General questions Flashcards
What are the S/S of hypermagnesemia? Hypomagnesemia?
Hypermagnesemia=Drowsiness, weakness, hypotension, hypocalcemia, arrhythmias, bradycardia. Hypomagnesemia=Weakness, muscle cramps, arrhythmias, irritability of the CNS.
What is the difference between slander and libel?
Slander is defamation by speech, libel is defamation by written word.
What are the essentials of K+ administration?
Never give IM/Sub Q/IV push. Dilute 1 mEq/10 mL solution. Infuse 5-10 mEq/hr never to exceed 20. Check IV site frequently for phlebitis and check renal function prior to administration.
What can cause a U wave to be present on telemetry?
Hypokalemia.
What are the clinical manifestations of hypocalcemia?
Chvostek’s and Trousseau’s signs, prolonged ST and QT intervals.
How does hyperkalemia affect an ECG?
Peaked T waves, flat P waves, widened QRS complex, and prolonged PR interval.
Which of these would create the GREATEST risk for hyponatremia, Diuretics, corticosteroids, Cushing’s, hyperaldosteronism.
Diuretics.
What are the S/S of hyponatremia?
Muscle weakness, flat neck veins if hypovolemic, diminished DTR’s, hyperactive bowel sounds.
What can cause low phosphorous levels?
Malnutrition (alcoholism), overuse of magnesium or aluminum hydroxide antacids, hyperglycemia, Respiratory alkalosis.
What is the difference between sensible and insensible fluid loss?
Sensible is what the person is aware of. Urine, wound drainage, gastrointestinal
Would a colostomy put a patient at risk for fluid volume overload/deficit?
Deficit
How would you describe Kussmaul respirations?
Deep, regular (not labored), and ↑ in rate.
Which serum amylase level would be indicative of chronic pancreatitis, 45/100/300/500?
- Acute pancreatitis can cause amylase levels to be as much as 5 times as high.
When changing TPN bags and tubing, what should you ask the client to do?
Turn the head away from the PICC line and do the Valsalva maneuver (take a dep breath, hold it, bear down).
What body position is used when an air embolus is suspected?
Left side, head lower than feet. (to trap the embolus in the right side of the heart).
What are the S/S of hyperglycemia?
Thirst, fatigue, restlessness, confusion, weakness, diuresis, Kussmauls, coma.
If you are hanging a bag of fat emulsions for a patient receiving TPN, and notice that the fats have separated into layers or globules, what do you do?
Return it to pharmacy and get a new bag.
What is closely monitored on a client receiving TPN at home?
Temperature and weight.
If TPN runs out, what is hung until a new bag is obtained?
10% Dextrose in water.
If you need to expand the volume of a hypovolemic patient quickly, what IV solution would you give?
5% dextrose in LR is a hypervolemic solution that would expand volume quickly.
How would you infuse fluids in a patient with HNNS?
Administer 2-3 LITERS OF FLUID RAPIDLY.
If you are going to suction a patient with bacterial meningitis, and then transport him, what PPE is needed?
Gloves, mask, and eye protection for suctioning, the put a mask on the patient for transport.
What is usually done before implantation of radioactive seed in a patient with cervical cancer?
Bowel cleanse.
What is a sign of congenital defect in an infant?
Unequal gluteal folds.
What type of IV tubing do you use for a 6 month old?
One with a volume control chamber.
What do you do with a central line after removal?
Put it in the sharps container.
Who gives consent for an infant in foster care?
The foster mother.
If there is no induration in the skin of an HIV patient after mumps/candida injection, what conclusion can be made?
Client is immune-deficient.
When is the best time for breast self-exam for a premenopausal woman?
Immediately after her period.
After moving the crutches forward, what comes next?
Move the bad leg forward.
Reyes syndrome usually follows what other illness?
Chicken pox.
What are the early S/S of dehydration?
Thirst/confusion.
After you move the walker, what is moved next?
The affected leg.
How big an induration after PPD testing warrants closer examination?
15 mm.
What position relieves pericarditis discomfort?
Leaning forward while sitting.
________ is an adverse reaction to mag. Sulfate.
Flushing, sweating, ↓ BP and cardiac function.
What equipment is needed to do a BPP?
Ultrasound and fetal monitor.
What is a major risk following general anesthesia?
Atelectasis.
What type of diet is needed for a child with cystic fibrosis?
High calorie high protein.
What is turbutaline used for?
To relax uterine muscle.
What drug is used to mature neonatal lungs?
Betamethasone.
Who do we refer an abused client to?
A social worker.
Are weak distal pulses normal after cardiac catheterization in an infant?
Yes
What vitamin supplement helps a cycle cell patient rebuild hemolyzed red blood cells?
Folic acid.
When does NPH peak?
8 to 12 hours after admin.
When does the single chambered heart begin to beat in an embryo?
About the 24th day.
How do you perform CPR on an infant?
Use the 2 thumbs/encircling hands technique.
What other electrolyte imbalance might occur in an alcoholic with hypomagnesemia?
Hypophosphatemia.
What is considered a “normal” adverse reaction to infant phototherapy?
Frequent, loose, watery green stools.
What is an early neonatal sign of CF?
Meconium ileus.
What is it important to do for a child with pinworms?
Treat the entire family.
What is an important first step in treating a child during a cycle cell crisis?
Begin IV fluids.
What is an ileal conduit?
Ureters are surgically attached to a detached part of the ileum and brought to the surface through a stoma.
What lab test best indicates HNNS?
Serum osmolarity.
What position is the client put in to best hear S3 heart sounds?
Left side.
If a child with spina bifida develops a rash after eating bananas or kiwi fruit, what type of allergy is suspected?
Latex
What vitamin should be stopped 1 week before an invasive procedure?
Vitamin E. It can cause bleeding.
How do you assess for hepatojugular reflux in a heart patient?
Hepatojugular reflux, a sign of right sided heart failure is assessed by pressing on the upper right abdomen over the liver.
What is an adverse effect of aspirin use?
Tinnitus.
Where is the fundus one day after delivery?
One finger below the umbilicus.
If a child has had cardiac arrest, what drug is administered after resuscitation?
Dopamine. Epi, atropine and sodium bicarb are used during resuscitation.
What diet is used for an infant in HF?
Increased caloric content per ounce.
What is the goal for FO2 for a patient on a vent?
0.5
What would x-rays of an osteoarthritic joint reveal?
Osteophyte formation.
What do you do if you find blood tinged urine in a neonates diaper?
Nothing. This is normal.
What are the 4 key concepts of most nursing theories?
Man, environment, health, nursing.
What are the S/S of a hip fracture?
External rotation and shortening of the affected leg.
Lightening is an early/late sign of preliminary labor.
Early.
When is a level II ultrasound ordered for a prego?
When fetal development is in question.
If your patient has MG, when is it most appropriate to complete procedures and care?
In the morning, with frequent rest periods.
If a client has phenylketonuria, and is trying to get pregnant, what guidelines should be offered?
Follow a low phenylalanine diet before trying to conceive.
Which nurse specialist deals with clients with ostomy’s?
An enterostomal nurse.
What are Kubler-Ross’s 5 stages of death/dying?
Denial, Anger, bargaining, depression, acceptance.
What test confirms a diagnosis of diabetes insipidous?
A fluid deprivation test.
What is the first sign of increasing ICP?
Changes in LOC and nausea.
How long does the second stage of labor usually last?
About 2 hours.
What is Methergine, and when shouldn’t it be used?
It is a vasoconstrictor, can cause hypertension, and shouldn’t be used on a hypertensive client.
If a 16 year old gives birth and the baby needs surgery, who needs to give consent?
The baby’s mother. She is considered emancipated if she gives birth.
Which over-the-counter meds can interfere with prescribed insulin?
Anything with alcohol, such as cough syrups.
What is a common side effect of turbutalene?
Fluttering or tightness of the chest.
What is the first treatment for SIADH?
Limit fluids to 800 mL/day.
If an IM injection is continuing to cause pain, what is the best course of action to relieve it?
Massage the area to increase absorption of the drug.
Which hormone is responsible for milk letdown?
Oxytocin.
What is the most appropriate nursing diagnosis for acute pancreatitis?
Deficient fluid volume due to vomiting/hemorrhage, plasma leakage into the peritoneal cavity.
Can sodium bicarb be given through an ET tube?
No! It is usually diluted in a large volume of water, and due to its alkalinity.
What causes Addison’s disease?
Mineralocorticoid deficiency.
Which BP med requires blood glucose monitoring?
Metaprolol.
How would you instruct a client to do a collection for a fecal fat analysis?
If the test begins on Monday, instruct the client to eat at least 150 g of fat per day for 3 days, then collect a fecal sample on Thursday.
Is it OK to spill sterile water on a sterile field?
NO! If your sterile field becomes wet, it is no longer considered sterile.
Which nursing diagnosis is a priority for a client with an ectopic pregnancy?
Fluid volume deficit. If it ruptures, massive blood loss may occur.
What is a therapeutic response to Plavix?
Client denies difficulty swallowing. Plavix is an antiplatelet aggregate.
Which is better during the last trimester, Motrin or Tylenol?
Tylenol. NSAIDS like Motrin affect the neonate.
What is the major side effect of Tuebutalene that should be monitored for?
Tachycardia. A HR > 120 should be reported.
How long does it take EMLA cream to take effect?
2 hours.
Is the oral polio vaccine a danger to an immunosuppressed person?
Yes. It is a weak, but live virus.
When reading a PPD, what size induration is considered a “positive” result?
15 or higher if they are low risk. 10 or higher if they are a moderate risk. 5 or higher if they are high risk, such as HIV +.
What position is proper for a child who just had a tonsillectomy?
Prone
When doing pursed lips breathing, are the cheeks puffed out during exhalation?
No!
How fast do you push 40 mg of Lasix?
Over 1 minute.
Where is it best to look for petechiae in a dark skinned client?
Oral Mucosa
