Med Surg/Complex Flashcards
What do you confirm pulmonary tuberculosis?
Sputum culture for acid-fast bacillus
What are the clinical manifestations of biliary atresia?
Dark urine
What is legally necessary to change a client’s code status to DNR?
A written prescription from provider
Between albuterol and cromolyn, which should be administered first?
When both cromolyn and albuterol are prescribed, albuterol should be inhaled first to open the airways because is a bronchodilator. After waiting a few minutes, the cromolyn can then be inhaled and will reach further into the lungs because of the dilatory effects of albuterol.
What foods are okay for a patient with dumping syndrome?
Peanut butter and toast
What precaution should a patient with rubella be placed on?
droplet
What precaution should a patient with measles be placed on?
Measles is transmitted through respiratory secretions of the infected person and is also found in blood and urine. Place clients who are diagnosed with measles on airborne precautions.
What precaution should a patient with hepatitis A be placed on?
Hepatitis A is transmitted through the fecal-oral route most often by eating contaminated foods.
Use of standard precautions when caring for a client who has hepatitis A
What are the first clinical manifestations of increase ICP?
Change in the level of consciousness, such as restlessness, irritability, disorientation, and lethargy are the first signs of increased ICP.
T/F: Substernal pain and wheezes are manifestations of oxygen toxicity.
True
T/F: Type 1 DM is contraindicated for receiving cold therapy.
True. Type 1 DM can have impaired circulation due to arteriosclerosis and a loss of sensory perception due to neuropathy. Ice can further impair circulation
What are manifestations of compartment syndrome?
pain, pallor, and paraesthesia from increased edema in the compartment involved
T/F: Atelectasis is a possible adverse effect of PEEP.
False. Tension pneumothorax is a possible AE of PEEP.
The nurse should monitor the client’s lung sounds hourly for indication of TP, such as tracheal deviation, absent breath sounds, and distended neck veins
T/F: PEEP is used to prevent atelectasis.
True, by strengthening gas exchange
What are manifestations of vaso-occlusive crisis?
Visual disturbances, hematuria, and painful swelling of hands and feet
T/F: Decreased BP is a physiological change associated with aging.
False. Older adults are more likely to have an increased systolic BP, and have increased incidence of orthostatic hypotension.
T/F: Older adults are more likely to have decreased lung expansion.
True, due to decreased mobility of the ribs
A patient with Crohn’s disease should have what type of diet?
Low fiber to reduce diarrhea and inflammation
When should an ileostomy pouch be changed?
When it is one-third to one-half full to prevent stool leakage or irritation
A nurse caring for a client who is receiving a continuous heparin infusion should review which laboratory test prior to adjusting the client’s heparin?
aPTT
A nurse caring for a client who is receiving a warfarin should review which laboratory test?
INR
What are normal potassium levels?
3.5-5 mEq/L
What are manifestations of hypokalemia?
muscle weakness and decreased deep tendon reflexes
What are the correct order of steps when doing an abdominal assessment on a client?
Inspection
Auscultation
Percussion
Palpation
How could the nurse assess for the correct placement of a client’s NG feeding tube?
Aspirate contents from the tube and verify that pH level is less than 5
What are clinical manifestations of multiple sclerosis?
Nystagmus (involuntary eye movements) and muscle spasticity
T/F: Abdominal striae are a manifestation of Cushing’s syndrome.
True
Ptosis is a clinical manifestation of what?
Myasthenia gravis.
Ptosis is the drooping of the upper eyelids due to a decreased level of acetylcholine
What precautions should be taken with a client who has neutropenia?
Prohibit fresh flowers in the client’s room dt increased risk of infection
Restricting visitors to healthy adult friends and family
What precautions should be taken with a client who has thrombocytopenia?
Avoid venipunctures when possible, bc those clients have a decreased platelet count and are a risk for bleeding
What are expected INR levels?
0.8-1.1
What are clinical manifestations of ovarian cancer?
Urinary urgency and frequency
Abdominal bloating
Increase in abdominal girth
Pelvic or abdominal pain
Early satiety
Constipation
What precaution is the nurse implement for a client with MRSA?
Contact precautions
What precaution is the nurse implement for a client with tuberculosis or measles?
Airborne
What precaution is the nurse implement for a client with pneumonia or influenza?
Droplet
What grade level should written material be provided in?
5th grade reading level
Should the nurse elevate a leg affected by a deep-vein thrombosis?
Yes, in order to reduce edema and decrease the risk of chronic venous insufficiency.
T/F: Heat is contraindicated for wound therapy.
True
What is the greatest barrier to a client’s ability to be compliant?
Absence of symptoms
T/F: A client has immunosuppression. The nurse should monitor the client’s WBC count every 48 hours.
False. The nurse should monitor the client’s WBC count every 24 hr.
T/F: A client has immunosuppression. The nurse should change the client’s tubing every 48 hours.
False. The nurse should change the IV tubing every 24 hr for a client who has immunosuppression.
T/F: A client has immunosuppression. The nurse should monitor the client’s mouth every 8 hours.
True. The nurse should monitor the client’s mouth at least every 8 hr for manifestations of an infection, such as sores or lesions.
What type of solutions should be used for irrigation of an NG tube?
0.9% sodium chloride, sterile water, or tap water
What finding should the nurse expect when assessing a client with macular degeneration?
Decrease or loss of central vision due to bleeding into the macula or yellow spots under the retina.
Floating dark spots are a manifestation of what?
Retinal detachment
Increased intraoccular pressure is a manifestation of what?
Glaucoma
Double vision is a manifestation of what?
Cataracts
How often should the nurse assess a client who has mechanical restraints?
The nurse should assess the client for physical needs, safety, and comfort every 15 to 30 min and document the findings.
How often is a new prescription needed for a restraints?
Every 4 hr for clients 18 years or older
Every 2 hr for children ages 9 to 17 years
Every 1 hr for children under the age of 9 years.
Assess a client’s ability to swallow assesses for which cranial nerve?
CN IX
Asking the client to restate directions assesses which cranial nerve?
CN VIII
Clearing objects from the client’s walking area is an action to accommodate loss of which cranial nerve?
CN II (Optic nerve)
What type of diet should clients with rheumatoid arthritis eat?
foods high in protein, vitamins, and iron to promote tissue repair
T/F: Clients who have rheumatoid arthritis should take cool sponge baths each morning.
False. Clients who have rheumatoid arthritis to take hot showers to help relieve morning stiffness rather than sponge baths or tub baths.
What position should the nurse place the client in in preparation for a digital evacuation?
Place the client in a side-lying position with the knees flexed.
HSV requires what type of precaution?
Contact precautions
What are clinical manifestations of hypocalcemia?
Muscle spasms, numbness around lips, and decreased calcium level
How often is a blood sample collected during a 3-hour oral glucose tolerance test?
Every hour
What are expected findings of a client who takes MDMA?
Diaphoresis, increased tactile sensitivity, lowered inhibition, chills, muscle cramping, teeth clenching, and mild hallucinogenic effects.
T/F: The nurse should instruct the client to void before a paracentesis.
True. The nurse should instruct the client to void prior to the procedure because an empty bladder decreases the risk of a bladder puncture and minimizes the client’s discomfort during the procedure.
T/F: Low back pain is a sign of hemolytic transfusion reaction.
True
What are signs of hemolytic transfusion reaction?
Low back pain
Tachycardia
Hypotension
What are manifestations of bacterial meningitis?
Nuchal rigidity
Weight loss
What site should the nurse use for IM administration for a client who is obese?
The nurse should use the ventrogluteal site because it has a thick area of muscle and contains no large nerves or blood vessels.
What conditions will distended neck veins appear?
A client who has cor pulmonale or tension pneumothorax will have distended neck veins.
What food allergies may be associated with latex allergies as well?
bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes, and/or peaches
What acronym is used for cane walking?
COAL
Cane
Opposite
Affected
Leg
What illnesses require airborne precautions?
AIRBORNE: “My Chicken Hez TB”
-Measles
-Chicken pox
-Herpes zoster
-TB
What illnesses require droplet precautions?
“SPIDERMAn”
-Sepsis
-Scarlet Fever
-Strep
-Pertussis
-Pneumonia
-Parvovirus
-Influenza
-Diphtheria
-Epiglottitis
-Rubella
-Mumps
-Adenovirus
What illnesses require contact precautions?
“MRS WEE”
-MRSA
-VRSA
-RSV
-Skin infections (herpes zoster, cutaneous diphtheria, impetigo, pediculosis, scabies, and staphylococcus)
-Wound infections
-Enteric infections (C. difficile)
-Eye infections (conjunctivitis)
A client taking furosemide should be encouraged to include what type of foods into their diet?
Clients prescribed potassium-wasting diurectics should be encouraged to eat foods high in potassium.
Oranges, dried fruits, tomatoes, avocados, dried peas, meats, broccoli, and bananas are all good sources of potassium.
What foods are food sources of potassium?
Oranges, dried fruits, tomatoes, avocados, dried peas, meats, broccoli, and bananas
How often should neurovascular and neurosensory status checks be done on a patient with restraints?
every 2 hours
How should hearing aids be cleaned?
Using mild soap and water
T/F: Bradykinesia is an expected symptom of Parkinson’s disease.
True
What pH value is a good indication of correct NG tube placement?
Between 0 and 4
What are the precipitating factors for angina?
4 E’s
Exertion
Eating
Emotional distress
Extreme temperatures
What are the signs of arterial occlusion?
4 P’s
Pain
Pulselessness
Pallor
Paresthesia
What is the treatment for congestive heart failure?
MADD DOG
Morphine
Aminophylline
Digoxin
Dopamine
Diuretics
Oxygen
Gasses (monitor arterial blood gasses)
What are causes of heart murmur?
SPASM
Stenosis fo a valve
Partial obstruction
Aneurysms
Septal defect
Mitral regurgitation
Where can you listen to the aortic heart sound?
2nd right intercostal space
Where can you listen to the pulmonic heart sound?
2nd left intercostal space
Where can you listen to Erb’s Point?
3rd left intercostal space
Where can you hear the tricuspid valve?
4th left intercostal space
Where you can you hear the mitral or apex heart sound?
5th left intercostal space
What are nursing interventions for hypertension?
DIURETIC
Daily weight
Intake and Output
Urine output
Response of blood pressure
Electrolytes
Take pulse
Ischemic episodes or TIAs
Complications (CVA, CAD, CHF, CRF)
What are the signs of stroke?
FAST
Face
Arms
Speech
Time
What are signs of compartment syndrome?
5 P’s
Pain
Pallor
Pulse declined or absent
Pressure increased
Paresthesia
Sign of hypoglycemia
TIRED
Tachycardia
Irritability
Restlessness
Excessive hunger
Depression and diaphoresis
Early warning signs of cancer
CAUTION UP
-Change in bowel or bladder
-A lesion that does not heal
-Unusual bleeding or discharge
-Thickening or lump in breast or elsewhere
-Indigestion or difficulty swallowing
-Obvious changes in wart or mole
-Nagging cough or persistent hoarseness
-Unexplained weight loss
-Pernicious Anemia
Leukemia S/S
ANT
Anemia and decreased hemoglobin
Neutropenia and increased risk of infection
Thrombocytopenia and increased risk of bleeding
What is dumping syndrome?
occurs as a complication of gastric surgeries that inhibit the ability of the pyloric sphincter to control the movement of food into the small intestine.
results in nausea, distention, cramping pains, and diarrhea within 15 min after eating.
Weakness, dizziness, a rapid heartbeat, and hypoglycemia may occur.
Small, frequent meals are indicated.
T/F: The patient should avoid eating frequent meals and snacks when they have Peptic Ulcer Disease.
True. Avoid eating frequent meals and snacks, as they promote increased gastric acid secretion.
Avoid alcohol, cigarette smoking, aspirin and other NSAIDs, coffee, black pepper, spicy foods, and caffeine.
What diet is prescribed for patients with diverticulosis and diverticulitis?
Low-fiber diet, to reduce bowel stimulation
Avoid foods with seeds or husks
What is cholecystitis?
Cholecystitis is characterized by inflammation of the gallbladder. The gallbladder stores and releases bile that aids in the digestion of fats.
What kind of diet should be prescribed for cholecystitis?
Fat intake should be limited to reduce stimulation of the gallbladder.
Other foods that may cause problems include coffee, broccoli, cauliflower, Brussels sprouts, cabbage, onions, legumes, and highly seasoned foods.
What are symptoms of heart failure?
Shortness of breath, fatigue, jugular vein distention, and an S3
A narrowing pulse pressure is indicative of what?
shock
A client who has dehydration secondary to vomiting. Which lab values is expected to be elevated?
Serum pH
Hematocrit
Urine osmolarity
Urine specific gravity
A client who has dehydration secondary to vomiting. Would serum potassium be elevated?
No, it would be lower.
T/F: Trousseau’s sign is an indicator of potassium.
False. Trousseau’s sign is an indicator of calcium.
T/F: Potassium affects heart rate.
False. Potassium affects heart rhythm, not HR.
What electrolyte causes peaked T-waves?
High potassium levels
What is the usual rate of urine output?
0.5mL/kg/hr (if weight is known)
30mL/hr
What electrolyte imbalance causes a strain on the brain?
Sodium. Neurologic symptoms
What is an example of a hypotonic solution?
0.45% NS
0.45% LR
Fluid moves into the cell (the cells will swell)
What is an example of a hypertonic solution?
Fluid moves out of the cell
D5 NS
What are symptoms of a fluid volume deficit?
- decreased weight
- thready pulse, low BP
- decreased urine output
- high sodium, causing confusion
What are symptoms of a fluid volume excess?
- increased weight
- edema
- bounding pulse, high BP
- increase urine output
- sodium decreased, decreased LOC (tired, lethargic)
- moist lungs, dyspnea, crackles
- distention, JVD
What are the interventions for the following respiratory tests?
Sputum collection
Bronchoscopy
Quantiferon-Gold
Thoracentesis
Sputum collection - Oral care
Bronchoscopy - Assess gag reflex before and after
Quantiferon-Gold - Isolated room
Thoracentesis - Chest tube
How many cc’s of fluid is in the water chamber?
2cc
What is done if the drainage becomes purulent in a chest tube chamber?
Assess and notify provider. Possibly infection.
If tidaling in the water seal chamber has stopped, what complication is most likely the cause?
Obstruction is present in the tubing
What diet should a client with acute cholecystitis adhere to?
Consume low fat diet rich in HDL food sources
Cholecystitis —> low functioning gall bladder, referred pain to right shoulder
How are medications for patients with NG tubes?
Crush pills, give one pill at a time, flush between each pill, flush before and after
Why should patients who have had bypass surgery recline after meals?
To slow digestion of food
What foods should be included in a low fiber, low residue diet?
- Cream of wheat
- Puffed rice cereal
- Canned green beans (not fresh green beans)
What type of diet should someone with Crohn’s disease adhere to?
Low fiber, low residue diet
T/F: You should clip hair surrounding a peristomal site.
True
T/F: You should add cranberry juice and yogurt to the diet of someone with a colostomy.
True
When should a colostomy bag be emptied?
When it is one third full
What disease process is described?
- Pain after activity
- Chronic
- Unilateral pain
Osteroarthritis
What disease process describe?
- Pain at rest
- Autoimmune
- Bilateral pain
- Morning stiffness
RA
What medication is given for Osteroarthritis?
Glucosamine
What medication is given for RA?
DMARDs
What medication is given for gout?
Allopurinol for chronic
Colchicine for acute
What are nursing interventions for gout?
Bed rest
Avoid touch
Increase fluids
NSAIDS, steroid injection
Diet
What bones can cause fat emboli?
Long bones and pelvic bones
What are symptoms of fat emobli caused by fractures?
Confusion, tachypnea, tachycardia, petechiae
What are complications of fractures?
Fat emboli
Compartment Syndrome
What are symptoms of Compartment Syndrome caused by fractures (6Ps)?
Pain
Pressure
Pallor
Paresthesia
Paralysis
Pulselessness
What are the 6Ps for Compartment Syndrome?
Pain
Pressure
Pallor
Paresthesia
Paralysis
Pulselessness
What are the main electrolytes affected with hypoparathyroidism?
Calcium and phosphorous
Low calcium and high phosphorous
What are normal fasting glucose levels?
70-105 mg/dL
What are normal A1c levels?
4-6%
What are common complications of DM?
Retinopathy
Skin ulcers
Hypertensions
Heart attack
Proteinuria
Neurogenic pain
T/F: If a patient is in afib, the nurse recognizes that the patient is at risk of developing CVA (cerebrovascular accident; a clot).
True.
What are the initial interventions for MI?
MONA
(morphine, oxygen, nitroglycerin, aspirin)
What are symptoms of left-side heart failure?
Left–>Lungs
Dyspnea
Frosty sputum
Crackles
Coughs
What are symptoms of right-sided heart failure?
Right–>Rest of Body
JVD
Weight gain
Edema
What are symptoms of venous insufficiency?
- Painless ulcers
- Lower leg edema
- Hyperpigmentation
What are symptoms of arterial insufficiency?
- Claudication
- Delayed capillary refill time
- Hair loss on legs
- Cyanotic extremities
What are early symptoms of shock?
- Pallor
- Tachypnea
- Confusion
- Tachycardia
What are late symptoms of shock?
- Cold, moist skin
- Weak, thready pulse
- Hypotension
- Anuria
- Metabolic acidosis
What symptoms are associated with DKA?
Confusion, tachycardia, hematocrit level, decreased LOC
What symptoms are associated with HHS?
Confusion, tachycardia, hematocrit level, gradual symptom onset, decreased LOC
Between DKA and HHS, which one has a gradual symptom onset?
HHS
What are complications of hemodialysis?
Infection
Closure
Disequilibrium syndrome
Hypotension
Bleeding
What is TRP?
Transurethral Resection of the Prostate
T/F: A nurse is caring for a client who has a spinal cord injury. The nurse should promote a high fiber diet and use of stool softeners to prevent autonomic dysreflexia.
True
T/F: A nurse is caring for a client who has a spinal cord injury. The nurse should monitor the patency of an indwelling bladder catheter to prevent autonomic dysreflexia.
True.
T/F: Clients can have caffeine prior to completing an EEG.
False. Avoid caffeine 8 hours prior to test.
What is BEFAST?
For CVA events
Balance, Eye, Face, Arms, Speech, Time
T/F: For a neutropenic patient, they should rinse their toothbrush in bleach solution at least weekly.
True
What is the Parkland formula?
4mL x kg x TBSA
1/2 total in first 8 hrs
1/2 in remaining 16 hours
What is HOP in regards to sickle cell?
Hydrate
Oxygenate
(Treat) Pain
A child with Tetralogy of Fallot is going through a hypercyanotic spell. What is the nursing intervention?
Knee-to-chest position
What types of patients would you get daily weights on?
Heart failure
Renal
T/F: The nurse should notify the provider if there is bubbling in the suction control chamber.
False.
T/F: For infiltration, the RN should apply a warm compress.
False. Elevate and apply cold compress. Warm compresses should be applied for phlebitis
T/F: The RN should apply a tourniquet for a catheter embolus.
True
T/F: If possible, the RN should aspirate the drug in the event of extravasation.
True
Should the RN apply a warm or cold compress for a patient with phlebitis?
Warm
What is the nursing intervention for a patient with a hematoma?
Light pressure
What are potential complications of a central line insertion?
Pneumothorax
Air embolism
What are manifestations of polycythemia vera?
Visual disturbances
Headache
Tinnitus
Joint pain
Cardiovascular symptoms (gout, HF, increased clotting time)
What are s/s of extravasation?
Extreme pain at the site
What are s/s of a catheter embolus?
Severe pain at the IV site and the absence of the catheter tip upon removal
What are s/s of phlebitis?
Pain at the IV site and a red streak extending up the extremity
What are s/s of cellulitis as a complication of IV therapy?
Pain, redness, and warmth at the IV site
What stage of pressure ulcer does this describe: Full thickness loss of dermis, subcutaneous tissue, slough, undermining, and tunneling may be present.
Stage III
What stage of pressure ulcer does this describe: Full thickness tissue loss, with exposed muscle, tendon, or bone is visible or palpable.
Stage IV
What stage of pressure ulcer does this describe: Partial thickness loss of dermis.
Stage II
What stage of pressure ulcer does this describe: area of dark purple/maroon bruise-colored discoloration or blood-filled blister, this often deteriorates into stage III or IV ulcers.
Suspected Deep Tissue Injury (DTI)
In a home setting, for how long can suction catheters be reused?
Up to 24 hours. Catheters should be flushed between each use utilizing water or recently boiled water and allowed to air dry
What are manifestations of toxic lithium levels?
Drowsiness
Confusion
Tremors
Muscle Twitching
T-wave Depression on ECG
Renal Impairment
What are toxic serum levels of lithium?
> 1.5 mEq/L
2.0 mEq/L is severe toxicity
For a patient s/p craniotomy, drainage of what amount should require the RN to notify the provider?
50mL or more per shift, suggestion of possible leak of cerebral spinal fluid
T/F: For patients with impetigo, the crusts should be removed with gloved hands before applying prescribed topical antibiotics.
True
T/F: For patients with impetigo, OTC antibiotics should be applied to the crusted lesions.
False. The crusts of the scores should be removed before applying a prescribed topical ointment.
What are s/s of hypoglycemia?
Diaphoresis
Cool, clammy skin
Trembling
Dizziness
Headache
Confusion
Hunger
Shaking
What are s/s of hyperglycemia?
Fruity breath odor
Ketones in urine
Vomiting
Cholestyramine, Colestipol, and Colesevelam are all part of what drug class?
Bile acid sequestrant
What is pink, frosty sputum an indication of?
Pulmonary edema d/t pulmonary congestion
T/F: An oropharyngeal airway can be used in a client with a gag reflex.
False. Clients who have an active gag reflex may vomit, which can obstruct the airway and cause aspiration.
T/F: An oropharyngeal airway cannot be used in a client with a palate fracture.
True. Doing so could cause damage to the roof of the mouth
What are early signs of hypoxemia?
Tachycardia, hypertension, pale skin and mucous membranes, restlessness and signs of respiratory distress
What are late signs of hypoxemia?
Confusion, stupor, cyanosis of skin, bradycardia, hypotension, cardiac dysrhythmias
What finding in a urinalysis is most specific for a UTI?
Nitrite.
Nitrites are a byproduct of breakdown of Gram negative pathogens associated with a UTI
T/F: Use of iron supplements or increased intake of food that contains iron should be avoided by clients with polycythemia vera.
True. Iron excess increases the production of hemoglobin.
What are the primary symptoms of perimenopause and menopause?
Vasomotor symptoms, sleep difficulties, and mood problems
T/F: A patient with Parkinson’s who experiences unsteadiness when turning is in stage 2 of the disease.
False. This is considered stage 3. Stage 3 is characterized by impairment of reflexes, which includes unsteadiness when turning.
Describe the stages of Parkinson’s disease.
Stage 1: Unilateral involvement with minimal/no functional impairment in movement
Stage 2: Bilateral and midline involvement w/o impairment in balance
Stage 3: Impairment of reflexes
Stage 4: Tremor, bradykinesia, rigidity, postural instabilitty
Stage 5: Confinement to bed
T/F: Cloudy urine is an expected finding of pyelonephritis.
True
T/F: Anemia is not a common finding with ulcerative colitis (UC).
False. Anemia occurs in UC d/t loss of blood from friable mucosa in the stool.
What are the two types of inflammatory bowel disease (IBD)?
Crohn’s disease and ulcerative colitis
Which IBD is contiguous in it’s inflammation?
Ulcerative colitis. Crohn’s has skip lesions.
What kind of lesions does Crohn’s disease cause?
Transmural lesions
What kind of lesions does ulcerative colitis cause?
Submucosa or mucosa lesions
T/F: It is common for ulcerative colitis to cause fistulas and strictures.
False. This is very uncommon. It is common for Crohn’s disease to cause fistulas and strictures.
What is a frequent cause of peptic ulcer disease?
H. pylori
Does a patient need to be NPO before a urea breath test for peptic ulcer disease?
Yes. Urea breath testing for H. pylori requires the client remain NPO after midnight.
T/F: When removing a NG tube, the nurse should instruct the client to lean forward.
False. The nurse should instruct the client to take a deep breath and hold it. Holding it closes the glottis, thereby preventing accidental aspiration of the gastric contents.
What is abdominal compartment syndrome?
Risk associated with surgery. Occurs as a result of gas and fluids accumulation in the intraabdominal cavity.
T/F: The taste for salt is learned through habitual use and can be unlearned or reduced.
True.
Is chewing sugarless gum a strategy to manage anticholinergic effects of fluphenazine?
Yes. Chewing gum can help the client cope with dry mouth.
Anticholinergic effects include dry mouth, blurred vision, photophobia, urinary retention, tachycardia, and constipation
Name the type of drainage associated with the following descriptions:
Thick with a foul odor
Clear and streaked with blood
Thick and reddish in color
Watery, clear, slightly yellow
Purulent: Thick with a foul odor
Serosanguineous: Clear and streaked with blood
Sangeuineous: Thick and reddish in color
Serous: Watery, clear, slightly yellow
T/F: Clients receiving TPN are at risk of hypo- and hyperglycemia.
True
What administering FFP, what lab results should the RN review?
Prothrombin time.
What complication should the RN monitor in the first 24 hours following a client who had a MI?
Ventricular dysrhythmias
What are manifestations of pericarditis?
Dyspnea, hiccups, and a nonproductive cough
What are manifestations of aplastic anemia?
Petechiae and ecchymosis.
In aplastic anemia, all three major blood components (RBC, WBC, and platelets) are reduced or absent, known as pancytopenia.
What should the HOB be for a client getting tube feeds?
At least 30 degrees
For a client who has bleeding esophageal varices, which of the following meds would the RN anticipate a prescription for?
Famotidine
Esomeprazole
Vasopression
Omeprazole
Vasopression bc it can constrict the distal esophageal and proximal gastric veins, which reduces inflow into the portal system and is used to treat bleeding varices.
PPI (-prazoles) are used to treat GERD and duodenal and gastric ulcers.
Famotidine is a H2 antagonist used to treat stress ulcers.
What are manifestations of a perforated peptic ulcer?
-Boardlike abdomen
-Severe pain in abdomen or back and radiates to right shoulder
What is the usual mode of transmission for Hepatitis A?
Fecal-oral
What population groups are most often affected by Hepatitis A?
Children and young adults
Elevations in serum amylase is most likely indicative of what condition?
Pancreatitis
What is the treatment for fulminant hepatic failure?
Liver transplant. Fulminant hepatic failure (often caused by viral hepatitis) is characterized by hepatic encephalopathy within weeks of onset. Mortality high.
What lab test is used to determine the possibility of recent excessive alcohol use?
GGT (Gamma-glutamyl transferase)
T/F: Right shoulder pain is an expected finding following a laparaoscopic cholecystectomy.
True, dt carbon dioxide being injected into the abdominal cavity during the procedure, which can irritate the diaphragm and cause referred pain in the shoulder.
What is the purpose of an EGD?
To visualize the esophagus, stomach, and dueodenum with a lighted tube to detect a tumor, ulceration, or obstruction
When should men begin annual PSA testing?
At age 50
T/F: Fasting is required for PSA testing.
False
Will clients require an indwelling urinary catheter following a TURP?
Yes, in order to monitor urine output and bleeding.
What type of breathing promotes carbon dioxide elimination?
Pursed-lip breathing, for COPD
T/F: Night sweats is a manifestation of tuberculosis.
True
What test measures the volume of air the lungs can hold at the end of maximum inhalation?
Total lung capacity
Increased tactile fremitus is a clinical manifestation of what condition?
Pneumonia
T/F: Diphenhydramine is contraindicated for clients who have glaucoma.
True, bc diphenhydramine can dilate the pupils. Clients who have glaucoma are administered medication to constrict the pupils, which improves circulation.
T/F: Folic acid intake is associated with a reduced risk for heart disease.
True
As adults get older, does their gastric pH increase or decrease?
Increases, becomes more alkaline
Halos when looking at lights is indicative of what condition?
Cataracts.
What condition requires a low potassium and a high sodium, carbohydrates, and protein diet?
Addison’s disease
What is the Somogyi effect?
Swing of high blood glucose level in the AM after extremely low blood glucose level at night.
What is the nurse intervention for a patient with Somogyi effect?
monitor client’s nighttime blood glucose levels
After a parathyroidectomy, what is expected to decrease as a therapeutic effect of the procedure?
Calcium
After a parathyroidectomy, what is expected to increase as a therapeutic effect of the procedure?
Phosphorus
What is the 17-OHCS test used for?
To determine if the client is producing an adequate amount of cortisol
What is the VMA test?
Measures level of catecholamine metabolities in a 24-hr urine specimen
What is the name of the HbA1c level?
Glycosylated hemoglobin levels
Degree of frostbite: the affected area is reddened and looks waxy.
First-degree
Degree of frostbite: the affected area has small blisters that are blood-filled and the skin does not blanch.
Third-degree
Degree of frostbite: the affected area has large, fluid filled blisters.
Second-degree
Degree of frostbite: the affected area is frozen. Blisters do not appear. Client’s muscles and bones are affected.
Fourth-degree
T/F: Redness or swelling around a mole is an indication of potential malignancy.
True
T/F: Fading of a mole is associated with potential malignancy.
False. Darkening of a mole is associated with malignancy
What type of skin lesion is a common manifestation of an allergic reaction?
Wheals, aka hives, are transient, elevated, irregularly shaped lesions
What type of skin lesion is a common manifestation of herpes simplex, poison ivy, and chickenpox?
Vesicles. Circumscribed, elevated lesion or blister containing serous fluid.
What type of skin lesion is a common manifestation of rubella?
Macules. Flat, variably shaped, discolored and small, typically smaller than 10mm in diameter. Freckles and rash associated with rubella are types of macules.
What are common skin lesions associated warts and elevated moles?
Papules. Small, solid, elevated lesion with distinct borders. Usually smaller than 10mm in diameter.
Heterograft dressings are obtained from what source?
Heterografts are obtained from an animal, usually a pig
What are AEs of LASIK surgery?
Dry eyes and blurred vision
Increased protein in the CSF can be a manifestation of what condition?
Bacterial meningitis
What are normal creatinine clearance rates?
Above 87 for female
Above 107 for male
T/F: Obesity is a risk factor for vitamin D deficiency
True
Why is epi administered in combination with lidocaine?
To delay systemic absorption of anesthetic properties of lidocaine
Epi causes vasoconstriction and decreases local blood flow. Delays systemic absorption
How often should patients self-catherize themselves at home?
Every 2-3 hours
For a client who is at 6 weeks gestation and diagnosed with hyperthydroidism, what medication should the RN anticipate a prescription for?
Proplythiouracil bc it does not cross the placental barrier well.
Methimazole is the preferred medication in the 2nd and 3rd trimesters.
What is the ideal settings for NG tubes?
Intermittent at 80-100mmHg
What is the purpose of feverfew?
Herb used for prophylaxis of migraine headaches
Do avocados have high levels of tyramine?
Yes. No safe to take with MAOIs
Does yogurt have high levels of tyramine?
No. Safe to have with MAOIs
What is the purpose of black cohosh?
Herb used for treatment of menopausal symptoms.
What is Kehr’s sign?
Positive if liver trauma present
What is Blumberg’s sign?
Rebound tenderness, positive if someone has cholecystitis
T/F: Ascites is found in clients who have pancreatitis or pancreatic cancer.
True
How long do bone marrow biopsies take?
5 to 15 minutes
What medication should the RN anticipate giving the client who has afib and is scheduled for a cardioversion?
Diltiazem
What factors increase a postmenopausal patient’s risk of developing breast cancer?
Increased breast density
Obese BMI
Undergoing HRT for 10 years
Consuming 3-14 alcoholic beverages per week
Women who are nulliparous
What are manifestations of lactic acidosis from metformin?
Myalgia, somnolence, malaise, hyperventilation
How often should JP drains be emptied?
Twice a day
T/F: A prescription for 40mg of furosemide is given undiluted over 2 minutes.
True
