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Nursing school 9- Med Surg 3 Final > Med Surg 3 Final Exam > Flashcards

Med Surg 3 Final Exam Flashcards

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1
Q

patho behind shock

A

cells lack blood suppply and are deprived of oxgyen and nutrients

not just circulation blood volume

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2
Q

Tx for Tachycardia

A

beta blockers, antipyretics, analgesics, fluid (dehydrated),

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3
Q

Each square in EKG represents how many seconds

A

0.04 seconds

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4
Q

Defribrillation procedure similarities to Cardioversion

A
  • placement over right sternal border and over apex of the heart–CLEAR perimeter
  • require conductive materials to the chest
  • operator applies 20-25 lbs pressure
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5
Q

Diet for SLE

A

limit sodium and protein intake (should be well balanced)

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6
Q

What test is used to determinue poluria is diabetes insipidus

A

Water Deprivation Test

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7
Q

What diet needs to be reducied in encephalopathy

A

protein.

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8
Q

AKI intervention during acute diuretic phase

A
  • you do not need to monitor glucose
  • monitor blood pressure
  • draw blood to check for hypokalemia
  • you do not need to place pt on fluid restrictive diet.
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9
Q

What is a priority assessment question for pt with end stage alcoholic cirrhosis

A

when did you have your last alcoholic drink

because could be at risk for tremors or withdrawal

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10
Q
A

Ventricular Fibrillation

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11
Q

what is always the priority in burn patients

A

hypoxia–then hyperkalemia

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12
Q

Full Thickness Burn

A

grafting may be required

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13
Q

S/Sx of Hyperglycemia

A
  • polyphagia
  • polydipsia
  • polyuria
  • fatigue
  • dry mouth
  • pruiritus
  • headache
  • nausea/vomiting
  • blurred vision
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14
Q

Vitals signs for Cardiogenic shock

A
  • Increased central venous pressure
  • decreased cardiac output
    • increase HR, decreased BP
  • decreased temperature
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15
Q

Creatnine

A

0.6 - 1.3 mg/dL

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16
Q

vasogenic shock think

A

afterload due to artery, need vasoconstrictors

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17
Q
A
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18
Q

What can PVC’s lead to?

A

angina, heart fiailure

Assess response to the dysrthmia , hemodynamic status to determine if drug therapy is needed

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19
Q

Normal Albumin levels

A

3.5 - 5.5 g/dL

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20
Q

What does acute pyelonephritis look like

A

fever, chills, flank pain, dysuria

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21
Q

Rehabilitation for spinal cord injury, medical nursing implementation

A

DVT risk, physical immobility, SQ anticoagulants (Lovenox)

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22
Q

What lab value shows signs of increased fluid shifts

A

increased hematocrit, dute to hemoconcentration

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23
Q
A

each normal beat is followed by an abnormal one

Bigeminy/ Premature Ventricular Complex

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24
Q

what is a complication of calcitonin nasal spray

A

nosebleeds, report to HCP

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25
Q

Diagnostic test for SLE

A

CBC and antinuclear antibody tests

anemia, leukopeia, thrombocytopenia

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26
Q

normal LDH levels

A

100-200 units

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27
Q

Neomycin

A

kills ALL bacteria in the gut good/bad for encephalopathy

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28
Q

In Cirrhosis where does blood get backed into?

A

Intestines, Spleen, Esophageal tract (swelling)

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29
Q

a complication of stress reaction to burn injury

A

curling ulcer, happens to those suffering from traumatic injury

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30
Q

superficial partial thickness burn

A

injury deeper in the dermis, blood supply is reduced

heals 10-21 days, with no scarring

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31
Q

What is Supraventricular Tachycardia

A
  • coduction signal loops and reenters atrium
  • HR > 140 bpm
  • Tx: Adenosine IV push
  • Narrow QRS
  • Atrial Tachycardia
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32
Q

Diet for burn injury patietn

A

protein for catabolism and vitamin c promotes wound healing

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33
Q

Endocrine disorders go unrecognized in older adults because

A

symptoms are attributed to aging

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34
Q

Deep partial thickness burn?

A

stage 2, still pink

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35
Q

What does Albumin do?

A

transports drugs, binds w/ calcium, attracts water into vascular space.

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36
Q

Why is cirrhosis pt increased risk of bleeding?

A

formation of coagulation factors, GI bleed Epistaxis common

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37
Q

What should you observe after concusiion

A

changes in level of consciousness, difficulty awakening, lethargy, dizziness, confusion, irritability

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38
Q

physical assessment of pt with MS

A
  • blurred vision
  • tremor, urinary
  • hesitancy
  • difficulty swallowing
  • fatigue (not the same as lethargy)
  • dymetria (under/overestimating range of movement
  • muscle flaccidity

fatigue and lethargy are not the same!

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39
Q

Electrolytes in repolarization

A

potassium goes up, sodium goes down

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40
Q

Risk with aspirin

A

otoxicity, tinnusitis

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41
Q

first action when caring for pt with electrical burn

A

turn off the electrical current.

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42
Q

what drug do you give for curling ulcer

A

PPIs, Cimetidine

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43
Q

When CKD patient is receiving peritoneal dialysis, what would you expect intake output to be

A

output should be more

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44
Q

If client has end stage liver failure, what could be a risk for developing hepatic encephalopathy

A

GI bleed

blood in the intestinal tract digests as protein, increasea ammonial levels.

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45
Q

Why does a Chronic Kidney Failure patient have metabolic acidosis

A

kidney cannot excrete increased levels of acid b/c they cannot excete ammonia or reabsorb sodium bicarb

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46
Q

Immediate tx for graves disease

A

propanolol, thionamide, glucocorticoids

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47
Q

Prevention Tx with RA

A

exercise, increase muscle strenth, improves joint stability, preserve joint motion/flexibility, boosting aerobic condition.

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48
Q

Causes for Ventricular Tachycardia

A

drugs, electroylte, hypotension, ischemia

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49
Q

what is an example of a secondary intervention for osteoporosis

A

bone density evaluation test

think screening.

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50
Q

If a client comes in from nursing home with catheter, what is you first intervention

A

change the catheter, can’t determine when the catheter was inserted otherwise

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51
Q

AST normal levels

A

10 - 40 U/L

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52
Q
A
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53
Q

post op surgery, what should be reported to HCP immediately

A

rigid abdomen- perforation??

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54
Q
A

3rd Degree Block

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55
Q

Atropine is for bradycardia, how are you supposed to administer it

A

rapidly boluse ever 3-5 minutes. Max total dose of 3 mg.

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56
Q

What nursing intervention should you do if patient has pain in right shoulder after laparscopic cholecystectomy

A

apply a heating pad to the abdomen for 15-20 minutes migrates CO2.

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57
Q

Early Signs of ICP

A

pupils fixed, Inc BP, Ataxia (can’t move), Uneven gate, 8 GCS, Rapid/deep breathing

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58
Q

All cells in the body have intracellular receptors for

A

thyroid hormone

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59
Q

HIV diet

A

high calorie, high protein, low residue

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60
Q
A

Premature Ventricular Complex

Wide QRS/bizarre

No P wave

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61
Q

Epidural Hematoma Nursing Interventions

A
  • HOB no more than 30 degrees
  • sedative for agitation
  • NO narcotics
  • Stool softeners
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62
Q

Assessment findings of pancreatitis?

A

High RR, SOB, Increase HR, Pain, Abdominal distention, absent bowel sounds.

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63
Q

If pt has gunshot wound to abdomen and acute renal failure what is the first intervention

A

administer normal saline. risk for shock.

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64
Q

hypovolemic shock kicks on ADH, how do you know this is happening with your patient

A

increased thirst

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65
Q

Priority Nursing Actions for Autonomic Dysreflexia

A
  1. raise hob
  2. loosen tight clothing
  3. check bladder distention or noxious stimulus
  4. administer antihypertensive medication
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66
Q
A
  • Sinus Bradycardia
  • Regular Rate
  • HR 50
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67
Q

Name some hypertonic solution

A
  • 10% dextrose + Water
  • 5% dextrose + 0.9% saline
  • 5% destrose + 0.45% saline
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68
Q

What does stress, illness and infection do to insulin needs

A

increases it

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69
Q

Other than bilirubin, what does the bile bus transport?

A

cholesterol, recycles waste in the body. LDLs go up, HDL decrease.

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70
Q

If you are a first responder for a head injury, what would you implement first

A

stabilize client’s cervical spine. Always assume head injury has a spinal injury

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71
Q

what is the most reliable and non invasive assessment to measure cardiac output and tissue perfusion

A

urinary output

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72
Q

Normal cardiac output

A

4-8 L/minute

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73
Q

AST

A

entire body sooo broad (Hear & Liver Cells)

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74
Q

Manifestations of neurogenic shock

A

bradycardia, hypotension

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75
Q

findings w/ fluid volume deficit

A

low plasma osmolality, low hematocrit (diluted), low specific gravity, low BUN, low sodium

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76
Q

ALT

A

Liver Specific

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77
Q

Post op laparoscopic cholecystectomy nutrition

A

may experience discomfort with high fat meals

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78
Q

What does the liver Produce?

A

Albumin, Bile Bus, Coagulation Factors

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79
Q

AV Node Rate

A

40-60 BPM

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80
Q

Post op care burn ,( after echarotomy, fasciotomy

A

CTMS, control bleeding, topical antimicrobial agents

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81
Q

What do the enzymes in the pancreas do?

A

explode things into the duodenum

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82
Q

What is temporary tx for portal hypertension

A

TIPS

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83
Q

Best way for burn patient to recieve medication

A

Intravenously

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84
Q

S/Sx of fat embolism

A

originates in bone marrow after fracture. Tachycardia, hypotension, confusion, pale

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85
Q
A

vtach

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86
Q

how is HIV tested

A
  • blood test with ELISA
  • if positive another ELISA
  • then Western Blot
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87
Q
A
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88
Q

The patient has hypokalemia, and the nurse obtains the following measurements on the rhythm strip: Heart rate of 86 with a regular rhythm; the P wave is 0.06 seconds (sec) and normal shape; the PR interval is 0.24 sec; the QRS is 0.09 sec. How should the nurse document this rhythm?

A

First Degree Av Block

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89
Q

Precautions for levothyroixine therapy

A
  • angina, or dysrhythmia (increase oxygen demand)
  • prevent of med interactions, reduce dosase
  • increase BS, DM
    • initially starts w/ 50 mcg, may be increased to 75-125mcg/day gradually)
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90
Q

Burn Shock MGMT

A
  • 2-4 mL LR/kg in first 24 hours
  • One half of that in first 8 hours
  • one half in next 8 hours.
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91
Q

burn patient how to receive feedings

A

jejunal feedings

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92
Q

What does adenosine do?

A

slows conduction time through the AV node. coronary artery vasodilation

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93
Q
A

AV Block Type 1

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94
Q

What does People Drink So Much Refer to with the Liver?

A
  • Produce
  • Detox
  • Store
  • Metabolize
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95
Q

Physical Assessment for Esophageal Varices

A

BP low, HR high, RBCs low because you are bleeding.

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96
Q

superficial thickness burn

A
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97
Q

afterload think

A

size of vessels (not volume)

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98
Q

How can pt relieve itching if in a cast?

A

ice pack to the area

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99
Q

Vital signs for vasogenic shock

A
  • decreased central venou pressure (preload)
  • increased output (early
  • Increased HR (early)
  • decreased BP
  • decreased SVR
  • Increased temperature
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100
Q
A

supraventricular tachycardia

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101
Q

Nursing interventions autonomic dysreflexia

A

elevate HOB, 45 degrees, notify physician, determine cause

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102
Q

Why does a client have to stay on bed rest if they have Acute Renal Failure

A

reduces the metabolic rate

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103
Q

Tx for Brady Cardia

A

Pacemaker, oxygen, epinephrine (don’t give fluids) atropine

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104
Q

Interventions for open fracture

A

ice pack for 10 minutes, remove for 20 minutes. Administer tetanus toxoid IM.

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105
Q
A

Afib, No Pwave, & Irregular

300-650 bpm

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106
Q

Nursing care for pancreatitis client

A

keep stomach empty and dry, NPO and NGT suction, BED REST

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107
Q

Assessment fo Glascow coma scale

A
  • eye opeing
  • verbal response
  • motor response
  • NOT–pupillary changes or gag reflex
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108
Q

What does Hypo ADH look like

A
  • DI, hypopopituitary
  • Hypokalemia, hypotension, thirsy
  • tx: Vasopressin
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109
Q

what is a by product of RBC destruction

A

bilirubin

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110
Q

why do we measure lactic acid in septic shock?

A

reflects perfusion and amount of oxygen. Lactic acid build up because of anaerobic metabolism

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111
Q

what could pain uppon dorsiflexion of the ankle indicate?

A

deep vein thrombosis

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112
Q

deep full thickness burn

A

in the subcutaneous. Red and white, edema.

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113
Q

Preicteric phase of hepatitis presents like

A

flu like symptoms

rest is important

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114
Q

What else does the thyroid gland secrete, what does it do>

A
  • Calcitonin-
  • response to high ca+
  • more calcium in blood, lower blood calcium levels
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115
Q

If glycogen is a wall of bricks, what are the individual bricks

A

glucose

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116
Q

What does glucagon in the pancreas do?

A

breaks down glycogen (brick wall, stored treaure)

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117
Q

autonomic dsyreflexia intervention

A

straight cath every 4-8 hours

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118
Q

Nursing Dx for Spinal Cord Injury

A
  • Ineffective breathing pattern r/t respiratory muscle fatique
  • Impaired skin integrity r/t immobility
  • impair urinary elimination
  • constipation r/t neurogenic bowel
  • risk for autonomic dyreflexia
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119
Q

Nursing Dx for Head Injury

A
  • Risk for ineffective cerebral tissue perfusion r/t interrupted CBF (hematoma)
  • Hyperthermia r/t metbaolism, infection hypothalamic injury
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120
Q

Late signs of ICP

A

fixed dilated pupils, decreased HR, Widening Pulse Pressure, Decerebrate, Decorticate, Less than 8 GCS, slow breathing

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121
Q

What is the most common condition that predisposes a client to prerenal failure

A

hypotension

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122
Q

What is important characteristic to know about TBI

A

it is a process not an event. Risk for urinary retention or constipation.

123
Q

What do the kidneys produce?

A

RBCs, erythropoetin (hormone)

124
Q

Sign of anaphylactic shock

A

shortness of breath, notice when delivering penicillin iv fluid. STOP THE INFUSION.

125
Q

S/Sx of IICP

A

decrease motor function, decrease LOC, headache, vomiting

126
Q

Parkinson’s disease and diet

A

may cause dysphagia and constipation

soft, frequent meals

127
Q

calculate burn to chest abdomen right arm and right leg

A
  • chest= 18
  • abdomen = 9
  • right arm= 9
  • right leg = 9
  • total= 45%
128
Q
A
  • Atrial Flutter
  • Regular Rate
  • QRS 0.06
129
Q

Nursing Care for esophageal varices

A

restrains, b/c LOCs. Skin Integrity, bleeding risk. Pruiritis

130
Q

ST depresseion indicates

A

Myocardial ischemia

131
Q

chemotherapy toxicity first affects

A

GI, cause for nausea and vomiting

give med 1 hour before treatment

132
Q

What does cirrhosis do to Kupffer Cells

A

kills them off, left with scar tissue

133
Q

When is hormone replacement therapy contraindicated

A

vascular thrombosis

134
Q

Who is the protein wrapper?

A

Albumin

135
Q

Corticosteroid therapy teaching

A
  • Assess for cataracts
  • avoid infected persons
  • exercise
  • protein, calcium potassium diet
  • low fat and simple carbohyrdates
136
Q

Name some isotonic solutions

A
  • Lactated Ringers
  • 0.9% NS
  • 5% dextrose in 0.225% saline
137
Q

Cardiogenic shock means…

A

broken heart pump, contractility

138
Q

Only treatment to asystole

A

epinephrine and atropine (no response to defribrillation)

139
Q

Intra AKI

A

holy crap fire is inside. HYperkalemia,

140
Q

Burns of the extremities porduce

A

compartment syndrome lead to vascular compromise

141
Q

What does a PSA test indicate?

A

urinary retention, BPH, prostate cancer, prostate infarct.

142
Q

2 major modifieable risk factors for CAD

A

Diabetes Mellitus, hypertension

143
Q

Lactulose does what

A

poops out ammonia

144
Q

intervention for BPH and urinary retention

A

insert catheter

145
Q

What organ is the washing machine of the body?

A

Kidneys

146
Q

Causes for Sinus dysrthmias

A

digoxin/morphine, autonomic dysfunction, diabetic neuropathy, slower HRs

147
Q

What would level of pressure would be considered portal hypertension

A

greater than 10mmHg

148
Q

Hypothyroidism and mental status

A

memory loss/confusion. Keep personal belongings in the same place.

149
Q

compartment syndrome tx

A

fasciotomy.

150
Q

what is a major problem for closed fracture wounds

A

neurovascular status

151
Q

Post op TURP what is a sign of catheter blockage

A

urine leakage around 3 way catheter at the meatus.

152
Q

Electrolytes in Depolarization

A

Sodium goes up, potassium goes down (exits intracellular)

153
Q

the Kidneys filter HUC, what does that mean?

A
  • Hydrogen Ions (very acidic by product
  • Urea (BUN, high dehydrated “Burned Buns”
  • Creatnine, by product of muscle/protein breakdown
154
Q

Priority Action for Burn Injury

A
  • assess airway patency
  • administer oxygen
  • vitals
  • IV line and begin fluid replacement
  • Elevate extremities if no factures
  • keep client warm and place the client NPO

primary goal maintain airway

155
Q
A
  • Normal Sinus Rhythm
  • Regular Rate
  • Heart Rate 70
156
Q

Teaching for an MRI

A

lie still, loud noise

157
Q

patietn with BPH and is weak what does he need

A

help if he needs to void.

158
Q

Occiptal Lobe

A

visual area

159
Q

Myxedema occurs..

A

low thyroid production, abrupt stop in medication, hypothermia, hypotension, hypoglycemia, bradycardia

160
Q

What are the 5 steps for reading and ekg

A
  1. Are there any P waves?
  2. Are there any QRS?
  3. Measure PR Interval
  4. Rate
  5. Rhythmn
161
Q

PR Interval should be no greater than

A

0.20 seconds

162
Q

what is happening with each different type of shock

A

a different type of O2 delivery system is effected

163
Q

SA Node rate

A

60-100 BPM = Pacemaker

164
Q

Hypercortex

A
  • Cushing’s Disease
  • moonface, buffalo hump
  • Hyperglycemia, hypernatremia, hairy face
  • tx: Potassium low surgar, exercise. Insulin NO, b/c dec potassium
165
Q

How does the Liver Detox

A
  • Kupffer Cells- trash man, breaks down bacteria
  • First Pass= liver is the border patrol
166
Q

When does Atrial flutter most often occur

A
  • COPD, CAD, Atrial Septal Defects
  • Tx: Same as Afib
167
Q

what does TNM stand for

A

Tumor Node Metasis

168
Q

Burns of the face are associated with

A

corneal abrasion

169
Q

what is the most important nursing management in burn patients

A

fluid replacement

170
Q

How does a pacemaker work

A

provides electrical stimuli to the heart muscle, stimulated to contract. If heart rate drops too low

pacemaker spike before CRS comples

171
Q

Where do PVC’s orginiate

A

focus in the ventricles

172
Q

Neurogenic shock treatment

A

dopamine, vasopressing, epinephrine, atropine

173
Q

Why should an aids patient have good nutrition, exercise and stress redction

A

improve immune function (not strenght/self care)

174
Q

What happens to renal tubules when ADH is released

A

reabsorb water, causes urine to be more concentrated

175
Q

What organ specificallly is concerning for SLE

A

kidney, proteinuria

176
Q

What causes the release of ADH

A

increase in serum sodium because that it when you are dehydrated

177
Q

What is the word association with ureters, urine etc

A

UREA

178
Q

What are the 3 most common complications in pts with neuro disorders?

A
  • respiratory infection, UTI, infected pressure ulcers
179
Q

Which enzyme in the pancrease breaks down carbohydrates

A

Amylase

180
Q
A

deep partial thickness burn

can become full thickness if tissue damage increases with infection, hypoxia or ischemia

heals 3-6 weeks

181
Q

Causes for Acute Renal Failure

A

Hypotension, Hypoperfusion (hypoxia), hypovolemia

182
Q

What is glycogen storage for?

A

Think Carb loading before a big marathon. That is for you to use later.

183
Q

which diagnostic test is most accurate for osteoporosis

A

dual energy xray asorptiometry (DEXA). Measures bone density.

184
Q

Post Op Parathryoidectomy

A

hypocalcemia is life threatening risk, HOB elevated

185
Q

Manifestations of spinal shock

A

flaccid paralysis, loss of reflex activity below the level of injury, bradycardia, hypotension, paralytic ileus

186
Q

precautions for health care providers treating cancer patients

A

must wear PPE

187
Q

Weight and 45% burn injury patient

A

loss of 10% of baseline is very concerning

188
Q

What is hyper ADH

A
  • SIADH
  • Specific Gravity will be high
  • Low Na+
  • CNS disorder
  • Tx: Lasix, fluid restriction, hypertonic solution
189
Q

How does a paraplegia promote skin integrity

A

keep skin clean

190
Q

AV Block 2nd Degree Type 1 is

A
  • Progressive prolongation of PR until P wave fails to conuct
  • No QRS follows a P wave
  • Usually benign, seen with normal agins
191
Q

Hypo thyroidism

A
  • Myxedema (non-pitting), Hashimoto
  • Cold, constipated, dry skin
  • Tx: levothyroxine -take in the morning
192
Q

Common characteristic of all hormones is…

A

influence cellular activity of target tissues

193
Q

Halo Sign and Closed Head injury

A

CSF leakage. Monitor and inform the physician, not an emergency though.

194
Q

7 warning signs of cancer

A
  1. change in bowel
  2. sore that does not heal
  3. unusual bleeding or discharge
  4. thickening or lump in brease or elsewhere
  5. indigestion or difficulty swallowing
  6. nagging cough
  7. persistnent hoarsness
195
Q

When should pt take tums

A

30-60 minutes before a meal. Hydrochloric acid is needed for calcium absorption.

196
Q

When assessing a patient with burn injury, what is MOST concerning sign

A

singed nasal hair, hoarseness, cough, drooling, difficulty swallowing, crowing, wheezing, stridor

197
Q

preload think

A

blood volume. Central Venous pressure

198
Q

First line of defense for increase ICP

A

Hyperventilation, because CO2 causes vasodilation which make it worse

199
Q

Sinus Bradycardia treatment

A

requires atropine if symptomatic

200
Q

Biggest problem with liver complications

A

Bleeding Risk

201
Q

What is an important intervention with osteoarthritis

A

needs to move, pain will decrease with movement

202
Q

Burns of the perineal area

A

prone to autocontamination by urine and feces

203
Q

a patient with parkinson’s should have appointment scheduled late in the morning after a bath, why is that?

A

so they have time to complete ADL’s without pressure

204
Q

A pt with RA has increased alterations in mobility. What should nurse do to keep pt safe

A

remove excess furniture, risk for falls.

205
Q

wound care for deep partial thickness burn

A

gently clean away debris and dirt. Leave blister in tact do not apply sterile gauze

206
Q

What does replacement of albumin cause?

A

high blood pressure, boudnign pulse, extra pressure on the heart, ICP, cerebral edema. Need to take with Diuretics.

207
Q
A

First Degree AV Block

208
Q

priority nursing diagnosis for pt with burn during acute phase

A

risk for infection

209
Q

How does defribllation differ from cardioversion

A

the sitch on the defibrillator is differemt

210
Q

an older woman has OP what intervention should be implemented to prevent secondary complication

A

provide nighttime lights to prevent falls!

211
Q

when does a burn involve fluid resuscitation

A

if more than 10% of the body

212
Q

Pancreatitis which electrolytes will be affected

A

low calcium, blood sugar

213
Q

if pt with total hip replacemtn has popping sounds what does this mean?

A

dislocation, closed reduction, report to HCP. Groin pain in the affected leg.

214
Q

Why would you need an NG tube for epidural hematoma

A

abdominal distention which could lead to IICP

215
Q

Who is the recylcing company in the body?

A

the Liver

216
Q

Risks with Premature Ventricular Contraction

A

may progress to Vetach and Vfib

217
Q

Why does a cancer patient take many different drugs?

A

cancer cells resits chemotherapy drugs. Using different drugs, more cells are destroyed before resistance develops.

218
Q

What is amiodarone

A

used to treat ventricular tachycardia or ventricular fibrillation

219
Q

Hyper Thyroidism

A
  • Graves, Thyroid Storm, Goiter
  • BP increase, hyperactive bowel, weight loss, bulging eyes
  • tx: Blockers, removal, propythioracil, radioiodine
220
Q

what does chronic pyelonephritis look like

A

fatigue, headache, poluria, anorexia, weight loss

221
Q
A

Av Block Type 2

222
Q

what is an appropriate long term goal for someone with acute glomerulonephritis?

A

the client will maintain normal renal function. Otherwise can lead to end stage renal disease

223
Q

post op position for pt with total hip replacemtn

A

high seated chair for flexion of less than 90 degrees

224
Q

Hypovolemic shock mean..

A

low volume, pre load

225
Q

body systems and chemo

A

infection control, increase workload of kidney,

226
Q

Burns of the ear are associated with

A

auricular chronditis

227
Q

What temporary tx for Ascites?

A

paracentesis, replace albumin

228
Q
A

higher the percentage the worse. Fluid and electrolye shift. Oxygen non rebreather mask

229
Q

In a spinal cord injury what causes headch and high blood pressure,

A

bladder distention

230
Q

Manifestation of basilar skull fracture

A
  • Battle’s sign (bruising mastoid)
  • Bulging of tympanic membranes
  • CSF
  • tinnitus or hearing difficulty
  • rhinorrhea
  • facial paralysis
  • deviation of gaze
  • vertigo
231
Q

What do you do for intra AKI

A

Bolus of fluids, Volume restriction (diuretics), dopamine to dilate and increase pressure)

232
Q

what should be kept at the bedside for pt with amputation

A

tourniquet for bleeding internally or externally

233
Q

Normal GFR

A

80-100. 65 is bare minimum

234
Q

How can you tell if a patient post op needs pain managment

A

shallow respirations

235
Q

radiation therapy risk factors & nursing care

A
  • anemia, immunse system, ulcers, hair, gonads. Visitors only for 30 minutes (6ft perimeter)
  • skin clean and dry
  • can’t use topical over the counter unless prescribed
  • nutrtional support
236
Q

normal hemoglobin values

A

12-16

below 8 requires blood transfusion

237
Q

Burns of the head and neck are associated with….

A

pulmonary complications

238
Q
A
239
Q

tx for Afib

A

Warfarin, Coumadin, Digoxin, Calcium Channel Blockers, Amiodarone

240
Q

What should you think with an addiosnian crisis

A

severe hypotension and vascular collapse

241
Q

S/Sx Of Hypoglycemia

A
  • shakiness
  • anxiety
  • nervousness
  • diaphoresis
  • palpitations
  • coldness
  • hunger
  • irritability
  • headache
242
Q

Signs and Symptoms of an old woman with pneumonia

A

confusion and lethargy

243
Q

Hematoma treatment

A

think blood, bleeding edema, mannitol, respiratory acidosis or alkalosis.

244
Q

Autonomic dysreflexia

A

diaphoresis, nasal congestion, throbbing headach, hyptertension, bradycardia

245
Q

Where does the washing machine send dirty blood to?

A

ureters into the potty and not the body

246
Q

2nd Degree Block Type II

A
  • Normal EKG, sudden Drop in QRS
  • Block in His thru Purkinje sys, ischemia
  • Implantable pacemaker
247
Q

After HCP inflates a triple lumen NG tube in client with esophageal bleeding, why does the nurse stay w/ client at all times

A

if it becomes dislodged it could occlude the airway

248
Q

Teaching for Addison’s Disease

A
  • Medic Alert Bracelet
  • avoid strenuous exercise (stress)
  • Call physician before dental procedures
  • Call for weakness or fatigue
249
Q
A

Trigeminy PVC.

PVC after 2 normal QRS

250
Q

How do you know if client is in remobilization phase for burn injury

A

rochni in lungs, increased urinary output, jugular vein distention, decreased heamtocrit and BUN. Client beocomes hypervolemic

251
Q

What is a priority problem for client diagnosed with RA?

A

Alteration in comfort due to chronic pain

252
Q

Teaching for Pt with OA

A

wear white socks when walking and supportive shoes

253
Q

BUN

A

8-25 mg/dL

254
Q

What is the first intervention for ventricular tachycardia

A

assess the client’s apical pulse and BP

255
Q

Atropine

A

SE- Myocardial Ischemia, antiarrythmic, increase HR

256
Q

what is escharotomy

A

crust formation dead tissue

257
Q

what is the first intervention of pt has a fractured injury

A

assess the nailbeds for cap refill time

258
Q

s/sx of thyroid storm

A

fever, tachycardia, hypertensioin, tremors, agitation, vomiting, coma

259
Q

What diagnostics can help determine if its pancreatitis or a liver issue

A

Xray, CT, ultrasound

260
Q

What defines cardiogenic shock

A

anything less than 2L/minute

261
Q

What does the liver store?

A

glycogen, iron, copper, fat soluble vitamins

262
Q

What can trigger anginal pain

A

stress emotion provoking situation

263
Q

What does the Thyroid do

A
  • decrease Calcium, metabolism
  • Increase protein and bone turnover
  • Increase response to catecholamines
  • Needed for fetal, infant growth
  • chief complaint is difficulty swallowing
264
Q

psychosocial issues associated with OA

A

depression and hopelessness.

265
Q

Post op, why is it important to Turn Cough Deep breath

A

risk for pneumonia

266
Q

If the protein wrappers don’t come off, what can happen

A

wind up in the brain, cause encephalopathy. Affected by metabolism

267
Q

early sign of shock

A

cooly clammy skin, blood is shunting to central organs

268
Q

Vital Signs for increasing ICP

A

high temp, high bp, low pulse, low respirations

269
Q

What is the priority for a patient with atrial flutter?

A

give supplemental oxygen 2-3 l/min

270
Q

In a person with RA what do movable nodules in SQ tissue represent

A

rapidly progressive destruction of affected tissue

271
Q

What is a sign client may have ulcer due to NSAIDS

A

vomiting blood, notify HCP

272
Q

What provokes the pain in pancreatitis?

A

eating, enzymes are being activated in the pancreas rather than the duodenum

273
Q

Looking at an EKG strip what would indicate to the nurse that the rhtymn is abnormal

A

2 P waves appear before each QRS complex

274
Q

3rd Degree AV Block

A
  • Irreversible damage to AV node following a MI
  • P-P length does not equal R-R length
  • Requires pacemaker
275
Q

If a client is dizzy and lightheaded from dialysis what is your first intervention

A

trendelenburg position

276
Q
A

deep full thickness burn. Down to bone and tendons

Lack of pain because nerve endings have been destroyed.

Healing takes months, grafts are required

277
Q

What is a high priority post op for nurse to identify

A

paint control, alteration in comfort. Pain can be life threatening

278
Q

What is a priority for DKA

A

fluid replacement

279
Q

what is Mean arterial pressure

A

measures perfusion, should be > 60. Diastolic - 1/3 Pulse Pressure.

280
Q

How does cardioversion work

A

synchronized with qrs, 50-200 joules, synch on

281
Q

Patient prep for EKG

A

no smoking or caffeine 24 hours bnefore, must lie still

282
Q

What labs would you find w. pancreatitis?

A

increased amylase, increased lipase, increase Blood Sugar

283
Q

Where will pancreatitis pain be located?

A

LUQ

284
Q

AV Block 1st Degree characteristics

A
  • PR Inverval above 0.2 seconds (> 1 big square)
  • Atropine for low heart rate
  • Usually benign
  • Delay in AV node
285
Q

Normal ALT levels

A

5-35 units

286
Q

The emergent phase of burn injury s/sx

A

decreased urinary output. Blood shunted away from kidneys.

287
Q

F &Es for chemo

A

uric acid will be hi, potassium will be high, caclium will be low.

these will occur with tumor lysis syndrome (complication

288
Q

A patient is recovering from DI if x4

A
  • decreaseing urine outut
  • increasing blood pressure
  • increasing specific gravity
  • decreasing serum sodium
289
Q

What is a major characteristics of ventricular fibrillation

A

pulseless, initiate code

290
Q

Cushings triad

A

systolic hypertension, widening pulse pressure, bradycardia, bounding pulse, irregular respirations)

291
Q

Nursing Dx for ICP

A
  • Ineffective Cerbral Tissue Perfusion
  • Impaired Physical Mobility
292
Q

Appropriate intervention for a pt with peripheral insufficiency

A

encourage moderate amount of exercise

293
Q

Post Op TURP you see large clots, which intervention should you complete

A

Titrate NS irrigation to run faster to flush it out

294
Q

This type of hematoma forms slowly and results from a venous bleed

A

subdural hematoma

295
Q

Why does Cirrhosis cause portal hypertension

A

increased pressure because of scar tissue blood cannot get passed

296
Q

how does amputee toughen their residual limb

A

push limb against harder sufrace to prep for prosthesis

297
Q

Why is Cushings disease at risk for infection

A
  • Decreased macrophage production
  • antibodies decreased
298
Q

Effects of corticosteroid therapy

A
  • hypokalemia
  • peptic ulcer
  • hypocalcemia
  • BP increase
  • protein depletion
299
Q

Rhthm strip reveals atrial rate 74 bpm, ventricular rate 62 bpm, and irregular P wave normal shape, PR interval lengthens progressively until P wave is not conducted. Priority Nursing Intervention?

A
  • AV Block Type I
  • Assess: Bradycardia, hypotension, Angina
  • TX: atropine or temporary pacemaker
300
Q

proper PPE for chemotherapy

A

face shield, gown and gloves

301
Q

Multiple myeloma symptoms

A

CRAB

Calcium elevatued

Renal Failure

Anemia

Bone breakdown

302
Q

What acid base imbalance occurs after vomiting

A

metabolic alkalosis, as a result of loss of hydrochloric acids

303
Q

palliative care pain medications consist of

A

anti anxiety (benzos), albuterol, oxygen

Nursing school 9- Med Surg 3 Final (1 decks)

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