test1-2

Question 1

Alcholism effects

Answer 1

peripheral neuropathy, alcohol myopathy, wernickes encephalopthy, korsakoffs psychosis, alcohol cardiomyopathy, GI-itis, Cirrhosis, blood dyscrasia, fetal alcohol syndrome

Question 2

alcohol detox

Answer 2

librium or ativan to prevent DTs, thiamine injections, multivitamins, and magnesium- hydrate -daily labs

Question 3

phychaitric assessment

Answer 3

always send mail through the post office- appearance, speech, mood/memory, thoughts, perception, orientation

Question 4

Benzodiazepines

Answer 4

AMs (alprazalam) sedative hypnotic for sleep, anxiety, panic- effect GABA in brain. SE: dizzy, drowsy, lethargy

Question 5

Buspirone

Answer 5

first choice for anxiety. se: psychomotor slowing- takes a week to start working. dizziness, nausea, headache, nervousness, lightheadedness, excitement- level increased with grapefruit. no tolerance, withdrawal, or abuse and no effect with CNS depressants

Question 6

pharm for OCD

Answer 6

First - SSRIs

second TCA- Clomipramine less tolerated. antidepressants relieve obsessive thoughts and subsequent compulsions

Question 7

Pharm for GAD

Answer 7

benzos, ssris or snores especially if also has depression.

Question 8

pharm for panic disorder

Answer 8

tcas or maois (need to avoid decongestants and certain foods- fish chocolate fermented foods)

Question 9

nms

Answer 9

from dopamine antagonist (antipsych) muscular rigidity, hyperthermia, sweat, pallor, dysphagia, dyspnea, tremors, incontinence,hypertension, altered mental status

Question 10

serotonin syndrome vs nms

Answer 10

all same except from serotonergic agents (MAOIs, SSRIs, SNRIs, Buspirone) dilated pupils, hyperreflexia (instead of hypo) and hyperactive bowel inste of normal or hypo

Question 11

anticholinergics

Answer 11

like benztopine not used much in parkinson anymore but used to treat parkinsonsian like side effects from antipsychotics

Question 12

v-q mismatch

Answer 12

v- ventilation q- perfusion. v is low then perfusion is normal- pneumonia or atelectasis, q (perfusion) low and ventilation normal- pulmonary embolism

Question 13

peak flow meter

Answer 13

how much can be inhaled and exhaled- stay in green for maintained disease process- compared to personal best. green >80%
yellow 50-80% use meds and reassess

Question 14

Pulmonary function test

Answer 14

most accurate test for dx of asthma and severity. measures CO2, forced vital capacity, forced expiratory volume, residual volume and total lung capacity. decreased FEV1 by 15-20 % expected in asthma and increase of 12% after med admin dx of asthma

Question 15

short acting beta 2agonsit

Answer 15

fast acting for attack or before exercise. albuterol. watch pt for tremors and tachycardia

Question 16

long acting beta 2 agonist

Answer 16

salmeterol. for prevention of attack- don’t take if having an attack

Question 17

anticholinergic

Answer 17

ipratropium. bock parasympathetic system (broncho dilation and decrease secretions) used to prevent bronchospasm

Question 18

corticosteroids

Answer 18

anti inflammatory-prevents attack from inflammation or allergen. take daily- only for when all other drugs fail. fluticasone, prednisone (corticosteroids) or nedocromil (croon) watch for decreased immunity fxn- avoid infection, report black stool, hyperglycemia,

Question 19

asthma health promotion

Answer 19

prompt tx for respiratory infections, lots of hydration (thin mucous) and lose weight, take albuterol 10-30 min before exercise. regular flu and pneumonia vaccination

Question 20

sx of asthma attack

Answer 20

labored breathing, altered LOC, coughing, accessory muscles, Low O2 sats, tachycardia

Question 21

response to inadequate O2 from attack

Answer 21

take vitals, assess cognition, LOA, secretions, elevate HOB, ensure venous access, suction if needed, notify provider

Question 22

respiratory status declining

Answer 22

wheezing, retraction of sternal muscles and premature ventricular complexes (PVCs)

Question 23

care of copd pt

Answer 23

high fowlers -90deg, encourage coughing or suction, deep breathing and incentive spirometer, hydration, exercise,chest percussions,call light and O2 near pt

Question 24

copd oxygen therapy

Answer 24

determined by ABGs. usually nasal cannula (1-4 L/min) or venturi mask (up to 40%)to control amount of o2

Question 25

signs and sx of pneumonia

Answer 25

tachypnea, dyspnea, hypoxemia, cough, pleuritic chest pain. confusion from hypoxia very common in elderly, yellow sputum, crackles and wheezes, fever, chills, sweating

Question 26

nursing care for pneumonia

Answer 26

for hypoxemia- nasal cannula and incentive spirometry. prevent obstruction- monitor secretions, promote hydration (monitor I&O, mucus membranes, skin turger and fever), encourage cough and deep breath, bronchodilators

Question 27

albuterol

Answer 27

watch for tremors and tachycardia

Question 28

clotting process

Answer 28

vasoconstriction, then platelet plug formation, then intrinsic or extrinsic pathway- coagulation cascade, next thrombin the tells fibrinogen to make fibrin and stabilize clot

Question 29

fibrinolysis

Answer 29

plasminogen to plasmin that breaks clot

Question 30

spleen function

Answer 30

fetal- makes rbcs, adults: helps clean out dead and defective RBCs, immunity support (removes bacteria from bloodstream, storage site for lymphocytes and immunoglobin) storage over 1ml of blood and 3/4 platelets.

Question 31

Liver funtion

Answer 31

filters blood, stores glucagon, produces procoagulants- which tell blood to clot, stores iron and RBCs

Question 32

normal INR

Answer 32

0.8-1.1, warfarin pts

Question 33

PTT

Answer 33

intrinsic coagulation bleeding time. normal 25-35. when on heparin should increase 1.5-2.5 Xs- get baseline before starting hep

Question 34

aPTT

Answer 34

newer version of PTT. 25-38 normal hep pts

Question 35

DVT Caused by

Answer 35

Most common- stasis in blood flow starts coag process. injury to vessel wall triggers clotting to fix (high blood sugar), hypecoaguability (polycythemia- high RBC count increases viscosity)

Question 36

increases risk of blood clot

Answer 36

ulcerative colitis, cancer (breast, brain, pancreatic sim RBC prodxn), Central vein/arterial cath (picc), diabetes, chronic hypoxia (stim RBC prodxn), sepsis (endotoxins increase hypercoaguability)

Question 37

assessment dvt

Answer 37

pain in calf or groin, swelling of extremity, compare extremities, warmth and/or redness on the area. don’t do homien sign.

Question 38

heparin

Answer 38

inhibits clotting factors to stop fibrin prodxn to prevent clot from getting any larger and any future clots. must go home on an oral like warfarin- clot will dissolve on own in 3-6 mos or with a thrombolytic. risk of bleeding

Question 39

administering heparin

Answer 39

obtain baseline aPTT, CBC and platelet. verify no bleeding disorders, allergy, or recent surgery/ wound. verify dose with another nurse. usually bolus given before drip started recheck aPTT in 6 hrs. antidote protamine sulfate For Hep Induced Thrombocytopenia (HIT)