NU335: chronically ill adult: exam 1 kahoot review Flashcards
Which is an example of “people first language”?
the patient that uses a walker
chronic illness is defined as ___
the human experience of living with a chronic health condition
what is the minimum time frame of a chronic health condition?
3 months
which one is NOT a modifiable factor of chronic health conditions?
-genetics
-poor nutrition
-physical activity
-smoking
genetics
living with multiple chronic health conditions is challenging because __
need to adapt life to potential resulting disabilities
stiff vessels result in __
decreased blood flow
patients with arterial insufficiency should have legs put ___
down
patients with venous insufficiency should have legs put __
up
Difficult pulses can be assessed using __
doppler
as a patients ankle brachial index decreases __
level of ischemia increases
atherosclerosis is a condition in which __
artery walls develop plaque build up
arteriosclerosis is a condition in which __
artery walls thicken
nicotine results in __
increased platelet aggregation
peripheral artery disease can result in __
leg pain that progresses to constant in nature
peripheral artery disease can result in __
decreased or absent pulses
a patient has just returned from OR following a thromboembolectomy. We will __
encourage early ambulation
Buerger’s disease is a type of __
peripheral arterial disorder
patients with Reynaud’s Phenomenon should be instructed to avoid __
triggers to their symptoms
a patient with a AAA is cared for with conservative measures. This will focus on __
controlling blood pressure
venous thromboembolisms can be avoided by __
promoting early ambulation
patients with chronic venous insufficiency are managed with ___
elevating legs
which insufficiency is characterized by intermittent claudication?
arterial
Cellulitis is managed with __
antibiotics
Hypertension is defined as __
BP 130/80
Hypertension will be diagnosed after how many visits to the provider?
at least 2 visits
primary hypertension __
has no identifiable cause
secondary hypertension __
has identifiable cause
patient’s with masked hypertension __
has normal BP when in the office, but elevated BP when at home
examples of target organ damage include all of the following EXCEPT:
-stroke
-vision loss
-sexual disfunction
-increased kidney function
increased kidney function
patients with white coat hypertension __
have elevated BP at office but normal BP at home
blood pressure will go up when __
cardiac output goes up
at what stage of hypertension will patients definitely be prescribed an anti-hypertensive?
stage 2 hypertension
the difference between hypertensive urgency and hypertensive emergency is ___
presence of target organ damage
left sided heart failure is associated with __
pulmonary congestion
left sided HF is often associated with all of the following EXCEPT ___: (which is more characteristic of right sided HF)
-low oxygen saturation
-dyspnea
-JVD
-confusion
JVD - jugular vein distension
Right sided HF is more often associated with all of the following EXCEPT __: (which is more common to left sided HF)
-paroxysmal nocturnal dyspnea
-hepatomegaly
-ascites
-peripheral edema
paroxysmal nocturnal dyspnea
a patient with HF may experience __
decreased ejection fraction
BNP is another lab associated with HF. What happens to BNP during acute exacerbations of HF?
value goes up
an elderly patient with CHF is placed on a diuretic. what risk is associated with this?
increased falls
caution should be used with what class of meds for a patient with HF and asthma?
Beta Blockers
Digitalis toxicity is associated with __
hypokalemia
patients with pulmonary edema can develop __
frothy sputum
acute kidney injuries are __
reversible
hypoperfusion of the kidneys can lead to
prerenal AKI
actual damage to kidney tissue can lead to __
intrarenal AKI
Obstruction to urine flow can lead to
postrenal AKI
patients with AKI will be encouraged to follow what diet modification?
high carb diet
can you give insulin via IV route?
only for hyperkalemic patients
patients on hemodialysis will be encouraged to follow what diet modification?
increased protein
nursing care of the patient with an AV fistula or graft includes __
not taking BP on affected limb
it is important to teach the patient completing peritoneal dialysis at home the importance of hand hygiene to avoid __
peritonitis
to facilitate drainage from a peritoneal dialysis exchange, the patient can try all of the following EXCEPT:
-stand up
-move from side to side
-manipulate catheter
-raise head of bed
manipulate catheter
which phase of an AKI is associated with fluid overload and will be treated with diuretics?
oliguric
which phase of an AKI can be associated with hypovolemia and hypotension requiring vigilant I&O monitoring?
diuretic
which finding is NOT associated with CKD?
-anemia
-fluid retention
-hypotension
-progression to CHF
hypotension
which medication would NOT be expected for use with CKD?
-vasopressor
-anti-hypertensive
-calcium carbonate
-erythropoietin
vasopressor
a patient prescribed an anti-HTN is undergoing hemodialysis. When should they be directed to take their medication?
AFTER dialysis with caution
TRUE OR FALSE
the first sign of peritonitis for a patient performing peritoneal dialysis is often the return of clear dialysate
FALSE
Barrel chest is associated with
COPD emphysema
Which condition is more often associated with entrapped air?
COPD emphysema
Oxygen must be used with caution for the COPD patient because __
their respiratory drive is controlled by low O2 levels
a patient in status asthmaticus may present with what lung sounds warranting EMERGENT concern
absence of wheezing
TRUE OR FALSE
patients using peak flow meter will be directed to “suck in” hard and fast with use
FALSE
a patient in status asthmaticus may require all of the following interventions EXCEPT:
-oxygen up to intubation
-bronchodilators
-systemic corticosteroids
-fluid restrictions
fluid restrictions
Asthmas is different than COPD because __
condition is reversible
FEV/FVC indicates what?
airflow obstruction
lung expansion techniques include all of the following EXCEPT:
-pursed lip breathing
-diaphragmatic breathing
-incentive spirometer
-purposeful increase in respiratory rate
purposeful increase in respiratory rate
status asthmaticus __
has rapid onset
lung cancer is the leading caner killer for __
men and women
all of the following are risks for lung cancer EXCEPT:
-radiation exposure
-smoking
-genetics
-nursing school
nursing school
TRUE OR FALSE
a change in a patients cough warrants evaluation for potential diagnosis of lung cancer
TRUE
TRUE OR FALSE
a common early sign of lung cancer is pain
FALSE
ischemic strokes __
result from vascular occlusion
what is the penumbra?
area around infarct with decreased blood flow
which type of stroke is often described as “worst headache of my life”?
hemorrhagic stroke
a stroke on the left will result in __
symptoms on the right
what assessment is of priority fora patient experiencing a stroke?
cardiovascular
as a patients NIH score goes up
severity of stroke goes up
which type of stroke will be treated with a thrombolytic?
ischemic stroke
care of the post stroke stable patient will include all of the following EXCEPT:
-encourage increasing activity as tolerated
-strict bed rest
-PT/OT
-swallow screen
strict bed rest
a patient with a hemorrhagic stroke and increased ICP should receive care that includes all of the following EXCEPT:
-encouraged ambulation
-strict bed rest
-dim lighting
-clustered care
encouraged ambulation
TRUE OR FALSE
diabetes is the number one risk factor for strokes
FALSE
which type of stroke most often will demand close monitoring for s/s of increasing ICP?
hemorrhagic stroke
TRUE OR FALSE
a priority for the stroke patient will be monitoring ABCs
TRUE
hemorrhagic strokes will most commonly be treated with
bed rest and close montioring
TRUE OR FALSE
generalized seizures will only affect one side of the body usually
FALSE
TRUE OR FALSE
the nurse should be vigilant about the first s/s a patient seizing presents with because it may help identify the site origin
TRUE
patients scheduled for an EEG will be directed all of the following EXCEPT:
-avoid caffeine
-do not eat anything the night before
-wash with shampoo only night before
-limit or avoid sleep the night before
do not eat anything the night before
for an actively seizing patient we will do all of the following EXCEPT:
-maintain a patent airway with functioning suction available
-loosen clothing
-restrain the patient
-turn to side lying position
restrain the patient
TRUE OR FALSE
if a patient closely follows their anti-seizure medication regime eventually their condition will be cured
FALSE
what patient teaching is crucial related to anti-seizure medications?
take medication at the same time every day
status epilepticus is best described by all of the following possible scenario’s EXCEPT:
-seizure lasting 5 minutes or longer
-serial seizures occurring without full recovery between attacks
-continuous seizures on EEG lasting at least 30 minutes
-seizure lasting 20 minutes or longer
seizure lasting 20 minutes or longer
TRUE OR FALSE
the nurse must be vigilant for respiratory depression and hypotension when treating status epilepticus
TRUE
