Shared Flashcard Set

Details

Med Surg- FINAL REVIEW
Final Review Questions
80
Nursing
Not Applicable
05/02/2013

Additional Nursing Flashcards

 


 

Cards

Term
Patient has a total hip replacement, what do you do to prevent dislocation?
Definition

- Keep legs ABDUCTED with a PILLOW between

- Do not cross legs

*Protect the hip- want to avoid injury

Term
Cirrhosis complications?
Definition

-Portal hypertension -> esaphageal varaceses (Can rupture and cause bleeding)

med: Propanolol

 

-Hepatic encephalopathy 

med: Lactulose (agitated and confused, end stage liver cancer *gives pt diarrhea)

 

 

Term
Guillain-Barre Syndrome
Definition
Paralysis from the feet up - ascending
Term
Heart Failure- How do you monitor at home?
Definition
Weigh self daily at the same time
Term
Pernicious anemia (B12)
Definition

-Weakness

-Monitor vitamin b12 levels, hematocrit, hemoglobin

-Neurological systems = monitor

Term
Type I- Juvenile Diabetes
Definition

Teach to decrease insulin need ->exercise, decrease sugar intake

Raise insulin need -> when get sick, still need insulin. Stress raises the need for insulin -> can cause hyperglycemia

Term
Dilantin vs Ativan
Definition

Dilantin -> long term seizure med

Ativan -> short term use, for active seizure

 

*Teach patient not to stop taking the med. 

Term
Bladder training for a stroke patient
Definition

Teach patient to go to the bathroom every 2 hours on a schedule.

 

*this is not for urge 

Term
A patient who loses a lot of blood volume- what happens to their vitals?
Definition

Blood pressure decreases

Heart rate increases

The heart is overcompensating to get more blood circulated

Term
Drinking alcohol daily affects what organ?
Definition
Liver
Term
What is Thrombocytopenia? What do you teach the patient?
Definition

Decreased platelets.

-Teach the patient to be careful not to hurt himself/herself, can get a hematoma

Clotting time is decreased

-Monitor for bleeding gums, nose bleed = could mean that platelets are even lower

Term
What color is the sclera in liver disease?
Definition
Yellow
Term
Patient received blood and gets complications - fever, chills, lower back pain, chest tightness, and nausea. What do you do?
Definition

Stop the infusion immediately. 

Complications usually happen within the first 15 minutes. 

Patient usually gets 2 doses of lasix before and in the middle of the transfusion.

Transfusion can last for maximum up to 4 hours.

Term
Patient comes in to ER with head injury, what do you assess?
Definition

Assess respirations! (AIRWAY!!)

 

*Do this before checking pupils etc.

Term
Patient will type 1 Diabetes is about to go into the OR for surgery and has a sugar level of 160, what do you do?
Definition

Document it. Do not to anything.

As long as it is under 180 it is fine. Sugar will drop too low if give insulin because patient is usually NPO and could result in more complications.

Term
Patient received IV Glucagon, what should you do now?
Definition
Put the patient on their side, they are at an increased risk for nausea and vomiting. (risk for aspiration).
Term
What do you do if too much Morphine is administered?
Definition
Give Narcan. Make sure have it ready.
Term
Acid/Base Question (know values)
Definition

Look at pH to tell if acid/base.

Resp - acidosis/ alkalosis = look at CO2 -> high= acidotic, low= alkalotic

Metabolic - look at HCO3

Comp/Uncomp -> look at pH, normal pH = Fully compensated

Term
How would you know if someone with pneumonia is hypoxic?
Definition

Confusion, agitation, cyanosis

*Act immediately!!

Term
Parkinsons - What would you teach the family that is normal?
Definition
Mask face, intention tremor, oily skin, cogwheel
Term
Parental nutrition = TPN
Definition

Infused in IV (central line)

If blood surgar is really high, give insulin.

Never want to stop because it is a set dose. It is based on weight and nutrition dose. (only made once a day)

Term
Malnutrition- What lab value do you look at?
Definition

Look at prealbumin levels. 

Watch to see if levels are increasing/improving.

Term
Prealbumin vs Albumin?
Definition

Prealbumin  = nutrition, anorexia, bulemia 

Albumin = liver disease, protein

Term
Chronic bronchitis= R sided chest pain when coughs. What kind of pain?
Definition
Pleuretic pain
Term
Chronic Alzheimers- What should we teach the family?
Definition
Get agitated easily, so teach the family to let the patient get an adequate amount of sleep.
Term
Pneumothorax - What sounds do you expect to hear and what is the treatment?
Definition

Collapsed lung.

Expect absent lung sounds, pain, and stats dropping.

Chronic COPD patients can collapse the lung by coughing. Treatment is a chest tube.

Term
Patient is experiencing an MI- what do you check?
Definition

DO FIRST: Troponin- Usually order 3 (want to see if the levels increase, if they do = MI)

Check CKMB - checks muscle breakdown of the heart

EKG - Also tells if patient is having an MI.

Term
What would you visibly notice of a patient with COPD?
Definition
Barrel Chest
Term
AV Fistula in arm, patient is receiving dialysis. What should you do/not do?
Definition

You should not check blood pressure/ sticks on the arm.

You should check for bruits/ thrills.

"super vein" = artery/vein

graph = artificial fistula (not patients own vein/artery)

Term
Patient is given oxycodon acetaminophen (Percocet) for chronic pain at home- what should the nurse teach the patient?
Definition

Have a high fiber, high fluid intake (to prevent constipation). Increase activity (exercise) as tolerated.

Patient can still take an aspirin.

Term
NG Tube- What is it used for? How should the patient be positioned/ NG tube be hooked up?
Definition

It is used for suctioning, decompress stomach. Can give meds, nutrition through it.

For bowel obstruction, nausea, vomiting.

Elevate the head of the bed>45 degrees (dont want them to aspirate)

Confirm tube in the right place with an x-ray.

Hook up the NG tube on low intermittent.

 

Term

Aortic regurg ("back up") - symptoms?

(LOOK UP- Didnt give answer)

Definition

Goes back into the ventricle, left sided heart failure.

Back up in the lungs.

 

Increased pulse pressure
Term
Plavix- what is the med used for? what is the patient teaching? what are adverse effects?
Definition

Plavix is anti platelet.

adverse effects (not given - look up!)

patient teaching- monitor for low platelets, bruising.

Term
Patient who has Alzheimers and is living at home- what should the family do for safety?
Definition
Bolt the doors so the patient doesnt wonder.
Term
Patient with kidney transplant ~12 hours ago and had only 2L urine output. What should you check?
Definition
Check patient's blood pressure. This will show if there is any strain on the heart.
Term
Angina- nursing diagnoses?
Definition

Impaired cardiac tissue profusion

Pain

Term
What is a probably cause for low potassium?
Definition

Medication - Lasix (diuretic - waste potassium)

If you have kidney disease - you will have elevated potassium.

Term
Patient comes back from EGD procedure and would like a drink of water one hour later, what do you do to make sure patient can drink?
Definition

Ask patient to swallow/ check gag reflex.

Throat is numbed and want to make sure won't aspirate.

Term
Patient has a foley catheter, what do you ask the provider during rounds in the morning?
Definition
Ask Dr when the foley can be removed (want it removed ASAP)
Term
Patient has diarrhea, high HR, low BP, vomiting = dehydration. What treatment is given to the patient?
Definition
Give patient an IV (dont give water because patient is nauseous/ vomiting)
Term
What lab value will be elevated in patient's with advanced cirrhosis?
Definition
Ammonia levels will be high in patients with liver disease.
Term
What would cause bright red streaks of blood in stool?
Definition
Hemorrhoids
Term
What would you see if patient has a lower GI bleed?
Definition
More blood in the stool
Term
Patient is discharged with advanced cancer with symptoms of nausea and vomiting? What type of meds should the patient be given?
Definition
Rectal route - so patient can do it at home. Oral won't be good because patient is throwing up.
Term
4g of Tylenol a day for pain- What labs would you look at?
Definition
Elevated liver enzyme test-  (ALT, AST)
Term

Inflammed gall bladder = Cholecystitis

Patient states she has pain in her right shoulder, what type of pain is this? 

Definition
Referred pain
Term
Patient is experiencing a stroke, has a pst embolitic stroke. Related to?
Definition
A. Fib (has small microclots because the heart is not pumping as effectively?)
Term
What instructions do you tell the patient who is going to be taking anticholinesterase for myostinea gravis?
Definition
Take the med before you eat, and eat food 40-60 minutes  after. Timing is crucial for max effect. (Risk for aspiration)
Term
Patient is oliuric (decrease urin, <400-500 in 24 hrs). What is the next step in treatment?
Definition
An IV of saline fluids is ordered to determine if the patient is in renal failure. Trying to flush the kidneys to get more urine out . Normally should urinate >30/hr
Term
Patient has a wound that is possibly infected - what would be observed? what lab value would be affected?
Definition

Warm, tender, pus.

The WBC level will be elevated.

Term
Patient is AB+,  what type of blood can they receive?
Definition

They can receive all. They are a universal recipient.

 

AB = universal recipient.

O = universal donor.

Term
Difference between ALS and MS?
Definition
ALS = respiratory paralysis (live shorter than MS)
Term
Bacterial meningitis = what protection needs to be worn?
Definition

Need to wear a mask 1st 24 hours.

 

Viral = let run it's course.

Term
Seizure safety
Definition
Turn patient on their side, clear the environment, and time it!
Term
Patient is having a hemorrhagic stroke, what would you noticed when they start deteriorating?
Definition

Decreased LOC.

 

(She said on the exam there was a disagree btwn headache and LOC- she said to go with LOC and she will confirm with Mrs. Davis)

Term
Receiving blood from someone else is against patient's religious beliefs, what other things can be done?
Definition

Patient can donate their own blood before the procedure. Can give patient IV fluids, iron.

Don't want to give patient false hope that they will not need blood so need to give the patient other options.

Term
Patient has retinal detachment, what teaching/ interventions can be done?
Definition

Have the patient wear an eye patch. 

Have patient lay flat.

Term
What do you teach a patient with iron deficiency anemia?
Definition
Teach the patient to eat green leafy veggies, red med.
Term
Patient with a vector 8 deficiency (clotting factor)- risk for what?
Definition
Increased bleeding
Term
What intervention should be done for a patient who needs low vision aids?
Definition

Refer them to a community agency. 

(not a cane lol)

Term
You are the nurse to a patient who is blind on your unit- how should you interact with them?
Definition
Do not want to startle them. Orient them to the room. Let them know who you are and that you are in the room when you enter it.
Term
Patient is getting a wound dressing change and asks for pain meds. What should you do?
Definition
CHANGE gloves before administering medication
Term
Patient is immobile from stroke, what do you want to implement to prevent complications?
Definition
Compression stockings
Term
Patient has peptic ulcer disease- you want to confirm it. What do you look for?
Definition
H. pylori - Check the acid in the stomach and see if there is presence of H pylori.
Term
Patient is given a lose dose of morphine post surgery- when should pain be rechecked/reassessed?
Definition

1 hour.

 

Term
If resp rate is 10 and patient is sleeping after being given morphine, what should you do?
Definition

Try to arouse the patient to see if they easily awaken before administering Narcan.

ALWAYS assess first!!! 

Give Narcan only if patient is difficult to arouse.

Term
How do you assess for osteoporosis?
Definition
See a change in the patients height from last exam and present exam.
Term
What do you teach a patient about the prevention of hypoglycemia?
Definition
Teach the diabetic patient to check sugars before each meal and bedtime. Pt should have food available after exercise so sugar doesn't drop. Encourage to eat meals and snacks through out the day.
Term
Adverse effects of aspirin?
Definition

Tinnitus

GI bleed

Term
What do you teach the patient about the Carotid endorectomy procedure?
Definition
Teach the patient that it clears out the buildup in the carotid (the plaque) to prevent a stroke.
Term
When giving blood, make sure cross matched with another nurse. What is checked?
Definition

Check to make sure right blood type, right name/DOB, how much fluid is in the blood, when it expires.

One nurse looks at the bag and one nurse looks at the paper. 

Patient's ID needs to match the bag, send the bag back ASAP if incorrect. Dont just assume its correct.

Bag expires after 3 days.

Term
One PICO question - remember what PICO stands for:
Definition

Population

Intervention

Compared to

Outcome

 

 

Term
Patient is Type I diabetic and metabolized fatty acids because not getting enough insulin- what type of complication will arise? What about Type II?
Definition

Type I: Patient will be DKA.

Type II: Patient will be HHNS. 

Term
Patient who is older and has an increased drug level, what is happening to their body?
Definition

-The ratio of fat-muscle tissue is decrease

-Decrease in GI mobility

Term
Teaching about peripheral neuropathy?
Definition

Decreased sensation in fingers/toes. Seen typically in diabetics.

Tell patient to check their feet, shoes

Term
What are informed consents typically needed for?
Definition

Surgery, any invasive procedure.

Have patient sign before meds are given.

If patient is getting meds, make sure sign the form before meds are given.

"TIME OUT FORM" -if done by the bedside, need to make sure have consent, if cant get a signature from the patient then ask family.

Term
Know the purpose of the American Nursing Code of Ethics. (NEED TO LOOK UP)
Definition
Term
Rash on body after medication given usually happens with what?
Definition

Antibiotics.

Ask the patient- do you have any allergies? what is the reaction?

Term

What do you teach a patient who has COPD?

(ANSWER NOT GIVEN)

Definition
Small meals, purse lip breathing?
Supporting users have an ad free experience!