Deck 1 Flashcards
What does the tongue of a pt with pernicious anemia look like?
Beefy red on the outer edges, smooth and irritated.
What is the glucose level in DKA that is considered an improvement?
Below 300
What precautions are required for tuberculosis?
Airborne - TB, measles, varicella, varicella zoster.
Which illnesses required droplet precautions?
Flu, rubella, pneumonia, streptococcal pharyngitis, pertussis, mumps.
Which illnesses require contact precautions?
Vanco-resistant enterococci, staphylococcus aureus, RSV, scabies, c. diff.
What lab value would cause a provider to withhold gentamycin?
WBC
Temperature
Blood pressure
Serum creatinine
Serum creatinine because the med is nephrotoxic.
Hormone replacement therapy for perimenopause has what adverse effects?
Calf pain
Numbness in the arms
Intense headache
What is the pain killer meperidine contraindicated for?
Pain in older adults because it can result in CNS toxicities.
Symptoms of autonomic dysreflexia?
BP increases by 20 to 40 points
Your heart rate slows.
A pounding headache (often the first symptom).
Sweating above the level of injury.
Bladder or bowel problems.
Red, blotchy skin above the level of injury.
Symptoms of what are reduced by feverfew?
Migraine. Can also increase the risk of bleeding.
What can ginkgo biloba cause?
Increased bleeding
What supplement is effective against joint pain?
Glucosamine
What root is effective against nausea?
Ginger
In what part of the anatomy would Zenker’s diverticulum be performed?
Neck - Zenker’s diverticulum develops when the muscle between the throat and esophagus, known as the cricopharyngeus muscle, over-tightens, causing the throat above it to pouch out. Overtime, the pouch can enlarge as the muscles below it tighten excessively. Food can catch in this pouch or it can cause an obstruction.
How often should a patient be moved to prevent pressure injuries?
q 1-2 hrs
Manifestations of disequilibrium syndrome from hemodialysis?
Restlessness
Dysrhythmias
Seizures
N/V
Fatigue
Headache
Postoperative instructions for mastectomy.
Drain will be removed when output is 25 ml or less over 24 hrs.
Exercise the right arm 24 hr after surgery
Elevate arm on pillow to promote lymphatic fluid return
HOB to 30° to promote drainage
How does a TENS unit relieve pain?
A tingling sensation replaces the pain
Recommendation for AIDS pts regarding cleaning toothbrush, flossing, eating raw F/V, leaving water at room temp, and taking temperature?
Toothbrush - clean in dishwasher or with bleach q 1 week
No flossing - prevent gum inflammation
Avoid eating raw f/v
Avoid drinking liquids that are standing at room temp for > or = 60 min.
Take temp daily
In what order should the nurse perform the following actions for a pt who has a gastric hemorrhage and is going into shock?
Insert an NG tube
Admin O2
Administer famotidine
Initiate IV therapy with large-bore catheter
Admin O2
Initiate IV therapy
Insert NG tube
Admin famotidine
What is the testing protocol for sputum in TB?
q 2-4 weeks until 3 negative cultures are reported.
A client with MRSA should be bathed with what?
Chlorhexidine.
Should a pt flex the foot hourly after total knee arthroscopy?
Yes.
Steps in administering metered-dose inhaler
Breathe in slowly and deeply
Hold breath for 10 sec after inhaling
Rinse case and cap with warm running tap water/vinegar q1 day
Wait 1 min between puffs
Manifestations in hemolytic transfusion rx?
Low back pain, hypotension, tachycardia, apprehension.
Adverse effect of mannitol for ICP?
Crackles as a manifestations of pulmonary edema. Other manifestations include dyspnea and decreased oxygen saturation.
Is a pacemaker artifact followed by a QRS complex normal with a pacemaker?
Yes, when a pacing stimulus is delivered to the ventricle, a pacemaker artifact appears as a spike on the ECG rhythm strip. The spike should be followed by a QRS complex, which indicates pacemaker capture or depolarization.
What condition is associated with long-term mechanical ventilation?
Stress ulcers in clients who are receiving long-term mechanical ventilation are caused by elevated levels of hydrochloric acid in the stomach. Stress ulcers increase the risk for systemic infection and require pharmacological treatment.
Precautions with family with tuberculosis
Pt no longer contagious after 2-3 weeks of continuous meds or following 3 negative sputum tests that are obtained q 2-3 weeks.
Airborne precautions not necessary in the home because all are already exposed.
Family members should all be tested for TB.
Dispose of used tissues in plastic bags.
What should be supplied with a pt who has a sealed radiation implant for cervical cancer?
Keep a lead-lined container and forceps at the bedside in case it is dislodged.
How long should visitors be allowed with a pt with a sealed radiation implant for cervical cancer?
30 minutes
A Penrose drain allows drainage to collect on what?
A sterile gause dressing
What should a nurse do with soiled linens from a pt with a sealed radiation implant for cervical cancer?
Keep the linens in the room until the client has the implant removed.
What types of diabetes are associated with DKA and HHNS?
DKA - type 1
HHNS - type 2
What’s the different in potassium levels with cardiac arhythmias and dysrhythmias?
Hyperkalemia - arhythmias (fast of slow heart rate)
Hypokalemia - irregular heart beat (dysrhythmias)
What type of insulin is used to treat dka?
Regular insulin - IV
Symtoms of Autonomic Dysreflexia
Flushing above the level of injury; pal below,
Hypertension
Bradycardia
Severe headache
Piloerection
Diaphoresis
Nasal congestion
How many L of water should an adult drink each day
2-3 L
How much sodium should an adult eat each day?
< 2.3 g or < 2300 mg. However, with lithium, a consistent amount each day is more important.
What do pupils look like with cocaine overdose
Dilated, due to sympathetic NS stimulation.
What is erotomania?
When someone thinks someone is in love with them who is not.
What do OCD behaviors relieve?
Anxiety
What should a schizophrenic have with them at all times?
Therapist and provider’s phone numbers.
