Advanced Med Surg Exam 2
A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse?
"A splint is applied when more swelling is expected at the site of injury.
A nurse is teaching a client about the side effects of ibuprofen. The client's learning is determined to be effective based on which statement by the patient describing the drug's effect on the immune system?
"Ibuprofen can cause neutropenia, which can increase my risk of infection."
Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.)
"Place pillows between your legs when you lay on your side." "Avoid bending forward when sitting in a chair." "Use a raised toilet seat and high-seated chair.
A client is seen in the emergency department for an injury acquired from falling off of a bicycle and fracturing the arm. The client also has a long laceration that has been sutured in the same area. The client asks the nurse why a splint is applied and not a cast. What is the best explanation by the nurse?
"We will need to monitor the status of the laceration to be sure it does not get infected."
An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker?
24 hours
When a nurse infuses gamma globulin intravenously, the rate should not exceed
3 mL/min
Antiretroviral medications should be offered to clients with T-cell counts less than
350 cells/mm3.
A client is to undergo surgery to repair a ruptured Achilles tendon and application of a brace. The client demonstrates understanding of activity limitations when stating that a brace must be worn for which length of time?
6-8 weeks
A nurse is developing a care plan for bone marrow suppression, the major dose-limiting adverse reaction to floxuridine (FUDR). How long after drug administration does bone marrow suppression become noticeable?
7-14 days
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery?
A cell-mediated response
A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?
Alkaline phosphatase Serum alkaline phosphatase levels are frequently elevated with osteogenic sarcoma or bone metastasis.
A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction?
Apply ice packs for the first 24 to 48 hours, then apply heat packs."
A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction?
Buck's An example of skin traction is Buck's traction. Crutchfield tongs, a Thomas splint, or balanced suspension traction are types of skeletal traction.
HIV targets
CD4+ cells, mainly helper T cells and impairs immunity which could lead to life threatening opportunistic infections
The nurse is assisting with the application of a cast. What will the nurse expect to be done first?
Cleaning the skin surface.
More than 50% of individuals with this disease develop pernicious anemia:
Common variable immunodeficiency (CVID)
Which assessment findings would cause the nurse to suspect compartment syndrome after casting of the leg?
Complaints of numbness and tingling in toes of affected leg
A client with allergic rhinitis is prescribed a mast cell stabilizer. Which would the nurse expect to be used?
Cromolyn sodium
Which of the following is the most frequent route of exposure to a latex allergy?
Cutaneous
This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte.
Cytotoxic T cell
A client who is being treated for complications related to acquired immunodeficiency disorder syndrome (AIDS) is receiving interferon parenterally as adjunctive therapy. Why does the nurse understand this route is being used?
Digestive enzymes destroy its protein structure.
What term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?
Dupuytren contracture
A client is suspected of having an immune system disorder. The health care provider wants to perform a diagnostic test to confirm the diagnosis. What test should the nurse prepare the client for?
Enzyme-linked immunosorbent assay
Clinical s/s of osteoarthritis
Heberdens nodes ( distal interphalangeal joint and bouchards nodes (proximal interphalangeal joint, pain, loss of function, ambulating with a limp and crepitus in the affected joint.
The provider asks a nurse to test a patient for Tinel's sign to diagnose carpal tunnel syndrome. The nurse asked the patient to:
Hold his palm up while the nurse percussed over the median nerve
Which of the following protective responses begin with the B lymphocytes?
Humoral
When malignant cells are killed (tumor lysis syndrome), intracellular contents are released into the bloodstream. This leads to which of the following? Select all that apply.
Hyperkalemia Hyperuricemia Hyperphosphatemia
Skin testing for allergies should not be performed
If bronchospams are present
What type of immunoglobulin does the nurse recognize that promotes the release of vasoa ctive chemicals such as histamine when a client is having an allergic reaction?
IgE
There are several types of reactions to latex. The nurse knows to be most concerned about laryngeal edema with the following reaction:
IgE-mediated hypersensitivity.
Which intervention should the nurse implement with the client who has undergone a hip replacement?
Instruct the client to avoid internal rotation of the leg.
A nurse would most likely expect the need for open reduction for a client with which of the following?
Joint fracture An open reduction is required when soft tissue is caught between the ends of the broken pieces of bone, the bone has a wide separation, open fractures are evident, comminuted fractures are present, and the patella or other joints are fractured. It is also done when wound debridement or internal fixation is needed.
A client visits an orthopedic specialist because of pain beginning in the low back and radiating behind the right thigh and down below the right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between which intervertebral disks?
L4, L5, and S1
Which type of immunity becomes active as a result of infection by a specific microorganism?
Naturally acquired active immunity
A client is brought to the emergency department after injuring the right arm in a bicycle accident. The orthopedic surgeon tells the nurse that the client has a greenstick fracture of the arm. What does this mean?
One side of the bone is broken and the other side is bent.
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of treatment does the nurse identity this as?
Open reduction
Which of the following is the medication of choice for early syphilis?
Penicillin G benzathine
What is the function of the thymus gland?
Programs T lymphocytes to become regulator or effector T cells
A client with HIV will be started on a medication regimen of three medications. What drug will the nurse instruct the client about?
Reverse transcriptase inhibitors are drugs that interfere with the virus' ability to make a genetic blueprint.
A client is about to have a cast applied to the left arm. What will nurse alert the client to as the cast is applied?
Sensation of warmth or heat with application
The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following?
Serum, which depletes the body's store of immunoglobulins
What assessment findings of the leg are consistent with a fracture of the femoral neck?
Shortened, adducted, and externally rotated
Most cases of osteomyelitis are caused by which microorganism?
Staphylococcus aureus
Morton neuroma is exhibited by which clinical manifestation?
Swelling of the third (lateral) branch of the median plantar nerve
Which of the following disorders is characterized by an increased autoantibody production?
Systemic lupus erythematosus (SLE)
The inflammatory response needs to be balanced so that what is helpful does not become harmful if mediators are secreted in excess. Which of the following are the primary mediators in an inflammatory response?
T cells and cytokines
T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do?
T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person.
A patient had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated?
The left leg is internally rotated.
A client is treated in the clinic for a sexually transmitted infection, and the nurse suspects that the client is at risk for HIV. The physician determines that the client should be tested for the virus. What responsibility does the nurse have?
The nurse ensures a written consent is obtained prior to testing
A nurse advises a patient with a casted femur fracture to check for signs of a fat embolism. She tells the patient that the onset of symptoms for FES occur:
The onset of symptoms for a fat embolism is rapid, usually within 12 to 48 hours after injury, but may occur up to 10 days after injury.
A continuous passive motion (CPM) machine is used to promote healing and flexibility in the knee and hip joint and increase circulation to the operative area. What is true about the use of CPM? Select all that apply.
The physician orders the amount of extension and flexion produced by the machine. The physician orders the frequency of use of the machine. The amount of flexion for clients with hip replacements should never exceed 30 degrees in the CPM machine.
External Fixation
The surgeon inserts metal pins into the bone or bones from outside the skin surface and then attaches a compression device to the pins.
Which of the following are antidepressants used in the treatment of AIDS? Select all that apply.
Tofranil Norpramin Prozac
Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
Tophi
Hypersensitivity reactions
Type 1-4 typically occur after re-exposure to an allergen that the body has been sensitized to
When the body mistakenly creates antibodies that attack the tissue of the host
Type 2 hypersensitivity diseases like myasthenia gravis can occur
An increase in neutrophils indicates
a bacterial infection while an increase in lymphocytes indicate a viral infection.
Hypercalcemia is an oncologic emergency and is marked by
a progressive change in LOC,, hyporeflexemia,ileus, constiopation, polyuria, and polydipsia.
a vaccine or pior exposure to a disease provides
active immunity isnce your immune system will actively generate antibodies in response to the antigen
Herpes or zoster is treated with
acyclovir , famiclovir, or valacyclovir.
Improve oral intake in the setting of nausea
by serving cold foods since they are less odorous, encourage oral hygiene, provide small frequent meals and make sure pain is managed.
Thrush
can make swallowing difficult and painful, could extend from the mouth to stomach if not treated.
extravasation of a vesicant
can result in tissue necrosis so never use the hand or wrist. Prevent by ensuring patency of intravenous device
Auto immune diseases increase the risk for
cancer. Karposis sarcoma and non hodgkin lymphoma.
The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout?
colchicine
Which of the following describes microorganisms present without host interference or interaction?
colonization
long term use of corticosteroids (predisone)
contributes to adrenal atrophy and hypofunction . abrubt s=cessation could lead to addisonian crisis. (acute renal failure).
Histamine
contributes to bronchospasms, wheezing, pruritis and localized edema while leukeotrienes trigger bronchial constriction, increase mucous production and skion reactions
Methotrexate
contributes to folic aced deficency and results in cell death. Med for Rheumatoid Arthritis.
Rinse mouth after using
corticosteroid metered dose inhaler
educate on foods high incalcium and magnesium
dairy products and dark green leafty veggies.
Acute respiratory failure is manifested by a
decrease in pa02 and an increase in paCO2 with respiratory acidosis.
An x-ray demonstrates a fracture in which the fragments of bone are driven inward. This type of fracture is referred to as
depressed
A nurse is monitoring the client's progression of human immunodeficiency virus (HIV). What debilitating gastrointestinal condition found in up to 90% of all AIDS clients should the nurse be aware of?
diarrhea
When assessing the skin of a client with allergic contact dermatitis, the nurse would most likley expect to find irritation at which area?
dorsal aspect of the hand
Instruct on factors that increase the risk for infection
excess alcohol, poor nutrition, smoking, gluccocorticosterioids and diabetes.
Manage pain in the setting of rheumatic diseases
exercise, joint protection, relaxation, foam mattress, splints and the app of heat or cold
Complimentary and Alternative Medicine (CAM)
extends beyond the use of nutritional therpaies and includes spiratual, guided imagery, positive affirmations, refelxology adn yoga.
clinical manifestations of hiv are
fever chills nightsweats weightloss, lymphadenopathy and fatigue.
Sepsis and bleeding are major complications
following bone marrow transplantation until new marrow engraftment occurs.
Trimethoprim/Sulfamethoxazole (Bactrim)
is used as a prophylactic therapy to prevent pneumocystits pneumonia and is started with t cell counts less than 200 cells.
Radiation safety precautions ( brachytherapy)
limiting time w client, wear dosimeter badge, keeping preg staff or visitors and children out of room, limiting visits to 30 min and keeping 6 feet away from the radiation source and keep a lead container in the room in case a radioactive device dislodges.
Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture?
maintain Buck's traction
Diarrhea could lead to
metabolic acidosis and electrolye imbalances esp. hypernatremia and hypokalemia.
Antihistamines (H1 blockers)
prevent histamine from binding to receptor sites thus preventing the development of new symptoms (this drug does not stop the release of histamine from mast cells so administer early)
The period from infection with HIV to the development of antibodies to HIV is known as which of the following?
primary infection
The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for?
pulmonary embolism
Limit adrenergic agents (vasoconstriction) to a few days because of the risk for
rebound congestion
Provide PCA
to help reduce complications r/t pain
The majority of patient with primary immunodeficiency are in which age group?
younger than 20
leukotriene modifers
zafirlukast, montelukast, zileuton ) liit production or block the inflmatory effects of leukotrienes.
The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given?
Alendronate
A client comes to the emergency department complaining of sudden onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills. Based on the client's history and physical findings, the physician suspects legionnaires' disease. While awaiting diagnostic test results, the client is admitted to the facility and started on antibiotic therapy. What's the drug of choice for treating legionnaires' disease?
Azithromyacin
Tumor markers
CEA, CA 125 are monitored to help determine the effectiveness of chemo.
CD4 cells
HELPER T cells- stimulate the immune system and help to destroy organisms
A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell?
Lymphocyte
A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby
Lymphocytes migrate to areas of the lymph node
The spleen acts as a filter for old red blood cells, holding a reserve of blood in case of hemorrhagic shock. It is also an area where lymphocytes can concentrate. It can become enlarged (splenomegaly) in certain hematologic disorders and cancers. To assess an enlarged spleen, the nurse would palpate the area of the:
Upper left quadrant of the abdomen.
Reduce the risk for infection by instituting neutropenic precautions
WBC less than 1000 avoid rectal or vaginal procedures, using electric razors, avoid stagnant water and reduce exposure to sources of infection
Gout attacks can be triggered by
alcohol, foods high in purines (shellfish, organ meets) or illness.
Natural immunity
allows the body to resist infection by respoinding to foreign substances with WBC, an inflammatory response and chemicals are all used to destroy pathogens
Which is a sign or symptom of septic shock?
altered mental status
Anaphlaxis could result in
angioedema, anxiety, bronchospasms, cough, dyspnea, dysphagia, dizziness, edema, hyopotension, pruritis, and wheezing.
Screen for cancer
annual mammogram at 40, colonoscopy at 50 q 10 years, annual fecal occult blood test at 50, pap test every 3 years
Breast feeding and immune globin are types of
aquired immunity since they contain antibodies that are given to you.
natural immunity
are the parts of your immune system that you are born with
Eosinophills
are typically elevated in an active allergic response
Treat wet desquamation
by leaving blisters intact and notifying pcp, avoid frequant washing of area bc of increased irritation, obtain an order for a cream or ointment and use a nonadhesive pad over the area
The reduction in t cells increases the risk for
oppurtunistic infections
Staging of a tumor is done
to communicate the size of the tumor, lymph node involvement, and metastisis.
The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?
Arthroscopy
During a routine physical examination of a client, the nurse observes a flexion deformity of the promixal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding?
Hammer toe
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
Methotrexate (Rheumatrex)
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
Stool specimen for ova and parasites
Movement ot inflammed joints can be limited by
applying splints to the area and allowing the joing to rest.
A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. What would the nurse describe as the first step?
attachment
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client?
autologuos
Clients with pneumonia may present with
dyspena, tachypnea, crackles, tachycardia, labored breathing, dullness on percussion and a decrease in o2 sats.
A hip spica cast
encloses the trunk and a lower extremity.
tx for anaphylaxis
epi, corticosteriods, and antihistamines.
The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of that complication?
foot drop
Immunodeficiency is marked by
frequent infections that could be severe, infections from organisms that do not typically cause a problem, poor treatment response and chronic diarrhea.
Arthrodesis is:
fusion of a joint (most often the wrist or knee) for stabilization and pain relief.
Buck's Traction (skin)
helps to decrease pain and muscle spasms and immobilizes the fracture
Some chemotherapy agents can induce
hemorrhagic cystitits which could lead to a life threatening hemorrhage so protect the bladder with IV hydration and diuresis.
Clinical s/s of tumor lysis syndrom
hyperkalemia, hyperphospahatemia, HYPOCALCEMIA, hyperuricemia, bradydysrhythmias, wide QRS complex, Tall tented t waves, tetany, seizures and flank pain.
Protein deficency
increases the risk for infection
The formation of immune complexes is followed by
phagocytic clearing
The nurse is reviewing the medication administration record of the client. Which of the following medications would lead the nurse to suspect that the client is at risk for osteoporosis?
raloxifene (Evista)
Classic signs of infection
redness, swelling, drainage, fever and chills, Elevated wbc.
maintaining or improving functional joint status and mobility
reducing inflammation and controlling pain are key goals in teh management of rhematic diseases.
CMV attacks the
retina and is the leading cause of blindness when individuals have autoimmune deficency
Notify the provider if a culture and sensitivity
reveals that the organism is resistant to the antibiotic
Assess nutritional status by monitoring
serum albumin, protein and transferrin level along with food intake
Educate on avoiding carcinogins
smoking, limiting alcohol and caloric intake, increasing activity, use sunscreen with min. of 15 spf, and using condoms
An increase in erythrocyte sedimentation reate
suggests there is an infection or inflammation
Radioallergosorbent test (RAST)
uses serum to measure allergen specific igE which decreases the risk of systemic reaction
The term used to define the amount of virus in the body after the initial immune response subsides is
viral set point
A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast?
Better molding to the client
Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm?
CDC category A: HIV asymptomatic
A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean?
Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?
Ergonomic changes can be incorporated into your workday to reduce stress on your wrist
Colony stimulating factors
Erythropoietin jstimulate rbc production decreasing the need for blood transfusions Nuepogen stimulates neutrophil production to decrease the risk for infection
A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My leg is burning, take it off." What action by the nurse is most appropriate?
Explain that the sensation being felt is normal and will not burn the client.
Antifungal agents
azoles can be used to treat oral candias.
Sjorgrens syndrome
drying of the mucous membranes and can make swallowing difficult.
A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth?
Electrical stimulation
allergen injections
could induce systemic reactions and should only be given where epi is available
Graft vs. Host disease
could present as blistering skin rash, diffuse inflammation to the GI tract with massive diarrhea or hepatomegaly.
Malignant neoplasms
invade other areas and branch off while benign tumors do not metastize.
A classic sign for low magnesium is
tetany like hypocalcemia.
A positive HIV test shows
that the individual has antibodies and has been infected with the virus
Being immunocompromised reduces
the clinical manifestations of infection so a temp of 100.4 for an hour is significant and should be reported.
A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?
Compound
A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client?
Cutting a cast window After the cast dries, a cast window, or opening, may be cut. This usually is done when the client reports discomfort under the cast or has a wound that requires a dressing change. The window permits direct inspection of the skin, a means to check the pulse in a casted arm or leg, or a way to change a dressing.
Which of the following diagnostics are used to evaluate spinal nerve root disorders (radiculopathies)?
Electromyogram
Preventing renal failure and electrolyte balance is a priority
in the setting of tumor lysis syndrom
Meformin should be stopped 48 hours beofre and after the administration
iodinated contrast medium
According to the TNM classification system, T0 means there is
no evidence of primary tumor.
A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse?
Assess for complications Unrelieved pain can be an indicator of a complication, such as compartment syndrome.
Reduce the risk of infection with elderly;
drink plenty of fluids unlesss contraindicated, use lotion, assess for signs of skin breakdown, change incontinence pads frequently, void after intercourse, pneumonoccal andflu vaccine, cough and deepbreathing exercising, and sitting up while eating
Suspect an increase for extravasion
if resistance is met while flushing the IV catheter, blood return is absent or there is burning pain or swelling to the site.
Signs of superior vena cava syndrome include
increased dyspena, facial/neck edema, JVD, visual disturbances and headache
Myeleosupression
induced by chemo, results in pancytopenia and increases the risk for infection, bleeding and fatigue
The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger promotes inflammation, fever, and angiogenesis?
interleukins
Lymphoid tissues, which perform a function within the immune response, are found throughout the body. While the thymus gland, tonsils and adenoids, spleen, and lymph nodes are lymphoid tissues, where else in the body can lymphoid tissues be found? Select all that apply.
intestines lungs
Anaphalaxis
is a life threatening sudden allergic reaction
Osteoarthritis (OA)
is a noninflammatory degeneration of aricular cartilage marked by joint pain that last less thatn 30 minn and resolves with rest.
Rhinitis medcamentosa
is a rebound rhinitis that accours with overuse of nasal decongestants, nasal mucosa is more edematous with med use prompting the use for more meds.
pneumocystis pneumonia
is caused by bacteria P. jirovecia and is the most common life threating infection that indidviduals with autoimmune deficency will ecounter.
Osteoarthritis
is initially treated with tylenol
RA
is marked by symmetrical joint pain and swelling involving small joints that last more than one hour.
Aquired immunity
is the type response that allows the body to respond to pathogens either actively or passive
Prevent dislodgement of intravavitary low dose radiation by
maintaing cl on bed rest, in private roome, give low residue foods, give antidiarrheal agents to prevent bowel movements, log roll to prevent dislodgement of device and insert foley
Prepare to give diphenhydramine for
mild allergic rx: urticaria, pruritis, flusihing,. give epi corticosteroids and vasopressors for severe reactions ( bronchospasms, hypoptension, shock, laryngeal edema).
Following a extravasion
neurovascular assessments of the affected extremity should be performed
A hypersensitivity reaction type 3
occurs when the immune complex is depositid into tissue or vascular endothelium (RA, systemic lumpus erythematous. ).
Serotonin Receptor blockers
ondansetron, granisetron and dopminergic receptor blockers (meclopramide, prochlorperazine) bland foods, small frequent meals are used to decrease nausea and vomiting.
A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period?
osteomyelitis Chronic osteomyelitis may occur after persistent infection in the late postoperative period.
Gout is typically marked by
pain and edema to the joint of the big toe
S/s of Rheumatic diseases
pain joint swelling with limited movement, stiffness, weakness and fatigue.
Common signs of thrombocytopenia include
petechiae and ecchymosis
Corticosteroids inhibit the inflammatory response
supress adrenal gland activity, increase the risk for hyperglycemia and hypernatremia and hypokalemia and could mask infection
Biologic disease-modifying antirheumatic drugs help to
supress inflammation and prevent joint eroision however, these drugs increase the risk for infection so monitor closely.
Painless chancres are associated with which systemic disease?
syphillis
systemic lupus erythematosus (SLE)
the immune system creates antibodies to part of the cells nucleus; theis disease affects nearly every organ in the body.
Cancer develops when
the immune system fails to recognize and destroy abnormal cells
HIV is primarily transmitted
thru blood, breast milk, semen and vaginal secretitons, this is also passed thru urine, saliva, and tears.
Encourage cl. who have diarrhea
to avoid foods that stimulate peristalsis ( fiber rich foods, lactulose and avoid nicotine which stimulates bowel motility.
Advise clients with stomatitis
to avoid mouthwashes that contain alcohol or tabacco bc they dry the mucousa, use a soft toothbrush, avoid rough hot or spicy foods and remove dentures unless eating.
Encourage the client to rest before meals,
to minimize fatigue wihich could decrease appetite
A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication will the client take for the treatment of this infection?
trimethoprim-sulfamethoxazole
A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for?
Left hip arthroplasty
