Round 1 Flashcards
The RN is reviewing blood pressure readings for a group of pt’s. Which patient is
the highest risk for complications related to hypertension?
Middle- aged African American male who has a serum creatinine level of 2.9
Rationale: normal serum creatinine
men: .74-1.35
women: .59-1.04
What should be taught with a patient taking medications for hypothyroidism?
Take in am
-No antacids
- On empty stomach absorbs better
- 30 min before or 2 hours after food helps absorption.
- meds should be at therapeutic level to avoid depression
Hypothyroidism- sleep/depression
Depression can result from untreated hypo
- falling/staying asleep difficult = avoid sedation
- frequent rest but stay action
What are the S/S of diverticulosis
- LLQ pain
- bowel pattern changes
- bloating
- fever
-N/V - Constipation
What is the typical medication for gout
When to take
Allopurinol
Rationale: Gout medication- allopurinol
- bone marrow depression, vomiting, abd. pain
- Avoid starting/ increasing med during active flare up
- AFTER MEALS
What Interventions are used for a patient taking allopurinol for gout?
- Increase fluid intake to prevent kidney stones
- increase movement
- avoid caffeine, alcohol, and dairy
- may take several weeks to work
- stop if rash develops.
- NO HIGH PURINE FOODS (organ meats, shellfish, fructose)
- avoid starting/ increasing med during active flare ups
- bone marrow depression
what tests Glucose and gets the best result?
A1C should be greater than 7%
- Dip stick for ketones turns purple when ketones are present.
- type 1 complications, serum glucose is 250+, ketonuria in large amounts in urine
What are right sided heart failure symptoMS
Systemic
- congestion
- peripheral edema
- ascites
- JVD
- hepatomegaly
What are left-sided heart failure signs and symptoms?
Lungs
- congestion
- dyspnea
- crackles
- fatigue
- pink/frothy sputum
what kind of exercise should someone with osteoarthritis do?
Low impact exercises
- yoga
-swimming
- small amounts of walking
what should you assess for a small bowl obstruction?
-Auscultate bowel sounds
- IV fluids will be given to replace depleted water, sodium, chloride and potassium
What is the first intervention for a patient with positive small bowel obstruction?
NG tube to suction placement with X-ray to confirm correct placemen
what are the second lines of interventions for small bowel obstructions
- Barium enema stud
What to do for a patient with pneumonia?
- antibiotics started
- Start o2
What tests are used to confirm pneumonia?
PCV 13= 19-64 YEAR OLDS
PPSVV 23=19-64 YEAR OLDS WHO SMOKE/ HAVE ASTHMA
What is the treatment for pneumonia?
- oxygen therapy
- hydration
- bed rest
- elevated Head of bed
- Deep breathing
- humidified air
- Chest physiotherapy
- suctioning PRN
What are the interventions for COPD?
low concentrated oxygen
<2-3L nasal canula
No petroleum-based lip products
DO NOT WANT Ph TO FALL.
ORAL OR IV CORTICOSTEROIDS
What is the treatment for Diverticulitis?
NPO diet or clear liquid diet to decrease exacerbations to decrease inflammation
- low fiber may be progressed from there
- antibiotics
what is the medication for Heart failure?
what does it do?
therapeutic level
DIGOXIN
Increases cardiac output and contractility
- DECREASES HEART RATE
- therapeutic level 0.5-2 ng/mL
What is an intervention for Heart failure
- take apical pulse prior to giving DO NOT GIVE IF HR IS LOWER THAN
60BPM
What is the antidote for Digoxin toxicity?
potassium and Digifab
What are the signs of Digoxin TOXICITY
Loss of appetite
- Lower stomach pain
- diarrhea
- Weakness
- Blurred or yellow vision
- headache
- Rash
What are the priorities for a patient on hypertonic IV fluids?
Lung sounds and O2 saturation.
hypertonic solution examples
5% dextrose in LR
5% dextrose in 0.45% saline
5% dextrose in 0.9% saline
10% dextrose in water
CAUSES CELLS TO SHRINK
Rheumatoid arthritis Prioritie
- Is based on what the patient looks like.
- Self-care deficits
- Pain management
- altered body image
Rheumatoid Arthritis treatment
Early
- NSAIDS
- Opioids
- Methotrexate can take up to 6wks to work.
Advance
- Use immunosuppressants such as Methotrexate, azathioprine
Peptic Ulcer Disease Treatment
NG tube to suction
- Confirmation that obstructed is the discomfort of the patient done by assessing
the amount of fluid aspirated. - Residual of > 400 mL indicates obstruction
What is expected upon assessment for PUD
- severe epigastric pain
- uncontrolled vomiting
What to expect upon an assessment for Prostatic hyperplasia?
urinary frequency
Urgency
hesitancy
decreased/ intermittent stream
incomplete emptying
less than 50-100 mL
What is prostatic Hyperplasia
- Benign growth
- occurs in men with elevated estrogen levels.
What should be taught to a patient with DM?
Properly monitor glucose
- Self administration of medication
When should chest physiotherapy be done?
an hour before meals and and hour before bed
What is the priority for Irritable Bowel Syndrome assessment?
- Distention
- Fever
- Nausea
- Vital signs
- Pain assessment BEFORE PAIN MEDICATIONS
Who has the highest risk for IBD?
women
What is the treatment for IBD
- Fluids
- antibiotic therapy
- colloid
- electrolyte replacement
What triggers asthma?
respiratory infection, exercise, sudden changes in either humidity or temperature
and air pollution
What should be taught to patient with asthma?
The need to be aware of what tigers it and how to prevent them.
The need to be aware of what tigers it and how to prevent them.
what is the priority when communicating with a patient with schizophrenia?
Establish Trust
Get patient the talk
Give positive feedback
Show empathy
Do not be judgmental
Never tell pt that you accept there delusions as reality
