Prep 1 Flashcards
1
Q
What size needle is recommended for a subcutaneous injection?
A
25G
2
Q
True or False:
You should massage skin after an intradermal injection
A
False.
Can irritate the site and interfere with results
3
Q
Technique for administering intradermal injection includes…
A
Hold the syringe almost flat against the patients skin (15 degrees) with the bevel up
4
Q
How does a mother know her new born is getting enough milk?
A
6-8 wet diapers
5
Q
What does APGAR stand for?
A
Activity, Pulse, Grimace, Appearance, and Respirations
6
Q
Normal response to Moro Reflex?
A
Moro reflex may involve the infant suddenly splaying their arms and moving their legs before bringing their arms in front of their body.
7
Q
A nurse has obtained packed red blood cells from the blood bank to administer to a client. The nurse should begin to administer the blood product within
A
30 minutes
8
Q
The nurse is caring for a client who needs a medication to decrease the acidity of the stomach. What class of medications would the nurse expect to use?
A
Proton pump inhibitors, antacids, Histamine 2 blockers
9
Q
A nurse is preparing to administer a dose of warfarin to a client. Based on the nurse’s knowledge of this drug, the nurse knows to monitor for which of the following side effects?
A
Signs of bleeding, and Black stools (manifested by blood in GI system)
Warfarin is an anticoagulant medication that prevents blood clots. Because of its anticoagulant effects, the risk of bleeding is also increased. The nurse should teach the client to watch for signs of bleeding, which in the gastrointestinal system can manifest as black stools
10
Q
The nurse is caring for a client who has become lethargic. A friend at the bedside reports that the client takes alprazolam. The nurse should prepare which medication?
A
Romazicon Alprazolam is a benzodiazepine. Romazicon is the antidote to reverse the effects of this class of drugs.
11
Q
client is prescribed a selective serotonin re-uptake inhibitor and the nurse knows that a benefit of taking an SSRI over other anti-depressants is
A
An SSRI affects only one neurotransmitter instead of several
Tricyclic antidepressants affect norepinephrine and serotonin neurotransmitters. MAOIs affect norepinephrine, epinephrine, serotonin, and dopamine. SSRIs selectively affect the neurotransmitter serotonin, which means SSRIs have less side effects than MAOIs and tricyclic antidepressants.
12
Q
A client has a family history of myocardial infarction and has been experiencing multiple episodes of chest pain. The client is prescribed a medication to prevent heart attacks. Which class of medications is appropriate for this condition?
A
Beta blockers
13
Q
Cycloplegic – eye drop that causes paralysis of the ciliary muscle, resulting in loss of accommodation for 2-48hrs. Doctors use this to allow them to..
A
measure pts vision problems
14
Q
Miotic – eye drop does what? used to treat?
A
that constricts the pupil. Used to treat glaucoma.
15
Q
Mydriatic – eye drop does what? used to for/treat?
A
dilates the pupil. Used for certain eye exams and tx of eye inflammations
16
Q
What is the THerapeutic class of donepezil (Aricept) pharm class- cholinergics (cholinesterase inhibitors)
A
anti-Alzheimers’s agents
17
Q
what is the therapeutic class of erythropoietin (Eprex) – (Epoetin)
A
antianemics
18
Q
fluoxetine (Prozac) is an SSRI - what is its therapeutic class? other treatments used for?
A
antidepressants
• Major depressive disorder.
• Obsessive compulsive disorder (OCD).
• Bulimia nervosa.
• Panic disorder.
• Acute treatment of depressive episodes associated with bipolar I disorder (when used with olanzapine).
• Treatment-resistant depression (when used with olanzapine).
• Premenstrual dysphoric disorder (PMDD).
19
Q
Factors affecting metabolism are: (4)
A
Liver failure
Genetics
Environment and other drugs
Age
20
Q
adrenergic receptors produce what kind of effect in the ANS?
Cholinergic receptors produce what kind of effect in the ANS?
A
1)Produce fight or flight response; Mimics sympathetic neurotransmitters (epinephrine and norepinephrine)
2)mimic the parasympathetic neurotransmitter acetylcholine.
Direct-acting (muscarinic agonists): Directly bind and activate nicotinic and muscarinic receptors eventually increase smooth muscle tone.
21
Q
What are some possible side effects of iron supplementation?
A
Constipation and can decrease absorption of vitamin
22
Q
• What vitamin is given with calcium to enhance absorption?
A
vit D
23
Q
• What are some side effects of magnesium? What GI issue may it be used to treat?
A
- Used as a laxative for constipation. Side effects may include diarrhea.
24
Q
Differences between thrombolytic drugs, anti-platelets, and anti-coagulants.
A
o Anticoagulants prevent clot formation
o Antiplatelet suppress platelet aggregation
o Thrombolytic are clot busters
25
Hypothyroidism is treated by
by replacement therapy with T3 or T4.
standard replacement regimen consists of levothyroxine (T4; Eltroxin, Synthroid), although combined therapy with levothyroxine plus liothyronine (T3; Cytomel) is an option
26
Hyperthyroidism Medications given to reduce secretion of
thyroid hormones (thiomides)
27
what are glucocorticoids used to treat? examples
```
Anti-inflammatory: suppresses acute inflammatory response by preventing cell –mediated immune reaction.
oExamples:
short-acting: hydrocortisone
intermediate-acting: prednisone
long-acting: dexamethasone
```
-These medication are given frequently in autoimmune diseases or condition where inflammation are dangerous
28
what is the appearance (Clear or cloudy) and the peak for Short-acting/Regular insulin (Humulin R) ?
clear, peak 2-4hrs
29
what is the appearance (Clear or cloudy) and the peak for intermediate-acting (Humulin N)?
cloudy, peak 5-8hours
30
what are often the first-line medications for HTN because they have few side effects and can control minor to moderate hypertension?
diuretics
31
What are the S&S of septic shock?
• Cool, pale arms and legs, high or very low temperature, chills, little or no urine, low BP especially when standing, palpitations, rapid heart rate.
32
• What is the antigen-antibody relationship?
o Antibodies bind with the specific matching antigen, destroying it. This specificity of antigen for antibody, similar to a key opening a lock, is a significant factor in the development of immunity to various diseases
33
Lymphocytes (primary cells in the immune response) : B-cells vs T-cells?
1- A B lymphocyte is a type of white blood cell that develops in the bone marrow and makes antibodies.
2-Type of white blood cell that is involved with the immune system. T lymphocytes mature in the thymus and differentiate into cytotoxic, memory, helper and regulatory T cells.
34
urinalysis: Proteinuria, albuminuria indicates
- Proteinuria (albuminuria) is a condition of having too much protein in the urine which results from damage within the kidneys. Proteinuria in diabetes will usually be the result of either long term hyperglycemia (high blood sugar levels) or hypertension (high blood pressure).
- -(had before: leakage of albumin or mixed plasma proteins due to inflammation and increased glomerular permeability)
35
urinalysis: Bacteria – bacteriuria – and pus – pyuria – indicates
UTI
36
urinalysis: Very low specific gravity (dilute urine) Indicates
kidney/renal failure
37
urinalysis: Glucose and ketones present indicates
uncontrolled diabetes
38
What is Blood Urea Nitrogen? What does it test for?
o BUN test measures the amount of nitrogen in your urine. It evaluates kidney function.
39
What is Creatinine? What does it test for?
o Creatinine tests kidney function. Creatinine is a chemical waste. Creatine is a substance that is found naturally in muscle cells. It helps your muscles produce energy during heavy lifting or high-intensity exercise
40
• What is dialysis?
o “artificial kidney” Dialysis is a procedure that performs many of the normal duties of the kidneys, like filtering waste products from the blood, when the kidneys no longer work
41
Medical term for broken bone?
Fracture. Break in the rigid structure and continuity of a bone
42
What is a soft tissue injury to the tendon called?
| What is tendon connective tissue for?
STRAIN
| - connects muscle to bone and is capable of withstanding tension
43
• What is a soft tissue injury to the ligament called?
sprain
44
what are the 4 main complications of bone healing?
1) muscle spasm
2) Ischemia
3) Compartment syndrome
4) Fat emboli
45
What is osteoporosis?
SandS?
some TX?
Bone disease - results in Decrease in bone mass and density
S/S:
- Back pain
- Kyphosis and scoliosis with accompanying loss of height
- Spontaneous fractures
TX:
- Dietary (calcium, vitamin D, protein) and fluoride supplements
-regular weight-bearing exercise
- Bisphosphonates (ex. Fosamax) – short term option to inhibit osteoclast activity and bone resorption
- Hormone therapy – inject human parathyroid hormone (PTH) to decrease bone resorption
46
What is osteoarthritis (OA)?
signs and symptoms?
tx?
* Degenerative, ”wear and tear” joint disease
* Weight-bearing joints (hips, knees) damaged and lost from excessive mechanical stress
S/S:
- Aching pain with weight-bearing and movement
- Limited joint movement => predisposition to falls, difficulty with mastication, speaking, yawning
TX:
• Minimized stress on the joint, rest, support to facilitate movement (canes, walkers)
• PT, OT, massage therapy, orthotic inserts
• Glucosamine-chondroitin supplements
• Injection of synthetic synovial fluid
• Analgesics, NSAIDs
• Joint replacement
47
What is Rheumatoid Arthritis (RA)?
signs and symptoms?
tx?
Autoimmune disorder causing chronic systemic inflammatory disease
SS:
• Inflammation first in the fingers/wrists (bilateral)
• Joints red, swollen, and sensitive to touch
• Joint stiffness following rest; subsides with mild activity
• Impaired joint movement
• Malocclusion of the teeth with TMJ involvement
• Marked systemic effects during exacerbation (fatigue, anorexia, mild fever, generalized lymphadenopathy, generalized aching)
TX:
• Balance between rest and moderate activity
• PT, OT
• NSAIDs, glucocorticoids, DMARDs
• DMARD – disease modifying antirheumatic drugs – blocks inflammation; each works differently (some restrict immune system broadly, some block pathways, some block cytokines)
• Heat and cold
48
What is hemostasis?
o is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. This involves coagulation, blood changing from a liquid to a gel.
49
• What is hemolysis?
o the rupture or destruction of red blood cells.
50
what is is polycythemia?
o When the body produces an excessive number of RBC
51
what is hemophilia?
o An inherited inability to produce certain clotting factors
52
what is leukemia
o Uncontrolled WBC production in the bone marrow
| o Leukemic cells infiltrate the lymph nodes, spleen, liver, brain, and other organs
53
What is pruritus? TX?
• Severe itching of the skin, can be treated by glucocorticoids or antihistamines - but more importantly the removal of the irritant
54
Common skin infections include..
c___
I____
F___
cellulitis: skin appears swollen and red and is typically painful and warm to the touch.
impetigo: highly contagious skin infection that mainly affects infants and children.
- Impetigo usually appears as red sores on the face, especially around a child's nose and mouth, and on hands and feet. The sores burst and develop honey-colored crusts
Furuncles: also known as a boil, is a painful infection that forms around a hair follicle and contains pus.
55
what is the eye disorder known as “pink eye” - a superficial inflammation or infection involving the conjunctiva lining the eyelids and covering the sclera
conjunctivitis
56
what is the eye disorder that results from increased intraocular pressure; .SandS: blurred vision, appearance of “halos”, mild eye discomfort, eye pain, nausea and headaches develop
Glaucoma
57
what is the eye disorder that is a a progressive clouding of the lens; patient experiences blurred vision that progresses over the visual field and the field becomes darker, damaged lens can be surgically replaced
Cataracts
58
what is the eye disorder that results in a black spot or “dark curtain” in the visual field, there is no pain and it needs to be repaired by surgery
Detached Retina
59
what eye disorder is is a common cause of visual disturbance in older adults and causes the centre of vision to be lost first , depth perception is also affected.
macular degeneration
60
Petechiae and purpura are common signs of:
Increased bleeding
61
What class is Prednisone and what does it do?
Corticosteroid
- decreases your immune system's response to various diseases to reduce symptoms such as swelling and allergic-type reactions.
62
extension vs flexion
extension - straightening out a joint
| flexion - bending a joint
63
What are signs of pulmonary edema?
- cough that produces frothy sputum that may be tinged with blood
- orthopnea, rales—in mild cases
- dyspnea
- Wheezing or gasping for breath
- cold, clammy skin
- A rapid, irregular heartbeat (palpitations
64
What is a TIA?
| signs and symps?
Transient Ischemic Attacks - Temporary localized reduction of blood flow
-TIA Signs and Symptoms
o Arm/leg muscle weakness
o Visual disturbance (double vision, blurred vision, or loss of vision in one eye)
o Numbness in face
o Transient aphasia
o Transient confusion
65
with progressive dementias, such as Alzheimer’s, initial memory loss includes
the ability to distinguish fine categories, such as species of animals or types of objects, but, over time, this lack of discrimination extends to broader, more general categories.
66
signs of MS?
o Manifestations determined by areas of demyelination
o Blurred vision, weakness in legs
o Diplopia (double vision), scotoma (spot in visual field)
o Dysarthria
o Paresthesia, areas of numbness, burning, tingling
o Progressive weakness and paralysis extending to the upper limbs
o Loss of coordination, bladder, bowel and sexual dysfunction, chronic fatigue
67
what is autonomic dysreflexia
sudden onset of excessively high blood pressure. It is more common in people with spinal cord injuries that involve the thoracic nerves of the spine or above (T6 or above).
68
most common trigger of autonomic dysreflexia (SNS) in spinal cord injuries?
- most common triggers are over-distension of the bowel or bladder
69
Huntington's disease is an inherited disorder that results in...
death of brain cells
70
What are the “3-Ps” of hyperglycemia?
1) Polyuria – frequent passage of large volumes of urine (excess glucose spills into the urine and is excreted. This causes water to follow the higher osmotic pressure of the urine (increased water loss)
2) Polydipsia- “condition of much thirst”. (Fluid loss through polyuria draws out water from the cells, leading to dehydration)
3) Polyphagia- “condition of much eating”. (Lack of nutrients (specifically glucose) entering the cells stimulates appetite in order to increase the amount of nutrients taken in )
71
Water Seal Chamber commonly used for chest tubes: what does Continuous bubbling in water-sealed chamber indicate? steps?
Indicates leak between patient and water seal
o Assess and tighten all connections
o Notify health care provider
72
Why is it important to release the suction on a bulb drain (Jackson-Pratt or Blake) prior to removal
will damage tissue (prevent trauma to tissue)
73
12-hour post op dressing is bleeding through the initial pot op dressing. What are your immediate actions?
a. Reinforce (2)
b. Check VS for hemorrhage
c. Outline (1)
d. Do not remove (4)
e. Monitor (3)
f. Call dr. if concerned about excess drainage (5)
74
What is PICC line?
a. Gives meds straight into the heart
b. PICC (peripherally inserted central venous catheters) lines are therefore delivering the med faster to the heart and the arterial blood circulation because of the area of insertion
75
While caring for a patient with IV therapy, the nurse should recognize the following as a first symptom of an air embolism
a. Cyanosis (Symptoms of an air embolism: cyanosis, dyspnea, hypotension, weak rapid pulse, and chest, shoulder & back pain)
76
What part of the heart delivers unoxygenated blood to the lungs?
pulmonary artery
77
true or False: The bicuspid/mitral valve is located on the left side of the heart.
true
78
```
blood enters on the left side of the heart through the ______________ and enters the left atrium. It then passes through the _____________to enter the left ventricle.
A. pulmonary vein, bicuspid valve
B. pulmonary artery, mitral valve
C. pulmonary vein, tricuspid valve
D. pulmonary artery, aortic valve
```
A. pulmonary vein, bicuspid valve
79
```
What part of the heart delivers richly oxygenated blood to the body?
A. Tricuspid Valve
B. Superior Vena Cava
C. Aorta
D. Pulmonary artery
```
c. aorta
80
True or False: Pulmonary veins take unoxygenated blood away from the heart.
false
81
True or False: Blood flows in the following sequence in the heart: Superior vena cava/Inferior vena cava, right atrium, tricuspid valve, right ventricle, pulmonic valve, pulmonary artery, lungs, pulmonary veins, left atrium, bicuspid valve, left ventricle, aortic valve, aorta
true
82
```
What part of the heart delivers oxygenated blood to the heart?
A. Pulmonary artery
B. Pulmonary vein
C. Aorta
D. Tricuspid Valve
```
B. Pulmonary vein
83
On the right side of the heart, blood flows from the right ventricle to the ____ to the ____?
Pulmonic valve to the pulmonary artery
84
True or False: The atriums are located below the ventricles.
false
85
Signs a patient needs to be suctioned may include (4)
1-gurgling respirations
2-respiratory distress
3-low oxygen-saturation levels
4- coarse crackles on auscultation.
86
Oropharyngeal/nasopharyngeal VS Orotracheal/nasotracheal
oropharyngeal and nasopharyngeal: used when client is able to cough effectively but is unable to clear secretions by coughing or swallowing
Orotracheal/nasotracheal: when client is unable to cough and manage their own secretions. Sterile procedure.
87
Chest tube: - Notify physician if drainage is greater than ___ml/hr or becomes bright red or increases suddenly
100ml/hr
88
Maintenance of infusion therapy:
| Change venipuncture site every __-__ hours, IV dressing every __ hours, IV tubing every __-__ hours
Change venipuncture site every 45-72 hours, IV dressing every 72 hours, IV tubing every 24-72 hours
89
- Promote fluid intake of ___-___ mL daily for average adult and an increased intake for clients at risk of UTI and renal calculi, and clients with catheters
1500-2000 mL
90
what are the single most important indicator of fluid status
daily weights
91
what is the purpose of NG tubes
2. Decompression: removal of secretions from the GI tract for the prevention and relief of abdominal distension
3. Feeding or gavage: instillation of liquid nutritional supplements into the stomach for clients unable to swallow
4. Compression: internal application of pressure by means od inflated balloon to prevent internal esophageal or GI hemorrhage
5. Lavage: irrigation of the stomach for active bleeding, poisoning, or gastric dilation
92
Reposition q2h or more frequent if there are reddened areas. ______ position is best as it does not put direct pressure on the trochanter
30 degree lateral
93
Trochanter rolls can be used to prevent
external hip rotation
94
- Braden Scale – measures risk for pressure ulcer and includes what 5 components?
and needs to be used when?
sensory perception, moisture activity, mobility, nutrition, and friction and shear. Needs to be used preventively (on admission) and consistently (daily in high risk clients)
95
what is the primary organs for regulating fluid and electrolyte balance. They selectively reabsorb or excrete water and electrolytes.
kidneys
96
Hypotonic solution uses
raises total fluid volume - replace or prevent dehydration
97
What is the quality of respirations of the newborn?
Shallow and irregular
98
when does Phase 1 of newborn care occur? Initial care includes?
birth-1h
• Maintaining thermoregulation
• Maintaining cardiorespiratory function
• Observing for urination and passage of meconium
• Identifying the mother, father, and newborn
• Performing a brief assessment for major anomalies
• Encouraging bonding and breastfeeding
99
what position and height is the uterus fundus immediately after placenta expelled? Descent rate?
can be felt midline, at or below umbilicus as a firm mass. After 24 hrs fundus begins to descend about 1 cm each day
100
what order does lochia go in
| alba, rubra, serosa
Lochia Rubra -> Lochia Serosa -> Lochia Alba
101
Describe the color, consistency and time seen of lochia
Lochia Rubra: Red, Mostly blood, About 3 days
Lochia Serosa: pinkish, Blood and mucus, 3rd to 10th day
Lochia Alba: Clear/colorless or white, Mostly mucus, 10th to 21st day
102
Signs of true labor
* Contractions gradually develop a regular pattern
* Contractions become stronger and more effective with walking
* Discomfort in lower back or abdomen
* Bloody show often present
* Progressive effacement and dilation of cervix
103
What is the first stage of labour
dilation and effacement (can last 4 to 6 hours)
3phases
•Latent phase: up to 3 cm of dilation (not very painful, happy. Contractions are far apart)
•Active (labor) phase: 4 to 7 cm of dilation (pain, not happy)
•Transition phase: 8 to 10 cm of dilation (lots of pain, not happy)
(dilate/contract cervix. Longest stage)
104
what occurs in the second stage of labour
expulsion of fetus (30 minutes to 2 hours)
| - ends with birth of infant
105
what occurs in the third stage of labor? Nurses responsibilities?
expulsion of placenta (5 to 30 minutes) – sometimes theres a massage to help expulsion
- cord is cut
Nurses responsibility to assess the placenta and monitor woman’s vital signs
106
what is the fourth stage of labor and what is the nursing care?
Recover stage - 1-4 hrs after birth of placenta
Nursing care:
- Identifying and preventing hemorrhage
• Evaluating and intervening for pain
• Observing bladder function and urine output
• Evaluating recovery from anesthesia
• Providing initial care to the newborn infant
• Promoting bonding and attachment between the infant and family
