Kaplan Flashcards
How long do special precautions need to be taken for handling body fluids after chemo?
48 hours
After a circumcision on a newborn, what is considered a normal finding? What would indicate an infection?
Yellow exudate
Moist and slight red at base –> infection
When a patient is refusing what kind of questions do you want to avoid asking them?
Avoid WHY questions
Should a patient ever have no socks on?
Even if don’t have non-skid socks then should wear slippers because barefeet can be slippery
A Glasgow come scale of 8 or less means what?
That they are likely in a coma and need intubated and monitored
Are straight caths at home sterile or clean?
It is a clean procedure and they can be reused after cleaned with antibacterial soap or povidone
If an order has a trailing 0 such as 4.0 what should the nurse do?
Question it
What does an absent red reflex in a newborns eye indicate?
An ophthalmic emergency
Atomoxetine is used for what? What teaching?
ADHD
Low risk for dependence
W/ or W/O food
Check weight weekly d/t anorexia
Fruits and veggies d/t constipation
Increases suicide risk
TPA should be used in caution if what s/s are present?
An infection s/s
What is the frontal lobe responsible for?
Memory
Voluntary eye and motor movement
Speech
Personality
Behavior
Emotions
Phenelzine is an.. you should avoid..
MAOi
Avoid aged cheeses
What is unique about nitro solutions?
They need to be protected from light
Who is at risk for TB?
TB is opportunistic so anyone with something that causes them to be immunocompromised is at risk
Should you removed skin/skeletal traction when changing a patient position?
NO
Skin/skeletal traction should not be removed unless provider order
What is the normal coagulation time?
2-8 minutes
When giving a blood transfusion, what are s/s of a hemolytic reaction?
Neck, chest and back pain
Hematuria
Skin flushing
Increase HR and RR
Hypotension
DIC
Vascular collapse
Shock
Death
What does cognitive therapy do?
Focuses on the immediate thought process
What puts a patient at increased risk for cholelithiasis?
Multiparity
Over 40 YOA
Fasting - decreases gallbladder movement
What are things that are included in primary health prevention?
Health education programs
Immunization
Physical and nutritional fitness activities
What is the hallmark s/s of myasthenia gravis?
Choking and aspiration so maintain a patent airway and preventing aspiration is top priority
How often should restraints be removed?
Every 2 hours to preform skin assessment and ROM
What is acetylcysteine? What patients is it used in?
Mucolytic - used to break up/liquify mucus
Can be used in pts with CF or pulmonary congestion
What is levofloxacin?
Broad spectrum antibiotic
What is the role of amniotic fluid? If oligo occurs what are the risks?
Prevent cord compression and promote lung development
Pulmonary hypoplasia - lack of alveolar distention so increase providers at birth
Cord compression - continuous fetal monitoring
What should be given for a tricyclic antidepressant (TCA) overdose?
Sodium bicarb because it raises the pH which neutralizes levels of toxic TCA leading to a reduced risk of life threatening arrhythmia
What is the best indicator that antibiotic treatment is working?
WBC count
Can you take NSAIDS in pregnancy?
Not recommended in the 1st and 2nd trimester of pregnancy
Contraindicated in the I 3rd trimester of pregnancy because could cause premature closure of the fetal ductus arteriousus
Can you use ACE inhibitors and ARBs in pregnancy?
NO both ACE inhibitors (-pril) and ARBs (-sartan) are contraindicated in pregnancy
Can cause fetal injury/death
What does systematic desensitization used for?
Decreases extreme response to anxiety producing situations. Most effective for patients with phobias
Electroconvulsive therapy is indicated for which patients?
Severe depression and catatonic conditions after medications have failed
What is a major concern with a spinal cord injury?
Breathing/diaphragm can be affected depending on the level of injury
If there are shared rooms, who should a post-op patient not share a room with
Someone who is considered contaminated so either has an infection or on antibiotics
What could severe persistent abdominal pain during pregnancy mean?
Ectopic pregnancy if early
Worsening pre-e
Placenta abruption
When is the third stage of AWS? What s/s?
3-4 days after last drink
Fever, HTN, delirium, drenching sweats, severe tremors
What vaccines should a 4 year old get?
MMR nad inactivated poliovirus
When collecting evidence for a crime scene from a patient what should you place it in?
Paper bag
Plastic bags can cause bacteria to grow
What are early s/s of alcohol withdrawal?
Hyperalterness
Easily startled
Anorexia
Increased HR
Anxiety
Tremors
Insomnia
Hallucinations
What is an adverse reaction to epoetin alfa?
DVT - swelling, pain, erythema
Painless vaginal bleeding after 20 weeks could indicate what?
Placenta previa
NO VAGINAL EXAMS
What 2 medications should alcohol withdrawal patients be on?
Benzos and thiamine (administer with glucose to prevent Wernicke encephalapathy)
For an intubated patient what should you auscultate?
The neck listening for any cuff leaks
What is the highest risk factor for stress-related disorder?
Death of a spouse
Doxazosin is a..
Anithypertensive
Prior to dialysis what medications should be held?
Antimicrobials because dialysate solution removes them
Anything that will affect BP
What SE should be monitored for with phenazopyridine?
Skin/sclera develop yellowish tinge CALL HCP
When should women get paps?
Every 3 years from ages 21-29
What will you see in the mouth in a patient with candidasis?
White patches
Should you use cold when relieving pain for a patient in a sickle cell crisis?
NO
Cold will cause vasoconstriction and further limits blood flow leading to increased pain
What history increased the risk of a patient having gastric cancer?
Peptic ulcer disease because of H. Pylori in the stomach
What is a s/s of psoriasis? Is it contagious?
Silver colored plaques
Genetic but not contagious
Does heat relieve itching?
No heat causes vasodilation –> itching
What is a SE of chemo to monitor for?
Peripheral neuropathies
What is autonomic dysreflexia? S/S?
Dangerously high BP and if untreated can lead to intracranial bleeding and death
HA is an sign
What is a SE of long term anti-retroviral therapy?
Hyperlipidemia and cardiovascular disease
What position is best what preforming a lumbar puncture?
Laying supine because is prevent HA form leaking CSF at puncture site
What should you avoid while preforming kegels?
Avoid flexing the abdomen, thighs and butt muscles
What S/S would you see with Right sided HF?
Congestion in the venous system
Peripheral edema, JVD, pink tinged sputum, anorexia, pulmonary congestion/crackles, ascites
Does latent TB require any interventions?
Yes requires medication
What does secondary health promotion focus on?
Screening for early detection of the disease
What foods are okay to eat with ulcerative colitis?
Food that are low-residue
Canned, cooked, seedless, skinless veggies, refined grains (white bread), cheese, milk, meats
If a nurse doesn’t document the whole shift what should you do?
Just document on the line right below it leaving no space
A nurse cannot document for another nurse
What does an esophagogastric tube treat? What is the patient at high risk for?
Treats bleeding from esophageal varies
High risk for bleeding and hypotensive shock
When accessing a PICC line what should the nurse do?
Flush with 10mL of NS
When does bloody show occur during labor?
In the transition (3rd) phase of the 1st stage of labor
What are the rules while giving care with a patient that has radiation device?
No more than 30 minutes
6 feet away from radiation source
No pregnant women visiting
What labs would you expect with adrenocortical insufficiency?
Hyponatremia
Hypoglycemia
Hyperkalemia
If you expect a CSF leak what should you test the fluid for to confirm?
CSF will have glucose
If you lower the HOB what ill happen to ICP?
ICP will increase
What is rotavirus? Precautions?
GI infection –> diarrhea
Contact
What precautions is streptococcus pneumoniae on?
Droplet
Does a patient having a miscarriage early on need immediate treatment? S/S?
No , should use pads and save/count them
Moderate cramping and frank red vaginal bleeding
What immunity is given via breast milk?
IgA
What is the hallmark sign of schizophrenia?
inability to trust others so difficult forming relationships is the priority
What can help to treat cluster HA?
Sumatriptan
100% O2 via facemark because causes vasoconstriction and increases serotonin
What are Atypical s/s of an MI for females?
Jaw pain
Fatigue
Nausea
What is the most common cause of ARDS?
aspiration
What education should you give about hydralazine?
Take with food to increase bioavailibilty
OTC meds should be avoided w/o speaking with HCP
Could cause orthostatic hypotension
What is isoniazid hard on?
Liver
Look for jaundice
In different races, may have to look at the hard palate for jaundice
For OCD what should you do if they are preforming a ritual that is harmful to themselves?
Divert attention towards other activities
When is sodium bicarb given in acidosis?
if pH is lower than 7
What is a late sign of a tension pneumothorax?
tracheal deviation
While in a leg cast what type of exercise should you do?
Quadriceps setting of affected limb
This contracts the muscle w/o moving the joint –> maintain muscle strength
How should you take iron supplements? What should be avoided?
Take on empty stomach or with a vitamin C drink
Avoid taking with antacids, milk, caffeine
What is an early sign of a pressure injury?
nonblanchable erythema
What electrolyte imbalances would you expect with anorexia nervosa?
Hypokalemia
Hypoglycemia
Hypomagnesemia
Hypophosphatemia
What diet should a patient with a radium implant be on?
Low residue diet so there is a decreases amount of stool and BM because these could dislodge the implant
When is a breast exam ideally done?
1 week after onset of menses when hormonal influence on breasts are low
What could cause iron deficiency anemia?
Chronic blood loss
Removal of duodenum because malabsorption of iron
What can long term corticosteroids lead to?
Osteoporosis
When there has been rupture of membranes, what is a risk when ambulating them?
Cord prolapse so should not be ambulated
What should you do when assessing child/baby ear?
pull pinna of ear down and back to straighten
What are appropriate toddler toys?
Pounding book
Cloth picture book
A prolapsed stoma.. A retracted stoma…
Prolapsed = protrudes
Retracted = sunken and inverted
What is a sign of malignant melanoma?
irregular shaped lesion
What lab is increased in a patient with sickle cell?
Reticoulcyte because there is a decrease in RBC lifespan
What happens if a patient does not rotate injection sites?
There is decrease absorption so with insulin it results in increase glucose
What is the goal in tertiary health promotion?
Prevent disability and complication of the condition
What VS compensates for increase blood in pregnancy?
HR increases
What occurs in lithium toxicity?
Vomitting, diarrhea, slurred speech, decreased coordination, drowsiness, muscle twitching
What food can decrease cholesterol by 10%?
Fiber
Can a patient with a graft/autograft on legs walk?
Need to be immobilized and elevated for 3-7 days
What is the safest place for a car seat?
Back center seat because it is away from airbag
What is the diet for a patient with Cushings?
high protein
low carb
low sodium
low calories
high potassium
ECT can cause injury to a person with this disease
Osteoporosis
Alendronate is a treatment for osteoporosis
What type of vaccine is polio?
Inactive
What should be avoided in patient with MS?
Extreme temperatures d/t change in sensation
When do children begin to get voluntary control of sphincters?
18-24 months
If you suspect your patient is having autonomic dysreflexia what should you do first?
Sit your patient up to decrease ICP and prevent cerebral hemorrhage and seizures
What should a patient diagnosed with respiratory failure limit in their diet?
Carb because it causes an increase in CO2 production
What is important to assess what a patient is getting a pacemaker?
If the patient has wireless hearing aids because they should no be within 6 inches of a pacemaker generator
What care should be included for a newborn that received a clamp circumcision?
Petroleum jelly pad placed on the penis before diapering
What type of breast pads should be avoided when breastfeeding?
breast pads with plastic because they retain moisture and increase risk of a yeast infection
What are s/s of Hodgkin lymphoma?
firm, painless, moveable adenopathy of cervical area
When is mannitol used? Why?
Given to a patient with increased ICP because it pulls water from the tissues back into the vessels –> decreased swelling and increase UOP
Monitor UOP to ensure its working
What is normal urine specific gravity?
1.010-1.030
When there is bone metastasis, what should you monitor for?
Hypercalcemia (LOC changes)
How do you assess the trigeminal nerve?
Palpate temporal/masseter muscles and use a cotton swab on face to test light touch
Who can place an abdominal binder?
UAP
What is the concern with HPV?
It can cause cervical or penile cancer but the vaccine decreases that risk and is given to both male and females at 11-12years old
What is an early sign of increased ICP?
slowed speech
Quickening is felt around when?
16-20 weeks
If patients come to the ED with hives and puritis, you should assess what?
Their breath sounds b/c can turn into anaphylaxis
For a patient in therapeutic hypothermia, what rate should they be rewarmed?
0.45 degrees F per hour
What should be avoided prior to a stress test?
Beta blockers 24-48 hours
NPO for at least 4 hours to decrease aspiration risk
Ask doctor about insulin (since activity w/o eating)
Why does a new mom get a temp 24 hours after birth?
dehydration and fatigue
If a paralyzed patient needs help getting up, what should be avoided?
avoid using their paralyzed size to help pull them up because it could lead to dislocation of the shoulder
Sign should be placed
What occurs if the brainstem was involved in the surgery?
The patient may have an increase temp
Can aminophylline and propranolol be given together?
No
Propranolol decreases bodies ability to metabolize aminophylline –> toxicity
After cardioversion, should patient continue to take their antiarrythmic meds?
Yes until the HCP says not to
What short hand should be written out instead to be correct?
Write out units do not put U
Write out daily do not put QD
What does myxedema refer to?
hypothyroidism
If a patient has had a dry cough for several weeks and night sweats then what is the concern?
TB
What is Paget disease?
increase in serum alkaline phosphatase, fractures, and abnormal remodeling and resorption of bone
What is the concern with lymphoma of the upper neck?
Pressure on airway
Why does cataracts occur?
Lense becomes less hydrated and dense
When a patient is receiving digoxin or amiodarone what should be monitored?
If they are seeing halos/blurred vision
Needs attention
A patient that had a transfusion related acute lung injury should be premeditated with what before a transfusion?
Leukocyte reduced RBC because the antibodies in the blood caused the reaction
What does wheezes sound like?
Continuous high pitched whistling sound mainly on expiration
When should citrus fruits be avoided?
avoid in kidney disease because high in potassium
Including juices like orange juice
If a patient is hypernatremic what should be given?
5% dextrose in water b/c dilutes sodium and decreases level in blood
Can a patient breastfeed with mastitis?
Yes and they should because stopping will increase engorgment and pain
What does a swollen eye after cataract surgery mean?
infection
What is the CN II?
vision
What is a classic sign of pheochromocytoma?
Really high BP
DI can lead to what electrolyte imbalance?
hypernatremia
How do you treat a negative nitrogen balance?
Give a complete protein
What diet should a patient with severe liver disease follow?
low protein, high carb
Because it decreases the risk of hepatic coma by decreasing the ammonia that results form the breakdown of protein
Are you concerned about facial edema during pregnancy?
Yes, could e a sign of pre-e
What should you do if a patient is gasping/coughing during NG tube insertion?
Take out the tube because its in the airway and give the patient res then reinsert
If a pregnant women is doing ____ they need further education b/c the risk of _____
Lying on their back
Vena cava syndrome
How does aging affect pain tolerance?
decreases it
What is the main use for a CCB?
antihypertensive
What should a patient with a hip replacement have while laying in bed?
Abduction pillow between the legs to prevent dislocation especially if patient is confused and cant follow directions
What does trazodone hydrochloride treat?
depression and insomnia
What occurs r/t ADH, renin and aldosterone in older age
Increase ADH with decreased renin and aldosterone –> decrease Na reabsorption –> increase water retention –> hyponatremia
Increase ASO titer means what?
glomerularnephritis and needs to be report to HCP
What does an elevated BUN mean?
dehydration (confusion, disorientation –> falls)
How do you confirm AIDs and cutaneous kaposi?
punch biopsy
What would make you think that patient has a struvite calculus?
S/S of UTI
Recurrent UTI
Flank pain
Staghorn calculus
Needs antibiotics
What are ADR of Tricyclic antidepressant?
Imipramine
Sore throat
Increased fatigue
Vomitting and diarrhea
Large amount of light brown foul smelling drainage could mean?
Fistula
If breathing tube is displaced from the stoma what should you do?
Dilate the opening of the stoma because a newly placed tract will not stay open w/o the tube
If a patient has fatty stools, what diet should they have?
High fat diet so their body is getting enough before its excreted
