Crisis 2 Final
tinnitus
A client is diagnosed with a disorder involving the inner ear. Which is the most common client complaint associated with a disorder involving this part of the ear?
Cardiovascular disease
A client is diagnosed with glaucoma. Which piece of nursing assessment data identifies a risk factor associated with this eye disorder?
gout
Protein metabolism is altered so that uric acid crystals deposits in joints and other body tissues, particularly the big toe, can be ankle or other parts of the foot; PAIN; decrease purine (organ meats, shellfish, wild game, beef, pork), no alcohol
open angle
outflow of aqueous humor impaired but can still get through, occurs over time, loss of peripheral vision
Cluster headaches
rare, occur weeks/months followed by periods of remission, severe; sharp stabbing, intense pain lasting a few minutes to 3 hours; around eye radiating to temple, forehead, cheek, nose, or gums
acromegaly
enlarged extremities, when ↑ GH occurs in adulthood
mucositis
inflammation and ulceration d/t chemo or radiation (rapid cell destruction)
Osgood-schlatter disease
inflammation of the patellar ligament at the tibial tuberosity. It is characterized by a painful bump just below the knee that is worse with activity and better with rest
Hypopituitary
lack of pituitary hormones, dwarfism and premature aging adults
ADH
A client has been hospitalized for impaired function of the posterior pituitary gland. The nurse plans to monitor for signs and symptoms of which hormone imbalance?
hypotension
A client is admitted to the hospital with a diagnosis of Addison's disease. The nurse would assess for which problem as a manifestation of this disorder?
fifths disease
Caused by parvovirus B19, causes distinctive red rash on face that makes a child appear to have a "slapped cheek"
Subluxation of radial head
common childhood injury that is characterized by the partial dislocation of the elbow due to the radius, a bone in the forearm, being pulled away from its normal position
Addison's
deficiency of cortisol, aldosterone, androgens (dysfunction of adrenal cortex), Autoimmune
cataract
dehydration of lens (UV ray exposure), immature to ripe phases; blurry vision, photophobia, sensitivity to glare, vision better in low light, cloudy appearance of lense
roseola
disease in young children in which fever is followed by a rash, occurring in measles, syphilis, and herpes virus
Oral candidiasis (thrush)
fungal infection, result of c. albicans overgrowth
Pneumatic retinopexy
gas bubble puts pressure on retina to connect to choroid
Salter-Harris
growth plate fracture
Paget's
idiopathic disorder, abnormal bone breakdown/formation, transfer of Ca from bone to blood; painful deformities in femur, tibia, lower spine, pelvis, skull, upper humerus
elevate the HOB
The nurse is caring for a client who sustained a spinal cord injury. During administration of morning care, the client begins to exhibit signs and symptoms of autonomic dysreflexia. Which initial nursing action should the nurse take?
Vitrectomy (diabetic retinopathy)
remove bloody vitreous, replace with NS to maintain shape of eye
Speak at a normal volume
The nurse is caring for a hearing-impaired client. Which approach will facilitate communication?
colon cancer
3rd most common, high in AA men and women
IBS
Chronic *functional disorder* with intermittent abdominal pain or discomfort and stool pattern irregularities more frequent in women have visceral hypersensitivity which causes abnormally strong response to stimuli (stretching after meal) S/S: abdominal pain, diarrhea/constipation, abdominal distention, excessive flatulence, bloating, urgency, sensation of incomplete evacuation, fatigue, sleep disturbances Risk factors: stress, anxiety, panic disorders, depression, PTSD, abuse history, gastroenteritis (norovirus/rotovirus)
Cauda Equine Syndrome
Injury to the lumbosacral nerve roots causing loss of bowel, bladder reflex, causes flaccid lower extremities (develops over time, sx on one side of body)
Heberdan's nodules and Bouchards nodules
Joint deformities in the hands
Place client in sitting position
The client with a spinal cord injury at the level of T4 is experiencing a severe throbbing headache with a blood pressure of 180/100 mm Hg. What is the priority nursing intervention?
Crohn's Disease
A chronic inflammatory disease of the intestines, especially the colon and ileum, associated with ulcers and fistulae. Effects anywhere in GI tract. cobblestone, lesions anywhere in GI tract, disease occurs in patches
Listen to breath sounds
A client admitted to the nursing unit from the hospital emergency department has a C4 spinal cord injury. In conducting the admission assessment, what is the nurse's priority action?
ADH excess or deficit
A client has a tumor that is interfering with the function of the hypothalamus. The nurse should monitor for signs and symptoms related to which imbalance?
Truncal obesity
A client has been diagnosed with Cushing's syndrome. The nurse should assess the client for which expected manifestations of this disorder?
Chicken liver
A client has been diagnosed with gout, and the nurse provides dietary instructions. The nurse determines that the client needs additional teaching if the client states that it is acceptable to eat which food?
HTN
A client has been diagnosed with pheochromocytoma. Which clinical manifestation is most indicative of this condition?
It has incompletely dislocated
A client has been diagnosed with subluxation of the shoulder. The nurse explains to the client that which injury has occurred to the joint?
BP
A client is admitted to the hospital with a diagnosis of pheochromocytoma. The nurse would check which item to detect the primary manifestation of this disorder?
Cortisol
A client is diagnosed with Cushing's syndrome. When reviewing the recent laboratory results, the nurse should expect an excess of which substance?
a. Irritability b. Complaints of nausea c. Sodium level of 128 e. BP lying 138/70 and standing 110/58
A client is hospitalized with a diagnosis of adrenal insufficiency. Which findings does the nurse identify as supportive of this diagnosis? Select all that apply a. Irritability b. Complaints of nausea c. Sodium level of 128 d. Potassium level of 3.2 e. BP lying 138/70 and standing 110/58
Autonomic dysreflexia (hyperreflexia)
A client who has a spinal cord injury that resulted in paraplegia experiences a sudden onset of severe headache and nausea. The client is diaphoretic with piloerection and has flushing of the skin. The client's systolic blood pressure (BP) is 210 mm Hg. What should the nurse immediately suspect?
Ringing in ears
A client who has been taking high doses of acetylsalicylic acid to relieve pain from osteoarthritis now has more generalized joint pain and an elevated temperature. The nurse should assess for which complication to determine whether the client has other signs of aspirin toxicity?
"Usually these physical changes slowly improve following treatment."
A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which statement should the nurse make to the client?
a. Hypotension c. Hyperkalemia
A client with a diagnosis of Addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply. a. Hypotension b. Leukocytosis c. Hyperkalemia d. Hypercalcemia e. Hypernatremia
Altered breathing pattern
A client with a spinal cord injury at the level of C5 has a weakened respiratory effort and ineffective cough and is using accessory neck muscles in breathing. The nurse carefully monitors the client and suspects the presence of which problem?
Acknowledge the client's anger and continue to encourage participation in care
A client with a spinal cord injury becomes angry and belligerent whenever the nurse tries to administer care. The nurse should perform which action?
Meal choices represent an area of client control and should be encouraged as much as is nutritionally reasonable.
A client with a spinal cord injury expresses little interest in food and is very particular about the choice of meals that are actually eaten. How should the nurse interpret this information?
b. After meals
A client with ulcerative colitis has a prescription to begin a salicylate compound medication to reduce inflammation. What instruction should the nurse give the client regarding when to take this medication? a. On arising b. After meals c. On an empty stomach d. 30 minutes before meals
Open trauma to the left leg
A hospitalized client has been diagnosed with osteomyelitis of the left tibia. The nurse determines that this condition is most likely a result of which event in the client's recent history?
I will maintain a normal sodium intake in my diet
A nurse has provided dietary instructions to a client with Addison's disease. Which statement made by the client indicates that the client understands instructions?
Graham crackers and warm milk
A nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. Which items would be the most appropriate choice for this client to meet nutritional needs?
Taking the clients BP
A nurse is performing an admission assessment on a client with a diagnosis of pheochromocytoma. The nurse should assess for the major sign associated with pheochromocytoma by performing which action?
High urine osmolality, low serum osmolality, hypotonicity of body fluids, continued release of ADH
A nurse is reviewing the assessment findings and laboratory data for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder?
Polyuria, polydipsia, complaints of excess thirst, specific gravity < 1.005
A nurse is reviewing the assessment findings for a client who was admitted to the hospital with a diagnosis of diabetes insipidus. The nurse understands that which manifestations are associated with this disorder?
Androgens, glucocorticoids, mineralocorticoids
A nursing instructor is teaching the class about Addison's disease. The instructor determines that the class understands the disease process if they indicate which are affected in this disease?
c. Because i have no symptoms, my disease is not progressing
A nursing student is providing health maintenance education to a client with osteitis deformans (Paget's disease). Which statement by the client indicates a need for further education? a. When I have pain, I will take ibuprofen b. I should perform low-impact exercises regularly c. Because i have no symptoms, my disease is not progressing d. I must notify my HCP if i experience any hearing loss
UC
An inflammatory bowel disease (IBD) that causes long-lasting inflammation and ulcers (sores) in your digestive tract. It affects the innermost lining of your large intestine (colon) and rectum. Only effects the LARGE intestine. Treated as autoimmune disease. confined to colon, disease is continuous
Fractures
An older client is diagnosed with osteoporosis. The nurse teaches the client about self-care measures, knowing that the client is most at risk for which problem as a result of this disorder of the bones?
Call the HCP
At 8:00 a.m., A client who has had a stroke (brain attack) was awake and alert with vital signs of temperature 98°F (37.2°C) orally, pulse 80 beats/min, respirations 18 breaths/min, and blood pressure 138/80 mm Hg. At noon, the client is confused and only responsive to tactile stimuli, and vital signs are temperature 99°F (36.7°C) orally, pulse 62 beats/min, respirations 20 breaths/min, and blood pressure 166/72 mm Hg. The nurse should take which action?
b. Red skin areas under the jacket
At the beginning of the work shift, the nurse assesses the status of the client wearing a halo device. The nurse determines that which assessment finding requires intervention? a. Tightening screws b. Red skin areas under the jacket c. Clean and dry the labs wool jacket lining d. Finger-width space between the jacket and skin
Alkaline phosphatase
Diagnostic studies are prescribed for a client with suspected Paget's disease. In reviewing the client's record, the nurse would expect to note that the health care provider has prescribed which laboratory study?
Decreased diarrhea
Diphenoxylate hydrochloride with atropine sulfate is prescribed for a client with ulcerative colitis. The nurse should monitor the client for which therapeutic effect of this medication?
RA
Erosive inflammation of joints; Affects more the metacarpophalangeal (MCP) joints and proximal (PIP) joints; Swan-neck deformities, Boutonniere deformity, ulnar drift; Women>men; Exacerbation and remission; bilateral inflammation, STIFFNESS IN MORNING
IBD
IBS symptoms, inflammation, ulcers, and other damage Includes chron's disease and UC
OA
Joint destruction and deformity, NOT inflammation, overuse disease, >65 y/o; Affected joints may exhibit crepitus; Occurs in the weight bearing joints primarily (hips and knees), but can affect hands; Joint deformities in the hands are called Heberdan's nodules and Bouchards nodules STIFFNESS AT NIGHT/AFTER USE
Diabetic retinopathy
LEADING cause of blindness, progressive, microscopic damage to blood vessels of retina
Autonomic dysreflexia
Massive uncompensated cardiovascular reaction mediated by sympathetic nervous system; life threatening: HTN, bradycardia, flushed, diaphoretic, h/a
C=calcinosis-small white deposits on tissues R=Raynaud's E=esophageal hardening S=Sclerodactyly (localized thickening and tightening of the skin of the fingers or toes) Scleroderma of the digits T=Telangiectasias-capillary dilations that form vascular lesions on the face, lips, fingers
Scleroderma nemonic
a. The med will cause constipation
Sulfasalazine is prescribed for a client with a diagnosis of ulcerative colitis, and the nurse instructs the client about the medication. Which statement made by the client indicates a need for further teaching? a. The med will cause constipation b. I need to take it with meals c. I may have increased sensitivity to sunlight d. This med should be taken as prescribed
Provide a clear path for ambulation without obstacles.
The client has an impairment of cranial nerve II. Specific to this impairment, what should the nurse plan to do to ensure client safety?
a. Using a rotorest bed b. Ensuring that weights hang freely d. Assessing the integrity of the weights and pulleys e. Comparing the amount of prescribed traction with the amount in use
The client with a cervical spine injury has cervical tongs applied in the emergency department. What should the nurse include when planning care for this client? Select all that apply. a. Using a rotorest bed b. Ensuring that weights hang freely c. Removing the weights to reposition the client d. Assessing the integrity of the weights and pulleys e. Comparing the amount of prescribed traction with the amount in use
Systemic symptoms such as fatigue, anorexia, and weight loss
The clinic nurse is performing an assessment on a client with a diagnosis of rheumatoid arthritis (RA). The nurse checks for which assessment finding that is associated with RA?
Leaving the client in an unchilled area of the room (The most common cause of autonomic dysreflexia is visceral stimuli, such as with blockage of urinary drainage or with constipation. Barring these, other causes include noxious mechanical and thermal stimuli, particularly pressure and overchilling. For this reason, the nurse ensures that the client is positioned with no pinching or pressure on paralyzed body parts and that the client will be sufficiently warm.)
The home care nurse is making a visit to a client who requires use of a wheelchair after a spinal cord injury sustained 4 months earlier. Just before leaving the home, the nurse ensures that which intervention has been done to prevent an episode of autonomic dysreflexia (hyperreflexia)?
"Is the pain experienced a stabbing type of pain?"
The home care nurse is preparing to visit a client with a diagnosis of trigeminal neuralgia (tic douloureux). When performing the assessment, the nurse should plan to ask the client which question to elicit the most specific information regarding this disorder?
a. Encourage the client to ambulate
The nurse cares for a client following a Roux-en-Y gastric bypass surgery. Which nursing intervention is appropriate? a. Encourage the client to ambulate b. Position the client on the left side c. Frequently irrigate the NG tube with 30mL saline d. Discourage the use of the PCA machine
b. Antimicrobial c. Corticosteroid d. Aminosalicylate e. Biological therapy f. Immunosuppressant
The nurse caring for a client diagnosed with inflammatory bowel disease (IBD) recognizes that which classifications of medications may be prescribed to treat the disease and induce remission? Select all that apply. a. Antidiarrheal b. Antimicrobial c. Corticosteroid d. Aminosalicylate e. Biological therapy f. Immunosuppressant
b. I will drive only during daytime
The nurse has completed discharge instructions for a client with application of a halo device. Which statement indicates that the client needs further clarification of the instructions? a. I will use a straw for drinking b. I will drive only during daytime c. I will be careful because the device alters balance d. I will was the skin daily under the lambs wool liner of the vest
d. I'll try to eat my food either warm or very cold
The nurse has given suggestions to a client with trigeminal neuralgia about strategies to minimize episodes of pain. The nurse determines that the client needs further teaching if the client makes which statement? a. I will wash my face with cotton pads b. I'll have to start chewing on my unaffected side c. I should rinse my mouth if toothbrushing is painful d. I'll try to eat my food either warm or very cold
Epinephrine
The nurse is admitting a client diagnosed with pheochromocytoma. The client is complaining of a pounding headache and palpitations and the blood pressure is 170/90 mm Hg. The nurse is aware that which substance is responsible for these clinical manifestations?
a. Initiate an infusion of 3% Nacl c. Restrict fluids to 800 mL over 24 hours e. Administer a vasopressin antagonist as prescribed
The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply. a. Initiate an infusion of 3% Nacl b. Administer intravenous furosemide c. Restrict fluids to 800 mL over 24 hours d. Elevate the HOB to high Fowler's e. Administer a vasopressin antagonist as prescribed
Pronator drift
The nurse is assessing a client's muscle strength and notes that when asked, the client cannot maintain the hands in a supinated position with the arms extended and eyes closed. How should the nurse correctly document this finding on the medical record?
Extend tongue
The nurse is assessing the function of cranial nerve XII in a client who sustained a stroke. To assess function of this nerve, which action should the nurse ask the client to perform?
Cervical cord injury
The nurse is assisting the neurologist in performing an assessment on a client who is unconscious after sustaining a head injury. The nurse understands that the neurologist would avoid performing the oculocephalic response (doll's eyes maneuver) if which condition is present in the client?
Bone resorption and regeneration
The nurse is caring for a client diagnosed with osteitis deformans (Paget's disease). Which does the nurse identify as the cause of the client's stooped posture and bowing of lower extremities?
Pyrexia, elevated WBC, elevated erythrocyte sedimentation rate, bone scan impression indicative of an infection
The nurse is caring for a client diagnosed with osteomyelitis. Which data noted in the client's record are supportive of this diagnosis?
Devascularization
The nurse is caring for a client diagnosed with osteomyelitis. Which mechanism of the disease process can result in necrosis of the bone?
"Pain is due to stimulation of the affected nerve by pressure and temperature."
The nurse is caring for a client diagnosed with trigeminal neuralgia. The client asks the nurse, "Why do I have so much pain?" Which is the appropriate response by the nurse?
c. Oral corticosteroids
The nurse is caring for a client experiencing an exacerbation of Crohn's disease. Which intervention should the nurse anticipate the health care provider prescribing? a. Enteral feedings b. Fluid restrictions c. Oral corticosteroids d. Activity restrictions
hypotension and fever
The nurse is caring for a client who has had an adrenalectomy and is monitoring the client for signs of adrenal insufficiency. Which signs and symptoms indicate adrenal insufficiency in this client?
Placing the client on a bed that provides spinal immobilization
The nurse is caring for a client who is brought to the hospital emergency department with a spinal cord injury. The nurse minimizes the risk of compounding the injury by performing which action?
Perform sterile dressing changes
The nurse is caring for a client who sustained an open fracture and is diagnosed with acute osteomyelitis of the right lower extremity. Which intervention should the nurse plan to perform?
tunnel vision
The nurse is caring for a client who was recently diagnosed with primary open-angle glaucoma (POAG). Which assessment finding is specific to this type of glaucoma?
"You need to increase salt in your diet, particularly during stressful situations."
The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how should the nurse inform the client?
Severe abdominal pain
The nurse is caring for a client with a diagnosis of Addison's disease and is monitoring the client for signs of addisonian crisis. The nurse should assess the client for which manifestation that would be associated with this crisis?
Moon face, HTN, truncal obesity
The nurse is caring for a client with a diagnosis of Cushing's syndrome. Which expected signs and symptoms should the nurse monitor for?
Uric acid level of 9.0 (2.4-7)
The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client?
Joint pain that diminishes after rest, joint pain that intensifies with activity
The nurse is caring for a client with osteoarthritis. The nurse performs an assessment knowing that which clinical manifestations are associated with the disorder?
Vital signs
The nurse is caring for a client with pheochromocytoma who is scheduled for adrenalectomy. In the preoperative period, what should the nurse monitor as the priority?
Vanilla wafers and room-temperature water
The nurse is caring for a client with trigeminal neuralgia (tic douloureux). The client asks for a snack and something to drink. The nurse should offer which best snack to the client?
c. rebound tenderness
The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, should the nurse report to the health care provider (HCP)? a. Hypotension b. Bloody diarrhea c. Rebound tenderness d. Hbg of 12mg/dL
Hematest-positive nasogastric tube drainage
The nurse is caring for the client who suffered a spinal cord injury 48 hours ago. What should the nurse assess for when monitoring for gastrointestinal complications?
a. Monitor for changes in mentation d. Encourage fluid intake of at least 3000mL/day e. Monitor vital signs, skin turgor, and I/O
The nurse is developing a plan of care for a client with Addison's disease. The nurse has identified a problem of risk for deficient fluid volume and identifies nursing interventions that will prevent this occurrence. Which nursing interventions should the nurse include in the plan of care? Select all that apply. a. Monitor for changes in mentation b. Encourage an intake of low-protein foods c. Encourage an intake of low-sodium foods d. Encourage fluid intake of at least 3000mL/day e. Monitor vital signs, skin turgor, and I/O
c. Eye medications will need to be administered for life
The nurse is developing a teaching plan for a client with glaucoma. Which instruction should the nurse include in the plan of care? a. Avoid overuse of the eyes b. Decrease the about of salt in diet c. Eye medications will need to be administered for life d. Decrease fluid intake to control the intraocular pressure
Fatigue, morning stiffness
The nurse is gathering subjective and objective data from a client with a diagnosis of suspected rheumatoid arthritis (RA). The nurse would expect to note which early signs and symptoms of RA?
c. I need to avoid foods high in potassium
The nurse is instructing a client with Cushing's syndrome on follow-up care. Which of these client statements would indicate a need for further instruction? a. I should avoid contact sports b. I should check my ankles for swelling c. I need to avoid foods high in potassium d. I need to check my blood glucose regularly
b. Leukocytosis d. Urinary output of 800mL/hr e. Clear drainage on nasal dripper pad
The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply. a. Anxiety b. Leukocytosis c. Chvostek's sign d. Urinary output of 800mL/hr e. Clear drainage on nasal dripper pad
A rounded "moonlike" appearance to the face
The nurse is performing an assessment on a client with a diagnosis of Cushing's syndrome. Which should the nurse expect to note on assessment of the client?
blurred vision
The nurse is performing an assessment on a client with a suspected diagnosis of cataract. Which clinical manifestation should the nurse expect to note in the early stages of cataract formation?
Bone pain
The nurse is performing an assessment on a client with suspected Paget's disease. On assessment the nurse would expect the client to report which as the most common symptom of this disease?
Abnormal
The nurse is performing the oculocephalic response (doll's eyes maneuver) on an unconscious client. The nurse turns the client's head and notes movement of the eyes in the same direction as the head. How should the nurse document these findings?
Cup the hands over the ears if loud noise is expected suddenly.
The nurse is planning a presentation on noise prevention and ear protection for a display booth at a local health fair. The nurse plans to incorporate which important concept regarding hearing loss in the presentation?
gabapentin
The nurse is providing discharge education to a client diagnosed with trigeminal neuralgia. Which medication will likely be prescribed upon discharge for this condition?
a. Do not drink fluids with meals b. Avoid foods high in carbohydrates e. Eat 6 small meals a day that are high in protein
The nurse is providing discharge instructions for a client following a Roux-en-Y gastric bypass surgery 3 days ago. What will the nurse include in the instructions? Select all that apply. a. Do not drink fluids with meals b. Avoid foods high in carbohydrates c. Take an extended-release multivitamin daily d. Maintain a clear liquid diet for about 6 weeks e. Eat 6 small meals a day that are high in protein
I should eat foods that have a lot of potassium in them
The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood?
a. S/S of hypoadrenalism b. S/S of hyperadrenalism c. Instruction to take the medications exactly as prescribed d. Importance of maintaining regular outpatient follow-up care
The nurse is providing home care instructions to the client with a diagnosis of Cushing's syndrome and prepares a list of instructions for the client. Which instructions should be included on the list? Select all that apply. a. S/S of hypoadrenalism b. S/S of hyperadrenalism c. Instruction to take the medications exactly as prescribed d. Importance of maintaining regular outpatient follow-up care e. Reminder to read labels on OTC medications before purchase
a. Eat yogurt b. Take loperamide to treat diarrhea c. Use stress management techniques d. Avoid foods such as cabbage and broccoli
The nurse is providing instructions to a client diagnosed with irritable bowel syndrome (IBS) who is experiencing abdominal distention, flatulence, and diarrhea. What interventions should the nurse include in the instructions? Select all that apply. a. Eat yogurt b. Take loperamide to treat diarrhea c. Use stress management techniques d. Avoid foods such as cabbage and broccoli e. Decrease fiber intake to less than 15 g/day
Avoid activities that may cause pressure near the face.
The nurse is providing instructions to the client with trigeminal neuralgia regarding measures to take to prevent the episodes of pain. Which should the nurse instruct the client to do?
Potassium level of 3.0
The nurse is reviewing the laboratory test results for a client with a diagnosis of Cushing's syndrome. Which laboratory finding would the nurse expect to note in this client?
Hypertension
The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of pheochromocytoma. The nurse reads the assessment findings and expects to note documentation of which major symptom associated with this condition?
Shift weight every 2 hours while in a wheelchair
The nurse is teaching a client with paraplegia measures to maintain skin integrity. Which instruction will be most helpful to the client?
Withdrawal reflex
The nurse is testing the spinal reflexes of a client during neurological assessment. Which assessment by the nurse would help to determine the adequacy of the spinal reflex?
"It's a sensorineural hearing loss that occurs with the aging process."
The nursing student is caring for a client with a diagnosis of presbycusis. The nursing instructor determines that the student understands presbycusis when which statement is made?
a. Urine specific gravity 1.001 d. Serum osmolality is 320 f. Urine output has increased from 1000ml in 24 hrs to 4000 in 24 hours
Which findings should raise suspicion to the nurse that a head-injured client may be experiencing diabetes insipidus? Select all that apply. a. Urine specific gravity 1.001 b. Ketones are present in urine c. JVD d. Serum osmolality is 320 e. Blood glucose is greater than 200 f. Urine output has increased from 1000ml in 24 hrs to 4000 in 24 hours
Serum uric acid level, synovial fluid aspiration, 24-hr urine acid level
Which tests can be used to diagnose gout?
urticaria
a rash of round, red welts on the skin that itch intensely, sometimes with dangerous swelling, caused by an allergic reaction, typically to specific foods.
Costochondritis
acute and often temporary inflammation of the costal cartilage, the structure that connects each rib to the sternum at the costosternal joint; common cause of chest pain
Macular degeneration
age-related degeneration of macula, central vision loss (helps read, drive, see fine details), wet or dry, NO EFFECTIVE TREATMENT/CURE (Supplements help reduce risk: Vit C, E, Veta-carotene, zinc, egg yolk)
chicken pox
an infectious disease causing a mild fever and a rash of itchy inflamed blisters, caused by the herpes zoster virus and mainly affects children, who are afterward usually immune
Systemic lupus
autoimmune, butterfly rash, SUNLIGHT IS A MAJOR CONTRIBUTOR TO EXACERBATION OF SYMPTOMS, REVIEW THE SIDE EFFECTS OF STEROIDS, Renal failure from glomerulonephritis is the leading cause of morbidity and mortality in the patient
LCPD (Legg-Calves-Perthes disease)
avascular necrosis (AVN) of the proximal femoral head resulting from compromise of the tenuous blood supply to this area; usually occurs in children aged 4-10 years; has insidious onset and may occur after an injury to the hip
Aura
blindness, bright lights, visual distortions, hearing voices/sounds, strange smells, weakness, paralysis, feeling that limbs are moving.
Laser photocoagulation
burns edges, prevents further damage
Barrett's esophagus
complication of GERD, normal tissue of esophagus changes and resembles that of the intestine, endoscopy every 2-3 years
carpal tunnel
entrapment of medial nerve, sensory/motor changes in thumb, index finger, middle finger, and radial aspect of ring finger
cushings's
excess corticosteroid
treatment for contusion begins at time of injury, apply ice immediately, see physician, and receive thorough eye examination to rule out other eye injuries.
eye injury treatment
Chondosarcoma
formation of tumor by cartillage cells, femur, pelvis, ribs, scapula age 30-60
SCFE (Slipped Capital Femoral Epiphysis)
fracture through the growth plate (physis), which results in slippage of the overlying end of the femur (epiphysis)
Scleroderma
hard skin
Osteomyelitis
infection of bone and surrounding tissue
Measles
infectious viral disease causing fever and red rash on skin, typical in childhood
Trigeminal neuralgia
intermittent intense pain in face, triggered by touch, cold, talking, chewing, brushing teeth, entrapped trigeminal nerve, compression, or tumor
IBS Increase fiber intake (20g/day), eliminate gas foods, eliminate fructose and sorbitol, use probiotics
intermittent pain/discomfort and stool irregularities
Retinitis pigmentosa
loss of peripheral vision → total blindness, progressive, genetic, d/t production of unstable protein, NO TREATMENT/CURE, genetic counseling
Fibrosarcoma
malignant collagen fibers, age 5-80
Antidepressants
medication: low dose tricyclic, decrease peripheral nerve sensitivity
Linaclotide (Linzess)
medication: men and women with IBS-constipation
Alosetron (Lotronex)
medication: serotonergic antagonist, severe pain and diarrhea. Last choice for women. Severe side effects: severe constipation and ischemic colitis.
Loperamide (Imodium)
medication: treat diarrhea, synthetic opioid, decrease intestinal transit
Lubiprostone (Amitiza)
medication: women with IBS-constipation
Ewing's Sarcoma
mimic's osteomyelitis, 5-15 years old
gastroenteritis and IBS
most common causes of abdominal pain
Osteosarcoma
most common, distal femur, proximal tibia: age 10-30
Neuropathy
nerve damage associated with diabetes, lose sensation in lower extremities, pain and paresthesia
retinal detachment
painless detachment from choroid, d/t advanced age/trauma, NO MED treatment, need procedure
Glaucoma Treatments: NO CURE, control symptoms - Cholinergics (pilocarpine gtts), beta adrenergic blockers (timoptic gtts), diuretics (mannitol) brings intraocular pressure down quick (only closed angle)
painless, ↑intraocular pressure, optic nerve atrophy, preventable; sudden H/A, red conjunctiva, cloudy cornea, N, V
Scleral buckling
place retina back in contact with choroid from outside of eye
ripe cataract
poor vision, poor light penetration
conductive hearing loss
problem with conducting sound waves, CAN be corrected; wax, foreign body, cotton ball, infection, otosclerosis (hardening of structures of inner ear)
photophobia, irritability, hyperactivity, cravings
prodrome symptoms
Hyperpituitary
results from pituitary adenoma
closed angle
root of iris occludes trabecular network, occurs quick, needs addressed immediately
immature cataract
some light gets through, useful vision
scarlet fever
strep rash
Gastric bypass
surgical reduction of gastric capacity for weight loss
ringworm
tinea
HOB 30-45 degrees for 30-60 min, water irrigation before/after feeding/drugs, check tube positioning before administrations, volume 200-500ml
tube feeding
Pheochromocytoma
tumors of adrenal medulla (benign), ↑ epi and norepi in blood
migrane
unknown cause, vascular, muscular, and biochemical factors, family history, associated with: seizures, ischemic stroke, asthma, depression, anxiety, MI, Raynaud's, IBS; triggers: menstruation, head trauma, physical exertion, fatigue, stress, missed meals, weather, drugs, foods (chocolate, aspartame, cheese, oranges, tomatoes, alcohol)
