Random from practice quizzes 2 Flashcards
Cystic fibrosis nutrition
Nutritional deficiencies so include in diet extra dairy, fat, protein and salt.
Bedwetting child
Collect UA first to rule out UTI! Rule out physiological information before psychosocial
What is pertussis?
This is a childhood disease WITH A VACCINE. It has reemerged because not all kids are vaccinated
Also known as whooping cough!
What is viral meningitis and what are the precautions
Meninges infection (thin layer covering brain) Use standard precautions!
What does a negative and positive pressure room do?
Negative pressure room keeps air IN
Positive pressure room keeps air OUT
Immunosuppressed patient should be in a positive or negative pressure room?
Positive
Airborne diseases are kept in a positive or negative pressure room?
Negative
What is tetralogy of fallot?
It is a dysfunctioned heart. Combination of 4 congenital abnormalities
Causes poor blood/O2 circulation leading to SOB and blue tinged skin
CPR for infants
- Place pt on firm, flat surface
- Use 2 fingers to do compressions
- Give compressions @ rate of 100-120 per minute
- Compressions about 1/3 anterior-posterior diameter of chest
- Compression to ventilation rate is 30:2
- Time to give breaths does not take longer than 10 sec
Abdominal guarding
Tensing of abdominal wall muscles to guard inflamed organs
INVOLUNTARY! A sign your body is trying to protect itself from pain. This is a symptom of a very serious, life threatening condition
What is tenesmus?
Urge to move bowels even if emptied
Common symptom of ulceritive colitis
What is a liver biopsy? What is a potential complication
Removing tissue from liver for diagnostic purposes. A potential complication is pneumothorax
What is a bronchoscopy? What is an expected finding post-op?
Dr. Inserts thin tube with light into lungs to examine. An expected finding is pink tinged mucus from sore throat with small amounts of blood
Diet for patient with cirrhosis
NO ALCOHOL!
Calculate Na intake to avoid fluid volume excess. Low Na diet!
What data should be collected for patient with hematemesis
Assess for SHOCK! Check vitals!
S/S of shock
DECREASED BP, Increased HR, thready rapid pulse
Cold/clammy skin, decreased UA,
Decreased LOC, SOB
What is PTT and PT? Normal range?
PTT monitors efficacy of HEPARIN
Range: 30-40 sec
PT monitors efficacy of WARFARIN
Range: 11-13.5 sec
Normal hemoglobin for men, women, pregnant?
Men: 13.5-17.5
Women: 12.0-15.5
Pregnant: 11.5 would be normal
Rheumatoid arthritis to know
Autoimmune disease!
Protect client by restricting visitors with illness
Body attacks synovium - lining of membranes surrounding joints
No cure, treatment to relieve symptoms
Dexamethasone is common drug used. Treats severe inflammation
COPD diet
Nutritious diet to avoid weight loss!
Eat small, frequent, high calorie meals.
High protein and fiber
1-2% milk to avoid increased mucus production
Pancreatitis signs
“Cullen’s Sign” - bruising around umbilicus indicating internal bleeding
Pain can cause tachycardia
Fever from inflammation
Pain in mid-gastric area radiating to back
Onset SUDDEN AND SEVERE!
Trousseau Sign
Elicited in Hypocalcemia
Hand contracts when BP cuff is inflated
Late stages of rheumatoid arthritis
- Effusion to knees - Water in knees. Look puffy and feel soft
- Swan neck deformity - in fingers. Distal joint is permanently bent toward palm
- Peripheral neuropathy
- Nodules on elbows
Iron deficient anemia teaching
- Consume iron rich foods
- Notify healthcare provider of glossitis (inflammation of tongue), anorexia, and paresthesia
- Iron is needed for RBC development
- Dilute liquid iron with water or juice. It stains teeth
Ebola virus transmission and precautions
- Spreads through direct contact with blood or body fluids. From people or contaminated inanimate objects
- Wear PPE - gown, apron, boot covers. N95 MASK
Gastric reflux position
Reverse trandelenburg! promotes gastric emptying and prevents esophageal reflux.
What is cystitis and s/s
Inflammation of bladder
Incontinence, urgency, frequency, hematuria, nocturia
What two diseases come from varicella virus?
Chicken pox and shingles
What do calcium channel blockers do?
Help relax the muscles in walls of vessels
What counteracts extrapyramidal side effects?
Benztropine Mesylate
Also used to treat parkinson’s
What is biofeedback?
Progressive muscle relaxation with use of electrodes placed on chest
TSH normal values
0.4-4.0
What is Akathisia?
Restlessness, nervous energy
Tardive Dyskinesia
Involuntary movement of tongue, chewing movement of mouth, lip smacking
Akinesia
Lack of movement
Bradykinesia
Slow movement
Dystonia
Upward gaze of eyes
How long do you wait between puffs from inhaler?
1 minute
Normal lab values for Potassium Sodium Calcium Magnesium
K 3.5-5
Na 135-145
Ca 9.0-10.5
Mg 1.3-2.1
What is the action of sodium polystyrene sulfonate?
Reduce K
Low sodium diet inclues:
Pork, salad, fresh fruit, lean meat.
NO instant pudding, tomato juice, pizza
Plaster leg cast takes how long to dry
24-48 hours. Do not cover with blanket!
Pernicious anemia
Autoimmune disorder! Lack of B12
Symptoms: Smooth, red tongue, burning feeling in feet, lightheaded, dyspnea on exertion, slow reflexes
How to use AED’s
What is synchronized cardioversion mode?
- Apply pads to bare skin
- Continue CPR until advised to deliver shock
- Stop CPR while machine analyzes rhythm
- Shout “clear” prior to activating shock button
Synchronized cardioversion mode is used when converting erratic rhythms to normal sinus rhythms
What is a mediterranean diet?
Vegetables, fruits, whole grains, low fat diary products, poultry, fish, legumes, nuts, limits sweets and red meats
Symptom of a stomach ulcer that is bleeding
Coffee ground emesis
What is scotoma?
Partial loss of vision or blind spot
What is movement agnosia?
Inability to recognize movement of an object
What are signs of injury to the occipital region
Scotoma and movement agnosia
Nutrition for burn patients
Vitamin C and protein to promote wound healing
Electrolyte drinks do not have protein just FYI
What is pyelonephritis?
Infection of renal pelvis and kidney
- Monitor for dark, cloudy, foul smelling urine
- Strict I’s and O’s
- Increase fluid to flush out bacteria
- Levofloxacin is an antibiotic… increases phototoxicity. Avoid direct sunlight and tanning beds. Use suncreen
- Monitor for hypotension, tachycardia, fever
Tylenol contraindications
Warfarin - inhibits warfarin metabolism. Causes to accumulate in toxic levels
Liver disease or alcohol consumption
Normal liver lab values
ALT: 7-55 units/L
AST: 8-48 units/L
Bilirubin: 0.1-1.2 mg/dl
Common NSAIDS
Ketorolac (Toradol)
Ibuprofen (Advil, Motrin)
Naproxen Sodium (Anaprox, Aleve)
Meloxicam (Mobic)
NSAID contraindications
Pregnancy, asthma, hepatic disease, peptic ulcer disease
Drop factor units
gtts/mL
How to decontaminate a client involved in a chemical exposure
Remove clothing FIRST, then complete flushing with water, then wrap pt in sheet or protective cover
Removal of PPE order
- Remove GLOVES and wash hands
- Remove protective eyewear
- Remove gown
S/S of pulmonary TB
Weight loss, anorexia, fatigue, bloody sputum, diaphoresis during sleep (night sweats)
Pt with concussion should report this to the provider
Difficulty waking up, vomiting, blurry vision, increasing pain
Chronic emphysema
What is it?
S/S
Gradual damage to lung tissue
Thinning and destruction of alveoli or air sacs
Creates large air spaces instead of many small ones
The alveoli then lose elasticity and the patient has trouble breathing
S/S: clubbing, increased anteroposterior diameter, use of accessory muscles, breathlessness
Blood transfusion signs of adverse reactions
Lower back pain is a sign of an acute hemolytic reaction
This occurs when donor blood is incompatible with the recipient
This is the most dangerous and potentially life threatening reaction
Assigning UAP random about vitals
UAP should not be assigned to obtain vitals on an unstable patient
Fluoxetine
SSRI - regulates serotonin levels in the brain
Antidepressant
Aplastic anemia
Client at risk for bleeding! Most life threatening… use soft toothbrush or swab for mouth care
This is where the body fails to produce blood cells in sufficient numbers - deficiency of all blood types
Presbyopia begins at what age
40’s
Anomia
Cannot name objects
Early sign of alzheimers
NEVER NORMAL
Apraxia
Unable to perform purposeful movements
INR
Increased INR means patient has potential for decreased clotting and bleeding
Normal: 2-3
Chorioamnionitis
Intra amniotic infection that is not contagious
Inflammation of fetal membrane
Proper foot care for pt with diabetes
Cut toes straight across, not round
Do not wash with harsh chemicals such as betadine
Sign of digoxin toxicity
Vision problems
Reason why infant should not have MMR vaccine
Known allergies to Gelatin
Acute cholecystitis
S/S
Occurs when bile is trapped in gallbladder
S/S: Fever, chills, N/V, rigidity of upper R abdomen, decreased appetite
Thyroidectomy diet
Soft diet post surgery
Hypothyroidism S/S
Decreased sensitivity to cold, dry skin, anorexia, fatigue, weight gain, constipation
Assault
An act that results in a person’s genuine fear and apprehension that he or she will be touched without consent
Battery
Unconsented touching of another person
Kava-Kava
Can cause liver damage. Consult with provider
Neuroleptic malignant syndrome
S/S
Adverse reaction to antipsychotic drugs
MEDICAL EMERGENCY!
S/S: Fever, altered mental status, muscle rigidity, autonomic dysfunction, tachycardia, tachypnea, diaphoresis, coma
Guaiac test
Foods that affect this test
Looks for hidden blood in stool
Raw broccoli, red meats, turnip greens, cantaloupe, radish and horseradish
Thyroidectomy complications
Positive chvostek’s sign - hypocalcemia - abnormal reaction to stimulation of facial nerve
Signing the consent form
Signing as a witness implies that the client willingly signed
Must be over 18, do not have to be an RN
Pantoprazole
PPI - treats stomach and esophagus problems
Methylprednisolone
What it does
Side effect
Steroid that treats inflammation or severe allergies
Side effect: peptic ulcer
Phenytoin
anticonvulsant for seizures
Trousseau sign
Indication of hypocalemia. Hand spasms during BP
Hypothyroidism
Increase fiber to help with constipation
Popcorn is a good source of fiber
Diabetes insipidus lab values (Diuresis inspidus)
Decreased specific gravity
Increased sodium and hemoglobin
Normal WBC count
5,000-10,000
Somogyi effect
BS decreases at night, increases in the AM. When insulin decreases BS too much it can trigger a release of hormones that rebound BS and cause to increase insulin
PTCA post op
Client must remain in bed for 4 hours. At risk for hemorrhage
Cholinergic crisis
Common cause is overdose of treatment drugs from myasthenia gravis DUMBELLS Diarrhea and abd cramping Urination increases Miosis (pinpoint pupils) Bradycardia Emesis Lacrimation Lethargy Salivation
ANC (Absolute neutrophil count)
<500 = severe neutropenia
Leads to risk for infection and sepsis!
Pt on clear liquids post op
Shouldn’t last longer than 3 days! Puts them at risk for nutritional deficiencies.
Magnesmium regulation
GI absorption and renal excretion!
Example: Hypermagnesmia comes secondary to renal insufficiency
Petroleum jelly
Combustible substance, so do not use with O2 therapy!
Gastric residual volume
If high, check again in 1 hr. If still high, then determine reason. Always 2 checks 1 hour apart! (High is around 250 ml’s or so)
Syncope
Fainting or sudden temporary loss of consciousness
Peritoneal dialysis
WARM effluent
2000 to 2500 mL is instilled over 30 min
Returned fluid should be CLEAR
Sweet taste may be experienced
Therapeutic digoxin levels
0.5-2 ng/ml
Ferrous sulfate (iron)
Causes constipation and GI upset
Cetirizine (Zyrtec)
Antihistamine - Treats hay fever and allergy symptoms
Lab values
WBC
Platelet
RBC
WBC: 5,000-10,000
Platelet: 150,000-400,000
RBC: Female 4.2-5.2 Male 4.7-6.1
Contact precautions
MRSA, VRE, Diarrheal Illnesses, open wounds, RSV
Airborne precautions
TB, Measles, Varicella
Neg pressure room
Wear N95 mask
Droplet precautions
Pneumonia, Influenza, Whooping Cough, Bacterial meningitis
LPN scope of practice
Can COLLECT data on admit, but RN has to verify and cosign to complete it
Can MONITOR a PCA pump but cannot initiate or administer medication
Cannot do IVP (push)
R sided HF S/S
Anorexia, ascites, hepatomegaly
All due to fluid buildup in abdomen
Kosher diet
No dairy and meat in the same meal
Steak okay if not bloody
Fish okay except for shellfish
No pork
B vitamins
Help reduce risk of peripheral neuropathy!
Neologism
Invention of new words by psychotic patient
Echopraxia
Imitation of movement
Depersonalization
Feelings of unreality “my heart is solid and my veins have turned to stone”
Ginseng
An herb that improves mental and physical abilities
Barbiturates
CNS depressors
They slow respiratory rate
Clang association
Rhyming and alliteration
Perseveration
Repeatings same word or idea
Early sign of hypoxia
Restlessness
Precautions for cleaning and changing foot ulcer drsg in diabetic patient
Sterile gloves!!!
