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Term 2 Comprehensive
Comprehensive exam notes for term 2
1583
Nursing
Professional
05/10/2010

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Term
It is the single best indicator of pain.
Definition
client's self-report
Term
nursing care is directed at _______.
Definition
relieving pain
Term
Pain-sensing nerve endings
Definition
Nociceptors
Term
Pain felt in limbs no longer present (ie, amputee patients)
Definition
phantom pain
treat it as any other pain
Term
Physical manifestatin of depression
Definition
Psychogenic pain
Term
psychogenic pain
Definition
Physical manifestation of depression
Term
Those at risk for poor pain management include ____ and ______
Definition
Children / mentally disabled
Term
natural pain-killers. Don't last long.
Definition
endorphins
Term
A form of pain management that utilizes imagination.
Definition
guided imagery
Term
nociceptive pain
Definition
Normal process of stimuli that damages normal tissues or has the potential to do so if prolonged; usually responsive to nonopioids and/or opioids.
Term
Examples include sprains, bone fractures, burns, bumps, bruises, inflammation (from an infection or arthritic disorder), obstructions, and myofascial pain (which may indicate abnormal muscle stresses).
Definition
nociceptive pain
Term
pain threshold
Definition
the point at which pain begins to be felt.
Term
pain tolerance
Definition
the amount of pain that a person can withstand before breaking down emotionally and/or physically.
Term
referred pain
Definition
pain perceived at a site adjacent to or at a distance from the site of an injury's origin.[
Term
NSAID
Definition
Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, are drugs with analgesic, antipyretic (fever-reducing) and, in higher doses, with anti-inflammatory effects (reducing inflammation)
Term
PCA
Definition
Patient-controlled analgesia (PCA) is a computerized pump that safely permits you to push a button and deliver small amounts of pain medicine into your intravenous (IV) line, usually in your arm.
Term
TENS
Definition
Transcutaneous electrical nerve stimulation - the application of electrical current through the skin for pain control.
Term
Needed in order for patient to feel pain
Definition
an intact nervous system
Term
Chemicals released during inflammatory pain
Definition
histamine, acetocholine, prostaglandis and bradykinin
Term
the four phases of nociception
Definition
Transduction, transmission, perception, modulation
Term
normal pain transmission and interpretation
Definition
nociception
Term
nervous system changes painful stimuli in the nerve endings to impulses.
Definition
transduction
Term
transduction
Definition
nervous system changes painful stimuli in the nerve endings to impulses.
Term
The impulses travel from their original site to the brain.
Definition
transmission
Term
transmission
Definition
The impulses travel from their original site to the brain.
Term
The brain recognizes, defines, and responds to pain.
Definition
perception
Term
perception
Definition
The brain recognizes, defines, and responds to pain.
Term
The body activates needed inhibitory responses to the effects of pain (Craven & Hirnle, 2007). If the modulation response of the body is not successful, external intervention is required to manage the pain. Some of these interventions are discussed later in this chapter.
Definition
modulation
Term
modulation
Definition
The body activates needed inhibitory responses to the effects of pain (Craven & Hirnle, 2007). If the modulation response of the body is not successful, external intervention is required to manage the pain. Some of these interventions are discussed later in this chapter.
Term
Acute pain
Definition
Usually a sensation that ends abruptly. Typically lasts less than six months. Usually intermittent, not constant.
Term
Usually a sensation that ends abruptly. Typically lasts less than six months. Usually intermittent, not constant.
Definition
Acute pain
Term
that originates in one body part but is perceived in another part of the body.
Definition
Referred pain
Term
Referred pain
Definition
that originates in one body part but is perceived in another part of the body.
Term
Verey severe pain that may be considered intractable and chronic
Definition
Cancer pain
Term
discomfort that continues for a long period (6 months or longer).
Definition
Chronic pain
Term
Signs of depression
Definition
withdrawn, sleeplessness, appetite changes, other behaviors out of thier norm.
Term
Sustained release pain med. When it isn't lasting long enough. What is that called?
Definition
Breakthrough of pain
Term
effect of most pain medications - slowing down of vitals, etc.
Definition
Conscious setation
Term
Problem with giving a placebo to a patient
Definition
It is only a fake, and you can't lie to the patient about what they're getting.
Term
Issue regarding effectiveness of pain patch
Definition
It's going to take a while. Give something fast acting to relieve in the short-term.
Term
What degree (strength) of pain med should you start with to treat long-term pains?
Definition
start low, work up as necessary. NSAIDs are a good start.
Term
Nociceptive pain
Definition
Acute pain
Term
Chronic pain
Definition
Neuropathic pain - longer than 6 months. Can be difficult to treat. Patient may complain of burning, tingling, shooting pains.
Term
psychogenic pain
Definition
A pain disorder associated with psychological factors. Some types of mental or emotional problems can cause, increase, or prolong pain
Term
Area of brain in which pain threshold is found
Definition
thalmus and cerebral cortex
Term
May decrease endorphine production
Definition
caffein, nicotein, alcohol
Term
Key concepts regarding the documentation of pain management.
Definition
Level
description
action taken
results.
Term
pain rating scales used for children
Definition
Wong-Baker and FLACC
Term
Used on children 3-7 (and those unable to effectively communicate verbally) to determine pain level
Definition
Wong-Baker
Term
Used on children under 3 to determine pain level
Definition
FLACC
Term
Pain assessment tool in which the nurse uses observed behaviors to determine pain level
Definition
FLACC - The nurse observes the child's face, legs, activity, cry, and consolability
Term
A person can continue to function with a pain rating of no more than ___
Definition
3
Term
When would we give planned pain medications?
Definition
Right after surgery and 30 min before a painful procedure.
Term
Cognitive behavioral measure of pain management
Definition
Guided imagery.
Term
what pain scale can be used for a patient 3years or younger?
Definition
FLACC scale
Term
Cause of Myocardial infarction pain
Definition
lack of oxygen
Term
What clients would you use the Wong-Baker scale for?
Definition
age 3-7 yrs or patients with language barrier.
Term
patient w terminal cancer at pain=7. vitals are unchanged.
Definition
Patient has adjusted.
Term
A pain that originates from one part of the body but is felt in another part of the body is called.....
Definition
referred pain
Term
what is the term used for a chronic pain that resists therapeutic actions.
Definition
intractable pain
Term
what is another word for a nociceptive pain
Definition
Acute pain
Term
another name for a chronic pain is......
Definition
neuropathic pain.
Term
what are the three class of analgesics commonly used to control pain?
Definition
NSAIDS,opoids,adjuvant drugs
Term
what is a phantom pain?
Definition
it is a pain that is felt from an amputated part of the body
Term
How does TENS help relieve pain
Definition
it sends electric stimulus to the pain site when an individual feels pain.
Term
what are the consequences of unrelieved pain?
Definition
visual disturbances,nausea and vomiting.
Term
what chemicals are released during inflammatory pain?
Definition
prostaglandins and bradykyn
Term
pain is..........
Definition
whatever the person experiencing it says it is
Term
What can past experiences of pain in our children do?
Definition
desensitize them
Term
how does fentynl patch help control pain?
Definition
it delivers continuous pain relief
Term
TENS means......
Definition
transcutaneous electric nerve stimulation
Term
Nerve endings specialized for pain reception
Definition
nocioceptors
Term
What are nocioceptors?
Definition
Nerve endings specialized for pain reception
Term
The most dangerous of the antidepressants
Definition
Triciclets
Term
Triciclets are what classification
Definition
antidepressants
Term
adverse effect of compezine that tends to defeat the purpose of the drug
Definition
dizzines - may exacerbate the nausea it is supposed to relieve.
Term
extreme fatigue inability to sleep or sleeping too much lack of interest in surroundings lack of or excessive appetite guilt feelings sexual impotence withdrawal from social activities
Definition
s/sx depression
Term
What are adjuvent medications?
Definition
Medications primarily indicated for one type of treatment, but can also be used for pain management.
Term
Endorphines and enkephalins
Definition
naturally occurring substances that relieve pain
Term
naturally occurring substances that relieve pain (2)
Definition

- endorphins

- enkephalins

Term
What is the traditional Chinese belief regarding pain?
Definition
That pain is related to the imbalance of yin and yang or hot and cold.
Term
What culture tends to believe pain is related to immoral behavior?
Definition
Mexican pain belief
Term
This culture believes religious beliefs may contribute to high pain tolerance
Definition
African American pain belief
Term
This culture tends NOT to express pain
Definition
Native American
Term
This culture tends to express pain quite regularly.
Definition
Jewish
Term
This culture tends to believe that pain is a sign of guilt or punishment from God
Definition
Greek
Term
The mneumonic used when gathering information on client symptoms (including pain).
Definition
COLDSPA CHARACTER: Describe the sign or symptom. How does it feel, look, sound, smell, and so forth? ONSET: When did it begin? LOCATION: Where is it? Does it radiate? DURATION: How long does it last? Does it recur? SEVERITY: How bad is it? PATTERN: What makes it better? What makes it worse? ASSOCIATED FACTORS: What other symptoms occur with it?
Term
Nurse documents an infant's FLACC scale as Legs-1, Crying-1. What did she likely observe?
Definition
Legs-1: uneasy, restless and/or tense Crying-1: Moaning/whimpering, occasional complaints.
Term
Nurse documents an infant's FLACC scale as Legs-0, Crying-0. What did she likely observe?
Definition
Legs: normal position, relaxed Crying: none.
Term
Nurse documents an infant's FLACC scale as Legs-2, Crying-2. What did she likely observe?
Definition
Legs: kicking or drawn up Cry: crying/screaming steadily, frequent complaints.
Term
What is uneasy, tense leg activity on the FLACC scale
Definition
level 1
Term
What pain assessment scale would be best used on a 2-year-old receiving paralytic medications?
Definition
FLACC
Term
What is meant by "Character" of the pain
Definition
What the pain feels like: ie, aching, burning, crushing, dull, pounding, etc.
Term
Surgery may be needed to relieve what kind of pain?
Definition
Chronic pain
Term
nursing interventions for pain management.
Definition
diversion, change position, bathing, back rub, massaging hands.
Term
A client holds a pillow against the incision while coughing. What is this called?
Definition
Splinting
Term
A client takes a deep breath and forces it out in several short quick breaths. What is this called?
Definition
Huffing
Term
A patient says to the nurse that he or she has a fear of dying,what do you do?
Definition
Ask the client to explain.
Term
Dehiscence
Definition
Splitting open or separation of a surgical incision.
Term
Evisceration
Definition
When an incision opens enough so that abdominal organs protrude.
Term
Formation of a blood clot in a vein
Definition
thrombophlebitis
Term
In which order should sutures or staples be removed?
Definition
every other one. Stop if incision line opens.
Term
Lab test for blood clotting
Definition
prothrombin time
Term
Patients most at risk for poor pain management
Definition
children and mentally disabled
Term
Progressive diet
Definition
Offer the client a clear liquid diet first. Progress to a full liquid diet, and finally a soft or general diet
Term
Ranitidine
Definition
Post-op Flatus
Term
Signs and symptoms of DVT
Definition
pain, swelling in one of both legs,warmth in the skin of the affected leg,redness of the leg,leg fatigue,visible surface veins


swelling,


warmth, and


redness.
Term
Splitting open or separation of a surgical incision.
Definition
Dehiscence
Term
What can be used to assist in deep-breathing exercises?
Definition
incentive spirometer
Term
What is a Homans' sign and what does it indicate?
Definition
Pain behind the knee during dorsiflexion. It is a sign of possible thrombophlebitis.
Term
What is the NPO time before surgery?
Definition
8 hours
Term
What is the nurse's responsibility for client signatures?
Definition
Make sure client (or legal guardian) signs all consent forms prior to anesthesia. Nurse may witness signatures. Nursing student may not.
Term
What is the purpose of huffing?
Definition
It helps loosen more secretions than just coughing.
Term
What is the purpose of splinting
Definition
relieves pressure on the abdominal suture line
Term
What to ask client before surgery.
Definition
Name, pain, underdstanding of procedure
Term
What to do if a post-op patient complains of dizziness when getting out of bed.
Definition
Assist the client with ambulation
Term
When an incision opens enough so that abdominal organs protrude.
Definition
Evisceration
Term
composed of serum and blood
Definition
serosanguinous
Term
direction to use (which way do you go) when irrigating an open wound?
Definition
From inside to outside.
Term
how can you get rid of post-op gas?
Definition
ambulate the patient
Term
how does a nurse give non-pharmacological pain remedy?
Definition
offer massage,back-rub,repositioning
Term
how does an incentive spirometer work?
Definition
it provides visual feed back to let the client know if they are breathing right .
Term
serosanguinous
Definition
composed of serum and blood
Term
signs of infection after surgery
Definition
Pain and redness around an incision occuring 2-3 days after surgery, elevated temp, pain, elevated WBC.
Term
signs/symptoms of pre-op anxiety
Definition
significant change in behavior,tachycardia,continuous questions,
Term
Pre-op test usually obtained for all clients older than 40 years
Definition
An electrocardiogram (ECG)
Term
what are Hemovac and jackson - pratt
Definition
they are closed drainage systems
Term
What is the priority of shock treatment.
Definition
airway,breathing,& circulation
Term
what are the sign and symptoms of shock?
Definition

Hypotension

Narrowed puse pressure

Tachcardia

restlessness

Difficulty breathing

Cyanosis

Extreme thirst

Cold, clammy skin

hypothermia

low oxygen saturation

slowed capillary refill

ringing in ears

difficulty seeing

Term
what are typical post op complications?
Definition
hemorrhage,shock,hypoxia,hypothermia
Term
Define general anesthesia?
Definition
it is an unconscious sedation.breathing is done artificially.
Term
Define local anesthesia
Definition
it is a blockage of pain or sensation in a specific area of the body.it is also known as infiltration or topical anesthesia
Term
what is a paralytic ileus?
Definition
there is absence of peristalsis.
Term
what is spinal anesthesia?
Definition
this is a conduction nerve block that is injected into the sub-arachnoid space of the spinal cord.
Term
what medication is often given post-op to reduce gas?
Definition
symethicone (aka mylicon)
Term
what steps does a nurse check before a pt goes to surgery?
Definition
1 I D band
2 Vital signs
3 fall risk
4 Blood id
5 Weight
6 Bathing and hygeine
7 remove jewelry and accesories
8 void before surgery
9 remove dentures
10 remove make-up,lipstick,etc
11 make sure client signs check list
12 administer pre-op meds
13 update charts
14 notify post-op
Term
what would postpone a scheduled surgery?
Definition
unsigned informed consent,if NPO orders were not followed.
Term
When would planned pain medications usually be ordered?
Definition
30 minutes before painful procedures are performed and right after surgery.
Term
How long before surgery should patients stop taking medications that affect blood coagulation?
Definition
at least 7 days
Term
where are consents signed before surgery?
Definition
in the operating room
Term
What kind of patient is typically high-risk for surgery?
Definition
diabetic,
Term
while witnessing a consent,what does the patient need to know?
Definition
patient needs to know what is being done and why it is being done
Term
who can sign a legal consent and what makes a consent legal?
Definition

A patient, unless they are a minor or mentally disabled. then their guardian signs it.

It's signed and witnessed BEFORE administration of pre-op meds.

Term
why do patients go NPO before surgery?
Definition
to prevent aspiration,nausea and vomiting
Term
why do we teach patient about turning,coughing and deep breathing?
Definition
to prevent atelectasis
Term
why is atropine given and what are the expected side effects?
Definition
it is given to reduce the respitory secretions.the most serious side effect is irregular heart beat.
Term
why is shaving done on a client before surgery?
Definition
to reduce the risk of infection.
Term
laminectomy
Definition
type of lumber decompession that exposes the spinal canal and allows for relief of compression of the spinal cord and spinal nerve roots.
Term
dislocation
Definition
subluxation
Term
Athrogram
Definition
x-ray of a joint
Term
electromyogram
Definition
test of electrical conductivity of the clients muscles.
Term
busitis
Definition
inflammation of the bursa
Term
kyphosis
Definition
humpback or hunchback
Term
artritis
Definition
joint inflammation.
Term
arthroscopy
Definition
invasive procedure using an endoscope designed to view joints.
Term
acrosclerosis
Definition
scleroderma of the distal extremeties and face.
Term
lordosis
Definition
swayback
Term
halo device
Definition
form of skeletal traction used for cervical fractures.
Term
gangrene
Definition
necrosis of tissue due to insufficient or lack of blood supply.
Term
compartment syndrome
Definition
results from inadequate or obstructed blood flow to muscles,nerves and tissues.
Term
Definition
metal pins or wires surgically inserted into client's bones so that traction is applied directly to them.
Term
Definition
adult vitamin D defficiency which results in softening of the bones.
Term
Definition
bone infection.
Term
Definition
narrowing of the intervertebral space.
Term
Definition
inflammation of the tendon sheath.
Term
Definition
speciality in medicine that examines and treats disease and injuries of the musculoskeletal system.
Term
Definition
excision of the synovial membrane.
Term
Definition
scleroderma of the fingers and toes.
Term
Definition
side-side or lateral angulation of the spinal column.
Term
Definition
frragments of dead bones loosen
Term
Definition
hard skin.
Term
Definition
disease that results from a defieciency of vitamin d during childhood.
Term
Definition
Magnetic resonance imagery is more expensive and invasive than biopsy,surgery,or the use of radioactive isotopes or dyes.
Term
Definition
during a mylogram,a contrast medium or air is injected into the spinal subarachnoid space,followed by x-ray examination.
Term
Definition
Ultrasound uses sound waves and their echos to display images to evaluate soft tissue masses,osteomylities,infection,congenital and acquired pediatric disorders.
Term
Definition
After an arthrosyntesis,the client will immiediately be able to ove the joint freely.
Term
Definition
the nurse should apply ice and elevate the clients joint following arthroscopy.
Term
Definition
to hold a half-cast splint in place,the nurse uses long strips of adhesive tape.
Term
Definition
inflatable splints are often used in emergency first aid to support th neck.
Term
Definition
A benefit of using splints is that they are light weight an do not need to be removed when x-rays are taken.
Term
Definition
plaster casts remain wet for up to 3 or 4 days.
Term
Definition
Synthetic casts are more lightweight but weaker than plaster casts.
Term
Definition
Metastatic bone tumors originate in the bone and are usually slow growing.
Term
Definition
one of the most significant signs of malignant bone tumor is pathologic fracture.
Term
Definition
a strain is an injury to the ligaments around a joint causing the ligaments to stretch and tear.
Term
Definition
Traction applied through a weight attached to a spreader bar below the foot.
Term
Definition
skin traction applied by means of a head halter.
Term
Definition
Buck's traction with the addition of the leg supported by a sling.
Term
Definition
Traction applied by belt or sling.
Term
Definition
traction that iserts skull tong device into the skull bone.
Term
Definition
skeletal traction with device drilled through shaft of a bone and attached to the traction apparatus.
Term
Definition
pain,pressure or itching sensations that occur in the area of the amputation.
Term
Definition
may be needed to relieve internal presure for a patient with compartment syndrome.
Term
Definition
An artificial device that replaces part or all of a missing extremety.
Term
Definition
is the reattachment of a completely severed body part back to the body.
Term
Definition
results from pressure to the spinal cord.
Term
osteopososis
Definition
is the condition in which bone mass is lost
Term
osteoporosis.
Definition
is the condition in which bone mass is lost
Term
Most types of arthritis are common in
Definition
Term
Definition
a condition of an immovable joint.
Term
people with gout may be placed in a diet low in
Definition
purines
Term
and
Definition
two types of bone tumors
Term
Definition
is a characteristic sign of systemic lupus erythematosus.
however a rash may appear over other body parts as well.
Term
Functions of the skeletal system
Definition
Support
Protection
Movement
Mineral storage
Hematopoiesis
Term
What are the functions of the skeleton?
Definition
Support, Protection, Movement, Storage, and Hematopoiesis (Blood Formation)
Term
Bone tissue comes in two types. Compact bone and Spongy bone. What is a compact bone and spongy bone?
Definition
A compact bone is hard and dense. A spongy bone is composed of small bony plates.
Term
Spongy bone contain marrow, what are the two forms?
Definition
Yellow and red bone marrow
Term
Red bone marrow is found in the ends of 1.__________, in the bodies of the 2._________ and in the 3.__________.
Definition

1.Long bones

2.Vertebrae

3.Flat Bones

Term
Red bone marrow is responsible for manufacturing 1._____,2._____,and 3.______. This is called Hematopoisesis.
Definition

1.RBC's

2.WBC's

3.Platelets

Term
Hard, fibrous connective tissue membrane that covers most of the outside of the bone.
Definition
Periosteum
Term
Periosteum also merges with 1._______ and 2._______ and contains 3.________ that supply oxygen and nutrients to the bone cells keeping them alive.
Definition

1. tendons

2. ligaments

3.blood vessels

 

Term
1._______ shaft of the long bone, is hard and compact.
Definition
1.Diaphysis
Term
1.________ is spongelike and is covered by a shell of harder bone. Located at the end of the long bones.
Definition
1.Epiphysis
Term
The points at which bones attach to each other are called 1.___________ or 2.____________.
Definition

1.Joints

2. Articulation

Term
Fixed, immovable joints
Definition

Synarthroses

(i.e., bones in the skull)

Term
Strong fibrous bands called __________ hold bones together.
Definition

Ligaments

 

Ligaments also support internal organs and other structures.

Term
The skeleton has two divisions, what are those divisions?
Definition

Axial skeleton

Appendicular skeleton

Term
What regions of the skeleton contain the axial skeleton?
Definition

Skull, hyoid, middle ear, vertebral column, and the thoracic (rib) cage, make up the axial skeleton.

 

 

For more info check pg 174

Table 18-3 Divisions of the adult skeletal system

Term

Spine Abnormality

Abnormal lateral (sideways) curvature of the spine.

 

Definition

Scoliosis

 

It occures most commmonly during adolescence and is mroe frequently found in girls than in boys.

Term

Spine Abnormality

"Sway back," is an exaggeration of the normal lumbar spine curve in the small of the back.

Definition
Lordosis
Term

Spine Abnormality

"Widow's hump" or "Humpback," may occure in aging and is more commen in women.

Definition

Kyphosis

 

Kyphosis is often caused by osteoporosis

Term
These disks act as shock absorbers during walking, jump, or falling.
Definition

Intervertebral disks

 

A "slipped" disk refers to an intervertebral disk that has shifted out of position.

 

A "ruptured" disk occures when pressure forces some less dense tissue sideways, causing a protrusions in the walls of the disk (like a squashed grape).

Term
What regions of the skeleton are contained in the appendicular skeleton?
Definition

upper and lower extremities (limbs) and the pelvic girdle.

 

The upper extremities include:

4 bones from the shoulder girdle

60 bones from the arms

 

The lower extremities include:

60 bones from the legs

 

The pelvic (hip) girdle has 2 bones

Term
Osteoporosis
Definition
Bones lose calcium, thus body gets it from blood. Expect low serum calcium levels.
Term
Axial skeleton
Definition
It is composed of five parts; the human skull, the ossicles of the inner ear, the hyoid bone of the throat, the rib cage, and the vertebral column.
Term
osteoclasts
Definition
a type of bone cell that removes bone tissue
Term
know PQRST pain assessment
Definition
Provoking: What causes the pain?
Quality: What kind of pain (sharp, dull, etc)?
Region/Radiation: Where is it? Does it move?
Severity: How bad (1-10)?
Time: How long has it existed? How long does it last?
Term
most common location of femural fracture
Definition
trocanter
Term
osteoblasts
Definition
cells that are responsible for bone formation
Term
Muscles involved in chewing
Definition
Masseter and Temporalis
Term
Appendicular skeleton
Definition
divided into six major regions:
1) Pectoral Girdles
2) Arm and Forearm
3) Hands
4) Pelvis
5) Thigh and leg
6) Feet
Term
diarthrosis
Definition
joints allowing free motion
i.e., arm
Term
minerals stored in the bones
Definition
calcium and phosphorus
Term
the most mobile type of joint in the human body. They allow you to swing your arms and legs in many different directions.
Definition
ball-and-socket joint
Term
ampiarthrosis
Definition
joints allowing for limited motion
i.e., spine
Term
synarthrosis
Definition
joints allowing little to no motion
i.e., skull
Term
such as the joint at the base of your index finger, allow bending and extending, rocking from side to side, but rotation is limited.
Definition
ellipsoidal joint
Term
What is bone marrow is made of
Definition
hematopoietic tissue and fat cells
Term
Haversian system
Definition
The osteon, or Haversian system, is the fundamental functional unit of much compact bone.
Term
[image]
Definition
dorsiflexion
Term
occur between the surfaces of two flat bones that are held together by ligaments.
Definition
Gliding joints
Term
What does the skeleton support?
Definition
internal organs & tissues
Term
Protection of the brain
Definition
cranium
Term
protection of the spinal cord
Definition
vertebrae
Term
protection of the lungs and heart
Definition
ribs
Term
protection of digestive and reproductive organs
Definition
pelvis
Term
Skeleton as used for movement
Definition
skeletal muscles attached to bones allow for movement
Term
Mineral storage by bones
Definition
calcium and phosphorus are stored in bones. Released if body is not supplied.
Term
Hematopoiesis
Definition
Red bone marrow makes platelets, RBCs and WBCs
Term
site within bone for hematopoiesis
Definition
spongy bone, found on the ends of long bones
Term
Where is compact bone found?
Definition
in the shafts of long bones and outer surfaces of other bones
Term
a type of bone cell that removes bone tissue
Definition
osteoclast
Term
cells that are responsible for bone formation
Definition
osteoblasts
Term
[image]
Definition
[image]
Term
[image]
Definition
[image]
Term
[image]
Definition
[image]
Term
[image]
Definition
[image]
Term
[image]
Definition
[image]
Term
[image]
Definition
[image]
Term
Appendicular bones
Definition
hip and shoulder girdle, pelvic girdle, arms, thighs, legs
Term
Osteocytes surround large blood vessels. Area around filled with protein fibers, calcium & minerals.
Definition
Haversian system
Term
Each looks like a cylinder. Network of blood vessels provide blood supply.
Definition
Haversian system
Term
Bone tissue arranged in plates called trabeculae. Separated by irregular spaces
Definition
Haversian systems
Term
Their structure lowers the overall weight of bones, and they contain bone marrow
Definition
Haversian Systems
Term
Enlarged ends of long bones
Definition
epiphysis
Term
layered structure of epiphysis
Definition
thin layer of compact bone overlying spongy bone. Covered by Cartilage.
Term
bands of hyaline cartilage located at the ends of long bones. Locus of bone growth
Definition
epiphyseal disc or growth plate
Term
epiphyseal disc
Definition
bands of hyaline cartilage located at the ends of long bones. Locus of bone growth
Term
part of the bone that provides strength
Definition
diaphysis
Term
Hollow center of diaphysis
Definition
medullary cavity
Term
medullary cavity
Definition
Hollow center of diaphysis
Term
connective tissue lining the medullary cavity
Definition
endosteum
Term
endosteum
Definition
connective tissue lining the medullary cavity
Term
tough fibrous connective tissue membrane covering the outside of the diaphysis
Definition
periosteum
Term
periosteum
Definition
tough fibrous connective tissue membrane covering the outside of the diaphysis
Term
tough fibrous connective tissue membrane covering the outside of the diaphysis
Definition
periosteum
Term
functions of periosteum
Definition
- protection
- point of attachment for muscle
- contains blood vessels that nourish underlying bone.
Term
articular cartilage
Definition
outer surface of epiphysis. Forms smooth shiny surface. Reduces friction
Term
outer surface of epiphysis. Forms smooth shiny surface. Reduces friction
Definition
articular cartilage
Term
bones of the hand are examples of ___
Definition
short bones
Term
these cells migrate to regions of flat bones
Definition
osteoblasts
Term
vertebrae are what kind of bones?
Definition
irregular
Term
bones of the skull are what type of bones?
Definition
flat
Term
[image]
Definition
[image]
Term
Number of bones in the vertebral column
Definition
26
Term
Abnormal lateral curvature of the thoracic area
Definition
scoliosis
Term
Abnormal posterior curvature of the thoracic area - "hunchback"
Definition
kyphosis
Term
exaggerated lumbar curvature - "swayback"
Definition
lordosis
Term
Bones of shoulder
Definition
clavicle, scapula
Term
function of scapula
Definition
supports arms - attachment of muscle
Term
function of clavicle
Definition
collar bone - stabilizes shoulder
Term
shoulder blade wing bone
Definition
scapula
Term
concave portion of the scapula that articulates with the humerus
Definition
glenoid cavity
Term
glenoid cavity
Definition
concave portion of the scapula that articulates with the humerus
Term
Bones of upper extremeties
Definition
humerus
radial
ulna
Term
Components of the pelvic girdle
Definition
ilium
ischium
pubis
Term
turning hand downward
Definition
pronation
Term
turning hand upward
Definition
supination
Term
Portion of femur most often broken in elderly
Definition
greater and lesser trochanters (neck of femur)
Term
muscle action that creates motion
Definition
contraction and relaxation
Term
vital functions performed by muscle contraction
Definition
motion
maintenance of posture
heat production
helps blood flow back to heart
Term
voluntary muscle control
Definition
conscious control (ie, arms, legs)
Term
involuntary muscle control
Definition
responds to internal commands (ie, heart)
Term
energy source for muscle contraction
Definition
ATP - adenosine triphosphate
Calcium - muscle stimulation causes CA release, causing ATP, actin and myosin to react
Term
What happens to calcium when a contracted muscle relaxes?
Definition
Calcium returns to sarcoplasmic reticulum
Term
needed to transmit message across a neuromuscular junction
Definition
Acetylcholene
Term
Connective tissue that attaches muscle to bone
Definition
tendons
Term
tendons
Definition
attach muscle to bone
Term
connects bone to bone
Definition
ligaments
Term
ligament
Definition
connects bone to bone
Term
cartilage
Definition
connective tissue found in the joints between bones
Term
connective tissue found in the joints between bones
Definition
cartilage
Term
necrosed bone
Definition
dead bone
Term
circular muscle that opens and closes a tube/canal
Definition
sphincter
Term
calcium level
Definition
8.5-10.5
Term
ESR Sed rate test of CT)
Definition
shows that inflammatory process in the body.
Term
uric acid= Male-2.1-8.1 Female
Definition
check for gout or kidney failure,increase ETOH level,
Term
like in your knee and elbow, enable movement similar to the opening and closing of a door.
Definition
hinged joint
Term
joint in your neck that allows you to turn your head from side to side.
Definition
pivot joint
Term
your thumbs. can rock back and forth and from side to side, but they have limited rotation.
Definition
saddle joints
Term
[image]
Definition
Plantar flexion
Term
1 Tbsp = ? ml
Definition
15-16 ml
Term
1 cup = ? ml
Definition
240 ml
Term
1 gr = ? mg
Definition
60 mg
Term
1 teacup = ? ml
Definition
180 ml
Term
1 tsp = ? ml
Definition
4-5 ml
Term
A client with thrombocytopenia is what kind of risk?
Definition
risk for injury
Term
A common complication of most chemotherapeutic agents
Definition
myelosupression
Term
A common diagnostic test that can help determine the presence of a sarcoma
Definition
Serum calcium - Sarcomas invade bone, thus increased calcium deposits in the blood may result.
Term
A complication of chemotherapy
Definition
It also destroys normal cells
Term
A mixed-tissue kidney tumor usually found in children
Definition
Wilms' tumor
Term
A personal history of which two CIBDs put a client at high risk for colorectal cancer?
Definition
- Ulcerative colitis
- Crohn's disease
Term
A woman in her 30's is receiving tamoxifen for breast cancer treatment. What side effects should she be aware of?
Definition
Those related to menopause. These side effects include amenorrhea, hot flashes, insomnia, and depression.
Term
Adverse effects of bleomycin (Blenoxane)
Definition
coughing and difficulty breathing
Term
Age at which women should start breast self-exams.
Definition
20
Term
Age at which women should start getting ANNUAL mammograms
Definition
40
Term
Age to start testing for colon cancer.
Definition
50
Term
Ages at which annual PSA tests should begin
Definition
50+
45+ if African-American or if a family history of prostate cancer exists.
40+ if multiple first-degree relatives were affected at an early age.
Term
Alpha-fetoprotein (AFP)
Definition
Germ-cell tumors, liver cancer
Term
Among factors that help reduce the chance of cancer are diets that are ...
Definition
low in fat and calories
Term
An occult blood test may help in the detection of which type(s) of cancer?
Definition
Colon and rectal
Term
Anaplastic cells
Definition
have little or no resemblance to cells from whith they developed
Term
Another name for tumor
Definition
Neoplasm
Term
Areas of the body that stem cells are usually taken from.
Definition
hip or sternum
Term
Aside from management of pain and control of side-effects, what is a goal of nursing intervention during cancer treatment?
Definition
maintenance of client weight
Term
At least 80% of cancers in the United States are due to __________________?
Definition
, alcohol, diet, and environmental factors (ie, mustard gas, asbestos and benzene).
Term
Because of the effects of chemotherapy on bone marrow and the GI tract, what precaution may be needed.
Definition
reverse (protective) isolation
Term
CA 125 tumor marker:
Definition
Ovarian, colorectal, and gastric cancers
Term
CAUTION
Definition

Change in bowel or bladder habits • A sore that does not heal • Unusual bleeding or discharge • Thickening or lump in breast or elsewhere • Indigestion or difficulty swallowing • Obvious change in wart or mole • Nagging cough or hoarseness

Term
Cachexia
Definition
sudden weigh-loss and malnourishment.
Term
Cancer defined
Definition
excessive growth (proliferation) of cells that lack the capabilities of normal cellular function.
Term
Cancer in situ
Definition
tumor cells that have not invaded surrounding sites
Term
Carcinoembryonic antigen (CEA):
Definition
Breast, colorectal, and lung cancers
Term
Carcinogenesis
Definition
the transformation of a normal cell into a malignant cell
Term
Carcinogens
Definition
agents that cause damage to cellular DNA that leads to the development of cancer
Term
Characteristics of a benign neoplasm
Definition
• Slow growth
• Encapsulated (contained within a fibrous cover)
• Composed of differentiated cells (resemble the cells of the tissue from which they develop)
• Lack metastasis (invasion of other tissues in the body)
Term
Characteristics of a malignant neoplasm
Definition

• Rapid growth

• Non-encapsulated

•Infiltrating and invading other tissues

• Anaplastic

• Commonly metastasized

Term
Chemotherapeutic agents are designed to be effective when?
Definition
during one or more of the phases of cell division.
Term
Chronic myeloid leukemia
Definition
Philadelphia chromosome:
Term
Common colorectal cancer risk factors
Definition
• A personal history of chronic inflammatory bowel disease
• A family history of a hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary non-polyposis colon cancer)
Term
Complications from surgery - nursing interventions for side effects (ie, stomatitis)
Definition
- avoid alcohol
- avoid foods that cause irritation, including citrus
- use soft toothbrush
- rinse mouth thoroughly
Term
Cryosurgery
Definition
malignant tissue is frozen
Term
Cystic tumors of the ovaries and polypoid tumors from the colon may be removed as a type of ________ measure.
Definition
prophylactic (preventative)
Term
Cytology
Definition
The study of cells
Term
DRE
Definition
Digital rectal exam
Term
Decreased WBC
Definition
Leukopenia
Term
Decreased platelets
Definition
Thrombocytopenia
Term
Describes the act of cancer traveling to a new site.
Definition
metastasis
Term
Diet considerations for those on chemotherapy
Definition
- High-protein, high-calorie meals
- several small meals throughout the day
- nutritional supplements
Term
Dietary consideration for reduction of cancer risk
Definition
low fat, high fiber, low sodium
Term
Do a PSA before doing a ____________
Definition
digital rectal exam
Term
Drugs that interfere with the formation of blood vessels that grow to feed the cancer cells.
Definition
Antiangiogenic drugs (eg, endostatin, angiostatin)
Term
Education of the client receiving radiation or chemotherapy: basic principle
Definition
avoid anything that may lead to injury
Term
Electrocauterization
Definition
malignant tissue is burned
Term
Excessive growth
Definition
Proliferation
Term
External-beam radiation
Definition
treatment machine is placed away from the body.
Term
Food that helps build up WBCs
Definition
parsley
Term
Grade of tumors that closely resemble normal cells
Definition
Grade I
Term
Grading
Definition
a system of looking at abnormal cells under a microscope to determine the cells' degree of dedifferentiation or lack of maturity
Term
Group of compounds derived from vitamin A
Definition
retinoids
Term
Hormonal Agents
Definition
produce temporary regression of metastatic cancers
Term
How can benign tumors be dangerous?
Definition
Their presence pushes against organs, disrupting their function.
Term
How many consecutive normal PAP tests would allow a client to reduce testing frequency to every 2 to 3 years?
Definition
three
Term
IV push, blocks receptors at nerve endings in the brain and GI tract.
Definition
Serotonin Antagonists
Term
Instruments used for visual observation of internal organs
Definition
sigmoidoscope, colonoscope, gastroscope, bronchoscope, and laryngoscope
Term
Largest size of a T1 tumor
Definition
1cm
Term
Loss of appetite
Definition
anorexia
Term
Measures for providing comfort for the client receiving radiation therapy.
Definition
- include calories, protein and vitamins (especially vitamin C)
- all fruits and vegetables must be peeled to reduce intake of germs.
- keep radiation site dry and free from irritation. Loose clothing advised.
- plain, tepid water. No scrubbing
- protect from sun
Term
Metastasis (M)
Definition
How much has the tumor spread?
Term
Monoclonal antibodies (MOAB, MoAb)
Definition
Highly specific antibodies that seek out and bind to specific targets on cancer cells, causing apoptosis. Produced by genetically fusing cancer cells with normal cells.
Term
Node (N)
Definition
How many nodes does the tumor have?
Term
Nursing awareness regarding interleukins
Definition
possible hypotension, edema (incl. pulmonary edema), dyspnea, and tachycardia.
Term
Nursing consideration (personal) when working with a client undergoing implanted radiation therapy
Definition
Do not stay with client longer than necessary.
Term
Nursing intervention for fatigue effect of treatment
Definition
planned activities, including rest periods
Term
Of the three types of rays involved in radiation dx and therapy, which penetrates deeply into body tissues?
Definition
gamma rays
Term
PSA
Definition
Prostate-specific antigen
Term
Philadelphia chromosome:
Definition
Chronic myeloid leukemia
Term
Place where cancer starts
Definition
primary site
Term
Proliferation
Definition
excessive growth
Term
Radiation or chemotherapy clients should not receive suppositories? Why?
Definition
clients to avoid all activities that could injure cutaneous or mucous tissues
Term
Recommended as an alternative to commercial mouthwash
Definition
• 1 teaspoon salt • ½ teaspoon baking soda • 500 milliliters water (1 cup)
Term
Recommended frequency of colonoscopy exams
Definition
Every 10 years.
Term
Reglan (metoclopramide)
Definition
antiemetic
Term
Removal of part of a tumor for evaluation
Definition
incisional tissue biopsy
Term
Replaces stem cells
Definition
bone marrow transplant
Term
Scheduling of pain control medications
Definition
"Around the clock" - aimed at prevention of pain.
be prepared to treat breakthrough pain
Term
Signs and symptoms of cancer
Definition
• General, unexplained feelings of discomfort
• Prickling, tingling, tightness, soreness that does not go away
• Weakness
• Unexplained loss of weight
• Abnormal findings on breast self-examination (BSE) or testicular self-examination (TSE)
Term
Special care in cleaning up chemotherapy spills
Definition
• use gloves
• special container needed for disposal
Term
Stomatitis
Definition
inflammation of the mouth
Term
TNM
Definition
Tumor, node and metastasis
Term
TRUE OR FALSE: A gene is the code for one DNA molecule.
Definition
FALSE - A gene is a segment of a DNA molecule
Term
TRUE OR FALSE: Chromosomes are made of DNA and protein
Definition
TRUE
Term
TRUE OR FALSE: In any human cell, most of the genes are always active.
Definition
FALSE
Term
TRUE OR FALSE: Messenger RNA carries the genetic code to the cell membrane
Definition
FALSE - It carries the code to the ribosome
Term
TRUE OR FALSE: Mitosis is necessary only for growth of the body.
Definition
FALSE - it is also necessary for the healing process.
Term
TRUE OR FALSE: Mutations are how cells become malignant.
Definition
TRUE
Term
TRUE OR FALSE: The process of mitosis produces two identical cells with 23 chromosomes each.
Definition
FALSE - 23 PAIRS of chromosomes each
Term
TRUE OR FALSE: Transfer RNA brings amino acids to the proper sites on the DNA
Definition
FALSE - it brings amino acids to the ribosome
Term
Teratomas, commonly found in the ovaries or testies, are of what type?
Definition
mixed-tissue
Term
Test designed to detect cervical cancer
Definition
PAP test (or PAP smear)
Term
The best time to have a mammogram done.
Definition
Two weeks after a period.
Term
The body uses its own defenses against tumor cells
Definition
biotherapy
Term
The chromosome number for a human cell
Definition
46
Term
The following conditions will likely be reason for the need for emotional support.
Definition
- Hair loss in women
- enlarged breasts in men
- general feelings of despair or discouragement.
- decreased sexual interest
-
Term
The largest group of cancer (tissue) types
Definition
Carcinomas
Term
The major cause of adult deaths in the US
Definition
Heart disease
Term
The mechanism of chemotherapy
Definition
Damage the DNA within these abnormal cells and cause self-destruction (apoptosis).
Term
The study of cells
Definition
Cytology
Term
These solid tumors develop from epithelial tissues that line skin, glands, gastrointestinal (GI), urinary, and reproductive organs.
Definition
Carcinomas
Term
These tumors develop from connective tissues, such as cartilage, bone, fat, muscle, bone marrow, and the lymphatic system.
Definition
Sarcomas
Term
They promote the immune response of the T lymphocytes
Definition
Interleukins (IL)
Term
They protect normal cells from invasion by intracellular parasites, including viruses
Definition
Interferons (IFN)
Term
Three general categories of cancer
Definition
carcinomas, sarcomas, and mixed tissue types
Term
Three places stem cells can be found
Definition
- bone marrow
- peripheral blood
- in umbilical cord blood
Term
Three surgical procedures used to prevent growth and spread of cancer
Definition
Cryosurgery
Electrocauterization
Fulgeration
Term
Tumor (T)
Definition
How big is the tumor?
Term
Tumor cells that closely resemble normal cells
Definition
Grade 1
Term
Tumor marker for breast, colorectal, and lung cancers
Definition
Carcinoembryonic antigen (CEA)
Term
Tumor marker for germ-cell tumors, liver cancer
Definition
Alpha-fetoprotein (AFP)
Term
Tumor marker for ovarian, colorectal, and gastric cancers
Definition
CA 125 tumor marker
Term
Tumor markers
Definition
specific enzymes, cancer antigens, oncofetal proteins, hormones, or genes that can indicate malignancies.
Term
Two possible types of tumors
Definition
benign and malignant
Term
Type AND frequency of enema done to test for colon and/or rectal cancer
Definition
double-contrast barium enema - every five years
Term
Types of tumors
Definition
Carcinomas
Sarcomas
Mixed tissues
Term
Under what conditions could a woman stop having PAP tests?
Definition
If she has had a total hysterectomy AND it wasn't done as a cancer treatment.
Term
Unusual bleeding or spotting after menopause is a sign of what?
Definition
Endometrial (uterine) cancer
Term
Used to determine if the cancer has spread
Definition
excisional biopsy
Term
What are tumors or neoplasms?
Definition
Growths that arise from normal tissue.
Term
What can be applied to areas in the mouth affected by stomatitis?
Definition
vitamin E
Term
What dietary adjustment should be the focus for cancer treatment?
Definition
Reduction in intake of fats and calories
Term
What do sealed mold internal radiation devices need (from nurses)?
Definition
protective protocols for nursing care.
Term
What is the confirming test to be done if a colon screening test results positive?
Definition
Colonoscopy
Term
What is the main charactristic of cancer?
Definition
Proliferation
Term
What makes cancer cells dangerous?
Definition
They invade normal tissue.
Term
What makes cancer cells different from normal cells?
Definition
They lack the capabilities of normal cell function.
Term
What should the nurse watch for during administration of monoclonial antibody treatment?
Definition
severe anaphylactic reactions
Term
What treatment could give MEN hot flashes?
Definition
antiandrogen therapy for prostate cancer
Term
When is a client considered cured of a disease?
Definition
after 5 years total remission
Term
When should cervical cancer screening begin?
Definition
Age 21 or 3 years after beginning vaginal intercourse.
Term
Which Phenothiazine is also classified as an antipsychotic?
Definition
chlorpromazine (Thorazine)
Term
Which cancer treatment drug causes hot flashes?
Definition
tamoxifen (Nolvadex)
Term
Which cancer treatment drug makes urine red and causes hair loss
Definition
doxorubicin HCl (Adriamycin)
Term
Which ethnic group is at highest risk for prostate cancer
Definition
African-American
Term
Why do chemotherapy and radiation therapy result in hair loss?
Definition
all rapid-growing cells are affected.
Term
Xerostomia
Definition
dry mouth
Term
a swish-and-swallow solution that often contains a mixture of diphenhydramine (Benadryl), viscous Xylocaine, and antacid is used. The nurse advises the client to swallow only small amounts. Why?
Definition
The mixture will anesthetize the throat and may cause difficulty in swallowing, talking, or even breathing.
Term
a system of looking at abnormal cells under a microscope to determine the cells' degree of dedifferentiation, or lack of maturity
Definition
Grading
Term
alopecia
Definition
hair loss
Term
apheresis
Definition
removal of peripheral blood through a large vein of blood that is then sent via tubing through special collection filters in a machine
Term
biotherapy
Definition
The body uses its own defenses against tumor cells
Term
blood condition that places patient at risk of infection
Definition
leukopenia
Term
bone marrow depression
Definition
myelosuppression
Term
can be used to excise precise areas of tumors such as on the glottis
Definition
Laser surgery
Term
can improve the client's immune response to cancer and interfere with the growth of cancer cells.
Definition
MOABs
Term
dietary recommendation in response to stomatitis:
A) a clear, full-liquid diet
B) a soft, bland, tepid diet
C) a high-protein diet.
D) TPN
Definition
B
Term
dry mouth
Definition
xerostomia
Term
dry mouth
Definition
Xerostomia
Term
fulguration
Definition
malignant tissue is destroyed by high-frequency current.
Term
hair loss
Definition
alopecia
Term
highly specific antibodies that seek out and bind to specific targets on cancer cells, causing apoptosis.
Definition
Monoclonal antibodies (MOAB, MoAb)
Term
include the hydrocarbons found in cigarettes, cigars, and pipe smoke
Definition
chemical carcinogens
Term
indicated by an absence of all signs of a disease
Definition
remission
Term
inflammation of the mouth
Definition
stomatitis
Term
inflammation of the mucous membranes, such as in the mouth and throat
Definition
Mucositis
Term
made by lymphocytes, enhance the effects of the immune system
Definition
Interferons (IFN)
Term
metastatic sites
Definition
Secondary sites or secondary lesions
Term
mutation of a cell occurs at the ______ level
Definition
genetic
Term
myelosuppression
Definition
bone marrow depression
Term
neutropenia
Definition
depression of WBCs
Term
nursing diagnoses for nausea and vomiting
Definition
imbalanced nutrition
Term
produced by genetically fusing cancer cells with normal cells
Definition
Monoclonal antibodies (MOAB, MoAb)
Term
radioactive implants deliver ionizing radiation from within the tumor or a body cavity
Definition
internal brachytherapy, interstitial irradiation, intracavity irradiation
Term
removal of peripheral blood through a large vein of blood that is then sent via tubing through special collection filters in a machine
Definition
apheresis
Term
remove the tumor as well as some of the margin of the tumor
Definition
excisional biopsy
Term
side effects of interferon use
Definition
flu-like symptoms
Term
signs of internal bleeding
Definition
• vomitus may be appear bright red (fresh) or like coffee grounds (old).
• stools may look black and tarry
Term
special consideration when using monoclonal antibodies
Definition
acute anaphylactic reaction
Term
specific enzymes, cancer antigens, oncofetal proteins, hormones, or genes that can indicate malignancies.
Definition
Tumor markers
Term
sudden weight-loss and malnourishment.
Definition
cachexia
Term
surgery or procedure intended to relieve complications, not to cure
Definition
palliative
Term
system of looking at abnormal cells under a microscope to determine the cells' degree of dedifferentiation, or lack of maturity
Definition
Grading
Term
term to describe substances that poison cells
Definition
cytotoxic
Term
the leading cause of cancer death for both men and women
Definition
lung cancer
Term
the most important means of diagnosing cancer.
Definition
Biopsy examination
Term
the second leading cause of death by cancer in men.
Definition
Prostate cancer
Term
the transformation of a normal cell into a malignant cell
Definition
Carcinogenesis
Term
therapeutic indications for chemotherapy
Definition
• To treat widespread or metastatic disease
• To provide a cure for clients with certain types of cancer
• To temporarily control or palliate (relieve) tumor-related difficulties
• To use as an adjuvant (assistive) therapy
Term
third most common malignancy and cancer death site for men and women
Definition
Colorectal cancer
Term
treatment machine is placed away from the body.
Definition
external-beam radiation
Term
tumor cells that have not invaded surrounding sites
Definition
Cancer in situ
Term
tumors that are very anaplastic, often having little or no resemblance to the tissue cells from which they developed
Definition
Grade V
Term
use of drugs to combat cancer
Definition
chemotherapy
Term
1. Which of these describes the type of immunity that protects newborns for the first 3 months of life as aresult of maternal transmission of immunoglobulin G?

A) Active natural immunity
B) passive natural immunity
C) passive artificial immunity
D) Active artificial immunity
Definition
B) passive natural immunity
BN253
Term
2. Which of these factors provides passive immunity?

A) Administration of a toxoid
B) Administration of a vaccine
C) Administration of immunoglobulin
D) Having an attack of the disease
Definition
C) Administration of immunoglobulin
BN253
Term
3. The nurse is caring for a patient who needs passive immunity and understands that a patient requires passive immunity for which of these situations?

A) As a booster dose to stimulate the production of specific antibodies
B) For permanent immunity against a disease
C) To overcome an allergic reaction that is relatively mild
D) For ready-made antibodies after an exposure to pathogens
Definition
D) For ready-made antibodies after an exposure to pathogens
BN253
Term
4. Which of these parts of the immune system provides for long-term immunity?

A) immunoglobulin G
B) Plasma cells
C) Immunoglobulin E
D) Mast cells
Definition
A) immunoglobulin G
BN249
Term
5. Which type of cell involved in cell-mediated immunity as a cytotoxic action on tumor cells?

A) Lysosomes
B) Histocompatability cells
C) memory cells
D) Natural killer cells
Definition
D) Natural killer cells
BN251
Term
6. Which of these types of immunity results from receiving a tetanus injection?

A) Artificial passive immunity
B) Humoral immunity
C) Artificial active immunity
D) Cell-mediated immunity
Definition
A and C: Passive or Active aritificial immunity (depending on injection type)
BN253
http://en.wikipedia.org/wiki/Passive_immunity
Term
7. Which of these tests does the nurse recognize would be performed to confirm a diagnosis, determine a prognosis, or evaluate the effectiveness of treatment?

A) Western blod
B) sedimentation rate
C) Skin tests
D) Biopsy
Definition
D) Biopsy
MS153
Term
For which of these conditions would the nurse review a patient's laboratory values for increased eosinophils?

A) Allergic reactions
B) Acute viral infections
C) Cancer
D) Autoimmune diseases
Definition
A) Allergic reactions
BN237-238
Term
9. Which of these medications suppresses C-reactive protein levels?

A) Antibiotics and diuretics
B) Epinephrine and antihistamines
C) Antihypertensives andf antineoplastic agents
D) Aspirin and steroids
Definition
D) Aspirin and steroids
CRP is a protein produced by the liver during inflammation.
Term
10. Of these tests used to diagnose HIV, which actually tests for the virus?

A) Enzyme-linked immunosorbent assay (ELISA)
B) Polymerase chain reaction testing
C
D) P24 antigen testing
Definition
C) Western blot
BN1287
Term
11. Which of these does the nurse understand is true about the classes of antibodies?

A) Immunoglobulin A is not found in breast milk.
B) Immunoglobulin G provides short-term immunity
C) Immunoglobulin M crosses the placenta.
D) Immunoglobulin E is not involved in allergy reactions.
Definition
B) Immunoglobulin G provides short-term immunity.
process of elimination
Term
12. Which of tehse diagnostic lab tests is used to confirm the diagnosis of HIV?

A) Antinuclear antibodies
B) Immunoglobulin assay
C) Rheumaoid factor
D) Western blot
Definition
D) Western blot
BN1287
Term
13. The body's ability to destroy specific pathogens and to prevent infectious disease is called a(n)

A) Immunity
B) Vaccine
C) Lymphocyte
D) Macrophage
Definition
A) Immunity
BN248
Term
14. A foreigh substance ithat enters the body and causes the body to produce an immune response is called a(n)

A) Lumphocyte
B) Antigen
C) Antibody
D) Leukocyte
Definition
B) Antigen
BN249
Term
15. The cells responsible for the "memory" that provides us with permanent immunity are the

A) B lymphocytes

C) Erythrocytes
D) Thrombocytes
Definition
B) T lymphocytes
BN251
Term
16. What does the body produce in response to an antigen?

A) Allergy
B) Antibody
C) Immunodeficiency
D) Leukocytes
Definition
B) Antibody
BN249, 251
Term
17. The thymus is responsible for
A) Maturation of T lymphocytes
B) Filtratoin of lymph fluid
C) regulation of antigen production
D) Active, aturally acquired immunity
Definition
A) Maturation of T lymphocytes
BN250
Term
18. Which of the following is not true regarding T lymphocytes?
A) T cells make up approximately 80-90% of the total lymphocytes.
B) T cells are responsible for cell-mediated immunity (they combine with antigens).
C) T cells are responsible for fighting cancer cells and viruses, and are responsible for tissue rejection after organ transplantation.
D) T cells are responsible for humoral immunity.
Definition
D) T cells are responsible for humoral immunity.
BN249, 253
Term
19. If Johnny is exposed to and develops chicken pox, he will develop a permanent immunity. This type of imunity is a(n)

A) Active natorally acquired immunity
B) Active artificially acquired immunity
C) passive naturally acquired immunity
D) Passive artificially acquired immunity
Definition
A) Active natorally acquired immunity
BN253
Term
20. Johnny visits his pediatrician who administers a vaccine to him. This immunity is a(n)

A) Active naturally acquired immunity
B
C) passive naturally acquired immunity
D) Passive artificially acquired immunity
Definition
B) Active artificially acquired immunity
BN253
Term
21. During pregnancy, the fetus is protected from disease by a(n)


A) Active natorally acquired immunity
B) Active artificially acquired immunity
C) passive naturally acquired immunity
D) Passive artificially acquired immunity
Definition
C) passive naturally acquired immunity
BN253
Term
22. The group of gamma globulins that are responsible for allergic responses are

A) A) IgG
B) IgM
C) IgD
D) IgE
Definition
D) IgE
BN250
Term
23. The group of gamma globulins that are responsible for protecting the fetus after birth are

A) IgG
B) IgM
C) IgD
D) IgE
Definition
A) IgG
BN249
Term
24. The elderly are more prone to infection because they have

A) Thinner skin
B) A decreased number of functioning neurons
C) A decreased number of T and B cells
D) Delirium
Definition
C) A decreased number of T and B cells
BN254
Term
25. You, the nurse, would suspect an allergic reaction if which of the following signs or symptoms were present?

A) Hives and asthma
B) Nausea and vomiting
C) heat and fatigue
D) Petechia and tachycardia
Definition
A) Hives and asthma
BN1279
Term
26. Children with spina bifida are a special concern with regard to the immune system because

A) These children have reduced growth and development; therefore, their immune systems remain immature until adulthood
B) These children are at risk ofr latex allergies and the results may be life-threatening
C) These children are at risk for skin breakdown as a result of lack of mobility
D) These children have less oral intake and less urine output as a result of spina bifida, and this puts them at risk for pneumonia.
Definition
B) These children are at risk ofr latex allergies and the results may be life-threatening
BN250
Term
27. Which of the following would be an example of nonspecific immunity?

A) Cilia in the respiratory tract
B) Neutrophils ingesting and destroying bacteria
C) Hydrochloric acid in the stomach
D) All of the above
Definition
D) All of the above
BN248
Term
The function of bone marrow is

A) Production of B and T luymphocytes
B) Development of thrombocytes
C) Development of erythrocytes
D) All of the above
Definition
D) All of the above
BN248
Term
29. The type of immunity that is described as a "lock-and-key" mechanism that causes an antigen to become harmless to the body is called

A) Antibody-mediated immunity
B) Phagocytotic immunity
C) Nonspecific immunity
D) Cell-mediated immunity
Definition
A) Antibody-mediated immunity
BN253
Term
30. Antibodies destroy antigens by which of the following mechanisms?
A) Neutralizing toxins
B) Complement fixation
C) facilitating phagocytosis
D) All of the above
Definition
D) All of the above
BN253
Term
31. The elderly have an increased susceptibility to infection. Which of the following is true with regard to the elderly person's immune system?

A) A change in temperature is often more significant than the actual temperature.
B) Delirium is always a sign of an infectious process in the elderly.
C) the baseline body temperature in an older adult is usually higher than in a younger adult because of an increased metabolic rate in the elderly.
D) The cerebral hypoxia that occurs in the elderly is a result of the imcreased number of T and B lymphocytes in the body that are fighting bacteria.
Definition
A) A change in temperature is often more significant than the actual temperature.
BN254
Term
32. The cornerstone of the immune system is

A) erythrocytes
B) Thrombocytes
C) Lymphocytes
D) Leukocytes
Definition
C) Lymphocytes
BN248
Term
33. If an initial ELISA test returns positive, which of these testing protocols is recommended for HIV testing?

A) RThe ELISA test is repeated
B) A rheumatoid factor test is done.
C) The western blot test is done.
D) Viral load studies are done.
Definition
C) The western blot test is done.
BN1287
Term
34. Which of the following types of immunity involve T-helper and B lymphocytes?

A) Humoral immunity
B) passive immunity
C) Cell-mediated immunity
D) Acquired immunity
Definition
A) Humoral immunity
BN249
Term
35. Which of these types of immunity involve only T lymphocytes?
A) Humoral immunity
B) Passive immunity
C) Cell-mediated immunity
D) Acquired immunity
Definition
C) Cell-mediated immunity
BN250
Term
36. Which of these is the older adult patient more prone to than a young adult?

A) High fevers
B) Autoimmune disorders
C) Antigen recognition
D) Antibody production
Definition
B) Autoimmune disorders
BN254
Term
Which of these occurs initially in Hashimoto's thyroiditis?

A) Thyroid production decreases.
B) Thyroid-stimulating hormone (TSH) production decreases
C) Thyroid production increases
D) TSH production increases
Definition
C) Thyroid production increases
MS1005
Term
38. Which of these immune cells is the defective cell in the disease hypogammaglobulinemia?

A) T cells
B) B cells
C) Mast cells
D) Plasma cells
Definition
B) B cells
MS318
Term
39. Serum sickness occurs after the administration of which of the following?

A) Penicillins and sulfonamides
B) Cryoprecipitate and factor IX
C) Whole blood and packed red blood cells
D) Steroids and immunosuppressants
Definition
A) Penicillins and sulfonamides
MS309
Term
40. Which of these would the nurse recognize as a complication of allergic rhinitis?

A) Nasal septal defect
B) Nasal polyps
C) Headaches
D) Rhinorrhea
Definition
B) Nasal polyps
MS1028
Term
41. Which of these nursing actions would be appropriate for a patient diagnosed with idiopathic autoimmune hemolytic anemia?

A) No intramuscular injections
B) Good handwashing techniques
C) Assistance with ambulation
D) manual blood pressures
Definition
C) Assistance with ambulation
Term
42. A patient has had a portion of his stomach removed and without vitamin B12 injections may begin to experience which of these manifestations?

A) Numbness and tingling, weakness, and glossitis
B) Fever, malaise, muscle soreness, and diarrhea
C) Urticaria,angioedema, anorexia, pruritus, and blistered lesions
D) Frequent infections, fever, malaise, vertigo, and lymphadenopathy
Definition
A) Numbness and tingling, weakness, and glossitis
MS1034
Term
Replacement therapy cannot be given for which of these types of immunoglobulins?

A) IgM
B) IgE
C) IgA
D) IgG
Definition
C
Term
44. A patient is stung by a wasp. Which of these manifestations would the nurse expect to see if an allergic reaction develops?

A) Pallor around the sting sites
B) Hives
C) Jugular vein distention
D) retinal hemorrhage
Definition
B) Hives
BN1278
Term
45. Which of these medications would the nurse anticipate being administered immediately to a patient having a severe allergic reaction?

A) Oral Benadryl
B) Oral epinephrine
C) IV Benadryl
D) IV epinephrine
Definition
D) IV epinephrine
BN1282
Term
46. Which of these medications would the nurse anticipate being administered secondarily to a patient having a severe allergic reaction to control itching?

A) Benadryl
B) Epinephrine
C) Immunosuppressives
D) Solu-Cortef
Definition
A) Benadryl
BN1279
Term
47. A patient is stabilized after having an allergic reaction. Which of these preventative instructions should be reinforced at this time?

A) She should stay indoors as much as possible.
B)She should wear insect repellent when she is outdoors.
C) Se should wear Medic-Alert identification
D) She should take corticosteroids prior to going outdoors.
Definition
A
Term
48. A patient has a long-standing history of allergies to pollen. Which of these actions, if performed by the patient, would indicate understanding of how to control his disease?

A) gardening outdoors on dry, windy days
B) Driving her car with the windows open during high pollen counts
C) Taking frequent walks outside in spring when the weather is warm
D) Wearing a mask when mowing the lawn
Definition
D) Wearing a mask when mowing the lawn
BN1281
Term
Which of these environmental modifications for a patient who is allergic to dust would be the most helpful in controlling symptoms?

A) Installing a hot air heater
B) Covering the floors with wall-to-wall carpeting
C) Using heavy draperies on sunny windows
D) Encasing mattresses in plastic
Definition
D) Encasing mattresses in plastic
BN1281
Term
50. A patient is experiencing an episode of urticaria. Which of these interventions may assist the patient in controlling the symptoms of this disease?

A) Using relaxation techniques
B) Avoiding tub baths
C) taking one aspirin daily
D) Drinking decaffinated coffee
Definition
A) Using relaxation techniques
Term
A patient has developed hemolytic anemia related to the administration of penicillin. How can the nurse best explain this disease process to the patient?

A) "An allergy to penicillin is destroying platelets for unknown reasons."
B) "An antigen-antibody reaction is causing destruction of red blood cells."
C) "Allergens are invading the bone marrow and interfering with red blood cell production."
D) "The red blood cells are being consumed inappropriately."
Definition
B) "An antigen-antibody reaction is causing destruction of red blood cells."
BN1253
Term
A patient is receiving a transfusion of packed red blood cells. Ten minutes after the infusion begins the patient complains of low back pain and a headache. Which of these nursing actions is essential now?

A) massage her back and elevate the head of the bed.
B) Change her position.
C) Turn off the blood infusion.
D) Administer aspirin as prescribed.
Definition
C) Turn off the blood infusion.
BN1251
Term
A patient is receiveing a transfusion of packed red blood cells. Before administering the transfusion, which of these nursing checks is essential?

A) Very patient's admitting medical diagnosis.
B) Verify blood type of paient and donor
C) Verify patient's hematocrit level.
D) Verify patients hemoglobin level.
Definition
B) Verify blood type of paient and donor
Term
The nurse is teaching a atient with allergic rhinitis what may rgger it. Which of these may trigger allergic rhinitis?

A) Dust
B) Topical ointments
C) Oral medications
D) Food
Definition
A) Dust
BN1311
Term
Urticaria is classified as which of these types of hypersensitivity reactions?

A) Type I
B) Type II
C) Type III
D) Type IV
Definition
A) Type I
MS999
Term
In which of these ways does the nurse understand urticaria differs from angioedema?

A) It is less pruritic.
B) It has more widespread skin lesions.
C) It has mucous membrane edema.
D) It lasts a shorter period of time.
Definition
D) It lasts a shorter period of time.
MS1001
Term
Which of these nursing actions would take priority when caring for a patient with a severe case of angioedema?

A) Maintenance of a patent airway
B) Strict use of infection control procedures
C) Maintenanc of fluid balance
D) Education regarding immunotherapy
Definition
A) Maintenance of a patent airway
MS1001
Term
Which of these nursing actions would be appropraite for a patient with serum sickness?
A) Discussing with the patient and significant other the need for genetic counselling
B) Administration of immunosuppression medications
C) Closely monitoring patient during the transfusion of blood products
D) Assessing for a decrease in urine output and pale extremities
Definition
D) Assessing for a decrease in urine output and pale extremities
MS1002
Term
Which of these irritants causes contact dermatities? A) Fire ants B) Poison ivy C) Rubber D) Bleach
Definition
B) Poison ivy MS1003
Term
A patient had a kidney transplant 5 days ago. She had been a very outgoing and jovial. This morning she is very quiet, refusing breakfast. She also is refusing AM care and ambulation. Which of these would be the most appropriate nursing action at this time?
A) Notify the physician for lab orders.
B) Inform the family that the patient is beginning to have signs of a rejection
C) Spend extra time with the patient, allowing her to verbalize her feelings.
D) notify the social worker for discharge follow-up care.
Definition
C) Spend extra time with the patient, allowing her to verbalize her feelings.
Term
Which of these nursing actions would be most appropraite for a patient with severe ankylosing spondylities?
A Administer narcotic analgesics
B Provide activity every 2 hours
C Encourage a high fiber diet
D Provide tepid tub soaks
Definition
B
Term
Which of these types of immunity is most affected in hypogammaglobulinemia?
A) passive natural immunity
B) Cell-mediated immunity
C) passive active immunity
D) Humoral immunity
Definition
D) Humoral immunity
Term
Which of these outcomes when caring for a patient who has acquired immunodefficiency syndrome(AIDS) should recieve priority?
A) Remain free of infection
B) Maintain baseline weight
C) Report high self-esteem
D) Remain socially active
Definition
A) Remain free of infection
Term
64. A patient who has human immunodeficiency virus(HIV) asks the nurse if thinking about dying frequently is common with HIV. Which ofthese ia an appropriate response by the nurse?

A) HIV is a serious disease that results in death
B) HIV has a very high mortality rate,so it is realistic to plan for death.
C) HIV is now considered a chronic disease with treatment
D) Thinking about death will not change the prognosis.
Definition
C) HIV is now considered a chronic disease with treatment
MS1008
Term
65. Which of these is a relatively common opportunistic infection that a patient with HIV may develop?

A) Toxoplasmosis
B) Kaposi sarcoma
C) Crytosporidiosis
D) Cryptococcosis
Definition
A) Toxoplasmosis
BN1290
Term
66. When caring for a patient with AIDS,which of these nursing actions would be most appropraite for infection control
A) Wear sterile gloves for any patient contact
B) Wear clean gloves for body fluid contact
C) Wear waterproof gown at all times
D) Wear a mask for any patient contact.
Definition
B) Wear clean gloves for body fluid contact
BN1292
Term
67. Which of these explanations would be appropriate for the nurse to tell the family of a patient diagnosed with HIV about the trasmission of the HIV virus?

A) HIV enters the body through breaks i the skin or mucous membranes
B) HIV can be spread by causual contact
C) HIV lives for long periods outside the body
D) HIV is most commonly transmitted via tears and saliva.
Definition
A) HIV enters the body through breaks i the skin or mucous membranes
MS1012
Term
68. When assesing a patient who has AIDS, which manifestations would the nurse expect to identify?
A) chest pain
B) Hypertension
C) Pustular skin lesions
D) Diarrhea
Definition
D) Diarrhea
BN1288
Term
69. Which of these explanations about the transmission of HIV virus should the nurse include in the teaching plan for the family of a patient who has HIV?

A) HIV spreads by contact with infected blood.
B) HIV can be spread by sharing eating utensils.
c) HIV is spread by casual contact with others
D) HIV is commonly transmitted by tears or saliva.
Definition
A) HIV spreads by contact with infected blood.
MS1012
Term
When a patient who has AIDS expresses concern about telling others, which of these responses would be appropriate by the nurse?

A) "You should tell those who have a reason to know"
B) "It would be best to tell everyone you know."
C) "Your diagnosis will be discovered anyway by those you know."
D) "Secrecy is a poor idea since it eill erode your self-esteem."
Definition
A) "You should tell those who have a reason to know"
Term
71. When caring for a patient who has had diagnosic testing for HIV, which of these tests should the nurse review to determine the presence of the virus?

A) Enzyme-linked immunosorbent assay
B) Polymerase chain reaction testing
C) Western blot
D) P24 antigen testing.
Definition
C) Western blot
BN1287
Term
72. Which of these actions would appropriate for the nurse to use in following standard precautions for protection from HIV exposure?

A) Wash your open skin lesion after providing care.
B) Put on gloves before touching body fluids.
C Recap intramuscular needles following injections.
D) Remove one finger of the gloves during venipuncture.
Definition
B) Put on gloves before touching body fluids.
Term
73. Which specific cell of the immune system is monitores to determine the progression of AIDS?

A) Neutrophils
B) Phagocytes
C) lymphocytes
D) CD4+ lymphocytes
Definition
D) CD4+ lymphocytes
BN1287
Term
74. In educating patients, the nurse should recognize that which of these is the most effective method known to control the spread of HIV infection?

A) Premarital serological screening
B) Prophylactic exposure treatment
C) HIV screening for pregnant women
D) Education about preventive behaviors
Definition
D) Education about preventive behaviors
Term
When a patient is exposed to HIV, initial symptoms would most likely include which of these? A) Ureticeria, sneezing, pruritus. B) Fever, rash,joint pain C) weight loss,night sweats D) Tremors, edema, coughing
Definition
B) Fever, rash,joint pain
Term
If the initial enzyme-linked immunosorbent assay (ELISA) test returns positive, which of these testing protocols is recommended for HIV testing? A) The ELISA test is repeated. B) A rheumatoid factor test is done. C) The Western blot test is done. D) Viral load studies are done.
Definition
A) The ELISA test is repeated. BN1287
Term
Which of these is used to describe when enough antibodies to HIV are circulating to produce positive test results to standard HIV testing?

A) Contagous phase
B) Seroconversion
C) Recovery Phase
D) Infection
Definition
B) Seroconversion
http://en.wikipedia.org/wiki/Seroconversion
Term
78. A patient asks, "What is the main purpose of these medications I take for my HIV." Which response by the nurse would be appropriate?
A) "They mark the virus for natural killer cekks to then destroy."
B) "They enacapsulate the virus-infected cells."
C) "They attract macrophages to the cells making the virus."
D) "They inhibit enzymes, which interferes with viral production."
Definition
D) "They inhibit enzymes, which interferes with viral production."
http://en.wikipedia.org/wiki/Reverse_transcriptase_inhibitor
Term
Which of these actions does the nurse recognize is the treatment goal for HIV?

A Treating opportunistic infections
B Killing the HIV virus with medication
C Stimulating the immune system
D Keeping the HIV virus from replicaing
Definition
D)
Term
When a patient is taking navirapine (Viramune), which of these instructions should be included in the teaching plan?

A) Monitor for flu-like symptoms
B) Monitor for rash
C) Observe urine color.
D) Report extremity pain.
Definition
B) Monitor for rash
http://www.rxlist.com/viramune-drug.htm
Term
Which of these manifestations should the family of a patient with AIDS, be instructed to report to the health practitioner immediately?
A) Dry mouth
B) Night sweats
C) Fever
D)Constipation
Definition
C) Fever
MS1020
Term
When teaching a patient how to prevent HIV transmission with condom use, which of these instructions should be include in the teaching plan?

A) Apply adequate oil-based lubricant.
B) Apply condom before penile erection occurs
C) Withfraw from partner while the penis is erect.
D) Use a nonlatex condom.
Definition
C) Withfraw from partner while the penis is erect.
MS1013
Term
83. A patient with AIDS has been taught about foods to eat to reduce the risk of infection. Which of these foods should the patient select to demonstrate correct understanding?

A) Soft egg yolks
B) Pasteurized milk
C) Raw vegetables
D) Raw fruits
Definition
B) Pasteurized milk
MS1021
Term
The 6 Easy Steps to ABG Analysis:
Definition
1- Is the pH normal?
2- Is the CO2 normal?
3- Is the HCO3 normal?
4- Does the CO2 or the HCO3 match the pH?
5- Does the CO2 or the HCO3 go the opposite direction of the pH?
6- Is the pO2 and the SaO2 normal?
Term
PaO2 (2)
Definition
- Partial pressure of oxygen
- 80-100
Term
PaCO2 (2)
Definition
- partial pressure of carbon dioxide
- 35-45
Term
pH (4)
Definition
- measures hydrogen ions in blood
- 7.35 - 7.45
- high is alkaline
- low is acidic
Term
HCO3 (2)
Definition
- bicarbonate
- 22-26
Term
SaO2 (3)
Definition
- oxygen saturation
- amount of hemoglobin carrying O2
- 95-100%
Term
Respiratory acidosis
Definition
- pH low
- PaCO2 high
- HCO3 normal
Term
Respiratory Alkalosis
Definition
- pH high
- PaCO2 low
- HCO3 normal
Term
Metabolic Acidosis
Definition
- pH low
- PaCO2 normal
- HCO3 low
Term
Metabolic Alkalosis
Definition
- pH high
- PaCO2 normal
- HCO3 high
Term
pH 7.22
PaCO2 55
HCO3 25
What do we do?
Definition
Treat for respiratory acidosis: O2 therapy, ventilation, bronchodilators, etc.
Term
pH 7.50
PaCO2 42
HCO3 33
What do we do?
Definition
Treat for metabolic alkalosis: IV fluids, measures to reduce excess base.
Term
Laryngectomy: s/sx
Definition
hoarse voice
Term
laryngectomy: risk factors (2)
Definition
- smoking
- drinking
Term
laryngectomy: nursing interventions (4)
Definition
- keep airway open
- keep water out of opening
- writing tools for communication
- no narcotics
Term
Complication for failure to take TB medication correctly
Definition
Developed resistance to TB meds: Will need something stronger.
Term
condition resulting from bradypnea
Definition
acidosis
Term
condition resulting from tachypnea
Definition
alkalosis
Term
CPAP
Definition
Continuous positive airway pressure
Term
Common treatment for sleep apnea (what does it do?)
Definition
CPAP - keeps airways open
Term
Tuberculosis: diagnostic
Definition
sputum culture
Term
effects of aging on respiratory system (6)
Definition
- Weakened and atrophied respiratory muscles
- Reduced elastic recoil of lung tissue
- Deteriorating cilia
- Decreased cough reflex
- Reduced effectiveness of alveolar macrophages
- Reduced number of alveoli
Term
best med order for pulmonary embolism
Definition
Heparin - works faster than coumadin
Term
Concern about nasal spray over-use?
Definition
Rebound effect.
Term
rebound effect
Definition
symptoms persist after disease process is over, due to overuse of nasal spray meds.
Term
Control test to order with TB test (rules out false positive
Definition
candida
Term
candida
Definition
Control test to order with TB test (rules out false positive
Term
length of antibiotic treatment for TB
Definition
6 months - 2 years
Term
Interventions to keep open airway for patient on bed-rest (5)
Definition
- turning
- coughing
- deep breathing
- fluids
- suctioning
Term
medication for thinning secretions
Definition
Mucomist
Term
Why are two different drugs used concurrently to treat TB
Definition
To minimize resistance to the drugs (by keeping low doses of each).
Term
Common drug treatment for TB: ________ with either ________, ________ or _______
Definition
INH with either rifampin, ethambutol or pyrazinamide
Term
What test is done to check for breathing condition?
Definition
arterial blood gases (ABGs)
Term
Pneumonia patient is on antibiotics. WBCs increase. Action?
Definition
change antibiotic.
Term
Pneumonia patient is on antibiotics. WBCs decrease. Action?
Definition
None (continue to monitor, meds working)
Term
typical test order to monitor condition of pneumonia
Definition
WBCs
Term
epistaxis
Definition
nosebleed
Term
drug class that is an epistaxis risk
Definition
NSAIDs
Term
post-bronscospy: what to look for before feeding
Definition
gag-reflex
Term
Consequences of strep not treated ASAP (2)
Definition
- rheumatic fever
- glomerulonephritis
Term
Dysphagia
Definition
difficulty swallowing
Term
difficulty swallowing
Definition
dysphagia
Term
Influenza: etiology (2)
Definition
- many strains
- can be fatal (from complications)
Term
Equipment needed for throat culture (2)
Definition
- Tongue blade,
- culture Q-tip (sterile)
Term
Another name for antibiotic
Definition
Anti-microbial
Term
inflammation of the pleura (2)
Definition
- pleuritis
- pleurisy
Term
pleurisy: definition
Definition
AKA pleuritis: inflammation of the pleura
Term
pleural effusion: definition
Definition
excess fluid fills the area between the membrane's layers
Term
excess fluid fills the area between the membrane's layers
Definition
pleural effusion
Term
symptomatic difference between pleurisy and pleural effusion
Definition
Pleural effusion:
- dyspnea
- tachycardia
Term
Pleurisy: s/sx
Definition
- sharp pains with each breath
- Friction rub heard
Term
PQRST
Definition
P - Provoking factors: What causes the pain
Q - Quality: what kind of pain
R - Radiation: does the pain travel anywhere
S: severity/symptoms - how bad (1-10); any other symptoms accompany the pain
T: Timing
Term
pleural effusion: treatment
Definition
thoracentesis
Term
pleuritis: basic cause
Definition
anything that inflames lungs
Term
pneumonectomy
Definition
removal of a lung
Term
removal of a lung
Definition
pneumonectomy
Term
Which of the following assessment findings in the patient with pneumonia most indicates a need to remind the
patient to cough and deep breathe?
a. The patient complains of chest pain.
b. The patient has removed her oxygen.
c. The nurse auscultates wheezes and crackles.
d. The nurse notes a fever of 101° F.
Definition
c. The nurse auscultates wheezes and crackles.
Term
The nurse is caring for a patient with tuberculosis who puts his light on because he needs to use the bathroom.
There are green surgical masks in the isolation cabinet
outside his room. What should the nurse do?
a. Fit the mask firmly to his or her face before going
into the room.
b. Place two masks together and fit them firmly to the
face.
c. Ask the patient to put on a mask before entering
the room.
d. Ask the patient to wait while the nurse obtains a
special high-efficiency mask.
Definition
d. Ask the patient to wait while the nurse obtains a
special high-efficiency mask.
Term
Which of the following assessment findings does the nurse expect in the patient with emphysema?
a. Purulent sputum
b. Diminished breath sounds
c. Generalized edema
d. Dull chest pain
Definition
b. Diminished breath sounds
Term
Which of the following assessment findings in the patient with pneumothorax does the nurse report immediately?
a. Positioning of the trachea toward the unaffected
side
b. Frequent dry cough
c. Moderate pain at the chest tube site
d. Diminished breath sounds over the affected area
Definition
a. Positioning of the trachea toward the unaffected side
Term

As the nurse enters Mr. Jones’s room, he notes that the patient has become confused and combative over the past hour. Which of the following actions is appropriate first?


a. Assess Mr. Jones; check to see if his oxygen is flowing correctly.

b. Page the physician stat.

c. Put up Mr. Jones’s side rails and apply soft restraints.

d. Administer an oral sedative.

Definition
a. Assess Mr. Jones; check to see if his oxygen is flowing correctly.
Term
Which of the following interventions is most appropriate for the patient with an ineffective breathing pattern?
a. Encourage the patient to cough and deep breathe.
b. Encourage oral fluids.
c. Teach the patient controlled diaphragmatic
breathing.
d. Allow the patient to rest between activities.
Definition
c. Teach the patient controlled diaphragmatic breathing.
Term
Mrs. Jackson had an abdominal hysterectomy yesterday. The nurse enters her room and finds her acutely short of
breath, with a look of panic in her eyes. Which of the
following additional symptoms is most important as the
nurse decides what to do?
a. Mrs. Jackson complained of pain in her left leg
earlier this morning.
b. Mrs. Jackson states that she also has a headache.
c. Mrs. Jackson has a recent history of an upper
respiratory infection.
d. Mrs. Jackson has not eaten in 24 hours.
Definition
b. Mrs. Jackson states that she also has a headache.
Term
1. Which of the following positions is recommended for a patient experiencing a nosebleed?
a. Lying down with feet elevated
b. Sitting up with neck fully extended
c. Lying down with a small pillow under the head
d. Sitting up leaning slightly forward
Definition
d. Sitting up leaning slightly forward
Term
2. Which of the following is the best explanation by a nurse for why a physician did not prescribe antibiotics for influenza?
a. “Most cases of influenza are caused by antibiotic-resistant bacteria.”
b. “Influenza is caused by viruses.”
c. “Antibiotics have too many serious side effects.”
d. “Antibiotics can interact with other medications used for influenza.”
Definition
b. “Influenza is caused by viruses.”
Term
3. Which of the following responses is correct when a patient asks why her physician didn’t order that new antiviral drug for her flu?
a. “The antiviral drugs are for AIDS, not the flu.”
b. “The side effects of the antiviral drugs are worse than having the flu.”
c. “Antiviral drugs are only for children.”
d. “These drugs only work if you start them within 48 hours after flu symptoms start.”
Definition
d. “These drugs only work if you start them within 48 hours after flu symptoms start.”
Term
4. After a laryngectomy, which of the following assessments takes priority?
a. Airway patency
b. Nutritional status
c. Lung sounds
d. Patient acceptance of surgery
Definition
a. Airway patency
Term
5. Which of the following communication methods will not work for the patient with a laryngectomy?
a. Placing a finger over the stoma
b. Providing a special valve that diverts air into the esophagus
c. Obtaining a picture board
d. Teaching the patient esophageal speech
Definition
a. Placing a finger over the stoma
Term
6. Which of the following statements best explains why the nurse is careful when administering narcotics to a
laryngectomee?
a. Most laryngectomees have been drug addicts in the past.
b. Even low doses of narcotics may cause respiratory arrest in the laryngectomee.
c. Narcotics can depress the cough reflex.
d. Laryngectomy patients have very little pain after surgery.
Definition
c. Narcotics can depress the cough reflex.
Term
epistaxis
Definition
nosebleed
Term
nosebleed
Definition
epistaxis
Term
medication to help stop epistaxis
Definition
Epinephrine (adrenalin)
Term
Epinephrine
Definition
vasoconstrictor
Term
coughing up blood
Definition
hemoptysis
Term
hemoptysis
Definition
coughing up blood
Term
nursing interventions for nosebleed (3)
Definition
- ice on forehead
- lean forward
- do not swallow blood (causes nausea)
Term
Risk factors for lung cancer (3)
Definition
- smoking
- chemical exposure
- environmental factors
Term
What would be the appropriate time to remove a chest tube? (2)
Definition
- when drainage stops
- NO bubbling in water seal chamber
Term
Post-op complication for Deviated septum
Definition
swallowing blood
Term
Requirement for TB patient to leave room
Definition
mask on patient
Term
What type of infection is NOT treated with antimicrobials
Definition
Any type of infection that is NOT bacterial (ie viral)
Term
s/sx of sinus infection (2)
Definition
- headache
- facial PRESSURE around the affected sinus
Term
Highest risk group for acquiring TB
Definition
HIV +
Term
laryngeal cancer: s/sx (2)
Definition
- hoarse voice over 2 weeks
- difficulty swallowing
Term
Patient has pneumonectomy: What side should patient lie on? Why?
Definition
UNAFFECTED side. Prevent remaining lung and organs from shifting toward the empty space.
Term
Note about chest tube dressing (what to do and why)
Definition
- Leave the dressing alone (don't change it)
- It is an occlusive (airtight) dressing designed to prevent air from entering thorax.
Term
Complications of untreated strep throat (2)
Definition
- rheumatic fever
- glomerulonephritis
Term
Type of speech used by larangectomees
Definition
esophageal speech
Term
esophageal speech
Definition
swallowing air and regurgitating it through esophagus to produce sound.
Term
cystic fibrosis: etiology
Definition
- affects any gland that secretes
- gives tenacious secretions
- genetic
Term
cystic fibrosis: diagnostic
Definition
sweat chloride test
Term
cystic fibrosis: nursing
Definition
- aggressive postural drainage (before meals)
- mouth care
Term
Tonsillectomy
Definition
Pt should avoid red-color drink
Term
what is the most complication of influenza
Definition
Pneumonia
Term
Tonsillectomy
Definition
No red fluid
No straw
Term
LEUKOPLAKIA
Definition
patches of keratosis
smoking
Term
DIVERTICULITIS
Definition
Diverticulitis develops from diverticulosis. Diverticulitis results if one of these diverticula becomes inflamed.
Term
DIVERTICULOSIS
Definition
involves the formation of pouches (diverticula) on the outside of the colon.
Term
INTESTINAL OBSTRUCTION
Definition
JELLY-LIKE STOOLS
Term
CANDIDIASIS
Definition
thrush
fungal CANDIDA infection
Term
STOMATITIS
Definition
inflammation of the mucus lining of the mouth.
Term
HEMORRHOIDS
Definition
painful Anal lesions involving a shallow local blood vessel
Term
Antispasmodic
Definition
dicyclomine hydrochloride(antispas,bentyl)
Term
E.COLI serotype 0157 H7 = what we need to KNOW
Definition
1)very VIRILANT 2)NOT a normal FLORA 3) transmitted by UNDERCOOKED MEAT 4)S/S abd cramping,bloody diarrhea,diffuse abd tenderness
Term
EGD intervention
Definition
look for gag reflex
Term
ERCP: description (3)
Definition
- exam of hepatobiliary system with flexible endoscope into esophagus
- multiple positions required
- if meds given, monitor for signs of respiratory and CNS depression, hypotension, oversedation, vomiting
Term
ERCP: postprocedure (3)
Definition
- V/S
- gag reflex
- monitor for signs of perforation
Term
ERCP: preprocedure (2)
Definition
- NPO several hours prior
- sedation
Term
FAILURE of the cardiac sphincter to relax, restricting passage of food to the stomach
Definition
ACHALASIA
Term
Gingivitis Etiology...
Definition
1)bacterial plaque on teeth as a ineffective oral hygiene
2)vitamin deficiencies
3)DM
4)anemia
5)leukemia
Term
Gingivitis S/S
Definition
1) bleeding gums, 2) erythematous gums 3) edematous and tender gums
Term
Parenteral nutrition: nursing considerations (6)
Definition
- start slowly
- check glucose q6hr
- strict steril when changing botles, tubing, filters, dressings
- constant rate
- monitor skin integrity
- client teaching re line management
Term
acholasia
Definition
motility disorder of the lower portion of the oseophagus in which food cannot pass into the stoma.
Term
anoscopy, proctoscopy & sigmoidoscopy: postprocedure
Definition
monitor for rectal bleeding and signs of perforation and peritonitis
Term
anoscopy, proctoscopy & sigmoidoscopy: preprocedure
Definition
enema until clear
Term
anoscopy: description (3)
Definition
- requires rigid scope to examine anal canal
- client in knee-chest position with back inclined 45 degrees
- biopsies and polypectomies possible
Term
ball of food that has mixed with saliva
Definition
bolus
Term
caries nursing intervention
Definition
if old people are not eating check mouth or check denture
Term
chief coenzyme of gastric juice
Definition
pepsin
Term
commonly administered antiemetics(13)
Definition
Diphenidol
Dolasetron(Anzemet)
Dronabinol(Marinol)
Granisetron(Kytril)
Hydroxyzine pamoate(Vistaril)
Meclizine hyrochloride(Antivert)
Metoclopramide(Reglan)
ondansentron(Zofran)
prochlorperazine(compazine)
Promethazine hydrochloride(phenergan)
Scopolamine transdermal(transderm-scop)
Thiethylperazine meleate(Torecan)
trimethobenzamide hydrochloride(tigan)
Term
controls gastric acidity
Definition
gastrin
Term
diagnostic tests for alcholasia
Definition
Esophageal manometry
Term
difficulty in swallowing
Definition
dysphagia.
Term
duodenal ulcer: causes (5)
Definition
- alcohol
- smoking
- stress
- caffeine
- NSAIDS, aspirin, Corticosteroids
Term
duodenal ulcer: definition
Definition
breakdown of mucosa in duodenum
Term
duodenal ulcer: nursing interventions (6)
Definition
- monitor V/S
- monitor for signs of bleeding
- abdominal assessments
- bland diet
- small frequent meals
- stop smoking
Term
duodenal ulcer: s/sx (4)
Definition
- burning pain in epigastric area 2-4 hrs after eating and at night
- pain is often relieved by eating
- weight gain
- melena
Term
duodenal ulcers: complications (4)
Definition
- bleeding
- perforation
- gastric outlet obstruciton
- intractable disease
Term
duodenal ulcers: description
Definition
break in the mucosa of the duodenum
Term
duodenal ulcers: interventions (10)
Definition
- V/S
- bland diet
- small frequent meals
- rest
- no smoking
- no alcohol
- no caffeine
- no aspirin, corticosteroids, NSAIDs
- antacids
- H2-receptor antagonists
Term
duodenal ulcers: risk factors (8)
Definition
- alcohol
- smoking
- stress
- caffeine
- aspirin
- corticosteroids
- NSAIDs
- H. pylori
Term
duodenal ulcers: s/sx (3)
Definition
- burning pain in midepigastric area 1.5-3 hrs after meal
- food relieves pain
- melena (more often than hematemesis)
Term
edentulous mean...
Definition
without teeth
Term
effects of Aging on the Digestive System (5)
Definition
- The mouth becomes drier
- Taste decreases, especially sweet and sour tastes.
- Cardiac sphincter relaxes - leads to reflux and heartburn
- Food stays in stomach longer - indigestion
- Peristalsis decreases - constipation
Term
gastric ulcers: client education (7)
Definition
- no alcohol
- no caffeine
- no chocolate
- no smoking
- no aspirin or NSAIDs
- reduce stress
- rest
Term
gastric ulcers: complications (3)
Definition
- hemorrhage
- perforation
- pyloric obstruction
Term
gastric ulcers: description
Definition
ulceration of mucosal lining that extends to submucosal layer of stomach
Term
gastric ulcers: interventions (8)
Definition
- V/S
- bland diet
- small, frequent meals
- H2 receptor antagonists
- antacids
- anticholinergics
- mucosal barrier protectants 1 hr before meal
- prostaglandins
Term
gastric ulcers: interventions during active bleeding (10)
Definition
- V/S
- NPO
- IV fluid replacement
- monitor I & O
- monitor hgb/hct
- blood transfusions
- ng tube
- lavage (saline or tap water)
- Pitressin
- assess for signs of other problems (see other card)
Term
gastric ulcers: interventions during active bleeding; assess for signs of ..
Definition
- dehydration
- hypovolemic shock
- sepsis
- respiratory insufficiency
Term
gastric ulcers: postop interventions (10)
Definition
- V/S
- Fowler's
- fluids and electrolytes
- I&O
- bowel sounds
- monitor ng suction
- do not irrigate or remove tube
- NPO 1-3 days (wait for peristalsis)
- progressive diet
- monitor for postop complications
Term
gastric ulcers: risk factors (8)
Definition
- stress
- smoking
- corticosteroids
- NSAIDs
- alcohol
- gastritis
- family history
- H. pylori
Term
gastric ulcers: s/sx (3)
Definition
- gnawing, sharp pain in or left of midepigastric region
- food accentuates pain
- hematemesis (more than melena)
Term
gastric ulcers: surgical interventions (5)
Definition
- gastrectomy
- vagotomy
- gastric resection
- Billroth (I and II)
- pyloroplasty
Term
gastritis: definition
Definition
inflammation of gastric mucosa
Term
gastritis: nursing interventions
Definition
- hold fluids and food until symptoms subside. Then feed progressively
- ice chips
- clear liquids
- solid food
Term
gastritis: s/sx (4)
Definition
- abdominal discomfort
- headache
- anorexia
- hiccups
Term
gastroesophageal reflux disease: description (2)
Definition
- backflow of contents into esophagus
- caused by incompetent lower esophageal sphincter, pyloric stenosis, or a motility disorder
Term
gastroesophageal reflux disease: interventions (7)
Definition
- avoid factors that decrease lower esophageal sphincter pressure
- low-fat, high-fiber diet
- no caffeine, tobacco, carbonated drinks
- loose clothes
- elevate head of bed on blocks
- no anticholinergics
- laparoscopic fundoplication
Term
gastroesophageal reflux disease: s/sx (5)
Definition
- pyrosis
- dyspepsia
- regurgitation
- pain and difficulty swallowing
- hypersalivation
Term
gingivitis
Definition
Def: the inflammation of the gums;
N/I: limit acidic food
Term
hiatal hernia has to do with the
Definition
diaphragm
Term
hiatal hernia: complications (7)
Definition
- ulceration
- hemorrhage
- regurgitation and aspiration
- strangulation
- necrosis
- peritonitis
- mediastinitis
Term
hiatal hernia: description (2)
Definition
- part of stomach herniates through the diaphragm into the thorax
- result of weakening of muscles of diaphragm
Term
hiatal hernia: interventions (5)
Definition
- med/surg like GE reflux
- small frequent meals
- limit fluids with meals
- do not recline for 1 hr after eating
- no anticholinergics
Term
hiatal hernia: risk factors (5)
Definition
- pregnancy
- ascites
- obesity
- tumors
- heavy lifting
Term
hiatal hernia: s/sx (4)
Definition
- heartburn
- vomiting
- dysphagia
- feeling full
Term
in infants, projectile vomiting (vomiting with great force) can be a sign
Definition
pyloric stenosis (a narrowing of the pyloric sphincter)
Term
inflammatory disease of the intestines, tends to exacerbate, affects any part of the GI tract.
Definition
CROHN'S DISEASE
Term
medication therapy for H.pylori(triple therapy)(3)
Definition
Metronidazole(Flagyl),omeprazole (prilosec),and clarithromycin (Biaxin)
Term
nursing consideratons for acholasia!
Definition
1 Teach the clients to eat slowly and in a peaceful setting.
2 Chew your food slowly to help move the food down into the stomach and drink plenty of fluids to help in movement of food.
Term
proton pump inhibitors(4)
Definition
Esomeprazole(Nexium)
Lansoprazole(prevacid)
omeprazole(prilosec)
pantoprazole(protonix)
Rabeprazole(Aciphex)
Term
signs and symptoms of achalasia. (6)
Definition
- dysphagia.
- regurgitation
- weight loss
- coughing when lying down
- pain like heartburn.
- aspiration
Term
surgical intervention for acolasia
Definition
Heller myotomy.
Term
surgical treatment includes:
Definition
Dialation of the cardiac splinchter
Term
treatment of appendicities
Definition
appendectomy
Term
ulcerative colitis: description (5)
Definition
- ulcerative and inflammatory disease of the bowel resulting in poor absorption of nutrients.
- commonly begins in rectum, spreading upward
- edematous colon
- bleeding lesions- scar tissue, causing loss of elasticity
- remission and exacerbation periods
Term
ulcerative colitis: interventions (10)
Definition
- NPO if acute
- restrict activity
- bowel sounds
- monitorfor abdominal tenderness/cramping
- monitor stools (color, consistency, blood)
- monitor for bowel perforation, peritonitis and hemorrhage
- low-residue, high-protein diet
- avoid gas-forming foods
- avoid whole grains, nuts, alcohol, etc.
- no smoking
Term
ulcerative colitis: s/sx (8)
Definition
- anorexia
- weight loss
- malaise
- abdominal tenderness/cramping
- severe diarrhea (may contain blood/mucus
- dehydration/electrolyte imbalances
- anemia
- vitamin K deficiency
Term
ulcerative colitis: surgical intervention
Definition
ostomy
Term
[image]
Stomach-numbered
Definition
[image]
Stomach-named
Term
Which of the following is a waste product of red blood cell destruction?
A. Thrombin
B. iron
C. Bilirubin
D. intrinsic factor
Definition
C. Bilirubin
BN, pg 239
Term
which of the following is the stimulus for the formation of a blood clot or a platelet plug?
A. A rough surface
B. A smooth surface
C. An intact vessel
D The endothelial lining of a vessel
Definition
A. A rough surface
HB, pg 265
Term
Which lymph nodes remove pathogens in the lymph coming from the head?
A. Thoracic nodes
B. Axillary nodes
C. cervical nodes
D. inguinal nodes
Definition
C. cervical nodes
HB, pg 325
Term
Which lymph nodes remove pathogens in the lymph coming from the legs?
A.Thoracic nodes
B. axillary nodes
C. cervical nodes
D. inguinal nodes
Definition
D. inguinal nodes
HB, pg 325
Term
Which of the following anatomical sites is used to obtain a bone marrow specimen?
A.posterior iliac crest
B. Long bones in the legs
C. ribs
D. humerus
Definition
A. posterior iliac crest
HB, pg 259
Term
Which of the following are white blood cells produced from the spleen?
A.macrophages and neutrophils
B Basophils and lymphocytes
C lymphocytes and monocytes
D. monocytes and eosinophils
Definition
C. lymphocytes and monocytes
HB, pg 263
Term
Which term describes hemoglobin that has given up its oxygen to the body"s cells?
A reduced
B detached
C oxyhemoglobin
D Hyphoxyhemoglobin
Definition
A. reduced
Term
How long does the average red blood cell in live in the body?
A 30 days
B 60 days
C 90 days
D 120 days
Definition
D. 120 days
HB, pg 259
Term
T cells and B cells are groups of which cell type?
A red cells
B lymphocytes
C platelets
D Eosinophils
Definition
B. lymphocytes
BN, pg 238
Term
Which ion is most necessary for blood clotting?
A potassium
B sodium
C calcium
D Magnesium
Definition
C. calcium
BN, pg 239
Term
What is the normal number of red blood cells for a healthy adult?
A 8 to 10,000/mm3
B 1 to 2.5 million/mm3
C 4.5 to 6 million/mm3
D 8 to 10 million/mm3
Definition
C. 4.5 to 6 million/mm3
BN, pg 239
Term
Which organ removes old red blood cell from circulation?
A kidney
B spleen
C lung
D pancreas
Definition
B. spleen
BN, pg 242
Term
Which of the following terms describes a large area of discoloration from hemorrhage under the skin?
A petechiae
B pallor
C Rubor
D Ecchymosis
Definition
D. Ecchymosis
Medicine.net
Term
Which of the following manifestations indicates long-term hypoxia?
A pulmonary crackles
B clubbed fingertips
C Dyspnea
D pallor
Definition
B. clubbed fingertips
wikipedia
Term
Which of the following nursing actions is essential when caring for a patient after a bone marrow biopsy?
A observe for bleeding
B Administer heparin as ordered to prevent clotting
C Hold pressure on the antecubital space for 30 minutes
D keep the patient NPO for 6 hours.
Definition
A. observe for bleeding
BN, pg 1249
Term
A patient has a bone marrow aspiration from his posterior iliac crest. Before the procedure,his blood pressure was 132/82 mmHg,pulse 88/min.one hour after the procedure,his blood pressure is 108/70 mmHg,pulse 96/min.Which of the following assesments is least important at this time?
A check the punture site.
B Check to see whether he had any medication before the procedure
C Ask him if he feels lightheaded or dizzy.
D check his most recent complete blood count report.
Definition
D. check his most recent complete blood count report.
Term
Which activity should be avoided for a patient with thrombocytopenia?
A Visits from family members
B intramuscular injections
C eating fresh fruits and vegetables
D Ambulation
c
Definition
B. intramuscular injections
MS, pg 527
Term
Which of the following medications should be witheld from a patient with a bleeding disorder?
A. Digoxin(Lanoxin)
B. Thyroid hormone
C. Morphine
D. Aspirin
Definition
D. Aspirin
Term
Which of the following blood products might be ordered for a patient to correct a clotting disorder?
A Packed red blood cells
B Albumin
C Packe1d white blood cells
D cryoprecipitates
Definition
D. cryoprecipitates
MS, pg 516
Term
A patient who is taking warfarin(coumadin),5mg daily,has an international Normalized Ratio(INR) of 2.5 seconds.Which response by the nurse is best?
A. Hold the next dose of coumadin
B. Notify the physician ASAP
C. Give the daily coumadin as ordered
D. Prepare to administer vitamin K.
Definition
C. Give the daily coumadin as ordered
MS, pg 515
Term
A patient is anemic and 2 units of packed red blood cells are prescribed.Which of the following intravenous solutuions is compatible with a blood transfusion?
A D5W
B D5/0.45NaCL
C 0.9% NaCL
D Lactated Ringers
Definition
C. 0.9% NaCL
BN, pg 858
Term
Which of the following nursing assessments measures is necessary before and during a blood product infusion? A Vital signs B Bowel sounds C Pulpil reactivity D skin turgor
Definition
A. Vital signs BN, pg 1250
Term
What is the maximum time that blood can hang during infusion before it begins to deteriorate?
A 1 hour
B 2 hours
C 3 hours
D 4 hours
Definition
D. 4 hours
BN, pg 1250
Term
A patient recieving blood begins complaining of severe chest pain and says she feels warm.Which of the following actions should the nurse take first?
A call the physician
B Take temperature,pulse, and respiration;do a cardiovascular assessment.
c. stop the blood transfusion
D. Administer nitroglycerin if ordered.
Definition
c. stop the blood transfusion
BN, pg 1250
Term
Which needle size should a nurse insert if blood is to be infused?
A 12 gauge
B 18 gauge
C 22 gauge
D 26 gauge
Definition
B. 18 gauge
MS, pg 517
Term
What is the best way a licensed practical nurse can assist the health team to prevent a transfusion reaction?
A Warm the blood to 98.6 F before infusion.
B Assisit the registered nurse in correctly identifying the patient and the blood product.
C administer diphenhydramine(benadryl) before infusion
D Monitor vital signs every 15 minutes.
Definition
B. Assisit the registered nurse in correctly identifying the patient and the blood product.
MS, pg 516
Term
A patient recievoing blood complains of dyspnea. The nurse ausculates the patients lungs and find cracles that were not present before the start of the transfusion.Which type of reaction should the nurse suspect?
A Hemolytic
B Anaphylactic
C Urticarial
D Circulatory overload
Definition
D. Circulatory overload
MS, pg 518
Term
A patient has a white cell count of 8000/mm3.What concern does the nurse have about this finding?
A The patient has an infection
B The patient is at risk of infection
C The patient has a hematological disorder.
D There is no concern;this is a normal finding.
Definition
D. There is no concern; this is a normal finding.
MS, pg 509
Term
What type of blood cells are deficient in a patient with anemia?
A Red blood cells(RBCs)
B White blood cells(WBNCs)
C Platelets
Definition
A. Red blood cells(RBCs)
MS, pg 509
Term
Which of the following nutrient deficiencies are most likely to be the cause of anemia?
A Vitamin C,D, and selenium
B Iron,folic acid,and vitamin B12
C Vitamin A,calcium, and phosphorus
D Aluminum, vitamin E, and beta carotene.
Definition
B. Iron,folic acid,and vitamin B12
MS, pg 510
Term
Which blood tests does the nurse check to monitor the progress of the patient with anemia?
A Electrolytes;blood urea nitrogen(BUN) and creatine
B Thrombin clotting time and prothrombin time
C WBC and platelet counts
D Hemoglobin and hematocrit
Definition
D. Hemoglobin and hematocrit
MS, pg 509
Term
Which nursing diagnosis is most appropraite for the patient with anemia?
A Inefffective airway clearance related to dyspnea
B Activity intolerance related to tissue hypoxia
C Risk for infection related to reduction in circulating WBCs
D pain related to bone marrow dysfunction
Definition
B. Activity intolerance related to tissue hypoxia
MS, pg 522
Term
Which of the following foods should the nurse encourage the patiennt with iron deficiency anemia to eat?
A molasses and red meats
B citrus fruits and dairy products
C yellow vegetables,green teas
D Berries and natural cereals
Definition
A. molasses and red meats
MS, pg 522
Term
The nurse is preparing to give an injection of iron (imferon) to a patient with anemia.why should the Z-track method for injection be used?
A To prevent tissue damage at the site
B To prevent pain at the site
C To prevent discoloration of the tissue at the site
D To promote faster absorption of the medication.
Definition
C. To prevent discoloration of the tissue at the site
MS, pg 524
Term
A patient with thrombocytopenia is having pain.if each of the following medications is ordered,which should the nurse choose to administer?
A Acetaminophen with codeine(Tylenol#3)po
B Meperidine (demerol)IM
C Oxycodone with aspirin (perocodan)PO
D Morphine SQ
Definition
A. Acetaminophen with codeine(Tylenol#3)po
Term
A patient with aplastic anemia is to receive an injction of erythropoietin (Epogen). She asks what the injection intended to do.Which of the following responses by the nurse is best?
A it works like a blood transfusion to give you extra red blood cells
B it will inhibit the protein that is attacking byour red blood cells.
c It will stimulate your body to produce more of its own red blood cells
D it will give you energy while your body is recovering from the anemia.
Definition
C. It will stimulate your body to produce more of its own red blood cells
MS, pg 525
Term
A 16 year old patient is admitted with sickle cell crises and has complaints of dyspnea and leg pain.What is the cause of pain in this patient?
A. A disturbance in cellular metabolism
B Expansion of bone marrow with a decrease in the number of circulating red blood cells.
C. Clumping of abnormal red blood cells,leading to obstruction of capillary blood flow.
D. Bleeding into joints because of rapid destruction of RBCs by the bone marrow.
Definition
C. Clumping of abnormal red blood cells,leading to obstruction of capillary blood flow.
MS, pg 525
Term
Patients from which cultural background are most likely to have sickle cell anemia?
A Hispanic
B African
C Asian
D European
Definition
B. African
MS, pg 526
Term
Which of the following activities should the nurse discourage the patient with sickle cell anemia from engaging in?
A sexual activity
B Long distance driving
C Sitting for long periods
D skiing in the mountains
Definition
D. skiing in the mountains
MS, pg 529
Term
What is the rationale for providing warm compress and blankets for the patient with sickle cell crises?
A sickle cell crises causes shivering and discomfort.
B Heat prevents vasoconstriction and impaired circulation
C Heat helps prevent the cells from becoming sickled
D Heat speeds production of new healthy red blood cells.
Definition
B. Heat prevents vasoconstriction and impaired circulation
MS, 529
Term
Because they can trigger a crises,which of the following foods should be avoided by patients with sickle cell anemia?
A Alcoholic beverages
B Citrus fruits
C Chocolates and colas
D Whole grain products
Definition
A. Alcoholic beverages
MS, pg 529
Term
A patient is admitted to he hospital with hypertension and vertigo related to polycythemia vera.For which of the following treatments should the nurse prepare the patient?
A injection of colony-building factors
B Therapeutic phlebotomy
C Splenectomy
D Myelogram
Definition
B. Therapeutic phlebotomy
MS, pg 530
Term
Which laboratory study does the nurse monitor to help evaluate the effectiveness of treatment for polycythemia?
A Total protein
B WBC differential
C BUN
D Hematocrit
Definition
D. Hematocrit
MS, pg 530
Term
Which of the following nursing interventions best helps prevent complications in the patient with polycythemia?
A Encourage 3 liters of water daily
B Monitor intake and output
C Avoid use of injections for pain
D Maintain bedrest during treatment
Definition
A. Encourage 3 liters of water daily
MS, pg 530
Term
Which of the following manifestations alerts the nurse to the possibility of disseminated intravascular coagulation(DIC)?
A Weakness of paralysis on one side
B Rising blood pressure and pulse
C Petechiae
D Absence of pulses in extremeties
Definition
C. Petechiae
MS, pg 530
Term
Which nursing intervention is least likely to cause complications in the patient with DIC? A Administering intramuscular (IM) meperidine(Demerol) for pain B use of electric razor C Assisting the patient to brush his teeth D Offering aspirin for mild pain
Definition
B. use of electric razor
Term
Which of the following definitions of purpura is correct?
A Small red spots over the skin
B Purpulish discoloration of the mucous membranes
C Hemorrhage into the skin
D Splinter hemorrhages under the fingernails
Definition
C. Hemorrhage into the skin
MS, pg 531
Term
A comatose patient is admitted to the emergency department after an automobile accident.The nurse notes a Medic-Alert identification bracelet on his arm,which states that he has hemophilia. What should the nurse do first?
A Notify the physician of the bracelet
B Remove the bracelet and give it to the patients family member
C tape the bracelet to the patients arm
D Call the phone number on the bracelet.
Definition
A. Notify the physician of the bracelet
Term
Which of the following assessment findings is not unusual in the patient with hemophilia?
A unequal pupils
B joint deformities
C Elevated white cell count
D Distended abdomen
Definition
B. joint deformities
MS, pg 532
Term
A patient walks into the urgent care clinic,stating he has hemophilia and that he is bleeding.The triage nurse does a quick assessment and sees no signs of active bleeding.several patients are already in the waiting area.which of the following actions by the nurse is most appropraite?
A Place the patient in an examination room and tell the doctor that the patient may be bleeding.
B Ask the patient to sit in the waiting room until his name is called
C Send the patient for routine x-rays to look for the source of bleeding before placing him in an examination room
D Palpate the suspected area to determine whether bleeding is present.
Definition
A. Place the patient in an examination room and tell the doctor that the patient may be bleeding.
MS, pg 533
Term
A patient with hemophilia A is bleeding.Which of the following treatments should the nurse anticipate?
A IM injection of factor VIII
B IM injection of factor IX
C Intravenous (IV) infusion of factor VIII.
D IV infusing of factor IX.
Definition
C. Intravenous (IV) infusion of factor VIII.
MS, pg 533
Term
A 54-year-old patient is admitted to the hospital in the final stage of chronic lymphocytic leukemia(CLL). Which of the following manifestations of CLL would the nurse expect to find while collecting admission data?
A Nausea and vomiting
B Hypotension and alopecia
c Cervical lymphadenopathy and chest pain.
D Fever and abnormal bleeding.
Definition
D. Fever and abnormal bleeding.
Term
Why is it important for the nurse to institute measures to protect the patient with leukemia from infection?
A The drugs needed to fight infection are dangerous for the patient with leukemia
B Leukemia seriously impairs the leukocytes and the body's ability to fight infection
C Infection can precipate hemorrhage in the patient with leukemia
D Infection in the patient with leukemia can lead to permanent neurological damage.
Definition
B. Leukemia seriously impairs the leukocytes and the body's ability to fight infection
MS, pg 526
Term
A patient is being tested for possible leukemia.With which of the following diagnostic tests should the nuse anticipate assisting?
A Bone marrow biopsy
B Thoracentesis
C Liver biopsy
D Arterial blood gas analysis
Definition
A. Bone marrow biopsy
MS, pg 536
Term
The nurse is emptying the bedside commode of a patient with chronic leukemia and notes the stool is very dark.Which assumption should guide the nurses decision about what to do?
A The patient ate something that turned the stool a dark color
B The patient is most likely on iron supplemients
C The patient may be bleeding
D The patient is dehydrated.
Definition
C. The patient may be bleeding
MS, pg 537
Term
A patient recieving chemotherapy for chronic myelocytic leukemia has irritated mucous membranes.Which of the following mouth care interventions will clean the teeth without causing further mucous membrane complications?
A Swab teeth and mucous membranes four times daily with lemon-glycerin swabs.
B Brush teeth twice a day with a firm toothbrush
C Use sponge toothettes to clean teeth after meals.
D Use waxed floss between meals and at bedtime.
Definition
C. Use sponge toothettes to clean teeth after meals.
MS, pg 538
Term
A patient with multiplw myeloma is being care for at home.Which of the following nursing diagnoses should guide the nurse when teaching the family how to provide care for the patient?
A Ineffective airway clearance related to cervical lymphadenopathy
B Ineffective tissue perfussion related to vascular occlusion
C Risk for deficient fluid volume related to bleeding disorder
D Risk for injury related to compromised bone integrity.
Definition
D. Risk for injury related to compromised bone integrity.
Term
The patient with multiple myeloma is at risk for hypercalcemia.What is one nursing intervention that will help minimize complications related to this imbalance?
A Encourage fluids
B Offer citrus juices and fruits
C Place the patient on a low-sodium diet
D Disscourage intake of alcoholic beverages.
Definition
A. Encourage fluids
Term
Which question by the nurse helps evaluate the patients response to treatment for anemia?
A is your appetite improving?
B Are you sleeping all night?
C Are you keeping up with your work schedule?
D Are you requiring many analgesics?
Definition
C. Are you keeping up with your work schedule?
Term
A patient with hodgkins disease has cervical lymph node enlargement. Which of the following symptoms should the nurse attend to first?
A Fever
B Stridor
C Fatigue
D Jaundice
Definition
B. Stridor
Term
Which of the following beverages should the patient with Hodgkins disease be instructed to avoid?
A coffee
B Orange juice
C Wine
D Ginger ale.
Definition
C. Wine
MS, pg 540
Term
Where would the nurse expect to find enlarged lymph nodes in a patient with stage III Hodgkins disease?
A In the neck only
B Above the diaphragm only
C Below the Diaphragm only
D Generalized throughout the body.
Definition
D. Generalized throughout the body.
Term
A patient with lymphoma wants to attend her daughter's graduation, but she says she is too tired to even think about it. The nurse develops a plan for fatigue related symptoms of lymphoma. How will the nurse know if the plan has been effective?
A The patient is able to sleep 8 hours at night
B The patient can list three ways to combact fatigue
C The patient is able to attend her daughters graduation
D The patient is able to walk for 10 minutes without tiring.
Definition
D. The patient is able to walk for 10 minutes without tiring.
Term
A patient with terminal lymphoma says to the nurse,"i m tired of living like this. can't you just give me a big shot of morphine and help me end this suffering?" Which of the following responses by the nurse is most appropraite?
A. "You have orders for morphine 10 to 15 mg.i dont think thats enough to do the job."
B "You sound frustrated.Would you like me to contact the chaplain to come and speak with you?"
C "I could get into big trouble for doing that,Would you like a shot just to take away the pain?"
D "Are you sure that is what you want me to do? Maybe you should think about it first."
Definition
B. "You sound frustrated.Would you like me to contact the chaplain to come and speak with you?"
Term
A patient is being prepared for splenectomy. What is the purpose of the order for a vitamin K injection?
A It will correct clotting factor deficiencies.
B It will replace Vitamin K lost during night sweats
c It will correct a dietary deficiency.
D It helps the body prepare for wound healing.
Definition
A. It will correct clotting factor deficiencies.
MS, pg 544
Term
Which of the following nursing interventions will best help prevent respiratory infection in a patient who has had a splenectomy?
A Ausculate lung sounds every shift.
B Administer scetaminophen(Tylenol) for fever
C Teach the patient to cough and deep breath ever hour
D Keep the head of the bed elevated at least 30.
Definition
C. Teach the patient to cough and deep breath ever hour
MS, pg 544
Term
A patient who has had a splenectomy complains of malaise. The nurse checks his temperature and finds it is 102 F(39 C).Which of the following actions by the nurse should take priority?
A Administer acetaminophen to reduce fever and relieve discomfort
B Encourage fluids to reduce fever and prevent dehydration.
C Explain to th patient that low-grade fevers are not uncommon after splenectomy because the spleen is part of the immune system.
D Notify the physician, because postsplenectomy patients are at risk for deadly infection.
Definition
D. Notify the physician, because postsplenectomy patients are at risk for deadly infection.
MS, pg 544
Term
What follow-up care is important for a patient who has had a splenectomy?
A Monthly coagulation studies
B Lifetime use of vaccinations against infections
C A course of radiation therapy to prevent malignancy
D Routine transfusion of packed cells to prevent anemia.
Definition
B. Lifetime use of vaccinations against infections
MS, pg 544
Term
Which of the following nursing actions is the best way to prevent infection in the post operative patient?
A Practice good hand washing
B Check vital signs every 4 hours
C Change wound dressings daily.
D Encourage 2 liters of fluid daily.
Definition
A. Practice good hand washing
Term
Orthopnic position is similar to what other position
Definition
high-Fowlers
Term
How is Orthopnic position different from High Fowler's
Definition
Arms are supported in front of patient (on bedside table, pillows, etc)
Term
Purpose for Orthopnic position
Definition
used for patients who have difficulty breathing.
Term
What determines that a client has AIDS (3)
Definition
- two positive ELISA tests
- one positive Western Blot test
- T-Cell count below 200
Term
Test that determines the presence of HIV (the virus itself)
Definition
Polymerase Chain Reaction (PCR) test.
Term
s/sx of hypoxia (5)
Definition
- altered LOC
- cyanosis
- headache
- nausea
- SOB
Term
chronic bone condition characterized by disorder of the normal bone remodeling process.
Definition
Pagett's disease
Term
Pagett's disease: nursing outcomes
Definition
similar to osteoporosis
Term
Casts: indentations could lead to this:
Definition
Compartment syndrome
Term
Compartmental knee replacement
Definition
partial knee replacement
Term
compartment syndrome: complication
Definition
Volkmann's contracture
Term
Blood circulates from the lung through this
Definition
pulmonary artery
Term
What is compartmental knee replacement
Definition
partial knee replacement
Term
Complication of compartment syndrome
Definition
volkmann's contracture
Term
blood travels to the lungs through this:
Definition
pulmonary artery
Term
med classes used for pain (4)
Definition
- NSAIDS
- anti-convulsants
- opioids
- anti-depressants
Term
referred pain: definition
Definition
pain originates in one place, perceived in another
Term
AKA intractable pain
Definition
chronic pain
Term
AKA nociceptive pain
Definition
acute pain
Term
AKA chronic pain
Definition
neuropathic pain
Term
Used to rate pain in children 3-7. Uses pictures
Definition
Wong-Bakker
Term
Used to rate pain in children under 3
Definition
FLACC
Term
Allows patient to control their own pain medication
Definition
PCA pump
Term
Pain: nursing interventions (6)
Definition
- backrub/massage
- hot/cold treatment
- position changes
- bath
- distraction
- music
Term
pre-op nursing care (5)
Definition
- patient teaching
- family support
- NPO
- meds and foods to DC 7 days (bleeding)
- pre-op meds (narcotics, drying agents, antibiotics)
Term
Intestinal surgery: meds given pre-op (2)
Definition
- enema with neomycin
- GoLYTELY
Term
Post-op: nursing (6)
Definition
- meds preventing pulmonary embolism
- Lovenox
- NOT atropine
- watch for dehiscence/evisceration/infecion
- turn
- cough/deep breathe
Term
Type of surgeries (4)
Definition
- elective
- required
- urgent
- emergency
Term
anesthesia: types
Definition
general - out cold
local - treated area numbed
Term
urinary retention: s/sx (4)
Definition
- retention 6-8 hrs
- dribbling small amounts
- distended bladder after voiding
- urgency after voiding
Term
shock: s/sx (7)
Definition
- hypertension
- tachycardia
- cold/clammy skin
- hypothermia
- low ox sat
- ear ringing
- difficulty seeing
Term
hemorrhage: s/sx (4)
Definition
- bruises
- constant swallowing
- bleeding gums
- melena
Term
hypoxia: s/sx (7)
Definition
- SOB/dyspnea
- tachycardia
- mild BP increase
- confusion
- cool, moist skin
- drowsiness
- cyanosis
Term
post-op O2 sat range
Definition
>95%
Term
hypothermia: definition
Definition
core body temp below 97.5
Term
hypothermia: interventions
Definition
keep client warm
Term
paralytic ilius: prevention
Definition
ambulation
Term
atelectysis: prevention
Definition
ambulation
Term
pulmonary embolism: usual cause
Definition
fat embolism
Term
normally observed in collection chamber
Definition
steady drip of fluid
Term
normally observed in water seal chamber
Definition
fluctuation of water in rhythm with breathing
Term
normally observed in suction chamber
Definition
gentle bubbling
Term
Embolism: medications given
Definition
- thrombolytic
- heparin
Term
DVT prevention (3)
Definition
- ambulation
- TED hose
- sequential compression
Term
How does a malignant tumor differ from a benign tumor? (5)
Definition
- may be life-threatening - fast growth - non-encapsulated - anaplastic cells - matastesis
Term
position for a patient getting a throacentesis
Definition
orthopnic
Term
Cancer grading criteria (staging)
Definition
- size (T)
- affected nodes (N)
- metastesis (M)
Term
Cervical cancer: when to begin testing
Definition
age 21 or within 3 yrs sexual activity
Term
PAP smear: frequency and when to begin
Definition
every 2-3yrs after age 30
Term
Breast cancer: age to begin mammograms
Definition
age 40
Term
colon/rectal cancer: when to begin testing
Definition
age 50
Term
Occult blood test: frequency
Definition
annual
Term
occult blood test: when to begin
Definition
age 50
Term
flexible sigmoidoscopy: frequency
Definition
every 5 years
Term
double-contrast barium enema: frequency
Definition
every 5 years
Term
colonoscopy: frequency
Definition
every 10 years
Term
clinical breast exam: frequency and when to begin
Definition
every 3 years after age 20
Term
clinical breast exam: when to begin annual testing
Definition
age 40
Term
when to stop PAP tests
Definition
after age 70 AND 3 straight clean tests
Term
endometrial uterine cancer tests: how often and when started
Definition
annually after age 35
Term
Prostrate cancer screening: when begun
Definition
age 50 OR
age 45 if high risk (African)
Term
considered tumor markers (5)
Definition
- PSA
- CA125
- Oncofetal proteins
- CEA
- Philadelphia chromosome
Term
Amputation: nursing diagnosis
Definition
disturbed body image
Term
epistaxis: treatment
Definition
- lean forward
- pinch bridge of nose
- ice on sinus area
- prevent swallowing blood (hemophagia)
Term
Why are alveoli and pulmonary capillaries made of squamous epithelium?
Definition
squamous alveolar cells are responsible for gas exchange in the alveoli
Term
What is found in alveoli?
Definition
Epithelial cells that produce surfactant.
Term
Result of air pressure building in the chest (AKA pneumothorax)
Definition
Possible cause of lung collapse
Term
Why are alveoli and pulmonary capillaries made of squamous epithelium?
Definition
squamous alveolar cells are responsible for gas exchange in the alveoli
Term
What is found in alveoli?
Definition
Epithelial cells that produce surfactant.
Term
Result of air pressure building in the chest (AKA pneumothorax)
Definition
Possible cause of lung collapse
Term
Location of chemo-receptors
Definition
On the ventrolateral surface of the medulla.
Term
May cause decreased total lung capacity
Definition
possible lung effect of atelectasis, pneumonia.
Term
What is normal PCO2?
Definition
35 - 45
Term
What is the normal lung pH?
Definition
7.35 - 7.45
Term
How does surfactant prevent the alveolar walls from collapsing?
Definition
A mixture of phospholipids (ie, lecithin & sphingomyelin). Acts to break up surface tension in pulmonary fluids to reduce friction
Term
What does a low PCO2 indicate
Definition
Alkaline environment in the lung. Breathing will be fast.
Term
Respiratory alkalosis symptom
Definition
Breathing faster than normal
Term
What makes us breathe?
Definition
CO2
Term
What are the protective respiratory reflexes
Definition
Coughing, sneezing, yawning
Term
normal respiration, 12-20 RPM
Definition
Eupnea
Term
What is ciliated epithelium and what does it do?
Definition
Hairlike tissue. It assists in removing dust particles and other unwanted foreign bodies that have entered the air passages.
Term
How is the trachea kept open?
Definition
Horseshoe-shaped cartilaginous rings, known as the tracheal windpipe.
Term
Cause of respiratory alkalosis
Definition
Hyperventilation, excessively rapid deep breathing.
Term
CO2 affects pH how?
Definition
It reacts with water to form carbonic acid. This acid breaks down into H+ and HCO3-, which buffer the system and maintain pH levels.
Term
Where and what are the palatine tonsils
Definition
Located posterially on each side of the oral cavity. Destroys foreign substances that are inhaled or ingested. Commonly removed in a tonsillectomy
Term
laryngopharynx
Definition
It extends from the epiglottis to the openings of the larynx and esophagus Separates passageways for food and air.
Term
Major portion of the brain controlling respiration
Definition
Medulla (specifically the pons)
Term
How do we exchange CO2 and O2
Definition
Oxygenated blood passes through the walls of the alveoli into lung capillaries, where the exchange occurs.
Term
What prevents friction in pleural membrane?
Definition
Serous lubricating fluid, is excreted by the pleura
Term
parietal pleura and visceral pleura
Definition
Serous membranes that cover lung
Term
Why we yawn
Definition
lack of oxygen (or accumulation of CO2). Equalizes pressure between middle and outside atmosphere, to help maintain balance.
Term
tubinates
Definition
Three small bones that increase the nasal mucosa surface area
Term
volume of air inhaled and exhaled with each breath
Definition
Tidal volume
Term
Where do most foreign substances aspirate?
Definition
To the right lung
Term
volume of air in lungs after a maximum inspiration
Definition
Total lung capacity
Term
Where is air moistened and warmed?
Definition
Turbianates or conchae
Term
Function of epiglottis
Definition
When swallowing, it covers the entrance to the larynx to prevent food and drink from entering the windpipe.
Term
nasal septum
Definition
a structure consisting of bone and cartilage, divides the internal nose into two sides or cavities.
Term
What does a high PCO2 indicate
Definition
acid environment in the lung. Breathing will be slow.
Term
residual air
Definition
air that remains in the lungs after exhaling.
Term
What helps in warming the air
Definition
blood vessels in the nasal cavity
Term
tiny hair-like projections on the membranes
Definition
cilia
Term
Causes of respiratory acidosis
Definition
emphysema, severe pneumonia, asthma, pulmonary edema.
Term
What guards the larynx opening
Definition
epiglottis
Term
Protective mechanisms of upper airway
Definition
epiglottis, trachea
Term
nasal pharynx
Definition
extends from the nares to uvula. Passageway for air only.
Term
Names of brain cavities
Definition
frontal sinus, maxillary sinus, ethmoidal sinus, sphenoidal sinus
Term
external respiration
Definition
gas exchange at the lung level
Term
Cellular (internal) respiration
Definition
gas exchange within the cells
Term
Surfactant: What is its function
Definition
helps prevent the alveolar walls from collapsing between breaths
Term
What can cause decreased residual lung capacity?
Definition
lung effect of ARDS - Acute Respiratory Distress Syndrome.
Term
What can cause decreased vital lung capacity?
Definition
may be found in neuromuscular disease, generalized fatigue, pulmonary edema, COPD, atelectasis.
Term
Know parts of pharynx (especially food-related)
Definition
nasal pharynx, oral pharynx, laryngeal pharynx.
Term
Eupnea
Definition
normal respiration, 12-20 RPM
Term
Nares
Definition
nostrils
Term
Serous membranes that covers lung
Definition
parietal pleura and visceral pleura
Term
Oral pharynx
Definition
part of the pharynx extending from the uvula to the epiglottis. Also known as the throat.
Term
air that remains in the lungs after exhaling.
Definition
residual air
Term
Respiratory acidosis symptom
Definition
respiration slower than normal
Term
How many lobes of each lung
Definition
three in right, two in left
Term
Cilia
Definition
tiny hair-like projections) on the membranes
Term
Three small bones that increase the nasal mucosa surface area
Definition
tubinates
Term
Name the serous membrane covering the lung tissue
Definition
visceral pleura
Term
Total lung capacity
Definition
volume of air in lungs after a maximum inspiration
Term
Tidal volume
Definition
volume of air inhaled and exhaled with each breath
Term
On the ventrolateral surface of the medulla.
Definition
Location of chemo-receptors
Term
The nasolacrimal ducts, or tear ducts
Definition
from the eyes, open into the upper nasal cavities, thereby causing the “runny nose” that often accompanies crying.
Term
from the eyes, open into the upper nasal cavities, thereby causing the “runny nose” that often accompanies crying.
Definition
The nasolacrimal ducts, or tear ducts
Term
located in the posterior wall of the nasopharynx and, along with the tonsils, assist the body in its immune response to foreign invaders
Definition
The adenoids
Term
The adenoids
Definition
located in the posterior wall of the nasopharynx and, along with the tonsils, assist the body in its immune response to foreign invaders
Term
transports food from the pharynx to the stomach
Definition
esophagus
Term
esophagus
Definition
transports food from the pharynx to the stomach
Term
These microscopic “balloons” give the lungs their spongy appearance
Definition
alveoli
Term
mediastinum
Definition
the area lying between the lungs in the thorax
Term
the area lying between the lungs in the thorax
Definition
mediastinum
Term
Premature newborns may suffer from respiratory distress syndrome for this reason.
Definition
This may happen because surfactant does not form until after the seventh month of gestation.
Term
This may happen because surfactant does not form until after the seventh month of gestation.
Definition
Premature newborns may suffer from respiratory distress syndrome for this reason.
Term
a smooth double-layered sac of serous membrane in the lower respiratory tract
Definition
pleura
Term
pleura
Definition
a smooth double-layered sac of serous membrane in the lower respiratory tract
Term
sac of serous membrane lining the chest cavity
Definition
Parietal pleura
Term
Parietal pleura
Definition
sac of serous membrane lining the chest cavity
Term
sac of serous membrane covering the lungs
Definition
visceral pleura
Term
visceral pleura
Definition
sac of serous membrane covering the lungs
Term
pleural cavity or pleural space
Definition
The space between the two layers of the pleura
Term
The space between the two layers of the pleura
Definition
pleural cavity or pleural space
Term
Phrenic nerve
Definition
conducts the breathing impulses.
Term
conducts the breathing impulses.
Definition
Phrenic nerve
Term
dome-shaped muscle separating the thoracic and abdominal cavities
Definition
diaphragm
Term
diaphragm
Definition
dome-shaped muscle separating the thoracic and abdominal cavities
Term
What is Surfactant?
Definition
a substance secreted by the great alveolar cells
Term
a substance secreted by the great alveolar cells
Definition
What is Surfactant?
Term
Who is most likely to require a high-calorie diet?
Definition
pneumonia
Term
CPR order
Definition
 establish unresponsiveness “Hey are you ok?”
 open airway
 check breathing,
 give breath,
 check carotid pulse
 do compressions
Term
Fire response (smoke in the utility room)
Definition
 Remove patients and close door to room
 Activate alarm
 Close doors/windows to the area,
 Extinguish the fire.
Term
Clostridium difficile is what kind of isolation?
Definition
 CONTACT
Term
Patient is weak right side, how should he use cane?
Definition
Cane in strong (left) hand, moving with weak (right) leg.
Term
Which area is injury most likely for IM injection?
Definition
Dorsogluteal
Term
Subjective vs objective information questions:
Definition
 If it can be verified by measurement (ie, patient eats ½ of meal), it is objective.
 “I feel warm” is subjective (How warm is warm?)
Term
O2 by mask on post-hemorrhoid surgery patient: Which way is best to take temp?
Definition
Tympanic
Term
Patient’s temp would be highest when?
Definition
Late afternoon.
Term
When would you be most worried about a dementia pt?
Definition
Night.
Term
Clear liquid diet, which one is not? (1) Ice cream (2) jello (3) tea (4) strong coffee
Definition
Ice cream
Term
35mg of lasix ordered for a patient, 50mg/ml available. How much do we put?
Definition
0.7 ml
Term
Salem sump (gastric tube) has air vents to
Definition
protect gastric mucosa
Term
Precautions for changing a dressing on an MRSA patient
Definition
gloves, gown, goggles.
Term
Of the following, what can CNA's do? (1)wound care (2)enemas (3)clean-catch urine (4)feed a CVA patient (5)give snacks
Definition

 

wound care - NO

enemas - NO

clean-catch urine - YES

feed a CVA patient - YES

give snacks - YES

 

Term
Apical/radial pulse:  Apical is 72, radial is 80, what do you do?
Definition
Repeat procedure – radial can’t be more than apical.
Term
Positioning for mouth care for unconscious patient?
Definition
Side-lying
Term
Patient complains of axillary pain while crutching.  What do you do?
Definition
Adjust height of crutches (too high) and teach client about use
Term

 

Can’t find brachial pulse. How do you verify brachial blood flow?

Definition
Radial pulse.
Term

Common sign of heat production

Definition
shivering
Term

 

About to give GT feeding.  Aspirating yields 90 ml of residual.  What do you do?

 

Definition
Return residual and give feeding.
Term

Who is most likely to have a decubitus ulcer?

Definition
COPD
Term

 In cleaning a crusty Foley catheter, soap and water does not work, what do you use?

Definition
hydrogen peroxide
Term

 

 What food has the most iron? (1)milk (2)eggs (3)meat (4)fish

 

Definition
Meat
Term
Pt. has osteoporosis, which vitamin would she most likely be deficient?
Definition
Vit. D
Term

Sign of vitamin K deficiency

Definition
Bleeding gums
Term
What can be counted as output, name all
Definition
Vomitus, urine, diarrhea
Term
Foley catheter insertion in order
Definition

-check patient MD order

-  sterile gloves

-  clean pt. perineum to groin

-  insert catheter until urine flash is witnessed

-inflate catheter cuff

Term
Client in SIMS position on left side.  What do you do with right arm?
Definition
Pillows
Term
Chest drainage system: What happens in a chest tube water chamber?
Definition
Fluctuation of water in sealed water chamber
Term
After giving medication through a nasogastric tube, what do you do?
Definition
Clamp NG tube for 30 minutes
Term
You drop a moistened sterile gauze on the edge of a sterile field, what do you do?
Definition
Leave dropped gauze where it is, get a new moistened sterile gauze and use that
Term
Confused patient gets frustrated, and keeps taking off his O2 mask, what do you do?
Definition
Use a nasal cannula
Term
Patient, confused, keeps trying to remove his indwelling Foley catheter, how do you restrain?
Definition
Mitts
Term
If giving 3ml  IM injection, which muscle don’t you use?  (1)dorsogluteal (2)ventrogluteal (3)deltoid (4)Vastus lateralis
Definition
deltoid
Term
A patient asks will my stage 3 decubitus ulcer leave a scar after it heals. Most appropriate answer is:
Definition
Wounds like this will most likely leave a scar
Term
An obese patient, wearing an abdominal binder post abdominal surgery, asks nurse “why am I wearing this?
Definition
"The binder will put less pressure on your sutures."
Term
A wound healing by second intention, what kind of dressing will most likely be ordered?
Definition
wet to dry dressing
Term
What is the purpose of a wet to dry dressing?
Definition
debridement of old, dead tissue
Term

A patient has a 3rd stage decubitus ulcer, what kind of order would you expect from the MD for its daily care?

Definition
debride the wound
Term
What is the purpose of the Advance Directive?
Definition
Patient maintains right to end-of-life decisions.
Term
A pt. with dyspnea with a fruity breath odor has a blood sugar tested at 700, he is most likely experiencing what kind of respiration?
Definition
Kussmaul’s
Term
Why does specimen for Ova and Parasite testing need to be sent ASAP?
Definition
Bugs in the specimen may die quickly.
Term
You believe that a pt is choking, what is your first intervention?
Definition
check for verbal sounds
Term
Terminal patient in last stages, has type of breathing with periods of apnea. What type of breathing is it?
Definition
Cheyne-Stokes
Term
What vital signs need attention
Definition
rectal temp 102.3
Term
Normal pulse for newborn?
Definition
120
Term
Which bp will be the cause of most concern?
Definition
140/60
Term
How do you check for subcutaneous emphysema?
Definition
Palpate chest suprasternally for  crackling sound of “air bubbles.”
Term
What is the best angle for an intradermal injection
Definition
15 degrees**
Term
Abdominal sq heparin injection parameters:
Definition

90 degrees of entry angle

1-2ml Max.

45-90 degrees

5/8 - 1 in

Term
When changing a colostomy bag, what is most important?
Definition
Assure you have the proper hole size
Term
Best way to prevent nosocomial infections in a facility
Definition
Hand washing between every pt.
Term
Cooling blanket is ordered for a patient who is hyperthermic. Nurses know that cooling blankets cool a patient by way of:
Definition
conduction
Term
Salem sump tubes have air vents to?
Definition
Prevent damage to stomach mucosa
Term
Question regarding blood clots and constricted limb.  What's the first sign?
Definition
Pain.
Term
Tube feeding, what is best position?
Definition

Bed at 45-degree angle.

Term
A patient’s O2 level drops down to 60%, what is the FIRST thing a nurse does?
Definition
Raise the patient’s head.
Term
O2 monitor alarm going off while patient chatting with family.  What do you do?
Definition
If patient appears OK, move monitor to another finger.
Term
IM injection parameters
Definition

1 1/2 - 2 inch needle

20-22 guage

90 degrees

 

Term
Tube feeding:  Residual = 120mL.  What do you do?
Definition
Return residual.  Stop feeding and wait for 30-60 minutes.  If residual does not decrease, contact charge nurse/MD
Term
What is the purpose of purse-lipped breathing?
Definition
Opens the alveoli to improve respiration.
Term
How to give care for chest tube
Definition

1)Assess for respiratory distress and chest pain, breath sounds over affected lung area, vital signs

2) Obdserve for increased respiratory distress

3) Observe/maintain chest tube patency

4)keep tube free of kinks, dependent loops or clots

5)keep drainage system upright and below level of tube insertion.

Term
Signs/symptoms of hyperthermia
Definition

Hot, dry skin

Low BP

Fainting/dizziness

Tachycardia

Tachypnea

Term
Purpose of antitussive
Definition
cough supressant.
Term

pH that is most consistent with stomach aspirate:

8.4

7.4

7.0

4.0

Definition
4.0
Term
Why are alveoli and pulmonary capillaries made of squamous epithelium?
Definition
squamous alveolar cells are responsible for gas exchange in the alveoli
Term
What is found in alveoli?
Definition
Epithelial cells that produce surfactant.
Term
Result of air pressure building in the chest (AKA pneumothorax)
Definition
Possible cause of lung collapse
Term
Location of chemo-receptors
Definition
On the ventrolateral surface of the medulla.
Term
May cause decreased total lung capacity
Definition
possible lung effect of atelectasis, pneumonia.
Term
What is normal PCO2?
Definition
35 - 45
Term
What is the normal lung pH?
Definition
7.35 - 7.45
Term
How does surfactant prevent the alveolar walls from collapsing?
Definition
A mixture of phospholipids (ie, lecithin & sphingomyelin). Acts to break up surface tension in pulmonary fluids to reduce friction
Term
What does a low PCO2 indicate
Definition
Alkaline environment in the lung. Breathing will be fast.
Term
Respiratory alkalosis symptom
Definition
Breathing faster than normal
Term
What makes us breathe?
Definition
CO2
Term
What are the protective respiratory reflexes
Definition
Coughing, sneezing, yawning
Term
normal respiration, 12-20 RPM
Definition
Eupnea
Term
What is ciliated epithelium and what does it do?
Definition
Hairlike tissue. It assists in removing dust particles and other unwanted foreign bodies that have entered the air passages.
Term
How is the trachea kept open?
Definition
Horseshoe-shaped cartilaginous rings, known as the tracheal windpipe.
Term
Cause of respiratory alkalosis
Definition
Hyperventilation, excessively rapid deep breathing.
Term
CO2 affects pH how?
Definition
It reacts with water to form carbonic acid. This acid breaks down into H+ and HCO3-