OTHER

Question 1

What position is preferred for thoracentesis?

Answer 1

The patient should be sitting up, leaning over a bedside table with arms rested, feet supported on the ground, or stool so the needle can be inserted appropriately

Supine is ok is unable to sit.

Question 2

Some manifestations of MI

Answer 2

• Denial
• Hypotension
• Orthopnea (dyspnea when lying flat)

Question 3

What is hemoptysis?

Answer 3

Coughing up small amounts of blood from the lungs

Question 4

What are 3 manifestations of Nephrotic syndrome?

Answer 4

• Proteinuria (renal glomerular damage)
• Hypoalbuminemia (protein from the bloodstream is being lost in the urine; there is decreased protein in the bloodstream)
• Edema ( from hypoalbuminemia causing decreased oncotic pressure in the vasculature)

Question 5

What lung sounds would you expect to hear with a pneumothorax?

Answer 5

Diminished breath sounds.
NO adventitious sounds

Question 6

How do you determine if a client has infectious pulmonary TB?

Answer 6

Sputum culture

Question 7

How does Superior Vena Cava Syndrome present?

Answer 7

Caused obstruction of blood flow to and from the superior vena cava resulting in venous congestion (puffiness in the face/ neck) and jugular-venous distension.

Frequent clinical features of venous congestion include blurred vision, hoarse voice, stridor, dyspnea, and nasal congestion.

Question 8

What kind of diet is appropriate for patients with kidney disease / ESRD?

Answer 8

a diet low in potassium, phosphorus, and sodium
* green beans, cabbage, lettuce, peppers, grapes, blueberries, cooked summer squash, cooked turnip greens, pineapple, and raspberries

Question 9

Signs of lithium toxicity and how to prevent

Answer 9

Signs and symptoms
* nausea, vomiting, lethargy, confusion, delirium, coma, seizures, and hypotension

Prevent by
* maintaining adequate fluid and salt intake

Question 10

What are some main roles of calcium?

Answer 10

1. promote blood clotting
2. increase bone density
3. promote healthy dentition
4. maintain neuromuscular health

Question 11

What are the targets for DKA treatment? What is the treatment?

Answer 11

Targets
* Aim to lower blood glucose by 50 to 75 mg/dL per hour (2.775 to 4.165 mmol/L/hr)

Treatment
* by giving a regular insulin bolus at 0.1 unit/kg followed by a continuous infusion at 0.1 unit/kg/hr until acidosis resolves
* monitor for hypoglycemia and hypokalemia

Question 12

What is the triad of symptoms for pre-eclampsia?

Answer 12

PRE-
* Proteinuria
* Rising BP
* Edema

Worsening pre-eclampsia may include: visual disturbance, severe headache, epigastric pain, or decreased fetal movements

Question 13

What is tympany? What is happening if the patient presents with it?

Answer 13

A hollow drum like sound over an area filled with gas or air.
* heard with ascites over the top of the abdomen where the intestines float
* & a pneumothorax where the chest cavity contains freeair

Question 14

What is ptosis?

Answer 14

Ptosis is drooping of the eyelid.
* Ptosis may be congenital or acquired
* may be a clinical feature of neurological conditions such as myasthenia gravis or multiple sclerosis

Question 15

What would a patients electrolytes look like with hyperparathyroidism?
What manifestations may this cause?

Answer 15

Hypercalcemia
* nephrolithiasis, polyuria, confusion, constipation, and shortened QT interval
* manage with loop diuretics

Hypophosphatemia
* Ca and Ph have an inverse relationship

Question 16

What are manifestations of appendicitis?

Answer 16

PAINS
* Pain RLQ
* Anorexia
* Increased temperature & WBC
* Nausea and vomiting
* Signs (McBurneys point, Psoas)

Monitor for rupture/perforation!
* sudden relief of pain is BAD

Question 17

Cranial nerves

Question 18

What is hemoglobinuria a sign of? What is it?

Answer 18

Red or brown tinged urine is a classic manifestation of a hemolytic reaction (incompatible blood)
* The hemolysis causes the body to spill hemoglobin in the urine

Question 19

Heat stroke treatment and signs
vs heat exhaustion

Answer 19

q23
qid11018

Question 20

What is dumping syndrome?

Answer 20

Common complication following gastric bypass surgery
* it is a rapid emptying of food contents into the small intestine, which shifts fluid into the gut, causing abdominal distention
* the client should lie down after meals to mitigate symptoms because this will slow gastric emptying
* avoid drinking with meals because this accelerates gastric emptying

Symptoms
* colicky abdominal pain, diarrhea, nausea, and tachycardia

Question 21

What is hemophilia?

Answer 21

Hemophilia is a genetic disorder that causes a factor VIII deficiency. Factor VIII is produced by the liver and is necessary for the formation of thromboplastin in phase I of blood coagulation. Bleeding is commonly found in the joints (termed hemarthrosis), which causes joint stiffness, aches, and a decreased range of motion. Hematuria is also a clinical feature that may be evident (either grossly or by microscopy that would be shown on a urine analysis). Epistaxis is a feature as well if trauma to the nose occurs.

Bleeding is commonly found in the joints that manifest as joint stiffness, limited range of motion, and swelling

✓ A client with hemophilia should be educated to avoid contact sports, the manifestations of bleeding, and adherence to follow-up care

✓ Clients with hemophilia should avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) because they inhibit platelet function

Question 22

What is pediculosis?

Answer 22

also known as head lice
* requires contact precautions until 24 hours after initiation of effective therapy.

Question 23

What is Buergers disease?

Answer 23

The small blood vessels of the feet and hands become blocked with blood clots. Over time, skin tissue is damaged or destroyed. Open, painful sores develop on the toes and fingers.

This impediment is caused by inflammation and is significantly worsened by smoking

Question 24

What is a slit lamp examination?

Question 25

What do you do for a patient with hypema?

Answer 25

• elevate HOB to 30+ degrees to prevent increased intraocular pressure
• apply eye patch to prevent injury
  *

Question 26

Differentiate warm and cold compress use

Answer 26

Warm compress
*

Cold compress
* fractures to reduce swelling

Question 27

What is atelectasis?

Answer 27

The collapse of part or all of a lung, is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the lung. BIG risk factor…
* rib fractures because the client does not fully expand the chest

Question 28

What is Guillain-Barré syndrome?

Answer 28

Guillain-Barré syndrome (GBS) is a rare acute inflammatory disorder that affects the axons and/or myelin of the PNS resulting in ascending muscle weakness or paralysis.
* monitor for respiratory distress

Question 29

What is urolithiasis?

Answer 29

Urolithiasis is the presence of calculi (stones) in the urinary tract
Typical signs/symptoms
* hematuria (blood in urine),
* renal colic (unilateral pain spasms in flank),
* severe radiating pain, which can cause nausea/vomiting, sweating, and elevated blood pressure.
* may experience dysuria & increased urinary frequency.

(not kidney stones = nephrolithiasis)

Question 30

What is trichomoniasis?

Answer 30

Trichomoniasis is primarily transmitted through sexual contact, including vaginal, oral, or anal sex with an infected partner.
* produces malodorous, thin, yellow discharge
* genital redness, burning, itching
* painful urination

Question 31

What does CK-MB measure? When is its peak?

Answer 31

CK-MB, or creatine kinase myocardial muscle, levels measure muscle cell death especially after an MI.
Post cardiac muscle damage CK-MB:
* begin elevating in 3 to 6 hours
* peak elevation at 18 hours
* levels begin to decrease witihin 48-72 hours

Question 32

What is scleroderma?

Answer 32

A progressive multisystem autoimmune disorder that causes fibrosis to the connective tissue.

False inflammation causes:
* thickening of the skin
* joint pain
* contractures
* vasospasm in the fingers
* dysphagia
* renal insufficiency
* pulmonary hypertension

Question 33

Diphtheria:
1. How does it present?
2. How do you prevent it?
3. What bacteria causes the infection?
4. How does it spread?

Answer 33

Presentation
* a thick, gray coating in the throat and nose, making it difficult to breathe and swallow.
* The toxin can also damage the heart, nervous system, and other organs.

Prevention
* vaccination at 2 months and booster after 10 years

Cause
* a serious bacterial infection caused by the bacterium Corynebacterium diphtheria

Infection control
* It is spread through respiratory droplets or contact with skin lesions of infected individuals.

Question 34

What diet is required for patients with Cystic fibrosis?

Answer 34

The diet should be rich in vitamins, fat, and protein.
Because a client with CF often excretes high amounts of sodium, dietary items rich in sodium are usually not restricted.

Answer 35

Hearing loss is divided into sensorineural or conductive.

Conductive hearing loss is caused by obstruction. Causes of this type of hearing loss include cerumen, foreign body, water, edema, infection, or tumor. This type of hearing loss may be reversible.
Impairments of the nerve fibers cause sensorineural hearing loss. Causes of this type of hearing loss include prolonged exposure to noise, ototoxic substances (aminoglycosides), diabetes mellitus, and presbycusis (age-related hearing loss). This type of hearing loss is often not reversible.