NCLEX
nurse prepares a nursing home unit for the client who had a stroke resulting in right-sided paralysis. Post a sign stating :
"Do not use client's arm for lifting."
A client in the psychiatric unit continually complains to the nurse that his stomach is missing.
"It sounds like you feel very empty and alone."
s/e of Capsicum (__)
(Cayenne Pepper) -GI discomfort -Burning pain eyes, mouth -Bronchospasm
There is blood at a venipuncture site and around an IV catheter. Indicator of ____. Sepsis is the most frequent cause.
(DIC) disseminated intravascular coagulation, a life-threatening problem
S/E of anticonvulsants (name them)
(Dilantin, Luminal, Depakote, Tegretol, Klonopin) -resp depression -aplastic anemia -gingival hypertrophy (gums overgrowth) -ataxia
s/e of ____: -heptatoxicity -nephrotoxicity -leukopenia -thrombocytopenia
(Sandimmune-cyclosporine)
ADD & narcolepsy treated with
(amphetamines) Ritalin Dexedrine
s/e and n/i of Librium Xanax Ativan Vistaril Equanil (what kind of meds?)
(anti-anxiety agents) s/e-confusion, sedation, hepatic dysfunction, depression n/i-addiction or overdose, avoid alcohol, monitor liver function(Alt, Ast, LDH)
3 n/i for Nystatin & Amphotericin B
(antifungals) -give with food -monitor liver -oral hygiene
impetigo (___ precaution) is a ___ or ___ infection treated with
(contact) staph or strep antibiotic
s/e & n/i of hypoglycemic agent (name it)
(glucagon, which is sugar for low sugar) -Hypotension -Bronchospasm -May repeat in 15 min -Give carb food when alert
normal albumin is
(greater than) >30 mg/24 h
Hypoglycemia blood sugar levels
(less than) <50-60
pt took lispro (peak in __) at 7:30am; eats breakfast at 8:30, and experiences h/a and trembling at 9.
(peak in 30 min) Pt should eat before insulin peaks to avoid hypogycemia
if a nursing assistant who has never had the chicken pox is scheduled to work with a herpes zoster pt (aka __)
(shingles) -assign pt to an immune nurse asst.
s/e & n/i of thrombolytics (drugs?)
(streptokinase, urokinase, TPA) -bleeding -brady cardia -dysrhytmias -monitor bleeding -check pulse of extremities -color, sensation of extremities -EKG
____: avoid -aged cheese -bologna -Pepperoni -Salami -bananas -raisins -beer -wine -sour cream -pickeled foods
(tyramine foods) MAOIs Nardil, Marplan, Parnate
pt taking pancreatic enzymes *(for__)* should take them when?
*(CF)* before or with meals to assist with digestion
Relationship between PaO2 & SpO2
*30-60-60-90* pressure 30 = sat 60 pressure 60 = sat 90
*REVIEW QB TEST #22 numbers 1-50 BECAUSE*
*ALL QUIZLET SLIDES WERE DELETED*
elderly client: The nurse finds the client sitting up in bed complaining of pressure in his chest and pain in his jaw. Vital signs are: BP 160/94, P 112, R 20, T 99.5°F (38°C). The client has a history of hypertension
*Administer oxygen at 4 L/min via nasal canula* Signs of ACS (acute coronary syndrome=MI or unstable Angina) -unstable angina -myocardial ischemia -infarction
Two drugs for: -angina -perioperative HTN -HF
*Antianginals* -Nitroglycerine -Isordil
______: watch for -Allergies (rashes, hives; anaphylaxis) <-give ? -Super-infection (where?) -Organ toxicity (liver, kidney)
*Antibiotics* (give benadryl antihistamine) (mouth, gi-gu)
S/e: blurred vision, dry mouth, urinary retention, change in heart rate
*Anticholinergics:* Pro-Banthine Atropine Scopace
_____: -Dilates pupil -Causes bronchodilation -Decreased secretion -Decreased GI mobility (Use with ophthalmic exam, motion sickness, pre-operative)
*Anticholinergics:* Pro-Banthine Atropine Scopace
meds that slow peristalsis and increase the tone of the sphincter
*Antidiarrheals* Kaopectate Lomotil Imodium Pargoric
_____: -Increase GI motility -Block effects of dopamine in chemoreceptor trigger zone
*Antiemtics* -Tigan -Reglan -Antivert -Compazine
Aspirin Plavix Persantine uses?
*Antiplatelet Agents-don't let platelets form clots* venous thrombosis pulmonary embolism
in autonomic dysreflexia, ____ is used if other means (such as sitting, urinary catheterization and emptying of the bladder, removal of fecal mass, or removal of skin stimuli) have not relieved the hypertension and headache
*Apresoline*-antihypertensive, non-nitrate vasodilator
Capoten Vasotec
*CAPVASACE HTN CHF* (cap & vas are Ace inhibs for HTN & CHF)
What herbal? Used for -Analgesia -Circulation -Nerve pain -PVD
*Capsicum/Cayenne Pepper*
What herbals? -for Collagen synthesis (arthritis/joint development)
*Chondroitin*-S/E include dyspepsia (indigestion), N, and potentiates anticoagulants *Glucosamine*-S/E include impedes or increases insulin resistance
Humulin 70/30 type- onset- peak- duration-
*Combination (pt doesn't have to mix different acting insulins) *0.5 hr *2-12 hr *24 hr
What type of reaction? -rash -hives -swollen joints What are n/i?
*Delayed Allergic Reaction* -Discontinue med -Topical Antihistamines -Corticosteroids -Comfort measures
Humulin R (Regular) type: onset: peak: duration:
*Fast acting *0.5-1 hr *2-4 hr *6-8 hr
How can allergies cause frequent epistaxis?
*Frequent use of nasal sprays* causes vasoconstriction --> atrophy of nasal membranes --> decreased integrity to blood vessels.
_____: Assessment reveals -Glucose >800 -Occurs in older type 2 DM -No ketosis or acidosis -Hypotension -Dry mucous membranes -Seizures
*HHNKS* (Hyperglycemic Hyperosmolar Nonketotic Syndrome)
NPH, Humulin N type: onset: peak: duration:
*Intermediate acting *2 hr *6-12 hr *18-26 hr
___ used for constipation & preparation for surgery & some procedures
*Laxatives/Stool softeners* -Cascara -Dulcolax (bisacodyl) -Colace (docusate) -Milk of Magnesia
action of ___: -Absorb water and increase bulk -Lubricate stool surface -Stimulates peristalsis
*Laxatives/Stool softeners* -Cascara -Dulcolax (bisacodyl) -Colace (docusate) -Milk of Magnesia
s/e of ___: -diarrhea -dependence -abdominal cramps -hypermagnesemia
*Laxatives/Stool softeners* -Cascara -Dulcolax (bisacodyl) -Colace (docusate) -Milk of Magnesia
Gold, Arsenic, Lead poisoining 3 drugs 3 s/e 4 n/i
*Metal antagonists* Desferal mesylate BAL in Oil EDTA Tachycardia Pain Induration at injection site I&O Kidney Function Give With Anesthetic Seizure precautions
n/i for ___ -apply pressure on lacrimal sac for 1 min -avoid sunlight -may experience transient brow pain and myopia
*Miotics* Isopto-Carpine Eserine Carbacel
s/e of what eye drops: -photophobia -H/a -hypotension -bronchoconstriction
*Miotics* Isopto-Carpine Eserine Carbacel
S/e of what eye drops? -photophobia -tachycardia -blurred vision -dry mouth
*Mydriatics* Atropine sulfate Cyclogyl
Large, irregular, flat macular patch on one side of the face; its color ranges from pink to red to purple and it may appear purple-black in Africans; grows proportionately as the child grows; does not fade; a laser pulse device is used to significantly lighten or completely clear the stain when the child is older
*Nevus Flammeus (port wine stain)*
-serotonin syndrome, which is a rare, life threatening event caused by taking ___; symptoms include abdominal pain, fever, sweating, tachycardia, hypertension, delirium, myoclonus, irritability, and mood changes; may result in death
*SSRI* Celexa Lexapro Prozac Luvox Paxil Zoloft
mania, hypomania, insomnia, impotence, headache, and dry mouth are s/e of
*SSRI* Celexa Lexapro Prozac Luvox Paxil Zoloft *SSRIs take 1-4 weeks to work*
Gantrisin Bactrim Azulfidine n/i:
*Sulfonomide Antibiotics:* -*take with meals* -encourage fluids (3,000ml/day) -mouth care
S/e of ____: -Peripheral neuropathy -Crystalluria -Photosensitivity -GI upset -Stomatitis
*Sulfonomide Antibiotics:* Gantrisin Bactrim Azulfidine
What drugs for -ulcerative colitis -Crohn's disease -otitis media -UTIs
*Sulfonomide Antibiotics:* Gantrisin Bactrim Azulfidine
H2 Blockers s/e
*Tagamet; Zantac* dizziness confusion hypotension impotence
3 drugs that dissolve (lyse) blood clots
*Thrombolytics* -Streptokinase -Urokinase -TPA (Tissue Pasminogen Activator)
What antidepressants cause these s/e? -sedation -anticholinergic effects (dry mouth..) -confusion -postural hypotension -urinary retention
*Tricyclics* Elavil Tofranil Nopramin
A patient complaining of a dry cough for several weeks with frequent night sweats.
*Tuberculosis* place in room with negative air pressure or fit with an appropriate mask to prevent spread of the disease until evaluation confirms that patient is free of disease
Pyridium is used for s/e: n/i:
*UTI* h/a, vertigo -urine will be orange
6 types of transfusion reactions
*allergic* (hives, itching, flushing)(benedryl, steroids, epinephrine) *hemolytic* (incompatibility; up to 24 hrs from transfusion) (low back pain, low BP, hematuria)(antihistamine) *febrile* (common in multiple transfusions)(aspirin) *bacterial* (fever, chills, hypotension) (volume expanders, antibiotics) *viral* (HIV) *fluid volume overload* (SOB, rales, crackles)(slow blood)
Give these drugs with antacids, milk, or food. Can cause agranulocytosis (?), GI upset, *renal calculi* <-so push fluids
*anti-gout* Cochicine Allopurinol Probenecid (agranulocytosis is failure of bone marrow to make enough WBCs)
Severe headache, diaphoresis, nasal congestion, distended bladder related to
*autonomic hyperreflexia/autonomic dysreflexia*, complication of spinal cord injury
Bethane*chol* (Ure*chol*ine)
*cholinergic* aka *parasympathomimetic* mimics action of acetylcholine -treats functional incontinence
*NPH*, an __acting insulin, has a *peak* action of _____
*intermediate-acting*; 6 to 12 hours
What drugs do you give for pancreatitis pain?
*narcotics (morphine)* (not dqemerol)
Nimodi*pine* is a ___
*pine= Calcium Ch Blocker* -prevents vasospasm & neuro deterioriation
*onset* of action for *lispro* insulin, a __acting insulin, is _____
*rapid-acting*;5 to 15 minutes
s/e of antianginals (think about their action)
*relax smooth muscle, decrease venous return* -Hypotension -Tachycardia -H/A -Dizziness
Ultralente, Humulin U type: onset: peak: duration:
*slow-acting *4 hr *8-20 hr *24-36 hr
The patient has a Pleur-Evac drainage system in place; most common cause of tubing obstruction is
*the patient lying on the tubing* (other causes are kinking, dependent loops, clots, or fibrin)
___ deficiency is the primary cause of alcohol-related changes such as Wernicke's encephalopathy and Korsakoff's syndrome
*thiamine (vitamin B1)*
In a thoracentesis a pt should expect
*tingling* sensation with injection of local anesthetic and feeling of *pressure*
absence of fluctuation indicates either that ____ (which is desired) or that ___ (which is not desired)
- the lung has re-expanded -there is an obstruction of the chest drainage tubes
*Slides deleted----Sensory and Perceptual Alterations video from 5:00-13:00*
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N/i for administering epinephrine in an anaphylactic pt
-0.3 mL of 1:1,000 solution -SQ injection -Massage site (speeds absorption) -Repeat in 15-20 min (if needed)
Position & neuro assessment after myelogram
-30-45 deg for 8-16 hrs (neuro q2-4 hrs)
what s/e would you expect with bronchodilators? (name some)
-Aminophylline -Arethine -Atrovent -Proventil -Primatene s/e: -tachycardia -dysrhythmias -palpitations -anticholinergic effects (urinary ret, dry mouth, blurred vison)
Implementations for Herpes Zoster
-Analgesics -Compresses -Anti virals -Corticosteroids
Nursing considerations for adrenergics (what meds?)
-BP -Peripheral Pulses -Output -Safety: ambulation, driving
Adminsitration of blood/blood products 6
-Baseline vitals (q15 min for 1st hr then hrly) -18 gauge needle for access -Start with 0.9% NaCl -Run Slowly (5 mLs/min) first 15 min -Stay with patient first 15-30 min -Infuse in 4 hrs or less
examples of Laxatives/stool softeners
-Cascara -Dulcolax (bisacodyl) -Colace (docusate) -Milk of Magnesia
PICC line implementations -Change -Flush
-Change dressing 2-3 times a week; or PRN(when wet or nonocclusive) -Flush with 2 ml NS followed by 5 ml heparin (100 u/ml) into each lumen
mid line catheter (MLC) Implementation -Change -Flush -Anchor
-Change dressing 2-3 times per week or PRN (wet or nonocclusive) -Flush with 5-10 ml normal saline followed by 5 ml heparin (100 u/ml) into each lumen q12h or after each infusion -Anchor securely
percutaneous central catheter implementation -Change site -Change tubing -Flush -Dressing change
-Change site q4wks -Change tubing q24h -Flush with diluted heparin solution BID, or after infusion, specimen withdrawal, and when discontinued -Dressing change 2-3 times a week
Self Monitoring of Blood Glucose (SMBG) nursing teaching
-Check eyesight -Calibrate monitor -Check test strips -Perform test 2-4 daily if on insulin -Keep log of results
Non-Penetrating eye contusions
-Cold Compresses -Analgesics
IV infiltration -Assessment -Implementation
-Cool skin, swelling, pain, decrease flow rate -Discontinue IV, warm compresses, elevate arm, start at new site proximal to infiltrated site
Complications of IV Clotting -Assessment -Implementation
-Decreased flow rate, back flow of blood into tubing -Discontinue IV, do not irrigate, do not milk, do not increase rate of flow or hang solution higher, do not aspirate cannula, *inject Urokinase*
Two reasons for increased in urine specific gravity
-Dehydration -Increased ADH (SIADH-trauma, stress reactions, surgery, and many drugs)
n/i for Renal Impairment
-Diet & fluid restrictions -Electrolye replacemtn -Dialysis -Rest
pt concerned about ordor and gas from colostomy (4 things to help)
-Drink cranberry juice and buttermilk -Eat crackers, toast, and yogurt -Use commercial deodorizer -Do no skip meals or chew gum
complications of IV Hematoma -Assessment -Implementation
-Ecchymosis, swelling, leakage of blood -Discontinue IV, apply pressure, ice bag 24 hrs, restart IV in opposite extremity.
Caridac cath prep
-Empty bladder -NPO 8-12 hrs -Signed consent
Penetrating eye trauma
-Eye patch -Surgery
What are the major complications of DKA? How do you treat?
-FVD -Metabolic Acidosis -Replace high volume 0.9% or 0.45% NaCl -Insulin R at 5 units/hr (decreases ketones) -Potassium replacement -EKG (hypokalemia) -VS q 15 min until pt stable
Child with Hirschsprung's Disease
-Failure to gain weight -Foul stools -Constipation
Hepatobiliary Disease disase?implementation?
-Fat malabsorption -Fatty stools -Low fat, High protein diet -Vitamins
s/s of Reye's syndrome
-Fever -Increased ICP -Decreased LOC -> coma -Decreased hepatic function -Diagnosed with liver biopsy
Post op care for Ulcers
-Gastric decompression -B12 IM for life -Teach to prevent dumping syndrome
2 n/i's for superinfections
-Good mouth/skin care -Antifungals
n/i for liver impairment
-Good skin care -Comfort measures -Rest
s/e of Hytrin and Flomax
-H/A -Dizziness -Orthostatic Hypotension
Tagamet is a
-H2 Blocker -Take with and
short leg cast care
-Handle cast with palms of hands. -Affected limb elevated to level of the heart. -Compare toes of casted leg with opposite leg. -Place a fan in the client's room
Post test Angiography -Assess for ___ -Compare ___ -Check __
-Hematoma, Distal Pulses -Skin temperature, color, sensation -VS
Skin & Foot care for DM
-Inspect feet daily; Use mirror if necessary -Wear well fitting shoes -Break in new shoes slowly -Buy new shoes later in the day (feet are largest) -Don't walk barefoot or use heating pads -Cut toenails straight across
Pyloric stenosis Assessment in infants
-Irritability -Always hungry -Fails to gain weight -Projectile vomiting -Palpable olive shaped tumor in epigastrium (infants) -Peristaltic waves -Epigastric fullness (adults)
diphtheria, tetanus toxoid, and attenuated pertussis vaccine (DTap) given in ___ and then again in ___
-Kindergarten -10 years after Td booster vaccine
S/e of drugs for bipolar (name them) n/i
-Lithium -Depakote -Tegretol n/i=give with meals, and FLUID INCREASE (GI upset, Tremors, Polydipsia, Polyuria)
Implementations for PKU
-Low protein diet -Milk substitutes
n/i for cholinergic effects
-Lozenges (sugarless) -Good Mouth care -Void before taking medication (avoids urinary retention)
Esophageal Atresia or Tracheoesophareal Fistula preop implementations
-Maintain patent airway -Position *supine or prone* with HOB inclined 30 degrees at least
Nursing care for bone marrow depression:
-Monitor CBC: -Protect from infections (leukopenia) -Avoid injury (thromboyctopenia; pressure for several minutes) -Watch urine/feces color
What two n/i for pt taking vitamins for vitamin deficiency?
-Monitor levels -Don't mix w/meds
3 implementations for paralytic ileus post op
-NG suction -IV fluids -Decompression tube
Implementations for Peritonitis
-NOP -Gastric decompression -F&E -Analgesics -Surgery -Antibiotics
Implementation for Embolism after surgery
-Oxygen -Heparin -IV fluids
-Streptokinase -Urokinase -TPA (Tissue Plasminogen Activator) *3 uses?*
-PE (Pulmonary Emboli) -Thrombosis -MI
Albuterol should be taken ____ The beclomethasone should be taken ___
-PRN for SOB -Daily to prevent asthma attacks
Complications of PICC (picc lines go into the __ system)
-Pneumothorax -Dysrhythmias, thrombophlebitis -Nerve or tendon damage -Respiratory distress -Embolism (venous)
immediate prosthetic fitting after an above-the-knee amputation;
-Provide cast care to the affected extremity. -closed, rigid cast prevents bleeding and controls pain; because rigid plaster cast is used, cast care is required
physician's examination reveals age-related macular degeneration (ARMD) to a pt who experienced sudden visual loss in a portion of the visual field. Priority is
-Pt's feelings about permanent loss of vision -For the nurse to allow the client to verbalize fears about the future and to assist the client to maximize remaining vision
Phlebitis, thrombophlebitis -Assessment -Implementation *Thrombophlebitis is phlebitis (vein inflammation) related to a thrombus (blood clot).*
-Redness, warm, tender, swelling, leukocytosis (elevated wbc) -Discontinue IV, warm moist compresses, restart IV at new site
A patient came to the emergency department after witnessing a friend shot to death on her front balcony. The patient is shaking, crying, and states she feels very nervous. The nurse observes the patient to be severely anxious. The nurse's plan of care should include which of the following?
-Remain w/pt -Give Ativan (antianxiety) -Provide privacy (too much stimulation) -Write down important info
treatment of HHNKS
-Restore fluid volume 0.9% NaCl -Regular insulin IV -Check vital signs -Monitor glucose *-Determine and treat cause*
How to prevent dumping syndrome
-Restrict fluid with meals -Lie down 20-30 minutes after eating -Low carb, Low fiber (slows passage of food)
-Sore throat, fever, increased fatigue, vomiting, diarrhea -Dry mouth, nasal stuffiness, weight gain
-S/e of Tofranil tricyclic antidepressant; alter dose -S/e of antidepressants; client learns to manage, do not alter doese
n/i for CNS Impairment
-Safety for injury -Avoid activities that require alertness -Orient to surroundings
Pancreatitis s/s
-Severe abdominal pain -N, V 24-48 hrs after heavy meal or alcohol consumption -Hypotension, acute renal failure -Hyperglycemia -elevated amylase
breastfeeding moms can use ___ ___ ___ positions
-Side lying -Sitting upright -Infant facing mother (tailor position)
Guillain-Barre Syndrome implementations *(pt can't ____ at all sometimes)*
-Steroids -Aggressive Respiratory Care -Physical Therapy -Eye care -Prevent Complications *(move)*
Implementations for SLE (Systemic Lupus Erythematosus)
-Steroids, NSAIDS -Protect skin from sunlight
Esophageal Atresia or Tracheoesophareal Fistula assessment may reveal:
-Stomach distention -Choking, coughing cyanosis (when trying to eat or drink)
Transfusion Reaction Implementations
-Stop blood -Restart 0.9% NaCl -Airway -Benadryl, aspirin -Return blood container and tubing to blood bank -Collect blood and urine sample -Monitor voiding
Appropriate position for client after right cataract surgery
-Supine -HOB elevated 30 deg decreases swelling and pain -Eyeshield appropriate
Complications of MLC (midline catheter)
-Thrombosis -Phlebitis -Air embolism -Infection -Vascular Perforation
Pt shows what signs w/Echinacea allegy?
-Tongue Tinging -N/V
Vagotomy is done to treat __ and it functions by ___
-Ulcers -Decreasing HCl secretion
3 symptoms of MS
-Urinary retention -Numbness -Decreased short-term memory
N/i for parkinson's drugs
-Urinary retention -Reverses vit B6 -Avoid use of CNS depressants
acute pain after a *laparascopic cholecystectomy* in the right shoulder
-abdomen insuflated with CO2 for procedure (pt needs to walk around to excrete gas)
Thyroid storm usually happens -after -by using -because of
-after illness/infection/surgery -by using iodine in CT scan -because of radioactive iodine therapy
Explain why each of these pts is at risk for pneumonia: -A 43-year-old homeless man consumes a quart of wine daily -A 56-year-old woman NPO due to perforated bowel -A 76-year-old man with dysphagia following a cerebrovascular accident
-alcohol suppresses body reflexes, ciliary motion, and white blood cell mobilization -surgery increases pharyngeal colonization of organisms; should promote oral hygiene -persons with swallowing difficulties are at risk for bronchial pneumonia; suctioning and frequent position change will help to prevent pneumonia
meds for colitis
-analgesics -anticholinergics -antibiotics -corticosteroids -antidiarrheals
Isordil is taken for ___ and may be taken every ___. pt needs to place one ___
-angina -q 5 min X 3 doses (after 3rd dose if still pain then hospital) -under tongue after pt wet's it with saliva first
Meds for Meniere's Syndrome
-antihistamines -antiemetics -antivertigo -medications -diuretics
s/e and n/i of antidepressant SSRIs
-anxiety -GI upset -Urinary *-Suicide precautions first2-3 wks*(gives them energy) -take in AM -takes 4 weeks to work
Newborn, no tub baths until cord falls off so
-apply alcohol to cord -apply a sterile gauze with petroleum jelly to the circumcision.
Meds for migraines:
-aspirin a day -beta adrenergic blockers -antidepressants -calcium channel blockers -ergotamines (vasoconstrictor, take at start) -NSAIDS -antiemetics
patient who has just been intubated in preparation for mechanical ventilation. priority is
-assess for bilateral lung sounds and bilateral chest excursions; patent airway
In the 2nd stage of labor priority is
-assessing if baby is crowning (check perineum)
High fowlers used for
-assists with SOB -breathing treatments -feeding pt -abdominal surgery -grooming
Side effects of parkinson's meds
-ataxia -dizziness -anticholinergic aka atropine effects(dry mouth, blurry vision, urinary retention)
order for infant assessment
-auscultate HR & RR -record HR & RR -palpate abdomen -examine eyes, ears, mouth -Moro reflex last
Stoma post op First few days ___ Notify doc if ___
-beefy red; swelling should gradually recede -stoma dark blue/purple
Antitussive agents would have what kind of side effects?
-bradycardia -resp depression -drowsiness -dizziness -anticholinergic
Iron preps s/e & n/i
-constipation -dark stools -tachycardia -take on empty stomach -Vit C increases absorption of ___ (the answer is on rev side) -Hct Hgb
S/e of antacids n/i
-constipation, diarrhea, acid rebound -watch for drug-drug interaction, monitor bowel function, f&e (M.O.M. magnesium)
elderly person in an adult care center wears knee-high nylon stockings -____circulation to extremities -promotes ___ -can cause ___ & ___
-constricts -venous stasis -thrombi & pulmonary emboli
s/e of diuretics
-dizziness -orthostatic hypotension -leukopenia -take with food or milk in the morning -monitor f&e
Symptoms of Auditory Impairment
-dizziness -ringing -hearing loss
n/i for anticonvulsants
-don't discontinue abruptly -I&O -Caution with use of medications that lower seizure threshold (MAOIs antipsychotics)taken with food, mouth care, no alcohol
four n/i when giving antihistamines
-give with food -use sunscreen -avoid alcohol -assess respirations
what two nursing considerations are important for antiplatelets (aspirn, plavix, persantine)?
-give with food or milk -bleeding (in urine, feces, blood-- TESTS)
What would you tell a pt expected s/e of Videx Famvir Cytovene AZT Zovirax are?
-h/a -dizziness -GI symptoms -Fluids (3,000 ml/day)
s/e of eye drops
-h/e -dizziness -blurred vision -pupil dilation
During cardiac cath procedure pt may experience
-heat -palpitations -desire to cough when dye injected
S/e of heparin
-hematuria -tissue irritation
streptokinase, urokinase, TPA are ___ and are c/i in
-hemophila -bleeding irregularities -active CVA -trauma/surgery/paramedic chest compression! within past 2 months -75 yrs or older -on heparin or coumadin
___ water dissolves lead in the pipes more quickly and contains higher levels of lead than cold water; Use ___ for drinking and cooking
-hot -cold water
s/e of Florinef (mineralcorticoid)
-hypertension -hypokalemia -edema
Oral hypoglycemic agents may - -
-increase release of insulin from beta cells in pancreas -may decrease insulin resistance of tissues *-may do both-*
hypercalcemia - - -
-lack of coordination -confusion -depressed or absent tendon reflexes
S/e of antidysrhythmics n/i
-light headed, bradycardia, hypotension, urinary retention -VS, cardiac rhythm, position change pt slowly
2 n/i for eye drops (Visine)
-light pressure on lacrimal sac for 1 min after drops -BP and pulse
n/i Anticholinergics (Pro-Banthine, Atropine, Scopace)
-monitor output (retention) -c/i glaucoma (interferes with ophthalmic fluid drainage) -do not use with paralytic ileus, BPH
small clots the size of a dime or quarter are ___ after delivery; golf ball size clot indicates___
-normal -more than anticipated uterine bleeding
pt is brought to the emergency department (ED) by EMS with a blood glucose of 32 mg/dL. The patient received 1 mg of glucagon IM 10 minutes prior to arrival (what does nurse tell nursing asst to do first?)(How often do you check blood glucose?)
-obtain 1/2 cup of orange juice -q15 min
What s/e of st johns' wart?
-photosensitivity -fatigue -allergic reaction -restlessness
is most important to gain control with a physically aggressive client in manic phase; client has significant sympathetic nervous system stimulation and will ____ intervention with ____
-require meds -both sedative medications and mood stabilizing agents
s/e of ADD agents n/i
-restlessness -insomnia -tachycardia -palpatations n/i: growth rate in kids, give in morning
feeding (and sleeping position) instructions for hiatal hernia pts
-small, frequent feedings -do not lie down for one hour after eating -Elevate head when sleeping
Oral contraceptive pts should not
-smoke
client receiving cholestyramine (Questran) take how? monitor for?
-sprinkle on liquid -constipation (don't take with other meds and replenish vitamins)
Implementations for atelectasis (pneumonia)
-suction, cough, and turn -postural drainage -antibiotics
DM sick rules
-take insulin as ordered -check glucose q 3-4 hrs -check urine for ketones (means not enough insulin) -Report to physician and take liquids q 30 min to 1 hr if V, D, or F
injury to parathyroid glands causes decrease in serum calcium
-tingling around mouth, toes, fingers -muscle twitching
Parenteral Fluids main purpose: secondary purpose:
-to resotre f&e balance -give meds, nutrtion, or blood
c/i to thromboembolytic therapy
-trauma in past 2 months -active internal bleed -history of hemorrhagic stroke -intracrania/intraspinal surgery -intracranial neoplasm -areteriovenous malformation -aneurysm -severe uncontrolled HTN
best IM site for adult____ , best site for children ____
-upper outer quadrant of buttocks -midlateral thigh
multiple myeloma involves overproduction of plasma cells, with resultant destruction of bone and of bone marrow products; multiple myeloma is unique as a neoplastic condition that is better detected with a ____ because ____ occur.
-with a plain radiograph (X-ray) -false-negative results occur
Bilirubin
0.3-1
-Lactated Ringer's -0.45% NaCl -0.9% NaCl -Hetastarch (Hespan) *Which is incorrect to give to a pt in shock?*
0.45% NaCl because it's hypotonic
normal digoxin serum levels
0.5-2.0
Stage __ of CRF: -Polyruria & nocturia
1
Type ___ diabetes: -Acute onset before age 30 -Beta Cells destroyed -Insulin required -Ketosis
1
Antacids are given
1 hr before/after meals
___ of space should be left between the end of the condom catheter and the tip of the glans penis. Also hair at base of penis should be clipped before applying.
1 to 2 inches
Tripling of birth weight present at
1 year
stroking outer sole of foot upward causes toes to hyperextend and fan and great toe to dorsiflex; disappears after ___
1 yr old Babinski's reflex
1. The infant lifts the head 45 degrees when in prone position. 2. The infant rolls over from front to back and from back to side. 3. The infant plays with her own hands and toes. 4. The infant grasps objects with both hands.
1) 1-3 months 2-4) 4-6 months
severity of edema is characterized by grading it ____
1+ (2-mm pitting) to 4+ (8-mm pitting)
During thoracentesis no more than ___ are taken at one time
1,000 mL
therapeutic level of lithium is ___ mEq/L
1-1.5
A mother of a 7-year-old girl and 2 1/2-year-old boy tells the clinic nurse that she works full-time, loves to garden in her spare time, and has lots of house plants. She relates to the nurse that her 2 1/2-year-old is "into everything all the time and drives me to distraction!" Which of the following responses by the nurse is BEST? 1. "What kind of plants do you have?" 2. "Who is available to care for your son when you need a break?" 3. "Was your daughter like this when she was his age?" 4. "It must be hard balancing work and children."
1-addresses safety issues; some plants are poisonous and/or can cause a variety of symptoms, such as irritation of oropharynx and GI tract; respiratory, renal, and CNS symptoms; dermatitis; choking; allergic reactions
A severe storm has blown out the windows on a 30-bed medical/surgical unit. The nurse determines that clients have to be evacuated to other rooms throughout the hospital. Which of the following clients should the nurse transfer FIRST? 1. A 40-year-old client admitted with exacerbation of asthma who is receiving nebulizer treatments. 2. A 56-year-old client with unstable type 1 diabetes and a recent blood glucose of 124 mg/dL. 3. A 58-year-old client transferred from cardiac intensive care earlier in the day post-myocardial infarction. 4. A 60-year-old client with a peptic ulcer who is receiving a blood transfusion.
1-client is at risk of ineffective airway clearance due to particles in the air from storm debris and damage to the windows
The nurse plans care for an adult woman admitted with toxic shock syndrome priority is 1. pt vomited 12 times past 24 hrs 2. pt used extra-absorbant tampons
1. (2. is for teaching)
1. The patient's use of language. 2. The patient's insight into the depression. 3. The patient's socialization history and skills. 4. The patient's attitude toward medications.
1. cognitive therapy 2. psychoanalytic & psychodynamic therapy 3. behavioral therapies, milieu therapies, & interpersonal psychotherapies 4. biochemical & psychologic therapies
Uses: depression & smoking cessation S/e: 1.___:agitation,insomnia 2. ___:sedation N/i: avoid____
1. wellbutrin-agitation, insomnia 2. desyrel-sedation alcohol and CNS depressants
serum lithium (particularly in acute mania)
1.0-1.5
Specific Gravity
1.010-1.030
if PTT not at least ____ then pt is clotting too fast
1.5 times the norm (20-40 sec)
Magnesium
1.5-2.5
Infatn should feed __ minutes on the first side and until satiated on the alternate breast
10
The infant eats with the fingers between ___ and ___ months
10 and 12
The infant eats using the fingers.
10-12 months
When suctioning with suction catheter, never suction longer than ___
10-15 seconds
normal IOP is __-__
10-21 mm Hg
normal IOP
10-21mm hg
LDH (lactate)
100-225
The nurse cares for the client diagnosed with type 1 diabetes. The client has been taking NPH 40 units SQ at 0700. The health care provider changed the client's insulin to NPH 30 units and regular insulin 10 units at 0700. The nurse should instruct the client that an insulin reaction may occur at which time?
1100
normal heart rate for an infant is ___ (resting); bradycardia is rate below ___; withhold digoxin if rate is below ___; excessive ____ may indicate digitalis toxicity
120-140; 80-100; 90-110 slowing of beats
normal urinary output daily
1200 ml/day
chickenpox vaccine given to people over ____ years of age if they are susceptible because they have not had the disease and have not been immunized
13
"Your son's clumsiness is expected at this age."
13 yrs old
Walking without help begins at ___ months
13-15
Total Cholesterol
130-200
Sodium
135-145
MMR is given at ___ months
15
Women need __mg of iron a day (with pregnancy)
15 (30)
The infant assumes a standing position without support.
15 months
Post test for lumbar puncture. Do neuro assessment q
15-30 min
A patient has a Levin tube connected to intermittent low suction. At 7 A.M., the nurse charts that there is 235 ml of greenish drainage in the suction container. At 3 P.M., the nurse notes that there is 445 ml of greenish drainage in the suction container. *Twice during the shift, the nurse irrigates the Levin tube with 30 ml of normal saline*, as ordered by the physician. What is the actual amount of drainage from the nasogastric tube for the 7 to 3 shift?
150
triglycerides should be below
150
Plt
150,000-450,000
The infant builds a tower of three to four cubes.
16-18 months
Nurse should inform parents that in Hirschsprung's disease that colostomy can be reversed when child reaches what weight?
17-22 lbs
Building a tower of 3 to 4 blocks occurs at ___ months
18
can begin toilet training at ___ months
18
Autonomy vs. shame and doubt.
18 mo-3 yrs (toddler)
Autonomy vs shame and doubt
18 months-3 years
able to walk and begin to coordinate movements such as playing with a push-pull toy at what age?
18-21 months
Intimacy vs isolation
19-35
Stage ___CRF: -Oliguria & Edema
2
The hospice home care nurse assists a terminally ill client with personal care. The client says to the nurse, "Why do you bother with me?" Which of the following responses by the nurse is MOST appropriate? 1. "Would you like to be alone?" 2. "I care about you and how you are doing." 3. "I understand how you feel." 4. "This is a difficult time, isn't it?"
2
The industrial nurse supervises the health care needs at a local plant. It is announced on the news that a device has exploded in a heavily populated area away from the plant and that individuals near the site have become ill. Several hours later, workers at the plant come to the nurse and demand antibiotics to protect them against potential effects of the device. Which of the following responses by the nurse is MOST appropriate? 1. "I cannot administer medication without a physician's order." 2. "Tell me about how you are feeling." 3. "The cause of the illness has not been identified." 4. "Do you have any allergies to medications?"
2
Type __ diabetes -Insidious onset after 30 -Insulin resistance -Obesity -No Ketosis (rare) -Treatment varied
2
Type __ risk factors: -*History of gestational diabetes mellitis* -Parents or siblings with it -Obesity -African American, Hispanic, Native American, Asian -greater than 45 -HTN
2
posterior fontanelle closes at ___ months
2
turn the client every __ hours to facilitate drying the cast, support major joints when turning
2
need to be able to fit ___ when putting SCDs on pt
2 fingers
Give antidiarrheals when in relation to other meds?
2 hrs before or 3 hrs after
1.-A 29-year-old woman undergoing peritoneal dialysis. The outflow appears bloody 2.-A 45-year-old woman diagnosed with P. jiroveci pneumonia. The client complains of a persistent dry cough.
2 is priority
if pill is missed 2 days in a row, instruct to take
2 tablets a day for the next 2 days, continue on regular dosing schedule; use another form of contraceptive for remainder of cycle
The child runs after a rolling ball.
2 years old
emergency: 2 yr old drowning victim on a ventilator or 80 yr old hypertensive crisis?
2 yr old
normal INR
2-3
IV diuretics make pt pee in
2-3 minutes
How long after giving first administration of narcan for opiate toxicity should nurse give second dose?
2-3 minutes (short half-life)
Posterior fontanelle closes at
2-3 months
Change myelomeningocele dressing every
2-4 hrs
Autologous blood can be given in amounts of __-__ of blood
2-4 units
Child walks up and down stairs
2-4 years
A patient is brought to the emergency department by a family member, who reports that the patient had a sudden onset of decreased level of consciousness, blurred vision, headache, and slurred speech. Before sending the patient for a stat head CT scan, which of the following actions should the nurse take FIRST? 1. Elevate the head of the bed 90 degrees. 2. Obtain a finger-stick blood glucose level. 3. Pad the side rails of the patient's bed. 4. Obtain a urine specimen from the patient.
2-may be a CVA but check for hypoglycemia because symptoms are similar and quickly remedied if need be
*PHOSPHORUS*
2.5-4.5
rate of KCl IV administration should be no faster than ___
20 mEq/hour
____ weeks — fundus at the level of the umbilicus
20 to 22
A miscarriage occurs before __-__ weeks of pregnancy; indications are persistent uterine bleeding and cramp-like pain
20-24
insertion of an epidural and should be administered over ___ and the epidural procedure begun shortly thereafter
20-30 minutes
to get digoxin therapeutic level
20-40 X 1.5-2.5
ventricular fibrillation, and the patient is prepared for defibrillation set at ___ joules then ___-___ joules then ___ joules
200 200-200 360
CPK
21-232
at ___ months child says only first name. at ___ months child says first and last name.
24 30
after____ of antibiotic therapy, strep throat is no longer contagious and a health care provider can resume responsibilities
24 hours
Change IV bag every ____
24 hrs
Expect nausea, headache, and dizziness for at least ___ hrs after child had minor head injury
24 hrs (Vomiting unexpected even though nausea)
In an infant post op pyloric stenosis parents need to know to start formula ____ and diaper needs to ___
24 hrs post op avoid incision
The child kicks a ball without falling
24 months
The infant discriminates between pictures of objects.
24 months
Using 2 or 3 word phrases at what age
24 months
child builds a block tower of 6 blocks, turns a doorknob, and unscrews lids
24 months
child uses 2-3 word phrases; has 300 word vocabulary
24 months
alcohol withdrawal peaks ____ after last drink
24-48 hours
SQ injection ___needle
25-27 gauge 3/8-5/8"
all pts eat their meds (start on ___intercostal)
2nd
Need dialysis in what stage CRF?
3
The nurse reviews procedures with the health care team. The nurse should intervene if an RN staff member makes which of the following statements? 1. "It is my responsibility to ensure that the consent form has been signed and is attached to the patient's chart." 2. "It is my responsibility to witness the signature of the patient before surgery is performed." 3. "It is my responsibility to explain the surgery and ask the patient to sign the consent form." 4. "It is my responsibility to answer questions that the patient may have before surgery."
3
3-month-old infant scheduled for a barium swallow needs to be NPO for __
3 hrs
HA1C glucose test over
3 month time
palmar grasp disappears after ___ plantar grasp disappears after ___
3 months 8 months
the entire grieving process can take up to
3 years
The child rides a tricycle
3 years old
can stand on one foot momentarily, and jumps with both feet
3 yrs (30 months)
when encouraging fluids on a pt, how much per day?
3,000 ml/day (normal is 1,500)
sudden jarring causes extension and abduction of extremities and fanning of fingers with index finger and thumb forming a C shape; disappears after ___
3-4 months Moro's reflex
When head is turned to side, arm and leg extend on that side, and opposite arm and leg flex; disappears by age
3-4 months Tonic neck reflex
If post op infection of wound occurs __ post op
3-5 days post op
clients with total hip replacements discharged ____
3-6 days post op to rehab or home
A client with a possible fracture of the right femur comes to the emergency department. The nurse supervises the transfer of the client from the car to a stretcher. Which of the actions by the nurse is BEST? 1. Instruct the client to stand on her left leg and ease herself onto the stretcher. 2. Determine if the client fell from a high place. 3. Support the right leg above and below the right femur. 4. Ask the client if she can move her right hip or right knee.
3-appropriate if client must be moved before splinting fracture; support prevents rotation and angular motion
normal serum albumin is__-__
3.5 to 5.5
Potassium
3.5-5
normal serum albumin is ____ g/dL; albumin *deficit* decreases oncotic pressure and fluids shift from vascular area to tissue. assess for ____
3.5-5.5 edema
Uric Acid (gout)
3.5-7.5
administer analgesic____ before wound care
30 minutes
Anti-cholinergics for ulcers are given
30 minutes after meals
The child jumps with both feet and can run well
30 months
The *onset* of action for *regular (Humulin R)* insulin is ____.
30 to 60 minutes
Fluid intake to improve UTI?
3000 mL daily
___ weeks — fundus just below ensiform cartilage
36
The nurse who is caring for patients in the outpatient clinic receives four phone calls. Which of the following calls should the nurse return FIRST? 1. A patient reports a headache that is unrelieved by medications. The patient reports taking two propoxyphene napsylate acetaminophen (Darvocet-N) and two acetaminophen (Tylenol) every 4 hours for 3 days. 2. A patient complains of left ankle pain and swelling that is reddened and warm to the touch. The patient states the redness and swelling occurred spontaneously and denies injury to the ankle. 3. The mother of a toddler calls to report that her child has a rash and a sore throat. 4. The father of a toddler calls to report that his child swallowed a dime.
4
enema tube should be inserted no more than ___ inches
4
Restraint orders are good for
4 hrs
Tampons should be changed every
4 hrs
Tourniquet should be placed __ inches above IV insertion site
4 inches
Moro reflex should disappear by
4 months
likelihood of hypertension and seizures increases if hematocrit increases by more than ____; contact physician to decrease dose
4 points in 2 weeks
How long do MAOIs take to work for the pt with depression? if pt has a cold?
4 wks beware otc cold meds
Associative play in
4 yr olds (preschool)
"Your child should be able to choose his clothes and dress himself with assistance."
4 yrs old
Myelogram NPO
4-6
Child hops and skips
4-6 yrs
The nurse on a bone marrow transplant unit receives a call from a coworker who reports that 2 days ago her husband was possibly exposed to tuberculosis (TB) at his job. Which of the following responses by the nurse is BEST? 1. "When did you have your last TB test?" 2. "What were the results of your last TB test?" 3. "Has your husband ever been exposed to TB before?" 4. "Are you concerned that you may be infected with TB?"
4-Even though it's a yes/no question, it's the only one that addresses the coworker's possible contamination
The home care nurse makes an *initial* visit to a client diagnosed in the early stages of COPD. The nurse *plans to discuss the client's perception about the disease*. Which of the following responses by the nurse is BEST? 1. "I have brought some materials for you to read." 2. "Tell me what you understand about the disease." 3. "The focus of this visit is to get to know you." 4. "How has the COPD changed your life?"
4-allows client to explain the impact of the disease on his life; information *will help nurse plan client's care*`
RBC (men)
4.6-6.2 million
The client compares life's accomplishments against goals at around age
40
age over ___ yrs is a risk factor for type 2 diabetes
45
Generativity vs stagnation
45-64
Child with impetigo needs to be on antibiotics for ___ before having close contact with other children
48 hrs (do not isolate child)
symptoms of alcohol withdrawal occur from __-__hours after the last drink
48 to 72
children younger than __ should not skateboard
5
Mantoux test is for ____ (results for positive TB in HIV pt) (results for positive TB in non-HIV pt)
5 (immunocompromised doesn't elicit as much of a reaction) 10
The nurse has a 20 mL multi-dose vial of heparin labeled 5,000 units per mL. The ordered concentration is to mix 25,000 units of heparin per 500 mL of normal saline. How many mL will the nurse add to the 500 mL bag of normal saline?
5 mL
WBC
5,000-10,000
normal neutrophil
5,000-10,000
child should be able to sit on toilet for ___ without getting off
5-10 minutes
Child w/nosebleed: initially, should apply direct pressure for___ continuously; if this is ineffective, may require treatment with silver nitrate applicator and Gelfoam
5-10 minutes silver nitrate applicator and Gelfoam
Dehiscence after surgery can occur _-_ days post op Implementations?
5-6 days -Low Fowler's -No coughing -NPO -Notify doc
Birth weight doubles at ___
5-6 months
Client age differences between duodenal and gastric ulcers; Gastric ulcers ___
50 yrs and older
breast-feeding mother should increase her daily caloric intake by how many calories?
500
Fundus rises to level of umbilicus___ after delivery; Afterwards, beginning with day 1, the fundus descends about ___
6 to 12 hours 1 fingerbreadth per day
How long can post op abdominal hernia not pull, push, or lift heavy objects?
6 wks
industry vs inferiority
6-12
Industry vs inferiority
6-12 (school age)
Bronchoscopy: NPO
6-12 hrs prior
Preparation for Health Care Procedures ____: -Fears strangers, heights -Model desired behavior
6-12 months
glycosylated hemoglobin (HbA1c) test indicates how well blood sugar has been controlled the past _____
6-8 weeks
radiation implant pt can take showers but must avoid activities that cause abdominal strain for ____
6-8 weeks
If pulse is less than ___ antihypertensive meds must be held.
60
pt taking propanolol nurse watches for pulse rate less than
60
PaO2 should be kept at or above ___ to avoid ___
60 Hypoxemia
Lying with the head of the bed elevated ____ allows *optimal pulmonary expansion and decreases venous return* which assists in *lowering the ventricle's output* and pulmonary congestion
60 ° to 90°
fasting blood glucose
60-110
normal (fasting blood sugar)FBS is
60-110 mg/dL
Integrity versus despair and disgust
65 and older
Integrity vs despair and disgust
65 and older
change catapress patch every
7 days
BUN
7-18
anterior fontanell closes at
7-19 months
The infant sits alone to play usually between __ & ___ months
7-9
Glucose
70-110
Normal fasting blood sugar
70-110
normal glucose __-__
70-110
___ immediate blood glucose
70-110 mg
second stroke may occur up to ___after first one
72 hours
Change IV tubing every ___
72 hrs
Acoustic neuroma is damage to CN
8
If contrast dye is used, NPO ___ before test
8 hrs
Calcium
8.5-10.6
by age of ___ most children begin to develop an adult concept of death and begin to understand that death is irreversible
9
A pincer grasp present at
9 months
infant can sit unsupported and pull himself up to a standing position, stand while holding furniture, compares two cubes and can follow simple verbal commands, but can't hug his mother on request.
9 months (hugging parents on request more appropriate for a 12 month old)
Chloride
98-107
Triglyceride
<150
A urine specific gravity of ____ is considered dehydration.
>1.035
A client returns from surgery after a right mastectomy with an IV of 0.9% NaCl infusing at 100 ml/h into her left forearm. Several hours later, the IV infiltrates. The nurse supervises a student nurse preparing to insert a new peripheral intravenous catheter. The nurse should intervene in which of the following situations? 1. The student nurse selects a site where the veins are soft and elastic. 2. The student nurse selects a site on the distal portion of the left arm. 3. The student nurse selects a site close to the joint to provide for stability. 4. The student nurse holds the skin taut to stabilize the vein. [Show/hide explanation] Strategy: "Nurse should intervene" indicates an incorrect action. (1) acceptable site selection (2) acceptable site selection (3) correct inappropriate; movement in area could cause displacement (4) acceptable procedure
????
Instruct the client to schedule an appointment before leaving the country. -OR- Ascertain when the client is scheduled to leave.
A
_____ female refuses to bathe because she is menstruating.
A Mexican American
most indicative of serious irreversible neuro impairment
A client whose muscle tone of all four limbs is flaccid.
A middle-aged female who started drinking after the sudden death of her husband 6 months ago is not an ideal candidate for widow's support group. Why?
AA First
Post op ___test -Note if pt was receiving oxygen -Check for swelling, discoloration, pain, numbness, tingling
ABC
Prep for ___: -Perform Allen test -Heparinized needle for test
ABG
Cylert treats
ADD w/hyperactivity (it's a CNS stimulant)
head injury causes interference with production or release of ___
ADH
Cisplatin Myleran Cytoxan ____ agents
ALKYLATING Leukemia, multiple myeloma
___is characterised by rapidly progressive weakness due to muscle atrophy and muscle spasticity, difficulty in speaking (dysarthria), swallowing (dysphagia), and breathing (dyspnea)
ALS (amyotrophic lateral sclerosis) aka Lour Gehrig's Disease
post op client out of bed
ASAP (if possible)
Pt has a lump in his abdomen that disappears when supine
Abdominal Hernia
___ can be inguinal, femoral, umbilical, ventral
Abdominal Hernias
premature separation of placenta; painful vaginal bleeding, abdomen is tender (firm between contractions), painful, tense, possible fetal distress; prepare for immediate delivery
Abruptio placenta
Cystic Fibrosis Absence of _____ Malabsorption of ___ (complications?implementations?)
Absence of pancreatic enzymes Malabsorption of fat, fat soluble vitamins (infection and lung disease) (High protein, High Calorie diet)
____ is an ACE inhibitor that blocks the release of aldosterone, which promotes potassium retention; client should avoid foods high in potassium; broccoli and bananas are high in potassium; so are salt substitutes
Accupril
dry cough is a side effect of what BP med?
Ace Inhibitor
Meds for HTN & CHF
Ace inhibitors (Antihypertensives)
Ventilatory tubes and myringotomy for
Acute Otitis Media
___: Assessment -Head rolling, crying, ear-tugging -Deafness -Sharp pain, H/A -Fever, chills
Acute Otitis Media
symptoms of _____ include fatigue, weakness, dehydration, decreased BP, "eternal tan," decreased resistance to physical stress, alopecia
Addison's disease
Preparation for Health Care Procedures ___: -Fears social incompetence, war, accidents, death -Explain long term benefits -Accept regression -Provide privacy -
Adolescent
Fears of Surgery _____: Loss of independence/change in body image; involve in procedures, express understanding; point out strenghts
Adolescents
What age more likely to be involved in injuries related to recreational water sports?
Adolescents
medication causes urine to turn red for 1 to 2 days; inform client of occurrence
Adriamycin
An ____ female's hair is shampooed every third day is too much
African American
Watch should the nurse tell the pt on antipsychotic meds to avoid
Alcohol & Caffeine Monitor blood work
Tremors, elevated temperature, nocturnal leg cramps, complaints of pain symptoms are symptoms of
Alcoholism
Alpha Adrenergic Blockers VS Centrally Acting Alpha Adrenergics
Aldomet Catapres (Centrally Acting Alpha Adrenergics-ACT ON CNS)
Allogenic vs Autologus blood
Allogenic-donor Autologous-pt's own
A nurse is promoted to charge nurse, and the staff is very excited about the promotion. Three months later, the staff is very unhappy and feels as if their colleague has abandoned them
Allow the staff time and space to adapt to their colleague's role change.
___ are used to decrease urinary urgency and hesitancy, nocturia, prostatic hyperplasia
Alpha 1 adrenergic blockers (Flomax, Hytrin)
Minipress Prazosin uses?
Alpha Adrenergic blockers -HTN -BPH -Reflex Tachycardia
How do alpha adrengergics treat hypertension?
Alpha blockers relax certain muscles and help small blood vessels remain open. They work by keeping the hormone norepinephrine (noradrenaline) from tightening the muscles in the walls of smaller arteries and veins. Blocking that effect causes the vessels to remain open and relaxed. This improves blood flow and lowers blood pressure.
the patient may be unable to understand and/or control his behavior; provide calm, predictable environment with regular routine; give clear and simple explanations
Alzheimer's
_____ is used to control bleeding that occurs when blood clots are broken down too quickly as a result of thrombolytic therapy (3 drugs)
Aminocaproic acid
Gentamycin Neomycin Streptomycin Tobramycin
Aminoglycoside Antibiotics for Pseudomonas & E. coli
s/e of ___ & ___ -hepatotoxicity -thrombocytopenia (bleeding) -leukopenia (infections) -pruritis
Amphotericin B & Nystatin (antifungals)
Symptoms of _____: -hives -rash -difficulty breathing -diaphoresis
Anaphylaxis
Tell pt that they may experience nausea, flushing, warmth, salty taste with injection of dye
Angiography
Cande*sartan* Lo*sartan*
Angiotensin 2 blockers
These meds interfere with: -absorption of antibiotics -iron preps -INH -oral contraceptives
Antacids
Amphojel Milk of Magnesia Maalox (both combined) (class? uses?)
Antacids (neutralize gastric acid; not coat) peptic ulcer, indigestion, reflex esophagitis
Librium Xanax Ativan Vistaril Equanil
Anti-anxiety meds (manic episodes, panic attacks, anxiety disorders)
Teaching for ____: -Do C & S first (important for NCLEX order questions) -Take until gone -Increase fluids -Check expiration date
Antibiotics
__ & __ medications will balance out Parkinson's-like effects from other meds (also watch for ___)
Anticholinergics Antiparkinson (Safety measures for gait)
Atropine sulfate (increases HR) Isoprenaline (increases HR) Quinidine (increases HR) Lidocaine (slows HR) Pronestyl (slows HR) (class?uses?)
Antidysrhythmics atrial fibrilation, flutter, tachycardia, PVCs premature vent cont
-Tigan -Reglan -Antivert -Compazine are ___ drugs and their s/e are___
Antiemetic -sedation, anticholingergic effects
Uses of ___: -Pulmonary embolism -Venous thrombosis -Prophylaxis AFTER MI
Antigoagulants (Heparin & Coumadin stop clotting action)
Questran & Lipitor are ___
Antihyperlipidemic Agents used for pts w/elevated cholesterol & cardiovascular disease
____: se: constipation & fat-soluble vitamin deficiency ni: take at bedtime or mealtime or 30 min after take 1 hour before or 4-6 hr after other meds
Antihyperlipidemics Questran Lipitor
s/e of ____ -GI upset -Orthostatic hypotension -Dizziness
Antihypertensives prils (cap & vas-ace inhib)
s/e for ___ agents: -hepatotoxicity -bone marrow suppression -bleeding, echymosis (platelets down) -gi tract -n, v
Antineoplastic
Videx Famvir Cytovene AZT Zovirax
Antivirals (HIV, HSV-herp simp virus)
____ represents an unconscious conflict of needs. the conflict between expressing unacceptable impulses and the need to hold onto social approval
Anxiety
Exhausted after accident, pt sleeps for hour hours then wakes up declaring back pain
Anxiety and fatigue are pain distracters; when they are reduced, the back pain returns.
-Low grade fever -McBurney's point -Localized tenderness and muscle guarding
Appendicitis
Preop for ___: -NPO -No analgesics(masks pain) -Ice bag to abdomen
Appendicitis
Pre-umbilical abdominal pain shifts to right lower quadrant (?)
Appendicitis (McBurney's point)
The nurse cares for a patient with chest tubes. Two days after insertion, the chest tube is accidentally pulled out of the pleural space.
Apply pressure with a dressing that is tented on one side.
The nurse in the emergency department assesses an elderly client. The client's daughter states that her mother has glaucoma, is extremely hard of hearing, and has been experiencing abdominal pain for the past 24 hours
Ask the client if she wears hearing aids.
____ is c/i for anyone under 21 years of age due to risk of Reye's syndrome. Use ___ instead
Aspirin Tylenol
Because of their bleeding s/e these meds are c/i in hemophilacs
Aspirin & NSAIDS
Assessment, risk factors, & implementations for Atherosclerosis
Assessment: High cholesterol & triglycerides Risk factors: poor diet, HTN, diabetes, smoking Implementations: Low saturated fat diet and cholesterol lowering agenst (statins)
pt with Dilantin toxicity
Ataxia, slurred speech, nystagmus.
Post op assessment reveals: -Dyspnea -Cyanosis -Cough -Tachycardia -Fever -Pain on affected side*(A ___ involves puncture of the pleural lining of the lung, releasing air into the chest cavity. ___ is simply a collapsed lung which is unable to expand.)*
Atelectasis (Pneumonia) *(Pneumothorax, Atelectasis)*
Helps keep your heart rate stable after a heart attack or during surgery. Lowers the amount of body fluids inside your mouth and throat before a surgery. This keeps you from possibly choking on your saliva while you are unconscious.
Atropine
The nurse gives a report to the next shift. During the report, a client's ventilator alarm is activated. Which of the following actions should the nurse take FIRST?
Auscultate breath sounds
____Transfusion -Collected 4-6 wks before surgery -Prevents viral infection -Used for clients with history or transfusion reactions or rare blood types -C/I: infection, chronic disease, cerebrovascular or cardiovascular disease
Autologous
Severe pounding headache Profuse sweating Nasal congestion Due to overfilling of bladder Bradycardia Hypertenion
Autonomic Dysreflexia
injury above T6; paroxysmal hypertension
Autonomic dysreflexia
obsessive compulsive rituals are mean to
Avoid severe levels of anxiety.
Intercourse and Monistat 7?
Avoid sex; condoms/diaphragms can be contaminated with fungal infection
A) "It's normal to feel anxious when starting a new job." -or- B) "You appear to have concerns about your ability to do the job."
B-therapeutic; allows client to further verbalize concerns (A is wrong because it's a closed response and assumes it's anxiety)
NSAIDS & Aspirin
BOTH CAUSE BLEEDING
Monitor __ & __ when on bronchodilators
BP and HR
high ___ can cause confusion, disorientation, convulsions, which could easily lead to falls
BUN (7-18)
stroke bottom of foot and toes fan. normal for infant but otherwise indicates CNS involvement
Babinski sign
this drug causes relaxation of the arteries and mild to moderate rash is the most common side effect.
Bactrim
client diagnosed with dementia. Why is #1 wrong? 1. Reinforce the client's thought patterns. 2. Use simple, short phrases when speaking with the client.
Because "Reinforce" means you're reinforcing the pt's already altered thought patterns
Post op cardiac cath
Bedrest 6-8 hrs with STRAIGHT INSERTION SITE
Diabinese Orinase Dymelor Micronase When to take?
Before breakfast avoid alcohol
Nurse on the previous shift did not complete the chart and did not sign the nurses' notes
Begin charting on the next line; Leave a note on the front of the chart asking the nurse to make a late entry and begin charting on the line below the last entry in the nurses' notes.
Excessive drooling seen in __ palsy
Bell's (Facial paralysis)
Damage to CN 7 Symptoms improve with time
Bell's Palsy
Pt may think they had a stroke in ___ but not usually permanent
Bell's Palsy
Implementations for ___ -Prevent corneal abrasions (pt can't close eye) -Isometric exercises for face -Analgesic or Steroid therapy
Bell's Palsy (CN 7)
____: Assessment reveals: -Inability to close eye -Increased lacrimation -Distorted side of face -Speech difficulty
Bell's Palsy (CN 7)
the "olol" drugs are
Beta Blocker Antihypertension -HTN -Angina -SVT
two blood pressure meds that don't work as well on African-American pts
Beta Blockers ACE Inhibitors
These drugs mask the signs of shock and hypoglycemia
Beta Blockers (olol)
suffix 'olol'
Beta blockers; affects sympathetic ns; S/E are bradycardia, hypotension, CHF, bronchospasm, or asthma attacks. (Dry cough normal)
removal of distal segment of stomach and antrum; anastamosis with jejunum
Billlroth 2
partial removal of stomach
Billroth 1
useful for reducing stress associated with physiologically based disorders
Biofeedback
-Fosamax -Risedronate -Ibandronate s/e?
Biophosphonates (Osteoporosis, Paget's Disease) -arthralgia (joint pain), esophagitis (must sit or stand for 30 min after taking meds)
Treatment for pt with cirrhosis and ____: -Vassopressin or propranolol IV -Saline lavage room temp -Balloon tamponade (Sengstaken-Blakemore) -Endoscopic sclerotherapy -TIPS (Transjugular Intrahepatic postsystemic shunt) -Surgery
Bleeding Esophageal varices.
Care of ___ pt: -Address by name -Foster Independence (allow self feeding if pos) -Introduce self, inform when leaving room -Keep furniture arrangement consistent -Walk 1/2 step ahead -Use walking stick
Blind
symptoms of _____: -Back pain -Dark urine -Anemia -Fever -Chills -Sore throat
Bone Marrow Depression
While pt is in ___ have pt dorsiflex affected leg; assess function of the peroneal nerve; weakness of dorsiflexion may indicate pressure on the nerve
Buck's Traction
-remove the foam boot three times per day to inspect the skin. -turn to unaffected side -dorsiflex foot on affected leg -elevate foot of clients bed
Bucks Traction
A ___ pt has died nurse should close the door to provide privacy for chanting around the bedside.
Buddhist
vasculitis of blood vessels in upper and lower extremities
Buerger's disease
___ causes pseudomembranous colitis and should be ___ precautions.
C. diff contact
CN ____responsible for differentiation of taste
CN 9 (glossopharyngeal)
magnesium is a ___ depressant
CNS
____ Impairment: -Insomnia AND Drowsiness -Confusion -Hallucinations
CNS Impairment
What 2 things need to be withheld for 24-48 before EEG
CNS stims or depres (meds or coffee, nicotene)
____, patients on 02 therapy, should initially be maintained at an oxygen saturation between 90 and 92% until ABGs are available to guide therapy further
COPD
client who had coronary artery bypass graft (CABG) says: "After I go home, I may see some swelling in the leg used for the donor graft."
CORRECT— edema increases at home because client is usually more active
Air is delivered under pressure to keep airway open. avoid drugs that depress upper airway and alcohol
CPAP (continuous positive airway pressure)
When the total __ level is very high, it usually means there has been injury or stress to muscle tissue, the heart, or the brain.
CPK (Creatine phosphokinase)
Why can't client with CRF have OJ?
CRF = hyperkalemia
Hemiplegia, diplopia, dysathria
CVA
Postop care: monitor
CVP
the pressure of blood in the thoracic vena cava, near the right atrium of the heart. ___ reflects the amount of blood returning to the heart and the ability of the heart to pump the blood into the arterial system.
CVP (Central Venous Pressure)
___ is a calcium channel blocker, depresses myocardial contractility, decreases work of ventricles and O2 demand, dilates coronary arteries; when used with other antihypertensives can cause hypotension and heart failure
Calan assess for peripheral edema
Pro*cardia* *Card*izem *The Calan Card* *"pine"* Calcium = ____
Calcium Channel Blockers Cardio
A client with clear lung sounds and unlabored breathing receives aminophylline IV. Which of the following is the MOST appropriate nursing action if the client's IV infiltrates?
Call the physician and recommend that the IV medications be changed to PO.
Digoxin & Synthrhoid ____be taken with grapefruit juice
Can
uses for ____ blockers: -HTN -HF -MI -Diabetic Neuropathy -Stroke Preventin
Cande*sartan* Lo*sartan*
support group for families who have lost a child to cancer
Candlefighters
Why are BUN levels in cirrhosis low?
Cannot make urea
What herbal? -May decrease effectiveness antihypertensives -Increase risk of cough with ACE inhibitors -Potentiate antiplatelets -Hypertensive crisis on MAOI -Increase theophylline absorption
Capsicum/Cayenne Pepper
Treats high blood pressure and congestive heart failure. A lower blood pressure will reduce the risk of stroke and heart attack. This medicine is also used to increase survival after a heart attack, and it is used to treat kidney problems caused by diabetes.
Captopril
is the volume of blood being pumped by the heart, in particular by a left or right ventricle in the time interval of one minute
Cardiac Output
Adrenergic Blockers VS Angiotensin 2 Blockers
Cardura Minipress (Adrenergics)
Urinary retention 8-12 hrs post op with bladder distention
Catheterize as needed
Intestinal malabsorption of wheat and rye leads to malnutrition, diarrhea, FTT (implementation?)
Celeiac Disease (No wheat, oats, rye, barley)
Inborn error in wheat & rye metabolism
Celiac Disease (Sprue)
pt with pneumonia shares a room with -fracture pt -fever of unknown origin pt -cellulitis of right food pt -89 yr old alzheimers pt
Cellulitis; both pts have infections; the others are "clean"
S/e of ____ -bone marrow depression -superinfections -rash
Ceph Antibiotics
____: -*take with food* -cross allergy with PCN (penicillin) -avoid alcohol -C&S before giving
Cephalosporin Antibiotics
Ceclor (cefaclor) Ancef (cefazolin) Keflex (cephalexin) Rocephin (ceftriaxone) Mefoxin (cefoxitin)
Cephalosporin Antibiotics -tonsillitis, otitis media, peri-operative prophylaxis, meningitis (tip: the "cef and ceph" treats the "itis")
____ sign is a bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow. It is considered an indication of pregnancy
Chadwick's sign
The nurse recognizes which of the following nursing interventions is MOST important when caring for a client just placed in physical restraints?
Check that the restraints have been applied correctly
How should the nurse assess laryngeal nerve function?
Check the client's ability to swallow.
___ burns: Irrigate eye 15-20 min
Chemical
Antiemtics are used before ____
Chemotherapy
___ is appropriate follow-up to a positive PPD to further diagnose possible TB
Chest X-ray
Periods of hyperpnea alternating with periods of apnea.
Cheyne-Stokes respirations; crescendo breathing; cause is cerebral lesion
____ and ____ may be asymptomatic in females, pelvic inflammatory disease can develop if left untreated
Chlamydia & gonorrhea
T-tube
Cholecystectomy
Laparoscopic laser -outpatient procedure-4 small puncture holes -NPO prior -Resume normal activity within one week
Cholecystectomy (Can be laparoscopic or open incision)
____ usually presents as a pain in the right upper quadrant or epigastric region
Cholecystitis
Risk factors for ___: -Obesity -Sedentary Lifestyle -Women; multiparous -Age 40+ -Pregnancy *-HYPOthyroidism* -Increased serum cholesterol
Cholecystitis Cholelithiasis
Intolerance to fatty foods, indigestion, fever, diaphoresis, nausea, burping, flatulence can be due to
Cholecystitis or Cholelithiasis
Severe pain upper right abdomen radiating to back
Cholecystitis (gallbaldder inflammation) Cholelithiasis (gall stones)
Avoid fried foods, pork, cheese, alcohol
Cholecystitis, Cholelithisasis
Low fat liquids, NG suction (to rest gut)
Cholecystitis, Cholelithisasis
Fat Female Flatulent Forty
Cholesystitis Cholelithiasis
-Dry Mouth -Urinary Retention -Blurred Vision -Dysphagia -Impotence -Nasal Congestion (airway issue)
Cholinergic Effects
tests to assess for hypocalcemia or tetany
Chvostek's sign and Trousseau's sign
Probenecid increases the action of ____
Ciproflaxin (antibiotic) (probenecid is for chronic gout)
Complications of ____: -Peripheral edema and ascites leads to dehydration and *hypokalemia* -Hepatic encephalopathy -Hepatorenal syndrome (Azotemia & Renal failure)
Cirrhosis
Implementation for ____: -Shunt to relieve portal hypertension -Early: high protein, high carb diet -Advanced: restrict fiber, protein, fat, sodium -Avoid alcohol -Sodium & Fluid restrictions -Monitor for bleeding; give blood -Abdominal girth; daily weights -Respiratory difficulties
Cirrhosis
Post-necrotic ____: Due to previous viral hepatitis
Cirrhosis
____: -Portal hypertension -Esophageal varices (hemorrahge from rupture leading cause of death)
Cirrhosis
_____: -Indigestion, nausea, vomiting -Flatulence, constipation, diarrhea -Anorexia, weight loss -Esophageal varices, hematemesis -Ascites, anemia -Jaundice, pruritis -Dark urine, clay-colored stools
Cirrhosis
Laennec's is
Cirrhosis due to alcoholism
____ induces ovulation by changing hormonal effects on the ovary
Clomiphene citrate (Clomid)
___ is an atypical antipsychotic; side effects include leukopenia, gram-negative septicemia, drowsiness, tachycardia, and hypotension. *If WBC fall below 2,000 drug will be discontinued.*
Clozapine
The angle between the nail plate and the proximal nail fold is straightened to 180 degrees.
Clubbing (hypoxia)
risk factors include age over 40 and history of *ulcerative colitis*; diet for ulcerative colitis is high protein, high calorie and low residue; *diet high in fat, high in protein, and low in residue is a risk factor for* _____
Colorectal Cancer
___ hearing loss: -Infection -Trauma -Surgery -Foreign body -Ear wax
Conductive
disorder in auditory canal, eardrum, or ossicles is what type of hearing loss?
Conductive hearing loss
Hypoglycemia implementations -Conscious: -Unconscious:
Conscious: Oral liquids w/10-15 grams glucose (Skim Milk, 4 oz juice); Hard Candies Unconscious: Dextrose 50% IV, Glucagon IM
Which of the following is an appropriate and cost-effective measure for the charge nurse to implement during a low-census shift?
Contact the hospital supervisor; excessive staff may be floated to another unit that requires additional personnel; only supervisor will have this information
____(formerly known as___) causes patients to suffer from neurological symptoms, such as numbness, blindness, paralysis, or fits without a definable organic cause. It is thought that symptoms arise in response to stressful situations affecting a patient's mental health
Conversion Disorder (hysteria)
_____ is a mental health condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.
Conversion disorder
The nurse cares for a client admitted with a diagnosis of cerebrovascular accident (CVA) and facial paralysis. Nursing care should be planned to *prevent* which of the following complications?
Corneal abrasion
garlic, ginko, ginger will INCREASE the effects of
Coumadin
thyroid replacement meds enhances effects of ___ & ___
Coumadin & Antidepressants
Anticoagulant deals with vitamin K
Coumadin (aka warfarin)
Vitamin C will decrease effectiveness of ____
Coumadin (warfarin)
Pt at the hospital on anticoagulants was on IV drip and now going home. Which anticoagulant will the pt be taking at home? why?
Coumadin (warfarin) PO
clients with ____ tend to lose weight in their legs and have petechiae and bruising
Cushing's syndrome
___ is an invasive test that allows your doctor to look at the interior lining of the bladder and the urethra.
Cystoscopy
X-ray study of bladder and urethra; radiopaque dye injected, patient voids, x-rays taken during voiding
Cystourethrogram reveals vesicoureteral reflux.
Prevents or controls thirst and frequent urination caused by diabetes insipidus and certain brain injuries.
DDAVP (Desmopressin)
____: Assessment reveals -Blood sugar 300-800 -H/A -Drowsiness, Weakness -Skin warm & dry, elevated temp -Fruity odor to breath -Kussmaul's respirations (deep labored)
DKA (Diabetic Ketoacidosis)
first dose of the ___ may be given at 2 months of age, the second is given around 4 months
DPT (diptheria, tetanus, pertussis)
megsulphate, OB drug anticonvulant two unique n/i's
DTR resp arrest
Homan's sign post op to test for
DVT
Symptoms of ____: -Unilateral leg pain -Extremity pain -Warm skin -Erythema (n/i)
Deep Vein Thrombosis (DVT) (anticoagulants, limited activity)
hyperpnea=__,__ respirations causes include ____ & ____
Deep, rapid metabolic acidosis & diabetic ketoacidosis
Nurse should Assume a face-to-face position when speaking to pt with ___.
Dementia
MAO inhibitors indication and s/e
Depression; Hypertension and slurred speech.
____ reactions: -hives -erythema multiform excidativum (stephen johnson syndrome-dark red papules all over body) (n/i)
Dermatological Reactions N/i: gentile on skin not hard cooling bath
_____: -Firm stool -Foul smelling, fairly corrosive drainage -May wear pouch, or regulate colostomy with irrigations -Diet not restricted after first 6 weeks
Descending or Sigmoid Colostomy
The nurse determines that the staff is not consistently using correct body mechanics when transferring patients. Which of the following suggestions should the nurse make FIRST?
Determine if help is required to transfer pt
Mentally retarded pt being discharged with new meds
Determine the client's comprehension of the medication administration
Hypoglycemia as well as an allergic skin reaction and GI upset occur with
Diabinese Orinase Dymelor Micronase (type 2 only)
What med? s/e: bradycardia, n, v, visual disturbances n/i: take apical pulse, monitor K, *notify physician if adult <60 bpm or child <90-110 bpm*
Digoxin Linoxin
used for LS HF
Digoxin Linoxin
student's eyes have been severely inflamed for 10 days. The student stated to school nurse that her parents refused to take her to a physician.
Discuss w/parents(may have been a surgical procedure)
Redirecting emotion or feelings to a subject that is more acceptable or less threatening.
Displacement
Aldactone & Mannitol are___ used in __ & __
Diuretics (Aldoctone potassium sparing) CHF & renal disease
-Colicky pain in LLQ relieved by passage of stool or flatus -Fever, leukocytosis -Constipation/diarrhea
Diverticular Disease
Surgery for ___: -Drain abcess and resect -Temporary transverse colostomy
Diverticular Disease
shouldn't eat meals with seeds
Diverticulosis (diverticulum)
augments cardiac output by increasing myocardial contractility and stroke volume
Dopamine
8 yr old child on ritalin loses 4 lb in 2 wks
Dose too high; contact physician (kids get anorexia with ritalin so asking about what they're eating isn't priority, don't assume weight loss is due to food; weight loss is excessive so address that)
Bilaterally low set ears, flat occiput, broad nasal bridges, eyes that have epicanthal folds and slant upward, large tongue, high palate, small chin
Down Syndrome
___Ulcer: -Vomiting rare -Hemorrhage less likely -Not malignant
Duodenal
Low gastric pH and a hypersecretion of acid causes pain on an empty stomach (2-3 hrs after meals and night time)
Duodenal Ulcer
____is a slow progressive contracture of the palmar fascia causing flexion of the fourth and fifth fingers; results from inherited autosomal dominant trait; occurs most often in men over 50 years of age, of Scandinavian or Celtic descent, and is associated with diabetes, gout, arthritis, and alcoholism; age and diagnosis are risk factors
Dupuytren contracture
expected effects after an ___ include headache, disrupted short and long term memory, and general confused state
ECT electroconvulsive therapy treatment
___: -May be asked to hyperventilate during -Kept awake night before test
EEG
before a(n)___test, food may be consumed but caffeine should not.
EEG (electroencephalogram)
symptoms of ___-stage ___include recent memory loss and changes in motor activity, such as continuous pacing, wandering, and agitation
Early Stage Alzheimer's
What herbal? -Decreasses effectiveness of immunosuppresant -Avoid if allergic to ragweed or daisies
Echinacea
What herbal? -Immunostimulant: to prevent and treat colds/flu/UTI/Wound healing
Echinacea
Children will have dry, reddened skin lesion that weeps and crusts Adults will have hard, dry, scaling patches
Eczema
Tricyclic Antidepressants 3 drugs 2 uses
Elavil Tofranil Nopramin Depression Sleep Apnea
Client on Fosamax should not have
Electroconvulsive Therapy (ECT)
____ is a technique for evaluating and recording the electrical activity produced by skeletal muscles. Electrodes are usually placed on the legs.
Electromyography
what is most important for pt with below the knee amputation? -Elevate residual limb on pillow or -Encourage client to lie in prone position
Elevate limb; minimizes edema; do not elevate more than 24 hrs because of hip flexion
____: Assessment reveals -Dyspena, pain, hemoptysis -Restlessness -Low PaO2; High PaCO2
Embolism
An older client diagnosed with emphysema becomes restless and confused
Encourage the client to perform pursed lip breathing; prevents collapse of lungs; helps patient control rate and depth of breathing
The nurse cares for a client in labor. The client's examination reveals that the cervix is 5 cm dilated and 100% effaced and the fetal head is at -1. The *membranes rupture* and the nurse notes clear fluid. Which of the following actions should the nurse take FIRST?
Encourage the client to void every 1-2 hours and take her *temperature every hour* because membranes ruptured
If there's a fire on the eighth floor, the nurse in the psych unit on the third floor will
Ensure that all patients are out of their rooms and in the dayroom.
mom asks kid allergic to bee stings what she should do if he gets stung again
Epi-Pen (Epinephrine SQ 0.3 mg)
___: -elicits fight or flight response -bronchodilation
Epinephrine (adrenaline)
____ is located in the third intercostal space just to the left of the sternum; both aortic and pulmonic murmurs may be auscultated at this location.
Erb's point
Elevated ___ indicates inflammatory or degenerative tissue destruction
Erythrocyte sedimentation rate (ESR)
____ treats -menopausal symptoms -cancers -osteoporosis
Estrogen
pt calls in with gynecomastia, nausea, contact lens difficulty
Estrogen s/e
noted with respiratory distress of a newborn
Expiratory wheezing & substernal retractions
______ uses two belts: one that uses ultrasound to measure your baby's heart rate and the other is a pressure transducer used to measure your contractions
External fetal monitoring
Evisceration is ___ Implementation?
Externalization of bowel -Cover viscera with sterile saline dressing -Low fowler's -No coughing, NPO -Notify doc
_____side effects include akathisia (motor restlessness), dystonias (protrusion of tongue, abnormal posturing), pseudoparkinsonism (tremors, rigidity), and dyskinesia (stiff neck, difficulty swallowing) and are caused by _____
Extrapyramidal Antipsychotics (thorazine)
A nursing assistant obtains and records the daily weight for a pancreatitis pt due to____; assess _______
F&E imbalance I&O, skin turgor, and mucus membranes
Asking the client to show her teeth and stick out her tongue evaluates what CNs?
Facial & Hypoglossal
____ occurs when an irregularly-shaped eye prevents light from properly lining up with the retina and it's hard for the pt to see up close
Farsightedness or hyperopia
Chills and fever occurring about an hour and a half after the infusion has started is what type of transfusion reaction?
Febrile (aka pyrogenic)
risk factors for GERD
Female over 45 Obese Caucasian
Early decelerations occur before peak of contraction; result from
Fetal Head Compression *veal-chop*
What can the client not eat when experiencing dumping syndrome?
Fiber & Sugar
____ is an illness caused by a virus that leads to a rash on the cheeks, arms, and legs. Isolation only required BEFORE rash appears.
Fifth Disease
Lithium toxicity (antimanic med) early- late-
Fine tremors, nausea, vomiting, diarrhea Ataxia, confusion, seizures
Patient disconnects catheter from central line.
First, lock open catheter. Then place the patient on the left side in Trendelenburg position, initiate oxygen therapy, and notify the physician
The nurse assists the physician to perform a lumbar puncture on a patient with a high fever. At the completion of the procedure, the nurse should instruct the patient to remain in which of the following positions?
Flat Supine
used for adrenal insufficiency (Addison's disease)
Florinef (Mineralcorticoids)
newborn infant not nursing at risk for
Fluid Volume Def
______: -Cipro (ciproflaxin) -E. coli, Pseudomonas, S. aureus
Fluoroquinolone Antibiotics
s/e of _____: -decreased WBC & HCT -elevated AST, ALT, & alkaline phosphatase -diarrhea (n/i: c&s before, fluids, 1 hr ac or 2 hr pc (ac, pc=before,after meals)
Fluoroquinolone Antibiotics
What would Vitamin B6 be given to a person with TB?
For peripheral neuritis (pain and tingling, nerve inflam), a s/e of TB meds
___ inhibits bone resorption; can be highly irritating to the GI tract, particularly the esophagus, causing irritation and ulcerations/erosions; dysphagia can also result; after taking the medication, patient should sit for at least 30 minutes in order to facilitate delivery to the stomach and prevent acid regurgitation and esophageal reflux
Fosamax
What implementation for parents with infant that has abdominal distention from Hirschsprung's Disease?
Foster infant/parent bonding
An anti-infective you give with food or milk, or cranberry juice. May cause asthma attacks so monitor pulmonary status.
Furadantin
lateral recumbent position; head should be elevated 6 to 12 inches to prevent nighttime reflux
GERD
What herbal may potentiate: -anticoagulants & antiplatelets -antihyperlipidemics -antihypertensives -antidiabetic -oral contraception
Garlic
What herbal s/e? -Flatulence -Heartburn -GI (mouth to stomach) Irritation -Allergic reaction
Garlic
What herbal? -Antimicrobial -Antilipedemic -Antithrombotic -Antitumor -Antiiflammatory
Garlic
___ Ulcers *-3 meals a day* -No alcohol, caffeine, or coffee *(no caf or decaf)* -Avoid milk, cream -Avoid temp extremes
Gastric
___Ulcer: -Normal gastric pH; no acid hypersecretion -Pain 30 min to 1 hr after meals or when fasting which is relieved by vomiting -Hematemesis -May be malignant
Gastric Ulcer
Assessment of ____: -Abdominal pain -H/A -Anorexia, nausea, vomiting -Hiccupping
Gastritis
Implementation for ____: -NPO progressing to bland diet -Antacids -Referral if alcohol abuse
Gastritis
MOST helpful in determining subtle changes in the client's level of consciousness?
Glasgow coma scale
_____ 1 hr then 2 hr >200 diagnostic diabetes
Glucose Tolerance Test
Mechanism of action is produced by blocking potassium channels in the beta cells of the islets of Langerhans.
Glucotrol
osmotic agent; diuretic; including aqueous humor and vitreous humor from the anterior chamber of the eye, thus decreasing intraocular pressure
Glycerin
-High uric acid level -Joint deterioration
Gout
restless heat intolerance (inc met rate) weight loss hyperactive reflexes
Graves disease (hyperthyroidism)
_____: Assessment reveals -Paresthesia -Motor losses beginning in lower extremities, rapidly ascending if acute -Altered autonomic function: hypotension, tachycardia, flushing, sweating
Guillain-Barre Syndrome
Respiratory failure, flaccid paralysis, urinary retention.
Guillain-Barré syndrome
trauma, surgery, acute illness, or immunizations often precede the onset of the neurologic symptoms of ___
Guillain-Barré syndrome
Paralysis starts in periphery and then affects trunk; last several days and recovery can take months
Guilliain-Barre Syndrome
Head circumference for newborn Chest circumference
H-33-35 C-30.5-33
electroconvulsive therapy (ECT) s/e
H/A memory (long and short-term) confusion
meds for hiatal hernia ___, ___, ___
H2 receptor blockers antacids cytoprotective agents (coat the stomach/esophagus)
ABG values HCO3 CO2 PaO2 SaO2
HCO3:22-26 CO2:35-45 PaO2:80-100% SaO2>95%
PTT monitors
HEP
The patient has a productive cough of pink-tinged sputum.
HF; fluid in longs; life threatening
The mother of an 8-month-old boy is concerned because her son has started to scream and refuses to eat when left with the child-care provider. Which of the following statements by the nurse is BEST?
Hand your child his blanket as you say goodbye
_____ is caused by rodents; symptoms include hematuria, hematemesis, bleeding gums, melena, fever, aching, and nausea; no seizure precautions necessary
Hantavirus pulmonary syndrome
The nurse on a medical/surgical unit admits a young adult *suspected* of having acute glomerulonephritis. Which of the following questions should the nurse ask FIRST?
Have you had a *sore throat* within the last few weeks? (infection often occurs before the onset of acute glomerulonephritis; sore throat caused by group A beta-hemolytic Streptococcus is a common cause)
pt with DVT; may be first sign of pulmonary embolus and requires immediate attention
Heaviness in chest
Which IV complication gets cold ice pack instead of warm compresses?
Hematoma (ice reduces bleeding)
maternal antibodies destroy fetal RBCs; bilirubin secreted because of hemolysis
Hemolytic disease of the newborn
most frequent site of bleeding is into muscles and joints; repeated bleeding episodes cause changes in bone and muscles
Hemophilia
cold clammy skin inc pulse dec BP
Hemorrhage
anorexia, malaise, lethargy and easy fatigability are most common symptoms of ___ in children
Hep A
communicable 2 to 3 weeks before onset of jaundice and about 1 week after onset of jaundice
Hep A
standard precautions should be used on everyone; sources for this virus are saliva, feces, and blood; use contact isolation if fecal incontinence
Hep A
Administer immune globulin (IG)
Hep A *(But proper handwashing priority to prevent spread of infection)*
Pruritic vesicles on nose, lips, oral mucous membranes
Herpes Simplex
Vesicles and pruritis along nerve route (face, thorax, trunk) Due to reactivation of chicken pox varicella
Herpes Zoster
____ used for increasing plasma volume during shock
Hespan
___ position for post op appendicitis
High Fowler's
ostomy pre-op diet
High cal Low residue High protein High carb 1 wk before
Florinef (Mineralcorticoid) sodium and potassium
High sodium & Low potassium
The family of a terminally ill ___ man places him on the floor after the bed bath.
Hindu
priest may tie a string around the waist or neck of deceased
Hindu
Pt dies nurse may provide a basin of warm water and a washcloth.
Hindu; priest pour water into the mouth of the corpse and the family washes the body before cremation
Newborn with failure to pass meconium and refusal to suck
Hirschsprung's Disease
_____: Implementations -Enemas -Low fiber, High protein, High Calorie -Measure girth at umbilicus -Oral antibiotics
Hirschsprung's Disease
How do you sleep at night? or How many breaks do you get at work? To a client with kids who works and volunteers at the school
How many breaks to you get? - clients with low back pain should avoid standing for long periods of time; important for the nurse to determine how many rest periods client receives during working hours
Pt comes to ER because she overdosed on sleeping pills. The nurse should ask ___
How much medication did you take?
____ does not cause the formation of antibodies because the protein structure is identical to your own.
Human insulin
Chorea in the upper and lower extremities is a sign of ___chorea, resulting from ___
Huntington atrophy of parts of the brain.
____ disease -Depression -Personality changes -Choreiform movements (video; superimposed movements)
Huntington's
____? -muscle weakness -nausea & fatigue -tingling sensations. -slows heart (stops heart when severe)
Hyperkalemia
Farsightedness is called
Hyperopia
Tapazole SSKI (saturated solution potassium iodine)
Hyperthyroidsm
Irritability, confusion, coma Tremors, blurred vision, skin cool clammy tachycardia
Hypoglycemia (Insulin Reaction)
_____? -muscle weakness, -muscle aches & cramps -dysrrhythmias (can lead to ventricular -tachycardia and death)
Hypokalemia
____ must be injected deeply into large muscle mass; injection too close to nerve or blood vessel causes neurovascular damage
IM
adverse reaction of ___ is hepatitis; instruct client to avoid ingesting alcohol when taking drug; avoid tuna, aged cheese, red wine, yeast extracts; may cause flushing, hypotension, palpitations, and diaphoresis
INH
Sickle cell crisis priority
IV NS at least 200mL/hr (next give O2)
The nurse cares for an elderly client who is receiving IV fluids of 0.9% NaCl at 125 mL/h into the left arm. During a routine assessment, the nurse finds that the client has distended neck veins, shortness of breath, and crackles in both lung bases. Which of the following actions should the nurse take FIRST?
IV line may be necessary still; decrease rate to 20 mL/H and notify physician
The bladder is NOT dilated during
IVP
The nurse plans care for a patient in hemorrhagic shock from injuries sustained in a fall. It is MOST important for the nurse to take which action?
Identify source of bleeding
_______ -Liquid, semi-liquid, soft returns -Slightly odorous, highly corrosive drainage -Wear appliance at all times -Koch pouch-remove contents 2-4 times/day with catheter -Low residue diet; No corn or nuts
Ileostomy
Prevents production of T cells and their response to interleukin-2
Immunosuppressants (Sandimmune-cyclosporine)
-Reddish macule becomes vesicle, crusts, pruritis -Caused by *staphylococcus, streptococcus*
Impetigo
Implementations for ___: -Skin isolation -Careful handwashing -Antibiotics -Restraints as needed; mitts for infants *-Monitor for acute glomerulonephritis*
Impetigo
Abdominal Hernia; Incarcerated vs Strangulated
Incarcerated-intestinal flow blocked Strangulated-blood flow blocked (emergency)
Why would a client diagnosed with meningitis due to Haemophilus influenza be placed on fluid restriction? Why are vitals done more often than q4?
Increased ICP shock
___ is contraindicated in clients with uncompensated heart failure and pulmonary edema
Inderal (Beta blockers)
beta-blocker that is used as an antianginal, antiarrhythmic, and antihypertensive; side effects include weakness, hypotension, bronchospasm, and depression
Inderal (propanolol)
The patient's lower abdomen is enlarged and sounds dull on percussion. (priority after hemorrhoidectomy because____)
Indicates probably urinary retention; should be monitored for that; CATHETERIZE
should be pink, not red; indicates possible if an incision line is red indicates ____
Infection (other signs include increased warmth, tenderness, pain, and purulent or odorous drainage)
-Chronic diarrhea stools occurring 10 to 12 times per day -Diarrhea and vomiting with severe abdominal distention
Inflammatory bowel disease (ulcerative colitis or Crohn's disease)
The nurse cares for an older client diagnosed with terminal lung cancer. When told about the diagnosis, the client becomes very angry. He curses, throws objects, and hits the nurse tech and LPN/LVN when they attempted provide care for him
Inform client that injury to staff not acceptable (cliet cannot hit)
The nurse cares for prenatal client at 8 weeks' gestation with a positive VDRL
Instruct the client on the importance of taking the penicillin for the prescribed time.
____ obstruction: High pitched bowel sounds ABOVE obstruction; Absent or decreased below.
Intestinal
-Intestinal decompression -NPO -F&E replacement -Fowler's position -Bowel surgery
Intestinal Obstruction
Preop for ____ -Antibiotics 12-18 hrs before surgery -Visited by enterostomal clinician -Clear liquids day before; NPO after midnight
Intestinal Ostomies
Salem sump (NG) Miller-Abbott tube Cantor tube (intestinal)
Intestinal obstruction
____: Assessment reveals -N/V -Abdominal pain and distention -Absence of stool or gas (obstipation)
Intestinal obstruction
one symbolically takes the characteristics of another
Introjection (ex: one person starts saying "Ridiculous!" all the time for everything because his best friend says it all the time)
Vitamin C increases Vitamin E delays
Iron
The nail plate is concave, curving up from the nailbed and appearing spoon-shaped.
Iron-defiency anemia *spoon made out of iron*
check expiration date on ___. If it's expired the pill won't fizz or burn a little bit
Isordil Nitroglycerine (Antianginals)
Can antianginals be stopped abruptly?
Isordil, Nitrogycerine No, must be weaned off.
Parenteral Fluids Isotonic fluids: Hypotonic fluids (pulls fluid into tissue): Hypertonic fluids(pulls fluid into vessles):
Isotonic: 0.9% NaCl, D5W Hypotonic: 0.45% NaCl Hypertonic: D10W
Dark-colored urine, clay-colored stools, Pruritis
Jaundice
____ -Hemolytic (sickle cell, transfusions) -Hepatocellular (cirrhosis, hepatitis) -Extrahepatic (obstructive)
Jaundice
Post op cholecystectomy; observe for ___ after removal of ___
Jaundice T-Tube (Low Fat, High Carbo, High Protein diet)
control of pain (palliative treatment-morphine) during end of life is most important to ___ persons
Jewish
Diabetes mellitus, Paget's disease, & hemophilia (blood disorders) can cause ___
Joint degeneration
____: -Do not use with abdominal pain -Monitor for urinary retention
Kaopectate Lomotil Imodium Pargoric (antidiarrheals)
acute systemic vasculitis of unknown cause; treated with IV immune globulin and salicylate therapy; requires standard precautions
Kawasaki syndrome
"When I do the contractions I will pretend I am trying to stop passing gas."
Kegel (urinary incontinence)
avoid foods that are high in oxalates such as spinach, asparagus, and cabbage
Kidney stones
Mycin = Mice = Ears = ____
Kidneys (Mycin affects the kidneys)
____ is an organic solvent, can be toxic, absorbed through scalp; may be repeated 5 to 7 days after first application
Kwell
When it comes to lice medicine, ____ requires a second treatment with 5-7 days, but ____ kills both lice and nits after one application.
Kwell Nix
___ is most often measured to check for tissue damage. The protein is in many body tissues, especially the heart, liver, kidney, muscles, brain, blood cells, and lungs.
LDH
the main use of the test for ____ is as a general indicator of the existence and severity of acute or chronic tissue damage and, sometimes, as a monitor of progressive conditions such as kidney disease, liver disease, and some cancers
LDH (lactate dehydrogenase)
____ indicates vertex presenting part with fetal occiput on the mother's left side toward the back of her pelvis; because infant is vertex, FHT heard below the umbilicus.
LOP
A client diagnosed with a stage 2 pressure ulcer requiring a sterile dressing change. (this can be done by)
LPN/LVN
A client diagnosed with an abdominal wound that requires a sterile dressing change can be assigned to ____
LPN/LVN
can be delegated activities related to bladder training; establishing the bladder training program is the responsibility of the RN
LPN/LVN
reassigned RN from postpartum unit; given same clients as ____; assign stable client with expected outcome; burning on urination indicative of UTI
LPN/LVN
___ indicates that the presenting part is the sacrum (breech) and the fetal back is on the mother's left side; because infant is breech, FHT heard at or above the umbilicus.
LSA
____ replaces electrolytes lost in the labor process and adds volume to expand the vascular bed to reduce the incidence of hypotension
Lactated Ringer's
___ is a potassium-wasting diuretic; client needs to increase intake of potassium
Lasix
Lumbar puncture: position in
Lateral recumbent (fetal) position at edge of bed
WBC >10,000
Leukocytosis (elevated WBC count)
____ is an antianxiety; additional side effects include constipation, slurred speech, dermatitis, anorexia, polyuria, pancytopenia, and thrombocytopenia; administer after meals or with milk to decrease GI irritation
Librium
should drink 2 to 3 liters per day and ingest adequate amounts of sodium; side effect include dizziness, headache, impaired vision, fine hand tremors, and reversible leukocytosis
Lithium
Meds for bipolar disorder to treat mania
Lithium Tegretol Depakote
-Tremors -Polydipsia -Polyuria -GI upset s/e of
Lithium Tegretol Depakote (for mania/bipolar)
Avoid pt becoming overheated or dehydrated during exercise and in hot weather while on this medication.
Lithium (regulates flow of sodium through nerve cells, sodium affects excitation or mania)
symptoms of ____: -Light stools -Dark urine -Jaundice -Abdominal pain -Elevated AST & ALT -Altered PTT
Liver Impairment
restrictions for Meniere's syndrome
Low sodium, avoid alcohol, nicotene, caffeine -bed rest when acute
If left side of heart (LS HF) not working, then blood backs up into
Lungs -Tachypnea -Rales -Crackles -Cyanosis (late sign)
hypertensive crisis when taken with tyramine-containing foods
MAOIs antidepressants
____: Erythromycin Cleocin (clindamycin)
Macrolide Antibiotics -acute infections -acne -URI -Prophylaxis -Before dental procedure if allergic to PCN
MAOIs (Monamine Oxidase Inhibitors) 3 examples
Marplan Parnate Nardil
"failure to thrive" is a ___ diagnosis.
Medical
Implementations for Huntington's disease
Meds: Librium, Haldol, Thorazine -Genetic testing for parents wanting kids -Supportive care to pt and family
____ Disease -Vertigo -Nystagmus -Fluctuating, progressive loss of hearing on involved side
Meniere's Disease
Brudzinski's sign chin to chest causes pain
Meningitis
Kerning's sign-knees can straighten knees without pain
Meningitis
the category of laxative that is usually seen as the safest,
Metamucil (bulk forming laxative)
____: -Prodromal: Irritability, anorexia -Aura: light flashes and bright spots, numbness of lips, diplopia -Headache: throbbing, unilateral pain associated with photophobia, nausea, vomiting
Migraines
Eliminate what foods with Eczema?
Milk, eggs, wheat, citrus
n/i for ____ -1st dose at bedtime to avoid fainting -Monitor BUN, weight, edema -Change pos slowly
Minipress Prazosin (Adrenergic Blockers)
What drugs cause -reflex tachycardia -ortho hypotension -nasal congestion (unique one)
Minipress Prazosin (Alpha Adrenergic Blockers)
Isopto-Carpine Eserine Carbacel
Miotics for glaucoma and ocular surgery
___ Diffuse bluish-purple, bruised-looking areas on the buttocks; may be bluish-black or gray-blue or purple; may be mistaken as bruises and should be documented in the chart, as should all birthmarks; usually appear in sacral and/or gluteal area, back, shoulders; common in newborns of African, Asian, Native American, or Hispanic descent; gradually fade during first or second year of life
Mongolian spots
the full number of doses prescribed should be taken, even if menstruation occurs or symptoms resolve; given for vulvovaginal candidiasis
Monistat 7
given for chest pain caused by MI to reduce preload and afterload pressure
Morphine
decrease blood return to the right side of the heart, and decrease peripheral resistance (decreases cardiac workload; causes vasodilation and pooling of fluid in extremities; provides relief from anxiety)
Morphine sulfate
Symptoms of Addison's disease
Muscular weakness, fatigue, dark skin pigmentation, GI disturbances, anorexia
Atropine sulfate Cyclogyl are ___
Mydriatics
n/i for ___: -c/i with glaucoma -wear dark glasses -apply pressure on lacrimal sac
Mydriatics
Prep for ____: -Phenothizines, CNS depressants, stimulants withheld -Table moved during test
Myelogram
The nurse cares for a client diagnosed with _____. The nurse stands directly in front of the client when speaking to decrease vertigo attack.
Ménière's syndrome
between hair loss, weight loss, constipation, and nausea AND vomiting, which is priority for pt on chemo for the nurse to ask about?
N&V
Intestinal Ostomy post op ___, ___ until peristalsis ____ first 6-8 weeks
NG tube, NPO until peristalsis Clear liquids progressing to solid, low-residue diet
Should client be mixing food and fluid during dumping syndrome?
NO
side effects include headache, dizziness, gastrointestinal distress, pruritus, and rash
NSAID
Indocin (Indomethacin) Naprosyn uses?
NSAID arthritis, fever
s/e & n/i of __ are like __: -Gi upset -Dizziness -H/A -Bleeding -Fluid Retention -Take with food or after meals -Monitor liver and renal
NSAIDS, Aspirin
The Estimated Date of Confinement (EDC) calculated by
Naegele rule; add 7 days to first day of last menstrual period and subtract 3 months
will cause signs and symptoms of opioid withdrawal: nausea, vomiting, restlessness, abdominal cramping
Narcan (naloxone)
-Demerol -Dilaudid -Percodan -Morphine Sulfate -Codeine uses?
Narcotics mod-sev pain
Culture where the client may not arrive at the appointed time. Silent, reserved, more attuned to listening and observing body language. Accept western medicine along with their own traditions.
Native American
handshaking is considered aggressive; instead, a passing of the hands may occur
Native American
Preparation for Health Care Procedures ___: -Fears loud noises, sudden movements -Involve parents -Mummy restraint to decrease stimulation
Newborn
Nurse wears gloves when handling ___ and may have to shave the pt
Nitroglycerine
The nurse cares for a toddler diagnosed with pneumonia receiving oxygen in an oxygen tent. He's having a birthday party. What not to do.
No candles (oxygen combustible)
Child nosebleed mom calls nurse. Do you ask mom how much bleeding has occured?
No, difficult for lay person to estimate
Can you give aspirin for a concussion after a fall?
No, give tylenol
After pt has already started taking Plavix, does he need continuous blood work?
No, only once before beginning drug
Responsibility of ___ to activate hospital's disaster plan
Nurse Supervisor
Blood types: O AB
O-universal donor AB-Universal Recipient
OJ or Gatorade for pt on lasix?
OJ for potassium (gatorade too much sodium)
client who screams constantly. The nurse plans a behavior modification program to deal with the screaming. Which of the following actions should the nurse take FIRST?
Observe the client's behavior at regular intervals to establish baseline.
____impairment -blurred vision -color vision changes -blindness
Ocular
Miotics ___ pupil used in
Ocular surgery & open-angle glaucoma
Man with urinary frequency should be told to watch position changes, avoid alcohol and CNS depressants, and give at bedtime
On Flomax or Hytrin (Alpha 1 Adrenergic Blckrs)
COPD pt on O2 2L/min is experiencing SOB and chest pain
Oxygen toxicity
-High blood phenylalanine -Results in MR
PKU (Phenylketonuria)
The initial specimen should be collected as close to discharge as possible but not after 7 days. if initial specimen is collected before newborn is 24 hours old, a repeat test should be performed by 2 weeks of age.
PKU (phenylketonuria) test
coumadin (warfarin) is given via what route? s/e? its antagonist?
PO -hemorrhage (monitor bleeding) -alopecia -Vitamin K (AquaMEPHYTON)
A police officer with a post-traumatic stress disorder (PTSD) history who was admitted with agoraphobia after two of his co-officers were shot and killed in a drug raid.
PRIORITY -high potential for violence to self and/or others; male; easy access to weapons, and has knowledge of how to use them; needs assessment, orientation to the physical surroundings, staff, unit schedules and expectations, rules, and procedures for asking for help; any visitors would need to be particularly monitored for potential weapons, especially if they are other police officers and accustomed to carrying their guns
Diet for ____: -Bland -Low fat -Frequent feedings -No alcohol or caffeine
Pancreatitis
Elevated serum amylase
Pancreatitis
Implementations for ___: -NPO, gastric decompression -antacids, antibiotics, anticholinergics, analgesics, PPI -F&I balance -TCDB q 2 hrs (decreases pneumonia risk)
Pancreatitis
A 45-year-old male client presents with acute mid-abdominal pain and acute vomiting. Priority is asking client about pain and its relationship to either the ingestion of meals or alcohol
Pancreatitis males: age 40-45 alcoholics females: 50-55 biliary disease
PN vs PPN
Parenteral Nutrition (central line) Peripheral Parenteral Nutrition (limbs)
____ symptoms: -Akinesia (pill rolling) -Akasthisia (leg shaking) -Dyskinesia -Drooling -Tremors -Rigidity
Parkinson's-like
Antiparkinson medication used to counteract effects of neuroleptic malignant syndrome
Parlodel
____: -amoxicillin -ampicillin -augmentin
Penicillin antiobiotics -mod to severe infections -syphillis -gonococcus -Lyme disease
____ is an antiprotozoal agent used to prevent and/or treat Pneumocystis jiroveci pneumonia
Pentam
No coffee (decaf or caf) for
Peptic Ulcer Disease (PUD)
older man diagnosed with a cerebrovascular accident with an neurogenic bladder
Perform an intermittent catheterization for residual urine volume.
full colon can create outflow problems; ensure that bowel evacuation has occurred
Peritoneal Dialysis
____: -Severe abdominal pain -Abdominal rigidity (board-like abdomen), rebound tenderness -Ascites -Paralytic ileus -Fever, leukocytosis
Peritonitis
Fear of going crazy, somatic complaints, difficulties with intimacy, increased anxiety.
Personality disorders
Prevents and controls motion sickness, nausea, vomiting, and dizziness. Also used to relieve or prevent allergic reactions, helps people go to sleep, and control their pain or anxiety before or after surgery or other procedures.
Phenergan
S/e of ____: -drowsiness -dry mouth -photosensitivity -bronchospasm
Phenergan Chlor-Trimeton Benadryl
Why would you check hydration status on pt taking Phenergan?
Phenergan is for vomiting; pt may be dehydrated from vomiting; causes orthostatic hypotension
Area around the IV site is reddened with red streaks. (what is it?(what do u do?)
Phlebitis -Discontinue IV -Warm, moist compresses -Restart IV at new site
complications of IV inflammation of the vessel
Phlebitis, thrombophlebitis
direct-acting parasympathetic function causing miosis
Pilocarpine (miosis means pupil constriction)
-see small size but normal body proportions -delayed sexual maturity -appear younger than chronological age -usually see fine, smooth skin
Pituitary Dwarfism
older woman 12 hours after a right total hip replacement. The client appears disoriented
Place an abductor pillow between the patient's legs to prevent dislocation of hip while turning; important to use because client is confused; (orienting client is second to preventing dislocation)
client reporting of weakness, confusion, and hypoactive bowel sounds. Potassium at 1.8; priority is
Place the client on a cardiac monitor while preparing administration of potassium chloride
placenta is implanted near or over the cervical os; symptoms include *painless*, sudden, profuse bleeding in third trimester
Placenta Previa
antineoplastic that is ototoxic; other side effects include hepatotoxicity, bone marrow suppression, tremors, and confusion
Platinol
Which 2 vaccines can be administered at the same time?
Pneumococcal & Influenza
What can result in pneumonia, infection of the blood (bacteremia/sepsis), middle-ear infection (otitis media), or bacterial meningitis?
Pneumococcal infection
___ may follow surgery, particularly abdominal surgery, or an injury (trauma), particularly a chest injury, because of the resulting shallow breathing, impaired ability to cough, and retention of mucus. Also at risk are people who are debilitated, bedridden, paralyzed, or unconscious, because the cough reflex may be impaired or breathing may be shallow.
Pneumonia
Absent or restricted movement on the affected side after an automobile accident indicates
Pneumothorax
A client with rheumatoid arthritis is taught by the nurse to perform range-of-motion (ROM) exercises. In implementing her care, the nurse should include which of the following actions?
Point out small accomplishments that the client makes.
Implementations for Acoustic Neuroma
Pre & Post-op Craniotomy (removes tumor; access base of skull)
What actions of the nurse *prevents* hypoxia associated with tracheal suctioning ?
Preoxygenating the client
condition in which the lens of the eye becomes less flexible and makes seeing words in a book or an online article difficult
Presbyopia
Initiative vs guilt
Preschool
Preparation for Health Care Procedures ___: -Fears separation, ghosts, scary people -Play with puppets, dolls -Demonstrate equipment -Talk at eye level
Preschool
Fears of Surgery ___: Mutilation; encourage expression of feelings; allow to play with models
Preschooler
___ signs of pregnancy are felt by the woman; amenorrhea, nausea/vomiting, breast sensitivity, fatigue, quickening woman starts to feel or perceive fetal movements in the uterus)
Presumptive
The 8-year-old states that no one will play with him.
Priority; depression
24 hours postoperative after intracapsular cataract extraction a client states that her eyelid is swollen and she has difficulty seeing with the affected eye.
Priority; may indicate bacterial infection; assess for yellow or green drainage
Mother of a toddler with hemophilia says "It scares me to think that he will be bleeding all the time."
Priority; misconception because child will not be bleeding all the time; must address first
A patient taking haloperidol (Haldol) for 4 days has a temperature of 102°F (38.9°C).
Priority; neuroleptic malignant syndrome (NMS)
____: -Angina -HTN -Interstitial Cystitis
Pro*cardia* *Card*izem *The Calan Card* (calcium chan blockers)
___ signs are observed by the examiner: Positive urine pregnancy test, uterine enlargement, souffle and contractions, positive urine pregnancy test, Hegar's sign, Chadwick's sign
Probable
A 75-year-old client is brought by his wife to the outpatient clinic. The nurse notes that the client has a 10-year history of chronic renal failure and has been taking cimetidine (Tagamet) for two weeks
Problems with memory indicate CNS side effects of med; older pts with renal problems more susceptible
may experience flu-like symptoms at beginning of therapy; side effects include arthralgias, nausea, edema, reaction at injection site
Procrit (for anemia)
purpose of care plan including turn, cough, and deep breathe q 2 h
Promotes ventilation & prevents resp acidosis
with is the antagonist to the anticoagulant heparin?
Protamine sulfate (sc or iv NOT PO)
dry mouth, hypotension, wear sunscreen
Prozac
Relieves ____ in ____: -Meds antihistamines -Baking soda baths -Keep nails trimmed and clean -Moderate temp
Pruritus in Jaundice
Assessment of ____: -Thick, itchy, erythematous papules -Covered with *silvery white scales*
Psoriasis
pt taking oral contraceptives begins 7-day treatment with ampicillin
Pt should continue taking oral contraceptives, but use a barrier (condom) method of birth control for the rest of the menstrual cycle.
___ prep -Clean site using cotton ball, soap, and water, then alcohol -Dry skin
Pulse Ox (Rotate skin q4h to prevent irritation)
Implementation for ____ Preop: -IV fluids -Skin tugor, fontanelles, urine output -Gastric decompression with NG tube -F&E correction (hypokalemia, dehydration) -Monitor for shock
Pyloric Stenosis
caring for a patient with a casted left leg recommend what type of exercise?
Quadriceps setting of the affected limb.
___ is found in the right anterior chest between the fourth and sixth intercostal spaces
RML right middle lobe
A client recovering from excision of a malignant melanoma. Who should care for this pt?
RN
___ indicates vertex is the presenting part with fetal occiput on the mother's right side toward the front of her pelvis; because infant is vertex, FHT heard below the umbilicus.
ROA
auscultate the aortic area.
RS 2ND Intercostal
__ burns: Prevention only (eye shields)
Radiation
____ is a form of intermittent arteriolar vasoconstriction; ____ interrupts the sympathetic nerves; stable client with an expected outcome
Raynaud disease Sympathectomy
temporary changes to the skin in response to cold or stress - usually in the fingers, toes and nose. The skin turns pale, blue and then red. It returns to normal when warm or no longer stressed
Raynaud's Phenomenon
"I love my family with all my heart, even though they don't love me."
Reaction formation
Venereal Disease Research Laboratory (VDRL)
Reactive 2-6 weeks after Syphillis infection (treat with antibiotics)
Abdominal Hernias; Reducible vs Irreducible
Reducible-Can be resinserted by manipulation Irreducible-Cannot be reinserted by manipulation
____ colitis -Involves all layers of bowel wall
Regional (Crohn's)
____: -Steathorrhea -Colicky absominal pain after meals -Diarrhea rare; 5-6 unformed stools/day -Weight loss, anemia, dehydration -Fistula formation; bowel abcess
Regional Enteritis (Crohn's Disease)
High Protein High Calorie Low Fiber Low Fat diet
Regional Enteritis (Crohn's Disease) & Ulcerative Colitis
return to an earlier level of development and the comfort measures associated with that level of functioning. used as a defense mechanism.
Regression
only insulin given by IV
Regular; Humulin R
infiltration intervention
Remove the IV and place the client's arm on a pillow
symptoms of ____: -Elevated BUN & Creatinine -Decreased Hct -Altered electrolytes -Fatigue -Edema
Renal Impairment
The nurse cares for a client diagnosed with conversion reaction. The nurse identifies the client utilizes which of the following defense mechanisms?
Repression
support group for infertile clients
Resolve
Abdominal Hernias; preop assess & implement
Respiratory system Turn, deep breathe but AVOID COUGH Relieve urinary retention Ice packs for swollen scrotum No pulling, pushing, heavy lifting 6 weeks
S/E of antipsychotics
Restlessness, shuffling gait, involuntary muscle movements, elevated WBC, fever, orthostatic hypotension
____: High concentration of oxygen causes premature infant's retinal vessels to constrict.
Retinopathy of Prematurity (ROP)
____: -Neuro checks -Maintain IV hydration -May need intubation and ventilation -Monitor CVP or Swan-Ganz -Do not use aspirin with viral illnessess (teach)
Reye Syndrome
When antiemetics are used with viral infections it may cause ___
Reye's syndrome
_____ is sudden (acute) brain damage and liver function problems of unknown cause (toxic encephalopathy)
Reye's syndrome
it prevents the mother from forming antibodies to the Rh+ blood; sensitization may occur during pregnancy, birth, abortion, or amniocentesis
RhoGAM (Rho [D] globulin)
left-sided cerebral infarct which side weakness?
Right
Impulsive behavior, disorientation to person, place, time ___ CVA
Right Hem CVA
MOST pertinent to the diagnosis of cholecystitis
Right Upper Abdominal pain
The stem of a vibrating tuning fork is held against the mastoid bone until the child indicates that she can no longer hear the sound. Then the tuning fork is moved in front of the auditory canal
Rinne test
client who is receiving a tube feeding around the clock; ___ the bag and change the formula every ___ hours
Rinse 4
What can you give a pt with URI or COPD to decrease viscosity of secretions and suppress cough?
Robitussin Benylin DM
long-term use of ____ can cause overgrowth of organisms; monitoring of tongue and oral cavity is recommended
Rocephin
the opening of the ___ should be at the knee (in front) and at the popliteal pulse point (in back)
SCD
lung cancer is a common cause of ____ results in increased water absorption and dilutional hyponatremia
SIADH (abnormal secretion of ADH)
support group for parents who have had an infant die from sudden infant death syndrome
SIDS
Less energy from day to day, anorexia assess rest/activity; teach pacing and relaxation techniques
SLE
Assessment for ___: -Joint swelling, pain -Butterfly rash on nose and cheeks -Pericarditis -Pleural effusion
SLE (Systemic Lupus Erythematosus)
antidiarrheals ___ GI tract
SLOW
do not aspirate or massage ___ injections
SQ
Celexa Lexapro Prozac Luvox Paxil Zoloft
SSRI
Prozac Paxil Zoloft uses?
SSRIs depression, obsessive compulsive disorders, bulimia
A client is receiving packed red blood cells. Several minutes after the infusion is started, the client complains of nausea and low back pain. It is MOST important for the nurse to take which of the following actions?
STOP not decrease transfusion then obtain urine specimen to determine cause of hemolyti reaction
form of vagal or Valsalva maneuver, which can reverse _____; blowing should occur for 30-60 seconds; other possible vagal maneuvers include ice to the face, holding the breath and then bearing down, massaging the carotid artery on only one side of the neck; if vagal maneuvers do not work, IV adenosine (Adenocard or Adenoscan), an antidysrhythmic agent, may be given
SVT (supraventricular tachycardia)
___: -Minute, reddened, itchy lesions -Severe itching, especially *at night*
Scabies
-Skin precautions; isolate laundry
Scabies (rash may continue 2-3 weeks) highly contagious
____ method to detect clubbing; *if diamond shape is visible between the nails, then there is no clubbing*; clubbing indicates oxygen deprivation from respiratory or cardiovascular conditions
Schamroth *there is no clubbing*
charge nurse trying to decide who to give a 12 month leave of absence to to two nurses requesting it. one is 5 yrs seniority to the other.
Schedule a meeting with the two staff members to discuss the available options.
Fears of Surgery ____: Loss of control; allow choices
School Age
bicycle and sports related injuries and proper nutrition are the two greatest concerns in what age group of children?
School Age
Preparation for Health Care Procedures ____: -Fears dark, injury, being alone, death -Allow questions -Explain why -Allow to handle equipment
School-age
pt with anorexia nervosa takes classes on being assertive to deal with issues of
Self-identity and self-esteem
_____ hearing loss: *-Ototoxicity* -Infection -Drug Toxicity -Congenital issues -Labirinth dysfunction
Sensorineural Hearing loss
disorder of organ of Corti or auditory nerve will cause what type of hearing loss?
Sensorineurial
___is a painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox.
Shingles (herpes zoster)
Colostomy irrigation for ____: -warm water 5-10 min infusion
Sigmoid colostomy
The nurse cares for clients in the emergency department (ED). A newly married woman is brought to the ED by her parents, who relate that their son-in-law was killed 3 days ago in a boating accident. The parents report their daughter has been uncontrollably screaming and crying since the boating accident. Which of the following actions should the nurse take FIRST?
Silently sitting with the wife maintaining eye contact.
kava is an herbal supplement that alters the effects of ___
Sinemet (parkinson's drug)
feelings of faintness can occur as the moist heat of ____ redirects blood to the rectal area; an ice bag on the head during the bath may prevent faintness feelings; should be done three or four times per day beginning after 12 hours postop to manage pain
Sitz baths
Test visual acuity
Snellen Test
___ effect, normal or elevated blood glucose at bedtime, hypoglycemia at 0200-0300, and a rebound hyperglycemia in the morning
Somogyi
PEG tubes and liquid medicine
Sorbitol in liquid medicine may cause diarrhea
____measures how much air you can inhale and exhale. it also measures how fast you can exhale.
Spirometry
___ is classified as a potassium-sparing diuretic
Spironolactone (Aldactone)
What herbal? -Antidepressant, sedative, antiviral, antimicrobial
St John's Wart
____ decreases effectiveness of: -digoxin -antineoplastics -antivirals -AIDS meds -antirejection meds -theophylline -coumadin *-oral contraceptives!!!!*
St John's Wart
full-thickness skin loss involving damage or necrosis of SQ tissue, looks like a deep crater
Stage 3
____: Swollen gums and tongue difficulty swallowing, bad breath, mouth pain (n/i:)
Stomatitis n/i: good mouth care small feedings antifungals local anesthetics
Abdominal hernia that's been ____: -severe abdominal pain -nausea -vomiting -distention
Strangulated
A toddler who is making harsh, high-pitched noises on inspiration this called ____ and indicates ____
Stridor Upper Airway Obstruction
central venous catheters
Subclavian Internal Jugular Femoral
symptoms of _____: -fever -diarrhea -black hairy tongue -glossitis -vaginal itching & discharge
Superinfections
During the acute phase of a cerebrovascular accident, the nurse should maintain the patient in which position?
Supine, Semi-Fowler's
Appropriate action to provide stability to weak leg so that client can stand during transfer
Support leg with nurse's knee
Confusion, weight gain, urine output of 15 cc/hr are symptoms of _____, water retention due to excessive ADH; most common cause is cancer (especially lung cancer) other causes are various pulmonary and CNS disorders and certain drugs.
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
form of behavior modification; used in conjunction with deep muscle relaxation designed to decrease the extreme response to anxiety-producing situations
Systematic desensitization
If right side of heart (RS HF) not working, then blood backs up into
Systemic Circulation -edema -ascites -hepatomegaly -JVD
T or F for anorexic pt admitted: "I know that someone will be watching me during and after I eat."
T
T or F: The anterior fontanel becomes taut when the infant cries.
T
injuries at level of __-__ result in decreased respiratory reserve, however, pt should be fully independent in self-care and in wheelchair and should learn to observe his respiratory function. For skin integrity he should turn himself every __ hours.
T1 - T6 2
___ is endemic to Asia, Middle East, Africa, Latin America, and Caribbean; consider screening if child has traveled to an endemic region
TB
symptoms include progressive fatigue, lethargy, nausea, anorexia, weight loss, low-grade fever, and night sweats.
TB
use airborne precautions for ___, private room with negative air pressure
TB
Ethambutol Rifampin Streptomycin PAS (2nd line) PZA (2nd line)
TB (also INH)
Peripheral neuritis (inflammation of a nerve) and hepatitis are s/e of
TB drugs
If ___ is discontinued abruptly insulin levels remain high while glucose levels decline; results in hypoglycemia; will also see restlessness, headache, weakness, irritability, apprehension, lack of muscle coordination
TPN
Post op nourishment for Esophageal Atresia and Tracheoesophageal Fistula
TPN until gastrostomy or oral feeding if tolerated (antibiotics also)
s/e of autologous blood transfusion
Tachycardia Chills Fever
Which antibiotics WITH food?
Take all antibiotics 1h before or 2h after meals EXCEPT for Sulfonimides and Cephlosporins (Gan-Bac-Azu & Ceph/Cef) **Also Steroids WITH food**
____; Irregularly shaped pink patches on the back of the infant's neck. May be pink or red and are often on the nape of the neck (the lower occipital bone) and/or on the eyelids, between the eyebrows, on the nose or upper lip; fade as the infant gets older
Telangiectatic nevi or "stork bites"
A chart review reveals that clients report pain medication being less effective, and the clients receive more medication when a particular nurse is working
Temporarily assign another nurse for PRN meds (nurse may have substance abuse problem)
Phalen's maneuver; put back of hands together and bend both wrists at the same time. Hold for about 60 secs.
Test for carpal tunnel syndrome
Muscle spasms, tingling sensations in fingertips and around mouth, confusion result from
Tetany (hypocalcemia)
Vibramycin Panmycin (class?uses?)
Tetracycline Antibiotics -acne -infections -prophylaxis for ophthalmia neonatorum (prevent infection of baby passing through birth canal)
become toxic if taken past the expiration date.
Tetracyclines(vibramycin, panmycin)
cardiac abnormality detected at birth; pulmonary stenosis, ventricular septal defect, overriding aorta, hypertrophy of right ventricle
Tetralogy of Fallout
____ is a term describing the estimated delivery date for a pregnant woman
The Estimated Date of Confinement (EDC)
The nurse supervises an LPN/LVN provide care to a patient with an infected abdominal wound
The LPN/LVN dons clean gloves, removes the soiled dressing, changes to sterile gloves, and uses sterile dressings to cover the wound.
The client has a chest tube connected to a three-chamber water-seal drainage system (Pleur-evac) with 20 cm suction. The nurse determines the lung has re-expanded if which of the following is observed?
The fluid in the water-seal chamber does not fluctuate with respirations.
The physician orders morphine sulfate 8 mg IM q 3 to 4 h for pain PRN. In which of the following situations should the nurse consider withholding the medication until further assessment is completed?
The patient's level of consciousness fluctuates from alert to lethargic; too much CNS depression
pulmonary edema, hypoxia, hemothorax, pneumothorax, subcutaneous emphysema, spleen and liver puncture, SOB, faintness, chest pain, bloody sputum are all potential complications of
Thoracentesis
Alcoholic pt after a pneumonectomy; symptoms include tremors, insomnia, alcoholic hallucinations is ordered Thorazine by the doctor
Thorazine is an antipsychotic/antiemetic (pt should be on valium or other sedative)
Slightest stimulation will bring on immense pain
Tic De Laroux (Trigeminal Neuralgia)
Scaly areas in rings Vesicles on foot Breakage and loss of hair
Tinea
Fear of Surgery ___: Separation; teach parents what to expect: regression, difficult separations
Toddler
Preparation for Health Care Procedures ___: -Fears separation, animals, change in environment -Provide simple explanations -Distract -Allow choices
Toddler
Measures in intraocular pressure
Tonometry
Tx for Tinea
Topical or PO antifungal Frequent shampoos
this drug helps control and prevent certain kinds of *seizures*. Also prevents *migraine headaches* in adults.
Topiramate (Topamax)
use non-hormonal contraceptives when taking _____
Topiramate (Topamax)
_____: -Soft to fairly firm returns -Very foul smelling, corrosive drainage -Pouch worn continuously -Usually single-loop colostomy -Diet not restricted after 6 weeks
Transverse Colostomy
test is used with a client who may have varicose veins
Trendelenburg test
-monitor for suicide -takes 2 to 6 wks to work
Tricyclics (elavil, tofranil, nopramin)
____: Implementation -Analgesics, Tegretol -Alcohol injection of nerve -Surgery to decrease pressure on nerve
Trigeminal Neuralgia
____: Assessment reveals -Stabbin, buring facial pain -Twitching of facial muscles
Trigeminal Neuralgia-Tic De La Roux (CN#5)
The nurse notes 3 consecutive late decelerations on the client's electronic fetal monitor tracing
Turn off the infusion of oxytocin (Pitocin)
CVC pt starts coughing, is pale and dyspneic, and has tachycardia
Turn the patient to the left side and lower the head of the bed. (Left Trendelenburg) keep this position for 20-30 minutes
Topical coal-tar Steroids Anthralin Antimetaboites Ultraviolet light
Tx for Psoriasis
Foods with ____ that should not be taken with MAO's (nardil) (food examples)
Tyramine (liver, dried fish, tea, pepperoni pizza)
Foul-smelling urine can be ___ Implementation?
UTI -Antibiotics -Force Fluids
Furadantin is for ___ s/e
UTIs asthma attacks, diarrhea
___ colitis -Involves mucosa layer of bowel -Begins in rectum -Continuous segments affected -Remissions and relapses
Ulcerative
Anemia in ____ & ____ Colitis
Ulcerative & Regional (Crohn's)
_____: -Fat not present in stool -Blood, pus, mucus, in stool -Rectal bleeding -Abdominal pain before defecating -Diarrhea 10-20 liquid stools/day, often bloody -Weight loss, anemia, dehydration -No Fistula formation
Ulcerative Collitis
examines the esophagus, stomach, and duodenum to identify factors that can complicate the care of a patient with cirrhosis, such as esophageal varices or gastric or duodenal irritation, ulcerations, or bleeding
Upper GI Endoscopy
Obtain and record ____: provides baseline for anesthesiologist
VS
Serious complication with hormone (estrogen) therapy
VTE (venous thromboembolism)
Prevention of meningitis with ___
Vaccinations
Pt preparing for bronchoscopy will be premedicated with ___, ___, & ___
Valium Versed Demerol
Apresoline Minoxidil (also used in alopecia)
Vasodilators-relax smooth muscle; used in HTN
Common complication to watch for in glomerulonephritis (ASGN)
Venous Thrombosis
reduces efficiency of heart; common after MI
Ventricular Dysrrhythmias
___is a medication or IV solution that causes blisters and tissue sloughing (ex: Gentamicin, Penicillin, Vancomycin, Dilantin, antineoplastics, Calcium, Potassium, Epinephrine)
Vesicant
S/e of ____: -discoloration of primary teeth if taken during pregnancy -glossitis -rash -*phototoxic reactions (avoid sunlight)*PT MUST AVOID SUN OR USE SUNBLOCK!!! (do not take with antacid, milk, iron)
Vibramycin Panmycin (tetracycline antibiotics)
Which drugs do you give with Allopurinol (Zyloprim)?
Vincristine Vinblastine
What topical anesthetic for herpes simplex?
Viscous Lidocaine
An older client with a history of hypertension and closed-angle glaucoma visits the clinic for a routine check-up. Which of the following medications, if ordered by the physician, should the nurse question? 1. Propranolol (Inderal), 80 mg PO QID. 2. Verapamil (Nifedipine), 40 mg PO TID. 3. Tetrahydrozoline (Visine), 2 gtt both eyes TID. 4. Timolol (Timoptic solution), 1 gtt both eyes daily.
Visine is contraindicated; ophthalmic vasoconstrictor, contraindicated with closed angle glaucoma; use cautiously with hypertension -all others are for hypertension
____Test: Measures peripheral vision
Visual Fields Test
Green vegetables, pork, rice, yogurt, some cheeses, fish, and milk all are sources of ____ and ___ won't work.
Vitamin K (coumadin won't work)
abnormal posturing; catatonic schizophrenia causes sudden loss of animation and a tendency to remain motionless in a stereotyped position
Waxy Flexibility
The stem of a vibrating tuning fork is held in the middle of the forehead, and the girl's hearing is assessed in both ears
Weber test
client with a pacemaker calls to report that he just had an episode of dizziness and shortness of breath. Nurse asks:
What is your pulse? (symptoms may indicate malfunction of pacemaker)
Steroids give ____ meals
With -decreases GI irritation
Take Zantac and Tagamet
With meals or at night
Zovirax should be taken (with/without) food? frequency?
Without 5 times a day
To determine the amount of visual impairment experienced by the client
Would you please tell me what you have difficulty seeing?
Do you apply a sequential compression device to the patient's lower extremities when a pt just returned from surgery after a total knee replacement?
Yes, improves circulation & prevents clots
transdermal cata-pres patch. Can pt shower with it?
Yes, patch left on for 7 days
Pt on CPAP (continuous positive airway pressure) asks nurse if he can smoke in the room with the CPAP?
Yes, they can. CPAP uses room air, not oxygen, and is not combustible; used with spontaneous ventilation to keep alveoli open and decrease hypoxia
Is it ok for pt with diarrhea to eat foods at room temp?
Yes, very hot or very cold foods may stimulate colon
parkinson's pt shoud sleep on a ___
a *firm mattress without a pillow* to prevent flexion of the spine
how to perform breast self-examination
a gentle rotating motion with the palmar surfaces of the middle three fingers is used to press the breast tissue against the chest wall; palpation is begun in the upper lateral quadrant; it moves from the periphery to the areola, and moves around the breast counterclockwise
To facilitate healing of the surgical area after a tracheostomy, how is nutrition passed to pt?
a nasogastric tube may be utilized and tube feedings may be implemented.
skeletal traction (Buck's traction) weights should never be removed unless there is ____, including when repositioning the patient; such an action would be very painful for the patient and would interrupt the line of pull
a physician's order
when is best time of day for pt to self administer urine reageant test?
a specimen obtained 10 to 20 minutes after the first specimen is more accurate because it has not been accumulating in the bladder
the only body system assessment that does not end with auscultation is ___, because once the ___ is palpated and percussed, ___
abdominal abdomen, the bowel sounds will be altered
most frequent type of surgery in which wound dehiscence and evisceration appear
abdominal surgery
position of ____ should be maintained for an elderly client who has just had a prosthetic hip implant
abduction
to prevent dislocation after total joint replacement, maintain leg in position of ____
abduction for 2-3 months
The skin over the patient's ischial tuberosities appears blanched.
abnormal; should be red
An ___ is a collection of pus in any part of the body that, in most cases, causes swelling and inflammation around it.
abscess
pril = ____ = vasodilation
ace inhibitors
PO tetracycline and accutane (monitor ___)
acne vulgaris (liver)<--can't use while pregnant
Prevents systemic overload
action of diuretics
contractions every 3-4 min indicates ___ labor
active
Thorazine Haldol Trilafon
acute & chronic psychoses
Risperdal Clozaril n/i:
acute & chronic psychosis -monitor blood -change position slowly -SUNSCREEN
When are laxatives c/i?
acute abdomen symptoms (you don't know what's going on)
indication of ____; sitting upright to breathe better, tongue protrusion increases pharyngeal movement; drooling caused by difficulty swallowing because of pain and excessive secretions
acute epiglottitis
symptoms of _____; vomiting and hematemesis may be seen with gastritis stemming from alcohol abuse; other symptoms are epigastric pain or discomfort, cramping, nausea and vomiting
acute gastritis
occurs 5-21 days after infection of pharynx or skin by group A β -hemolytic streptococci (ex: impetigo)
acute glomerulonephritis
A client complaining of redness and pain in his left great toe.
acute gout
Ear plugs in bath tub and avoid swimming for what pts?
acute otitis media
inability of kidneys to concentrate urine occurs in ____; normal is 1.010 to 1.030
acute renal failure (ARF)
nephrotic syndrome diet
adequate protein (may be limited), low sodium
standard transfusion sets are *not used* for platelet administration because the filter traps the platelets, and also there is increased adherence of platelets to the lumen of the longer tubing; ____ particularly designed for platelets must be used; it has a _____
administration set smaller filter and shorter tubing
Identity vs role diffusion
adolescent
death as a concept based on past experience
adolescent
Identity versus role diffusion
adolescents
Immunosuppressants (Sandimmune-cyclosporine) are used with what other meds?
adrenal corticosteroids
response to early hypovolemic shock by ____ stimulation
adrenergic (tachypnea)
pt on oral contraceptives experiencing breast tenderness and nausea
adverse effect (not common s/e)(contact phys)
To give autologous blood client must be __ and have appropriated __ & ___
afebrile hemoglobin & hematocrit
Acute Otitis Media; position pt on ___ ear to promote drainage
affected
Using crutches: Which goes first? three-point crutch-walking gait
affected leg is moved forward at the same time as the crutches, followed by the strong leg
Child neatly ties shoelaces
after age 6
When obtaining a specimen from a client for sputum culture and sensitivity (C and S), the nurse identifies which of the following instructions is BEST?
after awakening in the morning
infant diagnosed with congenital heart disease feed
after awakening; fatigues easily
after radiation implant must wait how long before resuming intercourse or tampon use?
after follow up visit 6 weeks
How should the feet be positioned in the bed for a comatose adult pt?
against food board; maintains dorsiflexion prevents foot drop
Describe the procedure to the child in short, concrete terms while talking calmly.
age 3; need simple explanations
cigarette smokers have a significantly higher risk of developing
age-related macular degeneration (ARMD)
Nardil is an MAO inhibitor; eating____ may cause a hypertensive crisis
aged cheese (cheddar)
The nurse notes that the client stares blankly and has an unsteady gait, stiff muscles, and eyes that are moving rapidly side to side and up and down. The nurse plans care. Which is MOST important for the nurse to anticipate?
aggression (pt on PCP)
pt wanting to wear a scarf is of concern if
aggression or suicide is an issue
Care of the blind client includes walking a half step ____
ahead
continuous bubbling in the water-seal chamber indicates (gentle bubbling)
air leak; need to check for location of leak; clamp tubing close to chest and check for bubbling, and then clamp tubing close to container and check for bubbling (gentle: normal)
disseminated herpes zoster (shingles)
airborne & contact
disseminated herpes zoster requires what kinds of precautions?
airborne and contact
TB requires ___ precautions
airborne precautions, particulate respirator
Pt with ascites: ___ is given to pull fluid back into the blood vessels, from which ___ can then promote excess fluid excretion
albumin (Albuminar) diuretics
pt is receiving albuterol (Proventil) two puffs, and beclomethasone (Vanceril) two puffs, through inhalers. which inhaler should pt use first?
albuterol (Proventil) is a bronchodilator that will open the passageways so the steroid medication (Vanceril) can get into bronchioles
____ is recognized as the leading cause of preventable mental retardation
alcohol
Increased pulse, anxiety, tremors, insomnia, hallucinations, Hyper-alert, startles easily, and anorexia
alcohol withdrawals
A client diagnosed with chronic ___ needs supplementation with all B vitamins, especially *thiamine (vitamin B1)*;
alcoholism
private room is best for a patient with latex allergy; if a private room is not available, then ____
all patients in the room with the patient with latex allergy must be treated as though they too were latex-sensitive
_____ to blood transfusion is characterized by wheezing, urticaria (hives), facial flushing, and epiglottal edema
allergic reaction
Uticaria, itching, respiratory distress describes
allergic transfusion reaction
spouse of phobic client refuses to ride elevators
allow spouse to avoid elevators
used to treat and prevent wheezing and trouble breathing caused by ongoing lung disease (e.g., asthma, emphysema, chronic bronchitis)
aminophylline
major side effect of ____; toxic effects include confusion, headache, flushing, tachycardia, and seizure; notify the physician immediately if symptoms of drug toxicity occur
aminophylline (asthma drug)
Hepatic encephalopathy is accumulation of ____ and leads to
ammonia -Asterixis (flapping hand tremor) -Disorientation to comatose
Early problems with the baby's blood & spinal cord can be identified with this test.
amniocentesis
Why is this wrong?: A patient with sacral decubitus lies on the left side with the right leg extended and resting on the mattress.
among potential trouble areas of the side-lying position are hip joints that are internally rotated, adducted, and unsupported; to prevent this, upper leg should be mildly flexed and rest on a pillow from groin to feet
loss of the upper airway increases the ____ and ____ of secretions
amount viscosity
drains not usually used with ___, instead provide cast care
amputations
First trimester nausea is caused by___
an elevation in the hormones.
contractions that last continuously for ___ generally indicate labor
an hour
Solitary play describes play for
an infant
butorphanol tartrate (Stadol) IM
anelgesic for mod to sev pain monitor for bradycardia, change in BP, resp dep
bruit over the aorta
aneurysm
The client has edema of the lower extremities & lanugo. (what eating disorder?)
anorexia
Making jewelry with the occupational therapist is more important than assisting dietician to plan the week's menus for ___ pt
anorexia nervosa
The physician orders chlorpromazine (Thorazine) to control an alcoholic client's restlessness, agitation, and irritability following surgery. The nurse should check the order with the physician based on which of the following rationales? 1. The nurse believes that the client's symptoms reflect alcohol withdrawal. 2. The nurse does not know if the client is allergic to this medication. 3. The nurse knows that the client is not psychotic. 4. The nurse routinely checks on the doctor's orders.
ans is #1 (3 not best rationale for checking with doctor about this order)
____ are most effective after digestion has started, but prior to the emptying of the stomach; take after meals; prevent pain by protecting gastric mucosa
antacids (aluminum hydroxide (Amphojel))
increased intake of ____and ___ can cause hypermagnesemia
antacids (w/magnesium) & laxatives
Vesicular breath sounds present over lung periphery can be ausculated on
anterior, posterior, and lateral chest
-discontinue meds slowly -if pt takes up smoking or drinking caffeine will it decrease effect of this med
anti-anxiety agents (ativan, xanax, equanil, librium, vistaril)
BuSpar is
antianxiety
Librium
antianxiety and sedative/hypnotic used to treat anxiety and alcohol withdrawal; causes drowsiness and sedation; use caution when driving or operating equipment; confusion may indicate immediate n
Prevents premature ventricular contractions (PVCs) is the action of
antiarrhythmics (quinidine)
___ affect oral contraceptives
antibiotics
3 meds for acute otitis media
antibiotics antihistamines nasal decongestants
Gi infections meds could be __,__,__
antibiotics antispasmodics antiemetics
meds for meningitis can be __ or ___
antibiotics or antifungals
Do not give aspirin or NSAIDS with
anticoagulant
pink urine from
anticonvulants
Tegretol is a
anticonvulsant
tegretol is an ___
anticonvulsant
Dilantin Luminal Depakote Tegretol Klonopin
anticonvulsants
____ can cause folate and vitamin D deficiencies; folate deficiency can cause anemia, symptoms reflective of these nutritional deficiencies; good sources of folate are green leafy vegetables, legumes, tomatoes, and various fruits such as oranges and cantaloupe; good sources of vitamin D include milk
anticonvulsants
Kaopectate Lomotil Imodium Pargoric are ___ drugs and their s/e are ___
antidiarrheals s/e constipation, anticholinergic effects
digibind
antidote of digoxin
compazine is a
antiemetic
dramamine is a
antiemetic
Phenergan is __ & __
antihistamine & antiemetic
Phenergan & Chlor-Trimeton
antihistamine, *Phenergan also for motion sickness, sleep aid, mood disturbances*
hypotension dizziness GI distress (from taking ___)
antihypertensives
N/i for ___ agents: -check hematopoietic function (RBCs,WBCs) -force fluids -good mouth care
antineoplastic
___ cause ototoxicity
antineoplastics
Ginko, Garlic, Ginger have ___ effects
antiplatelet effects (c/i with antiplatelet & anticoagulants)
Shuffling gait, rigidity, photosensitivity, jerky movements are s/e of ____
antipsychotic drugs
____ are drugs passed on to the infant through breastmilk
antipsychotics
s/e of ___: -akathisia -dyskinesia -dystoinias -Parkinson's syndrome -tardive dyskinesias -orthostatic hypotension *-leukopenia*
antipsychotics
Tylenol is an ___ agent used for ___ s/e n/i
antipyretic fever -GI irritation, liver dysfuntion -C/I for under 21 yrs old
clients with ____ are often manipulative, untrustworthy, and unreliable they tend to act out, have poor impulse control and show poor judgment they usually move from situation to situation in an opportunistic fashion and experience problems with authority
antisocial personality disorder
S/e: -Bitter taste -Burning in mouth (flush with water PO) -Stains teeth (use a straw) -Give with meals -Check CBC -Rash -Bleeding -Leuokpenia (infection)
antithyroid
BuSpar is for
anxiety
____ is normal response to a threat
anxiety
the fourth to fifth intercostal space at the midclavicular line.
apical pulse
4 yr old with abdominal pain, is nauseated and vomiting, and refuses to eat
appendicitis
in acute ____, the pain usually comes prior to nausea and vomiting
appendicitis *appen-pain-prior*
Post ABG test
apply pressure for 5 min 15 if receiving anticoagulant
Client is disoriented to person, place, and time, and vital signs are irregular takes priority over pt that is hostile, agitated, or
apprehensive
___ is loss of purposeful movement in the absence of motor or sensory impairment; when it affects an ADL, such as dressing, the client may not be able to put clothes on properly
apraxia
although client has permanent tracheotomy, will be able to eat normally after ___
area has healed
Lung biopsy and thoracentesis pt position
arms on over-bed table or lying on side
7-year-olds see death ____
as a punishment
pt with pain that sounds unlikely due to surgery do not treat with same pain meds ____
as prescribed for surgery
Pt telling new home nurse about her meds but forgot one.
ask physician (don't let pt describe it or anything)
An allergy to tartrazine (FD&C yellow dye #5) is a c/i for
aspirin
following a scleral buckling
assess for N, V (inc intraocular pressure)
most important before putting on a cast
assess neuro, pain, pallor, pulselessness, paralysis
After a major power outage, a confused client with an unsteady gait arrives at a portable emergency response station
assist to chair before any assessment
rate is variable but the tidal volume is preset so each breath is delivered at a set volume regardless of patient's needs
assist-control ventilation
The client rotates the vial of insulin between both hands for ___.
at least one minute
tot cholesterol should be
at or below 200
if discontinued abruptly, may cause life-threatening dysrhythmias, hypertension, or myocardial ischemia; should be tapered gradually over 2 weeks; take medication with meals
atenolol
HTN, SVT, Angina drugs
atenolol nadolol propanolol
____ decreases excitability of the heart; reduces cardiac workload and oxygen consumption; decreases release of rennin; lowers blood pressure by reducing SNS stimuli; should not be discontinued abruptly; may develop tachycardia, diaphoresis, malaise
atenolol (beta-blocker)
The synch button is for cardioversion to treat __ __ __ synchronizes shock with R wave
atrial flutter, atrial fibrillation, supraventricular tachycardia; Synch button
A lesion that is shiny and translucent is a description of ___
atrophy
____leadership is appropriate in a crisis or emergency situation
autocratic or directive
caused by uninhibited sympathetic discharge; symptoms include pounding headache, profuse sweating, nasal congestion, hypertension; precipitated by full bladder or bowel
autonomic dysreflexia
Skin graft pts and sunlight
avoid sunlight for 1 year after healing
a macrolides anti-infective that causes diarrhea, nausea, and abdominal pain; notify health care provider if diarrhea occurs
azithromycin (Zithromax)
acute diarrheal illness, often caused by E. coli, which is transmitted by the fecal-oral route; standard infection control procedures are sufficient unless patient is diapered or incontinent, in which case contact precautions are required
bacterial gastroenteritis
1. Medium baked potato. 2. One slice of white bread. 3. One medium apple. 4. One scrambled egg. 5. 1 1/4 cup of corn flakes. 6. 1 cup of cantaloupe.
baked potato-407 mg potassium cantaloupe-825
nurse suspects 6th grader broke leg after tree fall
bandage legs together (uninjured leg can be used as a splint)
____ can interfere with x-rays, ultrasound, tests using iodine, proctoscopy, and colonoscopy and should be scheduled after these tests
barium radiography
A 2-day-old infant delivered of a mother receiving intrapartum antibiotic therapy for vaginal group B-streptococcus (GBS).
because mother received intrapartum prophylaxis, infant has 1-in-4,000 chance of developing sepsis due to GBS
Why assess for dependent edema on pt complaining of cold hands, feet, and nose that is on balanced suspension traction?
because of recumbent position, cardiac workload increases
Why do you not give solution containing dextrose as a pre-epidural bolus?
because the glucose can be transferred to the fetus
Why is there an increase in specific gravity in SIADH?
because there is a decrease in urine output
Why does pancreatitis pt need to be on bed rest?
bed rest decreases the metabolic rate and the secretion of pancreatic enzymes
all equipment should be ready ___ blood is ordered from the blood bank
before
Pt w/multiple sclerosis during conversation building up can lead to confusion and frustration caused by difficulty concentrating and fatigue; most important points should be communicated at the ____ of the sentence
beginning
MI with 4-6 premature beats per hour is ____
benign
Treats symptoms of alcohol withdrawal, and anxiety; tremors, increased heart rate, fever, confusion, delusions, and hallucinations
benzodiazepine (Librium) (calcium ch blocker)
testicular self-exam
best done in shower when muscles relaxed
"Each of you will summarize what you hear the other person saying. The other person will then validate the summary."
best way to intervene when two staff members are arguing consistently
norepinephrine dopamine epinephrine dobutamine (used for what?)
beta adrenergics: *use in cardiac arrest and COPD* Increase peripheral resistance and increase bronchodilation
lowers the excitability of the heart
beta blockers
The infant's grasp reflex is strong ____
between 1 and 3 months and generally *disappears after 3 months*
Trust vs mistrust
birth - 18 months
Trust vs. mistrust
birth-18 months
Credé maneuver for
bladder control
Diet for herpes simplex
bland soft food (avoids cracking vesicles)
s/e of antiplatelet drugs (aspirin, plavix, persantine)
bleeding thrombocytopenia
esophagogastric tube used to treat ____; assess___
bleeding esophageal varices -VS for dec BP inc pulse -Ensure balloon pressure & volume maintained
Why do you do neuro checks (and how often) when pt begins antithrombolytic therapy?
bleeding into brain q 15 min X 1st hr q 30 min after for up to 2-8 hrs
hematuria dark stool
bleeding/thrombolytics
Hep B causes infection through
blood & body fluids
Why would you have to watch for bleeding for pt taking antineoplastic?
bone marrow suppresion = bleeding
Fosamax is a ___ s/e
bone reabsoprtion inhibitor (doesn't prevent osteoporosis) esophagitis take in AM on empty stomach
interval between injection of the tracer and the actual scanning is usually 1 to 3 hours; large amounts of fluid maintain hydration and decrease radiation dose to the bladder; client should void immediately before scan to prevent a distended bladder
bone scan
The nurse cares for an older patient scheduled for a colon resection this morning. The nurse notes the patient had polyethylene glycol-electrolyte solution (GoLYTELY) and a soapsuds enema the previous evening. This morning the patient passes a medium amount of soft brown stool. Which of the following conclusions by the nurse is MOST accurate?
bowel prep incomplete; colon should not have remaining soft stool
Why does it make sense to have TPN in Colitis?
bowel rest
The nurse cares for a client after surgery do not offer oral fluids until ____
bowel sounds are heard
opioid overdose will cause__cardia & __tension
bradycardia hypotension
A ___ is a collection of pus, immune cells, and other material in the brain, usually from a bacterial or fungal infection.
brain abscess
Bowel and bladder incontinence controlled by what part of the brain?
brain stem
after CBI urine may be ___ for ___
bright red 12 hrs
three-way Foley catheter should be irrigated rapidly when ____ are present;
bright-red drainage or clots (repeat process until return is clear)
When using steroid inhaler and bronchodilator, use the ___ first.
bronchodilator
Terbutaline is __ used for __
bronchodilator preterm labor
Use ___ for COPD
bronchodilators -Aminophylline -Arethine -Atrovent -Proventil -Primatene
beta=beat=___
bronchospasm
olol drugs can cause ___; monitor ___
bronchospasm; monitor airway
Sputum analysis -before test pt should not -collect __-
brush teeth, eat, or use mouthwash early in AM
rubber tip can be placed at the side of the mouth to avoid the operative area and to prevent sucking on the tubing; infants with cleft lip swallow excessive amounts of air, so they require frequent ___
bubbling
ischial tuberosity are the
butt bones
Child learns to identify mother or primary caregiver____; results in preference for mother or primary caregiver demonstrated by behaviors typical of stranger anxiety (crying in presence of stranger and clinging)
by 5 to 6 months
hypoparathyroidism: diet for the client should provide high ____ and low ____ because the parathyroid controls ____ balance
calcium phosphorus calcium
Verapamil is a ___ used as ___
calcium channel blocker antianginal
"pine" meds are
calcium channel blockers
____ are found to be particularly effective in older patients and in African Americans with HTN
calcium channel blockers
s/e of ___: -angioedema -ortostatic hypotension -renal failure
calcium channel blockers the CARD or PINE drugs
Pt taking estrogen should ____ when -blurred vision -edema -dark urine -breast lumps -vaginal bleeding
call physician
BuSpar Calan Tegretol Zocor ____ be taken with grapefruit juice.
can't
What's wrong with this nursing dx?: Risk for anxiety secondary to hypoparathyroid disease
can't be RT (secondary to) a medical diagnosis
Vinblastine Vincristine treat? s/e?
cancer -stomatitis -alopecia -loss reflexes -bone marrow suppresion
Platinol treats
cancer of the testicles, bladder, ovaries, or lung.
You can't drink ___ with depakote
carbonate beverage
depakote, cannot drink ____
carbonated beverages
What foods should be avoided if *dumping syndrome*? What about liquids?
carbs (get digested first) No fluids during meal, 1 hr before, 2 hrs after
tire manufacturing worker exposed to
carcinogens
Dilantin IV administration given too quick causes ___ and given ___
cardiac arrest; with no other med
_____ related to low serum calcium would be the highest priority
cardiac dysrhythmias
-client positioned with pillow between legs -prevent orthostatic hypotension -incentive spirometer (prevent atelectasis) -keep heels of elderly off bed to prevent bed sores
care for total hip replacement
____ should not be caring for plants and clients
caregivers; nursing assistants
A sufficient ROM assists the elderly to ________
carry out activities of daily living (ADLs).
___, also known as ___ is an unusual but serious and urgent complication most often seen in patients in a hip spica or body cast; cast pressure itself and/or accumulated intestinal gases cause the duodenum to be compressed between the aorta and the superior mesenteric artery, resulting in distention, abdominal pain, nausea and vomiting; may need to cut a window into the abdominal area of the cast to relieve pressure; bivalving of the cast is another option; NG intubation may assist in decompressing the intestine, and IV fluids may be given
cast syndrome superior mesenteric artery syndrome
multiple activity restrictions required to prevent increased intraocular pressure; avoid straining, no heavy lifting; bend from knees to pick up objects
cataract surgery
____occurs because lens becomes less hydrated and more dense
cataracts
partial or total opacity of the normally transparent crystalline lens
cataracts
most narcotic addicts do not inject sterile purified material with aseptic techniques; ___ is a common complication because of skin popping or using an infected drug apparatus
cellulitis
"The drops should go into the ___ of the lower eyelid."
center
false positive for proteinuria glycosuria from pt receiving what med?
ceph anti
If a client is allergic to penicillin, he/she may also be allergic to ___
cephalosporin antibiotics
all antibiotics are before or after meals except for ___, ___ which are taken with meals.
cephalosporins(cef & ceph) and sulfonimides(gan, bac, azu)
symptoms of ___ include painless vaginal bleeding
cervical cancer
slight to moderate vaginal bleeding expected after discharge; color of flow normally begins pink, turns brown and becomes white (happens 48 hrs after discharge from ____)
cesium 137 implant (notify phys if bleeding more than 2 days)
draining abdominal abscess; check for character or consistency?
character
A client in early labor complains of not being able to hold my urine
check pH (urine-acidic or amniotic fluid-alkaline?)
how do you evaluate for increased intraocular pressure
check pupils with penlight to observe for constriction
first 24 hours after ____, as much as *500-1,000 mL* of drainage can occur, with 100-300 mL being in the first 2 hours and then a progressive decline in amount
chest surgery
7-year-old child hospitalized with a diagnosis of staphylococcal pneumonia. how do you promote air expansion
child blows bubbles
Creatinine (child and adult)
child:0.4-1.2 adult:0.7-1.4
low in fat; fatty foods and gas-forming foods should be avoided
cholecystitis
Addison's disease is
chroni adrenal insufficiency
Why would a client scheduled for a mastoidectomy be priority?
chronic ear infections cause vertigo, priority client due to safety
history of ___ is a risk factor for colorectal cancer
chronic inflammatory bowel disease
histamine H 2 antagonist; side effects include diarrhea, dizziness, hirsutism
cimetidine (Tagamet)
Wet breath sounds, severe shortness of breath describes symptoms of ____
circulatory overload
pyloric stenosis post op keep incision ___ monitor ___
clean and dry warmth
because of the need to visualize the abdominal area, ____ the evening before an IVP are usually ordered
cleansing enemas
The newborn's uvula has two lobes indicates there may be a ____; further assessment of
cleft in the palate: -sucking ability -palate size, shape
The nurse observes a client who is taking phenelzine (Nardil) eat another client's lunch. After a few minutes, the client complains of headache, nausea, and rapid heartbeat, and begins to vomit.
client experiencing hypertensive crisis due to ingesting tyramine; Procardia to treat HTN
The LPN/LVN maintains nasogastric suctioning for a pancreatitis pt because____
client is NPO, NG suctioning removes gastric secretions and decreases abdominal distention
The client is asian female 5 feet tall and weighs 100 pounds. Why at risk for osteoporosis?
client is at risk for developing osteoporosis because of gender, age, ethnicity, and small body frame; encourage client to increase foods high in calcium, take prescribed medication (Fosamax and Evista), and exercise regularly
The nurse plans care for a client diagnosed with paranoid schizophrenia. The nurse knows that questioning the client about the client's false ideas will elicit which of the following responses?
client will defend ideas
Place the client on the left side in Trendelenburg position, initiate oxygen therapy, and notify the health care provider.
client's IV tubing disconnected from the client's central line
apply pressure for a few minutes (pressure dressings) when __ not forming
clots not forming (too much thrombolytic therapy)
clear (reg) first then
cloudy (NPH)
health care provider will monitor CBC; drug will be *discontinued if WBCs fall below 2,000*
clozapine (Clozaril) atypical antipsychotic
this medication has the potential to suppress bone marrow and cause agranulocytosis; fatal side effect in 1-2% of patients
clozapine (Clozaril) atypical antipsychotic
carafate
coats the stomach -give 1 hr before or 2-3 hrs after
Mini-Mental Status Examination (MMSE) meausres
cognitive function
The infant has mottling of the skin and acrocyanosis with irregular respirations of 60
cold stress
Due to lifestyle factors, such as crowded living situations, bar patronage, active or passive smoking, irregular sleep patterns and sharing of personal items, college students living in residence halls are more likely to acquire meningococcal disease than the general college population.
college students living in residence halls
Diet high in fat and low in fiber risk for ___ cancer
colorectal (another risk factor is age over 50)
pt with seizure disorder has reddish-brown urine, and the patient complains of constipation.
common occurrences with *Dilantin*; may turn urine pink, red, or reddish-brown, and is a harmless effect; constipation or diarrhea may occur
what type of activities can a psych pt in manic phase NOT participate in?
competitive games
door locks for Alzheimers
complex-any stage up high-middle stage (can't look up anymore)
____ used to identify extent of a brain injury, including intracranial bleeding and presence of lesions requiring surgery, such as epidural or subdural hematomas
computed tomography (CT) scanning
provides three-dimensional assessment of the lungs and thorax; if client is claustrophobic, scan may cause severe anxiety; must lie still for half an hour
computerized axial tomography (CAT or CT scan)
The nurse cares for a client hospitalized for treatment of uncontrollable aggressive impulses. MOST important for the nurse to record before beginning a behavior modification plan?
concrete evidence of aggressive behavior
elastic adhesive strip should be wrapped in a *spiral* pattern without overlapping onto itself to ensure circulation to the penis is not impaired; tape should be snug but not too tight
condom catheter
3 types of hearing loss
conductive, sensorineurial, mixed (sensorineurial not fixed by hearing aids)
Besides typical s/e like diarrhea, hepatotoxicity, & superinfections, what is one s/e that erythromycin and cleocin (macrocodes) that are not found in other antibiotics?
confusion (coumadine and theophyline are affected by these antibiotics)
Talipes equinovarus
congenital deformity detected at birth; foot twisted out of normal position, clubfoot
a fistula is an abnormal
connection
s/e of iron is
constipation dark colored stools
The shorter word miotics short is small makes pupils ___
constrict
A client diagnosed cellulitis of the left calf infected with group A streptococcus requires ___ precautions until 24 hours after initiation of effective therapy
contact
MRSA required ___ precautions
contact
changing draining abscess requires ___ precautions
contact
respiratory syncytial virus (RSV) is ___ precautions, wear ____, and remove them ___
contact gown & gloves before leaving the pt's room
acute viral infection; requires ___ precautions
contact precautions; assign to private room or with other RSV-infected children
rotavirus is spread by fecal-oral route and requires ___ precautions if client is diapered or incontinent
contact; private room by nurse's station
how do you know a feeding tube is in the right place?
contents aspired have acidic pH of 3
____ ; keeps urine flowing and prevents formation of clots that can lead to obstruction and spasm in the postoperative TURP (transurethral prostatectomy) client
continuous bladder irrigation (CBI)
respiratory syncytial virus (RSV) __ precautions
contract; sleeping accommodation for child's parents
Hand-washing helps the client avoid undesirable thoughts and maintain some ___ over guilt and anxiety.
control; compulsive behavior is an unconscious attempt to control and/or relieve the tension and anxiety the client is experiencing.
delivers a set volume at a set rate; does not allow patient-initiated respirations
controlled ventilation
priority in a crisis is to determine how the client usually ____; assessment should be focused
copes
some materials (__ __ __) can result in intense inflammatory reaction
copper, iron, steel
Nitroglycerin is a ____; given to treat ____
coronary vasodilator angina
An 8-year-old has been receiving chemotherapy for 6 months. During her nursing care she asks, "Am I going to die?"
correct to answer pt: "are you afraid of dying." ("We won't leave you alone" is not good because ignores pt's question)
converts proteins and fat into glucose is the action of
cortisol
Vitamin E will increase effectiveness of ___
coumadin
kid with glass in the eyes; mom calls the nurse
cover loosely and go to hospital
formulas that use enzymatic hydrolysis to break down or predigest the casein protein into its amino acids are recommended for infants with ___ allergies
cow's milk
normal ___ is 0.7 to 1.4 mg/dL normal ___ is 7 to 18 mg/dL
creatinine BUN
Appropriate to wear backpack and check rubber tips when using ___
crutches
a disoriented, confused client who is unable to care for himself will require ___ from the nurse in order to eat; goal is for client to feed self
cues
weight gain moon face purple striae osteoporosis mood swings susceptibility to infections
cushing's syndrome
A=Artery. Ace Inhibitors ____ BP by affecting the arteries.
decrease
B = BEATS so Beta blockers
decrease BP by working in the HEART
Pt with rheumatoid arthritis, when inflammation is severe, ____
decrease the number of repetitions of the exercise; consistency is important to maintain joint mobility
Place a heating pad on the client's feet is contraindicated for ___
decreased circulation
Heart failure diet is
decreased sodium
magnesium toxicity __ respirations
decreases
Enablex
decreases bladder spasms (anti-spasmodic)
The nurse knows that the purpose of the cuff on the tracheostomy tube includes
decreasing chance of aspiration; seals trachea
eye surgery or brain surgery should __ but not ___
deep breathe not cough
Antacids _____ of other meds
delay absorption
can't predict exact time of ___ but can speculate based on Friedman's labor curve
delivery (1-1.2 cm/hr)
SHARE will provide you with the opportunity to get support when
delivery of a stillborn; lost a newborn, miscarriage
5 stages of grief
denial anger bargaining depression acceptance
Bronchoscopy pt removes ___ prepars for ___ after procedure
dentures sore throat
antconvulsants s/e
depress bone marrow leukopenia thrombocytopenia anemia monitor ambulation, i&o, cbc
Difficulty in decision-making, preoccupation with self, distorted perceptions
depression
a regular daily routine of scheduled activities provides structure and decreases the problem solving; participating in activities will increase self-esteem
depression
MAOIs two uses three examples
depression, chronic pain Marplan, Parnate, Nardil
An ice storm paralyzes a community during the night. The two nurses on a 24-bed medical/surgical unit learn that it will be 12 to 15 hours before they can expect the next shift to arrive. priority is ___
determining treatments and medications that are vital to the well-being of the clients
Bronchodilators may aggravate ____
diabetes
low specific gravity (1.001 and 1.005) is characteristic of _____
diabetes insipidus
HTN high triglycerides low HDL (risk factors for __)
diabetes type 2 *key points teaching*
____ must remain in the vagina at least 6 hours after intercourse; before insertion place 1 tsp spermicidal gel around rim and in the dome
diaphragm
should be rechecked for correct size annually, after childbirth, and if the client's weight has changed by more than 15 lb
diaphragm
0.5 load 0.2 daily maint
digoxin
___ is a med that slows the heart; potential s/e are bradycardia and asystole
digoxin
____ is a great concern in the presence of diarrhea or any circumstances that lead to alteration in fluid and electrolytes.
digoxin toxicity (Confusion and reports of yellow halos around lights)
Mydriatics ___ the pupil and are used in
dilate -diagnostic procedures -acute irititis -uveitis
Meningitis room lights
dim-photophobia
Hydralazine hydrochloride (Apresoline)
direct vasodilator
___ (shifting of emotion concerning person or object to another neutral or less dangerous person or object)
displacement
should avoid seeds, nuts, corn, popcorn, cucumbers, tomatoes, figs, strawberries, and caraway seeds
diverticulosis
____ is indicated for correction of hemodynamic instability as a result of shock
dopamine
______ is indicated for correction of hemodynamic instability as a result of shock monitoring ____ provides most appropriate information regarding effects of drug
dopamine vital signs
Central venous pressure is of no benefit when evaluating whether pt responding well to ____.
dopamine (cariac output is more appropriate)
The_____ is located on the top of the foot in line with the groove between extensor tendons of the great toe and the first toe.
dorsalis pedis
child ear drops
down and back
post test thoracentesis check site for
drainage (sterile dressings to site)
The student nurse releases manual pressure on the drainage evacuator after the plug is in place, and the unit rapidly inflates. (what's wrong here?)
drainage evacuator (jackson pratt) rapidly inflating means there's an air leak. Compress unit again and check plug for secure fit.
Meningitis is __ precautions
droplet
influenza: ____ precautions used for organisms that can be transmitted by face-to-face contact; door may remain open
droplet
Rubella (Viruses) require __ precautions
droplet (mask)
maintain spatial separation of 3 feet between client and visitors and other clients, door may remain open
droplet precaution
The nurse cares for clients in the outpatient clinic during an outbreak of the flu. The nurse notes many family members accompanied clients to the clinic. Several of the family members appear to have a dry cough and runny noses
droplets; Instruct the coughing family members to sit at least 3 feet way from others.
assessment; check temperature, color, sensation; immediate nursing care for plaster cast: don't cover cast until ___ (48 hours), handle with palms, not fingertips; don't rest on hard surfaces; elevate affected limb above heart on soft surface until dry; *don't use heatlamp*; check for blueness or paleness, pain, numbness or tingling sensations on affected area; if present, elevate casted area; if it persists, contact physician; *child should remain ____ while cast is drying*
dry inactive
anticholinergic effects
dry mouth, urinary retention, blurred vision
the umbilical cord stump of a 5 day old infant should look how?
dry with no redness
Pts with ___ should lie down for 30-60 min or sit in a recliner after meals
dumping syndrome
_____ulcers have an increased association with clients who experience increased psychological pressures
duodenal
antacids are given to ____ ulcer clients
duodenal
clients with ____ ulcers experience pain after meals
duodenal
pain two to three hours after meal during night prior to ingestion of food
duodenal ulcer
Carafate for __ s/e
duodenal ulcer -constipation -vertigo -take 1 hr after meals -take 2 hrs before/after other meds
pts with hiatal hernia will complain of ___, ___, & ___
dyspepsia regurgitation heartburn
pacemaker inserted to treat _____ ____ useful to treat heart failure, hypertension, or cirrhosis
dysrhythmia
s/e of adrengerics (adrenaline, epinephrine, norepinephrine, dobutamine)
dysrhythmias, tremors, anticholinergic effects (dry mouth, urinary retention)
PVCs are ___ can be caused by ___
dysrrhthmias hypokalemia
muscle spasms of any muscles of the body -____ reaction
dystonic
____ should be at room temperature; hot or cold solutions could be painful and cause nausea and vertigo
ear solutions
A client receiving digoxin (Lanoxin) complaining of nausea and vomiting.
early effects of digitalis toxicity
a slowing early in the contraction, and is usually a normal finding.
early fetal decelerations
pt taking digoxin begins to experience diarrhea
early signs of dig tox
Why is this patient priority?: The restrained driver who has faint discoloration around the umbilicus and complains of abdominal pain.
ecchymosis around the umbilicus or in either flank indicates retroperitoneal bleeding
A woman at 6 weeks' gestation who complains of left lower quadrant abdominal pain and vaginal spotting
ectopic pregnancy-priority; life threatening
A child with clusters of small, erythematous, intensely pruritic papules in the antecubital space.
eczema
asthma or hayfever can be seen in kids with
eczema (not contagious)
in the primipara woman, ___ occurs before descent and dilatation
effacement
aspirin alcohol sulfonimides oral birth control MAOIs increase ___ therefore increase ___
effects of antidiabetic meds risk for hypoglycemia
The influenza vaccine is contraindicated if the client is allergic to ___
eggs
only contraindication to the flu vaccine is an allergy to ____
eggs
What age group greatest factor for developing pneumococcal infection?
elderly
reduced gastrointestinal motility due to decreased muscle tone, decreased exercise; other factors include prolonged use of laxatives, ignoring urge to defecate, side effect of medications, emotional problems, insufficient fluid intake, and excessive dietary fat
elderly pts constipation
shoes with THIN, nonslip soles are safest; avoid slippers and athletic shoes with deep treads
elderly with fall risk
monitor __ and __ in menengitis
electolytes and urine specific gravity
___ is indicated for severe depression and catatonic conditions after medications have failed to improve conditions
electroconvulsive therapy (ECT)
osteoporosis is an ___ imbalance
electrolyte
this position improves circulation to the brain and vital organs without increasing workload or impairing respiratory effort in case of shock
elevate lower extremities
____ is a s/e of immunizations
elevated temp
the patient appears restless and complains of difficulty breathing. The nurse notes bibasilar crackles on auscultation of the patient's lungs. Which of the following interventions should the nurse perform FIRST?
elevating the head of the bed maximizes respiration while stopping the infusion prevents further overload and progressive complications
reaction of significant others to a rape victim
emotionally distressed and needing assistance
pt postoperative with an epidural catheter in place takes priority over pt post coronary artery bypass graft because ___
epidural pt is unstable with pain that's why epidural is in place
drug? Prepares the body for "flight or fight."
epinephrine
Anaphylaxis meds start with ___ then you may later use ___
epinephrine antihistamine
dilated veins in submucosa of lower esophagus
esophageal varices
pt taking Fosamax experiencing abdominal pain
esophagitis; contact physician
Sengstaken-Blakemore tube
esophagogastric tamponade for esophageal varices
nausea at breakfast time is common s/e of ___ , subsides after weeks of med use; take after eating to reduce incident
estrogen
time of concern for hypoglycemia if giving ultralente
evening that day or morning next day
how often is blood drawn to test for Lithium serum levels?
every 2 weeks
During CPR, check for a return of the client's pulse after ____ by the nurse.
every minute
How often should a newborn be bathed?
every other day or twice a week for first 2 weeks
client complaining of "burning with urination; assessment will include
examining urethral meatus and vaginal introitus
diagnosis of heart failure, pt is fluid volume ___
excess (should be on fluid restrictions)
Fluid volume excess BP VS Fluid volume deficit BP
excess-bounding pulses, HYPERtension deficit-tachycardia, HYPOtension
Asthma wheezing occurs with ___
expiration
guy wearing a sweater slips and falls hard. He gets up with a grimace and says "I think my arm is broken." What is the first step?
expose the extremity by cutting away any clothing; if any bleeding noted, apply direct pressure to the area
antipsychotic drugs: high potency means more ___ s/e and less __ s/e
extrapyramidal histamine (sedative)
Hemorrhagic shock elevate
extremities 12 inches *(NOT HOB!!!)*
Tearisol Liqufilm Visine Timoptic are used for ___ and cause ___
eye irritation vaso constriction
Non-Penetrating eye abrasion
eye patch 24 hrs
medications can cause client to be drowsy or light-headed, which can contribute to ____
falls
In the elderly, blood glucose monitoring is preferred over urine testing for glucose because the renal threshold for glucose is elevated in the elderly leading to _____ readings resulting in ___ glucose levels.
false-negative elevated
mantoux test for HIV pt will result in
false-negative (pt doesn't have immune system to elicit a response)
Hydralazine hydrochloride (Apresoline) 10 mg IV.
fast acting anti-hypertensive
Cholesterol testing for atherosclerosis should be done while pt is
fasting
___ is a useful guide in gauging activity tolerance in patients with decreased cardiac output; cardiomyopathy is subacute or chronic enlargement of heart
fatigue
Angiography done via __ artery
femoral
diabetic mother; newborn baby's insulin needs
fetus produces increased insulin to match mother's increased glucose level during pregnancy; infant continues to have high insulin output after birth, resulting in hypoglycemia
lecithin/sphingomyelin (L/S) ratio by an amniocentesis is a test that will evaluate the ____.
fetus's lungs
In infection ___ is absent in 25-30% of elderly pts
fever
Diverticulum associated with poor __ intake
fiber (put on high fiber)
hypothyroidism requires high ___, high ___ foods to prevent constipation
fiber cellulose
if insulins are to be mixed, the regular or short-acting insulin should be withdrawn ___ and then the NPH or intermediate-acting; "1" and "2" will remind of the order in which the insulins should be withdrawn
first
B/P of 90/60 and skin is hot and dry to touch
first stage of diabetic ketoacidosis
lab tech draws specimen and drops of blood are then seen on the floor and wall next to needle container
first-call housekeeping to clean and disinfect second-report to nurse manager
The chest on the affected side is pulled inward during inspiration and bulges outward during expiration.
flail chest
probably having PTSD flashbacks; when combat veteran is having a flashback, she/he is psychologically in a war zone reliving a trauma as if it were occurring now and may misidentify people as a threat; maintain a safe distance and limit stimuli. calm, slow approach is useful when client is diagnosed with PTSD, but not during ____
flashback
Post test positioning for lumbar puncture
flat 4-12 hrs
Lung biopsy performed with
floroscopy
The fluid in the water seal chamber should ___ with the respirations of the patient, rising with inspiration and falling with expiration;
fluctuate
will see increased pulse rate with thready quality, decreased BP, fever, and increased rate and depth of respirations
fluid volume deficit
-client has difficulty breathing in supine position or with minimal activity -skin is pale and cool with pitting edema -decrease LOC and moderate ascites
fluid volume overload
sedative/hypnotic used for short-term management of insomnia; side effects include confusion, daytime drowsiness, blurred vision
flurazepam (Dalmane)
why encourage PO fluids after CAT scan?
flush dye (also monitor kidney)
The nurse cares for a client who has been raped. Priority action is
focus on the here and now (assist client to identify immediate needs and concerns)
A client at 12 weeks' gestation needs supplementation with ____ to prevent neural tube defects in the fetus
folic acid (vitamin B9)
Aldomet Catapres
for HTN (Centrally Acting Alpha Adrenergics) they act on cns
Parallel play describes play
for a toddler
c-reactive protein measures
for inflammation
Sinemet (carbidopa-levodopa) Parlladil Artane Cogentin L-Dopa
for parkinson's disese
____ is the most appropriate conflict management technique; enables nurses to exchange information; client care takes priority over interpersonal conflict
forcing (if two nurses are arguing while doing report tell them to please lower ur voices and finish it)
The leg appears to be shortened and is adducted and externally rotated.
fractured hip
after tonsillectomy nurse tells mom to watch child for
frequent swallowing (excessive bleeding)
boggy uterus deviated to right indicates ____
full bladder, encourage client to void
client diagnosed with degenerative joint disease; pt shoudl place joints in their ____ position to maintain joint mobility.
functional
what surgery for hiatal hernia?
fundoplication
Steroids can cause ___ infection in mouth and throat
fungal
Histoplasmosis, candidiasis, & oral thrush are all ___ and treated with what 2 drugs?
fungi *Antifungals:* Amphotericin B Nystatin
fat-free meal is associated with a ____ series
gallbladder
can have direct hypoglycemic effect; may potentiate action of diabetic drugs; information should be reported to physician
garlic capsules
Cucumbers, broccoli, and beans are high in ___ and should be avoided in a pt who just was just diagnosed with ___
gas cholecystitis
food may cause nausea or vomiting in ___ ulcers
gastric
pain one half to one hour AFTER a meal
gastric ulcer
which ulcer type is seen in both males and females?
gastric ulcer
Nausea and vomiting BEFORE abdominal pain frequently indicate ____
gastroenteritis
Cluster of painful blisters; may have difficulty voiding; recurrence during times of stress, infection, menses
genital herpes
decreased hearing and vertigo occur as a result of involvement of the eighth cranial nerve, which is caused by ___ toxicity.
gentamicin
in MS, a spastic leg should be
gently rotated in the direction it is being pulled and then gradually rotated in the opposite direction, which is usually outward since spasticity usually is into an adducted position; these rotations are repeated, going a little farther each time
ultrasound detects the _____
gestational age
The home care nurse visits an elderly client 1 day following a colonoscopy. The daughter states that her mother has been confused since coming home from the procedure
get VS
____, a very long acting insulin, has continuous effect with no peak
glargine
Cogentin anticholinergic for parkinson's and is c/i with ___
glaucoma
Timolol treats
glaucoma
mydriatics (Atropine, Ephedrine) dilate pupil; and are contraindicated in
glaucoma
pts with ____ return to the clinic for periodic tonometer readings 1-2 times a year
glaucoma
Elevated serum antistreptolysin O (ASO) titer indicates
glomerulonephritis
inflammation of glomeruli caused by immunological response and is not hereditary
glomerulonephritis
_______ indicated for *severe* hypoglycemia *or if client not able to take oral fluids* (unconscious)
glucagon *(severe <35)*
Hypoglycemic agent (how does it work?)
glucagon (stimulates liver to change glycogen to glucose)
s/e of ____: -infection -masks infection -insomnia -hypoglycemia -hyperglycemia -hyokalemia -DEPRESSION -PSYCHOSIS -STUNTED GROWTH
glucocorticoids (don't discontinue abruptly)
Decadron Prednisone Hydrocortison stimulate formation of ____ used in ___
glucose -Addison's disease -Crohn's disease -COPD -Leukemias
client with four school-aged children. The client is diagnosed with severely disabling migraine headaches. Which of the following instructions by the nurse is MOST appropriate?
go to bed at the same time every night
Why do antibiotics cause fungus?
good bacteria killed by antibiotics keeps fungus in check
A client had a kidney transplant yesterday, and the client's son has come to visit. The nurse should instruct the son to do which of the following?
good hand washing
Tai Chi good or bad for elderly pts with risk of falling?
good-exercise helps balance
Inborne error in purine metabolism
gout
high purine foods increase incidence of ___; foods include organ meats, meat soups, gravy, anchovies, sardines, fish, seafood, asparagus, spinach, peas, dried legumes, wild game
gout
Cochicine Allopurinol Probenecid are used to treat ___ and function by decreasing production & resorption of ___
gout uric acid
What causes visual changes in diabetes?
gradual destruction and degeneration of retina (vessel damage and edema)
what is considered hyperactive bowel sounds?
greater than 30 sounds per minute; indicates increased motility due to gastroenteritis, diarrhea, and laxative use
most effective therapy for abusive spouses
group therapy
s/e of viagra, levitra, cialis
h/a hypotension priapsm (do not take with grapefruit juice-(lipitor&anticonfulsants) either) or if taking nitrates, alpha blockers)
If overweight, should lose how much per week?
half pound to one pound
major side effects of ____ include hematologic problems, primarily blood dyscrasia and extrapyramidal symptoms (EPS)
haloperidol (Haldol)
Using crutches, the weight of the body is transferred to the ____
hands and arms
_____ is the single most effective technique for preventing infection transmission on burn units
handwashing
Lumbar puncture; why order oral analgesics?
head ache (check site for drainage also)
Pt shouldn't c/o __ after an epidural.
headache
the straps of the Pavlik harness may require adjustment every 1-2 weeks because of infant's growth by ___; some harnesses are not removed, even for bathing
health care prof
2 things to monitor in auditory impairment
hearing & falls (vertigo)
low sodium diet useful to treat __,__,&__.
heart failure hypertension cirrhosis
APGAR: 2 points given for each of the following four categories:
heart rate muscle tone respiratory effort reflex irritability skin (Appearance Pulse Grimace Activity Respirations)
used to identify an *undesirable* effect of dopamine
heart rhythm
Hypotension, tachypnea, tachycardia, temp of 105°F, skin hot and dry, bizarre behavior, confused, delirious, comatose
heat stroke
anhydrosis (absence of sweating or diaphoresis) is usually present in _____, so skin is hot and dry
heat stroke
elderly female diagnosed with peripheral arterial insufficiency. Nurses teaches to apply a
heating pad to abdomen once daily (causes reflex vasodilation of extremities)
____ reaction to blood transfusion is hypotension, chills, low back discomfort
hemolytic
signs and symptoms of a ___ reaction include chills, headache, backache, hypotension, fever, & dyspnea
hemolytic
children MOST at risk for crippling knee and joint deformities?
hemophilia
A distended bladder puts a post partum pt at risk for
hemorrhage
A client 10 hours postop after a right mastectomy complaining of wet sheets under her back may indicate ____ and therefore ___
hemorrhage from operative site pt unstable
You're most likely to contract ___ from contaminated food or water or from close contact with someone who's already infected. Mild cases don't require treatment, and most people who are infected recover completely with no permanent liver damage.
hep A-wash hands
Protein restricted if imending
hepatic coma
____ is a form of viral hepatitis transmitted by the fecal-oral route; standard infection control procedures are sufficient unless patient is diapered and incontinent, in which case contact precautions are required
hepatitis A
Complaints of awakening at night with heartburn. Classic symptom of
hiatal hernia
diet for pt with deep partial thickness burns of the legs
high protein (the answer choice with most # of items w/protein)
impaired intestinal absorption due to cystic fibrosis necessitates a diet ____
higher in protein and calories; fat is decreased because it may interfere with absorption of other nutrients
lying prone prevents ____; wrap stump with elastic bandage to shape; reduce edema and keep dressing in place; encourage client to roll from side to side
hip contracture
after hip replacement surgery avoid
hip flexion of more than 40 to 60° do not bend over, no crossing legs
tamoxifen (female s/e) testosterone (male s/e) are ____ agent used to treat ___ s/e? n/i?
hormonal cancer -bone pain -hypercalcemia (monitor calcium) -leukopenia (check cbc unique)
Besides oral contraceptives being used for birth control they are used for
hormonal control
sengstaken-blakemore tube irrigated
hourly
humidification of a stoma should be provided with _____
humidifier or nebulizer
during sickle cell crisis, ____ is most important
hydration
confusion is a sign of ___thyroidism
hyper
demyelination of motor nerve fibers causes __reflexia
hyper
constipation depressed reflexes decreased muscle strength
hypercalcemia
could cause decreased deep tendon reflexes (DTRs)
hypercalcemia
____ causes hyperglycemia; other symptoms include fatigue, weakness, osteoporosis, cramps, edema, hypertension, decreased resistance to infection, truncal obesity, buffalo hump, moon face
hypercortisolism
Glucosuria, osmotic diuresis, loss of water and electrolytes
hyperglycemia
Besides buffalo hump, what imbalances are seen in cushing syndrome?
hyperglycemia & hypernatremia (hypersecretion of adrenal)
symptoms of ___ include nausea, fatigue, muscle weakness, tingling sensations, slow heartbeat and weak pulse. When severe can result in fatal cardiac standstill (heart stoppage).
hyperkalemia
signs of pre-eclampsia (Eclampsia is ___)
hypertension proteinurea swelling (seizures)
propanolol treats
hypertension; antianginal, reduces cardiac oxygen demand
A 54-year-old with a history of hypertension complaining of headache and blurred vision. (why priority?)
hypertensive crisis
A solution that contains more dissolved particles (such as salt and other electrolytes) than is found in normal cells and blood.
hypertonic
too much magnesium sulfate does what to reflexes?
hypoactive DTR
Trousseau's sign
hypocalcemia (tetany)
BP meds can mask a diabetic pt's __.
hypoglycemia
Inderal may mask symptoms of ___, removing your body's early warning system."
hypoglycemia
headache, lightheadedness, slurred speech, impaired coordination, confusion, & tremors
hypoglycemia
s/e of insulins
hypoglycemia
Chronic use of laxatives can cause ___
hypokalemia
____ can precipitate digoxin toxicity
hypokalemia
what potassium imbalance with metabolic alkalosis?
hypokalemia
chronic alcohol use is the most common cause of ____, which may result in cardiac arrest; manifestations include increased neuromuscular irritability, tremors, tetany and seizures
hypomagnesemia (<1.5 mEq/L)
Addison's ___natremia (everything is low except ___)
hyponatremia (potassium, causes hyperkalemia)
Irritability is seen in ____
hypoparathyroidism
s/e of beta blockers
hypotension bronchospasm *changes in heart rate*
Auscultating breath sounds important action but priority is to determine if client is ____ due to spinal anesthesia after surgery
hypotensive
Intolerance to cold is seen in
hypothyroidism
-Synthroid -Liothyronine
hypothyroidsm, Grave's disease
body responds to early ____ by adrenergic stimulation; vasoconstriction compensates for loss of fluid (cool clammy skin, tachypnea)
hypovolemic shock
FHR 120-160 beats/min.; tachycardia (above 160) early sign fetal ___
hypoxia
increase in the respiratory rate and tachycardia are early signs of ____
hypoxia
When are drains used in amputations?
if soft dressing used
in severe colitis cases __ may be needed
ileostomy (stool will be liquid)
clients are prone to orthostatic hypotension in the ____postpartum time period; should not ambulate independently____
immediate the first time out of bed after delivery
in a possible spinal cord injury priority is
immobilize pt's neck and spine
split-thickness autograft to a burn on the right arm; priority is
immobilizing graft (takes 7-10 days to adhere)
Sandimmune (cyclosporine) is an ___ used for __
immunosuppressant prevention of organ transplants
pt on (Sandimmune-cyclosporine) is
immunosuppressed (don't handle raw meat, dirt..)
A patient at 37 weeks' gestation with pregnancy-induced hypertension and epigastric pain indicates ____, prepare for ___
impending seizures delivery
____ is caused by Staphylococcus and Streptococcus ; untreated, can cause acute glomerulonephritis; periorbital edema indicates poststreptococcal glomerulonephritis
impetigo
fluid-filled vesicles, honey-colored crusts, and reddened areas around mouth and axillae
impetigo
The home care nurse performs an assessment of a client diagnosed with pneumonia secondary to chronic pulmonary disease. Which of the following nursing goals is MOST appropriate?
improve the quality of ventilation-refers to levels of carbon dioxide and oxygen
How does pt store insulin?
in a cool place; does not have to be refrigerated
young children typically become restless and overactive if ___; grimacing, clenching teeth, rocking, and aggressive behavior may also be observed
in pain
intracapsular cataract extraction of the right eye should lie
in semi-Fowler's position or on the nonoperative side
Implementation for gout:
inc fluids low purine diet no fish or organ meats
using the__ indicates teen can breathe without pain; nurse can measure effectiveness of respiratory efforts; Harrington rod is inserted to fuse spine to treat scoliosis
incentive spirometer (teen refusing pain med is not measurable for pain assessment)
effects of aminophylline include ___(take__)
include nervousness, nausea, dizziness, tachycardia, seizures (food or full glass of water)
drugs for hypothyroidism ___ metabolic rate
increase
how will diabetic pregnant woman's insulin needs change after delivery?
increase insulin need during pregnancy decrease insulin need after delivery
Fluids in gout
increase; 2000-3000 mL daily; urine excretes gout
High-pitched cry in an infant is a sing of
increased ICP
total replacement of the right hip pt complains of ___ is priority
increased hip pain (dislocation of prothesis)
changes in level of consciousness, increasing drowsiness or difficulty arousing the client are initial signs of _____
increased intracranial pressure
fontanelle should feel soft and flat; fullness or bulging indicates ____
increased intracranial pressure
high-carbohydrate diet ____ uric acid excretion
increases (good diet for gout)
action of cardiac glycosides such as digoxin
increases force of myocardial contraction
Two minutes after epidural initiated B/P 80/48. Turned to left side
increases placental perfusion
____ intraocular pressure; causes retina to re-detach; first week avoid rapid eye movements: reading, writing, closer work such as sewing; avoid stooping or straining at stool; use proper body mechanics
increases; retinal detachment surgery
Place the child in a supine position with arms to the side, and elevate the foot of the bed. This is useful for_____
increasing venous return in peripheral vascular disease (PVD)
Pt with fruity breath smell complaining of thirst.
indicates *metabolic acidosis from ketosis*
A client with a blood urea nitrogen (BUN) of 35 mg/dL and serum creatinine of 2.5 mg/dL.
indicates renal failure (normal BUN 7-18; creatinine 0.7-1.4)
tachycardia, tachypnea, and confusion may be signs of ___ in elderly patients
infection
in the elderly, change in mental status, particularly confusion, is very often the presenting symptom of ____ (__ may be absent)
infection (fever may be absent)
Interstitial Cystitis is
inflammation of the bladder (give calcium channel blocker)
Baker-acted pt for assault is yelling and insulting nurse trying to do admission interview
inform pt you will return in 30 min
Suggests ____ hernia: -bulge in LRQ -Pain at umbilicus down to groin
inguinal
the ____ pulse is midway between the symphysis pubis and antero superior iliac spine.
inguinal
Cred é maneuver used to
initiate urination when there is retention
type of gloves required for inserting foley removing foley
inserting-sterile removing-clean
____ includes shape and configuration of the chest, facial expression, level of consciousness, color and condition of skin, and quality of respirations
inspection of anterior chest
correct sequence during cardiac assessment is ____;
inspection, palpation, and then auscultation
Suction on suction cath is never applied when catheter is ___
insterted
after abdominal surgery pt complains of gas
instruct to ambulate frequently
____ is the only medication that can be given, compatible with TPN
insulin
thyroid replacement meds decrease the effects of ___ & ___
insulin digoxin
____ (excessive reasoning or logic used to avoid experiencing disturbing feelings)
intellectualization
Humulin N insulin is an ____-acting insulin that peaks from ____ after administration; this is when signs and symptoms of hypoglycemia will occur
intermediate 8 to 12 hours
To monitor the oxygen status of the fetus during labor
internal fetal monitor
patient will be on strict bedrest on her back with head of bed elevated no more than 20 degrees; movement is restricted; a Foley catheter is inserted into bladder in order to prevent it from being dislodged by a full bladder or by voiding attempts; severe __ burns can result from a distended bladder
internal radiation implant
____ (incorporation of someone else's opinion as one's own)
internalization
pts are candidates for _____: -cancer of colon -diverticulitis -intestinal obstruction
intestinal ostomies for fecal diversion
The health care provider is able to examine the urinary tract by x-ray.
intravenous pyelogram (IVP)
_____ is a special x-ray examination of the kidneys, bladder, and ureters
intravenous pyelogram (IVP)
if sensitive to ____, patient may develop anaphylaxis; assess for allergy to shellfish, *chocolate, eggs, milk*
iodine
No vomiting occurred after administration of the ____ so must repeat dose in 20 minutes
ipecac
TB drugs; assess for side effects; _____-peripheral neuritis, hepatic enzyme elevation, hepatitis, hypersensitivity; ____-hepatitis, febrile reactions, nausea and vomiting; ____ - optic neuritis, skin rash
isoniazid rifampin ethambutol
extravasation caused by
iv infiltration
____ is a symptom of cardiac tamponade, a potential complication after a CABG caused by blood accumulating around the heart (from bleeding and nonpatent mediastinal tubes) and compressing the myocardium, atria, and ventricles
jugular vein distention
Can give iron prep with ___ but not ___
juice milk (use straw stains teeth)
Kussmaul respirations and lethargy occurs in
ketoacidosis
Kussmaul respirations are associated with diabetic ___; hypoxia and anxiety are associated with _____.
ketoacidosis tachycardia
___ result from fatty acid metabolism, and usually are completely metabolized by the liver; ketone bodies in the urine (ketonuria) are a sign of ketoacidosis which, in pregnancy, is a major factor contributing to intrauterine death
ketones
"Captopril is the best drug for preventing or slowing down the destruction of your ___."
kidneys
"I should bend at the _____, keeping my back straight when I pick things up off the floor."
knees
Why do pts on antineoplastics/antimetabolites (chemo) get tired?l
lack of RBCs (RBCs carry oxygen)
___ should be used on the nipples of breast-feeding mothers only if they encounter problems with nipple dryness/cracking
lanolin
patient diagnosed with bulimia nervosa. Which of the following findings warrant an IMMEDIATE referral to the physician?
laryngitis; at high risk for tracheoesophageal fistula from esophageal tear
two ototoxic drugs
lasix & NSAIDS
____ are correlated with uteroplacental deficiency
late decelerations
no bowel sounds heard in 3 to 5 minutes; indicates _____
late intestinal obstruction
Decerebrate posturing, BP 160/100, pulse 56
late signs of increased intracranial pressure
cross-reactive foods with ___; foods to avoid include *apricots, cherries, grapes, kiwis, passion fruit, bananas, avocados, chestnuts, tomatoes, and peaches*
latex
should be cautious around microwave because leaking radiation can heat it and make it burn (what drug/route?)
leaking radiation can heat the transdermal patch's metallic backing and result in burns
____ hemisphere controls speech, math skills, analytical thinking
left
position on the __ side to prevent aspiration
left
point of max impulse (apical pulse)
left of sternum, midclavicular, right fifth intercostal
appropriate order; loop diuretic that promotes the excretion of excess water; decreases blood volume and pressure in the ____
left ventricle
Call a plumber to set the hot-water tank's thermostat at 100 degrees.
legally blind person
Old pt says: "My food doesn't have taste so I don't eat much sometimes" and "My legs throb when I walk." Which is priority
legs throbbing; could indicate peripheral vascular disease
___ are an economical source rich in protein
legumes (beans)
Normal therapeutic range for serum lithium after treatment
less than 1.5 meq
optimal LDL level
less than 139
A multigravida at 12 weeks' gestation experiencing heavy white vaginal discharge.
leukorrhea caused by hyperplasia of vaginal mucosa, normal finding
____ is an antiarrhythmic
lidocaine
Controls mania
lithium
diarrhea is sign of ___ toxicity along with oversedation, ataxia, tinnitus, slurred speech, and muscle weakness/twitching; stop drug and obtain serum levels when diarrhea present
lithium
drugs: ____ metabolize ____ excrete
liver kidneys
Bumetanide Ethacrynic acid (Edecrin) Furosemide (Lasix) Torsemide (Demadex)
loop diuretics (loops are the BEFT)
Thorazine (__ traditional) Triafon (medium traditional) Haldol (___ traditional)
low high
Complication of Surgery: Embolism ___PaO2 ___PaCO2
low high
Florinef pt's diet (Addison's pt)
low sodium high protein & potassium
patients with Ménière's disease require a ____ diet to ____
low-sodium decrease fluid retention
when both upper and lower GI series are ordered, the ____ series should be done first
lower GI
meningitis diagnosis
lumbar puncture
Should not work in the garden because of joint pain, exposure to sunlight, bacteria in dirt
lupus erythematosus (SLE)
characteristic facial butterfly-shaped rash, which is over the bridge of the nose and cheeks, may be distressing to ___ patient because s/he feels disfigured and embarrassed
lupus erythematosus (SLE)
to ensure client safety, begin assessing client's movement when the client is___then ask client to sit on side of bed, transfer to the chair, and then observe the client's gait
lying in bed
Hgb (men and women)
m:13-18 w:12-16
A flat, red lesion that is nonpalpable.
macule
___ given to preeclampsia
magnesium sulfate
Dexamethasone suppression test may be ordered to determine presence of
major depression
genetic predisposition disorder transmitted as autosomal dominate trait; life-threatening complication of general anesthesia; indications include tachycardia, dysrhythmias, tachypnea, hyperthermia, hypotension; treatment includes *dantrolene sodium (Dantrium)*
malignant hyperthermia
A lesion with an irregular surface and variegated colors. May see shades of red, white, and blue; blue color is ominous; commonly found on upper back and lower legs
malignant melanoma
____ is an osmotic diuretic; increases urinary output and decreases intracranial pressure.
mannitol (Osmitrol)
pt on mechanical ventilator experiencing hypoxemia
manually ventilate with 100% oxygen
Tell the bride-to-be to make a medication and seizure chart is she's worried
may help identify seizure triggers such as alcohol, stress, caffeine, constipation; may be increase in seizure activity during menses
creatinine kinase (CK)
measures muscle damage (used for MI)
Guillain-Barre Syndrome with respiratory distress
mechanical ventilation
if birth asphyxia in newborn you would see
meconium-stained amniotic fluid
___ need 1,500 to 1,800 kcal/day
men
Otitis Media can cause ___
meningitis
Tooth abcesses, mastoiditis, otitis media can result in
meningitis
bulging fontanels and high pitch cry
meningitis
During lung biopsy have client ___ during mid-expiration
mid
stress, mences, bright lights, sleep dep, tyramine (cheese, chocolate, milk) may bring on
migraine headaches
NSAIDS treat __ to __ pain
mild to mod
providing a therapeutic social, cultural, and physical environment.
milieu therapy
kid ingests lead, give ___
milk
client who had coronary artery bypass graft (CABG) ___ incisional pain and tenderness may occur for___ after surgery
minimal 6-12 weeks
When do you elevate cast on a pillow? why?
minimizes swelling, elevated for first 24 to 48 hours, protects from pressure and flattening of cast
Located in the fifth intercostal space at the left of the midclavicular line; located at the apex of the heart; auscultate for S1.
mitral area
Give RhoGAM when mother is ____ and baby is _____
mom-neg baby-pos
The nurse makes patient assignments on the obstetrics unit. Which of the following patients should the nurse assign to an RN who has been reassigned to the obstetrics unit from outpatient surgery? 1. A patient at 16 weeks' gestation admitted with hyperemesis and receiving IV fluids. 2. A patient at 26 weeks' gestation in premature labor and receiving terbutaline (Brethine). 3. A patient at 32 weeks' gestation with a placenta previa and ruptured membranes. 4. A patient at 37 weeks' gestation with pregnancy-induced hypertension and epigastric pain.
monitor IV therapy, administer antiemetics and nutritional supplements
The nurse cares for a client receiving glipizide (Glucotrol) and prednisone (Deltasone). What is the priority nursing assessment?
monitor glucose
lack of energy, malaise, sore throat, and fever, headache, epistaxis, and severe sore throat
mononucleosis cauesed by Epstein-Barr
Depakote and Tegretol are ___
mood stabilizers
client with reactive depression has the highest level of physical and psychic energy in the ___
morning
take Fosamax in
morning: fos*AM*ax (if dose missed, skip it)
infant's extremities extend and return to their previous position when the crib is bumped.
moro reflex
The nurse cares for clients on the medical/surgical floor. Because of a staffing shortage, an RN has been reassigned from postpartum. which client gets assigned to that nurse?
most stable client (chronic conditions)
When assessing the infant assess __ last
mouth and ears (so infant won't start crying and mess up ausculation)
order for a fire emergency
move clients away from fire pull alarm close all fireproof doors locate residents
Pancreatitis can be due to ____ infection
mumps
A child with a fever who complains of headache, malaise, anorexia, and an earache when chewing indicates probably ____; communicability greatest before AND after the ____
mumps Swelling Begins
patient diagnosed with bipolar disorder has not eaten breakfast and lunch.
must be addressed immediately
-Ptosis -Diplopia -Muscle weakness that improves with rest
myasthenia gravis
caused by acetylcholine deficiency, transmission of nerve impulses is limited, resulting in difficulty stimulating or initiating muscular movement; muscle weakness increases with exertion; administer medication on time and plan activities to follow medication
myasthenia gravis
client has increased muscle fatigue, needs more assistance toward end of day
myasthenia gravis
The test involves a lumbar puncture with injection of contrast medium, allowing x-ray visualization of the vertebral canal
myelogram
Flulike symptoms, night sweats, elevated temperature, decreased deep tendon reflexes. (could be two things)
narc withdrawal infection (TB)
FHR variability is affected by ___ administration
narcotic (demerol in ex)
Watery eyes, cramps, and tremors
narcotic withdrawal
grape-like swellings in the mucus membranes of the sinuses; may cause obstruction and chronic infections BUT NOT BLEEDING
nasal polyps
discomfort and ___ expected following a cholecystectomy
nausea
27-year-old female diagnosed with type 1 diabetes. Two days after admission, the client begins complaining of severe nausea.
nausea not associated with diabetes; perform comprehensive assessment
What's the deal with metformin (Glucophage) and contrast media surgery?
need to discontiue metformin use 48 hrs prior to procedure; contrast media can cause life-threatening lactic acidosis
A woman returns to her room following a myelogram using Pantopaque, an oil-based dye. It is MOST important for the nurse to take which of the following actions?
need to replace fluid lost with removal of oil-based dye; offer analgesics
if my baby has less than six to eight wet diapers a day,
needs more fluids (should void 5-8 times per day)
neg homan's sign is
neg for thrombosis
allergy to ___ is contraindication to MMR, IPV, and varicella vaccines
neomycin
Platinol (cis*pla*tin) is a
neoplastic
s/e & n/i for thyroid replacement agents
nervousness tachycardia weight loss take in morning monitor pulse/BP monitor weight
unexplained chronic fatigue with nervousness, anxiety, and irritability
neuresthenia
symptoms include sudden high fever, rigidity, tachycardia, hypertension, and decreased LOC
neuroleptic malignant syndrome, which is a serious complication of antipsychotic drugs
does spouse confront pt experiencing anxiety?
no
what of massages, lotions, and powders for pavlik harness kids
no
If pt scheduled to receive lithium and serum level is 1.5, would the nurse give the med?
no (norm is 1-1.5, this next dose would put him over)
Blood tinged outflow during a patient's peritoneal dialysis
no need for intervention; could be menstruation or can also be noted if the client has been lifting heavy objects or exercising
Pulmonary function test ___ 4 hrs before test May withhold ___ (Post op monitor for __)
no smoking bronchodilator meds (Dyspnea)
creatinine test and going to the gym before
no, muscle break down excretes creatinine
Are gloves needed for a stage 1 pressure ulcer? why/why not?
no, skin intact
The nurse knows that which of the following changes in the pattern of urinary elimination normally occurs with aging?
nocturia
Coreg is a nonselective beta-blocker used to treat hypertension and heart failure
nonselective beta-blocker used to treat hypertension and heart failure
drug? Enhances musculoskeletal activity
norepinephrine
Acrocyanosis and edema of the scalp is a ___ finding in a newborn
normal
A harsh, hollow sound is auscultated over the trachea.
normal breathing sounds
A primigravida at 17 weeks' gestation states that she has not felt the baby move.
normal finding for primigravida
Place pressure on the nose using an ice-cold washcloth for 5-10 min
nosebleed
If taking acidic juice (cranberry juice) pt should not be eating almonds, coconut, milk, some veggies) because
not be eating alkaline
radium implant
not handled by RN, only radiology tech
taking temp after rhinoplasty
not orally, pt can breathe through nose
suspected reaction to drugs (even topical iodine) should be reported to the doctor and ____
noted on list of possible allergies
Teaching about food and water temp for Trigeminal Neuralgia (Tic De La Roux)
nothing extremely hot or cold (tepid temp)
In Buck's traction, if injured leg feels less warm than uninjured leg
notify physician
The red reflex is absent in the newborn's right eye.
notify the physician immediately; Indicates an ophthalmic emergency because light is not being transmitted to the retina, and the early suppression of optic nerve function which results from the obstruction of the light can cause blindness
"If I tell you something, will you tell anyone my secret?"
nurse cannot keep secret information vital to safety of the child or others; do not promise to withhold information
Islamic ritual prayer done five times per day
nurse should accommodate this practice to the best of the patient's ability
A client diagnosed with a left-sided cerebrovascular accident complaining of incontinence can be delegated to
nursing assistant
describing returns from the enema is a part of the responsibilities delegated to a ____. The nurse should monitor performance and results according to established goals
nursing assistant
performing a finger stick is within the scope of practice of the ____and the task should be carried out as delegated
nursing assistant (say: "Please page me when you have completed the task.")
The nurse identifies the MOST reliable client measure to evaluate the desired response of diuretic therapy includes
obtaining daily weights
Visual impairments controlled by what part of the brain?
occipital lobe
pt taking prozac misses a dose
omit that dose and continue regular schdule
if gas or oil used to reattach retina, sleep
on abdomen with affected eye down for several days
infant with pyloric stenosis
on abdomen with head turned to side
Post bronchoscopy the pt should sit or lie how?
on their side
irrigating colostomy
once a day; same time
I should discard my first morning specimen, collect all urine for 24 hours, and place the urine in _____
one container
All antacids should be given when in relation to meals and other drugs?
one hour after eating and taking other meds
decreased motility of bowel when auscultation reveals
one or two sounds heard in two minutes
_____ are permitted for 12 hours before plasma cholesterol screening to achieve accurate results
only sips of water (normal diet the week before test)
above-knee amputation (AKA) should elevate leg
only the first 24 hrs
Diamox is for __ monitor for ___
open angle glaucoma -blurred vision, lethargy, depression
beta blockers given for systemic use, such as propanolol and atenolol, can enhance the therapeutic and toxic effects of beta blockers prescribed for ___ use
ophthalmic
____ medication is not recommended in labor because of the decrease in GI motility
oral
In bed with her head elevated 60 degrees and her arms resting on the overhead table is the position for ___
orthopnea
water depletion could also result in falls due to ____
orthostatic hypotension (low fluid-low BP)
Angry bipolar psych pt is able to use phone unless ____
otherwise indicated by court order or physician's order
s/e
ototoxicity anorexia nausea vomiting diarrhea (check 8th CN hearing, renal function, take for 7-10 days, encourage fluids)
critically low hemoglobin indicates less circulating ____
oxygen
hyperthermia increases the ___ requirements
oxygen
breastfeeding causes release of ____
oxytocin
acts to regulate cardiac rhythm; increases cardiac output
pacemaker
hearing aid battery may affect placement of ___; should not be placed under the left clavicle in this client
pacemaker
What would cause a pt with a pacemaker implanted one year ago to feel dizziness with SOB?
pacemaker battery failure decreases cardiac output
body does not respond to significant levels of ___ in two different areas of the body at one time
pain
when assessing a client's response to ____, begin with least noxious stimulation (speak to client) and proceed to more painful stimulation; trapezius squeeze, supraorbital pressure, mandibular pressure, and sternal rub are central stimulation; if no response to central stimulation demonstrating brain function, apply peripheral stimulus to the extremities; client's finger or toe should be braced on nurse's thumb and pencil placed sideways on top of nail bed at base of cuticle and pushed down hard; *use peripheral assessment only on extremity that did not move*
pain
Trigeminal neuralgia causes tic douloureux; treat the
pain (even tegretol which is for seizures will be to treat the nerve pain)
____ should be color of amniotic fluid. Report if __
pale or straw-colored; green or brownish amniotic fluid should be reported
Smooth, symmetrical chest expansion noted by
palpating over anterior chest wall
Clonic jerks in the affected foot can occur in a person who has been
paralyzed from spinal cord injury
Regulates calcium metabolism
parathyroid hormone
2-month-old infant immediately after a surgical procedure. Encourage
parents to stroke infant (tactile stimulation imperative for emotional development)
___ lobe is the primary center for sensation
parietal
mask-like face
parkinson's syndrome
A ____is an instrument that measures the level of air flowing out of the lungs as you blow quickly and forcefully into the mouthpiece. This device alerts you to the narrowing of your airways before an asthma attack happens. Used daily.
peak flow meter
18 yr old male trying to put on weight for football, should he eat more bread in meals or snack on pecans and raisins?
pecans & raisins (bread adds carbs but not cals)
A client at 34 weeks' gestation diagnosed with generalized edema and complaints of epigastric pain
pending eclampsia
client diagnosed with a cerebrovascular accident (CVA). When creating a teaching plan ask the client to Discuss his perception of his health status or Identify the client's strengths and weaknesses?
perception about his health problem
Insertion of ________: -Placed supine in head-low position -Turn head away from procedure -Perform Valsalva maneuver (bear down) -Antibiotic ointment and transparent sterile dressing -Verify position with x-ray
percutaneous central catheter
Diminished reflexes, pain, paresthesia relates to ____ problems
peripheral nerve
common s/e of INH
peripheral neuropathy
Alpha Blockers act on the ___
peripheral vessels (not the heart)
Abdominal pain, rigidity and distention, nausea and vomiting indicate
peritonitis, complication of paracentesis
A client diagnosed with ____needs supplementation with vitamin B12
pernicious anemia.
symptoms are characteristic of an infected residual limb wound?
persistent pain at operative site
This medication is used to treat mental/emotional conditions. It is also used to treat nausea and vomiting
phenothiazine (phenergan)
When is Prednisone given to pt with a bee sting reaction?
phrophylactically
ventricular fibrillation, and the patient is prepared for defibrillation. First?
place gel pads on chest
client with a postlumbar puncture headache
place in *side lying* position (H/A from excessive CSF loss)
pt newly diagnosed with meningitis due to Haemophilus influenza-___ precautions until ____
place on droplet precautions until 24 hours after antibiotics started
symptoms reflect *autonomic dysreflexia*; emergency life-threatening condition which can occur with spinal cord injuries above T6 after spinal shock resolves, which is 1 to 6 weeks after injury; causes include visceral distension and noxious stimuli such as skin pressure, temperature extremes; a primary symptom, and of most major concern, is severe rapid hypertension; other symptoms include bradycardia; *What should be done immediately to help decrease the blood pressure and prevent increased intracranial pressure with cerebral hemorrhage and seizures?*
placing patient in sitting position
risk factors for ___ include advanced age, underlying lung disease, bedridden, and postop
pneumonia
A patient diagnosed with pneumonia; patient increasingly confused and has a temperature of 104°F (40°C). (indicates ____ and confusion can indicate ___)
pneumonia is worse hypoxia
Maintain Pler-evac drainage system required for ___ not flail chest
pneumothorax
Following lung biopsy check x-ray for
pneumothorax (check site for drainage)
If kid swallows mom's medicine administer syrup of ipecac only after
poison has been identified
___ is given at 2 and 4 months and again at 12 to 18 months
polio
s/s of diabetes insipidus
polydipsia polyuria
may indicate elder abuse
poor nutrition and hygiene
Hair thin, dull, and dry indicates
poor nutritional status
greatest risk to develop heart disease
poorly controlled type 1 diabetes
The nurse notes that a client receiving parenteral nutrition (PN) suddenly is dyspneic, diaphoretic, anxious, restless, coughing, and reporting of chest pain. Which action should the nurse take FIRST?
position patient lateral (left side) Trendelenburg
rotate breast-feeding ___; position nipple so that infant's mouth covers a large portion of the ___ and release infant's mouth from nipple by inserting ___ to break suction
positions areola finger
____ sign of pregnancy; palpation of fetal movement; sonogram of fetus
positive
delivers positive pressure during expiration to keep airways constantly open; used with seriously ill patients
positive end expiratory pressure (PEEP).
___ procedures: -incentive spirometery -leg exercises -deep breathing
post op
diaphragmatic excursion percussed on _____
posterior chest wall
____ syndrome; includes pleural pain, elevated white count, dysrhythmias
postpericardiotomy; after coronary artery bypass graft (CABG)
Ace inhibitors cause you to have high ___
potassium
Licorice will pull __ from the body
potassium
Pt should avoid salt substitutes while taking the ___ supplement.
potassium
A 64-year-old admitted yesterday for hypertension, congestive heart failure, and digitalis toxicity with frequent PVCs (premature ventricular complexes). Indicates ____ imbalance
potassium imbalance (hypokalemia); dysrhythmias (cardiac/circulatory problem) can rapidly deteriorate to ventricular tachycardia or sudden death
Amiloride Eplerenone (Inspra) Spironolactone (Aldactone) Triamterene (Dyrenium)
potassium-sparing diuretics (TESA spares the pot)
A multigravida at 32 weeks' gestation experiencing malaise and bilateral dependent and facial edema. Symptoms of ___
pre-eclapmpsia
_____ is a risk factor for early postpartum hemorrhage and also for amniotic fluid embolism
precipitous (rapid) labor-less than 3 hrs
The dosage of ___ will be increased and decreased gradually.
prednisone
____is defined as high blood pressure and excess protein in the urine after 20 weeks of pregnancy in a woman who previously had normal blood pressure. Even a slight increase in blood pressure may be a sign
preeclampsia
epigastric pain is a warning sign of seizures in the client with
preeclampsia
What age learns through play?
preschool
Death is temporary and gradual
preschool child
____ require bedtime rituals that should be followed in hospital; nurse should assess before implementing
preschoolers
A postoperative cataract client is cautioned about not making sudden movements or bending over in order to prevent
pressure on the ocular suture line
Why encourage fluids on post op client
prevent DVT
thermal burns of the eye: before injury___ after injury___
prevention: wear goggles after injury: analgesics
lightening occurs when the fetus settles into the pelvic inlet. Causes increased pelvic pressure. When does it occur? primipara- multi-
primipara-2 weeks before labor multipara-during labor
85% of people with eczema had
prior onset before 5 yrs (resolves by age 3 in half of infants)
apply antiembolism stockings ___ applying the sequential compression device sleeves
prior to
A client is receiving ciprofloxacin (Cipro) and complains of a fine macular rash is ____ over client receiving IV potassium with burning at IV site.
priority
preparing a client for any procedure is ____
priority
a major common adverse effect of ethambutol is optic neuritis, with reduced visual activity; lessened ability to see green is a possible initial sign this would be ___
priority for TB pts on these meds
The mother fails to wash her hands before handling the newborn.
priority intervention; handwashing key to preventing infection.
several workers in a local plant have been exposed to radioactive materials. Which of the following actions should the nurse take FIRST?
priority is to notify hospital administration and then disaster plan will be implemented
A client with an esophagogastric tube inserted
priority; Esophagogastric tamponade: A procedure in which a balloon is inflated within the esophagus and stomach to apply pressure on bleeding blood vessels, compress the vessels, and stop the bleeding. Used in the treatment of bleeding veins in the esophagus (esophageal varices) and stomach
Side effects of chemotherapy
priority; could be reason pt skips chemo that day
A 60-year-old with one episode of fainting
priority; may be the result of an irregular cardiac rhythm or rate change; requires an immediate cardiac evaluation
A patient complaining of frequent small amounts of watery diarrhea with abdominal pain and nausea.
priority—may indicate a possible bowel obstruction that can be life-threatening if the bowel perforates
___ (attributing one's thoughts or impulses to another) displacement (shifting of emotion concerning person or object to another neutral or less dangerous person or object)
projection
reattached retina sleeping position
prone
full-thickness burns of the right leg (meal)
protein and increased calories
___ & ___ are common with systemic lupus erythematous
proteinuria & hyperlipidemia
once hepatitis immunity has been established, confirmation can be done by
providing copy of results of hep screening
Prolixin treats
psychotic disorders
The patient care technician places personal care items in reach of a patient with stage 2 dementia of the Alzheimer type and then leaves to fill the wash basin with water.
pt at risk for choking
If an inhaler's spacing is making a whistling sound that means
pt inhaling too quickly
Peripheral edema, hypertension, pulmonary congestion.
pulmonary edema
An elderly man who used all his diuretic medication and is expectorating pink-tinged mucus. symptoms of
pulmonary edema; requires immediate attention
infant with ___-irritable and always hungry
pyloric stenosis
hyperuricemia can occur with ____, resulting in acute gout symptoms, such as severe pain in the great toe; this indicates that the drug should be discontinued
pyrazinamide (PZA)-TB drug
how often should pt due incentive spirometry post surgery?
q1-2 hrs
after a cardiac catheterization using the brachial artery determine the presence of the ___ pulse bilaterally
radial
The nurse cares for a client with an internal radium implant. It is MOST important for the nurse to take which of the following actions?
radiation (limit time spent in pts room)
As you lower the blood pressure, you are going to ___ the pulse unless ___
raise med given to lower pulse
Why is it wrong for the anorexic female pt to say this: "The faster I gain weight, the faster I will be able to return to school."
rapid weight gain can put undue stress on the heart, which already has diminished output from starvation; needs slow, steady weight gain of no more than 2 lb per week
___ (attempt to make behavior appear to be the result of logical thinking)
rationalization
_____ (development of conscious attitudes and behavior patterns into opposite of what one really wants to do)
reaction formation
delusions of ___ are a false belief that public events or people are directly related to the individual
reference
clients with dementia respond better to a routine that is ___
reinforced
tenderness over the liver is a sign of
rejection
Action of nitroglycerine ___ smooth muscle ___ venous return
relaxes smooth muscle decreases venous return
___ nitroglycerine pads prior to putting on a defibrillator on a client.
remove
A Miller-Abbott tube
removes fluid and gas from small intestine
symptoms of ____ include abdominal or flank pain, nausea and vomiting, hematuria, and renal colic (abdominal pain caused by condition)
renal calculi
What's the deal with elevated creatinine and decreased BUN?
renal impairment; no contrast dye
care of a newborn with fetal alcohol syndrome
replace vitamins depleted as a result of poor maternal diet
The right leg is outwardly rotated after a total joint replacement of right hip, shortening of extremity, inability to move it, altered alignment, abnormal rotation, increased pain
report to physician; indicates prosthesis dislocation
The nurse works with a client who has just indicated a wish to kill herself. The client then asks the nurse not to tell anyone. Which of the following responses by the nurse is BEST?
report to staff to protect client
A client diagnosed with meningococcal meningitis requires ___ precautions until __after________.
requires droplet precautions until 24 hours after initiation of effective therapy
insert suction catheter until ___ is met without applying suction, withdraw 0.4 to 0.8 inches (1 to 2 cm), and apply intermittent suction with ___ motion
resistance twirling
Insert the suction catheter until ___ is met, and then withdraw it slightly. Apply suction intermittently as the catheter is ___.
resistance withdrawn
ABG's numbness and tingling
respiratory alkalosis
sengstaken-blakemore tube should be removed if
respiratory distress (disinflate balloon first)
intermittent catheterization only for problems with
retention
resume light work after 3 weeks, normal activities after 6 weeks; no hair washing for 1 week; avoid strenuous activity for 3 months; avoid sneezing, coughing, or straining at stool, bending down
retinal detachment repair surgery
infants are less likely to be allergic to ____ than to any other solid food; usually started between 4 and 5 months of age; breast-fed infants may be started on solids even later
rice cereal
___ position after an infant is fed assists with digestion by allowing the feeding to flow to the lower end of the stomach, as well as facilitates expelling of gas bubbles from the stomach by allowing any swallowed air to rise above the fluid and through the esophagus
right-side
evidentiary specimen collection in criminal or forensic cases. Which are right and which is wrong? 1. "Shotgun wadding, bullets, or head shot projections should be wrapped in gauze and put in a cup or envelope." 2. "It is important to save any gravel, soil, grass, twigs, or glass that are on the victim or on the sheets used for transport." 3. "Swabs of both dry and moist secretions should be air-dried prior to placement in the appropriate container." 4. "The victim's clothing should be carefully removed and put into new, clean *plastic bags*."
right: 1, 2, 3 wrong 4 (clothing should be removed and bagged; however, the bags should be made of paper, not plastic, because bacteria could destroy DNA evidence if plastic bags were used)
Tinea is
ring worms
A lethargic 2-month-old who has refused to nurse for 8 hours is priority because
risk for dehydration & acidosis rate of fluid exchange significantly higher than adult's; metabolism rate twice of adult's; immature kidneys cannot concentrate urine to conserve water
4 risk factors-age greater than 45, Native American, obesity, and family history of diabetes; instruct to reduce calories, maintain low-fat diet, and exercise regularly
risk for type 2 diab
insulin should be given at what temp?
room temp
contagious skin disease caused by mites; transmitted by close contact, either directly person-to-person or via contaminated personal items such as clothing, bedding; requires a private room and contact precautions
scabies
Lice; where found on pt body ___: White eggs on hair shafts ___: Macules and papules ___: Red macules
scalp body pubis
difficulty forming relationships with a marked inability to trust others is the main problem for a client with ____
schizophrenia
provide food in closed containers to prevent the suspicion of tampering
schizophrenic pt thinks food is poisoned so won't eat
Industry vs inferiority
school age
The pulmonic area is located in the ____just to the left of the sternum; auscultate for ___, caused by ____
second intercostal space S2; closure of semilunar valves
antipsychotic drugs: low potency means more ___ s/e and less __ s/e
sedation EPS
EEG post test observe for
seizures
pulling lead out of the body (as with metal antagonists) may cause
seizures
phenytoin (dilantin) treats (caution in__)
seizures (impaired liver function)
Client taking tegretol for ___ and hormonal contraceptives.
seizures -tegretol interferes; should use other form of birth control; increased pigmentation; avoid sun
patients with closed head injury position
semi-fowler's (promote venous drainage dec ICP)
during outbreak of the flu nursing asst shows up with flu symptoms
send home
Tinnitus, vertigo = __ hearing loss
sensorineurial
Meniere's Disease has periods of attacks but remissions can last
several years
Legionnaires' disease is a
severe form of pneumonia — lung inflammation usually caused by infection. Legionnaires' disease is caused by a bacterium known as legionella found in warm, stagnant water like in hot water tanks.
__ contact can spread pubic lice
sexual
shield in pt room being treated with a radioactive implant for vaginal cancer
shield should be placed on hallway side of client's bed to protect caregivers and visitors; do not stand at foot of bed
A client complaining of lightheadedness; nurse notes client is clammy, pulse 112, respirations 28.
shock
ADH deficiency causes the excretion of large volumes of dilute urine; if deprived of fluids, may cause ___
shock
in the first stages of ___ there is decreased urine output, even when there is normal fluid intake
shock
tachycardia and hypotension indicative of ___
shock
indicates flail; monitor for ___
shock give humidified oxygen, manage pain, monitor ABGs
The nurse completes postop teaching for a patient scheduled for a total abdominal hysterectomy.
should be encouraged to perform early ambulation to prevent thromboembolism; cough and deep breath, incentive spirometry; avoid heavy lifting or strenuous activity
A negative Allen test means the radial artery
should not be used for this procedure
Insulin administration while pt is sick
should take usual dose and substitute easily digested foods and fluids to provide adequate nutrition and prevent dehydration
administering an enema position patient
side-lying (Sim's) with knee flexed.
cracked lips, urinary output of 4L/24 hrs with a spec grav of 1.004
signs of dehydration
ileostomy teaching for orthostatic hypotension
sit edge of bed before getting up
pounding headache and profuse sweating are indications of autonomic hyperreflexia; place in a ___ position immediately to decrease blood pressure and reduce risk of cerebral hemorrhage
sitting
basal cell carcinoma
skin cancer
2 yr old immunization common s/e
slight elevation of temperature, localized response at injection site, and increased irritability are anticipated responses, usually occur within a few hours or days of immunization
palpating the carotid pulses together can cause a vagal response and ___ the client's heart rate
slow
Increases force of myocardial contraction and ___ the heart rate (___)
slows (digoxin)
Pt with 20 yr history of asthma comes to ER with acute respiratory distress and he is not wheezing, what does that mean?
small airways completely constricted; pt requires immediate intervention
The nurse expects to see which of the following physical characteristics in fetal alcohol syndrome?
small head circumference, low birth weight, undeveloped cheekbones, small for gestational age, may have feeding difficulties, poor sucking ability, respiratory distress related to preterm birth, neurologic damage, small trachea, floppy epiglottis
pt with hep A has anorexia
small, frequent feedings
What should infant feeding be post op for pyloric stenosis?
small, frequent feedings of glucose water or electrolyte solution for first 4-6 hrs
Eczema: avoid ___ but do apply ___
soap lotion, topical steroids
acute glomerulonephritis may begin with
sore throat and fever (Streptococcus infection)
Pattern of alternating diarrhea and constipation is a condition called ____ during ____ syndrome
spastic bowel disease irritable bowel syndrome
Ensure that the client is adequately hydrated before ____ will prevent hypotensive problems
spinal anesthesia
This position assumed by children with congential heart disease, particularly Tetralogy of Fallot, in an effort to relieve hypoxia, especially when exercising
squatting position with the arms wrapped around the legs
client receiving tissue plasminogen activator (t-Pa) not
stable; anaphyaxis, bleeding
___ precautions used for cutaneous anthrax
standard
infectious mononucleosis ___ precautions
standard
During procedures on a badly burned pt should be
sterile (cap, gown, mask , gloves)
elderly more susceptible to osteoporosis, which is exacerbated by oral ___; encourage exercise
steroids
Reglan stimulates (Also treats..)
stimulates motility of upper GI tract; used to treat nausea of chemotherapy (GERD). Also treats nausea, vomiting, and heartburn caused by a stomach problem called gastroparesis in patients with diabetes
sleeping on the pt's ___ *may minimize spasm of the flexor muscles of the hips and knees* of a person with multiple sclerosis; if these spasms are not relieved, joint contractions will occur as well as pressure ulcers on the sacrum and hips from difficulty positioning the patient correctly
stomach
s/e of penicillins n/i
stomatitis diarrhea allergic reactions renal/hepatic check for hypersensitivity give 1-2 hr ac or 2-3 hr pc cross allergy with cephalosporins
urolithiasis is
stones
client receiving a continuous infusion of heparin. The client's aPTT is greater than 150 seconds
stop heparin notify physician (need order for protamine sulfate)
Red, raised, rough-surfaced, clearly delineated nodules; benign cutaneous capillary tumors which gradually disappear, usually by the first year of life
strawberry hemangiomas
Edema and inflammation of the upper airways (as in laryngotracheobronchitis LBT) are characterized by ___
stridor & restlessness
to go up stairs with a cane advance ___ then ___.
strong leg weak leg and cane
if client has weaker side, transfer toward the ____ side
stronger
___ (diversion of unacceptable drives into socially acceptable channels)
sublimation
client has problems with increased intraocular pressure should avoid
sudden movement when bending over.
diabetic eye and kidney damage complications are caused by blood vessel damage from ____
sugar and fat deposits
males over 50 and adolescents ages 15-19 are at risk
suicide
predisposing factors include males over age 50, age range of 15-19 years, poor social attachments (risk for ___)
suicide
____ used to treat inflammatory bowel disease; increase fluids to prevent crystallization in the kidney tubules
sulfonamides
administer with meals or food; may turn the urine an orange-red color temporarily
sulfonamides (Azulfidine)
Acetazolamide (Diamox) allergy to
sulfunomides
Toxic shock syndrome historically has been associated primarily with the use of ____
superabsorbent tampons
infant may aspirate; place in what positions?
supine/prone semi fowlers
oral contraceptives ____ production of breast milk
suppress
Remove dentures, jewelry, nail polish before
surgery
____ increases the demand for corticosteroids; nurse should monitor vital signs and blood sugar, and check for infection and bleeding
surgery
Psychosis can be a complication of
surgery (laughing, crying, or flat affect)
particles aren't totally dissolved in a ____; need to be shaken
suspension
_____ (something represents something else); It is involved in phobias
symbolization
The nurse notes that a client receiving parenteral nutrition (PN) suddenly is dyspneic, diaphoretic, anxious, restless, coughing, and reporting of chest pain
symptoms indicate air embolism, a central line-related complication related to catheter insertion, tubing changes, or catheter breaking
pt with COPD on O2 at 2L/min experiences SOB & chest pain
symptoms of O2 toxicity
Weight gain of 5 lb, pulse 116, serum sodium 110 mEq/L
symptoms of SIADH (syndrome of inappropriate antidiuretic hormone) opposite of diabetes insipidus
allows for spontaneous breaths at his own rate and tidal volume between ventilator breaths
synchronized intermittent mandatory ventilation (SIMV)
statins interfere with fat ___
synthesis
A papule-like lesion in the vaginal area.
syphillis
side effect of aminophylline; levels above ___ mcg/L are considered toxic; after long-term use, clients may tolerate higher blood concentration; other side effects include hypotension, nausea, vom
tachycardia 20
First thing pt can do to prevent spread of their TB infection
take meds
Most important thing pt must do daily if pacemaker
take pulse
transport team asks for a sign off on MRI from a nurse, the nurse responds
talk with nurse assigned to client
Abnormal Involuntary Movement Scale (AIMS) tests for
tardive dyskinesia (due to long-term antipsychotic meds)
best to teach mother of 4 yr old who began to stutter
tell mother to slow down her speech and talk to her daughter calmly
____ lobe contains auditory center
temporal
Unilateral hearing loss controlled by what part of the brain?
temporal lobe
The nursing assistant spends a half hour in the room of a client with a radioactive implant for vaginal cancer helping with morning care
that's ok
catheter collection bag is attached to ___ and the drainage tubing is brought up through the side rails onto the bed
the bed frame
300 divided by number of big boxes
the heart rate
Trochanter Roll: From ___ to ____
the lateral aspect of the hip the mid-thigh
Synthroid (thyroid preparation should be taken in ____
the morning on an empty stomach 30 minutes prior to breakfast to increase absorption and decrease insomnia
cat presents a toxoplasmosis risk to____ toxoplasmosis is a parasitic disease transmitted in the feces of cats who have eaten infected mice and animals; preventive measures include handwashing after touching cats, have the litter box changed daily (it takes about 48 degrees for the cat's feces to become infectious) by someone other than the pregnant woman, prevent cats from eating raw meat or wild animals, wear gloves when gardening, *do not garden in areas frequented by cats*, avoid undercooked meat and contact with stray animals
the pregnant woman and her unborn/newborn infant
The gallbladder is soley for
the storage of bile
therapeutic range 10-20 mcg/mL; toxicity occurs with levels over 20 mcg/mL; ___ is xanthine-derivative bronchodilator
theophylline
local elementary school notes that several female students have been diagnosed with urinary tract infections (UTI)
they're young (elementary) nurse must teach girls to clean perineum from front to back
2 symptoms of Wernicke's syndrome, form of dementia that results from ____
thiamine deficiency B1 -Diplopia -Nystagmus
Chlorothiazide (Diuril) Hydrochlorothiazide (Microzide) Indapamide Metolazone (Zaroxolyn) Chlorthalidone
thiazide diuretics (HIM, Chlor, & Chloro)
___: -Shave around insertion site -Position with arms on over-bed table or lying on side
thoracentesis
The nurse cares for a patient diagnosed with COPD who is brought to the hospital by EMS for increasing shortness of breath. The patient is placed on a cardiac monitor and an IV access is established. The patient's vital signs are: B/P 130/70, HR 84, RR 26, and oxygen saturation is 100% on 6 L oxygen per nasal cannula. Which of the following interventions should the nurse perform FIRST?
though the oxygen is high for COPD and should be lowered, POSITIONING IS FIRST
medication into an established IV line by IV push
time IV push med with watch
Pt taking aspirin for years multiple times a day. nurse asks about ___
tinnitus
What age more likely to drown?
toddler and preschool age
"I am talking to my daughter who is 2 yrs old about being a big sister once I have this baby."
too young, must be preschool age
shortening of affected leg, leg rotation, soft popping sound heard when affected leg is moved; maintain abduction, use wedge pillow, avoid stopping, do not sleep on operated side until directed to do so, flex hip only 1/4 circle, never cross legs, avoid position of flexion during sexual activity, walking is excellent exercise, avoid overexertion; in 3 months will be able to resume ADLs, except strenuous sports
total hip replacement
flexion is usually limited to 60°for 6-7 days, then limited to 90°for 2-3 months; instruct patient not to sit or stand for long periods of time, do not cross legs beyond midline of body, and use assistive device to put on shoes and socks
total joint replacement right hip
symptoms of ____ in an infant: -drooling -frothy saliva
tracheal-esophageal fistula
___ dressings should not be cut; could leave fibers that would occlude airway
tracheostomy
should not use powder for patient with ___; could occlude airway
tracheostomy
a full bladder is necessary for which test for several reasons?
transabdominal pelvic ultrasound
One day after a coronary artery bypass graft (CABG), the nurse discovers a client sitting in a chair. The client is cold and pale, and responds to loud verbal stimuli. Priority is
transfer client to bed -needs to be reclining in bed
The woman asks for help to go to the bathroom would likely be in the ___ phase of labor
transition
Semi-fowlers used for
tube feedings
Use __ motion when withdrawing catheter
twirling
Diabinese Orinase Dymelor Micronase
type 2 diabetes stimulates pancreas to release insulin
Tagamet and Zantac are used for
ulcers; gastroesophageal reflux
Have client lie on ___ side for ear drops
unaffected
Astigmatism is
uneven curvature of lense
when exiting room, untie gown, remove gloves, remove mask, take gown off working from inside
untie gown remove gloves remove mask remove gown (from inside)
Adult ear ear drops
up and back
mucous plug expelled ___labor
up to 2 weeks before onset of
autologous blood can be given ____ before surgery
up to 5 weeks
How long can PICC lines stay in a patient?
up to 6 months
using crutches, going up stairs-___ going down stairs-___
up-strong leg leads way down-crutches lead then weak leg
NSAIDS & aspirn
use cautiously together (aspirin allergy)
____ a sound made by the blood within the arteries of the gravid uterus.
uterine souffle
Late decelerations occur after the peak of the contraction; result from ____
uteroplacental insufficiency
some unwanted s/e of vitamins
uticaria bronchospasm toxicity
Cord compression causes
variable decelerations
angiotensin 2 causes vasoconstritction. So an ACE inhibitor causes ____
vaso dilation
Angiotensin 2 is a powerful ____ (so Angiotensin 2 blockers work are for ___)
vasoconstrictor pts with HTN
S/e of Minoxidil (?)
vasodilator lowers BP -tachycardia (remember lowers BP raises pulse) -increase in body hair (commercials)
A primigravida at 22 weeks' gestation complains of feeling dizzy and clammy when lying on her back.
vena cava syndrome; instruct client to lie on side
machine is adjusted to deliver lowest concentration of oxygen to maintain normal arterial blood gasses
ventilator
____ is indicated for the treatment of supraventricular tachycardias, so the client's heart rate should be checked prior to administration. (also for hypertension)
verapamil (Calan)
A circumscribed lesion filled with fluid is called a
vesicle
A child with an apparent upper respiratory infection (URI) and an inflamed conjunctiva with swollen eyelids and watery drainage
viral conjunctivitis (pink eye)
monitor ___ & ___ in ocular impairment
vision & exposure to light
The nurse prepares an elderly client newly diagnosed with type 1 diabetes for discharge. The client is alert and oriented and lives alone in her home. It is MOST important for the nurse to assess for
vision and manual dexterity
long term use of estrogen
visual disturbances tinnitus
indicates homonymous hemianopsia (loss of half of the visual field); client neglects one side of body; instruct client to turn head in direction of ____
visual loss
____ is given to prevent the peripheral neuropathy, dizziness, and ataxias that can occur with this INH
vitamin B6
Cyanocogalamin, Folic Acid are ___ that ___ metabolic process
vitamins for pts w/vitamin deficiencies speed up
in true labor, contractions are regular with decreasing intervals between contractions, contractions increase in intensity and duration, intensity usually increases with ____, cervix dilates and effaces
walking
A teenager diagnosed with anorexia nervosa is admitted to the hospital. In planning to care for the client, the nurse would expect the client to
want to talk about and plan her meals; displays preoccupation with food (client with anorexia NOT hypoactive and withdrawn)
Raynaud disease; pt needs to keep
warm
___ skin above operative site would indicate infection
warm
apply ___ packs to child 3 times daily for Otitis Media
warm
treat DVT with ____, moist soaks
warm
___ can keep food hot, safe, and appealing during the slow eating process of a parkinson's pt
warming trays
Colostomy irrigation for Sigmoid Colostomy allows for no need to ____ and is performed when?
wear pouch applance after meal; same time once daily
fundal height should correlate with ___ of pregnancy
weeks
SSRI (Citalopram) S/e
weight gain
what do you ask a 16 yr old who is consistently thirsty even though she is drinking enough water?
weight loss?
inability to control diabetes mellitus by diet and oral agents, coupled with surgically induced metabolic changes, being NPO both before and after surgery, and the infusion of intravenous fluids necessitates temporary control by insulin
why the physician orders subcutaneous insulin injections after surgery
oral corticosteroids cause gastric irritation and should be taken ___ meals
with
if a patient uses crutches weighing the pt should be done
with crutches in place so patient can support weight during the process; afterward, the crutches should be weighed and their weight then subtracted from the total to get accurate weight of the patient
H2 Blockers are given
with meals (Tagamet for ulcers)
6 month old sits
with support
IV antibiotic should be administered in how long?
within an hour
____ need 1,200 to 1,500 kcal/day
women
Can infants receive PPD test for TB?
yes
Encourage client to turn, cough, and breathe deep for flail chest?
yes
can a schizophrenic pt shave with a disposable razor with staff supervision?
yes
post op pt says pain is 4 out of 10. does nurse give pain meds?
yes; moderate pain gets pain meds
Intimacy vs isolation
young adult
