Study Guide HESI V5

Study Guide HESI V5 Note: The blue highlighted questions came out also on my V2 exam. 1.) Something about a breast cancer patient refusing drugs: ANS: Go find out why she is refusing 2.) How would you relieve MASTITI ...

Study Guide HESI V5 Note: The blue highlighted questions came out also on my V2 exam. 1.) Something about a breast cancer patient refusing drugs: ANS: Go find out why she is refusing 2.) How would you relieve MASTITIS and what is it caused from? Mastitis is an inflammation of the breast, caused by blocked milk ducts/ there is NON-Infective or BACTERIAL infective/ Treatment for mastitis should begin immediately. Your doctor may not immediately be able to distinguish between simple inflammation and a bacterial infection, but will usually treat you as if it is infected. Options include:  Continued breastfeeding and/or expressing to drain the breast  Antibiotics (for example, flucloxacillin or cephalexin)  Anti-inflammatory medication (such as ibuprofen) or analgesia (such as paracetamol) to relieve pain, if necessary  Rest and adequate fluid intake  Heat to breasts (such as hot showers) before a feed and cold after  Varying the feeding position to increase breast drainage 3.) SEPSIS- Related to endotoxins release by bacteria, which cause vascular pooling, diminished venous return, and reduced cardiac output Medical Treatment for SHOCK A. Correct decreased tissue perfusion and restore cardiac output A.1. OXYGENATION & VENTILATION A.2. FLUID RESUSITATION : Rapid infusion of volume-expanding fluids(colloids), whole blood plasma, iso’s such as Ringers Lactate A.3. DRUG THERAPY: Restoration of cardiac function is priority, drugs will be based on effect of shock on preload, afterload, or contractility A.3.a. Drugs that increase preload (blood products, crystalloids)/ decrease preload (morphine, nitrates, diuretics) A.3.b. Drugs that increase afterload ( vasopressors, dopamine)/ decrease afterload ( nitroprusside, ACE-I, ARB) A.3.c. Drugs that decrease contractility (beta blockers, calcium channel blockers)/ increase contractility (digoxin [Lanoxin], dobutamine) A.4. MONITOR: CVP, LOC, ABG’s, VITALS, Skin changes, Fluid status