MEDICAL SURGICAL Nursing Examination Correct Answers

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MEDICAL SURGICAL Nursing Examination Correct Answers normal EF: What is the normal PSA level? PNA: what are the 8 risk factors? Name 2 conditions that can result in portal HTN? ... What characterizies guillan barre? 4 things to watch out for when on oral antidiabetic meds: Meds for VF or pulseless VT: (BEV LAMP) modes of Hep B transmission: What are the late S&S of hypoxemia? Two common manifestations of pna in older adults? S&S of hypoglycemia: What 4 things are decreased in the blood for Addison's? What 3 things are elevated in the blood for Cushings? Assessment findings of pleural effusion? What 2 meds can be given to treat SIADH by blocking renal response to ADH? 5 S&S of myxedema coma: 6 common S&S of PE: Chain of survival involves...? 3 characteristics of Asthma: COPD encompasses 2 diseases: S&S of colon cancer: Pts with strong hix of colorectal cancer should reduce intake of what 2 things? What is extracorporeal shock wave lithotripsy and to include in discharge teaching? What are S&S of autonomic dysreflexia? Common findings for acute renal failure: Blood test results for malignant hyperthermia would reveal: S&S of hyperglycemia: 6 S&S of thyroid storm: Manifestations of shock? 10 most common causes of Pulseless Electrical Activity (PEA): Hallmarks of ARDS: Difference in age of pts with IBD versus pts with diverticulitis: 5 side effects of corticosteroids: T-tube drainage range: What 3 things are decreased in the blood for Cushings? What 4 things are elevated in the blood for Addison's? What are some systemic effects of guillain barre? Differentiate diet prescriptions for IBD versus diverticulitis. How do you diagnose guillain barre? What 3 things should pts avoid in their diet 48 hours prior to FOB testing? What are 5 S&S of malignant hyperthermia? What are the S&S of oxygen toxicity? Name 3 nephrotoxic drug groups: Rifampin (RIF): 2 things about RIF? What kind of respiratory S&S do you expect to find in lung cancer pts? 5 ARDS indicators: What's Guillain Barre? What are 3 complications of dumping syndrome to watch out for? Encourage foods rich in what 3 things for TB pts:? 3 characteristics of nephrotic syndrome: High pressure alarm sounds on the vent indicates? Manifestations of myasthenia gravis: Name 3 differences between osteoarthritis and rheumatoid arthritis. - RA is bilaterally symmetrical, OA is not - RA pain after rest, OA pain with movement - RA is autoimmune, OA is not Goals for management of cardiac arrest include...? - rapid ID of S&S - initiate circ and resp support - activate EMS - use emergency equipment - stabilize pt - Dx and Tx What are nursing implications for VMA testing? - restrict caffeine, vanilla, licorice for 2-3 days in advance - hold aspirin and anti-HTN meds - maintain moderate acitivity Name 4 disorders associated with Myasthenia Gravis: - rheumatoid arthritis - SLE - ulcerative colitis - pernicious anemia Monitor for which 3 complications following a paracentesis? - shock - peritonitis - perforated bladder Tracheal shift in 3 kinds of pneumothorax: - simple pneumothorax: usually no shift - tension and hemothorax: shift to contralateral (unaffected) side 3 characteristics that set small bowel obstruction apart from large bowel obstruction: - spasmodic colicky pain instead of constant diffuse pain - visible peristaltic waves rather than significant abd distention - sudden projectile vomiting that relieves pain rather than infrequent vomiting The thyroid gland produces which 3 hormones? - T3 - T4 - calcitonin What are the early S&S of hypoxemia? - tachypnea - tachycardia - restlessness - pallor - HTN - resp distress Topical glucocorticoids do WHAT to the skin? - THINS the skin - DOES NOT darken skin. A pt with cirrhosis is prescribed lactulose for what? what do you monitor for to make sure it's working. - to decrease serum ammonia levels - you monitor for LOC 3 top risk factors for laryngeal cancer? - tobacco - alcohol - harmful chemicals (chronic exposure) Low pressure or low volume sounds on the vent indicates? - tubing disconnections - air leaks around cuff What 6 metabolic abnormalities can result in seizures? - uremia (ARF) - hepatic failure - PKU (phenylketouria) due to lack of a hepatic enzyme (genetic) - nutritional deficits - drug/alcohol w/drawal - drug/alcohol use How much fluid can be taken out during a paracentesis? - Usually limited to 1L in a short period of time. (Slow drainage can be used to take out >1L of fluid over several hours.) 3 diagnostic tests for pheochromocytoma: - VMA - Clonidine - phentolamine (Regitine) 4 things to consider when taking Isoniazid (INH)? - watch for hepatitis - watch for neurotoxicity - take on empty stomach - take Vit B6 to prevent toxicity Normal Creatinine range: 0.6-1.2 (1.5) mg/dl Amount of fluid removed via thoracentesis is limited to how much at a time? 1 L (to prevent cardiovascular collapse) Normal INR: 1-2 How long does it take for pts exposed to pathogens to exhibit S&S of infeciton? Proper CPR steps (list 9) What are the leading risk factors for developing COPD? Defibrillator Steps: Normal urine specific gravity range: Normal Mg+ range: Ostmomy bags should be cut how much larger than the stoma? Normal BUN range: What's the normal rate for chest tube drainage? Normal PT range: Normal Hgb range: Diabetes is diagnosed when fasting blood sugar is at what level? Normal Na+ range: Suctioning should not exceed how many seconds? A decrease in FEV1 or PERF by how much is common for asthma pts? Normal plt range: How do the ABG's change as a PE progresses? For chest tubes, the water seal should be maintained at what level? TB skin test will be positive how long after exposure to TB? Normal phosphate level: How long should pressure be applied on a puncture site for a patient receiving anti-coagulant therapy? TB pts are no longer considered infectious after how many negative sputum cultures? Must administer tPA drug for CVA victims within how long of onset? Normal CVP range: Normal K+ range: Normal albumin range: Normal APTT range: Normal Hct range: T/F. surfactant activity is reduced in ARDS. Prednisone class and side effects What are Miotics for and what side effect does it cause? What 6 metabolic abnormalities can result in seizures? What characterizies guillan barre? Why be careful of giving too much oxygen to COPD patients? S&S of hypoglycemia: What is Cushing's triad and what does it indicate? TB skin test will be positive how long after exposure to TB? What type of trach provides a seal between the upper and lower airway and is used for pts receiving mechanical ventilation? What characterizes osteomyelitis? What characteristics differentiate BPH from prostate cancer during an digital rectal exam? 5 S&S of myxedema coma: what position do you keep the pt following a thyroidectomy? 6 common S&S of PE: Should hormone replacement therapy (HRT) be used on a short-term or long-term basis? What is the leading cause of cancer-related deaths? Distinguish pneumothorax from hemothorax by percussion: Post-thoracentesis CxR is for? What is used to confirm or rule out diagnosis of glomerulonephritis? How do you check for laryngeal nerve damage in pts following a thyroidectomy? what ABG values indicate ARF? T/F. Pts with hyperthyroidism often experience decreased appetite. Taking aluminum-containing antacdis concurrently does what to Ciprofloxacin absorption? 10 most common causes of Pulseless Electrical Activity (PEA): - hypovolemia (low volume) - hypoxia (low oxygen) - hydrogen ion excess (acidosis) - hyper-/hypo-kalemia (high/low K+) - hypothermia (low body temp) - taking drugs (overdose) - tamponade (cardiac) - tension pneumothorax (oneway valve in pleural cavity) - thrombosis (pulmonary) - thrombosis (coronary) Why is chemotherapy not used in the case of superior vena cava syndrome caused by breast cancer tumor? Why is surgical removal of breast cancer tumor not suggested in case of superior vena cava syndrome? T/F. Organ donation must be completed within 24 hours of patient death. T/F. aluminum overload causes constipation. what are S&S of autonomic dysreflexia? what is autonomic dysreflexia? blood test results for malignant hyperthermia would reveal: the neuromuscular blocking agent succinylcholine is a trigger for what dangerous condition? what are 5 S&S of malignant hyperthermia? what causes malignant hyperthermia/hyperpyrexia? What is secondary adrenal insufficiency? T/F. Addison's disease is autoimmune. Addison's disease is a form of what condition? A pt with cirrhosis is prescribed lactulose for what? what do you monitor for to make sure it's working. what kind of isolation precaution is needed for SARS? what is extracorporeal shock wave lithotripsy and to include in discharge teaching? do pts with chronic renal failure have HYPO- or HYPER- calcemia? T/F. Pts who are about to undergo EGD's should be on a 24 hr clear liquid diet and have GI cleansing prior to the procedure. T/F. the paralysis that accompanies Guillian barre is temporary. tracheal shift in 3 kinds of pneumothorax: what helps the burning pain after an IM injection? what type of MI is associated with heart failure? T/F. in treating a burn victim, remove ALL clothing from the burnt areas. describe what a 1st degree burn looks like: red, no blisters, dry what are the ABCDE's of emergency are? Airway/neck/spine Breathing Circulation Disability Exposure Heat stroke presentation and Tx Frostbite presentation and T define Cardiac Arrest without sufficient O2 supply, the brain will suffer cell anoxia within how many minutes? goals for management of cardiac arrest include...? Chain of survival involves...? Meds for VF or pulseless VT: (BEV LAMP) Defibrillator Steps: Proper CPR steps (list 9) What are the normal ranges for ABG? What is Allen's test? how long should pressure be applied on a puncture site for a patient receiving anti-coagulant therapy? what S&S should be reported to the doc following an arterial puncture? what are the early S&S of hypoxemia? what are the late S&S of hypoxemia? what are the S&S of oxygen toxicity? why be careful of giving too much oxygen to COPD patients? suctioning should not exceed how many seconds? what do you do for ventilator patients right before you suction? what is a contraindication for a bronchoscopy? what 2 things do you check for before giving anesthetic agents to patients? contraindication to chest tube insertion and thoracentesis? what do you do first if the chest tube tubing becomes disconnected? S&S of pneumothorax? (similar to CHF in older adults) Heat stroke presentation and Tx Frostbite presentation and Tx define Cardiac Arrest without sufficient O2 supply, the brain will suffer cell anoxia within how many minutes? goals for management of cardiac arrest include...? Chain of survival involves...? Meds for VF or pulseless VT: (BEV LAMP) Defibrillator Steps: Proper CPR steps (list 9) What are the normal ranges for ABG? What is Allen's test? how long should pressure be applied on a puncture site for a patient receiving anti-coagulant therapy? what S&S should be reported to the doc following an arterial puncture? what are the early S&S of hypoxemia? what are the late S&S of hypoxemia? what are the S&S of oxygen toxicity? why be careful of giving too much oxygen to COPD patients? suctioning should not exceed how many seconds? what do you do for ventilator patients right before you suction? what is a contraindication for a bronchoscopy? what 2 things do you check for before giving anesthetic agents to patients? contraindication to chest tube insertion and thoracentesis? what do you do first if the chest tube tubing becomes disconnected? S&S of pneumothorax? (similar to CHF in older adults) instruct the patient to do what during a chest tube removal? Assessment findings of pleural effusion? Amount of fluid removed via thoracentesis is limited to how much at a time? How to position a patient for thoracentesis? Manifestations of shock? indications for thoracentesis: client position for thoracentesis: after thoracentesis, place pt on which side and for how long? post-thoracentesis CxR is for? T/F. It is important to assess the trach pt for risk for aspiration. what type of trach provides a seal between the upper and lower airway and is used for pts receiving mechanical ventilation? what type of trach is used for kids under 8 yrs and for those who can protect the airway from aspiration? what type of trach is used for pts with long or extra-thick necks? what type of trach is used permanently? for cuffed trachs, keep pressure below what level to reduce risk of tracheal necrosis due to prolonged compression of tracheal capillaries? provide trach care how often? what vent mode provides preset ventilator rate and tidal volume but requires pt to initiate breaths? what is SIMV mode? What is PSV mode? What is PEEP? high pressure alarm sounds on the vent indicates? low pressure or low volume sounds on the vent indicates? 3 characteristics of Asthma: what test is the most accurate for diagnosing asthma and its severity? a decrease in FEV1 or PERF by how much is common for asthma pts? Albuterol: class Ipratropium (Atrovent) theophylline (Theo-dur) Prednisone class and side effects Montelukast (Singulair) cromolyn sodium (Intal) Status Asthmaticus: what is it and what to do when it happens? COPD encompasses 2 diseases: What is emphysema? What are the leading risk factors for developing COPD? T/F. Most people with emphysema also have chronic bronchitis. What is used to classify COPD as mild to very severe? Why monitor H&H in COPD pts? Provide COPD pts with 2-4L/min O2 via NC. For pts with chronic hypercarbia, provide more or less O2 and why? what is Cor Pulmonale? characteristics of PNA? PNA: what are the 8 risk factors? what does high-Fowler's position help with? what kind of O2 therapy is prescribed for pna? why give corticosteroids for pna? 5 side effects of corticosteroids: diminished or absent breath sounds could indicate? two common manifestations of pna in older adults? how long does it take for pts exposed to pathogens to exhibit S&S of infeciton? ghon tubercles are a characteristic of what infection? TB T/F. A person with TB is not contagious until S&S are present. TB skin test will be positive how long after exposure to TB? TB dx is confirmed by what? the best sputum samples should be taken when? 4 things to consider when taking Isoniazid (INH)? Rifampin (RIF): 2 things about RIF? Pyrazinamide (PZA): watch for what when taking this drug? Ethambutol (EMB): watch for what when taking this drug? Streptomycin: watch for what when taking this drug? encourage foods rich in what 3 things for TB pts:? TB pts are no longer considered infectious after how many negative sputum cultures? Hallmarks of ARDS: decreased UO with tall peaked T waves indicate: describe second degree AV block (type I): Expect what if pt is malnurished and is breaking down fats for energy? Why be sure to take calcium and thyroid hormone supplements several hours apart? T/F. Thiazides reduces renal excretion of calcium. high BS, hx of pituitary tumor, and osteoporosis may indicate: What blocks coagulation by enhancing the inhibitory effects of antithrombin, which prevents conversion of prothrombin to thrombin and fibrinogen to fibrin? What interferes with the hepatic synthesis of Vit. K-dependent clotting factors, thereby reducing the supply of coagulation factors II, VII, IX, and X? modes of Hep B transmission: T/F. Acoustic neuroma results in reversible hearing loss. What is a life-threatening finding in an asthma pt that suggests severe airflow obstruction? T/F. Traction pins should be covered with dressing and changed daily. How can cardiac cath result in intrarenal renal failure? What distinguishes MI from angina pectoris? Rest and Nitroglycerine do not relieve MI pain. topical glucocorticoids do WHAT to the skin? T/F. Constant bubbling in a chest tube closed water-seal system is normal. T/F. Use salt substitutes for chronic renal failure pts. Why do chronic renal failure pts need folic acids supplements? an aura precedes what type of seizure? common findings for acute renal failure: name 3 nephrotoxic drug groups: must administer tPA drug for CVA victims within how long of onset? what is tPA? extreme paralysis is an indication of CVA in which hemisphere? what's Guillain Barre? what characterizies guillan barre? what are some systemic effects of guillain barre? which two CN's are not affected by Guillain barre? how do you diagnose guillain barre? what is one cardio side effect of Timolol? T/F. Simple seizures do not involve a change in consciousness. What 6 metabolic abnormalities can result in seizures? What is Myasthena Gravis? Name 4 disorders associated with Myasthenia Gravis: manifestations of myasthenia gravis: which protein marker gives you the earliest diagnosis for an MI? followed by what else? which marker is a very sensitive indicator of MI? how long does it remain elevated for? Normal BUN range: normal Creatinine range: 0.6-1.2 (1.5) mg/dl normal Na+ range: normal K+ range: normal Mg+ range: normal Ca++ range: normal albumin range: normal Cl- range: normal Hgb range: normal Hct range: normal WBC range: full blown AIDS CD4+ level: normal APTT range: normal PT range: normal plt range: normal INR: normal phosphate level: normal CD4+ range in healthy adult: diabetes is diagnosed when fasting blood sugar is at what level? ARF leads to metabolic acidosis or alkalosis? normal urine specific gravity range: normal CVP range: normal MAP range: normal EF: what does CVP tell us? What 3 things are elevated in the blood for Cushings? What 3 things are decreased in the blood for Cushings? - K+ - Ca++ - ACTH What 4 things are elevated in the blood for Addison's? What 4 things are decreased in the blood for Addison's? For Cushings and Addisons, which one results in fluid volume overload and which one results in dehydration? What is the vasopressin test used for and what does it do? What is the UO like for DI? What is DDAVP for? Why is tegretol used for DI? Is vasopressin therapy lifelong for DI pts? T/F. encourage DI pts to use mouthwash in response to thirst. tall peaked T wave, prolonged PR interval, and widened QRS indicate: flattened T wave, depressed relfexes, flabby muscles, parasthesia, and hyperglycemia indicate: lethargy, depressed reflexes, stupor/coma, N/V, fractures, and shortening of ST segment and QT interval indicate: numbness/tingling around mouth, hyperreflexia, tetany, seizures, and elongation of ST segment and QT interval indicate: What are the "groans, moans, bones, stones, and overtones" for HYPERcalcemia: one major characteristic of HYPOmagnesemia: one major characteristic of HYPERmagnesemia: phosphorous levels are opposite of what levels in the blood? KCL supplements should never exceed what rate? what is used to treat severe hyperkalemia? what is used to moderate hyperkalemia? T/F. Never give Calcium IM. T/F. Loop diuretics are used for hypercalcemia. always assess which 3 electrolytes together? main CNS characteristics of dehydration/hypovolemia: main CNS characteristics of hypervolemia: what is pheochromocytoma? why should you avoid abd pressure, such as abd palpation for a pheochomocytoma pt? what is VMA? What are nursing implications for VMA testing? What is a Clonidine supression test? 3 diagnostic tests for pheochromocytoma: How is Regitine (phentolamine) used to diagnose pheochromocytoma? T/F. After bilateral adrenalectomy, glucocorticoid and mineralocorticoid replacement is required for pts with pheochromocytoma for LIFE. S&S of hypoglycemia: S&S of hyperglycemia: if hypoglycemic pt is unconscious, give what? via what route? what do you advise for diabetic women of childbearing age who are on oral antidiabetic meds and are also using oral contraception? What drink should diabetics avoid in their diet, esp when taking oral antidiabetic meds? 4 things to watch out for when on oral antidiabetic meds: which insulin cannot be mixed with any other type? besides, foot ulcers, cardio problems, and blindness, what else can diabetes result in? What is HHNS? most common cause of DKA: HHNS is more common in what kind of people? DKA is more common in what kind of people? T/F. There is an absence of ketones as well as acidosis in HHNS. T/F. SIADH results in renal reabsorption of sodium and water. early S&S of SIADH include: Very late S&S of SIADH include: confusion, Cheyne-Stokes respirations, seizures, coma moderate progression of SIADH can result in what S&S? personality changes, HYPOreflexia, N//V What 2 meds can be given to treat SIADH by blocking renal response to ADH? - demeclocycline (Declomycin) - lithium what's Cretinism? state of severe hypothyroidism in infants. hypothyroidism occurs more often in what kind of people? women in their 40s and 50s. Is serum cholesterol decreased or increased in hypothyroidism? increased. T/F. Anemia commonly accompanies hypothyroidism. True. what kind of drugs is contraindicated for a pt with hypothyroidism? CNS depressants, barbiturates, sedatives, etc. Is levothyroxine (Synthroid) for HYPO- or HYPER- thyroidism? for HYPOthyroidism. Is thyroid hormone therapy lifelong or temporary? lifelong. what kind of diet for hypothyroidism? low calorie, high bulk (for constipation) is cold intolerance a characteristic of HYPO- or HYPER- thyroidism? HYPOthyroidism. 5 S&S of myxedema coma: - depressed respirations - stupor (cerebral hypoxia) - hypothermia - bradycardia (low CO) - hypotension T3 and T4 secretion is regulated by what gland? anterior pituitary the thyroid gland produces which 3 hormones? - T3 - T4 - calcitonin TSH is secreted by which gland? anterior pituitary what does calcitonin do? prevents bone resorption and keeps blood calcium lvls low what's the most common cause of hyperthyroidism? Graves dz Why is PTU given for hyperthyroidism? blocks thyroid hormone synthesis T/F. Pts with hyperthyroidism often experience decreased appetite. False. They experience increased appetite, but their fast metabolism keeps their weight down. what is thyroid storm? a sudden surge of large amts of thyroid hormones into bloodstream (a medical emergency!) 6 S&S of thyroid storm: - hyperthermia - HTN - tachydysrhythmia - delirium - vomiting - abd pain goiters appear in HYPO or HYPER thyroidism? HYPERthyroidism why watch for hypocalcemia following a thyroidectomy? it may indicate that the parathyroid glands are damaged. what do you give in case of hypocalcemia? IV calcium gluconate. how many milliliters of drainage do you expect in the 1st 24hrs following a thyroidectomy? 50ml what position do you keep the pt following a thyroidectomy? high fowlers (to promote venous return) how do you check for laryngeal nerve damage in pts following a thyroidectomy? ask the pt to speak as soon as they awaken from anesthesia. what do you do to prevent hemorrhage in pts following a thyroidectomy? avoid neck flexion/extension and always align neck with body what do you monitor for in hypocalcemia? tingling of fingers and toes, spasms, and convulsions do you experience constipation or diarrhea with colon cancer? you may experience either one or both. S&S of colon cancer: - fatigue - weight loss - abd distension, bloating - constipation, diarrhea, change in bowel habits - anemia what 3 things should pts avoid in their diet 48 hours prior to FOB testing? - meats - NSAIDs - Vit. C what is the definitive test for colorectal cancer? colonoscopy/sigmoidoscopy what color should stomas be? reddish pink pts with strong hix of colorectal cancer shoulud reduce intake of what 2 things? - fats - meats which positions should the pt use during a paracentesis? either: - supine or - upright with arms over bedside table and legs dangling volume of fluid removed during paracentesis should no more than how much? no more than 1L (1kg, or 2.2lb) what do you measure before and after a paracentesis? abd girth what do you monitor throughout the paracentesis procedure? respiration rate monitor for which 3 complications following a paracentesis? - shock - peritonitis - perforated bladder which serum level can drop dangerously low following a paracentesis? serum albumin what is the primary risk factor for development of esophageal varices? portal HTN name 2 conditions that can result in portal HTN? - alcoholic cirrhosis - viral hepatitis what is the most serious complication of esophageal varices? hypovolemic shock what's the most definitive test for diagnosing peptic ulcers? EGD = esophago-gastro-duodenoscopy how is Sucralfate (Carafate) different from other antacids? give 1 hr before meals instead of 1-3hrs after meals. what types of food should a pt with dumping syndrome avoid? avoid milk, sweets, sugars (e.g. fruit juice, sweetened fruit, milk shakes, honey, syrup, jelly) what are 3 complications of dumping syndrome to watch out for? - postprandial hypoglycemia - malnutrition - F&E imbalance 3 characteristics that set small bowel obstruction apart from large bowel obstruction: - spasmodic colicky pain instead of constant diffuse pain - visible peristaltic waves rather than significant abd distention - sudden projectile vomiting that relieves pain rather than infrequent vomiting Differentiate WBC count for appendicitis and peritonitis. Usually, 10-18 x10^9/L for appendicitis >20 x10^9/L for peritonitis Differentiate temperature levels for appendicitis and peritonitis. Usually, low fevers (<101) for appendicitis higher fevers (>101) for peritonitis Differentiate diet prescriptions for IBD versus diverticulitis. - low fiber diet for IBD - high fiber diet for diverticulitis Difference in age of pts with IBD versus pts with diverticulitis: - IBD: age 15-40, younger - Diverticulitis: usually over 50 Major complication for ulcerative colitis: toxic megacolon major complication for Crohn's dz: fistulas T-tube drainage range: - initially may be up to 500ml/day, then gradually decrease overtime. - NEVER >1L/day major complication of casts: compartment syndrome major evidence that points to compartment syndrome: unrelieved pain or pain that is out of proportion to the injury. - other points include paresthesia, pallor, diminished pulses major complication of tractions: osteomyelitis what characterizes osteomyelitis? bone pain that is worse with movement - other signs include fever, edema, and erythema the primary concept of pin care to avoid cross-contamination is: use one cotton tip swab per pin (cotton swab soaked with peroxide or iodine) what are 3 LATE signs of neurovascular compromise in a pt with a cast/splint/traction? polar - cool/cold fingers/toes paralysis of fingers/toes pulses - weak what are 3 EARLY signs of neurovascular compromise in a pt with a cast/splint/traction? pain - not relieved w/ elevation or meds paresthesia - numbness or tingling pallor - cap refill time >3 sec, blue fingers/toes name 3 differences between osteoarthritis and rheumatoid arthritis. - RA is bilaterally symmetrical, OA is not - RA pain after rest, OA pain with movement - RA is autoimmune, OA is not should hormone replacement therapy (HRT) be used on a short-term or long-term basis? short term, generally <5 years what is considered excess vaginal postop bleeding following a hysterectomy? more than 1 saturated pad per 4hrs what characteristics differentiate BPH from prostate cancer during an digital rectal exam? BPH: enlarged but elastic Prostate Cancer: hard, irregular what kind of catheter is used following a prostatectomy or a TURP? an indwelling 3-way catheter when do you increase bladder irrigation rate? when you see bright red blood clots flow out (you need to dilute it) what is continuous bladder irrigation for? to keep catheter free of obstruction and to keep the irrigation pink or lighter. what is the normal PSA level? <4 ng/ml what is the priority nursing action immediately following a prostectomy? maintaining continuous bladder irrigation what should a woman not use prior to a mammogram? talcum powder or deodorant when should a baseline screening mammogram be done? age 40 what are Miotics for and what side effect does it cause? used for Glaucoma side effect = blurred vision what happens to the CNS with multiple sclerosis? plaque deposits in the white matter that damages myelin sheaths what's used for definitive diagnosis for MS? MRI brain and spine (for plaques) What kind of precaution should be used for pts with chicken pox (Varicella)? airborne What kind of precaution should be used for pts with TB? airborne What kind of precaution should be used for pts with disseminated varicella Zoster? airborne What kind of precaution should be used for pts with measles (Rubeola)? airborne What kind of precaution should be used for pts with HIB? droplet What kind of precaution should be used for pts with pertussis? droplet What kind of precaution should be used for pts with mumps? droplet What kind of precaution should be used for pts with Rhinovirus? droplet What kind of precaution should be used for pts with rubella? droplet What kind of precaution should be used for pts with scarlet fever? droplet What kind of precaution should be used for pts with C. Diff? contact What kind of precaution should be used for pts with congenital rubella? contact What kind of precaution should be used for pts with Hep A? contact What kind of precaution should be used for pts with shingles? contact What kind of precaution should be used for pts with impetigo? contact What kind of precaution should be used for pts with MRSA? contact What kind of precaution should be used for pts with herpes simplex? contact What kind of precaution should be used for pts with rabies? standard What kind of precaution should be used for pts with rheumatic fever? standard What kind of precaution should be used for pts with West Nile fever? standard acute glomerulonephritis usually commonly follows what illness? strep throat what is used to confirm or rule out diagnosis of glomerulonephritis? renal biopsy what is nephrotic syndrome? glomerular capillary damage resulting in loss of serum proteins and decreased serum osmotic pressure. 3 characteristics of nephrotic syndrome: - proteinuria - HYPOalbuminemia - edema what happens to serum cholesterol, triglycerides, and LDLs in nephrotic syndrome? they're all elevated Laryngeal cancer usually affects what gender and age? men over 60 3 top risk factors for laryngeal cancer? - tobacco - alcohol - harmful chemicals (chronic exposure) encourage what kind of diet for laryngeal cancer pts? high protein and high calories T/F. Pts who undergo total laryngectomies will lose their natural voices. True. If a nodal neck dissection (radical neck) is done for laryngeal cancer, what happens to the shoulders following surgery? shoulders drop because CN XI (spinal accessory nerve) is cut. what's a cordectomy? excision of a vocal cord aspiration can lead to the development of what respiratory condition? pneumonia what is the leading cause of cancer-related deaths? lung cancer what type of lung cancer is fast growing and almost always associated with the hx of smoking? small cell lung cancer most lung cancers belong in which category (small cell or non-small cell?) non-small cell The TNM system for staging lung cancer stands for what? T = tumor N = nodes M = metastasis what kind of respiratory S&S do you expect to find in lung cancer pts? - persistent cough w/ or w/o rust/blood-colored sputum - dyspnea - unilateral wheezing - chest wall pain what kind of diet is prescribed for lung cancer pts? high protein high calorie T/F. superior vena cava syndrome is a medical emergency. True. What are early signs of Superior vena cava syndrome? facial edema, tightness of shift collars, nosebleeds, peripheral edema, and dyspnea what are late signs of superior vena cava syndrome? mental status changes, cyanosis, hemorrhage, and hypotension. what's the most common cause of pulmonary embolism? DVT T/F. Oral contraceptives and estrogen therapies are risk factors for PE. True. What is commonly used to diagnose PE? CT scan How do the ABG's change as a PE progresses? 1st respiratory alkalosis (initial hyperventilation) 2nd respiratory acidosis (due to hypoxemia) T/F. Onset of S&S for PE is slow. False. Onset of S&S for PE is sudden and rapid. 6 common S&S of PE: - Dyspnea, air hunger - tachycardia - tachypnea - Anxiety - decreased O2 sat - hypotension why are streptokinase and alteplase used for PE? used as fibrinolytic therapy to break up blood clots what's the highest nursing priority for a pt with PE? Oxygen therapy crystalloids are used to: restore intravascular volume and prevent shock dobutamine is used to: improve cardiac contractility T/F. Recent surgery is a contraindication to fibrinolytic therapy. True. classification of acute respiratory failure (ARF) is based on what? ABG's what ABG values indicate ARF? PaO2 <60 & SaO2 <90% or PaCO2 >50 & pH <7.30 T/F. Clients w/ ARF are always hypocapneic. False. Client with ARF are always hypoxemic. T/F. ARDS is a state of ARF. True. mode of transmission for SARS is: droplet 5 ARDS indicators: - persistent hypoxemia despite administration of 100% O2 - decreased pulmonary compliance - dyspnea - bilateral pulmonary edema that is noncardiac - dense pulmonary infiltrates ("ground glass" on CxR) T/F. surfactant activity is reduced in ARDS. True. which setting on mechanical ventilator is used to prevent alveolar collapse during expiration? PEEP T/F. PEEP can lead to increased cardiac output. False. PEEP increases intrathoracic pressure and leads to decreased cardiac output. what needs to be done to confirm hemothorax? thoracentesis in tension pneumothorax, tracheal deviation occurs on which side? deviates to the unaffected side Distinguish pneumothorax from hemothorax by percussion: pneumothorax = hyperresonnance hemothorax = dull T/F. Increased cardiac output resulting in HTN is a possible complication of pneumothorax. False. Increased intrathoracic pressure with decreased CO resulting in HYPOtension is a possible complication of pneumothorax What's a definitive sign of tension pneumothorax? tracheal deviation. for chest tubes, the water seal should be maintained at what level? 2 cm T/F. continuous bubbling is expected with a water seal chamber. False. Tidaling is expected, but continuous bubbling is a sign of air leak. Taking nitrates along with Viagra can cause what serious problem? severe hypotension T/F. Use lotions on dry skin following radiation to prevent cracking. False. Using lotions on the dry skin patches caused by radiation can further irritate the skin. Taking aluminum-containing antacdis concurrently does what to Ciprofloxacin absorption? decreases Cipro absorption ostmomy bags should be cut how much larger than the stoma? 1/16 to 1/8 in larger than the stoma T/F. Hyperkalemia decreases GI motility. False. HYPOkalemia decreases GI motility. T/F. An adverse rxn of furosemide is HYPOnatremia. True. What's the normal rate for chest tube drainage? 100ml/hr or less. Report to physician if >100ml/hr. T/F. Increased ESR occurs with any inflammatory process. True. how much fluid can be taken out during a paracentesis? - Usually limited to 1L in a short period of time. (Slow drainage can be used to take out >1L of fluid over several hours.) what is Cushing's triad and what does it indicate? Cushing's triad: - widened pulse pressure - bradycardia - irregular respiratory rate == indicates increased ICP what color is a full thickness burn? cream, tan, brown, black what color is a 3rd degree burn? white, charred-looking describe a 2nd degree burn? red, blistered describe what a 1st degree burn looks like: red, no blisters, dry T/F. in treating a burn victim, remove ALL clothing from the burnt areas. False. Remove only those pieces of clothing that is not sticking to the skin. If it sticks, don't remove. what type of MI is associated with heart failure? anterior MI (causes L ventricular dysfxn) what helps the burning pain after an IM injection? warm compress tracheal shift in 3 kinds of pneumothorax: - simple pneumothorax: usually no shift - tension and hemothorax: shift to contralateral (unaffected) side T/F. the paralysis that accompanies Guillian barre is temporary. True. T/F. Pts who are about to undergo EGD's should be on a 24 hr clear liquid diet and have GI cleansing prior to the procedure. False. GI tract cleansing and a clear liquid diet are interventions for a client having a lower GI tract procedure, not an upper GI procedure. - the client should be NPO for 6-12 hours prior to an EGD. do pts with chronic renal failure have HYPO- or HYPER- calcemia? HYPOcalcemia (due to hyperphosphatemia) what is extracorporeal shock wave lithotripsy and to include in discharge teaching? - for renal calculi - instruct to intake lots of fluids to flush out fragments what kind of isolation precaution is needed for SARS? airborne and contact A pt with cirrhosis is prescribed lactulose for what? what do you monitor for to make sure it's working. - to decrease serum ammonia levels - you monitor for LOC Addison's disease is a form of what condition? adrenal insufficiency T/F. Addison's disease is autoimmune. True. What is secondary adrenal insufficiency? lack of hormones (e.g. ACTH, CRH) from the hypothalamus or pituitary that regulate steroid production in the adrenal glands what causes malignant hyperthermia/hyperpyrexia? adverse reaction to certain anesthesia what are 5 S&S of malignant hyperthermia? - muscular rigidity - tachycardia - hyperthermia - hypercapnia - red-brown urine the neuromuscular blocking agent succinylcholine is a trigger for what dangerous condition? malignant hyperthermia blood test results for malignant hyperthermia would reveal: - high K+, P, CK, & myoglobin - low Ca++ - acidosis what is autonomic dysreflexia? a medical emergency characterized by a massive SYMPATHETIC discharge that can occur in association with spinal cord injury or disease (e.g. MS) what are S&S of autonomic dysreflexia? - high BP (often >200) - intense headaches - profuse sweating - feeling of doom - goosebumps - nasal stuffiness - facial erythema T/F. aluminum overload causes constipation. True. T/F. Organ donation must be completed within 24 hours of patient death. False. It should be completed within 72 hours. Some can be stored for longer. Why is surgical removal of breast cancer tumor not suggested in case of superior vena cava syndrome? surgical removal is too invasive and may increase intrathoracic pressure, which worsens the superior vena cava syndrome. Why is chemotherapy not used in the case of superior vena cava syndrome caused by breast cancer tumor? chemo does not shrink size of tumor, it only halts the growth. 10 most common causes of Pulseless Electrical Activity (PEA): - hypovolemia (low volume) - hypoxia (low oxygen) - hydrogen ion excess (acidosis) - hyper-/hypo-kalemia (high/low K+) - hypothermia (low body temp) - taking drugs (overdose) - tamponade (cardiac) - tension pneumothorax (oneway valve in pleural cavity) - thrombosis (pulmonary) - thrombosis (coronary [Show More]

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