question

Abdominal Aortic Aneurysm (AAA)

answer

Priority is to prevent intra abdominal pressure, to prevent rupture of aneurysm - Do not elevate legs above heart level, increase heart volume & pressure & can lead to rupture - Don't lift heavy objects, increase abdominal pressure - Use proper lifting techniques - Increase fluids & fiber to prevent constipation & bowl strains which will cause rupture

question

Myasthenia Gravis

answer

Nerve impulse of motor movements are damaged - Tired/fatigued easily, improves with rest - Moving becomes difficult, muscle weakness that improves with rest & worst with over exercion - Ptosis (dropling of the eyelids), dysphagia, imparied speech and diplopia can occur - Rigidity or gain all seen with Parkinson not MGravis

question

Light Protected Medications with Foil

answer

- Nitropress - Amphotericin

question

Central venous catheters including PICCs

answer

- Must be done using sterile technique; this would include cap, mask, sterile gloves, sterile gown, and a large sterile sheet - Insertion site, some use transparent dressing and some sterile gauze dressing while taping down all 4 corners

question

Newborn Examinatio

answer

- The left side of the newborn's face is drooping, normal maybe 7th nerve paralysis, should disappear within 3 weeks, or maybe permanent - The newborn's uvula has two lobes, indicates clef palate- check sucking ability, hard & soft palate - The newborn's ears are low-set bilaterally, indicates down syndrome - The red reflex is absent in the newborn's right eye, emergency- objects are not being transmitted on retina & can lead to blindness

question

Precipitous Labor- Risk Factors- Complications

answer

Fast, short labor that begins & ends all within 3 hours Risk Factors - Multiple pregnancies, history of short labor, small fetus Complications - Early post partum hemorrhage, amniotic fluid embolism Need to monitor patient carefully, priority

question

Newborn of alcoholism & drug abuse mother- Short & long

answer

Must assess newborn for short & long term withdrawl symptoms Short - Irritable, jittery, poor feeding, diarrhea, hyperextend when held, crying, malnourshied (feed with Vit B complex), poor sucking & feeding, SGA, small head circumference, low birth weight Long Term (Fetal Alcohol Syndrome)

question

Ventilators & Ambu Bags

answer

If ventilators fail they use ambu bags to continue manual ventilation

question

NG Tube Feeding Guide

answer

- Elevate HOB (aspiration) - Aspirate before feeding- Insures correct placement of tube in stomach - Warm food, prevents cramps - Feed for at least 30 minutes - Clamp tube proximal, to prevent air from entering tubing

question

LOA- FHR

answer

Indicates Vertix position - FHR heard best left of the pubis, under the umbilicus

question

Weaning off TPN- Solution

answer

Use hypertonic Dextrose to wean patients off TPN, prevents hypoglycemia

question

Adriamycin

answer

Chemo drug used to treat Leukemia Expected Side Effects - Red urine 1-2 days after use - Stomatitis (ulceration in the mouth), 5-10 days after use- Good mouth care with water, use sponge brush after eating & drinking - Alopecia- Avoid too much shampooing, brushing hair & blow dryer Report to Doctor - Bone marrow suppression - Sore throat - Fever - Infection

question

Diverticulosis- Foods to avoid

answer

Seeds, nuts, corn, pop corn, cucumber, tomato, strawberry, figs,

question

Lithium Carbonate

answer

Lithium is used for Bipolar, antimanic medication Theraputic levels are reached after 7-14 days of use Values Normal- 0.5-1.2 Theraputic- 1-1.5 Toxic- 1.5 or above Expected Side effects- Normal - Polyuria, thirst, dry mouth, atexia (hand tremors) Toxic Side Effects- Report - Slurred speech, muscle weakness, N/V, diarrhea Diet - Normal diet, normal sodium, more fluids (2-3 Liters)

question

Child & Immunization- Normal vs Not normal Reactions

answer

Normal Reaction- hours or few days - Low grade fever, irritability, reaction at injection site Not Normal - High fever, N/V, screaming, LOC Don't administer immunization if child has history of reactions

question

Topamax

answer

Anti convulsion Medication Side Effects - Can cause kidney stones- Drink 2-3 Liters - Hypotention- Stand slowly Can't be taken with hormone contraceptives, non hormone has to be used

question

Ear irrigation & Ear solutions

answer

Ear irrigation is contraindicated with foods like pasta, beans, penuts Ear solution should room temp, not cold or hot. Will cause pain, N/V, vertigo

question

Plaster Cast Care

answer

Assess - check temperature, color, sensation; pulse, cap refill, paleness, pain, blueness, numbness or tingling - Avoid covering the cast until dry (48 hours) - Handle with palms, not fingertips, don't rest on hard surfaces; elevate affected limb above heart on soft surface until dry (pillow) - Don't use heatlamp; if present, - Child should remain inactive while cast is drying- 48 hours

question

Assessment, when started on ventilator

answer

When pt/ is started on a ventilator, Cardiac Output decrease and will cause hypotention. Monitor Blood Pressure - Respiration is controlled by machine no need to check

question

Contraindications to Influenza, Dye, & MMR-Varicrlla-IPV

answer

Influenza- Allergy to Eggs Dye- Allergy to shellfish & iodine MMR, varicella, IPV- Allergy to Neomycin

question

Tagamet

answer

Histamin blocker used for Peptic Ulcer Disease (PUD) - Small Frequent meals are not required, 3 large meals is better Avoid foods /drinks that cause reflex - Aspirin, coffee( decaf or regular), Cream, milk, carbonated drinks, stimulants, alcohol Continue to use medication until prescription is over, don't stop when symptom free

question

CVA- Left Sided, Right sided, Brain Stem

answer

Left Side Controls - Speech, language, math, thinking, concentration, reasoning, problem solving, numbers - Personality change Right Sided - Impulse, imagine, emotions, place, time, person, creative, color, music Brain Stem - Voluntary Bladder & bowl

question

Barium Enema- Procedure

answer

Instruct pt. to take a slow deep breath through the mouth as the nurse inserts the barium, it help pt. not defecate

question

Potassium Rich Foods

answer

- Potato, cantaloupe, spinach, broccoli, orange, banana, avocados, tuna, beets

question

Inderal- OLOL

answer

Beta blocker used for hypertension as an antihypertension medication Side Effects - Bradycardia, brochospasms, Orthostatic hypotention Contraindicated - Diabetics- masks hypoglycemia s&s like tachycardia - Asthmatic patients - Heart problems & pulmonary edema Discontinue Gradually - Tachycardia, malaise , diaphorisis

question

TPN- Changing Procedure

answer

TPN should be hang no more than 24 hours at a time - Discard anything left over when 24 hrs is up - Change TPN tubing & filter every 24 hours - Change catheter insertion site every 4 weeks Don't speed up the solution, cause hyper glycemia Don't slow the infusion, cause rebound hypo glycemia

question

Albuterol & Vanceril

answer

Inhale medications used for asthma Albuterol, causes the brocho dilatation & vanceril is the steroid - Must take albuterol first to open airway & than wait 1-5 minutes & than Vanceril - Albuterol is used when your having symptoms & Vanceril is used to prevent symptoms Side Effects Albuterol - Tachycardia, hand tremors, headache, hyperactivity Side Effects of Vanceril - Dry mouth, fungal infection, stomatisis, sore throat - Rinse mouth with water after eating & drinking

question

Infants with Cows Milk Allergy

answer

- Can't use cows milk, goats milk, yugart, or soy milk - Must use predigested formulas Yugart can be used for anyone who is lactose intolerance because yugart does not have lactose, but can't be used for an infant who is allergic to cows milk

question

Insulin- Onsets & Peaks

answer

Short- Lispro- Onset- 5-15 min Rapid- R- Onset-30-60 min, Peak- 2-3 hrs Inter- NPH- Onset- 2-4 hrs, Peak- 6-12 Hrs Long- Lantus- No peaks- Contentious Hypoglycemia occurs at Onset times & Peak Times

question

Colostomy Care for Odor & Gas

answer

- Place peppermint inside pouch Avoid Foods with Gas -onions, gum, beer, smocking, skipping meals, beans, cucumber Foods that are good - Yogurt, butter milk, cranberry juice, toast, crackers, parsley

question

Aids & Home Care

answer

- Can use same bathroom as family, Aids not in urine or feces unless has incontinent and diarrhea - Eat with family - Wash cloths with family, hot water & detergent destroys virus - Heavy soiled cloths with body fluid or blood, wash separate with bleach - Don't use same razor

question

Schizophrenia- Relationships

answer

Can't form relationships and don't trust others

question

Elevated serum antistreptolysin O (ASO) titer.

answer

Indicates glomerulonephritis

question

Dementia Patient Verbal Communication

answer

- Keep phrases simple & short - Allow plenty of time for them to complete task - Speak slowly & face to face with patient - Have a routine schedule

question

Contraindications to Thrombolytic Therapy - 10

answer

- Accident or trauma or surgery within the past 2 months - Internal bleeding, arteriovenous malformation, spinal or cranial surgery, uncontrolled hypertension, history of hemorrhagic stroke, intracranial neoplasm, aneurysm,,

question

Acute Epiglottitis- Signs? Treatment

answer

Leaning forward to get air, tongue out, drooling Treatment - Moist air - IV antibiotics - Apply oxygen probe to see levels of oxygen to know if oxygen therapy is needed

question

Antabuse

answer

Used to treat alcohol dependence - Take at night because has sedative effects - Can not be in contact with any form or any amount of alcohole ( even paint, wood stain, craft) any amount inhaled or through skin will cause a reaction - Shock & cardiac dysrhythmias

question

Chronic Pain- Lupus

answer

Patients will chronic pain son't show typical S&S of tissue injury pain - They are in pain, but you think they are not because don't show s&s

question

DVT Care

answer

Don't ambulate, bed rest for 5-7 days, because of pulmonary embolism (dislodge) - Keep leg elevated - Anti coagulation therapy - Apply warm moist packs

question

Liquid Medications & Sorbitol

answer

Liquid medications contain Sorbitol & cause diarrhea

question

Physiological Jaundice & Pathological Jaundice

answer

Physiological Jaundice - Occurs after 24 hrs of birth, peaks at 72 hrs and last for 5-7 days - Immature liver that can't clear bilirubin from the blood Pathological Jaundice - Occurs with first 24 hrs - Caused by mothers Rh blood killing immature RBC of the infant, incompatibility of bloods

question

Haldol

answer

Antipsychotic medication, like all antipsychotic meds can cause NMS NMS S&S - Fever - Muscle stiffness - Increase BP, Pulse, Respiration - Drooling

question

Defibrillation

answer

Jolts are 200, 300, 360 - Place pads securely on patient, the better on patient the less shock & resistance - Cream, gel, saline soaked gauze

question

Plasmapheresis

answer

Similar to hemodialysis, remove antibodies that may be causing the symptoms- used with Guillain-Barré syndrome Complications - Chills, hypothermia Important to offer warm blanket

question

Chronic Alcohol Abuser

answer

Priority because they are in danger of Hypo magnesia

question

Actions during a fracture injury

answer

Splint leg above & below the fracture, other leg can be used as a splint

question

Parkinson & speaking & speech Difficulty

answer

The same muscles that are used for speech & speaking are the same muscles used for swallowing - If patient is seen to have more difficult time speaking, you need to assess airway & swallowing because may be at risk for aspiration

question

Sleeping & Parkinson's

answer

Patients who have Parkinson must avoid flexing of neck & shoulder - It's best for them to sleep on a firm mattress without a pillow

question

Cane- Right Side Weakness

answer

Hold cane on opposite side (Left Side), move cane forward first followed by weak leg and than good leg

question

Stelazine

answer

Antipsychotic medication. - Contraindicated with breast feeding mothers - Cause dry mouth and eyes - Use artificial tears - Causes weight pain, so monitor calories

question

Post-Op Hip Replacement

answer

Goal- is to prevent dislocation & prevent DVT from forming - Pillow between legs, prevents Adduction & dislocation - Encourage fluid intake, prevents DVT - Assess for swelling, edema, pain, redness, hotness - Wear elastic stockings & perform leg exercises - Encourage Incentive Spirometer every 2 hrs Signs of Dislocation - Shortening of limb - Adduction

question

Pavlik Harness

answer

Used for childern with hip dysplasia, its a abduction harness that sometimes its worn for 23 hours a day even when you shower - Needs to be adjusted by doctor ever 1-2 weeks - Harness may be wron for 3-5 months - Baby wears knee socks to prevent skin break down

question

Digoxin

answer

0.75-1.25 in divided doses in 24 hours

question

Cholecystitis- Foods

answer

Foods high in fat & gas should be avoided

question

Clozapine

answer

Psychotic medication, that effects WBC -- Contraindicated in breast feeding mothers - If WBC are below 2000, drug will be stopped Side Effects - Decrease WBC - Lukopenia - Gram negative septecima - Tachycardia, hypotention, drowziness - Sore thoart & fever

question

Back pain & Driving

answer

Sit close to the pedals with back support. Far from the pedal will cause extension of the hips & legs & will cause more pain

question

Elavil

answer

Anti depressant medications - Takes 3-4 weeks for it to work - Photosensitivity, wear sunblock - Dry mouth, hypotension, weight gain, urinary retention, constipation, blurred vision - Stand slowly

question

Upper/Lower GI

answer

When barium enemas are ordered, lower GI is done first, because upper GI will change the results of lower GI if it's done first

question

PJP, Guillain-Barré syndrome, Cutaneous anthrax Precautiions

answer

Standard Precaution

question

PVD-Venous or Arterial- Position

answer

Avoid crossing the legs and constrictive clothing - Should sit with feet flat on the floor

question

Post tyroidectomy

answer

Monitor for tremors, twitching, hypocalcemia signs - May have removed parathyroid hormones

question

Breast Feeding - Instructions

answer

Teach mother how to position the baby, wash breast with water allow to air dry and check babies gag reflex, sucking, and swallowing

question

Tegretol

answer

Nerve impulse (agonizing pain) & anticonvulsant (prevents seizures) - Cant take hormone counterceptives - Causes photo sensitivity (increase pigmentation) - Patients with (tic douloureux) use Tegretol for pain Having a surgery - Don't stop taking Tegretol (because prevents seizures), notify the anesthesia to lower the dosage of anesthesia

question

COPD patients & oxygen

answer

COPD your are at risk for oxygen induced hypoventilation within first 30 minutes of oxygen therapy. After oxygen administration your skin will go from gray to pink, but I'm worried because in 30 minutes you can go into respiratory arrest

question

Prozac

answer

Antidepressant, can cause dry mouth, hypo-tension, photo sensitivity - Can cause suicide behaviors, insomnia, drowsiness

question

Internal Radiation

answer

Lasts inside 1-3 days - On strict bed-rest with no ambulation, urinary cath is place to prevent abdominal distention, low fiber to prevent bowl movement (enema is used pre op to clean bowls & prevent bowl movement) - HOB elevated no more than 20 degrees

question

Hypothermia Patients & risk

answer

Hypothermia patients are at risk for Venticular Fibrilation, they must be cared for with genitally - Hypothermia cause irritability to the heart muscle and can cause rewarming shock

question

Bruit Sound Over the Aorta

answer

Aneurysm

question

Pler Evac Drainage system

answer

-Used for pneumothorax - Absent breath sounds or absent lung movement on effected side is pneumothorax

question

Breast Cancer Risk Factors

answer

- Age over 50 - Family history, mother, grandmother, sister - Personal history - First pregnancy after the age of 30

question

Urine Catheter After urine retention

answer

Clamp down catheter after 300-500 ml of urine output, rapid emptying of bladder can cause bladder wall damage

question

Catapres- TTS

answer

Transdermal Patch for hypertension - Change pad every 7 days - Avoid microwaves, cause burns - Cut patch in small peaces before trash - Avoid heat lamps or blankets Side Effects - Hypotesion - Drowsiness - Sedetation - Heart Failure

question

Foods to avoid with Kidney Stone

answer

Foods high in oxalates - Spinach - Asparagus - Cabbage

question

Ménière's disease Diet

answer

Low in sodium to decrease fluid retention

question

Fail Chest

answer

Multiple rib fractures that cause paradoxical breathing

question

Esophagogastric tube

answer

Used for bleeding esophageal varices. Needs constant monitoring for hypotention, tachycardia, increased respiration= shock - Make sure ballon pressure is maintained

question

Upper GI Enema

answer

Must be done last because it interferes with colons copy, x ray, ultrasound Does not effects EKG

question

Wilms Tumor

answer

Don't auscultate the abdomen because the tumor can break & metastesis Tumor is on abdomen & kidneys , can effect kidney function & cause hypertention Priority before surgery is to measure abdomen girt

question

EEG

answer

- Stop all stimulants 24-48 hours before test, smoking, tea, coffee, cola - May be asked to hyperventilate for 3-4 minutes to see bright, flashing lights

question

EMG

answer

Electromayogram - Assess muscle activity - Pads are placed on the muscle nerves & will administer some electricity

question

Abusing spouse Therapy

answer

Group Theraphy

question

Moro Reflex

answer

Infants crib is hit, baby extends extermities & than back to normal

question

Bowl movement pattern for newborn

answer

1 bowl movement every 24 hrs is normal

question

Umbilical cord- Normal

answer

Dry with no redness moist & red = infection -No tub baths until cord has fallen off, use alcohol to clean cord - Put on diaper below the cord

question

Bbacillus Calmette-Guerin

answer

Shot for TB, active immunity agents TB If you had the shot, skin testing of TB is contraindicated because it will cause a false positive respond

question

Ambulatory Electrocardiography

answer

Monitors heart activity for 24 hours, you must keep journal & log, even when you become lightheaded just record it, don't call doctor - Don't shower for the 24 hrs, sponge bath is fine - Don't change diet

question

Intopin/Dopamin

answer

Given to resolve shock, best way to know positive response is to check Blood Pressure/Vital Signs

question

Zovirax

answer

Antiviral medication - Used to treat genital herpes & herpes zoster (localized) - Take with meals (causes N/V) - Does not cure, only controls - Taken 5 x a day

question

Amphojel

answer

Antaacid for GERD - Taken 1 hr after meals - Taken several times a day - Taken to prevent epigastric pain

question

mononucleosis s&s

answer

- Malaise, feverm sore throat, tired, no energy, headache, nose bleed

question

Dilantin- Precautions

answer

Causes deficientcy in folate & vit D Folate rich foods - Vegtables - Fruits- orange, cantaloup - Beans - Tomato Vit D - Milk

question

Bells Palsy

answer

- You can wear eye shield to protect corneal irritation - Avoid going out when its cold because its irritating to nerve endings - Apply heat to effected side, it will help with the discomfort - No need to worry about bending over with sudden movements (that is a issue when increase intra ocular pressure) glucoma

question

Pregnancy & Preeclampsia

answer

To a pregnant women who has preeclampsia, we administer magnesium to prevent seizures - After administration, monitor for S&S of hypermag, depressed respiration, absent deep tendon reflexes - Patient should be positioned on her left side, to allow placenta profusion

question

Ulcerative Colitis, Inf Bowl D, & Crons D- Diet

answer

High protein, high calorie, low residue (no bowl movement) Foods to Avoid - Fruits - Whole grain - Beans - Bran cereal

question

CABG

answer

Cardiac Artery Bypass Graft surgery Expected Sides Post Op - Sharp local pain over sternum, because area used access the hear, administer pain medication - Lower temp, due to heat loss of open chest Complications of CABG - Cardiac Tamponade- Due to blood loss during surgery, blood accumulates around the heart and compresses it Effects - Jugular vein distention & clear lung sounds

question

Injuries between T1-T6

answer

Effect respiratory status, must monitor

question

Anorexia & weight gain

answer

Slow steady weight gain is better than fast gains, no more than 2 lbs per weeks - Too fast of a weight gain, can put stress on the heart which is already under stress

question

Atrial Fibrillation & Cardioversion

answer

Atrial Fibrillation is a cardiac dysrhythmia that is treated with synchronized mode cardioversion counter shock Pre-Op - Withhold digoxin for 48 hours before procedure, because it can cause Ventricular Fibrillation after cardioversion - Administer Versed (consciouss sedation/hypnotic), which will cause drowziness & dizziness post op for 24 hours, cant drive

question

Phalens Maneuver

answer

Place back of the hand together & bend at both wrist & 80% who have carpel tunnel syndrome will have paresthesia within 60 seconds, a positive Phalens maneuver

question

Peritoneal Dialysis

answer

- Biggest complication with P. Dialysis is peritonitis, which shows itself when outflow is cloudy - Normal outflow should be clear to light yellow - Constipation occurs typically with P. Dialysis due to not enough inflow or outflow issue, need a diet high in fiber & stool softeners - Weight gain can occur, because there is a high concentration of dextrose in the dialysis solution - The outflow sometimes is a little bloody, not unusual

question

Spinal Anesthesia- Post-Op

answer

Must always assess for hypotention, gradually & slowly raise HOB

question

Incident Report

answer

-Submit the report to the risk manager within 24 hrs - Never photocopy report, used against you in court

question

Child with Larygnitis

answer

Have child not whisper, no use voice, no use singing, to rest using voice for 24 hrs, give pencil & board to communicate - Don't drink milk because it will cause tickling of throat & cause secretions

question

Phototherapy

answer

Used for hyper bilibrubin levels, increased urine output + green stool means excretion of bilirubin - Eyes should be completely covered or damage will be caused to retina

question

Random

answer

Colostomy- you can take baths & relax Hip replacement- Cant play tennis, will dislocate Joint replaement in knee- walking is encouraged

question

A-V Fistula (Hemodialysis)

answer

-Elevate arm post-op - Dont use arm to carry bags, BP checks, venipuncture - Squeeze balls to promote circulation

question

Diaphragm Use

answer

- Does not protect against AIDS or stds, only protects against pregnancy - After intercourse, must be left on for 6 hrs before removal - Place spermicide on the rim before insertion, but if 4 hrs pass and still no intercourse, place more spermicide - Must be checked by doctor annually for refitting, or if you had a baby, or gained or lost 15 lbs or more

question

Increased ICP

answer

- Coughing or deep breathing increases ICP - Don't suction, increases ICP - HOB elevated 15-30 degrees - When patient has ICP, it effects gag reflex & cough reflex, must assess them before starting feeding ( Aseess cough reflex & ability to swallow)

question

Cleft Lip Repair- Post-Op / Feeding

answer

When feeding & post feeding position infant upright to prevent aspiration - Never position on prone, because cause damage to suture lines, place on back, side or infant seat - Post feeding clean suture with cotton swab with saline & hydrogen peroxide - Feed infant with rubber tip on opposite side of operation & have frequent bubbling syringe (because cleft lip infant swallow lots of air & need frequent bubbling)

question

Aspirin & Tartrazine

answer

Cross allergy between the two, if you are allergic to one you are allergic to the other - Taking aspirin with milk can decrease GI irritation

question

Diebetic care with foot

answer

Never walk barefoot, wear slippers around the house - Avoid wearing nylon anything cuts circulation - Shoes made with natural fiber rather than manmade fiber are better , because allow for drying - Wear insulated boots in the cold, to prevent cold related injury

question

Tyroidectomy Post-Op Care

answer

Normal Findings - Pain & some bleeding for the first 24 hrs - Hoarseness voice is not expected but for the first 24 hrs its ok, because it can related to edema, if hoarsensss continues after 24 hrs, than im worried because it might be laryngeal nerve damage Complications - Parathyroid removal, and resulting in hypocalcemia

question

L1 Accident Injury

answer

With an accident injury you can loose control of you bladder, and emptying your bladder completely Goal- Is to regain bladder control & empty bladder completely to prevent infections Cred E Maneuvers- Performing them daily at the same time (Manuel pressure to empty bladder) will help with reducing infections & gaining control of bladder over time - This control will help patient have a normal life

question

Shoes & Clothsd for the Elderly

answer

Shoes with laces is the best for the elderly - Sweaters is good because their body temp is lower, and they are sensitive to the cold - Nylon never should be used, it will cut off circulation & cause thrombo & pulmonary emboli

question

CPR- Guidlines

answer

Heel of the palm on the lower end of the patients sternum, hands straight and elbows locked, shoulders over the patient, keep correct posture to prevent injury - Check patients pulse after every minute

question

Pneumonia Risk Factors

answer

- Advanced age - Lung diease - Smoking - Immuno suppressed - Bed riddin - Post- Op

question

TB Medications & Sides

answer

Mayambutol - Can cause Optic nuritis, change visual activity & lessen ability to see green is a first sign Rifadin - Causes discoloration of bodily fluids, sweat, urine, feces, tears, sputum and can cause staining of cloths & soft contact lenses - Harmless, stains can be removed from clothing - Avoid wearing contacts

question

PZA medication

answer

Pyrazinamide can cause build up of uric acid, can cause goat arthritis & and cause pain in the big toe, if pain occurs medication should be stopped

question

Anxiety

answer

Is unconscious conflict of needs

question

Emphysema Patient

answer

Pursed lips Breathing is best, because helps lungs re expand and prevents lung collapse - With COPD & Emphysema administer low oxygen administration not 5 L, to prevent oxygen induced hypoventilation

question

Hearing Loss

answer

Two types sensorial & conductive hearing loss - Sensorial is due to prolonged hearing of loud music & age and is permenant and can't be helped with medical or surgery

question

Toxic Shock Syndrome

answer

Severe onset of fever, hypotension, and rash - Change tampons every 3-6 hrs - Use sanitary napkins at night - Do not use extra absorbent tambons - Monitor for fluid volume deficit

question

Oral Candidiasis

answer

- Avoid using commercial mouthwashes because contain alcohol - Can use warm saline & hydrogen proxide - Mycostatin is used for fungal infections, suspension, shke swish & swallow, allow time to stay in your system dont drink water or fluids right after - Avoid spicy, hot, acid foods & drinks

question

Toxoplasmosis & Pregnant Women

answer

Cat feces is infected with toxoplasmosis & can be harmfull to pregnant mom & her fetus - Cats get infected by wild animals, mice, uncooked meat, stary animals - Cat litter becomes infected once it reached 48 degrees, so cat litter must be changed every 24 hrs by someone other than pregnant women - If in contact with the cat, pregnanct women must wear gloves - Avoid gardening in areas where cat feces is avaliable - Avoid stray animals & uncooked meat

question

Sexual Activity after MI

answer

Can resume sex when patient can walk around the city block once or climb 2 flights of stairs without chest pain or SOB - Avoid sex after a heavy meal - Maintain supine position during sex

question

Care for patient in Bucks Traction

answer

- Provide counter traction by elevating foot of bed - Several times per day take foot boot off & inspect skin under boot, but make sure another nurse is supporting the extermity - Provide back rubs to prevent pressure ulcers every 2 hrs - If patient has a fracture turn patient to unaffected side, if no fractures turn patient to either side every 2 hrs - If patient complains of pain (assess), because i'm worried about nerve pressure (compartment syndrome)

question

Pulse Oximeter Probe

answer

Can be placed on nose, ear lobes, fingers, toes, forehead - Keep site with probe attached away from light, or sunlight - Rotate site every 4 hrs, to prevent skin break down - Sa02 should be at 95%-100%, 86%-91% is an emergency, Below 70% is life threatening

question

Providing care to an infected abdominal wound

answer

Remove soiled dressing with clean gloves, remove & wash hand, than put on sterile gloves & place sterile dressing

question

Nocosomial Infections

answer

Acquired from health care professionals to patients Risk Factor - Burn patients - Patients on NG tubes - Patients with Foley Cathters

question

Foods for child with diarrhea

answer

If there is no indication of dehydration, then start child back on regular normal diet, so he can gain weight fast & reduce effects of sickness (needs carbs, protein, electrolytes) BRAT diet is not recommended for children with diarrhea (banana, rice, apples, toast)

question

Pancrease Capsules

answer

Can be opened & sprinkled over cool, soft food (applesauce) and swallowed immediately, without chewing - Avoid chewing capsules - Don not pour capsules into milk, ice cream, yogurt because pancrease enzymes will spoil milk products

question

Sitz Baths

answer

Used to help heal new wounds, increase blood circulation & oxygenation, remove waste products, decrease inflammation

question

Bottle Mouth Caries

answer

Tooth decay for children whos teeth is socked in carb or sugar rich fluids for hours, milk or juice, or honey on pacifier - If you allow child in bed with bottle it should only contain water

question

Blood Transfusion Reaction

answer

Headache & low back pain, stop transfusion

question

Ventilator settings

answer

- Sigh is set at 1.5 times tidal volume to occur every 1-3 hrs - Lowest concentration of oxygen should be administered - Settings are based on ABGs - Never add water to tubing

question

Candidates for Hep A Vaccine

answer

-Traveling to asia, africa, south america - Chronic liver disease - Hemophilia receiving clotting factors

question

Tonsillectomy Care Post-Op

answer

Complications post-op is bleeding, so must assess for bleeding frequently, earliest sign is frequent swallowing - If child is sleeping, place in prone - If awake place uprigh, but must always stay rested in bed - Restrict all fluids until there is no more bleeding (Avoid red/brown fluids) - White patches on the throat means healing

question

Laryngectomy Stoma Care

answer

Cover with scarf when outside, protects from debris & secretions on cloths - Use humidifier or nebulizer to lesson secretions - Uncover in bubble baths for humidity - Apply vit A&D to remove old scabs with sterile tweezers

question

Scoliosis

answer

There is no pain associated with the child who has scoliosis - Look for not symmetrical, rib cage, shoulder (scapulae) , and spinal curvature

question

Dried processed anything contains sodium

answer

Dried fruits or dried cereal not good for heart patients

question

Prostate Urinary Inconinence

answer

Pelvic muscle exercises are best to control & strengthen bladder control - Avoid artificial sweeteners, they cause bladder irritation 7 can cause more incontinence

question

Burn Autograft

answer

Priority is to immobilized & elevate recipient graft site for 7-10 days (time to heal) - Pressure dressings are removed after 3-5 days & assessment of skin is done - After healing of 7-10 days, avoid & protect new graft site from sunlight & UV light for 1 year - Usually pain is at donor graft site rather than recipient graft site

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Birth weight with infant & Moro Reflex

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Birth weight can double by 5-6 months - Moro reflex should disappear at 3-4 months, so if infant abducts legs & fans his fingers when he hears noise at 5 months, that is moro reflex that should have disappeared & that is a concern

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Antisocial Personality Dosorder Patients

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Act rude, controlling & manipulative so you must set limits in a non punitive manner for their inappropriate behaviors, this is done with group therapy

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Dissociative identity disorder or Multiple Personality Disorder

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- Patient has two personalities, names, feeling, behaviors and actions - At times one or the other is in charge, if person start replying to just one name when called it is a sign of improvement

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Non Stress Test

answer

Looks at FHE with activity - Favorable results- 2 or more FHR accelerations of 15 beats lasting 15 seconds in a 20 minute period

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Stress Test

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Looks at fetal respiration & placental per fusion status with pitocin

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Mouth Care for the Elderly

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Use petro jelly for lips, saline or hydrogen peroxide for mouth wash, soft toothbrush - Avoid glycerin swabs cause dehydration & mouth irritation

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Child Abuse

answer

If you suspect child abuse always ask parents what happened or what caused the injuries - Best way to know is to see if injuries match with what parents explain what happened

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Post Op cataracts Surgery

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When surgery is done to remove cataracts & lens implant is placed, lens implant will correct distance vision but might still need reading glasses - Avoid straining, heavy lifting or bending at the hips - Should not have swollen or pain after surgery it indicates an infection or complication

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Signs of Infection in the Elderly

answer

tachypenea, tachycardia, confusion

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Doxycycline (Vibramycin)

answer

It is used usually to treat Clemedia - It cause photosensitivity & one should wear sunblock - Should avoid taking med before going to bed - Avoid anaacids within 1-3 hrs of taking medication - Use other forms of birth control, no hormones - Vaginal discharge, it may mean an infection- not expected

question

Evisceration- What to do?

answer

Place patient in low fowlers position and instruct not to cough - Cover bowls wit sterile dressing that is soaked in normal saline

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ARMD

answer

Age Related Macular Degeneration, permemnant loss of central vision related to age - Goal of nursing is to comfort patient (because maybe is depressed) - Try to save & use remaining vision left - Smoking may be a risk factor

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Ascites Treatment

answer

Is to administer Albumin, it pulls fluids back to the vascular space

question

Addisons Crisis Symptoms

answer

N/V, diarrhea, abdominal pain Treatment- Provide fluids + steroids

question

Alcohol & Hept

answer

Should not consume alcohol for up to 6 months after recovery of Hepatitis

question

Alcohol Withdrawle Sysmptoms

answer

N/V, tachycardia, fever diaphorisis, tremors, confusion, delusions, hallucinations

question

Low budget Seasons

answer

As a charge nurse you should contact the supervisor before anything else, because a cost effective way to manage nurses is to see what other departments need nurses at this time - Supervisor has that list of low nurse departments - instead of giving them the day off, contact supervisor to see the low nurse departments, that other nurses can float to those departments

question

Displacement. Conversion. Projection.

answer

Displacement- You take your anger to another, example- supervisor yells at you and you take your anger on patient Coversion- Anxiety is repressed and converted to physical symptoms Projection- You contribute to others thoughts, felling, wishes, behaviors, impulses

question

Digoxin Administration

answer

0.75-1.25 administered in doses over 24 hrs - Always administer digoxin at least over 5 minutes, not faster than 5 min

question

Post Surgery- NPO

answer

Maintain NPO until bowl sounds are heard - Early ambulation will help flatus - Avoid Catheter unless necessary

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Urine Test for Glucose

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Dip the stick in & compare to color charts - Discard first void & use void after the first in 10-20 minutes

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Pleur Evac Drainage System

answer

Water should fluctuate, rise when you inhale & fall when you excell

question

Post Cataract Surgery

answer

Follow uo appointment in 1 day, 1 week, 1 months - You can wash hair with shampoo 1-2 days post op but tilt head back, avoid increase in intraocular pressure - For several weeks avoid activities such as vaccum, sports, bending, lifting heavy objects, rapid movements

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Bowl Sounds

answer

Absent Bowl Sounds- no sounds in 3-5 minutes Hypo Active Sounds- 1-2 sounds in 2 minutes Normal- 5-30 sounds in 1 minute Hyper active- Higher than 30 sounds in 1 minute

question

Applying Stockings

answer

- You can apply powder before applying stockings because it will help stockings go on easier - Elevate legs when applying stockings - Watch out for obese thighs, risk for blood constriction

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Oral Contraceptives

answer

Should be taken at the same time everyday, to keep stable hormone levels - Usually 99 % effective but if your taking antibiotics, it will lower effectiveness - If you miss a pill take it as soon as possible, if you miss 2 pills in a row you must use another form of birth control for the rest of the month - When you start pills, you should use diaphargm for first 3 weeks

question

Setting Up a Sterile Field

answer

Open all supplies & set up all materials with bare hand without sterile gloves or gown - Once you have set up supplies & opened supplies, than you wear your gloves & gown to start sterile work

question

Dumping Syndrome

answer

Avoid carbohydrates with meals, because they are fast digested and we want slow digestion foods

question

Abdominal Hysterectomy Post-Op

answer

Will have a Foley catheter for first 24 hrs - Limited activity is encouraged - Ambulation, coughing, deep breathing, incentive spirometer are all encouraged to prevent thromboembolisim - Avoid heavy lifting and strenuous activity

question

Complications of Thorocentesis- 7

answer

- Pulmanory edema, hypoxia, hemothorax, pneumothorax, subcutaneous emphysema, spleen and liver puncture

question

Myelogram Using Dye

answer

Myelogram dye help visualizes spinal colume - Post Op there is no swelling, need to lie flat for 12-24 hrs - If water based dye is used, place patient on seizure precautions & monitor neurological assessment every 2-4 hrs - If its oil based dye, offer fluids post op and analgesics for headache

question

Hypoglycemic patient

answer

-Always give simple carbs (OJ) - Check Glucose - In severe cases of hypoglycemia or if patient can't take oral carbs you give Glucagon

question

Pre Eclampsia Signs for a Pregnant women

answer

If patient has symptoms of malaise & facial edema, im worried, that's pre eclampsia

question

Catheter removal & insertion & Pressure Ulcers

answer

- Sterile gloves required when inserting a catheter but regular gloves for removal - Stage 1 pressure Ulcers, the skin is intact & gloves are not needed

question

Post- Op Cateter

answer

- Take Tylenol for pain but avoid Aspirin - If it itches, apply cold compressess - Yellow, green drainage with pain, or swollen means infection

question

Aminophylline & Side Effects

answer

Aminophylline is a broncho dialator - Side effects that need to be reported Asap are confusion, flushing, tachycardia, seizures, headache

question

Pre Lumber Puncture

answer

Assess Vital Signs, Because ICP is contraindicated with a Lumber Puncture

question

Up/Down Stairs with Crutches

answer

Strong leg leads going up, crutch and weak leg follow and than good leg coming down the stairs

question

Cervical Dialation

answer

Expect1-1.2 cm dialation per hour

question

To roll

answer

Lateral Aspect of the hip and mid thight

question

Peritoneal Dialysis

answer

If outflow is bloody, ask if patient is on her period, because if patient is on her period than blood will be pulled from uterus, no intervention is required

question

Drinking Lots of Water but still Thirsty

answer

Signs of type 1 Diabetes, Polydipsia, PolyPhagia, Polyuria, and weight loss

question

Creatine Clearance Test

answer

Will have blood drawn & urine collected for 24 hrs, first void is discarded , drink fluids to void - Avoid gym for at lest 8 hrs

question

Cervical Cancer & Post Op

answer

Expect slight bleeding after discharge, but if bleeding continues after 48 hrs, contact doctor - Avoid activities that cause straining, lifting, sports, babies for at least 6-8 weeks - Avoid sex & the use of tampons for at least 6-8 weeks, until follow up with doctor - Take showers & avoid baths for at least 2 weeks

question

Tracheostomy & child

answer

If child is eating raisins its dangerous because he might accidentally place raisins in tracheotomy instead of mouth

question

Dissassociative Disorder

answer

I don't know who I'm and where I'm, it's about memory and consciousness

question

Left Lower Abdominal Pain, when pregnant with spooting

answer

Ectopic Pregnancy and it's an emergency

question

Beta Blockers & ACE I

answer

OLOL & Catopril are less effective in african americans. - Also Beta blockers are contraindicated in patient with heart problems because it slows down the heart causing brady cardia and patient with heart problem cant have brady cardia

question

Psych Ward

answer

Sharp items are allowed for personal care, like shaving as long as its under staff supervision- Szcinophernic shaving its ok as long staff is in the room - Leaving items around someone with dementia is a danger

question

Positive Bibonski Redlex

answer

Is normal for the first 6 months of life of an infant- Shows by dorsiflexion of great toe when sole of feet is stroked

question

ICP Signs in Infants

answer

Irritability, high pitched cry, bulging anterior fontanels, increased frontal occipital circumference - Posterior fontanel can't be bulging with 4 months infant because it closes at 2 months _ Trick

question

Transition Phase of Labor

answer

Cervix is 8-10 cm dilated and women feels the urge to urinate because the increased pressure in the pelvis

question

Pancrititis & signs

answer

Acute mid abdominal pain & acute vomiting, also causes diarrhea and fatty stools - Males between 40-45 increased risks - Need to assess for alcohol consumption

question

Insulin & allergic Reactionn

answer

It's normal foe people to have insulin reactions of red, swollen, itchy skin at injection site for a few weeks of starting insulin and should disappear after a few weeks, if persistent than contact doctor

question

Azulfidine

answer

Helps decrease Inflammatory Bowl Disease, should be taken with meals or after meals, - Will cause urine to turn orange red color, does not discolor stool - Need to drink lots of fluids and may cause diahrrea but continue taking medication

question

24 hr urine collectio

answer

Discard first void, save all urine for net 24 hrs and place all urine in one container

question

Common Symptoms with Lupus

answer

Proteinuria & hyperlipids so always should have these 2 values checked when you have Lupus

question

carbidopa/levodopa

answer

Given to patients with Parkinsins, it will assist with ambulation, bradykinases, rigidity not with tremors -- Take med before meals, don't take high protein meals it will affect absorption

question

Surgery & Taking Prednison

answer

If patient is taking Prednison ( steroid), doctor will increase dosage because surgery will create a higher demand for steroid because of stress

question

Posey Vest Restraint

answer

Should be reevaluated every 4 hrs, because the time limit is 4 hrs - You don't need to ask patient for permission especially if he has a altered mental status

question

External Radiation For Breast Lump- Care

answer

Protect site, don't apply lotion, cream, perfume, deoderent - Protect from cold and hot, don't apply anything hot or cold (even wheater), no sun, no cold - Wear loose, cotton bra, assess skin frequently

question

Body Cast & Hip Spica Cast- Complication

answer

Can cause pressure that need to be relieved & it's an emergency and you need to contact the doctor - S&S- Abdominal pain and bloating, N/ V omitting - Care- May need to cut the cast, NG tube to decompose the GI content, IV fluids

question

During a Fire= RACE

answer

Remove people from fire Alarm- Pull fire alarm C- Confine fire/Close fireproof Dors E- Evacuate, locate all residents

question

Acute Pancriitis

answer

NG suction to empty stomach & prevent abdominal distention -NPO - Food & ambulation cause pancreatic enzyme secretion, bed rest and NPO is ordered - Pain med- is Demerol not morphine=spasms= more pain

question

Librium

answer

Anti anxiety Medication Should be taken with milk or after meals to prevent GI irritation Side Effects- Constipation, dermatitis, slurred speech, anorexia, polyuria, pancytopenia, and thrombocytopenia Toxic & needs Reporting is- Drowsiness or blurred vision

question

Digoxin Toxicity

answer

Confusion, yellow hallos around light

question

Care after Ileostomy

answer

input/output is very important, post op - Empty pouch when it is 1/3 full - Avoid lotion around stoma, prevents good seal of stoma - Don't cover stoma with anything (gauze), only pouch

question

MRSA open Woumd Precautions

answer

Non sterile, gloves and gown

question

milk

answer

milk is only good with aspirin, and librium helps prevent GI irritation milk is not good with iron, tectecycline, avoid with laryngitis, avoid dairy with pancreatic enzymes (spoils), fosomax

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