Exam 3 Flashcards
Who has the highest risk for osteoporosis?
-Menopausal Women
-Advanced Age of 65 or older
-smoking + alcohol use
-prolonged use of steroids, lasix, anticonvulsants
-immobility
Diet for osteoporosis?
High protein, calcium, and vitamin D
What medications are used for osteoporosis?
Calcitonin
Alendronate
Raloxifiene
How is reyes syndrome diagnosed?
Liver biopsy, LFTs will be low as well
What is crucial of a child who has Reyes syndrome?
Keep TV volume low, dimmed room, quiet and calm environment so brain can relax
What are some clinical signs of chronic renal failure?
High BUN
Low GFR
Azotemia
Oliguria
What diet should a renal failure client follow?
Low sodium, low potassium low protein
Avoid dairy products
A client is newly diagnosed with HTN, what should the nurse discuss with the client?
Keep daily log of BP reading
Bake, Roast, Boil Food
Avoid OTC Meds
Avoid Coffee
Low Sodium Diet
4/5 Veggies Daily
Exercise
What education should be provided to a client post arthroscopy?
Monitor for infection
apply ice up to 5 times a day for 48 hours
Elevate
Weight bearing as tolerated
Report severe joint pain
Tx pain w/ tylenol
Patient has a post op layrngectomy with a new stomas, what should the nurse educate?
Prevent and monitor signs of infection
wear high collared shirts/ scarfs
increase humidity in home
avoid showers
avoid swimming
avoid sick people
increase fluid intake to 3000ml/day
What is important to tell the client diagnosed with Hepatitis A?
Strict handwashing
bleach toilet seat after every use
If a client comes in and there A1C is elevated the nurse should?
ask the client to watch them draw up insulin
What does A1C results tell a nurse?
what the glucose control has been over the past 90 days
A client may need more teaching about drawing up their insulin when they..?
Draw up NPH first
What two clients on this exam are priority to be seen first?
A client with a blood transfusion going
A client with a crushing injury
What can the nurse delegate to the UAP?
Make beds
answer call lights
routine + baseline VS
Transport client to the OR
Apply pulse ox
Assist HCP with Pap Test
Drawing blood
What are examples of accountability?
Monitoring client for care
seeking outcome report
What is an example of effective delegation?
Supervising and monitoring LPN
A client has been medicated prior to a procedure, the OR is ready for the client but the nurse notices there is no signed consent. What action should the nurse take?
Call and cancel surgery
get consent from family
What is the nurses code of ethics?
Advocacy
responsibility
confidentiality
accountability
What must nursing documentation contain?
factual information and nothing documented that says “seemed”
What diagnostic test requires low levels of stress before being done?
Cortisol testing
Who is at highest risk for abuse?
Elder women with dementia
A couple is fighting and the nurse wants to know more, how does she ask the client?
“fighting is normal, but how do you guys deal with conflict?”
If the nurse is aware about family violence occurring around a client, what information should be given at discharge?
Information about shelters
What is most important to ask a client going through or may go through alcohol withdrawl?
-last drink
-type of alcohol
-how much alcohol
-how long have they been drinking
What should the nurse implement of a client going through alcohol withdrawl?
-seizure precautions (side rails padded, suction, O2)
-safe environment
-address hallucinations
-reorient to reality
-monitor VS
What is important to do when caring for a client with DID?
Develop trusting relationship
orient client
allow them to express painful experiences
Identify conflict
provide a simple non challenging routine
Prior to working and interacting with a client who has DID, what should the nurse do?
identify and support client strengths
What interventions should be done with a client who has manipulative behaviors?
-communicate expected behaviors to client
-assist in identifying limits
-follow through about consequences
-have the client state back consequences
If a client is in a mania, what is important for the nurse to do?
allow the client to take frequent breaks
A child looses a sibling and is curious about death, the parents are concerned.. what should the nurse explain to the parents?
“school aged children are inquisitive and ask a lot about death’
A family with a child who has a mental health disorder, it is important for the nurse to do what?
Complete an entire assessment of the family
A new nurse is preparing to work in a community clinic, what is something that may benefit their nursing approach?
Investigate cultural differences and reactions to medications and procedures,etc.
A client states her life is good and she intends to die how she lived. What can the nurse do during the clients end of life care?
Support patient in use of own resources
A client with hashimotos thyroiditis requires immediate attention if the nurse notices what changes?
New onset of voice changes
During a crisis what intervention should the nurse complete?
develop a care plan individualized to the client
A client has stroke on the right side of the brain, what will the nurse see?
Left side neglect
paralyzed left side
hemiplegia
A client has Right sided hemiparesis from a stroke, what other symptoms will the client have?
-aphasic
-weak on right side
-weak right side of face and tongue
If a client has a stroke on the right side, what will be most beneficial for the client?
placing objects on the left side
A client who had a stroke has right leg and arm paralysis, what other symptom will you see?
will have difficulty comprehending instructions
What are the risk factors for a stroke?
HTN
TIA
Smoking
Oral birth control
What is one way to tell a client is adapting well after a stroke?
Consistently using adaptive equipment
What are seizure precautions?
Padded side rails, suction, O2 at bedside
If a female client is taking phenytoin, what is important for the nurse to tell her?
use an extra form of birth control, this med suppresses it
A client is taking phenytoin and the nurse gets a blood test result back about elevated phenytoin, what symptom may the client have?
slurred speech
When taking phenytoin what is important for any client to do when taking it?
Good oral care, flossing, brushing, etc.
What is azathioprine?
Immunosuppressant
can treat autoimmune disorders and prevent organ rejection after a transplant
What are important things to do when taking azathioprine?
Take with food
Wear sunscreen + protective clothing
Common symptoms of azathioprine?
N/V, Hair loss, diarrhea, joint pain
Fire safety as a nurse and extinguisher use?
RACE
R-rescue / remove pts
A-alarm
C-confine
E-extinguish + evacuate
P- Pull
A- Aim
S- Spray
S-Sweep
