Med-Surg 5 Flashcards by Yuko Porter

Hypothyroidism s/s
a) Tremors
b) Weight loss
c) Feeling cold
d) Loss of body hair
e) Persistent lethargy
f) Puffiness of the face

c,d,e,f
hyperthyroidism s/s

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Hyperthyroidism s/s?

Everything is high and hot
Grave’s disease
fever, nausea, tremors, confusion

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Hyperthyroidism
Treatment
a) radioactive iodine?
b) PTU?
c) Thyroidectomy?

a) PT should in a room by themselves in 24hrs
Watch out in urine, if urine spills on the floor, the hazmat team must be called
b) Slows thyroid down
Monitor WBC count!!
c) Total need lifelong med, watch out hypocalcemia
Sub-total watch out thyroid storm

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Thyroid storm s/s

Super high fever (105&up)
Extremely high BP
Severe tachycardia
Psychotic delirium

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Addison’s disease
They cannot adapt to stress. When they stress….
a) what vitals are changed?
b) What complication will occur?
c) treatment?

a) Decrase BP and glucose
b) shock
c) glucocorticoids
all steroids endin “SONE”
Add sone=addison

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If you are on steroids and you are diabetic, what do you do?

Need a lot more insulin
Steroids increase blood glucose!

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impetigo
s/s
why is it so important to complete antibiotics?

Lesion is commonly around the mouth and nose but it may show up on broken skin such as an insect bite
leads secondary infections such as glomerulonephritis

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Prescribed lindane shampoo to treat lice.
Who is contraindication?

child younger than 2 years old
because they have more permeable skin and high systemic absorption may occur

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Which factor will affect?
Glomerulonephritis
CKD stage 5
AKI(pre-renal)
a) GFR
b) Tachycardia
c) BUN
d) Hypertension
e) Inc K

a) CKD and AKI
b) all
c) all
d) glomerulonephritis and CKD
e) all

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a) uremia?
b) Kidney disease cause anemia, what treatment?

a) A condition involving abnormally high levels of waste products in the blood d/t kidney disfunction
b) Type and cross for 2u PRBC

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Pre-renal AKI
a) What vital must immediately follow up?
b) Treatment for this issue?

a) Hypotension
This cause decreased perfusion to organs, only 20 min poor perfusion causes tubular necrosis
Blood can’t get into kidny d/t obstraction
b) IV fluid

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UTI cause infection
cystitis
pyelonephritis
urosepsis
a) they all will occur?
b) cystitis characteristic?
c) pyelonephritis
d) urosepsis

a) urgency, dysuria, hematuria
b) NOT present with systemic s/s so vital won’t change
c) CVA tenderness
d) Tachycardia, hypotension

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What is dysuria?

the sensation of pain and/or burning, stinging, or itching associated with urination

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Before administering alteplase(tPA) what nurse need to check?

the pt’s current weight
because tPA dosing is weight-based

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a) dependent position?
b) rubor
c) s1 sound? s2 sound?
d) what is Glycosylated hemoglobin?

a) hanging down
b) redness or erythema of the skin
c) APT-M 2245
s1-T4 left s2 P2 left
d) HbA1c

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A pt with Parkinson’s disease takes benztropine. What ADR?

a) Urinary retention
b) Diarrhea
c) Constipation
d) Blurred vision
e) Tinnitus
f) Dry mouth
g) Drowsiness

a,c,d,f
Parkinson’s=ABC advaers reacion

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Guillain-Barre syndrome
a) Respiratory failure
b) Pulmonary congestion
c) Hypertension
d) Flaccid paralysis
e) Hemiplegia
f) Urinary retention

a,d,f
a-classic s/s
A condition in which the immune system attacks the nerves

A older adult pt refused to eat and drink for several days. Which action by the nurse is best?
a) Check the pt’s oral temp
b) Assess pt’s urine output
c) Check the skin turgor on the back of the hand
d) Obtain the BP in the sitting and standing position

d
They are dehydrated and have an increased risk for orthostatic hypotension.
When check skin turgor on the older pt, we check on their sternum or forehead

A pt with DM2 taking Metformin. which are common adverse effect? SATA
a) Hypoglycemia
b) Nausea
c) DIarrhea
d) Vomiting
e) Increased appetite
f) headache

b,c,d
a-Metformin decreases glucose levels in the liver(decrease production) they don’t produce extra insulin

A pt with NG tube is vomitus a moderate amount of green fluid. What action should be taken?
a) Change the suction from intermittent mode to continuous mode
b) Measure the amount of vomitus
c) Replace the NG tune with a larger one
d) Irrigate the NG tube with 20ML of normal saline

d
If a pt with NG tube vomiting, the tube is obstructed. Use normal saline (NS) for irrigation.
b- vomiting is result of an obstruction, which is the primary problem

What is a myelogram?

The test involves a lumbar puncture with an injection of contrast medium, allowing x-ray visualization of the vertebral canal

a) Accountability?
b) Advocacy?
c) Beneficence

a) responsibility
b) Respect pt’s decision
Acting to protect their right
participate in the decision-making process
Help pt become more independent
c) promotion of good and prevention of harm

a) IVP what order would expect before?
b) After right-side cataract surgery, which side should avoid lying down
c) euthanasia?

a) cleansing enemas improves visualization of the urinary tract
b) Affected side(right)
c) 安楽死

a) What is Erythrocytes?
b) What is Psoriasis?
c) NG tube pH normal level
d) Which disease reduces pain when move joint? OA or RA?

a) RBC
b) Silver white scaly patches
patches are everywhere but most commonly on the elbow, knees
autoimmune disease
c) 1-5
d) RA

NG tube how to insert?

Place the tube at the **tip of the nose,** and measure by extending the tube to **earlobe** and then down to the **xiphoid process**

A pt with dementia has been identified as having a high BUN in lab results. Which non-pharmacological actions would be best for the nurse to take? a) Assist the pt to the bathroom every morning b) Place water in front of the pt every hour to encourage oral hydration c) Notify HCP

b BUN=dehydration DO NOT confuse with creatine level and BUN. creatine indicates Kindy failed.

Tamsulosin hydrochloride has been prescribed for a client with benign prostatic hypertrophy (BPH). How would the nurse instruct the client to take the medication? a) with breakfast b) with a glass of milk c) with the lunchtime meal d) Thirty minute after a meal

a) when would be risk of early toxicity occur associated with radiation therapy? b) MAOI food, is white wine OK or bad? what about citrus fruits? c) What if emulsion parenteral nutrition solution notes layer of fat floating?

a) 2 weeks b) White wine-OK Citrus fruits-NO c) Return the bag to the pharmacy(cracking)

A nurse is reviewing information to a group of pt. What info should be included? SATA a) the concentrations of lipid emulsions can be up to 30% b) Adding lipid emulsion gives the solution a milky appearance c) Check the pt for an egg allergy d) Lipid emulsion prevent essential fatty acid deficiency e) IV lipids given via piggyback should typically hang for 16hrs

a,b,c,d Lipid emulsion is available in 10%,20% and 30% Lipid emulsion formulated from safflower, soybean oil, and egg phospholipids Lipid emulsion should not hang for longer than 12hrs

a) when pt has oral mucositis, do they use a straw to drink fluids or not? b) What is the tidal volume on the ventilator setting? c) cricothyrotomy. What is the next step after penetration of the cricothyroid membrane and confirmation of the incision?

a) Yes, use b) The amount of air inhaled with each breath c) insert the needle catheter at a 45degree angle downward toward the trachea

a) endolymphatic hydrops. s/s? b) Biot's respiration? c) Peak blood level draw

a) endolymphatic hydrops=Meniere's disease hearing loss, vertigo, tinnitus, aural fullness b) shallow, rapid breaths followed by periods of apnea caused by head injuries, neurological deficits c) time sensitive, when medication is finished, this can be the #1 priority

The medical-surgical nurse receives a hand-off shift report for assigned clients. ➤Which client does the nurse see first? a) An adult client who just returned from a cardiac catheterization 10 minutes ago b) A school-aged client prescribed intravenous (IV) pharmacotherapy following an asthma attack.

A because this order placed AFTER asthma attack

A client who is diagnosed with a terminal illness. The client’s living will states, “No advanced care, including food and fluids.” The healthcare provider prescribes intravenous (IV) fluids to be maintained at 100 mL/hour. Which action by the nurse is appropriate? a) Manage the IV infusion as prescribed. b) Ask the client to clarify the living will parameters. c) Clarify the prescription for IV fluids with the healthcare provider.

c b-The client’s advance directive clearly outlines the terminally ill client’s wishes related to the receipt of fluids. Therefore, no clarification is needed, and the nurse should follow these wishes

a) Hepatocellular jaundice caused what? b) When to perform the Heimlich maneuver? c) Benzodiazepines, contraindication disorder?

a) Intense and uncontrollable itching Keep the client’s fingernails cut short and provide relief from itching b) When pt cannot talk or cough. If they say "help" means they don't need this c) history of glaucoma

a) Pruritis? b) Psoriasis contagious? trigger? c) s/s?

a) itching b) no infections, stress, and cold c) dry, cracked, scaly skin Bumps and blister silver-colored plaques accompanied by pruritis

a) Respiratory distress sign? b) Hydralazine? what for and what teaching? c) Hydrochlorothiazide for?

a) Dyspnea, use of accessory muscles, dec or absent breath sounds, sitting forward with neck extended b) For HTN Sit up in bed for a few min before standing c) Diuretic

A pt with A hemothorax and pneumothorax are suspected. What s/s would the nurse anticipate? a) Shortness of breath b) Decreased heart rate c) Wheezing in the affected area d) Chest pain e) Cough f) lung sounds will be diminished

a,d,e,f

a) 1 hr after electroconvulsive therapy, expect findings? b) Blood transfusion, what find contraindication? (lung) c) TB. How many negative results are needed? d) What is a sign of acute respiratory distress?

a) headache short and long-term memory disruption Transient confusion(amnesia) b) crackles=fluid excess c) 3 times d) Increase RR

What potential contributing factors for transient urinary incontinence? a) Chronic urinary retention b) Fecal impaction c) Menopause d) Restricted mobility e) Stroke

b,d Transient means a temporary type caused by an illness or medication.

A pt with cardiac tamponade, S/S? a) Bradycardia with wet lungs b) Increased central venous pressure c) Distended bilateral neck veins d) A widening pulse pressure e) Decreasing blood pressure

b,c,e b,c,e The classic sign is dec blood pressure while CVP(HR) increased

A pt reported a squeezing pain in the chest. What additional s/s should the nurse monitor for this pt? SATA a) dyspnea b) dry, flushed skin c) indigestion d) restlessness e) Tachycardia

a,c,d,e Think worst case, MI! b-The skin should be cool and clammy since decreased perfusion

a) When wheezing occurs? b) What is the most sensitive test for PE?

a) When air tries to get through narrowed passages b) Pulmonary angiography