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NURS-114 > final exam per allison's notes > Flashcards

final exam per allison's notes Flashcards

1
Q

what medicine is given for sinus bradycardia? what must you do before administering

A

IV atropine- assess to see if they are symptomatic

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2
Q

what may be placed in the pt if they have sinus bradycardia?

A

transcutaneous pacemaker

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3
Q

how do you treat sinus tachycardia?

A

correct causes first

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4
Q

if your pt with sinus tachycardia has a fever, what do you do?

A

give them acetaminophen

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5
Q

if your pt with sinus tachycardia is dehydrated, what do you do?

A

give them IV fluids

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6
Q

what medicines can you give pts with sinus tachycardia?

A

calcium channel blockers and beta blockers

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7
Q

how do calcium channel blockers lower the heart rate?

A

prevent calcium release and relax the heart muscle

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8
Q

what are some examples of calcium channel blockers?

A

-pines, ditiazem, amioderone, verapamil

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9
Q

what is important to remember about a fib?

A

no p wave, irregular rhythm, pattern

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10
Q

someone with afib has an increased risk of

A

clots

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11
Q

how would you control a high afib rate?

A

digoxin, beta blockers, calcium channel blockers

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12
Q

what is a common antiarrhythmic medications?

A

amiodarone

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13
Q

what are the procedures to treat afib?

A

cardioversion, ablation

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14
Q

what do the waves look like on atrial flutter?

A

sawtooth

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15
Q

describe the ECG of a pt with a flutter?

A

no p waves, irregular rhythm

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16
Q

what medicines can be given for a flutter for rate control?

A

beta blocker, calcium channel blockers, digoxin

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17
Q

what is superventricular tachycardia?

A

over 150 bpm

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18
Q

describe the ecg of an ECG for someone with a flutter?

A

p wave may be hidden, regular rhythm, high rate

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19
Q

what happens with the heart in SVT?

A

reduced cardiooutput

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20
Q

what is the key to treating SVT?

A

slow the heart rate to identify the underlining rhythm

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21
Q

what medicines are given for SVT?

A

adenosine, calcium channel blockers, beta-blockers, or amiodarone

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22
Q

if your pt has a low heart rate, do not give ______-

A

beta blockers

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23
Q

heparin increases the risk for

A

bleeding

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24
Q

what is the drug of choice for stable angina?

A

sublingual nitrates

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25
Q

what is unstable angina? when does it occur?

A

it occurs at rest

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26
Q

Patient comes to ER with suspected ACS with chest pain unrelieved by rest and other clinical manifestations of MI. What do you do first?

A

nitroglycerin

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27
Q

what is the drug of choice of prinzmetal’s angina?

A

calcium channel blockers (-dipine)

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28
Q

what are the post-procedure nursing interventions for heart-caths?

A

bed rest, bed no higher than 30 degrees, immobilize extremity access site, VS, pulses, bleeding assessment every 15 min 4 times, 30 min 4 times then 1 hours twice

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29
Q

what are common clinical manifestations of endocarditis?

A

osler’s nodes, janeway lesions, splinter hemorrhage

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30
Q

what are osler’s nodes?

A

painful/tender, red or purple pea sized lesions on fingertips

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31
Q

what are janeway lesions?

A

flat, painless, small red spots on the palms and soles

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32
Q

what are splinter hemorrhages?

A

black longitudinal streaks along fingernails

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33
Q

what are the ways to diagnose infective endocarditis?

A

blood cultures and echocardiogram

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34
Q

whats the primary diagnostic for endocarditis?

A

Blood cultures

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35
Q

what are the medications for infective endocarditis?

A

IV antibiotic therapy for 4-6 weeks

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36
Q

what will you hear with pericarditis?

A

pericardial friction rub

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37
Q

what test is done first for pericarditis?

A

ECG

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38
Q

what is the number one thing you need to treat with medications?

A

pain

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39
Q

what medicines can be given for pericarditis?

A

aspirin, NSAIDs, anti-inflammatories (colchicine)

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40
Q

what are the actions you should do for someone with pericarditis?

A

keep HOB elevated, administer medications as ordered, provide emotional support

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41
Q

what should you teach the pt with pericarditis?

A

avoid strenuous activites and distinguish between pericarditis and heart attack

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42
Q

what is a key sign and symptom of left sided heart failure?

A

paraoxysmal nocturnal dyspnea (SOB that wakes you during sleep)

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43
Q

what are the key signs and symptoms of right-sided heart failure?

A

peripheral edeman, abdominal ascites, hepatomegaly, JVD

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44
Q

left sided HF can eventually cause…

A

right sided hf

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45
Q

what is a sign and symptom of worsening heart failure?

A

confusion

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46
Q

what are signs and symptoms of pulmonary edema?

A

pink frothy sputum

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47
Q

what is the treatment for pulmonary edema?

A

o2, iv diuretics

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48
Q

what would you give to a pt with normal potassium, 58 BPM, hypotension and HF?

A

Ace-I

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49
Q

what should you teach your patient with heart failure?

A

avoid NSAIDS

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50
Q

white male comes in with BP of 158/92, what would you do?

A

smoking cessation and daily bp measurements

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51
Q

what is normal blood pressure?

A

120/80

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52
Q

what is an elevated blood pressure?

A

120-129/ 80

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53
Q

what is high blood pressure/hypertension stage 1?

A

130-139/ 80-89

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54
Q

what is hypertension stage 2

A

> 140/>90

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55
Q

what is a hypertensive crisis?

A

> 180/>120

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56
Q

what diet should someone with HTN be on?

A

DASH: fruit, vegetables, fat-free or low-fat milk, whole grains, fish, poultry, beans, seeds, and nuts, fat free cheddar cheese, greek yogurt

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57
Q

how do you know that antihypertensive medications are effective?

A

no signs and symptoms of TOD

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58
Q

what are the signs and symptoms of peripheral artery disease?

A

round/punched out arterial ulcers

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59
Q

what are the symptoms of critical limb ischemia?

A

tight, shiny, taut skin, arterial ulcer, no hair on legs

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60
Q

what is most effective for claudication in pts with peripheral artery disease?

A

walk until pain then rest

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61
Q

what is the first line treatment for PAD?

A

antiplatelets

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62
Q

what should you teach your patient with PAD?

A

don’t cross legs, keep extremity dependent, inspect feet daily, DASH diet, no alcohol, no smoking, moderate exercise

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63
Q

what is used for DVT prophylaxis?

A

low molecular weight heparin

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64
Q

what would you give to a patient for pvd?

A

antiplatelets

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65
Q

what can be given to a patient who is at low risk of DVT after d/c from outpatient surgery?

A

low molecular weight heparin

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66
Q

what can be delegated to the UAP for pt with DVT?

A

elevate limbs

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67
Q

what do you need to monitor for when your pt is taking thiazide therapy?

A

low potassium

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68
Q

what is the most effective treatment for hypertension?

A

thiazide

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69
Q

what should you monitor for pts taking thiazides?

A

i and o

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70
Q

what do ace inhibitors end in?

A

“pril”

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71
Q

how do ace inhibitors work?

A

by blocking the formation of angiotensin II

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72
Q

what do angiotensin II receptor blockers (ARBS) end in?

A

“-sartan”

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73
Q

how do angiotensin II Receptor blockers (ARBS) work?

A

blocking the action of angiotensin 2

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74
Q

when would an angiotensin II receptor blocker be given?

A

if the pt can’t handle the dry cough that ACE inhibitor gives

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75
Q

how do angiotensin Ii receptor blockers work?

A

decrease afterload

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76
Q

how long do angiotensin II receptors take to work?

A

3-6 weeks

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77
Q

when should you hold beta blockers?

A

if their bp is 90/60 or hr less than 60

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78
Q

what type of medicine can you NOT give with ACE-I?

A

angiotensin receptors

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79
Q

what medicine can you not give in HF?

A

calcium channel blockera

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80
Q

what are the risk factors for iron deficiency anemia?

A

very young or very old, women in reproductive years, poor diet, hemorrhage, chronic blood loss, GI problems, malabsorption

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81
Q

what are the clinial manifestations of iron-deficiency anemia?

A

pallor and glossitis

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82
Q

what are the signs and symptoms of phlebitis?

A

warmth, tenderness, hardness of vein

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83
Q

what do you do if your patient has phlebitis?

A

withdraw catheter, apply a warm, moist compress on the affected site

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84
Q

signs and symptoms of infiltration

A

swelling, burning, pain, coolness, blanching

85
Q

what do you do if your patient is experiencing infiltration?

A

remove catheter

86
Q

what can you not give via midline?

A

vesicant

87
Q

what is the treatment of iron deficiency anemia?

A

increase iron intake

88
Q

what are risk factors for vitamin b12 anemia?

A

surgery, excessive alcohol ingestion, smoking, autoimmune disorders, crohn’s disease, celiac disease, strict vegetarians, long-term use of PPIs

89
Q

what are the clinical manifestations of vitamin B12?

A

sore, red, beefy, shiny tongue, peripheral neuropathy, altered mental status, visual changes

90
Q

what is the medical management of vitamin b12 anemia

A

parenteral or intranasal administration of cobalamin

91
Q

folic acid deficiency has an increased risk for

A

bleeding

92
Q

what are foods high in folate for folic acid deficiency?

A

green leafy vegetables, beans, legumes, nuts, bran, yeast, liver, wheat

93
Q

what are the clinical manifestations of sickle cell anemia?

A

pallor, pain and swelling in joints, jaundice, gallstones, typical patient is asymptomatic except during sickling episodes

94
Q

what is the first priority if a patient is in sickle cell crisis?

A

get pain meds and iv fluids

95
Q

what is a sickle cell crisis?

A

severe, painful, acute exacerbation of RBC sickling causing a vaso-occlusive crisis

96
Q

what is the treatment for sickle cell anemia?

A

administer oxygen, provide aggressive iv hydration, administer pain medication and antipyretics, provide supportive measures

97
Q

what should you teach your patient with sickle cell anemia?

A

avoid cold temperatures, high altitutde, dehydration, overexertion

98
Q

what are the clinical manifestations of aplastic anemia?

A

pallor, tachycardia, dizziness, SOB, fatigue, susceptibilty to infections, bleeding

99
Q

a cancer patient with radiation may have

A

aplastic anemia

100
Q

when you are verifying the patient for a blood transfusion, who should be there

A

two rns

101
Q

if a pt is having a blood reaction what should you do?

A

stop the infusion

102
Q

T OR F: never leave a transfusion reaction pt alone

A

T

103
Q

if there is a transfusion reaction, what should you do?

A

stay with pt for 15 min and assess vs q5min

104
Q

foods high in vitamin D

A

fish and eggs

105
Q

what are the steps to give packed red blood cells?

A

check hcp order, get consent, get iv materials, get the blood bag supplies, start blood

106
Q

what are the signs and symptoms of adrenal cortical insufficiency?

A

dark/bronze hyperpigmentation, weight loss, hypotension, tachycardia, hypoglycemia

107
Q

what are the signs and symptoms of adrenal cortex hyperfunction?

A

hyperglycemia, fluid retention, decreased muscle mass, thin/easily bruised skin, delayed wound healing, deepend voice, amenorrhea

108
Q

what should you teach patients that are taking corticosteroids?

A

monitor for hyperglycemia,, prescribe GI prophylactic meds, don’t stop abrubtly, long-term use can cause cushing’s disease, causes immunosuppression

109
Q

what are the signs and symptoms of hypothyroidism?

A

myxedema (moon face), obesity, amenorrhea, intolerance to colds, fatigue, anorexia, goiter

110
Q

what medicine should you give someone with hypothyroidism/hasimotos?

A

levothyroxine

111
Q

what is there to remember about patient teachings regarding levothyroxine?

A

make sure the medicine always looks the same, take in the morning at the same time every day, therapy will be lifelong, take on an empty stomach

112
Q

what are the signs and symptoms of hyperthyroidism?

A

hyperthermia/heat intolerance, weight loss, weakness, elevated heart rate, exophthalmos, goiter

113
Q

what are the medicines given to someone with hyperthyroidism?

A

propylthiourcail, methimazole, lithium carbonate

114
Q

what should you monitor post thyroidectomy?

A

respiratory rate/airway compromise

115
Q

what are signs and symptoms of hypoparathyroidism?

A

tingling around the mouth, muscle cramps, spasms, tetany, positive chvostek’s and positive trousseaus

116
Q

what are the signs and symptoms of hyperparathyroidism?

A

bone pain, low back pain, constipation, lethargy

117
Q

what are the things you should do for your pt with hyperparathyroidism?

A

administer fureosemide and oral phosphates and calcium binders, and use a lift sheet

118
Q

what diagnostics reveal someone has diabetes mellitus?

A

HgbA1c>6.5%; fasting blood glucose >126mg/dL; >200mg/dL

119
Q

what are the signs and symptoms of type 1 diabetes?

A

polyuria, polydipsia, polyphagia, fatigue, weight loss, ketones in blood and urine

120
Q

what is the onset of lispro?

A

15-30 min

121
Q

what does peak mean regarding insulin?

A

when the pt is at highest risk of hypoglycemia

122
Q

is it ok to mix insulin with long acting?

A

no

123
Q

if someone is using an insulin pump, when should they monitor glucose?

A

AC, 2 hours after eating, and HS

124
Q

you should monitor blood glucose more freqently when…

A

acute or ongoing illnesses

125
Q

what are the signs and symptoms of type 2 diabetes?

A

polyuria, polydipsia, polyphagia, fatigue, overweight, poor wound healing, recurring infections, visual disturbances

126
Q

what is the first line of medicine for type 2 DM?

A

metformin

127
Q

what is important to remember about metformin?

A

use with caution in renal insuffiency and discontinue 2 days before iv contrast procedure

128
Q

what medicines do you give someone with type 2 DM?

A

metformin, glyburide, jardiance

129
Q

what are side effects of sulfonylureas (glyburide, glipizide)?

A

hypoglycemia

130
Q

how do SGLT-2 inhibitors (jardiance) work?

A

reduce glucose reabsorption

131
Q

what are side effects of jardiance

A

genital yeast infection and increased uti risk

132
Q

when is someone considered hypoglycemia?

A

glucose <65

133
Q

what are the signs and symptoms of hypoglycemia?

A

shaky, irritable, anxious, hunger, slurred speech, sleepy

134
Q

what rule should you follow if your hypoglycemic patient is conscious?

A

rule of 15= check BG, give oral glucose, check again 15 min later and then again in 15 min later

135
Q

what are complications of long term hyperglycemia?

A

diabetic peripheral neuropathy, autonomic neuropathy

136
Q

what is diabetic peripheral neuropathy

A

numbness, tingling, or pain

137
Q

what is diabetic autonomic neuropathy?

A

gastroparesis

138
Q

in the water seal chamber of a chest tube, if you see continuous gentle bubbling is this good or bad?

A

bad

139
Q

what should you see in the water seal chamber of a chest tube?

A

tidaling when breathing

140
Q

when tidaling ceases in the water seal chamber, what does this mean?

A

the pneumothorax is healed

141
Q

when should you notify HCP regarding fluid drainage?

A

> 100 mL/hr

142
Q

what should you do before a chest tube removal?

A

premedicate 30-60 minutes before

143
Q

what should you ask the pt to perform during removal of a chest tube?

A

valsalva maneuver

144
Q

what is the most effective long term control med of asthma?

A

fluticasone

145
Q

how often are long term control meds used?

A

daily

146
Q

what are the rescue medications of an asthma attack?

A

albuterol

147
Q

what is an axample of an anticholinergic? what are side effects?

A

ipratropium; dry mouth

148
Q

how to use a metered dose inhaler?

A

remove cap and shake inhaler, breathe out gently, put mouthpiece in mouth, push canister down, and inhale slow and deep, hold the breath for 10 seconds or as long as possible, breathe out slowly, wait 1 minute then repeat steps 2-4

149
Q

how do you use a peak flow meter?

A

exhale as quickly and forcibly as possible

150
Q

how often do you repeat the peak flow meter?

A

3 times and record the highest of the three

151
Q

when should you measure the peak flow?

A

the same time every day

152
Q

when do you take a peak flow?

A

during an asthma attack and every day

153
Q

what is emphysema?

A

injury to alveoli, destruction of lung tissue

154
Q

what are the signs and symptoms of emphysema?

A

pink/reddish complexion, puffing when breathing, pursed-lip breathing, increased chest, no chronic cough, tripoding

155
Q

what are the nursing interventions of copd?

A

position in semi fowlers and provide small frequent meals

156
Q

what should you teach your patients?

A

pursed lip breathing

157
Q

who is more likely to get sick at a hospital?

A

a patient with chronic COPD

158
Q

what medicine should you give a patient with pneumonia to open up their airway?

A

albuterol

159
Q

what should you teach your patient to do that has pneumonia?

A

incentive spirometer, turn cough, deep breathe every hour, early ambulation

160
Q

does a person with latent TB have to be worried about spreading it?

A

no

161
Q

person with latent tb cannot transmit the TB to others but it may become…

A

an active infection

162
Q

what are the symptoms of tuberculosis?

A

weight loss, night sweats, low grade fever, hemoptysis (rusty, blood streaked sputum)

163
Q

what medicines are given for the treatment of tuberculosis?

A

“RIPE” rifampin, isoniazid, pyrazinamide, ethambutol

164
Q

what are side effects of rifampin?

A

causes tears/saliva/urine to turn a reddish-brown color

165
Q

there is an increased risk of developing _______ when taking rifampin that is an emergency

A

SJS (painful rash that causes blisters and tissue necrosis)

166
Q

what precautions are patients with tuberculosis on?

A

airbone

167
Q

describe airborne precautions

A

private negative air pressure room, gloves, gown, N95 mask

168
Q

if a patient with tuberculosis needs to be transported, what should they have?

A

a mask

169
Q

patients with tuberculosis may have to undergo what type of therapy? what does this do?

A

DOT direct observation therapy; it ensures medication adherence by the RN watching the patient take the pill

170
Q

when do you know a patient with tuberculosis is noninfectious?

A

2 consectuive negative AFB smears over 3 days from early morning specimen

171
Q

what should you monitor for with a patient with an 02 delivery system?

A

skin breakdown around nose and ears

172
Q

what is the flow rate for COPD patient for nasal cannula?

A

1-2 L/min

173
Q

what should you teach your patient who has oxygen therapy at their home?

A

no smoking, keep oxygen 6 ft away from flame or heat sources, check electrical equipment in the same room, keep fire extinguisher at home, keep tanks upright, do not change settings of o2 tank, if power fails call 911, assess for skin breakdown around the nose/ears and oral/nasal cavity for dryness/irritation

174
Q

what is the treatment for SVT?

A

adenosine

175
Q

what should you monitor for your pt if they are on heparin?

A

pt, ptt

176
Q

what is the drug of choice for prinzmetal’s/varian angina?

A

calcium channel blockers

177
Q

what is most sensitive to heart damage?

A

troponin

178
Q

invasive procedure in which a catheter is advanced through an artery to check for blockages

A

heart cath

179
Q

if your patient is having a MI, what is the order that should be used for pharmalogical treatment?

A

morphine, oxygen, nitroglycerin, aspriin

180
Q

if your pt is experiencing phlebitis, what should you do?

A

stop the infusion first and then discontinue the IV

181
Q

what is an adverse reaction for ace inhibitors?

A

angioedema

182
Q

before you give digoxin, what should you do?

A

monitor hr

183
Q

a patient with HF should be on what type of diet?

A

low sodium

184
Q

what is the most common side effect of an ace inhibitor?

A

dry cough

185
Q

what are the clinical manifestations of peripheral artery disease?

A

intermittent claudication (muscle pain, numbness)

186
Q

what test is used for a DVT?

A

D dimer (tests for probability of pt getting a DVT

187
Q

what is the menumonic for sickle cell anemia?

A

HOPS (hydrate, oxygen, pain control, support

188
Q

if your pt is experiencing hypoglycemia and they are unconscious what do you do?

A

IV- 25-50 mL of 50% dextrose and if they have no IV then 1 mg IM glucagon

189
Q

what medications are given to pts with hyperthyroidism?

A

propylthiouracil and methimazole

190
Q

what is a common symptom of hypoparathyroidism?

A

positive chvostek and trousseau sign

191
Q

what are the common signs and symptoms of cushing’s disease in females?

A

breast atrophy, vocal changes, amenorrhea, hair on chin and chest

192
Q

if your pt with asthma has absent or diminished breath sounds what does this mean?

A

it is an emergency

193
Q

what are the emergency medications given to someone with asthma?

A

albuterol and levoalbuterol

194
Q

what is the key prevention measure from COPD getting worse?

A

smoking cessation

195
Q

what is a size effect of pyrazinamide?

A

painful joints

196
Q

what should you teach your patient to report if they are taking ethambutol?

A

visual changes/disturbances

197
Q

what should you teach your pt to do for pneumonia?

A

pulmonary hygeien (early mobility, incentive spirometer, turn, cough, and deep breathe

198
Q

what do you do if the chest tube becomes disconnected from the drainage system?

A

immediately submerge the end of the chest tube in sterile water

199
Q

if the chest tube becomes dislodged from the chest, what should you do?

A

apply a vaseline gauze dressing and notify hcp

200
Q

what do you need to get before administering anti-rheumatic medications?

A

baseline liver and renal functions

201
Q

what should you teach your patients who are taking leflunomide?

A

use birth control during the time of treatment and up to 2 years after it is stopped

202
Q

what are the triggering factors of lupus?

A

pregnancy, exposure to sunlight, illness, major surgery, silica dust, medication allergies

203
Q

when is HIV considered AIDS?

A

CD4+ count is less than 200

204
Q

what are the clinical manifestations of HIV?

A

skin lesions, night sweats, enlarged lymph nodes

205
Q

if a pt participates in high risk behaviors, they should be screened every…

A

3-6 months

206
Q

what are the manifestations of anaphylaxis?

A

dyspnea, SOB, wheezes/crackles, hives

207
Q

what is the number one treatment for anaphylaxis?

A

epipen

208
Q

when a pt is undergoing brachytherapy, what should you teach men to do?

A

wear a condon

209
Q
A

NURS-114 (5 decks)

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