B248 Exam 1 (Giddens Chapters)
The nurse reviews the patient's complete blood count (CBC) results and notes that the neutrophil levels are elevated, but monocytes are still within normal limits. This indicates what type of inflammatory response?
Early stage acute
While caring for a patient preparing for a kidney transplant, the nurse knows that the patient understands teaching on immunosuppression when she makes which statement?
"The medications that I take will help prevent my body from attacking my new kidney."
The parents of a newborn question the nurse about the need for vaccinations: "Why does our baby need all those shots? He's so small, and they have to cause him pain." The nurse can explain to the parents that which of the following are true about vaccinations? (Select all that apply.)
- Are part of primary prevention for system disorders - Help protect individuals and communities - Are recommended by the Centers for Disease Control and Prevention (CDC)
The nurse reviews the patient and notes all of the following. Which of the findings indicates systemic manifestations of inflammation? (Select all that apply.)
- Oral temperature 38.6 C/101.5 F - WBC 20 cells/McL x 10^9 /L - Patient reports, "I'm tired all the time. I haven't felt like myself in days."
Individuals of low socioeconomic status are at an increased risk for infection because of which of the following? (Select all that apply.)
- Uninsured or underinsured status - High cost of medications - Mostly female gender
The nurse is caring for a patient with a diagnosed case of Clostridium difficile. The nurse expects to implement which of the following interventions? (Select all that apply.)
- Use of personal protective equipment - Patient teaching on methods to inhibit transmission - Administration of intravenous fluids - Strict monitoring of intake and output
The nurse is caring for a patient who was started on intravenous antibiotic therapy earlier in the shift. As the second dose is being infused, the patient reports feeling dizzy and having difficulty breathing and talking. The nurse notes that the patient's respirations are 26 breaths/min with a weak pulse of 112 beats/min. The nurse suspects that the patient is experiencing which condition?
Anaphylactic reaction
On admission to the clinic, the nurse notes a moderate amount of serous exudate leaking from the patient's wound. The nurse realizes what information about this fluid?
Contains the materials used by the body in the initial inflammatory response
The nurse is preparing to administer medications to a patient with rheumatoid arthritis (RA). The nurse should explain which goal of treatment to the patient?
Control inflammation
The nurse is caring for a postoperative patient who had an open appendectomy. The nurse understands that this patient should have some erythema and edema at the incision site 12-24 hours post operation dependent on which condition?
His immune system is functioning properly.
While reviewing the complete blood count (CBC) of a patient on her unit, the nurse notes elevated basophil and eosinophil readings. The nurse realizes that this is most indicative of which type of infection?
Parasitic
The nurse is working on a plan of care with her patient which includes turning and positioning and adequate nutrition to help the patient maintain intact skin integrity. The nurse helps the patient to realize that this breaks the chain of infection by eliminating which element?
Portal of entry
An 18-month-old female patient is diagnosed with her fifth ear infection in the past 10 months. The physician notes the child's growth rate has decreased from the 60th percentile for height and weight to the 15th percentile over that same time period. The child has been treated for thrush consistently since the third ear infection. The nurse understands that the patient is at risk for which condition?
Primary immunodeficiency
A patient is being treated with an antibiotic for an infected orthopedic injury. What explanation should the nurse give to the patient about this medication?
"An antibiotic helps to kill the infection causing the inflammation."
A patient comes to the clinic with a complaint of painful, itchy feet. On interview, the patient tells the nurse that he is a college student living in a dormitory apartment that he shares with five other students. What teaching should the nurse provide for this patient?
"Avoid sharing razors and other personal items."
A nurse is instructing her patient with ulcerative colitis regarding the need to avoid enteric-coated medications. The nurse knows that the patient understands the reason for this teaching when he states which of the following?
"Enteric-coated medications are absorbed lower in the digestive tract and can be irritating to my intestines or inadequately absorbed by my inflamed tissue."
A patient is diagnosed with a sprain to her right ankle after a fall. The patient
"Ice should be applied for 15-20 minutes every 2-3 hours over the next 1-2 days."
A nurse is teaching a group of business people about disease transmission. The nurse knows that additional teaching is needed when one of the participants states which of the following?
"If I don't feel sick, then I don't have to worry about transmitted diseases."
Which set of assessment data is consistent for a patient with severe infection that could lead to system failure?
BP 90/48, P 112 beats/min, RR 26 breaths/min, urine output 240 mL in past 24 hours
The nurse is caring for a patient who is being discharged home after a splenectomy. What information on immune function needs to be included in this patient's discharge planning?
Basic infection control techniques
In order to provide an intervention for a patient, the nurse is often responsible for obtaining a sample of exudate for culture. What information will this provide?
The specific type of pathogen that is causing an infection
