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Medsurg test 5
Cards for Barnes' test
103
Medical
Undergraduate 4
11/06/2008

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Cards

Term
How long can an occlusive dressing be kept in place?
Definition
No more than 12 hours per day.
Term
What is the benefit of moisture-retentive dressings over wet dressings?
Definition
They are more efficient at removing exudate because of their higher moisture-vapor transmission rate. Some also have reservoirs that can hold excessive exudate.
Term
Which dressing is ideal for autolytic debridement of wounds because of the high moisture content?
Definition
Hydrogels
Term
Which wound dressing requires a secondary dre3ssing to keep them in place?
Definition
Hydrogels, foam dressings and calcium alginates.
Term
Which dressings are adherent and non permeable to water vapor and oxygen?
Definition
Hydrocolloids
Term
What is a big advantage of hydrocolloid dressings?
Definition
They can be removed without damage to the wound by pouring water over the surface.
Term
If the hydrocolloid dressing starts to produce a foul-smelling, yellowish covering over the wound, what should the nurse do?
Definition
This is normal. Nothing.
Term
How long can hydrocolloid dressings be left in place?
Definition
As long as seven days, without having to be removed for bathing.
Term
Which dressings are helpful over bony prominences and provide cushioning?
Definition
Foam dressings
Term
Which dressings work well when packed into a deep cavity, wound or sinus tract with heavy drainage?
Definition
Calcium alginates
Term
What is the effect of apligraf on a wound?
Definition
When embedded in a dressing, these agents stimulate platelet activity and potentially decrease wound healing time.
Term
When are baths or soaks useful?
Definition
When large areas of skin are affected.
Term
What should be done in the case of any untoward response to a topical medication?
Definition
They should be reported immediately and discontinued.
Term
What is typically used to replace lost skin oils and treat pruritis?
Definition
Lotions
Term
How often must lotions be applied for therapeutic affect
Definition
every 3 to 4 hours.
Term
How can you reduce the recurrence of skin cancer?
Definition
Daily use of SPF of at least 15 reduces risk by at least 40%. At least 30 min before leaving house, apply to head, neck, arms and hands, and reapply every 4 hours with sweating.
Term
Why are oil emulsions preferred for drying and flaking dermatoses?
Definition
Because they are greasier.
Term
Which topical medicines are widely used in treating dermatologic conditions to provide anti-inflammatory, antipruritic, and vasoconstrictive effects?
Definition
Corticosteroids
Term
How can the nurse enhance the absorption of corticosteroids?
Definition
By hydrating the skin or covering the effected area by an occlusive or moisture-retentive dressing.
Term
What topical skin treatment should not be used with an occlusive dressing?
Definition
corticosteroids.
Term
Which skin lesions are treated with intralesional therapy?
Definition
Psoriasis, Keloids, and cystic acne
Term
What type of burn destroys the epidermis, dermis and underlying tissues?
Definition
Full-thickness burns
Term
How often should dressings containing corticosteroids be removed to prevent skin thinning, striae and tangielectasias?
Definition
12 of every 24 hours
Term
Patient arrives to the hospital after a burn injury. What lab values would be considered?
Definition
Hyperkalemia, resulting from massive cell destruction.
Term
What is the leading cause of morbidity and mortality in patients with thermal injuries?
Definition
Sepsis
Term
What is the significance of exposure to warm environments, ETOH, and hot foods and liquids in relation to pruritis?
Definition
They can all increase pruritis b/c of vasodilation.
Term
A small, waxy nodule with rolled, translucent, pearly borders is the beginning of what?
Definition
Basal cell carcinoma
Term
Which skin cancer appears as a rough, thickened, scaly tumor that may be asymptomatic or may involve bleeding?
Definition
Squamous cell carcinoma
Term
Does squamous cell carcinoma which arises without overexposure to the sun provide a better or worse prognosis and chance of spread than those that arise with sun exposure?
Definition
No, prognosis w/o sun exposure is worse.
Term
A patient has just been administered a shot of a medication. what is the nurse's next immediate action?
Definition
Dispose of the needle in a puncture-resistant container without recapping.
Term
For follow up teaching after removal of a cancerous skin lesion, what should the nurse tell the patient to expect as far as future visits?
Definition
Follow-up exams will be done every 3 months for a year, and will include palpation of adjacent lymph nodes.
Term
Which melanoma appears as a tan, flat lesion, but in time undergoes changes in size and color?
Definition
Lentigo-maligna melanoma
Term
Stage II phase
Definition
Full thickness skin loss with necrosis of sub q tissue.
Term
Turn with draw sheet to avoid
Definition
Shearing force
Term
Explosion at a chemical plant what would you see?
Definition
Full thickness burns with electrical burn
Term
Don't clean pressure ulcer with?
Definition
Dakin's solution
Term
How do you know if the pressure ulcer is healing?
Definition
Increase in granulation tissue
Term
hat type of dressing would you use on an autolytic debridement?
Definition
Hydrocolloid dressing
Term
A pt. Has partial and full thickness burns. How would the nurse help the pt. remain free of infection?
Definition
Wear gown, gloves, mask, etc.
Term
What affects in lab values would you expect to see with the use of silvadene?
Definition
WBC
Term
When assessing a pressure ulcer in a darker skinned person, what would you observe?
Definition
The area feels warmer than the surrounding tissue
Term
What would you teach a family about a bed bound family member?
Definition
Turn them every 2 hours.
Term
What would you increase in a pt. that has the following lab valued: serum albumin <3.0g/dl, urine output of 40cc/hr and 30 lb wt. loss in the past 2 months?
Definition
Increase fat, protein and fluids
Term
What would you tell a parent that is going to the beach for summer vacation?
Definition
Use SPF 15 or better and reapply every 4 hours.
Term
A parent is asking about her risk factors for malignant melanoma which her mother has. What would you tell the parent?
Definition
Avoid excessive exposure to sunlight.
Term
Manifestations of drug induced photosensitivity
Definition
Exaggerated sunburn with swelling and erythema
Term
Basal cell carcinoma characteristics?
Definition
Depression of center with rolled boarders
Term
Impetigo
Definition
Apply topical antibiotic cream
Term
Herpes simplex type 1
Definition
Acyclovir (zovirax) decreases recurrence and acute pain.
Term
You notice a white, cheesy plaque that resembles milk curds. What would the nurse question the patient about?
Definition
Medication use
Term
Phototherapy with psoralen
Definition
Wear protective eye wear that blocks 100% of UVL
Term
Topical fluorauracil (5-FU)
Definition
Pt may complain of pain, burning, and skin that looks worse. Tell the pt that you know this is hard but they must continue using it.
Term
When would a patient with impetigo need more teaching?
Definition
If they have it covered.
Term
Pt. with full and partial thichkness burns has decreased pedal pulses and fingers are tingling?
Definition
Call the doctor
Term
What would you warn a patient about that is taking systemic antihistamines?
Definition
Driving due to drowsiness.
Term
A patient comes to the ER with acidic burns. what do you do?
Definition
Flush them with tap water.
Term
A patient with electrical burns should be assessed for which type of bone abnormality?
Definition
Spinal fractures
Term
What is a complicatio of the emergent phase?
Definition
Hypovolemia and ATN
Term
Burn to neck, face, and arms
Definition
Supine with no pillow and arms extended and elevated on pillows
Term
Adequate fluid therapy includes what type of output?
Definition
40cc/hr
Term
With hyponatremia in the emergent phase, what would be the treatment of choice?
Definition
Prolonged hydrotherapy
Term
What shot does an admitting burn patient need?
Definition
Tetanus
Term
Cutured epithelial autografts are needed when?
Definition
When limited unburned skin is available and it is permanent.
Term
A nurse needs to educate a patient about psoriasis when she says:
Definition
It is caused by an infection and can lead to arthritis
Term
Irregular shaped moles that bleed
Definition
Malignant melanoma
Term
To irrigate a yellow wound
Definition
Use small gauge needle and NS
Term
Goal of HIV therapy?
Definition
Maintain CD4 and T-cells above 200
Term
Sign of HIV?
Definition
Reverse rates of CD4 and CD8
Term
Fat pads except for the limbs
Definition
expected side effect of ART.
Term
When assessing the homeless for HIV, what would you ask?
Definition
Have you had unprotected sex?
Term
Is outercourse okay for HIV?
Definition
Yes.
Term
Mast cell stabilizing drug advantages are?
Definition
Low occurrence of side effects
Term
Cardinal principle in the therapeutic managment of allergic (anaphylaxis)?
Definition
Teach patient to avoid allergen, and speedy recognition of signs and symptoms.
Term
For type I latex allergies, when do they occur, and how can they prevent mortality?
Definition
Within hours of treatment. Carry an epi-pen and wear a medic alert bracelet.
Term
What is the most important thing that can predispose a patient to an allergy?
Definition
Genetic predisposition
Term
What is one of the first things you may notice in an anaphylactic reaction?
Definition
Dyspnea
Term
A patient has been takin antihistamines for the past few days and comes in for an allergy test. What should you tell them?
Definition
Come back another day.
Term
Which of the following means the patient understands immunotherapy?
Definition
The patient will remain in the office 30 minutes after the injection to be monitored for complications.
Term
An immunocompromised patient is being taught the importance of good nutrition,exercise, and stress reduction. Which of the following does adhering to these guidelines help with?
Definition
Increasing immune function
Term
Which of the follwoing is a good education for an immunocompromised patient to know?
Definition
cook all foods well.
Term
Which of the following is a good precaution to follow?
Definition
Wear gloves at all times
Term
Which of the following would you put an immunocompromised patient on?
Definition
Reverse contact isolation
Term
A patient who has a decreased immune function is scheduled to have an x-ray. Which of the following should you the nurse schedule for that patient to be able to have it?
Definition
Schedule for portable x-ray machine to be brought into their room.
Term
A patient comes in and they have a positive EIA. What would you expect to order next?
Definition
Western blot
Term
A patient comes in and they have been in fected with HIV. After about 3 weeks with the virus, what symptoms would you expect them to see?
Definition
No symptoms
Term
A man and his partner are on vacation and he comes to the ER with Pneumocystis. What would you expect the doctor to order?
Definition
EIA
Term
A patient with AIDS has been experiencing diarrhea. What would you expect to teach them to help with this?
Definition
BRAT (bananas, rice, applesauce and toast)
Term
Which of the following is true about skin changes in adults?
Definition
-Dry skin
-Increased fragility and increased potential for injury
-Diminished hair (not alopecia)
-Reduced healing ability
Term
What is the most important thing when assessing a patient with impetigo?
Definition
-wear gloves
Term
Which statement by the client with psoriasis indicates they need further teaching?
Definition
She states they need to buy separate beds to sleep in.
Term
a lady is in her garden when she states she has a flare up of dermatitis. what would you tell er to do to help with the itching?
Definition
apply a cool moust dressing and take warm baths.
Term
what is the most important for a nurse to ask family members of a patient with herpes zoster (shingles)?
Definition
Have they had chickenpox?
Term
What would you tell a patient wit pediculosis to look for?
Definition
See white ovals in the hair shaft.
Term
A lady comes in to the ER from a nursing home. She has webs on her fingers and is dirty. What do you expect?
Definition
Scabies.
Term
What is the best prevention of skin cancer?
Definition
To avoid excessive sun exposure.
Term
A pt comes in with a central ulceration to the face. What would you expect them to have?
Definition
Basal cell carcinoma (remember, they are most common on the face)
Term
A patient with squamos cell carcinoma, what would be a characteristic of it?
Definition
A person with a history of smoking.
Term
What should you educate a person to do about malignant melanoma?
Definition
Tell the doctor if there are any changes in moles.
Term
What is the most important factor to determine how bad the moles are?
Definition
the color
Term
A patient has a burn with dry pale leathery skin. What type is this?
Definition
Full thickness.
Term
What is the most important indicator of shock?
Definition
urine output
Term
In a patient with a stage 1 pressure ulcer, which dressing would you use?
Definition
Wet to dry dressing.
Term
When applying silver sulfadiazine what would you do?
Definition
Wear sterile gloves
wear mask, gown and gloves when handling
toes?
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