Med Surge II Midterm
What should the patient be encouraged to eat during the active phase of acute renal failure
A diet high in fats
What should the nurse caution a type one diabetic about exercise
You can decrease the need for insulin and me also result in hypoglycemia
nurse explains the diagnostic text that can scan chest and the abdomen in less than 30 seconds
spiral or helical CT scan
older adult with emphysema complains of a sharp pleuritic pain after a severe period of coughing. heart and respiratory rate is increased.auscultation reveals no breath sounds on left side
spontaneous pneumothorax
information should be obtained from the pt. before an iodine 131 test
status of possible pregnancy
what pt assessment indicates the most severe respiratory distress
substernal retraction SaO2 84%
when assessing the SaO2 with a pulse oximeter the nurse will place the oximeter on finger
that is normal temperature
inspiratiory capacity
the amount of air that can be inhaled in one breath from the resting expiratory level
prepares pt for the procedure of _ which will remove the fluid from around the lung to improve the respiration and obtain a specimen
throacentesis
Exercises to increase muscle tone of the pelvic floor are known as
Kegel
Which is a sign of acute angle closure glaucoma (AACG)?
Large fixed pupil
Progressive deafness caused by ankylosis of the stapes is the condition of
Ostoscleriosis
What is a common mistake that hinders communication when communicating with the hearing impaired?
Overaccentuating words
nurse recognizes _ the reading in arterial gas report indicates the amount of oxygen dissolved in the plasma
PaO2
nurse explains to the person with pneumonia in the left lung that being positioned in the "good lung down"
PaO2 rising in the good lung the dependent lung being better perfused decreased hypoxia
An intravenous pyelegram confirms the presence of a 4 mm renal calculus in the proximal left ureter of a newly admitted patient division orders include demoral 100 mg IM highest priority when planning of care for this patient would be
Pain related to irritation of a stone
What is the first indication of macular degeneration?
The loss of central vision
a pt. 69 has emphysema. on assessment nurse notes "barrel chest" what pathophysiology results from
an increased anteroposterior diameter cause by over inflation of the alveoli
The nurse clarifies that the difference between a photorefractive keratectomy (PRK) and a laser in-situ keratomileusis (LASIK) is that a LASIK:
removes some internal layers of the cornea
The nurse notes the amount and color of urine the patient with urolithiosis has voided while using standard for cautions what should be the nurses next action
strain the urine
pt with history of graves disease is admitted to the unit with shortness of breath. v/s: T 103, P 160, R24, BP 160/80
thyroid storm
The human insulin who is onset of action occurs with in _____minutes is lispro
15
nurse cautions the pt who is being instructed on self medication with insulin 25-30, 50, and 100 unit syringes. how is 100 unit syringe marked
2 unit increments
The nurse is aware that the patient has 20/40 vision. This means that the patient can see at 20 feet what the normal eye can see at _______ feet
40
When the newly blind male home health patient asks the nurse how he might get assistance, who might the nurse suggest he contact?
American Foundation for the Blind for a list of agencies
In diabetes insipidus a deficiency of which hormone causes clinical manifestations
ADH
What is a hormone from the posterior pituitary gland that influences the amount of water that is eliminated with the Urine
ADH
To which day should be patient with Cushing's syndrome adhere
Less sodium
What is the process when the lens of the eye changes its curvature to focus on the retina
Accommodation
When the home health patient is started on dialysis the home health nurse refers the patient to a community support group that assists with adjustments necessary to living with dialysis which group offers this service
American Association of kidney patients
Is a term for generalized exema
Anasarca
When the patient stares at the black dot on an Amsler grid, what should the nurse ask him to report?
Any distortion of the grid
A patient who had an enucleation of the right eye has been admitted PACU. What should the nurse include in the plan of care?
Apply a pressure dressing over the right eye socket
Impatient age 78 has been admitted to the hospital with dehydration and electrolyte in balance she's confused and incontinent of urine on admission which nursing intervention did the nurse include in developing a plan of care
Apply absorbent incontinence pads
What should the nurse advise the 20-year-old to do who has been put on cefaclor (Ceclor) for a resistant otitis media?
Avoid alcoholic beverages
What instructions should a nurse give to a diabetic patient to prevent injury to the feet
Avoid going barefoot and always wear shoes with soles
Which foods should the home health nurse consul hypokalemic patience to include in their diet
Bananas oranges cantaloupe
A cuteglomerulonephrin is commonly a result of a pre-existing infection of
Betahemo strep
What does the cataract treatment of phacoemulsification involve?
Breaking the cataract with ultrasound
Select all the conditions that may cause conductive hearing loss
Build up of cerulean Foreign bodies osteosclerosis of external auditory canal otitis media with effusion
What does diabetes retinopathy result from?
Capillaries in retina hemorrhage
What should the nurse comes out the young man with chronic prostatitsis to avoid
Cessation of intercourse
A patient who is receiving continuous bladder irrigation following a transurethral resection of the prostate complains of spasm like pain over his lower abdomen what should the initial intervention be by the nurse
Check the catheter and drain system for obstruction
As a nurse is shaving a patient who is today's post operative from a thyroidectomy the patient has a spasm of the facial muscles what should the nurse recognizes as
Chvostek sign
What is a significant risk factor for renal cancer
Cigarette smoking
What factors mostly nurse consider when assessing readiness to learn when teaching health promotion practices for the visually and hearing impaired
Cultural believes values habits
The nurse councils the 16-year-old boy playing his music at high-volume can result in which impairment in hearing related to
Damage of the fine hair cells in the organ of Corti
The patient has an stage renal disease and is it made it to the hospital with a blood urea nitrogen and level of 48 and excessive elevation of Brian could result from
Dehydration
What should the nurse do you want assisting a blind person to walk in and unfamiliar hospital environment
Describe the surroundings encourage the patient to ask for verbal cues place patient's hand on your shoulder or elbow
A patient has undergone test that indicate a deficiency of the parathyroid hormone secretion she should be informed of which potential complication
Laryngeal spasm
The purpose of the use of radioactive iodine in the treatment of hypothyroidism is to
Destroy some of the thyroid tissue
When the patient in the emergency room complains of seeing flashing lights and a curtain down over his right eye, the nurse recognizes this as a symptom of which condition?
Detached retina
Which complaint made by a 64-year-old patient during a health interview would alert the nurse to the possibility of cataracts?
Difficulty driving at night
A male patient age 71 has benign prosthetic hypertrophy he is recovering from a trans urethral prosthetic resection . the physician orders removal of the indwelling catheter two days after the procedure what made the patient experience after the catheter is removed
Dribbling of urine
term that describes a condition of normal thyroid function
Euthyroid
It is two days after a 42-year-old male patients urinary diversion surgery he continues to be critical of the hospital and the nursing care even though the staff has spent time explaining that cared to him what is the most likely explanation for his behavior
He is reacting to the loss of self-esteem and altered body image
Four hours after a stapedectomy the patient complains that hearing has not improved at all. What knowledge would the nurse use to shape a response?
Hearing will not return until edema subsides
Which of the following are causes of cataracts
Long-term use of corticosteroids congenital from exposure diabetes smoking
Chevostek and trousseau indicate
Low levels of calcium
The surgical incision into the air drum with either a knife or heating wire loop to relieve pressure in the middle ear is
Myringotomy
Is a prosthetic pain without evidence of infection or inflammation
Proatatodynia
The nurse is caring for a 75-year-old man who has developed diabetes insipidus falling ahead injury will include a plan Of care for
Protecting the patient from injury
In nephrotic syndrome the glomeruli are damaged by inflammation and allow small to pass through the urine
Proteins
The nurse reassured the patient recovering from acute glomerulonephritis that after all other signs and symptoms of the disease of side it is normal to have some residual
Proteinurea hemateria
To help a patient control incontinence what should the nurse recommended patient avoid
Spicy foods
The technique which involves an incision through the abdomen and the bladder is a
Suprapubic
Why would the nurse encourage a group of teenagers to protect their eyes with dark sunglasses by using a UV lamp
The lamp can cause cataracts
What should a patient who has had a cataract repair avoid?
The lifting of heavy objects
The patient tells the nurse that he is legally blind. How would this information impact the nurse's plan of care for this patient
The nurse would need to determine how this patient's visual impairment affects normal functioning.
The nurse explains that the negative feedback system controls formal release by communication between
The pit and other target organ
How would the nurse explain the purpose of photocoagulation to a diabetic patient with diabetic retinopathy?
The procedure will destroy new blood vessels, seal leaking vessels, and help prevent retinal edema
The patient with the nephrosis complains about the need for bedrest how would the nurse explained the benefit of bedrest
The recumbent position me in the indicate diuresis
What action should the nurse provide at the bedside when you post operative thyroidectomy patient
Trache tray
how should the newly diagnosed patient who has been prescribed isoniazid (INH) for the treatment of active TB
accept that therapy is long term
structures of the lung in which gas exchanged occurs
alveoli
leukotriene modifiers reduce the symptoms of asthma
by causing bronchodilation and anti-inflammation effects
27 year old pt with hypothyroidism is referred to the dietitian for dietary consultation.
calorie restricted meals
nurse should instruct pt who is hypocalcemic from hypoparathyroidism about a diet
canned fish with bones cucumbers tofu vit D supplement
what happens when there is a decrease in the oxygen level in the blood
chemo-receptors in the carotid body and aortic body stimulate the respiratory centers to modify respiratory rates
what instruction by the nurse is inappropriate for teaching the proper technique for collection of sputum specimen
collect specimens before meals
another term for hyperglycemic reaction
diabetic ketoacidosis
nursing caring for a pt who has a closed chest drainage system notes there is fluctuation (tidaling) in the water seal chamber.
document the tidaling
purpose of chest drainage
drains air blood and fluid from pleural space restores negative intrapleural pressure allow route for medication administration
nurse caring for pt who is receiving calcium gluconate for treatment of hypoparathyroid tetany. what assessment would indicate an adverse reaction
drop in blood pressure
pt on postoperative day 2 after undergoing a total hip replacement. pt complains of chest pain and is coughing up blood tinged sputum
elevate head of bed and administer oxygen
83 year old admitted with temperature of 102, chest pain, and fatigue. what is the infected fluid that the physician removes
empyema
The nurse will assess for _____________ when the older adult home health patient complains that the entire right side of his head hurts and he cannot chew without pain.
external otitis
how would the nurse examining a pt with pleurisy document a low pitched grating lung sound
friction rub
nurse explains the opening between the vocal cords
glottis
adrenal cortex secretes glucocorticoids. most important is cortisol
glucose metabolism providing extra reserve energy during stress
three major life threatening complications postoperatively of thyroidectomy
hemorrhaging tetany thyroid crisis
condition with a deficiency in growth hormone is
hypopituitary dwarfism
true about activities such as walking for the pt with emphysema
increase capacity to use oxygen
exacerbation
increase in the seriousness of a disease or disorder
s/s of hypoglycemia
irritability tremors diaphoresis
glyburide for pt age 57 when diet and exercise have not been able to control type 2 diabetes
it is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites
55 year old man comes to the health nurse at his place of work with epistaxis. reports having frequent nosebleeds that can usually control himself. whats the helpful assessment to do after
obtain blood pressure
stertorous
pertains to respiratory effort that is strenuous
master gland of the endocrine system
pituitary
appropriate nursing intervention for a patient age 40 who is diagnosed with active tuberculosis
place the pt in acid-fast bacillus (AFB) Isolation precaution
activity intolerance related to an imbalance between the oxygen supply & demand
plan care to provide optimum rest
independent nursing measure are effective in aiding pt to expectorate
positioning orthopneic position suctioning assisting to cough providing hydration
what should the nurse do to keep the chest tubes from becoming occluded
prevent dependent loops
a nursing diagnosis for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to removal of the larynx. what is an appropriate nursing intervention?
provide a pad and pencil or magic slate
pt with long term emphysema is admitted with secondary diagnosis of cor pulmonale.
pt will present with edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation
only insulin can be administered IV
regular
The nurse explained that a pneumatic retinoplexyis a repair of a retinal detachment using a bubble of _______to put pressure on the damage retina
Gas
What portion of the nephron is involved with the alteration
Glomerous of the bowman capsule
What should the nurse instructed patient to do before obtaining the urine specimen the urine for a culture
Obtain a clean catch specimen
The patient age 43 has cancer of the urinary bladder he has received a cystectomy with an illeal conduit which characteristics would be considered normal for his urine
Clear amber with mucus shreds
Irrigate with normal saline solution for 20 minutes
Conductive hearing loss
A patient has returned his room after a thyroidectomy with signs of a thyroid crisis during thyroid crisis exaggerated hyperthyroid manifestations my lead to the development of the potential little complication of
Congestive heart failure
What do miotic eyedrops do for a patient with glaucoma?
Constrict the pupil and open the canal of Schlemm
pt treated fro hypothyroidism should be instructed to eat well balanced meals including intake of iodine. which food contains iodine
Eggs
What should the nurse include in the plan of care following a tympanoplasty?
Elevating head of bed with operative side facing upward
The home health patient complains of tearing and a feeling of dryness in the right eye nurse assesses that the eyelid is turned in word and the Scalera is red the nurse documents this as the presence of
Entropion
The total removal of an eye is
Enucleation
What diagnosis test for diabetes provides a measure of glucose levels for the previous 8 to 12 weeks
HB A1 C
The nurse teaching a patient with type one diabetes about early signs of insulin reaction would include information about
Hunger and trembling sensation
The nurse assessing a patient who is taking furosemide finds an irregular pulse this is likely a sign of
Hypokalemia
A home health patient with end-stage renal this order has a nursing diagnosis of powerlessness related to life-threatening disease which nursing intervention would be most helpful
Include patient in making a plan of care
What should the nurse encourage bearing any other contraindication when teaching a patient how to decrease the chance of further problems with urolothiasis
Increase his fluid intake
How should the nurse advise a patient who has severe vertigo from labyrinthitis
Lie immobile and hold the head in one position until the vertigo lessens
A 56-year-old patient with cancer of the bladder is recovering from a cystectomy with a new Illeal conduit. what is the important aspect in nursing interventions of the patient with any Ileal conduit
Maintaining skin integrity
The patient is on postoperative day one after having undergone a TURP procedure he has continuous bladder irrigation actual urine output during continuous bladder irrigation is calculated by
Measuring total output and deducting the amount of irrigating solution used
A patient has come to the clinic because it in large hands and feet in Ammenoria an increase hair growth the symptoms are most likely indicate problems with
Pituitary gland
Activity intolerance related to an imbalance between the oxygen supply and demand
Plan care to provide optimum test
What must a patient do following a left vitrectomy
Position self in a face-down position for 4 to 5 days
The patient is scheduled for transuretheral of the prostate during pre-operative teaching what should the nurse emphasize about what the patient can expect after procedure
Red drainage from catheter
What should the nurse remind the hearing aid wearer to do when the nurse hears a whistling hearing aid?
Reinsert the ear mold
What is a long-term complication of diabetes
Renal failure
Because the kidneys are located in proximity to the vertebrae and are protected by the babes their location in documentation is referred to as
Retroparatpneal
What is the postoperative position for a person who has had a thyroidectomy
Semi Fowler
The physician orders and 1800 cal diabetic diet and 40 units of Humulin N insulin subcutaneously daily for a patient with diabetes why would a mid afternoon snack of milk and crackers be given
To prevent an insulin reaction
when nurse inflates the sphygmomanometer cuff exceeding the systolic blood pressure and observes a carpal spasm
Trousseau sign
What would a nurse do when the patient arrives in the pacu after a left stapedectomy
Turned a patient to his right side leave the bed flat medication immediately upon the complaint of nausea
What would you patient with hyperthyroidism be prescribed the drug met them Methimazole
Two block production of thyroid hormones
Which precaution should the nurse take when caring for a patient who is being treated with radioactive iodine
Wait three days after those before assigning a private nurse to care for this patient
how does pursed lips breathing assist patients with asthma during an attack
it opens bronchioles by backflow air pressure
age related changes in the older adult that make them @ risk for respiratory diseases
kyphosis decreases in pulmonary blood flow stasis pooling of secretions reduced number of cilia
administering long acting insulin once a day, provides insulin coverage for 24 hrs.
lantus
important precaution should nurse include when instructing emphysema on the use of home oxygen
limit 1 to 2 L oxygen flow
The nurse takes into consideration that the Weber test indicated a conductive hearing loss in a patient because the patient reported hearing the tone:
louder in his affected ear.
what should nurse include provision for the postoperative care of the pt who has thyroidectomy
maintaining anatomic position doing voice check every 2 hours checking for bleeding at the sides and the back of the head
How will the kidneys behave in respiratory acidosis
retain bicarbonate to increase the pH
What is an appropriate nursing diagnosis for a patient who has recently been diagnosed with acromegaly
risk for trauma
instructions should be included in the discharge instruction for a 47 year old with hypothyroidism
seeing the physician regularly for follow up care
assessing an 11 year old who has asthma attack expects to hear adventitious sounds of
sibilant wheezes
pt be postponed after thoracentesis is completed and the dressing applied
side lying unaffected side
what is the purpose of the cilia?
sweep debris toward nasal cavity
If patient is receiving cholorothiazide A diuretic for hypertension what nursing action is most important for prevention of complications
Is this for hypokalemia
One of the housekeepers splashes a chemical in the eyes. What should be the first priority
Irrigate with normal saline solution for 20 minutes
The home health nurse suggested use of complementary and alternative therapies to prevent and or treat urinary tract infections which is an example of such a therapy
Cranberry juice
As the body breaks down proteins nitrogen wastes are broken down into urea ammonia and
Creatinine
Why is otitis media found more frequently and children 6 to 36 months
Estucian tubes and children are shorter and straighter
Patient was the status is receiving pyridium for pain and is avoiding a bright red orange urine what should the nurse do
Explain to the patient that this is normal
Which may contribute to otitis media
Exposure to cigarette smoke allergies upper respiratory infections
Which test will furnish immediate feedback for a new diagnosed diabetic who is not yet under control
Fasting blood sugar FBS
Why are pediatric patients especially girls susceptible to urinary tract infections
Females have a short and proximal urethra in relation to the vagina
The nurse is aware that a person ages there is a loss of _______mechanism of the Kidney to decrease and loss of nephrons
Filtering
Which action to reduce the risk of skin impairment secondary to urinary incontinence
Frequent toileting and meticulous skin care
Which of the following signs of fluid overload in the patient
Increased pulse rate increase daily weight edema labored respirations
As the nurse and a dietitian review a female patients diet plan with her she shouts that with her diabetes and now the kidney failure there is just nothing she can eat she says she might as well eat what she wants because there is nothing she can do to help herself . based on the patient's response which nursing diagnosis does the nurse identify
Ineffective coping related to sense of powerlessness
The patient is a 20-year-old college student who has type one diabetes and normally walks each evening as part of an exercise regimen the patient plans to enroll in a swimming class which adjustment should be made based on this information
Monitor glucose level before during and after swimming to determine the need for alterations in food or insulin
Why are your urinary tract infections common in older adults
Older adults her we can muscular in the bladder and urethra older adults have urinary stasis the effects of medications of meds sucas as diurtetics The effects medication such as diuretics
The 62-year-old home health patient who is recovering from eye surgery complains of a feeling of "grittiness" in the eye and is having blurred vision. The eyes are reddened and have stringy mucus. What do these complaints indicate?
Sjögren syndrome
how should the nurse administer insulin to prevent lipohypertrophy
at room temperature
major advantage of video assisted throacoscopic surgery (VATS)
surgeon can remove tumors of the lung through a small keyhole incision
pt age 22 admitted with acute asthma, patient shows a pulse oximetry level of SaO2 of 82%
there is only 82% of oxygen bound to the hemoglobin compared with the amount available
preoperative teaching should a nurse include for a person scheduled for a partial laryngectomy
tracheal suction will be frequent presence of a temporary tracheotomy surgery involves removal of a diseased vocal cord some speech will be retained
The nurse is reviewing the urine analysis report on an assigned a patient the nurse recognizes which of the following to be normal
turbidity clear PH 6 glucose negative
young man who has bronchoscopy 1 hr ago and asks when he can eat.
when gag reflex returns
