PNP Class #124 Combined Quizlet. All Level Two Units, Lab Values, Medications and Practice Questions from Moodle

Deltoid IM injection amount limit

1 mL

Levimir and Lantus Onset

1 to 2 hours

Intramuscular needle length - deltoid

1"

Intradermal injection amount

0.1 ml

Creatinine

0.6-1.2

Regular Onset

1/2 to 1 hour

C) avoid strenuous activity and allow time for rest periods.

10) The nurse is providing discharge teaching to a client with cardiomyopathy. The nurse should instruct the client to: A) maintain a daily intake of vegetables high in vitamin K. B) keep the lower extremities elevated whenever sitting. C) avoid strenuous activity and allow time for rest periods. D) take vitamin B12 supplements daily.

PT normal result

10-13 seconds

BUN

10-20

D) Heparin therapy

100) A client has just been diagnosed with a pulmonary embolism. The nurse anticipates that the physician will order which medication therap A) Bronchodilator and nebulizer treatments B) Antibiotic therapy C) Nitroglycerin therapy D) Heparin therapy

B) "It detects the presence of bacteria that contribute to formation of peptic ulcer disease."

106) A client scheduled to have a urea breath test asks the nurse what the purpose of the test is. What should the nurse explain? A) "It identifies the pressure of the esophageal sphincter." B) "It detects the presence of bacteria that contribute to formation of peptic ulcer disease." C) "It is done to determine the amount of hydrochloric acid secreted by your stomach." D) "It measures the acidity of your esophagus and gastric fluids."

D) metabolism of drugs.

107) The nurse is assigned to care for a client with cirrhosis of the liver. The nurse recognizes that the client's impaired liver function will affect: A) formation of red blood cells. B) formation of hydrochloric acid. C) production of digestive enzymes. D) metabolism of drugs.

D) losing weight.

11) The nurse is explaining to a client that the peripheral vascular system plays a large part in regulating the blood pressure. The client at risk for alterations in the peripheral vascular system can help decrease vasoconstriction by: 11) _____ A) increasing alcohol intake. B) increasing sodium in the diet. C) decreasing calcium intake. D) losing weight.

A) upper-body obesity has a greater chance of complications.

110) Obesity contributes to a number of alterations in health, such as heart disease, hypertension, and cancer. The nurse should explain to the client that: A) upper-body obesity has a greater chance of complications. B) obesity is not caused by hormone imbalances. C) a person with an obese parent has a 20% chance of being obese. D) under-eating causes obesity.

C) place the client in Fowler's position and ensure a patent airway.

111) A client with peptic ulcer disease (PUD) becomes dizzy and begins to vomit blood. The initial action by the nurse should be to: A) place a nasogastric (NG) tube in the client. B) notify the nursing supervisor. C) place the client in Fowler's position and ensure a patent airway. D) call the physician.

B) will need to be NPO for 8-12 hours prior to the exam.

112) The nurse is instructing a client in preparation for a colonoscopy. The nurse should explain that the client: A) will be given a soap-suds water enema shortly before the exam. B) will need to be NPO for 8-12 hours prior to the exam. C) is permitted to drink clear liquids up until the time of the exam. D) should eat a low-residue meal the evening before the exam.

D) Hemoptysis

113) The nurse caring for a client admitted with a diagnosis of suspected lung cancer might expect to find what on assessment? A) Dysphagia B) Cyanosis C) Night sweats D) Hemoptysis

C) decreased albumin levels.

114) A client is admitted with malnutrition. The nurse should expect laboratory studies to show: A) elevated bilirubin levels. B) elevated blood sugar. C) decreased albumin levels. D) decreased alkaline phosphate level.

A) Bright red blood in the gastric return

115) A client with gastrointestinal (GI) bleeding is receiving gastric lavage. For what should the nurse monitor this client? A) Bright red blood in the gastric return B) Increased urine output C) Jaundice D) Bloody stools

Hemoglobin

12-18

B) Withdraw the tube.

128) The nurse is placing a NG tube in an older client with malnutrition. During placement, the client begins to cough. What should the nurse do? A) Check for placement of the tube. B) Withdraw the tube. C) Ask the client to swallow during insertion. D) Pause and then continue inserting the tube.

B) Elevate the scrotum on a small pillow.

129) A male client had a herniorrhaphy for an incarcerated inguinal hernia. Postoperatively, the nurse identifies pain as the primary problem associated with edema of the scrotum. Which nursing intervention is appropriate for this problem? A) Administer narcotics for pain. B) Elevate the scrotum on a small pillow. C) Provide warm sitz baths several times a day. D) Apply moist heat to the abdomen.

D) clear lung sounds.

13) A client has been treated with a cardiac glycoside and diuretics for congestive heart failure (CHF). The nurse determines that the treatment has been successful when the client experiences: A) weight loss. B) an increase in energy level. C) improved level of consciousness. D) clear lung sounds.

Humalog Onset

15 minutes

A) Higher doses of cortisone

150) A client being treated with cortisone for Addison's disease is admitted to the ICU seriously ill. What should the nurse expect to be a part of this client's care? A) Higher doses of cortisone B) Placed on a healthy diet C) Changed to a different drug D) Ambulated as soon as possible

Platelets

150,000-400,000

C) "I will be careful not to hurt myself, since I could break a bone easily."

155) A client with Cushing's syndrome was taught by the nurse about safety precautions to use at home. Which comment indicates that the client understands the instructions? A) "I should get up slowly from bed or my chair because I might faint." B) "I should avoid direct sunlight to prevent my skin from developing dark patches." C) "I will be careful not to hurt myself, since I could break a bone easily." D) "I should learn some relaxation exercise so that I do not become suicidal."

C) the client is wearing cotton socks.

170) The nurse is evaluating a client with diabetes 3 months after discharge from the hospital. The nurse determines that goals have been met if: A) the client leaves her shoes and socks on. B) urine for ketones is positive. C) the client is wearing cotton socks. D) the fasting blood sugar is 130.

Vastus Lateralis IM injection amount limit

2 ml

INR therapeutic Result

2-3

Intramuscular needle gauge

20-22 guage

Levimir and Lantus Duration

24 hours

Subcutaneous needle guage

25-28 gauge

Normal PTT time

25-35 seconds

D) The client smokes two packs of cigarettes per day and is obese.

27) From collected data the nurse determines that a client is at risk for hypertension. Which is the most significant risk factor that the nurse assessed in this client? A) The client is a manager at Microsoft. B) The client's maternal grandmother died of complications related to malignant hypertension. C) The client only exercises three times per week and is 15 pounds overweight. D) The client smokes two packs of cigarettes per day and is obese.

C) The extremity suddenly became white, cold, and painful.

29) The nurse is performing a circulatory system assessment with a client. Which finding suggests that the client has a total arterial occlusion? A) The client complained of itchy skin. B) The extremity has full and bounding pulses. C) The extremity suddenly became white, cold, and painful. D) The client experiences transient loss of sensation in an extremity.

B) Vision color changes indicate digoxin toxicity.

3) The nurse is teaching a client about the newly prescribed medication digoxin (Lanoxin). Why should the nurse instruct the client to report signs of yellow- or green-colored vision? A) The client is also taking antacids. B) Vision color changes indicate digoxin toxicity. C) Color changes indicate an allergic response to digoxin. D) The potassium level is in danger of being too high.

Potassium

3.5-5.2

D) "Avoid drinking any alcohol while taking this med.

34) A client being discharged following treatment for a deep venous thrombosis (DVT) will be taking warfarin (Coumadin) at home. What should the nurse instruct this client? 34) _____ A) "If you miss a dose of the drug, wait until the next day to take the next dose." B) "Include a lot of dark green, leafy vegetables in your diet." C) "Use over-the-counter anti-inflammatory drugs for pain or a headache." D) "Avoid drinking any alcohol while taking this med.

has had a blood transfusion in the past.

35) In an effort to determine whether a client has been exposed to HIV, the nurse might inquire whether the client: A) has had a blood transfusion in the past. B) makes frequent trips to the bathroom to void. C) has decreased fluid intake. D) is married.

Hematocrit

35-52%

A) "How much meat do you consume in a week?"

36) The client with anemia is in the emergency department. During the assessment and health history, what should the nurse ask the client? 36) _____ A) "How much meat do you consume in a week?" B) "Has your face been unusually red?" C) "Have you been experiencing bouts of energy?" D) "Do you have swelling in your groin?

C) "It is indicative of sickle-cell disease or trait."

37) The physician has informed the parents that the results of a hemoglobin electrophoresis performed on their child indicate the presence of hemoglobin S. When the parent asks what this means, the nurse should explain that: A) "Hemoglobin S is a type of immature red blood cell." B) "Hemoglobin S is found in people with pernicious anemia." C) "It is indicative of sickle-cell disease or trait." D) "It verifies the presence of hemolytic anemia."

Therapeutic PTT time

37-70

B) decreased platelets.

39) A client is admitted with purpura and blood in the urine and stool. The nurse reviews the ordered blood work and suspects that the client might be experiencing: A) decreased monocytes. B) decreased platelets. C) an increased red blood cell count. D) increased eosinophils.

B) Limit sodium in the diet.

4) The client experiencing right-sided heart failure is prescribed digoxin and spironolactone (Aldactone). Which diet change should the nurse instruct the client to make? A) Include oranges and bananas in the diet. B) Limit sodium in the diet. C) Take a diuretic before going to bed. D) Eat spinach three times a week.

White Blood Cells

4,000-11,000

Red Blood Cells

4-6 million

D) Purpura

40) While bathing the client, the nurse observes large purple-colored rashes on the client's chest. How should the nurse document this finding? A) Erythema B) Papules C) Petechiae D) Purpura

A) pernicious anemia

42) A client with extreme fatigue is being interviewed by the nurse. The client reports a sore tongue and frequent bouts of diarrhea. The nurse should suspect that the client is experiencing: A) pernicious anemia. B) a lack of iron in the diet. C) lymphedema. D) folic acid deficiency.

D) platelet transfusion.

46) The nurse is caring for a client with thrombocytopenia. The nurse expects that the client might be treated with: A) blood transfusion. B) Heparin. C) iron. D) platelet transfusion.

D) Maintaining skin integrity

50) The nurse is planning care for a client who is experiencing chronic lymphedema of the left arm. What should be the priority for this patient? A) Monitoring urine output B) Increasing dietary sodium C) Keeping the affected arm immobile and flat D) Maintaining skin integrity

B) Cheilosis

51) The nurse is assessing a client with chronic iron deficiency anemia. What finding should the nurse expect during this assessment? A) Clubbing of the fingernails B) Cheilosis C) Jaundice D) Petechiae

A) constriction of blood vessels.

52) The nurse instructs clients with hypertension to drink beverages with caffeine (coffee, tea, cola drinks) in moderation because caffeine causes: A) constriction of blood vessels. B) accumulation of plaque in blood vessels. C) dilation of blood vessels. D) hardening of the arteries

A) alveoli.

55) The arterial blood gas results for a client indicate low oxygen and elevated carbon dioxide levels. The nurse realizes that the client is having difficulty exchanging gases in the: A) alveoli. B) bronchi. C) pleura. D) trachea.

C) keep well hydrated.

57) The nurse is preparing a client recovering from sickle cell crisis for discharge. To prevent future crises from occurring, the nurse should instruct the client to: A) avoid doing any types of exercise. B) abstain from alcohol use. C) keep well hydrated. D) eat a high-protein diet.

C) Anorexia, nausea, malaise, and blurred vision

6) The nurse is teaching a client recently started on digitalis preparation the signs and symptoms of toxicity. The client should be instructed to notify the physician if what is experienced? A) Loss of night vision, anxiety, and leg cramps B) Anorexia, anxiety, and pulse rate below 70 C) Anorexia, nausea, malaise, and blurred vision D) Vision disturbances, abdominal cramps, and pulse above 80

NPH peak

6-12 hours

Regular duration

6-8 hours

C) The laryngeal and cough reflexes do not function if the client is unconscious.

60) The nurse is caring for an unconscious client. For which reason should the nurse prevent the aspiration of fluid into the client's lungs? A) The cough reflex is diminished when the client is unconscious. B) The sinuses drain when the client is unconscious. C) The laryngeal and cough reflexes do not function if the client is unconscious. D) The client who is unconscious does not breathe.

D) hold the pressure for 5 minutes or longer.

62) A client has blood drawn for an arterial blood gas. When applying pressure to the puncture site, it is important for the nurse to: A) keep the extremity elevated above the heart. B) have a tourniquet available in case bleeding does not stop. C) hold the pressure for at least 60 seconds. D) hold the pressure for 5 minutes or longer.

A) "You will be asked to breathe in a specific manner, and measurements are taken."

66) A client scheduled for a pulmonary function test asks what is involved in the test. The nurse should explain: A) "You will be asked to breathe in a specific manner, and measurements are taken." B) "An x-ray of your lungs is taken after a dye is injected into your vein." C) "A sensor is placed on your fingertip or earlobe, and your oxygen levels will be measured." D) "You will have blood drawn from an artery in your wrist."

A) breathing is controlled by the respiratory center in the brain

67) The nurse caring for a client who has sustained a head trauma closely monitors respirations because: A) breathing is controlled by the respiratory center in the brain. B) the client will be unable to cough and clear secretions. C) the client will be lethargic and will forget to breathe. D) the trauma might cause the client to be disoriented.

Normal Fasting Blood Glucose

70-100

C) Stridor and use of accessory muscles

71) A client is diagnosed with epiglottis. For what should the nurse monitor the client? A) Increased nasal secretions B) Deep cough C) Stridor and use of accessory muscles D) Severe sore throat

A) Pace activities to allow the client to rest.

74) The nurse is caring for a client with a nursing diagnosis of Ineffective Breathing Pattern. Which intervention should the nurse plan for this client? A) Pace activities to allow the client to rest. B) Lower the head of the bed. C) Teach the client how to cough effectively. D) Force fluids.

A) dysphagia.

76) When assessing a client with streptococcal pharyngitis, the nurse can expect the client to complain of pain and: A) dysphagia. B) palpitations. C) nausea and vomiting. D) headache.

B) Dyspnea, orthopnea, and cough

8) A 78-year-old client is admitted with the diagnosis of left-sided congestive heart failure. When assessing the client, what signs and symptoms should the nurse expect to find? A) Signs of fluid volume deficit, hypokalemia, and hypernatremia B) Dyspnea, orthopnea, and cough C) Enlarged liver, venous congestion, and distended neck veins D) Peripheral dependent edema and bradycardia

D) inflammation of the airways.

81) The nurse is teaching a client who is newly diagnosed with asthma. The nurse explains that air is trapped in the alveoli due to: A) decrease of the production of mucus. B) shortening of the expiratory phase of ventilation. C) the release of antihistamines in the body. D) inflammation of the airways.

B) checking nasal or ear drainage for glucose.

82) The nurse monitors a client with suspected nasal bone fractures for cerebrospinal fluid leakage by: A) checking the nasal drainage for blood. B) checking nasal or ear drainage for glucose. C) determining the amount of postnasal drainage. D) gently palpating nose for presence of crepitus.

A) Immunosuppression B) Pregnant C) Diagnosed with a chronic disease

83) A 35-year-old client is not a candidate for the intranasal influenza vaccine. For which reasons is this type of vaccine contraindicated? (Select all that apply.) A) Immunosuppression B) Pregnant C) Diagnosed with a chronic disease D) Recent surgery E) Age

D) Improve shallow breathing.

85) A 24-year-old client is in the hospital with pneumonia. Why should the nurse encourage the client to request medication for pain? A) Promote sleep. B) Improve appetite and strength. C) Reduce the accumulation of fluid in the lungs. D) Improve shallow breathing.

A) fluid in the alveoli.

91) The nurse auscultates crackles at the bases of the lungs of a client with adult respiratory distress syndrome (ARDS). The nurse knows that these adventitious lung sounds are due to: __ A) fluid in the alveoli. B) constriction of the airways. C) mucus in the airways. D) hyperinflated alveoli.

B) to prolong exhalation to help remove carbon dioxide from the lungs.

92) The nurse instructs the client with chronic obstructive pulmonary disease (COPD) to practice pursed-lip breathing and explains that this breathing technique is done: A) to prolong inhalation to help bring more oxygen to the lungs. B) to prolong exhalation to help remove carbon dioxide from the lungs. C) to use the abdominal muscles to breathe, giving the diaphragm a rest. D) to break up mucus that has accumulated in the airway.

B) "Have you taken all of your medicines as prescribed?"

93) A client with tuberculosis has been on drug therapy for several months, but his sputum is still positive for tuberculosis bacilli. It would be most important for the nurse to ask: A) "Are you feeling better now that you are taking medicine?" B) "Have you taken all of your medicines as prescribed?" C) "When did you last take your medications?" D) "Have you had any reaction to your medications?"

D) Deviated trachea

94) A client with a gunshot wound to the chest is suspected as having a tension pneumothorax. What should the nurse expect to assess for this health problem? A) Wheezes in all lung fields B) High blood pressure C) Audible sucking sounds on inspiration D) Deviated trachea

B) Intrinsic factor

95) A client is diagnosed with pernicious anemia. What should the nurse instruct is needed to absorb vitamin B12? A) Hydrochloric acid B) Intrinsic factor C) Enzymes D) Chyme

B) glaucoma.

97) A client with asthma is taking being started on tiotropium (Spiriva) to help dilate the bronchi. The nurse should monitor the client for: A) fever. B) glaucoma. C) cardiac disease. D) jaundice.

B) Oranges

98) The nurse is teaching a client with a large leg wound about foods that aid in healing. Which food should the nurse suggest that the client ingest each day? A) Whole wheat bread B) Oranges C) Chicken D) Spinach

A) Return of the client's gag reflex

99) The nurse is caring for a client who has just returned from surgery. The client is asking for fluids due to thirst. What should the nurse assess before providing the client with fluids? A) Return of the client's gag reflex B) Ability to sit up C) Urine output D) Ability to ambulate

Intermittent claudication

A specific indicator for PVD which is characterized by pain in the calves, arches, or foot that is increased with exercise is called?

Liver

ALT, ALP, and GGT are tests to determine the function of what organ?

50

After what age are you more likely to see a diagnosis of leukemia?

Nephrotoxic - make these assessments BUN, Creatinine, I&O, Daily weight, damage to auditory nerve

Aminoglycoside considerations

Arterioles

Arteries branch into smaller vessels called:

Anti-Alzheimers Nursing Care

Assess pulse, monitor weight, assess for NVD, Assess cognitive function

Less than 4,000

At what level would a client be placed on neutropenic precautions?

Penicillin

Augmentin (Amoxicillin)

If the client has received the vaccine, they will always test positive for tuberculosis.

BCG is a vaccine given to people to prevent tuberculosis in developing countries. What should you remember about this vaccine?

Sulfonimides

Bactrim (trimethoprim/sulfamethoxazole)

Help control viral and bacterial infections

Besides destroying cancer and foreign tissue what else do cytotoxic t-cells do?

Monitor glucose levels due to pancreatic complications Monitor for signs of infection due to the spleen playing a role in immune defense. Encourage good nutrition Encourage vaccination for the flu

Besides making sure your client who has undergone a splenectomy does their deep breathing an coughing, what should you make sure to do?

Liver, Pancreas, Colon

Biopsies are performed in what GI organs?

Blood, colon cancer

CEA, carcinoembryonic antigen) is a _________ test, and levels are increased in patients with ____________.

CK and CK-MB

CK comes in two forms, what are they?

Heart and skeletal

CK or CPK indicates necrosis in what muscles?

Penicillin

Cephalosporin has a cross sensitivity to:

Proteinuria, Glycouria

Cephalosporins can lead to false positives for

Cardiac Markers

Certain proteins that are released by necrotic heart muscle after an MI are called:

COPD

Chronic bronchitis may also be classified under what other pulmonary condition?

Pancytopenia

Clients with aplastic anemia usually have decreases of all blood cell counts. What is this called?

The small intestine/Duodenum

Digestion is completed here.

Yes.

Do you need to fast for a serum bilirubin test?

Tetracycline

Doxyclycline

Fatty acids and glycerol

Fats are broken down into

to determine the type of cells present (diagnose cancer)

For what purpose would a provider order a biopsy?

Testing occult blood Checking for ova and parasites Culture

For what purposes would a provider order a stool sample?

Culture for bacteria, cytology

For what reason would someone collect the fluid of a patient who is undergoing a paracentesis?

Duodenal

Gastric or duodenal ulcer? Discomfort 1.5-3 hours after a meal, often occurs at night, pain is relieved by food.

Anti-Anemics Nursing Care

Give one hour before or two hours after meals with OJ, monitor for constipation, stool will be black and tarry, give with straw to protect teeth from staining, injectable - give with z track, DO NOT give milk products.

Blood, semen, vaginal secretions, breast milk, and the plancenta.

HIV can be transmitted through which bodily fluids?

The rule of nines.

How does a provider estimate the extent of burns?

IV

How does the recipient receive the donated marrow?

EKG, abnormal stress testm abnormal Thallium stress test, angiogram/cardiac catheter

How is angina pectoris diagnosed?

Chest Xray. Will show white

How is pleural effusion/empyema diagnosed?

One cell

How thick is a capillary wall?

A dark area where the Thallium is not picked up by ischemic or infarcted cells.

How will tissue with inadequate perfusion appear on a Thallium scan?

Blood

If you client is HIV positive, which bodily fluid contains the highest number of viral cells?

Things that relax the sphincter. (Smoking, Caffeine, Alcohol)

In general, GERD symptoms are worsened by:

Adolescents and young to middle age adults.

In what population does Acne Vulgaris usually occur?

Blood forming tissue.

Leukemia is a disease of:

X

On which gene is hemophilia carried?

Empty

Pencillin should be given on an _____ stomach.

A or O

People with type A blood can receive which blood types?

Universal recipient

People with type AB+ can receive which blood types?

Amino Acids

Proteins are broken down in digestion into:

Hemoglobin

Red blood cells are composed of a protein called:

Ph is low, CO2 is high

Respiratory Acidosis occurs when

Ph is high, Co2 is low.

Respiratory Alkalosis occurs when

Cephalosporin

Rocephin, Keflin, Ancef,

Hemolytic

Sickle cell disease is considered what kind of anemia?

Dizziness, photosensitivity

Side effects of Flouroquinolines

Medications, Chemo, Cancer

Sometimes, thrombocytopenia can be linked to a specific cause. What are they?

Aorta, arteries, arterioles, capillaries, venules, veins, vena cava.

Starting with the aorta, explain the path of blood around the body and back to the vena cava.

The ability to develop collateral circulation. Older people have developed smaller blood vessels that can sidestep an occlusion. Young people have not, therefore the risk of a fatal MI is greater.

The extent of the damage that occurs during a myocardial infarction depends upon this.

Reabsorb electrolytes and fluids into the body.

The function of the large intestine is

Peritoneum

The large serous membrane lining the abdominal cavity.

The AV node

The signal from the SA node travels through heart tissue to what?

HGB, HCT, RBC's.

The term anemia is used when these three tests are below normal.

The nervous system The level of a substance in the blood. Another hormone

There are three ways the body uses to trigger the release of a hormone. What are they?

Reduced immune function Certain viral infections Family history of lymphoma Exposure to chemicals (herbicides)

There is no real cause for lymphoma, but what are some of the risk factors?

CKMB

This subset of the marker CK indicates nercrosis specifically in cardiab muscle.

Hemophilia

This word is a blanket term for a group of diseases in which normal clotting factors are missing.

Pyloric

Through which sphincter does chyme travel to the duodenum?

Caucasian females between 25-65

Thyroid Cancer occurs most often in what population?

True. It is often called Ideopathic Aplastic Anemia because the cause is unknown.

True or False: Primary Aplastic Anemia has no known cause.

Artherosclerosis

What CAD is characterized by plaque developing on the linings of arteries & begins to occlude them?

Ateriosclerosis

What CAD is characterized by the walls of arteries becoming this and stiff, not expanding to accomodate blood pressure.

Rifaximin

What antibiotic is used to treat e coli?

Curling's ulcer

What are the effects of burns on the gastrointestinal system/

Smoking Elevated cholesterol Ration of HDL/LDL important Weight reduction and exercise Cholesterol reducing drugs Hypertension - 140/90 Diabetes higher lipid levels - high glucose damages vessels Obesity Sedentary lifestyle Stress Oral Contraceptives Psychological - "type A" personalities

What are the modifiable risk factors for cardiovascular disease?

Confusion, forgetfulness, changes in behavior, depression, anxiety, trouble walking, dementia

What are the neurological complications associated with AIDS?

Complete bed rest for 24-48 hours, assist with ADL's After 48 hours increase activity with monitoring Diet - NPO. Liquid, Cardiac Food not very hot or very cold 6 small meals instead of 3 large Ted Hose VS every 4 hours Anti Anxiety medication May experience stages of grief

What are the nursing considerations for a client who has suffered an MI?

Maintain airway Monitor for signs of hypercalcemia (vomiting, disorientation, abdominal pain and weakness) Assess for respiratory distress and renal involvement Instruct client in high calcium/low phosphorus diet Restrict milk and milk products which increase phosphorus Client should wear medic alert bracelet Calm quiet environment Seizure precautions PT teaching on S/S of hypo and hypercalcemia

What are the nursing interventions for hypoparathyroidism?

Caloric needs increase to between 4000 and 6000 calories the client may not be able to meet needs by eating Enteral (gastrostomy or peg tube) or TPN (Central Venous Catheter) may be necessary High protein high calories when patient can eat again.

What are the nutrition needs during treatment for burns?

Chronic Heb B or C, liver damage from drugs and chemicals, heart failure, biliary obstruction

What are the other causes for Cirrhosis?

Smoking, tobacco products, alcohol, prolonged exposure to sunlight

What are the risk factors for oral cancer?

Middle aged women Obesity Diabetes Pregnancy Hormones - birth control/estrogen

What are the risks of developing Cholecystitis/Cholelithiasis

Visible lice Pruritis Petechaie Skin excoriation

What are the signs and symptoms of Pediculosis?

Sudden chest pain, agravated by lying down, deep brathing coughing or swallowing

What are the signs of pericarditis?

fatigue, pallor, progressive weakness, dyspnea, headache, tachycardia, heart failure, bleeding problems, infections, purpora, patechia

What are the symptoms of Aplastic Anemia?

Fever, weight loss, weakness, anorexia, fatigue, productive cough. Later symptoms include night sweats and hemoptysis.

What are the symptoms of TB?

Plasma

What is the liquid portion of blood?

antibiotics and antivirals

What medications are likely to be given prior to a transplant?

Hypovolemic

What type of anemia results from blood loss?

INR normal result

under 2

Subcutaneous injection amount limit

up to 1 ml

A) "I will feel dizzy if the right side of my heart begins to fail."

1) The nurse is providing information to a client at a senior center regarding the manifestations of left- and right-sided heart failure. The nurse concludes that further teaching is necessary when the client states: A) "I will feel dizzy if the right side of my heart begins to fail." B) "My feet will be swollen with right-sided failure." C) "My appetite might decrease with right-sided failure." D) "I will need pillows when I sleep with left-sided failure."

Intramuscular needle length- vastus lateralis and ventrogluteal

1-1/2"

NPH Onset

1-2 hours

B) the upper right quadrant.

101) When conducting a physical examination on the client's GI tract, the nurse includes palpation of the liver in: A) the lower right quadrant. B) the upper right quadrant. C) the lower left quadrant. D) the upper left quadrant.

B) do nothing special for the test.

102) A client with nutritional deficits is about to undergo a serum albumin test. The nurse should instruct the client to: A) refrain from food for 4 hours prior to the test. B) do nothing special for the test. C) eat a diet high in protein. D) abstain from fluids containing caffeine.

D) The mouth with a penlight

103) A client is experiencing manifestations of stomatitis. What should the nurse include when assessing this client? A) Swelling in the neck B) The teeth C) The upper left quadrant of the abdomen D) The mouth with a penlight

C) Elevated amylase level

104) The nurse is caring for a client being treated for pancreatitis. Which laboratory study best indicates the treatment is being effective? A) Normal lipase level B) Normal liver function tests C) Elevated amylase level D) Decreased bilirubin level

D) has a current or past infection with H. pylori.

105) A client is found to have the H. pylori antibody. The nurse understands that the client: A) will be at increased risk for diarrhea. B) has had a recent viral infection. C) will not need to be medicated for gastric reflux. D) has a current or past infection with H. pylori.

A) eat a high-fat diet for 3 days prior to the test.

108) The client who experiences pain when eating fats is to undergo a fecal fat test. The nurse should instruct the client to: A) eat a high-fat diet for 3 days prior to the test. B) withhold food and fluids for 12 hours prior to the test. C) drink barium before arriving for the test. D) drink a liquid diet for 2 days prior to the test.

B) presence of gallstones.

109) A client with complaints of right upper quadrant pain is scheduled for an ultrasound of the gallbladder. The nurse explains that the test will help to identify: A) presence of an abdominal aneurysm. B) presence of gallstones. C) blockages in the common bile duct and sphincter of Oddi. D) the ability of the gallbladder to store and excrete bile.

D) starting an IV and fluids.

116) An older client who has had vomiting and diarrhea for 3 days is in the Emergency Department. The priority of care for this client would be: A) infection control. B) inspecting for pressure sores. C) oral care. D) starting an IV and fluids.

B) Swish the medication throughout the mouth and swallow.

117) A client with candidiasis is prescribed Nystatin oral suspension. What should the nurse instruct the client about this medication? A) Swish the medication throughout the mouth and spit out the excess. B) Swish the medication throughout the mouth and swallow. C) Dilute the medication with water. D) Drink the medication through a straw.

A) Smoking retards the healing process

118) A client with peptic ulcer disease (PUD) who smokes 1 ppd is being discharged home. What teaching about the client's smoking behavior should the nurse provide? A) Smoking retards the healing process. B) Smoking impedes the absorption of food. C) Smoking increases the production of stomach acid. D) Smoking decreases intrinsic factor.

C) Notify the physician.

119) A client undergoes a gastroduodenostomy for treatment of a perforated ulcer. Postoperatively, the nurse cannot detect bowel sounds, and there is 200 mL of bright red blood in the NG drainage container. What is the most appropriate nursing action? A) Assess the client's pain level. B) Irrigate the NG tube. C) Notify the physician. D) Apply an abdominal binder.

C) Fatigue D) Shortness of breath

12) The nurse is reviewing data collected from a client with infective endocarditis. Which data should be documented that indicates the client's condition is not improving? (Select all that apply.) A) Thirst B) Hunger C) Fatigue D) Shortness of breath E) Itchy red skin

D) dehydration.

120) A client visits an urgent care center and tells the nurse that he has had nausea and vomiting for 3 days and thinks he has the flu. The nurse should assess the client for symptoms of: A) vitamin C deficiency. B) chronic fatigue. C) adequate carbohydrate intake. D) dehydration.

B) absorbs the majority of water for the body.

121) The nurse is conducting an inservice for a group of seniors to explain the functioning of the intestines. The nurse should include that the large intestine: A) is responsible for the absorption of nutrients from digestion in the stomach. B) absorbs the majority of water for the body. C) is only responsible for evacuation of waste. D) mixes the digested food with water.

C) Stools that are black and tarry occur with prolonged bleeding from the stomach or small intestine.

122) The nurse is teaching a client with a history of upper gastrointestinal bleeding to check his stool for occult blood. Which information provided by the nurse is most accurate? A) Blood is never obvious in the stool, and must be detected by guaiac testing. B) Acute bleeding in the upper gastrointestinal tract will result in bright red blood in the stool. C) Stools that are black and tarry occur with prolonged bleeding from the stomach or small intestine. D) If a client is vomiting blood, stools will not be black and tarry.

A) Decrease fluid intake with meals and lie down after meals.

123) A client is recovering from a gastrojejunostomy for treatment of duodenal ulcer. About 20 minutes after lunch, the client develops dizziness, weakness, palpitations, and the urge to defecate. To avoid recurrence of these symptoms, what should the nurse teach the client? A) Decrease fluid intake with meals and lie down after meals. B) Eat a high-carbohydrate, low-fat diet in six small feedings a day. C) Drink fruit juice after each meal. D) Increase fluid intake with meals and lie down 30 minutes after meals.

B) Carrots

124) An older client complains about experiencing constipation. What should the nurse suggest that this client consume? _ A) Milk B) Carrots C) Eggs D) Meat

A) Risk for Deficient Fluid Volume related to diarrhea

125) The nurse is caring for an older client with diarrhea. Which would be a priority nursing diagnosis for this client? A) Risk for Deficient Fluid Volume related to diarrhea B) Potential for Impaired Skin Integrity related to diarrhea C) Risk for Fluid Volume Excess related to diarrhea D) Risk for Imbalanced Nutrition less than Body Requirements related to diarrhea

B) Treatment for shock

126) A client was admitted to the emergency room with severe abdominal pain, anorexia, chills, skin pallor, a weak and thready pulse of 118, a blood pressure of 70/40, rebound tenderness, and abdominal rigidity. For what should the nurse prepare this client? A) Exploratory laparoscopy B) Treatment for shock C) Administration of antibiotics D) Diagnostic testing with barium and endoscopy

D) impaired peristalsis.

127) A client recovering from a small bowel resection is experiencing gas and abdominal distention. The nurse should plan care for the client based on the knowledge that postoperative gas pain occurs as a result of: A) hyper-motility of the bowel. B) inflammation of the bowel at the site of the anastomosis. C) nasogastric suctioning. D) impaired peristalsis.

A) cholelithiasis

130) A 45-year-old client has been on oral contraceptives for 24 years. The nurse discusses the possible risk of developing: A) cholelithiasis. B) cholecystitis. C) kidney stones. D) hepatitis.

C) Fowler's

131) When caring for a client with cholecystitis, the nurse should place the client in which position? A) Lithotomy B) Trendelenburg C) Fowler's D) Supine

B) Promoting perineal drainage and healing

132) A client had a sigmoid colostomy with abdominal-perineal resection incisions. The perineal resection is partially closed and has two drains attached to Jackson-Pratt suction devices. During the early postoperative period, which goal should be given the highest nursing priority? A) Teaching colostomy irrigation B) Promoting perineal drainage and healing C) Providing a clear liquid diet D) Encouraging acceptance of the colostomy

C) clamped.

133) The nurse is caring for a client post-cholecystectomy with common duct exploration who has a t-tube. The nurse will be responsible for keeping the t-tube: A) attached to continuous suction. B) covered with dressings. C) clamped. D) patent.

B) Icteric

134) A client with hepatitis C is experiencing pain in the right upper quadrant, jaundice, and nausea. The nurse recognizes that the client is in which phase of hepatitis? A) Post-icteric B) Icteric C) Terminal D) Preicteric/prodromal

Sodium

134-145

C) cold, small in quantity, and low in fats.

135) The nurse should assist the client with chronic cholecystitis to plan meals that are: A) hot and high in carbohydrates. B) high in calories. C) cold, small in quantity, and low in fats. D) cold, large in quantity, and infrequent.

D) Reduces serum ammonia levels

136) A client with cirrhosis is prescribed lactulose (Cephulac), which causes diarrhea. What should the nurse explain about this medication? A) Promotes excess fluid loss B) Prevents constipation C) Prevents gastrointestinal bleeding D) Reduces serum ammonia levels

B) Velvety red patch on inner cheek

137) Which finding would indicate the need to evaluate the client for oral cancer? A) Presence of dental caries B) Velvety red patch on inner cheek C) White, curd like patches on the mucous membranes D) Gingivitis

B) Have the client lie on the right side with the bed flat.

138) A client is recovering from a liver biopsy. What should the nurse do when caring for this client after the procedures? A) Check the client's coagulation time. B) Have the client lie on the right side with the bed flat. C) Instruct the patient to avoid deep breathing to prevent liver pressure. D) Elevate the head of the bed.

D) Empty the bladder.

139) A client with ascites is scheduled for a paracentesis. What should the nurse instruct the client to prepare for this procedure? A) Lie on the left side. B) Lie on the right side. C) Drink nothing by mouth 12 hours prior to the procedure. D) Empty the bladder.

B) decrease stress.

14) The sympathetic nervous system releases chemicals that cause vasoconstriction and increase the blood pressure. When teaching clients about triggers of the sympathetic nervous system, the nurse should advise to: A) monitor urinary output. B) decrease stress. C) change dietary habits. D) increase fluid intake.

A) Monitor consistency of stools. B) Monitor frequency of stools. C) Monitor for rash, hives, and joint pain.

140) A client with chronic pancreatitis is prescribed pancrelipase (Pancrease). What care should the nurse provide associated with this medication? (Select all that apply.) A) Monitor consistency of stools. B) Monitor frequency of stools. C) Monitor for rash, hives, and joint pain. D) Administer between meals. E) Weigh every day.

C) reduction of pancreatic secretions.

141) The physician orders a nasogastric (NG) tube for the client with pancreatitis. The nurse explains that the purpose of the tube is: A) relief from nausea and vomiting. B) control of fluid and electrolyte balance. C) reduction of pancreatic secretions. D) removal of irritants.

D) "That is your adrenal glands protecting you."

142) A client is in the clinic and tells the nurse that the family was hiking and came across a snake. The client told the family to run, but became concerned when the client's heart rate felt very high. The best response by the nurse is: A) "You should probably make an appointment with a cardiologist." B) "I will ask the doctor to order an ECG." C) "You were just frightened." D) "That is your adrenal glands protecting you."

C) the secretion of PTH is dependent on normal levels of vitamin D.

143) A client who is experiencing a low calcium level is being assessed for the possibility of an alteration in the function of the parathyroid. When the levels of PTH reveal a low level, the nurse should tell the client: A) the problem is due to problems in the thyroid gland. B) the client should increase phosphorous intake. C) the secretion of PTH is dependent on normal levels of vitamin D. D) the adrenal glands are not functioning appropriately.

B) "Part of the pituitary gland releases growth hormone."

144) The nurse is explaining to a group of clients how the hormones in the body work. The nurse concludes that learning has occurred when a client states: A) "My adrenal cortex helps support me during stress." B) "Part of the pituitary gland releases growth hormone." C) "My thyroid gland produces a hormone that regulates my body temperature." D) "The acini cells of the pancreas regulate my blood sugar."

C) Urine glucose and ketones

145) A client has a fasting blood glucose of 180. The nurse should expect the physician to order which test? A) Water deprivation test B) Aldosterone level C) Urine glucose and ketones D) Serum calcium level

B) Weight gain

146) A client is experiencing an alteration of the adrenal cortex. What should the nurse expect to assess if excess cortisol is being produced in this client? A) Lethargy B) Weight gain C) Anorexia D) Bronze color over knuckles

A) notify the physician.

147) A client is in the hospital for heart failure and respiratory management. During a focused assessment, the nurse notes that the client coughs frothy pink sputum. The immediate intervention by the nurse would be to: A) notify the physician. B) place the client in a high Fowler's position. C) stop the administration of oxygen. D) ask the laboratory to obtain an arterial blood gas.

C) Thyroid scan

148) A client is suspected as having a thyroid tumor. For which test should the nurse prepare this client? A) Serum electrolyte studies B) Urine studies C) Thyroid scan D) Abdominal CT scan

B) Hypotension, rapid pulse, weakness, and confusion

149) A client is in the ICU recovering from a bilateral adrenalectomy. What should the nurse monitor as a priority for this client? A) Weight gain B) Hypotension, rapid pulse, weakness, and confusion C) Swelling in the neck D) Depression

C) burning or numbness in the legs.

15) The nurse is assessing a client who is experiencing manifestations of peripheral vascular disease. When gathering subjective information from the client, the nurse should ask about: A) the distribution of body hair. B) blood pressure. C) burning or numbness in the legs. D) the client's temperature.

Therapeutic PT result

15-33 seconds

A) Tremors

151) A client who had surgery to remove part of the thyroid is experiencing symptoms of parathyroid hyposecretion. Which symptom of hypoparathyroidism should the nurse expect to assess? A) Tremors B) Polyuria C) Muscle weakness D) Pathologic fractures

B) intolerance to cold, dry skin, and menstrual dysfunction.

152) The nurse explains that symptoms a client with hypothyroidism might experience would include: A) intolerance to heat, lethargy, and headache. B) intolerance to cold, dry skin, and menstrual dysfunction. C) weight loss, oily skin, and periorbital edema. D) tachycardia, hypertension, and rapid respirations.

D) taking the medication at the same time every day.

153) A client who is recovering from thyroid storm has been started on methimazole (Tapazole) prior to discharge. The nurse should teach the client the importance of: A) monitoring for enhanced taste. B) monitoring carefully for edema. C) monitoring for hyperthyroidism. D) taking the medication at the same time every day.

A) "I should not take Synthroid with antacids."

154) A client with hypothyroidism is taking levothyroxine sodium (Synthroid). The nurse concludes that the client has met a goal of care when the client states: A) "I should not take Synthroid with antacids." B) "I should notify the physician if my heart rate is 70." C) "I should eat a low-fiber diet." D) "I should report unusual weight gain."

B) damage to the parathyroid glands during surgery.

156) Following a thyroidectomy, the client complains to the nurse that she is having leg spasms and cramps. The nurse realizes that these symptoms could indicate: A) postanesthesia reaction. B) damage to the parathyroid glands during surgery. C) damage to the cervical nerves. D) potassium depletion.

D) A large amount of dilute urine

157) Following a hypophysectomy for a pituitary tumor, the client is monitored for the presence of diabetes insipidus. Which finding indicates this condition? A) A rise in blood pressure B) Hyponatremia C) Fluid retention and dependent edema D) A large amount of dilute urine

C) regular feedings throughout the day.

158) An important nursing intervention for the nurse to provide when caring for a client with Addison's disease is: A) stimulating recreational activities. B) insulin continuously by intravenous drip. C) regular feedings throughout the day. D) a vigorous exercise regimen.

D) "Thirst is diminished in the older client."

159) An older client is experiencing symptoms that the client feels are associated with aging. The client says that the symptoms are similar to those of a friend who has diabetes mellitus but the client is not thirsty. What should the nurse respond to the client? A) "Do you have blurred vision?" B) "The best indication of diabetes mellitus is urinary incontinence in the older client." C) "Older clients do not get diabetes." D) "Thirst is diminished in the older client."

B) inquiring about dietary habits.

16) The client with peripheral vascular disease is in the physician's office for a checkup and reevaluation. The nurse should assess subjective data by: A) determining level of edema. B) inquiring about dietary habits. C) noting skin lesions. D) checking pedal pulses.

C) giving the client three glucose tablets

161) A client with diabetes mellitus is in the clinic with symptoms of shakiness, confusion, rapid pulse, and hypotension. The nurse acts immediately by: A) calling 911. B) giving the client 12 oz of orange juice. C) giving the client three glucose tablets. D) starting an IV and giving dextrose 10% rapidly.

B) Obtain a yearly flu vaccination.

162) The nurse is planning care for a client with diabetes. What should the nurse encourage the client to do? A) Decrease fluid intake. B) Obtain a yearly flu vaccination. C) Eat a diet high in carbohydrates. D) Clean foot wounds with hydrogen peroxide.

B) "Parathyroid hormones stimulate cells of the gastrointestinal tract to absorb dietary calcium, raising the blood level."

163) In teaching a client with hypoparathyroidism about the disorder, which statement by the nurse best explains how the parathyroid hormone controls calcium levels in the blood? A) "When blood calcium levels fall, parathyroid hormones stimulate bone resorption and increase calcium in the blood." B) "Parathyroid hormones stimulate cells of the gastrointestinal tract to absorb dietary calcium, raising the blood level." C) "Parathyroid hormones promote magnesium excretion by the kidneys, which raise blood calcium levels." D) "Parathyroid hormone blocks phosphorous excretion by the kidneys, which then decreases the blood calcium level."

A) due to high blood sugar and reduced circulation, foot wounds do not heal well.

164) The nurse is reinforcing teaching for a client who has type 2 diabetes mellitus. The nurse should instruct the client regarding the appropriate foot care because: A) due to high blood sugar and reduced circulation, foot wounds do not heal well. B) due to frequent bouts of hyperosmolar hyperglycemic state (HHS), the client experiences low blood sugars, which impairs circulation. C) the client experiences low blood sugar too often. D) the client is at risk for renal failure.

A) Give 6 oz of orange juice to drink.

165) A client hospitalized with diabetic ketoacidosis calls the nurse and reports feeling hungry, shaky, and anxious. Which action by the nurse is most appropriate? A) Give 6 oz of orange juice to drink. B) Check the client's blood pressure and pulse. C) Call the lab to draw blood for a glucose level. D) Administer 10 mg glucagon intramuscularly.

D) Instruct the client to wear shoes or slippers at all times.

166) The nurse is planning care for a 28-year-old client with diabetes who has a nursing diagnosis of Risk for Injury. Which intervention should be planned for this diagnosis? A) Not allow the client to ambulate alone. B) Cross the legs at the ankles, not the knees. C) Apply lotion to the feet, particularly between the toes. D) Instruct the client to wear shoes or slippers at all times.

A) an IV infusion of regular insulin.

167) A client with type 1 diabetes mellitus is admitted to the emergency department with Kussmaul's breathing and severe dehydration. The nurse anticipates that the client will have an order for: A) an IV infusion of regular insulin. B) an IV infusion of Lantus insulin. C) an IV infusion of Actos. D) an IV infusion of Novolin NPH 70/regular 30 insulin.

C) it reduces irritation to the tissues and increases absorption.

168) The client who is self-injecting insulin was advised by the nurse to rotate injection sites because: A) it reduces the chance of infection and increases absorption. B) insulin can reach all parts of the body and be used more efficiently. C) it reduces irritation to the tissues and increases absorption. D) it reduces the danger of nerve damage and decreases absorption.

A) Cells shrink by losing fluid with aging.

169) An older client is experiencing increased itching and asks why this is occurring. What should the nurse explain to the client? A) Cells shrink by losing fluid with aging. B) Reduced efficiency of the kidneys causes uremia. C) Decreased respiratory compliance causes pruritus. D) Increased thirst causes the problem.

A) regurgitation of blood from the left ventricle into the left atrium.

17) A client diagnosed with mitral insufficiency has a murmur with a musical quality over the apex of the heart. The nurse recognizes that this is caused by: A) regurgitation of blood from the left ventricle into the left atrium. B) regurgitation of blood from the right ventricle into the right atrium. C) regurgitation of blood from the aorta into the left ventricle. D) enlargement of the right ventricle due to increased pressure in the right atrium.

B) "Exercise increases the use of insulin in the body, so it requires less insulin."

171) A client with diabetes asks the nurse why it is so important to exercise several times a week. Which is the best response by the nurse? A) "Exercise helps reduce high ketone levels, so the body stays healthier." B) "Exercise increases the use of insulin in the body, so it requires less insulin." C) "Exercise brings down high sugar levels, so the body needs less food." D) "Exercise helps to increase blood sugar levels, so the body needs less food."

B) If the client experiences numbness and tingling around the mouth

172) The nurse is preparing to assess a client's endocrine function. Which subjective information should the nurse assess in this client? A) If the client's breath sounds are normal B) If the client experiences numbness and tingling around the mouth C) How the client prepares meals D) If the client experiences edema in the fingers

D) Relationship between stress and hormone levels

173) The nurse is preparing to discharge a client who is being treated for Addison's disease. What should the nurse ensure the client understands? A) Notify the doctor if symptoms of thyroid storm occur. B) Take the medication when he remembers to. C) Notify the physician of muscle weakness. D) Relationship between stress and hormone levels

C) sitting and standing are not allowed during recovery.

18) A client is about to undergo a vein stripping for varicose veins. The nurse should instruct the client that: A) ambulation is forbidden. B) pressure bandages will not be applied following surgery. C) sitting and standing are not allowed during recovery. D) the legs are kept flat after surgery.

NPH duration

18-26 hours

C) Cautioning regarding taking NSAIDs or aspirin.

19) The nurse is planning a teaching program for clients who are taking anticoagulants for peripheral artery disease. What should the nurse include in this teaching? A) Encouraging eating a diet rich in pork and rice. B) Taking an extra dose if a dose is forgotten. C) Cautioning regarding taking NSAIDs or aspirin. D) Limiting alcohol intake.

A) conserve energy to reduce fatigue and weakness.

2) When planning care for a client with heart failure, the nurse should plan priority interventions that will assist the client to: A) conserve energy to reduce fatigue and weakness. B) prepare their meals. C) select complementary therapies. D) promote cleanliness in the home.

Regular Peak

2-3 hours

B) "I can use a disposable razor to shave."

20) The nurse is teaching the client who is to start taking warfarin (Coumadin) for peripheral vascular disease. The nurse determines that further teaching is needed when the client states: A) "I need to be careful about falling." B) "I can use a disposable razor to shave." C) "I need to limit my intake of vitamin K-rich foods." D) "I should use a soft toothbrush."

B) Maintaining a healthy weight

21) The nurse is preparing teaching material for a group of young adults about measures that can help prevent peripheral vascular disease (PVD). What should the nurse include in this teaching? A) Decreasing fat and cholesterol in the diet at age 50 B) Maintaining a healthy weight C) Avoiding smoking after age 40 D) Eating low-sodium diets

C) rise slowly when changing from sitting or lying position.

22) During early treatment, the client with hypertension experienced orthostatic hypotension. The nurse can minimize symptoms of this problem by instructing the client to: A) increase fluid intake. B) lie down for 1 hour after taking antihypertensive medications. C) rise slowly when changing from sitting or lying position. D) limit Na in the diet.

D) Serum electrolytes

23) The nurse is performing a focused assessment on a client who was admitted with heart failure. What should the nurse expect to review for this client on a daily basis? A) CBC B) Cardiac catheterization C) MRI D) Serum electrolytes

A) A lean hamburger on a whole wheat bun, a side salad, and a pear

24) The nurse is assisting a client with hypertension to select a low-sodium, low-fat diet. The nurse determines that the client has met dietary goals when the client selects which meal? A) A lean hamburger on a whole wheat bun, a side salad, and a pear B) Ham, mashed potatoes, and cookies C) Cheese sandwich, whole milk, and an apple D) Bacon, eggs without salt, and orange juice

C) Make an appointment with an ophthalmologist.

25) The nurse is instructing a 26-year-old client diagnosed with hypertension. What should the nurse instruct the client to do to determine an adverse effect of the disease process? A) Have hearing checked. B) Prepare for a colonoscopy. C) Make an appointment with an ophthalmologist. D) Make an appointment with a cardiovascular surgeon.

C) dietary management, exercise regimen, and stress reduction.

26) In management of a newly diagnosed, low-risk client with hypertension, the nurse should expect the initial treatment to include: A) aggressive treatment with diuretics, beta blockers, and a 1,000-calorie diet. B) lifestyle modification and a diuretic medication. C) dietary management, exercise regimen, and stress reduction. D) restriction of fluid and sodium intake.

Intradermal needle guage

26-27 gauge

Ventrogluteal IM injection amount limit

3-4 ml

Humalog and Novalog Duration

3-5 hours

Intradermal needle length

3/8-5/8

Humalog and Novalog Peak

30 min-1 hour

D) Wear gloves and warm socks during cold weather.

30) When caring for a client with Raynaud disease, what should the nurse instruct this client? A) Restrict your fluid intake to less than 1,500 mL of liquids daily. B) Engage in high activity and stressful situations to promote circulation. C) Drink red wine because it is a vasodilator and would be helpful. D) Wear gloves and warm socks during cold weather.

C) Decreased red blood cells

31) A client is being evaluated for anemia. What laboratory value should the nurse expect in this client? A) Microcytic red cells B) Increased platelets C) Decreased red blood cells D) Increased monocytes

A) lymphatic system.

32) A client has groin swelling. The nurse should suspect that the client is experiencing a disturbance in the: A) lymphatic system. B) white blood cell system. C) renal system. D) cardiovascular system.

D) "Stop and rest when your legs start to hurt."

33) A client with PVD tells the nurse that even short walks cause leg pain and muscle cramps. What should the nurse recommend to this client? A) "Wear elastic hose to prevent the leg pain." B) "Take pain medication before you go walking." C) "You might try using an exercise bicycle instead of walking." D) "Stop and rest when your legs start to hurt."

D) space activities in order to conserve energy.

41) During the change-of-shift report, the nurse learns that an assigned client has a hemoglobin level of 8 g/dL. Based on this information, the nurse should plan to: A) keep the client on strict bedrest to restrict activity. B) prevent exposure to infectious diseases. C) encourage ambulation to prevent thrombophlebitis. D) space activities in order to conserve energy.

A) the sickled cells accumulate in tissue.

43) A young adult is admitted to the hospital experiencing respiratory distress. After assessment, the nurse concludes that the client is in sickle cell crisis. The nurse plans care for the relief of pain because: 43) _____ A) the sickled cells accumulate in tissue. B) there is an absence of white blood cells. C) the red blood cells are numerous. D) there is painful swelling of the lymph nodes

D) via the z-track method.

44) The nurse is caring for a client who is being treated for anemia and is taking Imferon IM. The nurse should plan to administer this medication: A) IV. B) subcutaneously. C) PO. D) via the z-track method.

D) oral contraceptives.

45) A client in the outpatient clinic is scheduled to have blood drawn for an iron level. Recognizing that certain medications will affect the results, the nurse should determine whether the client is taking: A) antihypertensives. B) acetaminophen. C) antidepressants. D) oral contraceptives.

B) Protection from infection

47) The client with thrombocytopenia is being started on prednisone. What should the nurse plan as a priority of care? A) Diet counseling B) Protection from infection C) Preparation for surgery D) Frequent ambulation

D) a transfusion of fresh frozen plasma.

48) The client with hemophilia is about to undergo extensive dental work. The nurse instructs the client that, prior to going to the dentist, the client will need: A) to sign a consent for the dental work. B) to eat a diet high in folic acid. C) an infusion of chemotherapy. D) a transfusion of fresh frozen plasma.

D) to monitor the client for bleeding.

49) The client with disseminated intravascular coagulation (DIC) is being treated with fresh frozen plasma and heparin therapy. The nurse should explain to the family that the priority for this client is: A) performing blood studies once daily. B) daily x-rays. C) ensuring that the client drinks plenty of fluids. D) to monitor the client for bleeding.

D) "I need to protect myself against infection."

5) The client who had a heart transplant is ready for discharge from the hospital. The nurse instructs the client about self-care at home and determines that learning has occurred when the client states: A) "I should begin jogging in a few days." B) "I can take my medication only when needed." C) "I am cured, and will have no more heart problems." D) "I need to protect myself against infection."

Novolog Onset

5-10 minutes

Subcutaneous needle length

5/8-1/2

A) Infection prevention measures

53) The nurse is instructing a client with Hodgkin lymphoma. What should the nurse include in this teaching? A) Infection prevention measures B) How to monitor urine output C) How to take a pulse D) How to administer chemotherapy

A) flattens during inspiration to allow for expansion of the lungs.

54) The client who has nervous system damage to the diaphragm asks the nurse why there is a feeling of not being able to take a breath. The nurse should explain that the diaphragm: A) flattens during inspiration to allow for expansion of the lungs. B) controls the diameter of the trachea. C) expands during expiration, causing the client to feel like there is not enough air entering the lungs. D) can cause collapse of alveoli.

C) chest expansion on inspiration.

56) The nurse is aware that a client with broken ribs is likely to have difficulty with: A) movement of air through the bronchi. B) gas exchange. C) chest expansion on inspiration. D) movement of the diaphragm.

A) wheezing noted on expiration

58) When performing a physical assessment, the nurse auscultates adventitious breath sounds. The nurse should documents this finding as: A) wheezing noted on expiration. B) breath sounds diminished. C) breath sounds clear. D) breath sounds unequal.

D) past exposure to chemicals and smoking.

59) The nurse is conducting a focused respiratory assessment on a 78-year-old client. When collecting the nursing history, the nurse should ask the client about: A) usual diet. B) elimination habits. C) liver infections. D) past exposure to chemicals and smoking.

A) upper respiratory infections.

63) The nurse is assessing an elderly client who is 2 days after abdominal surgery. The nurse recognizes that alterations in the respiratory system of the elderly put the client at risk for: A) upper respiratory infections. B) rib fractures. C) pulmonary embolus. D) increased vital capacity.

D) in the morning.

65) The nurse tells the client suspected of having pneumonia that a sputum specimen is necessary and will be obtained: A) by drawing blood. B) after lunch. C) by suctioning the client's nose. D) in the morning.

A) Acid-fast bacillus positive B) Pulse oximetry 88% D) Blood pH 7.32

68) The nurse is reviewing data collected on a client with shortness of breath. Which findings should be immediately reported to the health care provider? (Select all that apply.) A) Acid-fast bacillus positive B) Pulse oximetry 88% C) Negative cytology cells D) Blood pH 7.32 E) Sputum culture and sensitivity negative

C) Prothrombin time is 20 seconds.

69) The nurse checks the coagulation studies on a client who is not receiving any type of anticoagulant therapy. Which finding should be reported to the physician? A) Platelet count is 250,000 mm3. B) INR is 2.5. C) Prothrombin time is 20 seconds. D) APTT is 25 seconds.

C) weigh weekly.

7) A client recovering from pericarditis is prescribed NSAIDs for inflammation. The nurse should instruct the client to: A) take the medication on an empty stomach. B) restrict fluids. C) weigh weekly. D) take two baby aspirin a day.

C) strep throat.

70) The nurse is caring for an elderly client who has had an abrupt onset of a severe sore throat and high fever. The nurse notes that the client is drooling and is having difficulty swallowing. The nurse suspects that the client has: 70) _____ A) rhinitis. B) viral pharyngitis. C) strep throat. D) sinusitis.

A) hypertension.

72) A client with rhinitis asks the nurse for a prescription for oxymetazoline (Afrin) to help with the swelling in the nose. Before asking the doctor for the prescription, the nurse should assess the client for: A) hypertension. B) normal kidney function. C) abdominal pain. D) presence of chest petechiae.

B) green or rust-colored sputum.

73) The nurse is planning care for an older client who has been admitted for influenza. The nurse plans to monitor this client closely for: A) anorexia. B) green or rust-colored sputum. C) decreasing body temperature. D) renal failure.

D) excessive bleeding.

75) The nurse is caring for the client who has undergone a tonsillectomy. The nurse should monitor the client carefully for: A) increased urine output. B) progression of the respiratory infection. C) intake of food and fluids. D) excessive bleeding.

A) The client's weight remains stable.

77) The nurse is assisting the client to learn to eat with a tracheostomy. When evaluating the client's ability to eat, the nurse should use which goal? A) The client's weight remains stable. B) The client takes medications PO. C) The client is able to choose appropriate food. D) The client is able to ambulate.

B) Have the client tilt his head forward and apply pressure by pinching the nares toward the septum

78) The nurse is caring for a patient who develops epistaxis. Which nursing intervention is advisable? A) Have the client tilt his head back and hold pressure to his nose by pinching the nares toward the septum. B) Have the client tilt his head forward and apply pressure by pinching the nares toward the septum. C) Have the client lie supine and place ice packs to his forehead. D) Apply heat to the client's nose.

A) Provide the client with a pen and paper for writing.

79) A client recovering from laryngectomy and radical neck dissection has a nursing diagnosis of Impaired Verbal Communication. Which intervention should be included in the care plan? A) Provide the client with a pen and paper for writing. B) Provide uninterrupted time for the client to attempt communication with the nurse and health care team. C) Teach the client to read lips. D) Instruct the client to speak softly when talking.

C) "I will take the medication exactly as ordered."

80) A client with strep throat is being discharged to home. Which client statement indicates that discharge teaching has been effective regarding antibiotic use? A) "If I miss my morning dose, I can double the dose at night." B) "I will take the medication until I feel better." C) "I will take the medication exactly as ordered." D) "I do not have to take the medication at all."

C) the older client has less cilia and a weaker cough that makes it difficult to get secretions out of the lungs.

84) An older client is admitted to the hospital with bronchitis. The client's family asks the nurse why the family member is so sick when others in the family are not affected in the same way. The nurse should teach the family that: A) the older client has much thinner secretions than does the young one. B) the chest wall of the older client is more elastic, allowing a buildup of more secretions. C) the older client has less cilia and a weaker cough that makes it difficult to get secretions out of the lungs. D) older clients have problems with adequate nutrition and are more susceptible to respiratory infections as a result.

C) ensuring that the endotracheal tube is secured.

86) The nurse is assessing the client who is on a mechanical ventilator. A priority assessment for this client is: A) assessing pedal pulses. B) providing dehumidified oxygen. C) ensuring that the endotracheal tube is secured. D) using hand signals to communicate with the client.

B) Inhale through the nose and exhale through pursed lips.

87) The nurse is teaching the client with asthma about a method of breathing that helps the client reduce the respiratory rate and keeps the airways open during exhalation. What should the nurse include when teaching this breathing technique to the client? A) Take three deep breaths and then cough. B) Inhale through the nose and exhale through pursed lips. C) Inhale deeply while leaning forward. D) Inhale by sniffing.

D) increases with deep breathing.

88) A client informs the nurse that he is having pleuritic pain. Before documenting this complaint, the nurse should verify whether the pain: A) subsides when the client coughs. B) is constant along the costal borders. C) increases with expiration. D) increases with deep breathing.

B) Characteristics of the cough

89) The nurse is assessing a client demonstrating signs of chronic bronchitis. What would be the most important for the nurse to question the client? A) Pain location B) Characteristics of the cough C) Medication history D) Occupation history

B) "How often do you get short of breath?"

9) A client with a history of rheumatic heart disease is being evaluated for mitral stenosis. To identify symptoms that support the diagnosis of mitral stenosis, the nurse should ask which question? 9 A) "Do you have to urinate often during the night?" B) "How often do you get short of breath?" C) "Do you experience numbness or tingling in your extremities?" D) "Have you had a lot of headaches recently?"

A) To keep the collection device below the chest

90) A client recovering from thoracic surgery has a chest tube to water seal drainage. The family ambulates the client. What should the nurse teach the client and family at this time? A) To keep the collection device below the chest B) To disconnect the collection device when ambulating C) To walk with a pillow D) To cough while walking

C) Stores the bile made by the liver

96) The nurse is explaining to a client with stones in the gallbladder about the role the gallbladder plays in digestion. What should the nurse explain about the gallbladder? A) Releases enzymes into the small intestine B) Produces the bile necessary for fat absorption C) Stores the bile made by the liver D) Produces clotting factors that aid with digestion

Superficial Partial Thickness Deep Partial Thickness

A 2nd degree (Partial Thickness) burn is classified into two types. What are they?

NPO After midnight

A HIDA scan for gall bladder function requires what preparation?

Sinus bradycardia

A client experiencing a heart rate of less than 60 and is not an athlete. What would this be called?

Sinus Tachycardia

A client is experiencing a heart rate of more than 100 and may have palpitations and shortness of breath. What is this called?

Fluid overload

A client receiving whole blood should be monitored for a transfusion reaction. What else should you monitor for?

The inability to fight off an infection

A client with leukopenia would experience what?

Repostion gently and carefully Change postion every 2 hours Provide trapeze Place needed items close at hand bed in lowest position Uncluttered room

A client with multiple myeloma will experience limited and painful mobility. What are the nursing considerations in regard to this?

stomach cancer

A history of H. pylori increases the risk of what condition?

54%

A patient presents with extensive burns on both of their arms and their torso. Using the rule of nines what percentage has been involved?

Serum electrolytes

A provider is attempting to determine if a clients heart issue revolve around too much or too little potassium or sodium. What test would they run?

The SA node.

An electrical signal fires to tell the heart to beat in what is known as the heart's pacemaker. What is the pacemaker called?

Bence Jones Protein

An elevation of what protein will be present in the urine of clients who have Multiple Myeloma

Therapeutic communication Non-judgemental acceptance of the family's reponse to the diagnosis Help the client identify coping strategies Provide info about support groups, American Cancer Society

An emotional aspect of a Leukemia diagnosis and treatment involves Anticipatory Grieving. What are the nursing care elements relating to this?

ACE Inhibitors Nursing Care

Assess blood pressure and pulse, daily weight, lungs sounds, urine protein, monitor potassium, monitor for orthostatic blood pressure, discontinue gradually

Medications - lithium A complication of treatment for hyperthyroidism.

Besides glandular or pituitary problems, what are some other causes of Hypothyroidism?

Avoid things that increase intracranial pressure- coughing, sneesing, nose blowing, straining with BM

Besides teaching about breathing and incentive spirometry, what else should you tell your patient about what to expect after a transphenoidal hypophysectomy?

Glucose, Galactose, Fructose

Carbohydrates are broken down into:

Flouroquinolones

Cipro (ciprofloxacin) Levaquin (levofloxacin)

Vitamin K is the antidote for

Coumadin

INR and Prothrombin Time Monitor what?

Coumadin Therapy

A mole that is present at birth with an irregular surface and a regular border.

Define "Congenital nevi"

An atypical mole that appear during childhood and change after puberty. Most often seen on face, trunk, and arms, also scalp, breasts, groin and buttocks. They have an irregular border and pigmented colors.

Define "dysplastic nevi"

Tan or black patch that looks like a freckle. becomes mottled, thick, dark and nidular. Seen on one side of the face on older adults with frequent sun exposure.

Define "lentigo nevi"

Apply topical antimicrobial and cover with guaze or a non adherent dressing. wrap with gauze roll blandage. Usually done twice per day Apply distal to proximal Wrap fingers and toes separately.

Describe the closed method of burn wound management

Wound is open to air Topical antimicrobial is applied but the wound is not dressed Allows assessment but client must be placed in protective isolation and everything that comes into contact with the client must be sterile.

Describe the open method of burn wound management

Vena Cava, Right Atrium, Right Ventricle, out to the lungs via the pulmonary artery, back from the lungs via the pulmonary vein, into the left ventricle, up to the left atrium and out to the aorta

Describe the pathway from the vena cava that results in deoxygenated blood becoming oxygenated blood and returned to the body.

Contractures

During the healing process, scar tissue shrinks and becomes fixed and inelastic. What could this cause?

Client drinks a carbon enriched urea solution and then breathes into a container. The result is tested for Carbon 13, which is an indicator of the presence of H. pylori bacteria.

Explain a urea breath test.

Tests for antibodies to specific diseases via blood test.

Explain antibody titer testing.

Right and left coronaries form a "crown" around the myocardium. Coronary arteries fill with O2 rich blood during ventricular relaxation. After perfusing the heart, the coronary veins drain into the coronary sinus, which empties into the right atrium.

Explain how the heart is provided with oxegenated blood.

theophylline and coumadin

Flouroquinolones increase the action of:

The bundle of His

From the AV node, the electrical signal travels to what?

The Purkinje Fibers

From the bundle of his, the electrical signal travels to what?

The sternum or the iliac crest

From where is a bone marrow aspiration or biopsy usually taken?

Gastric Ulcer

Gastric or duodenal ulcer? Discomfort 30-60 minutes after a meal, rarely occurs at night, pain worsens with food.

Dermis

Healing occurs with scar tissue when the burn involves which layer of skin?

PTT monitors what therapy?

Heparin

Protamine Sulfate is the antidote for

Heparin

sexual activity, infested clothing, linen

How are Pediculosis Pubis transferred?

Patient is placed in Trendelenberg position until veins empty, then a tourniquet is placed on the thigh. The person is then asked to stand up, and they should refill slowly from below. If, after the tourniquet is taken off, they fill suddenly from above, the client has incompetent valves.

How are Varicose veins diagnose

Undercooked meat, drinking unpasteurized cider, milk Can be found in lakes and pools Can be found on unwashed veg and fruit

How are cases of e-coli contracted?

Splints Active and passive ROM performed every 2 hours Early ambulation Uniform pressure Tubular support bandages 5-7 days post graft Custom elastic pressure devices.

How are contractures prevented?

Endoscopy.

How are esophageal varices diagnosed?

Increase in bulk forming laxative - Metamucil High fiber diet High water intake Stool softeners Anesthetic suppositories or ointment Warm sitz baths

How are hemorrhoids managed

Detailed history Allergy skin testing Elevated serum IgE

How are hives diagnosed?

Microscopic examination of infected skin. Skin scraping test.

How are scabies diagnosed?

Skin to skin contact or infested bedding (can live for 2 days)

How are scabies spread?

Same as lice Also Eurex Treat the entire family, clothing and linens

How are scabies treated?

Gastroscopy with samples taken for h. pylori Urea breath test Stool sample for occult blood CBC for anemia

How are ulcers diagnosed?

Fire safety Fire alarms Children taught - stop, drop and roll Chain ladder on second floor Don't play with matches, keep cords away from reach, keep pan handles away from reaching hands.

How can burns be prevented?

Air filters, limiting carpet, overstuffed furniture

How can someone change their environment to help their allergies?

Vaccines when available Immune globulins if exposed Standard precautions No unprotected sex Do not share needles Health care workers - do not recap needle

How can you prevent hepatitis?

They slow the absorption of glucose from the GI tract.

How do Alpha-Glucosides work?

They reduce liver glucose production and improve glucose use by skeletal muscles.

How do Biguanides work?

They increase the release of insulin from the pancreas and decrease the resistance of insulin by cells.

How do Sulfonylureas work?

They decrease resistance to insulin by the liver, muscle, and fat cells.

How do Thiazololidinediones work?

Lower the body temperature.

How do they lower the body's need for oxygen during CABG surgery

Blood sugar level and symptoms.

How do you diagnose Diabetic Ketoacidosis?

Blood pressures upper and lower extremities venogram Doppler ultrasound Exercise stress test Angiograph

How do you diagnose PVD

Take the client's blood sugar

How do you diagnose hypoglycemia?

Minimize exposure to the sun Avoid the sun between 10-4 use hats, long sleeves, umbrella, sunglasses Use sunscreen at least 15 SPF, the higher the number the better, Reapply often even on cloudy days. Reapply often near sand, snow water or concrete. Avoid tanning.

How do you prevent Malignant Melanoma?

Flu vaccine Pneumonia vaccine ABX therapy for high risk candidates before invasive procedures

How do you prevent endocarditis?

Sudden and severe drop in BP Nausea and Vomiting Hyperkalemia Dysrythmia Exteremely high temp Confusion and cyanosis Progresses to vascular collapse and death

How do you recognize Addisonian Crisis?

No stool Abdomen is firm. Fever

How do you recognize a bowel obstruction

Bleeding - obvious or with petechiae, purpura or ecchymosis Tachycardia, hypotension, tachypenia Cold, mottled skin and toes Obvious or occult blood in vomit and/or stool Abdominal distention Hematuria, oliguria, renal failure Anxiety and confusion Decreased level of consciousness

How does DIC manifest?

It secretes a substance that breaks down the protective lining of the stomach and increases gastric acid production.

How does H. pylori contribute to ulcers?

enlarged and painless lymph nodes pruritis fever night sweats weight loss fatigue malaise

How does Hodgkins lymphoma manifest?

Pain in RLQ (colicky, dull) Abdominal tenderness Disturbed bowel pattern (either diarrhea or constipation) Abdominal distention Bloating (feeling of abdominal fullness) Flatulence N&V Pain is relieved by defecation Mucus in stool Hyperactive bowel sounds

How does IBS manifest?

Spontaneous fractures Infections Anemia and bleeding tendencies Elevated blood calcium Increased blood viscosity leading to renal failure Neurological symptoms caused by spinal compression Back or bone pain

How does Multiple Myeloma manifest?

Gradual onset of diarrhea with 4-10 instances a day with intermittent rectal bleeding with mucus Severe diarrhea - loss of electrolytes, dehydration Rectal inflammation causes urgency to defecate Abdominal cramping relieved by defecation Fatigue, anorexia, weakness Accompanied by arthritis in severe cases

How does Ulcerative Colitis manifest?

HIV targets CD4 cells which assist immunity by calling for help and giving the cells that respond information about what they are fighting. The virus uses those cells to make multiple copies of itself, both spreading the virus and taking out the CD4 cell. Fewer CD4 cells = impaired immunity.

How does a HIV attack the immune system?

A red cell is deprived of oxygen. If it "sickles" the test is positive.

How does a lab determine whether a client has sickle cell disease?

The presence of an embolus does not allow injected material to perfuse into the pulmonary arteries. What is inhaled does not match what is injected.

How does a lung scan diagnose an embolus?

Produces blood cells.

How does bone marrow contribute to immunity?

Too much alkaline fluid is lost from the intestines.

How does diarrhea cause metabolic acidosis?

Fatigue, new heart murmur, cough, dyspnea, headache, joint pain, weight loss, rapid pulse, petechial lesions on mouth, legs, purple lesions on palms and soles of feet

How does endocarditis manifest

Muscles take in the glucose without insulin. The client will need to monitor glucose levels when changing or intensifying exercise patterns. Extra carbs may be needed to counteract the use of glucose by the muscles. Consistency is key to maintaining blood sugar levels.

How does exercise affect the metabolism of someone with Diabetes Mellitus?

The body makes antibodies & memory cells when exposed to specific antigens.

How does having a disease or getting an immunization work against contracting a disease?

Multiple swollen lymph nodes abdominal pain GI distress

How does non-Hodgkins lymphoma manifest?

Due to lack of feeling, they may be unaware of a pressure ulcer or wound developing.

How does peripheral neuropathy put a client at risk for skin breakdown and infection?

Carbon dioxide combines with water in the blood, forming carbonic acid.

How does respiration influence blood pH?

Each body cell has surface markers that are unique to each person called Human Leukocyte Antigens.

How does the body distinguish between itself and something foreign/

Macrophages in the lungs encapsulates the bacteria and seals them off. In cases where the person is under stress or immunocompromised, the bacteria can reactivate.

How does the body respond to tuberculosis?

Chemoreceptors in the carotid arteries and the aorta monitor the level of CO2 in the blood.

How does the brain know when its time to tell body to take a breath?

lymph nodes contain macrophages, T-cells and B-Cells which ingest bacteria and filter the lymph as it passes through.

How does the lymphatic system contribute to immunity?

Contains microphages which destroy bacteria. Filters damaged and old RBC's. Stores blood for future use.

How does the spleen contribute to immunity?

They test every baby born in PA and notify the parents of positive tests.

How does the state of PA encourage early intervention children who are sickle cell positive?

It matures T-cell lymphocytes?

How does the thymus gland contribute to immunity?

ABG - oxygen is low, co2 is high, bicarbonate is low CXR will show infiltrates and whiteout patterns Ventilation/Perfusion scan

How is ARDS diagnosed?

Inspection of the lesions and a health history.

How is Acne Vulgaris diagnosed?

Cleansing preparations with benzoyl peroxide Consistent washing of skin - gentle soap, pat dry 2-3 times per day Avoid cosmetics Keep hands and hair away from the face.

How is Acne Vulgaris treated without a prescription?

Decreased serum Na, Glucose, increased serum K 24 hour urine shows decreased levels of 17 ketosterioids & 17 hydroxysteriods Fasting plasma cortisol and aldosterone levels are low Abnormal glucose tolerance testing CT Scn and MRI will show atrophy of glands

How is Addison's Disease diagnosed?

Take at the same time daily Often held prior to tests that use dye

How is Biguanide given?

Fecal study (high fat content) Elevated bilirubin level Ultrasound (abd) Oral cholecystogram Operative cholangiography Elevated liver enzymes

How is Cholecystitis/Cholelithiasis diagnosed?

Barium - UGI, BE Endoscopy Stool - blood, mucus, bacteria CBC Serum albumin and vitamin levels

How is Chron's disease diagnosed?

Local antiinflammatories - Sulfasalazine (Azulfidine), Mesalamine (Asacol) Corticosteroids to reduce inflammation - methylprednisolone (Solumedrole) Deltasone (Prednisone) Methotrexate (Imuran) to maintain remission Antidiarrheals Antibiotics - Flagyl, Cipro Biologic agents - Humira, Remicade to target immune responses

How is Chron's disease medically managed?

Plasma cortisol levels are increased Plasma ACTH levels may be increased with pituitary disorder CT/US to diagnose tumors Hypernatremia Hyperglycemia 24 hour urine will show elvated levels of 17 ketosteriods or 17 hydroxysteroids

How is Cushing's Disease diagnosed?

Clotting studies - fibrinogen, Factors V and VIII will be low.

How is DIC diagnosed?

Treat the underlying cause Fresh frozen plasma and platelet concentrates Heparin

How is DIC treated?

Ace inhibitors to manage blood pressure. Overtime the condition will develop into chronic renal failure requiring dialysis or renal transplant

How is Diabetic Nephropathy treated?

Colonoscopy or sigmoidoscopy History or physical CT Scan Barium Enema

How is Diverticular disease diagnosed?

Barium Swallow, Gastroscopy to rule out hiatal hernia

How is GERD diagnosed?

Medical with OTC meds Histamine blockers, Proton Pump Inhibitors

How is GERD treated?

Direct person to person through sexual contact Direct injection with contaminated blood, blood products, or needles. Mother to fetus

How is HIV transmitted?

Factor VIII concentrate or cryoprecipitates

How is Hemophilia A treated?

Factor IX concentrate

How is Hemophilia B treated?

Assessment of the skin Cultures of the lesions

How is Herpes Simplex Virus diagnosed?

Assessment of the skin Culture of the vesicles

How is Herpes Zoster diagnosed?

History and physical exam Stool - occult blood, rule out ova, parasite, culture Endoscopy Upper GI Lower GI

How is IBS diagnosed?

Constipation dominant IBS: high fiber, low suger Diarrhea dominant IBS - low residue diet Avoid milk, highly seasoned foods, gas forming foods, caffiene Stress reduction, exercise

How is IBS managed?

Biopsy May assess for metastasis with liver, bone, lung, scans and blood work - liver enzymes.

How is Malignant Melanoma diagnosed?

Chest Xray or bronchoscopy.

How is PJP diagnosed?

Increased glood levels of epinephrine and noroepinephrine, 24 hour urine for Vannillymandelic Acid and elevated catacholamines CT of adrenals MRI/US

How is Pheocromocytoma diagnosed?

Based on symptoms.

How is Psoriasis diagnosed?

Surgical Removal - cryosurgery or electrodessication

How is Squamous Cell Carcinoma treated?

Biopsy Provider may also do scans, xrays, and blood work for metastasis.

How is Squamous cell Carcinoma diagnosed?

Three of the following symptoms: Butterfly rash, alopecia, photosenstivity, polyarthralgia, arthritis, pleural effusion, pericarditis, renal disorder, hemolytic anemia, seizures

How is Systemic Lupus Erythematosus diagnosed?

Goal: Relieve symptoms and achieve remission NSAIDS - anti inflammatory and analgesic Aspirin - anti-inflammatory and analgesic Antimalarial - hydroxchloroquine (Planqunil) - treats joing pain, rashes, lung inflammation Corticosteriods Topical steroids for rash Immunosuppresants - Imuran, Leukeran, Cytoxan Antiinfectives Analgesics Diuretics

How is Systemic Lupus Erythematosus treated?

Routine thyroid studies Thyroid scan shows cold spot. Aspiration of nodule may done, but may seed metastasis.

How is Thyroid Cancer diagnosed?

Platelet count PTT PT Clotting assays to determine which factors are missing.

How is Von Willebrand's disease diagnosed?

With cryoprecipitate, Factor VIII, and Desmopressin (DAVP).

How is Von Willebrand's disease treated?

CXR CT scan V/Q scan Pulmonary angiogram D Dimer serum test - indicates the presence of a clot Lung Scan EKG to rule out MI

How is a PE diagnosed?

Range of motion, early ambulation, elevate legs, TED hose, anticoagulants, aspirin, increase fluid intake

How is a PE prevented?

Thrombolytic drug - Streptokinase, Urokinase Anticoagulant therapy O2 Analgesics to relieve pain and anxiety Monitor for dysrythmia Heparin

How is a PE treated?

Flat plate of abdomen History and physical

How is a bowel obstruction diagnosed?

NG tube or weighted intestinal tube is used with partial obstruction

How is a bowel obstruction medically managed?

CXR Low Pulse ox Symptoms

How is a pneumothorax diagnosed?

After two positive Elisa tests, a Western Blot test will be done. If the Western Blot test is positive, the client has HIV.

How is a reliable positive HIV diagnosis made?

Doppler Angiography

How is a suspected thrombus or embolus diagnosed?

Shortness of breath, drastically elevated temp, pack or flank pain, blood pressure drop, chills, tachypenia, hemoglobinuria

How is a transfusion reaction most likely to manifest.

Xray CT scan MRI Ultrasound.

How is an anuerysm diagnosed?

Immediate and aggressive treatment Medical emergency - ABC Epinephrine - IM or IV Oxygen Benadryl

How is anaphylaxis treated?

WBC Ultrasound of the abdomen CT scan of abdomen, with or without contrast

How is appendicitis confirmed?

Bronchodilator and steriods

How is asthma treated?

Biopsy

How is basal cell carcinoma diagnosed?

Surgical removal (Mohs surgery - thin layers of tumor are shaved off horizontally) Cryosurgery Electrodessication

How is basal cell carcinoma treated?

Necessary with a complete obstruction Relieve the obstruction Sometimes a bowel resection

How is bowel obstruction surgically managed?

History and physical Pulmonary function test ABG CXR CBC Sputum specimen Pulse Ox Scans - CT, MRI Serum alpha-antitrypsin level

How is bronchiectasis diagnosed?

Bronchodilators

How is bronchiectasis treated?

Symptoms and lung sounds CXR to rule out pneumonia Sputum specimen

How is bronchitis diagnosed?

Cough suppressants Antipyretics Brochodilators Steriods Antibiotics to treat existing infection or to prevent one High fluids Conserve energy High humidity Avoid smoking and other irritatants Patient teaching about medications, cessation of smoking, what to do if symptoms worsen

How is bronchitis treated?

Laryngoscopy with biopsy Xrays of head, neck, and chest CT scans MRI Needle Biopsy Barium Swallow

How is cancer of the larynx diagosed?

Symptoms, cultures

How is cellulitis diagnosed?

Identify cause - electrolyte study, thyroid study, barium enema, colonoscopy

How is chronic constipation diagnosed?

Barium enema CBC - anemia Elevated CEA Chest X-ray Scans, MRI, Ultrasound for metastasis Digital exam Sigmoidoscopy CT of pelvis and abdomen Biopsy to identify cells

How is colon cancer diagnosed?

Increase fiber (fresh fruit, veg, whole grains) Bulk forming agents(fibercon, metamucil) Laxative unless bowel obstruction is suspected Stool softeners Enemas, suppositories Assess BM's

How is constipation managed?

Intradermal testing Elimination diet High Serum IgE

How is dermatitis diagnosed?

High calorie diet, fat soluable vitamins No roughage, spices, coffee, alcohol or fried foods. Meds _ Antidiarrheals and antispasmotics

How is diarrhea managed?

Identify the cause and treat. Let the body fight the infection. Replace fluids and electrolytes as needed No solid food for 24 hours - bowel rest Antiobiotics for prolonged or positive bacteria in the culture

How is diarrhea treated?

Antibiotics, fluids, rest

How is e coli treated?

CBC - WBC will be high, Hct, Hgb, RBC will be low Stool sample to rule out ova, parasites Gastroscopy Gastric Analysis for h. pylori

How is gastritis diagnosed?

Elevated liver enzymes Elevated bilirubin levels Prolonged PT time Positive for viral antigens (Heb B) Postive for hepatitis antibodies

How is hepatitis diagnosed?

Generally, the same medications and care for GERD. In severe cases, surgery to repair the hole in the diaphragm might be performed.

How is hiatal hernia cared for?

Increased blood levels of PTH Increase alkaline phosphate levels Increased serum calcium Decreased serum phosphate levels X rays show decalcification

How is hyperparathyroidism diagnosed?

Symptoms Determine what aggravates and what alleviates the symptoms. Frequency and duration of symptoms Seasonal? Environmental? Occupational? Lab Tests: CBC, Skin Testing, IgE

How is hypersensitivity diagnosed?

Antihistamines Systemic management medications Environmental control Immunotherapy Steroids Epinephrine

How is hypersensitivity treated?

History and physical Elevated t3, t4, TSH levels in the blood Increased Radioactive Iodine uptake test Thyroid Scan for Nodules

How is hyperthyroidism diagnosed?

15 grams of rapid acting sugar: 3 glucose tabs 1/2 cup of fruit juice or regular soda, 8 oz of skim milk, 6-8 life savors, 2-3 tablespoons of honey, cake icing or glucose gel.

How is hypoglycemia treated?

Decreased serum calcium levels Decreased PTH levels Increased serum phosphorus levels

How is hypoparathyroidism diagnosed?

History and physical Decreased level of T3, T4, & TSH

How is hypothyroidism diagnosed?

Liver scan Liver biopsy High AFP (alpha feta protein) in primary liver cancer MRI CT Scan US Symptoms

How is liver cancer diagnosed?

CXR, MRI, CT of chest, - tumor size and location Bronchoscopy Needle biopsy or aspiration of pleural fluid Sputum mediastinoscopy determines spread to lymph nodes

How is lung cancer diagnosed?

Surgery - removal of the entire lung or a part of the lung Radiation and chemo

How is lung cancer treated?

Chest Xray, Chest and Abdominal CT scan Biopsy of tissues

How is lymphoma diagnosed?

Biopsy, CT/MRI to stage tumor

How is oral cancer diagnosed?

Elevated CEA Endoscopy, ERCP Scan of pancreas

How is pancreatic cancer diagnosed?

CT Ultrasound, elevated pancreatic enzymes, endoscopic retrograde cholangiopancreatography (ERCP) Needle biopsy of pancreas

How is pancreatitis diagnosed?

NPO, IV fluids to avoid stimulating pancreas, TPN NG Tube Narcotic analgesia Antacids Antibiotics Diet free of alcohol and gastric stimulants Oral Hypoglycemics, insulin No Smoking Stress Reduction

How is pancreatitis managed?

Flat plate CBC - elevated white blood cell count Blood cultures Paracentesis - culture of fluid

How is peritonitis diagnosed?

Antibiotics NPO NG tube IV Fluids Electrolyte replacment TPN Bedrest- fowlers position to localize infection, decreases dyspnea Analgesics Sedatives

How is peritonitis medically managed?

Laparotomy with irrigation of the peritoneum with NS, draingage of abcess, repair damage. May have drainage tube post op, may leave wound open.

How is peritonitis surgically managed?

Thoracentesis, Chest Tube

How is pleural effusion/empyema treated?

Codeine (decreases pain, suppresses cough) Analgesics NSAIDS Antipyretics Oxygen Splint affected side Apply heat to affected area Cough and deep breathing.

How is pleurisy treated?

Blood and sputum culture CXR WBC Pulmonary Function Test Arterial Blood Gases Bronchoscopy

How is pneumonia diagnosed?

Mobilise and remove excretions - bronchodilators and expectorants Antibiotics after sensitivity Chest Physiotherap Assess respiratory system Raise HOB, deep breathing and coughing q 2hrs. space nursing care, increase fluids to 2.5-3 liters per day

How is pneumonia treated?

Eat 6 small meals per day - high in protein, moderate fat, low in carbs Do not drink fluids when eating. Recline after eating for 60 minutes to delay gastric emptying Anticholinergics

How is someone who is predisposed to dumping syndrome cared for?

As with a client who has cancer. (Emotional support, infection control, nutrition, skin integrity, pain management, encourage rest.)

How is someone with lymphoma cared for?

GI Series Endoscopy Stool for occult blood Gastric analysis - cytology CEA (carcinoembryonic antigen) high Hgb, Hct low

How is stomach cancer diagnosed?

Surgical removal - partial gastrostomy Total gastrostomy (rare) Chemotherapy Radiation therapy

How is stomach cancer managed?

CBC, bone marrow examination, ANA

How is thrombocytopenia diagnosed?

By using the HLA and blood type

How is tissue matching done?

Antihistamines ID the cause and avoid Steroids Atarax (hydroxysine) or Benadryl (diphenhydramine) Epinphrine may be used for respiratory distress

How is uticaria managed?

Genetics

How is your blood type determined?

Every 15 minutes. Repeat sugar administration until the glucose is above 60.

How long after administering a fast acting glucose should you reassess blood sugar?

48-72 hours

How long after the PPD is administered is the test read?

6-10 hours

How long after the event can an embolectomy be carried out?

48 hours.

How long does Stage One generally last?

Two

How many lobes does the thyroid gland have?

Morphine sulfate and versed to depress respiratory rate and sedate client Treat the underlying cause Mayneed intubation - increased risk of infection, TPN feeding required Pavulon to depress and control ventilatory assistance May need a tracheostomy if a ventilator is needed for a long period of time Mortality rate of 40% if severe.

How might ARDS be managed?

Gastroparesis - delayed emptying of stomach Neurogenic bladder - inability to fully empty - UTI Erectile dysfunction Orthostatic hypotension

How might DM affect other nerves in the body?

Increased risk of bacterial and fungal infections as excess glucose collecting on the skin provides a good environment for bacterial and fungal growth.

How might Diabetes Mellitus affect the immune system?

Albuminuria (protein in the urine) Edema in hands and feet Gradual increase in blood pressure Elevated BUN level Elevated Creatinine Decreased serum albumin

How might Diabetic Nephropathy manifest?

Shillings Test, bone marrow aspriration, B12 levels

How might a provider determine a diagnosis of pernicious anemia?

Palpitations, angina, tachycardia

How might anemia manifest in the cardiovascular system?

Spoon shaped fingernails.

How might anemia manifest in the fingernails?

Fatigue weakness, night cramps, joint pain

How might anemia manifest in the muscoloskeletal system?

Fatigue or dyspnea with exertion due to tissue hypoxia.

How might anemia manifest in the respiratory system?

Pallor of the skin, mucous membranes, nail beds and conjunctiva

How might anemia manifest in the skin?

Well balanced diet with supplements (Ensure) High fiber unless bowel obstruction occurs Vitamin b12 Eliminate milk and milk products Avoid foods known to cause a flare Acute Episodes - TPN

How might someone with Chron's be counseled in regards to the diet? Acute

500-800 ml

How much marrow is harvested from a donor?

Prior to transfusion Q 15 minutes for the first half hour Hourly during transfusion One hour after transfusion

How often should vital signs be assessed when your client is receiving a transfusion?

every 15-30 minutes.

How often should you monitor vitals during a blood transfusion?

3-5 hours. Most effective within 30 mins - 1 hour

How quickly must TPA be administered to be effective?

On the unaffected side

How should a client be positioned after a thoracentesis?

HGB should increase 1g/dl per unit transfused

How should lab values respond to a client receiving blood?

Relieve the edema Maintain skin integrity Prevent/treat infection

How should someone who has a lymph disorder be cared for?

High Sodium- Low Potassium diet until stabilized and then just high calories Food high in sodium - processed cheeses, milk, yogurt Six small meals per day instead of 3

How should you educate a client with Addison's Disease to eat?

Take with food Do not abruptly stop Make sure diet is High in Sodium and low in Postassium Weigh daily Large dose in AM Monitor glucose levels Monitor temp

How should you educate a client with Addison's disease about their steriods?

Monitor respiratory system Monitor puncture site

How should you monitor a client after a thoracentesis?

Set the pump to result in 30-50 ml of urine per hour.

How should you set your pump when replacing fluids?

Teach them the difference between sputum and saliva Increase fluids to help get it up and out. Try to get it before antibiotics are started Deep breathe before coughing to get a better specimen.

How should you teach the client before a sputum specimen is taken?

Fever, chills, cough, uticaria, orthopnea

How would a mild transfusion reaction manifest?

fever, chills, uticaria, wheezing, back pain

How would a moderate transfusion reaction manifest?

Hypotension, respiratory distress, chest pain, RALES

How would a severe transfusion reaction manifest?

The platelet count will be normal. The PTT, PT will be delayed.

How would labs for von Willebrand's disease come back?

Hypotension, tachycardia, dizziness, confusion, anemia

How would recognize a peptic ulcer that is hemorrhaging?

Severe epigastric pain Hypo to hyperactive bowel sounds Rebound tenderness Referred pain to R shoulder

How would you recognize a gastric perforation?

Severe pruritis, lesions appear 4 weeks after contact. Lesions are red-brown lines about 2 mm ling, sometimes covered with vesicles. Secondary infection can occur from excoriation due to itching and scratching.

How would you recognize a scabies infestation?

Autoimmune

ITP is considered what kind of disorder

Heparin is given via

IV or SQ

Proton Pump Inhibitors and antibiotics (either tetracyline or biaxin - myacin family)

If H. pylori is present, how is it treated?

Insert a greenfield Filter (umbrella in Vena Cava)

If a client has continuing episodes of thrombophlebitis, what might the provider elect to do?

ESR - Erythrocyte Sedimentation Rate

If a client is experiencing elevated inflammation as a result of an MI, endocarditis, or Rheumatic fever what test would reveal it?

may be asymptomatic palpitations SOB

If a client with sinus tachycardia is symptomatic, what might you see?

Call the provider.

If a person who has right sided heart failure gains more than 2lbs in one day, what should they do?

High enzyme levels can return if client has pancreatitis or pancreatic cancer.

If a serum amylase and serum lipase test comes back high, what can that indicate

Z-track

If iron must be given by injection, what method should be used?

Edema Change in pigmentation (red lower limbs) Ulceration of tissue Peripheral pulses present Pain or aching when limb is raised or with low activity D-Dimer elevation

If the client's PVD is affecting his veins, what would you expect to see?

HDL - 60 LDL - under 100

If the total cholesterol level should be under 200, what are the desired levels for HDL and LDL?

Recurrent infection Blurred vision Parasthesia Delayed wound healing

In addition to the symptoms you would see for Type 1 Diabetes Mellitus, what might you also see with Type 2?

Insert a Greenfield filter

In cases where a client continues to have blood clots, what might provider choose to do to prevent embolus?

Older Adults

In what population does the immune system gradually decline, making them at higher risk for infection?

Dizziness, headaches, forgetfulness, pica

In what ways would anemia manifest in the neurological system?

Undiagnosed Type 2 Diabetes Clients on medications that elevate blood sugar levels Dialysis patients Clients receiving TPN Post op Clients with infections

In whom would HHNKS be most likely to occur?

Adults 40-50, 90% are benign.

In whom would Pheocromocytoma be most likely to occur?

Hodgkin's and Non-Hodgkins Lymphoma

Into which two categories is lymphoma classified?

Pericardium, Myocardium, Endocardium

List the three layers of the heart.

Anti-Anginals Nursing Care

Medications are only good for a short period of time, should fizzle under the tongue, Should be kept in light-blocking containers, do not use alcohol,

PH is low, Bicarbonate is low

Metabolic Acidosis occurs when:

Ph is high, bicarbonate is high

Metabolic Alkalosis occurs when:

Anti-Arrhythmic Nursing Care

Monitor vital signs, EKG, give around the clock at set intervals.

Anasthetics Nursing Care

Monitor vs. seziure precautions, LOC, arrythmia, I/O, maintian IV for emergency use, be ready for CPR, patiend ed for NPO, post op interventions.

40

Multiple myeloma rarely occurs before the age of

Lung Scan/Ventilation Scan

Name the procedure: A radioactive material is both injected and inhaled and then the lungs are scanned.

Protease, Amylase, Lipase

Name the three pancreatic enzymes:

Levimir and Lantus Peak

None

B or O

People with type B blood can receive which blood types?

Universal donors

People with type O- are considered what?

VS's as per post operative Assess heart and lungs, I&O Send fluid for C&S Document procedure

Post procedure steps for pericardiocentesis are:

Respiratory complications due to the incision being so high on the abdomen.

Post-operative patients are at high risk for what complications?

Liver function and nutrition

Serum albumin and total protein measure?

Pancreas

Serum amylase and serum lipase are tests to determine the function of what organ?

pruritis, red man syndrome, hypotension, ototoxicity, nephrotoxicity

Side effects of vancomycin

UTI, ear and eye treatment for newborns

Sulphonimides are generally used for:

Assess the oral mucous membranes every 8 hours. Rinse every 2-4 hours with H2O2 or & h2o with saline Petroleum jelly to lips Soft toothbrush or sponge Topical anesthetics Avoid alcohol based foods Bland, cool food and liquids

Taking are of the oral mucous membranes is important for a client with leukemia. What are the nursing considerations this element of care?

Dairy products

Tetracycline should not be given with

Pregnant women in the third trimester or children under the age of 8

Tetracyclines should not be given to:

treat only if symptomatic - atropine and pacer.

That are the treatments for sinus bradycardia?

Pancreas

That endocrine gland is also an exocrine gland?

Cortex, Medulla

The adrenal glands have two parts, what are they?

hives, pruritis, flushing, dyspnea, bronchospasms

The client is suffering a mild allergic reaction to her blood transfusion yesterday. What might you observe?

Ileocecal valve

The sphincter that controls the emptying of the ileum into the colon.

Vessel Spasm

This clotting process step causes the damaged vessel to to narrow and decrease blood flow.

Clot formation

This clotting process step involves fibrin forming a meshwork.

Formation of the platelet plug

This clotting process step involves platelets attaching to the injured tissue and change to attract more platelets. The platelets are then stabilized by fibrin.

Clot retraction

This clotting process step involves the clot contracting and pulling the edges of the opened vessel together.

Clot dissolution

This clotting process step involves the removal of the clot by the body once the tissue has healed.

Cardiac Catheterization

This diagnostic test involves passing a catheter into the heart via a peripheral vessel.

Thallium Scan (Radionuclear Scan)

This diagnostic test involves using an intracellular ion to determine if tissues are not getting adequate perfusion while the client exercises on a treadmill.

Aortagram

This diagnostic test is a form of angiogram that uses a dye to show the abdominal aorta and major leg vessels/

Angiogram

This diagnostic test is a series of xrays taken after injection of a radio opaque dye into an artery.

Gastrin

This digestive hormone stimulates the release of HCL.

Secretin

This digestive hormone stimulates the release of bicarbonate.

Cholecystokinin

This digestive hormone stimulates the release of bile.

Pancreozymin

This hormone stimulates the release of pancreatic enzymes.

Aminoglycoside

Tobramycin Gentamycin

Anemia

Too few RBC's would result in what condition?

Oxygen

Too few RBC's would result in what deficit to the body's tissues?

False - Wounds may be treated by either the open or closed method

True or False - Burns must always have dressings.

False. Children can have both blood disorders at the same time.

True or False: A child who is hemophilic cannot develop von Willebrand's disease.

False. It means that you aren't currently showing antibodies for the disease. If you have been exposed you should retest 6-12 weeks after the initial test.

True or False: A negative HIV test means that you don't have the disease.

True.

True or False: Heart failure is the most common reason cited for hospital admission.

False. Moderate reactions can occur 30-90 minutes after beginning a transfusion. Mild reactions can occur hours to days after the trasfusion.

True or False: If your client has not had a transfusion reaction within the first 15 minutes, they're safe.

FALSE: Psoriasis is non-infectious.

True or False: You should avoid touching someone with Psoriasis because it is communica

Myxedema Coma

Untreated hypothyroidism could result in what life threatening condition?

Red Man Syndrome

Vancocin (Vancomycin) side effect

IV

Vancomycin is given via

Venules

Veins receive blood from smaller vessels called:

Shiny, cyanotic skin Pedal pulses are present Cells which form stasis ulcers Necrotic tissue sloughs

Venous insufficiency can cause:

Cytomegalovirus Viral Hepatitis Herpes Simplex Human Papilloma Virus

What Viral Infections are associated with AIDS?

Smoking.

What activity doubles the risk of Peptic Ulcer disease because it inhibits the secretion of bicarbonate?

Coumadin

What anticoagulant would the client leave the hospital with?

Synthetic materials used to promote healing or prepare the wound for grafting. Placed on the wound as soon as possible Reduces pain and acts as a barrier to infection

What are biologic and biosynthetic Dressings?

Diet - a well balanced diet If hemorrhage is present, replace fluids (isotonic) and blood. Endoscopy to identify where bleeding is and cauterize. Lifestyle changes.

What are non medication treatments for ulcers.

Hypoxia, cold, increased exercise, anesthesia, dehydration, infection, alcohol or tobacco use, stress, acidosis

What are sickle cell crisis triggers?

Neucleoside Reverse Transcriptase Inhibitors: AZT, Epirivir, Videx, Combivir

What are some Antr-retrovirals used to reduce the viral load in a client's blood?

Biobrane Dermagraft Integra Alloderm Trancyte

What are some biologic or biosynthetic dressings?€

atererial ulcers cellulitis gangrene

What are some complications of Perpheral Atherosclerosis?

Bacteria, viruses, transplanted tissue

What are some examples of antigens?

Hay fever, blood transfusion reaction, organ transplant rejection

What are some examples of hypersensitivity?

Thick toe nails No hair Extremities are pale when elevated, dark when dependent (lowered) Cyanosis (artery)

What are some indicators of Peripheral Artheriosclerosis

Client teaching to push organs back into the proper cavity Wearing a truss or binder.

What are some non-surgical interventions for hernias?

monitor vitals after activity (HR, BP) Discontinue activities with reports of chest pain, SOB, palpitations, dizziness Identify ways to conserve energy with ADL's Space nursing care to allow rest. Indentify priorties Involve family Encourage them to quit smoking Oxygen

What are some nursing care considerations for people with anemia?

Assess for pain often and treat accordingly Assist clients to most comfortable position Support with pillows Patient teaching regarding pain control Relaxation techniques Provide uninterrupted rest periods Report unrelieved pain to the provider

What are some nursing considerations regarding pain for the client with Multiple Myeloma?

CNS stimulation - nervousness, tremors, restlessness, hyperactivity, hypertension, tachycardia, palpitations, nausea, vomiting

What are some of the side effects of bronchodilators?

smoke inhalation, near drowning, direct Shock or sepsis, indirect

What are some of the triggers for ADRS?

Active involvement with the family Teach the signs and symptoms to report Educate regarding Hospice services and refer

What are some patient and family teaching elements for the client with multiple myeloma?

Hemorrhages in body tissues Spontaneous bleeding episodes Bleeding of the mouth, lips, and tongue Hematuria Bleeding in the joints. History of bleeding with circumcision History of bruising

What are some signs of Hemophilia

Weight gain, feeling cold, lethargy, depression, memory loss, slowing of thought process, anorexia, constipation, coarse-dry-thinning hair, voice becomes low and hoarse, decreased BP, decreased pulse, decreased respirations, edema or face, hands, feet, (mask like face) exercise intolerance.

What are some symptoms of hypothryroidsm?

Drugs causing agranulocytosis are discontinued Filigrastim (Neupogen) to increase production

What are some treatments for agranulocytosis?

Remove the cause (if secondary) Transfusions Splenectomy Bone marrow transplant if under 50

What are some treatments for aplastic anemia?

Steriods to suppress the immune system Immunosuppressive medications Cyclosporine IV platelets Plasmapheresis Spenectomy

What are some treatments for thrombocytopenia?

progressive dyspnea, very thin, cachexia, orthopnea, diminished breath sounds, use of accessory muscles when breathing, shoulders lift with breathing, tachcardia, tachypnea, clubbing of the fingers,

What are symptoms and signs of Emphysema

skin rashes, skin sloughing, diarrhea, GI bleeding, liver damage

What are symptoms of graft vs. host disease?

A - Assymetry B - Border irregularity C- Color variation or dark black color D - Diameter greater than 5mm

What are the ABCD's of assessing suspicious lesions?

Nausea, upper abdominal pain, back or jaw pain, fatigue weakness of upper arms and shoulders

What are the MI symptoms that women should pay attention to?

Close monitoring and assessment Neuro checks every 2-4 hours Lung sounds every 2-4 hours for crackles (pulmonary edema) Serum electrolytes, Urine Na, Urine Specific gravity Daily weight, I&O, output is guide to regulating intake Patient teaching re: fluid restriction divide for each shift Allow patient to choose fluids. 55 ml or ice chips = 100 ml of water Fluids should be high in sodium Avoid salty foods that increase thirst Frequent mouth care Protect client's skin Antiemetics with nausea

What are the Nursing Care elements for someone with SIADH?

Deep breathing and coughing Pursed lip breathing Abdominal breathing Avoid triggers or irritants Teach about use of home oxygen, oxygen safety Teach about medications.

What are the Patient teaching elements for a client with COPD?

Increased levels of aldosterone increase sodium and water retention and decrease potassium levels.

What are the affects that Cushing's Syndrome has on fluid balance in the body?

Pressure over insertion site to prevent hemorrhage Assess CSM on affected limb q15 minutes for 1 hour, q30min for two hours, then q shift. Monitor heart and for chest pain Bedrest with head no higher than 30* pressure dressing on site assess for bleeding at site Increase fluids, I & O check lab values.

What are the aftercare considerations for a cardiac catheterization?

Increased sclerotic changes Coronary artery changes Development of collateral circulation Many meds Higher risk for HTN Heart failure from rapid IV infusion Patient teaching about diet, meds, exercise important

What are the age related changes to the cardiovascular system

lymphocytes and monocytes

What are the agranulocytes?

Morphine Sulfate

What are the analgesic that is also used to lessen the oxygen demand by the heart?

Mycobacterium Avium Complex (MAC) Tuberculosis Samonellosis

What are the bacterial infections associated with AIDS?

History of gallstones, alcohol and substance abuse.

What are the biggest risk factors for pancreatitis?

purforated ulcer, ruptured appendix, surgical contamination, ruptured diverticulum

What are the causes for pertitonitis?

sleep/sleep apnea, vomiting, electrolyte imbalance, CAD, MI, endocarditis, hypothermia, hypothyroidism, intracranial tumor

What are the causes for sinus bradycardia?

Autoimmune disorder where antibodies destroy the cells in the adrenal gland.

What are the causes of Addison's Disease?

HTN, PE, MVP, COPD, Hyperthyroid

What are the causes of Atrial Fibrillation?

Usually secondary to Upper Respiratory Infection, but can be caused by irritants such as smoke, gas, or chemicals.

What are the causes of Bronchitis?

Long term for corticosteriod therapy Adrenal tumor - causes increased levels of cortisol Disorder of the pituitary gland causing increased levels of ACTH which cause the adrenal cortex to secrete more hormones Tumor of the pituitary, lung, or pancreas

What are the causes of Cushing's Syndrome?

Exact cause is unknown - can result from: Stress Pregnancy Adolescence Women Older Adults People with infection May be caused by pituitary gland secreting too much TSH

What are the causes of Hyperthyroidism?

Excess acid or inadequate bicarbonate in the body.

What are the causes of Metabolic Acidosis?

Use of NSAIDS and aspirin Severe stress Disorders that cause hyperproduction of HCL Bacteria - 3/4 of ulcer sufferers are positive for H. pylori

What are the causes of Peptic Ulcers?

Hyperventilation - anxiety or pain

What are the causes of Respiratory alkalosis?

bees, wasps, hornets, insects, medications, vaccines, contrast dye, foods

What are the causes of anaphylaxis?

Infection - bacteria or virus Medications Stress Foods Systemic disease Malabsorption of nutrients

What are the causes of diarrhea?

danders, pollen, foods, chemicals, drugs, incompatible blood, horse antitoxins, latex, chemicals, plants

What are the causes of hypersensitivity?

asbestos, radiation, air pollution, smoking, second hand smoke

What are the causes of lung cancer?

Vomiting, Gastric Suction

What are the causes of metabolic alkalosis?

Radiation or chemical exposure, chemotherapy, viruses such as mono, Hep. C, or HIV

What are the causes of secondary aplastic anemia?

Leukocytes

What are the cells that destroy foreign invaders?

Involves the entire dermis and hair follicles but not sweat or sebaceous glands Burned area is pale, waxy, and can be dry or moist Large blisters Capillary refill is decreased, but pain is present Less painful than a superficial burn.

What are the characteristics of a Deep Partial Thickness Burn?

Involves all layers of skin May extend down to connective tissue, muscle or bone Burn may appear pale, waxy, yellow, brown, charred or non-blanching red Usually no pain as pain receptors have been destroyed.

What are the characteristics of a Full Thickness (3rd Degree) burn?

Involves the entire dermis Bright red, moist, glistening, blister formation Burned area blanches with pressure Severe pain with exposure to air or temperature changes

What are the characteristics of a Superficial Partial Thickness Burn?

Polyuria Polydipsia Polyphagia Hyperglycemia Weight loss Fatigue Malaise

What are the classic symptoms of Diabetes Mellitus Type 1

Signs and symptoms of hypo/hyper Weight reduction Balance medication, diet, and exercise When to contact the provider Importance of regular exams by provider, opthamologist Protect from injury, infection Maintain skin integrity.

What are the client teaching elements regarding DM mellitus and avoiding complications?

Hemorrhage, vascular injury, MI, hematoma at insertion site.

What are the complications associated with a stent?

Neuralgia Vision loss if the opthalmic nerve is affected

What are the complications for Herpes Zoster?

Ventricular fibrilation, cardiogenic shock, congestive heart failure, dysrythmia

What are the complications for MI treatment?

Heart failure, infarctions of other organs, emboli or vegetative fragments

What are the complications for endocarditis?

Scarring

What are the complications of Acne Vulgaris?

Bowel obstruction Abcess Fistula Increases CA of the small intestine and colon by 5-6 times

What are the complications of Chron's disease?

Peritonitis Acid/base and electrolyte imbalances Shock and organ failure

What are the complications of bowel obstruction?

fecal impaction

What are the complications of constipation?

Hemorrhage Peritonitis Abscess formation Fistula formation Obstruction Perforation of bowel

What are the complications of diverticular disease?

Perforated gall bladder/peritonitis Infection Fistula formation Cancer

What are the complications of gall Cholecystitis/Cholelithiasis

Incarceration - fecal material cannot pass through the herniated section Strangulated hernia - the muscles constrict round the hernia causing ischemia, necrosis, gangrene

What are the complications of hernia?

Abcess formation Sepsis Hypovolemic shock Formation of adhesions which could lead to to obstructions

What are the complications of peritonitis?

Atelectasis and pneumonia

What are the complications of pleurisy?

Bowel can perforate leading to peritonitis Toxic megacolon

What are the complications of ulcerative colitis?

Hemorrhage Obstruction Perforation

What are the complications related to ulcers?

When they have taken one nitro tablet every five minutes x 3 and the pain has not been relieved.

What are the conditions under which someone who is experiencing angina should go to the emergency room.

Assess pain and treat appropriately Handle extremities gently Cool compresses to painful joints.

What are the considerations for pain in relation to to DIC?

Monitor ABG's and O2 sats Administer O2 as ordered Semi-fowlers or Fowler's Maintain bed rest to decrease O2 needs Encourage deep breathing and coughing

What are the considerations for the respiratory system in regard to DIC?

Infection Diet Smoking Stress

What are the contributing factors for Ulcerative Colitis?

If input is less than output, hypovolemic shock may occur Dehydration and electrolyte imbalances

What are the dangers of Diabetes Insipidus?

Heart enlargement ECG changes Vegetation on valves noted by echo High WBC High ESR Blood cultures indicate causative agent

What are the diagnostic indicators for endocarditis?

CBC Iron Levels Schilling Test Sickle Cell screening Bone Marrow aspiration

What are the diagnostic studies for identifying anemia?

MRI CT Scan Thyroid Scan Radioactive Iodine Uptake test.

What are the diagnostic studies for the thyroid gland?

Individual hormone levels Blood Glucose levels Urinalysis

What are the diagnostic studies to test hormone levels?

Biopsy Culture and Sensitivity Skin Scraping Patch Test Wood's LIght Exam

What are the diagnostic tests associated with the skin?

CXR ABG's - acidosis and alkalosis

What are the diagnostic tests for Left Sided Heart Failure

Anti-DNA antibody (positive) Anti-Nuclear Antibodies (positive) C-reactive protein elevated ESR (sed rate) elevated - indicates inflammation Renal function tests to assess kidneys

What are the diagnostic tests for Systemic Lupus Erythematosus?

High WBC High ESR Abnormal EKG Serum Cardiac Markers Echocardiography

What are the diagnostic tests that pinpoint an MI

Propylthoracil (Propyl-Thoracil or PTU) Methimiazole (Tapezole) Potassium Idodide, saturated solution (SSKI) Logol's Solution (Strong Iodine Solution)

What are the drugs used for hyperthyroidism?

Potassium loss can cause dysrhythmias.

What are the effects of a burn on electrolyte balance?

Serum levels of immunoglobulins are diminished putting the client at risk for infection Monitor for infection until the burn has healed.

What are the effects of burns on the Immune System?

Decreased urinary production Urine is very concentrated Hemolysis can lead to obstruction of renal circulation and renal failure.

What are the effects of burns on the Urinary System?

The skin prevents fluid loss and infection. These functions will be impaired until healing occurs.

What are the effects of burns on the integumentary system?

If an inhalation injury has occured, it can cause inflammation or pulmondary failure. Inhalation of soot, toxic gases or smoke can cause cell and cilia death Can lead to pulmonary edema, inactivation of surfactant Sloughing of tissues can obstruct airway.

What are the effects of burns on the respiratory system?

Allow the client and family to verbalize concerns Answer questions truthfully Identify coping strategies Provide emotional support Maintain a calm environment Respond to calls promptly Encourage relaxation techniques

What are the emotional considerations in relation to DIC?

Anal irritation Pruritis Pressure

What are the external symptoms of hemorrhoids?

Ingesting highly refinded, fiber-free foods Aging Sedentary lifestyle Postponing BM's.

What are the fisk factors for diverticular disease?

Protection - from water loss/injury Excretion Absorption Temperature Regulation Production - Vitamin D Sensation

What are the functions of the skin?

Candidiasis (thrush) Cryptococcal Meningitis

What are the fungal infections associated with AIDS?

Erythema, edema, eruption of vesicles, pruritis, skin excoriation and scale formation.

What are the general symptoms of dermatitis?

Loose stools Fever Nausea Cramping Dehydration Electrolyte imbalance Metabolic acidosis

What are the general symptoms of diarrhea?

Adrenal

What are the glands located above the kidneys?

Maintain a near normal glood sugar by balancing diet, exercise and medication. Achieve optimal serum lipid levels Provide adequate calories to maintain or attain a reasonable weight Prevent and treat acute and chronic complications

What are the goals of treatment for Diabetes Mellitus?

neutrophils, eosinohils, basophils

What are the granulocytes?

Blood with BM May prolapse May become strangulated May thrombose

What are the internal symptoms of hemorrhoids?

Hypertension Coronary Heart Disease Angina Myocardial Infarction

What are the major causes of heart failure?

Anemia Infection - fever, night sweats, ulcers mouth/throat, URI, UTI Septicemia Bleeding Spenomegaly Hepatomegaly Pain Headache Anorexia Nausea Weight Loss

What are the manifestations of Leukemia?

A sore or lesion that does not heal Leukoplakia Eryhthroplakia Visible or palpable masses Sore throat or feeling something is caught in the throat. Difficulty chewing or other jaw movement Asymmetry of head, face, jaw, or neck Loosening of teeth or dentures that no longer fit Swollen lymph nodes Bloody sputum

What are the manifestations of oral cancer?

Abnormal bleeding, purpura, eccymosis, petechiae Nosebleeds Abnormally heavy menstrual flow Spontaneous brain bleeds Weight loss, headache, fever

What are the manifestations of thrombocytopenia?

Diuretics - Aldactone, Lasix Laxatives - Lactulose (reduces ammonia) Anti-Infectives - Neomycin sulfate kills bacteria, reducing ammonia) Anti-Emetics Vitamin K to promote clotting Beta Blockers - reduce portal HTN Histamine blockers to reduce GI Bleeding Anti-Anxiety med - Serax is not metabolized by the liver

What are the medical treatments for cirrhosis?

Alupent, Brethine, Bronkosol, Proventil, isuprel, serevent, xopenex, duonebs, theophylline, aminophylline, epinephrine, advair, atropine

What are the medications that provide quick relief of COPD symptoms?

Increased cortisol causes changes in CHO, Fat and protein metabolism and decreased calcium absorption.

What are the metabolic consequences associated with Cushing's Syndrome?

Clostridia (C. diff) Salmonella Shigella E. coli - the strain that does not normally occur in the human bowel

What are the microbes that can cause diarrhea?

Smoking Obesity Hyperlipidemia Hypertension Diabetes Mellitus Stress Sedentary Lifestyle

What are the modifiable risk factors for MI?

Age Heredity/Family History Gender - men at higher risk until menopause Race/Ethnicity

What are the non-modifiable risk factors for Cardiovascular disease?

History of heart disease Age Gender Heredity

What are the non-modifiable risk factors for myocardial infarction?

Maintain the function of vital organs, tissue perfusion, pain management, relieve anxiety Assess pulses, warmth, and capillary refill Bowel sounds Monitor LOC Vital signs Monitor Urine output Reposition every 2 hours Discourage leg crossing Minimize tape use. Assess for tissue necrosis

What are the nursing care considerations for DIC?

Check the donor's sites for bleeding and infection.

What are the nursing care considerations for a bone marrow donor?

Bleeding precautions Assess knowledge and reinforce teaching about self-administering injections Home Infusion Therapy by a home health nurse. Safe home environment Prescription medications for pain (NO NSAIDS or Aspirin) Medic Alert bracelet Good oral hygeine Keep BP down Safe sex practices

What are the nursing care considerations for a client with Von Willebrands?

Raise HOB O2 Auscultate lungs q 4 hours Vital signs every 4 hours POX every 4 hours I&O Morphine Sulfate Diuretics Daily weight Dobutamine Domamine

What are the nursing care considerations for a client with left sided heart failure

Monitor LOC and Vital SIgns Observe for signs of bleeding (from any and all orifices, in vomit, from nose, vagina, gums etc.) Avoid straining during BM, forceful sneezing or nose blowing Bleeding precautions Fall Risk precautions

What are the nursing care considerations for the Bleeding Risk element of Leukemia?

Maintain protective isolation if ordered Good hand washing technique Good daily hygiene Restrict visitors with infection Oral hygiene after every meal. Avoid invasive procedures Report signs of infection STAT Monitor vital signs at least every four hours Monitor white blood cell count

What are the nursing care considerations for the infection risk of Leukemia?

Monitor weight weekly Oral hygiene before and after meals Increase liquids Decrease milk intake (makes mucous more tenacious) Elevate the head of bed at meals. Odor free environment Medicate for pain/nausea 1/2 hour before meals Six feedings per day No painful procedures immediately before and after meals.

What are the nursing care considerations regarding nutrition in the client with Leukemia?

Maintain the airway Monitor oxygen levels I&O Tube Feedings Monitor for depression due to body image issues Communication through writing Lost Chord Club

What are the nursing care elements after surgery for Cancer of the Larynx?

Encourage verbalization re: self esteem Compliance is difficult due to slow improvement Diet - good nutrition - avoid high fat and chocolate Stess reduction Use hyperallergenic makeup.

What are the nursing care elements for Acne Vulgaris

I&O, Daily weight, Elevate HOB Assess mental status Client teaching - rehab Oxygen PRN Measure abdominal girth daily

What are the nursing care elements for Cirrhosis?

I&O - monitor for deficit or fluid overload Monitor skin turgor, mucous membranes Daily weight - report a gain or loss of 2 or more lbs should be reported A specific gravity that shows a dilution of urine Medical alert bracelet Patient teaching re: all of the above Monitor for all fluid loss: perspiration, diarrhea, etc.

What are the nursing care elements for Diabetes Insipidus?

Monitor LOC Monitor IV Infusions I&O Evaluate response to treatment Document

What are the nursing care elements for HHNKS?

ICU post up while body adjusts Routine post-op care for abdominal surgery Large amounts of hydrocortisone Close monitoring of BP Rest - no stress- sedatives if needed Careful I&O May require additional hormonal therapy Diet should have no stimulants Follow up 24 hour urines If tumor is inoperable lifelong supervision Medical alert bracelet PT teaching - self monitoring of BP Prognosis good with surgery/unknown with inoperable tumor

What are the nursing care elements for Pheocromocytoma?

Good nutrition Keep fingernails short Encourage client not to scratch lesions Measures to relieve stress Emotional support - lesions are visible, depression may occur

What are the nursing care elements for Psoriasis?

Keep Vaseline, gauze, and a clamp at the bedside. Never clamp chest tube unless it is disconnected Note any leaks in the system Check for kinks in the tubing Assess VS and respiratory system I&O Position on unaffected side Keep drainage below the chest. Notify provider if bubbling in the chamber Cough and deep breathing every 2 hours Mark drainage level each shift

What are the nursing care elements for a chest tube?

Teds Pedal Pulses Measure calf circumference Homan's sign Bleeding precaustions if on anticoagulant therapy Oxygen therapy

What are the nursing care elements for a client at risk for clots?

Increased calories to counteract higher metabolic rate Between meal snacks Soft and easily swallowed food for dysphasia caused by enlarged gland Avoid stimulants Stress free environment Cool room, space nursing care, back rubs Fluid and electrolyte monitoring and replacement I&O, daily weight Attempt to stabilize the hormone leve. Patient teaching - support head without straining neck. After surgery COUGHING MAY BE CONTRAINDICATED. DEEP BREATHING ONLY. Patient teaching re: Resting the voice ANXIETY WILL BE HIGH

What are the nursing care elements for a client scheduled to undergo a subtotal thyroidectomy?

Reduce the movement of the arm on the side of the pacemaker for 24 hours Check for redness/infection at the site for 24-48 hours wear a medic alert bracelet Report vertigo, CP, pulse changes, fever, weakness, palpitations

What are the nursing care elements for a client who has a new pacer?

Tracheostomy - not be able speak, need feeding tube Assess for patency of airway and respiratory status Fowler's position post op Turn, cough, deep breathe every two hours I and O, weekly weights Tube Feeding, TPN If client can eat - soft bland foods Communication tools/Yes and No Questions Speech therapy consultation Call bell in reach - do not expect an answer on intercom Emotional support Teaching of trach care, tube feedings, avoiding risk factors.

What are the nursing care elements for a client who has undergone surgery for oral cancer?

Same as a thyroidectomy Monitor for hemorrhage, respiratory distress, laryngeal nerve damage, tetany, thryoid storm.

What are the nursing care elements for a client who is post op for a parathyroidectomy?

Elevate head of bed - support neck and shoulders Teach patient not to overextend neck (sutures) Suction equipment should be available at bedside Cool mist humidifier to decrease coughing VS - OBSERVE FOR RESIPIRATORY DISTRESS (edema, bledding) NPO until gag reflex returns Observe for hemorrhage - fullness, anxiety, Dyspnea cyanosis Monitor for bleeding at site and behind shoulders Reinforce dressings - should be tight Assess for tetany Monitor for thyroid storm Assess speech for hoarseness due to laryngeal nerve damage

What are the nursing care elements for a client who is post-op for a thyroidectomy?

Protect the client from infection Vital Signs Assess Wounds Aseptic Technique when performing wound care, invasive procedures Preventative Measures - Oral Care, ROM, Good Nutrition, Turning, Deep Breathing) Emotional Support

What are the nursing care elements for a client who is post-transplant?

Assess stool Assess bowel sounds I&O, daily weight Assess for dehydration Change positions slowly Liquid diet to rest bowels - BRAT diet (bananas, rice, applesauce, toast) Gradually add driber to the diet Increase fluids to 3000 mL per day Avoid spicy, fried, foods, alcohol, chocolate, and red meat Protect perineal area Standard precautions Teaching Re: medications Teaching about ways to avoid diarrhea in future

What are the nursing care elements for a client with diarrhea?

Emotional support for appearance changes Gentle handling and frequent skin checks to prevent injury Assist with ADL's/space activities Medic alert bracelet Avoid stress and infections Monitor glucose levels. Monitor for infections Skin protection - heels, elbow, air mattress, High protein, low sodium, low calorie diet with potassium supplements VS q 4 hours - specifically temp Assess for edema Falls risk Space nursing Private room Sterile technique for would care Assess wounds carefully Encourage physical activity Patient teaching - do not stop corticosteroid abruptly Teach re: symptoms of Addison's Disease and wound care

What are the nursing care elements for a client with who has ungergone an adrenolectomy

Between the 6 & 7th, or 8th and 9th intercostal spaces Hepatic tissue removed Sign consent form Check PT, Platelet, Clotting, and bleeding times checked first VS q 15 minutes Some pain is common Watch for pneumothorax Risk for hemorrhage Lay on Right side for 2 hours to splint puncture site Keep flat in bed for 12 hours

What are the nursing care elements for a liver biopsy?

High Fowler's Assess respiratory status/VS/Pulse OX Administer oxygen prn

What are the nursing care elements for a pneumothorax?

Ensure consent is signed. Inform patient they may feel pressure Dressing to puncture site - assess for bleeding Position on unaffected side for 1 hour Respiratory and vitals assessment Label specimen and send to lab for culture CXR

What are the nursing care elements for a thoracentesis?

Assess respiratory status Assess circulatory status Vital Signs I&O Assess mental status. Reassure patient Patient Teaching re: avoidance of allergen, Epinephrine Reactions - mild, moderate, severe

What are the nursing care elements for anaphylaxis?

Assess GI system Increase fluids to 2500 ml per day Encourage activity Client education Regular time for evacuation

What are the nursing care elements for constipation?

Assess nutritional status High risk for aspiration Assess airway and respiratory status TPN or gastrostomy feedings to increase weight and provide nutrients. Client teaching - wound care, tube feedings, home TPN

What are the nursing care elements for esophageal cancer?

Nutritional supplements Dietary consult Teaching to avoid risk factors Teaching re: medications

What are the nursing care elements for gastritis?

I&O Strain urine for calculi Low calcium diet Cranberry juice to increase acidity of the urine - decreasing stone formation Calcitonin, Pamidronate (Aredia) or alendronate (Fosamax) to prevent calcium release from bones Mithramycin (anti-neoplastic) to lower serum calcium levels Pain management

What are the nursing care elements for hyperparathyroidism?

Monitor for bone changes Monitor for renal decline - (renal calculi due to excess calcium) Hydration - 2000ml per day with NSS - dilution of serum calcium levels by dilution Increase physical activity Lasix (furosemide) to increase renal secretion of Ca

What are the nursing care elements for hyperparathyroidism?

Warm room, extra clothes - blankets Stool softeners or bulk forming laxatives Avoid concentrated sweets to inhibit weight gain High protein, high fiber, low cholesterol diet Increase fluid intake to 2000 ml of low calorie liquids Increase activity Space nursing Reorient prn Patient teaching - will need meds for lifelong treatment, don't stop meds without consulting provider, Patients are more susceptible to sedatives - use cautiously

What are the nursing care elements for hypothryroidism?

Assess Pre and post op care VS's every 4 hours I&O Daily Weight Care of NG tube Measure abdominal girth Pain management Client teaching Monitor any drainage tubes Preventative measure - CBD, leg exercises

What are the nursing care elements for peritonitis?

Assessment Monitor vital signs I&O Daily weight Analgesics Fowler's Position

What are the nursing care elements for someone who has undergone surgery for bowel instruction

Careful assessment of the CV system I&O, daily weight Increase fluids to 3,000 ml per day Monitor skin turgor Stress free environment Monitor BP (ortho) and temperature closely

What are the nursing care elements for someone with Addison's Disease?

High Fowlers or Orthopneic Position Low levels of oxygen therapy Chest Physical Therapy Postural Drainage High fluid intake if tolerated High Humidity Allow for rest periods, assistance with ADL's High nutrition - more protein and calories Small frequent meals Suction PRN

What are the nursing care elements for someone with COPD

Assess nutritional status I&O, weekly weights Pre and post op care Monitor IV fluids May need feeding tubes or TPN Client teaching re: dressings, tube feedings

What are the nursing care elements for stomach cancer?

Assessment of respiratory system Prevention of infection Airway management Coughing and deep breathing Assess for pleural effusion Patient teaching re quitting smoking Emotional support Care of client undergoing chemo or radiation Patient teaching re: infections, respiratory distress, metastasis

What are the nursing care elements for the lung cancer?

ROM Ambulation increase fluids unless contraindicated DO NOT CROSS LEGS Wear loose clothing Wear ted hose Pneumatic compression

What are the nursing care elements for thrombophlebitis?

Assess pain - be alert for changes in severity or pattern Monitor vital signs - bleeding will cause changes (shock) Monitor NG tube drainage for blood. If vomiting, monitor electrolytes, and I&O

What are the nursing care elements for ulcers?

Vitamin K injections weekly Monitor electrolytes and blood sugar levels Central line care Client education to control stress As resolved, low residue diet

What are the nursing care elements for your client who is receiving TPN after a severe Chron's flare up?

Assess wound Assist with hydrotherapy Application of medications Administration of medications Monitor nutritional feedings IV, I&O, daily weight, respirations Oxygen Dressing changes Monitor for infection Assist with movement Apply splints as directed Pain management Emotional support

What are the nursing care elements of burn wound management?

Elevate HOB Suction PRN Client may be intubated if airway is obstructed Administer oxygen based on ABG's May be on a ventilator May have a tracheotostomy

What are the nursing care interventions for the respiratory system during treatment for burns?

The client must be NPO until the gag reflex returns.

What are the nursing considerations for TEE?

Isolation in negative air flow room Respiration mask - not just a surgical mask Respiratory isolation (mask, gown, gloves) Teach handwashing after sneezing and coughing Teaching to stay on medications and follow prescriptions Teaching related to medication side effects: Rifampin will cause urine, sweat, and saliva to change color Good nutrition and side effects Report changes in resp status, other symptoms Increase fluids to 2.3 -3 L per day unless contraindicated. Avoid crowds Dispose of tissues properly Health Department must be notified Screen family Followup cultures.

What are the nursing interventions for tuberculosis?

Respiratory rate Chest movement Speech - are they pausing to breathe? Orthopnea Lung Sounds - wheezes, rhonchi, crackles, pleural friction rub Hypoxia Pulse Ox Barrel Chest

What are the objective assessments that can be made in regards to the respiratory system?

Toxoplasmosis Cryptosproidiosis

What are the parasitic infections associated with AIDS?

Educate the patient re: their type of anemia, treatments, medications Refer to a nutritionist Importance of follow up visits

What are the patient education elements for anemia?

Teach to avoid stress, monitor fluid balance, Report symptoms: N&V, pain, thirst, anxiety, malaise, infections

What are the patient teaching elements for Addison's Disease?

No smoking Keep extremities warm Protect from injury

What are the patient teaching elements for Peripheral Artherosclerosis/PVD

Good nutrition Adequate rest Avoid sun exposure Keep skin clean and dry Good handwashing Monitor vital signs Protective isolation may be necessary (avoid people who are ill) Emotional support Avoid stress May need counseling Use mild soap products Hypoallergenic makeup

What are the patient teaching elements for Systemic Lupus Erythematosus?

Teach the client how to protect themselves from infection Teach the client the side effects of medications Teach how to recognize signs of rejection Teach how to monitor their temperature at home Encourage good nutrition Encourage keeping skin integrity Wear a medic alert re: transplant recipient Referral to social services - transplant meds are expensive

What are the patient teaching elements for a client who is post transplant?

Avoid high output electrical generators, large magnets, MRI is contraindicated Avoid injury of the affected arm Report pulse rate if 5 bpm less than set rate Notify all caregivers of pacer

What are the patient teaching elements for a client with a pacer?

Avoid things that cause venous pooling - crossing legs, constrictive clothing, standing for long periods, long plane or car rides, Bleeding precautions No pillows under knees Keep blood pressure under control With coumadin - don't increase ingestion of Vit K foods Need to have PT/INR rates monitored periodidcally

What are the patient teaching elements for a patient at risk for clots

Teach the client to carry a fast acting sugar. Teach family members what to do Will most likely occur when medications/insulin peak

What are the patient teaching elements for hypoglycemia?

See the podiatrist often, Inspect feet daily. Wear properly fitting shoes, wear socks of natural materials - non constricting, protect feet from cold (insulated boots) in winter, do not cross knees.

What are the patient teaching elements of foot care for a client with DM?

Carpopedal spasms Chovstek's Sign is positive - grimacing when facial nerve is tapped. Trousseau's sign is positive - BP cuff inflatation causes carpal spasms.

What are the physical signs of tetany?

The burn area allows water to leave the cells and blood and shift to the interstitial spaces decreasing blood volume and may cause hypovolemic shock. The fluid in the intersitial spaces causes edema, which puts pressure on blood vessels, impairing circulation and causing ischemia and necrosis. The body tries to compensate by causing vasoconstriction leading to ischemia and clot formation below the burned area. RBC's in the burned are hemolyzed (ruptured).

What are the physiological changes a burn causes to the cardiovascular system?

Routine VS Temporary ventilator Cardiac monitor TED Keep emergency equipment nearby Client teaching - gradual return to activity No lifting more than 10 lbs. No crossing Diet changes

What are the post operative nursing considerations for a client who has under gone CABG surgery?

Elevate the head of the bed Assess dressings for excess bleeding and CSF I&O to assess for diabetes insipidus Medications to decrease cough and stool softeners Remind patients to avoid activities that increase intracranial pressure toothbrushing is avoided Hormone replacement is done individually

What are the post-op care elements after a hyposystectomy?

Check bowel sounds Assess for bowel distention Monitor respiratory status May have an NG tube, connect to low suction, irrigate Surgical drains (note drainage) Stoma care

What are the post-operative care elements for a bowel resection or colectomy?

Baseline VS, EKG, elevate HOB to 40-6- degrees

What are the pre-procedure steps for pericardiocentisis

Eating - client is sensitive to wheat, rye, barley, chocolate, milk and caffeine Stress Drugs Hormones

What are the precipitating factors for IBS

2-3 days of bland, clear liquids Go-Lytely or enemas until clear Antibiotics

What are the preoperative care elements for a bowel resection or colectomy?

High fat/low fiber diet Over the age of 50 Personal history Family history Polyps IBD Smoking Alcohol

What are the risk factor's for Colon Cancer

Under the age of 4 Adults over 65 Careless smoking Alcohol and drug intoxication Physical or mental disabilities

What are the risk factors associated with burns?

Likely genetic Increase instance in urban areas Increased instance in North America Increased instance in Jewish people More common in people 10-30 years old

What are the risk factors for Chron's disease?

Exposure to chemicals, radiation, viruses Immune disorders Down Syndrome Radiation or chemotherapy

What are the risk factors for Leukemia?

ADH is released in response to stress. Lung tumors Head injury Pituitary surgery Barbituate use Anesthetic Diuretics Pain, Stress Elderly BE ALERT FOR SIADH IN CLIENTS WHO HAVE RISK FACTORS AND ARE UNDER STRESS.

What are the risk factors for SIADH?

impaired venous blood flow, immobility, trauma to blood vessels, hormones, post surgical client, altered coagulation, pregnancy and the postpartum period, varicose veins, obesity, elderly - most common cause is IMMOBILITY

What are the risk factors for a Pulmonary Embolism/

Heavy smoking Alcohol use Chewing tobacco and cigars Poor nutrition Occupational exposure (chemicals and paint)

What are the risk factors for cancer of the larynx?

Flu-like symptoms, fatigue, weight loss, muscle and joint pain

What are the side effects for Interferons and Interleukins?

Calf pain or tenderness, dull aching pain in the leg while ambulating

What are the signs and symptoms for Thrombophlebitis?

Pain Redness Warmth Palpable cord like structure to vein

What are the signs and symptoms for a Superficial Thrombophlebitis

Buffalo hump & moon face result from deposits of adipose tissue Weight gain with obesity especially in the trunk Thin skin with purple striae (stretch marks) Thin arms and legs (muscle wasting) Osteoporosis Pathological fractures Kyphosis Back pain Kidney stones Proteinuria Hyperglycemia Hyperpigmentation of the skin Hypernatremia Changes in mental status Emotional changes Hypokalemia Susceptibility to infection Cataracts Glaucoma Hypertension Heart failure Hirsutism Poor wound healing

What are the signs and symptoms of Cushing's Disease?

Vesicles form on the face, open, crust and ulcerate - general malaise and fatigue

What are the signs and symptoms of HSV1?

Vesicles form on the genitals, erythema, burning, tingling, pain, malaise, fatigue, myalgia, fever, anorexia. Vesicles turn into pustules, open and crust. Healing takes place in 10-14 days. The first outbreak is often the most severe - may include a fever and sore throat.

What are the signs and symptoms of HSV2?

Raised erythmatous, silvery white scaling plaques on scalp, elbows, knees, scarum, around the nails, arms and legs. Pruritis - mild to severe

What are the signs and symptoms of Psoriasis?

Affected areas turn pale, blue and then red Numbness Tingling Stiffness Decreased sensation Aching

What are the signs and symptoms of Reynauds Disease?

Protruding mass or bulge A bulge noticeable with exercise or strain

What are the signs and symptoms of a hernia?

Decreased or absent chest sounds Sudden sharp chest pain, Tachycardia, Tacypnea diaphoresis Sucking sounds with chest injury decreased or no chest movement on affected side

What are the signs and symptoms of a pneumothorax?

Leukiplakia (white patches) Erythroplakia (red patches) Hoarseness Dysphagia Englarged lymph nodes Cough Sore throat Hemoptysis Weight Loss

What are the signs and symptoms of cancer of the larynx?

Skin is red, edematous, painful, may see vesicles. Client will have fever, chills, malaise, headache, lymphadenopathy

What are the signs and symptoms of cellulitis?

Difficult to arouse - hepatic encephalopathy Dyspnea - portal HTN leads to ascites and esophageal varices Low plasma proteins (albumin) lead to edema Bleeding and decreased resistance to infection UGI bleeding and Purpura Splenomegaly High ammonia levels Renal failure Asterixis - flapping tremor of the hand.

What are the signs and symptoms of cirrhosis?

Changes in bowel habits Excessive flatus Cramping Anorexia Weight loss Palpable mass Rectal bleeding Pain Nausea Cacexia, ascites

What are the signs and symptoms of colon cancer?

Dysphagia (first), weight loss, regurgitation, blood loss

What are the signs and symptoms of esophageal cancer.

Abrubt, sharp pain with deep breathing, coughing or movement Breathing is rapid, shallow Diminished lung sounds High Fever Pleural friction rub can be heard

What are the signs and symptoms of pluerisy?

JVD, Anorexia, Nausea, Abdominal distention, Hepatosplenomegaly, tenderness of liver and spleen, fatigue, activity intolerance, edema, feet, ankle

What are the signs and symptoms of right sided heart failure.

Distended abdomen Decreased bowel sounds Digital exam reveals a hard stool

What are the signs of constipation?

Client pay pass liquid or watery stool Client feels full or crampy

What are the signs of fecal impaction?

Severe crushing pain, burning or squeezing behind the sternum Pain radiating to the left arm, jaw, teeth or epigastric area Sweating, nausea, anxiety, cool clammy skin tachycardia, SOB Pain that lasts longer than 15-20 minutes and is not relieved by nitrates, rest or change in position

What are the signs or symptoms of an MI?

Dyspnea, If on exertion, what kind of exertion and how long it lasts. What makes it better/worse. Cough - what kind, what triggers it, sputum? If sputum, how much, what color?

What are the subjective assessments you can make regarding the respiratory system?

Partial laryngectomy Total laryngectomy Radical neck dissection

What are the surgical interventions for Cancer of the Larynx

Lung transplant or lung reduction

What are the surgical interventions for someone with COPD?

Colectomy with ostomy (ileostomy) Bowel resection

What are the surgical interventions if a client's Chron's disease?

Laryngeal spasms Stridor Cyanosis Asphixia Bizarre posturing Spastic movements lethargy Psychosis Hypocalcemic tetany Convulsions Death

What are the symptoms for hypoparathyroidism?

Usually occurs 12-48 hrs after injury Decreased breath sounds Low PaO2, High PaCo2 tachycardia, hypertension, low urine output Dyspnea - nasal flaring, cyanosis, crackles, wheezing decreased level of conciousness OXYGEN DOESN'T HELP

What are the symptoms of ARDS?

Nausea, anorexia, craving for salt, postural hypotension, vertigo, muscle weaknesss, athralgia, headache, disorientation, abdominal or lower back pain, diarrhea, weight loss, hypoglycemia Darkly pigmented mucous membranes and skin. (Bronze over knees, elbows, knuckles) NOTE: Abnormally high or low body temperature, hyponatremia, hyperkalemia are signs of inmpending adrenal crisis

What are the symptoms of Addison's Disease?

Instep pain Intermittent claudication Decreased pulses Cold, pale and thin skin Thick toe nails Limbs are red in dependent position Necrosis and gangrene

What are the symptoms of Buergers Disease?

Vague indigestion Colicky pain in the RUQ, often following eating a large or fatty meal Pain may radiate to right arm, shoulder, back May also see N/V, Low grade fever, dark urine, anorexia May also see fatty stool

What are the symptoms of Cholecystitis, Cholelythiasis?

Diarrhea, usually not bloody Fatigue Abdominal pain and tenderness Weight loss Fever Fissues and fistulas Palpable pass RLQ

What are the symptoms of Chron's Disease?

Malaise, fatigue, hepatomegaly

What are the symptoms of Chronic Hepatitis?

Blood pressure drops Pulse is rapid and thready Respirations are deep and smell like acetone Electrolyte imbalance - Dehydration Coma Death

What are the symptoms of Diabetic Ketoacidosis?

Frequent or prolonged heartburn - dyspepsia Chronic cough/dysphagia Belching (eructation) Flatulence Chest pain exacerbation of Asthma

What are the symptoms of GERD?

hypotension mental changes extreme thirst dehydration fever tachycardia paralysis lethargy coma seizures hyperglycemia Low potassium levels

What are the symptoms of HHNKS?

Weightloss Jittery and excitable insomnia Overreactive memory loss Tachycardia elevated blood pressure Arrythmia and palpitations LONG TERM - congestive heart failure, cardiac arrest Skin is warm and flushed hair is find and soft Amenorrhea Intolerance to heat Hyperactivity, clumsiness, tremors of the hand Exophthalmos

What are the symptoms of Hyperthyroidism?

Deep, rapid respiration as the body tries to "blow off' carbon dioxide.

What are the symptoms of Metabolic Acidosis?

Depressed respiration.

What are the symptoms of Metabolic Alkalosis?

seizures, lethargy, coma, hypothermia, system shut down

What are the symptoms of Myxedema Coma?

Hypertension - intermittent or persistent Exaggerated symptoms - overexertion, stress, sometimes nothing Severe pounding Heart, flushing, palpitations, dizzy, dyspnea, parasthesia, nausea, heat intolerance, insomnia, anxiety, tachycardia, tachypnea, profuse diaphoresis, glycosuria, hyperglycemia

What are the symptoms of Pheocromocytoma?

Dyspnea, RALES, tachypnea, cyanosis, cough, fever,

What are the symptoms of Pneumocystis Jiroveci Pneumonia (PJP)

Fluid overload without edema Weight Gain Hyponatremia (lab result <125) Increased BP Pounding pulse Headache Anorexia Oliguria Urine specific gravity greater than 1..0030 Muscle cramps, weakness due to electrolyte imbalance CRITICAL: Watch for changes in level of consciousness, lethargy, absent reflexes = Brain swelling - BAD NEWS (coma, seizures, and death).

What are the symptoms of SIADH?

Oral ulcers Arthralgias Arthritis Vasculitis BUTTERFLY RASH ACROSS NOSE AND CHEEKS nephritis pericarditis anemia Luekopenia Thrombocytopenia alopecia photosensitivity depression dementia peripheral neuropathies immunosuppression

What are the symptoms of Systemic Lupus Erythematosus?

a rounded painless mass or nodule is palpated on examination, may press on trachea causing dysphagia and difficulty breathing.

What are the symptoms of Thyroid Cancer?

Sudden excrutiating pain, hypertension, absense of peripheral pulses.

What are the symptoms of a dissecting aneurysm?

Severe abdominal pain Distention nausea and vomiting Tachycardia, Fever

What are the symptoms of a strangulated hernia?

Sudden decrease in loose stools. Fever Tachycardia hypotension dehydration abdominal tenderness cramps

What are the symptoms of a toxic megacolon?

Fatigue, weakness, sore throat, stomatitis, dysphagia, fever and chills.

What are the symptoms of agranulocystosis?

Knawing pain in the abdome, flank, or back Bruit Hypertension

What are the symptoms of an aneurysm?

abrupt onset, coughing, wheezing, dyspnea, chest tightness, pale, tachypnea, tachycardia.

What are the symptoms of an asthma attack?

Rebound tenderness of the abdomen in the RLQ (McBurney's Point) N&V Fever Anorexia Increased pain with moving, coughing When client extends right hip, pain increases

What are the symptoms of appendicitis?

gradual onset, headace, malaise, muscle and joing pain, flu-like symptoms, dry, hacking non-productive cough that persists for up to 6 weeks.

What are the symptoms of atypical pneumonia

Colicky pain Abdominal tenderness Distention Vomiting that may smell like feces Signs of dehydration No stool/No flatus Bowel sounds initially high pitched and loud, and eventually none

What are the symptoms of bowel obstruction?

Chronic morning cough, sputum is greenish yellow with foul odor, amount of sputum increases over time, hemoptysis, weight loss, crackles, wheezing, decreased breath sounds, anorexia, fatigue, SOB, recurrent pneumonia

What are the symptoms of bronchiectasis?

Dry cough that develops into productive Continuous uncontrollable cough delading to chest pain, rhonchi, wheezing, dyspnea, fever, malaise, chest tightness

What are the symptoms of bronchitis?

Polyruria, polydipsia, nocturia Urine is dilute - low specific gravity Output may exceed 5-15 liters in 24 hours

What are the symptoms of diabetes insipidus?

anorexia, nausea, yellow halo, dysrhythia

What are the symptoms of digoxin toxicity?

Mild to severe lower left quadrant pain that may be steady or cramping. Fever High WBC and Sed Rate Abdominal distention Nausea/Vomiting Constipation or diarrhea

What are the symptoms of diverticular disease?

increased peristalsis, diaphoresis, nausea, vomiting, pain, cramping, diarrhea, tachycardia, dizziness, postural hypotension, hypoglycemia, borborygmi

What are the symptoms of dumping syndrome?

Bloody diarrhea Hemolysis of blood cells can cause kidney damage.

What are the symptoms of e-coli?

dyspnea, tightness in the chest, tachycardia, tachypnea, orthopnea, jugular vein distention, crackles, anxiety, headache, hypertension

What are the symptoms of fluid overload?

Epigastric pain, nausea, vomiting Hemateemesis, Melena Possibly a fever Headache, anorexia, diarrhea Vague discomfort after eating Anemia Fatigue

What are the symptoms of gastritis?

Jaundice, prutitis, dark urine, clay colored stool

What are the symptoms of hepatitis during the Icteric phase?

Malaise, headache, myalgia, nausea, diarrhea, nasal discharge, sore throat, arthalghia, URQ pain

What are the symptoms of hepatitis during the podromal phase?

Weakness, headache, nausea, drowsiness, anxious, hungry, tremors, diaphoresis, cool, clammy

What are the symptoms of hypoglycemia?

Dyspnea, othropnea, cough, tachycardia, pulmonary edema, dizziness, syncope, fatique, weakness, activity intolerance, wheezing, crackles

What are the symptoms of left sided heart faiture

Dull pain in the right upper quadrant and epigastric area Jaundice, anorexia, N/V, weakness, fever Epigastric fullness Weigh loss

What are the symptoms of liver cancer?

Hemoptysis, dyspnea, fever, chills, wheezing, weight loss, chronic cough, hoarseness, chest pain, dysphagia

What are the symptoms of lung cancer?

Epigastric pain that is gnawing, burning, aching or hunger like Heartburn or vague discomfort? Anemia or weight loss.

What are the symptoms of peptic ulcers?

Severe abdominal pain Abdomen boardlike and client might bring knees up to relieve Rebound tenderness Distention Nausea/vomiting Absent bowel sounds Fever Tachycardia tachypenia Oliguria Restleness Confusion

What are the symptoms of peritonitis?

weakness, dyspnea, weight loss, diarrhea, edema, Smooth, red, sore "beefy" tongue

What are the symptoms of pernicious anemia?

Respiratory distress, tachypnea, dyspnea, decreased breath sounds. If empyema - chills, fever, mailaise, anorexia, productive cough with purulent and blood-tinged sputum.

What are the symptoms of pleural effusion/empyema?

Mental cloudiness, dizziness, dyspnea, restlessness, tachycardia

What are the symptoms of respiratory Acidosis?

Parasthesia around the mouth and distal extremities, lightheadedness, inability to concentrate, dyspnea, tachycardia

What are the symptoms of respiratory alkalosis?

fatigue, dizziness, syncope, confusion, hypotension

What are the symptoms of sinus bradycardia?

Fullness, anorexia, indigestion, weight loss, hematemesis, melena, anemia.

What are the symptoms of stomach cancer?

Abrupt onset, productive cough, fever, high HR and respiratiory rate, crackles, dyspnea, chest pain, cyanosis

What are the symptoms of typical pneumonia?

Severe abdominal pain radiating to the back, jaundice, clients may lean forward or assume fetal position. Anorexia, N/V. restlessness, malaise, fever, tachycardia, streatorrhea

What are the symptoms related to pancreatitis?

Cholecystogram, IV Choleangiogram, Operative Choleangiogram, Ultrasound, HIDA Scan, Liver Scan

What are the tests used to assess Gall Bladder function

Remove excess secretions, mucus, foreign body

What are the therapeutic uses for bronchoscopy?

Close contact, sharing combs, hats, brushes, linens.

What are the transfer conditions for Pediculosis Capitus?

Bedrest, elevation, moist heat Anticoagulants, Ted stockings HEPARIN MONITOR PTT

What are the tratments for thrombophlebitis?

Restoration of fluids and electrolyte balance Florinef (fludrocortisone) - replacement hormone Gluticorticoids - Hydrocortisone

What are the treatments for Addison's Disease?

IV Fluids (saline and glucose) Corticosteriods Keep warm and quiet

What are the treatments for Addisonian Crisis?

slow the ventricular response, cardioversion, digoxin, Ca channel blockers, Procainimide, antiarrythmics, anticoagulants, ALWAYS COUMADIN AT DISCHARGE.

What are the treatments for Atrial Fibrillation?

Stop smoking Exercise Keep extremities warm Amputation in extreme cases Fibronolytic to dissolve clots Anticoagulants Protect from injury

What are the treatments for Buergers Disease

Identify and treat the cause Tumors removed or irradiated - adrenal or pituitary Medication if tumors inoperable Diet low in sodium to decrease edema Low CHO/Calories to control hyperglycemia Adrenalectomy - lifelong corticosteriod and mineralcorticoid therapy following

What are the treatments for Cushing's Disease?

If nephrogenic, give fluids by mouth or IV - 1/2 NS (0.45%) will shift fluid into cells. (hypotonic) Removal of tumor Im, Sq, Or Nasal ADH. Vasopressin (Pitressin) DDAVP (Desmopressin), or Iypressin (Diapid) Diet : no caffeine Decreased sodium intake and diuretics may be ordered for nephrogenic clients.

What are the treatments for Diabetes Insipidus?

Correction of electrolyte imbalances Correct fluid imbalance Give regular insulin IV and an isotonic solution Give Potassium

What are the treatments for HHNKS?

Symptoms relieved by antivirals - Acyclovir, Zovirax which can be given PO or topically. Keep lesions dry and avoid direct contact Analgesics

What are the treatments for Herpes Simplex Virus?

Pain management Steriods Antipruretic lotions (calamine) Medicated baths Anti-viral medications like Acylovir

What are the treatments for Herpes Zoster?

Reperfuse the heart Reduce workload on heart Promote tissue oxygenation Rest with gradual increase in activity Beta Blockers Ace Inhibitors Oxygen Fibrolynic Agent - Streptokinase TPA

What are the treatments for MI?

Depends on biopsy and staging of disease Wide Surgical exision is the treatment of choice Skin grafts may be required Radiation if tumor is inoperable. Immunotherapy Client teaching re: frequent skin assessments Emotional support (open ended questions) Wound Care

What are the treatments for Malignant Melanoma?

Antiarryhmatics - lidocaine, pronestryl, Bretolyl

What are the treatments for PVC?

Topical applications - Kwell, Rid, Nix, follow directions Treatment may need to be repeated Everything the client came in contact with needs to be treated.

What are the treatments for Pediculosis?

Antiplatelets ASPIRIN OR PLAVIX Endararectomy (plaque removal) Angioplasty (stents) Bypass Amputation

What are the treatments for Peripheral Atherosclerosis?

Surgical removal of tumor - sometimes entire adrenal gland Stabilize the blood pressure Metyrposine (Demser) pre-op to inhibit catecholamine production Mesylate (Regitine) and phenooxybenzamine (Dibenzyline) to control blood pressure before surgery.

What are the treatments for Pheocromocytoma?

Slow the proliferation of epithelial layer of the skin Corticosteriods - oral, topical, injected into lesions Tar Preparation - topical or bath Retinoids (Tazorac) topical Dovonex (Vitamin D analog) topical Enebrel (biologic) injections for severe Psoriasis and psoriatic arthritis Methotrexate or Cyclosporine (chemo meds) Photochemotherapy

What are the treatments for Psoriasis?

Identify and treat the underlying cause Fluid restriction - 500-1,000 ml per day Normal Saline or Hypertonic IV to increase sodium levels Medications - Declomycin (demclocycline) or Lithium Diuretics LASIX Surgical resection radiation or chemo for malignant neoplasm

What are the treatments for SIADH

Subtotal or Total thyroidectomy Lifetime replacement therapy External radiation and chemotherapy Radical neck dissection may be done with metastasis

What are the treatments for Thyroid Cancer?

Oral Antidiabetics Exercise Diet Insulin when necessary

What are the treatments for Type 2 Diabetes

Benadry Steriods Epinephrine Cold Packs/Compresses Constant assessment of respiratory system - if it occurs its a medical emergency

What are the treatments for Uticaria

Depends on severity May resolve on its own May require a thorocentesis to withdraw air May require a chest tube (usual treatment)

What are the treatments for a pneumothorax?

Ruptured esophageal varices is a medical emergency. Maintain airway Control bleeding IV fluids and blood replacement Sengstaken Blakemore tube High HOB, NPO, Gastric lavage with Iced saline Endoscopic Sclerotherapy Surgical shunting to reduce portal hypertention

What are the treatments for a ruptured esophageal varices?

Anticoagulants Fibrinolytics Thrombolytics Surgical - Endarectomy Embololectomy

What are the treatments for a thrombus or embolus?

Monitor for complications Control HTN Surgical intervention Fusiform (the circumfrence of a vessel is repaired Saccular - portion of a vessel removed and sutured or patched with a graft.

What are the treatments for an aneurym?

Vasolidilators - beta blockers, calcium channel blockers, nitroglycerin Oxygen Low dose aspirin therapy No smoking Manage weight Low Sodium Diet Low Cholesterol Diet Monitor Blood Pressure Change Position slowly

What are the treatments for angina pectoris?

Treat the cause Reduce cardiac workload Correct dysrythmia Heart transplant

What are the treatments for cardiomyopathy

Anti-infectives

What are the treatments for cellulitis?

Steroids, Antihistamines Atarax (hydroxyzine) Identify the offending agent and avoid Soothing baths Assess for infection

What are the treatments for dermatitis?

Surgical removal. chemo, radiation Possible feeding tube.

What are the treatments for esophageal cancer?

antibiotics, immunosuppressants, steriods, stem cell transplants.

What are the treatments for graft vs. host disease?

Goal is to reduce blood calcium levels Surgical removal of existing tumor or parathyroid glands.

What are the treatments for hyperparathyroidism?

Aministration of Hypterthyroid Drugs that block the production of thyroid hormones and reduce vascularity Radiation to destroy the hypertrophied thyroid Tissue Subtotal thyroidectomy

What are the treatments for hyperthyroidism?

Immediate treatment of tetany - iv calcium gluconate Oral Vitamin D to increase calcium absorption High calcium diet/oral calcium supplements

What are the treatments for hypoparathyroidism?

Control the bleeding Replace the fluids Administer blood products

What are the treatments for hypovolemic anemia?

Injections of B12 Injections of erythropoetin(procrit/epogen) Oral supplements

What are the treatments for pernicious anemia?

Analgesia High fluids to add volume and keep blood moving to flush the vessels. Oxygen Hydroxyurea

What are the treatments for sickle cell crisis?

IV Fluids Antithyroid Medications Cooling blanket Anti-pyretics - NOT ASPIRIN Beta Blockers to relieve alleviate symptoms Oxygen as needed Do not palpate thyroid - will release more hormones Resolves in 12-24 hours

What are the treatments for thyroid storm?

Treatment may last 6-12 months INH(Isoniazid) and Rifampin Client should use birth control during treatment due to defects caused by INH Zinamide Ehtambutol - watch for vision changes Streptomycin - Nephrotoxic and ototoxic Do not drink alcohol or take tylenol - all drugs are toxic to liver

What are the treatments for tuberculosis?

exercise, stress, anxiety, electrolyte imbalance, digoxin toxicity, hypoxia, MI, tobacco, alcohol, caffeine

What are the triggers for PVC?

Acute and chronic

What are the two classes of Leukemia?

Ulcerative Colitis and Chron's Disease

What are the two primary types of Inflammatory Bowel Disease?

Fatigue Depression Confusion Increased urination Nausea Vomiting Hypertension Cardiac Arrhythmias Low back pain Impaired memory Psychosis Constipation Pathological fracture Kidney stones Abdominal pain Peptic ulcers Congestive heart failure is a long term effect

What are they symptoms of hyperparathyroidism?

TTE - transducer chest wall TEE - Trans-espophageal - endoscopic transducer is placed in the esophagus

What are two ways an echocardiogram is performed on the heart?

Assess for hypoglycemia

What assessment should you make for Meglitinides

Estimate the extent of burns. Initiation of first aid measures Fluid stabilization Assess for hypovolemic shock Assess for respiratory distress

What assessments are performed during burn Stage One?

Assess for pruritis, edema, burning pain Assess the respiratory system as it can sometimes be involved in cases of hives.

What assessments should be made if the client presents with uticaria

Sex with an infected person Sexual relations without the use of a condom Sharing needles and drug paraphernialia Heterosexual intercourse with an IV drug user Multiple sex partners. Exchanging sex for drugs Receiving blood or IV clotting factors Needle sticks

What behaviors put someone at risk of contracting HIV?

Interferons and Interleukins

What bioligical treatment for leukemia slows the growth and proliferation of abnormal cells?

Colony Stimulation Factors

What biological treatment for leukemia stimulates the growth of blood cells?

kidneys, lungs, CNS, blood vessels, CV system

What body systems does Systemic Lupus Erythematosus affect?

Stage Two (Acute Stage)

What burn stage lasts from 48 hours post injury to the point the wounds close?

The heart's chambers, valves, great vessels, coronary arteries.

What can a cardiac catheter visualize?

Pressure within the heart, valvular defects, arterial occlusion and congenital abnormalities.

What can be determined using a cardiac cathether?

Tumor Bowel obstruction Lack of exercise Low fiber diet Decreased fluid intake Medications Intestinal disease Rectal or anal changes Systemic disease Misuse of laxatives Pregnancy Ignoring the urge to defecate.

What can cause constipation?

Aspiration, oversedation, immobility, bacterial and viral infections.

What can cause pneumonia?

Scarring and pyloric obstruction.

What can chronic gastritis cause?

Liver failure, malaise, hepatomegaly

What can chronic hepatitis lead to?

Non-Hodgkins Lymphoma

What cancer associated with AIDS affects the lymph system?

Angina Pectoris

What cardiac condition is characterized by sudden and acute chest pain during exercise and is relived when resting.

Cause is unknown but diet, (high in fat, chocolate), stress, heredity, overactive sex hormones, cosmetics seem to play a role.

What causes Acne Vulgaris?

When the cells do not have glucose for energy, they turn to fats. The byproducts build up as acids in the cells, blood and urine, and when there are more ketones than the kidneys can deal with, KA results. This affects the acid/base balance and if untreated can depress the CNS, causing coma and death.

What causes Diabetic Ketoacidosis?

A relaxation of the cardiac sphincter muscle or delayed gastric emptying.

What causes GERD?

Cold temperatures, infection, surgery, drugs, trauma, CNS depressants (narcotics and tranquilizers)

What causes Myxedema Coma?

Often has a hereditary link Can be caused by a virus or environmental toxin

What causes Type 1 Diabetes?

a deficiency in Von Willebrand's (vW) factor and sometimes factor VIII

What causes Von Willebrand's disease?

Lack of iodine in the diet - it is needed to manufacture t3, t4

What causes a goiter?

atherosclerosis, thrombus, or embolus

What causes a myocardial infarction?

Generally smoking, alcohol, stress, meds (aspirin, NSAIDS, steriods, chemo)

What causes gastritis?

Usually an allergic reaction to drugs, food, animals, chemicals, insect bites.

What causes hives?

Benign tumor Chronic renal failure

What causes hyperparathyroidism?

pneumonia, lung cancer, trauma, CHF, Chronic kidney disease

What causes pleural effusion?

Infection, alcohol, drugs, lupus, rheumatoid arthritis, crack cocaine abuse.

What chronic conditions lead to cardiomyopathy?

Chronic Bronchitis (Blue Bloaters)

What classification of COPD is charachterized by A dry cough that becomes productive over time, occurs after age 35, a history of recurrent episodes of bronchitis, may look obese, have edema, cyanosis, distended neck veins. Auscultation reveals wheezing and rhonchi. May go into right sided heart failure.

Brochiectasis

What classification of COPD is characterized by chronic dilation of the bronchi where the walls become permanently distended?

Asthma

What classification of COPD is characterized by chronic inflammation and recurrent episodes of wheezing, dyspnea, chest tightness, coughing

1:10 bleach/water

What cleaning solution will destroy the HIV virus?

Heparin

What common drug can result in ITP?

Dumping Syndrome

What complication of stomach cancer surgery is characterized by rapid emptying of stomach contents into the duodenum which causes distention.

Diabetic Retinopathy

What condition associated with DM is characterized by changes in retinal capillaries which cause a decreased blood flow?

Diabetic Nephropathy

What condition associated with DM is characterized by the kidney's inability to excrete nitrogen and waste products?

Esophageal cancer

What condition does GERD increase the risk of?

Peripheral Neuropathy

What condition is a complication of DM and is characterized by a pathological change in nerve function due to chronic elevated blood glucose levels.

Cirrhosis

What condition is characterized as a degenerative disease of the liver in which normal cells replaced by scar tissue.

Diverticulosis

What condition is characterized by "out pouchings" in the intestine and may have no symptoms.

Tuberculosis

What condition is characterized by a bacteria transmitted by inhaled droplets - airborne

Diabetic Ketoacidosis

What condition is characterized by a blood glucose between 300-1000 and a change in blood pH?

Chronic Obstructive Pulmonary Disease

What condition is characterized by a chronic and progressive obstruction of of the air flow to or from the bronchioles?

Pneumothorax

What condition is characterized by a collection of air or gas in the pleural space, causing collapse of the lung?

Transfusion reaction.

What condition is characterized by a hypersensitivity to receiving blood or blood products that are incompatible with their own?

Scabies

What condition is characterized by a parasite that penetrates the skin and makes a burrow?

Systemic Lupus Erythematosus

What condition is characterized by a systemic autoimmune response in which the antigen-antibody reaction is turned on healthy connective tissue?

Thyroid Storm

What condition is characterized by a very high fever, tremors, delirium, confusion, seizures, cardiac failure and coma due to thyroid manipulation, hyperthyroidism, infections, diabetes or trauma?

Aneurysm

What condition is characterized by a weakening and dilation of a vessel - usually and artery or aorta?

Adult Respiratory Distress Syndrome (ADRS)

What condition is characterized by acute respiratory failure that does not respond to oxygen therapy?

Type 1 Diabetes (Insulin Dependent Diabetes Mellitus)

What condition is characterized by an autoimmune disorder in which antibodies destroy the beta cells in the pancreas, shutting down insulin production entirely?

Cellulitis

What condition is characterized by an infection that is localized in the dermis and subcutaneous tissue.

Hepatitis

What condition is characterized by an inflammation of the liver, sometimes caused by drugs, virus, alchohol, & gallbladder disease?

Pancreatitis

What condition is characterized by an inflammation of the pancreas?

Pleurisy(Pleuritis)

What condition is characterized by an inflammation of the visceral or parietal plueral lining?

Acne Vulgaris

What condition is characterized by an inflammatory condition of the sebaceous glands usually on the face, neck, and back.

Mechanical Bowel Obstruction

What condition is characterized by an obstruction of the bowel caused by scar tissue,hernias, or twisting of bowel?

HSV1 (Herpes Simplex Virus 1)

What condition is characterized by an outbreak of cold sores and fever blisters?

Appendicitis

What condition is characterized by an ulceration, infection, necrosis, or perforation of the appendix?

Dermatitis

What condition is characterized by chronic inflammation of the skin?

Uticaria (hives)

What condition is characterized by elevated areas of edema usually white in color and red edges?

Cushings Syndrome

What condition is characterized by elevated levels of cortisol and aldosterone?

Hyperthyroidism

What condition is characterized by excess production of the T3 and T4 hormones, which increases metabolic activity?

Reynaud's Disease

What condition is characterized by exposure to cold or emotional stimuli?

HHNKS (Hypersmolar Hyperglycemic Non-Ketotic Syndrome.

What condition is characterized by extremely high blood glucose level without ketosis?

Pleural Effusion

What condition is characterized by fluid collecting in the pleural spaces as a result of inflammation?

Diarrhea

What condition is characterized by frequency, volume, and water content of stool that is loose and watery.

Gastroesophageal Reflux Disease (GERD)

What condition is characterized by gastric contents and enzyme leakage into the esophagus

Hyperparathyroidism

What condition is characterized by hypercalcemia and hypophosphatemia?

Hypoparathyroidism

What condition is characterized by increased serum phosphorus levels and decreased serum calcium levels?

Cholecystitis

What condition is characterized by inflammation of the gall bladder & cystic duct?

Gastritis

What condition is characterized by inflammation of the lining of the stomach?

Bronchitis

What condition is characterized by inflammation of the trachea and bronchial tree causing vasodilation and edema?

Pediculosis

What condition is characterized by insects that infest the hair, body, and genital regions?

Addison's Disease

What condition is characterized by insufficient amount of gluticoricoids and mineralcorticoids or the pituitary may decrease the amount of ACTH it releases.

Psoriasis

What condition is characterized by lesions with silvery white scaling plaques?

Irritable Bowel Syndrome (IBS)

What condition is characterized by pain and disturbed bowel pattern (either diarrhea or constipation).

Toxic megacolon

What condition is characterized by paralysis of a portion of the colon causing a bowel obstruction and distention?

Cholelithiasis

What condition is characterized by stones in the gall bladder or duct system?

Pulmonary embolus

What condition is characterized by the blockage of a pulmonary artery or its branches, disrupting blood flow?

Type 2 Diabetes Mellitus

What condition is characterized by the body producing enough insulin to prevent ketoacidosis, but not enough to feed the body's tissues sufficiently?

Functional Bowel Obstruction (Paralytic ileus)

What condition is characterized by the bowel being clear of obstruction, but peristalsis has stopped?

Heart Failure

What condition is characterized by the hearts inability to pump enough blood to sustain the body's metabolic needs?

Peritonitis

What condition is characterized by the inflammation of the peritoneum caused by fecal matter being introduced?

Pernicious Anemia

What condition is characterized by the lack of an intrinsic factor that is necessary for B12 absorption?

Pneumonia

What condition is characterized by the lungs inability to remove accumulated secretions and as a result, an infection develops.

Peptic ulcers

What condition is characterized by the mucosa of the stomach or doudenum has eroded to the point that the epithelium is exposed to gastric acid?

Hiatal Hernia

What condition is characterized by the part of the stomach protruding through an opening in the diaphragm?

SIADH

What condition is characterized by the pituitary releasing too much ADH?

Hypothyroidism

What condition is characterized by the slowing of the metabolism as a result of the thyroid not producing enough hormones, or by the pituitary not secreting adequate TSH?

Pheocromocytoma

What condition is characterized by tumor found in the adrenal medulla causing excessive secretion of epinephrine and noroepinephrine (catacholamines) and stimulates the central nervous system?

Esophageal Varices

What condition is characterized by varicosed veins in the esophagus as a result of cirrhosis of the liver.

Hemorrhoids

What condition is characterized by varicosed veins in the rectum.

HSV2 (Herpes Simplex Virus 2)

What condition is transmitted via sexual contact and generally affects the genital area?

Constipation

What conditions is characterized by difficult or infrequent passage of stool (less than 2 per week).

Diverticulitis

What conditions is characterized by the inflammation of one or more diverticula with symptoms.

Higher than 240/120

What constitutes a hypertensive crisis

Stress EKG

What diagnostic test includes using a treadmill or medication to put an increased workload on the heart

ECG

What diagnostic test studies the electrical activity of the heart?

Echocardiography

What diagnostic test uses high frequency sound waves to form a picture of the heart?

Serum Immunoglobulins Antibody Titer Testing Patch Testing Prick Test RAST test Intradermal test

What diagnostic tests are used in relation to the immune system?

Liver biopsy Endoscopy

What diagnostic tests would be ordered for a client suspected of having cirrhosis?

Prevention and Screening. Screening and Prevention

What did Mrs. Gramlich say is the most important thing about colon cancer?

Stimulate the pancreas to secrete insulin

What do Meglitinides do?

Periods of exacerbation (flares) and remission (no symptoms) They may be autoimmune disorders Both have diarrhea has the predominant symptom Both have clients who present with history of arthritis Both affect primarily younger adults or older adults

What do Ulcerative Colitis and Chron's have in common?

Glucagon

What do the alpha cells of the Islets of Langerhans secrete?

Insulin

What do the beta cells of the Islets of Langerhans secrete?

Serious and life threatening Caused by acute adrenal insufficiency Caused by stress, abrupt withdrawal of medication, surgery, trauma or severe infection

What do you need to know about Addisonian Crisis?

The herpes virus lives in the body near the spinal cord and is generally dormant unless it is activated by stress, illness, sunlight, or menstruation. It is a virus that cannot be cured and will require lifetime management.

What do you need to know about Herpes Simplex Virus?

After having chickenpox, the virus lies dormant in the body and can be reactivited if the immune system is supressed. It begins with a rash in the thorasic region but can occur elsewhere (face). The vesicles will only erupt on one side of the body. Vesicles will erupt for 3-5 days and resolve in 4-6 weeks.

What do you need to know about Herpes Zoster?

It grows slowly at first and then goes through a period of rapid growth. Metastasis likely will occur during the rapid growth period. Pre-existing moles need to be monitored

What do you need to know about Malignant Melanoma?

Starts in the epidermis and is characterized by a firm, flesh colored papule that may crust, ulcerate and bleed. The tissue surrounding it may become a nodule and harden. Early detection and treatment is important. It can also metastasize.

What do you need to know about Squamous Cell Carcinoma?

Synthroid (levothyroxine) is a hormone replacement therapy. Usually given in the morning on and empty stomach and at the same time each day. Check blood levels often until maintenance level is achieved, then annually. Adverse side effects will mimic hyperthryoidism.

What do you need to know about Synthroid?

spread by cats, raw or undercooked meat, unwashed fruit and veg Spreads to every organ in the body Can lead to encephalitis

What do you need to know about Toxoplasmosis?

Use only insulin syringes Guage 27 or 28, needle is usually 1/2 inch long Rotate site Do not aspirate

What do you need to know about administering an insulin injection?

Begins at admission Goal: return client to the highest level of function May take years of therapy Mobility limitations and contractures are a major concern Want the client to be self-sufficient Assist client with development of coping skills. Client may have a nylon suit to prevent contractures.

What do you need to know about burn rehabilitation?

Your body is exposed to a substance and responds to it. If it is exposed again, reaction occurs. The substance may be inhaled, ingested, injected, or touched. It raises the production of IgE which causes the release of histamine. Symptoms can be local (GI, Skin, Respiratory, Conjunctival) or systemic.

What do you need to know about hypersensitivity?

Give 1 hour before meals and at bed time. Give other medications 2 hours apart due to absorption interference due to the coating of the stomach lining.

What do you need to know about sucralfate(carafate)?

Early - sense of foreboding, urticaria, cyanosis, pallor, congestion, sneezing, edema of the tongue, larynx, stridor occlusion of the airway. Gastrointestinal - NVD, dysphagia, involuntary stools, Cardiovascular - tachycardia, hypotension

What do you need to look for if you suspect anaphylaxis?

PULSES APPEARANCE TEMPERATURE CAP REFILL HARDNESS EDEMA SENSATION

What does PATCHES stand for?

Syndrome of Inappropriate Antidiuretic Hormone

What does SIADH stand for?

stimulates bone marrow production of granulocytes and monocytes. Increases the function of mature WBC's

What does Sagramostim do?

Pneumothorax, Plural Effusion, pneumonia, pulmonary edema

What does a CXR reveal in regards to the respiratory system?

Tumors, polyps, rectal sygmoid ulcerations

What does a Lower GI/Sigmoidoscopy look for?

The client has been exposed to TB.

What does a positive PPD test indicate?

lung volume and capacity, amount of air that remains in the lung after respiration

What does a pulmonary function test tell a provider?

The acidity or alaklynity of blood and the Carbon Dioxide and Bicarbonate levels of the blood.

What does an ABG monitor?

Detects arrhythmia(dysrhythmias), myocardial damage, or enlargement, effect of drugs, areas ischemia, injury or infarction?

What does an ECG tell the provider?

Counts the number of viral copies in the blood. Used to determine if treatment is necessary (Yes = 5000-10000)

What does an HIV viral load test do?

Esophagus, Stomach, Duodenum

What does an Upper GI, Barium swallow examine?

Vessel occlusion

What does an angiogram show?

The gall bladder

What does an oral cholesystogram examine?

Stimulates the production of red blood cells.

What does epoetin do?

Stimulates the production of granulocytes and neutrophils

What does filgrastim (neupogen) do?

Tissue necrosis.

What does infarction mean?

Liver, gall bladder, pancreas

What does serum bilirubin test?

The presence of a bacteria involved with ulcers.

What does the test "serum H. pylori' diagnose?

Digoxin. Take apical and radial pulses before administering. Hold if if below 60

What drug can cause or worsen bradycardia?

Digoxin Ace Inhibitors Diuretics Monitor a urine outut of less than 30 ml - kidney impairment

What drugs might a person with right sided heart failure take?

Anticholinergics/Antispasmotics - Bentyl Antidepressants - Zoloft and Prozac may relieve pain and spasm Bulk forming laxatives IBS - C - Amitiza (lubiprostone), Linzess (linaclotide) IBS - D - Xifaxin Alternative therapies

What drugs might be used for IBS?

Extrinsic factor

What else might b12 be known as?

Avoid Sun Can elevate blood lipid levels Hepatoxicity Monitor lipid levels and liver enzymes during therapy

What else should you know about medications for Acne Vulgaris?

Pituitary

What endocrine gland located in the brain is considered the "Master Gland".

18 gauge needle with a Y connector.

What equipment will you need to administer a blood transfusion?

100-126

What fasting glucose result would determine a client is pre-diabetic?

Colloids (Albumin) Crystalloids (Normal Saline and Lactated Ringers) Blood and Blood Products

What fluids are used for replacement during burn treatment?

Organ meat, LIVER, red meat, poultry, tuna, shrimp, clams, tofu, green beans, green peas, spinach, broccoli, dried beans, whole grains, potatoes, brown rice

What foods are rich in iron?

Fatty, fried foods Chocolate Peppermint Spicy foods Tomatoes Citrus Fruits

What foods relax the cardiac sphincter and contribute to the symptoms of GERD?

Sickle Cell

What form of anemia is characterized by an abbormal gene inherited from both parents?

Status asthmaticus - asthma attack that fails to respond to treatment

What form of asthma is a emergency situation?

PVC - premature ventricular contraction

What form of dysrhythmia is characterized by a feeling of the heart "skipping a beat", butterflies, palpitations, dizziness and weakness

Atrial Fibrillation

What form of dysrhythmia is characterized by disorganized electrical activity in the atria, decreased cardiac output, quivering rather than contracting - 350-600 bpm.

V tach

What form of dysrythmia is characterized by a fluttering in the chest, SOB, palpitations, hypotension, decreased cardiac output, weak or non-palpable pulse, loss of consciousness. Ventricular rate: 120-140 and regular

V Fib

What form of dysrythmia is characterized by cardiac arrest and a need to perform CPR and defibriolate within 4 minutes or death will occur?

Glucose level below 60

What glucose level is considered hypoglycemia?

Men, African Americans, and older adults.

What groups are at highest risk for laryngeal cancer?

Hydrotherapy, Escision and grafting of skin Enteral or parenteral nutrition interventions Application of topical antimicrobials or systemic antiinfectives Administration of narcotic analgesia before painful procedures Physical therapy.

What happens during Stage Two of a burn injury?

A second, stronger test is administered. If negative - no TB. If second test is positive, chest xrays are used to determine disease process.

What happens if a first PPD test is positive?

The kidneys reabsorb too much water, decreasing urinary output.

What happens with someone who has SIADH?

The first Rh+ child prompted the mother to develop antibodies against her first child's Rh+ blood. With the second child, the mother's body attacks the baby's blood, causing a hemolytic reaction.

What happens with the second child of a woman who is Rh-, but her baby is Rh+?

Myocardial Infarction

What heart condition is characterized by major occlusion of a coronary artery subsequent necrosis of the myocardium?

Right Sided heart failure

What heart failure is characterized by a fluid backup into the systemic venous circulation?

Parathyroid Hormone

What hormone does the parathyroid gland secrete?

atrial natriuretic factor (ANF)

What hormone is release when the atria are stretched to get rid of extra fluid?

B-type natriuetic peptide (BNP)

What hormone is release when ventricles stretch to get rid of extra fluid?

Glucocorticoids (sterioids) Mineralcorticoids (aldosterone)

What hormones does the adrenal cortex secrete?

Epinephrine Noroepinephrine

What hormones does the adrenal medulla secrete?

Growth hormone (GH) Thyroid Stimulating Hormone (TSH) Adrenocorticotrophic Hormone(ACTH) Follicle Stimulating Hormone (FSH) Luteinizing Hormone (LH) Prolactin Melanoctye Stimulating Hormone (MSH)

What hormones does the anterior lobe of the pituitary secrete?

Oxytocin, Antidiuretic Hormone (ADH, Vasopressin)

What hormones does the posterior lobe of the pituitary secrete?

T3, T4, Calcitonin

What hormones does the thyroid gland secrete?

They are carries and may be symptomatic, but to a much lesser degree.

What if someone inherits the sickle cell trait from only one parent?

Assess for hypoglycemia

What important assessment should you do after administering an oral antidiabetic or insulin?

A baseline neurological assessment.

What important assessment should you get from your patient before the go to surgery for a hyposysectomy?

Pneumocystis Jiroveci Pneumonia (PJP)

What infection is caused by a fungus-like organism and causes a specific type of pneumonia?

When the body is under stress, the stomach can create excess HCL, causing an ulcer.

What is Curling's ulcer?

A combination of retroviral medications used together for the purpose of keeping HIV virus in check.

What is HAART?

A autoimmune disorder in which antibodies attack the thyroid, decreasing its ability to produce hormones. Goiter usually accompanies this disorder/

What is Hashimoto's Thyroiditis?

A deficiency in clotting factor VIII

What is Hemophilia A?

A deficiency in clotting factor IX

What is Hemophilia B?

A tumor of the blood vessel walls causing red or purple lesions on the skin and mucous membranes.

What is Kaposi's Sarcoma?

Performed during hydrotherapy (shower, spray or immersion tub) where loose dead tissue & eschar is gently removed by washing the area with a washcloth or sponge. MEDICATE BEFORE PROCEDURE Dead tissue can be grasped with dry gauze and removed Eschar and edges of blisters can be trimmed away with scissors. Wounds need to be rubbed hard.

What is Mechanical Debridement?

Oral methoxsalen is given and then the client is exposed to Ultraviolet A light two hours later. 2-3 times per week for 1-2 months Exposure to Ultraviolet B slows the rate of epidermal growth rate.

What is Photochemotherapy?

inflammation of a vein with blood clot formation

What is Thrombophlebitis?

An xray of the abdominal region

What is a "flat plate abdomen"?

Coronary Artery Bypass Graft

What is a CABG?

Measures the amount of IgE to specific allergents. Expensive and time consuming.

What is a RAST (radioallergosorbent) test?

A tube that puts pressure against the vessels to control bleeding and gastric aspiration

What is a Sengstaken Blakemore tube?

A pacer

What is a battery operated generator that works to regulate the heart rate?

To diagnose hemolytic disorders, tumors, leukemia, and infectious disease.

What is a bone marrow aspiration or biopsy used for?

Hormone

What is a chemical that one part of the body secretes in order to tell another part of the body to act?

Telemetry.

What is a form of cardiac monitor that can be worn when ambulating?

A condition where the thyroid increases in size in order to attempt to produce more thyroid hormone?

What is a goiter?

Record activity that may not happen often

What is a holter monitor used for?

A wearable EKG used for 24-72 hours.

What is a holter monitor?

Removal of the pituitary gland.

What is a hypophysectomy?

Febrile reaction.

What is a less drastic response to a transfusion that might occur?

Chest Physical Therapy

What is a non-medical treatment for lung disorders in which mucus is tenacious and is not easily removed?

0.5-2.0

What is a normal Digoxin level?

Below 2

What is a normal INR level

10-13

What is a normal PT level

25-35 seconds

What is a normal PTT result?

80-100

What is a normal lab reading for Pa02? (the amount of oxygen dissolved in the blood)

95-100

What is a normal reading for pulse oximeter?

Allergens are placed on a dressing and applied to skin which is assessed for a reaction after 48 hours.

What is a patch test?

The allergen is places on the skin and then the skin is punctured. Redness and wheals would be assessable in 10-15 mins.

What is a prick test?

Rapid HIV 1

What is a quick finger stick test for HIV that can be confirmed with a Western Blot assay?

Shock

What is a risk for someone suffering hypovolemic anemia?

Bone pain. Assess for the need of analgesia

What is a side effect of Filigrastim (Neupogen)?

Not enough of all the blood cells

What is a simple explanation for the term pancytopenia?

2-3

What is a therapeutic INR level

2-3

What is a therapeutic INR result?

15-33

What is a therapeutic PT level?

37-70

What is a therapeutic PTT level

Cardiac monitor

What is a visual display of electrical activiyt and heart rate called?

A endocopic study of the biliary system and pancreatic duct

What is an ERCP?

Human Leukocyte Antigen

What is an HLA?

A protein that destroys antigens.

What is an antibody?

Allergen

What is an antigen that is generally harmless but causes an immune response in some people?

a foreign substance that induces an immune response in the body, especially the production of antibodies

What is an antigen?

A sterile incision is made longitudinally along the extremity or trunk to prevent constriction, impaired circulation, or gangrene.

What is an escharotomy?

Are you allergic to iodine or shellfish

What is an important question to ask the client prior to a cardiac catheterization?

A small amount of allergen is injected into the skin.

What is an intradermal test?

One that would not sicken someone with a healthy immune system.

What is an opportunistic infection?

A severe reaction to histamines.

What is anaphylaxis?

Christmas Disease

What is another term for Hemophilia B?

Thyrotoxicosis

What is another word for Hyperthyroidism?

Myxedema

What is another word of hypothyroidism?

skin is removed from healthy tissue (donor site) and placed over the injured area. It is then immobilized.

What is autografting?

Normal Saline

What is blood always infused with?

The body will naturally bypass areas of low circulation

What is collateral circulation?

Skin cells are removed from healthy tissue, minced, and then placed in a culture medium to grow a new skin graft from the client's own cells.

What is culture epithelia autografting?

A thin layer of a topical agent is applied to dissolve and remove necrotic tissue. Usually applied after hydrotherapy Thin layer of agent then a fine mesh gauze.

What is enzymatic debridement?

A condition in which donated cells recognize the host's tissues as foreign and react with an immune response.

What is graft vs. host disease?

Check for allergies before administering Client teaching about taking as prescribed, finishing the course, etc.

What is important to remember about anti-infectives?

Empyema

What is it called when a pleural effusion becomes infected?

Autoimmune disorder

What is it called when the body's normal immune system mistakes something in the body for an antigen?

When burning fat, ketone bodies form, causing ketosis.

What is ketoacidosis?

The overproduction of immature white blood cells.

What is leukemia?

Excess tissue fluid.

What is lymph?

The craving to eat things that are not food.

What is pica?

The provider will place bands around the the varicosed vein to intentionally cause the vein to necrose.

What is rubber band therapy for hemorrhoids?

Injecting a medication into the the vein that causes complete occlusion. The limb is then dependent on collateral circulation to provide blood supply.

What is sclertherapy?

To test pancreatic function. False negative can occur with IV dextrose or meds.

What is serum Amylase test used for?

Feces with a high fat content.

What is streatorrhea?

Its a medication that coats the lining of the stomach and protects healing ulcers. .

What is sucralfate(carafate)?

If an accidental removal of one of the parathyroid glands occurs, the client will have low serum calcium levels which causes numbness and tingling around the mouth, muscle spasms and possibly cardiac dysrythmias.

What is tetany as is relates to thyroid surgery?

Smoking

What is the #1 cause of COPD?

Heparin

What is the SQ or IV anticoagulant used in the hospital as part of MI treatment?

Protamine Sulfate

What is the antidote for Heparin?

9 Days

What is the average life span of a WBC?

Hypoventilation or neuromuscular problems depressing the respiratory center of the brain.

What is the cause of Respiratory Acidosis?

Chemotherapy, sulfonimides, some psychotropics

What is the cause of agranulocytosis?

The cause of leukemia is unknown.

What is the cause of leukemia

Bleeding

What is the client with thrombocytopenia at risk of?

Clots

What is the client with thrombocytosis at risk of?

Islets of Langerhans

What is the cluster of cells that secretes insulin in the pancreas called?

If a client's blood sugar is higher than it should be on their long acting insulin, they will be given an additional dose of regular insulin.

What is the concept of "sliding scale" coverage?

The body works to keep the blood at a constant ph, when it is too acid or too alkaline, the body uses Co2 and Bicarbonate to regulate it.

What is the concept of homeostasis in regards to to acidosis and alkalosis?

Severe diarrhea can lead to fluid and electrolyte imbalance and malnutrition.

What is the concern if your client with AIDS contracts Cryptosporidiosis?

The premature destruction of red blood cells prevents proper oxygen delivery.

What is the concern with sickle cell anemia?

Diabetes Insipidus

What is the condition associated with an insufficient amount of ADH/Vasopressin?

Endocarditis

What is the condition characterized by inflammation of the inner layer of the heart?

Medulla

What is the control center for breathing in the brain?

Clot becomes an ebolus and travels to the lungs. Asess for complaints of chest pain, cyanosis, dyspnea

What is the danger with Thrombophlebitis?

DIC - Disseminated Intravascular Dissemination

What is the dangerous blood disorder characterized by simultaneous clotting and hemorrhage?

An injury caused by heat that causes tissue damage.

What is the definition of a burn?

Diet - no alcohol, high calories, restricted protein, low sodium, fluid restricted, vitamins, minerals B12 May be NPO with TPN

What is the diet treatment for cirrhosis?

HIV causes the infection, AIDS is the syndrome that occurs at a later stage of HIV infection.

What is the difference between HIV and AIDS?

The TTE is non-invasive. The TEE requires conscious sedation, local anesthesia to deaden the gag reflex.

What is the difference between TTE and TEE?

Acute has a rapid onset, chronic is gradual.

What is the difference between acute and chronic Leukemia?

Often an obstruction blocks the flow of pancreatic enzymes. Obstruction can be edema, stones, scar tissue. When the pressure of the enzymes build up m the duct ruptures and begin to digest the pancreas.

What is the disease process for acute pancreatitis?

Fibrotic tissue and necrosis occurs

What is the disease process for chronic pancreatitis?

Creatine Phosphokinase (CK)

What is the enzyme released by necrotic tissue?

Skin, mucous membranes, body secretion

What is the first line of defense against infection?

Prevention - high fiber diet, lots of liquid, do not ignore the urge to use the bathroom.

What is the focus of care for hemorrhoids?

Remission

What is the goal of treatment for Leukemia?

Carries oxygen

What is the importance of hemoglobin in the blood?

Endocardium

What is the innermost layer of the heart which lines the interior of the heart, the valves, and larger vessels?

The closest tissue match possible.

What is the key to performing the most successful transplant possible?

A platelet count of less than 100,000

What is the lab result necessary for a diagnosis of thrombocytopenia?

Lung cancer

What is the leading cause of cancer death in the US?

Buergers Disease (Thromboangiitis Obliterans)

What is the less common condition that is characterized by inflamation of a blood vessel causing it to become spastic and thrombotic?

4 months

What is the life span of a red blood cell?

4 hours.

What is the longest period of time a unit of blood can hang during an infusion?

Conservative for mild attacks Bed rest, NPO, Possible NGT, IV fluids Pain Meds - morphine Antibiotics Low fat diet - avoid spicy foods Shockwave therapy to break up stones Drugs to dissolve stones (Actigall, Chenix)

What is the medical management for Cholecystitis/Cholelithiasis?

Supportive therapy Hospitalized for severe symptoms Bleeding precautions Bed rest Small frequent meals, low fat, high carb IV fluids if N/V exists Vitamins C, B, K Avoid things that damage the liver I&O, Daily weight Assess for infection Recovery takes 3-16 weeks

What is the medical management for hepatitis?

Stage the disease Polyp removal Radiation of the tumor is confined to the vocal cords Chemotherapy if metastasis has occured

What is the medical management of cancer of the larynx?

Chyme

What is the medical name for food that has been churned and mixed with gastric juices?

Serum Lipids

What is the medical name for the test used to determine someone's cholesterol level?

Erythrocytes

What is the medical term for RBC's?

Leukocytes

What is the medical term for WBC's?

Leukopenia

What is the medical term for a decrease in ALL white blood cells?

Agranulocytosis

What is the medical term for a decrease in neutrophils, basophils, and eosinophils?

Cardiac Arrhythmia or Disrhythmia

What is the medical term for any deviation from Normal Sinus Rhythm?

Leukoplakia

What is the medical term for irregular white patches anywhere in the mouth?

Thrombocytes

What is the medical term for platelets?

splenectomy

What is the medical term for removal of the spleen?

Erythroplakia

What is the medical term for slightly raised irregular red patches that bleed easily?

Hemostasis

What is the medical term for the body's action of clotting to prevent blood loss?

Idiopathic Thrombocytopenia Purpura (ITP)

What is the medical term for the most common cause of thrombocytopenia - often occuring with no reason.

Leukopenia

What is the medical term for too few WBC's.

Radiation and chemotherapy.

What is the medical treatment for colon cancer?

Hypersensitivity

What is the medical word for an excessive reaction to a particular stimulus that results in harm to the individual?

Hypophysis

What is the medical word for the anterior pituitary?

Adenohypophysis

What is the medical world for the posterior pituitary?

von Willebrands's disease

What is the most common bleeding disorder?

Thrombocytopenia

What is the most common cause of abnormal bleeding?

A virus.

What is the most common cause of acute pericarditis?

Artherosclerosis

What is the most common cause of an aneurysm?

Hashimoto's Thyroiditis

What is the most common cause of hypothyroidism?

Left sided heart failure

What is the most common cause of right sided heart failure?

Iron deficiency

What is the most common form of anemia?

Graves disease

What is the most common form of hyperthyroidsm?

Laennecs or Alcoholic

What is the most common type of cirrhosis?

Bleeding precautions

What is the most important nursing care element for thrombocytopenia?

Keep hands, feet, and nose warm

What is the most important patient teaching element for Reynaud's Disease

Control the bleeding.

What is the most important treatment for hypovolemic anemia?

Pericarditis

What is the name for an inflammation of the sac around the heart?

22-26

What is the normal HC03 level in the blood (bicarbonate)

Less than 2

What is the normal INR result?

10-13 seconds

What is the normal PT result?

35-45

What is the normal PaCo2 level (the amount of Co2 dissolved in the blood?)

4,000-11,000

What is the normal lab value for WBC's?

4-6 million

What is the normal lab value for erythrocytes?

150,000-400,000

What is the normal lab value for platelets?

7.35-7.45

What is the normal pH of blood?

Negative for the antigen

What is the normal result for a Hepatitis Associated Antigen/Hepatitis B Surface Antigen test?

800-1200

What is the normal value for CD4 cells?

Pericardium

What is the outer layer of the heart which consists of two layers of serous membrane?

Obstruction by gall stone increases pressure and causes ischemia. Bile can cause chemical irritation of the gall bladder. Gall bladder becomes inflamed. Necrosis or perforation can occur

What is the pathology for Cholecystitis?

Confined to the mucosa and submucosa of the colon Edema and bleeding of the mucosa Starts on the left side of the rectum and progresses to the right. Usually confined to the rectum and sigmoid colon Colon develops continuous lesions Scar tissue forms, interfering with absorption Abscesses may form Pus can be present in the stool

What is the pathology if ulcerative colitis?

Tiny ulcers and deep fissures form on various parts of the intestine Fistulas (abnormal connections) my form between the bowel itself or other organs Inflammation causes narrowing of the colon, causing fibrosis and scarring segments of healthy tissue alternate with diseased tissue Primarly involves the small intestine (ilieum) Malabsorption Pernicious anemia Fluid, electrolyte imbalance, acid/base disturbances Usually insidious at onset.

What is the pathology of Chron's disease?

its an automimmune disorder where antibodies attack the cells in the thyroid gland.

What is the pathology of Graves disease?

Fecal material, stone, inflammation, or parasites may obstruct the opening of the appendix impairing the blood supply.

What is the pathology of appendicitis

Scar tissue in the liver forms restrictive bands that restrict blood flow and bile flow. This increases portal venous pressure which causes portal hypertension - nearby blood vessels become dilated and form varices (esophagus, stomach, rectum), Spleen enlarges and ascites occurs. As liver fails, cognitive changes occur.

What is the pathology of cirrhosis?

The release of histamine which causes capillaries to dilate resulting in high permeability of water.

What is the pathology of hives?

Tenderness and edema prior to comedone formation Comedone formation - sebum, epithelial cells, and bacteria occlude the follicles. Comedones = pimples, whiteheads, and blackheads Skin is oily, and shiny Lesions last up to 10 days Lesions can include pustules and inflamed cysts.

What is the patholology of Acne Vulgaris?

When oxygen in the blood decreases, the red blood cell changes shape and degrade, causing them to break apart and occlude blood vessels. the result of the occlusion is ischemia to the cells and tissues, resulting in severe pain.

What is the pathophysiology for sickle cell anemia?

Surface of the alveoli become altered, allowing air to leak into the interstitial spaces. Pulmonary edema and hypoxia resulst. Surfactant is inactivated and the alveoli collapse, gas exchange is impaired/

What is the pathophysiology of ARDS?

Intrinsic or extrinsic clotting factors are activated, usually in response to other serious circumstances, causing a massive coagulation response which causes the clots. The blood not involved in clotting has been stripped of its clotting factors, which causes the hemorrhaging.

What is the pathophysiology of DIC?

The body develops antibodies that destroy platelets more rapidly than normal.

What is the pathophysiology of ITP?

Immature white blood cells are overproduced by the marrow, crowding out RBC's and platelets. Immature while blood cells increase the risk of infection, as well as invade the spleen, liver, and lymph nodes.

What is the pathophysiology of leukemia?

The stomach secretes intrinsic factor which allows the intestines to absorb B12. B12 is necessary for the production of red blood cells. Lack of B12 results in an overabundance of immature red blood cells that are less capable of carrying the full oxygen load to the tissues.

What is the pathophysiology of pernicious anemia?

The abdomen

What is the preferred injection site for insulin?

Tongue blade to hold tongue down. Swab back of throat with sterile swab Ask client to stick out tongue and say ah Do not allow swab to touch the tongue Swab tonsils, reddened area, and exudate Bag, tag, send to lab

What is the procedure for a throat specimen?

PTCA - purcutaneous transluminal coronary angioplasty

What is the procedure peformed in the cardiac cath lab that works to open cardiac arteries and keep them open?

Thoracentesis

What is the procedure that aspirates excess fluid from the pleural space?

Fibronolysis

What is the process of clot dissolution called?

Serious but treatable. Lethal without treatment.

What is the prognosis for SIADH?

Better in younger people and women Prognosis is worse if on hands, feet, scalp

What is the prognosis of Malignant Melanoma?

Immunoglobulin

What is the protein that makes up antibodies?

Fight pathogens

What is the purpose of WBC's?

Necessary for blood clotting.

What is the purpose of platelets

Assists the immune system be removing foreign matter, infectious organisms and tumor cells from the lymph.

What is the purpose of the lymphatic system?

Serum ammonia rises with liver disease. ABX could cause a low ammonia level

What is the rationale for a serum ammonia test?

Blood is tested, but cannot always pick up HIV. It does not show up in the blood in the early stages.

What is the risk for a client with a hemophilic blood disorder in receiving blood products?

Oxygen deprivation

What is the root cause of all anemias?

Colon cancer

What is the second leading cause of death in the US

Inflammatory response WBC's attach and neutralize harmful invaders

What is the second line of defense against infection?

Resection of colon affected by tumor and surrounding lymph tissue. Removal of the rectum, anus, and sigmoid colon (permanent colostomy)

What is the surgical intervention for colon cancer?

The transphenoidal approach.

What is the technique of choice for a hypophysectomy?

PTT, ATTP

What is the test that monitors heparin therapy?

15-33 seconds

What is the therapeutic PT result?

37-70 seconds

What is the therapeutic PTT result?

Myocardium

What is the thickest and strongest layer of the heart, composed of muscle tissue and responsible for the pumping of blood?

The building up of immunity.

What is the third line of defense against infection?

Without treatment, ketoacidosis will develop. The only treatment is insulin.

What is the treatment for Diabetes Mellitus Type 1

Iron intake. Preferably food sources.

What is the treatment for Iron deficiency anemia?

There is no cure. Treatments are palliative in nature.

What is the treatment for Multiple Myeloma?

Maintain patent airway Increase blood volume Stabilize Cardiovascular System Raise the body temp elevate thyroid levels via IV hormones

What is the treatment for Myxedema coma?

antipyretics

What is the treatment for a febrile transfusion reaction?

PO, IV therapy, antisposmatic, sedatives, analgesics, antibiotics, analgesics, TPN, stool softeners. Gradually introduce foods as tolerated to a high fiber diet If client has diarrhea, five low residue diet until it subsides.

What is the treatment for diverticulitis?

High fiber, avoid foods with small seeds that could obstruct the diverticula, stool softeners to prevent constipation

What is the treatment for diverticulosis?

Lower the workload of heart ABX for 2-4 months

What is the treatment for endocarditis?

NPO for a period of time Progress diet as tolerated Antacids Antibiotics if bacterial infection exists IV fluids if dehydrated

What is the treatment for gastritis?

Usually palliative Sometimes a hepatectomy

What is the treatment for liver cancer?

Surgery - radical neck surgery in extreme cases Chemo Radiation

What is the treatment for oral cancer?

Pericardiocentesis

What is the treatment for pericarditis?

Surgery

What is the treatment of choice for hernias?

Berry

What is the type of aneurysm in the brain that may not be repairable?

Immunocompetent

What is the word for a body that is capable of identifying and destroying antigens?

Non Competent

What is the word for a body that is not correctly identifying and destroying antigens?

PATCHES

What is the word used for aterial assessment for PVD?

Loss of at least 10% of body weight - caused by diarrhea, fatigue, vomiting, malabsorption, anorexia, chronic weakness, fever.

What is wasting syndrome?

The policy and procedure manual.

What is your resource for your facility's requirements in regards to preparation, implementation, and post care in diagnostic studies?

25-35

What it a normal PTT level?

The "window period".

What it the period of time between infection and a positive HIV test called?

A platelet count of less than 20,000

What lab result could result in spontaneous external or internal bleeding?

A CD4 count below 200

What lab result would alert the provider that their client has declined from HIV into AIDS?

Elevated Casual Plasma Glucose - Above 200 Elevated Fasting Blood Glucose - Above 126 Oral Glucose Tolerance Test - Above 200 Urinalysis for glucose and ketones HbA1C above 7%

What lab results would you expect to see for a diagnosis of Type 2 Diabetes.

High bilirubin Elevated liver enzymes High Blood ammonia levels CBC (anemia, low platelets, low WBC) Prolonged Prothrombin Time Low Protein Low Albumin Abnormal Electrolytes

What lab results would you expect to see if a client is suspected of having cirrhosis?

Lymphadenopathy

What lymph disorder is characterized by an enlargement of the lymph nodes as a result of infection, inflammation or cancer?

Lymphoedema

What lymph disorder is characterized by obstruction of the lymph nodes?

Malignant Lymphoma

What lymphatic disorder is characterized by tumors in the lymphatic system?

Treponin

What marker is a definitive indicator of heart muscle damage?

Protease Inhibitors.

What medication for HIV/AIDS is used to block a specific enzyme used to make a mature virus?

Persantine

What medication is a client who cannot tolerate exercise given to simulate exercise induced stress?

Metformin (Glucophage)

What medication is considered a Biguanide?

Digoxin

What medication level is commonly checked in cardiology?

Lovenox

What medication may be used prophylactically to prevent thrombophlebitis?

Thyazide Duiretics (HCTZ, aldomet,). They decrease renal excretion of calcium and exacerbate hypercalcemia.

What medication would be contraindicated with hyperparathyroidism?

Acarbose (Precose) Miglitol (Glyset)

What medications are considered Alpha-Glucosides?

Repaglinide (Prandin) Nateglinide (Starlix)

What medications are considered Meglitinides?

Rositglitazone (Avandia) Pioglitazone (Actos)

What medications are considered Thiazololidinediones?

Analgesics - morphine, fentanyl, dilaudid Topical antimicrobials - Mafenide Acetate (Suflamylon), Silver Sulfadiazine (Silvadene), 0.5% Silver Nitrate Systemic Antiinfectives Anti-Ulcer Medications

What medications are used during burn treatment?

Lysodren (mitotane) suppress adrenal glands Metyraprone and aminoglutethimide (Cytadren) ihibits cortisol production

What medications are used for Cushing's Disease?

Systemic Antibiotics - tetracycline, erythromycin, minocycline Azelaix Acid (Azelex) topical cream Retinoic Acid (Retin-A) topical cream Accutane

What medications are used to treat Acne Vulgaris?

Benadryl, Claritin, Hismanol, Zyrtec, Allegra

What medications are used to treat hypersensitivity?

Theophylline Nitrates CA Channel blockers Anticholinergics Valium NSAIDS

What medications relax the cardiac sphincter and contribute to GERD symptoms?

Immunosuppressants.

What medications will a bone marrow recipient take for the rest of their lives?

Tigan, Compazine, Zofran

What medications would be used to prevent vomiting?

Disturbances in the metabolism of CHO, fats, proteins, salts. and water - Sodium loss and potassium retention If aldosterone is deficient, sodium and water are lost - hypotension and tachycardia results Low cortisol levels cause hypoglycemia, weakness, fatigue, confusion, and psychosis

What metabolic changes will you see in someone who has Addison's Disease?

All of the the other blood cells will be decreased, except immature white cells.

What might a CBC look like if a client has leukemia?

Schlerotherapy

What might a provider do for hemorrhoids that involves injecting a chemical into the vein to cause inflammation and scarring?

Reveals the presence of tumors, can take tissues for biopsy, cells for cytology

What might a provider use a bronchoscopy, diagnostically?

Size, shape, position of cardiac structures Detects pericardial effusion, ventricular function, cardiac chamber size, septum motion, cardiac output, cardiac tumors and congenital defects.

What might an echocardiogram assist the provider in determining?

Sterility. It is common to harvest sperm and eggs before treatment.)

What might be a concern for a young client with lymphoma?

exercise, anxiety, fever, shock, caffeine, tobacco and drug use, PAIN, HYPOXIA, ANEMIA, ELECTROLYTE IMBALANCE, HYPERTHYROIDISM

What might some causes of sinus tachycardia be?

Confusion, poor balance, headache, personality changes, bone pain, pathologic fractures, spinal cord compression, jaundice, anorexia, RUQ pain

What might you expect to see when lung cancer metastasizes?

The client must have chemo or radiation to destroy their marrow.

What must happen before the recipient can receive the donor marrow?

Remain in isolation and receive immunosuppressants and chemotherapy drugs.

What must the recipient do after receiving marrow?

16-18 guage

What needle gauge should be used for replacement of fluids during treatment for burns?

May receive blood products Surgical - liver transplant

What non-medication treatments exist for cirrhosis?

NG Tube to relieve abdominal distention Suction maintained and NPO until peristalsis returns Assess position (gastric ph should be less than 4) Assess patency (irrigate with normal saline) IV's I&O Vital Sings, Ostomy care Emotional support Client teaching Pain management Preventative measures.

What nursing care elements would you expect for a bowel resection?

Hiatal hernia

What other GI condition can increase the risk of GERD?

Increased risk of Artherosclerosis Coronary Heart Disease Peripheral Vascular Disease

What other complications regarding the Cardiovascular System are associated with Diabetes Mellitus?

Asthma

What other condition might adults with GERD also have?

The expiration date.

What other information should you look for on the vial?

Steriods, Antibiotics to prevent infection, Diuretics, Antitussives and Expectorants

What other medications might be used for COPD class disorders?

Erytropoetin B12 Iron supplemental oxygen Bone marrow transplant (rare due to donor unavailablility) Blood Transfusion

What other treatments might a client with sickle cell anemia receive?

Radiation, chemotherapy to reduce tumor size Pain Control Transfusions to treat anemia Antibiotics

What palliative treatments might you see for multiple myeloma?

80-90%

What percentage of lung cancer cases can be linked to smoking or second hand smoke?

Obesity Tight Clothes Ascites Pregnancy Overeating

What physical things can worsen the symptoms of GERD?

Multiple Myeloma

What plasma cell disorder is characterized by B lymphocytes to multiply rapidly and infiltrate bone marrow, lymph nodes, and other tissues.

Anyone who has not had chicken pox or been vaccinated for it. Chicken pox can be contracted from someone who has shingles. Pregnant women who have not had chicken pox are especially at risk of having a baby with birth defects if they contract chicken pox while pregnant.

What populations may be at risk of coming into contact with someone who has the Herpes Zoster virus?

Bowel Prep

What preoperative tasks should you expect for a bowel resection?

Biopsy, removal of small tumors, coagulate active bleeding, early detection of tumors.

What purpose does a colonoscopy serve?

A diet high in salt, smoked, or preserved foods and diet low in fresh fruits and vegetables, a history of polyps

What put someone most at risk for stomach cancer?

CBC with differential

What routine blood test might also be used by a cardiologist?

Increase dosage of medications.

What should be done if a client with Addison's disease is under stress or will undergo surgery?

Place an occlusive dressing over the site.

What should be done when a chest tube has been removed?

mobilize rapid response Get vital signs Prepare for ABG's Ensure IV access Arrange for higher level of care Try to keep the patient calm

What should be done when you suspect a PE?

Keep blood pressure down.

What should be the goal for reducing the risk that an esophageal varices will rupture?

infection, dehydration, temperature irregularity

What should someone with intensive burns be monitored closely for?

more than 1 mg per day

What should the daily intake of iron be?

HCT should increase by 5-15%, Hemoglobin should increase by 2-5% within 3 weeks.

What should the lab value response be with successful treatment for iron deficiency?

A malignant melanoma

What should you be worried about if you see an irregularly shaped black or blue lesion on your patient.?

Stress can increase blood glucose levels and someone with DM should be monitored more closely. Those who are not currently taking insulin may need it, and those who are using insulin may need more.

What should you consider if your client has Diabetes Mellitus and has an infection or is under emotional stress?

Stop the infusion Keep the NS running. Notify the nurse Send the blood product to the lab Institute emergency procedures

What should you do if you suspect the client is suffering a transfusion reaction?

They should be taken with food.

What should you know about Alpha-Glucosides?

It is a non-infectious skin disorder for which the cause is unknown, but 33% have a family history. It is characterized by periods of flare up and remisssion. Contributing factors to flares include sunlight, change of seaon, trauma, medications, stress, hormone changes. It may be an autoimmune disorder with a close link to arthritis.

What should you know about Psoriasis?

Assess for liver toxicity Can cause fluid retention, especially in combination with insulin.

What should you know about Thiazololidinediones?

Emtpy when 1/3 full Replace appliance as needed Assess and clean around the stoma - mild soap and water Release gas from bag as needed Low residue diet Increase liquid

What should you know about caring for client with an ostomy?

Standard precautions Assess the skin around the stoma Assess stoma (should be wet, red - not purple) Clean with mild soap Let dry Apply appliance Stool will be liquid

What should you remember about stoma care?

It may be 6-8 weeks before the client notices a change They may then become hypothyroid, so assess and treat with thyroid meds Radioactive material is out of the body in 2-3 days and is too low a dose to warrant precautions.

What should you remember if the client has had radiation therapy for hyperthyroidism?

It's important to inspect them everyday.

What should you tell a client with DM about their feet?

See the eye doctor every six months. This medication can damage the retina.

What should you tell your client who has been prescribed Panqueril (an antimalarial) for Systemic Lupus Erythematosus?

Stools may become black. Constipation or diarrhea may happen.

What should you tell your client who is taking iron supplements?

Stage One (Emergent or Resuscitative)

What stage of burn lasts from the onset of the injury to the stabilization of fluids.

blood clot, fat, air, amniotic fluid.

What substances can cause an embolism?

Resect involved area

What surgical interventions might be expected for diverticular disease>

Brittle spoon shaped nails Cheilosis Pica

What symptoms are specific to iron deficiency anemia?

Sneezing, nasal secretions, tearing, rash, inflammation, diarrhea, cough, wheezing, dyspnea hypertension or hypotension

What symptoms might someone with a hypersensitivity have?

C-Reactive Protein

What test comes back with an increased level if there is inflammation and may predict coronary heart disease?

PTT

What test is used to determine the efficacy of heparin treatment?

Hepatitis B surface antigen

What test would a provider who is looking to rule out Hepatitis B order?

Blood Culture

What test would be used to determine bacteria in the blood or diagnose endocarditis?

PT, PTT, INR

What tests are commonly referred to as coagulation studies?

CDB with diff Bone marrow aspiration

What tests are used to diagnose leukemia?

PT/INR

What tests are used to monitor the efficacy of coumadin therapy?

CXR EKG/ECG Echocardiogram Labs

What tests might be used to determine heart failure?

Neuropathy, Peripheral Vascular changes, susceptibility to infection

What three conditions provide the "perfect storm" for foot problems associated with DM?

Nephrogenic

What type of Diabetes Insipidus is associated with kidney damage and the kidney does not respond to ADH?

Neurogenic

What type of Diabetes Insipidus occurs when there has been a damage to the pituitary.

Dissecting

What type of aneurysm is characterised by the weakiening of the middle layer or the aorta that allows blood to seep in between the layers, separating them.

Capillaries

What type of blood vessel provides the connection between the arterioles and the venules?

Atopic Dermatitis (eczema)

What type of dermatitis concerns an abnormal reaction to irritants?

Contact Dermatitis

What type of dermatitis concerns direct contact with agents in the environment (ie, poison ivy)

Exfoliative dermatitis

What type of dermatitis is characterized by excessive peeling and shedding of the skin?

Seborrheic Dermatitis

What type of dermatitis is found on the scalp and eyebrows?

Left Sided Heart Failure

What type of heart failure is characterized by fluid backing up into the lungs?

Non-infectious Hepatitis

What type of hepatitis is not contracted but caused by Alcohol abuse, Tylenol, Antiobiotics, Food Toxins, Metals, Obstruction of the Biliary Apparatus?

Umbilical

What type of hernia can be found near the belly button?

Ventral

What type of hernia is associated with incisions?

Femoral or inguinal

What type of hernia is found in the groin?

Hernioplasty

What type of hernia surgery would involve a synthetic mesh to keep the organs from protruding?

Active Immunity

What type of immunity can be naturally or actively aquired through having a disease or being immunized against it?

Natural Immunity

What type of immunity occurs as a result of gender, race, heredity, age, and health status?

Passive immunity

What type of immunity passes from the mother to a baby or my injection of serum from humans or animals?

Acute myelocytic leukemia

What type of leukemia is characterized by association with toxins, genetics, and treatment of other cancers?

Lymphocytic or Lymphoblastic

What type of leukemia is characterized by immature lymphocytes in the bone marrow, spleen, lymph nodes and CNS?

Chronic myelocytic leukemia

What type of leukemia takes 3-4 years to reach its aggressive phase?

Chronic Lymphocytic Leukemia

What type of leukemia usually occurs in older adults and often does not require treatment?

Thrombogenic

What type of medication is used to coat stents?

Hypertrophic Scars

What type of overgrowth of scar tissue remains within the wound?

Acute Rejection

What type of rejection is characterized by signs of inflammation (fever, edema, redness) and impaired organ function.

Graft vs. Host Disease

What type of rejection occurs with bone marrow transplants and is actually the transplanted tissue causing the immune response?

Keloid

What type of scarring is characterized by extreme overgrowth of scar tissue beyond the wound?

Malignant Melanoma

What type of skin cancer is characterized by a cancer of the cells that pigment the skin, and invades the epidermis, dermis, and sometimes subcutaneous tissue.

Squamous Cell Carcinoma

What type of skin cancer starts in the epidermis and is characterized by a firm, flesh colored papule that may crust, ulcerate and bleed?

Herniorrhaphy

What type of surgery involves suturing the hole in the muscle through which the organs protrude?

Allograft

What type of transplant uses a donor that is not genetically identical?

Xenograft

What type of transplant uses an animal's tissue?

Isograft

What type of transplant uses an identical twin's tissue?

Autograft

What type of transplant uses the client's own tissue

Abscess formation, general infection, "third spacing" of fluid into the peritoneum

What types of infection might you see with peritonitis?

Pneumococcal, Influenza, Hep B,Haemophilus Influenza B

What vaccines should someone with HIV get?

Saphenous Vein

What vein is most likely to develop a varicose vein?

Saphenous

What vein is usually harvested for a CABG?

Continous drainage, vehicle for medication, maintain negative air pressure to keep lungs inflated

What work does a chest tube perform in a pleural effusion?

Chronic liver disease and failure

What would Hepatitis C leave a person at risk of?

The size, shape, and position of the heart. Lung congestion and pleural effusion

What would a CXR show?

If there are microbes present in the blood.

What would a blood culture tell a provider?

Jaundice, pancretitis, sepsis, or hepatic damage

What would happen if bile back flows into the liver and pancreas in a client with Cholecystitis?

Liver cancer

What would having a history of Hepatitis B leave a person at risk of?

CBC shows anemia Urine positive for Bence Jones and other proteins Bone marrow will show excessive immature plasma cells. X rays will show low density areas or holes in bones Blood calcium levels are elevated BUN may be elevated if renal damage has occured

What would the labs look like if you suspect multiple myeloma?

Aneurysms

What would the provider use an aortagram to diagnose?

Hemorrhoidectomy

What would the surgical intervention involving the removal of the varicosed vein causing the hemorrhoid be called.

Stop transfusion, keep the IV line open with Normal Saline. Steriods and Diuretics may be used.

What would you do for a mild transfusion reaction?

Stop transfusion, keep IV line open with NOrmal saline, antihistamine, epinephrine

What would you do for a moderate transfusion reaction?

Stop transfusion, keep IV line open with normal saline. Return the blood products and urine specimen to lab for testing.

What would you do for a severe transfusion reaction?

Urine specific gravity < 1.005 Serum Na Levels - >145 CT/MRI to identify tumor

What would you expect lab results to look like for someone who has Diabetes Insipidus?

Serum Na <125 BUN and Creatinine Low to Normal Specific gravity is elevated - concentrated

What would you expect to see labs look like for someone who has SIADH?

At the same time daily, Usually 30 minutes before meal

When are Sulfonylureas usually administered?

If the client has burns on over 20% of the body.

When are fluid replacements necessary in burn treatment?

Too much medication Exercised too much Not eaten enough or is vomiting Ingested alchohol - lowers blood sugar

When could hypoglycemia happen?

within the first 15 minutes

When does a transfusion reaction usually occur?

5-30 minutes after eating

When does an instance of dumping syndrome usually occur?

Add Air to NPH Add Air to Regular Draw Regular Draw NPH

When drawing a mixture by hand, what is the order in which you add air and draw the mixture?

30 minutes to 6 hours after transfusion

When is a febrile reaction to a transfusion likely to occur?

When the thyroid is in normal range.

When is a subtotal thyroidectomy performed?

Within the first 15 minutes.

When is a transfusion reaction most likely to occur?

4 days to 4 months after transplant

When is an acute rejection most likely to occur?

4 months to years after transplant. It is a gradual organ failure.

When is chronic rejection likely occur?

Anytime during the first 100 days after transplant.

When is graft vs. host most likely to occur?

In the morning, when there are the most secretions.

When is it best to collect a sputum specimen?

90% or below. (provider or facility may have different guidelines.)

When is it necessary to act on a low Pulse Ox reading?

Within 24 hours

When is rejection of a transplant most likely to occur?

Only when at risk for MI or symptomatic

When is sinus tachycardia treated?

When the client has had three negative cultures in a row.

When is tuberculosis considered cured?

The most distal pulse will not be able to be palpated.

When palpating pulses, how would you be able to determine where a suspected occlusion exists?

1300-1500 ml's

When performing a thoracentesis, no more than how much fluid should be removed at one time?

NPH

When reading a vial of manufacturer mixed insulin, which insulin is listed first?

Within minutes - days after transplant.

When would a hyperactive rejection occur?

In the first 12 hours post op.

When would a thyroid storm typically occur?

When the mom is Rh- and the baby is Rh+.

When would the RH factor be an issue with a pregnancy?

In the winter Females over the age of 60

When would you most expect to see myxedema coma?

The last portion of the small intestine (ileum)

Where are bowel obstructions more likely to be found?

In the sigmoid colon

Where are you likely to find diverticula?

In the seams of clothing.

Where do Pediculosis Coporis hang out?

Usually begins in toes and feet, and moves up to affect fingers and hands.

Where does peripheral neuropathy usually begin?

In the capillaries

Where does the exchange of oxygen and carbon dioxide along with other nutrients and waste happen?

Immediately after surgery they will go to ICU as the body makes adjustments to the change in hormones. Monitor for adrenal crisis.

Where is a client who has undergone a adrenalectomy go?

The base of the right atrium

Where is the AV node located?

In the wall of the right atrium

Where is the SA node located?

Arms, hands, body folds, genitalia, between fingers, inner wrists, elbows, axilla, nipples, penis, belt line, gluteal folds.

Where on the body would you look if you suspect a scabies infestation?

CK-MB

Which CK test is a more accurate indicator of Acute Miocardial Infarction?

Hepatitis A

Which Hepatitis is contracted by ingesting contaminated food or water and shellfish?

Hepatitis Delta

Which Hepatitis is contracted by those who already have Hepatitis B?

Hepatitis B

Which Hepatitis is transmitted via blood, contaminated needles, sexual intercourse, and pregnancy?

Non-nucleoside Reverse Transcriptase Inhibitors: Viramune, Rescriptor

Which antiretrovirals are used to block HIV production?

Treponins

Which cardiac marker (isoenzyme) is a more specific test for heart damage and rises 4-6 hours after damage and remains elevated for 1 week?

B-Cell Lymphocytes

Which cells are responsible for body fluid immunity?

T-Cell Lymphocytes

Which cells are responsible for cellular immunity?

Cytotoxic T Cells.

Which cells destroy cancer cells and attach transplants and grafted tissue?

Suppressor T-cells (CD8)

Which cells keep the body from destroying itself?

Helper T-Cells (CD4+)

Which cells turn the immune system on?

Reed Steenberg Cells

Which cells will be present for a diagnosis of Hodgkin's Lymphoma

Emphysema (Pink Puffers)

Which classification of COPD is characterized by the walls of the alveoli causing air to become trapped during exhalation, causing distention, rupture and scar tissue. Client may have a barrel chest, very skinny with a barrel shaped, muscular upper torso, prolonged expiration to rid the body of trapped Co2.

Chronic

Which classification of ITP is seen more often in adults and often has no precipitating factor?

Acute

Which classification of ITP is seen more often in children and is often preceded by a viral infection?

People over 65, Immunosuppressed, Chronic cardiac or respiratory disease, Diabetes, alcoholics

Which clients should be encouraged to get the pneumococcal vaccine?

HIV

Which condition is characterized by a virus that destroys the cells in the immune system and interferes with the body's ability to fight viruses, bacteria, fungi, also making them susceptible to certain types of cancers and opportunistic infections?

Hypothalmus

Which endocrine gland located in the brain is considered the "control center"?

Parathyroid

Which gland regulates the level of calcium in the blood?

Thyroid

Which gland regulates the metabolism?

Ceruminous

Which glands in the skin produce ear wax?

Sudoriferous

Which glands in the skin produce sweat?

Sebaceous

Which glands in the skin secrete an oily substance to protect from water loss and to moisturize skin and hair?

Hepatitis E

Which hepatitis is caused by the ingested of water contaminated with infected feces and can be very severe in pregnant women?

Hepatitis C

Which hepatitis is transmitted via blood and sharing contaminated needles, is more prevalent in the Hispanic and African American population?

Autologous - the client "saves up" their own blood in case it is needed prior to a procedure/surgery.

Which is the safest kind of blood transfusion?

Hypodermis

Which layer of skin connects the skin to underlying muscle layers and contains adipose tissue (fat cells)?

Dermis

Which layer of skin is characterized by the presence of connective tissue, cells, blood vessels, nerves, glands, and hair follicles?

1st Degree

Which level of burn involves only the epidermis and if widespread, may also involved Nausea/Vomiting, chills, and headache?

Corticosteroids Cytotoxic Agents (Imuran, Cyclosprorine, Cytotoxin, Methotrexate, Tacrolimus, Cellcept) Monoclonal Antibodies Antilymphocyte Globulins

Which medications are used to suppress the immune system after a transplant?

Accutane. Use 2 reliable forms of birth control. Do a pregnancy test at least two weeks before starting the drug.

Which medications for Acne Vulgaris is contraindicated for pregnancy?

Theophylline, Aminophylline - a level above 20 indicates toxicity

Which medications for COPD require monitoring?

Glimepriride (Amaryl) Glipizide (Glucotrol) Glyburide (DiaBeta)

Which oral anti-diabetic medications are considered Sulfonylureas?

Caucasions with a history of severe sunburn, living in a sunny environment, people who sunburn easily, and those who use tanning beds.

Which populations are most at risk of developing Malignant Melanoma?

Herpes Zoster (Shingles)

Which skin condition is an outbreak later in life of the same virus that causes chickenpox?

Epidermis

Which skin layer is characterized by an outer layer of stratified squamous cells?

CBC

Which test includes RBC's, Hemoglobin, Hematocrit, platelets and white blood cells?

CBC with differential

Which test includes a count of the different white blood cells in addition to RBC's, Hemoglobin, Hematocrit, platelets, and total WBC's?

PT, INR

Which tests evaluate coumadin therapy?

Hodgkin's Lymphoma

Which type of Lymphoma is considered the most curable?

Aplastic Anemia

Which type of anemia is characterized by the bone marrow failing to produce red blood cells?

Pernicious

Which type of anemia results in the inability of the clients intestines to absorb B12?

Unstable angina

Which type of angina is not predictable and may mimic the signs of an MI, but is relieved by rest and nitroglycerin?

Stable Angina

Which type of angina is relieved by rest and use of nitrates?

Radiation

Which type of burn is a sunburn?

Thermal

Which type of burn is caused by a source of heat - dry or wet?

Electrical

Which type of burn is caused by contact with an electrial current?

Chemical

Which type of burn is caused by exposure to an acid or alkaline agent?

Acute lymphoblastic leukemia

Which type of leukemia is characterized by its manifestation primarily in children and having a 70% cure rate with aggressive treatment.

Myelocytic

Which type of leukemia is characterized by myeloid stem cells becoming granulocytes and interfering with RBC's and platelets?

Chronic Rejection

Which type of rejection is characterized by a gradual deposit of WBCs and antibodies in the transplanted organ, inhibiting blood flow and causing ischemia?

Hyperactive Rejection

Which type of rejection is characterized by a seemingly healthy organ turning soft and white and dying?

Basal Cell Carcinoma

Which type of skin cancer is the least serious and may present as a smooth itchy pimple or a papule that turns red and ulcerates?

Patients who have lower resitance to infection. (chemo, steriods, HIV)

Who is at greatest risk of developing shingles?

African Americans, Hispanics from the Carribean and Central/South America

Who is at the most risk for carrying the sickle cell trait?

Women who are between 30 and 50 years old.

Who is more likely to develop Hashimoto's Thyroiditis?

People between the ages of 15 and 35, and men over 50

Who is more likely to develop lymphoma?

surgical patients, older patients, patients with tube feedings.

Who is most at risk for aspiration pneumonia?

The body compensates for low oxygen in the blood by moving it faster.

Why does the client suffering from anemia experience tachycardia?

B12 is necessary for the production of red blood cells.

Why is B12 so important?

Untreated in can progress to V tach

Why is PVC so important to treat?

The effect is noticed faster - within a week. Oral supplements take longer to take effect.

Why is a B12 injection the preferred treatment for pernicious anemia?

A small injury will heal slowly or not at all eventually deteriorating into gangrene and progressing deeper into muscle and bone. Abscess formation can lead to osteomylitis or other life threatening infection requiring amputation.

Why is a small injury left untreated in a client with DM dangerous?

The spleen is the site of red blood cell destruction and antibody production.

Why is a splenectomy a treatment for aplastic anemia?

It is the site for antibody production. Can produce partial or total remission from the disease.

Why is a splenectomy considered a good treatment for thrombocytopenia?

It occurs rapidly and causes low B/P, laryngeal edema, bronchispasm, leading cardiovascular collapse, MI, respiratory failure (anaphylactic shock).

Why is anaphylaxis a medical emergency?

If the appendicitis perforates, it causes peritonitis.

Why is appendicitis an emergency?

Mucous production increases and thickens.

Why is bronchitis the ideal condition for the growth of bacteria?

The appendix has likely burst and they will need surgery to prevent peritonitis.

Why is it a concern if your client who has suspected appendicitis suddenly feels much better?

Leukemic cells will continue to replace other cells if left untreated, leaving the client with limited RBC's and platelets.

Why is leukemia fatal if untreated?

It receives messages from the Hypothalmus, interprets them, and relays them to the appropriate glands for action.

Why is the Pituitary considered the Master Gland?

The bacteria has an outer capsule that is resistant to treatment.

Why is tuberculosis difficult to treat?

The kidneys release erythropoetin to stimulate blood cell production.

Why might a person suffering anemia experience bone or joint pain?

To prevent bacteria from entering the heart and growing on the valve, causing endocarditis.

Why might an antibiotic be given someone with an artificial valve before a minor procedure?

Serum ammonia rises it affects the brain.

Why might you see cognitive changes with cirrhosis of the liver?

Both drugs interfere with ADH and cause polyuria

Why would Declomycin (demclocycline) or Lithium be ordered for client with SIADH?

To prevent straining while having a bowel movement that will create stress on the heart.

Why would a laxative or stool softener be given to a client who is recovering from an MI?

They are less able to fight off an infection.

Why would a patient with less than 4,000 WBC's be placed on neutropenic precautions?

to identify fungal infections that are present on the skin

Why would a provider order Wood's Light Exam?

To monitor for anemia, leukopenia, thrombocytopenia

Why would a provider order a CBC for an HIV+ client

To detect the presence of tuberculosis - an opportunistic infection with AIDS

Why would a provider order a PPD for an HIV+ client?

To determine the bacteria present if an infection exists and decide which antibiotic to use.

Why would a provider order a culture and sensitivity?

To identify allergens the client is sensitive to

Why would a provider order a patch test?

To diagnose scabies or fungal infections

Why would a provider order a skin scraping test?

Looking for: Mucosal inflammation Hiatal Hernia Polyps Ulcers Presence of H pylori stricture Obstructions Bleeding Biopsy

Why would a provider order an EGD?

To determine what type of infection or inflammatory response is present.

Why would a provider request a CBC with differential?

When the glucose level in the blood becomes more than the kidneys can handle, the excess spills into the urine.

Why would someone with uncontrolled diabetes have glucose in their urine?

GLucose is a magnet for water and the excess glucose in the blood draws fluids away from the cells and tissues into the blood. The lack of fluid in the cells signals thirst.

Why would someone with uncontrolled diabetes suffer an intense thirst?

As water follows the extra glucose into the blood from the tissues, the body attempts to prevent fluid overload by urinating.

Why would someone with uncontrolled diabetes urinate alot?

Stool sample for bacteria, blood, fat, ova and parasites CBC Blood ph Electrolytes Endoscopy

You client has come to the clinic with unresolved diarrhea. What would you expect the provider to order?

As shock reverses itself, fluid is reabsorbed into the blood and may cause fluid overload.

Your burn client is stable an is no longer considered in shock. What should you monitor for?

It's well contained and usually does not spread beyond the lymph nodes. Cure rates are excellent.

Your client has been diagnosed with thyoid cancer and is anxious about their diagnosis. What can you tell them?

Meat, poultry, eggs Fish and Shellfish Milk and cheese

Your client has decided to forego B12 injections in favor of improving her B12 intake through dietary changes. What recommendations would you make to her?

Sudden severe pain in the abdomen, chest, back or joints May have jaundice

Your client is in Sickle cell crisis. What would you expect from your assessment?

Seems to simulate normal HGB production, decreasing abnormal HGB in the blood.

Your client is taking Hydroxyurea to prevent sickle cell crisis. What does this do?

Take 1 hour before meals unless GI distress occurs. Liquid iron can stain teeth - give with a straw. Administer with orange juice. Do not give with milk or calcium supplements. Do not take with caffeine or bran as it interferes with absorption.

Your client needs an iron supplement. What should you consider when caring for him?

Seroconversion

Your client who has been exposed to HIV was not testing positive last month, but now tests postive for HIV Antibodies. What has occured?

Erythromycin/Macrolides

Zithromax (azithromycin)