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Nursing school level 2 > theory test #2 > Flashcards

theory test #2 Flashcards

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1
Q

Partial foot amputations

A

removes one or more of the toes. Affects walking and balance.

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2
Q

Ankle disarticulation

A

removal of the foot at the ankle. Able to more around without the need for a prosthesis.

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3
Q

transtibial

A

removal of the leg below the knee joint retaining the use of the knee joint.

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4
Q

Through the knee

A

removal of the lower leg and knee joint. Still able to bear weight because the femur is retained.

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5
Q

transfermoral

A

removal of the leg above the knee joint. Able to bear weight because the femur is retained

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6
Q

Hip disarticulation

A

the removal of the entire limb up to and including the femur.

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7
Q

leading causes of amputation

A

infection, PAD, diabetes, trauma

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8
Q

what method do you use to wrap an amputated limb

A

figure of 8 method

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9
Q

Metacarpal

A

removal of the entire hand with the wrist still intact.

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10
Q

Shoulder disarticulation and forequarter amputation

A

removal of the entire arm including the shoulder blade and collar bone.

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11
Q

two types of surgical amputations

A

open and closed (flap)

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12
Q

nursing goals of pt with amputation

A

Support psychological and physiological adjustment
Alleviate pain
Prevent complications
Promote mobility and functional abilities
Provide information about surgical procedure and treatment needs

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13
Q

_________ stump to decrease swelling

A

elevate

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14
Q

what type of exercises do you want to assist with on the affected limb compared to the non affected limbs

A

ROM on affected and active/isometric exercises for unaffected

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15
Q

instruct patient to lie in _______ as tolerated at least twice a day

A

prone position

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16
Q

there is a risk for what after amputation

A

infection, ineffective tissue perfusion, and low self esteem

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17
Q

what do you what to place on non-operated leg for DVT prophylaxis

A

sequential compression device and give low dose anticoagulants

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18
Q

arthroplasty

A

the surgical removal of a diseased joint
due to osteoarthritis, osteonecrosis, rheumatoid arthritis,
trauma, or congenital anomalies, and replacing it with
prosthetics or artificial components made of metal or
plastic.

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19
Q

Total Joint arthroplasty

A

total joint replacement involves

replacement of all components of an articulating joint.

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20
Q

Total knee arthroplasty

A

replacement of the distal femoral
component, the tibia plate, and the patellar button. Total
knee arthroplasty is a surgical option when conservative
measures fail.

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21
Q

Unicondylar knee replacement

A

done when a patient’s joint is diseased in one compartment of the joint.

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22
Q

Total hip arthroplasty

A

involves the replacement of the acetabular cup, femoral head, and femoral stem.

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23
Q

Hemiarthroplasty

A

refers to half of a joint replacement. Fractures of the femoral neck can be treated only with the replacement of the femoral component

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24
Q

how to care for incision after arthroplasty

A

with soap and water

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25
Q

avoid positions of _______ of the knee to prevent contractures

A

flexion and no pillows under knee

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26
Q

_________ are given 30 minutes prior to incision

A

prophylaxis antibiotics

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27
Q

intracapsular hip fracture

A

within the hip joint

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28
Q

extracapsular hip fracture

A

outside the joint

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29
Q

types of extracapsular hip fractures

A

subtrochanteric and trochanteric fracture

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30
Q

clinical manifestation of hip fracture

A 
External rotation and shortening
Muscle spasm
Severe pain
Shock 
No weight!
No walking!
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31
Q

what type of repair is preferred with intracapsular fracture

A

endoprosthesis

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32
Q

what type of repair is preferred with extracapsular fracture

A

ORIF - open reduction and internal fixation

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33
Q

bucks traction

A

Skin traction is applied by strapping the patient’s affected lower limb and attaching weights.

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34
Q

pre-operative care for patients going in for a hip replacement

A

maintain immobilization of affected leg, monitor neuromuscular status of affected leg, administer pain meds, explain procedure, and apply ice pack

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35
Q

post op care for patients that got a hip replacement

A

ambulation, prevention of thromboembolism, neuromuscular evaluation, splint or pillow, infection prevention, pneumonia prevention,

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36
Q

complications of joint surgery

A

infection and DVT

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37
Q

5 Ps

A

pain, paresthesia, pallor, paralysis, pulselessness

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38
Q

surgical drainage devices

A

hemovac and Jackson pratt

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39
Q

open fracture grade 1

A

minimal skin damage

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40
Q

open fracture grade 2

A

damage includes skin and muscle contusions but without extensive soft tissue injury

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41
Q

open fracture grade 3

A

damage is excessive to skin muscles, nerves, and blood vessels

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42
Q

Complete fracture vs. incomplete

A

through the bone vs through part of the bone

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43
Q

Simple vs. comminuted

A

one fracture line vs multiple

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44
Q

Displaced vs non-displaced

A

not aligned vs aligned

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45
Q

Fatigue (stress)

A

excessive strain – athletic activities

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46
Q

Compression

A

from a loading force, common in osteoporosis, bone metastasis, infection

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47
Q

Pathological

A

occurs to bone that is weak from a disease process, such as bone cancer or osteoporosis

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48
Q

oblique fracture

A

complete fractures that occur at a plane oblique to the long axis of the bone

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49
Q

comminuted fracture

A

a break or splinter of the bone into more than two fragments.

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50
Q

spiral fracture

A

is a type of complete fracture. It occurs due to a rotational, or twisting, force.

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51
Q

compound fracture

A

broken bone

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52
Q

greenstick fracture

A

fracture in a young, soft bone in which the bone bends and breaks

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53
Q

impacted fracture

A

also called buckle or torus. when the broken ends of the bone are jammed together by the force of the injury.

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54
Q

clinical manifestations of traumatic injuries/fractures

A 
Edema and Swelling
	Pain and Tenderness
	Muscle Spasm
	Deformity
	Ecchymosis/contusion
	Loss of Function
	Crepitation
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55
Q

treatment of injuries

A

immobilization/stabilization and fracture reduction

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56
Q

types of fracture reduction

A

closed - manual realignment of the bone

open - surgical realignment (ORIF)

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57
Q

complications of fractures

A 
Compartment syndrome
Fat embolism
Deep vein thrombosis (DVT)
Complications of immobility
Complications of fracture healing
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58
Q

patient may become _______ & ________ with a fat embolism

A

tachycardia and hypotensive

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59
Q

compartment syndrome

A

Increased pressure within a body compartment usually with the arm or leg following trauma

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60
Q

what does comportment syndrome result in

A

insufficient blood supply to the muscles and nerves

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61
Q

what do you need to do for compartment syndrome

A

Fasciotomy required to relieve pressure and Emergent surgery required to prevent loss of limb

62
Q

causes of compartment syndrome

A 
Prolonged compression
Fractures
Casting
Burns
Hemorrhage
63
Q

clinical manifestation of compartment syndrome

A

Pain whose severity appears out of proportion to the injury
Pain described as burning, deep and aching
Pain worsened by passive stretching of the involved muscles
Hardened, tight muscle mass

64
Q

complications of fracture healing

A 
Delayed union
Nonunion
Malunion
Angulation
Pseudoarthrosis
Refracture
Myositis ossificans
65
Q

fracture angulation

A

displacement where the normal axis of the bone has been altered

66
Q

nonunion

A

Nonunion is permanent failure of healing following a broken bone unless intervention is performed

67
Q

myositis ossificans

A

bone forms within the muscle, and this occurs at the site of the hematoma

68
Q

osteomyletitis

A

Inflammation of bone caused by infection, generally in the legs, arm, or spine.

69
Q

nursing care for patient getting a cast

A

monitor neuromuscular status every 1 hour for 24 hours. assess pain. apply ice. elevate casted area 24-48 hours above heart to prevent swelling

70
Q

plaster cast vs fiberglass

A

plaster is inexpensive, heavy, gives more support. fiberglass has more durability, hardens quickly, fewer skin problems, cost more

71
Q

CSM

A

C- color plus cap refil, pulse, and temp
S- sensation
M- ability to move

72
Q

sanguineous vs serous-sanguineous vs serous

A

sanguineous- red discharge (bleeding)
serous-sanguineous- pink discharge
serous- white discharge

73
Q

what is the purpose of traction

A

decrease muscle spasms and relieve pain prior to surgery

74
Q

what is halo tractions used for

A

cervical fractures

75
Q

type 1 diabetes

A

beta cells destroyed by autoimmune process

76
Q

type 2 diabetes

A

decreased insulin production and decreased sensitivity to insulin

77
Q

clinical manifestations of diabetes

A

polyuria, polydipsia, polyphagia, fatigue, tingling or numbness, recurrent infections

78
Q

fasting plasma glucose levels

A

should be below 126

79
Q

Hgb A1C levels

A

should be below or equal to 6.5

80
Q

2 hour post prandial glucose levels

A

should be below or equal to 200

81
Q

blood glucose levels do what with age

A

increase with advancing age

82
Q

1 unit of insulin lowers blood glucose by about

A

50 mg/dL

83
Q

regular insulin usually given 1 U per _______ carbohydrate

A

15 g

84
Q

insulin guidelines

A

0.5-1 units/kg/day

85
Q

regular insulin onset, peak, and duration?

A

onset - 30 minutes
peak - 2-4 hours
duration 6-8 hours

86
Q

NPH insulin onset, peak, and duration?

A

onset - 1-2 hours
peak - 6-12 hours
duration 18-24 hours

87
Q

lispro

A

ultra short acting insulin that is given 15 minutes before meal and leak levels seen within 30 minutes

88
Q

what do you need to use with Lispro

A

Lantus or other long acting insulin for a Basal/Bolus affect

89
Q

Lantus

A

called insulin Glargine - provides a continuous low level of insulin secretion and cannot be mixed with any other insulin

90
Q

how often is Lantus administered

A

once a day

91
Q

hyperglycemic influences

A

stress, decreased physical activity, medication errors, fear of hypoglycemia

92
Q

hypoglycemic influences

A

decreased caloric intake, gastrointestinal illness, altered cognition

93
Q

basal insulin

A

amount of insulin necessary to regulate glucose levels between meals and overnight

94
Q

nutritional insulin

A

required to cover meals

95
Q

correctional insulin

A

doses of short or rapid acting insulin given to correct blood glucose elevations

96
Q

when do you check insulin

A

right before a meal

97
Q

what do you want to encourage the patient to do if they are receiving insulin

A

eat

98
Q

what do you want to document if patient has hypoglycemia

A

FSBG, time of hypoglycemic event, if patient is symptomatic, treatment and their response to treatment`

99
Q

most protocols define hypoglycemia as

A

below 70 mg/dl

100
Q

mild symptoms of hypoglycemia

A

hunger, weakness, diaphoresis, dizzy, anxiousness, impaired vision, headache, and pounding heart

101
Q

moderate symptoms of hypoglycemia

A

personality changes, irritability, confusion, difficulty concentrating, slurred speech

102
Q

severe symptoms of hypoglycemia

A

mental status changes, coma, death, unconsciousness, seizures

103
Q

key to hypoglycemia treatment

A

do not overtreat because it causes post treatment hyperglycemia

104
Q

target blood sugar for patient with diabetes on a med/surg/tele floor

A

140-180

105
Q

target blood sugar for patient with diabetes on a critical care

A

110-140

106
Q

mild/moderate hypoglycemia is defined as

A

FSBG 41-69 with or without symptoms

107
Q

severe hypoglycemia is defined as

A

41-69 if patient has mental status change or is unconscious, or NPO or FSBG is 40 or less

108
Q

what is the first thing you do for a patient with mild to moderate hypoglycemia

A

feed them immediately if meal try is available. if tray is not available then give glucose tablet or juice

109
Q

adding sugar to juice it considered

A

overtreating

110
Q

if hypoglycemia is resolved but there is an hour before the next meal what should you give

A

5 crackers and 1 ounce of cheese or 6 crackers and 2 tbsp of peanut butter

111
Q

severe hypoglycemia treatment

A

stat lab glucose but don’t wait for the lab to get back to treat. if IV is available give D50 and retest FSBG 15-20 minutes later. if IV is not available give glucose IM

112
Q

glucagon

A

important hormone in carbohydrate metabolism that is released by the pancreas. helps maintain the level of glucose by causing liver to release its stored glucose.

113
Q

what can be given for severe hypoglycemia as an IM interjection

A

glucagon. patient may wake up vomiting or feeling sick

114
Q

what precaution should severe hypoglycemia patient be put on

A

seizure precautions

115
Q

treating hypoglycemia

A

give 15-30 grams of carbohydrate every 15-30 minutes until FSBG is above 70 mg/dl

116
Q

diagnostic test for meningitis

A

nasopharyngeal swab, test for kerning’s and brundzinski’s sign, x-rays, gram strain, cultures

117
Q

brudzzinski’s sign

A

severe neck stiffness causes a patients hips and knees to flex when the neck is flexed during meningitis

118
Q

kerning’s sign

A

severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed 90 degrees

119
Q

bacterial meningitic labs

A

WBC- greater than 1000
protein - greater than 500
glucose - decreased

120
Q

viral meningitis

A

WBC- 25-500
protein 50-500
glucose- normal

121
Q

treatment for bacterial meningitis

A

isolate patient, antibiotics that penetrate blood brain barrier, dexamethasone to recuse inflammation

122
Q

how do you rule out bacterial meningitis

A

lumbar puncture

123
Q

encephalitis

A

acute inflammation of the brain that is usually caused by virus

124
Q

meningitis vs encephalitis

A

patient with meningitis may be uncomfortable, lethargic, or distracted while encephalitis causes alteration in brain function

125
Q

goal in treatment of encephalitis

A

regain as much neurological function as possible

126
Q

TIA s/s last

A

60 minutes or less

127
Q

type fo ischemic strokes

A

thrombotic - narrowing of artery

embolic - thrombus breaks off and lodges in vessel

128
Q

clinical presentation of acute stroke

A

altered LOC, headache, aphasia, paralysis, weakness…

129
Q

BP will be _____ during a hemorrhagic stroke

A

elevated

130
Q

right hemisphere

A

attention span, impulse control, movement of left side, drawing skills, remembering visual object, face recognition, left side awareness, measuring distance of objects to body

131
Q

left hemisphere

A

motor speech, expressive speech, movement of right side, emotion, math, writing, reading letters and numbers, recognizing objects, remembering written info

132
Q

FAST

A

facial drop, arm weakness, speech difficulty, time to call 911

133
Q

first thing after stroke

A

assess body systems and gag reflux

134
Q

tonic - clonic seizure (grand mal)

A

stiff-jerking/loss of consciousness

135
Q

typical absence (petit mal)

A

usually occurs in children looks like day dreaming and might be smacking their lips

136
Q

atypical absence seizure

A

staring with peculiar behavior

137
Q

focal seizure

A

pertain seizures
simple - unexplained feelings/sensation
complex- unable to interact

138
Q

psychogenic seizures

A

resemble tonic/clonic and are often misdiagnosed. related to emotional/physical abuse

139
Q

testing for seizures

A

MRI or CT and EEG

140
Q

medications for seizures

A

Ativan if status epilepticus. tonic-clonic: dilantin, tegretol…

141
Q

nursing care for seizure patients

A

safety! maintain airway and prevent injury

142
Q

Guillain-Barre syndrome

A

acute, rapidly progressing motor neuropathy involving segmental demyelination of the nerve roots in the spinal cord and medulla

143
Q

demyelination causes

A

inflammation, edema, rapidly ascending paralysis

144
Q

clinical manifestations of Guillain barre syndrome

A

paralysis that starts in lower extremities and ascends bilaterally, paralysis of respiratory muscles, difficulty swallowing and talking, facial flushing, hypotension

145
Q

what happens as patient recovers from Guillain Barre syndrome

A

paralysis decreases as patient recovers and most often without residual effects

146
Q

stages of Guillain Barre syndrome

A

acute, plateau, and recovery

147
Q

acute stage of Guillain Barre syndrome

A

Progressive from 1st symptom until no further deterioration

148
Q

plateau stage of Guillain Barre syndrome

A

No further worsening or improvement
Attack has stopped
Can last from a few weeks to months

149
Q

recovery stage of Guillain Barre syndrome

A

spontaneous improvement and recovery
Symptoms gradually disappear
Last a few weeks to years
Some case of relapse

150
Q

CSF will have what in Guillain Barre syndrome

A

elevated protein concentration

151
Q

treatment for Guillain Barre syndrome

A

respiratory support, corticosteroids, immunosuppressants, plasmapheresis

152
Q

care for patient with Guillain Barre syndrome

A

monitor VS especially RR, passive ROM every 4 hours to prevent contractures, pain meds, nutrition, support

Nursing school level 2 (15 decks)

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