MS1 Exam 2 Prep

normal albumin

6-8.3 g/dL 60-83 g/L

rheumatoid arthritis

A chronic systemic disease characterized by inflammation of the joints, stiffness, pain, and swelling that results in crippling deformities

AIDS treatment

HAART (highly active antiretroviral therapy) Multimodal approach

UTI dx

Urine dip or UA (Leuks, Nitrite, WBC or Bacteria)

hypertonic solution

increases sodium cell shrinks fluid leaves cell

A nurse reviews a client's laboratory results. Which results from the client's urinalysis would the nurse identify as normal? (Select all that apply.) a. pH: 6 b. Specific gravity: 1.015 c. Protein: 1.2 mg/dL d. Glucose: negative e. Nitrate: small f. Leukocyte esterase: positive

A, B, D

Which findings are AIDS-defining characteristics? (Select all that apply.) a. CD4+ cell count less than 200/mm3 or less than 14% b. Infection with Pneumocystis jiroveci c. Positive enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV) d. Presence of HIV wasting syndrome. e. Taking antiretroviral medications

ANS: A, B, D A diagnosis of AIDS requires that the person be HIV positive and have either a CD4+ T-cell count of less than 200 cells/mm3 or less than 14% (even if the total CD4+ count is above 200 cells/mm3) or an opportunistic infection such as Pneumocystis jiroveci and HIV wasting syndrome. Having a positive ELISA test and taking antiretroviral medications are not AIDS-defining characteristics.

AIDS

HIV+ CD4<200 Development of opportunistic infection

stress incontinence tx

Kegels avoid stimulants weight loss topical estrogen midurethral sling antidepressants (Imipramine)

low protein levels (albumin)

causes fluid to enter into the 3rd space; decreases osmotic pressure; hypovolemia

chronic bronchitis

chronic inflammatory disease of airway; increased mucus production; rhonchi, wheezing, overweight, peripheral edema

risk anticipation of chronic bronchitis

pneumonia

high protein levels

reclaims fluid from 3rd space back to vascular space; dehydration

risk anticipation for PTX

respiratory failure

teaching for LABA + steroid

rinse mouth after inhale to prevent thrush

isotonic solution

stabilizes sodium and cell size

risk anticipation of asthma

status asthmaticus

stress incontinence

the inability to control the voiding of urine under physical stress such as running, sneezing, laughing, or coughing; weak pelvic floor muscles; secondary to physical exertion

lupus tx goals

to prevent exacerbation and negative effects of sun exposure

RA tx goals

to slow disease progression

Lupus

when immune system attacks tissues causing redness, pain, swelling, and damage

5. Which symptom should a nurse recognize as being pertinent to a possible diagnosis of systemic lupus erythematosus (SLE)? a. Butterfly rash of the face b. Protruding abdomen c. Thinning hair d. Bloody diarrhea

ANS: A The classic butterfly rash of the face is one of the most recognizable signs. Because the symptoms come and go, SLE is extremely hard to diagnose quickly. DIF: Cognitive Level: Comprehension REF: p. 658 OBJ: 5TOP: Systemic Lupus Erythematosus KEY: Nursing Process Step: Assessment

indications for thoracentesis

Diagnostic: suspected pleural space infection, new onset pleural effusion. Therapeutic: relieve dyspnea

thoracentesis complications

- Pneumothorax - Postaspiration pulmonary edema - Infection - Bleeding - Organ damage - embolism - mediastinal shift

Urge incontinence tx

-Bladder training and Kegel exercises, decrease alcohol, caffeine, carbonated beverages; -Oxybutynin (antimuscarinic) - decrease detrusor contractions

indications for bronchoscopy

-Visualization of abnormalities such as tumors, inflammation, and strictures -Biopsy of suspicious tissue (lung cancer) -Aspiration of deep sputum or lung abscesses for culture and sensitivity and/or cytology (pneumonia)

Which actions will the nurse take when preparing a client before thoracentesis? Select all that apply. One, some, or all responses may be correct. A. Assist the client to sit up on the edge of the bed. B. Remind the client not to eat before the procedure. C. Instruct the client to rest the arms on the bedside table. D. Verify that the client has signed the informed consent form. E. Educate the client about when to cough during the procedure.

ANS: A, C, D Rationale: A- The client is usually positioned sitting up at the side of the bed or seated facing backward on a chair so that the posterior thorax is exposed. C- The client will rest the arms on the bedside table, which increases the size of the intercostal spaces. D- Informed consent is needed before thoracentesis. B- Because no sedation or general anesthesia is needed for thoracentesis, the client does not need to refrain from eating before the procedure. E- The client should be instructed to avoid coughing or moving during the procedure to decrease risk for pneumothorax.

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first? a. Methylprednisolone (Solu-Medrol) 60 mg IV b. Albuterol (Ventolin HFA) 2.5 mg per nebulizer c. Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI) d. Ipratropium (Atrovent) 2 puffs per metered-dose inhaler (MDI)

ANS: B Albuterol is a rapidly acting bronchodilator and is the first-line medication to reverse airway narrowing in acute asthma attacks.

Nephritic syndrome symptoms

Hematuria, hypertension, and oliguria. Blood + little bit of proteinuria; puffy eyes in AM, evidence of FVO.

what does albumin do

Holds onto fluid in the vascular space and maintains osmotic pressure. Prevents fluid from entering tissues.

UTI tx

abx (bactrim, ciprofloxacin) pain relief (antispamodic)

overflow incontinence tx

alpha-adrenergic blocker (BP meds) Flowmax (Tamsulosin) Hytrin (Terazosin); Antidepressants imipramine (Tofranil) cymbalta (duloxetine)

priorities for PNA

antibiotics, pulse ox, monitor for sepsis

priorities for PTX

assess chest expansion symmetry, restore negative pressure, maintain breathing and circulation

urge incontinence

bladder not full, with urge to go; secondary to a stimulant

Asthma

chronic inflammatory disease; bronchoconstriction, increased mucus production; wheezing, SOB, cough

overflow incontinence

continuous leaking from the bladder either because it is full or because it does not empty completely; bladder full, cannot go; secondary to SCI

priorities for tension PTX

decompress by immediately removing air from pleural space

nursing process

five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing, and evaluating

risk anticipation of emphysema

hypercapnia, hypoxemia, increased permeability

emphysema

hyperinflation of air sacs with destruction of alveolar walls; weak diaphragm, overuse of accessory muscles, silent chest, thin/old patients, barrel chest

glomerulonephritis

inflammation of the glomeruli of the kidney; follows streptococcal infection in children

hypotonic solution

lowers sodium cell swells fluid enters cell

nephrotic syndrome symptoms

massive proteinurea, hypoalbuminemia, edema & hyperlipidemia. No blood.

risk anticipation for tension PTX

obstructive shock; compression of vena cava and respiratory failure