med surg

Question 1

know what to assess first in a patient with coronary artery disease presenting with chest pain

Answer 1

chest assessment
characteristics of chest pain

Question 2

know what to tell a patient on how to prevent an attack of Raynaud Syndrome

Answer 2

warm hands in water to abort attack
if warming hands with water is impossible the nurse encourages the client to imagine warming them in some

Question 3

what labs need to be monitored in a patient taking oral anticoagulation meds

Answer 3

apTT
PT
INR

Question 4

know what to monitor for a patient who is postoperative from a vein stripping

Answer 4

swellingin operative leg (edema)

Question 5

why are beta blockers for a patient with coronary artery disease?

Answer 5

decrease work flow of the heart

Question 6

what is the length of time that a nitroglycerin patch needs to be worn

Answer 6

12 to 14 hours

Question 7

know the patient teaching for a PTCA

Answer 7

avoid lifting more than 10lb for at least 3 days if the groin was used for catheter insertion. Avoid prolonged sitting for at least 3 days. Shower rather than take a bath until the cutaneous catherization site heals. Expect to see bruising may as to 1 to 3 weeks. Report any signs of bleeding, infection, or impaired circulation, fever , swelling, redness, bloody or purulent drainage, acute pain in the extremity and cold or pale skin

Question 8

what is the most important step in preparing a patient for angioplasty?

Answer 8

stop anticoagulant therapy

Question 9

which cardiac enzyme will elevate 2 hours after the onset of chest pain to indicate an acute myocardial infarction

Answer 9

myoglobin

Question 10

what is the most important intervention in the management of a patient with Raynaud Syndrome?

Answer 10

warming hands in water to abort the attack
imagery mcintyre maneuver swinging motion distributes blood to the distal areas of the the finger.
educate family: wear gloves during households chores, avoid factors that precipitate attacks.

Question 11

know the patient teaching for a patient who is post vericose vein surgery

Answer 11

isometric exercise
antiembolism stocking

Question 12

know what a pacemaker is the treatment of choice for

Answer 12

bradycardia
heart block

Question 13

if drugs are ineffective in treating atrial fibrillation, what is the next course of action?

Answer 13

elective cardioversion

Question 14

when is transthoracic pacemaker used?

Answer 14

during open-heart surgery

Question 15

which medication is given for a heart rate of 34 beats per minute?

Answer 15

atropine sulfate

Question 16

what medication is indicated in a patient with atrial fibrillation?

Answer 16

anticoagulants

Question 17

know what equipment to have in the room for a patient with ventricular arrhythmias

Answer 17

defibrillator

Question 18

which nursing action is indicated before pressing the shock button on a defibrillator

Answer 18

yell “ CLEAR “ and make sure no one is touching the patient

Question 19

know what can cause secondary hypertension?

Answer 19

unknown disorder

Question 20

what is they organ is in regulating arterial blood pressure

Answer 20

kidneys

Question 21

know which symptoms would prompt the patient to contact physician

Answer 21

fatigue
insomnia
headache
blurred vision

Question 22

which actions by the patient can affect blood pressure?

Answer 22

smoking, drinking coffee

Question 23

which ethnic background is at higher risk for high blood pressure at an early age?

Answer 23

african american

Question 24

what complications can be associated with chronic untreated hypertension?

Answer 24

stroke or kidney failure

Question 25

which lab values indicate impaired renal perfusion?

Answer 25

BUN and creatnin

Question 26

know what must be monitored in an older older receiving digitalis

Answer 26

digitalis toxicity

Question 27

know what disease processes can contribute to chronic heart failure

Answer 27

renal failure

Question 28

which procedure determines the ejection fraction

Answer 28

echocardiogram

Question 29

know the 4 classes of heart failure

Answer 29

class 1 (mild) class 2 (mild) class 3 (moderate) class 4 (severe)

Question 30

know the signs of left-sided heart failure

Answer 30

crackles and pink frothy sputum

Question 31

what are the symptoms to orthopnea?

Answer 31

inability to breath unless sitting upright

Question 32

what are early symptoms of heart failure

Answer 32

dyspnea

Question 33

which lab value is the most important for a patient taking furosemide?

Answer 33

serum potassium

Question 34

what class of medication is captopril

Answer 34

ace inhibitor

Question 35

what is the valsalva maneuver?

Answer 35

slows down the heart

Question 36

know why the risk of surgery are greater for an older adult

Answer 36

they have more comorbities

Question 37

which interventions can provide adequate pain control for severe pain?

Answer 37

patient controlled analgesic pump

Question 38

know how to prevent wound dehiscence

Answer 38

by splinting or using a pillow

Question 39

know patient teaching for reducing reflux

Answer 39

dietary management consists of eating smaller meals and avoid foods, beverages that increase gastric acidity ( black, red pepper, regular, decaffeinated coffee, alcohol) avoid items that lower pressure in the LES (chocolate, peppermint, licorice, citrus fruits, caffeine, high-fat foods)

Question 40

know the symptoms of dumping syndrome

Answer 40

weakness, dizziness, sweating, palpitations, abdominal cramps, and diarrhea

Question 41

what are contraindications for administering ondansetron?

Answer 41

if a client has a heart block or prolonged QT intervals

Question 42

what can be done about mouth sensitivity for patients with oral cancer?

Answer 42

talk to the dr. about topical anesthetic mouthwash containing lidocaine (xyclocaine) which numbs the tissue

Question 43

know the nursing actions to confirm placement of an NG/ feeding tube, there are several

Answer 43

aspirate x-ray