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NSG 223 > exam 3 > Flashcards

exam 3 Flashcards

1
Q

Increase sodium intake especially during episodes of hot weather
Increase fluid intake
Limit potassium
high protein

A

Addison’s disease diet

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2
Q

D5 NS fluid of choice, and dextrose

A

Addison’s crisis treatment

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3
Q

Dark pigmented skin
Hypotension
Hyperkalemia
Hyponatremia
Muscle weakness
Low blood glucose levels
Confusion

A

Manifestations of Addison’s disease

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4
Q

Hypotension
Cyanosis
Fever
Nausea/vomiting
Signs of shock

A

S/S of Addison’s crisis

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5
Q

Hold live vaccines (like MMR) while receiving

A

Contraindications for Addison’s disease on Hydrocortisone treatment

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6
Q

Give with food, PRIOR to 9am

A

Administration of Hydrocortisone

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7
Q

too little steroids

A

Addison’s

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8
Q

too much steroids

A

Cushing’s

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9
Q

Weight gain
Central adiposity
Buffalo hump Hirsutism
Ecchymosis (bruising)
Hypertension

A

Manifestations of Cushing’s syndrome

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10
Q

They are at risk for muscle wasting and osteoporosis
give meals that include: protein, calcium and vitamin D such as cheese and milk

A

Cushing syndrome diet

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11
Q

excessive growth hormone in an adult; enlarged hands/feet, distortion of facial features, extremely tall, persistent headaches

A

Acromegaly

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12
Q

excessive growth hormone in a child

A

Gigantism

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13
Q

insufficient secretion of growth hormone during childhood

A

Dwarfism

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14
Q

under secretion of ALL anterior pituitary hormones; thyroid gland, adrenal cortex and gonads atrophy (shrink)

A

Panhypopituitarism

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15
Q

Take with full glass of water, coffee, tea, or fruit juice (acidic drinks enhance absorption)
Take with food
AVOID antacids, contraindicated because decrease absorption
Lowers production of androgen, must be given with steroid supplementation to prevent adrenal insufficiency
Adrenal enzyme inhibitor which is used to reduce hyper-adrenalism if the syndrome is caused by ectopic secretion by a tumor that cannot be eradicated
Adrenal ablating drug

A

Ketoconazole

teaching points (for Cushing’s)

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16
Q

Used to shrink pituitary tumor
Given IM, intragluteal (butt)

A

Octreostide

(for Acromegaly)

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17
Q

unchanged urine osmolarity

A

Fluid deprivation test

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17
Q

unchanged urine osmolarity

A

Fluid deprivation test

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18
Q

patient produces large quantities of urine and is unable to increase urine specific gravity and osmolarity even when the fluid is decreased

A

Diabetes Insipidus

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19
Q

Closely monitor fluid balance by measuring/monitoring I&O, daily weights, morning labs
Do NOT need sodium restricted diet or desmopressin
Patient will likely be on fluid restriction

A

Nursing management of patients with SIADH including diet precautions

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20
Q

Before giving, review vitals and labs
HOLD medication if creatine clearance is less than 50mL/ min (indicates renal impairment)

A

Desmopressin (DDAVP)

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21
Q

hypotension, tachycardia, low urine osmolarity, polydipsia

A

Manifestations of Diabetes Insipidus: DDAVP

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22
Q

Deformity
Crepitus
Swelling of the extremity
Bruising

A

Signs and symptoms of fracture

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23
Q

Immobilize leg prior to moving to a safer spot
Cover with sterile dressing to prevent contamination (wet gauze)

A

Open fracture care precautions for leg fracture

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24
Q

Takes 6-8 weeks to heal
Start to see bone ossification after 2-3 weeks

A

Discharge teaching for patients with fracture

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25
Q

Medical emergency
Increase in compartment volume (edema)
Decrease in compartment size (restrictive cast): pain and decreased sensation of fingers, toes or affected extremity

A

Signs and symptoms of compartment syndrome

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26
Q

Pain
Pallor
Pulselessness
Paresthesia
Paralysis

A

5 Ps

27
Q

Assess for developing pressure ulcers; reporting of burning pain, particularly over a bony prominence, you will notify provider for an intervention such as removing cast/splint, and assessing their skin

A

Care for patients with a cast

28
Q

Encourage isometric exercises; muscles are tensed and relaxed without moving the bone
Done every hour while awake

A

Teaching to prevent disuse syndrome

29
Q

Serous drainage and redness at pin site is expected within first 48-72 hours; monitor
Nurses NEVER adjust hardware frame

A

Assessment of pin site on orthopedic hardware

30
Q

Patients must be able to push pain button on their own
Nurse or family members NEVER press button
Assess for inability for patient to perform; if patient unable to push button due to physical restraint, mental compromise then other routes of pain medication administration should be considered

A

PCA management and teaching

31
Q

Anticipate a sling for immobilization
Ice
Pain medication

A

Care of a patient with a fractured clavicle

32
Q

Pain
Swelling
Bruising
Crepitus
Decreased mobility

A

Manifestations of a fractured wrist

33
Q

Hemorrhage
Shock (hypovolemic) due to blood loss

A

Problems that could occur for a patient with a pelvic fracture

34
Q

Pain in hip/groin
Pain worsened with movement
Muscle spasms in affected leg
Muscle shortening in affected leg
Bruising

A

Assessment findings of a patient with a hip fracture

35
Q

Have patient dorsiflex the great toe -> diminished sensation within the first webbed space
The branch of sciatic nerve supplies movement/sensation to the lower leg, foot and toes
a type of peripheral neuropathy; they can present with numbness, tingling, pain, weakness, and possible foot drop (unable to bend/flex the foot upward from the ankle)

A

Assessment finding of a patient with peroneal nerve damage

36
Q

Splinting with pillow
Incentive spirometer use
Pain medication
AVOID using chest binders because it decreases lung expansion and increases the risk for atelectasis

A

Care of a patient with rib fractures

37
Q

Splinting with pillow
Incentive spirometer use
Pain medication
AVOID using chest binders because it decreases lung expansion and increases the risk for atelectasis

A

Care of a patient with rib fractures

38
Q

done for arterial insufficiency, gangrene, uncontrolled diabetes, traumatic injury

A

Above the knee (AKA)

39
Q

damage to the distal tibial and surrounding muscle can cause need for

A

Below the knee (BKA)

40
Q

dislocation through a joint

A

Disarticulation

41
Q

Elastic dressing: compression bandage to prevent swelling
If it comes off with new amputation, immediately put it back on

A

Care of a patient with limb amputations

42
Q

Provide an accepting and supportive atmosphere and allow the patient to talk about their feelings

A

Interpersonal communication skills for patients who are having problems with self- esteem

43
Q

IV push: peaks 10-20 mins; assess for respiratory depression
PO: peaks 30-60 mins

A

Morphine administration considerations to assess for

44
Q

Avoid use of meperidine (Demerol) because it causes agitation, seizures and hallucinations

A

Medication considerations for elderly patients with amputations

45
Q

Fatigue
Depression
Weakness
Numbness
Difficulty in coordination
Loss of balance
Muscle spasticity
Pain
Visual disturbances: diplopia

A

Manifestations of multiple sclerosis (MS)

46
Q

poor muscle control, slurred speech

A

ataxia S/S

47
Q

Impaired coordination of movement

A

ataxia

48
Q

Baclofen: muscle relaxant

A

Drugs that treat muscle spasms

49
Q

Vision changes
Muscle weakness
Ptosis
Dysphagia
NO problems with sensation/coordination

A

Myasthenia Gravis S/S

50
Q

numbness
ataxia gait
Vision changes
Muscle weakness
Ptosis
Dysphagia
NO problems with sensation/coordination

A

MS S/S

51
Q

Daily stretching exercises such as walking, swimming, riding stationary bike
Avoid running/aerobics due to to risk of falls
Avoid soaking in hot bath due to risk for burns due to sensory loss

A

Recommendations of caring for a patient with muscle spasticity

52
Q

positive Tensilon test (acetylcholinesterase inhibitor test)
Given IV; 30 seconds after injection, facial muscle weakness and ptosis should resolve for about 5 minutes
Immediate improvement in muscle strength after administration indicatesa positive test
Have Atropine available to control side effects -> bradycardia, asystole, bronchoconstriction, sweating, cramping

A

Diagnostic test confirms Myasthenia gravis

53
Q

MRI confirms diagnosis

A

Diagnostic test confirms MS

54
Q

Improve symptoms in 75% patients but only lasts for a few weeks
Used to treat exacerbations of myasthenia gravis
Treatment, NOT a cure

A

Teaching modalities of plasmapheresis (TPE), s/s, implications for use

55
Q

Surgical removal of thymus gland

A

thymectomy

56
Q

Can produce antigen specific immunosuppression and result in clinical improvement
Performed in patients younger than 65 who have had MG diagnosed within the past 3 years

A

thymectomy implications for, care for (MG)

57
Q

Educate patient take medications on time to keep stable blood levels

A

Caring and treatment for a patient with myasthenia gravis

58
Q

Avoid tranquilizers because causes respiratory/cardiac depression
If provider orders this, nurse should question it

A

Medications that should be avoided for patients with Myasthenia gravis while on ventilatory support

59
Q

It improves skeletal muscle tone,
Increases salivary gland production
Increases tone of GI muscles
Relaxes smooth muscles of the bronchioles
Decreases heart rate

A

Neostigmine

60
Q

Enoxaparin (lovenox) given subQ to prevent DVTs

A

Signs and symptoms of Guillain Barre syndrome

61
Q

Diminished lower extremity weakness
Symmetrical weakness
History of a viral infection 2 weeks prior
Areflexia: absence of deep tendon reflexes
Ascending weakness: lower extremities and progress upward
Dyskinesia: inability to execute voluntary movements

A

Signs and symptoms of early onset of Guillain Barre syndrome

62
Q

inability to execute voluntary movements

A

Dyskinesia

63
Q

absence of deep tendon reflexes

A

Areflexia

64
Q

Impaired gas exchange
Impaired mobility
Anxiety

A

care planning for a patient with Guillain Barre syndrome, list nursing diagnoses

65
Q

AVOID opioids if at all possible
NSAIDS: used to treat the diffuse muscle aching and stiffness
TCAs: Elavil
Muscle relaxants: Flexeril
SNRI: Cymbalta
SSRI: Zoloft
Anticonvulsants: Gabapentin

A

Fibromyalgia meds

NSG 223 (4 decks)

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