Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 355: Med Surg I > Exam 2 Study Guide: Q > Flashcards

Exam 2 Study Guide: Q Flashcards

1
Q

what is the 3 step approach to managing pain?

A
  1. nonopioid drug (ibuprofen, tylenol)
  2. mild opioid (norco, ultram) in combination with the same or a new nonopioid
  3. stronger opioid (morphine, oxycodone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what information should the nurse obtain when a client reports pain?

A

assess all aspects of the pain -
character, onset, location, duration, exacerbation, relief, and radiation. PQRST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what type of pain manifests with nausea, vomiting, and restlessness?

A

acute pain:
sudden in onset and usually of short duration, presenting immediately after noxious stimuli and tissue damage and continuing for several hours to several weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

who is at an increased risk for opioid induced constipation and what can you do to reduce the risk?

A

older adults

increasing daily water intake and fiber-rich foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the goals of CAM?

A

promotion of wellness
prevention of illness
reduction in treatment side effects
improvement of the immune system
enhancement of quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what should you determine about clients who are interested in CAM?

A

a thorough assessment of the client’s attitudes related to CAM to determine their readiness to learn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

s/s of lupus?

A

FATIGUE
oral ulcers
thinning hair
butterfly (malar) rash
joint tenderness
pleural or pericardial effusions
renal disease
neurological disorders
hematological disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is lupus confirmed?

A

confirmed through positive antinuclear antibody test - ANA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when a patient with RA has red, hot, swollen joints, this indicates what?

A

a medical emergency:
- could be an infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what exercises should be encouraged for RA patients?

A

range of motion:
- to promote joint mobility, reduce stiffness, and improve muscle strength.

aerobic exercise:
- to promote cardiac health.

rest periods:
- to manage fatigue and joint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are risk factors for OA?

A

excessive use
age
obesity

(being female not risk factor)

encourage use and walking to help with OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

a BMI > 30 is a risk factor for which disease?

A

gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

s/s of gout

A

severe pain
redness
swelling in great toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how can gout patients reduce the formation of urinary stones?

A

increased fluid intake to dilute urine and prevent sediment formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what dietary restrictions should gout patients follow?

A
  • a strict, low-purine diet
  • avoid organ meats
  • shellfish
  • oily fish with bones (i.e. sardines)
  • red meat
  • alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

an HIV patient with a CD4 count < 400 - 500 is a risk for what and should take which precautionary measures?

A
  • spreading the infection
  • practice safe sex: use a condom and water-based lubricants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

an HIV patient with a CD4 count < 200 means what?

A
  • considered AIDS at this point
  • immunocompromised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

a low Hgb and Hct may indicate what?

A

bleeding/blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is ESR and elevations indicate what?

A

erythrocyte sedimentation rate (ESR) -
- elevation indicates chronic inflammation along with c-reactive protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does a WBC > 10,000 indicate and what should be the first action by the nurse?

A

leukocytosis: infection
- perform thorough assessment looking for cut/site of infection
- purulent drainage, warm, red, erythema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

elevated neutrophils indicate what?

A

early stage of bacterial infection
- they are responsible for phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

kaposi sarcomas are seen with what condition?

A

HIV
- purple lesions that affect the soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is neutropenia and what precautions must be taken with these patients?

A

neutrophil < 1000
- avoid rectal temperature
- restrict visitors
- no fresh fruit/flowers

use contact precautions
- wear mask

Avoid rectal temp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is thrombocytopenia?

A

platelet count <150,000
- usually patient’s on chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are thrombocytopenia patient’s at risk for?

A

prone to bleeding
- monitor urine and stool for occult blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are expected surgical site findings?

A

pain and serosanguinous drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the function of basophils?

A

release heparin and histamines during the early inflammatory response to increase permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the function of eosinophils?

A

destroy allergens (type 1 hypersensitivity rxns - rhinitis) and parasitic infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

where are T and B cells produced?

A

in the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

where does T cell mature?

A

in the thymus

31
Q

where does B cell mature?

A

in bone marrow

32
Q

which cells are primarily involved in antibody mediated immunity?

A

B cells

33
Q

what type of precautions are required for a patient with MRSA?

A

contact precautions

34
Q

what leads to MRSA?

A

unnecessary overuse of antibiotics

35
Q

what is MRSA currently resistant to?

A

resistant to all beta-lactam antibiotics
- including penicillin, cephalosporins, and carbapenems

36
Q

what is the preferred treatment for MRSA?

A

IV Vancomycin

37
Q

what leads to VRE?

A

prolonged exposure to antibiotics
- vancomycin - resistant enterococci

38
Q

clients on multiple antibiotics are at risk for what infection?

A

clostridium difficile (C-diff)
- antimicrobials suppress the normal flora and create an environment for C-diff to flourish
- the greater the number of antimicrobials, number of doses, and duration of administration - the higher the risk

39
Q

what is the most effective way to prevent the spread of infection?

A

hand hygiene
- with C-diff must be soap and water
- sanitizers are ineffective

40
Q

with a c-diff infection, what causes diarrhea?

A

the bacteria proliferate releasing toxins causing an inflammatory response in the colon
- which causes fluid to be secreted into the colon, resulting in diarrhea
- this increased BM frequency can result in dehydration

41
Q

what is the common cause of Acinetobacter Baumanni Infection?

A

Ventilator - associated pneumonia

42
Q

what are the first steps in sepsis treatment?

A
  1. assessment
  2. fluid bolus
  3. obtain blood cultures
  4. antibiotics
43
Q

what vital signs and lab findings indicate a client most at risk for sepsis?

A

SBP < 90
HR > 100
WBC > 12,000 = septic shock

44
Q

does a client with influenza require airborne precautions?

A

no droplet

45
Q

how long are client’s with influenza infections for and when does viral shedding occur?

A

infections up to 7 - 10 days

virus shedding ends 2 - 5 after symptoms appear

46
Q

does influenza require a cough to spread?

A

no, it is airborne

47
Q

what are contraindications to the flu vaccine?

A
  • pregnancy
  • immunocompromised
  • over 50 or under 2 are contraindications to the live attenuated influenza vaccine
  • egg allergy is a contraindication to any influenza vaccine (not shellfish or nuts)
48
Q

would patient with asthma benefit from the flu vaccine?

A

yes
- increased risk of respiratory complications

49
Q

when are live virus vaccines contraindicated in HIV patients?

A

CD4 count < 200
in household members of someone with HIV

50
Q

which vaccines are not live?

A

DTaP
HIB
Hepatitis B

51
Q

what are first and second line defenses against infection?

  • sneeze
  • purulent drainage/neutrophils in a cut
  • skin
  • saliva
A

firs line:
- skin
- sneeze
- saliva

second line:
- purulent drainage/neutrophils in cut

52
Q

which is an indication that the patient is experiencing a systemic response during an acute inflammatory response?

  • pain
  • fever
  • edema
  • drainage
A

fever

53
Q

is the WBC or RBC count impacted by chronic inflammation?

A
  • WBC increases with chronic inflammation
  • RBC is not influenced by inflammation
    • changes may be related to conditions affecting the bone marrow
54
Q

what type of hypersensitivity reaction is allergic rhinitis and asthma?

A

Type 1

55
Q

what type of hypersensitivity reaction is lupus, RA, and serum sickness?

A

Type III

56
Q

what type of hypersensitivity reaction is a blood transfusion reaction and rH sensitization?

A

Type II

57
Q

what type of hypersensitivity reaction is poison ivy, TB test, and a spider bite?

A

Type IV

58
Q

s/s of anaphylaxis?

A
  • bronchospasms
  • tachypnea
  • tachycardia
  • wheezing
  • hypotension
  • hypoxia
  • goal SpO2 > 95%
59
Q

what is the treatment for a patient with wheezing, pruritus, urticaria, and angioedema

A

for mild reactions:
- SC or IM epinephrine injection
- 0.3 - 0.5mL of 1:1000 to constrict blood vessels
- increase BP
- improve CO

60
Q

why are older adults more prone to infection, cancer, and autoimmune diseases?

A
  • increase number of autoantibodies
  • decreased production of antibodies
61
Q

how does protein deficiency impact older adult immune system?

A
  • decreased immunity
  • cellular immunity
  • phagocyte activity
  • complement ability
62
Q

risk factors of impaired immunity?

A
  • old age
  • chronic diseases
  • certain medications such as prednisone
63
Q

breast feeding is an example of which type of immunity?

A

natural passive

64
Q

what disease impacts joints bilaterally, morning stiffness, and popping/clicking in the joints?

A

RA

65
Q

what questions should you ask an older adult to evaluate their immune system?

A
  • nutritional status
  • medications
  • chronic illnesses
  • social history
  • vaccination status
66
Q

wat foods should an older adult consume to increase protein intake?

A

mainly animal products:
- beef
- chicken
- fish
- milk

67
Q

what chronic disease puts patients at risk for impaired immunity, eye damage, and CV damage?

A

diabetes

68
Q

what diseases are females at an increased risk for?

A

RA and lupus

69
Q

what is the progression of breath sounds with anaphylaxis?

A
  • wheezing, stridor, then nothing
  • if epi administration was effective - you will hear normal lung sounds
70
Q

what type of isolation is required for patients with MDR?

A

contact isolation

71
Q

what conditions does a patient have if they are on multiple antibiotics and start to have loose, watery stools?

A

C-diff
- must go in contact isolation

72
Q

is the varicella vaccine live?

A

yes

73
Q

a patient with what condition can have kidney damage and urine output < 30mL/hr?

A

lupus

74
Q

True or False:

T cells work with B cells to protect the body?

A

True

NUR 355: Med Surg I (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions