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STATE EXAM PREP > part 1 > Flashcards

part 1 Flashcards

1
Q

Surgery classifications?

A

Elective
Diagnostic
Acute

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2
Q

List 3 patient orientated goals post surgery?

A

Return to normal physical function
Remain free from post op complications
Achieve emotional and physical comfort

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3
Q

What is included in a pre-op assessment? (5)

A

Obtain history
Physical assessment
Determine patient understanding
Identify emotional state and coping skills
Check consent, pre anaesthetic form complete, other pre anaesthetic orders

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4
Q

What does atelectasis mean?

A

Collapse or closure of lung resulting in reduced or absent gas exchange

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5
Q

List 5 ways to safely care for post op patients?

A 
Fluid balance input and output
Pain management
Assessing wound
Vital signs
Checking IV site
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6
Q

What is meningitis?

A

A serious disease in which there is inflammation of the meninges

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7
Q

Signs and symptoms of meningitis?

A

Intense headache
Fever
Light sensitivity
Muscular rigidity

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8
Q

Main cause of meningitis?

A

Bacterial: Streptococcus pneumoniae
Viral: Enterovirus

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9
Q

Signs of raised intercranial pressure? (4)

A

Headache
Nausea
Increased bp
Confusion

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10
Q

What is the purpose of the nursing council?

A

To protect the health and safety of members of the public by ensuring RNs are registered, fit to practise, and competent.

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11
Q

Signs of otitis? (Ear infection/inflammation)

A

Ear pain
Fever
Difficulty hearing

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12
Q

What would you do if prescribed medication was not signed by the doctor?

A

Do not give until a signature or verbal consent has been given with a witness

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13
Q

Signs of a patient on methamphetamine? (5)

A 
Dilated pupils
Agitation
Increased bp
Loss of appetite
Paranoia
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14
Q

List 5 pieces of advice to give a patient following a total hip replacement?

A 
Place a pillow between legs when lying on side
Avoid bending past 90 degrees
Avoid crossing legs
Sit on chairs higher than knee height
Take short frequent walks
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15
Q

What is airway obstruction caused by?

A 
inhaling or swallowing a foreign object
allergic reaction
trauma 
viral infections
bacterial infections
croup
inflammation/swelling
asthma
cystic fibrosis
COPD
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16
Q

Treatment for airway obstruction?

A 
Correct positioning
o2 therapy
Suctioning
Close monitoring
Viral signs
Anti emetics
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17
Q

S/S of atelectasis?

A

Insidious onset
Early s&s: cough, sputum, low grade fever
Later s&s: respiratory distress, dyspnoea, tachycardia, pleural pain, cyanosis, anxiety

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18
Q

What is a pulmonary embolism?

A

A condition in which one or more arteries in the lungs become blocked by a blood clot.
Most times, a pulmonary embolism is caused by blood clots that travel from the legs, or rarely, other parts of the body (deep vein thrombosis or DVT).

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19
Q

Diagnosis of a pulmonary embolism?

A 
Chest X-ray
Ecg
Abg
Ultra sound
Pulmonary angiography
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20
Q

How to prevent a pulmonary embolism?

A 
Pre op weight loss
Compression stockings
Early animation
Hydration
Meds
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21
Q

What causes a deep vein thrombosis?

A

Occurs in leg veins due to inactivity, body positioning, and pressure

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22
Q

Risk factors for DVTs?

A 
Elderly
Poor nutrition
Surgery over three hours
Limited mobility
Long haul flights
Diabetes
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23
Q

What is wound dehiscence?

A

Disruption/reopening of previously joined wound edges due to an infection, too tight sutures, or injury to wound

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24
Q

Risk factors for wound dehiscence?

A 
Elderly
Poor nutrition
Diabetes
Abdominal surgery
Immunosuppressant
Smoking
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25
Q

Signs of wound inflammation?

A 
Redness
Warmth
Malaise ( general discomfort)
Tachycardia
Febrile
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26
Q

List some side effects of opioid use?

A 
Decreased bp
Decreased LOC
Vomitting
Respiratory depression
Constipation
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27
Q

What would you assume if someone’s temperature was slightly lower post surgery?

A

This could be normal due to lack of muscle movement to keep body warm

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28
Q

What would you assume if someone’s temperature was slightly higher post surgery?

A

This could be normal due to inflammation being the 1st sign of healing

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29
Q

What is autologous blood collection?

A

Providing blood for oneself

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30
Q

What fresh blood components are given in blood transfusions?

A

Red cells- used to treat anaemia, severe bleeding.
Platelets- to stop bleeding, used in ICU or cancer treatment
Fresh frozen plasma or cryoprecipitate- used for replacing clotting factors and rarely other blood proteins. Used in ICU or liver disease patients

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31
Q

Blood donations are always tested for?

A 
Infection
Hep B & C
HIV & AIDS
Syphilis
ABO group
Rh type
Blood group antibodies
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32
Q

What cell is carefully checked before a blood transfusion for incompatibility?

A

RBCs

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33
Q

What is a blood crossmatch?

A

When a sample of the patients blood is used along with the donors blood for a transfusion

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34
Q

List some risks for blood transfusions?

A 
Mild fever
Skin rash
Kidney failure
Dyspnoea
Minor virus infection
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35
Q

What type of burns are there?

A 
Thermal
Electrical
Caustic chemical injury
Radiation exposure
Inhalation of noxious fumes
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36
Q

What occurs with a thermal burn?

A

Proteins denature
Irreversible cellular damage occurs
Acute inflammatory response

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37
Q

What is a 1st degree burn + what occurs?

A 
Superficial partial thickness burn
Damage to epidermis
Triggers vasodilation
Increased capillary permeability
Heals within a week
e.g sunburn
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38
Q

What is a 2nd degree burn and what occurs?

A 
Deep partial thickness burn
Damage to epidermal skin layers
Penetrates some dermal skin layers
Epidermal and dermal layers seperate + Fluor accumulate between
Blisters form
Scars form
Healing takes 2-4 weeks
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39
Q

What is a 3rd degree burn and what occurs?

A 
Full thickness burns
Damage of the epidermis and dermis
Can penetrate subcutaneous layers
Destruction of blood vessels
Scaring is extensive
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40
Q

What is shock?

A

A syndrome of circulatory failure and impaired perfusion to vital organs

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41
Q

What commonly occurs to bp in shock?

A

Hypotension

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42
Q

List the different kinds of shock?

A 
Carcinogenic
Hypovolemic
Anaphylactic
Septic
Neurogenic
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43
Q

What occurs during cardiogenic shock?

A

Inadequate or inefficient cardiac pumping
Causes low output & restricted movement of oxygenated blood throughout circulation
Leads to systemic hypotension or pulmonary odema

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44
Q

How to treat cardiogenic shock?

A

Assess ECG & troponin levels
Give aspirin, GTN, morphine, clopidogrel
Give o2

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45
Q

What occurs during hypovolaemic shock?

A

Inadequate blood/plasma volume
Reduced circulation
Multiple organ failure

46
Q

What causes hypovolemic shock?

A

Severe haemorrhage, burns, diarrhoea, poluria

47
Q

How to treat hypovolaemic shock?

A

Apply pressure to wound if bleeding
Blood plasma, rbc, or platelet transfusion
Iv fluids
antiametics

48
Q

What occurs during anaphylactic shock?

A

Result of massive immune hypersensitivity response
Vasodilation and increased vascular permeability
Fluid leaves vascular space=swelling
Bp and circulation is reduced

49
Q

What is the treatment for anaphylactic shock?

A

Adrenaline

50
Q

What is septic shock?

A

Systemic infection
Chemical mediators produce inflammatory response
Damages endothelial cells

51
Q

What is the treatment for septic shock?

A

ICU admission

Iv abs

52
Q

What causes neurogenic shock?

A

Result of brain or spinal injury, depressant action of certain drugs, anaesthesia, hypoglycaemia, or hypoxia

53
Q

What occurs during neurogenic shock?

A

Neuronal transmission is altered
Loss is sympathetic control of tension of blood vessels
Unregulated vasodilation
Decrease in vascular resistance, bp, and vital organ perfusion

54
Q

What is the treatment for neurogenic shock?

A

Airway-jaw thrust manoeuvre
Iv isotonic crystalloid solution
Leg rolling onto a spine board

55
Q

What are the pro’s of using spinal anaesthetic?

A

Provides better pain relief (no analgesia for 24 hours post)
Less bleeding during surgery so lower risk of developing clots
You remain in full control of your breathing so lower risk of chest infection
Less v+n+drowsiness post operation

56
Q

Risks of spinal anesthesia?

A 
Headache
Dizziness
Bladder problems
Aches & pains
Bruising
57
Q

Risks of general anaesthetic?

A 
Headache
Sore throat
N+V
Dizziness
Bladder problems
Damage to lips & tongue
Temporary confusion & memory loss
Aches & pains
58
Q

What should a pt be aware for at home following a total hip replacement?

A 
Chest pain
Calf pain
SOB
Fever or chills
N+V
Bleeding or discharge from dressing
59
Q

What is the colon?

A

The first one and a half metres of the large bowel. It removes liquid from digested food and turns it into solid waste

60
Q

What is the rectum?

A

The last 12-15cm of the bowel, ending at the anus

61
Q

How common is bowel cancer?

A

One of the most common cancers amongst both men and woman. It may occur at any age although 90% is over 50 years

62
Q

What causes bowel cancer?

A 
Bowel polyps
A high fat and protein and low fruit and veg diet
Alcohol consumption
Weight gain
Low physical activity
Family history
63
Q

What is hereditary non-polyposis colorectal cancer? (HNPCC)

A

A condition where the tendency to develop cancer is inherited

64
Q

What is familial adenomatous polyposis? (FAP)

A

A condition that causes hundreds of polyps in the bowel and if left untreated, always turns to bowel cancer

65
Q

What is a disease of ten years that increase the chance of bowel cancer?

A

Chrohns

66
Q

What is a colectomy?

A

Surgery to remove part of the bowel

67
Q

What is a colostomy?

A

If the bowel cannot be rejoined the upper end is brought out onto the skin of the abdominal wall

68
Q

What is an ileostomy?

A

When the end of the small bowel (ileum) or loop of the ileum is brought out onto the right side of the abdominal wall

69
Q

What is removed during surgery for rectal cancer?

A

Tumour
Surrounding rectal tissue
Fatty tissue
Mesentery

70
Q

What is tonsellitis?

A

When the tonsils and pharynx which lie at the back of the throat become inflamed

71
Q

Causes of tonsillitis?

A

Viruses (herpes simplex)

Bacteria (streptococcus)

72
Q

Symptoms of tonsillitis?

A 
Sore throat
Swollen tonsils
Fever
Difficulty swallowing
Swollen lymph nodes
73
Q

Treatment of tonsillitis?

A

Virus cannot be treated by AB’s
Bacteria may be treated by AB’s
Food and fluids
Tonsillectomy (surgical removal)

74
Q

How long does it take to heal after a tonsillectomy?

A

10-14 days

75
Q

What is the pyramidal motor system?

A

Extends from the sensorimotor areas of the brain to the motor neurone of the central horns of the spinal cord. Controls voluntary movement

76
Q

What is the extrapyramidal system?

A

Basal ganglia. Fine tunes and stabilises movement

77
Q

Mechanisms of injury?

A

Traumatic
Ischaemic
Pressure
Excitation (electrolyte imbalance)

78
Q

What is neuronal injury? + 3 examples

A

Anything that alters the stable neutron environment
Sepsis
Hypoxia
Acidosis

79
Q

What is a traumatic brain injury?

A

Traumatic force to the skull and brain

80
Q

What is a closed head injury?

A

Skull is penetrated

81
Q

What is a open head injury?

A

Brain tissue is exposed

82
Q

What is the pathophysiology of a traumatic brain injury?

A

Disrupts intervertebral environment
Altered brain function: neuron/axon injury
Cerebral bruise, laceration, damage, haemorrhage may occur
Damage to cerebral cortex lobes

83
Q

What is raised intracranial pressure?

A

Decreased blood flow and displacement of brain tissue as well as increased pressure

84
Q

Signs of a traumatic brain injury?

A

Decreased LOC

Altered motor responses

85
Q

Signs of raised intracranial pressure?

A

Headache
N+V
Increased BP
Confusion

86
Q

Diagnostic criteria of a traumatic brain injury?

A

Hx and physical examination
GCS score, LOC score
Vitals
X-ray

87
Q

Treatment for a traumatic brain injury?

A

Preserve brain function
Prevent secondary complications
Stabilise cardio-respiratory function to maintain cerebral blood flow
Decrease increased intracranial pressure and haemorrhage
Meds
Rehab

88
Q

Risk factors for a stroke?

A 
Genetics and age
Hypertension and AF
IHD and hyperlipidaemia
Smoking and alcohol intake
Obesity and inactivity
89
Q

What is a stroke?

A

A clinical event causing impaired cerebral circulation

90
Q

What are the 3 different strokes?

A

Thrombotic
Embolic
Haemorrhage

91
Q

What occurs during a thrombotic stroke?

A

Cerebral artery occlusion often from atherosclerosis, commonly the middle cerebral artery (sensory or motor issues)

92
Q

What occurs during an embolic stroke?

A

Travelling clot, commonly to brain or lungs

93
Q

What occurs during a haemorrhagic stroke?

A

Bleeding. Caused by hypertensive arterioparthies, aneurisms, tumours, vasculitis, illicit drugs. Blood vessel ruptures

94
Q

Recognising a TIA or stroke?

A

F-face-check smile or one side droopy
A-arms-raise both arms is one side weak
S-speech-slurred speech
T-time-orientated to time

95
Q

What is agosias?

A

When a patient can’t recognise physical objects

96
Q

What is aphasia?

A

loss of ability to understand or express speech, caused by brain damage.

97
Q

What is expressive aphasia (Broca’s area)

A

Problems formulating speech, thoughts, writing ability

98
Q

What is receptive aphasia (Wernickes area)

A

Trouble with comprehension, can speak, may have word deafness or word blindness

99
Q

Characteristics of left sided brain lesion?

A

Apasia
Reading and writing problems
Labels emotions

100
Q

Diagnosis for a right/left sided brain lesion?

A

Hx and physical examination
Lab results
CT scan

101
Q

Treatment for a brain lesion?

A

Reduce cerebral oedema and increased intracranial pressure

Rehab

102
Q

What can degenerative disease cause?

A

Alterations in cognition, sensation, pain and motor responses

103
Q

Pathology of Parkinson’s disease?

A

A chronic, progressive, medical condition

Degeneration of pigmented dopaminergic neutrons of basal ganglia

104
Q

What is neurotransmitter imbalance?

A

Manifestations due to overactive cholingeric neurons and lewey bodies

105
Q

Cause of Parkinson’s disease?

A

Unknown. Might be inherited

106
Q

Signs and symptoms of Parkinson’s disease?

A

Impaired motor function: tremor, rigidity, bradykinesia
Autonomic nervous system responses: urinary retention, constipation
Cognitive and personality changes
Insomnia

107
Q

What is the pharmacological treatment for Parkinson’s?

A

Dopamine replacement
Anticholinergic agents
Paillidotomy (deep brain stimulation)

108
Q

What causes Alzheimer’s?

A

Unknown but believed to be environmental factors, mutated late onset genes (chromosome 19)

109
Q

Pathophysiology if alzheimers?

A

Amyloid plaques glue up the correct
Ray proteins form neurofibrillary tangles
Neurons degenerate
Neurotransmitter imbalance

110
Q

Signs of Alzheimer’s?

A

Cognitive decline
Decreased problem solving
Language loss
Confusion

111
Q

Treatment for Alzheimer’s?

A

Maximize quality of life and promote general health status

STATE EXAM PREP (4 decks)

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