QUIZ -

Digoxin therapeutic level

Therapeutic levels of digoxin are 0.8-2.0 ng/mL. The toxic level is >2.4 ng/mL.

A nurse is caring for a client hospitalized with Guillain-Barré Syndrome who has been in the intensive care unit on a ventilator for four days. Which of the following would be most appropriate in assessing for complications of immobility? Select all that apply.

1. Performing range of motion on the client's ankles, knees, and hips. 2.Assess the character of bowel sounds and frequency of stools. 3.Observe skin color over sacral, heels, and scapulae areas 4.To assess for complications of immobility it would be appropriate to auscultate for abnormal breath sounds. --------------------------- Potential complications of immobility could include the following: loss of joint motion and contractures, decreased gastrointestinal motility and constipation, deep vein thrombosis with erythema and swelling of the calf areas, and skin breakdown with early evidence of pallor, erythema, blistering over bony prominences.

An arterial line is a thin, flexible tube (catheter). It's put into an artery. An arterial line makes it easy to check your blood pressure. This is needed during certain hospital procedures when your blood pressure may go up and down a lot. The nurse should place a pressure bag around the flush solution of 0.9% sodium chloride because the pressure from an artery is greater than that of the line.

An arterial line is not appropriate access for administering antibiotics. The nurse should use the arterial line to obtain arterial blood gas samples and monitor hemodynamic pressures.

A nurse is providing dietary education for a client with cholecystitis. Which of the following food choices made by the client indicates a need for further teaching? a. Baked potato b. Broccoli with cheese sauce c. Chicken breast d. Wheat bread

Broccoli with cheese sauce CORRECT. Cholecystitis is characterized by inflammation of the gallbladder. The gallbladder stores and releases bile that aids in the digestion of fats. Fat intake should be limited to reduce stimulation of the gallbladder. Other foods that may be contraindicated include coffee, broccoli, cauliflower, Brussels sprouts, cabbage, onions, legumes, and highly seasoned foods.

How does digoxin improve heart failure?

Digoxin, also called digitalis, helps an injured or weakened heart pump more efficiently. It strengthens the force of the heart muscle's contractions, helps restore a normal, steady heart rhythm, and improves blood circulation. Digoxin is one of several medications used to treat the symptoms of heart failure.

perimenopause

Night sweats is incorrect. Night sweats are a manifestation of menopause and do not require notification of the provider.Calf pain is correct. Calf pain is an indication of deep-vein thrombosis. The client should report this finding to the provider immediately.Vaginal dryness is incorrect. Vaginal dryness is an expected finding of menopause.Numbness in the arms is correct. Numbness in the arms can indicate a cerebrovascular accident, which is an adverse effect of hormone replacement therapy. The client should report this finding to the provider immediately.Intense headache is correct. An intense headache can indicate a cerebrovascular accident, which is an adverse effect of hormone replacement therapy. The client should report this finding to the provider immediately.

digoxin education

Teach patient to take pulse and to contact health care professional before taking medication if pulse rate is <60 or >100. Pedi: Teach parents or caregivers that changes in heart rate, especially bradycardia, are among the first signs of digoxin toxicity in infants and children.

extubation of endotracheal tube 10 mins ago, report what to the provider?

The presence of oral secretions is nonurgent because it is an expected finding after extubation of a client's endotracheal tube. The nurse should encourage the client to cough to expel oral secretions Hoarseness is nonurgent because it is an expected finding after extubation of a client's endotracheal tube. The nurse should place the client in semi-Fowler's position, encourage the use of an incentive spirometer, and limit speaking. A sore throat is nonurgent because it is an expected finding after extubation of a client's endotracheal tube. The nurse should place the client in semi-Fowler's position, encourage the use of an incentive spirometer, and limit speaking. --------- the nurse should determine that the priority finding is stridor. Stridor can indicate a narrowing airway or possible obstruction caused by edema or laryngeal spasms. The nurse should report the finding immediately and implement an intervention.

A nurse provided discharge teaching to new parents on how to care for their newborn following circumcision. Which of the following statements by the parents indicates the need for further clarification? a. "I should not remove the yellow exudate on the end of the penis." b. "I can give him a tub bath in two days." c. "I will clean his penis with each diaper change." d. "The circumcision will heal completely within a couple of weeks."

b CORRECT. The newborn should not be immersed in water until the circumcision has healed and the umbilical cord has detached. The circumcision should heal within two weeks.

Digoxin toxicity s/s

can emerge during long-term therapy as well as after an overdose. It can occur even when the serum digoxin concentration is within the therapeutic range. Toxicity causes anorexia, nausea, vomiting and neurological symptoms. It can also trigger fatal arrhythmias.

nurse should determine that the priority finding to report to the provider is restlessness, which can be an indication the client is experiencing disequilibrium syndrome. Disequilibrium syndrome is caused by the rapid removal of electrolytes from the client's blood and can lead to dysrhythmias or seizures. Other manifestations include nausea, vomiting, fatigue, and headache.

hemodialysis

Crohn's disease is a type of inflammatory bowel disease(IBD). It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. Inflammation caused by Crohn's disease can involve different areas of the digestive tract in different people.

safe foods: refined grains (white pasta), lean protein, fully cooked vegs, low fiber fruit not safe: insoluble foods hard to digest, sugars, lactose, .....whole wheat & fiber vegs not good

high temp for thyroidectomy

the priority finding is an elevated temperature. An elevated temperature is a manifestation of excessive thyroid hormone release, or thyroid storm, due to an increase in metabolic rate. The nurse should report this finding immediately to the provider because it can lead to seizures and coma.

Dumping syndrome

when food is emptied from the stomach into the small intestine too quickly. Commonly seen after gastric (stomach) surgeries - such as gastric bypass, partial gastrectomy, pyloroplasty 2 phases for sx of dumping syndrome: early dumping & late dumping early dumping - may occur 10-30 min after meal (n/v/d, bloating, gas, cramps) late dumping - may occur 1-3 hours after meal, sx may include hypoglycemia (low blood sugars), dizziness, lightheadedness, & sweating making changes in the diet can help slow gastric emptying & minimize symptoms General guidlines: eat 3-6 small frequent meals throughout the day, eat slowly & chew foods well. limit concentrated sugars (found in cakes, fruit juices, soft drinks. avoid drinking liquids w/meals. drink liquids 30 mins before a meal or 30 mins after a meal include complex carbs & high fiber foods daily, speak out fiber intake throughout the day. complex carbs like fiber(beans, lentils, fruits, veg, whole grain) is hard for the body to digest include small amounts of extra fats (avocados, nuts, nut butters) include protein with each meal & snack you eat (high protein foods include meats, poultry, fish, eggs, dairy, tofu, & nut butters Avoid consuming milk, sweets, and sugars., Eat small, frequent meals during the day., Eliminate liquids with meals, and for one hour before and after meals. rest or lie down for 30 mins after a meal do not sit up after eating. It is contraindicated for the client with Dumping Syndrome to sit up after eating, as that position will speed movement of gastric contents into the duodenum and may trigger the symptoms of Dumping Syndrome. -------------------- Dumping syndrome frequently occurs after bariatric surgery and symptoms can include vertigo, syncope, pallor, diaphoresis, tachycardia, and palpitations. Therapy includes: small, frequent meals rather than large ones; avoidance of milk, sweets, and sugars; elimination of liquids with meals and for one hour before and after meals; reduction in the amount of fluid ingested at one time, eating a high-protein, high-fat, and low-to- moderate carbohydrate diet; and lying down after meals to slow transit time of food in the intestines.