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medsurg > Final Exam: SG Material > Flashcards

Final Exam: SG Material Flashcards

1
Q

Fractures can lead to what issue? What can this issue lead to?

A

Fractures can lead to compartment syndrome which can lead to amputation

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2
Q

What are s/s of fractures? (3)

A

Cool, pallor, numbness

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3
Q

What is used to treat fractures preoperatively? What happens if the patient moves?

A
  • Traction (weights) attached to the patient’s fractures to immobilize the patient; should not touch the floor (removes the traction)
  • Can be painful for the patient if they move
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4
Q

Fractures on long bones (eg: lower extremities) have a high risk for? (2)

A
  • pulmonary embolism (fat can break off and move to lungs or brain)
  • muscle spasms
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5
Q

Precautions for hip replacement? (2)

A
  • extending body to 90 degree angle

- raise toilet seat to avoid bending

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6
Q

Compound fracture is?

A

breakage that results in bone protruding through the skin and has a high risk for infection

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7
Q

Complications of broken hip? (2)

A
  • immobility

- chronic health issues with immobility (eg: malnutrition, muscle degeneration, skin breakdown)

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8
Q

Osteoporosis (bone loss) is more common in which gender and why?

A

In females related to post-menopause (loss of estrogen)

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9
Q

Why are women more susceptible to bone loss than men? How does the loss of estrogen contribute to osteoporosis?

A

Estrogen combines with calcium and vitamin D to help keep bones working; loss of estrogen makes more osteoclasts (bone reduction) and less osteoblasts (bone formation)

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10
Q

A fracture that occurs because of osteoporosis is classified as?

A

A pathological fracture (can trace back to the disease process)

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11
Q

What are the main concerns for patients with osteoporosis? (2)

A

Risk for falls (to prevent breaking bones) and fractures

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12
Q

What are the nutritional causes of osteoporosis? What nutritional supplement can treat osteoporosis?

A
  • lack of calcium/dairy

- take vitamin D to increase calcium bioavailability

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13
Q

Two days after surgery for a crushed pelvis, a CNA reports that the patient is complaining of SOB and demonstrating signs of confusion and restlessness. What should a nurse suspect from these signs alone that the patient has developed?

A

Fat embolism

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14
Q

What is a serious muscle issue that can result from osteoporosis or a fracture?

A

Rhabdomyolysis: muscle breakdown

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15
Q

A 78-year-old retired teacher with a hx of osteoporosis has fallen in her bathroom and sustained a sub capital femoral fracture. She is scheduled for an open reduction and internal fixation procedure in the morning. Which type of traction will most likely be implemented?

A

Bucks’ Traction

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16
Q

Difference between internal vs external fixation?

A

Internal: patient will be instilled internally with rods and pins
External: bolts and pins are instilled outside the patient

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17
Q

A patient with external fixation needs pin care, the patient teaching should include? (2)

A
  • expectations to feel itchy while healing around the pin sites
  • report exudate or drainage that is green or brown that is foul-smelling
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18
Q

A nurse is told that a patient has a compound comminuted fracture. What characteristic of the bone in this type causes the nurse to be concerned?

A

Broken in two or more pieces, bone fragment protrudes through the skin, leading to a high risk for infection

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19
Q

What action should the nurse implement when caring for a patient dx of a compound fracture?

A

Assess for pulses distal to the injury (breakage can affect circulation and oxygenation of the tissue distal from the injury, eg: for a knee injury, assess pulses at the pedal and tibial pulse)

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20
Q

What should a nurse who is documenting and reporting the s/s of infection underneath a cast include in the medical record? (5)

A
  • foul odor
  • redness
  • warmth
  • swelling
  • elevated temperature
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21
Q

A nurse is teaching an osteoporotic patient taking alendronate (Fosamax). Which instruction should the nurse stress? (2)

A

Keep patient upright for 30 minutes (patient should keep themselves upright) and take without regard to food

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22
Q

Alendronate (Fosamax) what type of medication and what is it used for? What is a patient at risk for?

A

Biphosphate medication; at risk for getting other fractures (drug use is to mobilize and decrease bone loss)

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23
Q

Peptic ulcer disease is?

A

Erosion of stomach lining and ulceration in the small intestine

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24
Q

What digestive enzymes does the stomach secrete (2)

A

Pepsin and hydrochloric acid

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25
Q

What is the main bacterial cause of peptic ulcer disease?

A

H. pylori bacteria

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26
Q

What medications propagate peptic ulcer disease?

A

NSAIDs

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27
Q

Gastric ulcers occur in the stomach and pain occurs when? Foods role?

A

Pain occurs 1-2 hrs after meal; food aggravates s/s

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28
Q

Duodenal ulcers occur in the duodenum and pain occurs when? Foods role?

A

Pain occurs 2-5 hrs after meal; food alleviates pain as it buffers acid secretion

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29
Q

What group of medications is used to treat peptic ulcer disease? How long does its effects last?

A

Antibiotic treatment; effect lasts for weeks

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30
Q

What are side effects of antibiotic treatment? (4)

A
  • GI issues
  • superinfection (eg: kills normal flora)
  • oral candidiasis
  • yeast infection (mostly in women)
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31
Q

What are 5 other groups of medications that treat peptic ulcer disease?

A
  • H2 receptor blockers (eg: ranitidine)
  • proton pump inhibitors (eg: ending in -prazole)
  • antacids
  • magnesium
  • aluminum antacids
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32
Q

H2 receptors are used for which patients?

A

Patients who are in the hospital for a long period of time to PREVENT a peptic ulcer

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33
Q

H2 receptors are?

A

The second fastest-acting medication and has the most duration

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34
Q

Sucralfate is a medication that does NOT?

A

Lowers stomach acid; provides a protective covering of stomach lining

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35
Q

Are there medications to physically fix a peptic ulcer?

A

No

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36
Q

What is the main concern with antibiotic treatment? (2)

A

C. diff infection and superinfections (eg: oral candidiasis or thrush, yeast infection)

37
Q

S/S of perforated ulcer?

A

Bright, red blood in vomit

38
Q

S/S of internal bleeding ulcer? (3)

A
  • hard, board-like ABD

- hypotension and tachycardia

39
Q

Where does fecal matter stay when it is expelled in the GI tract?

A

In the rectum

40
Q

At what age is it common for the appendix to get inflamed (appendicitis)?

A

Patients under 25

41
Q

What are 2 functions of the liver?

A
  • metabolize (CYP450 is the enzyme that metabolizes drugs in the liver)
  • makes bile (used to breakdown fat) and glucose
42
Q

Hepatitis A is?

  • route
  • causes (2)
  • s/s (3)
  • prevention
  • patient teaching (2)
A
  • ACUTE, inflammation cannot be chronic from hep A
  • route: oral-fecal route
  • causes: poor handwashing, poorly cleaned vegetables and fruits
  • s/s: jaundice, nausea, fatigue
  • preventable with a vaccine
  • practice good hand hygiene, wash produce thoroughly
43
Q

A nurse is educating a patient dx with hep A. What should the nurse instruct this patient to avoid sharing?

A

Food

44
Q

Hepatitis B is mainly a concern for?

  • causes (3)
  • chronic or acute?
  • prevention?
  • treatment (2)
A
  • concern for HCPs especially through a large bore needlestick
  • blood, bodily fluid, IV drug abuse
  • can convert to a chronic condition
  • use standard infection precautions (eg: PPE)
  • gamma-ray and interferon
45
Q

Hepatitis C

  • transmission (2)
  • requires what type of testing?
  • chronic or acute?
A
  • blood-borne, IV drugs
  • requires genotype testing
  • chronic and slow-damaging to liver overtime
46
Q

What precaution should a nurse initiate when caring for a patient with hepatitis B?

A

Standard precautions

47
Q

Liver function test includes? (2)

A

AST and ALT

48
Q

Diverticulosis?

A

primarily affects the outpouchings of the large intestine, becomes inflamed and starts to rot

49
Q

What is diverticulosis caused by? (2)

A
  • low fiber diet

- hx of hemorrhoids

50
Q

What is the difference between diverticulosis and diverticulitis?

A

Diverticulosis has less s/s and leads to inflammation (diverticulitis)

51
Q

Treatment for diverticulosis? (2) nutrition

A
  • high-fiber diet

- low-fat/non-fat diet

52
Q

When is a fat embolism most likely to occur?

A

24-48 hrs after a fractured tibia

53
Q

What foods can get stuck in the diverticula? (2)

A

Nuts and seeds

54
Q

What should a nurse include in the discharge teaching for a patient after a laparoscopic for a cholelithiasis?

A

Follow a low-fat diet (not enough bile to break down fat)

55
Q

S/S of cholelithiasis?

A

dark, amber-colored urine that may contain blood

56
Q

Ulcerative colitis is limited to which section of the GI tract? S/S? Surgical treatment for ulcerative colitis?

A
  • colon
  • bloody diarrhea
  • stoma (eg: ileostomy)
57
Q

A patient in acute pain is admitted with pancreatitis. A nurse reviews a lab report showing elevation that is diagnostic for acute pancreatitis. Which lab report did the nurse most likely review?

A

Serum amylase

58
Q

Causes of pancreatitis (3) Which is the most common?

A
  • gallbladder disease: most common (very painful)
  • chronic alcholism
  • diabetes
59
Q

Which gender population is more likely to have gallstones?

A

Males

60
Q

Describe pain associated with gallstones? (2)

A
  • radiates to the back

- can be acute or chronic

61
Q

Functions of the pancreas (2)

A

Endocrine functions: secretes insulin, glucagon

Exocrine function: digestive enzymes

62
Q

What can occur if enzymes are not released due to an obstruction in the pancreas?

A

Enzymes can injure the pancreas itself which can lead to issues in the GI (eg: digestion)

63
Q

Patient care for pancreatitis? (2)

A
  • administer pain medications

- low-fat diet

64
Q

Patients with which GI disorder have a GREATER risk for colorectal cancer?

A

Ulcerative colitis

65
Q

Precursors to colon cancer? (2)

A

ulcerative colitis and Crohn’s disease

66
Q

If a patient does not have first-degree relatives with colorectal cancer, at what age is a patient prone to getting the disease?

A

Starting at 50 years old

67
Q

What is the gold standard testing for colorectal cancer?

A

Colonoscopy (detects polyps)

68
Q

Diet that can lead to colorectal cancer (2)

A
  • high red meat intake

- fatty diet

69
Q

What gene is detected in patients with colorectal cancer?

A

APC gene (increased risk for colorectal cancer)

70
Q

Endoscopy goes through which tract?

A

Oral tract

71
Q

Cirrhosis is?

A

An ongoing inflammatory process in response to hepatocyte (liver cell) death

72
Q

A common cause of CHRONIC cirrhosis?

A

Alcohol consumption

73
Q

ACUTE cirrhosis is caused by?

A

Hepatitis A (eg: ingesting uncooked meat/unwashed produce)

74
Q

If a patient eats a poisonous vegetable and requires a liver transfer, is this acute or chronic cirrhosis?

A

Acute

75
Q

3 possible causes of cirrhosis?

A
  • excessive drinking
  • hepatitis C
  • non-alcoholic fatty liver disease (NAFLD)
76
Q

S/S of ascites? (2)

A
  • striae

- spider anginoma

77
Q

Which liver disease process is a result of cirrhosis?

A

End-stage liver disease

78
Q

What actions should a nurse implement to correctly assess the progress of ascites on a daily basis? (2)

A

Daily weight (fluid retention) and ABD girth measurements

79
Q

Why do I&Os not have to be assessed on a daily basis for a patient with ascites?

A

I&O measures the current fluid status (does not track daily progression)

80
Q

What is an indication of end-stage liver disease? It is most important to assess for?

A
  • hepatic encephalopathy (excess ammonia due to inability to convert ammonia to urea to be excreted in urine)
  • assess LOC
81
Q

What is necessary to restrict when the ammonia level of patient dx with cirrhosis continues to rise? (3)

A
  • meat/organ meat
  • alcohol intake
  • decrease protein intake
82
Q

A high ammonia level contributes to hepatic encephalopathy. Which nursing implementation needs to be added to the nursing care plan as this level continues to increase?

A

Increase frequency of neurologic checks

83
Q

S/S of esophageal varices? (3)

A
  • vomiting blood
  • hypotension
  • tachycardia
84
Q

Indications of internal blood loss? (3)

A
  • poor perfusion
  • SOB
  • decrease in BP
85
Q

Possible causes of internal blood loss (3)

A
  • trauma
  • loss of blood in the ABD cavity
  • GI bleed
86
Q

What is a hiatal hernia?

A

part of the stomach has moved upwards through the diaphragm (very painful!)

87
Q

What is GERD (gastroesophageal reflux disease)

A

loss of the ability to contain stomach acid

88
Q

Surgeries place the patient at a greater risk for?

A

Adhesions (the connection between two tissues that should not occur) and could contribute to a hernia

medsurg (16 decks)

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