NLCEX ADULT HEALTH

Serum vancomycin trough level is monitored before the 4th dose ____________________ [10.4-13.8 µmol/L] is optimal).

(15-20 mg/L

An elderly client has a 17-mm induration after a tuberculin skin test (TST). Based on this result, which statement is most accurate?

(Option 4) A positive reaction indicates a TB infection only.

Prothrombin Time (PT)

11-16 seconds

Partial Thromboplastin Time (PTT) on hepRIN

25-35 seconds

In a heathy client, an induration _____________ indicates a positive TST; this means that the client was exposed to TB, developed antibodies to the disease, and has a TB infection.

>15 mm

complete heart block or 3rd-degree atrioventicular (AV) block

Block in electrical activity at AV node. Atria and ventricles beat independently

Manifestations of septic shock include

Fever or hypothermia (>100.4 F [38 C]; <96.8 F [36 C]) - Either fever or low body temperature is found in sepsis and septic shock. Fever d/t infection, whereas low body temperature can occur as shock worsens due to metabolic alterations and inadequate tissue perfusion Hypotension - Systolic BP <90 mm Hg or mean arterial pressure <65 mm Hg in a client with infection may indicate septic shock. Altered perfusion from hypotension may cause lactic acid accumulation and metabolic acidosis Prolonged capillary refill - A refill time >3-4 seconds in adults indicates inadequate tissue perfusion as a result of altered peripheral circulation and hypotension. Tachycardia - A resting heart rate >90/min is common in septic shock to compensate for decreased systemic vascular tone and hypotension. WBC count >12,000/mm3 (12 x 109/L) or immature neutrophils (bands) of >10% - An increased WBC count, especially with bands, indicates severe infection low urine output d/t inadequAte organ perfusion

TB, regardless of location, commonly presents with constitutional symptoms, including:

Low-grade fever Night sweats Anorexia and weight loss Fatigue

Common applications of droplet precautions Neisseria meningitidis Haemophilus influenzae type B Diphtheria Mumps Rubella Pertussis Group A Streptococcus (strep throat) Viral influenza

Personal protective equipment Surgical mask Private room As needed for procedures with risk of splash or body fluid contact: gloves, gown, goggles/face shield

highly specific cardiac marker for the detection of MI

TROPONING Serum levels increase 4-6 hours after the onset of MI, peak at 10-24 hours, return to baseline after 10-14 days.

atrial fibrillation and rapid ventricular response has decreased cardiac output and may progress to hemodynamic instability.

Treatment goals include reducing the ventricular rate to <100/min with medications (eg, diltiazem), preventing thrombotic events (eg, ischemic stroke) with anticoagulants (eg, warfarin), and possibly conversion to normal sinus rhythm with antiarrhythmics (eg, amiodarone). This client is not the best choice for transfer.

Signs of septic shock include

altered mental status, cool and clammy skin, decreased urine output fever or hypothermia, hypotension, tachycardia, and leukocytosis WBC count >12,000/mm3

Sjögren's syndrome (triad of symptoms - dry eyes, dry mouth, and dry vagina) ◯ Caused by obstruction of secretory ducts and glands

avoid decongestants as they cause further dryness to the mouth and nasal mucosa use eye drops, sugar-free candy or artificial saliva, vaginal lubricants, frequent dental examinations, lukewarm showers with mild soap, and avoiding decongestants.

Cystitis is the most common community-acquired UTI. It is an infection of the lower urinary tract and involves inflammation of the bladder mucosa, leading to hyperemia, tissue hemorrhage, and pus formation.

burning with urination (dysuria), urinary frequency and urgency, hematuria, and suprapubic discomfort

signs and symptoms (narrowed pulse pressure, hypotension, and jugular venous distension) of developing. Emergency pericardiocentesis is needed.

cardiac tamponade,

pyelonephritis

clients become seriously ill with nausea, vomiting, fever with chills, and flank pain.

pulmonary TB disease include cardinal (major) signs (eg,

cough, sputum production, dyspnea) and constitutional (minor) signs (eg, anorexia, weight loss, fatigue, fever, night sweats).

Care for the client with meningococcal meningitis includes

droplet isolation precautions, seizure precautions, reduced stimulus environment (eg, quiet, dimly lit), and bed rest with the head of the bed elevated between 10-30 degree

1st degree AV block

every impulse is conducted to the ventricles, but the time of AV conduction is prolonged. This is evidenced by a prolonged PR interval of >0.20 second.

A client with chest pain is diagnosed with acute pericarditis by the health care provider. The nurse explains that the pain will improve with which of the following?

sitting up n lean forward supine or lying-down position worsens pericarditis pain.

Normal values

troponin I <0.5 ng/mL (<0.5 mcg/L); troponin T <0.1 ng/mL (<0.1 mcg/L).