Red Exam #4
A client is brought in by ambulance to the emergency department after being involved in a motorcycle accident. The client has an open fracture on his tibia. The wound is highly contaminated and there is extensive soft tissue damage. How would you grade this client's fracture?
Grade 3 (most severe)
A clinic nurse is caring for a patient admitted with AIDS. The nurse has assessed that the patient is experiencing a progressive decline in cognitive, behavioral, and motor functions. What complication is the patient more than likely experiencing?
HIV encephalopathy
what should be included in the care of a patient with leukemia?
Improve self-care, self-esteem, anxiety, and grief with empathetic listening and realistic reassurance (Ask if he would like you to sit with him while he collects his thoughts)
A client with a documented history of allergies presents to the clinic. She states that she is frustrated by her chronic nasal congestion, anosmia (inability to smell) and inability to concentrate. What would an appropriate nursing diagnosis be for this patient?
Ineffective individual coping with chronicity of condition and need for environmental modifications
what is a nursing diagnosis for a patient with allergic rhinitis?
Ineffective individual coping with chronicity of condition and need for environmental modifications (i.e. chronic nasal congestion, anosmia (inability to smell) and inability to concentrate)
patient with diabetes are more likely to have osteomyelitis affect what?
More common to affect the feet
before a transfusion of packed red blood cells (PRBC) what should you do?
Take patient's temperature, pulse, respiration, blood pressure and assess fluid volume status (e.g., auscultate lungs, assess for jugular venous distention) to serve as a baseline for comparison during transfusion
Is the following statement true or false? An antigen is a protein substance developed by the body in response to and interacting with a specific antibody
False An antibody, not an antigen, is a protein substance developed by the body in response to and interacting with a specific antigen, not antibody
Is the following statement true or false? Avascular necrosis is prolongation of expected healing time for a fracture.
False Avascular necrosis is death of tissue secondary to poor perfusion and hypoxemia. Delayed union is prolongation of expected healing time for a fracture.
Is the following statement true or false? Immunity refers to the body's nonspecific protective response to an invading foreign agent or organism
False Immunity refers to the body's specific, not nonspecific, protective response to an invading foreign agent or organism
Is the following statement true or false? Polycythemia is a form of anemia
False Polycythemia is a situation of excess red blood cells, not a deficiency, which would be called anemia
Is the following statement true or false? Polycythemia vera is a condition that places the patient at a risk for increased infection
False Polycythemia vera is a condition that places the patient at risk for thrombus formation and bleeding caused by dysfunctional platelets
True or False Primary immune deficiency disorders result from external factors such as infection
False Primary immune deficiency disorders are genetic
Is the following statement true or false? When having a reaction to a blood transfusion, patients will present with the same symptoms and assessment changes
False There are a variety of complications and reactions that can occur from a blood transfusion. Depending on the type will determine the presenting symptoms
Is the following statement true or false? Epiphysis is the bone-forming cell.
False. Epiphysis is the end of a long bone. Osteoblast is a bone-forming cell.
how should you treat a patient that has a brace, splint, or cast?
Treat with elevation, ice packs, and analgesics
Is the following statement true or false? Autoimmune disorders are more common in women than men
True Autoimmune disorders are more common in women than men
Is the following statement true or false? Disseminated intravascular coagulation is not a disease but a sign of an underlying condition
True Disseminated intravascular coagulation is not a disease but a sign of an underlying condition
Is the following statement true or false? Hematopoiesis is the complex process of the formation and maturation of blood cells
True Hematopoiesis is the complex process of the formation and maturation of blood cells
Is the following statement true or false? Polyarticular refers to a rheumatic disease affecting more than one joint
True Monoarticular (affecting a single joint) Polyarticular (affecting multiple joints)
Is the following statement true or false? Phantom limb pain is perceived in the amputated limb.
True Phantom limb pain is perceived in the amputated limb.
Is the following statement true or false? Proper standing posture occurs when the abdominal muscles contract, giving a feeling of upward pull, and the gluteal muscles contract, giving a downward pull.
True Proper standing posture occurs when the abdominal muscles contract, giving a feeling of upward pull, and the gluteal muscles contract, giving a downward pull.
Is the following statement true or false? The nurse must never remove weights from skeletal traction unless a life-threatening situation occurs.
True The nurse must never remove weights from skeletal traction unless a life-threatening situation occurs Removal of the weights completely defeats their purpose and may result in injury to the patient
Is the following statement true or false? The nurse never adjusts the clamps on the external fixator frame.
True The nurse never adjusts the clamps on the external fixator frame. It is the physician's responsibility to do so.
Is the following statement true or false? Bone is in a constant state of turnover.
True. Bone is in a constant state of turnover.
Is the following statement true or false? Testing for crepitus can produce further tissue damage and should be avoided.
True. Testing for crepitus can produce further tissue damage and should be avoided.
A hospital nurse has experienced percutaneous exposure to an HIV-positive patient's blood as a result of a needlestick injury. The nurse has informed the supervisor and identified the client. What action should the nurse take next?
after initiating the emergency reporting system, the nurse should report as quickly as possible to the employee health services, the emergency department, or other designated treatment facilities
positive HIV exposure prophylaxis for health care providers?
after initiating the emergency reporting system, the nurse should report as quickly as possible to the employee health services, the emergency department, or other designated treatment facility
what is viral set point?
amount of virus present in the blood after the initial burst of viremia and the immune response that follows
when assessing the neuromuscular status, what should you assess for?
assess for compartment syndrome (medical emergency, must notify provider immediately). Caused by increasing pressure in muscle compartment leading to nerve/muscle anoxia and necrosis
_________________ is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV infection: a. Cryptococcal meningitis b. Neuropathy c. Progressive multifocal leukoencephalopathy d. HIV encephalopathy
d. HIV encephalopathy
what may be seen in multiple myeloma?
decreased bone density, osteoporosis may be seen on bone imaging.
viral rather than bacterial antigens induce what?
induce a cellular response
A client from the ward is being discharged to be treated at home. What should be emphasized with this patient when engaging in self-care activities?
infection control is of high importance in patients living with HIV, thus personal hygiene is paramount
what is persistent leukocytosis?
is a hematologic malignancy (i.e., Leukemia)
aspirin may induce what?
may induce a platelet disorder
A patient seen in a practice appears to be having a severe allergic reaction. What should be done to assess the patient's respiratory status?
monitoring the respiratory rate and pattern, by assessing for breathing difficulties, low oxygen saturation, and abnormal lung sounds (like wheezing)
A patient presents with a laceration to her forearm as a result of falling through a glass patio door. At the wound site, what types of cells are invading?
monocytes
What is phagocytosis?
monocytes (phagocytic cells) responsible for engulfing and destroying foreign bodies and toxins
during an infection what happens?
neutrophil production increases
what does HIV encephalopathy lead to?
progressive decline in cognitive, behavioral, and motor functions
A client is being seen in practice who has developed a nutritional deficit. When it comes to an immune response inadequate intake of what nutrient will increase the client's susceptibility to infection?
protein
what is fatigue related to?
related to decreased hemoglobin and diminished oxygen-carrying capacity of the blood (i.e. iron deficiency anemia)
what is the treatment for hemophilia A?
replacement therapy of the clotting factor VIII
a person with an open or compound/complex fracture is at risk for what?
risk for infection
what should the patient do if they have gout?
severe dietary restriction is not necessary; however, the nurse encourages the patient to restrict consumption of foods high in purines, especially organ meats, and to limit alcohol intake
what is Morton neuroma?
swelling of the 3rd lateral branch of the median plantar nerve with artery changes leading to ischemia within the 3rd intermetatarsal space
A patient with an autoimmune disorder is being seen in practice. How would a nurse describe the humoral immune response for this patient?
the humoral immune response is characterized by the production of antibodies by B lymphocytes, in response to a specific antigen
A client with rheumatoid arthritis comes to the clinic reporting pain in the joint of his right great toe and is eventually diagnosed with gout. What dietary advice should be given to this patient?
the nurse encourages the patient to restrict consumption of foods high in purines, especially organ meats
A client has been identified as being in the primary infection stage of HIV. What does this mean?
the period from infection of HIV to the development of HIV specific antibodies is known as primary infection, the virus is not being eradicated and infection is certain
A client's primary infection with HIV has subsided and an equilibrium now exists between HIV levels and the client's immune response. What physiologic state is this?
the remaining amount of virus in the body after primary infection is referred to as the viral set point
what happens in primary hemostasis?
the severed blood vessel constricts
what are signs and symptoms of Morton neuroma?
throbbing burning pain relieved with rest and massage
Another client seen in practice is also diagnosed with rheumatoid arthritis. She is prescribed antimalarials for treatment. What side effect should the nurse educate the patient about with these medications?
visual changes (regular eye examinations are necessary)
where is vitamin B12 found?
vitamin B12 is found only in foods of animal origin, strict vegetarians (vegans) may ingest little vitamin B12
what are some factors that inhibit fracture healing?
-Age >40 years -Avascular necrosis -Bone loss -Cigarette smoking -Comorbidities (e.g., diabetes, rheumatoid arthritis) -Corticosteroids, nonsteroidal anti-inflammatory drugs -Extensive local trauma -Inadequate immobilization -*Infection* -Local malignancy -Malalignment of the fracture fragments -Space or tissue between bone fragments -Weight bearing prior to approval
what are some variables that effect the immune system function?
-Age and gender: higher incidence in females than in males -Nutrition: Inadequate intake of protein increases a client's susceptibility to infection
what are some common causes of anaphylaxis?
-Antibiotics most common; penicillin -Foods, medications, insect bites and latex -Other Pharmaceutical/Biologic Agents *refer to chart 37-2*
how do you promote usual bowel patterns?
-Assess for diarrhea -Avoid foods that are irritating to bowel -Administer medications: octreotide acetate (Sandostatin)
if a patient is suffering from anaphylaxis what should you do?
-Assess respiratory status (breath sounds, respiratory patterns and rate and oximetry) -Protect the airway
what are some delayed complications of fractures?
-Delay union: healing D/N occur within expected time frame -Nonunion: failure of the ends of fracture bone to unite -Malunion: healing of fracture bone in a misaligned position •Secondary to inadequate immobilization
what must you teach a patient that has a cast, brace, or splint?
-Extremity needs to be elevated above the Heart level to control pain and swelling -do not stick foreign object into the cast
what are the three grades for open or compound/complex fracture?
-Grade I: 1 cm long clean wound -Grade II: larger wound without extensive damage -Grade III: highly contaminated, extensive soft tissue injury, may have amputation
what should a patient do to prevent dislocation of a hip prosthesis?
-Instruct patient not to bring knees together -Correct positioning using splint, wedge, pillows (To prevent the affected extremity from Internal rotation)
how do you maintain fluid and electrolyte balance in a patient with leukemia?
-Intake and output, daily weights -Assess for dehydration and overload (Auscultating the client's lungs frequently) -Laboratory studies including electrolytes, blood urea nitrogen, creatinine, and hematocrit -Replacement as necessary
what are some examples of complications secondary to medications in patients that have rheumatic disease?
-Methotrexate, cyclophosphamide (Cytoxan), and azathioprine (Imuran) are highly toxic and can produce bone marrow suppression, anemia, gastrointestinal disturbances, severe birth defects, and rashes -Salycilate therapy: assess for tinnitus, gastric intolerance, GI bleeding, and purpura -Antimalarials: assess for visual changes, GI upset, skin rash, headaches, photosensitivity, bleaching of hair
how do you prevent infection?
-Monitor for signs and symptoms of infection: Candidiasis provide oral care before and after meals -Monitor lab test results for changes -Culture wound drainage, urine, stool, sputum, etc. -Educate patient and family in prevention of infection: i.e. the importance of personal and environmental hygiene
if compartment syndrome occurs, how do you treat it?
-Notify physician -cast may be removed -emergency fasciotomy may be necessary
what are some early complications of fractures?
-Shock -Fat embolism -Compartment syndrome: elevated compartment pressure that is above normal perfusion pressure •Incr. volume space (edema & swelling) •Decr. space (restrictive cast) •5 P's: pain, pallor, pulselessness, paresthesias, paralysis -VTE, PE
what are signs and symptoms of heart failure?
-Shortness of breath -peripheral edema
what should you do if a transfusion reaction occurs?
-Stop: reaction must be recognized promptly and the transfusion discontinued immediately -Assess -Notify primary provider and implement prescribed treatments. Continue to monitor -Return blood -Obtain any samples needed -Document
what is an open or compound/complex fracture?
-Wound extends to the bone -three grades
A client is admitted to the orthopedic unit with a fractured femur after a motorcycle accident. The client has been placed in traction until his femur can be rodded in surgery. Identify three complications that may occur for this patient.
-deep vein thrombosis -compartment syndrome -fat embolism
A client is being seen in practice following anaphylaxis as a result of a bee sting. Following this event, what alteration in laboratory values should be present?
-increased eosinophil count, it is considered moderate to severe eosinophilia -moderate eosinophilia is defined as 15 to 40% eosinophils, as is found in clients with allergic disorders
how would a nurse manage a bleeding disorder?
-limit injury (avoid activities that carry a risk for injury) -assess for bleeding -bleeding precautions
what is a contusion?
-soft tissue injury produced by blunt force -can be caused by a blow, kick, or fall -produces pain, swelling, and discoloration (ecchymosis)
what is acquired immunity?
-specific response against a foreign antigen -Result of prior exposure to an antigen -Active or passive.
what are some hormones that balance bone resorption (removal or destruction) and formation?
-thyroid hormone -growth hormone -Testosterone & Estrogen (sex hormones)
what is acute hemolytic reaction?
-transfusion complication -donor blood is incompatible with that of the recipient
when does clonal stem disorders occur?
-when the control mechanism fails and "indolent" clone cells may evolve to more aggressive clone cells. -Significant risk of malignancy
what is the ultimate goal for achieving physical mobility?
A client should be able to use assistive devices appropriately and safely prior to discharge.
A child is scheduled to have a vaccination for rubella. What type of immunity will develop following the vaccination?
active acquired immunity
Eosinophil chemotactic factor of anaphylaxis affects what?
affects the movement of eosinophils (granular leukocytes) to the site of allergens
How often must the nurse inspect the traction pin site for signs of inflammation and evidence of infection? A. Every 8 hours B. Every 12 hours C. Every 16 hours D. Every 24 hours
A. Every 8 hours The nurse must inspect the traction pin site for signs of inflammation and evidence of infection at least every 8 hours.
What findings can be identified with the use of radiography of the spine? A. Fracture, dislocation, infection, osteoarthritis, or scoliosis B. Infections, tumors, and bone marrow abnormalities C. Soft tissue lesions adjacent to the vertebral column D. Spinal nerve root disorders
A. Fracture, dislocation, infection, osteoarthritis, or scoliosis Radiography of the spine may demonstrate a fracture, dislocation, infection, osteoarthritis, or scoliosis. Bone scan and blood studies may disclose infections, tumors, and bone marrow abnormalities. Computed tomography is useful in identifying soft tissue lesions adjacent to the vertebral column. An electromyogram is used to evaluate spinal nerve root disorders
What is bursitis? A. Inflammation of a fluid-filled sac in the joint B. New bone growth around a sequestrum C. Disease of a nerve root D. Inflammation of muscle tendons
A.Inflammation of a fluid-filled sac in the joint. Bursitis is inflammation of a fluid-filled sac in the joint. Involucrum is new bone growth around a sequestrum. Radiculopathy is disease of a nerve root. Tendinitis is inflammation of muscle tendons.
What is atrophy? A.Shrinkage-like decrease in the size of the muscle B.Fluid-filled sac found in connective tissue C.Rhythmic contraction of muscle D.Grating or crackling sound or sensation
A.Shrinkage-like decrease in the size of the muscle Atrophy is shrinkage-like decrease in the size of the muscle. Bursa is a fluid-filled sac found in the connective tissue. Clonus is rhythmic contraction of muscle. Crepitus is a grating or crackling sound or sensation
You are caring for a client who has undergone a total hip replacement. What action should you take to ensure that the patient does not dislocate the new prosthesis?
Abduction of the hip helps to prevent dislocation of a new hip joint. Rotation and adduction should be avoided. While the hip may be flexed slightly, it shouldn't exceed 90 degrees and maintenance of flexion isn't necessary.
in cellular immunity, actions by cytotoxic T cells-antibodies or cytotoxic T cells do what?
Actions by cytotoxic T cells-antibodies or cytotoxic T cells combine and destroy the invading microbes
what should you do if complications secondary to medications occur in a patient that has rheumatic disease?
Administer medications in modified doses as prescribed if complications occur
alcohol consumption increases the risk for what?
Alcohol consumption increase risk for Anemia (effect on hematopoiesis, nutritional deficiency)
before and after splinting what should you assess for?
Assess neurovascular status, to prevent compartment syndrome (IF PRESENT, REMOVE THE CAST/SPLINT)
in patients with allergic disorders, a CBC test will have?
increased eosinophil count
What is a contusion? A. A musculotendinous injury B. Blunt force injury to soft tissue C. A break in the continuity of a bone D. An injury to ligaments and other soft tissues at a joint
B.Blunt force injury to soft tissue Strain is a musculotendinous injury. Contusion is blunt force injury to soft tissue. Fracture is a break in the continuity of a bone. Sprain is an injury to ligaments and other soft tissues at a joint.
What type of anemia results from red blood cell destruction? A. Bleeding B. Hemolytic C. Hypoproliferative D. None of the above
B.Hemolytic Bleeding results from red blood cell loss. Hemolytic anemia results from red blood cell destruction. Hypoproliferative anemia results from defective red blood cell production
What is a cast? A.Bandage used to support a body part B.Rigid external immobilizing device molded to contours of body part C.Device designed specifically to support and immobilize a body part in a desired position D.Externally applied device to support the body or a body part, control movement, and prevent injury
B.Rigid external immobilizing device molded to contours of body part A cast is a rigid external immobilizing device molded to the contours of a body part. A sling is a bandage used to support a body part. A splint is a device designed specifically to support and immobilize a body part in a desired position. A brace is an externally applied device to support the body or a body part, control movement, and prevent injury
How long does a patient taking bisphosphonates need to stay upright after administration? A. 10 minutes B. 20 minutes C. 30 minutes D. 120 minutes
C.30 minutes Bisphosphonates are administered on arising in the morning with a full glass of water on an empty stomach, and the patient must stay upright for 30 to 60 minutes.
What should any older adult patient be evaluated for whose chief complaint is back pain and who has an elevated total protein level? A. Anemia B. Leukemia C. Multiple myeloma D. Non-Hodgkin lymphoma
C.Multiple myeloma Any older adult patient whose chief complaint is back pain and who has an elevated total protein level should be evaluated for possible myeloma
Which type of cells increase in number when the patient is exposed to a bacterial infection? A. Erythrocyte B. Eosinophil C. Neutrophil D. Thrombocyte E. Monocyte
C.Neutrophil The neutrophils are the mature, circulating white blood cells. When a bacterial infection occurs, the neutrophils will increase in order to phagocytize the bacteria
Which statement is false about magnetic resonance imaging? A. Credit cards with magnetic strips may be erased B. Nonremovable cochlear implant devices can become inoperable C. Transdermal patches that have a thin layer of aluminized back must be covered with gauze D. Jewelry and hair clips must be removed before the MRI is performed
C.Transdermal patches that have a thin layer of aluminized back must be covered with gauze. Transdermal patches that have a thin layer of aluminized back must be covered with gauze is false. Transdermal patches that have a thin layer of aluminized back must be removed before the MRI is performed because they can cause burns. True statements are: -Credit cards with magnetic strips may be erased -Nonremovable cochlear implant devices can become inoperable. -Jewelry and hair clips must be removed before the MRI is performed.
Which leukocytes arrive at the inflammation site? A. Basophils B. Eosinophils C. Monocytes D. Neutrophils
D. Neutrophils Neutrophils arrive first at a site where inflammation occurs
When could a "rebound" anaphylactic reaction occur after an initial attack even when epinephrine has been given? A. 1 hour B. 2 hours C. 3 hours D. 4 hours
D.4 hours A "rebound" anaphylactic reaction can occur 4 to 10 hours after an initial attack even when epinephrine has been given
What is pes cavus? A.Flexion deformity of the interphalangeal joint that may involve several toes B.Deformity in which the great toe deviates laterally C.Common disorder in which the longitudinal arch of the foot is diminished D.Foot with an abnormally high arch and a fixed equinus deformity of the forefoot
D.Foot with an abnormally high arch and a fixed equinus deformity of the forefoot Hammer toe is flexion deformity of the interphalangeal joint that may involve several toes. Hallux valgus is a deformity in which the great toe deviates laterally. Pes planus is a common disorder in which the longitudinal arch of the foot is diminished. Pes cavus is a foot with an abnormally high arch and a fixed equinus deformity of the forefoot.
It is noted in a patient's chart that he is at risk for infection due to protein loss. How does protein loss inhibit the immune response?
Depletion of protein reserves results in atrophy of lymphoid tissues, depression of antibody response, reduction in the number of circulating T cells, and impaired phagocytic function
You are seeing a patient with diabetes who is attempting to prevent disease related complications. What action will you instruct the client to perform to reduce the risk of developing osteomyelitis?
Diabetic foot ulcers have a high potential for progressing to osteomyelitis. Meticulous foot care can help mitigate this risk.
A client has recently been admitted to the orthopedic unit following total hip arthroplasty. The client has a closed suction device in place and the nurse has determined that there were 320 mL of output in the first 24 hours. How would you report this in the patient's chart?
Drainage of 200 to 500 mL in the first 24 hours is expected. Consequently, the nurse does not need to inform the health care provider.
Which of the following is a type of leukemia? A. Acute myeloid B. Chronic myeloid C. Acute lymphocytic D. Chronic lymphocytic E. All of the above
E.All of the above These are four types of leukemia. Each caries a different treatment and prognosis
what is scoliosis evidenced by?
Evidenced by an abnormal lateral curve in the spine, shoulders that aren't level, an asymmetric waistline, and a prominent scapula which is accentuated by bending forward.
what should be taught to a patient who is newly diagnosed with rheumatic disease?
Explain the disease and principles of disease management (watch for signs and symptoms of infection, monitor body temperature) (requires frequent check-ups)
Is the following statement true or false? A patient's unrelieved pain should be reported to the physician 30 minutes after administered pain medication
False A patient's unrelieved pain must be immediately reported to the physician to avoid possible paralysis and necrosis.
You are caring for a client who has just had an arthroscopy as an outpatient and is getting ready to go home. You should teach the client to monitor closely for what postprocedure complication? Why?
Following arthroscopy, the client and family are informed of complications to watch for, including fever.
what is an intervention for a patient with skeletal traction?
Have patient perform deep breathing and coughing exercises
Humoral or antibody response is characterized by what?
Humoral or antibody response is characterized by the production of antibodies by B lymphocytes in response to a specific antigen
what is an intervention for a patient in skin traction?
Inspect skin at least three times a day. To prevent skin breakdown and lower the risk for impaired skin integrity
after an arthroscopy, what should the nurse instruct the family to do?
Instruct family to monitor signs and symptoms of complications (fever, excessive bleeding, swelling, numbness, cool skin)
what is usually prescribed for multiple myeloma?
Long-acting opioids are often prescribed to afford adequate pain relief
many clients with HIV use what?
Many clients with HIV use some type of alternative therapy and, as with most health treatments, there are benefits and risks
You are assessing a client who reports a throbbing, burning sensation in the right foot. The client states that the pain is worst during the day but notes that the pain is relieved with rest. These symptoms are indicative of what health problem?
Morton neuroma
what is more common with DM & peripheral vascular disease?
Osteomyelitis with vascular insufficiency is more common with DM & peripheral vascular disease.
when it comes to treating chronic myeloid leukemia (CML) what is it important for that patient to do?
Patient adherence to therapy is critical for optimal outcomes to be achieved.
when will a patient usually begin ambulation after a hip replacement surgery?
Patients usually begin ambulation within 1 day after surgery using walker or crutches. (Physical Therapy will ambulate patient the day after the surgery)
what should patients with anemia be assessed for?
Patients with anemia should be assessed for signs and symptoms of heart failure (SOB and peripheral edema)
what is stage 1 (primary/acute) in an HIV infection?
Period from infection with HIV to the development of HIV-specific antibodies
what is the malignant cell of Hodgkin lymphoma?
Reed-Sternberg cell
You notice that a client with a leg cast is using a pencil to scratch under the edge of the cast. What action should to you take to help the client?
Scratching should be discouraged because of the risk for skin breakdown or damage to the cast. Most clients can be discouraged from scratching if given a mild antihistamine, such as diphenhydramine, to relieve itching.
a diagnostic test used in people with allergic disorder would be?
Skin tests: prick, scratch, and intradermal; most accurate confirmation of allergy (Emergency equipment must be readily available to treat anaphylaxis)
what should you teach patients and caregivers with immune deficiency disorders?
Teach patients and caregivers to report any slight changes in the client's health status
You are explaining a client's decreasing bone density in terms of the balance between bone resorption and formation. Discuss three dietary nutrients and/or hormones that play a role in the resorption and formation of adult bones?
The balance between bone resorption and formation is influenced by the following factors: -physical activity -dietary intake of certain nutrients, especially calcium -and several hormones, including calcitriol (i.e., activated vitamin D), parathyroid hormone (PTH), calcitonin, thyroid hormone, cortisol, growth hormone, and the sex hormones estrogen and testosterone.
what is the goal of treating Hodgkin lymphoma?
The goal in the treatment of Hodgkin lymphoma is cure
when getting a bone scan what should the nurse encourage?
The nurse should encourage the patient to empty their bladder prior to completing their bone scan** (a full bladder interferes with accurate scanning of the pelvic bones)
You suspect the presence of compartment syndrome in a patient that had a cast placed for a humeral fracture. What action should you take?
This major neurovascular problem is caused by pressure within a muscle compartment that increases to such an extent that microcirculation diminishes, leading to nerve and muscle anoxia and necrosis. Function can be permanently lost if the anoxic situation continues for longer than 6 hours. Therefore, immediate medical care is a priority over further nursing assessment.
what are patients at risk for when using steroids?
Use of steroids for more than 3 months at doses higher than 5 mg puts patients at risk for osteoporosis (Prednisone)
Antiretroviral medications as post exposure prophylaxis for health care workers are started within ____ hours of exposure: a. 24 hours b. 72 hours c. 36 hours d. 12 hours
b. 72 hours
what is hemophilia A caused by?
caused by a genetic defect that results in deficient or defective factor VIII.
A patient presents with cellulitis and is experiencing an increase in WBC. During which process are pathogens engulfed by white blood cells capable of ingesting foreign particles?
during the first mechanism of defense, white blood cells, which have the ability to ingest foreign particles, move to the point of attack, where they engulf and destroy invading agents, this is known as phagocytosis
While providing care in this setting you notice that a colleague puts on a second pair of gloves over soiled gloves while performing a procedure. Why would this be a problem?
gloves must be changed after contact with material that may contain high concentrations of microorganisms even when working with the same patient
glycoproteins of HIV bind to what?
glycoproteins of HIV bind with the host's uninfected CD4+ receptor and chemokine coreceptors, which results in fusion of HIV with the CD4+ T-cell membrane
A client seen in practice has rheumatoid arthritis and has been prescribed cyclophosphamide. What is the most common adverse event associated with this drug?
highly toxic and can produce bone marrow suppression and infection
A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor may have contributed to this complication?
inadequate fracture immobilization can delay and prevent union
