exam 5 Flashcards
What histamine releasing mas cells are attached to?
organ tissue
with passive-acquired immunity, where are the antibodies acquired from?
outside the host and instilled in the host
what is a “large shift to the left” on a complete blood cell count
neutrophils are greater than 60%
what a symptom is that is pertinent to a possible diagnosis of systemic lupus erythematous
butterfly shaped rash on the face
If a hospitalized patient was prescribed dexamethasone (Decadron) for an allergic reaction, what teaching instruction would the nurse want to give at discharge?
do not stop abruptly and take with meals to prevent GI discomfort
if a person taking Decadron complains of insomnia, know what meal the patient should take the drug with
breakfast
When developing a nursing care plan on a patient with HIV, know what the care plan should include
aseptic technique to prevent infection
if an 11 year old girl is diagnosed with ITP, idiopathic thrombocytopenia purpura, know what the parental statement, regarding medications, would indicate nursing teaching has been successful
avoid sulfa drugs
If a nurse is preparing a patient for liver-spleen scan, know what intervention is the most important before the scan
any allergies to contrast medium
When healthy bone marrow is growing back after chemotherapy in patients with leukemia, what is the patient at greater risk for?
infection and bleeding
if the nurse has assessed a neutrophil count of 900/mm3, on a patient with acute leukemia, know what the nurse should implement on the patient
compromised host precautions
If a 24 year old woman is admitted to the hospital for a complete medical examination, know what s/s would indicate SLE?
joint pain, musculoskeletal pain
In a patient with acute leukemia, what lab result would indicate that the drug protocols are not effective
platelet count
what observation by the nurse, would indicate a patient’s acceptance of the diagnosis acute leukemia
asking for additional information
If a patient with leukemia has a nursing diagnosis of: imbalanced nutrition: less than body requirements”, know what goal would be realistic for this patient
stable body weight
what drug is given to a patient who has just undergone a bone marrow transplant to stabilize the immune response and prevent rejection
Decadron
the name of the bone marrow transplant that uses the patient’s own bone marrow
autologous
how would a nurse give an example of innate immunity, by comparing it with a human’s immunity, related to what disease
foot and mouth disease
in the preparation to perform skin testing, what should the nurse do?
re-examine in 2-3 days - check for swelling
according to the CDC, know what population is the highest risk for HIV infection in the US
African Americans
what does the enzyme reverse transcriptase transcribe
HIV RNA into HIV DNA
when a nurse takes into consideration planning care for a patient with HIV, what is a common for of HIV transmission and what would the nurse tell the patient?
male to male sexual contact
When assessing a patient with AIDS for risk factors, know what the most risky behavior is
anal sex with a condom
if a very anxious man comes to a clinic believing that he may have HIV infection, due to persistent influenza like s/s and his risky sexual behavior, know what the patients blood analysis would show
positive ELIZA - high levels of HIV infected cells with elevated antibodies
how long does the initial stage of an HIV infection last?
4-8 weeks
how would a nurse know that teaching for a patient with HIV in the latent phase, has been effective?
they won’t have any symptoms
In a patient diagnosed with HIV, that has “Microsporidiosis” what should the teaching plan include?
drink the liters of fluid everyday
When a patient with HIV is diagnosed with PML - progressive multifocal leukoencephalopathy, know what the nurse should encourage the patient to do
make a plan for their death
what is the nursing diagnosis that would take priority in the care of an outpatient with AIDS
therapeutic regimen - medications
by removing a potted plant from the room, of a patient with AIDS, what disease will this prevent?
aspergillosis
If a patient with HIV develops shingles, know what childhood disease exposure this is related to
chicken pox
when giving a patient with “oral hair leukoplakia” liquids, know what implementation the nurse could use for comfort
drink from a straw
if a patient is tested for HIV and the “ELISA” test is positive, then know what the next course of action is
western blot test
If a patient with HIV is prescribed “HARRT” therapy, know what the nurse should tell the patient about inconsistent administration of the drug
patient can develop a resistant strain of HIV
What is a major focus in a teaching plan for a patient with sickle cell anemia?
maintain good hydration
What is a normal hematocrit value, in comparison to hemoglobin value
3x
if an LVN is caring for a patient having a blood transfusion and the patient is wheezing and complaining of back pain, after the nurse stops the transfusion, know what the nurse should do next.
stop the blood and keep running the saline, notify physician or charge nurse
if a patient is receiving “Epogen” know how soon an increase in the RBCs will occur
2 -3 days
how would a nurse explain a sickle cell crisis, what happens to the sickle shaped red blood cells
they become stuck together and obstruct blood flow
which alternative therapy used for menopause s/s can cause purpura on a patients arms
black cohosh
what is the rationale for administering injections of B12 to patients with pernicious anemia?
it doesn’t need to be absorbed in the GI tract because intrinsic factor is missing
what foods does the nurse need to educate the patient to eat if the patient has iron deficiency anemia
beans, greens, whole wheat bran cereal, liver
based on a nursing assessment, what is an appropriate nursing diagnosis for a patient with hemophilia?
acute pain
If a child is placed on the drug “hydroxyurea” for sickle cell anemia, how would the nurse explain the drug
produces a certain type of hemoglobin that resists sickling
if a patient received 1 unit of platelets with a platelet count of 20,000/mm3 what would the patients platelet count increase to?
25,000 to 30,000
if a nurse gives Ferrous Sulfate (Feosol) to a home health patient, know what the nurse should do
administer through a straw to prevent teeth staining
know what a nurse should look for when assessing a patient for thrombocytopenia
petechiae and purpura
in preparing a care plan for a 90 lb, 82 year old woman with iron deficiency anemia, with a hemoglobin of 5.2, what would be the most appropriate nursing diagnosis?
risk for activity intolerance because of fatigue
if a school nurse starts a clean up campaign at a local elementary school, in an effort to combat some allergens, what one of the most common allergic response disorders is
asthma
what medication given to a patient with severe inflammatory response, mimics a hormone secreted by the adrenal cortex?
cortisol
with the exposure to an antigen, histamine is released, which is the initiator of the inflammatory response. what is histamine released from?
basophils
if a mosquito or a fly carries an organism that infects another living organism, what is this mode of transmission?
vector
what should a home health nurse teach a family to teach the most effective method to control the spread of communicable disease?
hand hygiene
why would a home health nurse recommend an air conditioner duct cleaning? diseases caused by what?
fungus
if a nurse is taking care of a patient that is immunosuppressed and trying to protect the patient from infection, what are some of the things the nurse wouldn’t allow in the patients room?
plant
some drugs reduce inflammation, but also hinder the body’s immune response. be able to give an example of some of those drugs
corticosteroids and bronchodilators
if a nurse has a patient coming into the doctors office for antigen injections, for allergies to pollen, know what the nurse would teach the patient regarding antigen injections
desensitization and decreasing severity of allergic response, increases tolerance
if a patient with c-diff infection asks the nurse what caused the diarrhea, know how the nurse would respond
long term use of oral broad spectrum antibiotics
know why a patient that just received a large IM dose of an antibiotic, was asked to wait 20-30 minutes before checking out
make sure they don’t have a reaction
if a patient, after receiving an injection of penicillin has an anaphylactic reaction, know what the nurse should immediately do
oxygen
if a patient is hospitalized with pneumonia and AIDS, what would be the most important standard precaution
hand washing
what are the organs that are involved in immunity
liver, spleen, lymphatic system, thymus, tonsils
what is the difference between medical asepsis and surgical asepsis?
clean technique and sterile technique
what does the c in caution stand for regarding the 7 warning signs of cancer?
change in bowel or bladder habits
what does the a in caution stand for regarding the 7 warning signs of cancer?
a sore that does not heal
what does the u in caution stand for regarding the 7 warning signs of cancer?
unusual bleeding or discharge
what does the t in caution stand for regarding the 7 warning signs of cancer?
thickening or lump in a breast or elsewhere
what does the i in caution stand for regarding the 7 warning signs of cancer?
indigestion or difficulty swallowing
what does the o in caution stand for regarding the 7 warning signs of cancer?
obvious change in a wart or a mole
what does the n in caution stand for regarding the 7 warning signs of cancer?
nagging cough or hoarseness
What is the latent period before the period of rapid growth of tumors phase is
promotion
in a teaching plan know how malignant tumors are similar to benign tumors
press on normal tissue and compete with normal cells
if a patient states I have lost my life and future due to my cancer, know what type of coping strategy the patient would be using at this time
avoidance
if a patient is scheduled for chemotherapy in 30 minutes and receives a meal tray, know what the best intervention would be
hold the tray
why would cannabinoids, Benadryl and Vistaril be ordered for a patient who is taking chemotherapy.
nausea and vomiting
if a nurse observes several large new bruises on a patient with cancer, what is the possible cause
DIC - disseminated intravascular coagulation
Hypercalcemia is an oncologic emergency. know what the s/s the nurse would asses for
confusion, polyuria, fatigue, weakness,
know how the nurse would interpret the following staging of this cancer T4N2M2
large size and extension, increased involvement of regional lymph nodes, metastasized to more than one site
if a patient is receiving the chemotherapy drug doxorubicin (Adriamycin) what should the nurse carefully assess the patient for
toxic to the heart
what during diagnosis would be appropriate for a diagnosis of breast cancer first made at stay T1N0M0
minimal size and extension, no regional lymph nodes involved and no distant metastasis. patient will have anxiety about treatment and spreading
what is the most common site of cancer in adult men
prostate
what is the potential for addiction with the narcotic medication roxanol
low
what the most common cytologic test is, usually performed out patient that indicates the need for further testing for cancer cells
PAP smear
how does radiation cause cell death
damages cell membrane
what is the best menu for a patient who is undergoing radiation treatments every other day
clear liquid, soups, mild and easily digested foods
if a patient is close to death with terminal liver cancer and calls the nursing staff to the room every 5 minutes, what inerventions would be most supportive
control pain, breakthrough pain
how would you know that a patient understands the pre-colonoscopy instructions
lighted tube is inserted into their rectal opening
