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258 Cards in this Set
- Front
- Back
most lethal complication of beta blockers |
angioedema |
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what to do before administer coumadin |
check pt&inr |
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when is it not okay to take out a central/picc line |
when platelet is below 50,000 |
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biggest teaching of ace inhibitors |
orthostatic hypotension -> could fall. dry cough is most common side effect |
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#1 med for chf |
ace inhibitor - heart works easier also coumadin |
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what do you have to check before admin ace inhibitor |
bp |
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if a patient is on lasix what should you also check if they're also on if they're on a potassium supplement? |
ace inhibitor cause hyperkalemia side effect |
|
propranolol toxicity signs |
angioedema. hear stridor cause can't breathe - restricted airway - medical emergency. do something now! rapid response |
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if walk into patient's room who is diabetic type 2. want to see how their dietary compliance is today going how |
accu check |
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if you want a check a person who is diabetic how their dietary compliance is for the past 90 days |
hemoglobin A1c |
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If walk into patient’s room who is diabetic. Who is hypoglycemic. how will they feel? |
cold and clammy. |
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If walk into patient’s room who is diabetic. Who is hyperglycemic. how will they feel? |
hot and dry. give insulin |
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if someone is hypo or hyperglycemic, what do you do next |
check accucheck |
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#1 reason for right sided heart failure |
left sided heart failure |
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right sided heart failure assessment |
head at 45 degrees, check for jvd |
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what causes jvd |
elevated arterial pressure |
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what confirms pneumonia |
wbc count |
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how do you know pneumonia patient is getting better |
inc wbc count |
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treatment for pneumonia |
antibiotics |
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what to do before giving antibiotic |
blood culture from 2 different areas. |
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if you think it's pneumonia what do you do |
give 2 types of antibiotics - narrow and broad. blood culture takes at least 1 day |
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patient has chf what do you have to do every day |
measure their weight |
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when to notify provider when you weigh something for chf |
2 lbs in 24 hours or 5 lbs a week |
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who is at risk of aspiration pneumonia |
just got out of anesthesia, g tube 0 put in side line position |
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what position should an unconscious person be |
high fowlers |
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what position works in any situation |
side line |
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when do you know it's a peripheral vascular disease? |
20-30 point difference between apical and radial pulse |
|
if your lvn gives you pulse of 80 do you give digoxin? |
check apical pulse yourself cause can have 20-30 points difference. |
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what do you do if you suspect tb? |
ng pressure room - airborne isolation |
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visitors of tb use what kind of ppe |
simple face mask |
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what mask does tb patient need if leaving room |
simple face mask |
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how to do afb |
3 consecutive sputum collection |
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when doing a sputum collection and their sputum is dry and can't get it out what do you do |
induce it! put saline down and suction it |
|
Patient who comes in really sob. what do you do |
assess lung sounds. assess before implement! |
|
patient has their first asthma attack. will go home with what med? |
inhaled steroids but Steroids – makes you more dependent on it. |
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to prevent then treat asthma attack, which med |
steriods |
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what med for a massive asthma attack |
bronchodilator. nebulizer. |
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what is an improvement of an asthma attack ? |
absence of wheezing. o2 sat above 90 |
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what o2 sat are copd comfortable at |
88-90 |
|
divericultosis s/s |
left lower quadrant pain. sigmoid colon, fever |
|
acute divericulotsis. what do we do for them |
1. npo&hydrate then antibiotics and steroids |
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divericulotisis can't eat what |
popcorn, seeds, nuts |
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can someone with stomach pain eat? |
no -> put on npo |
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versad is for what and why |
amnesia. to need less anesthesia |
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why do you prep teaching? |
to dec post op complications |
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what are you doing when you are gathering prep info like h&p |
plan a care |
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what do you anything you need to transfer a patient |
check id band |
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4 patients in er: all copd. 1. Loud expiratory wheezing 2. Jvd, peripheral edema3. Thick mucous 4. Respiratory is 38. Who to treat first? |
respiratory is 38 |
|
Patient rode a bike, fell, can see subq – what stage? |
can’tbe stage! Only pressure ulcers! |
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when to give iv k push in er? |
never! |
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pheynophitis side effect |
cva tenderness |
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how long to give 20meq of k, (will come diluted). |
giveover 2 hours. Iv piggyback. No more than 10 meq/hr |
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put 20 meq in 100 ml of saline rate? |
50mL/hr for 2 hours. |
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why people prone to uti should drink cranberry juice |
bacteria doesn’t like to grow in acid. Prevent not cure it. |
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#1 women with uti do |
azo– turns urine orange. Prescription – pridum. Not can’t take culture cause it’sorange. |
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most common cause of uti |
e coli |
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Patienthas bph. Agitated and confused. Have order for Ativan, catheterization, antibiotics, culture. Do what first? |
catheterize them! |
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Patient comes in with really bad blood in urine, colicky left flank pain – kidney stone. First thing you do |
pain management! |
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go home patient education for those with kidney sones |
3-4L/day |
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Position for orif – shoulders and hips |
abbuction |
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Comes in with crushed pelvis – expected signs |
pain, feel unstable |
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comes in with crushed pelvis unexpected sign |
no bowel sounds, distended bladder, not voiding |
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Patient comes in motorcycle accident, left lower accident. Sever pain. Xray is right tibal fracture. Hb is 11.6 cbc is 9.4, sob. First thing to do |
check air way. Check pulse ox. Abc! |
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3 primary isotonic solns |
ns,lr, d5w |
|
dr orders test w/ dyes. what do you do |
stop metformin. If on metformin, admin muconast to clean the kidneys |
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if put on cast – if too tight, check for what |
pallor |
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how to check circulatory in cast |
cap refill |
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when to take off skeletal traction |
cpr |
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when document for wound care, what do you document |
what drainage looks like |
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Dvt - complaint that would be most serious |
sob - anticipating pulmonary embolus->give o2 – not nasal, face mask, nonrebreather put head up, call rapid response. |
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first sign of fat emboli |
confusion |
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test for osteoporosis |
dexa scan |
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Patienthad orthopedic surgery – your job? |
pain control! Give it to them 30 mins before pt comes |
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Biggest complication of hypokalemia and hyperkalemia |
cardiac dysrhythmias |
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if they are recommended to inc fiber, what must they also do |
inc fluids |
|
if Assess iv and it's infiltrated. how is it? |
cool from fluids, iv gone out of vein and into skin. Damp, swollen |
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if assess iv and it's phlebitis. how is it? |
hot and swollen
|
|
Fluidvol deficient s/s |
poor skin turgor, low bp, dry/sticky mucous membrane, dec urine output, constipation |
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Fluid vol overload s/s |
bounding pulse, edema, jvd |
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test for chf |
bnp |
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test for mi |
troponin |
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test within 9 ins of heart attack |
ekg |
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emergency treatment for acute mi |
cath lab |
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Cold patient, sob, take o2 sat – 84 -> |
ventrimask, inc o2. Intubate if breathing still going down. |
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precautions for hiv |
standard |
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Any patient coming in for gastrectomy – worried about what |
vit b12 deficiency |
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all lab values are abnormal, which is most critical? |
potassium and wbc |
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most common drug in hospital |
protonix |
|
only insulin that can be given as iv |
regular |
|
o peritonistis s/s: |
o incpulse rate, pain, dec bowel sounds rigid abdomen |
|
separation or slitting open of layers of a surgical incision – |
o dehiscence |
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postop sudden chest pain , dyspnea, tachycardia, diaphoresis and hypertension |
§ pulmonaryemboli |
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o effect that infection have on the diabetic patient – |
o increasesin the patients blood glucose |
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o to prevent aspiration during a surgery this is ordered - |
npo 10-12 hours before surgery |
|
o types of hernias |
o strangulated, incarcerated, reducible |
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o left lower quadrant, pain, fever, leukocytosis – signs of what |
o diverticulitis |
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o to help dec chance of post op infection, this is done prior to the first incision of the surgery |
iv antibiotics within an hour of the first incision |
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o incentive spirometer is taught pre op toprevent this post op |
o atelectasis and pneumonia |
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preop teaching for these interventions help prevent dvt post operative |
ted hose and leg presses |
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o extrusion of the viscera or intestine through a surgical incision |
o evisceration |
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o age of inc risk of post op complications |
o elderly and young children |
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o greater risk of suffering from gerd |
o obesity, pregnancy, and smokers - |
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symptoms of hypoglycemia |
o dizziness, diaphoresis, drowsiness, weakness, tachycardia, irritability |
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o rebound tenderness in req at this point is indicative of appendicitis |
o mcburney’s point |
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a total knee replacement is an example of this type of surgery |
o a planned surgery |
|
*during surgical procedure: rn's job |
be the patient advocate |
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*what inc risk of poor outcome |
age |
|
*what makes youknow patient is at risk of maligent hyperthermia |
patient history |
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how to get rid gas post op |
ambulate |
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*First thing do when interacting with patient: |
right patient? -> name |
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why do you *listen to bowel sounds after surgery |
peristalsis? |
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why do you need zofran, aldasron |
anthesia makes them n/v |
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*ways to prevent post o p complications: |
ted hose, incentive spirometer, ambulate –helps pass gas and less pain |
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*why give benzodiazepine |
give even if calm cause it keep them calm in surgery and helps reduce the amount of anthesia that they will need |
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*nurse’s responsibility before going to preop: |
make sure informed consent is there, correct body part is marked, prep check list isdone, allergies? |
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what to do *Within 1 hour of surgery: |
antibiotic |
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position for colonoscopy |
left sims |
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patient can't breathe but don't know if dnr or not |
do cpr |
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rlq pain |
crohns and appendices |
|
Llq pain |
diverticulutisis, ulcerative coutis |
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Umbilical pain |
gerd |
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have diarrhea – give what med |
give antidiarrheal |
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vitals of hypervolemic shock symptoms |
high heart rate, low bp |
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prep meds |
zofran and valium |
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patient comes in with 6/10pain in right side of chest? |
ambulate to release gas |
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if patient has aka what do you do? |
give regular insulin iv |
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if patient is hot and sweaty? what do you do first |
check blood sugar |
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patient is unconsciousw/ an iv and hypoglycemic. what do you do? |
dextrose 50% |
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what do you hang first in surgery? |
antibiotics |
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Patient is n/v with abdominal pain. First priority |
ng tube and suction |
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First med out of surgery |
zofran |
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Gerd nocturnal problems: what do you do? |
head of bed elevated |
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treatmentfor maligent hyperthermia |
dantrolene |
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Orif - when to notify healthcare provider |
cool leg |
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person reports sob and pain. what do you do? |
check o2 sat |
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Separation of wound+ light brown drainage. what do you do? |
cover wound with sterile gauze first. occlusive dressing |
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Dark amber cloudy urine |
uti |
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when to notify provider regarding urine output |
<30 mL/hr |
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jp drains do what |
prevents fluid accumulation |
|
fracture priority |
immobilization & alignment |
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if leg cast is too tight, what do you check for first |
pallor |
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Multiple fractures increasing edema first sign |
acute compartment syndrome |
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Impaired venous return = |
increasing edema |
|
first sign of fat embolism |
confusion |
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Cast fractures tibia= check what |
check cap refill |
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Cast - leg warm to touch = |
infection |
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Wiggle toes = check for what |
circulatory status |
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patient had 3 tap water enemas, how will his electrolytes be like |
low k low na |
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patient has 5.4 potassium. what should you do? |
assess ecg changes |
|
Flexion contraction position |
position client prone several times |
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patient has Hyperkalemia, what could the patient be at risk for |
potential for dysrythmias |
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patient with kidney disease, how are their electrolytes? |
hyperkalemia |
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Openfracture from a 20 foot fall. what do you do? |
assess for acute compartment syndrome, fat embolism, osteomylitish |
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1. this group of meds work by reducinginflammation and causing bronchodilator and can be used on children as young as 2 years of age |
singular- leyukotrine antagonist |
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1. characterized by wheezes and sob on exertion |
exercised inducted asthma |
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1. you are discharging 64 year old patient with resolving pneumonia. this nurse knows that discharge teaching |
deep breathing and coughing and finish prescribed antibiotic |
|
disease process that cause inflammation and smooth muscle spams within the lungs |
asthma |
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1. exercise inducted asthma example of teaching point to include in d/c teaching – |
inhaler before exercise |
|
cold– 2L O2 via nasal cannula with o2 sat of 90% |
document results and continue to monitor the patient |
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1. usually symptom free in early stages, buteventually fatigue, malaise, weight loss, night sweats, persisting cough w/frosty white and blood tongue sputum |
tb |
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1. bronchoconstriction and increased mucousproduction, resulting in oxygenation issues and hypercapnia |
copd |
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1. rifampin tb med- common side effect |
orange urine and tears |
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1. rinse their mouth after using this type of inhaler and informs the patient that they are doing it for this reason |
corticosteroids and prevent rash or fungal infection |
|
admitted with acute exacerbation of copd |
order abg |
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1. tb order is placed for bacteriologic testing this is how the nurse will collect the samples |
3 consecutive sputum over 3 days |
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1. prepare for this procedure after 36 yearold carried to ed after a cva and no breath sounds on right side |
chest tube to relieve pneumothorax |
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1. fever, dyspnea, general malaise, produced cough w/ yellow sputum |
pneumonia |
|
priority intervention for acute asthma exacerbation - rescue inhaler - |
bronchodilator |
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1. for patient with seizures, cya and ngtube feedings the nurse suspects this is the most likely cause of pneumonia |
aspiration |
|
1. patient uses albuterol inhaler. hr inc 75to 94 bmp within 5 mins |
thisis a common reaction. document the findings. |
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Whichof the following pathophysiological mechanisms that occurs in the lung parenchyma allows pneumonia to develop? |
inflammation |
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1. Which of the following would be priority assessment data to gather from a client whohas been diagnosed with pneumonia? Select all that apply. |
Auscultation of breath sounds, Presence of chest pain, Color of nail beds |
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the nurse recognizes effective at home patientteaching in regards to digoxin when the clients… |
it’s not okay for me to consume licorice (black) |
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A 58 y/o clientwith a 40 year history of smoking one to two packs of cigarettes a day has achronic cough producing thick sputum, peripheral edema, and cyanotic nail beds.Based on this information, he most likely has which of the followingconditions? a. Adult respiratory distress syndrome (ARDS) b. Asthma c. Chronic obstructive bronchitis d. Emphysema |
d |
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A 66 y/o male client has marked dyspnea at rest, is thin, and uses accessorymuscles to breath. He’s tachypneic, with a prolonged expiratory phase. He hasno cough. He leans forward in with his arms braced on his knees to support hischest and shoulders for breathing. This client has symptoms of which of thefollowing respiratory disorders? a. ARDS b. Asthma c. Chronic obstructive bronchitis d. Emphysema |
d |
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Which of following physical assessment findings are normal for a clientwith advanced cold? a. increasedanteroposterior chest diameterb. underdevelopedchest muscles c. collapsed neckveins d. increased chestexcursions with respirations |
a |
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when instructing clients on how to decrease the risk of copd, the nurseshould emphasize which of the following? a. participateregularly in aerobic exercises b. maintain high protein diet c. avoid exposureto people with known respiratory infections d. abstain fromcigarette smoking |
d |
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1.A nurse is suctioning fluids from a client via a tracheostomy tube. Whensuctioning, the nurse must limit the suctioning time to a maximum of: a.1 minute b.5 seconds c.10 seconds d.30 seconds |
c |
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the patient has fallen and the patient's chesttube was accidentally pulled out. The nurse should quickly do which of thefollowing first? a.Call the physician b.Apply a sterile occlusive dressing c.Check lung sounds d.Put the chest tube back in |
b |
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Which of following physical assessment findings are normal for a clientwith advanced cold? a. increased anteroposterior chest diameter b. underdeveloped chest muscles c. collapsed neckveins d. increased chestexcursions with respirations |
a |
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when instructing clients on how to decrease the risk of copd, the nurseshould emphasize which of the following? a. participate regularly in aerobic exercises b. maintain high protein diet c. avoid exposureto people with known respiratory infections d. abstain fromcigarette smoking |
d |
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Aclient is being assessed for possible HF. Which of the following results wouldsupport a diagnosis of HF? |
Increased brain natriuretic peptide (BNP) |
|
A nurse isreviewing the health record of a client who is starting propranolol (Inderal) to treat hypertension. Which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Diabetes C. Angina D. Tachycardia |
a |
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A Nurse is monitoring a pt who is taking Beta Blockers. What Nursing Consideration should the Nurse pay attention to? A. Monitor Respiration Rate B. Monitor Heart Rate and BP C. Monitor For Edema D. Check for Constipation. |
b |
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a client with heart failure receives an injection of iv furosemide (laxis). Within one hear, a short run of ventricular tachycardia appears on thecardiac monitor. Which of the electrolyte imbalance should the nurse suspect? a. hypokalemia b.hypocalcemia c. hypernatremia d. hyperkalemia |
a |
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5. a client presents in the E.R. with the following symptoms of chills,fever, night sweats and hemoptysis which is a possible diagnosis for this client? a. cold b.pneumonia c. tb d. pulmonary edema |
c |
|
warfarin (Coumadin) is prescribed to treat clotting following a surgery. Which of the following findings require immediate nursing interventions? a. inr of 3.0 b. positive homan’s sign c. Tylenol prescribed for headache d. urinary output 1,000mL/day |
b |
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Whichstatement by a patient taking ACE inhibitors demonstrates the patient'sunderstanding of the medication? A."I don't need to exercise, the medication will make me feel better." B."If I feel weak or faint I should take my medication." C."I can use salt substitutes instead of the real thing." D."If I develop a cough that does not go away I should call my doctor." |
d |
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Which of these lab values would be a contraindication for taking an ACE inhibitor? A. Potassium3.3 B. Potassium5.6 C. BUN 10 D. Creatinine1.2 |
b |
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The nurser views an arterial blood gas report for a client with copd. Ph 7.35, pCO2: 62,pO2: 70 HCO3: 34 the nurse should a. apply a 100% nonrebreather mask b. assess thevital signs c. reposition theclients d. prepare forintubation |
b |
|
when developing a discharge plan to manage the care of a client withcopd, the nurse should advice the client to expect to a. developrespiratory infections easily b. maintaincurrent status c. require lesssupplemental oxygen d. show permanentimprovement |
a |
|
. which of the following indicates that the client with copd has been discharged to go home understands his care plan? a. the client promises to do pursed lip breathing b. the client states action to reduce pain c. the client says that he will use oxygen via nasal cannula at 5L/min d. the client agrees to call the physician if dyspnea on exertion increases. |
d |
|
The nurse is evaluating a hypertensive clients understanding of dietarymodifications to control the disease process. The nurse determines that theclient’s understanding is satisfactory if the client made which meal selection? |
Turkey, baked potato, salad w oil & vinegar |
|
The nurse teaches a client w HTN to recognize the s/s that may occur during periods of elevated BP. the nurse determines that the client needs additional teachingif the client states that which s/s is associated w this condition? |
A feeling of fullness in the head |
|
When assessing a client w suspected LSHF the nurse would expect to find? |
weight gain, crackles on auscultation, pleural effusion |
|
The nurse is reviewing lab values for this patient with LSHF. Intervention by the nurse is required if the results include: |
serum potassium level of 7.0 mEq/L |
|
Apt. diagnosed w mild HF is prescribed hydrochlorothiazide (Microzide). The nurse knows that the teaching about the medication has been successful when theclient states? |
It is important for me to change positions slowly because I might become dizzy |
|
developing a health teaching plan for a 65-year old patient with all these risk factors for CAD, the nurse will focus on the: |
low activity level the patient reports |
|
Which of the following are most likely to be early signs of cardiac problems in olderpeople? |
Mental status change, agitation, frequent falls |
|
Whichof the following actions is the 1st priority care for s/s CAD? |
Enhance myocardial oxygenation |
|
Difference between angina & pain associated w MI: |
-angina is relieved w/ nitroglycerin |
|
Which of the following type of angina is most closely related w an impending MI? |
-unstable angina |
|
What is the 1st intervention for a client experiencing MI? |
-administer oxygen |
|
A client w/ a MI is admitted to the cardiac unit. The nurse can best determine the effectiveness of the clients ventricular contractions by: |
-monitor UO hourly |
|
Clientswith chronic illnesses are more likely to get pneumonia when which of the following situations is present? A.Dehydration B. Group Living C. Malnutrition D. Severe periodontal disease |
b |
|
2. Which ofthe following organisms most commonly causes community-acquired pneumonia in adults? A.Haemiphilus influenza B.Klebsiella pneumoniae C.Streptococcus pneumonia D.Staphylococcus aureus |
c |
|
A nurse ispreparing to administer a Beta 2 agonist, albuterol, to a patient who is shortof breath. What is an expected clinical manifestation? |
hypertension |
|
Which type of infection control measure should the HCP put in place for a patient with TB? |
Airborne precautions |
|
A nurse is providing instructions to a young female adult who has a prescriptionfor bethclomethosone. Which of the following should the nurse include in the teaching? |
Rinse mouthafter each use (steroids can cause oral thrush) |
|
. A 70 year old client is brought to the ER. The client is a febrile, tachypneic, respiratory rate 36, non-productive cough, and cold. From his history, the client may have which of the following? |
Acute asthma |
|
A patient has been diagnosed with R sidedcongestive heart failure and is confused about return of deoxygenated blood from the tissue. To clarify the confusion, which chamber of the heart receives blood from systemic circulation? 1. Left atrium 2. Rightatrium 3. Right ventricle 4. Left ventricle |
2 |
|
1 A nurse is evaluating a client with left-sided heart failure. Which finding should the nurse expect to assess? 1 a. Ascites 2 b. Dyspnea 3 c. Hepatomegaly 4 d. Jugularvein distention |
b |
|
1 The client is admitted with left-sided congestiveheart failure. In assessing the client for edema, the nurse should check the: a Feet b Hands c Sacrum d Neck |
d |
|
what would you see if patient had compartment syndrome? |
edema |
|
Chronic kidney disease that we may giveerythropoietin?? |
Anemia (to stimulate RBC growth, it takes 90 days tomake a complete RBC) |
|
Emergency treatment for MI |
angioplasty |
|
COPD pt.. You walk in room O2 sat is 84 what do youdo?? |
Venturi mask O2, increasing oxygen to 4L/min or moreand anticipate intubating them!! |
|
A patient comes in with a rash that is spread alonglaterally around the rib cage what do you do? |
Stop assessment and donn gloves and a mask |
|
A nurse is assessing a cast and notes it feels warm inone section what can this be indicative of? |
infection |
|
Unpleasant odor, amber colored urine, nocturia,urinary frequency |
uti |
|
Nurse is caring for aclient whose wife under went EGD, colonoscopy, client complains of sore throatand wants something to drink, what do we do? |
o Assess the gag reflex |
|
Nurse is caring for a patient with diabetes pt is hot and dry &blurred vision, headache. What should you do first? |
o Check blood sugar |
|
The nurse is caring for a postoperative client who had a laparoscopiccolectomy, pt is complaining of RIGHT sided chest pain 6/10. Which is the mosteffective to relieve pain? |
o Gas pain related to not ambulating (start ambulating) |
|
pt is in the ER with diabetic keto acidosis, blood sugar 925, which would you give? |
o IV dextrose |
|
unconscious pt in ER begins to vomit, what do you do? |
Put him on his side |
|
Diabetic severe hypoglycemia, which of the following is prescribed withthe diabetics regimen? |
o Hemoglobin A1C |
|
Preoperative process includes which of the following teaching in orderto prevent post operative complication? |
o Spirometer, pain scale, range of motion |
|
Postoperative pt, what is the #1 side effect of surgery? |
o Nausea and you administer Zofran |
|
Why don’t we have patients eat or drink aftermidnight? (why are they NPO) |
o Preventaspiration |
|
· If you come into a room 1day post-op and see the surgical wound has split at the edges and brown fluidis draining out what is the first thing you do? |
o Cover surgical incisionwith damp sterile gauze and call surgeon· |
|
Why would you do an arthroplasty? |
TO restore function bycompletely replacing the joint |
|
Nurseis caring for a patient with diabetes receiving 25 units of NPH every morningand her blood glucose level is above 200. The nurse monitors the patient forhypoglycemia because NPH insulin peaks how long after administration? |
4-12hrs |
|
Thenurse is admitting a client to rule out peptic ulcer disease which statement bythe client supports diagnosis of gastric ulcer? |
Iget pain in my stomach about 30 mins after I eat, so I don’t eat much |
|
Clienthas been admitted for acute diverticulitis which is expected finding? |
Lowerleft quadrant pain and a low grade fever |
|
Clienthas an NG tube in place connected to low intermittent suction due to nausea& vomiting, how do you ensure patency? |
irrigate |
|
You are assessinga post op client and we are assessing bowel sounds, what do we expect aftersurgery? |
Monitor for return ofperistalsis |
|
What is the most lethal complication of pepticulcers? |
perforation |
|
Clienthas been admitted after 2 days of abdominal pain, vomiting & diarrhea andhas been diagnosed with acute gastritis, what is something the nurse wouldquestion? |
NEVER give anantidiarrheal |
|
Pthad abdominal surgery in order to control pt’s pain level effectively, which isthe first intervention? |
Give pain medicationbefore it gets severe |
|
Nurse is caring for aclient with type 2 diabetes been admitted for wound infection, the clients bloodglucose is over 200, the pt asks the nurse why his blood sugar is so high? |
Stress of illnesscauses extra cortisol to be released |
|
Nurseis caring for a post operative with nausea and abdominal pain, abdomen isdistended, hypoactive bowel sounds, possible paralytic ileus. Which order willthe nurse initiate first? |
Always give ice chipsand swallow to put NG tube down (putting the patient NPO doesn’t relieve thepain right away) |
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clientsare transported for surgery transported to pre-operative holding unit. What doyou do right before the surgery? Select all that apply |
Check two identifiersCheck if all consentsare signed Check preoperativecheck list DO NOT: do assessmentor teach spirometer |
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Clientadmitted for major surgery, sudden dizziness when getting up to ambulate BP88/32 HR 122 (hypovolemia) After assisting pt back to bed, what is the priorityof the nurse? |
Assess dressing tomake sure they are not bleeding (hypovolemic shock due to bleeding) |
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During a surgicalprocedure which of the following is the most important action for thecirculating nurse? |
Being the patientadvocate |
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Preoperativeprocess includes which of the following teaching in order to prevent postoperative complication? |
Spirometer, painscale, range of motion |
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Postoperativept, what is the #1 side effect of surgery? |
Nausea and youadminister Zofran |
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Nurseis preparing to transfer a client after preop sedative, there are also ordersfor on call what action should the nurse take in regards to the antibiotic? |
Send it with the pt |
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nurseis providing medication teaching for a client with type 2 diabetes, client isprescribed metformin, action? |
Medication inhibitsglucose production from the liver |
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Nurseis caring for a diabetic client order to administer insulin NPH 17 units BID,regular insulin per sliding scale. Blood sugar this morning is 378 and (10units for blood sugar between 350 – 400) |
27 |
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if you meet thecriteria for diagnosis of diabetes mellitus what is it? |
Fasting plasmaglucose of 202 |
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Why don’t we havepatients eat or drink after midnight? (why are they NPO) |
Prevent aspiration |
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What should youalways check prior to anesthesia? |
Malignanthyperthermia family history |
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Antibiotics moa: |
help preventinfections |
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Highest risk of pooroutcome for surgery? |
Young children andthe elderly |
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How to relievepostoperative gas? |
ambulate |
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What makes sterilefield no longer sterile? |
Turning your back,crossing the path |
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What happens if pthas no id bracelet? |
get them a new one |
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Two ID’s to identifypt? |
Name and DOB |