CHPN FLASH CARDS Exam 69 Questions with Verified Answers,100% CORRECT

CHPN FLASH CARDS Exam 69 Questions with Verified Answers Chronic renal failure is associated with several metabolic abnormalities. These include: (5 ANSWERS) - CORRECT ANSWER anemia, hypocalcemia, hyperphosphatemi ...

CHPN FLASH CARDS Exam 69 Questions with Verified Answers Chronic renal failure is associated with several metabolic abnormalities. These include: (5 ANSWERS) - CORRECT ANSWER anemia, hypocalcemia, hyperphosphatemia, metabolic acidosis, and hypoalbuminemia. How many nursing level hospice care hours is required by Medicare Hospice Benefit for it to be classified as continuous home care? - CORRECT ANSWER 8 Hypercalcemia is associated with several cancers, most commonly: (4 ANSWERS) - CORRECT ANSWER breast, lung, lymphoma, and multiple myeloma. _________________________ in cancer patients is indicative of widespread disease and is associated with a poor prognosis for long-term survival. (ELECTROLYTE IMBALANCE) - CORRECT ANSWER Hypercalcemia _____________pain is caused by nerve infiltration or injury and is usually described as burning, shooting, tingling, or shock-like. - CORRECT ANSWER Neuropathic ______________pain is caused by stimulation of skin, muscle, or bone, is well-localized, and is described as achy, throbbing, or dull. - CORRECT ANSWER Somatic ___________pain is caused by stimulation of abdominal or thoracic organs, is poorly localized, and is described as squeezing, cramping, or pressure. - CORRECT ANSWER Visceral Which electrolyte imbalance can cause n/v, anorexia, constipation, fatigue, weakness, confusion and increased thirst. - CORRECT ANSWER Hypercalcemia ____________ causes diaphoresis, agitation and seizures? - CORRECT ANSWER Hypoglycemia The most common cause of wound odor is? - CORRECT ANSWER anaerobic bacterial colonization Which medication can be used to help treat odor from anaerobic bacterial colonization? - CORRECT ANSWER topical metronidazole SVC obstruction comes on rapidly or is complete, the patient deteriorates rapidly because of? - CORRECT ANSWER increased intracranial pressure. Common symptoms of carcinoid syndrome include: - CORRECT ANSWER diarrhea, flushing, abdominal cramping, wheezing, right heart failure, and cyanosis. The most common presenting symptom of spinal cord compression is back pain, which is worse when ________ _______or straining (e.g., coughing, stooling) and improves upon _________. - CORRECT ANSWER Laying flat. Standing. What is Beck's triad? - CORRECT ANSWER Hypotension, Muffled Heart Sounds, JVD (increased venous pressure) **Caracteristic for Cardiac Tamponade** Sudden acute unilateral pleuritic pain, dyspnea, tachypnea, tachycardia, and slight cough along with unilateral decreased breath sounds are consistent with? - CORRECT ANSWER Pneumothorax pneumothorax - CORRECT ANSWER collapsed lung, air in the pleural cavity tension pneumothorax - CORRECT ANSWER A life-threatening collection of air within the pleural space; the volume and pressure have both collasped the involved lung and caused a shift of the mediastinal structures to the opposite side. (Chest tube needed ASAP) S3 heart sound - CORRECT ANSWER May indicate heart failure or left ventricular failure in older adults An opening snap on auscultation of the heart should make you think of what diagnosis? - CORRECT ANSWER mitral valve stenosis (can be caused from rheumatic heart disease) rheumatic heart disease - CORRECT ANSWER damage to the heart muscle or heart valves caused by one or more episodes of rheumatic fever An *ejection click* soon after S1 occurs in ______ - CORRECT ANSWER Aortic Stenosis; Pulmonic Stenosis (septal defects) septal defects - CORRECT ANSWER small holes in the wall between the atria (atrial septal defects) or the ventricles (ventricular septal defects) A friction rub is associated with - CORRECT ANSWER Pericarditis Left-hemisphere strokes often result in _________-sided paresis or paralysis and _________. May also experience _________-term memory loss and difficulty learning new materials. - CORRECT ANSWER Right sided, aphasia, short ________ strokes may cause ataxia, nausea and vomiting, headaches, and dizziness or vertigo. - CORRECT ANSWER Cerebellar Brainstem strokes may impair ________ and ___________. - CORRECT ANSWER Respiratory, cardiac function Right hemisphere strokes result in ______ paresis or paralysis and _____-sided neglect, as well as short-term memory loss and __________. - CORRECT ANSWER Left, left, depression Variant angina (Prinzmetal's angina) - CORRECT ANSWER Due to a coronary artery spasm, oftening occurring during periods of rest. Not caused by physical or emotional stress. Usually associated with intake of nicotine, alcohol or stimulant drugs. Domains of quality palliative care (guide of care) - CORRECT ANSWER Structure and processes, Physical, Psychological and psychiatric, Spiritual, religious, and existential, Cultural, Dying, Ethical and legal This type of respiration is characterized by hypernea (deep breaths) alternating with apnea (cessation of breath). - CORRECT ANSWER Cheyne-Stokes Respirations are characterized by labored, gasping breaths, and are associated with metabolic acidosis. - CORRECT ANSWER Kussmaul respirations _____________________ looks at the continuum of care a patient receives from admission to post-discharge. - CORRECT ANSWER Tracer Methodology For patients already receiving morphine, increasing the dose by _______ mg may relieve the sensation of breathlessness. Opioid naive patients may benefit from a dose of ____ mg Morphine orally. - CORRECT ANSWER 2.5, 5 Dysarthria - CORRECT ANSWER slurred speech The rescue dose for parenteral opioids should be approximately ____to ____ % of the hourly dose. - CORRECT ANSWER 25-50 (50-100%, can be given a 15 mins) For patients on oral opioids, the rescue dose should be ___ to ____ % of the 24-hour baseline dose. - CORRECT ANSWER 5-15 (10-20%) BTP pain med dose for Methadone should be _______% of 24 hour dose. - CORRECT ANSWER 10 ______________ is most commonly monitored for acute changes in nutritional status because it has a half-life of only 2 to 3 days. - CORRECT ANSWER Pre-albumin _______ is the ethical principle that relates to the distribution of limited healthcare resources. - CORRECT ANSWER Justice __________ is an ethical precept stating that healthcare professionals should act in the best interest of their patients, while nonmaleficence is the ethical code of doing no harm. - CORRECT ANSWER Beneficence When a medication has provided good pain control but significant side effects occur, the dose of the new opioid should start at ____ to ____% below the equianalgesic dose in the event that cross-tolerant symptoms occur. If the initial pain control was not adequate and significant side effects occurred, then opioids should be rotated at the _________. - CORRECT ANSWER 25-50, equianalgesic dose. The Confusion Assessment Method is used to assess the development of ____. The assessment tool covers __ factors. - CORRECT ANSWER Delirium, 9 __________ of esophageal varices occurs in about a third of those with portal hypertension and is the most common cause of death with cirrhosis. - CORRECT ANSWER Hemorrhage Beck's triad is commonly found with? - CORRECT ANSWER Cardiac tamponade Occurs with pericardial effusion in which fluid accumulates in the pericardial sac, causing pressure against the heart. - CORRECT ANSWER Cardiac tamponade cordotomy - CORRECT ANSWER surgical procedure that severs a nerve tract within the spinal cord to relieve intractable pain Cordotomy is recommended for intractable unilateral pain below _____ in patients whose life expectancy is less than one year. - CORRECT ANSWER C-5 What are the most common sites of cancer metastasis? - CORRECT ANSWER The lungs, liver, and bones For hospice patients, hypnosis has been found to be most effective for the relief of ________ pain. - CORRECT ANSWER Procedural Allodynia - CORRECT ANSWER Pain due to a stimulus that does not normally provoke pain Hyperalgesia - CORRECT ANSWER increased sensitivity to pain Aberrancy - CORRECT ANSWER Red flags: early refills, lost prescriptions, dose escalation w/out approval Do not use which tricyclic antidepressant in older adults? - CORRECT ANSWER Amitriptyline ( delayed response by 3-4 days) scleroderma - CORRECT ANSWER an autoimmune disorder in which the connective tissues become thickened and hardened, causing the skin to become hard and swollen ( can stiffen the throat and esophagus) sarcopenia - CORRECT ANSWER muscle wasting Phenytoin, tricyclic antidepressants, tramadol and amphetamines all lower the _______ threshold. - CORRECT ANSWER Seizure Akathisia - CORRECT ANSWER restlessness Dystonia - CORRECT ANSWER a condition of abnormal muscle tone that causes the impairment of voluntary muscle movement Antihistamine therapy and PT can help with what type of EPS? - CORRECT ANSWER Dystonia Beta blockers and Benzodiazepines can help with what type of EPS? - CORRECT ANSWER Akathisia Clozapine can help with what type of EPS? - CORRECT ANSWER Tardive dyskinesia Pink, blood-tinged frothy sputum - CORRECT ANSWER Pulmonary edema bladder outlet obstruction - CORRECT ANSWER blockage at the base of the bladder (end of life emergency) xerstomia - CORRECT ANSWER dry mouth Dysguesia - CORRECT ANSWER altered taste Kennedy ulcer (butterfly ulcer) - CORRECT ANSWER A rapidly developing sore that can appear in dying patients and is considered unavoidable arterial ulcers - CORRECT ANSWER Reddens when dangled or pale when elevated venous ulcers - CORRECT ANSWER Typically forms on the inner ankle. Scabbing or flaking. Improves with elevation