TERMINOLOGY

Drugs used to treat tuberculosis (TB)

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Non-Ischemic Cardiac Pain:

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Review needle sizes and nasogastric tube insertion

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TPN care review

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What findings should the practical nurse (PN) document to describe infiltration at a client's intravenous (IV) site? Infusion pump occlusion alarm noted. Edema and cool skin at insertion site. Blood backflow present in IV tubing. Client states insertion site is painful.

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4+ pitting edema

4+ pitting edema is very deep pitting, very edematous and distorted extremity, with depression lasting as long as 2 to 5 minutes.

As nurses today, we have to care for patients from many different cultures and backgrounds. Select all of the following ideas/beliefs from the Japanese culture about how illness is caused.

? Improper care of the body Lack of sleep

CT scan

A CT scan, also known as a CAT scan, is performed to detect pathologic conditions of the cerebrum and spinal cord using a technique of scanning without radioisotopes. The patient must lie still during the procedure; it may be done with or without contrast.

clinical nurse specialist

A clinical nurse specialist provides instruction to the patient and family who will assume the patient care.

furuncle

A furuncle, also known as a boil, is an inflammation that begins deep in the hair follicles and spreads to the surrounding skin, often located in the posterior area of the neck, the forearm, buttocks, and the axillae.

Normal Blood Glucose Levels:

A normal sugar level is currently considered to be less than 100 mg/dL when fasting and less than 140 mg/dL two hours after eating. But in most healthy people, sugar levels are even lower. During the day, blood glucose levels tend to be at their lowest just before meals.

epistaxis

A nosebleed is loss of blood from the tissue lining the nose. Bleeding most commonly occurs in one nostril only.

nosocomial

A nosocomial infection is an infection that is acquired at least 72 hours after admission to the hospital.

sigmoidoscopy

A sigmoidoscopy is a study of the lower gastrointestinal tract that uses an endoscope.

trapeze

A trapeze is used by the patient with limited mobility to assist with turning and positioning in bed.

Trochanter roll

A trochanter roll is used to prevent the external rotation of the legs.

While reviewing fire safety, a type A fire extinguisher can only be used on which type of fire?

A type A fire extinguisher is used on paper, wood, or cloth fires.

Which of the following statements about AIDS is accurate? The median time from AIDS diagnosis to death, without treatment, is 5 years. AIDS is used to describe the end-stage, or terminal phase, of the HIV infection. As HIV disease progresses, there are more T-helper cells (CD4+) than T-suppressor cells (CD8+). A patient with AIDS usually has a normal WBC count and PPD test.

AIDS is used to describe the end-stage, or terminal phase, of the HIV infection. Earlier phases of the disease include "early infection" (sometimes called the asymptomatic phase) and "early symptomatic disease," when the patient begins to have the symptoms of fevers, night sweats, diarrhea, headaches, fatigue, and persistent generalized lymphadenopathy (PGL).

What is the difference between a Saline Lock and an I.V. Site?

"A heparin or saline lock is an IV without being attached to that damn pole. Conventional IVs attach to a tube that leads to a solution bag hanging on the pole. A lock is an IV that is attached to a little chamber on your hand filled with either saline or heparin, thus the name. It is about the size of a nickel and provides access to your venous system if the nurses need to give you any medication fast but allows you freedom of movement (no tubes or poles).

A client who is 8 hours postoperative begins using the incentive spirometer (IS) with 750 ml inspiratory volume and coughs up a large, thick, light yellow-white mucous plug. Which action should the practical nurse (PN) take? Document the findings. Instruct client to use less inspiratory force. Request bronchodilator nebulizing treatment. Obtain client's temperature.

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A client who is postoperative is receiving an infusion at 80 ml/hour. At the end of 8 postoperative hours, the practical nurse (PN) documents that the client tolerated 100 ml oral intake of ice chips, and urinary output is 1,100 ml. What action should the PN take? Document the intake and output findings. Check the client for dry mucous membranes. Obtain a prescription to increase the IV fluids. Monitor for signs of electrolyte imbalances.

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A client with Clostridium difficile is placed on isolation precautions. Which transmission-based precaution should the practical nurse implement? Don a particulate respirator mask when in the room. Wear gown and gloves when rendering direct care. Close the door to the private negative airflow room. Prevent the client from leaving the room without a mask.

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A client with a forearm laceration arrives in the clinic applying direct pressure with a clean washcloth. The practical nurse (PN) notes that the washcloth is saturated with blood. What action should the PN implement? Remove the saturated dressing and apply a new one. Place a new dressing on top of the saturated one. Apply digital pressure to arm above the injury. Place an ice pack over the dressed wound.

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A patient has been admitted to hospice with end-stage colon cancer. During the initial assessment, the patient tells the nurse that he is having squeezing pain on the left side of his abdomen. The nurse performing the assessment knows this as what type of pain? Somatic pain Visceral pain Neuropathic pain Generalized pain

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An older client arrives at the outpatient clinic complaining of burning and severe right-sided "chest pain." The practical nurse (PN) observes vesicular eruptions in a line across the anterior and posterior chest wall. What action should the PN implement? Obtain a culture of any drainage. Ask about recent food exposures. Inquire about recent foreign travel. Wear gloves during palpation.

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An older male client who is incontinent receives a prescription for a condom (external) catheter. Which step(s) should the practical nurse implement when applying the external catheter? (Select all that apply.) Wrap the adhesive strip in a spiral around the penis. Shave the perineal area before beginning. Apply skin prep to the penile shaft and allow to dry. Leave 1 to 2 inches between the tip of the penis and condom catheter. Don sterile gloves prior to application of the condom catheter.

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Appropriate nursing interventions for a patient with chronic obstructive pulmonary disease (COPD) include which of the following? Administering high-flow oxygen, usually 40% or greater Performing physical therapy immediately before meals to stimulate appetite Encouraging a low-calorie, low-protein diet Encouraging the patient to get the flu vaccination each year and pneumococcal revaccination every 5 years

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Fill in the blanks for the following description of the blood circulation pattern in the body by placing the option numbers in the correct order here: _______. Do not use commas or spaces. Superior vena cava/inferior vena cava→Right atrium→ __________ valve→Right ventricle→ __________ valve→Pulmonary artery→Capillaries in the lung→Pulmonary veins→Left atrium→ __________ valve→Left ventricle→ __________ valve→ aorta. 1. Aortic semilunar 2. Bicuspid 3. Pulmonary semilunar 4. Tricuspid

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In a patient with acute renal failure (oliguric phase), you would expect which of the following? Decreased blood urea nitrogen Low levels of serum creatinine Urine output in excess of 2 L/day Anorexia, nausea, vomiting, and decreased urine output

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The family of a male client with terminal cancer decides to not tell the client about his prognosis. The client has asked the practical nurse (PN) several times if he is dying. What action should the PN implement? Discuss the client's frequent questions with family and healthcare provider. Respect the family's wishes and keep denying he has a terminal condition. Encourage client to think happy thoughts and to use distraction techniques. Respond honestly so the client can make his own end-of-life preparations.

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The healthcare provider prescribes an immediate transfer to the intensive care unit (ICU) for a client who has become unstable. Which action is most important for the practical nurse (PN) to implement? Call the phlebotomist to draw blood specimens. Document findings and nursing actions that occurred prior to transfer. Provide an SBAR report of the client's status to the charge nurse. Attach a portable cardiac monitor to the client.

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The practical nurse (PN) finds an older female client lying on the floor. What action should the PN take first? Inquire if the client has any pain. Assist the client back to bed. Ask the client why she got up. Obtain the client's vital signs.

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The practical nurse (PN) hears an auscultatory gap in the Korotkoff sounds of an older client with hypertension. What action should the practical nurse (PN) implement when obtaining the client's blood pressure? Stop deflating the cuff midway and re-inflate it again. Continue to listen for the next Korotkoff sound until the cuff is deflated. Pump up the cuff until no sound is heard, then let the air escape slowly. Place the bell of the stethoscope firmly over the artery.

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The practical nurse (PN) identifies four assigned clients that need additional follow-up care. Which client issue has the highest priority? Refuses a scheduled nebulizer treatment. Requests pain medication for a headache. Results of fasting glucose is 150 mg/dl. Infiltrated intravenous secondary medication.

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The practical nurse (PN) is caring for a client who begins to vomit copious amounts of blood. What action should the PN do first? Insert nasogastric tube for gastric suctioning. Report the client's vital signs to the healthcare provider. Initiate an infusion of normal saline (NS). Use a Yankauer-tip device for oropharyngeal suction.

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The practical nurse (PN) is caring for an older client who is receiving oxygen 4 L per nasal cannula. Which finding indicates a therapeutic response? Capillary refill less than 3 seconds. Respiratory rate 18 breaths/minute. Left and right lungs clear on auscultation. Client oriented to time and place.

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The practical nurse (PN) is documenting the administration of a client's medication. Which entry by the PN complies with The Joint Commission (TJC) guidelines for use of abbreviations? MS 4.0 mg IM given for pain rated "8" on a scale of "0-10". Novolog insulin 4 u given SC in the right arm. Doses of clonidine 0.15 mg given AC BID. Oral liquid vitamin supplement changed from 2.0 cc to 3.00 cc qd.

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The practical nurse (PN) is giving iron dextran (Imferon) 250 mg IM using the Z-track method to a client with anemia. Which needle should the PN select for this injection? 2-inch, 19 gauge needle. ½ inch, 23 gauge needle. 1-inch, 18 gauge needle. 1½ inch, 16 gauge needle.

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The practical nurse (PN) is obtaining a blood specimen from a client's peripherally inserted central catheter (PICC). What action should the PN to implement first? Transfer specimen using Vacutainer device. Discard first 5 ml of blood sample. Regulate the infusion rate as prescribed. Flush with 10 ml of normal saline.

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The practical nurse (PN) is obtaining blood specimens from a client. After inserting the needle into the arm, the client screams and reports an electric "shooting" pain in the arm. What action should the PN implement? Tell the client that discomfort can occur. Remove the tourniquet. Apply a topical anesthetic. Withdraw the needle from the arm.

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The practical nurse (PN) is preparing to reinforce information with a client who has chronic pain. Which learning objective should the PN review? Understands the use of herbal treatment options. Recalls two nonpharmacological interventions used to relieve pain. States the value of using several pain management approaches. Discusses the dangers of prescriptive drug abuse.

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The practical nurse (PN) is reviewing the electronic medication administration record (MAR) for a client who receives warfarin (Coumadin) daily. A notation on the MAR for yesterday is marked "hold" for the daily Coumadin dose and no other directions are noted for today's dose. What action should the PN take? Withhold the medication. Call the pharmacist. Administer the drug. Check the prescription.

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The practical nurse (PN) is reviewing the schedule of yearly inservice programs for competency-based nursing care. Which criteria should the PN use in selecting programs that provide the best content to maintain nursing competency? Complex procedures that are done only a few times a month. Techniques that involve management of biohazard waste products. Competency demonstrated in orientation with electronic medication administration. Urgent needs identified by quality assurance to ensure national patient safety goals.

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The practical nurse (PN) notifies the healthcare provider that a male client has become combative and needs a protective device to prevent injury to self and others. Which principle should the PN use when selecting a protective device? A protective device must be applied by qualified personnel. A restraining device is provided for behavioral use only. A protective device provides the least amount of immobilization. A restraining device ensures modification of unsafe client behavior.

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The practical nurse (PN) uses the SBAR format to report an acute client situation to the healthcare provider. Which information is the correct understanding of this method? The "S" stands for safety and indicates any issues related to safety, such as restraints. The "B" stands for bleeding and indicates any signs of hemorrhage. The "A" stands for airway and reports on the client's airway status. The "R" stands for recommendation and suggests an action for the healthcare provider.

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The practical nurse is administering otic drops to an adult client with otitis externa. Which action describes the correct administration technique? Manipulate the ear lobe back and down. Pull the pinna of the ear up and out. Apply drops to a cotton-tipped applicator for insertion. Administer the drops at a cool room temperature.

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What action should the practical nurse (PN) take when implementing daily focused assessments for this assigned group of 4 clients? Apply a blood pressure cuff on client's forearm when the upper arm cannot be used. Measure a child's length from feet to shoulders using a Breslow tape. Palpate the abdomen prior to auscultation for presence of bowel sounds. Dispose of the gastric residual volume after aspirating the client's nasogastric tube.

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When determining if the client is compliant with a prescribed medication regimen, which question is best for the practical nurse (PN) to ask? "When and where do you take this pill at home?" "Do you have any of the medication's side effects?" "Why was this medication prescribed for you?" "Are you taking this medication twice a day?"

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Which factors influence how the practical nurse (PN) obtains vital signs on a client? (Select all that apply.) Client height 5 feet 6 inches, weight 240 pounds (109 kg). History of right radical mastectomy two years ago. Daily use of oral digoxin (Lanoxin). NPO status of 12 hours for fasting blood test. Nasal congestion related to a "cold".

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Which finding should the practical nurse (PN) report to the healthcare provider prior to administering as IV infusion with added potassium chloride (KCL)? Oral temperature of 100.4°F (38°C). Urine output of 120 ml in 8 hours. Hemoglobin of 9.6 grams/dl. Pulse oximeter 91% on room air.

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chlorpromazine (Thorazine) rectal suppository

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deep tendon reflexes for diab...

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systemic lupus erythematosus (SLE).

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thoracotomy tray

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vitamin b-12 deficiency

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A patient with a tracheostomy has been assessed and needs suctioning. As the nurse, you will suction for a maximum of ____ seconds.

10 seconds: Suctioning for longer than 10 seconds depletes the oxygen supply.

PT normal range

11-13 seconds A longer-than-normal PT can mean a lack of or low level of one or more blood clotting factors (factors I, II, V, VII, or X). It can also mean a lack of vitamin K; liver disease, such as cirrhosis; or that a liver injury has occurred. A longer-than-normal PT can also mean that you have disseminated intravascular coagulation (DIC), a life-threatening condition in which your body uses up its clotting factors so quickly that the blood cannot clot and bleeding does not stop. A longer-than-normal PT can be caused by treatment with blood-thinning medicines, such as warfarin (Coumadin) or, in rare cases, heparin.

Nursing services in long-term care are centered around a functional assessment. Place the following nursing needs in the correct priority by number. Do not use commas or spaces: _________ 1. Elimination 2. Self-respect 3. Belonging 4. Security

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Place the six elements of the chain of infection in the correct order of the cycle. Do not use commas or spaces: 1. Host — another person or animal 2. Infectious agent — a pathogen 3. Method of transportation — exudates, feces, air droplets, hands, needles 4. Entrance — skin, mucous lining, mouth 5. Exit — from reservoir 6. Reservoir — where the pathogen can grow

2 6 5 3 4 1

2+ pitting edema

2+ pitting edema is somewhat pitting edema, no marked change in shape of the extremity, and depression disappears in 10-15 seconds.

OPEN BOTTLES OF IRRIGATION FLUID SHOULD BE DISCARDED AFTER HOW LONG?

24 HOURS BECAUSE THEY DO NOT CONTAIN A PERSERVATIVE

place the stages of family development in the correct order. Do not use commas or spaces: 1. Expectant stage 2. Engagement/commitment stage 3. Senescence stage 4. Parenthood stage 5. Establishment stage 6. Disengagement stage of parenthood

251463 2 5 1 4 6 3

Immediately after an injury, the wound healing process begins and follows the same pattern. Place the following phases of wound healing in the correct order. Do not use commas or spaces: 1. Maturation phase 2. Inflammatory phase 3. Hemostasis phase 4. Reconstruction phase

3 2 4 1

Place Kubler-Ross' stages of grieving and dying in the correct order. Do not use commas or spaces: 1. Bargaining 2. Acceptance 3. Depression 4. Denial and isolation 5. Anger

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List by number the following items in order from least complex to most complex. Do not use commas or spaces: _______. 1. Organs 2. Cells 3. Tissues 4. Systems 5. Atoms 6. Molecules

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how many hours after an indwelling urinary catheter is removal should the patient void?

8 hours. If patient does not void within time frame, the indwelling catheter needs to be reinserted.

The practical nurse (PN) is calculating an 8-hour intake for a postoperative client. Based on the client's bedside record, how many ml of intake should the PN enter in the client's electronic record? (Enter numeric value only.) One cup of coffee One 8-ounce glass of iced tea One 6-ounce dish of flavored gelatin One-half cup of chicken broth

8 oz. 8 oz. 6 oz. 4 oz. = 28 oz x 30 ml= 840 ml

In the long-term care setting, the interdisciplinary team reviews the resident's plan of care every _____ days.

90 days; The resident's plan of care is reviewed every 90 days for resolution of problems or revision of goals and interventions.

Abduction

Abduction is the process of moving the leg laterally away from the body.

Acetylcholine

Acetylcholine plays a role in nerve impulse transmission; it spills into the synapse area and speeds the transmission of the impulse.

Alanine transaminase (ALT)

Alanine transaminase (ALT) is an enzyme found in the highest amounts in the liver. Injury to the liver results in release of the substance into the blood. The alanine transaminase test is one of the liver function tests that is used to confirm liver malfunction

Which of the following maternal changes are presumptive signs of pregnancy? Select all that apply.

Amenorrhea; Chadwick's sign; Breast changes?

Amyotrophic lateral sclerosis (ALS)

Amyotrophic lateral sclerosis (ALS) is a rare, progressive neurologic disease characterized by loss of motor neurons in the brainstem and spinal cord. It usually results in death within 2 to 6 years of onset. Primary symptoms are upper extremity weakness, dysarthria, and dysphagia. There is no cure for ALS.

Oral cholecystography (OCG)

An oral cholecystography (OCG) is a method of visualizing the biliary tree, but it is ineffective in the patient with jaundice.

If a patient with an abdominal incision begins to cough, which intervention is the most appropriate?

Apply a pillow to the incision with slight pressure.

Many allopathic physicians (MDs) do not refer their patients for CAM therapies because they:

Are not familiar with the theories and have had little, if any, education and training in CAM.

The physician has ordered a sterile dry dressing change. The most appropriate way to cleanse the wound and surrounding area is to use a(n):

Aseptic swab, start from the incision outward, one stroke per swab, then allow to air dry. This method helps to remove bacteria from the wound area and prevents contaminating a previously cleaned area.

Borderline personality

Borderline personality is one who has not established self-identity; fears being alone.

CEA or cacinoembryonic antigen

CEA, or carcinoembryonic antigen, is an antigen whose production stops before birth, but may begin again in the presence of cancer. It also may be elevated in persons who smoke.

The nurse must know how to correctly compute medication doses for children. Which of the following is correct regarding dosage calculation for children?

Calculating the proportional amount of BSA to body weight is the most reliable method of determining children's doses.

Cerebral angiography (angiogram)

Cerebral angiography (angiogram) is a procedure used to visualize the cerebral arterial system by injecting radiopaque material. It allows the detection of arterial aneurysms, vessel abnormalities, and displacement of vessels by tumors or masses.

Complete spontaneous abortion

Complete spontaneous abortion is when all the product of conception are expelled from the uterus.

Contact dermatitis

Contact dermatitis is caused by direct contact with an irritant to which an individual is hypersensitive, such as soap, chemicals, or plants. If the patient has a history of asthma, he or she may experience an acute asthmatic episode.

Contractons

Contractions are tightening of the pregnant uterus that can be regular or irregular and cause the progression of dilation and effacement.

Which of the following characteristics are indications of true labor? Select all that apply.

Contractions follow a regular pattern. The cervix softens, effaces, and dilates. ?

Diet plays a role in the development of which types of cancer?

Diet plays a role in the development of cancer of the colon, rectum, and breast. A diet high in fiber and low in fat is recommended to reduce the risks of these cancers.

Dyspnea

Dyspnea is a subjective feeling of shortness of breath experienced by the patient.

Shortening and thinning of the cervix during the first stage of labor is called:

Effacement is the process of shortening and thinning of the cervix. Effacement is complete when only a thin edge can be palpated.

Elevate lower extremities off the bed

Elevating lower extremities off the bed assists in the prevention of pressure sores

Eosinophils

Eosinophils are WBCs that play a role in allergic reactions and are effective against certain parasitic worms. Normal values of eosinophils are 1% to 4%.

The type of tissue that is packed closely together and that contains no blood vessels is referred to as:

Epithelial tissue is the type of tissue that is packed closely together and that contains no blood vessels. It covers the outside of the body and some of the internal structures.

Erythema

Erythema indicates redness or inflammation of the skin or mucous membranes.

Generalized pain

Generalized pain is nonspecific pain and is usually described as achy all over.

Today you are assigned to care for a patient who has tuberculosis. What equipment should you routinely use when caring for this patient?

HEPA respirator: CDC and OSHA have guidelines for health care workers who care for patients with active TB. The use of a high-efficiency particulate mask is necessary because TB is transmitted by inhalation of droplets that remain suspended in the air when the patient coughs, sneezes, speaks, or sighs.

Handicap

Handicap is a disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a role that is normal for that particular individual.

health record

Health record is the comprehensive data about a patient.

Hegar's sign

Hegar's sign is a softening of the isthmus of the uterus and indicates a high likelihood that the woman is pregnant.

Herpes simplex, type 1

Herpes simplex, type 1, is commonly known as a cold sore.

hyperkalemia

Hyperkalemia is an elevated level of potassium and is considered the most dangerous. It can lead to serious arrhythmias or cardiac arrest.

Hyperlipidemia

Hyperlipidemia is a risk factor for cardiovascular disease. The ratio of high-density lipoproteins (HDLs) to low-density lipoproteins (LDLs) is the best predictor for cardiovascular disease. A diet high in saturated fat, calories, and cholesterol contributes to hyperlipidemia. Dietary control is an important factor in modifying the risk factor.

Hypermagnesemia

Hypermagnesemia restricts nerve and muscle activity but is not the most dangerous of the disorders listed.

Hypernatremia

Hypernatremia causes cellular dehydration and an interruption in cellular processes, but it is not the most dangerous of the disorders listed.

You are caring for a recently admitted patient who has suffered a pelvic fracture. In planning your nursing care, you recognize that the most serious physical assessment finding to report is:

Hypotension, tachycardia, and hematuria are signs of possible shock from hemorrhage. Hemorrhage is by far the most life-threatening complication to a patient with a pelvic fracture.

Hypotonic solution

Hypotonic solution is a solution of lower osmotic pressure that moves fluid into the cells, causing them to enlarge.

A car accident victim was ejected from the car. It has been determined that his airway needs to be opened. What is the most appropriate method for the rescuer to use?

If a neck injury is suspected, the face thrust with head tilt is used.

Normal Fasting blood glucose level

If you had a fasting blood glucose test, a level between 70 and 100 milligrams per deciliter (mg/dL) is considered normal.

Dyspepsia

Indigestion (dyspepsia) is a mild discomfort in the upper belly or abdomen,it occurs during or right after eating.

When infusing blood rapidly, the nurse knows that the size of catheter to be used is _____ gauge.

Infusing blood rapidly should be administered through an 18- or 19-gauge catheter to prevent hemolysis of the red blood cells or destruction of the components.

Magnetic resonance imaging

Magnetic resonance imaging is a painless diagnostic procedure that does not involve any exposure to radiation. As the person reclines on a narrow surface moved into a cylindrical tunnel containing magnetic coils, radiofrequency energy waves produce signals that are processed by a computer and displayed as images on a video monitor.

The main reason an increased number of debilitating chronic illnesses are now seen in home health care settings is:

Many illness are medically managed and controlled rather than cured, leading to an increasing number of debilitating chronic illnesses.

Which of the following is true regarding cell mechanisms and growth? Abnormal cell growth or proliferation equates with cancer. Cancer cells divide and multiply in the same manner as the cells from which they are derived. The loss of immunosurveillance, or B-cell function, increases the risk of certain cancers. Metastasis can occur via direct spread, circulation, or transplantation.

Metastasis can occur via direct spread, circulation, or transplantation.

Which action is most important for the practical nurse (PN) to implement for a client who has a Stage I pressure ulcer? Debride ulcer using a wet to dry dressing. Apply an antibiotic ointment to the wound. Encourage intake of additional vitamin C. Monitor client's serum pre-albumin levels.

Monitor client's serum pre-albumin levels.

Indications for the use of central lines include:

Monitoring of the central venous pressure (CVP) in acutely ill patients to quantify fluid balance Long-term Intravenous antibiotics Long-term Parenteral nutrition especially in chronically ill patients Long-term pain medications Chemotherapy Drugs that are prone to cause phlebitis in peripheral veins (caustic), such as: Calcium chloride Chemotherapy Hypertonic saline Potassium chloride (KCL) Amiodarone vasopressors (e.g. epinephrine, dopamine) Plasmapheresis Peripheral blood stem cell collections Dialysis Frequent blood draws Frequent or persistent requirement for intravenous access Need for intravenous therapy when peripheral venous access is impossible Blood Medication Rehydration

Monocytes

Monocytes are WBCs that function similarly to neutrophils. They circulate in the bloodstream and move into tissue, where they engulf foreign antigens and cell debris. Normal values of monocytes are 2% to 6%.

mottling or mottled

Mottling or mottled skin refers to blood vessel changes in the skin that cause a patchy appearance.

Multiple myeloma

Multiple myeloma is a malignant neoplastic immunodeficiency disease of the bone marrow. The tumor, composed of plasma cells, destroys osseous tissue, especially in flat bones, causing pain, fractures, and skeletal deformity.

Myelography

Myelography is an imaging examination that involves the introduction of a spinal needle into the spinal canal and the injection of contrast material in the space around the spinal cord and nerve roots (the subarachnoid space) using a real-time form of x-ray called fluoroscopy.

Myocarditis

Myocarditis is an inflammation of the myocardium, the middle layer of the heart wall. Myocarditis is usually caused by a viral infection. Signs and symptoms of myocarditis include chest pain, heart failure and abnormal heart rhythms. If myocarditis becomes severe, the pumping action of your heart weakens, and your heart won't be able to supply the rest of your body with enough blood. Clots also could form in your heart, leading to a stroke or heart attack.

Neutrophils

Neutrophils are granular circulating leukocytes essential for phagocytosis and release of lysozyme. The normal value of neutrophils is 60% to 70%.

2+ edema

Obvious edema of the lower extremities is documented as 2+

osmosis

Osmosis is an example of a passive transport process.

Physician's orders

Physician's orders are where a doctor prescribes medications, treatments, or diagnostic tests.

What are the possible complications of any type of catheterization?

Possible complications of any type of catheterization include the following: Bleeding, infection, and pain at the IV or sheath insertion site Damage to the blood vessels Blood clots Kidney damage due to the contrast dye (more common in patients with diabetes or kidney problems)

Posterior

Posterior refers to the back of the body.

When charting by exception, which acronym is generally used?

Problem, intervention, and evaluation (PIE) arose from the nursing process and often is used when charting by exception.

speech therapy

Speech therapy assists with disorders affecting normal oral communication.

Stage IV pressure ulcer

Stage IV is a full-thickness skin loss that occurs with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures.

Suppression

Suppression is the intentional exclusion of painful thoughts, experiences, or impulses.

Supraventricular tachycardia

Supraventricular tachycardia is the sudden onset of a rapid heartbeat, originating in the atria. It is characterized by a pulse rate of 150 to 250 beats per minute. The patient with supraventricular tachycardia may experience palpitations, lightheadedness, dyspnea, and angina.

Tachycardia

Tachycardia is where a patient's heart rate is greater than 100 beats per minute

The final phase of mitosis, in which the two nuclei appear and the chromosomes disperse is called:

Telophase is the final phase of mitosis, in which the two nuclei appear and the chromosomes disperse.

Tension pneumothorax

Tension pneumothorax: The accumulation of air under pressure in the pleural space. An imminent danger is that the lung will collapse under the pressure. In tension pneumothorax, what happens is that air enters the pleural cavity and is trapped there during expiration so the air pressure within the thorax mounts higher than atmospheric pressure, compresses the lung, may displace the mediastinum and its structures (including the lung) toward the opposite side, and cause cardiopulmonary impairment. Also called pressure pneumothorax.

The role of the Licensed Practical Nurse in writing a nursing diagnosis is:

The LPN/LVN is to work with the supervising RN to determine if the correct problem(s) have been identified and are accurate.

Type A Blood

The RBCs of type A contain type A antigen and the plasma contains anti-B antibodies.

Yankauer suction tip

The Yankauer suction tip (pronounced yang´kow-er) is an oral suctioning tool used in medical procedures. It is typically a firm plastic suction tip with a large opening surrounded by a bulbous head and is designed to allow effective suction without damaging surrounding tissue.

TED stockings

The application of thromboembolic deterrent (TED) hose is an antiembolism measure.

The body has systems that work to keep the pH in the narrow range of normal. These systems include the:

The blood buffers, respiratory systems, and kidneys are the body's three lines of defense that are constantly working to maintain a normal pH.

When preparing a liquid medication, where on the dosage cup is the amount read?

The cup needs to be at eye level and read at the lower level of the meniscus, or the curve formed by the liquid's upper surface.

cervical cord injury

The level of injury is a cervical spine C2 to C7 and involves paralysis of all extremities and trunk with respiratory failure

A patient delivered her infant 36 hours ago. She is sitting in bed when she feels a gush of warm fluid between her legs. She calls the nurse, who finds her bleeding. This is an example of late postpartum hemorrhage. The most common cause of late postpartum hemorrhage is:

The most common cause of late postpartum hemorrhage is retained fragments of the placenta.

Normal WBCs count range

The normal number of WBCs in the blood is 4,500-10,000 white blood cells per microliter (mcL).

nurses notes

The nurses notes are where nurses document their observation, care given, and patient responses.

Walk-through Angina:

The pain subsides as patient continues the activity.

The nurse is instructing a new mother about treatment for mastitis. Which of the following statements by the patient indicates the need for further teaching?

The patient will need to continue breast-feeding or use a breast pump to empty the breast and prevent milk stasis.

erythropoietin (EPO)

The primary role of erythropoietin is an essential hormone for red cell production. Without it, definitive erythropoiesis does not take place. Erythropoietin (EPO) is a hormone produced by the kidney that promotes the formation of red blood cells by the bone marrow. The kidney cells that make erythropoietin are sensitive to low oxygen levels in the blood that travels through the kidney.

Brain aneurysm

The wall of an artery (blood vessel) in the brain can become weak and balloon outward. This outward pouch is called an aneurysm (ANN-your-izm). You may hear it called a cerebral (seh-REE-brul) aneurysm. An aneurysm has thin walls. It can easily leak — or rupture — into the fluid-filled space that surrounds the brain. When this occurs, it is called a subarachnoid (sub-uh-RACK-noid) hemorrhage (HEM-ir-ij). This bleeding in the brain can lead to brain damage, disability, or death.

Threatened spontaneous abortion

Threatened spontaneous abortion is unexplained bleeding and cramping. The fetus may or may not be alive. Membranes remain intact and the cervical os remains closed

Trigeminal neuralgia

Trigeminal neuralgia is a disorder of cranial nerve 5 (the trigeminal nerve), caused by pressure on the nerve or degeneration, due to unknown reasons. It is characterized by excruciating, knifelike pain in the lips, upper or lower gums, cheek, forehead, or side of the nose.

ataxia

Uncoordinated movement is due to a muscle control problem that causes an inability to coordinate movements. It leads to a jerky, unsteady, to-and-fro motion of the middle of the body (trunk) and an unsteady gait (walking style). It can also affect the limbs.

Ventriculoperitoneal shunting

Ventriculoperitoneal shunting is surgery to treat excess cerebrospinal fluid (CSF) in the brain (hydrocephalus).

jugular venous distension

When the blood pressure in the jugular vein is higher than normal, its walls can swell or distend, resulting in a condition known as jugular venous distension. An elevated jugular venous pressure is the classic sign of right-sided heart failure.

What are the symptoms of bacterial meningitis?

You want to watch for high fever, headaches, and an inability to lower your chin to your chest due to stiffness in the neck. In older children and adults, you may see confusion, irritability, increasing drowsiness. Seizures and stroke may occur. In young children, the fever may cause vomiting and they may refuse to eat. Young children may become very irritable and cry. There may be seizures. Also, because the fluid around the skull may become blocked their heads may swell. The onset of symptoms is fast, within 24 hours. If allowed to progress, you can die from bacterial meningitis.

(PCA) infusion pump

a patient-controlled analgesia pump

An irreversible illness that may develop as a "normal" part of aging is a(n): chronic illness acute illness Disability Impairment

chronic illness

Molecule

two or more atoms that have combined to form a substance.

hematemesis

vomiting of blood

Give another name for heterograft?

xenograft

A client's serum potassium level is 2.9 mEq/L. Which is the most important finding that the practical nurse (PN) should report to the charge nurse? Bowel sounds hypoactive. Mental confusion noted. Urine copious and clear yellow. Pulse rate weak and irregular.

...

LEFT HEMIPLEGIA

...

Psoriasis

...

3+ pitting edema

3+ pitting edema is noticeably deep pitting, full and edematous extremity, with depression lasting more than 1 minute

Cholecystogram

A cholecystogram is another term for an oral cholecystography (OCG).

colonoscopy

A colonoscopy is a study of the colon (from anus to cecum that uses an endoscope.

Changing decubiti dressings for an immobile client.

A decubitus ulcer, also called a pressure sore or bed sore, is an open wound on your skin.

Which of the following should be included when writing a resume? Select all that apply. Name, complete address, telephone number Clear labels for each section Work experience after education Previous employment from earliest jobs to most recent jobs A font that is easy to read

A font that is easy to read You should cover your work experience before your education experience. Name, complete address, telephone number ?

A low-grade fever the first 24 hours after delivery is a normal postpartum physical sign or symptom. True or False?

A low-grade fever the first 24 hours (not 48) after delivery is a normal postpartum physical sign or symptom.

The nurse is caring for a patient in labor. While assessing the patient's vital signs, the nurse notes that the patient's blood pressure has dropped. To prevent supine hypotension, what position should the nurse encourage the patient to be in?

A semirecumbent position helps reduce pressure on the maternal vessels and prevents their compression.

While reviewing fire safety, a type C fire extinguisher can only be used on which type of fire?

A type C fire extinguisher is used for electrical fires.

Herpes simplex, type 2:

Herpes simplex, type 2, usually affects the cervix in women and the penis in men. Herpes simplex, type 2 causes lesions in the genital area and is commonly known as genital herpes. The primary mode of transmission is through sexual contact. Herpes simplex, type 1 is characterized by a vesicle at the corner of the mouth, lips, or nose. Herpes simplex, type 2, is accompanied by flulike symptoms 3 to 4 days after the vesicles erupt. Headache, fatigue, myalgia, elevated temperature, and anorexia are common.

Hirschsprung's disease

Hirschsprung's disease is a functional intestinal obstruction and is commonly seen in children with trisomy 21.

Urticaria

Hives or Urticaria is an allergic reaction commonly caused by drugs, food, insect bites, inhalants, emotional stress, or exposure to heat or cold. It is caused by the release of histamine in an antigen-antibody reaction. Capillaries dilate, resulting in increased permeability; respiratory involvement may occur.

Homocysteine

Homocysteine is not a cardiac marker. It is an amino acid produced during protein digestion. Elevated levels of homocysteine may act as an independent risk factor for ischemic heart disease, cerebrovascular disease, peripheral arterial disease, and venous thrombosis. It appears to promote the development of atherosclerosis by causing endothelial damage, promoting LDL deposits, and promoting vascular smooth muscle growth.

Hydrocephalus

Hydrocephalus is a buildup of fluid inside the skull that leads to brain swelling. Hydrocephalus means "water on the brain." Hydrocephalus is due to a problem with the flow of the fluid that surrounds the brain. This fluid is called the cerebrospinal fluid, or CSF. The fluid surrounds the brain and spinal cord, and helps cushion the brain.CSF normally moves through the brain and the spinal cord, and is soaked into the bloodstream. CSF levels in the brain can rise if: The flow of CSF is blocked. The fluid does not get absorbed into the blood properly. The brain makes too much of the fluid. Too much CSF puts pressure on the brain. This pushes the brain up against the skull and damages brain tissue.

Hypercalcemia

Hypercalcemia can depress neuromuscular activity and lead to the development of renal calculi, but it is not the most dangerous of the disorders listed.

Conditions of Sodium Imbalance

Hyperkalemia (hyper=too much + kal=potassium + emia=in the blood) is a potentially life-threatening situation because it causes abnormal electrical conduction in the heart and potentially life-threatening heart rhythm problems. High potassium levels are most often associated with kidney failure, in which potassium levels build up and cannot be excreted in the urine. Medications can be used to lower potassium levels until the kidneys are able to excrete the excess in the urine. However, emergency dialysis may be required to remove the potassium if kidney function is poor. Hypokalemia (hypo=too little) is most often seen when the body loses too much potassium from causes like vomiting, diarrhea, sweating, and medications like diuretics or laxatives. It is often seen in diabetic ketoacidosis, where potassium is excessively lost in the urine. Since chemicals in the body are related in their metabolism, low magnesium levels can be associated with hypokalemia.

Of all the electrolyte disorders, which disorder is considered the most dangerous and potentially fatal?

Hyperkalemia is an elevated level of potassium and is considered the most dangerous. It can lead to serious arrhythmias or cardiac arrest.

Conditions of Sodium Imbalance

Hypernatremia (hyper= too much + natr= sodium + emia=in the blood) is usually associated with dehydration, and instead of having too much sodium, there is too little water. This water loss can occur from illnesses with vomiting or diarrhea, excessive sweating from exercise or fever, or from drinking fluid that has too high concentrations of salt. Hyponatremia (hypo=too little) is caused by water intoxication (drinking so much water that it dilutes the sodium in the blood and overwhelms the kidney's compensation mechanism) or by a syndrome of inappropriate anti-diuretic hormone secretion (SIADH). SIADH can be associated with illnesses like pneumonia, brain diseases, cancer, thyroid problems, and some medications.

Hypertrophic pyloric stenosis

Hypertrophic pyloric stenosis is an obstruction in which the gastric outlet is mechanically blocked by a congenitally hypertrophied pyloric muscle. It is most commonly seen in infants younger than age 6 months.

INR test

INR (international normalized ratio) stands for a way of standardizing the results of prothrombin time tests, no matter the testing method. So your doctor can understand results in the same way even when they come from different labs and different test methods. In some labs, only the INR is reported and the PT is not reported. Blood clotting factors are needed for blood to clot (coagulation). Prothrombin, or factor II, is one of the clotting factors made by the liver. Vitamin K is needed to make prothrombin and other clotting factors. Prothrombin time is an important test because it checks to see if five different blood clotting factors (factors I, II, V, VII, and X) are present. The prothrombin time is made longer by: Blood-thinning medicine, such as warfarin. Low levels of blood clotting factors. A change in the activity of any of the clotting factors. The absence of any of the clotting factors. Other substances, called inhibitors, that affect the clotting factors. An increase in the use of the clotting factors. An abnormal prothrombin time is often caused by liver disease or injury or by treatment with blood thinners.

The LPN/LVN is transcribing the physician's orders from her patient's record to the MAR and is having a difficult time reading the orders. What is the most appropriate next step for the LPN/LVN to do? Transcribe what she thinks the order is. Verify that the chart is for the right patient. Verify with another nurse; if still unsure, call the physician. Skip the order and come back when finished with other orders.

If a nurse is unsure of a written order, then he or she needs to clarify the order with another nurse, and if still unclear, to call the physician for clarification.

Treatment for a pneumothorax

If a small portion of your lung is collapsed, your doctor may simply monitor your condition with a series of chest X-rays until the air is completely absorbed and your lung has re-expanded. Normally this takes a week or two. Supplemental oxygen can speed the absorption process. If a larger area of your lung has collapsed, it's likely that a needle or chest tube will be used to remove the air. The hollow needle or tube is inserted between the ribs into the air-filled space that is pressing on the collapsed lung. With the needle, a syringe is attached so that the doctor can pull out the excess air — just like a syringe is used to pull blood from a vein. Chest tubes are often attached to a suction device that continuously removes air from the chest cavity. If a chest tube doesn't resolve your problem, surgery may be necessary to close the air leak. In most cases, the surgery can be performed through small incisions, using a tiny fiber-optic camera and narrow, long-handled surgical tools. The surgeon will look for the leaking bleb and sew it closed. In some cases, a substance like talc may be blown in through the tube to irritate the tissues around the lung so that they'll stick together and seal any leaks. Rarely, the surgeon will have to make a larger incision between the ribs to get better access to multiple or larger air leaks.

Your older adult patient says to you, "All of my friends have cancer, it seems. Why is that?" In formulating your response, you recall the following true statement(s) about cancer and the older adult? Breast and lung cancers are rarely seen in older adults. The incidence of cancer increases with age. Multiple myeloma is seen more frequently in young adults than in older adults. It is easy to distinguish between cancer and normal changes of aging.

If cancer has already metastasized to other areas of the body, surgery may provide palliation by relieving some of the associated problems, such as obstruction, ulceration, hemorrhage, and pain. The use of laser beam as an alternative to some surgical procedures is increasing. It vaporizes tissue with little bleeding and low risk of infection. The major uses for laser surgery are in ophthalmology, gynecology, urology, neurosurgery, and otolaryngology. When surgery may result in an altered body image, such as with mastectomy, laryngectomy, or the formation of an ostomy, the patient may benefit from talking with another patient who has undergone a similar operation. The American Cancer Society sponsors support groups and prepares volunteers to visit people who need these types of surgeries.

Which of the following factors increases the probability of vertical transmission of an HIV infection? The mother is in the initial stage of the HIV infection. The mother's viral load is low. The baby is born at term. The mother has good nutritional status.

If the mother is in the initial stage of the HIV infection, there is an increased chance of vertical transmission of an HIV infection, because the initial and later stages of infection are the times when more virus is circulating in the mother's blood and body fluids.

Random Blood Glucose Level

If you had a random blood glucose test, a normal result depends on when you last ate. Most of the time, the blood glucose level will be below 125 mg/dL.

Immune dysfunction in HIV disease results primarily from dysregulation and dysfunction of (select all that apply): T-helper cells CD4+ lymphocytes B cells ZDV cells

Immune dysfunction in HIV disease results primarily from dysregulation and dysfunction of the T-helper cells, also known as the CD4+ lymphocytes. These cells are targeted because they have more CD4+ receptors on their surfaces than other cells. The CD4+ lymphocytes play a pivotal role in the ability of the immune system to recognize and defend against foreign invaders. CD4+ lymphocytes are another name for the T-helper cells.

You are caring for a patient who has had an organ transplant. She is asking you about rejection and medications used to prevent it. In answering her question, you base your response on your knowledge that (select all that apply): Immunosuppressive therapy is helpful in slowing the process of graft rejection. Tissue rejection usually occurs within 2 to 4 days of transplantation. Antigenic determinants on the cells lead to graft rejection via the immune process. Infection is a threat to the patient receiving immunosuppressive therapy.

Immunosuppressive therapy is helpful in slowing the process of graft rejection. Immunosuppressive therapy agents typically used include corticosteroids, cyclosporine, and azathioprine. Antigenic determinants on the cells lead to graft rejection via the immune process. Therefore, recipient tissue is matched as closely as possible to donor tissue antigenic determinants prior to transplantation. Tissue matching leads to a better chance of success. Infection is a threat to the patient receiving immunosuppressive therapy. Meticulous aseptic technique is required when caring for a patient on immunosuppressive therapy. Prophylactic antibiotic therapy may be advisable, and good skin care is necessary. Visitors are limited; individuals with infection are not allowed at the bedside

Immunotherapy

Immunotherapy is the technique of assisting the body to develop immunity by way of injecting a diluted antigen, in a series of injections of increasing strength, over a 1- to 3-year period. The theory behind immunotherapy is to assist the individual to build a tolerance to the antigen without developing fever or increased signs and symptoms. It is also known as desensitization.

The technique of assisting the body to develop immunity by way of injecting a diluted antigen, in a series of injections of increasing strength, over a 1- to 3-year period is known as: Immunization Immunotherapy Vaccination Anaphylaxis

Immunotherapy is the technique of assisting the body to develop immunity by way of injecting a diluted antigen, in a series of injections of increasing strength, over a 1- to 3-year period. The theory behind immunotherapy is to assist the individual to build a tolerance to the antigen without developing fever or increased signs and symptoms. It is also known as desensitization.

You have a pediatric patient who is being evaluated for a skin rash. The preliminary diagnosis is impetigo contagiosa. When asked about her condition, you remember that impetigo contagiosa:

Impetigo contagiosa is a bacterial skin infection, usually caused by Staphylococcus aureus, streptococci, or mixed bacteria. Impetigo contagiosa is a highly contagious inflammatory disorder. It is highly contagious to a person who directly contacts the exudate of a lesion. Impetigo contagiosa usually presents with a rash on the patient's face, hands, arms, and legs. Impetigo contagiosa is present in all age groups, but especially children.

Normal blood amylase and lipase levels:

In a healthy individual, a normal blood amylase level is 23-85 U/L (some lab results go up to 140 U/L). A normal lipase level is 0-160 U/L. If the pancreas is damaged, these digestive enzymes can be found in the blood at higher levels than normal. Blood levels more than four times normal levels of amylase (>450 U/L) and lipase (>400 U/L), likely indicate pancreatic damage or pancreatitis.

Anaphase

In anaphase, chromosomes are pulled to opposite ends of the cell and cell division begins.

A new LPN/LVN is seeking a place of employment. Which type of facility allows an LPN/LVN to advance to charge nurse and supervisory capacity with RN supervision? Hospital Home health agency Physician's office Long-term care facility

In long-term care facilities, the LPN is the backbone and has the opportunity to advance to supervisor under an RN direction.

Incomplete spontaneous abortion

Incomplete spontaneous abortion is the termination of pregnancy before 20 weeks and some, but not all, of the products of conception are expelled.

You are caring for a patient with hemophilia. Which of the following nursing diagnoses would you expect to see on his nursing care plan? Select all that apply.

Ineffective tissue perfusion will probably be on the nursing care plan; this is related to blood loss from his coagulation deficit. Fluid volume deficit will likely be on the nursing care plan; this is related to blood loss. Anxiety is a likely nursing diagnosis for this patient, as bleeding from coagulation deficits can be life threatening. missing ?

Inevitable spontaneous abortion

Inevitable spontaneous abortion is when bleeding increases and the cervical os begins to dilate. Membranes may rupture.

The most severe risk for a patient with agranulocytosis is that of:

Infection: The most severe risk for a patient with agranulocytosis is that of infection. Agranulocytosis is a potentially fatal condition of the blood characterized by a severe reduction in the number of granulocytes. Both the WBC count and the differential neutrophil counts are extremely low. The patient with this disorder is highly susceptible to a life-threatening infection.

Infiltration of WBCs into patient organs

Infiltration of WBCs into patient organs is not a blood dyscrasia, although it does occur in leukemia. Infiltration of WBCs into patient organs leads to problems such as splenomegaly, hepatomegaly, bone pain, meningeal irritation, and oral lesions. Enlarged lymph nodes and painless splenomegaly may be the first manifestations of the disease in some patients.

Intracerebral hemorrhage

Intracerebral hemorrhage occurs when a diseased blood vessel within the brain bursts, allowing blood to leak inside the brain. The sudden increase in pressure within the brain can cause damage to the brain cells surrounding the blood. If the amount of blood increases rapidly, the sudden buildup in pressure can lead to unconsciousness or death. Intracerebral hemorrhage usually occurs in selected parts of the brain, including the basal ganglia, cerebellum, brain stem, or cortex. The most common cause of intracerebral hemorrhage is high blood pressure (hypertension). Less common causes of intracerebral hemorrhage include trauma, infections, tumors, blood clotting deficiencies, and abnormalities in blood vessels (such as arteriovenous malformations).

Intracostal muscle

Intracostals are muscles between the ribs.

Intrauterine infection

Intrauterine infection is characterized by thick, cloudy, foul-smelling amniotic fluid.

The practical nurse (PN) is checking client care equipment in the clinic for proper functionality. Which finding should the PN identify as a piece of equipment in need of repair? Pulse oximeter shows "no pulse detected". Glucometer consistently reading "lo". Intravenous pump alarms constantly. Blood pressure cuff pops off during inflation.

Intravenous pump alarms constantly.

Which equipment malfunction should the practical nurse (PN) report as having the highest risk to client safety? Electronic thermometer does not register a temperature. Intravenous pump screen does not light up when turned on. Gauges on a tank do not move when regulator is attached. Fingerstick glucose monitor reads "quality control required."

Intravenous pump screen does not light up when turned on.

A nurse is caring for a 4-year-old child with abdominal pain related to an intestinal obstruction. The nurse knows that the most common cause of intestinal obstruction in a child this age is:

Intussusception is the result of one portion of the intestine telescoping into another. It occurs most commonly in a child between the ages of 3 months and 6 years.

The nurse is caring for a patient who is being treated with antipsychotic medications. As part of the plan of care, the nurse monitors the patient for dyskinesia. With dyskinesia, the nurse would see:

Involuntary movements of the mouth and tongue; Dyskinesia is an extrapyramidal symptom of pseudoparkinsonism characterized by involuntary movements, like lip smacking or tongue protruding.

Ipsilateral pupil dilation

Ipsilateral pupil dilation will occur due to compression of cranial nerve III (oculomotor) when the lesion is in one hemisphere. This occurs later in the process of increased intracranial pressure, when herniation is imminent.

Your patient is admitted for dehydration. Which type of IV fluid might the physician order to expand the body's fluid volume?

Isotonic solution is a solution of the same osmotic pressure that expands the body's fluid volume without causing a fluid shift from one compartment to another.

Since the patient's medical record is a legal document, the nurse know that it is important to chart:

It is always important to chart in a very detailed, defensive manner for reimbursement purposes and in case the health record is called into court.

Rehabilitation nurses have a unique position within the disciplinary team in that they:

It is the rehabilitation nurse who reinforces teaching and training completed by the other disciplines on a 24 hours a day, 7 days a week basis and Are the only team member with the patient on a 24-hour basis

Jaundice

Jaundice indicates a problem with the liver. Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. As red blood cells break down, your body builds new cells to replace them. The old ones are processed by the liver. If the liver cannot handle the blood cells as they break down, bilirubin builds up in the body and your skin may look yellow.

Jugular Venous Distension and Fluid Overload

Jugular Venous Distension and Fluid Overload: Congestive heart failure is a condition in which the heart fails to keep blood moving adequately. As a result, the supply of blood to the body's tissues decreases, lowering efficiency and endurance. With poor circulation, the kidneys fail to remove enough waste products, water and salt from the blood. In addition, the kidneys, because of the decreased blood flow presented to them, retain even more salt and water in an effort to increase blood volume. The increased blood volume makes more work for the already overworked heart, which may enlarge and beat faster in an attempt to provide the body with oxygen-rich blood. The veins distend with fluid and the blood volume increases. At the same time, there's a shift in the balance of pressures between fluids inside and outside the blood vessels, which causes fluid that normally stays in the bloodstream to leak into surrounding tissue. This fluid leakage is a primary factor in fluid overload in the lungs, abdomen and/or legs.

The physician is performing Leopold's maneuver on your laboring patient to check for fetal position. The most common position for delivery is:

LOA stands for left occipitoanterior, the most common position for delivery. ROA stands for right occipitoanterior. It is the second most common position for delivery.

Laminectomy

Laminectomy is surgery that creates space by removing the lamina — the back part of the vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.

A pregnant patient comes to the clinic for a prenatal visit. She complains of being frequently awakened at night by leg cramps. The nurse gives instructions to:

Leg cramps often occur in pregnancy, possibly due to pressure on the pelvic blood vessels and nerves or altered calcium and phosphorus. Dorsiflexion of the foot may help reduce these cramps.

A patient who receives oxygen via the transtracheal method usually achieves adequate oxygenation with:

Less oxygen flow than with other systems

Leukopenia

Leukopenia (also known as leukocytopenia or leucopenia) is a decrease in the number of white blood cells (leukocytes) found in the blood, which places individuals at increased risk of infection.

Leukopenia

Leukopenia, or a reduction in the number of circulating white blood cells, is a common problem for patients receiving chemotherapy, due to bone marrow depression. It can render the patient susceptible to life-threatening infections.

The nurse who is credited as being the first psychiatric nurse is:

Linda Richards, who practiced in the 1880s, has been credited as the first psychiatric nurse.

Linea nigra

Linea nigra is a line that is midline of the abdomen from the pubis to the umbilicus that darkens during pregnancy as a result of an increased amount of hormones.

Lipase

Lipase is produced by the pancreas to digest fats into fatty acids. Sugars and fatty acids can then be absorbed by the small intestine.

Lymphedema

Lymphedema is a primary or secondary disorder characterized by the accumulation of lymph in soft tissue and edema. This can be caused by obstruction, increased amount of lymph, or removal of lymph channels and nodes; it may be hereditary.

What is the function of the electrolyte magnesium?

Magnesium (Mg): Magnesium is an often forgotten electrolyte that is involved with a variety of metabolic activities in the body, including relaxation of the smooth muscles that surround the bronchial tubes in the lung, skeletal muscle contraction, and excitation of neurons in the brain. Magnesium acts as a cofactor in many of the body's enzyme activities. Magnesium levels in the body are closely linked with sodium, potassium, and calcium metabolism; and are regulated by the kidney. Magnesium enters the body through the diet, and the amount of the chemical that is absorbed depends upon the concentration of magnesium in the body. Too little magnesium stimulates absorption from the intestine, while too much decreases the absorption.

Your patient is going for a diagnostic test. You listen as the physician explains the procedure to the patient. The physician states that the test involves the use of differential signal characteristics of flowing blood to evaluate extracranial and intracranial blood vessels. In preparing to further answer your patient's questions, you realize that the diagnostic test being described is:

Magnetic resonance angiography (MRA) involves the use of differential signal characteristics of flowing blood to evaluate extracranial and intracranial blood vessels. It provides both anatomical and hemodynamic information and can be done with or without contrast media. This test is rapidly replacing cerebral angiography for use in diagnosing cerebrovascular diseases.

MICU

Medical Intensive Care Unit

bacterial meningitis

Meningitis is a bacterial infection of the membranes covering the brain and spinal cord (meninges). Meningitis can be caused by a bacterial, fungal or viral infection. Meningitis can be acute, with a quick onset of symptoms, it can be chronic, lasting a month or more, or it can be mild or aseptic.

The LPN is working in a long-term care facility. Which of the following analgesics is a particularly poor choice for pain control in older adults?

Meperidine (Demerol) should not be used in those who have decreased renal function. Generally, older adults have some degree of decreased renal function.

Metabolic disease

Metabolic disease is caused by a dysfunction that results in a loss of metabolic control of homeostasis in the body. A metabolic disorder occurs when abnormal chemical reactions in your body disrupt this process. When this happens, you might have too much of some substances or too little of other ones that you need to stay healthy.

What are the 3 routes of metastasis?

Metastasis can occur via direct spread (diffusion to other body cavities), circulation (via blood and lymphatic channels), or transplantation (direct transport of tumor cells from one site to another).

Midazolam (Injection Route) (Versed)

Midazolam is used to produce sleepiness or drowsiness and to relieve anxiety before surgery or certain procedures. Midazolam is also given to produce amnesia (loss of memory) so that the patient will not remember any discomfort or undesirable effects that may occur after a surgery or procedure . It is also used to produce loss of consciousness before and during surgery. Midazolam is sometimes used in patients in hospital intensive care units to cause unconsciousness. This may allow the patient to withstand the stress of being in the intensive care unit and help the patient cooperate when a machine must be used to assist with breathing.

You are caring for a patient with a new pacemaker. Nursing care for this patient would include which of the following?

Monitoring the heart rate and rhythm by apical pulse and ECG patterns. Nursing care for a patient with new pacemaker would include closely monitoring heart rate and rhythm by apical pulse and ECG patterns. Also, vital signs and level of consciousness are checked frequently. The insertion site is observed for erythema, edema, and tenderness, which could be signs of infection. Performing range of motion every 4 hours to the arm on the pacemaker side would be inappropriate. The arm on the pacemaker side should be immobilized for the first few hours, and the patient should not raise the arm above his or her head for several days. After this time, normal activities can be resumed. Scheduling of an MRI to verify pacemaker placement would be inappropriate. The patient must avoid proximity to high-output generators and to large magnets, such as MRI scanners. Bedrest for 24 hours is not necessary for a patient with a new pacemaker. Nursing care for a patient with a new pacemaker would include bedrest for the first few hours only, unless unexpected complications occurred. Performing range of motion every 4 hours to the arm on the pacemaker side would be inappropriate. The arm on the pacemaker side should be immobilized for the first few hours, and the patient should not raise the arm above his or her head for several days. After this time, normal activities can be resumed.

Name the 3 main functions of monocytes in the immune sytem?

Monocytes and their macrophage and dendritic-cell progeny serve three main functions in the immune system. These are phagocytosis, antigen presentation, and cytokine production. Phagocytosis is the process of uptake of microbes and particles followed by digestion and destruction of this material. Monocytes can perform phagocytosis using intermediary (opsonising) proteins such as antibodies or complement that coat the pathogen, as well as by binding to the microbe directly via pattern-recognition receptors that recognize pathogens. Monocytes are also capable of killing infected host cells via antibody-dependent cell-mediated cytotoxicity. Vacuolization may be present in a cell that has recently phagocytized foreign matter.

Causes of Aortic Aneurysm

Most aortic aneurysms occur in the part of your aorta that's in your abdomen. Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including: Tobacco use. Cigarette smoking and other forms of tobacco use appear to increase your risk of aortic aneurysms. In addition to the damaging effects that smoking causes directly to the arteries, smoking contributes to the buildup of fatty plaques in your arteries (atherosclerosis) and high blood pressure. Smoking can also cause your aneurysm to grow faster by further damaging your aorta. Hardening of the arteries (atherosclerosis). Atherosclerosis occurs when fat and other substances build up on the lining of a blood vessel, increasing your risk of an aneurysm. Infection in the aorta (vasculitis). In rare cases, abdominal aortic aneurysm may be caused by an infection or inflammation that weakens a section of the aortic wall. Aneurysms can develop anywhere along the aorta, but when they occur in the upper part of the aorta, they are called thoracic aortic aneurysms. More commonly, aneurysms form in the lower part of your aorta and are called abdominal aortic aneurysms. These aneurysms may also be referred to as AAA or triple A.

Your patient with rheumatoid arthritis is asking you about her condition. You base your patient teaching on the knowledge that:

Most patients affected by rheumatoid arthritis are women of childbearing age. Rheumatoid arthritis is a chronic systemic disease. It can affect many organ systems and is characterized by chronic inflammation of the synovial membrane of the diarthrodial joints (freely moveable joints in which continuous bony surfaces are covered by cartilage and connected by ligaments lined with synovial membrane). Rheumatoid arthritis is thought to be an autoimmune disorder, although there is evidence of genetic predisposition. Exercise is encouraged for the patient with rheumatoid arthritis to prevent the joints from "freezing" and the muscles from weakening.

A client has an automatic blood pressure cuff on the right arm where an intravenous (IV) is infusing. In the left arm, a saline lock is present. The practical nurse (PN) notes the presence of blood in the IV infusion line. What action should the PN implement? Discontinue the intravenous infusion. Pause the infusion to take the blood pressure. Move the blood pressure cuff to the left arm. Ask the charge nurse to move the infusion site.

Move the blood pressure cuff to the left arm.

Multiple sclerosis (MS)

Multiple sclerosis (MS) is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord (central nervous system).Multiple sclerosis (MS) is a disease in which your immune system attacks the protective sheath (myelin) that covers your nerves. Myelin damage disrupts communication between your brain and the rest of your body. Ultimately, the nerves themselves may deteriorate, a process that's currently irreversible.Signs and symptoms vary widely, depending on the amount of damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others experience long periods of remission during which they develop no new symptoms. In MS, this process destroys myelin — the fatty substance that coats and protects nerve fibers in the brain and spinal cord. Myelin can be compared to the insulation on electrical wires. When myelin is damaged, the messages that travel along that nerve may be slowed or blocked. There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

mumps

Mumps is a contagious disease that is caused by the mumps virus. Mumps typically starts with a few days of fever, headache, muscle aches, tiredness, and loss of appetite, and is followed by swelling of salivary glands called parotitis. Mumps spreads from person to person via droplets of saliva or mucus from the mouth, nose, or throat of an infected person, usually when the person coughs,sneezes, or talks. The virus may also be spread in -directly when someone with mumps touches items or surfaces without washing their hands and then someone else touches the same surface and rubs their mouth or nose. Mumps is less contagious than measles or chickenpox.

myasthenia gravis

Myasthenia gravis (my-us-THEE-nee-uh GRAY-vis) is characterized by weakness and rapid fatigue of any of the muscles under your voluntary control. Myasthenia gravis is caused by a breakdown in the normal communication between nerves and muscles. There is no cure for myasthenia gravis, but treatment can help relieve signs and symptoms, such as weakness of arm or leg muscles, double vision, drooping eyelids, and difficulties with speech, chewing, swallowing and breathing. Though myasthenia gravis can affect people of any age, it's more common in women younger than 40 and in men older than 60.

Myasthenia gravis

Myasthenia gravis (my-us-THEE-nee-uh GRAY-vis) is characterized by weakness and rapid fatigue of any of the muscles under your voluntary control. Myasthenia gravis is caused by a breakdown in the normal communication between nerves and muscles. There is no cure for myasthenia gravis, but treatment can help relieve signs and symptoms, such as weakness of arm or leg muscles, double vision, drooping eyelids, and difficulties with speech, chewing, swallowing and breathing. Though myasthenia gravis can affect people of any age, it's more common in women younger than 40 and in men older than 60.

Myasthenia gravis

Myasthenia gravis is caused by a defect in the transmission of nerve impulses to muscles. It occurs when normal communication between the nerve and muscle is interrupted at the neuromuscular junction—the place where nerve cells connect with the muscles they control. Normally when impulses travel down the nerve, the nerve endings release a neurotransmitter substance called acetylcholine. Acetylcholine travels from the neuromuscular junction and binds to acetylcholine receptors which are activated and generate a muscle contraction. In myasthenia gravis, antibodies block, alter, or destroy the receptors for acetylcholine at the neuromuscular junction, which prevents the muscle contraction from occurring. These antibodies are produced by the body's own immune system. Myasthenia gravis is an autoimmune disease because the immune system—which normally protects the body from foreign organisms—mistakenly attacks itself. In adults with myasthenia gravis, the thymus gland remains large and is abnormal . It contains certain clusters of immune cells indicative of lymphoid hyperplasia—a condition usually found only in the spleen and lymph nodes during an active immune response. Some individuals with myasthenia gravis develop thymomas (tumors of the thymus gland). Thymomas are generally benign, but they can become malignant.

Myoglobin

Myoglobin is a cardiac marker that is released into circulation a few hours after a myocardial infarction. Because it is also present in skeletal muscle, it lacks cardiac specificity.

Which organization has membership limited only for LPN/LVN students and graduates? NLN NFLPN NAPNES ANA

NFLPN is the National Federation of Licensed Practical Nurses. It was founded in 1949 and its membership is limited to LPN students and graduates.

NK cells

NK cells, or "natural killer" cells, are large, granular lymphocytes. Most of these are called natural killer (NK) cells because they are already specialized to kill certain types of target cells, especially host cells that have become infected with virus; host cells that have become cancerous. Natural killer cells (also known as NK cells, K cells, and killer cells) are a type of lymphocyte (a white blood cell) and a component of innate immune system. NK cells play a major role in the host-rejection of both tumours and virally infected cells. NK cells are cytotoxic; small granules in their cytoplasm contain special proteins such as perforin and proteases known as granzymes. Upon release in close proximity to a cell slated for killing, perforin forms pores in the cell membrane of the target cell through which the granzymes and associated molecules can enter, inducing apoptosis. The distinction between apoptosis and cell lysis is important in immunology - lysing a virus-infected cell would only release the virions, whereas apoptosis leads to destruction of the virus inside. NK cells are activated in response to interferons or macrophage-derived cytokines. They serve to contain viral infections while the adaptive immune response is generating antigen-specific cytotoxic T cells that can clear the infection. Patients deficient in NK cells prove to be highly susceptible to early phases of herpes virus infection.

What are the 5 primary types of leukocytosis?

Neutrophilia (or neutrophil leukocytosis) describes a high number of neutrophil granulocytes in blood. Neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of neutrophilia is a bacterial infection, especially pyogenic infections (bacteria that cause pus.)Neutrophils are also increased in any acute inflammation, so will be raised after a heart attack,other infarct or burns. A neutrophilia might also be the result of a malignancy. Lymphocytosis is an increase in the number or proportion of lymphocytes in the blood. A lymphocyte is any of three types of white blood cell in a vertebrate's immune system. All three are agranulocytes. They include natural killer cells (NK cells) (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic adaptive immunity), and B cells (for humoral, antibody-driven adaptive immunity). They are the main type of cell found in lymph, which prompted the name lymphocyte. Monocytosis is an increase in the number of monocytes circulating in the blood. Monocytes are white blood cells that give rise to macrophages and dendritic cells in the immune system. They are the largest of all leukocytes. They are part of the innate immune system of vertebrates and are amoeboid in shape, having clear cytoplasm. Monocytes have bean-shaped nuclei that are unilobar, which makes them one of the types of mononuclear leukocytes (agranulocytes). They play multiple roles in immune function. Such roles include: (1) replenishing resident macrophages under normal states, and (2) in response to inflammation signals, monocytes can move quickly (approx. 8-12 hours) to sites of infection in the tissues and divide/differentiate into macrophages and dendritic cells to elicit an immune response. Half of them are stored in the spleen (except in people who have undergone splenectomy). Monocytes are usually identified in stained smears by their large kidney shaped or notched nucleus. These change into macrophages after entering into the tissue spaces, and in endothelium can transform into foam cells. Monocytes are produced by the bone marrow from precursors called monoblasts, bipotent cells that differentiated from hematopoietic stem cells. Monocytes circulate in the bloodstream for about one to three days and then typically move into tissues throughout the body. They constitute between three to eight percent of the leukocytes in the blood. Half of them are stored as a reserve in the spleen in clusters in the red pulp's Cords of Billroth. In the tissues, monocytes mature into different types of macrophages at different anatomical locations.

Normal levels of AST and ALT:

Normal levels of AST and ALT may slightly vary depending on the individual laboratory's reference values. Typically the range for normal AST is reported between 10 to 40 units per liter and ALT between 7 to 56 units per liter.

An LPN/LVN hears his 1-year-old Vietnamese patient crying shortly after the parents enter the room. The LPN/LVN enters and observes an object in the mother's hand and bright red welts on the toddler's skin. What is the appropriate nursing intervention?

Nurses need to be aware of cultural practices. Coining is the repeated rubbing of a coin's edge until a welt appears to rid the body of disease.

What Is Nystagmus?

Nystagmus is a condition that causes involuntary, rapid movement of one or both eyes. The eye(s) may move from side to side, up and down, or in a circular motion. Nystagmus is often accompanied by vision problems, including blurriness. It is common for individuals with this condition to tilt their heads to compensate for their difficulty seeing. It is caused by abnormal functioning of the part of the brain or inner ear that regulates eye movement and positioning. The condition can be either congenital or acquired

OBRA

OBRA is the Omnibus Budget Reconciliation Act, which defines requirements for the quality of care given to residents of long-term care facilities.

OSHA

OSHA is the Occupational Safety and Health Administration, which regulates the setting to ensure patient safety.

OSHA

OSHA stands for Occupational Safety and Health Administration.

Objective data

Objective data are signs that a caregiver notes about a patient.

CAM (Complementary and Alternative Medicine) can be used in conjunction with traditional medicine, or a patient may choose to make CAM the main source of health care. What assessment data are important to obtain when taking a patient's health history?

Obtaining subjective data of race, culture, allergies, age, and illness is an important part of the health history.

odynophagia

Odynophagia: Pain on swallowing food and fluids, a symptom often due to disease of the esophagus. From the Greek roots odyno-, pain + -phagia, from phagein, to eat.

Orthostatic hypotension

Orthostatic hypotension is seen when there is a drop of 25 mm Hg systolic and a drop of 10 mm Hg diastolic when moving from lying to sitting, or from sitting to standing.

Osteoarthritis (OA)

Osteoarthritis (OA) is the most common joint disorder, which is due to aging and wear and tear on a joint.

Your patient has been diagnosed with osteoarthritis. She has numerous questions for you about the disorder. In answering her questions, you remember that osteoarthritis is:

Osteoarthritis is so common with age that it is almost considered to be an inevitable consequence of aging. It is a major cause of severe chronic disability and affects joints of the hand, knee, hip, and cervical and lumbar vertebrae. Osteoarthritis is usually treated with large doses of salicylates or NSAIDs. Steroids are sometimes used in low doses or are injected into joints to produce immediate pain relief and temporarily halt the destructive process.

Osteomyelitis (OM)

Osteomyelitis is a bone infection caused by bacteria or other germs. (sometimes abbreviated to OM, and derived from Greek words osteon, meaning bone, myelo- meaning marrow, and -itis meaning inflammation) is infection and inflammation of the bone or bone marrow.[1] It can be usefully subclassified on the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and anatomic location of the infection.

Otitis media

Otitis media (Latin for "inflammation of the middle ear") or tympanitis is the medical term for middle ear inflammation.

Your patient has just returned to the unit from surgery. The patient's skin color is pink; the dressing is intact with no drainage noted to be coming through, but the patient is moaning and showing facial grimacing and is restless. Which vital sign are you going to check?

Pain is considered the fifth vital sign and should be assessed along with the other vital signs. Since the patient's wound and skin color are normal, the nurse would need to address the moaning and restlessness.

Your patient has been recently diagnosed with Parkinson's disease. His wife asks you numerous questions about the disease. In answering her questions, you base your answers on your knowledge that:

Parkinson's disease is more common in men than in women by a ratio of 3:2. The tremor from Parkinson's disease is more prominent at rest, and decreases with movement of the affected body part. There is normally a balance between the neurotransmitters acetylcholine and dopamine in the basal ganglia. Symptoms of Parkinson's disease appear when either there is an decrease in dopamine or a increase in acetylcholine levels. Parkinson's disease is a syndrome of slowing down in the initiation of movement (bradykinesia), increased muscle tone (rigidity), tremor, and impaired postural reflexes

What 5 things does an AMG test measure?

Partial pressure of oxygen (PaO2). This measures the pressure of oxygen dissolved in the blood and how well oxygen is able to move from the airspace of the lungs into the blood. Partial pressure of carbon dioxide (PaCO2). This measures the pressure of carbon dioxide dissolved in the blood and how well carbon dioxide is able to move out of the body. pH. The pH measures hydrogen ions (H+) in blood. The pH of blood is usually between 7.35 and 7.45. A pH of less than 7.0 is called acid and a pH greater than 7.0 is called basic (alkaline). So blood is slightly basic. Bicarbonate (HCO3). Bicarbonate is a chemical (buffer) that keeps the pH of blood from becoming too acidic or too basic. Oxygen content (O2CT) and oxygen saturation (O2Sat) values. O2 content measures the amount of oxygen in the blood. Oxygen saturation measures how much of the hemoglobin in the red blood cells is carrying oxygen (O2).

Passive ROM exercises

Passive ROM exercises are used with a patient who is partially immobile and unable to move about freely.

Passive assisted ROM exercises

Passive assisted ROM exercises are used when a patient who is weak and may be able to move the limb partially, and a nurse then helps the patient finish the full ROM.

A newborn male infant is being assessed by the pediatrician in the nursery. The infant is showing signs of heart failure and an audible machine-like murmur is heard at the upper left sternal border. Further assessment finds a widened pulse pressure and bounding pulses. This assessment data identifies which type of congenital heart disease?

Patent ductus arteriosus; Failure of the ductus arteriosus to close within the first weeks of life leads to this assessment data.

In both the acute care and long-term care setting, a main priority in providing care is patient:

Patient safety in any setting has and always will be a priority in providing patient care.

Respiratory distress is seen often during the end stages of an illness. The nurse knows that 24 to 48 hours before death, the patient may exhibit:

Patients may exhibit the "death rattle," which is an accumulation of mucus and fluids in the posterior area of the pharynx.

The bath that aids in the reduction of inflammation of the perineal and anal areas of the patient is called a _____ bath.

Patients who have undergone rectal or vaginal surgery or given birth benefit from a Sitz bath, which aids in reducing inflammation in the perineal and anal areas.

The most lethal complication of a peptic ulcer is:

Perforation is considered to be the most lethal complication of a peptic ulcer. This occurs when the ulcer crater penetrates the entire thickness of the wall of the stomach or the duodenum. The release of gastric acid, pancreatic enzymes, or bile causes signs and symptoms of pain, emesis, fever, hypotension, and hematemesis.

You are caring for a patient after gastric bypass surgery. Which of the following conditions is he at risk for?

Pernicious anemia occurs when there is a lack of intrinsic factor produced in the lower portion of the stomach.

Your elderly patient has been diagnosed with pernicious anemia. You remember that this type of anemia results from:

Pernicious anemia results from the absence of a glycoprotein intrinsic factor secreted by the gastric mucosa. Intrinsic secretion fails because of gastric mucosal atrophy. This is an autoimmune disease; the gastric atrophy probably results from destruction of parietal cells.

Personality disorder

Personality disorder is a category of mental disorders. Personality disorders are inflexible maladaptive patterns of behavior or thinking that are associated with significant impairment of functioning.

phagocytosis

Phagocytosis is the process that permits a cell to engulf or surround any foreign material and digest it.

Philadelphia chromosome

Philadelphia chromosome is found in a patient with chronic myelogenous leukemia.

physical therapy

Physical therapy works with a patient's musculoskeletal function to regain strength and be at its highest functioning level.

A patient has come into your dermatology clinic. She states that she had a single 1-inch lesion that was scaly with a raised border and a pink center on her chest. Now, a little more than a week later, she has smaller matching spots of the rash on both sides of her chest. You observe pink, oval-shaped spots that are 1/4- to 1/2-inch across. You suspect that the physician will diagnose the condition as:

Pityriasis rosea

Placenta abruptio

Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from its attachment to the uterus wall before the baby is delivered.

planning

Planning is where the data collected are put into a plan of care.

Play therapy

Play therapy is used to help children express themselves by using toys as their "spokesperson" of feelings.

A patient is taking lithium carbonate to stabilize his mood and behaviors. The nurse knows that the patient is at risk for toxicity that is commonly encountered with lithium. Which of the following actions would increase the risk of toxicity?

Poor fluid intake and salt restrictions increase the risks of toxicity.

porphyia

Porphyrias are a group of rare disorders passed down through families, in which an important part of hemoglobin, called heme, is not made properly. Heme is also found in myoglobin, a protein found in certain muscles. They manifest with either neurological complications or skin problems or occasionally both.

Causes of steatorrhea:

Possible biological causes can be lack of bile acids (due to liver damage, hypolipidemic drugs, or gallbladder removal (cholecystectomy)), defects in pancreatic enzymes, defective mucosal cells, certain medicines that block fat absorption, or indigestible or excess oil/fat in diet. The absence of bile acids will cause the feces to turn gray or pale. Another cause of steatorrhea is due to the adverse effect of octreotide or lanreotide, which are analogs of somatostatin, used clinically to treat acromegaly.

What are the 3 most commonly monitored serum electrolytes in clinical practice?

Potassium (K): a mineral that is crucial for life and necessary for the proper function of the heart, kidneys, and other organs to work properly. Sodium (Na): a mineral needed for your muscles and nerves to work properly. The body uses sodium to control blood volume and blood pressure, osmotic equilibrium and pH. In animals, sodium ions are used against potassium ions to build up charges on cell membranes, allowing transmission of nerve impulses when the charge is dissipated. Chloride (Cl-) is a type of electrolyte. It works with other electrolytes such as potassium, sodium, and carbon dioxide (CO2). These substances help keep the proper balance of body fluids and maintain the body's acid-base balance. It is an essential electrolyte located in all body fluids responsible for maintaining acid/base balance, transmitting nerve impulses and regulating fluid in and out of cells.

A woman who is 32-weeks gestation arrives at the prenatal clinic and reports painless contractions and mucoid vaginal discharge. The fetal heart rate is 150 beats/minutes. What action should the practical nurse (PN) implement first? Place in the left lateral recumbent position. Correct Ask about recent sexual intercourse. Encourage an increase in oral fluid intake. Determine when the contractions began.

Preterm labor symptoms include contractions and mucoid vaginal discharge, so the PN should place the client in the left lateral position (A) to increase perfusion to the uterus. (B, C, and D) can be implemented after (A). Category: Maternity

Mannitol (Osmitrol) is used for:

Preventing or treating excess body water in certain kidney conditions, reducing swelling of the brain, or reducing pressure in the eye. Mannitol is a naturally occurring substance that causes the body to lose water (diuresis) through osmosis. Mannitol promotes diuresis in kidneys by increasing the concentration of filtrates in the kidney and blocking reabsorption of water by kidney tubules. Mannitol is an osmotic diuretic. It works by increasing the amount of fluid excreted by the kidneys and helps the body to decrease pressure in the brain and eyes.

The hospice nurse knows that constipation is a problem in terminally ill patients. The initiation of opioids to treat this condition should also be followed with:

Prevention of constipation is important thus the initiation of a stool softener and stimulant will help counteract the side effect of an opioid.

Primary biliary cirrhosis

Primary biliary cirrhosis is found more often in women than men and results from destruction of the bile ducts.

A patient is scheduled to undergo T-tube cholangiography. Prior to administration of contrast dye, it is essential that the nurse determine if the patient has any allergy to:

Prior to administration of contrast dye, it is essential that the nurse determine if the patient has any allergy iodine. Patients with iodine allergies may react to the contrast dye, and this reaction can be life-threatening.

Why is a PT done?

Prothrombin time (PT) is measured to: Find a cause for abnormal bleeding or bruising. Check the effects of warfarin (Coumadin). You will have the test regularly to make sure you are taking the right dose. Check for low levels of blood clotting factors. The lack of some clotting factors can cause bleeding disorders such as hemophilia, which is passed in families (inherited). Check for a low level of vitamin K. Vitamin K is needed to make prothrombin and other clotting factors. Check if it is safe to do a procedure or surgery that might cause bleeding. Check how well the liver is working. Prothrombin levels are checked along with other liver tests, such as aspartate aminotransferase and alanine aminotransferase. Check to see if the body is using up its clotting factors so quickly that the blood can't clot and bleeding does not stop. This may mean the person has disseminated intravascular coagulation (DIC).

Pseudomembranous colitis

Pseudomembranous colitis is inflammation of the colon that occurs in some people who have taken antibiotics. Pseudomembranous colitis is sometimes called antibiotic-associated colitis or C. difficile colitis. The inflammation in pseudomembranous colitis is almost always associated with an overgrowth of the bacterium Clostridium difficile. Severe pseudomembranous colitis can be life-threatening. However, treatment is usually successful. Signs and symptoms of pseudomembranous colitis include: Diarrhea that can be watery and sometimes bloody Abdominal cramps and pain Fever Pus or mucus in your stool Nausea Dehydration Symptoms of pseudomembranous colitis can begin within one to two days after you begin taking an antibiotic, or several weeks after you discontinue taking the antibiotic.

A client receiving parenteral nutrition (PN) is demonstrating signs and symptoms of an air embolism. What is the first action by the nurse?

Rationale: Lying on the left side may prevent air from flowing into the pulmonary veins. Placing the head lower than the body increases intrathoracic pressure, which decreases the amount of blood pulled into the vena cava during inspiration. The health care provider is notified, but this is not the first action. Stopping the PN will not treat the problem.

A nurse is caring for a client with heart failure. The client suddenly becomes anxious and restless, has a sudden onset of breathlessness, and becomes cyanotic. The nurse suspects pulmonary edema and immediately places the client in what best position?

Rationale: Positioning the client upright (high-Fowler's position), with the legs dangling over the side of the bed, has an immediate effect of decreasing venous return and decreasing lung congestion. Low-Fowler's position will not achieve this effect.

A nurse is caring for a new postoperative client and is monitoring the client for signs of shock. The nurse monitors for which signs of this postoperative complication?

Rationale: Postoperative hypotension or shock can have numerous causes such as inadequate ventilation, side effects of anesthetic agents or preoperative medications, and fluid or blood loss. The manifestations of shock include hypotension; tachycardia; cold, moist, pale, or cyanotic skin; and increased restlessness and apprehension.

A patient is receiving an I.V. infusion of blood. Once the infusion has begun, the length of time the nurse should stay with the patient to monitor vital signs and watch for an allergic reaction is:

Remaining with the patient while slowly infusing the first 50 ml of blood allows the nurse to assess the patient's response and monitor vital signs. Most reactions will occur within the first 15 minutes of the infusion.

Respiratory rate

Respiratory rate: A person's respiratory rate is the number of breaths you take per minute. The normal respiration rate for an adult at rest is 12 to 20 breaths per minute. A respiration rate under 12 or over 25 breaths per minute while resting is considered abnormal.

review the 5 rights of medication administration

Right drug, Right dose, Right route, Right time, and Right patient.

Salicylate toxicity

Ringing in the ears is a common sign of salicylate toxicity, and it is appropriate to ask a 4-year-old whether they hear an unusual sound

Routine orders

Routine orders are schedule orders to be give throughout the day.

When removing staples from a surgical incision, which of the following interventions is most appropriate?

Routinely, every other staple is removed first and replaced with steri-strips, unless the physician orders differently. You would want to monitor that the incision remains closed during the procedure.

You are caring for a patient who is being evaluated for a neurologic disorder. She is not able to comprehend the written or spoken word. The term for this is:

Sensory aphasia, also known as receptive aphasia, is the inability to comprehend the written word or spoken word.

Which medication side effects should the practical nurse tell the client to report to the healthcare provider? Constipation occurs when taking hydrocodone/acetaminophen (Vicodin). Multiple diarrhea stools begins after starting Clindamycin (Cleocin). A weight loss of more than 5 pounds is identified with exenatide (Byetta). A headache occurs after taking the morning dose of nitroglycerin (Nitro-Dur).

Severe diarrhea is an indication of pseudomembranous colitis that can result from taking Clindamycin, and the client should promptly report this side effect to the healthcare provider (B). Vicodin, a narcotic analgesic, slows peristalsis and causes constipation (A), which is a common side effect managed with increased dietary intake of bulk, fluids, and ambulation. Byetta is known to cause transient nausea, feeling full, and weight loss (C). Up to 50% of all clients experience mild to severe transient headaches after taking nitroglycerin (D) related to the vasodilation. Category: Medical-Surgical

The most common mode of transmission of HIV is by way of: Sexual transmission Injecting drug use Receiving blood or blood products Occupational exposure

Sexual transmission remains the most common mode of HIV transmission in the world today and is responsible for the majority of the world's total AIDS cases. Sexual activity provides the potential for exchange of semen, cervicovaginal secretions, and blood. Although the majority of HIV transmissions in the United States occur in the MSM category via receptive anal intercourse, heterosexual transmission via anal intercourse is becoming increasingly prevalent. Injecting drug users represent the second highest exposure category.

Herpes Zooster

Shingles (herpes zoster) is a painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox. Herpes zoster, commonly known as shingles, causes inflammation of the spinal ganglia, then advances to the skin by way of the peripheral nerves when a patient's resistance to infection has been lowered.

Simethicone (Oral Route)

Simethicone is used to relieve the painful symptoms of too much gas in the stomach and intestines. It is available without a prescription. US Brand Name Alka-Seltzer Anti-Gas Anti-Gas Ultra Strength Baby Gasz Equilizer Gas Relief Gas Aid Maximum Strength Gas-X Genasyme Maalox Anti-Gas Mylanta Gas Mylicon Mytab Gas Phazyme

Sinus bradycardia

Sinus bradycardia is a slow rhythm that originates in the SA node, and is characterized by a rate of less than 60 beats per minute. Causes can be sleep, vomiting, intracranial tumors, myocardial infarction, vagal stimulation, endocrine disorders, and hypothermia. It may be completely normal in athletes. Treatment of sinus bradycardia depends on the cause.

slander

Slander in malicious or untrue spoken words about another person or property.

Select the most appropriate nursing diagnosis for a child with a learning disability.

Social isolation related to excess time required for completing school work and limits on play activities; A child with a learning disability requires more time to complete tasks, such as school work, leading to a decreased amount of time to spend with friends or play. This decrease in social interaction leads to social isolation, the highest priority.

What is the function of the electrolyte sodium?

Sodium is most often found outside the cell, in the plasma (the non-cell part) of the bloodstream. It is a significant part of water regulation in the body, since water goes where the sodium goes. If there is too much sodium in the body, perhaps due to high salt intake in the diet (salt is sodium plus chloride), it is excreted by the kidney, and water follows. Sodium is an important electrolyte that helps with electrical signals in the body, allowing muscles to fire and the brain to work. It is half of the electrical pump at the cell level that keeps sodium in the plasma and potassium inside the cell.

Spider angioma

Spider angioma is an abnormal collection of blood vessels near the surface of the skin. (also known as a nevus araneus, spider nevus, vascular spider, and spider telangiectasia) is a type of telangiectasis (swollen blood vessels) found slightly beneath the skin surface, often containing a central red spot and reddish extensions which radiate outwards like a spider's web. They are common and may be benign, presenting in around 10-15% of healthy adults and young children. However, having more than 3 spider angiomas is likely to be abnormal and may be a sign of liver disease.

Hemoptysis

Spitting up blood or blood-tinged sputum from the respiratory tract. Hemoptysis occurs when tiny blood vessels that line the lung airways are broken. Hemoptysis can be harmless such as from irritated bronchial tubes with bronchitis, or be serious such as from cancer of the lung.

Stridor

Stridor is an abnormal, high-pitched sound produced by turbulent airflow through a partially obstructed airway at the level of the supraglottis, glottis, subglottis, and/or trachea. The tonal characteristics of the sound are extremely variable (ie, harsh, musical, or breathy); however, combined with the phase, volume, duration, rate of onset, and associated symptoms. Stridor may be inspiratory, expiratory, or biphasic depending on its timing in the respiratory cycle. Inspiratory stridor suggests a laryngeal obstruction, while expiratory stridor implies tracheobronchial obstruction. Biphasic stridor suggests a subglottic or glottic anomaly. In addition to a complete history and physical, as well as other possible additional studies, most cases require flexible and/or rigid endoscopy to adequately evaluate the etiology of stridor. Stridor refers to a high-pitched harsh sound heard during inspiration.. Stridor is caused by obstruction of the upper airway, is a sign of respiratory distress and thus requires immediate attention.

Subjective data

Subjective data are symptoms that the patient describes that may indicate illness.

From the following list, select all the events that require CPR: drowning, Hypothermia, Heatstroke, Sudden infant death syndrome, Asphyxiation

Sudden infant death syndrome, drowning, Asphyxiation

What are some of the Symptoms of Sodium Imbalance?

Symptoms of Sodium Imbalance: Too much or too little sodium can cause cells to malfunction. Lethargy, confusion, weakness, swelling, seizures, and coma are some symptoms that can occur with hyper - or hyponatremia. The treatment of these conditions is dependent on the underlying cause, but it is important for the health care practitioner to understand the reason for the abnormal sodium level and correct the sodium imbalance relatively slowly. Rapid correction can cause abnormal flow of water into or out of cells. This is especially important to prevent brain cell damage (central pontinemyolysis).

What does a widened QRS complex indicate?

Tachycardias are broadly categorized based upon the width of the QRS complex on the electrocardiogram (ECG). ●A narrow QRS complex (<120 msec) reflects rapid activation of the ventricles via the normal His-Purkinje system, which in turn suggests that the arrhythmia originates above or within the atrioventricular (AV) node (ie, a supraventricular tachycardia). ●A widened QRS (≥120 msec) occurs when ventricular activation is abnormally slow, most commonly because the arrhythmia originates outside of the normal conduction system (eg, ventricular tachycardia), or because of abnormalities within the His-Purkinje system (eg, supraventricular tachycardia with aberrancy). Much less common are pre-excited tachycardias; these are supraventricular tachycardias with antegrade conduction over an accessory pathway, resulting in direct activation of the ventricular myocardium, similar to the situation with a ventricular rhythm. This only occurs in a minority of patients with pre-excitations syndromes (eg, Wolff-Parkinson-White Syndrome).

The practical nurse (PN) is assisting the nurse with the care of a client with end stage emphysema who is on a mechanical ventilator. The PN auscultates decreased breath sounds in the right lung fields and notices that the client's neck veins are distended. Which additional assessment should the PN implement to report a tension pnuemothorax to the nurse? Evaluate the client's ventilatory effort against the ventilator. Check the ventilator pressure settings. Inspect the trachea to see if it is midline. Correct Determine if an emergency thoracotomy tray is available.

Tension pnuemothorax can occur when an emphysematic bullae or blebs ruptures causing air to accumulate in the pleural space and collapsing the lung. Additional findings are needed to differentiate the onset of right sided heart failure versus tension pneumothorax, which is manifested by worsening respiratory status, decreased breath sounds on the affected side, distended neck veins, and tracheal deviation from midline (C). The client's findings are due to a pneumothorax, not resisting the ventilator (A). Although (B) should be implemented, pressure changes do not resolve air accumulation with each inspiration. Although emergency insertion of a chest tube is indicated, the thoracotomy tray (D) can be obtained after additional data is reported to the nurse and healthcare provider.

Tetralogy of Fallot

Tetralogy of Fallot results in severe cyanosis and hypoxia, systolic ejection murmur, clubbing of the nail beds, dyspnea, squatting, poor growth, mental slowness, syncope, and cerebrovascular disease.

Cowper's glands

The Cowper's glands (or bulbourethral glands) are a pair of exocrine glands in the male reproductive system. Roughly the size of peas, they are located inferior to the prostate gland and lateral to the urethra in the urogenital diaphragm. The Cowper's glands are only found in the male body and play an important role in the protection of sperm during ejaculation.

Glasgow Coma Scale

The Glasgow Coma Scale or GCS is a neurological scale that aims to give a reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (the more widely used modified or revised scale). Severe, with GCS < 8-9 Moderate, GCS 8 or 9-12 (controversial)[3] Minor, GCS ≥ 13.

Magnetic resonance imaging (MRI) scan

The MRI scan uses magnetic forces to image body structures. Compared to a CT scan, it provides better images of soft-tissue structures. It is useful in detecting strokes, multiple sclerosis, tumors, trauma, herniation, and seizures.Magnetic resonance imaging (MRI) scan

A pregnant patient comes to the hospital saying she thinks her water has broken. The nurse checks the fluid with Nitrazine test paper to determine if the fluid is amniotic fluid or vaginal secretions. If the fluid is amniotic fluid, the nurse expects the paper to turn what color?

The Nitrazine paper will turn blue-green (pH 6.5), blue-gray (pH 7.0), or deep blue (7.5) if the fluid is amniotic because it is slightly alkaline.

Type B Blood

The RBCs of type B contain type B antigen and the plasma contains anti-A antibodies.

IM using the Z-track method benefits

The Z-track is a better injection technique. It's been shown to reduce leakage of medication through subcutaneous tissue and decrease skin lesions at the injection site. Plus, it doesn't hurt patients quite as much as a regular I.M. injection. When using the Z-track method, you displace the tissue before you insert the needle. Once the needle's withdrawn, the tissue's restored to its normal position. this traps the drug inside the muscle and prevents any leakage. The benefit: The patient gets the full dose of medication.

Select the true statement regarding diagnostic tests for HIV and AIDS. With HIV antibody testing, a seronegative test indicates that the individual is free from HIV infection. The ELISA test is considered to be more accurate than the Western blot for HIV antibody testing. CD8+ cell monitoring is one of the laboratory parameters used to track the progression of HIV disease. The ability to detect HIV viral load measurements in plasma is a significant advancement in the monitoring of HIV disease.

The ability to detect HIV viral load measurements in plasma is a significant advancement in the monitoring of HIV disease. Viral load or burden refers to a quantitative measure of HIV viral RNA in the peripheral circulation, or level of virus in the blood. The ability to detect HIV viral load measurements in plasma is a significant advancement in the monitoring of HIV disease. The Western blot test is considered to be more accurate than the ELISA for HIV antibody testing is. ELISA is the first test usually used to test for HIV; if the result is positive, the test is repeated. Upon the second positive ELISA test, Western blot is used to confirm the diagnosis, as this is a more specific confirming test. CD4+ cell monitoring is one of the laboratory parameters used to track the progression of HIV disease. As the disease progresses, there is a decrease in the number of CD4+ cells. The more significant the loss, the more severe immunosuppression becomes. With HIV antibody testing, a seronegative test does not indicate that the individual is free from HIV infection, because seroconversion may not yet have occurred. Transmission of the virus can still occur if the individual has HIV infection and engages in risky behaviors.

Which of the following reflects accurate information regarding the use of radiation therapy for the treatment of cancer? Skin care for the patient receiving external radiation therapy includes the use of powder or ointment on the marked area where the external radiation will be directed. Unsealed internal radiation is also known as brachytherapy. A patient with a radioactive implant will have radiation in the urine. Nursing care for the patient with a radioactive implant should be carried out with the nurse standing 6 feet away from the patient when not giving care, and limiting time in the room to 10 minutes.

The area on the body where the external radiation will be directed must be kept clean, dry, and protected. No lotions or creams should be used unless specifically prescribed by the physician (and usually only if the skin is becoming excessively dry from the radiation treatments). The area should also be protected from direct sunlight and the application of heat or cold. The use of sealed internal radiation is also known as brachytherapy. These are implants that are temporarily or permanently inserted into hollow cavities, within body tissues, or on the body's surface. The radioactive source delivers a specific radiation dose continuously over hours or days. The highly concentrated dose of radiation is delivered in or near a tumor. A patient who is treated with unsealed internal radiation (administered intravenously or orally) will have radiation in the urine and other body fluids, since it is distributed throughout the body. Special precautions must be taken to prevent exposure to radiation from direct contact with the patient or any of his body tissue or fluid. Nursing care for the patient with a radioactive implant should be carried out with the nurse standing 6 feet away from the patient when not giving care, and limiting time in the room to 10 minutes. Correct The nurse should follow the principles of time, distance, and shielding when caring for a patient with a radioactive implant. Directions supplied by the hospital related to the radioactive substance being used should be followed. In general, nursing care for the patient with a radioactive implant should be carried out with the nurse standing 6 feet away from the patient when not giving care, and limiting time in the room to 10 minutes.

The autoimmune disease of the neuromuscular junction characterized by fluctuating weakness of certain muscle groups is known as:

The autoimmune disease of the neuromuscular junction characterized by fluctuating weakness of certain muscle groups is known as myasthenia gravis. It is an unpredictable neuromuscular disease with lower motor neuron characteristics. Although there is no observable structural change in the muscle or nerve, nerve impulses fail to pass at the myoneural junction, resulting in muscle weakness.

Which of the following are true statements regarding cellulitis? Select all that apply.

The bacteria that cause cellulitis can be spread by direct contact with an open area on a person who has an infection. Although not considered to be contagious, the bacteria that cause cellulitis can be spread by direct contact with an open area on a person who has an infection. Cellulitis occurs when bacteria enter the body through a break in the skin, such as a cut, scratch, or insect bite when the injury occurs and is not cleansed with soap and water. Complications from cellulitis can include sepsis, meningitis, and lymphangitis.

Which observation by the practical nurse (PN) indicates that a piece of medical equipment is not functioning properly? The digital bedside glucose meter displays the word HI. Incorrect A pulse oximeter indicates it is unable to detect a pulse. The bed alarm sounds an audible alarm when client sits up. The sphygmomanometer's reading drops without a knob turn. Correct

The blood pressure reading that is not controlled by the knob (D) on the cuff indicates a malfunction of the equipment. (A) is a function that is set by the manufacturer to indicate an extremely elevated blood sugar. A pulse oximeter does not display (B). (C) is a function that warns the staff that a client is attempting to get out of bed without assistance. Category: Fundamentals

CEA test

The carcinoembryonic antigen (CEA) test measures the amount of this protein that may appear in the blood of some people who have certain kinds of cancers, especially cancer of the large intestine (colon and rectal cancer). It may also be present in people with cancer of the pancreas, breast, ovary, or lung. Used mainly to determine the success of treatment.

The practical nurse (PN) is caring for a client who is receiving chemotherapy for cervical cancer who is scheduled to go for a chest xray. Current laboratory results include hemoglobin 10.0 grams/dl, absolute neutrophil count (ANC) of 500, platelets 120,000/mm3, and white blood cells 4,000/mm3. What action should the PN implement first? Notify healthcare provider about laboratory results. Compare client's results with past laboratory values. Examine the client for the presence of ecchymosis. Place a protective mask on the client for transport. Correct

The client is immunosuppressed due to a side effect of chemotherapy, as evidenced by the client's ANC (which is calculated daily using # WBC x % neutrophils). If the ANC is less than 1,000, protective precautions (reverse isolation) is indicated, so the PN should place a protective mask on the client for transport to xray (D). (A, B, and C) are implemented after (D). Category: Medical-Surgical

A male client with recurrent angina is receiving oxygen at 2 liters/minute and begins to complain that he feels funny in his chest. The telemetry monitor reveals a rapid narrow QRS complex at 170 beats/minute. Which action is most important for the practical nurse to implement? Report the findings to the charge nurse. Correct Tell the client to remain on bedrest. Obtain the client's pulse oximetry reading. Call the rapid response team.

The client is likely experiencing supraventricular tachycardia (SVT), which should be reported to the charge nurse (A) and healthcare provider for immediate treatment. Bedrest (B) minimizes myocardial demand for oxygen, but rest does not change the rate of SVT. (C) may be indicated, but the first action is to report the findings. (D) is indicated if the client's rhythm progresses to ventricular tachycardia (VT) or ventricular fibrillation. Category: Medical-Surgical

The practical nurse (PN) is caring for four clients. Which client's data requires further nursing action? An adult with type 2 diabetes mellitus (DM) who has fasting glucose levels at 190 mg for 3 days. Correct An older adult with head injury who has sequential hourly Glasgow Coma Scale (GCS) scores of 13, 14, and 15. An adolescent with pneumonia who has white blood cell count of 10,000/mm3 2 days after receiving antibiotics. An adult with a pulse of 110 and blood pressure of 150/80 following a lumbar puncture.

The client with DM (A) who has fasting glucose levels of 190 mg for 3 days needs further action for the uncontrolled serum glucose. (B) is improving with a final GCS of 15, which is normal. (C) is improving since the white blood cell count is within normal. (D) may be related to anxiety after a lumbar puncture procedure, continued monitoring is indicated. Category: Medical-Surgical

coccyx

The coccyx or tailbone consists of 3 or more small bones fused together at the bottom of the spine. The sacrum tapers to a point at its inferior end, where it forms the fibrocartilaginous sacrococcygeal joint with the tiny coccyx.

Complement

The complement system is a system of approximately 25 serum enzymatic proteins that interact with one another and with other components of the innate and adaptive immune systems. Normally inactive, when activated by antigen/antibody interactions, the system functions in a "step-by-step" series, destroying the cell membrane of many bacterial species and attracting phagocytes to the area.

When the delivery of the placenta is complete, which stage of labor is complete?

The delivery of the placenta completes the third stage of delivery, lasting approximately 5 to 20 minutes.

A nurse working on a psychiatric unit knows that there are different therapeutic techniques used. The key component to psychiatric-mental health treatment is:

The development of a helping-trusting relationship; The development of a helping-trust relationship is a therapeutic professional relationship used by the nurse to assist the patient in learning new ways of responding to people or situations.

The diagnostic test that involves visualization of the esophagus, stomach, and duodenum via a flexible endoscope is called a(n):

The diagnostic test that involves visualization of the esophagus, stomach, and duodenum via a flexible endoscope is called an esophagogastroduodenoscopy. This is performed to look for tumors, varices, inflammation, hiatal hernia, polyps, ulcerations, strictures, and obstructions, among other things.

The muscle that separates the thoracic cavity from the abdominal cavity is called the:

The diaphragm, a muscle directly beneath the lungs, separates the ventral cavity into the thoracic (chest) and abdominal cavities.

An adolescent is admitted to the pediatric intensive care unit after suffering a seizure at school. She is alert on admission and tells the nurse that she has asthma and takes theophylline every day. She has a heart rate of 116 beats per minute with some shortness of breath. She also is complaining of nausea and vomiting. Which of the following would the nurse suspect as the reason for the complaints that were gathered during the data collection process?

The early signs of theophylline toxicity are nausea, vomiting, tachycardia, headache, and irritability. Seizures indicate a toxicity level greater than 30 mcg/mL. A normal theophylline level is 10 to 20 mcg/mL.

Frontal plane

The frontal plane is another name for the coronal plane. It divides the body into a ventral (front) section and a dorsal (back) section

The functional unit of the kidney is the ________

The functional unit of the kidney is the nephron. Each kidney contains more than 1 million nephrons, which are responsible for filtering the blood and processing the urine

The laboring patient has just had membranes ruptured by the physician. The amniotic fluid is greenish-brown in color. This is an abnormal finding indicating:

The greenish-brown color of amniotic fluid is an indication of the passage of meconium stool by the fetus that can lead to hypoxic episodes in the fetus.

ilium

The ilium is the uppermost and largest bone of the pelvis,

Trace the impulse pattern of the cardiac conduction system. Pacemaker→Bundle of His→SA node→Bundle branches Purkinje fibers→SA node→Right and left bundle branches→AV node SA node→AV node→Bundle of His→Right and left bundle branches→Purkinje fibers Pacemaker→SA node→Bundle of His→AV node→Purkinje fibers

The impulse pattern of the cardiac conduction system is as follows: SA node→AV node→Bundle of His→Right and left bundle branches→Purkinje fibers. The pacemaker is the same as the SA node.

You are caring for a female patient with cancer. The patient's daughter is worried about her mother, but also herself and her own cancer risk. In answering her questions about hereditary cancers, you formulate your responses based on your knowledge that: Smokers are more likely to develop lung cancer if they have a family history of the disease. Hereditary cancers are usually diagnosed at an advanced age. The incidence of breast cancer is the same whether there is a family history of the disease. About 50% of cancers are inherited.

The incidence of lung cancer in smokers with a family history of this disease is greater than in smokers without a family history of the disease. Hereditary cancers are usually diagnosed at an earlier age—usually 15 to 20 years earlier than cancers that are not inherited. Often, several relatives have the same or related cancers; they are more likely to be bilateral, and multiple cancers are seen in single individuals. The incidence of postmenopausal breast cancer is three times higher and the incidence of premenopausal breast cancer is five times higher in women with a family history of the disease. Breast cancer is rare in Asian women and common in white women. About 10% of cancers are inherited. Hereditary cancers are those cancers that arise from germline mutations.

When reviewing the safety precautions regarding newborns, what information should the practical nurse communicate to the parents? Position the infant to sleep on the baby's back. Correct Use a crib with slats no more than 4 inches apart. Propping a bottle can be done when the infant gets older. Place the infant a front-facing car seat in the automobile.

The incidence of sudden infant death syndrome (SIDS) declines when infants are positioned on their backs (A), instead of prone, for sleeping. Crib slats (B) should be no more than 2.375 inches apart to prevent the baby from slipping out or the entrapment of the infants head. To prevent injury, bottles should never be propped up (C) since a newborn or young infant cannot voluntarily remove a bottle from the mouth. Infants who weigh less than 30 pounds should be placed in a rear-facing car seat (D) in the back seat of a car. Category: Maternity

The loss of T-cell function increases the risk of what?

The loss of immunosurveillance, or T-cell function, increases the risk of certain cancers. When a cell becomes malignant, it carries a tumor-specific antigen on its membranes that is recognized by the body as nonself and destroyed. If age, drugs, poor nutrition, alcohol, serious infections, or certain disease processes suppress T-cell function, the risk of cancer increases.

Your female patient has been diagnosed with gastroesophageal reflux disease (GERD). You are beginning your patient teaching about lifestyle changes she can implement to minimize the symptoms of this disease. You will be certain to mention:

The meal recommendations for reducing the symptoms of gastroesophageal reflux disease are for the patient to consume four to six small meals per day (rather than four large meals). A LOW-fat, ADEQUATE protein diet may reduce symptoms for the patient with gastroesophageal reflux disease. Evening snacks should be avoided for the patient with gastroesophageal reflux disease, and the patient should not eat for 2 to 3 hours before bedtime for the best chance of reducing symptoms of reflux. Reducing caffeine and alcohol consumption may alleviate symptoms of gastroesophageal reflux disease. Caffeine can be found in chocolate, coffee, tea, and even over-the-counter analgesics, so checking labels is important.

What is the median time from AID diagnosis to death, without treatment?

The median time from AIDS diagnosis to death, without treatment, is 1.3 years. With treatment, however, the lifespan is unpredictable and can resemble a chronic illness in some patients.

Appropriate nursing interventions for the patient with increased intracranial pressure include which of the following? Select all that apply.

The neck of a patient with increased intracranial pressure must be kept in a neutral position to promote venous drainage. It should not be flexed or extended. The patient should be instructed to avoid the Valsalva maneuver. This needs to be explained to the patient in terms that he or she can easily understand. The patient needs to be positioned in such a way that the hips, waist, and neck are not flexed. Rotation of the head, especially to the right, also must be avoided. Extreme hip flexion causes an increase in intra-abdominal and intrathoracic pressures, which can trigger a rise in intracranial pressure missing one

The neurotransmitter that primarily affects motor function and is involved in gross subconscious movements of the skeletal muscles is known as:

The neurotransmitter that primarily affects motor function and is involved in gross subconscious movements of the skeletal muscles is known as dopamine. Dopamine also plays a role in emotional responses. In Parkinson's disease, there is a deficiency of dopamine, and the patient suffers from tremors or involuntary trembling movements.

WBC count

The normal number of WBCs in the blood is 4,500-10,000 white blood cells per microliter (mcL).

Normal Potassium test range

The normal range is 3.7 to 5.2 mEq/L. Note: mEq/L = milliequivalent per liter

Nucleus

The nucleus is the largest organelle within the cell, responsible for cell reproduction and control of other organelles.

Nurse coordinator

The nurse coordinator is a registered nurse who coordinates the implementation of the plan of care for each patient.

When assessing the skin, it is important that the nurse:

The nurse should ask the patient about recent skin lesions or rashes, where the lesions first appeared, and how long they have been present. It is important for the nurse to remember to wear gloves when inspecting the skin, mucous membranes, and any involved area. When assessing the skin, the nurse should have natural lighting. The patient should be asked about personal skin care. The nurse should ask about recent color changes, sun exposure (with and without sunscreen), and family history of skin cancer.

Which of the following accurately describes normal changes of aging of the immune system?

The older adult has increased susceptibility to infections. In addition, signs and symptoms of infection in the older adult are more subtle—and easily missed—?when compared with a younger adult. An older adult can have an infection without the presence of a fever. Changes in behavior, such as lethargy, fatigue, disorientation, irritability, and loss of appetite may be early signs of infection. Older adults have decreased tear production. This increases the risk of eye inflammation and infections. Older adults have decreased production of saliva and gastric secretions. This decreased production increases the risk of gastrointestinal infections and may affect (slow) the absorption of certain medications that require an acidic environment. The thymus gland decreases in size and activity with age; this is probably a primary cause of immunosenescence. Both T and B cells show deficiencies in activation, transit time through the cell cycle, and subsequent differentiation; however, the most significant alteration seems to involve the T cells.

A patient with a family history of PIH asks the nurse if there is a cure. The nurse's response is that the only cure is:

The only know cure for PIH is the termination of the pregnancy.

Your patient has recently suffered through a bout of acute pancreatitis. He is asking for a snack. You find each of the following four snack choices in the kitchen. Which one would you choose for your patient?

The optimal diet for a patient who has recently had pancreatitis is a bland, low-fat, high-protein, high-carbohydrate diet. The reduced fat cheese and whole wheat crackers best meet these recommendations.

Your patient with Herpes zoster is asking you about her condition. You base your patient teaching on the knowledge that:

The pain experienced by most patients is typically described as burning and knifelike. The rash usually occurs in the thorax region; vesicles erupt in a line along the involved nerve. Herpes zoster is usually not permanently disabling to healthy adults. The greatest risk occurs to patients who have had a lower resistance to infection, such as those on chemotherapy or patients receiving large doses of prednisone, in whom the disease could be fatal due to the patient's compromised immune system. Analgesics are often prescribed for pain, including opioid analgesics. Steroids may be given to decrease inflammation and edema. Lotions may be used to relieve pruritus, and corticosteroids may be used to relieve pruritus and inflammation.

A patient is being admitted to the surgical floor. Before the patient goes to surgery, the Admissions department will:

The patient will need to sign a Consent for Treatment when being admitted to the hospital. The vital signs, physician's orders, and belongings are the responsibility of the nursing staff.

Your oncology patient is about to undergo chemotherapy. What can you expect? Complete baldness always results from chemotherapy. Leukocytosis is a common problem for patients receiving chemotherapy. Fresh flowers should be discouraged in the room of a patient with neutropenia. Chemotherapy only affects malignant cells.

The pattern and extent of hair loss from chemotherapy cannot be accurately predicted for any given patient. It can begin within a few days or weeks of treatment, but when drug induced, is never permanent. Hair loss occurs due to the destruction of the hair follicles. Leukopenia, or a reduction in the number of circulating white blood cells, is a common problem for patients receiving chemotherapy, due to bone marrow depression. It can render the patient susceptible to life-threatening infections. Fresh flowers and live plants should be discouraged in the room of a patient with neutropenia. Mites, gnats, and other microscopic organisms could be a potential source of infection for the patient. The patient's diet should also be monitored with the goal of avoiding fresh fruits and vegetables due to the presence of microscopic pathogens. Both malignant and normal cells are affected by chemotherapy. Cells that multiply rapidly are affected the most, such as cells of the hematopoietic system, the hair follicles, and the gastrointestinal tract.

postictal state

The postictal state is the altered state of consciousness after an epileptic seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures and is characterized by drowsiness, confusion, nausea, hypertension, headache or migraine and other disorienting symptoms. Additionally, emergence from this period is often accompanied by amnesia or other memory defects. It is during this period that the brain recovers from the trauma of the seizure. While the postictal period is considered to be the period shortly after a seizure where the brain is still recovering from the seizure, the ictal period is considered to be the seizure itself, and the interictal period to be the period between seizures, when brain activity is more normal.

You are taking care of a patient who suddenly begins to have a seizure. The appropriate nursing response would be to:

The primary goals of the nurse caring for a patient having a seizure are (a) protect from aspiration and injury, and (b) observe and record the seizure activity. Diagnosis and subsequent treatment of a patient with a seizure disorder are often based on the description of the seizure activity. All aspects of the seizure should be recorded: preceding events, length of each phase, what occurred during each phase, etc.

An aspartate aminotransferase (AST) test and Alanine transaminase (ALT) is done to:

The ratio of AST to ALT sometimes can help determine whether the liver or another organ has been damaged. Both ALT and AST levels can test for liver damage. Alanine transaminase (ALT) is an enzyme found in the highest amounts in the liver. Injury to the liver results in release of the substance into the blood.

Renin-angiotensin system

The renin-angiotensin system regulates the amount of fluids and sodium in the body. Reduction of blood pressure and sodium concentration in the kidney result in the production of renin, which in turn produces aldosterone and angiotensin, retaining sodium in the urine. Because of the increase in sodium concentration, the production of renin decreases, and the sodium concentration returns to normal. Sodium is also important in neuron function and osmoregulation between cells and the extracellular fluid, their distribution mediated in all animals by Na+/K+-ATPase;[57] hence, sodium is the most prominent cation in extracellular fluid.[58] Unusually low or high sodium levels in humans are recognized in medicine as hyponatremia and hypernatremia. These conditions may be caused by genetic factors, physical factors associated with ageing or illnesses involving vomiting or diarrhea.

The somatic nervous system

The somatic nervous system (SoNS or voluntary nervous system) is the part of the peripheral nervous system[1] associated with the voluntary control of body movements via skeletal muscles. The SoNS consists of afferent and efferent nerves. Afferent nerves are responsible for relaying sensation to the central nervous system; efferent nerves are responsible for stimulating muscle contraction, including all the non-sensory neurons connected with skeletal muscles and skin.

Immunization

The theory behind immunization is that controlled exposure to a disease-producing pathogen develops antibody production while preventing disease. An individual is immunized with a vaccine or toxoid that is weakened, or attenuated, to reduce its strength without losing its ability to stimulate antibody production.

What are the 3 phases of urine formation?

The three phases of urine formation are filtration, reabsorption, and secretion. Filtration occurs in the glomerulus of Bowman's capsule. Reabsorption of water, glucose, and ions occurs in the proximal convoluted tubules, loop of Henle, and the distal convoluted tubules. Secretion of ions, waste products, and drugs occurs primarily in the distal convoluted tubul

Name the 3 types of muscle tissue?

The three types of muscle tissue are cardiac, skeletal, and smooth.

Transverse plane

The transverse plane cuts the body horizontally into the sagittal and the frontal planes, dividing the body into caudal and cranial portions. The transverse plane (also called the horizontal plane, axial plane, or transaxial plane) is an imaginary plane that divides the body into superior and inferior parts. It is perpendicular to the coronal and sagittal planes.

sickle-cell anemia

The type of anemia resulting from an abnormal crescent-shaped red blood cell containing a defective hemoglobin molecule is called sickle-cell anemia. It is the most common genetic disorder in the United States, affecting predominantly African Americans.

Exposure to viral invasion, medications, chemicals, radiation, or chemotherapy in which the hemopoietic tissue is replaced by fatty marrow, causing a defect in RBC production

The type of anemia resulting from exposure to viral invasion, medications, chemicals, radiation, or chemotherapy in which the hemopoietic tissue is replaced by fatty marrow, causing a defect in RBC production is known as acquired aplastic anemia. This is probably an immune-mediated disease. There is also a congenital form of aplastic anemia caused by chromosomal alterations. In both, depression of erythrocyte production results in lowered hemoglobin and RBCs. Leukopenia and thrombocytopenia may develop.

after a bone scan

There are no activity restrictions after a bone scan. The patient should be encouraged to drink water over the next 1 to 3 hours to aid renal clearance of the isotope.

Amylase and lipase levels

They are enzymes produced by the pancreas that help to digest food. If the pancreas is damaged, high levels of these enzymes can be detected in the bloodstream. Checking amylase and lipase levels can help determine if you have pancreatitis.

Third-degree heart block

Third-degree atrioventricular (AV) block, also referred to as third-degree heart block or complete heart block, is a disorder of the cardiac conduction system where there is no conduction through the atrioventricular node (AVN). Therefore, complete dissociation of the atrial and ventricular activity exists.[1] The ventricular escape mechanism can occur anywhere from the AVN to the bundle-branch Purkinje system

Antisocial personality

This adolescent has an antisocial personality. It is characterized by having a history of difficulties with personal relationships; does not profit from discipline; and relies on deceit to get his way.

Children older than age 3 are at greatest risk for aspiration of foreign bodies because hand to mouth activities are common at this age. True or False?

This answer is incorrect because children younger than age 3 are at greatest risk.

The nurse is talking with a neighbor who takes care of her elderly mother in the home. The woman reports that her mother has been having increased behaviors, not sleeping through the night, and requires constant watching. Her spouse works outside the home and tries to give her some time alone in the evening, but it doesn't seem to be enough. What type of care service should this nurse recommend?

This family needs respite care, which involves scheduled stays for the older adult needing care at a long-term care facility (1 week every 4 months) to give the caregiver and older adult with needs "time off."

A group of psychotic disorders characterized by severe and inappropriate emotional responses, by prolonged and persistent disturbances of mood and related thought distortions is called _____ disorders.

This is the definition of a group of mood disorders and other symptoms associated with either depressed or manic states.

Intimacy versus isolation

This stage occurs in young adulthood where people seek companionship and love with another person.

A nurse is in the home setting caring for a patient with COPD who is on 2 liters of oxygen continuously. Which of the following statements by the patient indicates a need for further education?

This statement warrants further teaching. The patient should remove the tubing and wash and dry the skin 2 to 3 times a day to stimulate circulation to those skin areas.

Capillary refill time

This test measures how well the vascular system works in your hands and feet -- the parts of your body that are farthest from the heart. If there is good blood flow to the nail bed, a pink color should return in less than 2 seconds after pressure is removed. The capillary nail refill test is a quick test done on the nail beds. It is used to monitor dehydration and the amount of blood flow to tissue. Pressure is applied to the nail bed until it turns white. This indicates that the blood has been forced from the tissue. It is called blanching. Once the tissue has blanched, pressure is removed. While the patient holds their hand above their heart, the health care provider measures the time it takes for blood to return to the tissue. Return of blood is indicated by the nail turning back to a pink color.

Of the events listed, which one may precipitate feelings of anxiety? Threats to self-esteem Encouragement in physical strengths Threats to those around us Emotional growth

Threats to self-esteem : Loss of significant relationships, loss of a spouse, difficulty at work, or loss of job are all threats to self-esteem and influence the amount of anxiety a person has.

Recombinent Tissue plasminogen activator (TPA)

Tissue plasminogen activator is a protein involved in the breakdown of blood clots. It is a serine protease found on endothelial cells, the cells that line the blood vessels. tPA is used in some cases of diseases that feature blood clots, such as pulmonary embolism, myocardial infarction, and stroke, in a medical treatment called thrombolysis. The most common use is for ischemic stroke. It can either be administered systemically, in the case of acute myocardial infarction, acute ischemic stroke, and most cases of acute massive pulmonary embolism, or administered through an arterial catheter directly to the site of occlusion in the case of peripheral arterial thrombi and thrombi in the proximal deep veins of the leg. Recombinant tissue plasminogen activators (r-tPAs) include alteplase, reteplase, and tenecteplase (TNKase).

Toxoplasmosis

Toxoplasmosis (tok-so-plaz-MOE-sis) is a disease that results from infection with the Toxoplasma gondii parasite, one of the world's most common parasites. Toxoplasmosis may cause flu-like symptoms in some people, but most people affected never develop signs and symptoms. If you have HIV/AIDS, are receiving chemotherapy or have recently had an organ transplant, a previous toxoplasma infection may reactivate. In that case, you're more likely to develop signs and symptoms of severe infection, including: Headache Confusion Poor coordination Seizures Lung problems that may resemble tuberculosis or Pneumocystis jiroveci pneumonia, a common opportunistic infection that occurs in people with AIDS Blurred vision caused by severe inflammation of your retina (ocular toxoplasmosis)

chlorpromazine (Thorazine)

Treats mental disorders, severe behavior disorders, severe hiccups, severe nausea and vomiting, and certain types of porphyria. Also used before and after surgery to relieve anxiety. Belongs to a class of drugs called phenothiazines. Chlorpromazine is classified as a low-potency typical antipsychotic and in the past was used in the treatment of both acute and chronic psychoses, including schizophrenia and the manic phase of bipolar disorder, as well as amphetamine-induced psychoses. Low-potency antipsychotics have more anticholinergic side effects, such as dry mouth, sedation, and constipation. Chlorpromazine has also been used in porphyria and as part of tetanus treatment. It still is recommended for short-term management of severe anxiety and psychotic aggression. Resistant and severe hiccups, severe nausea/emesis, and preanesthetic conditioning are other uses. Symptoms of delirium in medically-hospitalized AIDS patients have been effectively treated with low doses of chlorpromazine. Chlorpromazine is occasionally used off-label for treatment of severe migraine.[13][14] It is often, particularly as palliation, used in small doses to reduce nausea suffered by opioid-treated cancer patients and to intensify and prolong the analgesia of the opioids as well.[13][15] Chlorpromazine is the most effective substance against human infection by the brain-eating amoeba. One study concluded: "Chlorpromazine had the best therapeutic activity against Naegleria fowleri in vitro and in vivo. Therefore, it may be a more useful therapeutic agent for the treatment of primary amoebic meningoencephalitis than amphotericin B." There appears to be a dose-dependent risk for seizures with chlorpromazine treatment

Trichomoniasis

Trichomoniasis causes a frothy vaginal discharge that may be yellow-green or gray, itching and irritation of the genitals, burning with urination (sometimes confused with a urinary tract infection), discomfort during intercourse, and a foul smell. Because trichomoniasis is a sexually-transmitted disease, symptoms may appear within 4-20 days after exposure. Men rarely have symptoms, but if they do, they may have a thin, whitish discharge from the penis and painful or difficult urination. Trichomoniasis can be cured with a single dose of prescription antibiotic medication (either metronidazole or tinidazole), pills which can be taken by mouth. It is okay for pregnant women to take this medication. Some people who drink alcohol within 24 hours after taking this kind of antibiotic can have uncomfortable side effects.

Which of the following cardiac markers is specific to the heart, not influenced by skeletal muscle trauma or renal failure, and rises 3 hours following a myocardial infarction?

Troponin I is a myocardial muscle protein released into circulation after myocardial injury. It can identify very small amounts of myocardial injury. It rises 3 hours following a myocardial infarction, peaks at 14 to 18 hours, and returns to normal in 5 to 7 days. Troponin I is specific to the heart, not influenced by skeletal muscle trauma or renal failure, and is very useful in diagnosing a myocardial infarction.

Type AB Blood

Type AB blood is considered to be the "universal recipient" because it contains neither anti-A nor anti-B antibodies in its plasma. Therefore it does not clump any donor's RBCs containing A or B antigens.

An imaging technique whereby deep structures of the body are visualized by recording reflections or echoes of ultrasonic waves directed into the tissues is called:

Ultrasonography is an imaging technique whereby deep structures of the body are visualized by recording reflections or echoes of ultrasonic waves directed into the tissues. This test is not effective in examining all tissues because ultrasound waves do not pass through structures that contain air, such as the lungs. It requires no contrast medium and has no associated radiation, so it is useful for patients allergic to iodine and pregnant patients.

Which of the following diagnostic tests uses high frequency sound waves to examine internal structures of the body?

Ultrasound testing uses high frequency sound waves to examine internal structures of the body. A transducer is moved over the area being studied, an ultrasound beam is directed through the tissues, which reflects back to the transducer. The sound waves are converted into electrical impulses, which produce an image on a display screen. Ultrasound can show the size, consistency, and shape of a structure being studied.

Myocardial Infarct

Unstable angina lasting longer than 15 minutes that is not relieved by nitroglycerin.

When lifting and moving a patient up in bed, a lift sheet may be used. The best placement of a lift sheet under the patient is between the:

Upper back and the thighs: A lift sheet should extend from the shoulders to the thighs. This evenly distributes the patient's body weight, protects the nurses' backs, and facilitates the position change.

Urinary Urobilinogen Test

Urinary urobilinogen may be increased in the presence of a hemolytic process such as hemolytic anemia. It may also be increased with infectious hepatitis, or with cirrhosis. Comparing the urinary bilirubin result with the urobilinogen result may assist in distinguishing between red cell hemolysis, hepatic disease, and biliary obstruction. Increased amounts will be found hemolytic disease, and hepatic disease.

A woman comes to the clinic for her first prenatal visit. The nurse asks when her first day of her last menstrual cycle was. The woman reports July 10, 2004. Using Nägele's rule, the nurse calculates her estimated date of delivery to be:

Using Nagele's rule, the nurse counts back 3 months from first day of the last menstrual cycle and then adds 7 days. This results in April 17, 2005.

The nurse is caring for an adult patient with severe burns covering his face, anterior of his chest, and anterior and posterior of both his arms. Using the Rule of Nines, what percentage of this patient's body is burned?

Using the Rule of Nines, the face equals 4.5%, the anterior chest equals 18%, and the anterior and posterior of both arms equal 18% for a total of 40.5%.

vaccination

Vaccination is another term for immunization.

Ventricle septal defect

Ventricle septal defect shows signs of heart failure with a loud, harsh systolic murmur and palpable thrill.

Of the following, which is the most serious type of dysrhythmia? Atrial fibrillation Ventricular fibrillation Supraventricular tachycardia Sinus bradycardia

Ventricular fibrillation is a medical emergency that will result in death if left untreated. It is a state whereby the ventricles are quivering with disorganized electrical and mechanical activity. Prompt treatment, including CPR and defibrillation, are essential and must be performed promptly (ideally within 20 seconds) to give the patient the best chance of recovery.

gastroenteritis

Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal cramps, nausea or vomiting, and sometimes fever. The most common way to develop viral gastroenteritis — often called stomach flu — is through contact with an infected person or by ingesting contaminated food or water.

Visceral pain

Visceral pain originates from the internal organs. The words commonly used to describe the pain are cramping, pressure, dull, or squeezing.

Visceral:

Visceral: Referring to the viscera, the internal organs of the body, specifically those within the chest (as the heart or lungs) or abdomen (as the liver, pancreas or intestines).

The practical nurse (PN) is preparing to give a complete bed bath to an unconscious client. After implementing standard precautions before the procedure, what action should the PN implement first? Wear protective gloves while providing perineal and perianal care. Begin with a back wash and rub to assess for pressure areas over the sacrum. Change the water after washing the client's face, and again after washing the back. Wash each eye with a fresh area of a washcloth before washing the rest of the face.

Wash each eye with a fresh area of a washcloth before washing the rest of the face. The bed bathing procedure should begin and proceed from the cleanest to dirtiest areas. First, the eyes should be washed without soap and before the water is soiled by face washing (D). Gloves are required when providing care for highly contaminated body surfaces, such as the perineal and perianal care (A), which are commonly the last component of the bed bath. Back care (B) is usually performed after the face, arms, legs are washed and the client is turned to a side-lying position. Although wash basin water changes may be made at any time (C), clean water must be provided after washing the feet, and before and after perineal care.

A client with a possible mumps is admitted to an acute care facility. Which infection control precaution should the practical nurse (PN) implement? Wear a mask or respirator within 3 feet of client. Don a gown prior to entering the room. Move the client to a negative airflow room. Use only dedicated bedside equipment for care.

Wear a mask or respirator within 3 feet of client.

You have a patient who weighs 200 lb and is 62 inches. Using the formula for Body Mass Index, calculate the patient's BMI.

Weight to kilograms: 200/2.2 = 90.9; height to meters: 62/39.37 = 1.57; formula: 90.0/(1.57 x 1.57) = 36.95.

AMA

When a patient leaves a long-term care or acute care setting without a physician's order, it is considered "leaving AMA" and a form acknowledging that is usually signed by the patient.

As an LPN/LVN, you are responsible for giving end-of-shift reports. There are several types of reporting systems. No matter which system is used by your employing facility, the main thing to remember is: To pass on the most detailed information That you need to be as brief and quick as possible To gather all necessary information prior to beginning That confidentiality must be maintained

When passing on information at the end-of-shift report, the main thing for the LPN/LVN or RN to remember is that they must maintain patient confidentiality.

A patient is being discharged home and his peripheral I.V. site is to be discontinued. Following the removal of the catheter, what is the minimum length of time the nurse should hold pressure?

When the catheter is removed, the vein wall contracts to stop bleeding. Contraction is enhanced by pressure to the site for at least 2 to 3 minutes.

Upon entering the room of a patient you are assigned to care for, you find her unresponsive, not breathing, and with no pulse. You immediately call for assistance. What is your next nursing action?

While waiting for assistance, the nurse should continue assessing for the ABCs and begin by opening the patient's airway. possible error?

Which of the following are risk factors for osteoporosis? Select all that apply.

White and Asian women have a higher incidence of osteoporosis than do African-American women. Although this is one correct answer, it is not the only one. This question requires you to select all options that apply. High intake of caffeine has been found to be a risk factor for the development of osteoporosis. Although this is one correct answer, it is not the only one. This question requires you to select all options that apply. Steroid use has been found to be a risk factor for the development of osteoporosis. Women between the ages of 55 and 65 are identified as a high-risk group for the development of postmenopausal osteoporosis, and many researchers believe that this is related to the loss of estrogen. missing ?

A nurse is collecting information from a patient's mother while in the clinic. It is suspected that the patient has scarlet fever. Which of the following are signs or symptoms of scarlet fever?

White strawberry tongue Sandpaper-like red rash missing ?

Widening pulse pressure

Widening pulse pressure occurs because of an increased systolic blood pressure (due to excitation of vasoconstrictor fibers from ischemia of the vasomotor center) coupled with a stable diastolic blood pressure. This occurs later in the process of increased intracranial pressure, when herniation is imminent.

Metabolic alkalosis

With metabolic alkalosis, the pH is > 7.45, PaCO2 is normal or > 45 mm Hg, and the HCO3 is > 26 mEq/L.

A head injury patient has been admitted to ICU with dyspnea, tachycardia, tremors, lethargy, and disorientation. The results of an arterial blood gas showed pH = 7.28, PaCO2 = 60 mm Hg, HCO3 = 22 mEq/L. What condition is suspected?

With respiratory acidosis. the pH is < 7.35, PaCO2 is > 45 mm Hg and the HCO3 is normal.

respiratory acidosis

With respiratory acidosis. the pH is < 7.35, PaCO2 is > 45 mm Hg and the HCO3 is normal.

respiratory alkalosis

With respiratory alkalosis, the pH is > 7.45, PaCO2 is < 35mm Hg and the HCO3 is normal.

Fetal hemolytic disease

Yellow-stained amniotic fluid is an indication of fetal hemolytic disease or an intrauterine infection

Why would you need a lumbar puncture?

You may need an LP to check for one or more of the following: Infection, such as meningitis (men-in-JEYE-tis), or inflammation (swelling) of the brain. Bleeding in the brain, such as from a head injury. Increased pressure that may be causing certain kinds of headaches. A tumor (lump or mass) in the area of the spine or brain. Some diseases of the nervous system, such as multiple sclerosis or epilepsy (seizures). An LP may also be done as part of another test, such as a test that needs dye put into the CSF. Some medicines can be given into the spine during an LP. Examples include anesthesia (an-es-THEE-zah) medicine, antibiotics (an-ti-bi-AH-tiks), and cancer-treating medicine (chemotherapy).

Treatment of Hyperkalemia

You will need emergency treatment if your potassium level is very high, or if you have danger signs, such as changes in an ECG. Having a blood potassium level higher than 7.0 mmol/L can be dangerous and requires immediate treatment. Emergency treatment may include: Calcium given into your veins (IV) to treat the muscle and heart effects of high potassium levels Glucose and insulin given into your veins (IV) to help lower potassium levels long enough to correct the cause Kidney dialysis if your kidney function is poor. Medications that help remove potassium from the intestines before it is absorbed Sodium bicarbonate if the problem is caused by acidosis Water pills (diuretics) to decrease total potassium Changes in your diet can help both prevent and treat high potassium levels. You may be asked to: Limit or avoid asparagus, avocados, potatoes, tomatoes or tomato sauce, winter squash, pumpkin, and cooked spinach Limit or avoid oranges and orange juice, nectarines, Kiwis, raisins, or other dried fruit, bananas, cantaloupe, honeydew, prunes, and nectarines Avoid taking salt substitutes if you are asked to eat a low-salt diet Your doctor may make the following changes to your medicines: Reduce or stop potassium supplements Stop or change the doses of medicines you are taking, such as ones for heart disease and high blood pressure Take a certain type of water pill to reduce potassium and fluid levels if you have chronic kidney failure

Steps for a Z-track injection

Z-track method: →Verify the drug order on the patient's chart. →Wash your hands. →Reconstitute the drug as needed. Check the drug's color, clarity, and expiration date. →Draw the correct amount of drug into the syringe using aseptic technique. →After drawing up the dose, replace the original needle with a sterile needle of the appropriate length for the patient's size. →Put on gloves. →Confirm the patient's identity using two identifiers. →Select an injection site: the ventrogluteal or deltoid site in adults, the vastus lateralis site in infants and toddlers, and the vastus lateralis or deltoid site in children. →Position the patient so that the muscle at the injection site relaxes. →Clean the site with an alcohol pad and let it thoroughly dry. →Use your nondominant hand to pull the skin downward or laterally to displace the tissue about 1 inch (2.54 cm) →With the needle at a 90-degree angle to the site, pierce the skin using a smooth, steady motion. →Aspirate for 5 to 10 seconds to ensure that you haven't hit a blood vessel. →Inject the drug slowly at a rate of 10 seconds/mL of medication. →Once the drug is completely instilled, wait 10 seconds before withdrawing the needle. →Withdraw the needle with a smooth, steady motion and release the skin to its original position. Use dry gauze to apply very gentle pressure to the puncture site. →Never massage a Z-track injection site. This may cause irritation or force the drug into subcutaneous tissue. →Assess the site immediately after administering the injection and again 2 to 4 hours later. →Properly dispose of all used equipment and supplies.

Central Line

a central venous catheter ("central line", "CVC", "central venous line" or "central venous access catheter") is a catheter placed into a large vein in the neck (internal jugular vein), chest (subclavian vein or axillary vein) or groin (femoral vein). It is used to administer medication or fluids, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure.

flexion

a movement allowed by certain joints of the skeleton that decreases the angle between two adjoining bones, such as bending the elbow, which decreases the angle between the humerus and the ulna.

excoriation

a raw irritated lesion (as of the skin or a mucosal surface)

ampule

a sealed glass capsule containing a medication esp. a measured quantity ready for injection.

Excessive use or abuse, display of psychologic disturbance, decline of social and economic function and uncontrollable consumption indicating dependence are the four element that define:

addiction

Clear and copious urine is generally a sign of

adequate hydration. Copious abundant in quantity or in supply.

A patient is being cared for in the hospital and had the opportunity to formulate a Living Will and Durable Power of Attorney for Healthcare. These are examples of:

advanced directives

The term that best describes the external manifestation of inner feelings or emotions and is often reflected by one's facial expressions is:

affect; A persons affect is part of his or her feelings and behaviors, which are often reflected by facial expression.

thready pulse

an abnormal pulse that is weak, somewhat difficult to palpate, and often fairly rapid. The artery does not feel full, and the rate may be difficult to count. It is characteristic of hypovolemia, such as occurs with severe hemorrhage.

hematuria

blood in urine

pneumothorax

collapsed lung or Pneumothorax occurs when air leaks into the space between your lungs and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses. Symptoms usually include sudden chest pain and shortness of breath.

A cardiac catheterization is used to:

doctor can: Collect blood samples from the heart Measure pressure and blood flow in the heart's chambers and in the large arteries around the heart Measure the oxygen in different parts of your heart Examine the arteries of the heart Perform a biopsy on the heart muscle For some procedures, you may be injected with a dye that helps your doctor to visualize the structures and vessels within the heart. If you have a blockage, you may have angioplasty and a stent placed during the procedure. The test may last 30 - 60 minutes. If you also need special procedures, the test may take longer. If the catheter is placed in your groin, you will often be asked to lie flat on your back for a few to several hours after the test to avoid bleeding.

review WHO list of essential medications

http://en.wikipedia.org/wiki/WHO_Model_List_of_Essential_Medicines

Wheezes, crackles, pleural friction rub, bronchovesicular sounds heard:

http://www.cvmbs.colostate.edu/clinsci/callan/breath_sounds.htm

hypovolemia

hypovolemia (also hypovolaemia, oligemia or shock) is a state of decreased blood volume; more specifically, decrease in volume of blood plasma. It is thus the intravascular component of volume contraction (or loss of blood volume due to things such as hemorrhaging or dehydration), but, as it also is the most essential one, hypovolemia and volume contraction are sometimes used synonymously. Hypovolemia is characterized by salt (sodium) depletion and thus differs from dehydration, which is defined as excessive loss of body water.

cholecystitis

inflammation of the gallbladder. Acute gallstone attacks may be managed with intravenous medications. Chronic (long-standing) cholelithiasis is treated by surgical removal of the gallbladder. Left untreated, cholelithiasis can lead to serious complications such as tissue damage, tears in the gallbladder, and infection that spreads to other parts of your body.

polycythemia

is a disease state in which the proportion of blood volume that is occupied by red blood cells increases. Blood volume proportions can be measured as hematocrit level. It can be due to an increase in the number of red blood cells[1] ("absolute polycythemia") or to a decrease in the volume of plasma ("relative polycythemia").[2] Polycythemia is sometimes called erythrocytosis, but the terms are not synonymous because polycythemia refers to any increase in red blood cells, whereas erythrocytosis only refers to a documented increase of red cell mass.

Addison disease is a disease where what happens?

is a disorder that occurs when the adrenal glands do not produce enough hormones. The cortex produces three hormones: Glucocorticoid hormones (such as cortisol) maintain sugar (glucose) control, decrease (suppress) immune response, and help the body respond to stress. Mineralocorticoid hormones (such as aldosterone) regulate sodium and potassium balance. Sex hormones, androgens (male) and estrogens (female), affect sexual development and sex drive.

The Papanicolaou test (abbreviated as Pap test, known earlier as Pap smear, cervical smear, or smear test)

is a method of cervical screening used to detect potentially pre-cancerous and cancerous processes in the endocervical canal (transformation zone) of the female reproductive system. In the United States Pap smear screening is recommended starting around 21 years of age until the age of 65

Sumatriptan (Imitrex)

is a synthetic drug belonging to the triptan class, used for the treatment of migraine headaches. Sumatriptan is produced and marketed by various drug manufacturers with many different trade names such as Sumatriptan, Imitrex, Treximet, Imigran, Imigran recovery. Serious cardiac events, including some that have been fatal, have occurred following the use of sumatriptan injection or tablets. Events reported have included coronary artery vasospasm, transient myocardial ischemia, myocardial infarction, ventricular tachycardia, and ventricular fibrillation (V-Fib). Large doses of sumatriptan can cause sulfhemoglobinemia, a rare condition in which the blood changes from red to greenish-black, due to the integration of sulfur into the hemoglobin molecule.[2] If sumatriptan is discontinued, the condition reverses within a few weeks.

Lactulose

is a synthetic, non-digestible sugar used in the treatment of chronic constipation and hepatic encephalopathy, a complication of liver disease. Lactulose is a synthetic sugar used to treat constipation. It is broken down in the colon into products that pull water out from the body and into the colon. This water softens stools. Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body. Lactulose comes as liquid to take by mouth. It usually is taken once a day for treatment of constipation and three or four times a day for liver disease.

Diffusion

is the process whereby a solute (substance that is dissolved) may spread through a solution or solvent (solution in which the solute is dissolved.) The solute spreads the molecules from an area of higher concentration to an area of lower concentration. It occurs within fluid compartments in the body as long as the barrier between the compartments is permeable to the diffusing substances.

epigastric pain

pain is located in the upper central portion of the abdomen. It is located between the costal arch (lower edge) of the thorax and the sub-costal plane.

Home health care is viewed from different perspectives. Which perspective is defined as skilled and compassionate care provided on a one-to-one basis, based on individual needs and personalized schedules? Official Patient Family Provider

patient

In third-spacing, where may fluid be trapped and result in a fluid volume loss?

pericardial, pleural, peritoneal, or joint cavities; the bowel; or the abdomen or within soft tissues after trauma or burns.

postnecrotic cirrhosis

postnecrotic cirrhosis a nodular form of cirrhosis that may follow hepatitis or other inflammation of the liver. Also called posthepatic cirrhosis. See also cirrhosis.

acculturation

process of learning norms, beliefs, and behavioral expectations of a group other than one's own group.

erythrocytes

red blood cells or RBCs: A cell that contains hemoglobin and can carry oxygen to the body. The reddish color is due to the hemoglobin. Erythrocytes are biconcave in shape, which increases the cell's surface area and facilitates the diffusion of oxygen and carbon dioxide. This shape is maintained by a cytoskeleton composed of several proteins. Erythrocytes are very flexible and change shape when flowing through capillaries. Immature erythrocytes, called reticulocytes, normally account for 1-2 percent of red cells in the blood.

intracellular compartment

refers to all fluid inside the cell

extracellular compartment

refers to all fluid outside of the cell

What is second spacing?

refers to the abnormal accumulation of interstitial fluid (fluid that is between the cells and blood vessels.) Example: edema

At which stage of NREM sleep are sleep walking and enuresis most likely to occur?

stage 4: Stage 4 is the deepest stage of sleep and it is difficult to arouse a sleeper. Sleep walking and enuresis are most likely to occur at this stage.

When preparing a patient for an electrocardiogram (ECG), which is the best position for the patient to be in?

supine: Usually supine is the preferred position to place a patient in to ensure test accuracy.

gastrojejunostomy /gas·tro·je·ju·nos·to·my/ (-jĕ″joo-nos?tah-me)

surgical creation of an anastomosis (surgical connection between two structures) between the stomach and jejunum.

mEq or milli-equivalent

the unit of measure that expresses the combining activity of an electrolyte.

von Willebrand's disease

von Willebrand's disease is an inherited bleeding disorder characterized by abnormally slow coagulation of blood and spontaneous episodes of gastrointestinal bleeding, epistaxis, and gingival bleeding caused by a mild deficiency of factor VIII. It is common during postpartum periods, as menorrhagia, and after surgery or trauma. It affects both women and men.

Interstitial fluid is?

Also, called tissue fluid is a solution that bathes and surrounds the cells of multicellular animals. The interstitial fluid is found in the interstitial spaces, also known as the tissue spaces. Interstitial fluid consists of a water solvent containing sugars, salts, fatty acids, amino acids, coenzymes, hormones, neurotransmitters, as well as waste products from the cells. Red blood cells, platelets, and plasma proteins cannot pass through the walls of the capillaries. The resulting mixture that does pass through is, in essence, blood plasma without the plasma proteins. Tissue fluid also contains some types of white blood cell, which help combat infection. On average, a person has about 10 L of interstitial fluid (they make up 16% of the total body weight), providing the cells of the body with nutrients and a means of waste removal.

While reviewing fire safety, a type ABC fire extinguisher can only be used on which type of fire?

An ABC fire extinguisher is used on any type of fire.

anaphylaxis

Anaphylaxis is a term that refers to a life-threatening response of the body. It is an exaggerated allergic response brought about by large amounts of immunoglobulins that respond to the presence of foreign agents.

Name the different types of cardiovascular disease?

Arrhythmias

asthenia

Asthenia is a condition of debility and loss of strength and energy.

A "shift to the left" on the WBC differential indicates an increase in the number of:

Bands, or immature polymorphonuclear leukocytes, are in their final stage of development. In a severe infection, the bone marrow releases these immature cells, as it has used up its reserve. When the band count exceeds 8% of the number of polys, this is called a "shift to the left."

Behavior therapy

Behavior therapy is used to relieve anxiety by conditioning and retraining of behavioral responses by repetition.

CDC

CDC stands for Centers for Disease Control and Prevention.

cardiac tamponade

Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium). In this condition, blood or fluid collects in the pericardium, the sac surrounding the heart. This prevents the heart ventricles from expanding fully. The excess pressure from the fluid prevents the heart from working properly. As a result, the body does not get enough blood.

Cimetidine (Tagament)

Cimetidine is in a group of drugs called histamine receptor antagonists. Cimetidine works by decreasing the amount of acid your stomach produces. Treats heartburn and peptic ulcers. Cimetidine is used to treat and prevent certain types of ulcer, and to treat conditions that cause the stomach to produce too much acid. Cimetidine is also used to treat gastroesophageal reflux disease (GERD), when stomach acid backs up into the esophagus and causes heartburn. Avoid taking antacids unless your doctor recommends them for heartburn pain.

Coping responses

Coping responses are used to reduce anxiety brought on by stress.

Deficiency disease

Deficiency disease results from the lack of a specific nutrient.

Diabetes mellitus type 2

Diabetes mellitus type 2 arises from insulin resistance. In the past it occurred in those who were older than 45, overweight, and sedentary.

dysphagia

Difficulty with swallowing is the sensation that food is stuck in the throat, or from the neck down to just above the abdomen behind the breastbone (sternum).

Dilation

Dilation is the process of the cervix and cervical canal enlarging and widening of the cervical opening.

documentation

Documentation is the written data obtained by a health care worker.

During which phase of the nursing process does documentation take place?

Documentation takes place in the implementation phase and is necessary for the evaluation of patient care.

dyspnea

Dyspnea is the term for shortness of breath, which indicates a problem with the respiratory system.

Give examples of structure types of Epithelial tissues

Epithelial tissue is either simple squamous, stratified squamous, simple columnar, or stratified transitional.

Expressive aphasia

Expressive aphasia is another name for motor aphasia; this is the inability to use symbols of speech.

When a pregnant patient is being monitored for preeclampsia, fetal condition is monitored also. If the physician requests a kick count, how many counts per hour is considered serious?

Fetal activity decreases if hypoxia develops; therefore, fetal activity < 3 counts per hours is considered serious and needs to be reported.

Frequent heavy consumption of alcohol is a risk factor for cancer originating in which organs?

Frequent heavy consumption of alcohol is a risk factor for cancer of the esophagus, larynx, throat, and liver, as well as oral cancer.

Functional limitation

Functional limitation is any loss of ability to perform tasks and obligations of usual roles and normal daily life.

Group therapy

Group therapy is where a group of patients with similar problems gains insight through discussion or role playing.

HIV-1

HIV-1 is the more virulent strain of the HIV virus. It is found worldwide but is most prevalent in the United States and Europe.

Which of the following is the less virulent form of the HIV virus?

HIV-2 appears to be a less virulent form of the HIV virus, found primarily in western Africa and countries with historical or commercial ties to that geographic area. One study in Africa showed that women affected with HIV-2 did not develop AIDS during the 5-year period after infection, compared with 33% of those infected with HIV-1.

The most common form of hepatitis today, having an incubation period of 10 to 40 days, is hepatitis:

Hepatitis A is the most common form of hepatitis today. Formerly named infectious hepatitis, it is a short-incubation virus (10 to 40 days).

Hepatitis C

Hepatitis C has an incubation period of 2 weeks to 6 months, commonly 6 to 9 weeks.

Hydronephrosis

Hydronephrosis is a condition where urine overfills, or backs up, into the kidney, which causes the kidney to swell.

Signs and symptoms of Hyperkalemia

Hyperkalemia is a serious and potentially life-threatening disorder. It can cause: Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea

hypertension

Hypertension is a sustained blood pressure reading above 140/90.

Hypertonic solution

Hypertonic solution is a solution of higher osmotic pressure that pulls fluid from the cells.

Which of the following physical signs and symptoms might the postpartum patient experience following delivery? Select all that apply.

Increased urination beginning 4-6 hours after delivery Increased diaphoresis, most commonly at night A normal bowel movement within 2-3 days

When preparing a medication for a intramuscular injection, what size needle length is needed?

Intramuscular injections may require a 1- to 1 1/2-inch needle.

Malabsorption can be a major problem with Crohn's disease when what portion of the intestine is involved?

Malabsorption can be a major problem with Crohn's disease when the small intestine is involved. Megaloblastic anemia results from decreased absorption of vitamin B12 in the small intestine. Fluid and electrolyte disturbances can occur, particularly with a depletion of sodium or potassium associated with diarrhea or excessive small intestine drainage through fistulas.

occupational therapy

Occupational therapy teaches to adapt to physical handicaps by learning ADLs.

Pain control for a hospice patient is best attained using long-acting medications. Which of the following are long-acting medications?

OxyContin Duragesic patch missing ?

pain

Pain is one of the cardinal signs of infections and inflammation.

palpation

Palpation is where the nurse uses his or her hands and senses of touch to gather data.

A patient who is unable to move about freely and needs assistance from staff and a mechanical device would require _____ ROM exercises.

Passive ROM exercises are used with a patient who is partially immobile and unable to move about freely

Levine's Sign

Patient makes fist and holds it up to his chest, to describe the pain.

platelets

Platelets are the tiny blood cells that help stop bleeding by binding together to form a clump or plug at sites of injury inside blood vessels.

Homan's sign

Positive Homan's sign is used to watch for signs of a thrombus but is not a concrete action to prevent one from developing.

Ribosomes

Ribosomes are tiny free-floating structures in the cytoplasm or attached to the rough ER.

Serotonin

Serotonin induces sleep, affects sensory perception, controls temperature, and has a role in the control of mood.

In the home care setting, which type of service is most frequently provided?

Skilled nursing is the most frequently provided service owing to the trend toward shorter hospitalization and early discharge of seriously ill patients.

Steatorrhea (or steatorrhoea)

Steatorrhea (or steatorrhoea) is the presence of excess fat in feces. Stools may also float due to excess lipid, have an oily appearance and can be especially foul-smelling

Striae gravidarum,

Striae gravidarum, or stretch marks, are reddish, wavy streaks that can appear on the thighs, abdomen, and breasts.

What position should a nurse place a client in who is receiving an enteral tube feeding?

Supine with the head of the bed elevated 30-45 degrees, which uses gravitational to reduce influx.

SBAR Report

The SBAR technique offers hospitals and care facilities a solution to bridge the gap in communication, including hand-offs, patient transfers, critical conversations and telephone calls. It creates a shared expectation between the sender and receiver of the information being shared. (Situation, Background, Assessment and Recommendation) in sequence. Only the most relevant data is included, and everything irrelevant or of secondary importance is excluded.

A urine specimen that is obtained by catheterization within 10 minutes after the patient voiding is called a _____ urine specimen.

The amount of urine obtained after the voiding of a patient is considered a residual urine specimen.

brachial pulse

The brachial pulse indicates blood flow to the arm.

When performing chest compressions on a child, the breastbone is compressed to the depth of:

The chest is compressed with the heel of one hand at a depth of 1 to 1.5 inches at 100 times per minute.

Coronal plane

The coronal plane, also called the frontal plane, divides the body into a ventral (front) section and a dorsal (back) section.

3rd Stage of Delivery

The delivery of the placenta completes the third stage of delivery, lasting approximately 5 to 20 minutes.

The hands and feet contain what are known as ___ bones.

The hands and feet contain what are known as short bones.

The physician has ordered for your patient's leg wound to be irrigated using an antiseptic solution. To reduce the chance of contamination you would:

The irrigating solution needs to flow from the least contaminated to the most contaminated to avoid contamination of clean tissue by exudates.

Mediastinum

The mediastinum is a subdivision of the thoracic cavity that contains the trachea, heart, and blood vessels.

medical director

The medical director assumes overall responsibility for the medical component of the hospice patient's care program.

What is the most common cause of hyperkalemia?

The most common cause of genuinely high potassium (hyperkalemia) is related to your kidneys, such as: Acute kidney failure Chronic kidney disease Other causes of hyperkalemia include: Addison's disease (adrenal failure) Alcoholism or heavy drug use that causes rhabdomyolysis, a breakdown of muscle fibers that results in the release of potassium into the bloodstream Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Destruction of red blood cells due to severe injury or burns Excessive use of potassium supplements Type 1 diabetes

Amylase

The pancreas produces amylase to break down carbohydrates in food into simple sugars. Lipase is produced by the pancreas to digest fats into fatty acids. Sugars and fatty acids can then be absorbed by the small intestine.

Which of the following mnemonics is used most often to set priorities in case of a fire?

The priorities are: Rescue and remove all patients; Activate the alarm; Confine the fire by closing doors and window; Extinguish the fire using an extinguisher (RACE).

Sagittal Plane

The sagittal plane runs lengthwise from the front to the back.

The body plane that runs lengthwise from the front to the back is called the:

The sagittal plane runs lengthwise from the front to the back.

Generativity versus stagnation

This stage occurs in middle adulthood where adults are productive, performing meaningful work and raising a family.

Your patient with leukemia is susceptible to hemorrhage. Which blood dyscrasia makes him susceptible to this?

Thrombocytopenia associated with leukemia makes a patient susceptible to hemorrhage. Without sufficient numbers of thrombocytes, the body is unable to clot blood. It is essential that nursing care be delivered in a safe and gentle manner.

Transvestic fetishism

Transvestic fetishism involves wearing clothing of the opposite sex to obtain sexual gratification.

Type O Blood

Type O blood contains neither A nor B antigens. It can be used in an emergency as donor blood without the danger of anti-A or anti-B antibodies clumping its RBCs. Type O blood is known as the "universal donor."

pneumothorax

collapsed lung

Endoscopic retrograde cholangiopancreatography (ERCP)

is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is a procedure that looks at the bile ducts. It is done through an endoscope. Bile ducts are the tubes that carry bile from the liver to the gallbladder and small intestine. ERCP is used to treat stones, tumors, or narrowed areas of the bile ducts. The procedure is used mostly to treat problems of the pancreas or bile ducts that can cause abdominal pain (usually in the right upper or middle stomach area) and yellowing of the skin and eyes (jaundice).

urolithiasis

is the condition where urinary stones are formed or located anywhere in the urinary system.

Uticaria

or Hives are raised, often itchy, red welts on the surface of the skin. They are usually an allergic reaction to food or medicine.

How is a brain aneurysm diagnosed?

A CT scan of the head is done to look for blood in the brain. If the CT scan does not show the problem, a lumbar puncture and angiogram are done. A lumbar puncture (also called a spinal tap) looks for blood in the fluid inside the spine. This fluid is called CFS, or cerebrospinal (ser-EE-bro-spi-nal) fluid. Blood in the fluid means there may be a subarachnoid hemorrhage. An angiogram is done to show the exact location of the aneurysm. A catheter (thin tube) will be placed into a blood vessel in your neck. Through this, a dye will be injected into these vessels. The dye shows up on an x-ray, and if there is any bleeding, it will appear.

Hickman line

A Hickman line is a central venous catheter most often used for the administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis. Some types are used mainly for the purpose of apheresis or dialysis. Hickman lines may remain in place for extended periods and are used when long-term intravenous access is required. They are done under sedation or a general anesthetic by a radiologist or surgeon. It involves two incisions, one at the jugular vein or another nearby vein or groove, and one on the chest wall. At the former incision site (known as the "entrance" site), a tunnel is created from there through to the latter incision site (known as the "exit" site), and the catheter is pushed through this tunnel until it "exits" the latter incision site. The exit site is where the lumens are seen as coming out of the chest wall. The catheter at the entrance site area is then inserted back through the entrance site and advanced into the superior vena cava, preferably near the junction of it and the right atrium of the heart. The entrance site is sutured. The catheter at the exit site is secured by means of a "cuff" just under the skin at the exit site, and the lumens are held down otherwise by a sterile gauze or dressing centered on the exit site, which also serves the purpose of preventing potential contamination at the exit site. Throughout the procedure, ultrasound and X-rays are used to ascertain the positioning of the catheter.

You are teaching your patient about prevention and detection of cancer. The most appropriate advice would include which of the following? Select all that apply. Eat a balanced diet that includes vegetables, fruit, whole grains, and fiber. Know the seven warning signs of cancer. Seek out stress in order to "fully experience" life. Perform monthly breast examinations only if you are female. Seek immediate medical care if you notice a change in what is normal for you.

A balanced diet that includes vegetables (green, yellow, and orange), fresh fruit, whole grains, and adequate amounts of fiber helps prevent certain types of cancer. Other important dietary teaching points include reducing the amount of fat and preservatives consumed, including smoked and salt-cured meats. The seven warning signs of cancer are important to know. These are: change in bowel or bladder habits; a sore that does not heal; unusual bleeding or discharge; thickening or lump in the breast or elsewhere; indigestion or difficulty swallowing; obvious change in a wart or mole; and nagging cough or hoarseness Seeking immediate medical care if a change in what is normal for you is noticed is an important strategy in early cancer detection. Early detection of cancer has a positive impact on the prognosis

barium swallow

A barium swallow is a study using a contrast medium (barium) to detect tumors, strictures, or esophageal varices. If perforation is suspected, a substance called Gastrografin, which is water soluble, rather than barium, is used.

A bedfast patient has a sacral pressure ulcer. The nurse instructs the staff that the patient needs to be repositioned how often?

A bedfast patient on complete bed rest patient should be turned at least every 2 hours. Avoid the full lateral position.

A catheterization laboratory or cath lab

A catheterization laboratory or cath lab is an examination room in a hospital or clinic with diagnostic imaging equipment used to visualize the arteries of the heart and the chambers of the heart and treat any stenosis or abnormality found

The earliest sigh of increased intracranial pressure is:

A change in LOC is the earliest sigh of increased intracranial pressure. This change in LOC may include disorientation, restlessness, or lethargy.

A chronic subdural hematoma

A chronic subdural hematoma is an "old" collection of blood and blood breakdown products between the surface of the brain and its outermost covering (the dura). The chronic phase of a subdural hematoma begins several weeks after the first bleeding. A subdural hematoma develops when the tiny veins that run between the dura and surface of the brain (bridging veins) tear and leak blood. This is usually the result of a mild head injury.A collection of blood then forms over the surface of the brain. In a chronic subdural collection, blood leaks from the veins slowly over time, or a fast hemorrhage is left to clear up on its own. A subdural hematoma is more common in the elderly because of normal brain shrinkage that occurs with aging. This shrinkage stretches and weakens the bridging veins. These veins are more likely to break in the elderly, even after a minor head injury.

Blood Urea Nitrogen (BUN) test:

A common blood test, the blood urea nitrogen (BUN) test reveals important information about how well your kidneys and liver are working. A BUN test measures the amount of urea nitrogen that's in your blood. Results of the blood urea nitrogen test are measured in milligrams per deciliter (mg/dL) in the United States and in millimoles per liter (mmol/L) internationally. In general, 7 to 20 mg/dL (2.5 to 7.1 mmol/L) is considered normal.

A concussion

A concussion is a minor traumatic brain injury that may occur when the head hits an object, or a moving object strikes the head. It can affect how the brain works for a while. A concussion can lead to a bad headache, changes in alertness, or loss of consciousness.

creatinine clearance test

A creatinine clearance test requires a 24-hour urine specimen.

A client arrives in the clinic complaining of radiating back pain. Which finding related to a possible dissecting aneurysm should the practical nurse (PN) report to the healthcare provider? A) Ripping chest pain and blood pressures of 150/90 in right arm and 120/70 in left arm. B) Sudden right flank pain with gross hematuria. C) Sharp epigastric pain that radiates to the scapula. Incorrect D) Lower back pain that radiates down back of the leg and is more intense with coughing.

A dissecting aneurysm is a tearing of the intima of a major artery, such as the ascending aorta, and classically presents with the onset of sudden, severe, ripping pain that moves. Depending on the location, as the intima of the artery tears, a difference in the extremity perfusion (A), deceased urine output, or petechiae on the feet occur. (B) is characteristic of a kidney stone (renal lithiasis). (C) occurs with acute biliary colic and cholelithiasis. (D) describes pain associated with an intervertebral disc herniation. Category: Medical-Surgical

myocardial infarction

A heart attack occurs when blood flow to a part of your heart is blocked for a long enough time that part of the heart muscle is damaged or dies. The medical term for this is myocardial infarction.

A laceration is a wound that has

A laceration is a wound that has jagged, irregular edges caused by auto accidents, blunt objects, or heavy machinery.

Low viral load

A low viral load means that less of the virus is circulating in the blood and body fluids.

lumbar laminectomy

A lumbar laminectomy is also known as an open decompression and typically performed to alleviate pain caused by neural impingement that can result from lumbar spinal stenosis. condition that primarily afflicts elderly patients, spinal stenosis is caused by degenerative changes that result in enlargement of the facet joints. The enlarged joints then place pressure on the nerves, and this pressure may be effectively relieved with the laminectomy. The lumbar laminectomy is designed to remove a small portion of the bone over the nerve root and/or disc material from under the nerve root to give the nerve root more space and a better healing environment.

medical diagnosis

A medical diagnosis is the problem identified by the physician upon admission.

You are admitting a patient who has polycythemia to your unit. Which of the following patients best fits the profile of a patient with this disorder? A thin older white woman with a pale complexion An older male with pallor and activity intolerance A middle-aged woman with hypotension and syncope A middle-aged male with elevated blood pressure and an erythematous appearance

A middle-aged male with elevated blood pressure and an erythematous appearance: The typical patient with polycythemia is a middle-aged male with elevated blood pressure and an erythematous appearance. The elevated blood pressure results from fluid volume excess resulting from excessive bone marrow production. The erythema results from increased erythrocytes.

midstream urine specimen

A midstream urine specimen is collected after voiding is initiated but before voiding is completed.

normal platelet count

A normal platelet count is between 150,000 and 450,000 platelets per microliter (one-millionth of a liter, abbreviated mcL). Hesi normal platelets 150,000 to 400,000/mm3

patient goal

A patient goal is a statement that includes what the patient needs to do to make changes in the problem.

A peripheral smear

A peripheral smear is an examination of the size, shape, and structure of individual red blood cells and platelets. This is useful in differentiating various forms of anemias and blood dyscrasias.

Sundowning syndrome

A person with nocturnal delirium displays increased disorientation and agitation only during the evening and nighttime.

Brudzinski sign

A physical sign of meningitis, which is evoked by either passive flexion of one leg, resulting in a similar movement on the opposite side, or if the neck is passively flexed and flexion occurring in the legs.

What is the difference between Atelectasis and pneumothorax?

A pneumothorax more technically is air in the pleural space. The pleural space is the space between the visceral pleura and the parietal pleura. The visceral pleura is a thin membrane that covers the lungs, and the parietal pleura is a thin membrane that covers the inside of the chest wall. The space between the two is known as the pleural space. there should be no air in the pleural space. The absence of air in the pleural space establishes a pressure gradient within the chest that allows for lungs to inflate. But if air enters this space, the pressure gradient is broken. This means the lung is unable to expand against the pressure the air is exerting upon the lung from the pleural space. Atelectasis refers to improper amounts of air in the alveoli (air sacs), resulting in a loss of volume in all or part of the lung. This loss of air in the alveoli can be due to obstruction. For example, mucus may plug up the airways leading to the alveoli. A pneumothorax may lead to atelectasis as well. Just think about it. If the lung turns into something like a balloon that can't inflate, t

Babinski reflex:

A reflex used to determine adequacy of the higher (central) nervous system. The Babinski reflex is obtained by stimulating the outside of the sole of the foot, causing extension of the big toe while fanning the other toes. The examiner begins the stimulation at the heel and goes forward to the base of the toes. Most newborn babies and young infants are not neurologically mature, and they therefore show a Babinski reflex. A Babinski reflex in an older child or an adult is abnormal and is a sign of a problem in the brain or spinal cord. A Babinski reflex that is present on one side but not the other is also abnormal, and it can indicate which side of the brain is involved. Also known as plantar response, big toe sign, and Babinski phenomenon, response, or sign.

Interventions basic to long-term care include making rounds and monitoring for resident safety:

A resident should be seen, changed in position, assessed for incontinence, provided with skin care, or offered fluids at least every 2 hours. The LPN or RN has the responsibility of assessing and intervening to support progress toward the patient-centered expected outcomes by following the interventions.

Which protocol regarding standard policies about prescriptions should the practical nurse (PN) question? All drug prescriptions should have the date, time, and prescriber's signature. Incorrect Verbal orders are accepted from prescribers and should include signatures. Prescribers may write specific times at which the medications are to be given. Preoperative prescriptions should be resumed after a client returns from surgery. Correct

A standard policy about preoperative medications states that preoperative prescriptions are automatically canceled for surgery and should be rewritten, if indicated, in the postoperatively, so the PN should question (D). (A, B, and C) are correct statements. All providers' prescriptions must have a date, time, and provider's signature to be valid. Verbal orders can be taken by a nurse when the provider is not available to write a prescription and validated with signatures. Although many facilities have policies for prescriptions times of administration, the prescription should indicate the frequency for medication administration and may include a specific time of day. Category: Fundamentals

stenosis

A stenosis (plural: stenoses, /stəˈnoʊˌsiːz/) (from Ancient Greek στένωσις, "narrowing") is an abnormal narrowing in a blood vessel or other tubular organ or structure. The resulting syndrome depends on the structure affected. Examples of vascular stenotic lesions include: Intermittent claudication (peripheral artery stenosis) Angina (coronary artery stenosis) Carotid artery stenosis which predispose to (strokes and transient ischaemic episodes) Renal artery stenosis The types of stenoses in heart valves are: Pulmonary valve stenosis, which is the thickening of the pulmonary valve, therefore causing narrowing Mitral stenosis, which is the thickening of the mitral valve (of the left heart), therefore causing narrowing Tricuspid valve stenosis, which is the thickening of the tricuspid valve (of the right heart), therefore causing narrowing Aortic valve stenosis, which is the thickening of the aortic valve, therefore causing narrowing Stenoses/strictures of other bodily structures/organs include: Pyloric stenosis (gastric outflow obstruction) Lumbar, cervical or thoracic spinal stenosis Subglottic stenosis (SGS) Tracheal stenosis Obstructive jaundice (biliary tract stenosis) Bowel obstruction Phimosis Non-communicating hydrocephalus Stenosing tenosynovitis

stroke

A stroke happens when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack." If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage. A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to their brain (transient ischemic attack, or TIA).

A transrectal ultrasound is done to look at which of the following structures?

A transrectal ultrasound is a diagnostic test that is done to look at the prostate. With this test, the physician can differentiate between prostate enlargement and prostate cancer. Biopsy can also be performed to obtain tissue samples from various areas of the prostate.

A troponin test

A troponin test measures the levels troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood. The most common reason to perform this test is to see if a heart attack has occurred. Your doctor will order this test if you have chest pain and other signs of a heart attack. The test is usually repeated two more times over the next 6 to 24 hours. Troponin tests are sometimes ordered along with other cardiac biomarkers, such as CK-MB or myoglobin. However, troponins are the preferred tests for a suspected heart attack because they are more specific for heart injury than other tests (which may become positive in skeletal muscle injury) and remain elevated for a longer period of time. Because troponin is specific to the heart, even slight elevations may indicate some degree of damage to the heart. When a person has significantly elevated troponin levels and, in particular, a rise and/or fall in the results from a series of tests done over several hours, then it is likely that the person has had a heart attack or some other form of damage to the heart. When someone with chest pain and/or known stable angina has normal troponin values in a series of measurements over several hours, then it is unlikely that their heart has been injured. Troponin values can remain high for one to two weeks after a heart attack. The test is not affected by damage to other muscles, so injections, accidents, and drugs that can damage muscle do not affect cardiac troponin levels. Troponin may rise following strenuous exercise, although in the absence of signs and symptoms of heart disease, it is usually of no medical significance. Troponin levels may also be elevated with acute or chronic conditions such as myocarditis (heart inflammation), congestive heart failure, severe infections, kidney disease, and certain chronic inflammatory conditions of muscles and skin.

While reviewing fire safety, a type B fire extinguisher can only be used on which type of fire?

A type B fire extinguisher is used for flammable liquid fires.

Aids

AIDS is used to describe the end-stage, or terminal phase, of the HIV infection. Earlier phases of the disease include "early infection" (sometimes called the asymptomatic phase) and "early symptomatic disease," when the patient begins to have the symptoms of fevers, night sweats, diarrhea, headaches, fatigue, and persistent generalized lymphadenopathy (PGL). As HIV disease progresses, there is a gradual shift in this ratio, whereby there are more T- suppressor cells (CD8+) than T- helper cells (CD4+), owing to the reduction in the T-helper cells. A patient with AIDS often has a decrease in the number of white blood cells. The person's reactivity to skin tests, such as purified protein derivative (PPD tuberculin), is decreased or absent. An individual is said to be anergic if no skin response is noted

Symptoms of Aortic Aneurysm

Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Others expand quickly. Predicting how fast an abdominal aortic aneurysm may enlarge is difficult. As an abdominal aortic aneurysm enlarges, some people may notice: A pulsating feeling near the navel Deep, constant pain in your abdomen or on the side of your abdomen Back pain

Postoperative nursing care for a patient who has undergone a hip fracture repair includes:

Abduction of the legs is an important postoperative nursing consideration. This can be accomplished via an abduction pillow. The patient who has undergone a hip fracture repair usually is to be turned onto the nonoperated side, but it is important to check physician orders carefully and comply with the ordered positioning. The patient who has undergone a hip fracture repair requires an elevated sitting surface (e.g., raised toilet seat) to keep the angle of the hip within the prescribed limits when the patient is sitting. Postoperative nursing care for a patient who has undergone a hip fracture repair includes wound assessment with special attention paid to color, amount, and odor of exudate; frequent monitoring of vital signs; suture line assessment, and accurate intake and output recording. JP drains and Hemovac drains must also be assessed for amount and color of drainage every 4 hours.

What are the four common nonneoplastic growth patterns?

Abnormal cell growth can be categorized as either nonneoplastic growth or neoplastic growth. The four common nonneoplastic growth patterns are hypertrophy, hyperplasia, metaplasia, and dysplasia. Although not neoplastic conditions, these may precede the development of cancer.

Your patient has alcoholic cirrhosis of the liver. Which of the following items written on the nursing Kardex would you question with the R.N. prior to implementing?

Acetaminophen (Tylenol) is a known hepatotoxin, and would be inappropriate and dangerous for this patient. A high-calorie, low-fat, low-sodium diet is appropriate. Also, a moderate high-protein diet would be encouraged as well, as long as liver failure is not imminent. Diphenhydramine (Benadryl) is safe to administer to the patient with hepatic cirrhosis. A folic acid supplement will help to improve nutritional deficiencies in the patient with hepatic cirrhosis. Vitamins may be administered as well.

Active ROM exercises

Active ROM exercises are used with a patient who is mobile and can move about freely, and can independently perform ADLs.

Active assisted ROM exercises

Active assisted ROM exercises are used when the patient utilizes the strong arm to exercise the weaker, paralyzed arm.

Acute coronary syndrome

Acute coronary syndrome is a term used for any condition brought on by sudden, reduced blood flow to the heart. Acute coronary syndrome symptoms may include the type of chest pressure that you feel during a heart attack, or pressure in your chest while you're at rest or doing light physical activity (unstable angina). The first sign of acute coronary syndrome can be sudden stopping of your heart (cardiac arrest). Acute coronary syndrome is often diagnosed in an emergency room or hospital. Most cases of acute coronary syndrome occur when the surface of the plaque buildup in your heart arteries ruptures and causes a blood clot to form. The combination of the plaque buildup and the blood clot dramatically limits the amount of blood flowing to your heart muscle. If the blood flow is severely limited, a heart attack will occur.

Addictive personalitity

Addictive personality is a person who exhibits a pattern of compulsive and habitual use of a substance or practice to cope with psychic pain from conflict and anxiety.

The long-term care LPN/LVN has a new resident with glaucoma. Interventions for care of a patient with glaucoma include:

Administering prescribed eye drops and gently applying pressure on the lacrimal duct for 1 minute to assist in rapid systemic absorption; Patients with glaucoma will have eye medication to prevent the advancement of the disease.

Advanced directives

Advanced directives are signed and witnessed documents providing specific instructions for health care treatment in the event that a person is unable to make those decisions personally at the time they are needed.

The physician has ordered an aerobic culture from a patient's leg wound. Where on the wound would the nurse obtain this culture?

Aerobic microorganisms grow in superficial wounds that are exposed to air, and cultures need to be obtained from wound secretions.

A pregnant patient comes to the clinic for a prenatal visit. At how many weeks' gestation would the patient need to be in order to hear fetal heart tones using a fetoscope?

After 18 weeks, traditional equipment, such as a fetoscope, can be used to assess fetal heart tones.

After a CT scan

After a CT scan, pretest diet and activity can usually be resumed. Fluids are encouraged (unless contraindicated), and the patient must be observed for a delayed allergic reaction if contrast dye is used.

After which of the following diagnostic studies is it important that the patient lie quietly in a semi-Fowler's position for approximately 8 hours (12 hours if oil-based dye is used)?

After a myelogram, it is important that the patient lie quietly in a semi-Fowler's position for approximately 8 hours (12 hours if oil-based dye is used) to keep the dye in the lower spine. Encouraging fluids will also help the body absorb the dye from the spinal column.

After an MRI

After an MRI, routine vital sign measurements are taken. Pretest diet and activity can be resumed.

The most commonly abused drug in the world is:

Alcohol, a CNS depressant, is the most commonly abused drug in the world. It is easily available, and causes many adverse reactions, even death.

Alcoholic cirrhosis

Alcoholic cirrhosis, most commonly found in the Western world, affects more men than women. It is found in patients with a history of chronic ingestion of alcohol.

The two major skills needed for a nurse working in the home care setting are:

All of the skills listed are needed, but assessment and teaching are the two major skills that are crucial in caring for patients in their homes as well as in structured facilities.

To provide effective hospice care, the nurse needs to have an understanding of the goals of hospice. Which of the following statements appropriately addresses the goals of hospice? Select all that apply.

Allow the patient and caregiver to be involved in the decisions regarding the plan of care. Control and alleviate the patient's symptoms ?

The top priority when managing a patient with a ruptured esophageal varix is:

Although all answers may be important, the top priority is airway protection. This may be accomplished via endotracheal intubation if necessary. Administration of fresh frozen plasma (FFP), as well as packed red blood cells (RBCs), is important in replacing the blood and volume the patient has lost. Performing a portacaval shunt diverts blood from the portal vein to the inferior vena cava. This may be used in an emergency situation to control acute bleeding, or in a therapeutic situation when a patient has already bled. Control of bleeding is essential in managing the patient with a ruptured esophageal varix, as death from hemorrhage may happen due to the high pressure and high vascularity of the area. Vasopressin may be administered for this purpose, and a Sengstaken-Blakemore tube may be inserted (balloon inflation helps achieve hemostasis).

What are the symptoms of myasthenia gravis?

Although myasthenia gravis may affect any voluntary muscle, muscles that control eye and eyelid movement, facial expression, and swallowing are most frequently affected. The onset of the disorder may be sudden and symptoms often are not immediately recognized as myasthenia gravis. In most cases, the first noticeable symptom is weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be the first signs. The degree of muscle weakness involved in myasthenia gravis varies greatly among individuals, ranging from a localized form limited to eye muscles (ocular myasthenia), to a severe or generalized form in which many muscles—sometimes including those that control breathing—are affected. Symptoms, which vary in type and severity, may include a drooping of one or both eyelids (ptosis), blurred or double vision (diplopia) due to weakness of the muscles that control eye movements, unstable or waddling gait, a change in facial expression, difficulty in swallowing, shortness of breath, impaired speech (dysarthria), and weakness in the arms, hands, fingers, legs, and neck.

abdominal aortic aneurysm or AAA

An abdominal aortic aneurysm is when the large blood vessel (aorta) that supplies blood to the abdomen, pelvis, and legs becomes abnormally large or balloons outward.

antibody

An antibody (Ab), also known as an immunoglobulin (Ig), is a large Y-shape protein produced by plasma cells that is used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, called an antigen.

antiemetic

An antiemetic is a drug that is effective against vomiting and nausea. Antiemetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer.

antigen

An antigen is any substance that causes your immune system to produce antibodies against it. An antigen may be a foreign substance from the environment, such as chemicals, bacteria, viruses, or pollen.

appendectomy

An appendectomy is surgery to remove the appendix. The appendix is a small, finger-shaped organ that branches off from the first part of the large intestine. The appendix is removed when it becomes swollen (inflamed) or infected. This condition is called appendicitis.

Arterial Blood Gas (ABG)

An arterial blood gas (ABG) test measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery. This test is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. As blood passes through your lungs, oxygen moves into the blood while carbon dioxide moves out of the blood into the lungs. An ABG test uses blood drawn from an artery, where the oxygen and carbon dioxide levels can be measured before they enter body tissues.

An ataxic breathing pattern is an

An ataxic breathing pattern is an irregular and unpredictable breathing pattern with random, shallow, and deep breaths and occasional pauses. This will occur very late in the process of increased intracranial pressure.

Which of the following is/are true statements regarding angina pectoris? Select all that apply.

Angina indicates a lack of oxygen and blood supply to the heart. Angina may resemble heartburn or indigestion. Angina is usually relieved by nitroglycerin. Angina may appear as jaw pain. Although the pain from angina is typically substernal chest pain, it may be present in different ways: it may radiate to the chest, arm, or jaw. Angina may appear as posterior thoracic or jaw pain only. Although this is one correct answer, it is not the only one. This question requires you to select all options that apply. Angina is usually relieved by nitroglycerin. This is one way angina is differentiated from a myocardial infarction—pain from the MI is generally not relieved by nitroglycerin. The patient should be instructed to take a nitroglycerin tablet and lie down when experiencing an anginal attack. If the pain is not relieved, the patient may take two more nitroglycerin tablets, 5 minutes apart. If the pain is still unrelieved after the third nitroglycerin, he or she needs to seek emergency medical attention. chapter 48 not completed

Stable (typical) angina:

Angina upon effort, or angina induced by increased blood pressure or increased heart-rate. Angina is relieved by nitroglycerin although nitroglycerin is not specific to this type of angina.

The practical nurse (PN) is caring for a client with angina pectoris. Which assessment finding is most important for the PN to report to the health care provider? A) Premature ventricular beats (PVC) at 8 per minute. B) Chest pain subsides when the client returns to bed. C) Sinus tachycardia at 120 beats/minute. D) Oxygen flow rate at 4 liters/minute.

Answer A) Excessive and multi-focal PVCs (A) are ineffective beats originating from various foci in the myocardium that are a precursor for dysrhythmia progression to ventricular tachycardia or ventricular fibrillation. (B, C, and D) are important, but the client's increased myocardial irritability increases the client's risk a life threatening dysrhythmia and should be reported immediately. Category: Medical-Surgical

Antihypertensives

Antihypertensives are a class of drugs that are used to treat hypertension. Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction

Risk factors for Symptoms of Aortic Aneurysm:

Anyone age 60 and older who has risk factors for developing an abdominal aortic aneurysm, such as smoking or a family history of abdominal aortic aneurysm, should consider regular screening for the condition. Because being male and smoking significantly increase the risk of abdominal aortic aneurysm, men ages 65 to 75 who have ever smoked cigarettes should have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound.

You are caring for a patient with multiple sclerosis. Appropriate nursing care includes which of the following?

Appropriate nursing care for a patient with multiple sclerosis includes encouraging a well-balanced diet high in fiber and adequate fluids. Supplemental vitamins are usually encouraged. Obesity will make it more difficult for the patient to meet daily needs and maintain mobility; the patient who is obese will probably be referred to a dietitian and placed on a calorie-restricted diet. Appropriate nursing care for a patient with multiple sclerosis includes encouraging a well-balanced diet high in fiber and adequate fluids. Supplemental vitamins are usually encouraged. Obesity will make it more difficult for the patient to meet daily needs and maintain mobility; the patient who is obese will probably be referred to a dietitian and placed on a calorie-restricted diet. Appropriate nursing care for a patient with multiple sclerosis includes teaching the patient to exercise regularly, but not to the point of fatigue. Daily rest periods may be helpful. During an acute exacerbation, patients are usually kept as quiet as possible; this includes bed rest. Appropriate nursing care for a patient with multiple sclerosis includes teaching the patient to avoid hot baths, as they can increase weakness. Avoidance of hot weather to the extent possible can also help reduce fatigue in the patient with multiple sclerosis. Appropriate nursing care for a patient with multiple sclerosis includes teaching the patient to exercise regularly, but not to the point of fatigue. Daily rest periods may be helpful. During an acute exacerbation, patients are usually kept as quiet as possible; this includes bed rest.

Arterial septal defect

Arterial septal defect shows signs of heart failure with a harsh systolic murmur auscultated over the third intercostals space.

arthoroscopy

Arthroscopy is an endoscopic examination that enables direct visualization of a joint.

As a nurse caring for a dying patient, you know that there are changes in vital signs. While doing your assessment, you would note the patient's vital signs to be:

As a patient is nearing death, he or she will show signs and symptoms of decreased oxygenation by having a slow, weak, thready pulse; decreased blood pressure; and rapid, shallow, irregular respirations.

Which of the following accurately describes age-related changes of the neurologic system?

As neurons are lost with aging, there is deterioration in neurologic function, resulting in slowed reflex and reaction time. Becoming senile is not an inevitable consequence of aging. The incidence of physiologic dementia or organic brain syndrome increases with age. Older people possess the ability to learn, but the speed of learning is slowed with age. In performing patient teaching, the nurse needs to allow adequate time for the older adult. Short-term memory is more affected by aging than is long-term memory.

The practical nurse (PN) is documenting the results of a client's procedure on a bedside computer when a family member walks over and starts to read the documentation over the PN's shoulder. Which action should the PN take? Close the screen and go to a private area. Let the family member read the results. Tell the family member the behavior violates client confidentiality. Ask the client if the family member may read the chart information.

Ask the client if the family member may read the chart information.

Some infants and children require gavage feedings. The prudent nurse will check placement of the feeding tube prior to initiating the feeding by:

Aspirating for stomach contents and then injecting air into the feeding tube while listening for gurgling sounds per policy and procedure. To check for placement, the nurse needs to both aspirate stomach contents and listen for gurgling when air is injected.

Aspiration of fluid

Aspiration of fluid is performed using a needle that is inserted into a body cavity after administration of a local anesthetic.

assessment

Assessment is the actions of a health care worker regarding his or her patient(s). Assessment is the phase where data are collected about the patient.

After delivery, a newborn is classified according to weight at any given gestational age. A newborn weighing 2,500 g or less is:

At birth, an infant who weighs 2,500 g or less is classified as LBW.

Autonomic dysreflexia (AD)

Autonomic dysreflexia (AD) is a potentially life-threatening medical emergency that affects people with spinal cord injuries at the T6 level or higher. Autonomic dysreflexia requires quick and correct action. AD can lead to stroke. Some of the signs of AD include high blood pressure, pounding headache, flushed face, sweating above the level of injury, goose flesh below the level of injury, nasal stuffiness, nausea and a slow pulse (slower than 60 beats per minute). If AD is suspected, the first thing to do is sit up or raise the head to 90 degrees. If you can lower your legs, do so. Next, loosen or remove anything tight. Check blood pressure every five minutes. An individual with SCI above T6 often has a normal systolic blood pressure in the 90-110 mm Hg range. A blood pressure reading of 20 mm to 40mm Hg above baseline in adults may be a sign of autonomic dysreflexia, or 15mm above baseline in children, and 15mm to 20mm above baseline in adolescents. Most importantly, locate and remove the offending stimulus, if possible. Begin by looking for your most common causes: bladder, bowel, tight clothing, skin issues. Keep in mind as you remove the cause that your AD may get worse before it gets better. Autonomic dysreflexia is caused by an irritant below the level of injury, usually related to bladder (irritation of the bladder wall, urinary tract infection, blocked catheter or overfilled collection bag) or bowel (distended or irritated bowel, constipation or impaction, hemorrhoids or anal infections). Other causes include skin infection or irritation,cuts, bruises, abrasions or pressure sores (decubitus ulcers), ingrown toenails, burns (including sunburn and burns from hot water) and tight or restrictive clothing. AD can also be triggered by sexual activity, menstrual cramps, labor and delivery, ovarian cysts, abdominal conditions (gastric ulcer, colitis, peritonitis) or bone fractures.

Humoral immunity

B cells mediate humoral immunity, producing antibodies in response to an antigen challenge. On first exposure to a given antigen, a primary humoral response is initiated. This response is generally slow in comparison to subsequent exposures. When a second exposure occurs, memory B cells cause a quick response, regardless of whether the first exposure was to an antigen or to immunization. Many of the bacteria that cause infectious disease in humans multiply in the extracellular spaces of the body, and most intracellular pathogens spread by moving from cell to cell through the extracellular fluids. The extracellular spaces are protected by the humoral immune response, in which antibodies produced by B cells cause the destruction of extracellular microorganisms and prevent the spread of intracellular infections. The activation of B cells and their differentiation into antibody-secreting plasma cells (Fig. 9.1) is triggered by antigen and usually requires helper T cells.

Cultural and ethnic considerations for skin assessment include which of the following?

Baseline skin color should be assessed in areas with the least pigmentation. Examples are the palms of the hands, soles of the feet, undersides of the forearms, abdomen, and buttocks. Pallor in black-skinned individuals will appear as ashen or gray. To assess rashes and skin inflammation in dark-skinned individuals, the nurse should rely on palpation for warmth and induration rather than observation. The darker the patient's skin, the more difficult it is to assess for color change. A baseline needs to be established in natural lighting, if possible, or with at least a 60-watt light bulb.

During surgery, the physician requests more sterile water. What action must the nurse perform before pouring the solution into the sterile container?

Before pouring the solution into the container, the nurse pours a small amount into a waste receptacle, which cleans the lip of the bottle. This is referred to as "lipping" the bottle.

Bell's palsy

Bell's palsy causes sudden weakness in your facial muscles. This makes half of your face appear to droop. Your smile is one-sided, and your eye on that side resists closing. Bell's palsy, also known as facial palsy, can occur at any age. The exact cause is unknown, but it's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. It may be a reaction that occurs after a viral infection. For most people, Bell's palsy is temporary. Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell's palsy symptoms for life. Rarely, Bell's palsy can recur.

Bence Jones protein

Bence Jones protein is found in the urine of a patient with multiple myeloma.

Benign prostate hyperplasia (BPH):

Benign prostate enlargement or hypertrophy/hyperplasia (also known as BPH) is a common condition in men as they age. Prostate tissue can enlarge in response to certain hormones. It can swell and block the flow of urine from the bladder, causing uncomfortable symptoms and potentially infection. Retaining urine in the bladder due to BPH can also result in bladder stones. Stagnant urine in the bladder, a blocked urine flow, and UTIs can potentially result in kidney damage. A recent study by the Mayo Clinic showed that kidney damage and disease was three times more likely in men who experience BPH. The buildup of pressure caused by the urinary obstruction harms the bladder and kidneys.

causes of jaundice

Blood diseases Genetic syndromes Liver diseases, such as hepatitis or cirrhosis Blockage of bile ducts Infections Medicines Jaundice may be caused by liver disease (hepatitis), blood disorders (hemolytic anemia), or blockage of the tubes (bile ducts) that allow bile to pass from the liver to the small intestine.

Brain Stem

Brain stem: The stem-like part of the base of the brain that is connected to the spinal cord. The brain stem controls the flow of messages between the brain and the rest of the body, and it also controls basic body functions such as breathing, swallowing, heart rate, blood pressure, consciousness, and whether one is awake or sleepy. The brain stem consists of the midbrain, pons, and medulla oblongata.

What are common cancers often seen in older adults?

Breast and lung cancers are among the types of cancers often seen in older adults, as are prostate and colon-rectal cancer. Other cancers often seen in the older adult include cancers of the skin, bladder, vagina, and vulva.

Dyspnea

Breathing difficulty may involve: Difficult breathing; Uncomfortable breathing; Feeling like you are not getting enough air.

The cancer antigen that may be detected in the blood and may be elevated in gynecologic cancers is known as:

CA-125 is a cancer antigen that may be detected in the blood and peritoneal ascites. It may be elevated in gynecologic cancers (including ovarian) and cancer of the pancreas. This marker is useful primarily to signal a recurrence of ovarian cancer. Other conditions (endometriosis, hepatitis, pregnancy, and pelvic inflammatory disease) may increase CA-125 levels in the blood.

CK-MB

CK-MB is a cardiac enzyme that also is elevated following a myocardial infarction; however, it is also elevated by other factors (surgery, muscle trauma). It rises in 2 to 3 hours following a myocardial infarction, peaks at 24 hours, and returns to normal in 24 to 40 hours.

The preferred diagnostic test for evaluating deep lymph nodes is:

CT scan is now the preferred diagnostic test for evaluating deep lymph nodes. It is less invasive than lymphangiography, requires less patient preparation, and has no major side effects.

Calcitonin

Calcitonin is a hormone secreted by the thyroid gland in response to a rising serum calcium level. This level is increased in people who have cancer of the thyroid; it may be elevated in breast and oat cell lung cancer.

What is the function of the electrolyte calcium?

Calcium (Ca): calcitonin, which promotes bone growth and decreases calcium levels in the blood, and parathyroid hormone, which does the opposite. Calcium is bound to the proteins in the bloodstream, so the level of calcium is related to the patient's nutrition as well as the calcium intake in the diet. Calcium metabolism in the body is closely linked to magnesium levels. Often, the body's magnesium status needs to be optimized before the calcium levels can be treated.

Cardiac monitoring

Cardiac monitoring records the cardiac electrical activity of patients. A cardiac monitor displays information transferred via the conductive electrodes, which transfer electrical activity of the heart and relay it to a video display screen. This is useful for patients with known or suspected dysrhythmias, or patients who may be likely to develop dysrhythmias.

Causes of caridac tamponade

Cardiac tamponade can occur due to: Dissecting aortic aneurysm (thoracic) End-stage lung cancer Heart attack (acute MI) Heart surgery Pericarditis caused by bacterial or viral infections Wounds to the heart Other possible causes include: Heart tumors Hypothyroidism Kidney failure Leukemia Placement of central lines Radiation therapy to the chest Recent invasive heart procedures Recent open heart surgery Systemic lupus erythematosus

Methods of improving safety for blood transfusions include which of the following? Select all that apply. Careful selection of blood donors Use of microaggregate filters for blood administration Close monitoring of the patient receiving a blood transfusion Administering blood within 6 hours of refrigeration Refrigerating blood until 1 hour before administration Carefully checking donor and recipient numbers before administering blood

Careful selection of blood donors is an important method of improving safety for blood transfusions. Also important is careful typing and cross-matching of blood from donor to recipient. Use of microaggregate filters for blood administration is an important method of improving safety for blood transfusions. Filters are important to trap small particles or precipitates to keep them from entering the patient's bloodstream. The patient receiving a blood transfusion needs to be monitored closely, especially early in the transfusion, for signs or symptoms of a transfusion reaction. The most severe reactions occur within the first 15 minutes of the start of the transfusion. Moderate reactions can occur anytime during the first 90 minutes Carefully checking donor and recipient numbers before administering blood is an important method of improving safety for blood transfusions. Mismatched blood has a high rate of transfusion reactions and can have very serious consequences for the patient. missing ?

Cellular immunity comes into play when _________ is/are activated by an antigen. B cells T cells NK cells Complement

Cellular immunity comes into play when an antigen activates T cells. Once the T cells have been sensitized, they are released into the blood and body tissues, where they remain indefinitely. On contact with the antigen to which they are sensitized, they will attach to the organism and destroy it. Cellular immunity is involved in resistance to infectious disease caused by viruses and some bacteria.

causes of a pneumothorax

Chest injuries, Mechanical ventilation, Ruptured air blisters. Small air blisters (blebs) can develop on the top of your lung. While not considered to be a disease of the lungs, these blebs sometimes burst — allowing air to leak into the space that surrounds the lungs; Underlying lung diseases. Damaged lung tissue is more likely to collapse. Lung damage can be caused by many types of underlying diseases, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and pneumonia. A history of pneumothorax. Anyone who has had one pneumothorax is at increased risk of another, usually within one to two years of the first episode.

Cholelithiasis

Cholelithiasis is the medical name for hard deposits (gallstones) that may form in the gallbladder. The gallbladder stores bile and releases it into the small intestine when it is needed for digestion. Gallstones can develop if the bile contains too much cholesterol or too much bilirubin (one of the components of bile), or if the gallbladder is dysfunctional and cannot release the bile. Different types of gallstones form in cholelithiasis. The most common type, called a cholesterol stone, results from the presence of too much cholesterol in the bile. Another type of stone, called a pigment stone, is formed from excess bilirubin, a waste product created by the breakdown of the red blood cells in the liver. The size and number of gallstones varies in cholelithiasis; the gallbladder can form many small stones or one large stone.

chronic pain

Chronic pain is generally characterized as pain lasting longer than 6 months and can be continuous or intermittent and as intense as acute pain.

Regarding pharmacologic therapy for HIV, select the following true statement. Antiretroviral medications and prophylactic interventions have demonstrated limited success in treating opportunistic infections. Combination drug therapy is now the standard of care. When a medication for treatment of HIV is ordered to be taken three times a day, it is acceptable for the patient to be flexible with the schedule, as long as three doses are taken during waking hours. Zidovudine is the only medication approved to treat HIV disease.

Combination drug therapy is now the standard of care. A single dose (monotherapy) is no longer recommended due to the likelihood of the development of viral and therapeutic resistance. "Cocktails" are more effective than single-drug therapy. This is referred to as "highly active antiretroviral therapy," or HAART. Zidovudine was the first drug approved to treat HIV, but is no longer the only approved medication. Today, there are 18 approved anti-HIV medications available, and many more are being developed and researched. A medication ordered three times a day (t.i.d.) should be given as close to every 8 hours as possible, not three times while the patient is awake. When medications are not given regularly, the drug levels in the blood fall low enough to allow HIV to develop resistance. A number of opportunistic diseases and debilitating problems associated with HIV can be delayed or prevented through the use of antiretroviral medications and prophylactic interventions. Prophylactic medications have contributed to the decreased morbidity and mortality associated with HIV infection during the past several years.

Conditions of Calcium Imbalance

Conditions of Calcium Imbalance: Hypercalcemia (hyper= too much + calc=calcium + emia= in the blood) is associated with "moans, stones, abdominal groans"; symptoms include kidney stones, abdominal pain, and depression. Also, too much calcium can be associated with heart rhythm disturbances. Causes of hypercalceima include parathyroid tumors, other tumors including breast cancer, excess amounts of Vitamin A or D, Paget's disease, and kidney failure. Hypocalcemia (hypo=too little) is usually associated with eating disorders or lack of parathyroid hormone. Symptoms include weakness, muscle spasms, and heart rhythm disturbance.

Conditions of Magnesium Imbalance

Conditions of Magnesium Imbalance: Hypomagnesemia, too little magnesium in the blood stream, may occur because of many reasons. Some have to do with dietary deficiencies, inability of the intestine to absorb the chemical, or due to increased excretion. Common causes of low magnesium include alcoholism and its associated malnutrition, chronic diarrhea, and medications like diuretics (water pills used to control high blood pressure). More than half of hospitalized patients in ICUs may become magnesium deficient. Symptoms involve the heart with rhythm abnormalities, muscles with weakness and cramps, and the nervous system, potentially causing confusion, hallucinations, and seizures. Hypermagnesemia describes too much magnesium in the blood stream and most often occurs in patients with kidney function problems in which the excretion of magnesium is limited. In these patients, too much magnesium intake in the diet or from magnesium-containing medications like milk of magnesia or Maalox may cause elevated magnesium levels. Since the absorption and excretion of magnesium is linked to other electrolytes, other diseases may be associated with high magnesium levels, including diabetic ketoacidosis, adrenal insufficiency, and hyperparathyroidism. Hypermagnesemia is often associated with hypocalcemia (low calcium) and hyperkalemia (high potassium). Symptoms can include heart rhythm disturbances, muscle weakness, nausea and vomiting, and breathing difficulties.

Continuous passive motion (CPM) devices:

Continuous passive motion (CPM) devices are used during the first phase of rehabilitation following a soft tissue surgical procedure or trauma. The goals of phase 1 rehabilitation are: control post-operative pain, reduce inflammation, provide passive motion in a specific plane of movement, and protect the healing repair or tissue. CPM is carried out by a CPM device, which constantly moves the joint through a controlled range of motion; the exact range is dependent upon the joint, but in most cases the range of motion is increased over time. CPM is used following various types of reconstructive joint surgery such as knee replacement and ACL reconstruction.

The practical nurse (PN) is visiting a client with a colostomy and notes excoriated skin around the stoma opening. What information should the PN provide? Eliminate acidic foods from diet. Empty colostomy bag more often. Apply over-the-counter steroid cream. Cut a smaller opening in the adhesive.

Cut a smaller opening in the adhesive.

DRGs

DRGs are diagnosis-related groups that determine cost reimbursement

quadriplegia.

Damage to the cervical spine or neck that involves weakness or paralysis to all four extremities

Decerebrate posture

Decerebrate posture is an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backwards. The muscles are tightened and held rigidly. This type of posturing usually means there has been severe damage to the brain. A severe injury to the brain is the usual cause of decerebrate posture. Opisthotonos (a severe muscle spasm of the neck and back) may occur in severe cases of decerebrate posture. Decerebrate posture can occur on one side, on both sides, or in just the arms. It may alternate with decorticate posture. A person can also have decorticate posture on one side of the body and decerebrate posture on the other side.

Decorticate posture

Decorticate posture is an abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest. This type of posturing is a sign of severe damage in the brain. People who have this condition should get medical attention right away. Decorticate posture is a sign of damage to the nerve pathway between the brain and spinal cord. Although it is serious, it is usually not as serious as decerebrate posture. The posturing may occur on one or both sides of the body.

Deep venous thrombosis or DVTs

Deep venous thrombosis is a blood clot that forms in a vein deep inside a part of the body. It mainly affects the large veins in the lower leg and thigh.

Delirium

Delirium is a rapid change in consciousness that occurs over a short time and is associated with reduced awareness and attention to surroundings, disorganized thinking, sensory misinterpretation, and irrelevant speech.

Management in nursing uses different leadership styles. The style that is a people-centered approach allowing employees more control and individual participation in the decision-making process is: Autocratic Democratic Laissez-faire Situational

Democratic

Democratic leader

Democratic style is a people-centered approach that allows employees more control and individual participation in the decision-making process.

A patient who has just been sexually assaulted has come to the emergency department. The patient is very calm and quiet. The nurse identifies this behavior as part of which defense mechanism?

Denial

Dependent personality

Dependent personality is an individual who is overcooperative from a deep fear of abandonment.

You are getting ready to administer a subcutaneous injection of insulin. At what angle can the injection be given?

Depending on the amount of subcutaneous tissue the patient has, the injection can be administered at a 45- or 90-degree angle.

As a nurse caring for a child going through rehabilitation, you know the primary difference between children and adults is the:

Developmental potential: The child or adolescent may receive an injury resulting in disability at any age, with very different consequences for his/her future depending on the age and developmental level at which the trauma occurred.

Which of the following diagnoses is seen most commonly in home care patients?

Diabetes mellitus is one of the many debilitating and most commonly seen diagnoses requiring home care.

A young child is brought to the clinic to have tests run regarding an endocrine disorder. The nurse knows that the most common endocrine disorder in children is:

Diabetes mellitus type 1 results from an autoimmune destruction of the beta cells. It typically starts in children or young adults who are slim.

Your patient is undergoing diagnostic tests to rule out carcinoma of the oral cavity. Which of the following symptoms have been associated with the disease? Select all that apply.

Difficulty in chewing, swallowing, or speaking may be one of the first symptoms of carcinoma of the oral cavity once the disease progresses (earlier, often patients are asymptomatic). Edema in any part of the mouth may be one of the first symptoms of carcinoma of the oral cavity once the disease progresses. Although this is one correct answer, it is not the only one. This question requires you to select all options that apply. Numbness or loss of sensation in part of the mouth may be one of the first symptoms of carcinoma of the oral cavity once the disease progresses. Although this is one correct answer, it is not the only one. This question requires you to select all options that apply.

Disability

Disability is any restriction or lack of an ability to perform an activity in the manner or within the range considered normal for a human being.

Effective discharge requires careful planning and continuing assessment of a patient's needs:

Discharge planning occurs during hospitalization, beginning shortly after a patient is admitted.

Disease process

Disease process is a disturbance of a structure or functions of the body.

dissecting aneurysm

Dissecting aneurysm: An aneurysm in which the wall of an artery rips (dissects) longitudinally. This occurs because bleeding into the weakened wall splits the wall. Dissecting aneurysms tend to affect the thoracic aorta. They are a particular danger in Marfan syndrome. an aortic dissection is a serious condition in which the inner layer of the aorta, the large blood vessel branching off the heart, tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.

A grave disease process in which the patient experiences both bleeding and intravascular clotting at the same time is known as:

Disseminated intravascular coagulation, or DIC, is a grave disease process in which the patient experiences both bleeding and intravascular clotting at the same time. It results from the overstimulation of clotting and anticlotting processes in response to disease or injury, including septicemia, obstetrical complications, malignancies, tissue trauma, transfusion reactions, burns, shock, or snake bites.

Disseminated intravascular coagulation, or DIC

Disseminated intravascular coagulation, or DIC, is a grave disease process in which the patient experiences both bleeding and intravascular clotting at the same time. It results from the overstimulation of clotting and anticlotting processes in response to disease or injury, including septicemia, obstetrical complications, malignancies, tissue trauma, transfusion reactions, burns, shock, or snake bites.

The most common type of a secondary immunodeficiency disorder is: Drug induced Stress induced Related to hypofunction of the immune system Malnutrition induced

Drug-induced immunosuppression is the most common type of a secondary immunodeficiency disorder. Immunosuppressive therapy is prescribed for patients to treat autoimmune disorders or to prevent transplant rejection. Immunosuppression is also a side effect of cancer chemotherapy. Generalized leukopenia often results, leading to a decreased humoral and cell-mediated response. Therefore, secondary infections are common in immunosuppressed patients.

Echocardiography

Echocardiography uses high-frequency ultrasound directed at the heart. The reflected sound is recorded, outlining size, shape, and position of cardiac structures. This is useful in detecting pericardial effusion, evaluating ventricular function, cardiac chamber size and contents, ventricular muscle and septal motion and thickness, cardiac output, cardiac tumors, valvular function, and congenital heart disorders.

Eczema

Eczema, or atopic dermatitis, is a skin disorder primarily occurring in infants and children, associated with allergies to chocolate, eggs, wheat, and orange juice. Papular and vesicular lesions appear, which are surrounded by erythema.

A patient has been admitted with preeclampsia. Following an assessment the nurse notes the patient to have edema of the face, hand, and abdomen. The nurse would document this as:

Edema of the face, hands, sacrum, and abdomen is documented as 3+.

The nurse addresses the local PTA about accident prevention for adolescents. During the session, the nurse highlights:

Education and review of basic first aid; setting consequences for substance abuse, especially drinking; and discussing the dangers of swimming alone

Ego integrity versus despair

Ego integrity versus despair occurs in late adulthood when older adults are trying to make sense out of their lives.

electrolyte imbalance

Electrolytes are the smallest of chemicals that are important for the cells in the body to function and allow the body to work. Electrolytes such as sodium, potassium, and others are critical in allowing cells to generate energy, maintain the stability of their walls, and to function in general. They generate electricity, contract muscles, move water and fluids within the body, and participate in myriad other activities. The concentration of electrolytes in the body is controlled by a variety of hormones, most of which are manufactured in the kidney and the adrenal glands. Sensors in specialized kidney cells monitor the amount of sodium, potassium, and water in the bloodstream. The body functions in a very narrow range of normal, and it is hormones like renin (made in the kidney), angiotensin (from the lung, brain and heart), aldosterone (from the adrenal gland), and antidiuretic hormone (from the pituitary) that keep the electrolyte balance within those normal limits. Keeping electrolyte concentrations in balance also includes stimulating the thirst mechanism when the body gets dehydrated.

Your patient is undergoing a diagnostic procedure whereby needle electrodes are inserted into skeletal muscles to record electrical activity. This test is called:

Electromyogram (EMG): During an electromyogram (EMG), needle electrodes are inserted into skeletal muscles to record electrical activity. This electrical activity can be heard, seen on an oscilloscope, and recorded on paper simultaneously.

You have been assigned a patient who abuses alcohol. The patient is at risk for DTs (Delirium tremens). While monitoring the patient, which of the following signs would alert you to DTs?

Elevated temperature, changes in LOC, hallucinations

pupillary light reflex

Emergency room physicians routinely assess the pupillary reflex because it is useful for gauging brain stem function. Normally, pupils react (i.e. constrict) equally. Lack of the pupillary reflex or an abnormal pupillary reflex can be caused by optic nerve damage, oculomotor nerve damage, brain stem death and depressant drugs, such as barbiturates.

Encephalitis

Encephalitis (en-sef-uh-LIE-tis) is inflammation of the brain. Viral infections are the most common cause of the condition. Encephalitis can cause flu-like symptoms, such as a fever or severe headache. It can also cause confused thinking, seizures, or problems with senses or movement. However, many cases of encephalitis result in only mild flu-like symptoms or even no symptoms. Severe cases of encephalitis, while relatively rare, can be life-threatening.

Name the 4 Treatment options for cholelithiasis:

Endoscopic retrograde cholangiopancreatography (ERCP), an imaging procedure that allows treatment of some bile duct problems, including removal of gallstones that are causing obstruction Laparoscopic cholecystectomy (removal of the gallbladder through multiple small incisions; this is less invasive and a more commonly used technique) Lithotripsy (technique that uses electric shock waves to dissolve gallstones; it is not commonly used today) Medication to dissolve gallstones (this treatment takes a long time, and gallstones may recur) Open cholecystectomy (removal of the gallbladder through a single, large incision; this is a more invasive and less commonly used technique)

Epidural or extradural hematoma

Epidural or extradural hematoma (haematoma), also known as an epidural hemorrhage, is a type of traumatic brain injury (TBI) in which a buildup of blood occurs between the dura mater (the tough outer membrane of the central nervous system) and the skull.[1] The dura mater also covers the spine, so epidural bleeds may also occur in the spinal column. Often due to trauma, the condition is potentially deadly because the buildup of blood may increase pressure in the intracranial space, compress delicate brain tissue, and cause brain shift. The condition is present in one to three percent of head injuries

Erytropoisis

Erythropoiesis (from Greek 'erythro' meaning "red" and 'poiesis' meaning "to make") is the process which produces red blood cells (erythrocytes). It is stimulated by decreased O2 in circulation, which is detected by the kidneys, which then secrete the hormone erythropoietin.

evaluation

Evaluation is the review of the plan of care to see what revisions are necessary to the plan of care. Evaluation is the last step in the plan of care to see if the interventions are working or need to be changed.

You are caring for an older woman with cardiac disease. Based on your knowledge, you realize that the older cardiac patient is different from the younger cardiac patient because:

Even with lower doses of medications, the older adult should be observed for signs and symptoms of toxicity, because the rate of drug metabolism and excretion decreases with age. The older adult should be encouraged to maintain regular contact with his or her physician and to seek care at the first sign of problems.

Excessive exposure to ultraviolet rays of the sun is a factor in the development of what 3 types of skin cancer?

Excessive exposure to ultraviolet rays of the sun is a factor in the development of basal and squamous cell cancers and melanoma. Exposure to sunlamps and tanning booths carry the same risks. Exposure should be limited and monitored.

External rotation

External rotation is the process of turning the foot and leg away from the other leg.

While in the clinic, a first-time pregnant patient asks the nurse when she should be able to feel the fetus move. The best response is _____ weeks' gestation.

Fetal movement, also called quickening, can be felt as early as 14 to 16 weeks' gestation. The movements are subtle at first, and gradually increas

Fibromyalgia syndrome is a:

Fibromyalgia syndrome is a musculoskeletal chronic pain syndrome of unknown etiology that causes pain in the muscles, bones, or joints. It is associated with soft tissue tenderness at multiple characteristic sites. Tricyclic antidepressants are used in treating this disorder because they can help with antidepressive effects, decrease inflammation, relax skeletal muscles, and control pain. Fibromyalgia syndrome is a disorder that usually affects women between the ages of 20 and 50

Fight or flight response

Fight or flight response is a flooding of the body with epinephrine, an autonomic response created by acute pain as a warning of actual or potential tissue damage.

Flank pain

Flank pain refers to pain or discomfort in your upper abdomen or back. It is located below the ribs and above the pelvis and on the side. Flank pain basically refers to pain in your side and back. Usually, the pain is worse on one side of your body. Flank pain is often the sign of kidney problems, but it can also point to other medical conditions if it occurs along with other symptoms.

An example of a flat bone is one that is found in the:

Flat bones, one of the four bone types, are commonly found in the skull and sternum.

name the 4 bone types?

Flat bones, short bones, long bones, irregular bones

The diagnostic test that allows observation of real time movement via radiography is:

Fluoroscopy is the diagnostic test that allows observation of real time movement via radiography. This is invaluable for placement of pacemakers and intracardial catheter placement.

Folliculitis

Folliculitis is an infection of a hair follicle, usually from Staphylococcus aureus bacteria. The infection may involve one or several follicles. It often occurs after shaving.

According to Piaget, during the adolescent stage of growth and development, an individual's cognitive function reaches maturity. Piaget describes this stage as the _____ stage.

Formal operational thought

The physician has ordered an anaerobic culture from a patient's leg wound. Where on the wound would the nurse obtain this culture?

From deep inside the wound cavity Anaerobic organisms tend to grow within the body cavity and this specimen would be anaerobic.

According to the World Health Organization, which term is defined as any loss of ability to perform tasks and obligations of usual roles and normal daily life?

Functional limitation is any loss of ability to perform tasks and obligations of usual roles and normal daily life.

Which action should the practical nurse implement when administering an 8 ounce can of a concentrated nutritional formula via a client's gastrostomy tube (GT)? Determine the gastric residual's pH before starting the feeding at prescribed rate. Obtain stool specimen for culture of diarrhea stool that occurred after first feeding. Discards 60 ml of gastric residual before giving formula. Give 30 ml of tap water after administration of formula.

Give 30 ml of tap water after administration of formula. After administering formula, additional water should be given (D) to prevent obstruction of the GT and to provide the client with additional hydration. Although (A) provides evidence of aspirated gastric secretions, checking the pH with each feeding is not indicated. (B) is not indicated for administration of a concentrated formula. Residual should be returned to the client's stomach to prevent electrolyte imbalance (C). Category: Medical-Surgical

Metformin (Glucophage)

Glucophage (metformin) is an oral diabetes medicine that helps control blood sugar levels. Glucophage is for people with type 2 diabetes. Glucophage is sometimes used in combination with insulin or other medications, but it is not for treating type 1 diabetes.

Your patient has a chronic musculoskeletal disorder and is asking you about alternative therapies for her condition. You base your response on your knowledge that:

Glucosamine supplements have been linked with reduced articular pain, lessened joint tenderness, and less restricted joint movement in persons suffering from arthritis. Supplemental glucosamine acts like glucosamine found naturally in cartilage, working as a lubricant and shock absorber.

What is the difference between an aneurysm and a hemorrhagic stroke?

Good question. Basically there are multiple causes of a hemorrhagic stroke: hypertensive intracerebral hemorrhage, amyloid angiopathy and arteriovenous or cavernous malformations, as well as aneurysms.

Gout

Gout is a metabolic disease resulting from an accumulation of uric acid in the blood. It is an acute inflammatory condition associated with ineffective metabolism of purines.

Based on the definitions of gravida and para, select the documentation that best describes a woman in the clinic who is currently pregnant and has had two prior children.

Gravida is a term used for a pregnant woman and how many times she has been pregnant. Para is a term that denotes the number of births. This patient would be Gravida III and Para II.

Guillain-Barré syndrome (GBS):

Guillain-Barré syndrome (GBS) is a disorder in which the body's immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances the symmetrical weakness and abnormal sensations spread to the arms and upper body. These symptoms can increase in intensity until certain muscles cannot be used at all and, when severe, the person is almost totally paralyzed. In these cases the disorder is life threatening - potentially interfering with breathing and, at times, with blood pressure or heart rate - and is considered a medical emergency. Such an individual is often put on a ventilator to assist with breathing and is watched closely for problems such as an abnormal heart beat, infections, blood clots, and high or low blood pressure. Most individuals, however, have good recovery from even the most severe cases of Guillain-Barré syndrome, although some continue to have a certain degree of weakness.

Which of the following medications would be the most effective in treating a duodenal ulceration caused by Helicobacter pylori?

H. pylori, one of the causes of duodenal ulcerations, is a spiral-shaped bacterium. If this is determined to be the cause of the ulceration, the most appropriate therapy would be an antibiotic to which H. pylori is sensitive, one of which is amoxicillin.

HIDA scanning

HIDA scanning, done in the nuclear medicine department, uses a camera to record distribution of a tracer (technetium 99) in the liver, biliary tree, gallbladder, and proximal small intestine. It is considered to be safe, noninvasive, and accurate.

Which of the following statements accurately describes transmission of HIV? HIV transmission occurs as a result of sexual preferences. HIV transmission can occur via sharing food and/or utensils. HIV can be transmitted via inanimate objects, such as toilet seats or computer keyboards. HIV is transmitted from human to human via infected blood, semen, cervicovaginal secretions, and breast milk.

HIV transmission is dependent on the presence of the virus, the infectiousness of the virus, the susceptibility of the uninfected host, and any conditions that may put the person at risk. HIV is transmitted from human to human via infected blood, semen, cervicovaginal secretions, and breast milk. If these infected fluids are introduced into an uninfected person, the potential for HIV transmission exists.

Hepatic encephalopathy

Hepatic encephalopathy is the occurrence of confusion, altered level of consciousness, and coma as a result of liver failure. In the advanced stages it is called hepatic coma or coma hepaticum. It may ultimately lead to death. It is caused by accumulation in the bloodstream of toxic substances that are normally removed by the liver. The diagnosis of hepatic encephalopathy requires the presence of impaired liver function and the exclusion of an alternative explanation for the symptoms. Blood tests (ammonia levels) may assist in the diagnosis. Attacks are often precipitated by an intercurrent problem, such as infection or constipation. Hepatic encephalopathy is reversible with treatment. This relies on suppressing the production of the toxic substances in the intestine and is most commonly done with the laxative lactulose or with non-absorbable antibiotics. In addition, the treatment of any underlying condition may improve the symptoms. In particular settings, such as acute liver failure, the onset of encephalopathy may indicate the need for a liver transplant

Hepatitis B

Hepatitis B is a long incubation virus (28 to 160 days). Persons at risk for hepatitis B include health care workers, persons with high-risk lifestyles (drug users, tattoo recipients, homosexual men, and prostitutes), infants born to mothers who are HBsAg positive, hemodialysis patients, and persons sharing a household with a person infected with hepatitis B.

Hepatitis D

Hepatitis D, also known as the delta virus, has an incubation period of 2 to 10 weeks. It causes hepatitis as a coinfection with hepatitis B and may progress to cirrhosis and chronic hepatitis.

Hernias

Hernia is the protrusion of organs or portions of an organ through a structural defect or weakened muscle.

Herpes simplex type 1

Herpes simplex type 1, commonly known as a cold sore, is characterized by a vesicle at the corner of the mouth, on the lips, or on the nose.

A child newly diagnosed with juvenile rheumatoid arthritis (JRA) has come to the clinic for a check-up. While there, the parents ask about activities at school. What is the nurse's most appropriate response?

"Talk with the school nurse to arrange for medications and rest periods." JRA is a chronic disorder that affects the activities of daily living (ADLs) of a child. Allowing for as much independence as possible is necessary, with the need for pain management and rest periods.

Angina

(Ischemic cardiac pain or chest pain): Squeezing, crushing, strangling, constricting pain in the center of the chest. Pain may radiate to left shoulder, left arm, right shoulder, or jaw. Angina is chest pain thought to be from a part of your heart not getting enough blood flow.

Place the following steps for collecting a 24-hour urine specimen in the correct order. Do not use commas or spaces: 1. Discard the first void when time begins. 2. Assemble all necessary supplies. 3. Save all urine for a 24-hour period. 4. Explain procedure to patient. 5. Document procedure and observations. 6. Send urine specimen to lab with labeling.

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Place the four stages of schizophrenia in the correct order by number. Do not use commas or spaces: __________ 1. Residual phase 2. Prodromal phase 3. Acute phase 4. Prepsychotic phase

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A 24-hour urine specimen

A 24-hour urine specimen is obtained by discarding the patient's initial voiding. Subsequent voidings should be saved for the 24-hour period. The patient should be instructed to void a few minutes before the end of the 24 hours; this urine is part of the specimen as well.

When preparing a medication for a intradermal injection, what size needle length is needed?

A 3/8- to 5/8-inch needle is used for intradermal injections.

nursing diagnosis

A nursing diagnosis is a NANDA-approved statement that identifies a specific problem. The nursing diagnosis is the title or label given to an identified problem and is the first step is a patient's plan of care.

how much extra protein is needed during breast-feeding?

A nursing mother needs extra protein, but only approximately 500 extra calories per day.

pillow

A pillow provides support of the body or extremity; it elevates a body part.

The physician has ordered a sputum specimen to be collected on your patient. Which statement is an appropriate teaching for your patient?

A sputum specimen needs to come from deep in the bronchial tree. Any food or saliva in the specimen will not give the desired results.

A patient has returned to the surgical floor following hip replacement surgery. What assistive device is used for proper body alignment?

A wedge pillow (also called an abduction pillow) is used to maintain the legs in abduction after hip replacement surgery.

A patient comes into the emergency department with an open wound on his right leg. There is a large piece of tissue missing, leaving the tendon and muscles exposed. This is an example of which type of open wound?

An avulsion is a torn piece of tissue that results in a section being completely removed or left hanging by a flap. Underlying bones, tendons, or muscles may be exposed.

Angiography

Angiography is a series of radiographs taken following administration of contrast dye. This test aids in diagnosis of vessel occlusion, pooling in various heart chambers, and congenital abnormalities.

Angiography

Angiography is a type of blood vessel study using contrast dye. Blood vessels from various parts of the body can be examined using this technique. Prior to administration of contrast dye, it is essential that the nurse determine if the patient has any allergy iodine.

Ankylosing spondylitis

Ankylosing spondylitis is a chronic, progressive disorder of the sacroiliac and hip joints most commonly seen in young men. It is sometimes referred to as rheumatoid spondylitis.

Anomia

Anomia is a form of aphasia characterized by the inability to name objects.

PTT

Another blood clotting test, called partial thromboplastin time (PTT), might be used if you take another type of blood-thinning medicine called heparin. This test measures other clotting factors. Partial thromboplastin time and prothrombin time are often done at the same time to check for bleeding problems or the chance for too much bleeding in surgery.

A patient is having trouble abstaining from alcohol. Which drug is often prescribed to encourage abstinence?

Antabuse (disulfiram)

Anterior

Anterior refers to the front of the body.

Assault

Assault is an intentional threat to cause bodily harm to another.

Atelectasis

Atelectasis is defined as the collapse or closure of the lung resulting in reduced or absent gas exchange. It may affect part or all of one lung.[1] It is a condition where the alveoli are deflated, as distinct from pulmonary consolidation.

Your patient has undergone a needle liver biopsy 15 minutes ago. You enter her room to discover her sitting up in bed reading the newspaper. The first action you should take is to place her:

Following a needle liver biopsy it is important for the patient to lie on his or her right side for a minimum of 2 hours in order to splint the puncture site. In this position, the liver capsule is compressed against the chest wall, thereby decreasing the risk of hemorrhage or bile leak.

Dumping syndrome is a disorder associated with what condition?

Following gastric resection or peptic ulcer surgery: Dumping syndrome is a disorder that can occur in gastric resection procedures. It occurs in approximately one half to one third of patients who have undergone peptic ulcer surgery. It is a rapid gastric emptying causing distention of the duodenum or jejunum produced by a bolus of hypertonic food.

A nurse is writing a care plan for a diagnosis of imbalanced nutrition: less than body requirements. This nurse realizes that one of the most common nutrition-related discomforts of pregnancy is:

Hyperemesis gravidarum is one of the most common nutrition-related discomforts of pregnancy, because of the lack of fluid and food intake leading to metabolic problems.

The nurse is caring for a patient with a suspected fracture of his right arm. What is the most appropriate nursing action?

Immobilize by splinting the bone as is. The nurse should not attempt to realign the bone, but immobilize it as is. Circulation needs to be assessed below the injury and any bleeding stopped.

pyuria

In medicine, pyuria /paɪjʊəˈriːə/ is the condition of urine containing pus. Defined as the presence of 6-10 or more neutrophils per high power field of unspun, voided mid-stream urine. It can be a sign of a bacterial urinary tract infection. Pyuria may be present in the septic patient, or in an older patient with pneumonia.

Metaphase

In metaphase, the nucleus membrane and nucleolus disappear, and chromosomes are aligned across the center of the cell.

passive transport process

In passive transport, no cellular energy is required to move substances from higher concentration to lower concentration.

Prophase

In prophase, chromosomes form two strands in the nucleus, and centrioles in the cytoplasm form a network of spindle fibers.

When assessing cultural preferences of a laboring patient, the nurse remembers to ask about traditional birth practices. Which of the following birth practices is most common in non-American cultures?

In southeast Asia, Laos, India, and Iran, the most common practice is that the father is not present during the birth of a child.

While assessing a laboring patient, which of the following fetal heart tones (FHT) would the nurse consider cause for further or constant monitoring?

Late decelerations are an indication that there may be uteroplacental insufficiency. The fetus may not be getting enough oxygen. Constant monitoring will be needed to make sure the fetal heart tones do not decrease to the point of demise.

The largest glandular organ in the body, which functions as an accessory organ of digestion, is the:

Liver: The largest glandular organ in the body, which functions as an accessory organ of digestion, is the liver. It is also one of the most complex. In the adult it weighs 3 lb.

Long bones are found in the _______

Long bones are found in the extremities.

Of the new AIDS cases diagnosed in 2003, what percentage were acquired by heterosexual contact? 23% 56% 79% 95%

Of the new AIDS cases diagnosed in 2003, 79% were acquired by heterosexual contact. The category labeled as "men who have sex with men" (MSM) still accounts for the largest number of individuals with HIV and AIDS.

Which of the following statements best describes a characteristic of pain?

Often occurs where there is actual or potential tissue damage. Pain is an unpleasant sensation caused by the stimulation of the sensory nerve endings. Serves as a warning to the body and often occurs where there is actual or potential tissue damage.

Causes of orthostatic hypotension?

Older adults are more susceptible to a drop in blood pressure related to inactivity. Antihypertensives increase the risk of orthostatic hypotension, particularly when the patient rises after a period of bed rest.

One-time-only orders

One-time-only are orders that are carried out only once at a certain time.

Variant Angina or Prinzmetal angina

Paradoxic angina occurring during rest but usually not during exercised caused by coronary artery spasm. It can be difficult to spot because it can coexist with typical angina. Characteristic ECG findings can help distinguish variant angina from typical angina. Nitroglycerin will probably still relieve pain as it relaxes coronary arteries.

Paranoid personality

Paranoid personality is characterized by suspicion, secretiveness, distortion of reality, and oversensitivity.

Paraplegia

Paraplegia is the result of damage below the cervical area that involves weakness or paralysis in the trunk and lower extremities.

Paresthesia

Paresthesia is a sensation of tingling, tickling, pricking, or burning of a person's skin with no apparent long-term physical effect.

Paresthesia

Paresthesia is a sensation of tingling, tickling, pricking, or burning of a person's skin with no apparent long-term physical effect. The manifestation of a paresthesia may be transient or chronic.

Pedophilia

Pedophilia is fondling and or other sexual activities with a prepubescent child by an adult.

peer review

Peer review is when a professional coworker of equal status reviews the practice, education, or research of another.

percussion

Percussion is the use of fingertips to tap the body's surface to produce vibration and sound.

Percutaneous biopsy

Percutaneous biopsy is performed by using a needle inserted through a patient's skin to obtain a tissue sample, such as in a liver biopsy. There is special positioning of the patient, depending on what area of the body is being studied, and it may be done under ultrasound or CT guidance to accurately direct the physician toward the area to be biopsied

peritonitis

Peritonitis is a bacterial or fungal infection of the peritoneum, a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen.

The type of liver cirrhosis that is caused by viral hepatitis, exposure to hepatotoxins (e.g., industrial chemicals), or infection is called:

Postnecrotic cirrhosis is a type of liver cirrhosis that is caused by viral hepatitis, exposure to hepatotoxins (e.g., industrial chemicals), or infection. In cirrhosis, fibrous scar tissue covers the lobes, restricts blood flow to the liver, and contributes to the destruction of the liver.

What is the function of the electrolyte potassium?

Potassium (K): Potassium is most concentrated inside the cells of the body. The gradient, or the difference in concentration from within the cell compared to the plasma, is essential in the generation of the electricial impulses in the body that allow muscles and the brain to function.

Laissez-faire leader

This leadership style is often referred to as the "free-run" style or permissive leadership.

Formal operational thought

This stage occurs during the adolescent years, 12+ years.

Preoperational stage

This stage occurs during the preschool years, ages 2 to 6

Concrete operational

This stage occurs during the school age years, ages 7 to 11

Identity versus role confusion

This stage occurs in adolescents who are trying to figure out "Who am I?"

Give another name for homograft?

allograft

angina pectoris

also called stable angina is chest pain or discomfort that usually occurs with activity or stress. Angina is chest discomfort due to poor blood flow through the blood vessels in the heart.

ion

an atom that carries an electrical charge because it has gained or lost electrons.

Edema is?

an excess accumulation of fluid in the interstitial spaces

cation

an ion that carries a positive charge because it has given away or lost electrons.

anion

an ion that has gained electrons and therefore cares a negative charge.

Unstable angina

angina even at rest, or angina that has gotten worse. It is associated with sharply increased risk for myocardial infarct within 4 months.

IV therapy is a growing segment of home health. Three of the most common forms of home IV therapy include:

antibiotic, hydration, and Total parental nutrition (TPN)

Aphasia

is an acquired language disorder caused by damage to the brain. This class of language disorder ranges from having difficulty remembering words to losing the ability to speak, read, or write, but does not affect intelligence. This also affects visual language such as sign language. Aphasia is usually caused by brain damage, most commonly caused by stroke. Brain damage linked to aphasia can also be caused by other brain diseases, including cancer, epilepsy, and Alzheimer's disease

Tinnitus (TIN-ih-tus)

is noise or ringing in the ears. Tinnitus isn't a condition itself — it's a symptom of an underlying condition, such as age-related hearing loss, ear injury, medication (like aspirin toxicity), Meniere's disease, TMJ, tumor, or a circulatory system disorder....In rare cases, tinnitus is caused by a blood vessel disorder. This type of tinnitus is called pulsatile tinnitus

Osmosis

is the diffusion of water (movement of solvent water) diffusing across a semi-permeable membrane to an area of higher concentration of solvent.

cleansing enema procedure

look up

condom catheter

look up

Fluid in each of the body compartments contain what?

electrolytes; each compartment has a particular composition of electrolytes that differ from that of other compartments; in order to function normally, body cells must have fluids and electrolytes in the right compartments in the right amounts; whenever an electrolyte moves out of a cell another electrolyte moves in to take its places; the numbers of cations and anions must be the same for homeostasis to exist.

Endoplasmic reticulum

endoplasmic reticulum is a system of membranes that functions as a miniature circulating system for the cell.

interstitial fluids

fluid between the cells and blood vessels

intravascular compartment

fluid that is within blood vessels

Anasarca is?

generalized edema, which is an excessive accumulation of fluid in the interstitial space (tissue spaces) throughout the body as a result of conditions such as cardiac, renal, or liver failure.

solution

has a solvent and a solute

hypotonic solution

having a lower concentration of something. not too much of a low concentration of solute.

urticaria

hives

electrolytes

when a substance is dissolved in solution and some of its molecules split or dissociate into electrically charged atoms or ions.

Gastrojejunostomy Billroth II

more formally Billroth's operation II, is an operation in which the greater curvature of the stomach is connected to the first part of the jejunum in a side-to-side manner. This often follows resection of the lower part of the stomach (antrum).

Angina Decubitus

specific term for angina occurring at rest.

cultural imposition

tendency to impose one's own beliefs, values, and patterns of behavior on individuals from another culture.

What is third-spacing?

the accumulation and sequestration of trapped extracellular fluid in a body space as a result of disease or injury. This is trapped fluid that is unavailable for functional use. Basically, this fluid is in a place in the body where it is difficult or im possible for it to move back into the cells or blood vessels without medical intervention. It is

emesis

vomiting

Spider nevi

Spider nevi are branched growth of dilated capillaries on the skin caused by increased blood flow resulting from high estrogen levels.

spinal stenosis

Spinal stenosis is narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings (called neural foramina) where spinal nerves leave the spinal column.

Scoliosis, a lateral curvature of the spine that causes changes in the spine, chest, and hips, is most commonly seen in:

adolescents; Scoliosis can occur at any age, but is most often seen in adolescent females.

The process that permits a cell to engulf or surround any foreign material and digest it is called:

phagocytosis

A client is admitted with bacterial meningitis. Which intervention is most important for the practical nurse (PN)? Assess pain rating. Obtain vital signs. Dim the lights in the room. Implement droplet precautions.

...

A client who had abdominal surgery yesterday is receiving morphine via a patient-controlled analgesia (PCA) infusion pump. The client reports a pain level of 6 based on a pain scale of 1 to 10. What action should the practical nurse (PN) implement first? Take the client's blood pressure. Ask for a description of the pain. Remind client to push the PCA button. Check the intravenous tubing for kinks.

...

INCENTIVE SPIROMETER

...

Which medications can cause Leukopenia?

...

STEPS OF THE NURSING PROCESS

1) DATA COLLECTION 2) PLANNING 3) IMPLEMENTATION 4) EVALUATION

MASLOW'S HIERARCHY OF NEEDS THEORY:

1) Physiological needs are the priority 2) safety and security 3) love and belonging needs 4) self-esteem needs 5) self-actualization needs

1+ pitting edema

1+ pitting edema is slight pitting, no visible change in the shape of the extremity and depression disappears rapidly.

In order for the fetus to move through the pelvis, it must go through the mechanisms of labor. Place the following mechanisms in order by number if the fetus is in the vertex position. Do not use commas or spaces: _________ 1. Expulsion 2. Extension 3. Engagement 4. Internal rotation 5. Descent 6. External rotation and restitution 7. Flexion

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Stat order

A Stat order is one that needs to be followed immediately.

A bounding pulse

A bounding pulse is a strong and forceful heartbeat felt over one of the arteries in the body.

carbuncle

A carbuncle is a cluster of furuncles. It is an infection of several hair follicles that spreads to surrounding tissue.

central line

A central venous catheter, also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of ...

felon

A felon occurs when the soft tissue under and around an area, such as the fingernail, becomes infected. The involved finger becomes erythematous, edematous, and tender.

foot board

A foot board is used to prevent the complication of foot drop.

puncture wound

A puncture is a piercing wound of the skin caused by knives, nails, wood, glass, or other objects that penetrate the skin.

severe brain injury

A severe brain injury is characterized by unconsciousness or posttrauma amnesia in excess of 8 days. There are cognitive, psychosocial, and behavioral disabilities.

acute pain

Acute pain is intense and of short duration, usually lasting less than 6 months.

Adduction

Adduction is the process of moving the extremity toward the medial position of the body.

A male client who receives albuterol (Ventolin) nebulizing treatment PRN is asking the practical nurse (PN) for his breathing treatment. Which assessment should the PN implement before administering the PRN prescription? Incentive spirometer level. Breath sounds. Correct Respiratory rate. Accessory respiratory muscles effort.

Albuterol (Ventolin), a bronchodilator, is indicated for wheezing caused by narrowing of the air passages, so the client's breath sounds (B) should be auscultated to determine if the albuterol breathing treatment is indicated. Incentive spirometer (A) is an inspiratory exercise used to inflate alveoli and prevent atelectasis, not treat reactive airway disease. (C and D) do not provide accurate information about bronchial airway patency. Category: Medical-Surgical

Once a specimen has been obtained, the next step is to:

All specimens need to be labeled and a requisition made with the same information to identify the specimen properly.

air mattress

An air mattress is used in the prevention of pressure ulcers in immobile patients.

An example of a bacterial skin infection is ?

An example of a bacterial skin infection is cellulitis.

An example of a viral skin infection is ?

An example of a viral skin infection is Herpes zoster.

an incision is a wound that is

An incision is a smoothly divided wound made by sharp instruments.

infectious disease

An infectious disease results from the invasion of microorganisms into the body.

You are getting ready to administer an intradermal injection. At what angle can the injection be given?

An intradermal injection can be administered at a 15-degree angle.

Intravenous cholangiography (IVC)

An intravenous cholangiography (IVC) is a method of visualizing the biliary tree, but it is ineffective in the patient with jaundice.

Atrial fibrillation

Atrial fibrillation, although serious, is not as imminently life threatening as ventricular fibrillation. In atrial fibrillation, electrical activity is disorganized, and the atria quiver at a rate of 350 to 600/minute rather than contract in an organized manner. Ventricular response may be 100 to 180 beats per minute, and the patient experiences decreased cardiac output along with symptoms of palpitations, dyspnea, syncope, light headedness, decreased level of consciousness, and pulmonary edema. Treatment involves slowing the ventricular rate, treating the atrial irritability, and treating the cause of the dysrhythmia.

auscultation

Auscultation is the process of listening to sounds produced by the body which include the cardiovascular, respiratory, and gastrointestinal systems.

Autoimmune disorders

Autoimmune disorders fall into the category of "failure to recognize the body as self." One example of this category of diseases is systemic lupus erythematosus (SLE).

autoimmune hepatitis

Autoimmune hepatitis is inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them. Although the cause of autoimmune hepatitis isn't entirely clear, some diseases, toxins and drugs may trigger autoimmune hepatitis in susceptible people, especially women. Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can be controlled with drugs that suppress the immune system. A liver transplant may be an option when autoimmune hepatitis doesn't respond to drug treatments or when liver disease is advanced.

beneficence

Beneficence means doing what is good.

bilirubin

Bilirubin is excreted in bile and urine, and elevated levels may indicate certain diseases. Bilirubin is a brownish yellow substance found in bile. It is produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through the stool (feces) and gives stool its normal color. When bilirubin levels are high, the skin and whites of the eyes may appear yellow (jaundice).

Blood is delivered to the glomerulus by the ______ and exits through the __________.

Blood is delivered to the glomerulus by the afferent arteriole and exits through the efferent arteriole.

A nurse working the medical floor reports to his shift feeling tired, complains of feeling emotionally drained, and has trouble meeting the needs of his patients. This is an example of: Stress Laziness Burnout Unorganized

Burnout is the physical, emotional, and spiritual exhaustion of a caregiver.

A 9-month-old child is at the clinic for a wellness check-up. Which assessment finding is of most concern to the pediatric nurse?

By the time a child is 7 months old he or she should be able to sit up unassisted.

Your patient has a history of fluid retention. What is the best way to monitor the water balance in the body?

By weighing daily, a sudden change in weight will show an increase in fluid retention. Weighing needs to be the same time each day since there are fluctuations in weight throughout the day.

Cardiac catheterization

Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart. The catheter is most often inserted from the groin or the arm. A larger thin plastic tube called a sheath is placed into a vein or artery in your leg or arm. Then longer plastic tubes called catheters are carefully moved up into the heart using live x-rays as a guide.

Catastrophic brain injury

Catastrophic brain injury is characterized by a coma lasting for several months or longer.

Central visual acuity:

Central visual acuity: This refers to the relatively small but vital part of the visual field used for reading; it is tested with conventional eye charts (Snellen Chart) and corresponds to the function of the macular area of the retin

A child has been diagnosed with Down syndrome. In addition to decreased cognitive abilities, she is at risk for physical health problems including:

Children with Down syndrome also tend to have physical disorders, including upper airway infections, congenital heart defects, hypothyroidism, immune dysfunction, and studies show an increased incidence of leukemia.

chloasma

Chloasma is the mask of pregnancy characterized by irregular darkening of the pigment of the cheeks, forehead, and nose.

Chronic illness

Chronic illness is an irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care, function, and prevention of further disability.

Cognitive therapy

Cognitive therapy focuses on breaking negative thought patterns and developing positive feelings about memories or thoughts.

DNR

DNR stands for "Do Not Resuscitate," for which no interventions will be done to sustain life.

Adipose tissue, bone, cartilage, and blood are examples of:

Connective tissue "connects" joints, tissues, or structures of the body. Examples include areolar tissue, adipose tissue, fibrous connective tissue, bone, cartilage, blood, and hemopoietic tissue.

A growing number of older adults need home care services. When the admission nurse is developing an older patient's plan of care, it is important for the nurse to:

Consider the physical strength and functional abilities when making modifications to the home environment. It is important to preserve the older patient's autonomy. Any changes in the home environment need to take into consideration the patient's physical strengths and remaining functional abilities, not just the patient's disabilities.

Cranial

Cranial refers to the head.

Cyanosis

Cyanosis indicates a peripheral vascular problem. A bluish color of the skin and the mucous membranes due to insufficient oxygen in the blood

Defense mechanisms

Defense mechanisms are behavioral patterns that protect the individual against a real or perceived threat.

ecchymosis

Ecchymosis is a discoloration of an area of the skin or mucous membrane. (Bruise)

3+ edema

Edema of the face, hands, sacrum, and abdomen is documented as 3+.

Once a nurse is licensed, he or she can apply to another state for licensure by:

Endorsement

Endoscopic spinal microsurgery

Endoscopic spinal microsurgery is when surgery to the spine is performed using endoscopic equipment through small incisions.

Give examples of Nervous tissues?

Examples of nervous tissue are neurons and glial cells.

A filtration process

Filtration is an example of a passive transport process.

The purpose of positioning a patient at the 30-degree lateral position is to provide:

For patients with pressure ulcers or who are at risk for pressure ulcers, the 30-degree lateral position is used to avoid pressure points; Reduction of pressure points

Frotteurism

Frotteurism is sexual arousal achieved by rubbing against or touching a nonconsenting individual.

A young mother is at the clinic with her 5-year-old daughter. She has just been diagnosed with iron deficiency anemia. The physician has ordered iron supplements. As the nurse, what instructions would you give the mother?

Giving iron with citrus fruit juice and between meals enhances the absorption of the iron.

Global aphasia

Global aphasia is the inability to understand the spoken word or to speak.

Huntington's Disease

Huntington's disease is a genetically transmitted, autosomal dominant disorder that affects men and women of all races. It involves an overactivity of the dopamine pathway, resulting in abnormal and excessive involuntary movements (chorea). Also, there is deterioration in mental processes, including intellectual decline, emotional lability, and psychotic behavior. There is no cure, and death usually occurs 10 to 20 years after the onset of symptoms. Huntington's disease is an inherited disease that causes the progressive breakdown (degeneration) of nerve cells in the brain. Huntington's disease has a broad impact on a person's functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders.

Second-wind Phenomenon:

If patient repeats same activity after the attach, he may not feel the attack the second time.

Impetigo contagiosa

Impetigo contagiosa consists of macular lesions that rupture and form a dried exudate on the face, hands, arms, and legs.

A diabetic female patient asks the nurse if she knows anything about reflexology. The nurse's most appropriate response is:

In diabetics, overstimulation of the corresponding reflexes may cause the pancreas to start producing insulin again and cause a high level of insulin when the patient uses artificial insulin.

A nurse is collecting data on a patient who is 28 weeks pregnant. The nurse measures the fundal height in centimeters, and expects to measurement to be ____ cm.

In the second and third trimesters, the measurement of fundal height in centimeters should equal the same as the fetus age in weeks ± 2.

Internal rotation

Internal rotation is the process of turning the foot and leg toward the other leg.

INR normal range

International normalized ratio (INR): 0.8-1.1

Isotonic solution

Isotonic solution is a solution of the same osmotic pressure that expands the body's fluid volume without causing a fluid shift from one compartment to another.

(Kayexalate) SODIUM POLYSTYRENE SULFONATE

Kayexalate is indicated for the treatment of hyperkalemia.

Laennec's cirrhosis

Laennec's cirrhosis is the term formerly used to refer to alcoholic cirrhosis.

4+ edema

Massive, generalized edema is documented as 4+.

A child is admitted for severe abdominal pain and possible appendicitis. Laboratory and xray studies are prescribed. During the diagnostic period, the practical nurse should implement which nursing actions? (Check all that apply.) Maintain child's comfort. Relieve parent and child's anxiety. Prepare for surgery. Give oral home medications. Encourage ambulation.

Maintain child's comfort. Relieve parent and child's anxiety. Prepare for surgery.

malpractice

Malpractice in the failure to meet a legal duty that results in harm to another.

Which type of financial assistance provides payment for medical assistance to people with low income?

Medicaid is a federally funded, state-operated program of medical assistance to people with low incomes.

Mild brain injury

Mild brain injury is characterized by brief or no loss of consciousness.

1+ edema

Minimal edema on pedal and pretibial areas is documented as 1+.

Moderate brain injury

Moderate brain injury is characterized by a period of unconsciousness ranging from 1 to 24 hours.

Myasthenic crisis

Myasthenic crisis is a life-threatening condition that occurs when the muscles that control breathing become too weak to do their jobs. Emergency treatment is needed to provide mechanical assistance with breathing. Medications and blood-filtering therapies help people to again breathe on their own.

When preparing a medication for a subcutaneous injection, what size needle length is needed?

Needle length for subcutaneous injections is usually 5/8 - 1/2 inch.

negligence

Negligence is the commission or omission of an act that a reasonably prudent person would have done in a similar situation that leads to harm to another person.

neoplastic disease

Neoplastic disease is an abnormal growth of new tissue that is either malignant or benign.

Neuropathic pain

Neuropathic pain is initiated from the nerves or nervous system and is usually described as tingling, burning, or shooting.

Nonmaleficence

Nonmaleficence means to do no harm.

Norepinephrine

Norepinephrine has an impact on maintaining arousal, dreaming, and regulation of mood.

nursing intervention

Nursing intervention is the action used to meet the goal of the plan of care.

PRN orders

PRN orders are carried out only when needed by the patient.

Parkinson's disease

Parkinson's disease (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 50. Early symptoms of PD are subtle and occur gradually. In some people the disease progresses more quickly than in others. As the disease progresses, the shaking, or tremor, which affects the majority of people with PD may begin to interfere with daily activities. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.

Stage II pressure ulcer

Partial-thickness skin loss involves epidermis, dermis, or both. The ulcer is superficial and manifests as an abrasion, blister, or shallow crater.

Pinocytosis

Pinocytosis is the process by which extracellular fluid is taken into the cell.

Pityriasis rosea

Pityriasis rosea begins with a single lesion, 1 to 2 inches in diameter, known as a herald patch. This lesion is scaly with a raised border and a pink center, and is typically found on the patient's chest, abdomen, back, groin, or axillae. Seven to 14 days after the initial eruption, smaller matching spots of the rash become widespread on both sides of the body.

preeclampsia

Preeclampsia is when a pregnant woman develops high blood pressure and protein in the urine after the 20th week (late 2nd or 3rd trimester) of pregnancy.

Premature separation of the placenta

Premature separation of the placenta would have port wine-colored amniotic fluid.

Presbyopia

Presbyopia is a condition in which the lens of the eye loses its ability to focus, making it difficult to see objects up close.

At the beginning of the shift, the practical nurse (PN) is reconciling a client's medication administration record, the prescriptions, and the dispensed drugs. Which available medication should the PN give? Prescribed digoxin (Lanoxin); dispensed digoxin immune FAB (DigiFab). Prescribed nitroglycerin (Nitrogard, transmucosal); dispensed nitroglycerin (Nitrostat SL). Prescribed albuterol (Proventil); dispensed albuterol (Ventolin). Prescribed verapamil (Isoptin); dispensed verapamil SR (Calan SR).

Prescribed albuterol (Proventil); dispensed albuterol (Ventolin).

diaphoretic

Producing or increasing perspiration.

Projection

Projection is blaming personal shortcomings on someone else.

PT or Prothrombin test

Prothrombin time (PT) is a blood test that measures how long it takes blood to clot. A prothrombin time test can be used to check for bleeding problems. PT is also used to check whether medicine to prevent blood clots is working.

RACE FOR FIRE SAFETY

RESCUE ALERT CONTAIN EXTINGUISH

Radioisotope

Radioisotope studies require the injection or ingestion of a radioactive substance. A scanning device is used to identify the distribution of the substance in different areas of the body. Concentrations of the radioisotope in a specific organ, such as the thyroid gland or brain, identifies a tumor in that location.

When performing cardiopulmonary resuscitation, the nurse would deliver how many breaths per minute to an adult client?

Rationale: During cardiopulmonary resuscitation (CPR), the nurse would deliver 10 breaths per minute to an adult client.

Tachypnea

Tachypnea is where a patient has a rapid respiratory rate, usually higher than 20 times per minute.

Rationalization

Rationalization is a process of constructing plausible reasons to explain and justify one's behavior.

The vital signs of a newborn baby girl are: T?97.9, P?140, R?34 with brief periods of apnea, and B/P?80/40 with an increase in systolic when crying. The nurse's next intervention is to:

Realize these vital signs are normal for a newborn and document the data on the flow sheet.

Reciprocity

Reciprocity is another name for licensure from one state to another.

Which of the following is the main diagnostic feature of Hodgkin's disease?

Reed-Sternberg cells are atypical histiocytes consisting of large, abnormal, multinucleated cells in the lymphatic system found in Hodgkin's disease.

referred pain

Referred pain is felt at a site other than the injured or diseased organ or part of the body.

Regression

Regression is the barring from conscious thought of painful, disagreeable thoughts, experiences, or impulses.

The most common causes of early postpartum hemorrhage is ?

Retained placenta Laceration of the perineum Uterine atony

Reticulocytes

Reticulocytes are immature red blood cells, typically composing about 1% of the red cells in the human body. Reticulocytes develop and mature in the bone marrow and then circulate for about a day in the blood stream before developing into mature red blood cells.

Sandbags

Sandbags are used to provide support and shape to body contour

Scarring

Scarring is the result of a prior infection or surgery of the cervix and may slow cervical dilation.

Atypical angina

Sharp of stabbing pain rather than crushing pain. Angina pain with change in position rather than angina strictly upon effort. Other symptoms that are angina equivalents that are caused by myocardial ischemia: exertional dyspnea, nausea, indigestion, dizziness, and sweating.

Situational leadership

Situational leadership takes into account the style of the leader, the maturity of the group, and the situation at hand.

Snellen Test

Snellen chart is an eye chart used by eye care professionals and others to measure visual acuity. a Snellen chart is placed at a standard distance: 20 ft in the US, or 6 metres in the rest of the world.

Somatic pain

Somatic pain arises from the musculoskeletal system and is described as aching, stabbing, or throbbing.

Stage I pressure ulcer

Stage I is nonblanchable erythema of the intact skin

Stage III pressure ulcer

Stage III is a full-thickness skin loss that involves damage or necrosis of subcutaneous tissue that may extend down to but not through the underlying fascia.

Tinea capitis, Microsporum audouinii, Tinea corporis, and Tinea pedis are all examples of:

T. capitis, M. audouinii, T. corporis, and T. pedis are all examples of fungal skin infections. These dermatophytoses are superficial infections.

What are the 3 types of white blood cells or lymphocytes?

T cells (thymus cells) and B cells (bone marrow or bursa-derived cells[1]) are the major cellular components of the adaptive immune response. T cells are involved in cell-mediated immunity, whereas B cells are primarily responsible for humoral immunity (relating to antibodies). The function of T cells and B cells is to recognize specific "non-self" antigens, during a process known as antigen presentation. Once they have identified an invader, the cells generate specific responses that are tailored to maximally eliminate specific pathogens or pathogen-infected cells. B cells respond to pathogens by producing large quantities of antibodies which then neutralize foreign objects like bacteria and viruses. In response to pathogens some T cells, called T helper cells, produce cytokines that direct the immune response, while other T cells, called cytotoxic T cells, produce toxic granules that contain powerful enzymes which induce the death of pathogen-infected cells. Following activation, B cells and T cells leave a lasting legacy of the antigens they have encountered, in the form of memory cells. Throughout the lifetime of an animal these memory cells will "remember" each specific pathogen encountered, and are able to mount a strong and rapid response if the pathogen is detected again. NK cells are a part of the innate immune system and play a major role in defending the host from both tumors and virally infected cells. NK cells distinguish infected cells and tumors from normal and uninfected cells by recognizing changes of a surface molecule called MHC (major histocompatibility complex) class I. NK cells are activated in response to a family of cytokines called interferons. Activated NK cells release cytotoxic (cell-killing) granules which then destroy the altered cells.[2] They were named "natural killer cells" because of the initial notion that they do not require prior activation in order to kill cells which are missing MHC class I. Eosinophilia is a condition in which the eosinophil count in the peripheral blood exceeds 0.45×109/L (450/μl). Eosinophils usually account for less than 7% of the circulating leukocytes.[1] A marked increase in non-blood tissue eosinophil count noticed upon histopathologic examination is diagnostic for tissue eosinophilia.[2] Several causes are known, with the most common being some form of allergic reaction or parasitosis. Eosinophil granulocytes, usually called eosinophils or eosinophiles (or, less commonly, acidophils), are white blood cells and one of the immune system components responsible for combating multicellular parasites and certain infections in vertebrates. Along with mast cells, they also control mechanisms associated with allergy and asthma. They are granulocytes that develop during hematopoiesis (formation of blood) in the bone marrow before migrating into blood. Basophilia is a condition where the basophil quantity is abnormally elevated (more than 1010 basophils per liter of blood). Basophils contain large cytoplasmic granules and store histamine, a chemical that is secreted by the cells when stimulated. Like all circulating granulocytes, basophils can be recruited out of the blood into a tissue when needed. Basophils appear in many specific kinds of inflammatory reactions, particularly those that cause allergic symptoms. Basophils contain anticoagulant heparin, which prevents blood from clotting too quickly. They also contain the vasodilator histamine, which promotes blood flow to tissues. They can be found in unusually high numbers at sites of ectoparasite infection, e.g., ticks. Like eosinophils, basophils play a role in both parasitic infections and allergies.[2] They are found in tissues where allergic reactions are occurring and probably contribute to the severity of these reactions. Basophils arise and mature in bone marrow. When activated, basophils degranulate to release histamine, proteoglycans (e.g. heparin and chondroitin), and proteolytic enzymes (e.g. elastase and lysophospholipase). They also secrete lipid mediators like leukotrienes (LTD-4), and several cytokines. Histamine and proteoglycans are pre-stored in the cell's granules while the other secreted substances are newly generated. Each of these substances contributes to inflammation

Telophase

Telophase is the final phase of mitosis, in which the two nuclei appear and the chromosomes disperse.

extention

The act of straightening or extending a flexed limb.

Autocratic leader

The autocratic leader retains all authority and responsibility and is concerned primarily with tasks and goal accomplishment.

After a large scale community disaster occurs, many seriously injured victims need to be hospitalized. Which client who is currently hospitalized should the practical nurse most likely prepare for discharge? An older male who was admitted with heart failure (HF) and a troponin level of 3 ng/ml. A young adult male with a serum INR of 2 who was admitted for deep vein thrombosis. Correct An older female client who is admitted after experiencing numbness of the left side of face. An adult female with acute abdominal pain who has a hemoglobin of 10 grams/dl. Incorrect

The client with a deep vein thrombosis has an INR value that indicates a therapeutic response (B) to treatment and should be ready for discharge. Elevated troponin level (A) is diagnostic of an acute myocardial infarction. Unilateral facial numbness may indicate the client is experiencing an acute brain attack (stroke) (C). (D) may require emergency surgical intervention. Category: Medical-Surgical

2nd Stage of delivery

The second stage of labor ends with the birth of the baby.

First Stage of Delivery

The first stage of labor ends with the complete dilation of the cervix.

4th Stage of Delivery

The fourth stage of labor ends when the mother's vital signs are observed to be within normal ranges 2 to 4 hours after the birth.

mitochondria

The mitochondria is the "powerhouse" of the cell.

what is the outer covering of the kidney?

The outer covering of the kidney is called the renal capsule, a strong layer of connective tissue.

Pleural muscle

The pleural muscle is a fictitious muscle.

Gallbladder ultrasound

The preferred diagnostic test for visualizing the biliary tree in a patient with jaundice is a gallbladder ultrasound.

urolithiasis

The process of forming stones in the kidney, bladder, and/or urethra (urinary tract).

radial pulse

The radial pulse indicates blood flow to the hand.

sacrum

The sacrum is a large wedge shaped vertebra at the inferior end of the spine. It forms the solid base of the spinal column where it intersects with the hip bones to form the pelvis.

Social worker

The social worker evaluates and assesses the psychosocial needs of the patient, including filing of insurance papers and providing emotional and grief support.

The sodium-potassium pump is an example of:

The sodium-potassium pump is an example of an active transport process. Certain enzymes play a role in active transport, providing a chemical "pump" to help substances move through the cell membrane.

spiritual coordinator

The spiritual coordinator is the liaison between the spiritual community and the interdisciplinary team. Assists with the spiritual assessment of the patient and develops a plan of care regarding spiritual matters.

Brachytherapy

The use of sealed internal radiation is also known as brachytherapy. These are implants that are temporarily or permanently inserted into hollow cavities, within body tissues, or on the body's surface. The radioactive source delivers a specific radiation dose continuously over hours or days. The highly concentrated dose of radiation is delivered in or near a tumor.

The vertebrae are examples of ______ bones.

The vertebrae are examples of irregular bones.

Potassium (K+) test

This test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also helps move nutrients into cells and waste products out of cells. Potassium levels in the body are mainly controlled by the hormone aldosterone. Aldosterone is a hormone released by the adrenal glands. It helps the body regulate blood pressure. Aldosterone increases the reabsorption of sodium and water and the release of potassium in the kidneys. This action raises blood pressure.

Tomography

Tomography is a special technique of making multiple radiographic films at different depths of a specific area, organ, or structure. The details of each thin section can clearly be visualized.

A nurse is caring for a patient who has stopped drinking and runs the risk of alcohol withdrawal syndrome. The nurse monitors the patient knowing that tremors from alcohol cessation are usually seen how soon after cessation?

Tremors from alcohol cessation are seen 6 to 48 hours after the last drink and may last for 3 to 5 days.

The "universal recipient" with regard to blood type is type:

Type AB blood is considered to be the "universal recipient" because it contains neither anti-A nor anti-B antibodies in its plasma. Therefore it does not clump any donor's RBCs containing A or B antigens.

The preferred site for I.M. injections for children younger than age 3 is:

Vastus lateralis is the preferred site because it is free of nerves and blood vessels.

Your patient has been diagnosed with diverticulosis as a result of muscle thickening and increased intracolonic pressure. Which of the following recommendations would you give her regarding food choices?

When muscle thickening and increased intracolonic pressure are the causes of diverticulosis, a high-fiber diet of bran, fruits, and vegetables is recommended. Also, sulfa drugs and analgesics may be used in treating the disease.

metabolic acidosis

With metabolic acidosis, the pH is < 7.35, PaCO2 is normal or < 35mm Hg, and the HCO3 is below 22mEq/L.

ecchymotic or ecchymoses

a discoloration due to extravasation of blood, as in a bruise.

bleb

a fluid filled blister on the skin or a small air bubble

The very young, the old, and obese are most at risk for:

dehydration; This group of people have less fluid reserves, thus leading to fluid volume deficit that leads to dehydration.

dyspneic

difficult or labored breathing

To increase granulation on a stage 3 pressure ulcer the nurse should do what?

irrigate wound with sterile normal saline.

Beck's triad

is a collection of three medical signs associated with acute cardiac tamponade, an emergency condition wherein fluid accumulates around the heart and impairs its ability to pump blood. The signs are low arterial blood pressure, distended neck veins, and distant, muffled heart sounds

pericardiocentesis

is a procedure where fluid is aspirated from the pericardium (the sac enveloping the heart).

dystocia

is an abnormal or difficult childbirth or labor. (OBSTRUCTED LABOR)

Nucleic acid metabolism

is the process by which nucleic acids (DNA and RNA) are synthesized and degraded. Nucleic acids are polymers of nucleotides. Nucleotide synthesis is an anabolic mechanism generally involving the chemical reaction of phosphate, pentose sugar, and a nitrogenous base. Destruction of nucleic acid is a catabolic reaction. Additionally, parts of the nucleotides or nucleobases can be salvaged to recreate new nucleotides. Both synthesis and degradation reactions require enzymes to facilitate the event. Defects or deficiencies in these enzymes can lead to a v

Pyelonephritis

kidney infection caused by bacteria or viral infection.

In anatomical terms, the term "medial" refers to the:

midline

nuchal rigidity

neck stiffness

dysuria

painful urination

gastric tube feeding

review procedure

jugular vein

runs on both sides of the neck of a person and returns blood from the head to the heart. Serious injury to the jugular can drain blood from the head and brain and lead to a quick kill.

circumoral

surrounding the mouth

diaphoretic

sweating heavily.

Urinary incontinence

the loss of bladder control — is a common and often embarrassing problem.

Bradycardia

Bradycardia is where a patient's heart rate is slower than 60 beats per minute.

Bradypnea

Bradypnea is a patient with a respiratory rate less than 12 times per minute.

fluid volume deficit:

Dehydration in which the body's fluid intake is not sufficient to meet the body's fluid needs.

Eclampsia

Eclampsia is seizures (convulsions) in a pregnant woman. These seizures are not related to an existing brain condition.

Name the 4 body fluid compartments?

Extracellular compartments Interstitial fluids Intracellular compartments intravascular compartments

fluid volume excess:

Fluid intake or fluid retention that exceeds the body's fluid needs; also called over-hydration or fluid overload.

What is the cause of localized edema?

It occurs as a result of traumatic injury from accidents or surgery, local inflammatory processes, or burns.

justice

Justice in nursing means that nurses must allocate time among all the assigned patients to meet their needs.

What is the primary organ responsible for the retention and excretion of body sodium and water?

Kidneys

myxedema coma

Myxedema coma is a loss of brain function as a result of severe, longstanding low level of thyroid hormone in the blood (hypothyroidism). Myxedema coma is considered a life-threatening complication of hypothyroidism.

Nonverbal communication

Nonverbal communication includes tone and volume of voice, eye contact, gestures and body language.

hypertonic solution

having too much or a lot of something or higher concentration of something.

Addison's disease can result in?

hypoglycemia

homograft

A homograft is skin from another human, which is usually obtained from a cadaver and is provided through a skin bank.

hypercalcemia:

A serum calcium level that exceeds 10 mg/dl.

Solute

= any molecule that there is less of. It is the thing that is dissolved.

Solvent

= more of a particular molecule "many cases water is the solvent." It is doing the dissolving or what other things are dissolved in.

why does a pulse deficit occur?

Pulse deficit is a clinical sign wherein , one is able to find a difference in count between heart beat (Apical beat or Heart sounds ) and peripheral pulse .This occurs even as the heart is contracting , the pulse is not reaching the periphery.This can occur in few clinical situations . 1 . Atrial fibrillation. 2. Very early diastolic ventricular ectopic beats 3. Some patients with Pacemaker.

Autonomy

Autonomy refers to personal freedom of choice, a right to be independent and make decisions freely.

A nurse is caring for a client who had a tracheostomy tube inserted 1 week ago. The client begins to cough vigorously, and accidental decannulation of the tracheostomy tube occurs. The nurse immediately prepares to:

Rationale: If decannulation of a tracheostomy tube occurs 72 hours after surgical placement of the tracheostomy, the nurse prepares to replace the tube. The nurse also calls for help immediately. The nurse extends the client's neck and opens the tissues of the stoma to secure an airway. With the obturator inserted into the new tracheostomy tube, the nurse quickly and gently replaces the tube and immediately removes the obturator. The nurse checks for airflow through the tube and for bilateral breath sounds. If unable to secure the airway, the nurse notifies the respiratory therapist and attempts to ventilate the client with a bag-valve mask (resuscitation bag) while waiting for help. If the client is in distress and further attempts to secure the airway fail, the nurse calls the resuscitation team, including an anesthesiologist, for assistance and calls a code if necessary.

Pericardial refers to?

Referring to the pericardium, the sac of fibrous tissue that surrounds the heart.

A loss of 10 % of body fluid is ______ and 20% can be ___________.

Serious; fatal (Infants and older adults are at greatest risk for fluid imbalances.)

The diagnosis of herpes simplex encephalitis is made by what diagnostic method?

The diagnosis of herpes simplex encephalitis can be made by brain biopsy and is rarely made from the culture of cerebrospinal fluid obtained from a lumbar puncture.

dorsalis pedis pulse

The dorsalis pedis is the pulse to be palpated for blood flow to the foot.

Intravascular fluid is?

The fluid space within the blood vessels is made up of blood cells and serum (water, clotting factors, chemicals, and electrolytes.)

atom

The smallest part of an element that still has properties of the element and composed of particles known as protons (positive charge), neutrons (neutral charge), and electrons (negative charge.) Protons and neutrons are in the nucleus of the atom; therefore, positively charged. while electrons revolve around the nucleus. As long as the electrons and protons are equal, the net charge is zero. Atoms may gain, lose, or share electrons.

homeostasis:

The tendency of biological systems to maintain relatively constant conditions in the internal environment while continuously interacting with and adjusting to changes originating with or outside of the system.

pulse deficit

A pulse deficit is a difference between the radial and apical pulse rates, where the radial rate is less than the apical rate. It is confirmed by two nurses, one listening to the radial and the other the apical, at the same time and using the same watch.

Cardiogenic shock

Cardiogenic shock is a condition in which your heart suddenly can't pump enough blood to meet your body's needs. The condition is most often caused by a severe heart attack.

cardiac tamponade

Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium).

Reye's syndrome

Children should not be given aspirin due to the risks of Reye's syndrome. Reye's (Ryes) syndrome is a rare but serious condition that causes swelling in the liver and brain. Reye's syndrome most often affects children and teenagers recovering from a viral infection, most commonly the flu or chickenpox. Signs and symptoms such as confusion, seizures and loss of consciousness require emergency treatment. In Reye's syndrome, a child's blood sugar level typically drops while the levels of ammonia and acidity in his or her blood rise. At the same time, the liver may swell and develop fatty deposits. Swelling may also occur in the brain, which can cause seizures, convulsions or loss of consciousness. The signs and symptoms of Reye's syndrome typically appear about three to five days after the onset of a viral infection, such as the flu (influenza) or chickenpox, or an upper respiratory infection, such as a cold.

Give signs of a peritonitis infection if you are giving a peritoneal dialysis.

Cloudy dialysis fluid White flecks, strands or clumps (fibrin) in the dialysis fluid

A nurse is preparing for the intershift report when a nurse's aide pulls an emergency call light in a client's room. On answering the light, the nurse finds a client experiencing tachycardia and tachypnea. The client's blood pressure is 88/60 mm Hg. Which action should the nurse take first?

Rationale: The client is exhibiting signs of shock and requires emergency intervention. Placing the client in the modified Trendelenburg's position increases blood return from the legs, which increases venous return and subsequently the blood pressure. The nurse can then verify the client's blood volume status by assessing the urine output and ensuring that the IV is infusing without complications. The nurse would also check the client's pulse oximetry and notify the registered nurse.

What is the most abundant cation in the extracellular fluid and is the major regulating factor for bodily water balance. Extracellular (i.e., intravascular and interstitial) and intracellular sodium contents are closely affected by the body fluid status?

Sodium

Give symptoms of hypovolemia

Symptoms of hypovolemia include cool, clammy, and pale skin; feelings of anxiety and restlessness; and thirst. The nurse would check the vital signs. The nurse would not ambulate the client or encourage fluids until specific prescriptions are given to do so.

The pleura is?

The pleura is a thin membrane that lines the surface of the lungs and the inside of the chest wall outside the lungs.

popliteal pulse

The popliteal pulse indicates blood flow to the leg

Why is serum total carbon dioxide (CO2) often monitored in conjunction with electrolytes?

because it is a significant indicator in acid-base imbalances

Why is assessing for intravascular fluid loss difficult?

because it may not be reflected in weight changes or intake and output (I & O) records, and it may not become apparent until after organ malfunction occurs.

What is first spacing?

describes the normal distribution of fluid in the (ICF) intracellular fluid compartment (70% average adult) and (ECF) Extracellular fluid compartment (30% average adult) consisting of interstitial fluid (22%), intravascular fluid (6%), and transcellular fluid(2%)-cerebrospinal canals, lymphatic tissues, synovial joints and the eyes.

heterograft

A heterograft is skin from another species. The most commonly used type of heterograft is pigskin because of its relative compatibility with human skin.

Pleura effusion occurs when?

fluid accumulates in the space between the layers of pleura. Normally, only teaspoons of watery fluid are present in the pleural space, allowing the lungs to move smoothly within the chest cavity during breathing.

Diffusion

is the spreading of molecules or particles from high concentration to an area of lower concentration. They diffused to an area with more room and less particles.

syncope

syncope (fainting)