FINAL

Question 1

Antiulcer. To treat GERD and gastric ulcers. Interferes with gastric acid secretion.

Answer 1

Omeprazole

Question 2

Antiulcer, gastric acid proton pump inhibitor. To treat GERD and erosive esophagitis. Interferes with gastric acid secretion.

Answer 2

Pantoprazole

Question 3

Antiulcer agent, gastric acid secretion inhibitor. Short-term treatment of duodenal ulcers, benign gastric ulcers, heartburn and indigestion, and GERD. Prevents histamine from binding with H2 receptors on the surface of parietal cells, thus helping to prevent peptic ulcers and to heal existing ones.

Answer 3

Famotidine

Question 4

Antigout. To treat gout and hyperuricemia, gout attack, prevent uric acid nephropathy, and recurrent calcium oxalate calculi. Inhibits uric acid production.

Answer 4

Allopurinol

Question 5

Antitussive, opioid analgesic. To treat mild to moderate pain, cough from chemical or mechanical irritation. Prevents the release of pain neurotransmitters, altering perception of and emotional response to pain, acts on opiate receptors in the cough center to suppress cough

Answer 5

Codeine

Question 6

Analgesic. To manage severe pain in opioid-tolerant patients. Binds to and activates opioid receptors in gray matter, medulla and the spinal cord to produce pain relief.

Answer 6

Hydrocodone

Question 7

Antipyretic, non-opioid analgesic. To relieve mild to moderate pain, to reduce fever. Interferes with pain impulse generation in the PNS and acts directly on temp regulating center in the hypothalamus.

Answer 7

Antipyretic

Question 8

Anti-inflammatory, antiplatelet, antipyretic, non-opioid analgesic. Blocks the enzyme needed for prostaglandin synthesis, which cause local vasodilation with swelling and pain.

Answer 8

Aspirin

Question 9

Laxative, stool softener. To treat constipation. Acts as a surfactant that softens stool by decreasing surface tension between oil and water in feces.

Answer 9

Docusate Sodium

Question 10

Laxative. To treat constipation. Herbal supplement

Answer 10

Senna

Question 11

To treat deficiency, rickets, osteomalacia, hypophosphatemia, hypoparathyroidism, intestinal malabsorption.

Answer 11

Vitamin D (Ergocalciferol)

Question 12

To treat deficiency caused by nutritional intake imbalance or pernicious anemia

Answer 12

Vitamin B-12 (hydroxycobalamin)

Question 13

Antidepressant, antiobsessant, antipanic. To treat major depression, OCD, panic disorder and premenstrual dysphoric disorder. Inhibits reuptake of the neurotransmitter serotonin by CNS neurons, increasing the amount of serotonin available in nerve synapses.

Answer 13

Sertraline (Zoloft)

Question 14

Antianginal, antihypertensive, MI prophylaxis and treatment. Inhibits stimulation of beta1 receptor sites, resulting in decreased cardiac excitability, cardiac output, and myocardial oxygen demand, which helps to relieve angina and reduce blood pressure. Given for this patient’s history of MI.

Answer 14

Metoprolol

Question 15

Antihypertensive, vasodilator. Inhibits conversion of angiotensin I to angiotensin II; decreases release of aldosterone which reduces sodium and water reabsorption and increases their secretion, thus reducing blood pressure. To treat the patient’s hypertension.

Answer 15

Lisinopril

Question 16

Class III antiarrhythmic. Relaxes vascular smooth muscles and improved myocardial blood flow, relaxes peripheral vascular smooth muscles decreasing peripheral vascular resistance and myocardial oxygen consumption.

Answer 16

Amiodarone

Question 17

Antihypertensive, diuretic. Inhibits sodium and water reabsorption in the loop of Henle and increases urine formation. Also reduces intracellular and extracellular fluid volume, thus reducing blood pressure and cardiac output.

Answer 17

Furosemide (Lasix)

Question 18

Used to treat symptoms of hay fever and other allergies.

Answer 18

Loratadine

Question 19

Expectorant. To relieve cough, especially when secretions are thick, and to promote a productive cough. Increases fluid and mucus removal from the upper respiratory tract by increasing the volume of secretions and reducing their adhesiveness and surface tension.

Answer 19

Guaifenesin

Question 20

Bronchodilator. To prevent exercise-induced asthma, to treat bronchospasm in pts with reversible obstructive airway disease or acute bronchospastic attack. Relaxes bronchial smooth-muscle cells and inhibits histamine release.

Answer 20

Albuterol

Question 21

Interacts with verapamil, digoxin, methotrexate, St. John’s wort, and warfarin. Adverse reactions include agitation, dizziness, chest pain, hypertension, hypoglycemia, abd pain, and cough. Give before meals, preferably in the morning. Increases the risk for osteoporosis, monitor for hypomagnesemia, avoid alcohol, aspirin, ibuprofen and foods that increase gastric secretions.

Answer 21

Omeprazole

Question 22

Interacts with digoxin, diuretics, methotrexate and warfarin. Adverse reactions include anxiety, confusion, chest pain, hyperglycemia, abd pain, bronchitis. Administer delayed-release 30 minute before a meal mixed in apple juice or applesauce, if given through an NG tube mix in apple juice ONLY. Monitor PT, INR and indication of C. diff infection. Monitor for hypomagnesemia, can expect relief within 2 weeks of starting therapy.

Answer 22

Pantoprazole

Question 23

Interacts with antacids, bone marrow depressants. Adverse reactions include anxiety, confusion, arrhythmias, palpitations, dry mouth, abd pain, decreased libido, bronchospasm, acne. Shake oral suspension vigorously for 5 – 10 seconds before administration, Wait 30 – 60 minutes after taking famotidine before taking an antacid, avoid alcohol and smoking.

Answer 23

Famotidine

Question 24

Interacts with ACE inhibitors, thiazide diuretics, vitamin C. Adverse reactions include chills, drowsiness, vasculitis, abd pain, exacerbated renal calculi, and alopecia. Obtain baseline CBC and uric acid level and renal and liver function tests before and during therapy, don’t give vitamin C, drink at least 10 large glasses of water daily, results for prevention of acute gout attacks may take up to 2 weeks or longer.

Answer 24

Allopurinol

Question 25

Interacts with anticholinergics, antihypertensives, CNS depressants, MAO inhibitors, other opioids. Adverse reactions include coma, depression, bradycardia, altered taste, abd pain, muscle rigidity, apnea, decreased libido. Should not be given to children following tonsillectomy and/or adenoidectomy, Monitor respirations, assess for urinary retention, can take with food.

Answer 25

Codeine

Question 26

Contraindicated with bronchial asthma or hypercarbia, significant respiratory depression. Interacts with anticholinergics, CNS depressants, mixed agonist/antagonist analgesics. Adverse reactions include anxiety, hypercholesterolemia, dry mouth, hot flashes, abd pain, respiratory depression, UTI, dehydration. Use caution in pts with COPD, the elderly, debilitated patients, do not administer to a pt wearing a transdermal fentanyl patch until it has been removed for 18 hours. Monitor for respiratory depression, constipation, expect to taper dosage every 2 – 4 days, monitor vitals closely, encourage plenty of high-fiber foods.

Answer 26

Hydrocodone

Question 27

Contraindicated with severe hepatic impairment, severe active liver disease. Interacts with anticholinergics, barbiturates, oral contraceptives, warfarin, alcohol. Adverse reactions include abdominal pain, hepatotoxicity, hemolytic anemia, anaphylaxis. Tablets may be crushed or swallowed whole, serious skin reactions may occur, though rare.

Answer 27

Acetaminophen

Question 28

Contraindicated in patients with peptic ulcer disease. Interacts with ACE inhibitors, NSAIDs and anticoagulants. Adverse reactions include confusion tinnitus, GI bleeding. Administer with food or after meals to minimize GI upset. Monitor for bleeding.

Answer 28

Aspirin

Question 29

Contraindicated for fecal impaction, intestinal obstruction, nausea, vomiting or other symptoms of appendicitis, undiagnosed abdominal pain. Interacts with mineral oil and tetracycline. Adverse reactions include dizziness, syncope, palpitations, abdominal cramps and distention, and muscle weakness. Patients should expect long-term use. Administer with a full glass of water or milk.

Answer 29

Docusate Sodium

Question 30

Contraindicated with Crohn’s disease, ulcerative colitis, heart disease, stomach pain, nausea, vomiting. Do not take if pregnant or breast feeding, effects are unknown.

Answer 30

Senna

Question 31

Rotate sites for IM and SQ injections, avoid rapid administration to prevent fainting or dizziness when administering IV, incompatible with many drugs, protect from air and light.

Answer 31

VItamin C

Question 32

Will decompose in light

Answer 32

VItamin D

Question 33

Incompatible with many drugs, subQ should be injected deeply, protect from light.

Answer 33

Vitamin B12

Question 34

Interacts with antipsychotics, aspirin, NSAIDs, warfarin, MAO inhibitors, tricyclic antidepressants. Adverse reactions include abnormal dreams, agitation, atrial arrhythmias, hyperglycemia, abdominal cramps or pain, acute renal failure, bronchospasm, coughing, diaphoresis. Monitor for serotonin syndrome (agitation, hallucinations, coma, tachycardia, labile blood pressure, hyperthermia, nausea, vomiting, diarrhea, incoordination). Monitor for mania and suicidal tendencies. Dilute oral concentrate before taking, and take immediately after mixing.

Answer 34

Sertraline

Question 35

Contraindicated in acute heart failure, pulse less than 45 bpm, cardiogenic shock. Interacts with calcium channel blockers, antiarrhythmics, antidepressants, estrogens, insulin, and all foods. Adverse reactions include anxiety, angina, arrhythmias, blurred vision, constipation. Use caution in patients with CHF, monitor glucose and heart rhythm/rate, notify prescriber if pulse rate falls below 60 bpm.

Answer 35

Metoprolol

Question 36

Contraindicated in patients with diabetes or renal impairment. Interacts with diuretics, insulin, NSAIDs, high potassium diet. Adverse reactions include ataxia, confusion, arrhythmias, chest pain, altered glucose levels, abdominal pain, renal failure, bronchospasm. Use caution in patients with fluid volume deficit, heart failure, impaired renal function, or sodium depletion. Monitor for persistent nonproductive cough.

Answer 36

Lisinopril

Question 37

Incompatible with heparin. Contraindicated in bradycardia that causes syncope (unless pacemaker is present), cardiogenic shock, hypokalemia, hypomagnesemia, SA node dysfunction, second- and third- degree AV block (unless pacemaker is present). Interacts with anticoagulants, beta blockers, calcium channel blockers, St. john’s wort, digoxin, fentanyl, lidocaine, warfarin, grapefruit juice. Adverse reactions include ataxia, confusion, arrhythmias, abd pain, acute renal failure, muscle weakness, acute respiratory distress syndrome. If pt has an implantable cardiac device, monitor because drug can affect pacing or defibrillating thresholds, may cause phlebitis are higher rates, monitor continuous EKG, may cause or worsen pulmonary disorders that develop after therapy.

Answer 37

Amiodarone

Question 38

Incompatible with highly acidic solutions. Interacts with ACE inhibitors, digoxin, insulin, NSAIDs, norepinephrine, thiazide diuretics. Adverse reactions include dizziness, drowsiness, arrhythmias, blurred vision, hyperglycemia, abd cramps, muscle pain or spasms. Use caution in pts with advanced hepatic cirrhosis, allergy to sulfonamides, give in the a.m., monitor weight, blood pressure, and lab values, take at same time each day, pt should eat more high-potassium foods.

Answer 38

Furosemide

Question 39

Can be taken with or without food. Do not use to treat hives that are bruised or blistered, that are an unusual color, or that do not itch.

Answer 39

Loratadine

Question 40

Adverse reactions include dizziness, headache, nausea and vomiting, rash. Take each dose with a full glass of water, increase fluid intake to help thin secretions unless contraindicated, do not take longer than 1 week and notify prescriber about fever, persistent headache, or rash.

Answer 40

Guaifenesin

Question 41

Interacts with beta blockers, bronchodilators, digoxin, MAO inhibitors, potassium-wasting diuretics. Adverse reactions include anxiety, drowsiness, angina, arrhythmias, altered taste, hyperglycemia, UTI, muscle cramps. Administer inhalations during second half of administration. Use caution in pts with cardiac disorders, diabetes, digitalis intoxication, hypertension, hyperthyroidism, or history of seizures. Shake inhaler before use and spray 1 – 4 times into the air before use, wash mouthpiece once a week and let air dry, wait at least 1 minute between

Answer 41

Albuterol

Question 42

• an additional substance, treatment, or procedure used for increasing the efficacy or safety of the primary substance, treatment, or procedure or for facilitating its performance

Answer 42

Adjunct Analgesic

Question 43

• an effect wherein two or more substances or actions used in combination produce a total effect, the same as the arithmetic sum of the individual effects.

Answer 43

Additive Effect

Question 44

the interaction of elements that when combined produce a total effect that is greater than the sum of the individual elements, contributions

Answer 44

synergistic effect

Question 45

when their interaction causes a decrease in the effects of one or both of the drugs. Both synergy and antagonism can both occur during different

Answer 45

Antagonistic effect

Question 46

Erikson’s stage for middle adulthood (35-65)

Answer 46

Generativity vs. Stagnation

Question 47

Erikson’s stage:
Changes in physical state: Menopause, andropause
Focus on family, work, aging parents (Sandwich Generation)
Health Concerns: Health screening (mammograms, PSA), stress reduction, healthy lifestyle strategies, adjustment to life transitions

Answer 47

Generativity vs. Stagnation ( middle adulthood)

Question 48

Erikson’s stage for older adults (65+)

Answer 48

Ego integrity vs. Despair

Question 49

Erikson’s stage:
Ageism: a concern for nurses
Aging is a normal, healthy process that begins at birth
System-wide physical changes
Cognitive changes due to illness not aging
Numerous lifestyle changes
Goals:
Remain independent, accept aging, transitions, and loss.
Strategies:
Reminiscence/life review (Storytelling)
Exercise, nutrition, sensory stimulation
Health Concerns: Chronic illness, medications, depression, ETOH abuse, elder abuse

Answer 49

Ego integrity vs. despair

Question 50

age 55-75

Answer 50

young old

Question 51

75-84

Answer 51

middle old

Question 52

85 +

Answer 52

very old/frail old

Question 53

acknowledging the person’s feelings/emotions and responding

Answer 53

validation

Question 54

• Modifications include simplification, measurable reductions in complexity of grammar and vocabulary, and clarification strategies, which include adding repetitions and stressing and altering the pitch of one’s speech, resulting in speech that is overly caring and controlling and less respectful than normal adult-to-adult speech. Similar to baby talk.

Answer 54

Elderspeak

Question 55

After providing health information, nurses should have patients repeat back to them what information they have received. This is an easy and effective method to assess comprehension of health teaching.

Answer 55

teach back

Question 56

respectfully puts the person before the disability

Answer 56

person-first language

Question 57

Often say many words that don’t make sense.
May fail to realize they are saying the wrong words; for instance, they might call a fork a “gleeble.”
May string together a series of meaningless words that sound like a sentence but don’t make sense.
Have challenges because our dictionary of words is shelved in a similar region of the left hemisphere, near the area used for understanding words.

Answer 57

Wernicke’s aphasia (receptive)

Question 58

When a stroke injures the frontal regions of the left hemisphere, different kinds of language problems can occur. This part of the brain is important for putting words together to form complete sentences. Injury to the left frontal area can lead to what

Answer 58

Broca’s aphasia (expressive)

Question 59

Can have great difficulty forming complete sentences.
May get out some basic words to get their message across, but leave out words like “is” or “the.”
Often say something that doesn’t resemble a sentence.
Can have trouble understanding sentences.
Can make mistakes in following directions like “left, right, under, and after.”
“Car…bump…boom!” This is not a complete sentence, but it certainly expresses an important idea. Sometimes these individuals will say a word that is close to what they intend, but not the exact word; for example they may say “car” when they mean “truck.”

Answer 59

Broca’s aphasia (expressive)

Question 60

When a stroke affects an extensive portion of the front and back regions of the left hemisphere

Answer 60

Global Aphasia

Question 61

May have great difficulty in understanding words and sentences.
May have great difficulty in forming words and sentences.
May understand some words.
Get out a few words at a time.
Have severe difficulties that prevent them from effectively communicating.

Answer 61

Global Aphasia

Question 62

a rare disorder where people slowly lose their ability to talk, read, write, and comprehend what they hear in conversation over a period of time.

Answer 62

Primary progressive aphasia

Question 63

the person has word-finding difficulties

Answer 63

anomic aphasia

Question 64

the most common form of urinary incontinence, and mainly affects women. Occurs from a laugh, sneeze, cough, or heavy lifting puts added strain on the bladder, causing urine to leak.

Answer 64

stress incontinence

Question 65

occurs when the need to urinate comes on so quickly that you might fail to make it to the bathroom in time. Also known as overactive bladder or spastic bladder, this sudden need to urinate can be intense and frequent.The amount of urine in the bladder does not matter

Answer 65

Urge urinary incontinence

Question 66

The nerves communicate a need to urinate, and the ability to inhibit this urge is compromised. The bladder spasms on its own and pushes the urine out. . It can be caused by diabetes or a urinary tract infection, or by a nerve-affecting disorder like stroke,

Answer 66

urge urinary incontinence

Question 67

the opposite of urge incontinence. The urge to urinate isn’t felt, but the bladder begins uncontrollably leaking small amounts of urine anyway. The bladder is too full, and the urine is escaping to relieve pressure.

Answer 67

overflow urinary incontinence

Question 68

incontinence that occurs most often in men

Answer 68

overflow urinary incontinence

Question 69

can be caused by a tumor or an enlarged prostate gland blocking the flow of urine, preventing the bladder from ever emptying completely. Diabetes, spinal cord injuries, and medications also can cause this type of incontinence

Answer 69

overflow urinary incontinence

Question 70

incontinence affected by your inability to make it to the bathroom in time

Answer 70

functional urinary incontinence

Question 71

combination of incontinence problems, most often stress urinary incontinence and urge incontinence.

Answer 71

mixed incontinence

Question 72

variation on urge incontinence in which you feel no need to urinate but urine is lost when your bladder begins to contract uncontrollably.

Answer 72

reflex incontinence

Question 73

urinary incontinence caused by an easily cured problem such as a urinary tract infection, constipation, excess fluid intake, or medications.

Answer 73

temporary urinary incontinence

Question 74

complete loss of bladder control, usually due to fistula — an abnormal connection between the skin and urinary tract.

Answer 74

total incontinence

Question 75

For ____ recommendations include:
o Pelvic floor exercises. If you’ve had a baby, chances are you’ve been told to do Kegel exercises. These help to strengthen the pelvic floor after childbirth. They also help prevent stress incontinence.
o Injections and surgery. Shots to bulk up your urethral area may help. In more extreme cases, you may need surgery. One procedure pulls the bladder back up to a more normal position, relieving the pressure and leakage. Another surgery involves securing the bladder with a “sling,” a piece of material that holds up the bladder to prevent leakage.
o Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you’re urinating only every two to four hours.
o Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
o Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
o Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem

Answer 75

stress incontinence

Question 76

For ____ treatments include:
Timed voiding and bladder training. First, you complete a chart of the times you pee and the times you leak. You observe patterns and then plan to empty your bladder before an accident would happen. You can also “retrain” your bladder, gradually increasing the time between bathroom visits. Kegel exercises are also helpful

Answer 76

urge incontinence

Question 77

Medications used in urinary incontinence:

Answer 77

anticholinergics, alpha blockers, topical estrogen

Question 78

surgical procedures used in urinary incontinence:

Answer 78

sling procedures, bladder neck suspension, prolapse surgery, artificial urinary sphincter

Question 79

Strips of your body’s tissue, synthetic material or mesh are used to create a pelvic sling around your urethra and the area of thickened muscle where the bladder connects to the urethra (bladder neck). The sling helps keep the urethra closed, especially when you cough or sneeze. This procedure is used to treat stress incontinence.

Answer 79

sling procedure

Question 80

This procedure is designed to provide support to your urethra and bladder neck — an area of thickened muscle where the bladder connects to the urethra. It involves an abdominal incision, so it’s done during general or spinal anesthesia.

Answer 80

bladder neck suspension

Question 81

In women with mixed incontinence and pelvic organ prolapse, surgery may include a combination of a sling procedure and prolapse surgery.

Answer 81

prolapse surgery

Question 82

In men, a small, fluid-filled ring is implanted around the bladder neck to keep the urinary sphincter shut until you’re ready to urinate. To urinate, you press a valve implanted under your skin that causes the ring to deflate and allows urine from your bladder to flow. Artificial urinary sphincters are particularly helpful for men whose incontinence is associated with treatment of prostate cancer or an enlarged prostate gland.

Answer 82

Artificial urinary sphincter.

Question 83

activities designed to completely prevent a disease from occurring, such as immunization against pneumonia or influenza

Answer 83

primary prevention

Question 84

efforts are directed toward early detection and management of the disease, such as the use of colonoscopy to detect small cancerous polyps.

Answer 84

secondary prevention

Question 85

efforts are used to manage clinical diseases in order to prevent them from progressing or to avoid complications of the disease, as is done when beta-blockers are used to help remodel the heart in congestive heart failure

Answer 85

tertiary prevention

Question 86

Level of health screening recommendation where There is high certainty that the net benefit is substantial based on rigorous experimental research with results that are consistent.

Answer 86

Level A

Question 87

Level of health screening recommendation where May be provided to selected patients on an individual basis depending on the situation. Individuals without signs and symptoms would only receive a small benefit from this level of service.

Answer 87

Level C

Question 88

Level of health screening recommendation where There is high certainty that the net benefit is moderate or that there is moderate certainty that the net benefit is moderate or substantial.

Answer 88

Level B

Question 89

level of health screening recommendation where There is moderate or high certainty that the service has no net benefit or that the risks outweigh the benefits

Answer 89

Level D

Question 90

Level of health screening where There is a lack of supporting evidence, poor quality, and the balance of the risk and benefits cannot be determined.

Answer 90

Level I

Question 91

Provides three types of health protection
1) Health insurance for low-income families and people with disabilities
2) Long-term care for older Americans and persons with disabilities
3) Supplemental coverage for low-income Medicare beneficiaries for services not covered by Medicare such as glasses, hearing aids, or prescription drugs
o Federal funding for Medicaid comes from the general revenues; there is no trust fund set up for Medicaid as there is for Medicare. The state Medicaid office directly pays the doctor, hospital, nursing home, or other healthcare provider.

Answer 91

Medicaid

Question 92

An insurance program for those 65 or over who have paid into the Social Security system, the railroad fund, or are diagnosed with end-stage renal disease. Also covers hospice care for those patients who have been certified by the physician as having 6 months or less to live, so long as the care is provided by a Medicare-certified hospice agency. Covers home care provided by a Medicare-certified agency. Hospice and home care services have criteria that must be met for reimbursement.

Answer 92

Medicare

Question 93

Portion of Medicare that helps to cover inpatient hospital care, inpatient care in a skilled nursing facility (for transitional care), hospice care, and some home healthcare services. It is available without charge for those who are eligible to receive Social Security or Railroad Retirement benefits.

Answer 93

Part A

Question 94

Portion of Medicare that is Supplemental Medical Insurance” is considered medical insurance. It covers some of the cost for laboratory services, home healthcare services, doctor services, some outpatient therapies, mental health services, and outpatient hospital services.

Answer 94

Part B

Question 95

Portion of Medicare that is considered “Medicare Advantage” offers managed care plans like health maintenance organizations and preferred provider organizations. Provides all of the benefits of the hospital and medical insurance plans under original Medicare, but can charge different copays and deductibles.

Answer 95

Part C

Question 96

Portion of Medicare that is the Medicare prescription option, and it offers multiple plans from which the beneficiary can choose. Each plan identifies the prescription medication it covers as well as the pharmacies, premium, deductible, and copayment. The beneficiary must select the plan that covers most of the medications prescribed as well as determine whether to choose a higher premium of higher deductible

Answer 96

Part D

Question 97

Once a beneficiary has spent a certain amount of money during a year, all medication costs are out of pocket until the beneficiary is eligible for catastrophic coverage.

Answer 97

Doughnut Hole

Question 98

a syndrome that occurs relatively acutely and is often call acute confusion unlike dementia. Typically develops over a period of hours or days and is caused by some other underlying medical problem. Can present with a hyperalert state (in which ther person attends to all environmental stimuli simultaneously), hypoactive state (in which the patient seemingly retreats into inner thoughts and experiences that are abnormal), or mixed presentation.

Answer 98

Delirium

Question 99

4 Basic Features of Delirium

Answer 99

1) Acute onset or fluctuating course
2) Inattention
3) Disorganized thinking
4) Altered level of consciousness
* a diagnosis of delirium is made if both features 1 & 2 are present along with either of features 3 or 4

Question 100

Primary treatment for delirium is:

Answer 100

finding the etiology and treating the source

Question 101

Secondary interventions for delirium are:

Answer 101

treating symptoms, ensuring comfort

Question 102

a general term that refers to progressive, degenerative brain dysfunction, including deterioration in memory, concentration, language skills, visuospatial skills, and reasoning, that interferes with a person’s daily functioning. It is not considered a normal part of aging. Most common type is Alzheimer’s disease.

Answer 102

Dementia

Question 103

Risk factors for dementia:

Answer 103

age, family history, genetic factors, head trauma, vascular disease, infections

Question 104

Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area. The area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue.

Answer 104

stage 1 pressure ulcer

Question 105

Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled or sero-sanginous filled blister. Presents as a shiny or dry shallow ulcer without slough or bruising*. This category should not be used to describe skin tears, tape burns, incontinence associated dermatitis, maceration or excoriation.

Answer 105

stage 2 pressure ulcer

Question 106

Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling. The depth of a Category/Stage III pressure ulcer varies by anatomical location.

Answer 106

stage 3 pressure ulcer

Question 107

Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present. Often includes undermining and tunneling.

Answer 107

stage 4 pressure ulcer

Question 108

can extend into muscle and/or supporting structures (e.g., fascia, tendon or joint capsule) making osteomyelitis or osteitis likely to occur. Exposed bone/muscle is visible or directly palpable.

Answer 108

stage 4 pressure ulcer

Question 109

Full thickness tissue loss in which actual depth of the ulcer is completely obscured by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed. Until enough slough and/or eschar are removed to expose the base of the wound, the true depth cannot be determined;

Answer 109

unstageable pressure ulcer

Question 110

Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue.

Answer 110

suspected deep tissue injury

Question 111

a federal law that requires healthcare providers to routinely provide information about advanced directives

Answer 111

patient self-determination act

Question 112

help identify a person’s personal wishes in a legal manner & to share information with people around them.

Answer 112

advanced directives

Question 113

Durable power of attorney, living will, DNR and life-prolonging procedures declarations are _____

Answer 113

legal documents

Question 114

there are five wishes, AND (allow natural death), and physicians orders for life sustaining treatment (POLST) that are options for stating end-of life wishes but are _____

Answer 114

not legal documents

Question 115

patient is able to provide specific instructions in 5 categories

1) A durable power of attorney for healthcare: the person chosen to make decisions when the individual can no longer make them for himself or herself
2) A living will: the kind of treatment the person wants or doesn’t want
3) How comfortable the patient wants to be
4) How the person wants to be treated by others
5) What the person wants his or her loved ones to know.

Answer 115

Five wishes

Question 116

Focuses on allowing death as nature take its course at the end of illness. AND provides comfort measures so that even when the withdrawal of artificial nutrition or hydration occurs the dying process would occur as comfortable as possible.

Answer 116

allow natural death

Question 117

Designed to instruct emergency personnel on what actions to take when the patient is still at home-before emergency treatment is given. It has segments concerning CPR, Medical Interventions, antibiotics, and artificially administered nutrition.

Answer 117

physicians orders for life sustaining treatment