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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
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2
Q

Why do you check the residual volume before administering a tube feeding?

A

To evaluate absorption of the last feeding

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3
Q

A patient with GERD or heartburn should avoid what after eating?

A

Lying down

Being placed in a recumbent position

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4
Q

Hepatitis A contracted from

A
  • Contamination food

- Fecal oral route

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5
Q

If a patient has dermatitis venenata, the first intervention would be?

A

Wash area with large copious amounts of water

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6
Q

A patient that is prescribed coal tar treatments should be educated to avoid?

A

Sun exposure for 72 hours after use

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7
Q

With burns the most common cause of death after 72 hours is ?

A

Infection

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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

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9
Q

While taking Accutane, what should you avoid?

A

Avoid vitamin A & avoid sun exposure!

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10
Q

The classic sign of impetigo is?

A

Honey colored crust

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11
Q

Tinea capitis is

A

Fungal infection of the scalp/head

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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

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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

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14
Q

If a skin graft comes from the patient it is called…

A

Autograft

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15
Q

When you or another nurse witness an informed consent you are a witness too what?

A

The patient signature

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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

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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
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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)
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19
Q

What education would you provide for prevention of esophageal cancer?

A
  • Stop smoking
  • Good oral care
  • Regular checkups
  • Limiting alcohol consumption
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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
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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
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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
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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
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24
Q

What can you delegate to UAP?

A
  • Taking vital signs
  • Enema
  • Applying antiembolic stocking
  • Assisting with removal of clothing
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25
Q

What are the categories for anesthesia?

A
  • Conscious sedation
  • Regional
  • General
  • Local
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26
Q

To get 500 mg you have 1 g/ 2.5 ml. How many vials will you need to cover 8 days?

A

4g

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27
Q

What could you explain to a patient that is experiencing fatigue from tuberculosis and is stressed over this?

A
  • This is expected

- Should increase activity gradually as tolerated

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28
Q

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?

A

Refrigerate the specimen

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29
Q

Pharyngitis is……

A

Sore throat

30
Q

What interventions would you do for a patient with pharyngitis?

A

– Avoid foods that are highly seasoned
– Avoid hot foods
– Avoid rough foods
– Avoid acidic drinks and food

31
Q

What are the initial signs/symptoms of pulmonary embolism?

A

– Chest pain (most common early sign)
– Dyspnea
– Tachypenia
– Tachycardia

32
Q

If a patient is unable to speak what communication tools can you use?

A

– Picture or word boards best for personal needs
– Pad and paper
– White board

33
Q

Acid-Base Balance

A
  • pH – 7.35 to 7.45
  • PaCO2 – 35 to 45 mmHg
  • HCO3 – 21 to 28 mEq/L
34
Q

When suctioning a patient if they have distress or de-sat (oxygen levels fall) what do you do?

A

– Stop the suctioning let them rest and the oxygen saturation to go back to base line
– Then continue the suctioning

35
Q

How long do you apply suction for?

A

10 seconds

36
Q

Fluctuation in the water seal of a chest drainage system means?

A

The chest tube is functioning correctly

37
Q

Continuous bubbling in the water seal of the chest drainage system means

A

–There is an air leak in the system

38
Q

A client that has just had a pneumonectomy, you know which position would be contraindicated?

A

Lateral position

39
Q

What is the safe liter flow for a patient with COPD (emphysema, chronic bronchitis)?

A

1 to 2 liters of oxygen flow

40
Q

A low pitched grating lung sound would be….

A

Friction rub

41
Q

What is the lung sound for air moving through fluid in the air passage ways?

A

Crackles

42
Q

When placing a pulse Ox on the finger the nurse would make sure that

A

– 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
Q

What are the proper teaching technique for sputum specimen collection?

A

– 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
Q

What happens when oxygen levels drop in the body of a normal person?

A

– 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
Q

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?

A 
– 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
Q

If a patient is having malabsorption or deficiency in

vitamin K you would expect …..?

A

– Increased prothrombin time (PT)

– Becoming a bleeding risk

47
Q

If a patient’s albumin is low what could you see in your patient?

A

– 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
Q

Mechanical bowel obstruction is and would include….

A 
– Physical obstruction or cause
– Narrowed bowel lumen from inflammatory process
– Tumors
– Fecal impaction 
– Vovolus
49
Q

Nonmechanical bowel obstruction includes….

A

A non-physical obstruction like:
• Paralytic ileus
• Decrease or absent blood flow
• Spine cord injury

50
Q

What teaching/education should you do for the patient that has had a cast removed?

A
  • Gently wash and lubricate the leg
  • Remove gradually
  • patient should be instructed to avoid any vigorous scrubbing of the skin to avoid breaks
51
Q

What would you tell a patient to avoid after spraining their ankle?

A

Application of heat

*Heat could increase venous congestion, which would increase edema and pain

52
Q

What education/teaching would you do for the care of a sprain?

A

– 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
Q

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…..

A

Countertraction by slightly elevating the foot of the bed

54
Q

What would you assess for to make sure the client isn’t development compartment syndrome?

A
  • Increasing pain
  • Pain not relieved by analgesics
  • Increase pain when flexing the fingers or toes of the casted extremities
  • Loss of sensation
55
Q

What would indicate infection, which is always a high concern for us with our patients?

A 
– 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
Q

How do you teach a patient to use a cane?

A

– Hold it on the strong side
– Cane moves with the weak leg
– Hold the cane 6 inches lateral to the great toe

57
Q

As a nurse you know to educate the patient to avoid what activity?

A

– Crossing the legs
– Bending at the hips
– Leaning forward to get out of a chair

58
Q

What precautions are instated for a draining infectious wound?

A

– Contact precautions

– Another term would be drainage and secretion precautions

59
Q

What are the signs and symptoms of a fat embolis?

A 
– Sudden onset of chest pain
– Tachycardia
– Tachypenia
– Later sign is crackles
– Feeling of impending doom
60
Q

After a hip replacement you know that what leg position has to be maintained at all times?

A

Abducted so prosthesis does not become dislocate

61
Q

How would you explain phantom pain to your patient?

A

– 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
Q

What is begun in the rehabilitation phase?

A 
– 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
Q

Herpes Simplex, does it ever go away?

A

No, It can reactivate at any time

64
Q

Who would be at risk for skin cancer like basal cell carcinoma or melanoma?

A

– A person that is exposed to the sun a lot

65
Q

Folliculitis is….

A

Inflammation of a hair follicle

66
Q

What are the signs and symptoms of folliculitis?

A

Red lesions on the face after shaving

67
Q

Rules of nine for burns

A
  • 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
Q

What education would you perform for a patient with eczema?

A

– 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
Q

When you are assessing your patient for scabies what would you be looking for that indicates that the patient has them?

A

Wavy threadlike lines on the body and pruritus

70
Q

What could indicate that the patient has melanoma in a nevus or lesion?

A

– Irregular borders
– Multicolor
– Growing larger
– Abnormal asymmetry

71
Q

Ablative surgery is…..

A

Excision or removal of disease part

72
Q

With the older adult when using visual tools like printed material, you need to be aware of what?

A

Visual impairments

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