Random Mark K

Question 1

Underventilated ex

Answer 1

Emphysema
Pneumonia 
Drowning 
PCA pump toxicity 
Too low setting

Question 2

Prolonged suctioning or vomiting (lead to metabolic alkalosis)

Answer 2

Hyperemesis gravidum

Surgery w NG tube suction for 3 days

Question 3

Lead to metabolic acidosis

Answer 3

Acute RF
infant diarrhea
3rd degree burns over 60% of body
Hyperemesis gravidum with dehydration

Question 4

delirium tremens

Answer 4

severe form of alc withdrawal… manifesterd by AMS (global confusion) and sympathetic overdrive (autonomic hyperactivity)… which can lead to cardiovascular collapse

• • benzos are common meds used to calm NS
    i. e. lorazepam, diazepam, oxazepam, chlordiazepoxide
• • may also need IV fluids w vitamins and minerals to treat dehydration or bring electrolytes back to balance

Question 5

meds for dts

Answer 5

anti-hypertensives
tranquilizers
multivitamin containing vit B1

Question 6

what type of burns would you give pt aminoglycosides

Answer 6

infection from third degree wound covering > 80% of body

Question 7

when would you use CCBs

Answer 7

treat A, AA, AAA
antihypertensive
antianginal drugs (decrease O2 demand)
antiatrialarrhythmia

**SE –> H/A and hypotension

Question 8

examples of CCBs

Answer 8

• dipine

verapimil, cardizem (diltiazem) * diltiazem is given continuous IV drip

Question 9

tx for supraventricular arrhythmias

Answer 9

atrial arrhythmias (super = above)
adenocard (adenosine)
beta blockers
CCBs 
digoxin/digitalis, lanoxin (Another dig analog)

Question 10

what to do if water seal of a chest tube breaks

Answer 10

clamp clamp, unclamp, place tube under water must be done in 15 seconds or less
cut the tube away
submerge the end of the tube under sterile water THE MOST IMPORTANT STEP
unclamp tube if it was initially clamped clamping the tube prevents air to get into the chest but does not allow anything from the chest to get out

Question 11

what to do if drainage device (i.e. jackson pratt, emission, pneumovac, hemovac, etc) is knocked over?

Answer 11

ask pt to take a deep breath and set the device back up

NOT A MED EMERGENCY, no neet to call physician

Question 12

what to do if chest tube gets pulled out?

Answer 12

1. take a gloved hand and cover the opening first step

2. take a sterile vaseline gauze and tape 3 sides best step

Question 13

what does it mean if the water seal chamber is continuously bubbling

Answer 13

BAD

indicates a break/leak in the system (find it and tape it)

Question 14

what does it mean if suction control chamber is intermittently bubbling

Answer 14

BAD

suction pressure is too low, increase it at the wall until it is continuous

Question 15

rules for clamping tubes

Answer 15

do not clamp for more than 15 seconds w/o order

use a rubber tooth (will not puncture tubing), double clamps

Question 16

pediatric pt with congential heart defect

Answer 16

needs surgery now/soon to live
has a slowed/delayed growth and development (FTT)
shortened life expectancy
parents will experience

Question 17

acute glomerularnephritis

Answer 17

inflammation and subsequent damage of glomeruli leading to hematuria, proteinuria and azotemia higher BUN’

urine output may be decreased in early stages

Question 18

when should you notify healthcare provider for pt in labor for 16 hours

Answer 18

fetal HR above 160 for longer than 10 mins
variable decels report IMMEDIATELY **sharp and profound drops in the fetal HR unrelated to time of contractions are NON-REASSURING cord compression like prolapsed cord

Question 19

gastrotomy

Answer 19

insert a tube through the abdomen and into the stomach

• provide route for tube feeding if needed for four weeks or longer and or to vent the stomach for air or drainage
• children may need if they are having a intestine transplant or after intestinal transplant
• if pt can’t tolerate NG

Question 20

reasons for enteral feedings

Answer 20

stroke
cancer
critical illness/injury, which reduces energy/ability to eat
failure to thrive
serious illness, body in state of stress
neurologic/mov’t diorders that incr cal requirements
GI dysfunction or disease may require IV nutrition instead

Question 21

enteral vs parenteral feeding

Answer 21

if you’re at risk for malnutrition and don’t have a functional GI system… may need parenteral feeding
** port of PICC
if you need supplementary nutrition = peripheral parenteral nutrition (PPN) –> all nutritional requirements through IV = TPN

Question 22

late sign of incr ICP

Answer 22

babinski reflex
decorticate
decerebrate postures
seizures

Question 23

nonstress test reactive

Answer 23

assesses fetal HR and movement, noninvasive procedure has no risk to mom/child

• nonreactive indicates fetus needs more monitoring and testing
• test occurs over 20 min period
• 2 or more accelerations
• accelerations are 15 b/min lasting 15 seconds
• measures FHR in response to fetal mov’t

Question 24

examples of objective data

Answer 24

BP, HR, RR, O2 sat
gait and posture
uncoordinated or spontaneous body movements
hygiene and grooming

Question 25

side effects of levothyroxine sodium for hypothyroidism

Answer 25

slight heat intolerance weight loss insomnia

Question 26

tx for DI

Answer 26

desmopressin thiazide diuretics anti-inflammatories **pt at risk for fluid volume deficit bc client may be experiencing polyuria *may manifest as tachycardia, hypotension, thready pulse, hypernatremia** **hydrocortisone is short-actinhg corticosteroid and is indicated for ADRENAL INSUFFICIENCY

Question 27

hyperthyrodism tx

Answer 27

methimazole | propylthiouracil

Question 28

manifestations + tx of pheochromocytoma

Answer 28

type of neuroendocrine tumor that grows from cells called chromaffin cells - cells produce hormones needed for the body and are found in the adrenal glands ** hypertension, H/A, sweating and s/s of panic attack **life threatening** give antihypertensives (like prazosin *which is an alpha-adrenergic blocker*)

Question 29

what medication should pt not take with phenytoin

Answer 29

calcium carbonate **can decrease the effects of phenytoin, decrease bioavailability NO ANTACIDS separate times by at least 2-3 hours

Question 30

ace inhibitors uses and concerns

Answer 30

- manage HR and hypertension MED MAY BE NEPHROTOXIC... need to watch creatinine and GFR

Question 31

lugol's solution purpose

Answer 31

to reduce the size of the thyroid and reduce bleeding **given 10-14 days before surgery to decrease vascularity of thyroid

Question 32

brown-sequard syndrome

Answer 32

incomplete spinal cord injury - weakness/paralysis (hemi-paraplegia) on the ipsiolateral (same) and sensory loss (hemianesthesia) on the contralateral (opposite) side

Question 33

when would you use a 24-hour urine sample to diagnose

Answer 33

pheochromocytoma | abnormal protein quantification in multiple myeloma

Question 34

cystitis s/s

Answer 34

``` leukocyte esterase nitrite rbcs abnormal number of WBCs bacteria ```

Question 35

when would you hear fine crackles

Answer 35

pulmonary edema asthma obstructive diseases

Question 36

when would you hear coarse crackles

Answer 36

pulmonary edema pneumonia depressed cough reflex

Question 37

when would you hear wheezes

Answer 37

asthma bronchitis chronic emphysema

Question 38

when would you hear stridor

Answer 38

croup epiglottis any airway obstruction ** requires medical attention

Question 39

emphysema s/s

Answer 39

hyperventilation, breathing fast, trying to blow off CO2 PINK PUFFER - barrel chest - thin weight loss - SOB - severe dyspnea

Question 40

chronic bronchitis s/s

Answer 40

- mucus secretition - chronic productive cough BLUE BLOATERS - cyanotic too much CO2, hypexemia - peripheral edema - rhonchi and wheezing - chronic cough

Question 41

COPD meds

Answer 41

bronchodilators *first* corticosteroids *second* buproprion - asone - inide - olone

Question 42

Pneumonia meds

Answer 42

``` antipyretics antibiotics antivirals bronchodilators cough suppressants mucolytic agents ```

Question 43

status asthmaticus

Answer 43

``` life threatening asthma episode O2 HYDRATE NEBULIZATION SYSTEMIC CORTICOSTEROID ```