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Medical Surgical Nursing Lecture > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

What is PCA?

A

pt-controlled analgesic which allows the pt to control their own pain

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2
Q

How is PCA administered?

A
  1. it can only be pushed by pt (not by a fam member or dr)
  2. the patient must be alert and oriented x4
  3. the time restriction is set by physician (meds are only administered at a set time, even if the pt tried to push the button meds will only be released in a given set time)
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3
Q

What are the rapid acting insulins?

A
  1. asparrt (Novolog)
  2. lispro (Humalog)
  3. glulisine (Aspidra)
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4
Q

What is the short acting insulin?

A

regular (Novolin and Humulin R)

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5
Q

What are the long-acting insulin?

A
  1. glargine (Lantus)

2. detemir (Levemir)

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6
Q

What is the intermediate insulin?

A

NPH

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7
Q

What is the onset, duration, and peak of rapid-acting insulin?

A

onset: 10-30 mins
duration: 3-5 hr
peak: 30 mins- 1 hr

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8
Q

What is the onset, duration, and peak of short-acting insulin?

A

onset: 30min - 1 hr
duration: 5-8 hr
peak: 2-5 hr

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9
Q

What is the onset, duration, and peak of long-acting insulin?

A

onset: 0.8-4 hr
duration: 24+ hr
peak: no pronounced peak

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10
Q

What is the onset, duration, and peak intermediate insulin?

A

onset: 1.5-4 hr
duration: 12-18 hr
peak: 4-12 hr

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11
Q

Which type of insulin can be given IVP?

A

Regular

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12
Q

What are the nursing interventions for a patient who is vomiting?

A
  1. turn them to their side
  2. elevate HOB
  3. emesis bag or basin
  4. suction
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13
Q

What is ketamine (Ketalar)?

A

potent analgesic and amnesic; bronchodilator

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14
Q

Before administering Ketalar what should you know about the patient?

A

make sure the patient is not tachycardic or hypertensive

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15
Q

What are 2 side effects of taking Ketalar?

A

increase BP & HR

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16
Q

What type of drug is most commonly given to type II diabetics?

A

Metformin (glucophage)

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17
Q

What is a side effect of Metformin?

A

causes weight loss

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18
Q

Can a type II diabetic drink ETHOL?

A

No because alcohol increases the risk of hypoglycemia

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19
Q

What is the proper diet for a pt. with diverticulosis?

A

low fat (reduce red meats) and high fiber (fruits and vegetables)

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20
Q

What is the normal range of urine specific gravity?

A

1.003-1.030

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21
Q

What is the normal range of NA+?

A

135-145

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22
Q

What is the normal range of K+?

A

3.5-5.5

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23
Q

Of the electrolytes, which should be reported for diabetics?

A

K+, NA+, Urine specific gravity, and glucose levels

24
Q

If Jill is in PACU, how should I assess the neurologic system?

A
  1. LOC
  2. Orientation
  3. Sensory and motor status
  4. PERRLA
25
Q

If patient says my body’s cells are resisting insulin, is this a correct understanding of type II diabetes?

A

yes

26
Q

What is important when teaching a newly diagnosed pt. with diabetes

A
  1. teach the pt. to have their A1C monitored regularly
  2. diet
  3. exercise
  4. enough supplies
  5. keep simple carbs with the,
27
Q

If a patient with type I refuses food after insulin, what is a nursing action?

A

Offer another option or meds that increase appetite, so ask before the insulin if they will eat

28
Q

How do you assess for Type I?

A
  1. polyuria
  2. polyphagia
  3. polydipsia
  4. recurrent infxn
  5. weight loss
  6. weakness
  7. fatigue
  8. Kussmaul respirations
  9. Fasting glucose
  10. AIC
29
Q

What are some nursing interventions for GERD?

A
  1. Assess precipitating factors
  2. Avoid caffeine
  3. Avoid spicy foods
  4. NO OJ
  5. Cigarette smoking
  6. No late snacking
  7. Do not eat and drink together
  8. Decrease high fat foods
30
Q

Can LVNs teach patients?

A

No, only the RN

31
Q

If I am busy putting an IV in my new admit, can I delegate to a UAP to check the blood glucose of my other patient?

A

No, that is not under a UAP’s duties

32
Q

If I am busy checking the blood glucose of my patient, can I delegate my patient to administer insulin when i am done so I can move faster.

A

No, that is not under a UAP’s duties

33
Q

If my patient has a peptic ulcer, should I palpate the abdomen for tenderness?

A

no, do not palpate may cause bleeding and/or perforation

34
Q

If patient abdomen hardens, what is my next action?

A

notify the MD immediately

35
Q

What should I do as an RN for a preop pt?

A
  1. labs
  2. allergies
  3. history
  4. code status
  5. meds
  6. Ht and WT
  7. NPO (know last meal/ drink)
  8. If they smoke or drink
  9. Get consent form signed
36
Q

How do you assess a pt with GERD?

A
  1. They say they are experiencing heartburn
  2. dypepsia
  3. reguritation
  4. respiratory problems (wheezing, coughing, dyspnea)
  5. chest pain relieved with antacids
37
Q

If a patient reports numbness, tingling in both legs, what is a nursing intervention?

A
  1. manage blood glucose levels
  2. meds (topical creams)
  3. drug therapy
38
Q

What is a diabetic diet?

A
  1. follow my plate
    Carbs counting
    normal protein
    low fats (less than 200 mg/day)
39
Q

If while inserting an NG tube, the patient begins to cough, O2 sat decreases, and the becomes cyanotic, what is your nursing action?

A

stop and remove the tube

40
Q

While prepping the pt for surgery, he tells you his fam doesn’t want him to have the surgery and he no longer wants to go through with it, what is your nursing role?

A

act as the advocate for the patient and tell the surgeon the patient changed his mind

41
Q

What is the normal range for WBCs?

A

4.9-11.0 x 10^9/L

42
Q

What is the normal range for glucose?

A

70-120 mg/dl

43
Q

What are some teachings for a patient who is about to have mastectomy?

A
  1. breathing techniques
  2. arrival and length of surgery
  3. what to expect during preop and postOp
  4. Recovery
  5. food and fluid restrictions
  6. designated driver to drive them home
44
Q

If during postOP and the patient begins to vomit what are the nursing interventions?

A
  1. determine quantity, characteristics, and color of the vomitus
  2. assess the abdomen for distention and auscultate
  3. be ready to suction
45
Q

How is GERD typically diagnosed?

A

diagnosis is usually based on SI/Sx and the patient’s response to behavioral and drug therapies

46
Q

What is the diet for a patient with UC?

A

High protein and low residue

47
Q

What are some nursing interventions for patients with PUD?

A

Hemorrhage
- maintain patency of NG tube
Perforation
- take VS and record them every 15-30 mins
- stop all oral or NG drugs and feedings
Obstruction
- irrigate the NG tube with normal saline solution

48
Q

After surgery, what may be placed for a postOP pt with PUD?

A

An NG tube may be placed to decompress the stomach the remaining portion of the stomach

49
Q

What are some nursing interventions for those with IBS or IBD?

A
  1. Pain control
  2. fluid and electrolyte balance
  3. If pt. is experiencing diarrhea, keep them dry and free of odor
  4. increase fiber
  5. use a bulk-forming agent
50
Q

During postOp, a pt. vital signs alter, what is the nursing intervention?

A

after checking the vital signs, inspect the the surgical incision to determine if there is excessive bleeding

51
Q

What is the normal value for AIC?

A

<6.5%

52
Q

What is the normal range for fasting glucose?

A

<126 mg/dl

53
Q

What is the normal range for random plasma glucose?

A

<200 mg/dl

54
Q

What is the diabetes #1 cause of?

A

kidney failure

55
Q

What is the Dawn phenomenon?

A

hyperglycemia in the am upon awakening; can be experienced by anyone

56
Q

What is the Somogyi effect?

A

low blood sugar in the am (2-3am); if not on continuous insulin, the patient has to wake up between 2-3 to check levels

57
Q

DKA

A

acid buildup in the blood due to a profound deficiency oxf insulin

Medical Surgical Nursing Lecture (4 decks)

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