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NR 463_Final Exam Flashcards

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1
Q
  1. Failure of the aortic valve to close completely allow blood to flow from?
  2. Patient teaching with infective endocarditis
  3. S/Sx of endocarditis?
A
  1. Aorta to left ventricle
  2. alway notify healthcare providers of this hx
  3. retinal/splinter hemorrhage, osler’s nodes, painless erythematous macules on the palms
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2
Q
  1. What is a sign of decreased CO in pt w/ aortic valv regurg?
  2. How to differentiate pericarditis from other cardiopulmonary problems?
  3. Pericarditis complications
A
  1. SOB on minimial exertan & diastolic murmur
  2. Pericardial friction rub
  3. pulsus paradoxus, distant heart sounds, distenden jug veins, falling BP
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3
Q
  1. Complications of thrombolytic therapy
  2. post-CABG limitations first 6 weeks
  3. Pt w/ PAD should NOT
A
  1. Tarry Stools
  2. no weight bearing
  3. elevate legs above heart, use heating pad, soak feet in hot water
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4
Q
  1. S/Sx of dumping syndrome
  2. How to prevent dumping syndrome
  3. Early S/Sx of dumping syndrome
A
  1. weakness, ab discomfort, abnormal bowel evacuation, after meals, after surgery
  2. Limit fluids with meals
  3. Pallor, syncope
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5
Q
  1. Duodenal ulcer is relieved by…
  2. What med is a risk factor for PUD
  3. Foods to AVOID with ulcerative colitis
A
  1. Food intake
  2. Taking ibuprofen (Motrin) for osteoarthritis
  3. dairy, beans, dried fruits, high fiber, nuts, raw fruits and veggies, seeds.
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6
Q
  1. Stool type with Crohn’s
  2. Purpose of NG tube continuous suction pt w/ small bowel obstruction
  3. An antirheumatic drug irritant for pt w/ PUD
A
  1. Loose, watery
  2. remove gas/fluids from stomach & intestines
  3. Indocin
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7
Q
  1. Risk factors for colorectral cancer
  2. Foods that increase risk for stomach cancer
  3. Signs of flail chest
A
  1. hx of ulcerative colitis or GI polyps
  2. smoked foods like bacon or ham
  3. Paradoxical chest movement
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8
Q
  1. PT treated for TB, when will no longer be contagious
  2. Most frequent early symptom of lung cancer?
  3. TB s/sx
A
  1. 2-3 weeks of med thearpy
  2. Cough, later- hoarseness
  3. Cough (yellow), chills, night sweats, dyspnea
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9
Q
  1. Concerning assessment Tension Pneumothorax
  2. Nurse instruction during removal of chest tube?
  3. Early signs of compartment syndrome
A
  1. dec CO, hyperresonance, tracheal deviation to opposite side, bradypnea
  2. exhale and bear down
  3. Numbness and tingling in the fingers
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10
Q
  1. How long does a plaster take to dry
  2. How should cast extremity be positioned?
  3. Technique for drying cast
A
  1. 24-72 hours
  2. elevate to reduce edema
  3. Cool setting on hair dryer
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11
Q
  1. Risk with a cast
  2. What is pt instructed to monitor with cast
  3. How do you achieve proper traction
A
  1. Skin integrity, don’t stick anything underneath
  2. pain, swelling, color, tingling, numbness, coolness or diminshed pulse. (notify HCP fo circulatory impairment)
  3. Weights need to be free-hanging, with knots away from pulleys.
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12
Q
  1. HOB with traction
  2. Can the nurse remove or lift weights?
  3. What should you examine
A
  1. kept low for countertraction (30-40 degrees)
  2. no need Dr. Order
  3. temperature, peripheral pulses, skin breakdown, numbmness, increase in pain, ropes pulleys
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13
Q
  1. Instructions for Total Hip Anthroplasty
  2. What does caffeine do to pt high risk for osteoporosis
A
  1. raised toilet seat, do not adduct leg or flex more than 90 degrees, sit in chairs that have arms, avoid putting on socks and shoes for 8 weeks
  2. Increases calcium loss in urine, along w/ smoking ETOH, steroids.
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14
Q
  1. Pre-Op Teaching
  2. Pre-op assessment data give should be strictly
  3. Activites performed by the scrub nurse
A
  1. Where she will be taken post op, DB,
  2. Objective
  3. prep instrument table, passing instruments, counting
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15
Q
  1. Before admitting a patient to OR, which forms must the nurse make sure are in the chart of all patients
  2. Circulating Nurse Role
  3. How can you enable patient to ambulate TCDB?
A
  1. Signed Consent, Hx/Physica, Preanesthesia assessment.
  2. coordination of surgical suite, documentation, electrical equiment, counting
  3. pain meds
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16
Q
  1. Post op pt has delirium, ABC’s are good. What first action
A
  1. check pre op assessment for previous delirium or dementia
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17
Q
  1. Preop Fentanyl/Atropine is most likely used for
  2. Most critical Hx to know prior to surgery
  3. Timeout consists of..
A
  1. decreased asethetic required
  2. history of death during surgery
  3. verify id band, ask PT to state surgical procedure, Have PT state name & DOB, confirm Surgical site
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18
Q
  1. If patient has a temp 100.4 post op, what is first action?
  2. What should you do with a trach before deflating the cuff
  3. What are possibilities with a trach
A
  1. use IS due to atelactasis risk (infection takes 48 hours)
  2. Suction
  3. not possible to speak, fenestrated if no aspiration risk, speaking trach may be considered.
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19
Q
  1. Chest Tube major concern
  2. Standard Chest Tube is
  3. If a patient has a Tube feeding and a Ct scan scheduled, what action
A
  1. SubQ Emphysema at Insertion site
  2. -20cm H2O
  3. shuff off feeding 30-60 min before
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20
Q
  1. 1 lb = ?? oz
  2. 1 lb = ?? kg
  3. Drop factor Formula
A
  1. 16 Oz
  2. 2.2 kg
  3. Volume/Time x Drop Factor = flow rate
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21
Q
  1. Calculating Dosage formula
  2. 1 oz, how manly mLs
  3. 1 tsp, how many mL?
  4. 1 tbsp
A
  1. Desire/Available x amount
  2. 30
  3. 5
  4. 15
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22
Q
  1. Calcium
  2. Magnesium
  3. WBC
A
  1. 8.6 - 10
  2. 1.6 - 2.6
  3. 4500-11,000
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23
Q
  1. K
  2. Sodium
  3. Bicarb
A
  1. 3.5 - 5
  2. 135 - 145
  3. 22 -29
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24
Q
  1. Hematocrit
  2. Hemoglobin
  3. Platelets
  4. PTT
A
  1. 45%
  2. 12 -15
  3. 150,000-400,000
  4. 9.5 - 11.8
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25
Q
  1. Glucose
  2. BUN
  3. Creatnine
A
  1. 70-110
  2. 8-25
  3. 0.6 - 1.3
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26
Q
  1. Chloride
  2. RBC
  3. Troponin I
A
  1. 98-110
  2. 4 - 6
  3. < 0.6 ng/mL
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27
Q
  1. Troponin T
  2. Myglobin
  3. CK-MB
A
  1. < 0.1 - 0.2 ng/mL
  2. < 90mcg/L
  3. 0 - 5%
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28
Q
  1. Intermittent claudication is
  2. SE of nitroglycerin
  3. Warfarin antagonist
A
  1. cramping in the legs induced by exercise, obstruction of the arteries
  2. dizziness, headache, hypotension
  3. Vitamin K
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29
Q
  1. Purpose of Cornoary Artery Bypass Graft
  2. Femoral popliteal bypass, nurse is most concerned if pt is
  3. HF is
A
  1. insert graft, anastomosed distally & proximally to bypass obstruction
  2. Clammy- hypovolemic shock
  3. failure of muscle to pump sufficient blood to meet body’s metabolic demands
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30
Q
  1. Characteristic signs of heart failure
  2. What should you check following cardiac catheterization
  3. Most important factor to maintain circulation
A
  1. tachycardia increased respirations
  2. extremeties for pulses (concern is trauma to vessels)
  3. blood volume
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31
Q
  1. What major vital sign would be altered in an elderly patient?
  2. when should hydrochlorothiazide be taken
  3. Major symptom of HF while sleeping
A
  1. Temperature
  2. with breakfast, diuresis could occur if taken at bedtime
  3. orthopnea- inability to breath while lying flat
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32
Q
  1. What is the purpose of a cardiac monitor
  2. Type of edema with cardiac failure is
  3. Antidote for heparin
A
  1. displays the patient’s heart rhythmn, to observe abnormalities
  2. dependent
  3. protamine sulfate
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33
Q
  1. If pt with iron deficieny receives heparin, what are you most concerned about?
  2. Digitalis Toxicity S/Sx
  3. When administering dopamine IV drip how in what unit
A
  1. Bleeding
  2. N/V, anorexia, visual disturbances, bradycardia,
  3. kilograms
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34
Q
  1. After aortofemoral bypass what position should the client be placed in?
  2. How do analgesics help an MI
  3. What is a side effect of propanolol that could affect pt with asthma
A
  1. Full supine- hip remain straight to prevent bleeding
  2. reduces pain and preload, which reduces workload of the heart
  3. bronchospasms
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35
Q
  1. What concern might you have after a CABG
  2. pain in the lower extremities not relieved by rest indicates
  3. How can it be relieved?
A
  1. sudden cessation of mediastinal c.t., HALLMARK sign is cardiac tamponade
  2. peripheral arterial disease (cold)
  3. placing in a dependent position
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36
Q
  1. How does nitro work?
  2. What do you clean a stoma with
  3. increased pain after eating is a characteristic of
A
  1. dilate peripheral vessels, thereby decreaseing preload
  2. soap and water
  3. gastric ulcer, relieved by vomiting
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37
Q
  1. Most common symptom of duodenal ulcer
  2. Gas forming vegetables
  3. Appropriate amt of drainage post op
A
  1. abdominal pain 2-3 hours after eating, food relieve pain
  2. onions, broccoli, radishes, beans cabbage
  3. 50 mL
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38
Q
  1. What is a low residue diet
  2. what pt would have this type of diet?
  3. Cramping pain in the LLQ w/ irregular bowel function & diarrhea
A
  1. tender cooked meats, no fiber, or pulp in juices
  2. bowel inflammation, regional enteritis
  3. diverticulitits, increased pain w/ coughing bending lifting
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39
Q
  1. Why is PN delivered at a constant rate of infusion
  2. how is hep A is spread fecal oral route,
  3. Full liquid diet includes..
A
  1. to prevent unstable glucose level
  2. do not share eating utensils
  3. milk, custards, veg/fruit juice, strained cereal, butter margarine cream
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40
Q
  1. most important when applying new ileostomy bag
  2. Srugical unit after ileostomy, FIRST action
  3. Clear liquids
A
  1. fits snugly, to prevent fluid on the abdomen
  2. Measure output, assess
  3. minimal residual, relieve thirst/maintain f&E
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41
Q
  1. How do you always assess pain
  2. What can cause peritonitis
  3. S/Sx of Peritonitis
A
  1. Character and intensity
  2. ruptured appendix
  3. ab rigidity, dec bowel sounds, N/V,
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42
Q
  1. Common affect of chronic bronchitis
  2. What discourages a COPD pt to breath
  3. Best way to determine hypoxic
A
  1. Rust blood tinged sputum
  2. high flow oxygen eliminates their drive to breathe
  3. ABG’s
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43
Q
  1. Early sign of oxygen toxicity
  2. What is tension pneumothorax
  3. What urgent intervention is needed?
A
  1. non productive cough, nasal congestion, sore throat
  2. Air pressure lung, deviated trach
  3. Chest tube w/ suction drainage- converts to open pneumothorax
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44
Q
  1. If a chest tube for tension pneumo is no available, next best thing?
  2. Mantoux Test id aministered
  3. Where should head be positioned when trach is suctioned
A
  1. thoracentesis, removes air
  2. Intradermal, its the PPD
  3. the opposite from the bronchus being suctioned
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45
Q
  1. What is a potential hazard near oxygen tank
A
  1. nail polish, flammable
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46
Q
  1. osteoarthritis- stiffness or swelling?
  2. what is an early sign of compartment syndrome
  3. characteristics of paget’s disease
A
  1. stiffness
  2. inability of pain med to relieve pain (neurovascular assess)
  3. kyphosis and bowing of the legs
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47
Q
  1. Characteristic of myasthenia gravis
  2. Why?
  3. What could this lead to
A
  1. tiredness with slight exertion
  2. acetylcholine deficiency, difficult to stimulate muscular movement.
  3. weakness of respiratory muscles
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48
Q
  1. What are absence seizures
  2. What can basilar skull fracture cause
  3. What does MS involve
A
  1. momentary loss of consciousness, “blank stare”
  2. leakage of CSF test positive for glucose
  3. cerebellum- balance
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49
Q
  1. Manifestation of MS
  2. How to prevent sensory deprivation
  3. What is brudzinski’s sign
A
  1. Urinary retention, hyperreflexia of extremeities, ataxia, dec concentration
  2. asesss support sys for pt who is isolated
  3. flexing head and flexing hip and knee
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50
Q
  1. What does brudzinski’s, kernig’s sign represent
  2. Patient with right sided hemiglegia, what type of diet?
  3. Meniere’s disease pt experiences
A
  1. menigitis, call HCP
  2. pureed, easy to swallow
  3. vertigo, place pillow either side of head
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51
Q
  1. Technique for preventing sensory overload on a patient
  2. What should nurse prevent in patient with intracranial pressure
  3. Major risk factor for developing CVA
A
  1. combine activities into one visit
  2. valsalva maneuver
  3. hypertension
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52
Q
  1. Glascow coma scale of 7 or less indicates
  2. spinal cord injury T3, pounding headache and nasal congestion
  3. Parkinsons diet
A
  1. pt is comatose and eyes may stay open, preven corneal irritation
  2. bladder distention, foley cath for kinks
  3. thick liquids are easier to swallow
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53
Q
  1. patient with trigeminal neuralgia diet
  2. when do parkinsons experience tremors
  3. Caffeine and EEG test
A
  1. hot foods can trigger pain episode, also too cold
  2. at rest, give activity to perform
  3. restrice caffeine 1-2 days prior (hot chocalate included)
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54
Q
  1. Onset of parkinsons
  2. Is it unilater or bilateral
  3. Classic signs of parkinsons
A
  1. Gradual
  2. can start on one side of the body
  3. tremors, rigidity, bradykinesia (tremor is the 1st sign)
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55
Q
  1. How can you diagnose parkinsons
  2. Collaborative care for parkinsons included
  3. Drugs used for parkinsons
A
  1. positive response to antparkinson drugs, hx & physica, MRI, SE’s to haloperidol (psychotic drugs)
  2. antiparkinson drugs, deep brain stimulation, ablation surgery
  3. dopaminergics, dopamine agonists, anticholinergics, antihistamine, MOI, Catechol OMT
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56
Q
  1. Dopaminergic drugs
  2. anticholinergic drug
  3. antihistamine like benadryl have a…
A
  1. levodopa/carbidopa, converts to dopamine in basal ganglia
  2. benztropine- help balance cholinergic and dopaminergic activity
  3. anticholinergic effect
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57
Q
  1. drugs that end in -agiline
  2. COMT inhibitors
  3. What should you assess in appearance with parkinsons?
A
  1. Monoamine Oxidase inhibitors, block break down of dopamine
  2. block break down of levodopa
  3. Mask liked face, slow monotone speech
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58
Q
  1. What might you see in skin with parkinsons?
  2. Cardiovascular parkinsons
  3. GI Parkinsons
A
  1. sobrrhea, dandruff, ankle edema
  2. postural hypotension
  3. drooling
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59
Q
  1. What will you notice in hands of parkinsons
  2. MSK parkinsons
  3. What will be your first nursing dx
A
  1. pill rolling
  2. rigid, bradykinesia, contractures, stooped posutre, shuffling gait
  3. Impaired physical mobility r/t rigidity, bradykinesia
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60
Q
  1. Another very important nurisng dx
  2. What happens to their swallowing ability in parkinsons?
  3. Why should they perform physical exercise
A
  1. Imbalanced nutrition less than body requirments r/t inablility to ingest food
  2. impaired, assess gag reflex
  3. to deter muscle atrophy and joint contractures
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61
Q
  1. Other Nursing Dx
  2. Does parkinsons have acute exacerbations?
  3. goal is to
A
  1. Impaired swallowing, impaired verbal communication
  2. no
  3. maintenance, independence, avoid contractures and falls, promote exercise
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62
Q
  1. What happens to levodopa with Sinemet drug?
  2. How does MS develop, according to belief?
  3. 3 Pathological porcesses in MS
A
  1. converts to dopamine in the CNS, serves as a neuro transmitter. Relief fo tremors
  2. genetics, environmental exposure, infection
  3. Chronic inflammation, demyelination, gliosis (scarring) in the CNS.
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63
Q
  1. What is the primary neurpathic condition of MS
  2. What would an MRI of the brain or sminap cord show with MS
  3. What would CSF show with MS
A
  1. autoimmune, activated by T cells.
  2. plaques, inflammation, atrophy, tissue breakdown
  3. increase in IgG, oligoclonal banding
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64
Q
  1. How must a person be diagnosed with MS x3
  2. Early symptoms of MS
  3. End stage MS
A
  1. 2 inflammatory demyelinating lesions in CNS, attack occuring at diff times, rule out other dx
  2. blurred vision, thinking, balance/coordination, numbness, tingling
  3. Respiratory, SOB, secretions, pain, urinary retention, paralysis, nystagmus, dec hearing, hyperreflexia
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65
Q
  1. Treatment MS
  2. Drug therapy
  3. TX for incontinence
A
  1. maximize neuromuscul ftn, adls, mgmt fatigue, psychosocial, reduce exacerbations
  2. Interferon, immunomodulators, immunosuppressants, steroids, relaxants,
  3. no smoking, weight loss, scheduled voiding, pelvic floor muscle, kegil exercises
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66
Q
  1. Causes of exacerbation in MS
  2. Tx of flare ups
  3. General assessment of MS
A
  1. inflammation, stress
  2. steroids, focus on immobility, respiratory and UTI’s and pressure ulcers
  3. apathy, inattentiveness
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67
Q
  1. Skin assessment MS
  2. Neurologic asessment MS
  3. MSK MS
A
  1. pressure ulcers
  2. speech, nystagmus, ataxia, tremors, spasticity, decreased hearing
  3. muscle weakness, paresis, spasms, foot dragging, dyarthria
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68
Q
  1. What is the primary diagnoses for MS
  2. Name another nursing dx
  3. what is the purpose of a lumbar puncture?
A
  1. Impaired phys mobility r/t muscle weakness or paralysis
  2. impaired urinary elimination r/t sensorimotor deficits, knowledge deficit
  3. CSF is aspirated by needle insertion in L3-4, or L$-5 to assess CNS diseases
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69
Q
  1. What should you ensure patient does NOT have s/sx of for lumbar puncture?
  2. What position should pt be in for lumbar puncture
  3. Aseptic or Sterile technique?
A
  1. ICP, risk of downward herniation from CSF removal
  2. lateral recumbent
  3. Aseptic
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70
Q
  1. What position for post lumbar puncture?
  2. Assessment of fluid of lumbar puncture
  3. Complication of Lumbar puncture
A
  1. Prone for 4-8 hours, if not supine. Turn Side to Side.
  2. Clear, pressure 60-150, protein 15-45, glucose 50/75, minimal WBCs. No bacteria
  3. Spinal fluid leak (clear), severe headache
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71
Q
  1. Clincal manifestation of hemorrhagic stroke?
  2. S/Sx of stroke
  3. Pathophysiology of Stroke/TIA
A
  1. Same as ischemic stroke, sudden headache
  2. weakness paralysis of one side, numbness, sudden confusion, trouble speaking, slurred speech, vision problems, dizziness, loss of balance, difficulty swallowing
  3. Atherosclerosis
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72
Q
  1. How long does TIA last
  2. What is the difference between TIA and stroke
  3. Risk factors of stroke
A
  1. 1 hour to 24 hours, early warning sign
  2. no infarction, ischemia to brain, no brain damage, symptoms resolve
  3. HTN, exercise, diet, diabetes
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73
Q
  1. # 1 Intervention for stroke
  2. other ways of management
A
  1. CT scan immediately #1, standing order
  2. MIR, Cardiac Monitor (afib?), echo, carotid NIVA, lipid pane, Coag panel, Hgb A1c
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74
Q
  1. Treatment for Stroke
  2. What makes them a candidate for tPA
A
  1. Antihypertensive, Antiplatelet, Carotid Endarterectomy, thrombolytics, coumadin, Rehab, MGMT of cerebral edema, seizure prevention, clot retrieval, stents
  2. not a hemorrhagic, < 3 hours
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75
Q
  1. Cerebrum affects
  2. Basal Ganglia affects
  3. Diancephalon
A
  1. Cognition
  2. Motor control (parkinsons)
  3. ANS (breathing)
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76
Q
  1. Cerebellum affects
  2. Brainstem affects
A
  1. balance
  2. airway
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77
Q
  1. Emergency MGMT for Stroke
A
  1. CT scan
  2. Ensure patent airway
  3. Stroke code
  4. remove dentures
  5. pulse oximetry
  6. IV access
  7. Remove clothing
  8. baseline tab tests,
  9. head in midline
  10. HOB 30 degrees
  11. Seizure precautions
  12. NPO
78
Q
  1. Priority teaching family for stroke
A
  1. Call 911 and get med help if someon has 1 of the following symptoms
  2. check the time to know when first symptom appeared
79
Q
  1. Right Brain Stroke damage affects what side
  2. Symptoms
A
  1. Left paralyzed
  2. Spatial deficits, denies problems, rapid performance, short attention span, impulsive safety problems, impaired judgment, impaired time concept
80
Q
  1. Left brain stroke affects what side
  2. Symptoms
A
  1. Right Side paralyzed
  2. impaired speech/language, r/l discrimination, slow performance, cautious, aware of deficit, anxiety, depression, impaired comprehension r/t language math
81
Q
  1. Wernicke’s area affects
  2. Broca’s Area affects
A
  1. Senses and Speech, temporal lobe, AUDITORY center
  2. moral, emotions, reasoing, judgment, FRONTAL (Right Side Brain damage)
82
Q
  1. What is dysarthria
  2. Lowest possible score on Glasgow Coma
  3. Highest possible score?
A
  1. distsurbed muscular control of speech- pronunciation, articulation, phonation
  2. 3= deep coma or death
  3. 15, fully awake
83
Q
  1. What does the glasgow coma scale measure
  2. What is the NIHSS
  3. What is the procedure for NIH
A
  1. Motor, verbal, eye opening
  2. neuro exam, evaluate acute attack
  3. rates pt’s ability to answer questions and perform activites.
84
Q
  1. What is homonymous hemianopsia
  2. Cause of this?
  3. MGMT of homonymous hemianopsia
A
  1. loss of vision in one side of visual field
  2. lesions in the contralateral occipital lobe
  3. arrange env’t within perceptual field
85
Q
  1. Transfer technique for stroke patient
  2. What is a critical factor for stroke pt for discharge?
  3. When do pt have maximum recovery from rehab?
A
  1. Chair near pt’s strong arm, never lift from neck, ensure feet are flat on the ground when moving
  2. performing ADLs
  3. 1st year
86
Q
  1. What does the nurst pay attention to during rehab stroke? x6
A
  • Pt’s rehab potential
  • phys status of body systems
  • complication caused by stroke/chronic conditions
  • pt’s cognitive status
  • family resources/support
  • expectations of the pt & caregover rt/t rehab program
87
Q
  1. What does aspirin do?
  2. What does plavix do?
  3. What is a side effect of aspirin
A
  1. inhibiting prostaglandins, decrease platelet aggregation
  2. inhibits platelet aggregation by inhibit bind of ATP to receptors
  3. GI bleed, indigestion, nausea, anorexia
88
Q
  1. what should nurse monitor with aspirin
  2. what should nurse monitor with plavix (clopidogrel)
A
  1. don’t give to pt’s with asthma or allergies, hypersensitive
  2. monitor for signs of thrombocytic purpura. Bleeding time. Platelet count.
89
Q
  1. Purpose of an EGD
  2. Status of patient prior to procedure
A
  1. visualize mucosal lining of esophagus, stomach, and duodenum. Can see motility, inflammation, ulcerations, tomros, varices, or mallory weiss tears.
  2. 8 hrs NPO, local anestesia sprayed on throat, will be sedated
90
Q
  1. Post NPO EGD procedure
  2. What is the purpose of a colonoscopy
A
  1. NPO until gag reflex returns, saline gargles for relief, check temp q15-30 min
  2. Used to detect inflammaotry bowel disease, polyps, tumors and diverticulosis. Polyps can be removed.
91
Q
  1. Pre procedure colonoscopy
  2. Post procedure colonoscopy
A
  1. side lying position. Will be sedated.
  2. abdominal cramps, bowel is inflated during procedure, watch for rectal bleeding and perforation. Check vitals
92
Q
  1. Diet for patient with GERD/hiatal hernia
  2. What can caffeine, alvocol, smoking cause
  3. What should they do after eating
A
  1. Low fat, small frequent meals to prevent gastric distention
  2. increase in LES pressure (lower esophageal sphincter)
  3. DO NOT lie down for 2-3 hours, wear tight clothing, or bend over
93
Q
  1. When should GERD pt eat before bed
  2. HOB for sleeping
  3. When should they take PPI meds
A
  1. 3hr before
  2. 4-6 blocks, gravity fosters esophageal emptying. 30 degrees
  3. before first meal of the day
94
Q
  1. 3 Major complications of PUD
  2. What is the most lethal complications
  3. What is perforation
A
  1. Hemorrhage, perforation, gastric outlet obstruction
  2. Peforation, seen mostly in duodenal ulcrs
  3. spillage of gastric/duodenal contents in peritoneal space
95
Q
  1. What do H2 blockers do
  2. What do PPI’s do
  3. What do antacids do?
A
  1. promote ulcer healing -tidine
  2. reduce gastric acid secretion, healing, used in combo w/ antibiotics for H.pylori
  3. increase gastric pH
96
Q
  1. What does sucralfate used for
  2. What is misoprostol used for
  3. prior to gastric surgery when should you notify HCP
A
  1. short term tx of ulcers. provides cytoprotection of esophagus, stomach and duodenum.
  2. prostaglandin to prevent gastric ulcers caused by NSAIDS.
  3. If NG tube is not functioning properly
97
Q
  1. Actions for acute exacerbation of PUD with complications
A
  • NPO
  • NG suctioin
  • IV PPI
  • Bed rest
  • Fluid replacement LR’s
  • Blood transfusion
  • Stomach lavage
98
Q
  1. What color upper GI bleed
  2. Lower GI bleed
  3. complication with inflammotry bowel disease
A
  1. dark tarry
  2. red
  3. joints, finger clubbing, erythema, mouth ulcers, conjuctivitis, gallstones, kidney stones, liver disease, osteoporosis, embolism
99
Q
  1. Complications with Ulcerative colitis
  2. Complications with Crohn’s
A
  1. strictures, perforation due to toxic megacolon, CRC, surgery cures
  2. fistulas, strictures, anal abseccesses, perforation due to inflammation of entire bowel, increased incidence of Small intestine cancer
100
Q
  1. Goals of treatment for IBD
  2. What do 5 ASA do for IBD
  3. What does antimicrobes do for IBD
A
  1. rest bowel, control inflammation, combat infection, corect malnutrition, alleviate stress, provide sympotmatic relief, improve quality of life.
  2. decrease GI inflammation, through direct contac with bowel mucosa
  3. prevent secondary infection, decrease inflammation
101
Q
  1. Biologic and targeted therapy (immunomodulators)
  2. Antidiarrheals
A
  1. inhibit cytokine tumor necrosis
  2. decrease GI motility
102
Q
  1. What do hematinics and vitmains do
  2. why are enteral feeding preferred over parenteral
  3. Why would NG tube be used
A
  1. correct iron deficiency, anemia and promote healing
  2. bacterial overgrowth when the gut is not being used.
  3. during exacerbation when can’t tolerate reg diet
103
Q
  1. What does CBC show for IBD
  2. What does elevated WBC show
  3. Tests that can be done to diagnose
A
  1. iron deficiency anemia from blood loss
  2. toxic megacolon or perforation
  3. Barium enema, transabdominal ultrasound, CT, MRI, colonoscopy, occult blood
104
Q
  1. Priority Actions for Chest pain
A
  1. Assess, pain, HR, and BP
  2. Administer nitro tablet
  3. stay with pt
  4. reasses in 5 min
  5. admin another nitro tab if pain not relieved and bp is stable
  6. reassess in 5 min
  7. if third nitro tab does not relieve pain, contact HCP
105
Q
  1. Signs of Perforation
A
  1. guarding ab, increased fever/chills, pallor, ab distention, restless, tachycardia
106
Q
  1. What is a total gastrectomy
  2. What is a vagotomy
  3. What is gastric resection
A
  1. removal of stomach w/ attachment of esophagus to jejunum
  2. division of the vagus nerve to eliminate vagal impulses that stimulate hydrochloric acid secretion in the stomach
  3. removal of lower half of stomach, includes vagotomy
107
Q
  1. What i bill roth 1
  2. What is billroth 2
  3. What is pyloroplasty
A
  1. partial gastrectomy with remaining to duodenum
  2. anastomosed to the jejunuum
  3. enlargment of the pylorous to prevent obstruction enhancing gastric emptying
108
Q
  1. What about NG tube prior to surgery
  2. Manifestation of peritonitis
  3. Dx for peritonitis
A
  1. do not touch, contact HCP if tube is not functioning
  2. pain over involved area, tenderness, rigidity, distention
  3. CBC,, electrolytes, xray, paracentesis culture, CT scan, peritoneoscopy
109
Q
  1. Peritonitis Pre op
  2. Peritonitis Post Op
  3. Small intestine obstruction is rapid or gradual?
A
  1. NPO, iv fluids, antibiotics, NG suction, analgesics, oxygen PRN,
  2. NPO, NG tube low intermittent suction, SemiFowler, IV fluids, parenteral nutrition, antibiotic, blood transfusion, sedative/opioids
  3. rapid
110
Q
  1. Large intestine obstruction is rapid or gradulal
  2. Small intestine vomiting?
  3. Large intestine vomiting
A
  1. gradual
  2. frequent and copious
  3. rare
111
Q
  1. Small intestinte pain type (obstruction)
  2. Lg intestine paint type
  3. Bowel movement sm intestine obstruction
  4. Large intestine obstruction bowel movement
A
  1. Colicky, cramplike , intermittent
  2. low grade, cramping, ab pain
  3. feces for a short time
  4. absolute constipation
112
Q
  1. When is emergency surgery performed for bowel obstructino
  2. Nursing Care for bowel obstruction
  3. Problems caused by NG tube for obstruction
A
  1. strangulation
  2. NPO status, NG tube for decompression, IV fluids NS or LR, potassium verify renal function and pain control
  3. Fluid volume deficit related to suctioning
113
Q
  1. Manifestation with colorectal cancer
  2. Surgery for CRC
  3. # 1 Nursing Dx for -Ostomy
A
  1. iron deficiency, rectal bleeding, ab pain and change in bowel habits, obstruction or perforation
  2. Laparoscopic colectomy, right hemicolectoomy, abdonminal resection
  3. Risk for fluid volume deficit
114
Q
  1. What should you observe for with fluid volume deficit
  2. Another Nursing Dx related to Ostomy
  3. Goals
A
  1. dehydration, delayed cap refill
  2. Skin Integrity
  3. no signs of hypovolemia, maintain skin intact, demonstrate function of ostomy
115
Q
  1. Diet for person with diverticular disease?
  2. Lifestyle changes with diverticular disease
  3. What else should they consider
A
  1. High fiber, stool softeners, clear liquid, bulk laxatives,
  2. weight reduction
  3. Bed rest, anticholinergics,
116
Q
  1. Most common Sx of diverticulitis
  2. What are diverticula
  3. Diverticulosis
A
  1. Pain in LLq (sigmoid colon), palapable mass, infection.
  2. Outpouches of the colon
  3. no symptoms typically.
117
Q
  1. MI is commonly known as
  2. Angina is commonly known as
  3. Causes of MI
A
  1. Heart Attack
  2. Chest pain with activity
  3. Blockage of blood supply to heart muscle
118
Q
  1. Causes of Angina
  2. Damage of MI
  3. Damage of Angina
A
  1. decrease i blood sypply to heart muscle
  2. heart irreversible
  3. no damage
119
Q
  1. Symptoms of both MI and Angina
  2. Duration of pain for MI
  3. Duration of pain for Angina
A
  1. pressure in the chest, radiate to neck lower jaw, left arm/shoulder.
  2. more than 15 minutes
  3. < 15 minutes
120
Q
  1. Risk factors for CAD x7
A
  1. Hypertension, Lipids, Tobacco use, Sedentary, Stress, Obesity, Diabetes.
121
Q
  1. Hypotension priority response?
A
  1. O2
  2. Inspect Incision
  3. IV fluid bolusdrug intervention/vasoconstrictors.
122
Q
  1. Order of operation for post op assessment x8
  2. What do you assess in the airway?
A
  1. Airway, Breathing, Circ, Neuro, Gastro, GU, Surgical Site, Pain
  2. e tube, mask, oral/nasal airway
123
Q
  1. # 1 priority post op
  2. # 2 Priority post op
  3. What does TCDB prevent?
A
  1. Positioning, prevent skin break down, lateral recumbent until arousal, then semifowler
  2. Turn Cough Deep Breathe
  3. PE/FE, hypostatic pneumonia buildup of secretions
124
Q
  1. # 3 post op priority
  2. # 4 Post op priority
  3. # 5 Post op priority
A
  1. Incenstive Spirometer; risk for paralytic ileus- intestinal block, atelactasis
  2. I/Os, profusion of kidneys
  3. Early ambulation
125
Q
  1. Why is a tracheostomy used?
  2. What can a trach do?
  3. Examples of tach being used
A
  1. artifical airway for longer than 10 -14 days, bypasses an obstructed upper airway, clean and remove secretions
  2. can deliver oxygen easer
  3. vocal cord paralysis, obstructive sleep apnea, foreign body obstruction
126
Q
  1. What does a Cuffed (balloon) endo tube prevent?
  2. What does an inflated cuff prevent?
  3. What does a low pressure cuff do?
A
  1. Aspiration, ensures set tidal volume
  2. air passing to vocal cords, nose or mouth
  3. Reduce risk of pulmonary aspiration
127
Q
  1. Why is an obturaror at the bed side
  2. What type of procedure is trach
  3. What do you clean the inner cannula with
A
  1. to facilitate reinsertion of trach if dislodged outer cannula
  2. sterile
  3. Clorhexidine, peroxide, full or 1/2 strength, or saline
128
Q
  1. Adult suction pressure
  2. How long should you wait between suction
  3. How long should suctioning take
A
  1. -80 to -120
  2. 30 sec
  3. 15 sec
129
Q
  1. Ways to determine suction needs
  2. Open suction
  3. Closed suction
A
  1. O2, color, restless, breath sounds
  2. new sterile cather each suction
  3. suction is reusable
130
Q
  1. What is used to lubricate a trach catheter
  2. What is a trach plug
  3. what is it used for
A
  1. Saline
  2. decannulation of trach tube
  3. speech, not speaking valve.
131
Q
  1. What is a pneumothorax
  2. What is a hemothorax
  3. Name 3 chest tube systems
A
  1. air/gas in the cavity btwn lungs and chest causing collapse
  2. pleural effusion, blood accumulates in pleural cavity
  3. collection, water seal, suction control chambers.
132
Q
  1. What should physician order after removal of chest tube
  2. when checking to see of all connections of c.tube are secure what should you feel for?
  3. Prior to removal of chest tube, what to assess?
A
  1. pain med
  2. crepitus or empyema (air, gas under skin)
  3. RR, O2, Tachypnea, hypoxia, resp distress, lungs, pain
133
Q
  1. Bubbbles upon initial insertion or when air is being removed is…
  2. Fluctuation of the level of water in the seal with inspiration and expiration is called?
  3. Normal or abnormal
A
  1. Normal
  2. tidaling
  3. Normal
134
Q
  1. Constant bubbling is it normal or abnormal?
  2. Prioritis if chest tube becomes disconnected?
A
  1. Abnormal, could be an air leak
  2. submerge tube in saline t create water seal, stay w/ pt, assess resp distress, HCP
135
Q
  1. If chest tube becomes dislodges?
  2. -orrhaphy means
  3. -ostomy means
A
  1. pinch skin together, apply occlusive sterile dressing, cover with 2 inch tape, call HCP!
  2. repair of suture
  3. creation of an opening
136
Q
  1. -otomy
  2. -plasty
  3. What is a colostomy
A
  1. cutting into or incision
  2. repair or reconstruction
  3. opening to bring colon to surface of ab
137
Q
  1. What is a illeostomy
  2. How often do you change ostomy pouch
  3. When should you empty pouch
A
  1. opening to bring small intestine to surface of abdomen
  2. 3-7 days
  3. when 1/3 full. Assess outpus, odor, amount, color
138
Q
  1. Can you wear pouch inside underwear
  2. can you put tape to fix a leaking pouch
  3. what should you check before applying new wafer
A
  1. yes
  2. no
  3. skin is clean and dry
139
Q
  1. How do you know an NG tube is in the wrong place?
  2. How do you measure the proper length of tube for NG
  3. Why do you elevate HOB to 30 degrees?
A
  1. trachea- presence of air escaping
  2. tip of nose to ear , xiphoid process to sternum.
  3. promote swallowing, aspiration
140
Q
  1. How to assess tolerance of tube feeding?
  2. How oftern should gastric residual be checked
  3. When should you hold the feeding and notify HCP
A
  1. GRV, ab distention, N/V, diarrhea, constipation, delayed g. emptying, listen to lung osunds, monitor aspiration.
  2. 4 hours
  3. aspiration, GRV is > 500 ml, ab distention
141
Q
  1. How to prevent cloggin of feeding tube
  2. If dobhofff or PEG becomes dislodged
  3. How often do you replace TPN tube and bag?
A
  1. crush meds, flush before and after, dilute viscous solutions, use liquid meds
  2. stop infusion, flush with saline/heparin, if unsuccssful, aspirate, follow protocol
  3. every 24 hours
142
Q
  1. How often do you change lipid tube
  2. Where is tpn stored?
  3. What to do S/Sx of air embolism
A
  1. every 12 hours
  2. fridge
  3. left trendlenburg position
143
Q
  1. Can you adminster TPN on a gravity pump
  2. What can be added to a blood bag
A
  1. no must be at a constant rate in an infusion pump
  2. saline ONLY
144
Q
  1. Priority Action for blood transfusion reaction
A
  • stop transfusion
  • chang iv tubing, keep iv line open
  • notify HCP
  • stay with patient
  • monitor vs ever 5 min
  • prep ER meds
  • obtain urine specimen
  • return bag and tubing to blood bank
  • document
145
Q
  1. Pre transfusion
  2. How long can blood be left out of fridge
  3. how long does blood transfusion take
A
  1. need consent, baseline vs, if temp > 100 notify hcp
  2. 20-30 min
  3. 2 hours, risk for bacteria infection
146
Q
  1. Where is admin of blood take place and how many nurses?
A
  1. bedside, 2 nurses verify
147
Q
  1. How long should the nurse stay with the patient to ensure transfusion rx is NOt occuring?
  2. What is a standard isotonic solution
  3. Trach tube, suctioning, when to hyperoxygenate?
A
  1. 15 minutes
  2. Sodium Chloride (w/o dextrose)
  3. Before (step 1) and after
148
Q
  1. Why should you NOT suction while advancing the catheter?
  2. How often should you auscultate breath sounds for an unconscious patient
  3. Why should you hyeroxygenate before, during, after for unconscious pt.
A
  1. cause mucosal trauam and aspiration
  2. Every 2 - 4 hours
  3. minimize cerebral hypoxia
149
Q
  1. When is a cuffed tube used?
  2. Action before patient wants to eat with trach tube
  3. What could bleeding mean if longer than a few hours of trachostomy?
A
  1. Mechanical ventilation
  2. inflate cuff (if cuffed)
  3. rupture of a vessel call HCP, URGENT LIFE THREATENING
150
Q
  1. What sound indicates a need for suctioning?
  2. routine care of chest tube, make sure that….
  3. Where should drainage sys maintain w/ c.t.
A
  1. Rhonchi
  2. connection btwn c.tube & drainage sys is taped, occlusive dressing is maintated at insertion site
  3. below client’s chest
151
Q
  1. Approximately how much drainage w/ c.t.?
  2. If you see continuous gentle bubbling in suction control chamber…
  3. Water seal chamber constant bubbling indicates (insp, exper)
A
  1. 50 mL expected
  2. normal finding (b/c not intermittent)
  3. Leak, call HCP– (intermittent bubbling is normal!)
152
Q
  1. Complication w/ TPN
  2. Why taper TPN?
  3. Why monitor temp with PN
A
  1. glucose, infection, fluid overload, embolism, electrolyte imbalance
  2. Avoid hypoglycemia
  3. Risk of infection
153
Q
  1. Why monitor weight with PN?
  2. What % of dextrose solution to avoid sclerosing of veins
  3. When will pt experience delayed gastric emptying?
A
  1. Hypervolemia risk
  2. no higher than 10%
  3. residual is greater than 150 mL
154
Q
  1. How often should nurse check NG tube?
  2. When do you know a colostomy is functioning?
  3. Name a complication with ileostomys?
A
  1. every 4 hours
  2. passing gas
  3. F &E imbalance
155
Q
  1. Recommended diet first 4-6 weeks with colostomy?
  2. How do you know a pt has “accepted” colostomy?
  3. If a patient does not TCDB, what can it lead to
A
  1. Low fiber, (after-high carb, high protein)
  2. When they participate in the care.
  3. Pneumonia, retianed pulmonary secretions
156
Q
  1. What does heparin do
  2. Low molecular weight heparin
  3. Warfarin (Coumadin)
A
  1. prevents conversion of firbinogen to fibrin and prthrombin to thrombin
  2. bin to antithrombin III, enhancing its effect
  3. Interferes with hepatic synthesis of Vitamin K (alternative when aspirin or plavix can’t be used)
157
Q
  1. ACE inhibitors
  2. Beta blockers
  3. Thrombolytic agents
A
  1. prevent conversion of angiotensin I to angiotensin I result is vasodilation
  2. inhibit SNS of the heart, reduce rate, contractiility and BP, decrease afterload
  3. breaks up firbin meashwork in clots, only for ST elevation of MI
158
Q
  1. MI pt skin color
  2. Primary nursing DX for Acute Cornoary Syndrome
  3. Intervention
A
  1. clammy cool to touch
  2. Decreased cardiac output, AEB decrease in BP
  3. monitor rhthmn/rate and trends in BP, effective oxygen thearpy, Labs )troponin, CK-MB), also vital organs
159
Q
  1. What is the priority goal of Acute Coronary syndrome
  2. Most common complication post MI
  3. Other complications..
A
  1. stable signs of cardiac output
  2. dysrhythmias
  3. HF, Papillary Muscle Dysfunction, Ventricular Aneurysm, Dressler, Pericarditis.
160
Q

Priority Action ofr Dysrhythmias

A
  1. ABCs
  2. O2
  3. Baseline vitals, including O2 sat
  4. 12 lead EKG w/ continuous monitoring
  5. Rate/rhthm
  6. Identify
  7. Establish IV access
  8. Baseline labs
161
Q
  1. How do you decrease workload of heart after MI
  2. What position for Heart Failure
A
  1. Aspirin, other meds, oxygen, angioplasty
  2. High Fowler’s
162
Q
  1. Early signs of Heart Failure
  2. Goals for a patient having an MI
  3. Endovascular repair for AAA
A
  1. chest/jaw pain, SOB, N/V. seating, heart burn, malaise
  2. decrease pain
  3. minimally invasive, sutureless aortic graft into the abdominal aorta.
163
Q
  1. Open repair AAA
  2. What protein is released post MI
  3. What protein is sensitive to MI inury
A
  1. make an aincision, both techniques have similar morbidity rate
  2. Troponin
  3. Myoglobin
164
Q
  1. What hormone is released when ventricles are overworked?
  2. What hormone is released when atria is overworked
  3. Post op MGMT for AAA
A
  1. BNP, excessive stretch
  2. ANP
  3. continuous EKG, pulse ox,., chest tubes, pain meds, epidural or PCA
165
Q
  1. Complications post op AAA
  2. What else should you check for
  3. What should you check post op peripheral arterial bypass
A
  1. Ischemia, dysrhythmia, infection, VTE, neurlogic complications
  2. graft patency(BP) and renal perfusion.]
  3. CMS checks
166
Q
  1. Post Cardiac Cath, notify HCP if
  2. What if there is bleeding
  3. post op cardiac cath teaching
A
  1. dysrhythmias, cheest pain, numbness, tingling, cool extremeities
  2. apply pressure and call physician’
  3. no heavy lifting
167
Q
  1. What assessment is important for most valvular syndromes
  2. What diagnostic is important for most valvular syndromes
  3. What does it measure
A
  1. peripheral arterial, hypotension, abnormal rhythmn
  2. Cardiac Cath, Angiogram
  3. pressure gradient across valvues, size of valve openings
168
Q
  1. What valvular disease should you NOT give Nitro
A
  1. Aortic Valve Stenosis, hypotension
169
Q
  1. Nursing MGMT for Valvular disorders
  2. For a mechanical valve replament what is the med regiment
  3. What is a valvulotomy
A
  1. diagnose/tx strep infections, antibiotics for dental procedures
  2. lifetime anticoagulation, risk for endocarditis, click
  3. incision of a valve, open/bypass is preferred
170
Q
  1. What is vavlulotomy used for
  2. what is valvuloplasty
  3. What is it used for
A
  1. mitral stenosis
  2. repair of torn leaflets, chordae tendinae, pap muscles
  3. mitra or tricuspid regurgitaiton
171
Q
  1. What is annuloplasty
  2. What is it used for
  3. what is usually the result of tricuspid valve disease
A
  1. reconstruction of annulus, or leaking valve
  2. mitral, tricupsid regurgitation
  3. pulmonary HTN or Right ventricular dysfunction
172
Q
  1. Cause for Mitral Stenosis
  2. Cause for Mitral Regurg
  3. Cause for Aortic Stenosis
  4. Cause for aortic Regurg
A
  1. rheumatic fever, prego
  2. ischemia, infarcts
  3. calcification (aging)
  4. idiopathic, HTN
173
Q
  1. Mitral Valve stenosis sx look like
  2. Sx
  3. Aortic Valve Stenosis, Sx
A
  1. HF
  2. SOB, Extertional dyspnea (for all valve issues)
  3. Angina, syncope, exertional dyspnea, LV failure
174
Q
  1. What diagnostic procedure for inflammed heart complications
  2. What is pericardial effusion
  3. What should you do for cardiac tamponade
A
  1. Echocardiogram- show’s vegetation
  2. fluid in the pericardium
  3. Pericardiocentesis STAT
175
Q
  1. What happens in cardiac tamponade
  2. Coumadin lab test effectiveness
  3. Heparin labs
A
  1. heart is compressed by fluid, decreased LV filling, pulsus paradoxus
  2. PT- prothrombin
  3. PTT (partial thromboplastin time)
176
Q
  1. How is TB not spread
  2. How is it spread
  3. What does airbone entail
A
  1. by hands, objects, brief exposure
  2. airborne
  3. cough, speak, sneeze, sings
177
Q
  1. What does PPD stand for
  2. What indicates positive test
  3. Can you make diagnosis on chest xray for tb
A
  1. Purified protein derivative
  2. >10mm induration, only indicates exposure
  3. not on its own
178
Q
  1. What should you do for a homeless patient with TB
  2. Early symptoms of Lung Cancer
  3. Late symptoms
A
  1. encourage a shelter for a meal or nights rest to ensure therapy
  2. cough, chest pain, pneumonitis, dyspnea
  3. hoarseness, dysphagia
179
Q
  1. Nursing Dx for lung cancer
  2. Post op intervention for a thoractomoy
  3. Priority nursing interventions, thoractomy
A
  1. Ineffective airway clearnace, anxiety, impaired gas xchange, ineffective breathing pattern
  2. Chest tube
  3. respiratory, sputum, breath sounds, chest tube function. Pain, surgical site.
180
Q
  1. Pneumothorax intervention
  2. Hemothorax intervention
  3. Tension Pneumothorax intervetion
A
  1. chest tube with flutter valve, drainage sys
  2. c.t.w/drain. Autotransfusion of collected blood. Tx hypovolemia
  3. needle compression followed by c.t. w/ drain
181
Q
  1. Pneumothorax Sx
  2. Hemothorax Sx
  3. Tension Sx
A
  1. unequal expansion
  2. decreased Hgb, Shock
  3. Tracheal deviation, distended neck veins
182
Q
  1. A CXR measures
  2. EKG measures
  3. Respiratory complications Post op
A
  1. pulmonary, enlarged heart
  2. Cardiac disease, dyrhythmias
  3. hypoxemia, pneumonia, atelectasis
183
Q
  1. Priorities for fracture
A
  1. Hydration, respiratory, circulation, pain, hx of conditions/meds, prevention
184
Q
  1. Amputation grief/loss considerations
  2. What is an important assessment post amputation
  3. What is prone position
A
  1. explain procedure, simply, resources (children), case mgmt, chaplain
  2. Pain
  3. lying on stomach
185
Q
  1. Why would surgeon order prone position for amputee
  2. Intervention for amputee
A
  1. prevention of hip contractures (hardening of muscle)
  2. diabetes consult, long acting insulin, family coop for nutrition restriction, PT consult to increase activity/expend calories
186
Q
  1. Assessment of dressing of amputee
  2. Risk factors
  3. Why should you inquire about tighter glucose control
A
  1. snug to prevent edema but not tight for circulation, edema, erythema, amount/drainage
  2. Diabetes, atherosclerosis,
  3. To facilitate wound healing
187
Q
  1. S/Sx of Fat Embolism
  2. S/Sx of Compartment Syndrome
  3. Bone fracture
A
  1. ARDS, chest pain, tachypnea, cyanosis, tachycardia
  2. pain not relieved by pressure, numbness, tingling, pallor, paralysis, pulseless
  3. breaking a bone
188
Q
  1. What can mimic a stroke
  2. What prt of the brain would be affected with stroke
  3. Hemorrhagic Stroke Tx
A
  1. Hypoglycemia
  2. Cerebellar Function, movement problems.
  3. Airway
189
Q
  1. Aortic stenosis post mech valve replacement, which med
  2. Meds for Crohns Disease
  3. TPN
A
  1. Risk for clotting, take anticoagulants, COUMADIN (longterm)
  2. aspirin, steroids, immunosuppressants, antibiotics (flagyl), antidiarrheals, 5asa
  3. central line, aseptic, asess
190
Q
  1. Thoracotomy assess
A
  1. Respiratory rate at 6 breaths per minute, GET THEM AWAKE!
191
Q

Safe word choices

A

usually, almost, frequently, potentially, may sometimes, partial, some, might, should few, essentially, generally, occasionally, nearly, maybe could, commonly, often, normally

Nursing school pt 3 (13 decks)

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