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final exam > final exam review > Flashcards

final exam review Flashcards

1
Q

ADHD shows brain characteristics where there may be a deficit in….

A

catecholamines, dopamine, and norepinephrine

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2
Q

Clinical manifestations of ADHD are…

A

hyperactivity, impulsivity, lack of attention
difficulty completing tasks
decreased attention span
increased motor activity (cant sit still)

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3
Q

ADHD is guided by the….

How long must symptoms be present for before being diagnosed?

A
  • -DSM-5

- - >6 months

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4
Q

What is a non-stimulant med that can be given to a child?

A

atomoxetine

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5
Q

What observation may be seen if atomoxetine is working?

A

Able to sit still >15 minutes within 1st 10 days.

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6
Q

What instructions would be given when using the daytrana skin patch?

A

Alternate between left and right hip
can cause leukoderma in kids
REMOVE after 9 hours

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7
Q

If a child is prescribed adderral what should be monitored?

A

growth

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8
Q

This condition is characterized by and extra chromosome called trisomy 21….

A

Down syndrome

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9
Q

What are two common risk factors for Down syndrome?

A

maternal age >35

Paternal age >55

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10
Q

What are the common clinical manifestations seen in down syndrome?

A
  • -short legs and arms
  • -hypotonia
  • -protruding abdomen
  • -epicanthal folds
  • -reduced muscle tone
  • -protruding tongue
  • -short broad neck
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11
Q

What are two non-pharm treatments for down syndrome?

A
  • -cool mist humidifier

- -clear nasal passages with bulb syringe

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12
Q

What two nutrition interventions would be done on a patient with down syndrome?

A
  • -increase fiber

- -monitor calories

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13
Q

This syndrome is when an infant falls below the 5th percentile for weight and height?

A

Failure to thrive

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14
Q

What are some clinical manifestations of failure to thrive?

A
  • -minimal smiling
  • -poor eye contact
  • -lack anticipated stranger danger
  • -withdrawn
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15
Q

With FTT, what should the nurse educate the parents on?

A
  • -respond to hunger cues
  • -provide stimulation
  • -nurture child
  • -proper positioning/latching when BF
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16
Q

What will nutrition interventions be for a child with FTT?

A

–high calorie milk supplements
–multivitamin including zinc, and iron
–limit juice to 4oz a day
–dont force infant to eat
Home health nurse will visit and see how baby eats

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17
Q

What chronic condition affects body movement, coordination, and posture?

A

Cerebral palsy

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18
Q

Spastic CP is the most common type. What are the clinical manifestations associated with it?

A
  • -stiff and jerky
  • -increased muscle tone
  • -rigid
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19
Q

This form of CP has uncontrolled movements that affects basal ganglia

A

Dyskinetic

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20
Q

This type of motor function in CP is manifested by a damaged cerebellum with poor balance and coordination.

A

Ataxia

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21
Q
  • -To help prevent CP in a child. What vaccine should the mother be up to date on?
  • -What can it prevent?
A
  • -Hemophilis influenza

- -bacterial meningitis

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22
Q

What are some clinical manifestations of CP?

A
  • -abnormal muscle tone
  • -exaggerated DTR
    • > 6 months old may be arching back or cant sit up
  • -strabismus
  • -nystagmus
  • -hypertonia
  • -scissoring/crossing legs without intention
  • -excessive drooling
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23
Q

In a patient with CP this med can be given for nerve pain and seizures.

A

gabapentin

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24
Q

What other meds can be given for CP?

A
  • -baclofen
  • -benzos (valium)
  • -GI symptoms (cimetidine/ranitidine)
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25
Q

What injection can be used in conjunction with a stretching program, in a patient with CP?

A

BT-A

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26
Q

What would the nutrition plan be for a pt. with CP?

A
  • -high calorie 24kcal/oz of formula

- -use utensils with padded handles

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27
Q

What may a child with suspected CP show before preschool years?

A

hand dominance

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28
Q

What disorder is characterized by impaired imaginative/collaborative play prior to 3 years old?

A

Autism Spectrum Disorder

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29
Q

What are three core characteristics of a pt. with autism?

A
  • -social interactions
  • -language impairment
  • -repetitive behaviors
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30
Q

What clinical manifestations will a patient with Autism present with?

A
  • -stereotypy (rigid or obsessive behaviors)
  • -head banging
  • -flapping hands/arms
  • -rapid mood change
  • -twirling in circles
  • -biting themselves
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31
Q

A pt. with autism will have absence of ____ by age 1.

A

babbling

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32
Q

A pt. with autism will have an absence of two word sentence by age___

A

2

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33
Q

An autistic patient will use ____ instead of ___.

A

you

I

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34
Q

An autistic person will engage in echolalia and is fascinated with…..

A

rhythmic, repetitive songs or verses

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35
Q

What are some pharm. therapies for a patient with autism?

A
  • -SSRI’s (fluoxetine)
  • -antipsychotic (risperidone)
  • -melatonin (insomnia)
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36
Q

What are nutrition interventions for a patient with Autism?

A
  • -Vit. A, B6, and C
  • -gluten free (wheat, barley, rye)
  • -casein free (milk, eggs, cheese)
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37
Q

What are some red flags to look for when suspecting autism in an infant/toddler?

A
  • -no babbling/communication by 12 months
  • -no single words by 16 months
  • -no 2 word sentences by 2 years
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38
Q

What are some presumptive signs of pregnancy?

A
  • -breast changes
  • -quickening
  • -N/V
  • -amenorrhea
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39
Q

What are some probable signs of pregnancy?

A
  • -hegars, chadwicks, or goodells sign
  • -braxton hicks contractions
  • -positive pregnancy test
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40
Q

What are some positive signs of pregnancy?

A
  • -fetal heart sound
  • -fetal ultrasound
  • -fetal movement
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41
Q

How to calculate due date?

A

1st day of last period + 7 days - 3 months + 1 year

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42
Q

A woman with normal pre-pregnancy weight can gain….

A

25-35 lbs

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43
Q

A woman who is overweight pre-pregnancy can gain….

A

15-25 lbs

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44
Q

A woman who is obese pre-pregnancy can gain…

A

11-20lbs

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45
Q

A woman who is underweight pre-pregnancy can gain…

A

28-40 lbs

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46
Q

What does oxytocin do?

A

dilates the cervix and can be used to stop bleeding

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47
Q

What is misoprostol used for?

A

softens cervix and stops bleeding

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48
Q

What can be given to stop contractions in a patient?

A

magnesium sulfate

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49
Q

What is the antidote for magnesium toxicity?

A

calcium gluconate

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50
Q

Describe the latent phase of labor.

A
  • -0-3 cm dilated
  • -contractions irregular, mild to moderate
  • -occurs every 5-30 min
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51
Q

Describe the active phase of labor.

A
  • -4-7 cm dilated
  • -contractions regular, moderate to strong
  • -every 3-5 min
  • -monitor FHR q30 min, q15 if high risk
  • -make sure mom voids to avoid damage to bladder
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52
Q

Describe the transition phase of labor

A

10 cm dilated

  • -contractions strong q2-3 min
  • -mom may feel out of control and have urge to push
  • -Assess FHR q15 min, q5 if high risk
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53
Q

If patient has late decelerations the nurse would…

A
  • -dc oxytocin
  • -put mom on non-rebreather at 10-15L
  • -lower bed, lay on side
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54
Q

If patient has lateral displacement of fundus, what should the nurse have the patient do?

A

go pee

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55
Q

If fundus is soft and boggy, the nurse will….

A

massage fundus in circular motion

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56
Q

When giving vitamin K to newborn, what gauge needle is used?
Where would it be given?
How much should be given?

A
  • -25-27 gauge
  • -vastus lateralis
  • -0.5-1.0 mg
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57
Q

What is rooting?

A

stroke cheek= turn head

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58
Q

What is moro/startle reflex?

A

loud noise = jerky reflex

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59
Q

The APGAR score is done at….

A

1 minute and 5 minutes

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60
Q

What does APGAR stand for?

A
  • -Activity
  • -Pulse
  • -Grimace
  • -Appearance
  • -Respirations
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61
Q

What is a Type 1 hypersensitivity response?

What are some examples?

A

allergic response

Examples are: HYPOTENSION, asthma, hay fever, food allergies

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62
Q

What is a type II allergic response?

What are some examples?

A

–cytotoxic hypersensitivity

Examples are: transfusion reaction, Rh mom

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63
Q

What is a type IV reaction?

What are some examples?

A
  • -delayed reaction

- -Contact dermatitis, TB test, organ transplant

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64
Q

With type I reaction what would be the MAIN PRIORITY?

A

airway

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65
Q

What does the indirect Coombs test detect?

A

presence of circulating antibodies against RBC’s

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66
Q

What does the direct Coombs test?

A

detects antibodies on RBC’s

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67
Q

What is a chronic, progressive disorder that causes inflammation of tissue and organs, primarily in the joints?

A

Rheumatoid arthritis

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68
Q

What are some clinical manifestations of RA?

A
  • -has remissions and exacerbations
  • -occurs after prolonged inactivity
  • -lasts > 1 hour
  • -appears red, hot, and swollen
  • -symmetrical, multiple joints affected
  • -morning stiffness
  • -ulnar deviation, swan neck, boutonnieres deformities
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69
Q

This type of arthritis affects the knees, ankles, and elbows.

A

Pauciarticular arthritis

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70
Q

This type of arthritis affects multiple joints and internal organs and may present with fever, and rheumatoid rash.

A

Systemic arthritis

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71
Q

What drugs can be used for Rheumatoid arthritis?

A
  • -NSAIDS
  • -Corticosteroids
  • -DMARDS (methotrexate)
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72
Q

What non-pharm tx. can be used for RA?

A
  • -alternate heat and cold packs
  • -moist heat (most effective)
  • -dip hands in paraffin bath
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73
Q

Autoimmune disorder that causes destruction to healthy tissue that can have remissions and exacerbations

A

SLE

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74
Q

DLE affects the….

A

skin

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75
Q

SLE affects the….

A

connective tissue (lead to organ failure)

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76
Q

MILE is caused by….

A

Meds.

Usually gets better when stop the meds

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77
Q

What are clinical manifestations of Lupus?

A
  • -Raynauds phenomenon
  • -butterfly rash over nose and cheeks
  • -alopecia
  • -sun sensitivity
  • -friction rub when listening to heart
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78
Q

In Lupus, C3-C4 will be_____

ESR will be _____

A
  • -decreased

- -increased

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79
Q

What are some pharm tx.’s for Lupus?

A
  • -NSAIDS
  • -Corticosteroids
  • -Immunosuppressants (methotrexate)
  • -antimalarial (hydroxychloriquine)
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80
Q

Oral contraceptives in a pt. With lupus increases the risk of….

A

lupus exacerbation

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81
Q

Stage 1, progression of HIV is represented by a CD4+ and t lymph count of….

A

500

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82
Q

Stage 2, chronic asymptomatic infection is represented by a CD4+ and t lymph count of…

A

200-499

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83
Q

Stage 3, AIDS caused by HIV is represented by a CD4+ and t lymph count of…

A

<200

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84
Q

HIV meds are safe to take during____

A

Pregnancy. Should be continued to decrease risk of transmission to fetus

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85
Q

What are the clinical manifestations of HIV?

A
  • -fever
  • -sore throat
  • -headache
  • -rash
  • -nausea
  • -weight loss
  • -arthralgia, myalgia
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86
Q

What diet would a person with HIV be recommended?

A

high protein, and calorie

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87
Q

What are early signs of shock?

A
  • -oriented
  • -restless
  • -anxiety
  • -increase pulse
  • -reduced BP
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88
Q

What are intermediate signs of shock?

A
  • -reduced sensory perception
  • -slowed speech
  • -cool moist skin
  • -rapid/shallow respirations
  • -pale
  • -oliguria
  • -weak, thready pulse
  • -low BP
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89
Q

What are late signs of shock?

A
  • -reduced LOC
  • -cyanosis
  • -bradycardia
  • -cool moist skin
  • -labored resp.
  • -anuria
  • -BP continuing to drop
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90
Q

What will the nursing intervention be if someone has shock?

A
  • -Replace volume (give LR)
  • -Give vasopressor, monitor BP
  • -Protect airway (O2 or intubate)
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91
Q

What CN’s are sensory?

A

1,2,8

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92
Q

What is the normal ICP measurement?

A

0-15

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93
Q

Dysfunction of ICR is due to…

A
  • -impaired perfusion
  • -reduced oxygenation
  • -reduced glucose
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94
Q

Late signs of IICP involve the cushings triad. What is the cushings triad?

A
  • -bradycardia
  • -hypertension
  • -bradypnea
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95
Q

Someone presenting with IICP is an emergency. What should be the nurses actions?

A
  • -maintain airway
  • -elevate HOB 30 degrees(neck aligned)
  • -seizure precaution
  • -give mannitol (osmotic diuretic)
  • -monitor VS (maintain adequate CO)
  • -sedate patient, dim lights, limit visitors, control fever)
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96
Q

Meds for IICP are?

A
  • -mannitol
  • -phenytoin (seizures)
  • -dexamethasone (edema)
  • -acetaminophen
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97
Q

If a patient has IICP what diagnostic should NOT be performed?

A

lumbar puncture

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98
Q

What procedure can be done to relieve hydrocephalus in a child with IICP?

A

VP shunt

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99
Q

If a 12 year old patient presents with IICP, the nurse will instruct the parents to notify the physician if…

A

decreased LOC

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100
Q

What type of burn is a sunburn?

A

superficial thickness

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101
Q

If a patient presents with hypothermia, the nurse will…

A
  • -provide blankets

- -heat lamp

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102
Q

If a burn covers > 25% of TBSA it is considered a…

A

major burn

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103
Q

If body is burned <15% of TBSA it is considered a…

A

minor burn

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104
Q

If body is burned 15-25% of TBSA it is considered a…

A

moderate burn

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105
Q

The emergent phase of a burn begins with the injury and continues for 24-48 hours, what would be the nursing process?

A
    • Secure airway, NG tube (if burns >20% of TBSA)
  • -replace fluids (LR)
  • -prevent infection
  • -maintain body temp
  • -give morphine/fentanyl
106
Q

The acute phase of a burn begins 48-72 hours after injury, what is the nursing priority?

A
  • -NPO
  • -assess/monitor cardiac, respiratory, GI system
  • -wound care
  • -pain management
  • -psychosocial interventions
107
Q

The rehabilitative phase after a burn can last many years. The nursing priority is…

A

–psychosocial support, prevent scars and contractures, resume activities (work, family, social life)

108
Q

What are signs of heat exhaustion?

A
  • -fatigue, light headed
  • -N/V/D
  • -impending doom
109
Q

What nursing interventions would be done for a person with heat exhaustion?

A
  • -cool area, remove clothes
  • -give oral/IV NS
  • -monitor airway
110
Q

A heat stroke is an emergency. What are signs of heat stroke?

A
  • -reduced LOC
  • -hot, dry, ashen skin (no sweat)
  • -loss of muscle coordination
  • -temp. >105 degrees
111
Q

What will the nursing interventions be for a patient with heat stroke?

A
  • -cool area, remove clothes, ice packs, cool blankets, cool saline, peritoneal dialysis
  • -100% O2
  • -give diazepam (reduce shivering)
112
Q

What temp would mild hypothermia fall under?

A

89.6-95

113
Q

What temp would moderate hypothermia fall under?

A

82.4-89.6

114
Q

What temp would severe hypothermia fall under?

A

<82.4

115
Q

If a person has frostbite the nurse will…

A

immerse in warm water for 20-30 min, do not massage/rub

116
Q

What is pink frothy sputum a sign of?

A

Pulmonary edema

117
Q

What medicinal treatment is used for someone exposed to anthrax?

A

cirpo/penicillin

118
Q

Smallpox is what type of precaution?

Botulism?

A
  • -droplet

- -standard

119
Q

What organization ensures clinicians have updated info and acts as two way communication with the CDC?

A

COCA

120
Q

A client with an electrical burn is classified as having a…

A

major burn

121
Q

—during the initial burn phase what lab will nurse suspect to be elevated?

A

hct

122
Q

external rewarming involves…

A
  • -warm bath
  • -radiating heat
  • -forced warm air
123
Q

A client experiencing early signs of hypovolemic shock will have…

A
  • -slight increase in pulse
  • -slight decrease in BP
  • -normal respirations
124
Q

A form of sex therapy touching each others body parts is?

A

sensate therapy

125
Q

a female patient has been trying to get pregnant for the past 2 years, what can cause the woman to not concieve?

A
  • -alcohol consumption
  • -amount of exercise
  • -poor nutrition
  • -STI’s
126
Q

what is clomid?

A

–stimulates luteinizing hormone

127
Q

what type of HRT can be used in menopause?

A

–low dose vaginal estrogen

128
Q

surgical menopause can be treated with

A

–HRT

129
Q

what are some clinical manifestations of menopause?

A
  • -vaginal dryness
  • -dyspareunia (painful sex)
  • -hot flashes
  • -urinary stress incontinence
130
Q

what are the two labs that rise and remain elevated with menopause?

A

–FSH and LH

131
Q

clinical manifestations of primary dysmenorrhea are

A
  • -pelvic pain radiating to groin
  • -N/V/D
  • -fatigue
  • -breast tenderness
132
Q

what is menometrorrhagia?

A

–irregular excessive prolonged period

133
Q

what should a female patient do if she is experiencing post menopausal bleeding?

A

–seek medical attention

134
Q

what is an example of a COC?

A

depo-provera

135
Q

what meds can be given for a female with heavy bleeding?

A
  • -estrogen
  • -medroxyprogesterone
  • -iron
136
Q

what vitamin helps with dysmenorrhea?

A

B12

137
Q

what would the nurse include in the plan of care for a patient with ED due to a chronic condition?

A
  • -explain meds being prescribed

- -explain devices and surgeries available

138
Q

What oral meds can be given to a pt. with ED?

A
  • -viagra
  • -cialis
  • -levitra
139
Q

The nurse should inform a patient taking drugs for ED to refrain from taking….

A
  • -aplha blockers

- -nitrate based drugs

140
Q

Females have a higher risk for what STI’s?

A

gonorrhea, chlamydia

141
Q

This STI can present with white patches in the mouth, cloudy discharge from vagina or penis…

A

chlamydia

142
Q

This type of syphilis presents with papules on labia, anus, or corner of the mouth…

A

Secondary syphilis

143
Q

This type of syphilis presents with pock marks (holes) in skin…

A

Tertiary “late stage” syphillis

144
Q

A diaphragm is used with a spermicidal cream/jelly. How long after sex should it be left in place?

A

6 hours

145
Q

What med can cause a clinical interruption of pregnancy when a woman has decided on an abortion up to 49 days following conception?

A

Mifepristone

146
Q

What type of eye disorder is the most common cause of blindness in the elderly?

A

Macular degeneration (MD)

147
Q

What kind of stroke occurs when blood clot cuts off circulation to the heart?

A

ischemic

148
Q

When giving eye drops the nurse must be sure to apply…

A

pressure during and after administration

149
Q

To be able to drive after cataracts surgery the patient must be able to…

A

score above a certain level on acuity test to be able to drive

150
Q

If a patient has a burn to the eye the nurse will…

A
  • -flush eye with NS for 30 min

- -apply antibiotic ointment

151
Q

A patient with myopia may present with…

A
  • -headaches
  • -difficulty reading
  • -poor school performance (cant see board)
152
Q

What is esotropia?

A

deviation inwards

153
Q

what is exotropia?

A

deviation outwards

154
Q

What is hypertropia?

A

deviation upwards

155
Q

What is hypotropia?

A

deviation downward

156
Q

What is cataracts?

A

Gradual clouding of lens that affects ability to perceive images clearly

157
Q

What are some characteristics of a person with cataracts?

A
  • *cloudy, opaque lens
  • *reduced visual acuity
  • *reduced night vision
  • -blurry vision
  • -loss of red discrimination
158
Q

What meds prevent pupil constriction and is usually given during an eye exam? What would we teach the pt.?

A

1% atropine

–effects may last 7-12 days, wear sunglasses to protect eyes

159
Q

What condition presents with the gradual loss of peripheral vision and increased intraocular pressure?

A

Glaucoma

160
Q

What is the difference between Primary open angle and angle closure glaucoma?

A 
Primary Open angle (gradual)
Angle closure (Acute) and emergent
161
Q

What are the clinical manifestations of a person with open angle glaucoma?

A
  • -gradual
  • -tunnel vision (loss of peripheral vision)
  • -halos
  • -elevated IOP (>21 mmHg)
162
Q

What are the clinical manifestations of a person who has angle closure glaucoma?

A
  • -acute
  • -IOP (>30mmHg)
  • -reddening of eyes
  • -halos
  • -severe pain
  • -dilated pupils
163
Q

What meds can be given for glaucoma?

A
  • -timolol (beta blocker)
  • -alphagan (alpha2 adrenergic agonist)
  • -diamox (carbonic anhydrase inhibitors)
  • -Pilocarpine (cholenergic agonist)
164
Q

What drug can be used in the emergency treatment of closed angle glaucoma?

A

Mannitol

165
Q

What are clinical manifestations of Macular degeneration (MD)?

A
  • -loss of central vision
  • -vision distortion
  • -colors seem more dull
  • -blurred vision/blind spots
166
Q

What drug is useful in treating wet MD?

A

antiangiogenic drugs (lucentis)

167
Q

What should nurse teach for patient with MD?

A
  • -Use assistive devices (large print books, magnifying glass)
  • -teach patient to rely on peripheral vision
168
Q

If a patient has tinnitus they may experience…

A

buzzing, roaring, ringing in ears

169
Q

When examining the ears on an adult/child how will the nurse pull the pinna?

A

Adult- up and back

child- down and back

170
Q

The tympanic membrane should look…

A

pearly, grey and intact

171
Q

If a patient is experiencing sensironeural hearing loss what treatment would be done?

A

cochlear implant

172
Q

What is conductive hearing loss?

A

same loss in both ears

173
Q

What is conduction sound?

A

all sound frequencies

174
Q

What should be documented in the blood transfusion record?

A
  • -Blood type
  • -Rh factor
  • -Blood band number
  • -exp. date
175
Q

What are the signs and symptoms of anemia?

A
  • -weakness
  • -pallor
  • -fatigue
176
Q

How would anemia be treated?

A
  • -Give O2
  • -Give erythropoeitin
  • -Put up HOB
  • -rest
  • -keep pt. warm
  • -Give vitamin B12, iron, folic acid
  • -give PRBC’s if needed
177
Q

What is the top priority with an anemic patient?

A
  • -oxygenation
  • -perfusion
  • -nutrition
178
Q

What are signs of a pulmonary embolism?

A
  • -dyspnea
  • -tachypnea
  • -impending doom
  • -jugular vein distention
  • -restlessness
  • -cyanosis
179
Q

What are the nursing interventions for a pulmonary embolism?

A
  • -Give 500-1000 mL of fluid
  • -give vasopressor (epinephrine)
  • -give anticoagulants
  • -elevate legs
180
Q

A patient who has had a hemorrhagic stroke has become more drowsy during the day, what should the nurse do next?

A

–call provider

181
Q

A client is recovering from cataracts surgery, what statement shows the clients understanding of home instructions after the surgery?

A

Cook dinner the night after surgery

182
Q

A client is in the unit for 2 days and is experiencing auditory hallucinations, what could this be caused by?

A
  • -sensory overload (too much stimuli)

- -sleep deprivation

183
Q

If a person is experiencing an acute MI, what will the 12 lead EKG changes show?

A
  • -ST seg elevation
  • -enlarged Q waves in lead 2 and 3
  • -VF
184
Q

A client is recovering from cataract surgery, what can indicate an onset of retinal detachment?

A
  • -flashing lights

- -partial loss of visual field

185
Q

What is a common med that can be given for CAD?
What should the nurse monitor?
What may this med interfere with?

A
  • -statins
  • -liver enzymes
  • -coumadin
186
Q

What med can be given for angina (heart pain)?
How much can be taken?
What should not be taken with it?

A
  • -Nitro
  • -every 5min, max 3 times(call 911 if pain persists)
  • -ED meds (cialis, viagra)
187
Q

What will the EKG look like with a STEMI?

A

ST elevation (near complete blockage= death)

188
Q

What will an EKG look like with an NSTEMI?

What is our concern when we see this?

A
  • -ST depression or inverted T-wave

- -Cardiac arrest

189
Q

What are clinical manifestations of a MI?

A
  • -dull, substernal crushing pain
  • -tightness in chest
  • -dyspnea
  • -low BP
  • -High HR
  • -N/V
  • -denial
190
Q

What does the acronym MONA stand for when treating an MI?

A
  • -Morphine
  • -Oxygen
  • -Nitro
  • -Aspirin
191
Q

What will a normal sinus rhythm show?

A
  • -RR interval: regular
  • -Rate: 60-100 bpm
  • -P wave: upright, one per each QRS
  • -PR interval: 0.12-0.20 seconds
  • -QRS interval: <0.12 seconds
192
Q

If a person is showing signs of sinus bradycardia what tx. can be done?

A

–atropine 0.5-1.0 mg IVP

193
Q

What ECG wave shows a saw tooth like wave?

A

Atrial flutter

194
Q

What type of ECG wave shows an irregular “quivering” baseline pattern.

A

A-fib

195
Q

A person with an Idoiventricular rhythm will show signs of no p-wave, wide QRS, and a rate of about 20-40 bpm. What is the nurses priority?

A
  • -Initiate CPR if no pulse
  • -Restore volume
  • -give atropine, dopamine (give pacemaker if not responding to meds)
196
Q

This EKG wave shows a non measurable PR interval with wide and bizarre QRS waves due to the lower chambers of the heart beating very quickly. What is it and what is the tx.?

A
  • -V-tach
  • -give Amiodarone, K+, and mag.
  • -Pulse: cardiovert
  • -Pulseless: defibrillate/CPR
197
Q

What life threatening ECG wave shows the ventricles quivering uselessly instead of pumping blood?

A

V-fib

198
Q

In cellular regulation, what is the term used for an error that cannot be repaired?

A

apoptosis

199
Q

What is the difference between a benign and malignant tumor?

A

–Benign: local, cohesive, well defined borders, slow growth, pushes other tissue out of way, easily removed, does not recur

–malignant: invasive, non-cohesive, crosses tissue border, invades and destroys other tissue, rapid growth, not always easy to remove, can recur

200
Q

What do malignant cells need to grow?

A

blood source for nutrients

201
Q

One major indicator of cancer is if a patient comes in with this type condition and has never had it before or it is getting worse. What is the condition?

A

anemia

202
Q

What are common symptoms of leukemia?

A
  • -weight loss/loss of appetite
  • -SOB
  • -weakness/fatigue
  • -bone/joint pain
  • -swollen lymph nodes
  • -night sweats, easy bleeding/bruising, purple spots
203
Q

What are common clinical manifestations of cancer?

A
  • -anemia
  • -infection
  • -anorexia (cachexia syndrome)
  • -paraneoplastic syndrome (altered immune response)
  • -pain (late sign)
  • -stress
204
Q

What type of isolation precautions would be used in a patient with cancer receiving chemo?
What should the nurse consider with this precaution?

A
  • -reverse isolation (neutropenic precautions)
    - -no flowers, visitors, fresh fruits/veggies
    - -avoid invasive procedures
    - -keep dedicated equipment in room
205
Q

What are some examples of primary prevention for cancer?

A
  • -dont smoke
  • -exercise
  • -sunscreen/limit sun exposure
  • -balanced diet
  • -BRCA 1 (prophylactic surgery)
206
Q

What are some secondary preventions for cancer ?

A
  • -colonoscopy
  • -mammogram
  • -Pap smear
  • -Guaic testing (blood in stool)
  • -prostate specific antigen (PSA)
207
Q

What are some collaborative interventions for cancer?

A
  • -Surgery
  • -radiation
  • -chemo
  • -hormone, targeted, or biologic therapy
  • -bone marrow transplant
208
Q

What are three common therapies for cancer?

A
  • -Surgery
  • -radiation
  • -chemotherapy
209
Q

What can BRCA 1 and BRCA 2 genetic testing detect?

A

Breast cancer

210
Q

This stage of prostate cancer is confined to the prostate, non-palpable and well differentiated.

A

Stage 1

211
Q

What treatment can be done in stage 1 of cancer?

A
  • -observation
  • -beam radiation
  • -prostatectomy
212
Q

What stage of prostate cancer is characterized by palpable, poorly differentiated area that is confined to the prostate?

A

Stage 2

213
Q

What is the treatment for stage 2 prostate cancer?

A
  • -observation
  • -prostatectomy
  • -beam radiation
  • -cryosurgery
214
Q

What stage of prostate cancer shows an extension of the tumor outside of the prostate?

A

Stage 3

215
Q

What treatments can be used on someone with stage 3 prostate cancer?

A
  • -beam/interstitial radiation
  • -Radical prostatectomy
  • -hormone therapy
  • -Palliative surgery (TURP)
216
Q

What stage of prostate cancer is characterized by an extension of the tumor into surrounding tissues, lymph node involvement, and distant metastasis?

A

Stage 4

217
Q

What are some tx.’s for stage 4 prostate cancer?

A
  • -hormone therapy
  • -beam radiation
  • -radiation/TURP therapy
  • -radical prostatectomy with orchiectomy
  • -chemo
218
Q

What is the TNM staging system for cancer and what do the letters stand for?

A

used to stage cancer. The lower the number the better the prognosis.

  • -Tumor
  • -Node
  • -Metastasis
219
Q

Myocardial ischemia can be caused by a build up of…

A

lactic acid

220
Q

At how many hours does creatine Kinase peak?

A

18

221
Q

During an assessment of a pt. with anemia, what specific information should the nurse ask the patient about?

A

Stomach surgery

222
Q

A patient with hypovolemic shock is receiving LR for fluid replacement. What specific lab should the nurse monitor?

A

Serum pH

223
Q

By keeping the temp in the room warm, and wrapping the newborn in a blanket the nurse is preventing what heat loss?

A

Convection

224
Q

What are some effects of chemo toxicity?

A
  • -neuropathy
  • -fatigue
  • -alopecia
225
Q

If a patient is admitted to the burn unit, what would delay hydrotherapy?

A

attempting to neutralize the burn

226
Q

A patient has superficial partial thickness burns. What would the nurse expect to find?

A

fluid filled blisters

227
Q

A nurse assesses that a client has sensory impairment from long term use of furosemide. Which actions will the nurse implement?

A

when communicating with the client, use lower tone of voice

228
Q

A client diagnosed with a stroke is going to receive treatment with fibronolytic therapy using the rt-PA. Which information should the nurse include when performing medication teaching for the clients family?

A

given to break up existing clots and increase cerebral blood flow

229
Q

What vitamins can help slow dry Macular degeneration?

A

vitamins C, zinc, and beta carotene

230
Q

What are the oncofetal antigen tumor markers for lung and breast cancer?

A

CEA

231
Q

What is the specific protein tumor marker for adenocarcinoma of the prostate?

A

PSA

232
Q

What protein tumor markers are associated with breast cancer?

A
  • -CA 15-3
  • -CA 27-29
  • -EGFR
  • -HER1
  • -HER2
233
Q

What protein tumor marker is associated with lung cancer?

A

EGFR

234
Q

If a patient with cancer is having trouble maintaining good nutrition, what are some things the nurse can educate the pt. on?

A
  • -eat whatever is appealing (something is better than nothing)
  • -drink ensure, isocal, or protein powders
  • -eat small, frequent meals
  • -try icy cold foods (i.e. ice cream)
  • -numb mouth with lidocaine if have ulcers to make eating easier
  • -remove foods/odors that induce vomiting. Take antiemetic before meals to reduce N/V
  • -keep a food diary
235
Q

What are antineoplastic alkylating agents used for?

A

kills fast growing cancer cells by altering DNA structure and preventing cell reproduction

236
Q

What are examples of alkylating agents?

A
  • -cyclophosphamide
  • -carboplatin
  • -chlorambucil
237
Q

Antineoplastics are vesicants, How should they be administered?

A

central line

238
Q

What labs should the nurse monitor when taking an alkylating agent like cyclophosphamide?

A
  • -WBC
  • -platelet
  • -H & H (RBC’s)
  • -neutrophils
239
Q

What should the nurse advise the client about alopecia when it comes to taking alkylating agents?

A
  • -Hair loss may occur 7-10 days after taking meds and will last about 2 months
  • -advise clients who want to do so, to select hairpiece prior to starting treatment
240
Q

What do antitumor antibiotics do?

A

kills cancer cells by stopping synthesis of RNA, DNA, or proteins

241
Q

What do antimetabolites do?

A

kill cancer cells by interrupting S-phase

242
Q

what are some examples of antimetabolites?

A

cytarabine, fluoracil, methotrexate

243
Q

Methotrexate is a Pregnancy risk category X drug. What should the nurse should advise the patient on when taking this drug?

A
  • -do not become pregnant while taking it, or 6 months after stopping it.
  • -encourage use of Birth control
244
Q

What meds can be given for aggressive cancers?

A

Vinca alkaloids

  • -vinblastine
  • -vincristine
245
Q

What two meds classes are major contributors to chemo toxicity?

A

antimetabolics

antitumor antibiotics

246
Q

Due to bone marrow suppression the patient is at increased risk for…

A

bleeding and infection

247
Q

What is nadir and how long does it usually last?

A

lowest blood count after chemo

lasts 7-10 days

248
Q

What can be given in a patient with bone marrow suppression to treat anemia?

A

epogen

249
Q

What is tumor lysis syndrome and what labs should be monitored?

A
  • -caused by rapid tumor cell breakdown after therapy causing kidneys to work extra hard to remove substances in tumors. If the kidneys cant keep up, TLS develops
  • -monitor BUN, creatinine, and electrolytes
250
Q

What would the electrolyte labs look like in a person with TLS?

A
  • -high potassium, phosphate

- -low calcium

251
Q

What drugs are major contributors to TLS?

A
  • -cisplatin
  • -methotrexate
  • -mitomycin
252
Q

How would the nurse manage TLS?

A
  • -giving bicarbs, and allopurinol (prevent renal failure)
  • -may need dialysis
  • -kayexalate, hypertonic dextrose and insulin (restore electrolytes)
  • -phosphate binding gels (decrease phosphorus)
253
Q

What two antitumor antibiotic drugs are major contributors to reducing lung function causing pulmonary fibrosis?

A
  • -bleomycin

- -daunorubicin

254
Q

What cancer treatment drug is responsible for causing peripheral neuropathy?

A

cisplatin (assess for neuropathy)

255
Q

What are the two diagnostic tests done to biopsy for diagnosis?

A
  • -needle aspiration biopsy

- -excisional biopsy (cut)

256
Q

If a cure for cancer is not an option, maintaining quality of life is important. What procedure can be done to ease the passage of food?

A

stent

257
Q

What two procedures can be done to remove extra fluid in a person with cacner?

A
  • -thoracentesis

- -chest tube

258
Q

If a person were to undergo external radiation, what are they at risk for?

A

skin breakdown

259
Q

If a patient has impaired skin integrity due to external radiation, what are some things the nurse can educate the pt on?

A
  • -don’t use powders, lotions, soaps, deodorant
  • -avoid rubbing/scratching area
  • -avoid sun
  • -wear cotton clothes (no binding clothes)
  • -apply zinc containing ointment to area
260
Q

What are some side effects of radiation toxicity?

A
  • -malaise
  • -fatigue
  • -anorexia
  • -anemia
261
Q

What should the nurse be monitoring with all cancer pts.?

A
  • -VS (infection/bleeding)
  • -mucous membranes
  • -skin
  • -hair loss
  • -weight
  • -pain (may indicate progression)
  • -fatigue (from cancer tx)
  • -psychological status (do they have hope?)
  • -body image (mastectomy, hysterectomy)
  • -support system

final exam (2 decks)

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