Med Sure quiz #3

Question 1

Immunity, inflammation and infection-

Healthcare associated infections

Question 2

Stool Examination

Answer 2

• may be used to check for blood, parasites, bile, pathogenic organisms, fecal fat, and WBC
• collect in clean, dry container, no urine- destroys parasites, TP contains bismuth that ibterferes with test.
• Deliver specimen to lab immediately, if temp storage, parasite and ove warm, pathogens refrigerated.
• depending on what they are testing- blood= no red meat 2-3 days before.
• drugs salicylate, ascorbic acid, anticoagulants and steroids may interfere
• if visible bloos and or mucus, include it in the specimen.

Question 3

Enteral tube feedings

Answer 3

• confirm placemet of tube before feeding
• radiographucal is most reliable but not practical
• PH <5 grassy green, clear and colorless and brown
• elevate head 30 degress before and after feeding for 30 minutes
• stop feeding if patient has nausea or pain
• dumping syndrome may occure in very fast feedings
• S/S of dumping: cold sweat, abdominal distention, dizziness, weakness, rapid HR, nausea and diarrhea

Question 4

Total Parenteral Nutrition (TPN)

Answer 4

• bypasses the digestive tract, nutrients go straight to blood stream
• catheter, central venous or peripherally inserted cath in to large vein
• feeding passes directly to vena cava and RA
• allows for rapid dilution of concentrated feeding
• never administer TPN to smaller vein B/C it would cause throkmbophlebitis
• nutritin can obly be- water, glucose, electrolytes, minerals, and vitamins.
• short term
• 2 types of solutions used- glucose, amino acids, vitamins and minerals
• circulatory overload if infused too fast- changes in blood glucose, or diuresis

Question 5

types of stomatitis

Answer 5

• Canker sore ( aphthous) Cause- virus or immune system, tx: topical orsystemic corticosteroids-start tx when earliest s/s begin,
• Cold Sores (HS type 1) cause- virus, tx: oral antivirals, acyclovir, valacyclovir nd famciclovir. triggers: stress, excessive sun exposure and URI
• Thrush (candidiasis) cause- candida albicans- yeat tx: antifungals- nystatin- overgrowth of normal flora often triggered by steroid or antibiotic treatment.

Question 6

mouth shit interventions

Answer 6

• gentle oral hygiene
• medicated mouth wash
• exclude rough or spicy foods
• use soft toothbrush

Question 7

Inadequate nutrition

Answer 7

• high calorie, high protein diet recomended for cancer patients
• adjust size and texture of foods
• errect position preferred

Question 8

interventions

Answer 8

• increase LES pressure
• administer prescribed drugs, that increase LES pressure, neutralize acid, and reduce acid secretions.
• dietary alterations, changes in position.
• avoid food/fluid 2-3 hrs before bedtime to avoid aspiration
• elevate bed 6-12 inches for pt with hiatial hermia
• monitor wt changes
• small frequent meals
• avoid fatty foods, caffeine, chocolate and alcohol
• avoid acidic and spicy foods

Question 9

dumping syndrome pt teaching

Answer 9

• consume low carbs, refined sugar, moderate in fat, moderate to high protein aka keto
• smaller, frequent meals
• fluids between meals not with them
• lie down for 30 minutes

Question 10

post sx intervention bypass

Answer 10

• breathing exercises and spirometry, elevate head of bed 30-45
• skind and wound care, fat skin heals slower so keep skin dry and clean
• apply fabric between skin tissue to absorb moisture
• early ambulations and heparin to avoid DVT
• position changes, deep breathing, and leg exercises, compression devices
• imging studies need to be done before feeding pt to ensure no leaks in digestive tract
• water to clear liquids to full liquids
• 15-30 ml
• once solids 800-1200 calories in 4-6 meals high in protein, low fat and carbs, vitamins minerals