Med surge 2

The nurse clarifies that unconjugated bilirubin, which is made up of broken down red blood cells is:

A water-insoluble product that must be converted in the liver to conjugated bilirubin so that it may be excreted through the bowel.

Proton pump inhibitor

Omeprazole

What leads to the production of bilirubin when destroyed (think yellow baby)?

Red blood cells

When caring for an extremely jaundiced patient with cirrhosis, what should the nurse include provisions for in the plan of care?

Jaundice causes pruritus and can lead to skin lesions and pressure injury.

The patient tells the nurse that he is legally blind. How would this information impact the nurse's plan of care for this patient?

The nurse will need to collect more information as to the exact extent of the vision loss.

What Glasgow Coma Scale eating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement?

12 4 for eye opening 2 for incomprehensible speech 6 moving on demand

The enzyme that digests starch is:

Amylase

What should a patient who has had a cataract repair avoid?

Any activity that increases the intraocular pressure, such as lifting heavy objects, stooping, and bending.

The patient with cirrhosis has an albumin of 2.8 g/dL. The nurse is aware that normal is 3.5 to 5 g/dL. Based on these findings, what would the nurse expect the patient to exhibit?

Ascites or edema

If a nurse is sensitive to latex gloves, what potential food sensitivities might the nurse develop?

Avocados Kiwi Guava Bananas Water chestnuts Hazelnuts Tomatoes Potatoes Peaches Grapes Apricots

The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate (Pepto-Bismol) to combat helicobacter pylori. What color will this drug turn his stool?

Bismuth products turn the stool gray-black

The nurse should instruct the patient who is diagnosed with AIDS to report signs of Kaposi's sarcoma, which include:

Blue, red, or purple lesions seen mainly in Mediterranean men. Firm, flat, raised or nodular, hyperpigmented, multicentric lesions on the skin, and mucous membranes.

Which complaint made by a 64-year-old patient during a health interview would alert the nurse to the possibility of cataracts?

Blurring of vision and difficulty driving at night

How does normal aging change in immune system?

Causes deficiencies in both B and T cell activation, but the bone marrow is essentially uncompromised. The thymus decreases in size.

What is an early sign of increased intracranial pressure in a brain injured patient?

Change in level of consciousness

The patient has end-stage renal disease (ESRD) and is admitted to the hospital with a blood urea nitrogen (BUN) level of 48 mg/dL. In order to keep the patient safe, the nurse should remember that an excessive elevation of BUN could cause:

Disorientation or seizures

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are infested over a period of less than 20 minutes. What would the nurse suggest to reduce the risk of dumping syndrome?

Eat six small meals a day, high protein, high fat, low carbohydrates, avoid fluid during meals, lie down for 1 hour after meals

The patient's cirrhosis of the liver has also caused a dilation of the veins of the lower esophagus secondary to portal hypertension, resulting in the develop of the complication of:

Esophageal varices

H2 antagonists

Famotidine (Pepcid) Ranitidine (Zantac) Cimetidine (Tagamet)

What should the nurse encourage, barring any other contraindication, when teaching a patient how to decrease the chance of further problems with urolithiasis?

Fluid intake should be encouraged to at least 2000 mL of fluid in 24 hours, unless contraindicated.

Four hours after a stapedectomy, the patient complains that hearing loss has not improved at all. What knowledge would the nurse use to shape a response?

Hearing improvement will not be noted until edema subsides and the packing is removed.

What should the nurse point out as a significant advantage of the laparoscopic cholecystectomy?

Less invasive, causes less pain, and quick recovery

The accessory digestive organ that stores glycogen is the:

Liver

What are the effects of normal aging on the nervous system?

Loss of neurons, reduction of cerebral blood flow, appearance of lipofuscin, a decrease in oxygen use and brain metabolism, and a decline in velocity of nerve impulses.

Patient with cirrhosis is edematous. What could cause that symptom?

Low albumin

The cells in the liver that phagocytize are:

Macrophages Kupfer cells

Which person is most at risk for a hypersensitivity reaction?

The 84 year old with the deteriorated immune system is a prime candidate for a delayed hypersensitivity reaction.

The patient who had an asthma-like reaction to a desensitization shot was medicated with a subcutaneous injection of epinephrine. What effect should the nurse assure the anxious patient this will have?

The patient may experience an increase in heart rate.

A 56-year old man is admitted to the emergency room with an acute attack of diverticulitis. The patient has a temperature of 102 degrees Fahrenheit, and has an elevated white count. Which assessment would alert the nurse to impending septic shock?

The patient with diverticulitis who has fever and an elevated white count has an infection that could lead to septic shock, which will present as tachycardia and hypotension.

The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which of the following is the most appropriate suggestion to lessen these symptoms?

The symptoms of diverticulitis can be reduced or prevented by eating a high-fiber diet, reduction of meat and fats in the diet, and avoiding activities that increase intraabdominal pressure.