Term
Which finding indicates suctioning is required for the client who is being mechanically ventilated? |
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Definition
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Term
| Assessment finding after a l sided cardiac cath requires immediate intervention |
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Definition
| Weak hand grasps and confusion and absent pedal pulse |
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Term
| Uncomplicated rib fracture priority nursing dx? |
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Definition
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Term
| Which assessment laerts the nurse to the possiblity that the intrathoracic pressure in a mechanically ventilated client is too high? |
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Definition
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Term
| Baroreceptor simulation for hypotension |
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Definition
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Term
| Splitting of auscultation of S1 in young adult |
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Definition
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Term
| Best intervention after noting clubbing? |
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Definition
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Term
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Definition
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Term
| Which dysrthmia may occur in a client with PVCs |
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Definition
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Term
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Definition
| apex of the heart, closing of mitral and tricuspid valves, beginning of systole |
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Term
| what statement best described patent ductus arteriosis? |
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Definition
| Involves a defect in which the fetal shunt between the aorta and pulmonary artery fails to close |
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Term
| which conginetal heart defect results in a decreased heart flow to the rest of the body |
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Definition
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Term
| a pt as a systolic murmor, upon assessment the nurse would hear |
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Definition
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Term
| a client with hf develops and increase in workload, what contributes to this increase |
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Definition
| activations of RAAS system |
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Term
| earl stage heart failure assessment finding |
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Definition
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Term
| assessment finding in client with mitral valve prolapse |
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Definition
| mid systolic click and late systolic murmor |
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Term
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Definition
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Term
| claudication after walking a block, painful ulcer on toes of clients right foot |
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Definition
| Peripheral arterial disease |
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Term
| Which additional assessment finding does the nurse expect in the client with a venous ulcer? |
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Definition
| Brownish discoloration of the lower extremity at the ulcer site |
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Term
| Hypertension physical exam |
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Definition
| fundoscopic exam of the retina |
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Term
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Definition
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Term
| highest risk for high output HF |
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Definition
| young woman taking large doses of syntrhoid to promote weight loss |
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Term
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Definition
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Term
| diazide and lasix assesment finding abnormal finding |
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Definition
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Term
| exacerbation of HF priority intervention |
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Definition
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Term
| clinical manifestion of mitral stenosis has progressed |
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Definition
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Term
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Definition
| St segment elevation, t wave inversion, abnormal q wave |
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Term
| teaching plan for client after CABG surgery |
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Definition
| take pulse before, midway, and after exercising |
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Term
| post CABG serum potassium level of 4.5 mEq |
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Definition
| document the finding as the only action |
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Term
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Definition
| increased HR and decreased urinary output |
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Term
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Definition
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Term
| packed RBCs transfusion purpose |
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Definition
| improve oxygen carrying capacity |
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Term
| distributive shock after anaphlaxis assessment |
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Definition
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Term
| early signs of hypovolemic shock |
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Definition
| elevated HR, elevated resp rate |
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Term
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Definition
| chest pain that occurs with minimal exertion |
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Term
| digoxin min HR requirement - adult |
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Definition
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Term
| digoxin min HR requirement - peds |
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Definition
< 100 beats for infant and toddler
< 80 beats in the older child
< 60 beats in the adolescent |
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Term
| vaccine to prevent epiglottitis |
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Definition
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Term
| HIV with SOB, weight loss, cough, blood tinged sputum = signs of what? |
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Definition
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Term
| postural drainage is used for ___ |
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Definition
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Term
| further CF education needed when parent states |
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Definition
| no pancreatic enzymes will be necessary If our child has good appetite and regular BM |
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Term
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Definition
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Term
| pt with cuffed trach is at risk for developing |
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Definition
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Term
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Definition
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Term
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Definition
| plan to move infant to private one or one with another child with RSV |
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Term
| anemia assessment that they arent tolerating activity |
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Definition
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Term
| bone marrow biopsy monitoring |
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Definition
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Term
| low RBC count intervention |
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Definition
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Term
| platelet count is 30,000 – what is priority? |
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Definition
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Term
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Definition
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Term
| sickle cell disease genetics |
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Definition
| 2 hemaglobin s genes, one inherited from each parent |
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Term
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Definition
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Term
| myelodysplastic syndrome education |
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Definition
| use a soft-bristled toothbrus |
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Term
| premature infant need for iron |
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Definition
| premature babies require supplemental iron because the iron stores develop during 3rd trimester of pregnancy |
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Term
| thalacemia major teaching |
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Definition
| plasmapharesis will help remove the toxins that are destroying the RBCs |
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Term
| meningococcocemia is being admitted. What kind of room? |
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Definition
| private room in respiratory isolation |
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Term
| obtain a referal for genetic counseling for which diseases |
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Definition
| sickle cell, hemophilia a and b, thalasemia major |
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Term
| von Wellenbrand's expereincing hemathrosis |
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Definition
| apply cold packs 2 hours on and 2 hours off of the affected site for 24-48 hours |
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Term
| which client statement indicates potential sleep apnea |
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Definition
| I wake up feeling just as tired as when I went to bed |
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Term
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Definition
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Term
| COPD pt says he feels full after a little food |
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Definition
| avoid drinking fluids just before and during meals |
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Term
| Client asks when he will be non-infectious. Best response? |
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Definition
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Term
| COPD cause in young adult is caused by |
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Definition
| hereditary deficiency of alpha-1 antitrypsin |
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Term
| Client with chest tube is at greatest risk to develop pneumothorax when the tube ____ |
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Definition
| becomes disconnected from the drainage collector |
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Term
| Avian influenza precautions |
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Definition
| airborne and contact isolation |
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Term
| most important intervention for rhinitis |
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Definition
| monitor for drug SE such as vertigo, HTN, urinary retention, insomnia |
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Term
|
Definition
| increase fluid intake to more than 10 glasses daily |
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Term
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Definition
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Term
| intervention to prevent ventilator acquired pneumonia |
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Definition
| continuously remove subglottic secretions |
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Term
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Definition
| my nose doesnt stay open even though im using nasal spray every day |
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Term
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Definition
| closure of av valves; systole |
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Term
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Definition
| semilunar valves closing; diastole |
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Term
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Definition
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Term
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Definition
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Term
| Initial (early) shock s/s |
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Definition
| slight increase in heart and resp rate |
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Term
| Nonprogressive (compensatory) shock s/s |
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Definition
| decrease urine output, acidosis, hyperkalemia, restlness, thirsty, tachycardia, falling systolic, rising diastolic, dropping pulse ox |
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