Chronic care Flashcards
What is the term for the skin’s ability to return to its normal appearance after being subjected to pressure?
Question 1 options:
A)
Elasticity
B)
Ductility
C)
Turgor
D)
Sepsis
Turgor
What does PEEP stand for?
Question 2 options:
A)
Preliminary exhaustive expiratory plan
B)
Positive exhalation and excretion pressure
C)
Positive end-expiratory pressure
D)
Pulmonary expulsion/end perfusion
positive end-expiratory pressure
Which of the following best describes a tracheostomy?
Question 3 options:
A)
A surgical opening from the anterior neck into the trachea
B)
A temporary opening made from the posterior neck through the trachea
C)
An opening from the esophagus to the trachea
D)
An opening made by incision from the larynx through the neck
a surgical opening from the anterior neck into the trachea
Your patient has Guillain-Barré syndrome. Which of the following sets of symptoms would you expect to find?
Question 4 options:
A)
Fever, followed by weakness and paralysis
B)
Headache, respiratory distress, and neuropathy
C)
Visual disturbances and motor deficits
D)
Rash, GI upset, and dizziness
fever followed by weakness and paralysis
Which of the following factors has contributed to the increase in individuals who receive health care at home?
Question 5 options:
A)
There are tax breaks for individuals who provide care for a loved one at home.
B)
More families can afford home health care.
C)
Research shows that patients recover faster at home.
D)
Fewer people have insurance and therefore cannot afford hospital care.
research shows that patients recover faster at home
The majority of home health care patients fall into which demographic category?
Question 6 options:
A)
Males age 55+
B)
Females between ages 70 and 82
C)
Females age 65+
D)
Males between ages 75 and 85
females age 65+
While assessing a chronically ill 85-year-old male patient who is cared for at home, you notice that his wife appears tired and unkempt. The patient is well cared for; however, he has multiple health problems and requires constant attention. Understanding the psychosocial needs of a family member who provides care, which of the following would be appropriate to say to the wife?
Question 7 options:
A)
“It is very expensive to pay for a home health aide, but perhaps you could ask your children to help with the cost.”
B)
“I can see that you provide excellent care for your husband. Would you like some information on a support group for spouses who provide care?”
C)
“You are compromising your well-being for your husband and may require medical attention.”
D)
“It is obviously difficult for you to care for him. It might be best to put him in a nursing facility.”
I can see that you provide excellent care for your husband would you like some information on a support group for spouses who provide care
Which of the following is NOT a common reason for ALS intervention with a chronic care patient?
Question 8 options:
A)
Equipment failure
B)
Absence of a caregiver
C)
Change in condition
D)
Desire for hospice care
desire for hospice care
You are called to the home of a 75-year-old patient with end-stage lung cancer. The patient’s daughter states that she called because the patient is experiencing increasing dyspnea. The patient is on home oxygen at 4 liters per minute; however, the daughter states that the patient’s SpO2 is “way lower than normal.” What would be the best course of action in this situation?
Question 9 options:
A)
Transport the patient to the ED.
B)
Examine the patient’s oxygen equipment to be sure it is working.
C)
Ask the daughter if the patient has a DNR.
D)
Prepare to administer oxygen via CPAP.
examine the patients oxygen equipment to be sure it is working
A 13-day-old infant is suffering from bronchopulmonary dysplasia. His family, along with a home health nurse, called 911 after the child’s oxygen saturation began to fluctuate. The home health nurse reports that although the baby is on a ventilator, the nurse has been weaning him to lower intermittent mandatory ventilation settings. The child has a heart rate of 160 bpm and is ventilator dependent with an SpO2 of 86%. Lung sounds reveal crackles and rhonchi in the left lung; the child is hot to the touch and has cyanotic extremities and central mottling. You suspect:
Question 10 options:
A)
aspiration secondary to ventilator usage.
B)
barotrauma secondary to high ventilator pressure settings.
C)
sepsis secondary to lower respiratory infection.
D)
pneumothorax secondary to bronchopulmonary dysplasia.
sepsis secondary to lower respiratory infection
Which of the following is NOT a common sign of sepsis?
Question 11 options:
A)
Altered mental status
B)
Nausea and vomiting
C)
Fever
D)
Hyperactivity
hyperactivity
You are sent to a home for a cardiac arrest. You find a patient in cardiac arrest who has been under hospice care for end-stage AIDS. The palliative care nurse tells you that some family members who were present when the patient went into cardiac arrest became very upset and called 911. The patient has been pulseless and apneic for approximately 15 minutes without resuscitation. A relative interrupts and says she doesn’t care what the nurse says; she wants you to help her brother. What should your next action(s) be?
Question 12 options:
A)
Explain to the sister that because the family did not start CPR right away, the chances of resuscitation are extremely small.
B)
Have the nurse provide the DNR, ask the sister if she was aware of her brother’s end-of-life wishes, and explain that you are ethically bound to honor the DNR.
C)
Provide all the interventions you can—immediate family are always able to override the DNR.
D)
Start CPR and ACLS. Do a round of drugs, then call for orders for field termination of resuscitative efforts.
have the nurse provide the DNR ask the sister if she was aware of her brothers end of life wishes and explain that you are ethically bound to honor the DNR
When you arrive on the scene of an incident in which a home health care provider is present, which of the following is the best way to deal with the situation?
Question 13 options:
A)
Tell the home care provider that your certification overrides theirs and that you are in charge now.
B)
Respect the home care provider’s position, use the person’s information accordingly, and request the person’s help should the need arise.
C)
Let the person talk to a member of the crew not involved in patient care to keep the person busy and out of the way.
D)
Ascertain the person’s certification level. If the person is not an RN, ask the person to stand back.
respect the home care providers position use the persons information accordingly and request the persons help should the need arise
You are dispatched to an extended care facility for a “sick person.” On arrival, you speak with the staff who tells you that Ms. Johnson “just started acting differently and is slow to respond.” Your assessment reveals that she is febrile and has vomited. When you move her to the gurney, you notice a stage 3 ulcer on her lower back that has a foul smell. Which of the following statements is most likely to be TRUE?
Question 14 options:
A)
This is most likely a GI emergency, such as norovirus or C. diff.
B)
The ulcer may be infected, causing sepsis and requiring immediate intervention.
C)
This is most probably due to neglect. Report the facility to the appropriate authorities.
D)
The signs could be masking a more serious issue, such as a cardiac event.
the ulcer may be infected causing sepsis and requiring immediate intervention
You are caring for a child with muscular dystrophy who is on a home ventilator. The boy’s father called 911 after noticing his son repeatedly attempting to cough—something that is atypical for this patient. The father states that he believes the child’s tracheostomy tube may be dislodged, and he is unsure what to do. Your assessment reveals that the inner cannula appears to be dislodged. Which of the following is your best course of action?
Question 15 options:
A)
Attempt to reposition the inner cannula with sterile Magill forceps.
B)
Detach the home ventilator, orally intubate the trachea, and reattach the ventilator to the ET tube.
C)
Deflate the cannula cuff and remove the cannula, then hyperventilate the patient.
D)
Transport, with an early alert that a respiratory therapist will be needed.
deflate the cannula cuff and remove the cannula then hyperventilate the patient
