD ( protein, fish, eggs, nuts, dairy, citrus fruits, MODERATE green leafy vegs
RISK = gut issues (chrons, diverticulitis, baratric, diarrhea )

Question 57

Folic Acid
“FALL COLORED FOODS”

Answer 57

TX: squash, avacodo, tomatoes, apricots, zucchini
RISK = pregant woman, immunocompromised (cancer pts), malabsorption (wt loss)