Focused Review Exam 2 (SEM 2)

Normal platelet count

150,000-400,000

dailt dose of iron

150-200mg

what health history can be useful for a patient with anemia?

blood loss liver / renal disease GI disease

when do you give prednisone

in the am

Normal RBC levels

4.5-5 million

respiratory acidosis causes

: Hypoventilation : COPD, Pulmonary dz, Drugs, Obesity, Mechanical asphyxia, Sleep Apnea

A patient is the primary caregiver for a disabled family member at home, and has now been unexpectedly hospitalized for surgery. What action can the nurse take to enhance the coping ability of the patient? a. Ask if there is another family member who can help at home while the patient is in the hospital. b. Plan to transfer the patient to a rehabilitation unit after surgery to allow uninterrupted time to recover. c. Coordinate an ambulance transfer of the family member to an alternate family member's home. d. Ask social services to assess what the patient's needs will be after discharge to home.

a

The nurse is making a home visit to a patient who was discharged from the hospital on Lovenox and warfarin following replacement of the patient's pacemaker. Which observation indicates excessive bleeding? (Select all that apply.) a. New ecchymosis on the abdomen b. A nosebleed that does not stop with pressure c. Pain of the lower extremity with flexion d. Extreme fatigue e. Pallor f. Sudden onset of severe headache

a b d e f

chest physiotherapy

a series of maneuvers including percussion, vibration, and postural drainage designed to promote clearance of excessive respiratory secretions.

Which nursing observation would indicate that the nurse hold the medication warfarin (Coumadin)? a. INR (international normalize ratio) of 1.8 b. INR of 4.8 c. partial thromboplastin time (APTT) level of 25 seconds d. APTT level of 35 seconds

b The dosage of warfarin is adjusted to maintain an INR between 2 and 3. A level of 4.8 indicates that the patient is at risk for excessive bleeding.

The patient is hyperventilating from anxiety and abdominal pain. Which assessment findings should the nurse attribute to respiratory alkalosis? (Select all that apply.) a. Skin pale and cold b. Tingling of fingertips c. Heart rate of 102 d. Numbness around mouth e. Cramping in feet

b d e

Which iron-rich foods should the nurse recommend for a toddler-age client who is diagnosed with iron deficiency anemia? Select all that apply.

chicken iron lean steak

The nurse plans interventions for a client with smoke inhalation based on a negative chest x-ray and arterial blood gases that show a PO 2 of 85 mm Hg, a PCO 2 of 45 mm Hg, and a pH of 7.35. Which interventions should the nurse anticipate will be prescribed? Select all that apply.

cough deep breathing humidified o2

Which juice can affect Coumadin

cranberry juice

A client presenting to the emergency department with chest pain and dizziness is found to be having a myocardial infarction and subsequently suffers cardiac arrest. The healthcare team is able to successfully resuscitate the client. Lab work shows that the client now is acidotic. How does the nurse interpret the cause of the acidosis?

decreased perfusion caused lactic acid production

Verchow's Triad

hypercoaguability injured vessel stasis blood flow

what affect can liver disease have on clotting?

impairs clotting factor synthesis

A nurse is caring for two clients; one has polycythemia and the other has prolonged anemia. What do these clients have in common?

increased cardiac work load

A client is admitted for chest pain and a myocardial infarction. The nurse caring for the client is preparing to apply nitroglycerin ointment. Before applying the ointment, what action will the nurse take?

measure dose using dose tape

The arterial blood gases of a client with chronic obstructive pulmonary disease (COPD) deteriorate, and respiratory failure is impending. Which clinical indicator should the nurse assess first?

mental confusion

EC: Iron

not effective

CURB-65 for pneumonia

1) Confusion 2) BUN>19 3) RR>30 4) BP<90/60 5) 65yo One or less indicates patient can be treated outpatient, >1 =hospitalization

normal wbc levels

4,500-11,000/mm3

The parents of a 3-month old infant who is breastfed ask the nurse how to prevent nutritional anemia. What is the best response by the nurse?

Baby cereals are fortified with iron. The breastfed infant is ready to have this food introduced by about 4 months; if solid foods are not offered by this age, an iron supplement is needed.

The nurse is developing a care plan for a patient with ineffective coping skills. Which intervention would be an example of a problem-focused coping strategy? a. Scheduling a regular exercise program b. Attending a seminar on treatment options c. Identifying a confidant to share feelings d. Attending a support group for families

C

Causes of metabolic acidosis

DKA, severe diarrhea, renal failure, shock

The nurse is reviewing the patient's arterial blood gas results. The PaO2 is 96 mm Hg, pH is 7.20, PaCO2 is 55 mm Hg, and HCO3 is 25 mEq/L. What would the nurse expect to observe on assessment of this patient?

Disorientation and tremors disorientation, tremors, possible seizures, and decreased level of consciousness. T

what must the spirometry testing show before copd is dx'ed?

FEV <70%

respiratory alkalosis causes

Hyperventilation on a ventilator, Response to acidosis, Bacteremia, Thyrotoxicosis, Fever, Hepatic failure, Response to hypoxia, Hysteria

urine output is decreased with

Impaired perfusion / gas exchange

normal hemoglobin levels

Male: 13-18 g/100mL Female: 12-16 g/100mL

When assessing the breath sounds of a client with chronic obstructive pulmonary disease (COPD), the nurse hears coarse rhonchi. Which type of lung sounds will the nurse hear?

Moist rumbling sounds that clear after coughing

Microcytic anemia

iron deficiency small size

No cow milk before one year for infants / children with iron def should get

iron fortified formula

Side effect of albuterol:

Side effect of albuterol: tacky, nausea, excite

The nurse is providing teaching to the parents of a preschool-age client who is prescribed iron supplements for iron-deficiency anemia. Which parental statements indicate the need for further education? Select all that apply.

We will mix the iron with milk to enhance absorption." "We will mix the iron with black tea to enhance absorption." TOMATOES DECREASE ABSORBTION

macrocytic anemia

due to folate or vitamin B12(cobalamin) Large size

what is the perfered rescue asthma med?

albuterol fast acting

emphysemia

obstructive pulmonary disease characterized by overexpansion of the alveoli with air and destructive changes in their walls, resulting in loss of lung elasticity and gas exchange

what are the 5 p's with clotting?

pallor, paresthesia, pulseless, poikilothermia (cold skin), pain

cor polmonale (r/ side heart failure) is caused by

pulmonary htn -dyspnea

what are three behaviors displayed by someone with COPD

pursed lip breathing Tripod breathing during talking

what happens when plt's are below 50,000

risk of hemorrhage and trauma

Causes of metabolic alkalosis

severe vomiting, excessive GI suctioning, diuretics, excessive NaHCO3

Headache, hypertension, and gastrointestinal problems indicate

stress