question

BUN

answer

5 - 20 Too high = renal failure

question

CREATININE

answer

.6 - 1.3. Too high = renal failure

question

TSH adult level

answer

.25 - 4.30 High - Hypothyroid Low - Hyperthyroid

question

Cholesterol

answer

> 200. = Hyperlipidemia

question

HDL-C

answer

.40 - 7. Low = Lipid disorder

question

LDL

answer

65 - 100 High = Lipid disorder

question

Criteria for Dx of Diabetes

answer

Fasting BS >126 on 2 separate occasions or 2 hour BS > 200 during oral glucose test or Sx of diabetes + random BS >200

question

Symptoms of diabetes

answer

Polyuria Polydipsia Hyperglycemia Unexplained weight loss

question

Do not collect fecal occult blood if ...

answer

Rectal bleeding Hematuria Menstruation

question

7 days prior to colonoscopy avoid ...

answer

ASA - NSAIDS - Steroids - iron supplements

question

5 days prior to colonoscopy avoid ...

answer

Vitamin C, both dietary and supplements

question

3 days prior to colonoscopy avoid ...

answer

Red meat - broccoli - cauliflower - black grapes - raw fruit and vegetables

question

Triage / assessment of terminal illness

answer

Emotional Social support Perception of illness / disease ADL's Change in problem solving Change in lifestyle / financial S/sx depression and anxiety

question

Psychosocial intervention for terminally ill patients

answer

Decrease anxiety Promote coping End-of-life choices Palliative care Hospice care

question

COPD - chronic obstruction of airflow in and out Pulmonary emphysema Chronic bronchitis Asthma

answer

Treatment Nursing interventions Position, sit up, lean forward Frequent rest Nebulization Pulmonary toilet IPPB O2

question

CHF

answer

Treatment Nursing interventions Reduce pain and anxiety Improve oxygenation Reduce congestion Improve Myocardial contraction

question

MS Multiple Sclerosis Teaching Plan Readmission / Exacerbation

answer

Define readmission and exacerbation Safety precautions Medication including SEs and OTC interaction Exercise to promote strength and mobility Self manage bowel / bladder / catherization

question

MS Exacerbation reasons

answer

Infection, trauma, immunization, childbirth, stress, climate changes

question

MS community resources

answer

MS society, public health nurse, home health, support groups, vocational rehab service, Social workers, therapists, SNFs and financial counseling.

question

MS safety precautions

answer

Consider : Decreased sensation, visual disturbances, motor deficits

question

MS medications

answer

Corticosteroids, immunomodulators, cholinergics, anticholinergics, muscle relaxers

question

MS excercises

answer

Prevent contractures and skin breakdown, transfer techniques, body mechanics and use of assistive devices

question

MS bowel and bladder

answer

Risk for constipation, UTI and urinary retention

question

HIV Transmission

answer

Sex, parenteral exposure to blood/blood products Perinatal exposure and breast milk

question

Before 12 weeks of age

answer

Any fever over 101 is emergency

question

Gout

answer

Apply cold

question

Immunization site swelling and pain

answer

Apply cold

question

Amoxicillin rash

answer

Side effect only, not an allergy, no treatment

question

Hypertension

answer

140/90 Home care 150/100 See in 2 weeks 160/110 See in 3 days 180/120 See in 24 hours >180/120 ED

question

Fever without cause

answer

No longer than 24 hours

question

Fever with associated symptom

answer

...

question

Patient needs are UNHEALTHFUL responses

answer

Unhealthy responses

question

Patient strengths are HEALTHFUL responses

answer

Healthy responses

question

Child and adolescent screening

answer

Newborn metabolic devlopment & behavior High BP Genetic anemia Blood lead level Vision Hearing Dental Lipid disorders Scoliosis Depression Chlamydia, STD's Alcohol use Tobacco use Violence Cervical Cancer Sickle Cell and PKU

question

Sickle cell screening mandated in ____ states

answer

all 50

question

Sickle cell affects 1 in ____ African American newborns

answer

375

question

MDD - Major Depressive Disorder symptoms

answer

sadness, irritable, loss of interest, social isolation, anger, sleep and appetite disturbances, non-specific pain

question

MDD present when sx cluster together and persist for ___ weeks or more

answer

2

question

PHQ-A

answer

Patient Health Questionnaire for Adolescents

question

BDI-PC

answer

Beck Depression Inventory - Primary Care Version

question

Live, attenuated vaccine

answer

Cultured under conditions which disable their virulent properties or use closely-related but less dangerous organisms

question

Inactivated vaccine

answer

Contain toxoids, protein subunits, conjugate bacteria polysaccharide outer coats or killed organsms.

question

Immunization Early childhood Hepatitis B by age 2

answer

3

question

Immunization Early childhood Rotovirus (live) by age 2

answer

3

question

Immunization Early childhood Tdap by age 2

answer

by age two - 4 doses age four - 1 dose

question

Immunization Early childhood Hib (Haemophilus influenza bype B) by age 2

answer

3-4

question

Immunization Early childhood Pneumonia by age 2

answer

4

question

Immunization Early childhood IPV (inactivated polio) by age 2

answer

by age two - 3 age four - 1 dose

question

Early childhood immunization MMR (live) by age 2

answer

by age two - 1 age four - 1

question

Immunization Early childhood Influenza (live or inactivated) by age 2

answer

Yearly after 6 months

question

Immunization early childhood VZV (Varicella) live by age 2

answer

1

question

Immunization Early childhood Hepatitis A by age 2

answer

2

question

Immunization Early childhood given at age 4

answer

Tdap - Tet., Diphtheria, Pertussis IPV - Inactivated Polio MMR - Measles, Mumps, Rubella Varicella - Chicken Pox

question

Immunization Late childhood given at age 7-10

answer

Tdap

question

Immunization Late childhood given age 11-12 (females)

answer

HPV - 3 doses (female) Meningococcal - 1 dose Pneumonia - 1 (if high risk) Hepatitis A - 1 (if high risk) HepB, IPV, MMR, VZV catch up

question

National Childhood Vaccine Injury Act of 1986

answer

Report adverse events to Dept of Health & Human Services If acquired through public purchase, report to local, county &/or states health departments

question

Adult Screenings

answer

Depression Prostate Ca Obesity Breast Ca Osteoporosis Cervical Ca Dementia Blood Pressure Vision Lipids Hearing Diabetes Violence STD's Alcohol misuse

question

BMI

answer

Weight in kg / Height ...

question

BMI normal

answer

18.5 - 24.9

question

BMI overweight

answer

25.0 - 29.9

question

BMI obese

answer

30.0 - 39.9

question

BMI extreme obese

answer

>40

question

Immunization Adult - 2010

answer

Tdap - one every 10 years Flu - all ages > 6 months Zoster - 1 dose 60 years HPV - 3 doses Females 13 - 26 years Males 9 - 26 years

question

Immunization Adult Catch up

answer

MMR - during or after 1957 1 dose Varicella - 2 doses if no immunity Meningococcal - 1st year in dorm - others at risk

question

Immunization Adult high risk

answer

Pneumonia - max 2 in lifetime Hep A - not vaccinated, 2 doses Hep B - not vaccinated, 3 doses

question

Adult Screening - Alcohol Misuse

answer

Risky or Hazardous drinking Women >7/week, >4 per party Men >14/week, >4 per party Harmful drinking - physical, social or psych harm but not dependence

question

Adult Screening Alcohol Risky/hazardous drinking

answer

Women >7/week, >4 per party Men >14/week, >4 per party

question

Adult Screening Alcohol Harmful drinking

answer

Physical, social or psych harm but not dependence

question

Adult Screening Alcohol Tools

answer

National Institute on Alcohol Abuse and Alcoholism niaaa.nih.gov/Publications/AlcoholResearch/

question

Medical Emergencies

answer

Staff roles Skills (BLS, ACLS, PALS) Competency assessment (drills) Age-specific equipment and meds

question

Medical Emergency - CAB 1. Chest compression 2. Airway 3. Breathing

answer

Check responsiveness Check breathing Call for help Check for pulse 10 seconds only Give 30 chest compressions Open airway & give 2 breaths Resume compressions

question

HIV Course of infection

answer

Mono-like syndrome Asymptomatic seropositivity Symptomatic seropositivity

question

HIV Prognosis

answer

Strong correlation w/CD4 cell count Inversely related to HIV load

question

HIV Management

answer

Anti-retrovirals Prevent opportunistic infection No live virus vaccines Counseling

question

Normal test values HgB

answer

Men 13.5 - 16.5 g/dL Women 12.0 - 15.0 g/dL

question

Normal test values Hct

answer

Men 41 - 50% Women 36-44%

question

Normal test values Sodium

answer

135 - 145 mEq/L

question

Normal test values Calcium

answer

8.5 - 10.5mEq/L

question

Normal test values Magnesium

answer

1.7 - 2.3mEq/L

question

Normal test values Potassium

answer

3.5 - 5.5 mEq/l

question

EKG lead placement

answer

...

question

Head circumference

answer

...

question

Vision - Snellen chart

answer

Snellen at 20 feet, anything >20/40 needs eye doctor

question

Blood Pressure Measurement

answer

Cuff encircles 80 - 100% of arm Width 40% of circumference Bare arm Pump to 30mm Hg above radial pulse disappearance Release pressure 2-3 mm Hg/sec First 2 consecutive sounds Systolic Disappearance of sounds Diastolic

question

Peak Flow Meter

answer

Green 80-100% good control Yellow 50-80% caution, take quick relief med and seek care Red <50% danger, take med and seek emergency care if not returned to yellow or green immediately

question

Pulse Ox

answer

Arterial oxygen sat Leave on 75 seconds Normal >95% Critical <93%

question

Mammogram

answer

Every 1-2 years age 50 - 74

question

Pap smears

answer

Women with cervix - 3 years after becoming sexually active or age 21 Until 2-3 consecutive are normal, then every 3 years

question

Colorectal screening

answer

Fecal Occult Blood test q 3 yrs Flex sigmoid q 5 years w/ high sensitivity Fecal Occult Blood test. Colonoscopy q 10 years

question

Telephone Triage

answer

Interactive process between nurse and client involving id of the nature and urgency of the problem and determination of the appropriate disposition

question

Telephone Triage Guideline

answer

Directs in developing individual plan of care. Flexible but retains a standard of care Practice that allows some discretion in interpretation, implementation or use. Allows for nursing judgement Disadvantage is potential lack of consistency in implementation Decision-support tools based on pattern recognition, encouraging RN to use critical thinking, context and pattern matching to determine disposition.

question

Telephone Triage Protocol

answer

Plan for carrying out treatment. Actions are scripted, to be FOLLOW WITHOUT DEVIATION Best matches presenting problem Select the one that has highest likelihood of leading to appt. Ask patient what is most bothersome

question

Telephone Triage Algorithm

answer

Rules for solving problem in finite number of steps. Flow chart of questions guiding decisions in step-by-step logical sequence.

question

Telephone Triage Decision Making Tools

answer

Follow rigidly by yes/no answers to reach final disposition e.g. Protocols Require clinic thinking

question

Telephone Triage

answer

Why use Protocols? Standardization and structure Provides safe, effective care and appropriate disposition Eliminates common practice errors Provided legal protection Ease of documentation, efficiency & retrievability Meets accreditation standards

question

Telephone Triage Disposition

answer

Emergent 911 or ED Urgent ASAP 1-8 hrs Acute 8-24 hrs or next day Non-acute Phone advice ERR ON SIDE OF CAUTION

question

Telephone Triage Legal Issue

answer

Formal Nurse-Patient Relationship Maintain scope of practice Safeguards - Protocols Documentation Quality Assurance Accountability

question

Telephone Triage Legal Risk

answer

3 R's Right care, place, time Consistency Formal training Adequate resources and protocols Written assessment Documentation Quality Improvment program Compliance to License Compact

question

Normal Lab values Chloride

answer

85 - 115 mEq/l

question

Normal Lab values Bicarbonate

answer

22 - 29 mEq/l

question

Normal Lab values WBC

answer

4.5 - 11/cu mm

question

Normal Lab values RBC

answer

Female 4.2 - 5.4 million / cu mm Male 4.6 - 6.2 million / cu mm

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