week 1

Question 1

7 Tasks of a person with a chronic illness

Answer 1

1. preventing and managing crisis
2. carrying out prescribed tx regimen
3. controlling symptoms
4. reordering time
5. adjusting to changes in the course of the disease
6. preventing isolation
7. attempting to normalize interactions with others

Question 2

ADL

Answer 2

bathing
dressing
eating

Question 3

IADL

Answer 3

shopping
paying bills
housework
meal prep

Question 4

SCALES
assesses risk factors for poor nutrition

Answer 4

Sadness or mood change
Cholesterol high
Albumin low
Loss or gain of weight
Eating problems (swallowing, poor dentition)
Shopping or food preparation problems

Question 5

Types of elder mistreatments in an institution

Answer 5

• failure to follow plan of care
• use of physical or chemical restraints
• over or under medicating
• punishment by isolation

Question 6

Main goals in nursing for chronic care

Answer 6

identify strengths and abilities
include caregivers
Priority goals: gain a sense of control, feel safe, reduce stress

overall: functional independence and improve quality of life

Question 7

How to manage anemia from blood loss

Question 8

management in blood transfusion

Question 9

How is anemia diagnosed

Answer 9

CBC
reticulocyte count
peripheral blood smear

Question 10

What to eat to help anemia

Answer 10

red meat
grains
greens (folic acid)

Question 11

stool in anemia

Answer 11

black stool is a late sign so test stool even if it looks normal to test for GI bleed

Question 12

Iron administration

Answer 12

PO or parenteral

all iron have special instructions for administration

Question 13

Albumin administration

FFP

Answer 13

good for third spacing because it collects fluid

FFP has no platelets but used to control bleeding

Question 14

Febrile in transfusions (Allergic Febrile Hemolytic)

Answer 14

leukocyte incompatibility

give acetaminophen or diphenhydramine 30 min. prior to prevent reaction

occurs in the first 10-15 minutes or first 50 mL

Question 15

Transfusion reactions

Answer 15

reaction to plasma proteins:
antihistamines can be used
epinephrine or corticosteroids can be used to treat

circulatory overload: people with cardiac or renal disorders are at risk. GIve it slow and give lasix

sepsis

Question 16

TRALI (transfusion-reaction acute lung injury)

Answer 16

sudden dev. of non cardiogenic pulmonary edema

usually 2-6 hrs after transfusion begins but can occur 72 hrs after

*** leader in transfusion-related deaths

Question 17

Delayed Transfusion reactions

Answer 17

delayed hemolytic reaction
- infections such as: HIV, cytomegalovirus, human t-cell leukemia type 1, EBV, malaria
- iron overload
- hep B or hep C

Question 18

Assessment signs of bleeding

Answer 18

weakness
malaise
fever
petechiae
pallor
purpura
tachycardia
hypotension
tachypnea
hemoptysis
orthopnea
bloody stools
hematuria
vision changes
headache
change in mental status
bone/ joint pain

Question 19

DIC signs of thrombotic

Answer 19

cyanosis
ischemic tissue necrosis
tachypnea
pulmonary embolus
paralytic ileus
kidney damage

Question 20

DIC lab findings

Answer 20

• low platelet and fibrinogen
• prolonged clotting times by all measures (PT, PTT, TT)
• elevated fibrin split products (fibrin degradation products)
• D-dimer elevated -tells us if there’s a high breakdown of fibrin-

Question 21

Care for DIC

Answer 21

supplement with oxygen
resolve underlying cause

• if bleeding, support with necessary blood products; cryo, fibrinogen, factor 7, platelets, and FFP
• manifestation of thrombosis- administer heparin and low-molecular-weight heparin BUT NOT GIVEN if platelet < 30,000