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VN 22 Med Surg 1 > Test 10 > Flashcards

Test 10 Flashcards

1
Q

1.Nursing considerations for stem cell clients (pp slide 30)

A

-Avoid invasive procedures
-Avoid fresh fruit/fresh plants
-Limit # of visitors
-Monitor temp q 4hrs (minimum)

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2
Q

2.Adverse effects of radiation therapy (pp slide 23)

A

-desquamation (shedding of the skin), use soft wash cloth
-alopecia
-erythema
-stomatitis (irritation inside the mouth, mouth sores) > stay away from spicy, fatty foods
-xerostomia (dryness of the mouth) > sugar free gum to get rid of metallic taste
-anorexia
-nausea
-cystitis (inflammation of the bladder)
-pneumonitis
-fatigue
-Myelosuppression: depression of bone marrow (no fresh flowers, fruits, bottled water, limit visitors, no salad bars)
-Leukopenia: decreased WBC
-Thrombocytopenia: decreased platelet count
-Fibrosis: small intestine, lungs, bladder; cataracts, sterility, new cancers

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3
Q

3.Precautions when administering radiation therapy (pp slide 22)

A

-Time: plan ahead by having everything needed when entering client room
-Distance: stand at the greatest distance away from site of internal radiation
-Shielding: wear lead apron if close contact & prolonged care are needed

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4
Q

4.Docusate sodium K,H,K (pharm flashcard)

A

Stool softener
-relives constipation/prevents straining during BM
-Take w/full glass of water
-Contraindicated in those w/bowel obstructions
-Don’t take within 1hr of other drugs, antacids, or milk
-Not for long term use (1 week max)

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5
Q

5.Client education for chemotherapy, radiation (pp slide 25)

A

-Small, frequent meals
-Increase fluid intake: 2,500-3,000 mL/day
-Report excessive weight loss, change in LOC, paresthesia (tingling, prickling “pins & needles sensation)

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6
Q

6.Endometrial cancer manifestations (ATI pg.568, Timby pg.732)

A

-Irregular and or postmenopausal bleeding
-Late Symptoms: pain, pressure on the bladder or bowel & generalized wasting

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7
Q

7.TNM (pp slide 18)

A

T= indicates size of tumor
N= involvement of regional lymph nodes: N0- N3
M=metastasis M0 or M1, M2 or M3
-higher the grade the less differentiated
-higher the number the larger the tumor or more lymph nodes involved
-Carcinoma in situ: abnormal cells present but have not spread to surrounding tissue

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8
Q

8.Nursing considerations for xerostomia, stomatitis (ATI pg.542)

A

Xerostomia:
-sugar free gum to get rid of metallic taste

Stomatitis:
-stay away from spicy, fatty, salty, acidic foods
-try eating foods that are cold rather than hot

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9
Q

9.Risks of cancer (pp slide 7)

A

-Tobacco use
-Age
-Alcohol use
-Altered immunity
-Poor diet, lack of physical activity, or being overweight
-Some viruses & bacteria
-Hormones
-Exposure to radiation & or chemicals
-Family hx of cancer/genetics

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10
Q

10.Cancer prevention (pp slide 14)

A

-Healthy lifestyle (consume fruits & veggies, folic acid, omega 3)
-Awareness of warning signs & factors of cancer development
-Cancer screening programs
-Periodic physical examinations
-Avoid risk factors
-Genetic testing
-Emphasize & teach self-examinations (breasts, skin, testicles)

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11
Q

11.Warning signs of cancer (pp slide 13)

A

-Change in bowel/bladder habits
-A non-healing sore
-U unusual bleeding
-Thickening lump
-Indigestion
-Obvious change in size of wart/mole
-Nagging cough
*Additional: headaches; weight loss, chronic pain, fatigue, low-grade fever; infections

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12
Q

12.Tamoxifen (pp slide 28)

A

Breast cancer
-risk of PE/DVT & endometrial cancer (heavy vaginal bleed)
-AE: hot flashes

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13
Q

13.Doxorubicin (pp slide 28)

A

-HF/discoloration of urine/sweat/tears
-Monitor cardiac function

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14
Q

14.Vincristine (pp slide 28)

A

-no bone marrow suppression, but peripheral neuropathy & phlebitis

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15
Q

15.Interferon alpha 2b (pp slide 28)

A

Immunotherapy- enhances immune sx
-flu like sx & hx of depression

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16
Q

16.Filgrastim (neupogen) & Epotin (procrit) (pp slide 28)

A

Stimulate neutrophil
-wait 24hrs after chemo
-Epoetin: increase RBC

17
Q

17.Difference between strain and sprain (pp slide 1)

A

Strain: injury to a muscle when stretched or pulled, very often after overuse
Sprain: injuries to ligaments surrounding a joint, moved beyond their typical ROM like twisting

18
Q

18.Nursing considerations with open fractures (complications) (pp slide 14)

A

-Fat & Pulmonary embolism: can decrease oxygen w/manifestations > Change in LOC, SOB, chest pain; anxiety
-Use ABC’s as nurse approach. Assess for decrease oxygen, check cap. Refill for neuro status
-Avascular necrosis: assess neurovascular status
-Compartment syndrome
-Infection-redness, warm to the touch, fever (monitor vitals)
-Delayed bone healing

19
Q

19.Compartment syndrome manifestations (pp slide 14)

A

-Unrelenting pain
-Increased pressure in area
-Ischemia (pt might have cool skin, palored skin, altered sensation in toes, no pulse at affected side)
-Nerve pain (severe, no relief from medications)

20
Q

20.Risks for fractures (pp slide 11)

A

-Bone infections or tumors
-Diabetes
-Caucasian ethnicity
-History of steroid use
-Hx of smokers
-Osteoporosis
-Post menopausal
-Poor or inadequate nutrition
-Small, framed individuals

21
Q

21.Prosthesis care (pp slide 20)

A

-Placed immediately after amputation to promote post-op ambulation
-At risk for hip deformation > encourage prone position 20-30mins/day
-Assess for infection
-Inspect for skin breakdown using mirror
-Include active & passive ROM exercises
-Do not alter prosthesis
-Change the dressings daily
-Compression tape, wrap in figure 8 pattern

22
Q

22.Post op care for ortho surgery (pp slide 16)

A

-Prevent post op complications: fluid increase, good pin care
-Reduce risk for excessive bleeding: assess wounds
-If anti-embolic stockings: remove & assess every 8 hrs for skin integrity
-Vitals & capillary check every 2-4hrs
-Ambulation w/assistance after day 1
-Help reduce pain & inflammation

23
Q

23.Foods high in calcium

A

-kale, leafy greens, collard greens, broccoli
-milk/cheese products
-canned fish

24
Q

24.Diagnostic labs for bone disorders (Timby, pg.838 & ATI pg.395)

A

-DXA/DEXA
-Arthroscopy
-BMD (bone mineral density)
Nuclear scans:
-Bone scans
-Gallium & thallium scans

25
Q

25.Pin care for traction (ATI pg.419)

A

-Monitor for signs of infection, swelling, drainage, tenting
-frequent pin site care throughout immobilization to prevent loosening of pins (Pin care is provided usually 1-2 times/day, increase the frequency of care if an increased amount of drainage is noted or infection is suspected)
-clean w/clean sterile swab for each pin site (inner to outer)

26
Q

27.Manifestations of dislocations (pp slide 4)

A

-Sudden instability
-Limited ROM
-Altered structural shape
-Popping sound
-Pain

27
Q

28.Emergency procedure for traumatic amputation (pp slide 20)

A

-Put in plastic bag
-Avoid contact w/water or ice directly
-Wrap in sterile gauze or clean cloth (soaked in saline if available)

28
Q

29.Medical treatment of phantom limb syndrome

A

-anticonvulsants

29
Q
  1. Ruptured Achilles Tendon Nursing management (pp slide 8)
A

Prevention: warm up/warm down
Educate: brace to be worn 6-8 weeks

30
Q
  1. Rice Method (pp slide 9)
A

Rest (if joint is weight bearing, use canes, crutches, or other walking devices)
Ice (ice pack or cold compress)
Compression (bandages to encourage proper healing)
Elevation (above or at the same level as the heart)

31
Q
  1. Fractured or Dislocated Hip Manifestations (pp slide 15)
A

-Blood loss
-Extensive bruising
-Edema
-Severe pain
-Shortening, external rotation of the leg
-Contained bleeding

32
Q
  1. Positioning precautions for Hip replacement (pp slide 18)
A

-Have legs abducted w/pillows or abductor cushion and extended
-Avoid positions internal or external rotation of the affected hip
-Avoid adduction & flexion beyond 90 degree which can dislocate the prosthetic femoral head
-Sit in an elevated chair or on a seat raised by pillows so that flexion remains less than 90 degrees
-Do not cross legs
-Do not turn client on affected side

VN 22 Med Surg 1 (15 decks)

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