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NSG 233 > exam 4 > Flashcards

exam 4 Flashcards

1
Q

what is the best type of chemo for metastatic pancreatic cancer

A

gemcitabine - doesn’t cure but lengthens survival

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2
Q

how to give burn patients pain meds

A

via IV to provide the most rapid relief

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3
Q

sunburn with blisters

A

second degree burn

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4
Q

Patient’s with Tuberculosis and AIDs are treated with Rifampin

A

(Pts’ with TB need to be on airborne precautions and negative pressure room.

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5
Q

Normal finding of Rifampin

A

red/orange urine and body fluids.

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6
Q

What population is most at risk for burns?

A

Males in their 20’s and 30’s

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7
Q

Symptoms of primary acute phase of HIV infection

A

Fever, chills, and rash
(fever
headache
rash
sore throat.)

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8
Q

You have an order to administer Morphine to a patient with terminal gastric cancer with these VS: BP 107/67, HR 90, and respiratory rate 10. Do you hold the medication, notify the provider, or administer the Morphine?

A

Give the Morphine despite slow respiratory rate because pt is terminal.

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9
Q

Emergent resuscitative phase of burn management

A

Give fluids because with will be fluid deficient/hypovolemic due to loss of plasma.

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10
Q

how long doe the emergent resuscitative phase of burn management last?

A

24-48 hours.

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11
Q

Stage IV cancer

A

has metastasis.

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12
Q

What indicates that Anti-retroviral-therapy (ART) is being effective in the HIV/AIDs patient?

A

There will be an increase of CD4 which means the therapy is effective and the patient is less immunocompromised.

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13
Q

Encephalopathy occurs in which stage of HIV infection.

A

3

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14
Q

A patient with lung cancer is receiving Methotrexate. What to monitor?

A

Kidney function (Creatinine and BUN.)
elderly with poor kidney function will l not be able to clear the medication and will have a buildup in their body.

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15
Q

A patient underwent a colonoscopy and was discovered to have a mass. How to confirm if it has metastases?

A

CT scan
Carcinoembryonic Antigen (CEA) indicates metastases if elevated, but is not as reliable as CT

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16
Q

What will you test /need to be done prior to patient having surgical resection of a liver lobe? SATA

A

MRI
Biopsy
Liver Enzymes

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17
Q

What statement made by patient would indicate understanding of a left lung lobectomy?

A

“I am having one lobe of my left lung removed”

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18
Q

Risk factors for HIV

A

having condomless anal or vaginal sex

having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhea and bacterial vaginosis

engaging in harmful use of alcohol and drugs in the context of sexual behavior

sharing contaminated needles, syringes and other injecting equipment and drug solutions when injecting drugs

receiving unsafe injections, blood transfusions and tissue transplantation, and medical procedures that involve unsterile cutting or piercing

experiencing accidental needle stick injuries, including among health workers.

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19
Q

Patient is receiving Daunorubicin (anti-tumor antibiotic) for Kaposi Sarcoma-
what lab is monitored/concerning

A

Elevated bilirubin is the most concerning due to the drug being extremely hepatotoxic

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20
Q

What symptoms will be present in a patient with stage 3 colorectal cancer that would indicate they
are experiencing adverse reactions to chemo?

A

Paresthesia
Anemia
Palmar-Plantar-Erythrodysesthesia
Neutropenia
Fatigue
Diarrhea

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21
Q

What is the CD4 count of a patient with stage 2 HIV?

A

200-499

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22
Q

Why is Leucovorin administered in conjunction with Methotrexate?

A

It negates the harmful impact on the cells- cell protecting

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23
Q

Which animal is a xerograph usually from

A

pig

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24
Q

Therapeutic communication example

A

“It is routine to check areas nearby to make sure they are ok”.

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25
Q

RN gets dirty needle stick from an HIV positive patient. What is the first thing or priority for the RN to do?

A

Initial thing to do is report is to the supervisor
Second start post exposure prophylaxis

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26
Q

What will Labs look like immediately after a burn?

A

HYPERkalemia
HYPOnatremia
Decreased platelets (thrombocytopenia) *NOT Thrombocytosis
Increased Hematocrit (Hct)

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27
Q

RN is concerned about a burn patient with poor nutritional intake. What should the RN do?

A

Educate patient on the importance of nutritional intake for burn healing.

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28
Q

A RN is preparing a class to teach about gastric cancers. Which population is at highest risk for gastric cancer?

A

Patients with H. Pylori infections

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29
Q

Patient sustained burns to bilateral lower legs and feet. What is the burn percentage?

A

18%

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30
Q

Which med is preferred for gastric cancer?

A

Trastuzumab

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31
Q

RN is caring for a patient with burns to the face and neck who has wheezing, what type of injury is this concerning for?

A

Inhalation Injury

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32
Q

What is the most comfortable position for a patient with pancreatic cancer?

A

Sitting down and leaning forward

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33
Q

What adverse reactions do we need to monitor for in a patient with pneumocystis receiving (TMP-SMX ?) -Bactrim

A

Thrombocytopenia
Rash
Fever
Leukopenia
Hepatitis
Hyperkalemia
Azotemia ?

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34
Q

A pregnant patient with HIV is receiving Zidovudine, which labs need to be monitored?

A

Liver enzymes due to the hepatotoxic nature of the medication.

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35
Q

Name of the process or enzyme where the HIV enters the CD4 cell and changes?

A

Reverse Transcriptase

36
Q

HIV pt receiving ART developed immune-inflammatory-response-syndrome (IRIS), which medication will be used for treatment?

A

Steroids

37
Q

An electrocuted patient has blood in the urine which signifies increased myoglobin due to muscle breakdown and patient will develop…

A

Acute Kidney Injury

38
Q

Process of interventions for 2nd and 3rd burn care

A

Assess airway
Insert IV
Estimate BSA
Begin fluid resuscitation
Assess for secondary injuries

39
Q

Preferred IV fluid for burn patients

A

LR

40
Q

What should be included in a teaching a community nurse is doing about HIV/AIDS for high school students?

A

Pre-exposure prophylaxis medication

41
Q

Immediate post procedural care for a pancreatic cancer patient that underwent and WHPIL procedure? SATA

A

Nutritional needs
Fluid balance
Grieving
Pain control
NOT HOSPICE

42
Q

Interventions for patient on burn unit that states “I’m going to be so ugly.” SATA

A

Include patient in decision making for treatment plan
Encourage patient to talk about their feelings
Remember that withdrawal could be a coping mechanism
**NOT assist patient with looking at wounds
**NOT suggest patient see a therapist

43
Q

Burn prevention for children SATA

A

Practice home fire drill
Keep matches out of reach
Never leave child alone in bathtub

44
Q

What is the priority for HIV encephalopathy?

A

Risk for injury

45
Q

Early manifestation of liver cancer?

A

Dull ache in back

46
Q

Patient weighs 198 lbs and has 20% BSA burn. How much fluid will be administered in the first 8 hours?

A

3592ml (450ml/hr)
3600ml

4(ml)(kg)(%)

47
Q

Family teaching for a patient being discharged to home with a chemo port. SATA

A

Report s/s of infection
The port is for intermittent home infusions, not continuous infusions
Teach how to de-access port- DO NOT teach how to access port
Pt will have to return to the chemo clinic to have the port accessed

48
Q

Which interventions are associated with an improved outcome for a burn patient? SATA

A

Support groups
Adequate nutrition
Cleanliness
Early mobility
pain control
compression garments
**include family in wound care

49
Q

Stage 3 HIV Patient demonstrates understanding of teaching when he makes these statements. SATA

A

I will include high calorie nutrition
I will avoid sick people
I will cook food thoroughly (eggs and meat cooked thoroughly)
NO raw veggies, nuts, alcohol, or spicy foods
*Do not select I” will wash my hands after cleaning the liter box.” Patient should not be near a liter box.

50
Q

How to reduce risk of infection?

A

Replace all tubes and lines every 24 hours. Not VI access, but fluid and med lines

51
Q

IV drug user presents with flu like symptoms and states he had a negative HIV test last week. What to teach the patient. SATA

A

Still can have the virus but have not produced enough antibodies yet to test positive.
Patient will need to retest.

52
Q

A nurse is caring for a burn patient in the emergent resuscitative phase. Which nursing diagnosis would be appropriate.

A

Deficient fluid volume

53
Q

The nurse is assessing a client for HIV. The nurse identifies which of the following as a risk factor for this condition? sata

A

Being a bisexual man

Receiving an organ transplant

Breastfeeding infant of hiv positive mother okay if on antiviral

53
Q

The nurse is caring for a pt who has been dx with stage 2 colon cancer. The client tells the nurse, the doctor order some blood work to check my liver and I didn’t ask why. Do you know?. What is the nurse best response?

A

It is routine to check other areas that are close by to see if they are ok

54
Q

The nurse is caring for a patient who has suffered full-thickness burns of the face, neck, and upper extremities. The patient is hoarse, having trouble speaking and wheezing. The nurse suspect that the patient is suffering from which type of the following conditions?

A

Inhalation injury

55
Q

The nurse is preparing a class for a group of seniors on types of GI cancers. When preparing the segment on gastric cancer, which of the following would the nurse include when discussing the highest risk factor for the disease?

A

H. pylori infection

56
Q

A client is admitted with aids and is complaining of fever, coughing, night sweats, and hemoptysis. The patient is placed on airborne precautions. Which of the following additional orders should the nurse expect from the HCP?

A

Rifampin

57
Q

The HCP has prescribed targeted therapy for a pt with advanced gastric cancer. The nurse prepares to administer which of the following medications?

A

Trastuzumab

58
Q

The nurse is seeing a client with hiv in the doctor’s office for follow up after initiating of ART. For which of the following therapeutic response will the nurse assess?

A

Increase in CD4 count…

59
Q

A pt has been exposed to hiv by sexual contact and the virus has entered the pt system. The nurse is aware that when the virus enters the pt CD4+ cell, the virus changes it genetic material from RNA to DNA through the action of which enzyme

A

Reverse transcriptase

60
Q

Which of the following nursing interventions would be appropriate for a severely burned pt with the nursing dx. “High risk for infection”? s

A

Change intravenous lines every 24-72 hrs

Change tube feeding supplies every 24 hrs

Restrict fresh flowers from the room

Restrict visitors from the room

61
Q

The nurse is preparing to administer an opioid analgesic to a pt admitted 24 hr ago with partial and full thickness burn injuries over 40% of the body. The nurse should plan to administer the drug by which of the following notes?

A

Intravenous

62
Q

A nurse at a urgent care is assessing a client who presents with a severe sunburn with redness, swelling and blister formation. How would the nurse document the extent of burn injury?

A

2 degree

63
Q

The ED nurse is caring for a pt brought by ambulance with extensive second and third degree burns in what order should the nurse implement the following intervention?

A
  1. Assess airway status
  2. Insert a large bore intravenous catheter
  3. Estimate the percentage of TBSA burned
  4. Begin fluid resuscitation
  5. Assess the secondary injuries
64
Q

A pt presents to the ED w/ partial thickness burns of both lower legs and feet. What is the approximate (TBSA) total body surface area burned using the rule of nines?

A

18%

65
Q

A pt is receiving the antitumor antibiotic, daunorubicin, for treatment of Kaposi’s sarcoma. The nurse is reviewing the lab results prior to the next dose. The lab results are as follows hgb 9.5, wbc 4600, platelets 120,000, creatinine 1.4, bilirubin 4.2. which of the results would warrant notification of the physician?

A

Bilirubin

66
Q

Which of the following nursing dx would the nurse consider a priority for a pt with hiv encephalopathy?

A

Risk for injury

67
Q

A pt comes to the clinic with flu like sym. The pt reveals a current practice of IV drug use and needle sharing. The client reports having an hiv antibody test last week that was negative. What information should the nurse share with the pt.?

A

You could still have the virus and not have produced antibodies yet. You need to have another test that detects the actual virus

68
Q

The nurse is caring for a pt with hiv encephalopathy. The nurse knows that the patient is in which stage of HIV infection?

A

3

69
Q

A nurse gets an accidental needle stick from a needle that was used for a patient diagnosed with HIV. What is the nurse’s first action?

A

Report it to the supervisor

70
Q

A pregnant pt who is HIV positive is receiving monotherapy with zidovudine. The nurse needs to monitor which of the following lab test b/c of the pt increased risk?

A

Liver enzymes

71
Q

A pt with lung cancer is undergoing surgery for a lobectomy of the left lung. The nurse verifies the pt understanding of the procedure by which of the following statements?

A

I am having one lobe of my left lung removed

72
Q

A pt with liver cancer has had a hepatic artery port implanted as a way to deliver chemotherapy after the patient is discharged to home. The nurse is providing education to the client and family for the care of the port and the chemotherapy. Which of the following statements by the client indicates understanding of the teaching?

A

I will return to the infusion center to have the port accessed for each infusion

73
Q

The nurse is preparing to administer methotrexate to a 77 yr old pt w/ lung cancer. Which of the following lab results should be closely monitored before and during therapy?

A

Creatinine clearance

74
Q

A pt is dx with metastatic pancreatic cancer. When discussing the best chemotherapy drugs for treating the disease, the nurse tells the client that the current standard of care for treatment is which of the following drugs?

A

Gemcitabine

75
Q

.A pt is told after a colonoscopy that there was a mass in the colon. Which additional diagnostic test would the nurse expect the HCP to order to help confirm metastasis?

A

CT scan

76
Q

Which of the following RN interventions have been associated with improved outcomes
in the pt with severe burns? Select All That Apply

A

Early mobility
Peer support programs
Use of compression garments
Providing pain med around clock

77
Q

A nurse preceptor is supervising a new nurse in the burn unit. When the nurse is providing wound care to a patient, which of the following actions by the nurse would cause the preceptor to intervene?

A

The nurse prepares to remove a graft dressing that was applied the day before

78
Q

A patient with terminal gastric cancer has enacted a Do Not Resuscitate (DNR). The client is severe pain, is restless, and in and out of consciousness. The client’s vital signs are P 92, RR 8, BP 108/68. The patient has morphine ordered for pain. What is the appropriate action by the nurse?

A

Give the medication and assess for pain relief

79
Q

RN is caring for pt who suffered electrical conduction injury while working on power lines. Which clinical finding would prompt the RN to notify HCP immediately?

A

Hematuria

80
Q

A Pt is admitted to hospital with protein-calorie malnutrition and wasting syndrome secondary to AIDS. What is appropriate initial intervention by RN?

A

Perform the admission assessment and dietary history

81
Q

The oncology RN is giving leucovorin to pt with lung cancer who is also being treated with methotrexate. When the pt asks the RN why leucovorin is also being given, how should the RN respond?

A

Leucovorin will protect healthy cells from the effects of methotrexate

82
Q

The RN is concerned for severely burned pt because poor nutritional intake. Which initial intervention should the RN implement?

A

Start weighing the client weekly to assess nutritional status

83
Q

RN is caring for pt with non-small cell lung cancer (NSCLC) whose tumor is classified as stage IV. RN knows that stage IV means which of the following?

A

Metastatic spread

84
Q

Based solely on age and gender, which of the following clients would RN consider to be at highest risk for burn injury that would require admission to a burn center?

A

Male, age 28

NSG 233 (6 decks)

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