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Nur 201 Final > Final > Flashcards

Final Flashcards

1
Q

How to use a cane

A
  • Elbow should be flexed 30 degrees
  • Pt. should hold cane in hand opposite to affected extremity
  • Cane and affected leg should be moved together at same time
  • Pt. should bear down on cane when unaffected extremity is moved
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2
Q

Using a cane on stairs

A
  • Down: 1. Affected extremity 2. Cane 3. unaffected extremity.
  • UP: 1. Unaffected extremity, 2 Cane and affected extremity
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3
Q

How to use crutches

A
  • Crutch length should be 5 cm (2 in) below axilla

- 20 – 30 degrees of flexation should be allowed at elbow

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4
Q

Using crutches on stairs

A
  • Down: 1. Crutches 2. Affected 3. Unaffected

- Up: 1. Unaffected 2. Crutches and affected

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5
Q

Using a walker

A
  • Adjust height so patient arms have 20 – 30 degrees of flexion
  • Instruct pt. to never pull self up using walker and to look up when walking
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6
Q

Primary Prevention

A
  • Aims to prevent health disorders from occurring in the first place by decreasing risk factors and increasing protective factors

Examples of primary prevention activities include youth groups and clubs, which help to increase community bonds and support; parenting classes; and education to prevent substance abuse

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7
Q

Secondary Prevention

A
  • As this level a patient already has a disorder; secondary prevention aims at detecting the disorder early to intervene promptly

Essentially, this means screening. Screening patients for depression or suicide risk, for example, can lead to the early intervention ― and prevention — of a more dire outcome.

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8
Q

Tertiary Prevention

A
  • Focus is on period after mental health disorder or crisis has occurred; tertiary prevention aims to promote patient recovery and to prevent further complications.

Examples of tertiary prevention include outpatient support for a patient following a hospitalization related to a mental health disorder or crisis. It can include pharmacological therapy. And it can include support groups for family and friends of a patient who has committed suicide as a way for them to begin the healing process.

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9
Q

What to do before administering Zyprexa/Olanzapine (2)

A
  • Assess mental status (orientation, mood, behavior) before and periodically during therapy
  • Monitor BP
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10
Q

Clozaril/Clozapine – When to notify MD

A

If fever develops

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11
Q

Patient teaching for lithium

A
  • Weight gain is expected

- Be careful to eat healthy diet

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12
Q

Medications which require blood level monitoring (4)

A
  • Lithium
  • Clozapine/Clozaril
  • Valproic acid
  • Carbamazepine
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13
Q

Priority nursing diagnosis for patient with bipolar, insomnia and weight loss

A
  • Imbalanced nutrition: less than body requirements
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14
Q

The parents of a teenage son who was recently diagnosed with bipolar disorder ask the nurse to provide them with information about this illness, since they had previously been told their son had ADHD. Which of the following is evidence-based information that can be shared with the family? Select all that apply.

1) ADHD is the most common comorbid condition in children and adolescents with bipolar disorder.
2) Bipolar disorder in children and adolescents is an acute condition that they usually outgrow.
3) There is evidence to support that psychosocial therapy enhances the effectiveness of pharmacological therapy in treatment of bipolar disorder in children and adolescents.
4) Stimulants used in the treatment of ADHD can exacerbate mania in children and adolescents with bipolar disorder.
5) Medication discontinuation can be considered after the patient has been in remission for two months.

A

1) ADHD is the most common comorbid condition in children and adolescents with bipolar disorder.
3) There is evidence to support that psychosocial therapy enhances the effectiveness of pharmacological therapy in treatment of bipolar disorder in children and adolescents.
4) Stimulants used in the treatment of ADHD can exacerbate mania in children and adolescents with bipolar disorder.

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15
Q

Nursing diagnosis for patient twisting and pulling hair

A

Ineffective impulse control

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16
Q

What to monitor in patient taking Zoloft/sertraline (SSRI antidepressant)

A

Suicidal ideation

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17
Q

Education for patient who missed a dose of Wellbutrin/bupropion (antidepressant)

A

Missed doses should be omitted. Do not double dose

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18
Q

Therapeutic communication technique to get information from patient

A

Open ended questions

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19
Q

Medication for patient presenting with alcohol withdrawal (diaphoresis, nausea, tremors)

A
  • Ativan/lorazepam (antianxiety benzodiazepine)

- Librium (antianxiety benzodiazepine)

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20
Q

S&S of avoidant personality disorder

A
  • Social isolation

- Fear of rejection

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21
Q

Teaching for patient taking beta blockers

A

Change positions slowly

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22
Q

Why is thiamine given for alcohol detoxification?

A
  • To treat/reduce risk of Wernicke’s disease
  • To maintain neuronal activity

Wernicke’s disease is a brain and memory disorder. Caused by thiamine (b1) deficiency it causes cause ataxia, confusion and visual change; it must be treated immediately.

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23
Q

What can type 1 diabetes lead to?

A

Blindness

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24
Q

What should the nurse do first if a urinalysis tests positive for glucose?

A

Finger stick

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25
Q

Normal range for urine osmolarity?

What does a value of 1200 mean?

A
  • Normal range is 200-800
  • 1200 = dehydration
  • Nurse should push fluids
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26
Q

Medication teaching for patient experiencing a migraine headache after taking a betablocker

A
  • Expected finding

- Don’t stop taking the medication

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27
Q

A patient is using a continuous passive motion machine. What tasks can be delegated to the CNA

A
  • Move it away from the reach of the pt.

- Raise the lower siderail on the affected side

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28
Q

Normal urinalysis protein value

A

< 20 mg/day

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29
Q

Normal urinalysis specific gravity value

A

1.002 - 1030

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30
Q

Normal urinalysis PH value

A

5.0 - 9.0 (average of 6)

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31
Q

Normal urinalysis glucose value

A

Negative

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32
Q

Normal urinalysis ketones value

A

Negative

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33
Q

Normal urinalysis leukocyte value

A

Negative

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34
Q

Normal urinalysis hemoglobin value

A

Negative

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35
Q

How much water should a patient with renal calculi drink per day

A

2-3 L / day

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36
Q

Provider orders gentamicin for patient with pyelonephritis; what action should the nurse take?

A

Gentamicin is nephrotoxic, consult with pharmacist about antibiotic selection

37
Q

Teaching for a patient prescribed an antibiotic to treat otitis media

A

Complete entire course of antibiotic therapy

38
Q

Teaching for a child who has had a tympanostomy

A
  • Avoid getting water in ears

- Need for waterproof ear plugs

39
Q

Treatment for chronically recurrent ear infection?

A
  • Placement of ear tubes (for drainage) AKA tympanostomy
40
Q

Kind of headache associated with family history; unilateral throbbing preceded by prodrome of photophobia?

A

Migraine

41
Q

Intervention to relieve pain for patient with osteoarthritis

A
  • Warm morning bath
42
Q

Common microbial cause of UTIs

A

E. Coli

43
Q

Clinical manifestations of rheumatoid arthritis (4)

A
  • Low grade fever
  • Fatigue
  • Anorexia
  • Weight loss
44
Q

Difference between RA and OA

A
  • RA defined by “frequent remission and exacerbation”
45
Q

Patient is complaining of pain in epigastric region. What question to ask to determine if caused by peptic ulcer?

A
  • Does your pain resolve when you have something to eat?

Pain relief after eating is associated with duodenal peptic ulcers

46
Q

Principle of crutch walking after amputation

A
  • Start slow, don’t walk for long periods

- Lift weights in preparation

47
Q

Positioning of patient with amputation above the knee?

A
  • Supine with affected limb supported with pillows for the first 24 hours
  • Afterwards prone (stomach) for 20 – 30 minutes q3-4h
48
Q

Position for prostate exam?

A
  • Knee chest (side-lying fetal)
49
Q

What finding would be the priority in a patient with renal calculi?

A

Pain

50
Q

Prostate cancer and surgery

A

Surgery is not advisable during the early stage

51
Q

Suspected problem and action if patient presents with flank pain?

A
  • Suggests kidney issue

- Collect and strain urine

52
Q

Intervention to prevent a UTI (4)

A
  • Set up a toileting schedule
  • Avoid coffee, tea, cola and alcohol
  • Increase fluid intake
  • Perineal hygiene
53
Q

When can compression dressing be removed after AKA surgery?

A
  • During physical therapy

- When bathing

54
Q

Stump wound care (4)

A
  • Elevate stump for 24 hours
  • Analgesics
  • Discuss phantom limb pain
  • Observe for bleeding
55
Q

Stump care after wound has healed (4)

A
  • Wash, rinse and dry stump daily
  • Don’t apply anything to stump (No alcohol or lotions)
  • Assess for skin breakdown
  • Encourage use of prosthesis ASAP and all day to prevent stump swelling
56
Q

Antibiotic commonly prescribed for UTIs

A

Bactrim

57
Q

Risk factors for community acquired pneumonia (3)

A
  • Smoking
  • Substance abuse
  • Age > 65
58
Q

When to read a PPD & What is a significant finding?

A
  • Within 48 – 72 hours
  • 5 – 10 mm is significant
  • Significant = chest x-ray
59
Q

What is the QuantiFERON test?

A
  • Preferred diagnostic test for pts. who received the BCG vaccine and for pts who are not likely to return for reading of PPD.
  • Results available within 24-56 hrs.
60
Q

Should a patient with BPH decrease their fluids

A

No

61
Q

What assessment question should the nurse ask a patient presenting with a tension headache?

A

What OTC medications do you take?

62
Q

What potential allergy must the nurse check for before foley insertion?

A

Iodine

63
Q

Pain medications for arthritis

A
  • Tylenol
  • NSAIDs
  • Motrin
  • No narcotics
64
Q

Classic sign of OA

A

Joint pain relieved by rest

65
Q

How does anemia effect activites

A
  • Decreased tolerance to activities (low O2)

- Chronic fatigue

66
Q

Medication for anemia

A
  • Iron (ferrous sulfate)

- Iron causes constipation – stool softener (Colace) may also be prescribed

67
Q

Nurse’s responsibility with consent forms

A

Assess patient’s understanding

68
Q

Cancer screening ages

pap, mammogram, colon, prostate

A
  • Pap smear 21 (every 3 years)
  • Mammogram 40
  • Colon cancer 50
  • Prostate cancer 40
69
Q

S&S of phlebitis (4)

A

Phlebitis – inflammation of the vein

  • Redness, pain and warmth at site
  • Local swelling
  • Palpable cord along vein
  • Elevated temperature
70
Q

S&S of infiltration (4)

A

Infiltration – seepage of nonvesicant solution into surrounding tissues

  • Swelling
  • Tenderness
  • Pallor
  • Hardness and coolness at site
71
Q

S&S of Extravasation (4)

A

Extravasation – seepage of vesicant substance into tissues

  • Pain, burning and swelling at site
  • Blanching and coolness of surrounding skin
  • Blistering (late sign)
  • Possible necrosis of dermis
72
Q

S&S of Thrombophlebitis (3)

A

Thrombophlebitis – thrombosis and inflammation

  • Edema
  • Tender, cord like veins
  • Warmth and erythema at site
73
Q

S&S of infection at IV site (4)

A

Microbial contamination of the cannula or IV site

  • Redness
  • Swelling
  • Exudate
  • Elevated temperature.
74
Q

Cardinal signs of colon cancer

A
  • Streaks of red blood in stool
75
Q

BPH medications (2)

A
  • Tamsulosin/Flomax (alpha-adrenergic antagonist); relaxes smooth muscle of prostate to improve urine flow
  • Oxybutynin/Ditropan (Antispasmodic); relieves restrictive muscle spasms of the urethra
76
Q

How to tell albuterol is work for pt. with Asthma? (3)

A
  • No SOB
  • SpO2 > 95%
  • Clear lung sounds
77
Q

CROUP cardinal sign

A
  • Barking cough
78
Q

S&S Intussusception (4)

A
  • Red currant, jelly-like stools
  • Abdominal pain
  • Nausea & vomiting
  • Sausage-shaped mass in abdomen
79
Q

Treatment for Hirschsprung?

A

Surgery

80
Q

What does continuous bubbling in the water chamber of test tube mean?

A
  • There is a leak

- Bubbling should be intermittent

81
Q

What does it mean if a patient with CROUPs presents with stridor?

A

Emergency

82
Q

S&S of dumping syndrome (6)

A
  • N&V
  • Flushing
  • Tachycardia
  • Diarrhea
  • Dizziness
  • Diaphoresis
83
Q

Findings to report in pt. with peptic ulcer (3)

A
  • S&S of hemorrhage
  • S&S of penetration and perforation
  • S&S of pyloric obstruction
84
Q

S&S of hemorrhage (5)

A
  • Blood in stool
  • Cool skin
  • Confusion
  • Tachycardia
  • Dyspnea
85
Q

S&S of penetration and perforation (5)

A
  • abdominal pain
  • Vomiting
  • Elevated temperature
  • Rigid abdomen
  • Tachycardia
86
Q

S&S of pyloric obstruction (3)

A
  • N&V
  • Distended abdomen
  • Abdominal pain
87
Q

Methotrexate indications (2)

A
  • Cancers

- RA

88
Q

Methotrexate patient teaching

p1 4; p2 3

A

Notify provider for:

  • S&S of infection
  • Bleeding (gums, stools, urine, emesis)
  • Fatigue
  • Dyspnea

Avoid:

  • Risks to skin integrity
  • NSAIDS
  • Alcohol

Nur 201 Final (1 decks)

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