med surg proctored practice

Question 1

manifestations of SLE

Answer 1

1. butterfly rash
2. pericarditis
3. abdominal pain

Question 2

complication of plasmapheresis

Answer 2

1.hypocalcemia due to citrate

Question 3

adverse effects of hormonal therapy

Answer 3

1. calf pain or numbness in the arm (CVA)

2. intense headache (CVA)

Question 4

action post op total hip arthroplasty

Answer 4

place a pillow between the clients legs to prevent hip dislocation

Question 5

how to use crutches

Answer 5

Bad leg moves with crutches

1. place body weight on crutches
2. advance unaffected leg
3. shift weight to unaffected leg
4. move the crutches and the affected leg

Question 6

enoxaparin

Answer 6

1. acts like heparin (PTT and platelets)
2. inject with air bubbles (ensure that the client recieves the whole dose
3. give at the same time each day to maintain constant serum levels
4. do not massage to prevent bruising

Question 7

what lab value will be elevated in a patient who has prostate disease

Answer 7

acid phosphatase

Question 8

what does stridors indicate

Answer 8

narrow airway/possible obstruction

Question 9

nephrostomy tube actions

Answer 9

1. report back pain
   - indicates dislodged or clogged
2. red urine is normal for 24 hours

Question 10

how do you treat SVT

Answer 10

cardioversion

Question 11

what do you do if your TPN is about to run out but you dont have a new bag yet

Answer 11

run D10W or D20W

Question 12

when a client is restless after dialysis what can that indicate

Answer 12

disequilibrium syndrome caused by the rapid removal of electrolytes leading to dysrhythmias or seizures. Other manifestations include nausea, vomiting, fatigue, and headache

Question 13

modified mastectomy interventions post op

Answer 13

1. d/c the drain when there is an output of 25 mL or less in a 24 hour period
2. start exercising the arm 24 hours after surgery
3. keep arm elevated with pillow
4. keep HOB atleast 30

Question 14

metered dose inhaler

Answer 14

1. breath slowly and deeply
2. hold breath for 10 seconds
3. wait atleast 1 min inbetween puffs

Question 15

effects of long term ventilation

Answer 15

positive pressure decreases preload ->decreased CO -> fluid retention -> hyponatremia and decreased BP

Question 16

what condition do kussmaul respirations occur

Answer 16

hypercapnia and hyperglycemia

Question 17

what kind of dressing do you use for stage 3 pressure ulcers

Answer 17

hydrocolloid

Question 18

when do you use wet to damp dressing

Answer 18

for mechanical debridement

Question 19

when do you use nonadherent gauze dressing

Answer 19

little to no drainage

Question 20

interventions post lumbar puncture

Answer 20

1. dorsal recumbent position

2. fluids

Question 21

what does acetylcysteine do

Answer 21

thins pulmonary secretions

Question 22

what position do you put clients for insertion of central catheters

Answer 22

trendelenburg

Question 23

s/s of increasing ICP

Answer 23

1. increasing pulse pressure
2. decerebrate/decorticate
3. sleepiness

Question 24

what type of pain indicates cholecystitis

Answer 24

pain that radiates to the right shoulder

Question 25

suspected infiltration interventions

Answer 25

1. compare site to opposite extremity
2. if there is infiltration remove
3. apply warm compress to reduce pain and edema
4. elevate arm

Question 26

ileostomy teaching

Answer 26

1. dont let the bag get more then half full
2. avoid high fiber food
3. use a skin barrier when refitting the pouch system to protect the skin from enzymes and bile salts
4. clean the area around the stoma with mild soap and water

Question 27

what would you see for flail chest

Answer 27

paradoxic chest movements; outward on expiration and inward on inspiration

Question 28

s/s detached retina

Answer 28

1. curtain over eye
2. no pain
3. sudden onset
4. maintainence of peripheral vision

Question 29

hearing aid teaching

Answer 29

1. background noise will continue to be a challenge
2. dont wear it continuously
3. hearing wont go back to normal
4. keep hearing aid adjusted to lowest volume that allows client to hear

Question 30

what does tenting indicate

Answer 30

dehydration

Question 31

synchronous vs asynchronous mode

Answer 31

in asynchronous mode the pacemaker will fire at a continous fixed rate. in synchronous mode it will only fire if the heart rate falls below a certain level

Question 32

gastric lavage interventions

Answer 32

1. have client on left side to decrease the amount of NS that leaves the stomach and to prevent aspiration
2. instil 200-300 ml of NS at a time
3. use a large bore NG tube

Question 33

what medication can you give for cramps after hemodialysis

Answer 33

calcitriol -muscle cramps and tingling indicate hypocalcemia

Question 34

what is someone with diarrhea at risk for

Answer 34

hypokalemia

Question 35

myasthenia gravis

Answer 35

muscle weakness that gets worse with activity and better with rest. this occurs due to antibodies binding to or destroying acetylcholine receptors.

Question 36

s/s of hemolytic transfusion reaction

Answer 36

low back pain and apprehension(anxiety)

Question 37

s/s of a febrile transfusion reaction

Answer 37

chills and fever