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Complex Med Surg - Nrsg 200 > Final exam! > Flashcards

Final exam! Flashcards

1
Q
  1. What is the most common cancer among women?
A
  1. Breast cancer.
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2
Q
  1. What cancer causes the most deaths in women? No, men aren’t TECHNICALLY a cancer.
A
  1. Lung cancer. Breast cancer is second.
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3
Q
  1. What 2 things greatly affect breast cancer survival rates?
A
  1. Early detection is the key. If it gets to the lymphatic system or metastasizes survival rates drop significantly.
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4
Q
  1. What is the most common type of invasive breast cancer?
A
  1. Infiltrating ductal carcinoma.
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5
Q
  1. What is fibrosis?
A
  1. The replacement of normal tissue with connective tissue and collagen as the tumor grows.
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6
Q
  1. Once a lesion is palpable, what does it feel like?
A
  1. A poorly defined irregular mass.
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7
Q
  1. What is “peau d’orange”?
A
  1. The “orange peel look” caused by blocked skin drainage causing edema.
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8
Q
  1. What is the greatest risk factor for breast cancer? Others?
A
  1. Age. Family history, early menarche, late menopause, nulliparity, 1st birth after 30 years of age, alcohol use, HRT, obesity, nutrition, high dose radiation exposure to the thorax (especially before age 20), estrogen use.
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9
Q
  1. When should women begin yearly mammography?
A
  1. Age 40, but husbands/significant others should do their part long before that!
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10
Q
  1. How often should you do a breast self-exam?
A

Monthly beginning at 20 years old.

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11
Q
  1. How often should a woman have a clinical breast exam (CBE)?
A
  1. Every 6-12 months starting at age 25-35.
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12
Q
  1. As nurses, what must we avoid doing to a patient who has had a breast removed?
A
  1. Do not give injections, draw blood, or take BP in the arm on the affected side.
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13
Q
  1. What 3 labs might increase if breast cancer is present?
A
  1. Liver enzymes (AST/ALT), serum calcium, and alkaline phosphatase.
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14
Q
  1. Why is ultrasound used in breast examination?
A
  1. It can differentiate a fluid mass from a solid mass.
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15
Q
  1. If a mass is detected, and it is determined that it is euploid, what does that mean?
A
  1. It means that it has a normal number of chromosomes, which is good. These are more treatable.
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16
Q
  1. What are the #1 and #2 nursing diagnosis associated with breast cancer? Others?
A
  1. Anxiety and potential for metastasis. Anticipatory grieving, pain, sexual dysfunction, disturbed sleep and body image.
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17
Q

There is a small dressing over a drain that was inserted following mastectomy. How often can that dressing be soaked before calling the MD. 1/2/4/ or 8 times a day?

A
  1. If it’s getting soaked 8 times a day you are in a heap of trouble! If you need to change it more than once a day, call the doc.
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18
Q
  1. What kinds of exercises are appropriate BEFORE the drains are removed from a mastectomy patient?
A
  1. Exercises involving the wrist, hand, and elbow, such a flexing the fingers, circular wrist motions, and touching your hand to your shoulder.
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19
Q
  1. When is a drain removed after a mastectomy?
A
  1. When drainage is <25 mL/day.
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20
Q
  1. What is a major risk factor for vaginal cancer?
A
  1. STD’s such as syphilis. Herpes, HPV.
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21
Q
  1. What is the rarest gynecological cancer? Risk factors?
A
  1. Fallopian tube cancer. Usually over 50, nulliparous or infertile.
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22
Q
  1. What are the risk factors for cervical cancer?
A
  1. African or Native American, multiparity, < 18 years at first prego, smoking, Herpes, Cytomegalo virus, hiv, SEX PARTNER w/ Hx, DES.
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23
Q
  1. What are the S/S of cervical cancer?
A
  1. Painless vaginal/rectal bleeding, spotting, foul discharge, leg pain/sciatica, flank pain, weight loss, pelvic pain, dysuria, hematuria, chest pain, coughing.
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24
Q
  1. Is prostate cancer a fast growing cancer?
A
  1. No. 95% are slow growing adenocarcinomas.
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25
Q
  1. What are the risk factors for prostate cancer?
A
  1. Intact hypothalamus-pituitary-testicular pathway, age, history, heavy metal exposure, vasectomy, STD’s, cytomegalo/HSV 2.
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26
Q
  1. How do you test for prostate cancer?
A
  1. History, PSA, and after age 50, the doc bends you over annually and says, “take it like a man”. During the digital rectal exam, if a guy feels a hand on each shoulder instead of one, RUN! Also ultrasound, CT, and MRI.
27
Q
  1. What serum level is usually elevated with prostate cancer?
A
  1. Alkaline phosphatase.
28
Q
  1. What are some nursing diagnosis common with prostate cancer?
A
  1. Anxiety, pain, impaired urinary elimination, sexual dysfunction, grieving, potential for metastasis.
29
Q
  1. What is most often done with a diagnosis of prostate cancer?
A
  1. Watchful waiting.
30
Q
  1. What 3 problems associated with prostate cancer surgery did she mention?
A
  1. Retrograde ejaculation, erectile dysfunction, sterility.
31
Q
  1. What teaching is done pre-surgery?
A
  1. Kegels, GoLytely, clear liquids only after midnight, may take meds in AM.
32
Q
  1. What are some post-op teachings for prostate surgery?
A
  1. IV hydration, wound drain care, DVT prevention, antibiotics, analgesia (PCA and opioids), laxatives/stool softeners, catheter, antispasmodic, Kegels, spirometry, NG until BS return,ambulation day 2, Ice/elevate the boys.
33
Q
  1. What differentiates a multi-casualty and a mass casualty disaster?
A
  1. Multi= single local resource can handle it. Mass= must get outside help, collaborate with others.
34
Q
  1. What is the difference between an internal and an external disaster?
A
  1. Internal=within the hospital. External=outside the hospital.
35
Q
  1. What do red/yellow/green/black tags mean?
A
  1. Red=emergent/may die if not promptly treated, yellow=urgent, can wait a short time. Green=walking wounded. Black=dead/expected to die.
36
Q
  1. What are the S/S of heat exhaustion?
A
  1. Flu-like symptoms (HA, weakness, N/V) that develop over time. Temp not elevated.
37
Q
  1. What do we do about heat exhaustion?
A
  1. STOP activity, use cooling measures (cool spray, ice, immersion in cool water), rehydrate. Use 0.9% NS if in the clinical setting.
38
Q
  1. What is heat stroke?
A
  1. A true medical emergency. The body’s thermoregulation is haywire and temp may exceed 104 degrees.
39
Q
  1. What are the 2 types of heat stroke?
A
  1. Classic develops over time, and exertional is sudden onset from exercise.
40
Q
  1. What are some complications of heat stroke?
A
  1. MODS, renal impairment, ltyes, PH, coagulopathy, pulmonary edema, cerebral edema.
41
Q
  1. What type of care is provided for snakebites?
A
  1. O2, IV (NS or LR), cardiac/BP monitoring, Opioids, tetanus, wound care,antibiotics, baseline labs (CBC, CK, crossmatch).
42
Q
  1. How can you tell if a snake is north American pit viper?
A
  1. Triangular head, elliptical eyes, pits between the eyes, retractable/curved/hollow fangs. Now let’s get real, as a nurse, if you’re dumb enough to get close enough to see the eyes well, or check out it’s fangs, you deserve to get bitten!
43
Q
  1. What are some systemic physical manifestations of a poisonous snake bite?
A
  1. Minty/rubbery/metallic taste, paresthesia’s to the face/scalp/lips, twitching, DIC.
44
Q
  1. What is serum sickness?
A
  1. A hypersensitivity reaction to antivenom that develops within 3-21 days of use. It starts as a rash, then pruritis/fever/joint pain and hives (urticarial).
45
Q
  1. What are brown recluse spider bites known for?
A
  1. A necrotic wound. A big ol hole in the body!
46
Q
  1. What is lexocelism?
A
  1. It is the necrotic condition that sometimes occurs after a bite from a brown recluse spider (genus Loxosceles).
47
Q
  1. How is a brown recluse spider bite treated?
A
  1. Antiseptic/sterile drsg, antibiotics, reconstruction, supportive care for renal failure, leukopenia, seizures, hemolytic anemia, coma.
48
Q
  1. What are the systemic manifestations of lexocelism?
A
  1. Fever/chills, NV, hemolytic anemia, thrombocytopenia,DIC, death.
49
Q
  1. What care is given for a black widow spider bite?
A
  1. VS, opioids, muscle relaxants, tetanus, antihypertensives, treat pulmonary edema (mad dog), shock.
50
Q
  1. Are all scorpions in the US EXTREMELY dangerous?
A
  1. No. The venom of most scorpions is self limiting and you treat with analgesics and basic wound care. The bark scorpion is the bad boy that can kill you. Sooooo, if you hear a scorpion barking, ruuuuun forest ruuuun!!
51
Q
  1. What are the interventions for scorpion stings?
A
  1. VS, ice, analgesics/sedatives, treat fever, tetanus, basic wound care.
52
Q
  1. What is the first thing you do for a bee sting?
A
  1. Wait and see. You don’t give Epi without symptoms. Remove the stinger WITH TWEEZERS according to our book, and put ice on it. ABC!
53
Q

A life threatening allergic reaction is called ______________, and its S/S are ______?

A
  1. Anaphylaxis. Respiratory distress, laryngeal edema, hypotension, ↓ LOC, dysrhythmias.
54
Q
  1. What does a lightning strike affect? What is the most common effect of it? How do you treat it?
A
  1. CNS and heart (duh), asystole, CPR.
55
Q
  1. How is hypothermia defined and what are its levels?
A
  1. Core temp < 95 F (35 C), mild=90-97, moderate=82-90, severe=< 82. Here we go again! If > 95 is not hypothermia, then how can 90-97 be mild hypothermia? I give up!!!!
56
Q
  1. What is “After-drop”, and how is it avoided?
A
  1. The return of cold blood to systemic circulation can cause the core temp to drop during warming. To avoid this, warm the core first by using warm IV fluids, heated O2, heated gastric, peritoneal, bladder, and pleural lavage, or cardiopulmonary bypass (which is the best way, but not always available).
57
Q
  1. How do you prevent VFIB in a hypothermic patient?
A
  1. Supine, handle them carefully, then ABC.
58
Q
  1. What is HAPE and what are its manifestations?
A
  1. High Altitude Pulmonary Edema. Poor exercise tolerance, persistent cough, cyanosis of lips, tachycardia, and tachypnea.
59
Q
  1. What is HACE? What is its key sign?
A
  1. High Altitude Cerebral Edema. Ataxia (defective muscular coordination)
60
Q
  1. What are the S/S of acute mountain sickness (AMS), the precursor to HACE and HAPE?
A
  1. Hangover-like symptoms. HA, NV, chilled, irritable.
61
Q
  1. What meds are given for AMS/HACE/HAPE?
A
  1. The first med is O2, then maybe acetazolamide and/or dexamethasone.
62
Q
  1. If water enters the lungs, does it make a difference if it is fresh water or salt water?
A
  1. Actually, yes! Fresh water washes surfactant away, so it must be administered during recovery. Salt water pulls protein rich water out of the vascular spaces into the alveoli, causing pulmonary edema.
63
Q

Its almost over! I can taste freedom! I may actually get to have sexual relations (get laid) with my wife again!

A
64
Q
A

Complex Med Surg - Nrsg 200 (10 decks)

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