Med Surg Final Flashcards
1
Q
What interventions would aggravate the pain in someone with pancreatitis and needs to be avoided?
A
- Lying flat
- Walking
- Eating
2
Q
Why do you check the residual volume before administering a tube feeding?
A
To evaluate absorption of the last feeding
3
Q
A patient with GERD or heartburn should avoid what after eating?
A
Lying down
Being placed in a recumbent position
4
Q
Hepatitis A contracted from
A
- Contamination food
- Fecal oral route
5
Q
If a patient has dermatitis venenata, the first intervention would be?
A
Wash area with large copious amounts of water
6
Q
A patient that is prescribed coal tar treatments should be educated to avoid?
A
Sun exposure for 72 hours after use
7
Q
With burns the most common cause of death after 72 hours is ?
A
Infection
8
Q
With a female patient taking Accutane what do you want to make sure she knows?
A
Not to get pregnant
Use a dependable birth control
9
Q
While taking Accutane, what should you avoid?
A
Avoid vitamin A & avoid sun exposure!
10
Q
The classic sign of impetigo is?
A
Honey colored crust
11
Q
Tinea capitis is
A
Fungal infection of the scalp/head
12
Q
Oral medication is used to treat tinea capitis because…
A
Topical creams do not reach root of the hair to kill the infection
13
Q
You know that with medication a common principle is to make sure the patient does what?
A
Takes all doses of the medication
14
Q
If a skin graft comes from the patient it is called…
A
Autograft
15
Q
When you or another nurse witness an informed consent you are a witness too what?
A
The patient signature
16
Q
When you are preparing a patient for surgery and they can’t remove their ring you would?
A
Use tape to secure the ring and note it in the chart
17
Q
The main purposes of a chest tube/chest drainage is?
A
- Drain air, blood, and fluid from pleural space
- Restores negative intrapleural pressure
- Re-expanse the lung
18
Q
What interventions will you do to aid a patient to expectorate?
A
- Position in a sitting position
- Assist the patient to cough
- Provide hydration (increase fluid prior to collection)
19
Q
What education would you provide for prevention of esophageal cancer?
A
- Stop smoking
- Good oral care
- Regular checkups
- Limiting alcohol consumption
20
Q
What education would you perform with patient, for gout?
A
- No alcohol
- Maintain rest and immobility
- Check urine and urine output for kidney stones
- Use bed cradle to support linen
21
Q
What do you know about osteoarthritis?
A
- Cause Heberden nodes
- Results from wear and tear
- May only affect 1 side of body
- Occurs as we get older
22
Q
Traction has been ordered for a patient, the main purpose is to …..
A
- Relieve muscle spasms
- Prevent deformability
- Align and stabilize the fracture
23
Q
You are caring for an older adult and you know that normal age related changes in the skin include ?
A
- Dermal thinning
- Increase in Nail thickness
- Loss of skin elasticity
- Yellowing of the nails
- Dry skin
24
Q
What can you delegate to UAP?
A
- Taking vital signs
- Enema
- Applying antiembolic stocking
- Assisting with removal of clothing
25
What are the categories for anesthesia?
- Conscious sedation
- Regional
- General
- Local
26
To get 500 mg you have 1 g/ 2.5 ml. How many vials will you need to cover 8 days?
4g
27
What could you explain to a patient that is experiencing fatigue from tuberculosis and is stressed over this?
- This is expected
| - Should increase activity gradually as tolerated
28
Specimens need to be taking to the lab right away but it we are not able to get them there what should we do with them?
Refrigerate the specimen
29
Pharyngitis is......
Sore throat
30
What interventions would you do for a patient with pharyngitis?
– Avoid foods that are highly seasoned
– Avoid hot foods
– Avoid rough foods
– Avoid acidic drinks and food
31
What are the initial signs/symptoms of pulmonary embolism?
– Chest pain (most common early sign)
– Dyspnea
– Tachypenia
– Tachycardia
32
If a patient is unable to speak what communication tools can you use?
– Picture or word boards best for personal needs
– Pad and paper
– White board
33
Acid-Base Balance
* pH – 7.35 to 7.45
* PaCO2 – 35 to 45 mmHg
* HCO3 – 21 to 28 mEq/L
34
When suctioning a patient if they have distress or de-sat (oxygen levels fall) what do you do?
– Stop the suctioning let them rest and the oxygen saturation to go back to base line
– Then continue the suctioning
35
How long do you apply suction for?
10 seconds
36
Fluctuation in the water seal of a chest drainage system means?
The chest tube is functioning correctly
37
Continuous bubbling in the water seal of the chest drainage system means
–There is an air leak in the system
38
A client that has just had a pneumonectomy, you know which position would be contraindicated?
Lateral position
39
What is the safe liter flow for a patient with COPD (emphysema, chronic bronchitis)?
1 to 2 liters of oxygen flow
40
A low pitched grating lung sound would be....
Friction rub
41
What is the lung sound for air moving through fluid in the air passage ways?
Crackles
42
When placing a pulse Ox on the finger the nurse would make sure that
– The finger is normal temperature
– Not on the side where a blood pressure cuff is applied
– Not on the side where an arterial line is placed
– Not over fingernail polish or dark yellow nails
43
What are the proper teaching technique for sputum specimen collection?
– Collect first thing in the morning upon rising
– Rinse the mouth out before collection
– Have the patient sit upright or in high Fowlers position
– Have patient take 3 deep breaths then cough
– Bring the sputum up from the lungs
44
What happens when oxygen levels drop in the body of a normal person?
– CO2 rises
– Chemoreceptors in the carotid body and aortic body stimulate the respiratory centers (medulla and pons) to modify respiratory rates
– The breathing rate increases
45
As a nurse you know that in order to prevent dumping syndrome in a patient that had gastric surgery. You would educate the patient on what measures?
```
– Limit fluids taken with meals
– Recline or lie down after eating
– Eat 5 to 6 small meals through out the day
– Avoid high carbohydrate foods
– Low Fowler’s position during meals
```
46
If a patient is having malabsorption or deficiency in
| vitamin K you would expect .....?
– Increased prothrombin time (PT)
| – Becoming a bleeding risk
47
If a patient’s albumin is low what could you see in your patient?
– Edema
– Albumin holds the plasma (fluid) volume in the vessels so if it is low the vascular fluid (plasma) leaches out of the capillaries into the interstitial tissues
48
Mechanical bowel obstruction is and would include....
```
– Physical obstruction or cause
– Narrowed bowel lumen from inflammatory process
– Tumors
– Fecal impaction
– Vovolus
```
49
Nonmechanical bowel obstruction includes....
A non-physical obstruction like:
• Paralytic ileus
• Decrease or absent blood flow
• Spine cord injury
50
What teaching/education should you do for the patient that has had a cast removed?
- Gently wash and lubricate the leg
- Remove gradually
- patient should be instructed to avoid any vigorous scrubbing of the skin to avoid breaks
51
What would you tell a patient to avoid after spraining their ankle?
Application of heat
*Heat could increase venous congestion, which would increase edema and pain
52
What education/teaching would you do for the care of a sprain?
– R I C E
– Rest, Ice, Compression, and Elevation for the first 24 hours
– Do this intermittently for 20 to 30 minutes at a time for the first 24 hours
53
You are caring for a patient in traction, and you want to keep the patient from sliding down in the bed, so you would provide.....
Countertraction by slightly elevating the foot of the bed
54
What would you assess for to make sure the client isn’t development compartment syndrome?
* Increasing pain
* Pain not relieved by analgesics
* Increase pain when flexing the fingers or toes of the casted extremities
* Loss of sensation
55
What would indicate infection, which is always a high concern for us with our patients?
```
– Oral temperature above 100.2 degrees
– Increase redness in the area
– Pain
– Increase warmth in the area
– Purulent drainage, discharge
– Inflammation and edema in the area
```
56
How do you teach a patient to use a cane?
– Hold it on the strong side
– Cane moves with the weak leg
– Hold the cane 6 inches lateral to the great toe
57
As a nurse you know to educate the patient to avoid what activity?
– Crossing the legs
– Bending at the hips
– Leaning forward to get out of a chair
58
What precautions are instated for a draining infectious wound?
– Contact precautions
| – Another term would be drainage and secretion precautions
59
What are the signs and symptoms of a fat embolis?
```
– Sudden onset of chest pain
– Tachycardia
– Tachypenia
– Later sign is crackles
– Feeling of impending doom
```
60
After a hip replacement you know that what leg position has to be maintained at all times?
Abducted so prosthesis does not become dislocate
61
How would you explain phantom pain to your patient?
– It is related to the severed nerves that are still sending messages to the brain
– It is normal a lot of patients experience this
62
What is begun in the rehabilitation phase?
```
– Occupational therapy
– Physical therapy
– Return the patient to the highest level of health restoration
– Psychological counseling if needed
– Cultural counseling if needed
– Spiritual counseling if needed
```
63
Herpes Simplex, does it ever go away?
No, It can reactivate at any time
64
Who would be at risk for skin cancer like basal cell carcinoma or melanoma?
– A person that is exposed to the sun a lot
65
Folliculitis is....
Inflammation of a hair follicle
66
What are the signs and symptoms of folliculitis?
Red lesions on the face after shaving
67
Rules of nine for burns
- determines the TBSA burned
- divides the body into multiple of nine
- does not take into account the different levels of growth
- not accurate for children
68
What education would you perform for a patient with eczema?
– Avoid excessive use of soap and water
– Keep skin well hydrated with emollients
– Avoid harsh soaps like antibacterial soaps
– Apply emollients immediately after bathing
69
When you are assessing your patient for scabies what would you be looking for that indicates that the patient has them?
Wavy threadlike lines on the body and pruritus
70
What could indicate that the patient has melanoma in a nevus or lesion?
– Irregular borders
– Multicolor
– Growing larger
– Abnormal asymmetry
71
Ablative surgery is.....
Excision or removal of disease part
72
With the older adult when using visual tools like printed material, you need to be aware of what?
Visual impairments
