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Fluid And Electrolyte Balance
Nutrition
Test Answers on Bio Chapter 6 – Flashcards 80 terms

Jonathan Walsh
80 terms
Preview
Test Answers on Bio Chapter 6 – Flashcards
question
2. For the majority of exercisers, adding excess protein or amino acid supplements to an adequate diet will stimulate muscle building.
answer
F
question
4. Amino acid supplements are easy to digest and can relieve the digestive system from overworking.
answer
F
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5. When a person ingests a large dose of any single amino acid, absorption of others of its type may be limited.
answer
T
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6. If needed, protein can help to maintain a steady blood glucose level and so meet the glucose needs of the brain.
answer
T
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8. Without critical essential amino acids to perform their roles, many of the body's life-sustaining activities would come to a halt.
answer
T
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9. Overconsumption of protein-rich foods offers no benefits and may pose health risks, particularly for weakened kidneys.
answer
T
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10. Each amino acid has its own distinctive chemical side chain attached to the center carbon of the backbone.
answer
T
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11. The body is able to make all of the 20 amino acids needed from fragments derived from carbohydrate and fat.
answer
F
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13. Growing children are in negative nitrogen balance because they need more protein for adding blood, bone, and muscle cells.
answer
F
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14. Legumes are a good source of protein, many B vitamins, iron, and other minerals, making them exceptionally nutritious foods.
answer
T
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16. Vegetarians have significantly higher rates of hypertension than the general population.
answer
F
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17. The growth of well-fed vegetarian children is similar to that of their meat-eating peers.
answer
T
question
1. Which of the following is found in protein but not in carbohydrate or fat? a. carbon b. hydrogen c. nitrogen d. oxygen
answer
C: Nitrogen
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2. Which of the following accounts for the differences among the various amino acids? a. the amine group b. the side chain c. the acid group d. a and b e. b and c
answer
B: The side chain
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3. The body normally makes tyrosine from the essential amino acid: a. phenylalanine. b. leucine. c. valine. d. lysine.
answer
A: phenylalanine
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4. A(n) _____ bond is formed between the amine group end of one amino acid and the acid group end of the next amino acid in a protein. a. peptide b. amino acid c. ionic d. sulfur
answer
A: Peptide
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5. Which of the following is a protein catalyst that facilitates chemical reactions? a. hormone b. antibody c. lipoprotein d. enzyme
answer
D: Enzyme
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6. How many amino acids are considered to be essential amino acids? a. 5 b. 7 c. 9 d. 13
answer
C: 9
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7. The sequences of amino acids that make up a protein molecule are specified by: a. age. b. sex. c. heredity. d. the diet.
answer
C: heredity
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8. All of the following cause denaturation of proteins except: a. bases. b. alcohol. c. heat. d. light. e. salts of heavy metals.
answer
D: light
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9. For athletes, the path to bigger muscles includes a. vigorous physical training. b. well-timed meals. c. excess protein consumption. d. a and b e. b and c
answer
D: A and B (Vigorous physical training AND well-timed meals)
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10. The role of enzymes in the small intestine in protein digestion is to split polypeptides into all except: a. proteins. b. amino acids. c. dipeptides. d. tripeptides.
answer
A: proteins
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12. When amino acids are absorbed by the cells of the small intestine: a. they are absorbed best in large doses of a single amino acid. b. they are absorbed without preference at all sites on the cells. c. all proteins must be broken into single amino acids before they can enter the body. d. they can be circulated in the bloodstream to other cells and linked together to create new proteins.
answer
D: they can be circulated in the bloodstream to other cells and linked together to create new proteins.
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13. The process of protein turnover includes: a. eating food sources of amino acids every day to grow new cells and replace worn-out ones. b. synthesizing intestinal cells, which can live for months. c. preserving all old amino acids in the body to be re-circulated. d. excreting old amino acids that are left from cell breakdown.
answer
A: eating food sources of amino acids every day to grow new cells and replace worn-out ones.
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14. Proteins attract water and hold it within blood vessels, preventing it from freely flowing into the spaces between the cells. This is an example of how protein is used for: a. supporting growth and maintenance. b. building enzymes, hormones, and other compounds. c. building antibodies. d. maintaining fluid and electrolyte balance.
answer
D: maintaining fluid and electrolyte balance.
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15. When amino acids are degraded for energy, their amine groups are stripped off and used elsewhere or incorporated by the liver into: a. bile. b. urea. c. glucose. d. urine.
answer
B: Urea
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16. If amino acids are oversupplied: a. the body stores them until they are needed. b. the body removes and excretes their amine groups. c. the body converts amino acid residues to glycogen or fat. d. a and b e. b and c
answer
E: b and c ( the body removes and excretes their amine groups AND the body converts amino acid residues to glycogen or fat.)
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17. Amino acids are "wasted" (not used to build protein or nitrogen-containing compounds) in the body whenever there is: a. not enough energy from carbohydrate and fat. b. too much protein. c. adequate high-quality protein. d. a and b e. b and c
answer
D: a and b ( not enough energy from carbohydrate and fat AND too much protein.)
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18. The DRI for protein depends on: a. height. b. activity level. c. body size. d. sex.
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C: body size
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19. All of the following are needed for the body to synthesize protein except: a. adequate carbohydrate and fat. b. an adequate total amount of protein. c. all essential amino acids in the proper amounts. d. amino acid supplements.
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D: amino acid supplements.
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20. The DRI Committee recommends _____ percent of total calories as the minimum amount of protein. a. 5 b. 10 c. 15 d. 20
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B: 10
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21. The DRI for protein for healthy adults is _____ gram(s) per pound of body weight. a. 0.5 b. 0.4 c. 1.0 d. 0.8
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B: 0.4
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22. In making recommendations for protein intake, the committee on DRI took into consideration that the protein in a normal diet would be: a. primarily from animal sources. b. primarily from plant sources. c. a combination of animal and plant sources. d. used with 100% efficiency by everyone.
answer
C: a combination of animal and plant sources.
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23. Negative nitrogen balance occurs in: a. a surgery patient. b. growing children. c. pregnant women. d. lactating women.
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A: a surgery patient.
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24. The strategy of combining two _____ plant protein sources permits the amino acids in one food to make up for those lacking in the other food. a. complementary b. complete c. high-tryptophan d. a and b e. b and c
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A: complementary
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25. Which of the following provides amino acids that are best absorbed by the body? a. legumes b. animal proteins c. grains d. vegetables
answer
B: animal proteins
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26. Of the following foods, which likely contains the most easily digestible protein? a. oats b. whole wheat c. potatoes d. tuna
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D: tuna
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28. What is the result of a dietary protein deficiency? a. increased synthesis of proteins b. decreased breakdown of body protein c. a weakened immune system d. enhanced nutrient absorption
answer
C: a weakened immune system
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29. Which statement about the role of protein in a weight-loss plan is accurate? a. Protein should contribute 65 percent or more of the calories. b. There is no evidence that protein helps control the appetite. c. It is the proper proportion of nutrients that brings about long-term weight loss. d. Meeting protein recommendations during weight loss is critical for preserving lean tissues.
answer
D: Meeting protein recommendations during weight loss is critical for preserving lean tissues.
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37. Humans need to eat protein-containing foods regularly because: a. we need essential amino acids that can only be provided by foods. b. our bodies cannot make any amino acids needed for proteins. c. the function of protein is to maintain our muscle strength. d. protein is broken down quickly during digestion and lost from the body.
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A: we need essential amino acids that can only be provided by foods.
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30. Which of the following is not associated with an excess of protein? a. enlarged livers in humans b. enlarged kidneys in animals c. worsening of existing kidney problems d. high-fat foods that contribute to obesity
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A: enlarged livers in humans
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31. Removing the grain protein gluten from the diet has been shown to: a. resolve digestive problems in people with celiac disease. b. help with weight loss in people trying to lose weight. c. reduce problems with insomnia. d. reduce cancer risk.
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A: resolve digestive problems in people with celiac disease.
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33. An overemphasis on protein-rich foods can lead to: a. a low intake of iron. b. a low intake of folate. c. a low intake of vitamin C. d. a and b e. b and c
answer
E: b and c ( a low intake of folate. AND a low intake of vitamin C.)
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34. The more animal protein you eat, the higher your intake of _____. a. vitamin B12 b. vitamin A c. folate d. vitamin C
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A: vitamin B12
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35. Which of the following food groups does not provide significant protein? a. fruits b. grains c. vegetables d. milk, yogurt, and cheese
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A: fruits
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36. The heavy use of soy products in place of meat can inhibit _____ absorption. a. calcium b. folate c. iron d. vitamin C
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C: iron
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38. The recycling system for amino acids in the body is primarily used to: a. provide fuel for the cells to spare glucose. b. convert nonessential amino acids into essential amino acids. c. provide the cells with materials to build body proteins. d. add protein to muscles when there is a shortage of energy from foods.
answer
C: provide the cells with materials to build body proteins.
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40. Why should eggs be cooked, rather than eaten raw? a. Raw egg proteins bind the mineral iron. b. Raw egg proteins speed up protein digestion. c. Raw egg proteins bind the B vitamin biotin. d. b and c e. a and c
answer
E: a and c ( Raw egg proteins bind the mineral iron AND Raw egg proteins bind the B vitamin biotin.)
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41. Why is milk used as a first-aid remedy for someone who has swallowed a heavy-metal poison? a. The poison acts on the protein in the milk rather than on the protein of the gastrointestinal tract. b. Milk will cause the person to vomit and expel the poison. c. Milk will provide calcium, which serves to render the poison harmless. d. a and b e. b and c
answer
A: The poison acts on the protein in the milk rather than on the protein of the gastrointestinal tract.
question
43. Tim, who lost a large amount of weight during an illness, is thinking about taking amino acid supplements to help him regain muscle mass. What advice would you give him? a. Amino acid supplements are an excellent way to quickly provide energy to muscles for rebuilding. b. Taking amino acid supplements helps keep the digestive system from overworking while you recover from illness. c. Extra carbohydrate, but never extra protein, is needed for recovery. d. Whole protein is better handled by the digestive system and will better promote recovery.
answer
D: Whole protein is better handled by the digestive system and will better promote recovery.
question
44. When comparing the digestion and absorption of proteins with fats it is important to know that: a. proteins are broken down into individual amino acids and absorbed by all intestinal cells at an equal rate. b. larger peptide molecules must be completely broken down into amino acids to be absorbed into the bloodstream from the intestine. c. cells in the small intestine preferentially absorb different types of amino acids, which causes competition by amino acids at the absorption sites. d. amino acids need a carrier in the bloodstream because they do not transport very well alone.
answer
C: cells in the small intestine preferentially absorb different types of amino acids, which causes competition by amino acids at the absorption sites.
question
45. The process of protein turnover involves: a. the conversion of protein to glucose for energy in half of the protein we eat. b. the loss of amino acids by excretion through the kidneys when cells die. c. the use of amino acids that have been conserved from breakdown of old cells. d. the annual replacement of old cells with new protein that has entered the body in food.
answer
C: the use of amino acids that have been conserved from breakdown of old cells.
question
47. A child suffering from protein deficiency develops edema. This is an example of protein's role in: a. supporting growth and maintenance. b. building enzymes and hormones. c. maintaining fluid and electrolyte balance. d. maintaining acid-base balance.
answer
C: maintaining fluid and electrolyte balance
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48. Certain proteins act as buffers in the blood. In this role they are responsible for: a. providing immunity from foreign substances that invade the body. b. making sure that sodium is transported outside the cells. c. ensuring that too much fluid in the cells doesn't cause edema. d. picking up and releasing hydrogens in the blood to balance its pH.
answer
D: picking up and releasing hydrogens in the blood to balance its pH.
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50. An athlete consumes large amounts of meat in an effort to build extra muscle tissue. This practice does not work because: a. the body has no place to store extra amino acids. b. the body will dismantle its tissue proteins in this situation. c. the body converts amino acid residues to fuel or stores them as fat. d. a and b e. a and c
answer
E: a and c ( the body has no place to store extra amino acids AND the body converts amino acid residues to fuel or stores them as fat.)
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51. In times of energy shortage from carbohydrates or fats in foods, the body uses protein in what way? a. decreases the breakdown of food proteins for energy and uses stored glycogen b. stores amino acids in the cells to be used later for energy c. removes the nitrogen portion and burns the remaining fragments for energy d. converts it to fat to provide more concentrated energy
answer
C: removes the nitrogen portion and burns the remaining fragments for energy
question
52. A young man has said to you that he is eating much more protein in his diet than the recommendation but he feels he needs the extra amount just in case he wants to build more muscle mass in the near future. How would you respond to him? a. It should be fine because the cells will store the extra amino acids for future use. b. If he has excess calories in his diet, he may gain fat weight from converted protein. c. The extra protein will be used for fuel instead of the carbohydrate. d. The body won't digest the extra protein and it will be eliminated in feces.
answer
B: If he has excess calories in his diet, he may gain fat weight from converted protein.
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53. Which of the following statements is true? a. Athletes need slightly more protein than other healthy adults. b. Athletes should consume protein supplements to build muscle. c. Dieters should take protein supplements to spare body protein. d. a and b e. b and c
answer
A: Athletes need slightly more protein than other healthy adults.
question
55. What is the DRI for protein for a 40-year-old male who is 6'4" tall and weighs 180 pounds? a. 144 grams b. 90 grams c. 72 grams d. 180 grams
answer
C: 72 grams(180*.4=72)
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56. A sedentary male college student aged 23 needs how much protein if he weighs 175 pounds? a. 140 grams/day b. 70 grams/day c. 88 grams/day d. 175 grams/day
answer
B: 70 grams/day>>>(175*.4=70)
question
57. A 135-pound female athlete needs about how much protein? a. 81-108 grams/day b. 54-68 grams/day c. 68-81 grams/day d. 162-230 grams/day
answer
A: 81-108 grams/day(135*.6=81;135*.8=108)
question
58. A 10-year-old boy is going through a growth spurt. Because he needs to build new muscle tissue, what should his nitrogen status be? a. positive nitrogen balance b. negative nitrogen balance c. nitrogen equilibrium d. nitrogen deficiency
answer
A: positive nitrogen balance
question
59. Cells will do all of the following to create their own working proteins from available amino acids except: a. synthesize nonessential amino acids that are missing for the protein that is being made. b. obtain amino acids that are available in the cell's amino acid pool. c. slow down protein synthesis until enough of the limiting amino acid is available again. d. hold partially completed proteins until the diet provides the missing amino acids.
answer
D: hold partially completed proteins until the diet provides the missing amino acids.
question
60. An adolescent girl has decided to adhere to a vegetarian diet and has selected a tossed green salad, whole-wheat crackers, and apple juice for lunch. What would you advise her about her complementary protein sources? a. She has made good choices of complementary protein foods. b. Adding garbanzo beans to her salad would provide the protein combination she needs. c. She has to include milk or cheese with her meal or there will not be enough protein. d. She should not be following a vegetarian diet because it is not nutritionally adequate.
answer
B: Adding garbanzo beans to her salad would provide the protein combination she needs.
question
61. Examples of complementary protein combinations include all of the following except: a. pasta with tomato sauce. b. rice and black-eyed peas. c. whole-wheat cereal with almonds. d. peanut butter and jelly on whole-wheat bread.
answer
A: pasta with tomato sauce.
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63. What is one of the risks of consuming a diet high in protein? a. significant loss of iron from the body in urine b. development of kidney disease c. increased risk of heart disease with high intakes of fatty meats and whole milk d. increased risk of heart disease with high intakes of legumes and nuts
answer
C: increased risk of heart disease with high intakes of fatty meats and whole milk
question
64. Your neighbor has placed herself on a gluten-free diet to help her lose weight. What advice would you give her? a. She should be successful because it is an excellent way to lose weight. b. It will help relieve any digestive symptoms she may have. c. Gluten-free weight-loss diets offer no advantages over other low-calorie diets. d. Gluten-free diets help prevent cancer.
answer
C: Gluten-free weight-loss diets offer no advantages over other low-calorie diets.
question
Use Label for questions 66-70: 66. A vegetarian dish using textured vegetable proteins, such as this "chicken" patty, is an adequate substitute for meat because it: a. contains textured wheat protein, which is a high-quality protein. b. contains soy protein, which is a high-quality protein. c. provides a good source of carbohydrate. d. provides only limited amounts of fiber.
answer
D: provides only limited amounts of fiber.
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67. How will frequent consumption of this food item affect iron absorption in the body? a. increase iron absorption because soy has a high iron content b. decrease iron absorption because the textured wheat protein has a high iron content c. decrease iron absorption because soy inhibits iron absorption d. increase iron absorption because it is high in fiber
answer
C: decrease iron absorption because soy inhibits iron absorption
question
68. How does the fat content of this product compare with that of an actual piece of chicken eaten with the skin? a. Both foods have exactly the same type of fat composition. b. This product is higher in cholesterol. c. This product is higher in total fat. d. This product is lower in saturated fat.
answer
D: This product is lower in saturated fat.
question
69. This product: a. contains as much vitamin B12 as chicken. b. has been fortified with vitamin B6. c. contains no vitamin B12 because it is not an animal protein source. d. will provide adequate vitamin B12 when eaten with grains, fruits, and vegetables.
answer
C: contains no vitamin B12 because it is not an animal protein source.
question
70. Using this food product as part of a vegetarian diet: a. will likely result in excessive weight gain from eating too many grain products. b. may reduce the risk of developing heart disease. c. may increase blood pressure through excessive soy intake. d. may increase the risk of colon cancer.
answer
B:may reduce the risk of developing heart disease.
question
71. Your mother is considering changing her diet to include only non-meat proteins to reduce her risk of developing heart disease or cancer. What evidence is available to support her decision? a. vegetarian diets contain greater amounts of heart-protective omega-3 fatty acids b. plant-based diets are usually lower in saturated fat and higher in fiber, which reduces risk of heart disease c. substituting soy for meat proteins has resulted in a large decrease in heart disease risk d. lung cancer appears less frequently in people eating plant-based diets
answer
B: plant-based diets are usually lower in saturated fat and higher in fiber, which reduces risk of heart disease
question
73. Compared to meat eaters, vegetarians tend to have: a. higher death rates from heart disease. b. healthier body weights. c. lower blood pressure. d. a and b e. b and c
answer
E: b and c ( healthier body weights. AND lower blood pressure.)
question
75. Which statement is true of a vegan diet? a. Very young children may not consume enough plant sources of protein to build and maintain bone and muscle tissue. b. A vegan woman always has excellent stores of nutrients needed for pregnancy. c. Research shows that vegan diets promote normal growth in children. d. Vegan children's daily protein requirement is less than meat-eating children's.
answer
A: Very young children may not consume enough plant sources of protein to build and maintain bone and muscle tissue.
question
********Added question: Your friend is a vegetarian who consumes large quantities of soy products in the place of meat. From a nutrition perspective, your friend is at risk of developing _____ deficiency. a. vitamin C b. iron c. folate d. calcium
answer
*******B: iron
question
76. Poorly-planned vegetarian diets typically lack all of the following except: a. calcium. b. vitamin B12. c. zinc. d. folate.
answer
D: folate.
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78. Including which of the following foods in a vegan child's diet helps to ensure adequate growth and bone development? a. whole grains for zinc b. walnuts for omega-3 fatty acids c. raisins for calcium d. a and b e. a and c
answer
D: a and b ( whole grains for zinc AND walnuts for omega-3 fatty acids)
question
79. The best way for a vegetarian to ensure adequate absorption of dietary iron is to: a. include leafy greens because the iron they contain is absorbed readily. b. avoid dried fruits because they interfere with iron absorption. c. include vitamin C-rich foods because they enhance absorption of iron. d. consume 3 times the amount of iron recommended for meat eaters.
answer
C: include vitamin C-rich foods because they enhance absorption of iron.
question
80. To ensure adequate intakes of vitamin B12, vitamin D, and calcium, vegans need to: a. select fortified foods. b. use complete meal supplements. c. use supplements daily. d. a and b e. a and c
answer
E: a and c ( select fortified foods. AND use supplements daily.)
Fluid And Electrolyte Balance
Nutrition
Peanut Butter And Jelly
Nutrition Ch6 – Flashcards 88 terms

Lesly Nixon
88 terms
Preview
Nutrition Ch6 – Flashcards
question
Vegetarians have significantly higher rates of hypertension than the general population.
answer
False
question
Most people in the U.S. would find it next to impossible not to meet their protein requirements.
answer
True
question
Some foods are so high in acid that they are capable of making the acid in the stomach even stronger.
answer
False
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Sickle-cell disease is an example of an inherited mistake in the amino acid sequence.
answer
True
question
Amino acid supplements are easy to digest and can relieve the digestive system from overworking.
answer
False
question
When a person ingests a large dose of any single amino acid, absorption of others of its type may be limited.
answer
True
question
If needed, protein can help to maintain a steady blood glucose level and so serve the glucose need of the brain.
answer
True
question
Starvation always incurs wasting of lean body tissue as well as loss of fat.
answer
True
question
The growth of well-fed vegetarian children is similar to that of their meat-eating peers.
answer
True
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PEM is the world's most widespread form of malnutrition.
answer
True
question
For the majority of exercisers, adding excess protein or amino acid supplements to an adequate diet will stimulate muscle building.
answer
False
question
Sound nutrition authorities acknowledge that well-chosen vegetarian diets are consistent with good health and can meet nutrient needs.
answer
True
question
Certain proteins act as buffers in the blood. In this role they are responsible for:
answer
picking up and releasing hydrogens in the blood to balance its pH.
question
Which of the following groups of the USDA Food Guide contribute(s) an abundance of high-quality protein?
answer
b and c
question
Our body has the need to eat protein-containing foods regularly because:
answer
we need essential amino acids that can only be provided by foods.
question
Which of the following provides amino acids that are best absorbed by the body?
answer
animal proteins
question
A person who lost a large amount of weight during an illness has been advised by a health food store employee that he should add amino acid supplements to his diet to help in weight gain. What would you tell this person?
answer
if he needs additional protein for recovery it should be as whole protein because the digestive system can handle that form better
question
The process of protein turnover involves:
answer
the use of amino acids that have been conserved from breakdown of old cells.
question
For athletes, the path to bigger muscles includes
answer
a and b
question
Which of the following is a health benefit of a vegetarian diet?
answer
vegetarians tend to have lower blood pressure than nonvegetarians
question
The DRI Committee recommends _____ percent of total calories as the minimum amount of protein.
answer
10
question
The genetic coding or expression that determines our DNA messaging for cells is:
answer
available in all cells but is idle in some cells and active in others.
question
When planning a vegetarian diet, the following recommendation should be adhered to:
answer
fruits and vegetables high in iron and calcium should be emphasized.
question
When amino acids are degraded for energy, their amine groups are stripped off and used elsewhere or incorporated by the liver into:
answer
urea
question
A young man has said to you that he is eating much more protein in his diet than the recommendation but he feels he needs the extra amount just in case he wants to build more muscle mass in the near future. How would you respond to him?
answer
if he has excess calories in his diet, he may gain fat weight from converted protein
question
Poorly-planned vegetarian diets typically lack all of the following except:
answer
folate
question
What is the DRI for protein for a 40-year-old male who is 6'4" tall and weighs 180 pounds?
answer
65 grams
question
What change in body function will occur in a child with marasmus?
answer
the digestive tract develops dysentery, which results in diarrhea and mineral loss
question
The sequences of amino acids that make up a protein molecule are specified by:
answer
heredity
question
Which of the following is found in protein but not in carbohydrate or fat?
answer
nitrogen
question
Negative nitrogen balance occurs in:
answer
a surgery patient
question
The best way for a vegetarian to ensure adequate absorption of iron in the diet is to:
answer
include vitamin C-rich foods because they enhance absorption of iron
question
The more animal protein you eat, the higher your intake of _____.
answer
vitamin B12
question
Compared to meat eaters, vegetarians tend to have:
answer
b and c
question
A 3-year-old child from a homeless family has been brought into the health clinic with a swollen belly, fluid buildup around her ankles, brittle hair, and irritability. Her mother has been feeding her mostly bread and dry cereal over the past several months. Providers suspect that she may have which form of PEM?
answer
kwashiorkor
question
The process of protein turnover includes:
answer
eating food sources of amino acids every day to grow new cells and replace worn-out ones.
question
When comparing the digestion and absorption of proteins with fats it is important to know that:
answer
cells in the small intestine preferentially absorb different types of amino acids, which causes competition by amino acids at the absorption sites.
question
How many amino acids are considered to be essential amino acids?
answer
9
question
Proteins use the process of active transport to move substances in or out of the cell by:
answer
opening passages in the membrane and escorting substances through the cell.
question
What is one of the risks of consuming a diet high in protein?
answer
a high-protein diet can raise homocysteine levels in the blood
question
The heavy use of soy products in place of meat can inhibit _____ absorption.
answer
iron
question
The recycling system for amino acids in the body is used to:
answer
provide the cells with materials to build body proteins.
question
The role of enzymes in the small intestine in protein digestion is to split proteins into all except:
answer
oligopeptides
question
A 135-pound woman needs how much protein?
answer
49 grams/day
question
In times of energy shortage from carbohydrates or fats in foods, the body uses protein in what way?
answer
it removes the nitrogen portion and burns the remaining fragments for energy
question
A child suffering from protein deficiency has edema. This is an example of protein's role in:
answer
maintaining fluid and electrolyte balance.
question
Which of the following accounts for the differences among the various amino acids?
answer
the side chain
question
Your mother is considering changing her diet to include only non-meat proteins to reduce her risk of developing heart disease or cancer. What evidence is available to support her decision?
answer
plant-based diets are usually lower in saturated fat and higher in fiber, which reduces risk of heart disease
question
When amino acids are absorbed by the cells of the small intestine:
answer
they can be circulated in the bloodstream to other cells and linked together to create new proteins.
question
The stomach lining is protected from the very strong acid of the stomach by:
answer
a coat of mucus
question
All of the following are needed for the body to synthesize protein except:
answer
amino acid supplements
question
The roles of enzymes formed by body proteins are important when foods are eaten because:
answer
an enzyme acts as a catalyst to speed up a reaction without being altered itself.
question
Cells will do all of the following to create their own working proteins from available amino acids except:
answer
hold partially completed proteins until the diet provides the missing amino acids.
question
A woman who is on a vegan diet has become pregnant. What would be a health concern for her?
answer
she may have difficulty gaining adequate weight during her pregnancy
question
The strategy of combining two incomplete plant protein sources so that the amino acids in one food make up for those lacking in the other food is called:
answer
mutual supplementation.
question
Proteins attract water and hold it within blood vessels, preventing it from freely flowing into the spaces between the cells. This is an example of how protein is used for:
answer
maintaining fluid and electrolyte balance.
question
A boy 10 years old is going through a growth spurt. Because he needs to build new muscle tissue, what should his nitrogen status be?
answer
positive nitrogen balance
question
The DRI for protein for healthy adults is _____ gram(s) per kilogram of body weight.
answer
0.8
question
Your friend states that she avoids acid foods like tomatoes and orange juice because they give her an acid stomach. How would you respond to this statement?
answer
b and c
question
Which of the following statements is/are true?
answer
Athletes need slightly more protein than other healthy adults.
question
An athlete consumes large amounts of meat in an effort to build extra muscle tissue. This practice does not work because:
answer
a and c
question
Which of the following cooking methods would you use to increase the digestibility of protein?
answer
stewing
question
The body normally makes tyrosine from the essential amino acid:
answer
phenylalanine
question
Your friend is a vegetarian who consumes large quantities of soy products in the place of meat. From a nutrition perspective, your friend is at risk of developing _____ deficiency.
answer
iron
question
Which statement is true of a vegan diet?
answer
very young children and the elderly may not consume enough plant sources of protein to build and maintain bone and muscle tissue
question
In making recommendations for protein intake, the committee on DRI took into consideration that the protein in a normal diet would be:
answer
a combination of animal and plant sources.
question
If amino acids are oversupplied:
answer
b and c
question
Why is milk used as a first-aid remedy for someone who has swallowed a heavy-metal poison?
answer
The poison acts on the protein in the milk rather than on the protein of the gastrointestinal tract
question
All of the following cause denaturation of proteins except:
answer
light
question
The calorie-deficiency disease resulting from chronic starvation is known most specifically as:
answer
marasmus
question
Which of the following is not a characteristic of children with kwashiorkor?
answer
They look like skin and bones.
question
Which of the following is not a characteristic of children with kwashiorkor?
answer
They look like skin and bones.
question
An adolescent girl has decided to adhere to a vegetarian diet and has selected a tossed green salad, whole-wheat crackers, and apple juice for lunch. What would you advise her about her complementary protein sources?
answer
adding garbanzo beans to her salad would provide the protein combination she needs
question
To ensure adequate intakes of vitamin B12, vitamin D, and calcium, vegans need to:
answer
a and c
question
Why should eggs be cooked, rather than eaten raw?
answer
a and c
question
The DRI for protein depends on:
answer
body size
question
A child with marasmus would exhibit all of the following symptoms except:
answer
edema
question
Of the following foods, which likely contains the most easily digestible protein?
answer
tuna
question
A young man who is a sedentary college student needs how much protein if he weighs 175 pounds?
answer
64 grams/day
question
An overemphasis on protein-rich foods can lead to:
answer
b and c
question
Which of the following is not associated with an excess of protein?
answer
enlarged livers in humans
question
Amino acids are wasted (not used to build protein or nitrogen-containing compounds) whenever there is:1. not enough energy from carbohydrate and fat.2. low-quality protein.3. too much protein.4. high-quality protein.
answer
1,2,and 3
question
Which of the following would have the highest protein DRI per unit of body weight?
answer
a 6-year-old-child
question
A(n) _____ bond is formed between the amine group end of one amino acid and the acid group end of the next amino acid in a protein.
answer
peptide
question
Children adhering to a vegan diet need to include which of the following foods to ensure adequate growth and bone development?
answer
a and b
question
Examples of complementary protein combinations include all of the following except:
answer
pasta with tomato sauce
question
Which of the following is a protein catalyst, which acts on other substances to change them chemically?
answer
enzyme
question
Which of the following food groups does not provide significant protein?
answer
fruits
Anorexia Nervosa And Bulimia
Anorexia Nervosa And Bulimia Nervosa
Community Health
Fluid And Electrolyte Balance
Health Assessment
Negative Symptoms Of Schizophrenia
Nursing
White Blood Cell Count
HESI Case Study Integument Assessment – Flashcards 24 terms

Kaiya Hebert
24 terms
Preview
HESI Case Study Integument Assessment – Flashcards
question
1. When assessing the skin of a client with bulimia, which data is important for the nurse to obtain? -Texture -Pigmentation -Turgor -Thickness
answer
Turgor
question
The nurse assesses that Mandi's skin turgor is slightly inelastic. 2. What additional finding validates the nurse's initial assessment regarding the client's fluid status? -Areas of skin bruising -Dry Mucus membranes -Shiny appearance of the forehead -Rapid Facial flushing
answer
- Dry Mucus Membranes
question
Because Mandi shows early signs of fluid volume deficit, the nurse provides her with a sports drink. While Mandi drinks the fluid, the nurse continues the assessment. Since entering the nurse's office, Mandi's face has become flushed, with flushing also noticeable bilaterally on her neck. 3. The nurse observes that Mandi's skin pigmentation is deeply tanned. To evaluate the client for pallor, what are should the nurse assess? -Cheeks and chin -Earlobes -Hair follicles -Conjuctivae
answer
Conjuctivae
question
The nurse sees no evidence of pallor. 4. What follow up assessment should the nurse perform after observing the facial flushing? -Ask about any feelings of anxiety -Observe the color of the sclerae -Measure the oxygen saturation -Check for loss of skin integrity
answer
Ask about any feels of anxiety
question
5. The nurse observes that there are numerous blackheads around Mandi's chin and nose. What action should the nurse take in response to this finding? -Note any pustules or nodules -Palpate the areas for tenderness -Ask about a history of eczema -measure for pitting edema
answer
Note any pustules or nodules
question
The nurse attempts to question Mandi about her vomiting. Mandi refuses to talk about the vomiting episodes that occurred earlier in the day, stating that she must have "eaten something bad" the night before for dinner. However, she seems open to talking about other things, so the nurse continues with the client interview, focusing on the appearance of her skin, hair, and nails. 6. Which question is most important for the nurse to ask the client? -"How often do you use a tanning booth?" -"Do you use a hair coloring product?" -"What do you use to cleanse your skin?" -"Do you tend to bite or chew your nails?"
answer
How often do you use a tanning booth?
question
The nurse examines a mole on Mandi's abdomen. The mole is oval, solid tan, and approximately 2mm in diameter. 7. The nurse questions Mandi about the observable moles on her skin. What question is most important to ask the client? -"Have any of your moles changed in size or appearance?" -"Do you have any moles on your abdomen or chest?" -"Do the moles on your arms make you feel self-conscious?" -"Have you ever tried to cover up your moles with make up?"
answer
Have any of your moles changed in size or appearance?
question
8. What additional observation is important in assessing the mole? -There is no inflammation around the mole -The mole is surrounded by freckles -The mole does not blanche when compressed -The border of the mole is smooth
answer
The border of the mole is smooth
question
9. Mandi also points out a small (1mm), smooth, slightly raised bright red dot on her abdomen and asks the nurse to examine the spot as well. How should the nurse proceed? -Offer assurance that this lesion is not an abnormal finding -Apply pressure over the lesion and observe for blanching -Advise the client to be examined by a healthcare provider -Determine if the client experience any trauma at the site
answer
Offer assurance that this lesion is not an abnormal finding
question
After completing the assessment of Mandi's skin lesions, the nurse takes Mandi's hand and examines her fingernails. 10. The nurse observes that the nail surface is slightly curved and the angle of the nail base is 160 degree. What action should the nurse take in response to this finding? -Use a pulse oximeter to measure the oxygen saturation -Ask the Client about any current or past use of cigarettes -Continue the assessment, noting the color of the nail surface -Assess for crepitus underneath and around the nail surface
answer
Continue the assessment, noting the color of the nail surface
question
11. While assessing the Client's nails, it is most important for the nurse to follow-up on which assessment finding? -Ragged cuticles -Firm nail base -Irregular nail edges -brittle nail surface
answer
-brittle nail surgace
question
Mandi has colored her hair solid black and uses an assortment of colored hair ties for accents. The nurse comments on Mandi's hair color and proceeds to assess her hair. 12. Which assessment is most important for the nurse to complete? -Ask the client how long she has colored her hair -Observe the texture and distribution of hair growth on the scalp -Check the client's hair for split ends -Note the pattern of hair growth around the client's forehead
answer
-Observe the texture and distribution of hair growth on the scalp
question
12. Mandi tells the nurse that her scalp itches sometimes. The nurse observes while flecks on the client's shoulders. What action should the nurse take first? -Instruct the client about dandruff treatments -Explain how to treat the hair and scalp for head lice. -Remind the client not to share hair brushes -Observe the client's hair shafts and scalp
answer
-Observe the client's hair shafts and scalp
question
14. The nurse observes the overall hair distribution on Mandi's face and arms. There is visible hair growth on her forearms. She has thin eyelashes and eyebrows, and otherwise fine, downy facial hair. What action should the nurse take in response to these observations? -Document the areas of alopecia as an indication of the client's poor nutrition -Move on to the next area of assessment since the findings are within normal limits -Note the absence of normal hair growth patterns on the client's face. -Ask the client if the excessive hair growth on her arms is of concern to her
answer
-Move on to the next area of assessment since the findings are within normal limits
question
While observing the mole and cherry angioma on Mandi's abdomen, the nurse also observed several areas of apparent skin injury on Mandi's lower abdomen. Because the nurse feels a trusting relationship has now been established, the nurse believes that Mandi may respond to further assessment related to the injured areas and asks Mandi to allow the nurse to observe her abdomen again. Mandi agrees. 15. The nurse observes several bruises of various colors across Mandi's lower abdomen. What concern should the nurse address? -Painful injury with hot and cold objects -Recent injury with different sized objects -Repeated injury over a period of time -Self-inflicted injury to obtain attention
answer
-repeated injury over a period of time
question
16. The nurse observes areas of petechiae surrounding some of the bruises. How should the nurse respond to this finding? -Document the location of the bruises and petechiae -Ask the client how these burns occurred -Palpate the areas for warmth and swelling -immediately measure and record the vital signs
answer
-Document the location of the bruises and petechiae
question
17. After expressing concern about the bruises on Mandi's abdomen, how should the nurse begin the abuse assessment? -Determine if the client is sexually active. -Ask the client if someone else caused the injuries -Encourage the client to describe her family structure -Advise the client of her right to legal counsel during the interview
answer
-Ask the client if someone else caused the injuries
question
18. To gather data related to the frequency of abuse by Mandi's boyfriend, what action should the nurse take first? -Determine if the client has ever tried to break up with her boyfriend and how she attempted to the end the relationship -Provide a calendar for the client to mark the dates when any violent and abusive behavior by her boyfriend occurred. -Instruct the client that there is no point in denying the pattern of abuse because of the varying colors of the bruises -Ask the client about her boyfriend's use of any illegal drugs or frequency of alcohol abuse since they have been dating
answer
-Provide a calendar for the client to mark the dates when any violent and abusive behavior by her boyfriend occurred.
question
While conversing with the nurse about her boyfriend, Mandi starts to scratch her neck, and says "On no, this happens sometimes when I get really stressed." 19. What finding should the nurse expected in response to Mandi's itching? -Hirsutism -Urticaria -Purpura -Pustules
answer
Urticaria
question
20. The nurse observes raised, pink wheals on Mandi's neck. How should the nurse respond to this observation? -Apply a warm compress directly over the wheals -Offer assurance that this is a temporary response -Ask if the client has been stung by an insect recently -Explain that antibiotics will need to be prescribed
answer
-Offer assurance that this is a temporary response
question
21. The nurse prepares to administer diphenhydramine (Benadryl) 12.5mg orally. The tablet is supplied in a 25mg doe. How many tablet(s) should the nurse give?_________ (enter numerical value only)
answer
0.5 or 1/2
question
The nurse teaches Mandi about Benadryl. Which information should the nurse included? (select all that apply.) -Blurred vision or loss of balance are potentially serious side effects of this medication -This medication may cause an increase in secretions and moisten mucous membranes. -This medication may cause drowsiness. -Benadryl blocks the effect of histamine response to reduce itching -Benadryl products contain aspirin, so observe for signs of bleeding
answer
-Blurred vision or loss of balance are potentially serious side effects of this medication -This medication may cause drowsiness. -Benadryl blocks the effect of histamine response to reduce itching
question
Before reporting the information obtained about the physical abuse that Mandi experienced, the nurse documents the findings. 23. Which strategy should the nurse use to document the extent of the physical injuries? -Include xrays in the client record -use the numeric braden scale -prepare a detailed injury map -complete the abuse assessment screen
answer
prepare a detailed injury map
question
How should the nurse document the information obtained when charting Mandi's abuse assessment? -Refrain from including information that might identify the alleged abuser. -Summarize the abusive events without directly quoting the client -Delete any expletives the client used when describing the abuser -Quote the client's responses to the questions as verbatim as possible
answer
Quote the client's responses to the questions as verbatim as possible
Fluid And Electrolyte Balance
Nursing
Urology
Human Diseases Quiz 3 – Flashcards 69 terms

Rebecca Mallory
69 terms
Preview
Human Diseases Quiz 3 – Flashcards
question
How is urge incontinence different from stress incontinence?
answer
Urge incontinence is caused from an abnormal bladder contraction. Stress incontinence is caused from weak pelvic floor muscles.
question
Why is cystitis more common in females?
answer
Females have short, wide and adjacent to areas w/ resident flora
question
Patient has a malignant tumor of the bladder, what clinical manifest. is the initial symptom? a. fever b. frequency c. urinary retention d. painless hematuria
answer
d. painless hematuria
question
Hematuria
answer
blood in the urine
question
What is the glomerular filtration rate and what does it determine?
answer
Glomerular filtration rate is the speed of blood that moves through the glomerulus (cluster of capillaries). It determines the kidney function and the stage of kidney disease.
question
Glomerulonephritis
answer
question
Nephrotic Syndrome
answer
question
Acute Renal Failure
answer
question
Chronic Renal Failure
answer
question
What is the complication for a patient w/ a large renal calculi? a. chronic hypertension b. hydronephrosis c. polyuria d. dysuria
answer
b. hydronephrosis
question
Chronic hypertension
answer
question
Hydronephrosis
answer
abnormal dilation of the renal pelvis and the calyces of one or both kidneys
question
Polyuria
answer
question
Dysuria
answer
question
What prevention strategy will you teach the patient w/ risk for renal calculi? a. avoid dairy products and other sources of Calcium b. start taking antibiotics w/ the first sign of a stone c. Avoid aspirin and aspirin containing products d. Drink at least 3-4 liters of fluid a day
answer
d. drink at least 3-4 liters of fluid a day
question
Which assessment parameter most accurately determines fluid and sodium retention status in a patient w/ chronic kidney disease? a. capillary refill b. intake and output c. muscle strength d. weight and blood pressure
answer
d. weight and blood pressure
question
Which vitamin in insufficient when there is a chronic alteration in kidney function? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K
answer
b. vitamin D
question
Which of the following conditions is associated w/ over secretion of renin? a. hypertension b. renal calculi c. diabetes mellitus d. diabetes insipidus
answer
a. hypertension Rationale using RAAS; renin is secreted from the kidneys that is combined with angiotensinogen to create angiotensin I, ACE is added to create angiotensin II that acts on the pituitary gland- ADH (H2O absorption), adrenal gland- aldosterone(Na+, Cl- reabsorption, K+ excretion), arterioles (vasoconstriction) all which raise the blood pressure
question
Whish laboratory result for a patient w/ chronic renal failure will require rapid action by the nurse? a. Blood urea nitrogen of 54 mg/dL b. Serum potassium of 7.1 mEq/L c. Hemoglobin of 10.4 g/dL d. Serum pH 7.34
answer
b. serum potassium of 7.1 mEq/L (K+ deals with the heart)
question
Which results are normal in a urinalysis? a. protein small b. glucose negative c. leukocytes positive d. blood negative e. ketones negative
answer
b, d, and e there should be no protein or leukocytes in the urine
question
What is erythropoietin?
answer
A hormone the kidneys release in response to hypoxia. It stimulates the bone marrow to produce more red blood cells (if iron stores are adequate, then increase of red blood cells increases oxygen-carrying capacity)
question
Potassium
answer
Primary intracellular cation. Involved in: electrical conduction, acid-base balance, & metabolism. Shifts of K+ into intravascular space can be dangerous to the heart. Leaves little room for fluctuation, avg. 40-60 mEq
question
Sodium
answer
Most significant cation, extracellular. Primary func. is to control serum osmolarity & water balance. Regulated by kidneys & aldosterone (adrenal cortex to retain Na+ or discard Na+)
question
Bicarbonate
answer
question
Calcium
answer
99% found in bones & teeth, 1% ionized (unbound) in the blood; blood clotting, hormone secretion, receptor func, nerve transmission & muscular contraction. Inverse relationship w/ Phosphorus & synergistic relationship with Magnesium (needs Mg to func.) Avg. 800-1200 mg/day
question
Phosphorus
answer
Mostly found in bones & small amount in bloodstream. Inverse relationship w/ Ca+; bone & tooth mineralization, cellular metabolism, acid-base balance, & cell membrane formation. Average 1,000 mg/day
question
Magnesium
answer
Intracellular cation, stored in bone & muscle; helps maintain normal muscle & nerve func, regular cardiac rhythm, a healthy immune system, bone strength, blood glucose levels, & normal blood pressure. Avg 400 mg/day
question
Albumin
answer
Protein of the blood plasma, regulate the osmotic blood pressure; produced in the liver
question
Protein
answer
should not show up in the urine
question
BUN
answer
Blood Urea Nitrogen, test that measures nitrogen in blood from urea. Sees how well the kidneys are working
question
Creatinine
answer
Chemical waste from muscle metabolism, produced from creatine. Transported through bloodstream to kidneys and excreted; if largely increased can cause renal failure
question
Which of the following cancers of the female genitourinary tract is the most easily detected & cured? a. cancer of the vulva b. cancer of the cervix c. cancer of the ovary d. cancer of the endometrium
answer
b. cancer of the cervix
question
Ovarian cancer: a. is often asymptomatic until disease is far advanced b. is easily detected using the serum marker PSA c. is easily detected during a pelvic exam d. can be detected w/ the Pap smear
answer
a. is often asymptomatic until disease is far advanced PSA is for prostate cancer, isn't easily detected with pelvic exam or with Pap smear (no good screening for ovarian cancer, BRCA1 & 2 help predict the likelihood)
question
Reason that antibiotic therapy predisposes women to vulvovaginal candidiasis is that it: a. produces a decrease in immune function b. increases vaginal pH leading to yeast overgrowth c. decreases pH of vaginal secretions d. increases vaginal glycogen stores
answer
b. increases vaginal pH leading to yeast overgrowth becomes more alkaline- increases the risk for yeast infections
question
Which patient is most likely to have erectile dysfunction? A. middle-aged man who first had sexual intercourse at age 15 B. middle-aged man who has had diabetes mellitus for 25 yrs C. young man who had a myocardial infarction 2 yrs ago D. young man who is the president of a corporation/ large debt
answer
B. middle-aged man who has had diabetes mellitus for 25 years (decrease in blood circulation)
question
Without treatment, which infection may progress to damage the aorta, liver, & central nervous system? a. syphilis b. gonorrhea c. chlamydia d. trichomoniasis
answer
a. syphilis (can lead to death & affect the baby)
question
Which of the following types of vaginal discharge is characteristic of a trichomonas infection? a. mucopurulent b. thin & watery c. copious frothy green or yellow & foul smelling d. homogenous fishy smelling w/ pH above 4.5
answer
c. copious frothy green or yellow & foul smelling trichomonas infection- caused by a parasite
question
Which assessment finding in the patient indicates the highest risk of a malignant breast lesion? a. ill-defined painful rubbery lump in the outer breast quadrant b. 1-cm freely mobile rubbery mass discovered by the patient c. backache & breast fungal infection d. nipple discharge & dimpling
answer
d. nipple discharge & dimpling the rubbery lump is ill-defined but not painful and it can be mobile in early stages, but not at the highest risk then breast fungal infection (associated w/ lactation) is mastitis
question
Uterine prolapse, cystocele, & rectocele may all be the result of: a. repeated infections b. chronic constipation c. hormonal abnormalities d. pregnancy & childbirth
answer
d. pregnancy & childbirth cause lots of stress on the pelvic floor muscles, weakening them
question
Which of the following infections would increase risk for cancer development in the genital region? a. syphilis b. chancroid c. cytomegalovirus d. human papillomavirus
answer
d. human papillomavirus chancroid- venereal infection causing ulceration of the lymph nodes in the groin cytomegalovirus- part of the herpes viruses; can cause mental retardation & fetal death w/ maternal infections
question
Prostate cancer can be defined as: a. a rare malignancy b. slow-growing tumor often confined to the prostate c. most common among Caucasian men d. none of the above
answer
b. slow-growing tumor often confined to the prostate
question
Herpes
answer
Viral STI; infection that causes blisters on the genitals & in the reproductive tract, caused by herpes simplex virus (HSV) HSV1- above the waist, cold sores HSV2- (70%) occurs below the waist; transmissible through skin-to-skin contact, though increased risk when blisters are present (reoccurence of both types, more common in 2)
question
Condylomata acuminate
answer
Viral STI, genital warts; benign growths caused by HPV. Occur on external genital, vaginal wall, cervix, anus, thighs, lips, mouth, & throat. Lesions vary in appearance (cauliflower-like, rough, flat smooth, etc.) treat -preventative HPV vaccine, growth removal for aesthetic
question
Chlamydia
answer
Bacterial STI, intracellular parasite; neonatal conjunctivitis (eye infection- blindness), PID, epididymitis, prostatitis, infertility, & eptopic pregnancy S/S: dysuria, discharge (purulent), testicular tenderness/pain, rectal pain, & painful sexual intercourse. Treat- antibiotic azithromycin (zithromax), doxycycline, or erythromycin
question
Gonorrhea
answer
Bacterial STI, (the clap or the drip), aerobic bacterium w/ many drug-resistant strain. Attaches to the mucosa of the vag, mouth, or anus causing irritation & inflammation; complications like chlamydia & in other parts of the body- arthritis, dermatitis, & endocarditis. Manifest- dysuria, urinary frequency/urgency, discharge (white, yellow, or green), redness or edema at urinary meatus (in men), pharyngitis, white blisters that darken & disappear. Treat- antibiotics
question
Syphilis
answer
Bacterial STI, ulcerative infection spiral-shaped bacterium. Ulcerative lesions- chancres. Primary- one chancre forms, painless & goes away; bacteria goes dormant. Secondary- nonpruritic, brown-red rash, malaise, fever, & patchy hair loss; go away & dormant Latent/ Tertiary- final stage, spreads to brain, nervous system, heart, skin, & bones. Can cause blindness, paralysis, dementia, cardiovascular disease, & death. Treat- early on antibiotics like penicillin, etc. not effective in latent phase syphilis
question
Trichomoniasis
answer
Protozoan STI, the trick, a one-celled anaerobic organism. Parasite can burrow under the mucosal lining. Women- reside in vag & symptomatic when microbial imbalances occur, contracted through prolonged moisture exposure. Men usually have symptoms & resolve without treatment. Manifest- copious amounts of odorous, frothy, white or yellow-green discharge, irritates vag & vulva; itching, painful intercourse, & dysuria. Treat- antibiotic, metronidazole (Flagyl)
question
Prostate Cancer
answer
Most common cancer in men, usually confined to prostate. Prostate enlarges & impedes the urethra (difficulty urination & erectile disfunc), blood semen & hematuria Treat- prostatectomy or angiotestosterone drug therapy
question
Testicular Cancer
answer
Uncommon cancer, young (15-35 yr old men), slow growing or fast growing. Risk- history, infection, trauma, tobacco use, testicle abnormalities. Usually affects one testicle, metastasize to nearby lymph, lungs, liver, bone & brain. Manifest- hard, painless, palpable mass that does not transilluminate; discomfort, enlargement, & female-like breast). Highly curable; treat- orchiectomy, chemo/ radiation
question
Breast Cancer
answer
Most common malignancy in women, can occur in men; advancing age, early onset menstruation, history, genetics (BRCA1/2 genes), obesity, etc. Manifest- movable mass, hard, uneven edges, usually painless, change in nipple appearance (dimple, redness, or puckering), nipple drainage (bloody, clear-yellow/green or purulent) Treat- aggressive multimethod (chemo, radiation, surgery, & hormone therapy)
question
Cervical Cancer
answer
Pap smear can detect precancerous cells, which are 100% treatable. Usually caused by HPV, & asymptomatic when manifest- discharge (pale, watery, pink, brown, bloody, or foul smelling), abnormal vaginal bleeding, menorrhagia (abnormal heavy bleeding) Advanced cancer- anorexia, weight loss, fatigue, pelvic, back or leg pain, unilateral lower extremity edema, heavy bleeding, leaking urine or feces from vag, & bone fractures Treat- loop electrosurgical excision procedure, cryotherapy, laser therapy, adv- chemo, radiation, & surgery
question
Ovarian Cancer
answer
9th most common cancer in women, no reliable screening test, difficult to treat, & metastasize at time of diagnosis. Risks- genetic (BRCA1/2), advancing age, infertility, excessive estrogen exposure, obesity, & androgen hormone therapy Manifest- abdominal distention, pelvic pain, & eating disturbances, bowel pattern changes, GI discomfort, pair during intercourse, malaise, urine frequency, & menstruation changes. Treat- surgery, chemo, salpingo-oopho-rectomy (ovary & fallopian tube removal) & hysterectomy
question
Which of the four types of gastritis is the most common? a. chemical gastropathy b. multifocal atrophic c. autoimmune d. helicobacter pylori (H. pylori)
answer
d. helicobacter pylori
question
Chron's disease is characterized by: a. sharply demarcated granulomatous skip lesions of the bowel b. ulcerative lesions of the mucosal layer of the colon c. increased risk of colon cancer d. lack of systemic involvement
answer
a. sharply demarcated granulomatous skip lesions of the bowel
question
Which of the following patients is most at risk for developing hepatitis B: a. 54- yr old woman who takes acetaminophen (Tylenol) daily for headaches b. 24- yr old college student who has had several sexual partners c. 33- yr old business man who travels frequently d. 23- yr old college student that binge drinks
answer
b. 24- yr old college student who has had several sexual partners Tylenol is a risk if large amounts are consumed
question
Which of the following patients is at risk for intestinal obstruction? a. an elderly patient who is on bedrest bc post-operative abdominal surgery b. Jewish patient who smokes & consumes high amounts of caffeine c. an individual eating a low-fiber, high fat diet d. an adult diagnosed w/ cirrhosis of the liver
answer
a. an elderly patient who is on bedrest bc post-operative abdominal surgery abdominal surgery needs to be moving asap, & is often given meds that can cause intestinal obstruction
question
Decreased synthesis of which substance in the patient diagnosed w/ liver failure would be responsible for development of ascites? a. bile b. glucose c. albumin d. carbohydrates
answer
c. albumin -regulates fluid balance & is in the liver
question
Colorectal cancer w/ visible peristaltic wavers & auscultations, hear high-pitched bowel sounds match: a. patient's tumor has metastasized to the liver & biliary tract b. patient's tumor has caused a intussusception of the intestine c. patient's growing tumor has caused a partial bowel obstruction d. patient has developed toxic megacolon from the growing tumor
answer
c. patient's growing tumor has caused a partial bowel obstruction -showed by high pitched sounds intussusception- intestine folds into itself- telescope toxic megacolon- complication of IBD
question
What is the underlying pathology experienced by people w/ irritable bowel syndrome? a. impaired colonic reflexes resulting in decreased peristalsis b. excessive gastric secretions resulting in ulcer formation c. changes in mucous cell structure resulting in steatorrhea d. increased response to stretching & discomfort resulting in intestinal motility
answer
d. increased response to stretching & discomfort resulting in intestinal motility steatorrhea- abnormal amount of fat in feces
question
Acute right lower quadrant pain associated w/ rebound tenderness & systemic signs of inflammation are indicative of: a. gastritis b. peritonitis c. appendicitis d. cholecystitis
answer
c. appendicitis gastritis- inflammation of stomach's mucosal lining peritonitis- inflammation of peritoneum (lining of the abdominal wall & abdominal organs) cholecystitis- inflammation caused by calculi in biliary system
question
Patient admitted to healthcare facility w/ a diagnosis of a bleeding gastric ulcer, nurse expects stool to be: a. coffee-ground like b. clay-colored c. black & tarry d. bright red
answer
c. black & tarry - blood travels through GI tract & loses the color coffee-ground- blood in vomit clay-colored- biliary system problem (lack of bile salts)
question
Oral cancer can be defined as: a. painless, whitish thickening lesions b. can occur anywhere in the mouth c. alcohol & tobacco increase risk of oral cancer d. all of the above
answer
d. all of the above
question
Hepatitis A
answer
Type A- waterborne (fecal-oral), abrupt; fever, nausea & jaundice in children, mild severity Type B- perinatal (blood/skin), insidious; nausea & jaundice, moderate severity Type C- sexual (blood/skin), insidious; nausea, mild severity Type D- sexual (blood/skin), insidious; fever, nausea & jaundice, moderate-severe Type E- waterborne (fecal-oral), abrupt; fever, nausea & jaundice, severe
question
Pancreatitis
answer
inflammation of pancreas acute- medical emergency; upper abdominal pain radiates to back & worsens after eating, nausea/ vomiting, mild jaundice, low fever, blood pressure & pulse changes chronic- upper abdominal pain, indigestion, losing weight, streatorrhea, constipation, & flatulence Treat- no eating; intravenous nutrition (TPN), pancreatic enzyme supplements when diet is resumed, maintain hydration-intravenous, antibiotic if infected, pain management, etc.
question
Peptic ulcer
answer
Lesions affecting the the lining of the stomach or duodenum. Vary in severity based on depth of ulcer superficial erosion- complete penetration through wall
question
Cholelithiasis
answer
Gallstones (calculi in gallbladder), varying in sizes & shapes. More common in fair-skinned women. Risks- age, obesity, rapid weight loss, pregnancy, hormone replacement, some chronic diseases. Cholecystitis calculi cause inflammation or infection in biliary system, small asymptomatic, large -obstruct bile flow; gallbladder rupture, fistula formation, gangrene, hepatitis, pancreatitis, & carcinoma Manifest- abdominal pain, distension, nausea, clay-colored stool, fever, leukocytosis Treat- low-fat diet, meds to dissolve calculi, surgical removal
question
Gastric ulcer
answer
Ulcer in stomach lining- related to malignancy & NSAID use; pain worsens w/ eating
question
Duodenal ulcer
answer
Ulcer in duodenum- asociated w/ excess acid; epigastric pain relieved by food
question
Gastroesophageal reflux disease
answer
Chyme backs up into the esophagus, & occasionally bile. From: certain foods (chocolate, spicy or fatty, etc.), smoking, alcohol, obesity, pregnancy, meds, etc. Manifest- heartburn, epigastric pain (after meal), dysphagia, nausea (after eating), dry cough, "lump in throat" feeling, regurgitation of food, etc. Treat- avoid triggers, avoid NSAIDs, loose clothing, small frequent meals, reduce stress, losing weight, antacids, etc.
Fluid And Electrolyte Balance
Nursing
Nursing-LPN
PrepU Chapter 37: Management of Patients With HIV Infection and AIDS – Flashcards 65 terms

David Dunn
65 terms
Preview
PrepU Chapter 37: Management of Patients With HIV Infection and AIDS – Flashcards
question
Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy?
answer
CD4 counts
question
Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as containing the genetic viral material?
answer
Ribonucleic acid (RNA)
question
A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test?
answer
Western blot assay
question
A nurse is visiting the home of a client with AIDS who is experiencing HIV encephalopathy. When developing the plan of care for the client and his caregiver, the nurse identifies the nursing diagnosis of disturbed thought processes related to confusion and disorientation secondary to HIV encephalopathy. Which expected outcome would be most appropriate for the nurse to document on the client's plan of care?
answer
The client can state that he is at his home.
question
You are caring for a client who has a diagnosis of HIV. Part of this client's teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications?
answer
Side effects of drug therapy
question
Which of the following indicates that a client with HIV has developed AIDS?
answer
Herpes simplex ulcer persisting for 2 months
question
A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often."What should the nurse consult with the physician regarding?
answer
Testing the client for the presence of HIV
question
A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?
answer
Bank autologous blood
question
A new nursing graduate is working at the hospital in the medical-surgical unit. The preceptor observes the nurse emptying a patient's wound drain without gloves on. What important information should the preceptor share with the new graduate about standard precautions?
answer
Standard precautions should be used with all patients to reduce the risk of transmission of bloodborne pathogens.
question
A patient is diagnosed with pneumocystis pneumonia (PCP). What medication does the nurse anticipate educating the patient about for treatment?
answer
TMP-SMZ (Bactrim)
question
A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?
answer
Risk for injury
question
A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse demonstrates a need for a review of transmission routes by identifying which body fluid as a means of transmission?
answer
urine
question
The nurse is teaching a client with HIV how to use a male condom. The client demonstrates understanding of the information when he states which of the following? Select all that apply.
answer
-"I need to hold the condom by the tip to squeeze out the air before putting it on." -"I should unroll the condom all the way over my erect penis." -"I should avoid using baby oil or petroleum jelly with a condom."
question
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____.
answer
HIV-1 is more prevalent than HIV-2 subtypes
question
A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in?
answer
Primary infection
question
Which of the following options should the nurse encourage to replace fluid and electrolyte losses in a patient with AIDS?
answer
liquids
question
A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. Which of the following would the nurse describe as the first step?
answer
attachment
question
The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply.
answer
- Semen - Breast milk -Blood -Vaginal secretions
question
The nurse is collecting objective data for a client with AIDS at the clinic. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does the nurse understand this finding indicates?
answer
Candidiasis
question
A client has discussed therapy for his HIV-positive status. What does the nurse understand is the goal of antiretroviral therapy?
answer
Keep the CD4 cell count above 350/mm3 and viral load undetectable.
question
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
answer
Stool specimen for ova and parasites
question
Which blood test confirms the presence of antibodies to HIV?
answer
Enzyme-linked immunosorbent assay (ELISA)
question
The nurse teaches the patient that lowering his or her viral load will have what effect?
answer
A longer survival time
question
Diagnosis of Kaposi's sarcoma (KS) is made by which of the following?
answer
Biopsy
question
A patient taking amprenavir (APV, Agenerase) complains of "getting fat." What is the nurse's best action?
answer
Teach the patient about medication side effects.
question
During a routine checkup, a nurse assesses a client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most common AIDS-related cancer?
answer
Kaposi's sarcoma
question
A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when he schedules a return visit for viral load testing at which time?
answer
6 weeks
question
When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?
answer
Antibodies to HIV are not present in his blood.
question
A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
answer
AIDS dementia complex (ADC)
question
The client comes to the clinic to obtain the results from the test to determine if he is infected with HIV. The physician informs the client that he has a CD4 cell count of 300 cells/mm3 and a high viral load. What does the nurse anticipate the physician will discuss with the client?
answer
The initiation of antiretroviral therapy
question
Antiretroviral medications should be offered to individuals with T-cell counts of less than
answer
350 cell/mm
question
A client with AIDS is exhibiting shortness of breath, cough, and fever. The nurse most likely would suspect infection with which of the following?
answer
Pneumocystis jiroveci
question
HIV is harbored within which type of cell?
answer
Lymphocyte
question
A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus's ability to make a genetic blueprint. What drug will the nurse instruct the client about?
answer
Reverse transcriptase inhibitors
question
A client visits the nurse complaining of diarrhea every time they eat. The client has AIDS and wants to know what they can do to stop having diarrhea. What should the nurse advise?
answer
Avoid residue, lactose, fat, and caffeine.
question
A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?
answer
Trimethoprim-sulfamethoxazole (Bactrim, Septra)
question
While caring for a patient with pneumocystis pneumonia, the nurse assesses flat, purplish lesions on the back and trunk. What does the nurse suspect these lesions indicate?
answer
Kaposi's sarcoma
question
A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action?
answer
Call the health care provider to report.
question
The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started "acting funny" after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?
answer
"The patient may have cryptococcal meningitis and will need to be evaluated by the physician."
question
The nurse is administering an injection to a client with AIDS and, when finished, attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse?
answer
Report the incident to the supervisor
question
The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is:
answer
Chronic diarrhea.
question
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay with positive results twice. What is the next step for the nurse to explain to the patient for confirmation of the diagnosis?
answer
Perform a Western blot test for confirmation of diagnosis.
question
A patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions. The patient states to the nurse, "I am not going to have a transfusion because I don't want to get AIDS." What is the best response by the nurse?
answer
"I understand your concern. The blood is screened very carefully for different viruses as well as HIV."
question
A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find?
answer
Hypokalemia
question
A client suspected of having HIV has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive?
answer
ELISA
question
A client is prescribed didanosine (Videx) as part of his highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client?
answer
"Be sure to take this drug about 1/2 hour before or 2 hours after you eat."
question
A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next?
answer
Western Blot
question
Which assessment finding is not likely to cause noncompliance with antiretroviral treatment?
answer
past substance abuse
question
A patient receiving antiretroviral therapy is complaining of "not urinating enough." What is the nurse's best action?
answer
Assess BUN and creatinine.
question
A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?
answer
Gynecologic problems
question
Postexposure prophylaxis (PEP) medications should be started within __________ after exposure, but no longer than __________, to offer any benefit. It must be taken for __________.
answer
1 hour; 72 hours; 4 weeks
question
A patient is on ART for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year?
answer
50 mm3 to 150 mm3
question
When do most perinatal HIV infections occur?
answer
After exposure during delivery
question
Which of the following has not been implicated as a factor for noncompliance with antiretroviral treatment?
answer
Past substance abuse
question
The term used to define the balance between the amount of HIV in the body and the immune response is
answer
viral set point.
question
Which of the following is an early manifestation of HIV encephalopathy?
answer
Headache
question
As part of HAART therapy, a client is prescribed a non-nucleoside reverse transcriptase inhibitor (NNRTI). Which of the following would be an example of a drug from this class? Select all that apply.
answer
- Delavirdine - Efavirenz
question
A patient in the clinic states, "My boyfriend told me he went to the clinic and was treated for gonorrhea." While testing for the sexually transmitted infection (STI), what else should be done for this patient?
answer
Inform the patient that it would be beneficial to test for HIV.
question
The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care?
answer
Assist with chest physiotherapy every 2 to 4 hours.
question
The nursing instructor is talking about HIV/AIDS with their pre-nursing pathophysiology class. The instructor explains to the class that the virus that causes HIV/AIDS is called a retrovirus. What characteristics of this retrovirus would the instructor talk with the class about?
answer
HIV-1 and HIV-2 subtypes
question
There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS?
answer
Disclosure of the client's condition
question
When assisting the patient to interpret a negative HIV test result, what does the nurse tell the patient this result means?
answer
His body has not produced antibodies to the AIDS virus.
question
What test will the nurse assess to determine the patient's response to antiretroviral therapy?
answer
Viral load
question
Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm?
answer
CDC category A: HIV asymptomatic
question
The development of a positive HIV antibody test following initial infection generally occurs in which timeframe?
answer
4 weeks
Fluid And Electrolyte Balance
Pharmacology Final Exam – Flashcards 165 terms

Viola Marenco
165 terms
Preview
Pharmacology Final Exam – Flashcards
question
Common side effects of medications for endocrine diseases include all of the following EXCEPT
answer
no changes in growth and cardiac function
question
Which of the following are true of somatropin?
answer
1, 2, 4, and 5
question
Which of the following are true of glucocorticoids and other steroids?
answer
1, 2, 3, 4, and 5
question
Signs and symptoms of hypoglycemia/insulin shock include all of the following EXCEPT
answer
Slow onset
question
Glucose absorption inhibitors
answer
all of the above
question
Which of the following statements is NOT true about adverse reactions to insulin?
answer
Insulin may cause allergic reactions in most patients
question
Hormones may be used for all of the following EXCEPT
answer
Visual Disturbances
question
Which of the following is true of thyroid hormones? 1. The three hormones secreted are thyroxine, triiodothyronine, and calcitonin. 2. Hyposecretion is cretinism in infants and children and myxedema in adults. 3. Hyposecretion may be the result of lack of iodine as well as radiation therapy and surgical removal of the thyroid. 4. Replacement therapy is lifelong. 5. Replacement therapy regimen should be taken in the mornings because of the hormone's side effect of insomnia.
answer
1, 2, 3, 4, and 5
question
Which of the following is NOT true of thiazolidinediones or glitazones?
answer
They do not delay the progression of the disease.
question
Which of the following are common symptoms of endocrine diseases? 1. skin, hair, and nail changes 2. mental deviations 3. changes in urinary output and edema 4. changes in energy levels, blood pressure, and possible heart irregularities 5. sexual irregularities
answer
1,2,3,4,5
question
Which of the following is NOT true of TSH?
answer
It decreases the uptake of iodine.
question
Sort the following insulin preparations from the shortest to the longest duration of action. 1. Lispro 2. Lantus 3. NPH 4. Regular
answer
1,4,3,2
question
Which of the following is NOT true of Lispro insulin?
answer
A person taking Lispro insulin may have more carbohydrates in the diet.
question
Calcitonin is secreted by the thyroid gland but is regulated by the parathyroid gland to ensure an adequate supply of calcium for neuromuscular and endocrine function.
answer
true
question
When a local ophthalmic anesthetic is used a patient may lose the blink reflex and pain associated with ophthalmic procedures.
answer
true
question
Eye infections should be treated with topical anti-inflammatory and antiinfective agents without doing a culture of the secretions.
answer
False
question
Drugs may be used to obtain mydriasis and miosis with ocular examinations and treatment of eye diseases.
answer
True
question
The side effects of miotics include
answer
a,b,c
question
Symptoms of ototoxicity include tinnitus, loss of balance, and vertigo.
answer
True
question
Otic antiinfective agents
answer
a,b,c
question
To safely store ophthalmic and otic medications, medications with the same name should be stored next to each other or in close proximity so that the allied health professional can be sure to use the correct medication.
answer
false
question
Which of the following statements is NOT true?
answer
Most medications used in the eye and ear have no side effects.
question
Local ophthalmic anesthetic agents are used for tonometry.
answer
True
question
When using ophthalmic anticholinergics, patients should wear dark glasses in sunshine and use dimmed lights but should have no problems with moving about after dark.
answer
False
question
Which of the following are true of keratolytic agents? 1. Keratolytic agents are used to promote the formation of the horny layer of skin. 2. Local side effects of keratolytic agents include burning and local irritation. 3. Keratolytic agents promote shedding of warts, calluses, and corns. 4. Keratolytic agents are used to treat dandruff, seborrheic dermatitis, acne, venereal warts, and psoriasis. 5. Systemic side effects of keratolytics include tinnitus, dizziness, ototoxicity, and headache.
answer
all except 1
question
Which of the following is NOT true about skin preparations?
answer
Emollients are always used to soothe and do not contain medications.
question
Occlusive dressings allow antifungals to remain in contact with the skin for a longer period of time, and these dressings increase the efficacy of the drug.
answer
false
question
Topical anesthetics are found in all of the following forms EXCEPT
answer
ophthalmic preparations
question
Which of the following is NOT true of medications used on the skin?
answer
Minoxidil is used for baldness, and it should be applied to the hair every 3 days.
question
With skin conditions, topical corticosteroids are less likely to cause systemic responses.
answer
True
question
Which of the following is NOT true of topical corticosteroids?
answer
They should be applied thickly so that the medication will stay in contact with the lesion for a longer period of time.
question
Which of the following statements is NOT true about treatment of burns?
answer
Sulfonamides should be placed on tissue before débridement to soften the area, but this treatment has no antibacterial effect.
question
Common symptoms of skin disorders include all of the following EXCEPT
answer
fever and eschar
question
Which of the following are true about the treatment of acne vulgaris? 1. Topical and systemic antibiotics are used to treat acne. 2. Many preparations for acne are available OTC, and some require a prescription. 3. Treatment of acne includes reduction of sebum and bacteria. 4. Side effects of medications for acne include dryness, scaling, and peeling of the skin; stinging and burning; itching; erythema; and skin tenderness. 5. Some medications for acne cause irritation followed by skin peeling.
answer
1, 2, 3, 4, and 5
question
Patient teaching regarding gout should include which of the following?
answer
All of the above
question
The use of colchicines is specific for gout
answer
True
question
Biphosphonates are used to prevent fractures
answer
True
question
Which of the following are found in the names of gold salts?
answer
au
question
Which is NOT true of salicylate NSAIDs?
answer
They are relatively safe and have the advantage over other medications of not causing gastrointestinal symptomatology
question
Centrally acting muscle relaxants include all of the following EXCEPT
answer
probenecid (Benemid)
question
Steroids are given to treat an exacerbation of rheumatoid disease.
answer
True
question
Central-acting and direct-acting muscle relaxants are the drugs of choice for muscle spasticity.
answer
True
question
Medications used for arthritis include
answer
All of the above
question
Which of the following are used to treat osteoporosis?
answer
A and C
question
Which of the following is true of opioid/synthetic opioid medications for diarrhea?
answer
All of the above statements are true.
question
Which of the following is NOT true of gastric pump inhibitors
answer
They are safe for treating ulcers before their confirmed diagnosis.
question
Which of the following is NOT true of H2-receptor antagonists that interact with histamine to inhibit gastric secretions?
answer
They should not be used for GERD.
question
Which of the following is necessary in patient teaching concerning laxative use
answer
All of the above are necessary.
question
Use the following to answer the following questions. 1. baking soda 2. Riopan 3. Amphojel 4. milk of magnesia 5. Tums 6. Gelusil 7. Alka Seltzer 8. Maalox 9. Rolaids 10. Gaviscon Which are calcium-based antacids?
answer
5 and 9
question
Which of the following are indications for laxative use?
answer
all except b
question
Which of the following is true of adsorbents used to treat diarrhea?
answer
All of the above statements are true.
question
Which of the following is NOT true of bowel evacuants?
answer
They are used for normal constipation.
question
Suppositories may cause rectal irritation.
answer
true
question
Which of the following is NOT true about taking medications for motion sickness?
answer
They should be taken when symptoms occur.
question
Xanthine derivatives such as theophylline are not always the drugs of choice for asthma because of the narrow therapeutic range.
answer
True
question
Which of the following is NOT a common side effect of medications for respiratory disorders?
answer
Fever and Rhinorrhea
question
Which of the following is NOT true of combination OTC products?
answer
If a patient has only a runny nose, a combination product is indicated
question
Cromolyn is for the prophylaxis of asthma.
answer
true
question
Which of the following is NOT true of medications to inhibit influenza?
answer
They are substitutes for the influenza vaccine.
question
Which of the following is NOT true of antitussives?
answer
All opioid antitussives require a prescription.
question
Medications for chronic pulmonary disease may be administered by
answer
a, b, and c
question
Which of the following is NOT a use for antihistamines?
answer
chest congestion
question
Which of the following is NOT true of mucokinetic agents?
answer
Hypotonic saline is used as a mucolytic agent.
question
Which of the following is NOT true of cromolyn sodium?
answer
It is more effective if used after the onset of allergic symptoms caused by histamines.
question
Which of the following is NOT a medication group used in treating hypertension?
answer
cardiac glycosides
question
Which of the following is NOT true of nitroglycerin?
answer
Sublingual nitroglycerin is a stable medication and is effective until the expiration date whether the bottle has been opened or not.
question
Which of the following are NOT symptoms of circulatory disorders?
answer
diuresis and homeostasis
question
Which of the following is NOT true of medications used as antidysrhythmics?
answer
All of the above statements are true.
question
Which of the following is NOT true of vasodilators?
answer
They increase heart rate and cardiac output.
question
Which of the following is NOT a type of medication used for coronary conditions?
answer
aminoglycosides
question
Which of the following is NOT true of HMG CoA reductase inhibitors?
answer
They may be discontinued when lipoprotein levels are lowered.
question
Antihypertensives cure hypertension.
answer
FALSE
question
Which of the following is NOT true regarding the treatment of cardiac dysrhythmias?
answer
ardiac dysrhythmias are cured by the medications that are used in treatment.
question
Nicotinic acid reduces LDL and VLDL levels and raises HDL levels but is limited by its side effects.
answer
true
question
Common foods that may irritate the urinary bladder include all of the following EXCEPT
answer
milk and milk products
question
Lower urinary tract infections are associated with all of the following symptoms EXCEPT
answer
headache
question
Which of the following is NOT true of urinary tract antiseptics?
answer
They are the first choice in treating UTIs.
question
Which of the following is NOT true of urinary tract antispasmodics?
answer
They are indicated for use in children under the age of 5 to relieve enuresis.
question
Which of the following is NOT true of sulfonamides?
answer
Those found on the market today are divided into short-acting, intermediate-acting, and long-acting drugs.
question
Drugs that are used to treat urinary tract infections include
answer
all of the above
question
DDVAP is a drug used in older adults who have enuresis.
answer
True
question
Which of the following are NOT common side effects of medications for urinary tract disorders?
answer
enuresis and incontinence
question
Drugs for enuresis reduce incontinence, frequency, and urgency due to spasms of the smooth muscles of the bladder.
answer
True
question
Which of the following is NOT true of medications used to treat overactive bladder and enuresis?
answer
All of the above statements are true.
question
Which of the following is NOT true of testosterone?
answer
It has no use in females.
question
Which of the following medication classes is NOT used to treat premenstrual syndrome?
answer
progesterone and calcium
question
Which of the following is NOT true of oral contraceptives?
answer
All oral contraceptives are combinations of estrogen and progestins.
question
Which of the following is true about treatment of benign prostatic hypertrophy?
answer
All of the above statements are true.
question
Adjusting the estrogen and progestin content of oral contraceptives will not change the side effects encountered with them.
answer
False
question
Which of the following is NOT true of progestins?
answer
Progesterone is an artificially produced progestin.
question
The side effects of testosterone replacement therapy include all of the following EXCEPT:
answer
a decrease in libido but never an increase
question
Which of the following does NOT apply to postcoital contraception?
answer
Emergency contraceptive pills (ECPs) are either estrogen pills or progestin pills, not combination medications.
question
Which of the following is NOT a common symptom of male reproductive tract diseases?
answer
genital lesions
question
Which of the following is NOT true regarding adrenergic antagonists used in treating BPH?
answer
They increase libido; therefore gaining compliance is easy.
question
Which of the following is NOT true of central nervous system stimulants?
answer
They may be prescribed over long periods of time for obesity.
question
Medications to treat migraine headache include all of the following EXCEPT
answer
all are used
question
Which of the following is/are NOT (a) side effect(s) of beta-blockers?
answer
mental awareness
question
Which of the following is NOT true of antiseizure medications?
answer
Patients taking antiseizure medications can adjust their doses as needed to stay seizure free without consulting a physician.
question
Medications to prevent migraine headache share all the following characteristics EXCEPT
answer
Both b and d are not true statements.
question
Medications known as adrenergic agents are catecholamines and noncatecholamines.
answer
True
question
Which of the following is NOT true of parasympatholytic medications?
answer
Parasympatholytic agents and anticholinergic medications are entirely different compounds that have similar actions.
question
Which of the following is NOT needed in patient teaching with analgesics?
answer
Medication may be stopped at any time owing to the dangers of physical dependence and habituation.
question
Common signs and symptoms of neurological disorders include all of the following EXCEPT
answer
diarrhea or constipation
question
Which of the following is true of medications for migraine headache?
answer
All of the above statements are true.
question
Antipsychotics are contraindicated in
answer
Children and the elderly
question
Which of the following is NOT a side effect of antipsychotic agents?
answer
all are side effects
question
Antianxiety medications are also called
answer
b and c
question
Common side effects of medications for mental disorders include all of the following EXCEPT
answer
hypertension and bradycardia
question
The major forms of psychosis include
answer
a and b
question
The medication(s) approved by the FDA for Alzheimer's disease is/are
answer
a,b,c
question
Mental health is concerned with which of the following aspects of a person? 1. physical health 2. cognitive health and affective being 3. behavioral and social health 4. the environment
answer
1,2,3,4
question
Antipsychotics are classified by
answer
all except c
question
Reasons for using medications in psychotherapy include
answer
all of the above
question
Low potency, intermediate potency, and high potency traditional antipsychotics all have an equal therapeutic effect.
answer
True
question
What is NOT a source of inhalants commonly used for euphoria and hallucinations?
answer
all of the above are sources of inhalants
question
Personal characteristics of drug misusers and abusers include all of the following EXCEPT
answer
feelings of self-worth
question
Which of the following are the most frequently abused chemical substances?
answer
caffeine
question
Which of the following is NOT a sign or symptom of drug abuse/misuse that should be recognized by allied health professionals?
answer
keeping medical appointments and maintaining good health practices
question
The half-life of cocaine is fairly long, leading to toxicity and the chance of acute intoxication.
answer
false
question
Which is NOT true of drugs used with alcoholism?
answer
Disulfiram should be given to a person who abuses alcohol whether the person desires to stop consuming alcohol or not.
question
Which of the following is NOT true of ethyl alcohol?
answer
It has no medicinal indications.
question
Which of the following is NOT true of marijuana?
answer
The potency of marijuana is always the same.
question
The side effects of smoking cessation include all of the following EXCEPT
answer
decreased appetite, nausea, and diarrhea
question
Which of the following is NOT a hallucinogen, psychedelic, or psychomimetic?
answer
marijuana
question
Which of the following statements are true concerning ophthalmic anti-inflammatory and antiinfective agents? 1. Most ophthalmic antiinfective/anti-inflammatory agents are effective on mucous membranes that have been injured or are inflamed. 2. To discourage drug-resistant strains of antiinfectives, antibiotics for ophthalmologic problems should be administered locally. 3. Any topical medication may be used in the eye. 4. With viral infections, both eyes may need to be treated. 5. In irrigating eyes, the head should be turned toward the affected side to prevent cross-contamination of the unaffected eye.
answer
1,2,4,5`
question
Which of the following statements is NOT true?
answer
Mydriatics are used to cause pupil constriction for diagnostic tests.
question
OTC ophthalmic medications are always safe for use by all people because the FDA has approved the use of these drugs.
answer
False
question
Agents that mimic the sympathetic nervous system bring about pupillary dilation, while cycloplegic agents cause paralysis of the ciliary muscles and prevent accommodation. These medications are used primarily for diagnostic testing.
answer
True
question
Medications used in the ear often contain more than one ingredient so that more than one symptom or condition is treated at one time.
answer
True
question
The rate of medication absorption through the skin depends on which of the following?
answer
all of the above
question
Which of the following are true of topical fungal preparations? 1. They may be used on hair, nails, or skin. 2. Most are used to treat Candida and tinea infections. 3. Most are available OTC as well as by prescription. 4. They should be used completely even if symptoms improve. 5. Therapy for fungal infections is long-term.
answer
1,2,3,4,5
question
Topical creams and ointments for pediculosis should be applied to the affected area and left on for 12 hours, and then the area should be thoroughly washed.
answer
True
question
Common side effects of musculoskeletal medications include
answer
All of the above
question
TNF inhibitors block the immune response to prevent inflammation of joints.
answer
True
question
The goal of arthritis therapy includes all of the following EXCEPT
answer
Curing the disease
question
Which of the following is an immunosuppresant agent and a DMARD?
answer
methotrexate
question
Anticholinesterase agents increase muscle tone.
answer
True
question
Which of the following is true concerning medications acting on gastrointestinal system tissues?
answer
All of the above statements are true except for d.
question
Which of the following is true of oral antiviral agents?
answer
All of the above statements are true.
question
Which of the following is NOT true of gastric pump inhibitors?
answer
They are safe for treating ulcers before their confirmed diagnosis.
question
Which of the following should not be given to persons with diabetes?
answer
phosphorated carbohydrate solution (Emetrol)
question
Which of the following is NOT true of histamine?
answer
It is not a problem with most upper respiratory inflammatory diseases.
question
Which of the following is NOT true of decongestants?
answer
They are very safe for persons who have diabetes mellitus.
question
Which of the following is NOT true of expectorants?
answer
They are not found as combination medications.
question
Which of the following is NOT a common side effect of circulatory medications?
answer
edema and shortness of breath
question
Antihypertensives receive the same response in all ethnic and cultural groups.
answer
false
question
Which of the following are routes of administration for nitroglycerin?
answer
all of the above
question
Which of the following is NOT true of hemorrheologic agents?
answer
All of the above statements are true.
question
Which of the following is NOT true of medications used to affect coagulation?
answer
Anticoagulants include vitamin K, heparin, and warfarin.
question
TMZ-SMZ is the abbreviation for trimethoprim-sulfonamide.
answer
false
question
Which of the following statements about fluid and electrolyte balance is NOT true?
answer
Infants and obese persons have less fluid in their bodies than normal adults.
question
DDVAP is an antidiuretic hormone.
answer
True
question
Which of the following is NOT true of testosterone replacement therapy?
answer
The treatment and dosage are the same for all males, regardless of the diagnosis.
question
Which of the following is NOT true about forms of contraception?
answer
All IUDs provide long-term contraception of 8 years and are intrauterine progesterone inserts.
question
Which of the following is true of sildenafil (Viagra)?
answer
All of the above statements are true.
question
Common side effects of medications for neurological conditions include all of the following EXCEPT
answer
muscle turgidity or spasticity
question
Beta-blockers are the drugs of choice in migraine headache prophylaxis
answer
True
question
Which of the following is NOT true about the use of CNS stimulants as anorexiants and for narcolepsy?
answer
They may be taken after 6:00 PM in persons desiring to lose weight and for narcolepsy without causing excessive stimulation.
question
Which of the following is NOT true of adrenergic agonists?
answer
They are not sympathomimetic medications and do not simulate the "fight-or-flight" response of the body.
question
Mental health is concerned with which of the following aspects of a person? 1. physical health 2. cognitive health and affective being 3. behavioral and social health 4. the environment
answer
1, 2, 3, and 4
question
Psychotherapeutic agents were first introduced in the ______. Before that time, psychotic patients were institutionalized.
answer
1950s
question
Antipsychotics are also called
answer
A and C
question
Antipsychotics include
answer
a, b, and c
question
Common signs and symptoms of mental disorders include all of the following EXCEPT
answer
proper work ethics and work skills
question
Which of the following is NOT true of abused central nervous system stimulants?
answer
There is an antidote for amphetamine and cocaine toxicity that stops the toxic effects with few side effects.
Fluid And Electrolyte Balance
Pharmacology
HSC3147_CMB-15Spring Final – Flashcards 180 terms

Sara Edwards
180 terms
Preview
HSC3147_CMB-15Spring Final – Flashcards
question
Common side effects of medications for endocrine diseases include all of the following *EXCEPT*
answer
no changes in growth and cardiac function
question
Which of the following are true of somatropin? 1. It is also known as growth hormone. 2. It is expensive to prescribe. 3. It should be used for any child who is of short stature. 4. It has a drug interaction with insulin. 5. Variations in its secretion may lead to acromegaly in adults and dwarfism in children.
answer
1, 2, 4, and 5
question
Which of the following are true of glucocorticoids and other steroids? 1. They are potent anti-inflammatory agents. 2. Their adverse effects include "moon face," "pot belly," and "buffalo hump." 3. They cause the kidney to retain sodium. 4. They may be administered orally, intramuscularly, intravenously, intraarticularly, and topically. 5. They have distinct methods of administration that include alternate-day therapy and declining dosages.
answer
1, 2, 3, 4, and 5
question
Signs and symptoms of hypoglycemia/insulin shock include all of the following *EXCEPT*
answer
slow onset
question
Glucose absorption inhibitors
answer
all of the above
question
Glitazones are a class of antihyperglycemics that are similar to other oral antidiabetic medications.
answer
false
question
Which of the following is *NOT* true of TSH?
answer
It decreases the uptake of iodine.
question
Insulin acts as a key to open body cells to glucose.
answer
true
question
Which of the following is true of insulin preparations?
answer
Both a and b are true.
question
Signs and symptoms of hypoglycemia/insulin shock include all of the following *EXCEPT*
answer
slow onset
question
All of the following are true about sulfonylureas *EXCEPT* they
answer
are insulin-like preparations
question
Hormones may be used for all of the following *EXCEPT*
answer
visual disturbances
question
Hyperglycemics
answer
all of the above
question
All of the following are true of Lantus insulin *EXCEPT* it
answer
is cloudy
question
Calcitonin salmon is safe for use because the drug has the same metabolic effects as human calcitonin.
answer
true
question
Which of the following statements are true concerning ophthalmic anti-inflammatory and antiinfective agents? 1. Most ophthalmic antiinfective/anti-inflammatory agents are effective on mucous membranes that have been injured or are inflamed. 2. To discourage drug-resistant strains of antiinfectives, antibiotics for ophthalmologic problems should be administered locally. 3. Any topical medication may be used in the eye. 4. With viral infections, both eyes may need to be treated. 5. In irrigating eyes, the head should be turned toward the affected side to prevent cross-contamination of the unaffected eye.
answer
1, 2, 4, and 5
question
Which of the following statements is *NOT* true?
answer
Mydriatics are used to cause pupil constriction for diagnostic tests.
question
OTC ophthalmic medications are always safe for use by all people because the FDA has approved the use of these drugs.
answer
false
question
Agents that mimic the sympathetic nervous system bring about pupillary dilation, while cycloplegic agents cause paralysis of the ciliary muscles and prevent accommodation. These medications are used primarily for diagnostic testing.
answer
true
question
Medications used in the ear often contain more than one ingredient so that more than one symptom or condition is treated at one time.
answer
true
question
Which of the following statements is *NOT* true?
answer
Mydriatics are used to cause pupil constriction for diagnostic tests.
question
To safely store ophthalmic and otic medications, medications with the same name should be stored next to each other or in close proximity so that the allied health professional can be sure to use the correct medication.
answer
false
question
Corticosteroids may cause increased ocular pressure, while ibuprofen may alter color vision and may cause blurred vision.
answer
true
question
Ear analgesics may be warmed mineral oil, sweet oil, or glycerin as well as medications with benzocaine.
answer
true
question
OTC ophthalmic medications are always safe for use by all people because the FDA has approved the use of these drugs.
answer
false
question
Which of the following statements is *NOT* true?
answer
Most medications used in the eye and ear have no side effects.
question
Otic antiinfective agents
answer
a, b, and c
question
Medications used in the ear often contain more than one ingredient so that more than one symptom or condition is treated at one time.
answer
true
question
Which of the following is *NOT* true of agents for glaucoma?
answer
Medications used topically in the eye do not have side effects.
question
Symptoms of ototoxicity include tinnitus, loss of balance, and vertigo.
answer
true
question
The rate of medication absorption through the skin depends on which of the following?
answer
all of the above
question
Which of the following is *NOT* true of topical corticosteroids?
answer
They should be applied thickly so that the medication will stay in contact with the lesion for a longer period of time.
question
Which of the following are true of topical fungal preparations? 1. They may be used on hair, nails, or skin. 2. Most are used to treat Candida and tinea infections. 3. Most are available OTC as well as by prescription. 4. They should be used completely even if symptoms improve. 5. Therapy for fungal infections is long-term.
answer
1, 2, 3, 4, and 5
question
Topical anesthetics are found in all of the following forms *EXCEPT*
answer
foams and shampoos
question
Topical creams and ointments for pediculosis should be applied to the affected area and left on for 12 hours, and then the area should be thoroughly washed.
answer
true
question
Topical creams and ointments for pediculosis should be applied to the affected area and left on for 12 hours, and then the area should be thoroughly washed.
answer
true
question
Oral contraceptives may be used to treat acne in females after menarche and those who have not responded to topical medications.
answer
true
question
Which of the following statements is *NOT* true about treatment of burns?
answer
Sulfonamides should be placed on tissue before débridement to soften the area, but this treatment has no antibacterial effect.
question
Common side effects of medications for skin disorders include all of the following *EXCEPT*
answer
loss of hair
question
Which of the following is *NOT* true of skin preparations?
answer
Persons with oily skin should bathe less frequently.
question
Topical preparations come in which of the following forms?
answer
all of the above
question
Most topical antiviral medications are applied only once a day.
answer
false
question
Which of the following are true about the treatment of acne vulgaris? 1. Topical and systemic antibiotics are used to treat acne. 2. Many preparations for acne are available OTC, and some require a prescription. 3. Treatment of acne includes reduction of sebum and bacteria. 4. Side effects of medications for acne include dryness, scaling, and peeling of the skin; stinging and burning; itching; erythema; and skin tenderness. 5. Some medications for acne cause irritation followed by skin peeling.
answer
1, 2, 3, 4, and 5
question
Which of the following is *NOT* true of topical corticosteroid medications?
answer
They should be spread on the affected area and beyond, and the area may be covered for greater absorption.
question
Topical anesthetics are found in all of the following forms *EXCEPT*
answer
foams and shampoos
question
Common side effects of musculoskeletal medications include
answer
all of the above
question
TNF inhibitors bock the immune response to prevent inflammation of joints.
answer
true
question
The goal of arthritis therapy includes all of the following *EXCEPT*
answer
curing the disease
question
Which of the following is an immunosuppressant agents and a DMARD?
answer
methotrexate
question
Anticholinesterase agents increase muscle tone.
answer
true
question
Patient teaching regarding gout should include which of the following?
answer
All of the above should be included.
question
TNF inhibitors, methotrexate, and DMARDs may be used concurrently.
answer
true
question
The use of colchicine is specific for gout.
answer
true
question
Anticholinesterase agents increase muscle tone.
answer
true
question
TNF inhibitors bock the immune response to prevent inflammation of joints.
answer
true
question
The goal of arthritis therapy includes all of the following *EXCEPT*
answer
curing the disease
question
Which of the following are found in the names of gold salts?
answer
"au"
question
Which of the following is an immunosuppressant agents and a DMARD?
answer
methotrexate
question
Common side effects of musculoskeletal medications include
answer
all of the above
question
Biphosphonates are used to prevent fractures.
answer
true
question
Which of the following is true concerning medications acting on gastrointestinal system tissues?
answer
All of the above statements are true except for d.
question
Which of the following is true of oral antiviral agents?
answer
All of the above statements are true.
question
Which of the following is *NOT* true of gastric pump inhibitors?
answer
They are safe for treating ulcers before their confirmed diagnosis.
question
Which of the following should not be given to persons with diabetes?
answer
phosphorated carbohydrate solution (Emetrol)
question
Which of the following are indications for laxative use?
answer
all except b
question
Which of the following is *NOT* true of bulk-forming laxatives?
answer
They interfere with food absorption.
question
Which of the following should not be given to persons with diabetes?
answer
phosphorated carbohydrate solution (Emetrol)
question
Which of the following is *NOT* true concerning medications for H. pylori?
answer
They always include an antacid.
question
Which of the following is *NOT* true about fluoride treatment?
answer
Fluoride tablets and solutions may be administered with meals and are better given with food because of the bad taste that follows administration.
question
Which of the following is true of lubricant laxatives?
answer
All of the above statements are true.
question
Which of the following is *NOT* true about antacids?
answer
They have no other indications except the treatment of gastric hyperacidity.
question
Use the following to answer the following questions. 1. baking soda 2. Riopan 3. Amphojel 4. milk of magnesia 5. Tums 6. Gelusil 7. Alka Seltzer 8. Maalox 9. Rolaids 10. Gaviscon Which are calcium-based antacids?
answer
5 and 9
question
Which of the following is true of opioid/synthetic opioid medications for diarrhea?
answer
All of the above statements are true.
question
Which of the following is *NOT* true of laxatives and cathartics?
answer
People need a bowel movement everyday and should take laxatives and cathartics to ensure this normal body function.
question
Which of the following are used in mouthrinses?
answer
all of the above
question
Cromolyn is for the prophylaxis of asthma.
answer
true
question
Which of the following is *NOT* true of histamine?
answer
It is not a problem with most upper respiratory inflammatory diseases.
question
Which of the following is *NOT* true of decongestants?
answer
They are very safe for persons who have diabetes mellitus.
question
Which of the following is *NOT* true of combination OTC products?
answer
If a patient has only a runny nose, a combination product is indicated.
question
Which of the following is *NOT* true of expectorants?
answer
They are not found as combination medications.
question
Which of the following is *NOT* true of decongestants?
answer
They are very safe for persons who have diabetes mellitus.
question
Cromolyn can be used long-term for the prophylaxis of asthma.
answer
true
question
Which of the following is *NOT* true of cromolyn sodium?
answer
It is more effective if used after the onset of allergic symptoms caused by histamines.
question
Which of the following is *NOT* a common side effect of medications for respiratory disorders?
answer
fever and rhinorrhea
question
Which of the following is *NOT* true of medications to inhibit influenza?
answer
They are substitutes for the influenza vaccine.
question
Which of the following are *NOT* common symptoms of respiratory tract disorders?
answer
nausea, vomiting, and anorexia
question
Which of the following is *NOT* true of histamine?
answer
It is not a problem with most upper respiratory inflammatory diseases.
question
Which of the following is *NOT* true of xanthine derivatives?
answer
They are still the drugs of choice for pulmonary diseases.
question
Which of the following is *NOT* true of treatment for COPD?
answer
Xanthine derivatives constrict smooth muscle, so sputum may be expectorated.
question
Which of the following is *NOT* a use for antihistamines?
answer
chest congestion
question
Which of the following is *NOT* a common side effect of circulatory medications?
answer
edema and shortness of breath
question
Antihypertensives receive the same response in all ethnic and cultural groups.
answer
false
question
Which of the following are routes of administration for nitroglycerin?
answer
all of the above
question
Which of the following is *NOT* true of hemorheologic agents?
answer
All of the above statements are true.
question
Which of the following is *NOT* true of medications used to affect coagulation?
answer
Anticoagulants include vitamin K, heparin, and warfarin.
question
Which of the following is *NOT* true of nitroglycerin?
answer
Sublingual nitroglycerin is a stable medication and is effective until the expiration date whether the bottle has been opened or not.
question
Which of the following is *NOT* true of hypertension and its treatment?
answer
Compliance with antihypertensive therapy is easily accomplished because the patient has headaches and lethargy that are reminders to take medications.
question
Which of the following is *NOT* true of topical hemostatics?
answer
The size and place of a wound have no bearing on which topical hemostatic agent is used.
question
Which of the following is *NOT* true about the treatment of hyperlipidemia?
answer
Medications are the first line of treatment for hyperlipidemia.
question
Which of the following is *NOT* true of antiplatelet medications?
answer
All of the above statements are true.
question
Which of the following is *NOT* true of drugs used for angina pectoris?
answer
Medications for angina should last only a short time—only the time necessary to stop the angina attack.
question
Antihypertensives receive the same response in all ethnic and cultural groups.
answer
false
question
Thiazide diuretics (diuretics that reduce blood volume) are the most frequently used class.
answer
true
question
Which of the following is *NOT* a medication group used in treating hypertension?
answer
cardiac glycosides
question
Which of the following is *NOT* true of vasodilators?
answer
They alleviate edema.
question
TMZ-SMZ is the abbreviation for trimethoprim-sulfonamide.
answer
false
question
Which of the following are *NOT* common side effects of medications for urinary tract disorders?
answer
enuresis and incontinence
question
Which of the following statements about fluid and electrolyte balance is *NOT* true?
answer
Infants and obese persons have less fluid in their bodies than normal adults.
question
Lower urinary tract infections are associated with all of the following symptoms *EXCEPT*
answer
headache
question
DDVAP acts in much the same manner as antidiuretic hormone.
answer
true
question
Lower urinary tract infections are associated with all of the following symptoms *EXCEPT*
answer
headache
question
Skin rashes may occur as a side effect of UTI medications.
answer
true
question
Which of the following is *NOT* true of urinary tract antiseptics?
answer
They are the first choice in treating UTIs.
question
Which of the following is *NOT* true of urinary tract analgesics?
answer
Pyridium will not stain clothing.
question
Drugs that are used to treat urinary tract infections include
answer
all of the above
question
Upper urinary tract infections are associated with all of the following symptoms *EXCEPT*
answer
burning and frequency of urination
question
DDAVP is an antidiuretic hormone.
answer
true
question
Which of the following is *NOT* true of sulfonamides?
answer
Those found on the market today are divided into short-acting, intermediate-acting, and long-acting drugs.
question
Which of the following is *NOT* true of medications used to treat overactive bladder and enuresis?
answer
All of the above statements are true.
question
Drugs for enuresis reduce incontinence, frequency, and urgency due to spasms of the smooth muscles of the bladder.
answer
true
question
Which of the following is *NOT* a symptom of sexually transmitted diseases?
answer
congenital malformations
question
Which of the following is *NOT* true of testosterone replacement therapy?
answer
The treatment and dosage are the same for all males, regardless of the diagnosis.
question
Which of the following is *NOT* true about forms of contraception?
answer
All IUDs provide long-term contraception of 8 years and are intrauterine progesterone inserts.
question
Which of the following medication classes is *NOT* used to treat premenstrual syndrome?
answer
progesterone and calcium
question
Which of the following is true of sildenafil (Viagra)?
answer
All of the above statements are true.
question
Which of the following is *NOT* true of medications used to treat endometriosis?
answer
Women taking danazol (Danocrine) may become pregnant any time during the treatment of endometriosis.
question
Which of the following is true about treatment of benign prostatic hypertrophy?
answer
All of the above statements are true.
question
Uses of estrogen include which of the following?
answer
all of the above
question
Combination oral contraceptives occur in which of the following formulas? 1. Monophasic: Daily doses of estrogen and progestin remain the same throughout the menstrual cycle. 2. Biphasic: Estrogen remains constant, but the progestin dose is increased during the second half of the cycle. 3. Triphasic: The menstrual cycle is divided into three phases, with the amount of progestin changed in each phase. 4. Estrophasic: The amount of progestin remains constant, and the estrogen dose is gradually increased throughout the cycle.
answer
1, 2, 3, and 4
question
Which of the following does *NOT* apply to spermicides and barrier devices as means of contraception?
answer
Spermicides come in gels, foams, creams, and ointments and may be bought OTC.
question
The side effects of testosterone replacement therapy include all of the following *EXCEPT*
answer
a decrease in libido but never an increase
question
Which of the following is *NOT* true of testosterone?
answer
It has no use in females.
question
Adjusting the estrogen and progestin content of oral contraceptives will not change the side effects encountered with them.
answer
false
question
Which of the following is *NOT* a symptom of sexually transmitted diseases?
answer
congenital malformations
question
Which of the following is *NOT* true of oral contraceptives?
answer
All oral contraceptives are combinations of estrogen and progestins.
question
Common side effects of medications for neurological conditions include all of the following *EXCEPT*
answer
muscle turgidity or spasticity
question
Beta-blockers are the drugs of choice in migraine headache prophylaxis.
answer
true
question
Which of the following is *NOT* needed in patient teaching with analgesics?
answer
Medication may be stopped at any time owing to the dangers of physical dependence and habituation.
question
Which of the following is *NOT* true about the use of CNS stimulants as anorexiants and for narcolepsy?
answer
They may be taken after 6:00 PM in persons desiring to lose weight and for narcolepsy without causing excessive stimulation.
question
Which of the following is *NOT* true of adrenergic agonists?
answer
They are not sympathomimetic medications and do not simulate the "fight-or-flight" response of the body.
question
Which of the following is *NOT* true of medications for spasticity?
answer
Most muscle relaxants are effective for spasticity.
question
Alcohol will have a synergistic effect with hypnotics and sedatives.
answer
true
question
Medications to treat migraine headache include all of the following *EXCEPT*
answer
all are used
question
Groups of drugs that are used to treat seizures include which of the following?
answer
a, b, and c
question
Which of the following statements is *NOT* true?
answer
Catecholamines are produced and stored in the brain to increase the stimulation of the autonomic nervous system.
question
Which of the following is *NOT* needed in patient teaching with analgesics?
answer
Medication may be stopped at any time owing to the dangers of physical dependence and habituation.
question
All of the following are true of drugs for parkinsonism *EXCEPT*
answer
They are effective in arresting the disease.
question
Which of the following is *NOT* true of parasympatholytic medications?
answer
Parasympatholytic agents and anticholinergic medications are entirely different compounds that have similar actions.
question
Which of the following is *NOT* true of local anesthetics?
answer
The onset of most local anesthetics is slow, and they last for prolonged periods of time.
question
Which of the following is *NOT* true of anesthetics?
answer
Allied health professionals in an ambulatory care setting have no responsibility in preparing a patient for general anesthesia; this is the responsibility of the surgeon and anesthetist.
question
Mental health is concerned with which of the following aspects of a person? 1. physical health 2. cognitive health and affective being 3. behavioral and social health 4. the environment
answer
1, 2, 3, and 4
question
Psychotherapeutic agents were first introduced in the ______. Before that time, psychotic patients were institutionalized.
answer
1950s
question
Antipsychotics are also called
answer
a and c
question
Antipsychotics include
answer
a, b, and c
question
Common signs and symptoms of mental disorders include all of the following *EXCEPT*
answer
proper work ethics and work skills
question
The medication(s) approved by the FDA for Alzheimer's disease is/are
answer
donepezil (Aricept)
question
Mental health is a lifelong process to form a sense of harmony and balance for the individual.
answer
true
question
A person who is in contact with reality but is fearful and has difficulty adjusting to surroundings is considered to have
answer
neurosis
question
The major forms of psychosis include
answer
a and b
question
Mental health is concerned with which of the following aspects of a person? 1. physical health 2. cognitive health and affective being 3. behavioral and social health 4. the environment
answer
1, 2, 3, and 4
question
Most drugs that are used to treat ADHD are
answer
b and c
question
Antipsychotics are contraindicated in
answer
a and b
question
Low potency, intermediate potency, and high potency traditional antipsychotics all have an equal therapeutic effect.
answer
true
question
Antidepressant medications include
answer
a, b, and c
question
Tricyclic antidepressants are generally not recommended for children under 12 years of age.
answer
true
question
The side effects of smoking cessation include all of the following *EXCEPT*
answer
decreased appetite, nausea, and diarrhea
question
Which is *NOT* true of drugs used with alcoholism?
answer
Disulfiram should be given to a person who abuses alcohol whether the person desires to stop consuming alcohol or not.
question
The half-life of cocaine is fairly long, leading to toxicity and the chance of acute intoxication.
answer
false
question
Which of the following is *NOT* true of abused central nervous system stimulants?
answer
There is an antidote for amphetamine and cocaine toxicity that stops the toxic effects with few side effects.
question
Which of the following is *NOT* a hallucinogen, psychedelic, or psychomimetic?
answer
marijuana
question
Which of the following is *NOT* true of hallucinogens, psychedelics, and psychomimetics?
answer
There is no medication to dissipate "bad trips" found with hallucinogens, psychedelics, and psychomimetics.
question
Which of the following is *NOT* related to withdrawal of opiates/opioids?
answer
When in a withdrawal program, the person exhibits few symptoms.
question
Which of the following are the most frequently abused substances?
answer
A and C are correct
question
Which of the following is *NOT* true of abused central nervous system stimulants?
answer
There is an antidote for amphetamine and cocaine toxicity that stops the toxic effects with few side effects.
question
Which of the following is *NOT* a hallucinogen, psychedelic, or psychomimetic?
answer
marijuana
question
The half-life of cocaine is fairly long, leading to toxicity and the chance of acute intoxication.
answer
false
question
Not all socioeconomic, ethnic, or cultural classes have problems with drug and substance abuse—just those persons at the opposite ends of the cultural spectrum.
answer
false
question
What is *NOT* a source of inhalants commonly used for euphoria and hallucinations?
answer
all of the above are sources of inhalants.
question
Which of the following medications do *NOT* interact with nicotine?
answer
all of the above interact with nicotine
question
Which of the following is *NOT* a side effect of abused and misused drugs?
answer
hypertension and bradycardia
Fluid And Electrolyte Balance
Pharmacology
Sexually Transmitted Diseases
Pharmacology Final – Flashcards 155 terms

Briley Leonard
155 terms
Preview
Pharmacology Final – Flashcards
question
Topical preparations come in which of the following forms?
answer
all of the above
question
Which of the following are true of keratolytic agents? 1. Keratolytic agents are used to promote the formation of the horny layer of skin. 2. Local side effects of keratolytic agents include burning and local irritation. 3. Keratolytic agents promote shedding of warts, calluses, and corns. 4. Keratolytic agents are used to treat dandruff, seborrheic dermatitis, acne, venereal warts, and psoriasis. 5. Systemic side effects of keratolytics include tinnitus, dizziness, ototoxicity, and headache.
answer
all except 1
question
Which of the following statements is NOT true of prophylactic agents?
answer
Sunscreens have no effect on premature aging or in precancerous conditions, although these products do prevent cancer.
question
Topical creams and ointments for pediculosis should be applied to the affected area and left on for 12 hours, and then the area should be thoroughly washed.
answer
true
question
Which of the following is NOT true about skin preparations?
answer
Emollients are always used to soothe and do not contain medications.
question
Which of the following are true of topical fungal preparations? 1. They may be used on hair, nails, or skin. 2. Most are used to treat Candida and tinea infections. 3. Most are available OTC as well as by prescription. 4. They should be used completely even if symptoms improve. 5. Therapy for fungal infections is long-term.
answer
1-5
question
Which of the following is NOT true of medications used on the skin?
answer
Minoxidil is used for baldness, and it should be applied to the hair every 3 days.
question
The rate of medication absorption through the skin depends on which of the following?
answer
all of the above
question
Which of the following is NOT true of skin preparations?
answer
persons with oily skin should bathe less frequently
question
Which of the following is NOT true of topical corticosteroids?
answer
They should be applied thickly so that the medication will stay in contact with the lesion for a longer period of time.
question
Topical anesthetics are found in all of the following forms EXCEPT
answer
foams and shampoos
question
Common side effects of musculoskeletal medications include
answer
all of the above
question
TNF inhibitors bock the immune response to prevent inflammation of joints.
answer
true
question
The goal of arthritis therapy includes all of the following EXCEPT
answer
curing the disease
question
Which of the following is an immunosuppressant agents and a DMARD?
answer
methotrexate
question
Anticholinesterase agents increase muscle tone.
answer
true
question
Which of the following are used to treat osteoporosis?
answer
a & c
question
Centrally acting muscle relaxants include all of the following EXCEPT
answer
probenecid (Benemid)
question
Central-acting and direct-acting muscle relaxants are the drugs of choice for muscle spasticity.
answer
true
question
Which of the following is NOT true of alendronate?
answer
it may given without regard to vit D
question
The same nostril may be used for administration of nasal calcitonin salmon.
answer
false
question
TNF inhibitors, methotrexate, and DMARDs may be used concurrently.
answer
true
question
Patient teaching regarding gout should include which of the following?
answer
- all should be included
question
Which is NOT true of salicylate NSAIDs?
answer
They are both anti-inflammatory and analgesic agents.
question
Common side effects of musculoskeletal medications include
answer
all of the above
question
Which of the following is true concerning medications acting on gastrointestinal system tissues?
answer
all true except d
question
Which of the following is true of oral antiviral agents?
answer
all are true
question
Which of the following is NOT true of gastric pump inhibitors?
answer
They are safe for treating ulcers before their confirmed diagnosis
question
Which of the following should not be given to persons with diabetes?
answer
phosphorated carbohydrate solution (Emetrol)
question
Which of the following are indications for laxative use?
answer
all but b
question
Which of the following is NOT true of osmotic saline laxatives?
answer
They work in response to the amount of medication given, making water replacement insignificant.
question
Which of the following is NOT true of anorexiants?
answer
They can stand on their own to produce long-term weight loss
question
Which of the following is NOT true concerning medications for H. pylori?
answer
Two antibiotics are usually ordered to prevent drug resistance.
question
Which of the following is true of anti-inflammatory agents for the GI tract?
answer
all of the above are true
question
Which of the following is true of opioid/synthetic opioid medications for diarrhea?
answer
all are true
question
Use the following to answer the following questions. 1. baking soda 2. Riopan 3. Amphojel 4. milk of magnesia 5. Tums 6. Gelusil 7. Alka Seltzer 8. Maalox 9. Rolaids 10. Gaviscon Which are magaldrate antacids?
answer
2
question
Cromolyn is for the prophylaxis of asthma.
answer
true
question
Which of the following is NOT true of histamine?
answer
It is not a problem with most upper respiratory inflammatory diseases
question
Which of the following is NOT true of decongestants?
answer
They are very safe for persons who have diabetes mellitus
question
Which of the following is NOT true of combination OTC products?
answer
If a patient has only a runny nose, a combination product is indicated.
question
Which of the following is NOT true of expectorants?
answer
They are not found as combination medications
question
Which of the following is NOT true of antihistamines?
answer
They may be used chronically for several years because tolerance does not develop.
question
Cromolyn can be used long-term for the prophylaxis of asthma.
answer
true
question
Chlorpheniramine is the antihistamine of choice in the elderly.
answer
false
question
Which of the following is NOT true of mucokinetic agents?
answer
Hypotonic saline is used as a mucolytic agent.
question
Antitussives are especially effective for the productive cough.
answer
false
question
Medications for chronic pulmonary disease may be administered by
answer
a,b,c
question
Which of the following is NOT a use for antihistamines?
answer
chest congestion
question
Which of the following is NOT a common side effect of circulatory medications?
answer
edema and shortness of breathe
question
Antihypertensives receive the same response in all ethnic and cultural groups.
answer
false
question
Which of the following are routes of administration for nitroglycerin?
answer
all of the above
question
Which of the following is NOT true of hemorheologic agents?
answer
all of the above
question
Which of the following is NOT true of medications used to affect coagulation?
answer
Anticoagulants include vitamin K, heparin, and warfarin.
question
Which of the following is NOT true of cardiac glycosides?
answer
They decrease congestion in the heart by increasing the force that increases the amount of blood pumped from the heart.
question
Which of the following is NOT true about the treatment of hyperlipidemia?
answer
Medications are the first line of treatment for hyperlipidemia
question
Nicotinic acid reduces LDL and VLDL levels and raises HDL levels but is limited by its side effects.
answer
true
question
Which of the following is NOT a type of angina pectoris?
answer
-chronic
question
Which of the following is NOT true of HMG CoA reductase inhibitors?
answer
They may be discontinued when lipoprotein levels are lowered.
question
Which of the following is NOT a medication group used in treating hypertension?
answer
cardiac glycosides
question
Which of the following is NOT true of antiplatelet medications?
answer
all above are true
question
TMZ-SMZ is the abbreviation for trimethoprim-sulfonamide.
answer
false
question
Which of the following are NOT common side effects of medications for urinary tract disorders?
answer
enuresis and incontinence
question
Which of the following statements about fluid and electrolyte balance is NOT true?
answer
Infants and obese persons have less fluid in their bodies than normal adults.
question
Lower urinary tract infections are associated with all of the following symptoms EXCEPT
answer
headache
question
DDVAP acts in much the same manner as antidiuretic hormone.
answer
true
question
Skin rashes may occur as a side effect of UTI medications.
answer
true
question
DDAVP is a drug used in older adults who have enuresis.
answer
true
question
Common foods that may irritate the urinary bladder include all of the following EXCEPT
answer
milk products
question
Sulfonamides suppress the synthesis of folic acid.
answer
true
question
Which of the following is NOT true of urinary tract antiseptics?
answer
They are the first choice in treating UTIs.
question
Upper urinary tract infections are associated with all of the following symptoms EXCEPT
answer
burning and frequency of urination
question
Major electrolytes that need replacement include all of the following EXCEPT
answer
chlorides
question
Which of the following is NOT true of urinary tract analgesics?
answer
Pyridium will not stain clothing.
question
Which of the following are NOT common symptoms of urinary tract disorders?
answer
chest pain and nausea ** pg494
question
Which of the following is NOT a symptom of sexually transmitted diseases?
answer
congenital malformation
question
Which of the following is NOT true of testosterone replacement therapy?
answer
The treatment and dosage are the same for all males, regardless of the diagnosis.
question
Which of the following medication classes is NOT used to treat premenstrual syndrome?
answer
progesterone and calcium
question
Which of the following is true of sildenafil (Viagra)?
answer
All of the above statements are true.
question
Common side effects of medications for endocrine diseases include all of the following EXCEPT
answer
no changes in growth and cardiac function
question
Which of the following are true of somatropin? 1. It is also known as growth hormone. 2. It is expensive to prescribe. 3. It should be used for any child who is of short stature. 4. It has a drug interaction with insulin. 5. Variations in its secretion may lead to acromegaly in adults and dwarfism in children.
answer
1, 2, 4, and 5
question
Which of the following are true of glucocorticoids and other steroids? 1. They are potent anti-inflammatory agents. 2. Their adverse effects include "moon face," "pot belly," and "buffalo hump." 3. They cause the kidney to retain sodium. 4. They may be administered orally, intramuscularly, intravenously, intraarticularly, and topically. 5. They have distinct methods of administration that include alternate-day therapy and declining dosages.
answer
1-5
question
Signs and symptoms of hypoglycemia/insulin shock include all of the following EXCEPT
answer
slow onset
question
Glucose absorption inhibitors
answer
all of the above
question
Sort the following types of insulin from the slowest to the longest onset of action. 1. Regular 2. Levemir 3. Lispro 4. NPH
answer
-1, 2, 3, 4 -3,4,2,1 -3,1,4,2 -4,3,2,1
question
Which of the following is true of thyroid hormones? 1. The three hormones secreted are thyroxine, triiodothyronine, and calcitonin. 2. Hyposecretion is cretinism in infants and children and myxedema in adults. 3. Hyposecretion may be the result of lack of iodine as well as radiation therapy and surgical removal of the thyroid. 4. Replacement therapy is lifelong. 5. Replacement therapy regimen should be taken in the mornings because of the hormone's side effect of insomnia.
answer
1-5
question
Signs and symptoms of hyperglycemia/diabetic coma include all of the following EXCEPT
answer
no thirst
question
Which of the following is a modified human derivative of insulin and is therefore less antigenic and the preferred insulin for use today?
answer
all of the above
question
Calcitonin is secreted by the thyroid gland but is regulated by the parathyroid gland to ensure an adequate supply of calcium for neuromuscular and endocrine function.
answer
true
question
Which of the following is NOT true of calcitonin salmon?
answer
There are no drug interactions with calcitonin salmon because it acts like human calcitonin.
question
Growth hormone stimulates almost all tissues and organs for growth.
answer
true
question
Hormones may be used for all of the following EXCEPT
answer
endocrine diagnostic testing**
question
Insulin preparations vary in
answer
all of the above
question
Which of the following statements are true concerning ophthalmic anti-inflammatory and antiinfective agents? 1. Most ophthalmic antiinfective/anti-inflammatory agents are effective on mucous membranes that have been injured or are inflamed. 2. To discourage drug-resistant strains of antiinfectives, antibiotics for ophthalmologic problems should be administered locally. 3. Any topical medication may be used in the eye. 4. With viral infections, both eyes may need to be treated. 5. In irrigating eyes, the head should be turned toward the affected side to prevent cross-contamination of the unaffected eye.
answer
1, 2, 4, and 5
question
Which of the following statements is NOT true?
answer
Mydriatics are used to cause pupil constriction for diagnostic tests.
question
OTC ophthalmic medications are always safe for use by all people because the FDA has approved the use of these drugs.
answer
false
question
Agents that mimic the sympathetic nervous system bring about pupillary dilation, while cycloplegic agents cause paralysis of the ciliary muscles and prevent accommodation. These medications are used primarily for diagnostic testing.
answer
true
question
Medications used in the ear often contain more than one ingredient so that more than one symptom or condition is treated at one time.
answer
true
question
Drugs may be used to obtain mydriasis and miosis with ocular examinations and treatment of eye diseases.
answer
true
question
When a local ophthalmic anesthetic is used a patient may lose the blink reflex and pain associated with ophthalmic procedures.
answer
true
question
Medications used for systemic diseases have no ocular side effects.
answer
false
question
Cerumenolytics are used to harden watery wax in the ear.
answer
false
question
Which of the following is NOT true of agents for glaucoma?
answer
Medications used topically in the eye do not have side effects.
question
Eye infections should be treated with topical anti-inflammatory and antiinfective agents without doing a culture of the secretions.
answer
false
question
Local ophthalmic anesthetic agents are used for tonometry.
answer
true
question
Which of the following is NOT true concerning infertility and its treatment?
answer
all of the above are true
question
Which of the following is NOT a common symptom of female reproductive tract diseases?
answer
frequency and urgency of urination
question
Which of the following does NOT apply to spermicides and barrier devices as means of contraception?
answer
spermicides come in gels, foams, creams, and ointments and may be bought OTC*****
question
Which of the following medication classes is NOT used to treat premenstrual syndrome?
answer
progesterone and calcium
question
Uses of estrogen include which of the following?
answer
all of the above
question
Which of the following is NOT a common symptom of male reproductive tract diseases?
answer
all of the above
question
The side effects of testosterone replacement therapy include all of the following except
answer
a decrease in libido but never an increase
question
Which of the following does NOT apply to postcoital contraception?
answer
Emergency contraceptive pills (ECPs) are either estrogen pills or progestin pills, not combination medications.
question
Which of the following is NOT true of oral contraceptives?
answer
All oral contraceptives are combinations of estrogen and progestins.
question
Which of the following is NOT true of estrogens?
answer
They do not change the shape of the cornea and have no effect on the fitting of contact lenses
question
Which of the following is NOT a symptom of sexually transmitted diseases? Correct!
answer
congenital malformations
question
Which of the following is NOT true of testosterone replacement therapy?
answer
the treatment and dosage are the same for all males, regardless of the diagnosis.
question
Which of the following is NOT true about forms of contraception?
answer
All IUDs provide long-term contraception of 8 years and are intrauterine progesterone inserts.
question
Common side effects of medications for neurological conditions include all of the following EXCEPT
answer
muscle turgidity or spasticity
question
Beta-blockers are the drugs of choice in migraine headache prophylaxis.
answer
true
question
Which of the following is NOT needed in patient teaching with analgesics?
answer
Medication may be stopped at any time owing to the dangers of physical dependence and habituation.
question
Which of the following is NOT true about the use of CNS stimulants as anorexiants and for narcolepsy?
answer
They may be taken after 6:00 PM in persons desiring to lose weight and for narcolepsy without causing excessive stimulation.
question
Which of the following is NOT true of adrenergic agonists?
answer
They are not sympathomimetic medications and do not simulate the "fight-or-flight" response of the body.
question
Successful treatment of seizures requires individualization of the medication to the person.
answer
true
question
Which of the following is NOT true of parasympathomimetic medications?
answer
Cholinergic medications have few side effects and are considered safe for use in most patients.
question
Sedatives and hypnotics are entirely different pharmaceutical compounds.
answer
false
question
Which of the following is NOT true of endorphins and enkephalins?
answer
Endorphins are part of the blood-brain barrier
question
Medications known as adrenergic agents are catecholamines and noncatecholamines.
answer
true
question
Which of the following is NOT true of central nervous system stimulants?
answer
They may be prescribed over long periods of time for obesity.
question
Alcohol will have a synergistic effect with hypnotics and sedatives.
answer
true
question
Which of the following is NOT true of medications for spasticity?
answer
Most muscle relaxants are effective for spasticity
question
Mental health is concerned with which of the following aspects of a person? 1. physical health 2. cognitive health and affective being 3. behavioral and social health 4. the environment
answer
1-4
question
Psychotherapeutic agents were first introduced in the ______. Before that time, psychotic patients were institutionalized.
answer
1950s
question
Antipsychotics are also called
answer
a & c
question
Antipsychotics include
answer
a,b,c
question
Common signs and symptoms of mental disorders include all of the following EXCEPT
answer
proper work ethics and work skills
question
Which of the following is NOT a side effect of antipsychotic agents?
answer
all side effects
question
The most commonly prescribed medications for neurosis are benzodiazepines. Side effects include
answer
-sensitivity to sunlight -interactions with alcohol -a and c - a, b, and c
question
Common side effects of drugs for Alzheimer's disease are related to
answer
all but c
question
Tricyclic antidepressants are generally not recommended for children under 12 years of age.
answer
true
question
The major difference in the benzodiazepines is
answer
he duration of action
question
Antianxiety medications are also called
answer
-b and c
question
The dangers with monoamine oxidase inhibitors are
answer
-interactions with tyramine-containing foods
question
The side effects of smoking cessation include all of the following EXCEPT
answer
decreased appetite, nausea, and diarrhea
question
Which is NOT true of drugs used with alcoholism?
answer
Disulfiram should be given to a person who abuses alcohol whether the person desires to stop consuming alcohol or not.
question
The half-life of cocaine is fairly long, leading to toxicity and the chance of acute intoxication.
answer
false
question
Which of the following is NOT true of abused central nervous system stimulants?
answer
There is an antidote for amphetamine and cocaine toxicity that stops the toxic effects with few side effects.
question
Which of the following is NOT a hallucinogen, psychedelic, or psychomimetic?
answer
marijuana
question
Which of the following medications do NOT interact with nicotine?
answer
all of the above do
question
Which of the following is NOT true of nicotine?
answer
Peripheral blood vessels constrict, raising blood pressure in persons who start smoking.****
question
Personal characteristics of drug misusers and abusers include all of the following EXCEPT
answer
feeling of self-worth
question
Which of the following is NOT a side effect of abused and misused drugs?
answer
hypertension and bradycardia
question
Which of the following is NOT true of central nervous system depressants?
answer
Withdrawal from barbiturates and benzodiazepines should be done rapidly to prevent long-term withdrawal signs and symptoms.
question
Not all socioeconomic, ethnic, or cultural classes have problems with drug and substance abuse—just those persons at the opposite ends of the cultural spectrum.
answer
false
question
Which of the following is NOT true of ethyl alcohol?
answer
it has no med indications
question
Which of the following is NOT true of smoking cessation products?
answer
all above are true
Blood In The Urine
Emphasize The Importance Of
Fluid And Electrolyte Balance
Patho Unit 7 – Flashcards 64 terms

Marvel Brown
64 terms
Preview
Patho Unit 7 – Flashcards
question
The clinical significance of BPH resides in its tendency to compress the ________ and cause partial/complete obstruction of urinary outflow, resulting in over-distention of the bladder.
answer
Urethra
question
Testicular __________ is a twisting of the spermatic cord that suspends the testis.
answer
torsion
question
Testicular torsion obstructs venos drainage, with resultant edema and hemorrhage and subsequent _______ obstruction. This is a medical emergency needing imediate attention.
answer
Arterial
question
____________ cancer is the second most frequently diagnosed cancer in men, and the highest rates in the world are found in the United States.
answer
Prostate
question
A weak urinary stream, postvoid dribbling, frequency of urination, and nocturia are classic symptoms of an enlarged prostate.
answer
True
question
In regards to polycystic ovary syndrome, elevated _________ _________ results in increased androgen productio and contributes to a vicious cycle of anovulation and multiple cyst formation. (Please spell out)
answer
Luteinizing hormone
question
Certain types of sexually transmitted human papillomaviruses are risk factors for a neoplasia, which can be a precursor lesion of invasive carcinoma.
answer
True
question
Polycystic ovary syndrome is a common ___________ disorder.
answer
Endocrine
question
Risk factors for ______ ______ include increasing age, family history and hormonal influences (late menopause).
answer
Breast cancer
question
Ovarian cancer has severe early symptoms and is most often diagnosed in its early stages.
answer
False
question
Symptoms that are believed to have a strong correlation to ______ _______ include increased abdominal size, dyspepsia, early satiety or bloating.
answer
Ovarian cancer
question
________ therapy is used to block the effects of estrogen on the growth of breast cancer cells.
answer
Hormone
question
________ represents an inflammation of the vagina that is characterized by vaginal discharge and burning, itching, redness and swelling of the vaginal tissues. Infections transmitted sexually are a common cause.
answer
Vaginitis
question
Cancer of the breast is the most common cancer in females.
answer
True
question
The incidence of _______ _______ is much lower in countries where women bear numerous children.
answer
Ovarian cancer
question
_______ lubricates the hair and skin, preventing evaporation of moisture and helps conserve body heat.
answer
Sebum
question
________ is an unpleasant sensation of itch leading to the desire to scratch.
answer
Puritius
question
________ are small fluid-filled blisters (often seen with Herpes).
answer
Vesicles
question
The ________ ______ are structures that become inflamed in acne.
answer
Sebaceous glands
question
_____________, or the sensation of itch, is a symptom common to many skin disorders.
answer
pruritus
question
Sebaceous glands, which release a lubricant for the skin and hair, are located over the entire skin surface except for the palms, soles, and sides of the feet.
answer
True
question
Skin cancers affect light-skinned persons more commonly than dark-skinned persons.
answer
True
question
Although ________ represents a small subset of skin cancers, it is the most deadly since it's a rapidly progressing, metastatic form of cancer.
answer
Melanoma
question
_______-_______ full-thickness burns involve the entire epidermis and dermis.
answer
Second degree
question
Varicella in adults is of similar significance and severity as in children.
answer
False
question
Allergic and hypersensitivity ___________ involved the inflammatory response to multiple agents. The disorders are usually characterized by edema.
answer
Dermatoses
question
The structure of the skin renders it susceptible to bacterial and fungal infections but resistant to viral infections.
answer
False
question
_________ instability begins almost immediately with injury to capillaries in the burned area and surrounding tissue. Patients often present with hypovolemic shock in the ER.
answer
Hemodynamic
question
This produces direct damage to the DNA and other nuclear proteins (in the skin) and produced free radicals: _______ radiation.
answer
Ultraviolet
question
Moderate to severe cases of ____ may be managed with systemic antibiotics.
answer
Acne
question
Dysplastic (pre-cancerous) _____ are usually larger than others. Their appearance is flat, slightly raised plaque with a pebbly surface.
answer
Nevi
question
This disease is usually manifested by raised, well-demarcated, erythematous plaques with adherent silvery scales:_________. Histologically it is characterized by increased epidermal turnover with marked epidermal thickening.
answer
Psoriasis
question
This common childhood disease is characterized by macules over various parts of the body, mild to extreme puritus and cold-like symptoms: _________.
answer
Varicella, Chickenpox
question
Malignant melanoma, which is a malignant tumor of melanocytes, is a rapidly progressive and metastatic form of skin cancer.
answer
True
question
PTH prevents serum calcium levels from falling below and serum ________ levels rising above normal physiologic concentrations.
answer
Phosphate
question
The process of bone formation and mineral metabolism is complex and involves the interplay among the actions of PTH, ____________, and vitamin D.
answer
calcitonin
question
The articulating areas of a joint are nourished indirectly by the ______ _____ rather than by blood vessels.
answer
Synovial fluid
question
The tendons and ligaments of the joint capsule are sensitive to position and movement, particularly stretching and twisting. Their _________ function reflexively to adjust the tension of the muscles that support the joint.
answer
Proprioceptors
question
Whereas PTH increases blood calcium levels, the hormone _______ lowers blood calcium levels.
answer
Calcitonin
question
________ involves reabsorption of the excess bony callus that develops in the marrow space and encircles the fracture site.
answer
Remodeling
question
_______________ represents an acute or chronic infection of the bone and is very difficult to treat and eradicate.
answer
Osteomyelitis
question
_________ formation is thought to be necessary for the initiation of cellular events essential to bone healing.
answer
Hematoma
question
______________ is an aggressive and highly malignant bone tumor with primary symptoms of deep localized pain with nighttime awakening and swelling in the affected bone.
answer
Osteosarcoma
question
The treatment of bone tumors includes surgery in combination with multi-agent ________, both before and after surgery.
answer
Chemotherapy
question
Legg-Calvé-Perthes disease is a childhood disorder that specifically involves the knee.
answer
False
question
__________ is an aggressive and highly malignant tumor of the bone.
answer
Osteosarcoma
question
All forms of scoliosis can be corrected with continued use of a brace.
answer
False
question
____________ osteomylitis originates with infectious organisms that reach bone through the bloodstream.
answer
Hematogenous
question
[X] __________ [Y] _______ fractures occur when normal stress is applied to bones that have been weakened by disease or tumors.
answer
Pathologic, stress
question
[X]_____-[Y]_____-[Z]_____ disease is an ideopathic osteoneocrotic disease of the proximal femoral epiphysis with later reabsorption.
answer
Legg, Calve, Perthes
question
Sclerosis, or formation of new bone and cysts, usually occurs at the joint margins, forming abnormal bony outgrowths called estophytes or spurs. This is charachteristic of _________.
answer
Osteoarthritis
question
_________ of joints (crepitus) and joint locking may occur when the joint is moved.
answer
Cracking
question
_______________ arthritis is a systemic inflammatory disease that attacks joints by producing a proliferative synovitis that leads to destruction of the articular cartilage and underlying bone.
answer
Rheumatoid
question
The pathogenesis of ___________ ________ can be viewed as an aberrant immune response that leads to synovial inflammation and destruction of the joint architecture.
answer
Rheumatoid arthritis
question
_______ is a condition that is common to all metabolic bone diseases.
answer
Osteopenia
question
Regular exercise and adequate calcium and vitamin D intake are important factors in preventing ________. Calcitonin is also one of the drugs used in treatment.
answer
Osteoporosis
question
Often, the first manifestations of the disorder are those that accompany a skeletal-fracture, a _________ compression or fracture of the hip, pelvis, humerus or other bones
answer
Vertebral
question
_______________ is a skeletal disorder characterized by the loss of bone mass and deterioration of the architecture of cancellous bone with a subsequent increase in bone fragility and susceptibility to fractures.
answer
Osteoporosis
question
Arthalgias and arthritis are among the most common occurring early symptoms of [X]_______ [Y]______ [Z]________. Renal involvement occurs in about half to two-thirds of persons as well.
answer
Systemic, Lupus, Erythematosus
question
All persons affected with rheumatoid arthritis have the presence of the rheumatoid factor, an auto antibody that reacts with a fragment of immunoglobulin G to form immune complexes.
answer
False
question
Systemic lupus erythematosus is a chronic inflammatory disease that can affect virtually any organ system, including the musculoskeletal system.
answer
True
question
Rheumatic disorders have signs and symptoms that are limited to the skeletal system.
answer
False
question
Premature __________ is increasingly being seen in female athletes owing to an increased prevalence of eating disorders and amenorrhea.
answer
Osteoporosis
question
_______________ is a condition that is common to all metabolic bone diseases and is characterized by a reduction in bone mass greater than expected for age, race, or sex.
answer
Osteopenia
Breast Fed Infants
Fluid And Electrolyte Balance
Nutrition
NURTRITION FINAL – Flashcards 116 terms

Rebecca Mallory
116 terms
Preview
NURTRITION FINAL – Flashcards
question
Anyone who eats a meal high in salt can temporarily increase his or her body's water content.​
answer
true
question
After about 25 years of age, regardless of calcium intake, bones begin to lose density.​
answer
false
question
A deficiency of sodium is not harmful.​
answer
false
question
Low salt intakes have been linked with lower rates of stomach cancer.​
answer
true
question
The bioavailability of calcium in calcium-fortified orange juice is comparable to that of milk.​
answer
true
question
The body will signal thirst before dehydration occurs to prevent problems with fluid loss.​
answer
false
question
Soft water contains sodium, which may aggravate hypertension.​
answer
true
question
Some minerals act as buffers to help maintain body fluids at the correct pH to permit life's processes.​
answer
true
question
The main source of iodine in the U.S. is plants grown in the middle part of the country.​
answer
false (less iodine in the soil)
question
The primary role of fluoride is to prevent dental caries throughout life
answer
true, not a necessary nutrient
question
Women in their reproductive years are likely to carry more intra-abdominal fat than are women past menopause.​
answer
false
question
Waist circumference indicates visceral fatness, and above a certain girth, disease risks rise.
answer
true
question
Eating certain foods can elevate the basal metabolic rate, and thus promote weight loss.​
answer
false
question
For someone with at least one obese parent, the chance of becoming obese is estimated to be between 30 and 70 percent.​
answer
true
question
Taller people need proportionately more energy than shorter people to balance their energy budgets.​
answer
true
question
Physical inactivity alone does not cause obesity.​
answer
false
question
The BMI is very valuable in helping muscular athletes determine their health risks.
answer
false
question
No single body composition or weight suits everyone; needs vary by gender, lifestyle, and stage of life.​
answer
true
question
Leptin is a hormone produced by the body to stimulate the appetite and encourage eating.
answer
false
question
The set-point theory states that the body's regulatory controls will maintain body weight over time and resist efforts to lose weight by dieting.​
answer
true
question
People who regularly engage in physical activity live longer on average than those who are physically inactive.
answer
true
question
By strengthening the muscles of the back and abdomen, resistance training can improve posture.
answer
true
question
Iron-deficiency anemia impairs physical performance because iron helps deliver the muscles' glucose.
answer
false
question
Active people do not need extra fluid in cold weather.
answer
false
question
Active people do not need extra fluid in cold weather.
answer
false
question
Muscle hypertrophy is an increase in size in response to use.
answer
true
question
The body is able to store unlimited amounts of glycogen in muscles.
answer
false
question
Taking vitamin or mineral supplements just before competition will help to improve performance.
answer
false
question
An athlete should weigh herself before and after her workout to determine how much fluid she should replace.
answer
true
question
What is the intensity level of a physical activity that causes some increase in breathing, is a perceived exertion of 5 or 6, and allows you to have a conversation while doing the activity?​
answer
moderate
question
Chronic diseases are the only type of diseases that afflict people in developed countries.
answer
false
question
Degenerative conditions are also referred to as chronic diseases.
answer
true
question
Dietary supplements can trigger extra immune power to fend off dangerous infections in well-fed people.
answer
false
question
A deficiency or toxicity of even a single nutrient can weaken the body's defenses considerably.
answer
true
question
​Just as a virus causes influenza, a risk factor causes a chronic disease.
answer
false
question
Thirty minutes of brisk walking on at least 5 days a week can improve the odds against heart disease.
answer
true
question
Metabolic syndrome, with its cluster of factors, raises the risk of CVD.
answer
true
question
Constituents in foods may be cancer causing, cancer promoting, or protective against cancer.
answer
true
question
Excess calories from carbohydrates, protein, and fat all raise cancer rates.
answer
true
question
Obesity is a risk factor for certain cancers such as colon, breast, endometrial, pancreas, and kidney cancer.
answer
true
question
All varieties of sushi are made from raw fish.
answer
false
question
​Numerous health organizations have concluded that irradiation of food is safe and can improve food safety in the United States and the world.
answer
true
question
​Properly irradiated food does not become radioactive.
answer
true
question
BHT protects fruits and vegetables from browning caused by exposure to oxygen.
answer
true
question
Food additives used in the U.S. are strictly controlled and pose little cause for concern.
answer
true
question
Current evidence indicates that moderate intakes of nonnutritive sweeteners pose no health risks.
answer
true
question
Incidental food additives sometimes find their way into foods, and adverse effects are common.
answer
false
question
Water-soluble vitamins are affected by canning.
answer
true
question
Raw produce does not pose a threat for foodborne illness because it is low in protein content.
answer
false
question
Salmonella bacteria from a hen may enter the egg she lays as well as contaminate its shell.
answer
true
question
​A low-birthweight baby is nearly 40 times more likely to die in the first year of life than is a normal-weight baby.
answer
true
question
A low-birth weight baby is defined as one who weighs less than 5 1/2 pounds.
answer
true
question
During pregnancy, the recommended carbohydrate intake is less than 175 grams per day.
answer
false
question
Folate fortification has lowered the number of neural tube defects that occur each year.
answer
true
question
The DRI recommendation for calcium intake is higher for pregnant than non-pregnant women in the same age group.
answer
false
question
For normal-weight women, the ideal pattern of weight gain during the first trimester is one pound per week.
answer
false
question
Physical activity during pregnancy can improve fitness, facilitate labor, and reduce psychological stress.
answer
true
question
​The energy nutrient composition of breast milk is much different from that of a healthful adult diet: it is much lower in protein but higher in fat.
answer
true
question
Alcohol crosses the placenta and is directly toxic to the fetus.
answer
true
question
An infant's basal metabolic rate is only half that of an adult, based on body weight.
answer
false
question
warning symptoms of botulism
answer
difficulty breathing difficulty swallowing double vision weak muscles
question
hazard anaylsis critical control point
answer
all food producers have a plan to limit contaminations of food
question
ideal conditions for bacteria
answer
nutrients, moisture, warmth (40-140 degree Fahrenheit)
question
four practices to defeat bacteria
answer
clean, separate, cook, chill
question
bovine spongiform encephalopathy
answer
disease in meats that causes fatal brain disorder
question
honey
answer
clostridium botulinum spores that affect infants
question
irridation
answer
application of ionizing radiation to foods to reduce insect infestation or microbial contamination or to slow the ripening or sprouting process
question
solanine
answer
greek toxin in potatoes
question
growth hormone
answer
increase lean tissue growth, milk production, reduce feed requirements
question
arsinic
answer
in pourtyl, rice, fish, offs, milk, drinking water
question
methylmercury
answer
poisoning in food that can cause blindness, deafness, and retardation
question
gras list
answer
for food additives
question
salt and sugar
answer
overused as additives to prevent bacterial growth by withdrawing water from food
question
nitrate
answer
additive in meats to preserve color and prevent acidity, safety issues in colon cancer
question
sulfite
answer
additive to preserve, severe allergies, not in raw foods, decrease thiamine in foods
question
aspartame
answer
link with insulin resistance, pku
question
monosodium gluamate
answer
used in restaurants, banned in infants bc brain cells, protective against cancer, msg system complex in those that are sensitive
question
fat replacers
answer
add Taste, texture, and cooking with fewer or no calories
question
olestera
answer
fat non nutritive that takes away vitamins so fortified with it
question
obese women are likely to suffer from gestational diabetes, hypertension, and complications during and infections after birth
answer
true
question
women requires ... carloeis using second trimester and extra ... calories during third
answer
340, 450
question
protein is higher ... dri for pregnant
answer
25 grams
question
folate amounts in pregnancy
answer
400-600 mpg so enough RBC
question
choline in pregnancy
answer
vital for structural integrity of cell membranes, synthesis of important NT, metabolism of lipids. needed to close neural tube and for development of brain and spinal cord. in eggs, milk, legumes, meats
question
build the skeleton during pregnancy
answer
vitamin d, calcium, phosphorus, magnesium
question
iron in pregnancy
answer
increase blood volume and provide for placental and fetal needs. increase abosportion and tease menurstration. should chose heme iron, additional iron sources, and enhance vitamin c to enhance absorption
question
zinc during pregnancy
answer
vital for protein synthesis and cell development.
question
wanted weight gain in pregnancy
answer
3.5 pounds in frist, 1 pound per week in others
question
smoking during pregnancy
answer
damage fetal dan, restrict blood supply, limit oxygen and removal of waste, slows growth reduce brain size, improper development skids low birthweight
question
listeriosis
answer
bad food poisoning in women thet can be deadly
question
preeclempsia
answer
HTN and protein in urine, can lead to mother and fetal death and seizures
question
lactacting
answer
spends 500 calories, eat an extra 330. drink lots of lid
question
breast milk provides all nutrients a healthy infant needs for six months except for
answer
vitamin d
question
great milk contains a generous proportion of essential fatty acids lanolin acid and linolenic acid as well asarachiodonic and ha.
answer
true
question
protein in breast milk
answer
alpha-lactalbumin
question
vitamin d in infants
answer
cause rickets deficiency. sunlight exposure
question
infant supplements
answer
viamon d, iron, and fluoride
question
coloustrum
answer
antibodies in breastmilk
question
iron in abbies
answer
4-6 months need from greater formulas. iron refortified cerairles, then protein foods likee meat and eggs, contribute iron but bioavailability poor. serve vitamin c to advance absorption
question
zinc in babies
answer
less in breast milk, rely on complementary foods like protein foods
question
look up minerals
answer
u fool
question
glucose and fiber needs of 1 year old
answer
falls in adult range because of size of brain
question
fat recommendations of children
answer
1-3 is 20-40, 4-18 is 25-35
question
vitamin d in children
answer
15 mpg, to maximize calcium absorption, ensure none growth
question
iron in children
answer
7-10 mg per day. lean meats, eggs, legumes, whole grains. deficiencies lead to behavior and inteleecultal dampening,
question
lead poisoning
answer
decreased bone and muscle growth, near damage, kidney malfunction, hearing impraitment, speech and language difficulty, developmental delay. absorbed more if lac iron, calcium, and zinc
question
Hunger results primarily from food poverty
answer
true
question
Federal programs to relieve hunger are crucial to many people, even if not fully successful in preventing hunger.
answer
true
question
SNAP debit cards cannot be used to purchase foods of low nutrient density such as chocolate doughnuts.
answer
false
question
Natural causes of famine have become more important in recent years than political or social causes.
answer
false
question
There is a strong, credible body of evidence documenting that the earth is warming and that this is largely due to human activities
answer
true
question
​By 2050, one billion additional tons of grains will be needed to feed the world's population.
answer
true
question
Poverty is associated with a high human birth rate.
answer
true
question
Energy Star products rank in the top 1% for energy efficiency.
answer
false
question
Poverty drives people to restrict the number of children they have.
answer
false
question
In countries with high malnutrition rates, both personal and national economies decline as productivity ceases
answer
true
Current Health Status
Fluid And Electrolyte Balance
Non Small Cell Lung Cancer
Nursing
Oncology
Pharmacology
Small Cell Lung Cancer
Pharm: Treatment of Cancer PrepU – Flashcards 30 terms

Patricia Harrah
30 terms
Preview
Pharm: Treatment of Cancer PrepU – Flashcards
question
Cytotoxic antineoplastic medications can produce several adverse effects that can affect the treatment used. In caring for patients undergoing chemotherapy, for which of the following should monitoring occur? (Select all that apply.)
answer
> Mucositis > Tetany
question
A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation?
answer
Inspect the site frequently for redness or swelling
question
An adverse effect of tamoxifen therapy involves menopausal symptoms.
answer
True
question
The nurse may be asked to administer which medication to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?
answer
Allopurinol (Zyloprim)
question
A nurse is caring for a client who is undergoing chemotherapy. The client has experienced several episodes of vomiting. Which activity should the nurse perform as part of ongoing assessment for signs of dehydration and electrolyte imbalances?
answer
Measure all fluid intake and output
question
A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy?
answer
Take special care when shaving or brushing her teeth.
question
The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response?
answer
"Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue."
question
A client asks the nurse what cancer cell growth is called. What would the nurse tell the client?
answer
proliferation
question
A patient is to start with chemotherapy. The patient is worried about going bald in the course of the treatment. How can the nurse assist the patient in being comfortable with his or her body image?
answer
Suggest the use of a wig or cap.
question
A nurse is caring for a patient who is at risk for erythema during antineoplastic drug therapy. What should the nurse suggest to this patient?
answer
Wear loose protective clothing.
question
A patient undergoing antineoplastic drug therapy is administered an alkylating drug. The patient is also administered an aminoglycoside as an anti-infective agent. Which of the following interactions of the alkylating drug with the aminoglycoside should the nurse assess the patient for?
answer
Increased risk of nephrotoxicity
question
A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?
answer
Non-Hodgkin's lymphoma
question
A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?
answer
The patient's bone marrow function is significantly depressed.
question
An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?
answer
Prostate cancer
question
A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing:
answer
dyspnea
question
The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are:
answer
cell cycle-specific.
question
A patient taking high doses of cyclophosphamide is exhibiting muscle cramps and confusion and reports headaches. The nurse assesses the laboratory tests and notices the sodium level is low. What does the nurse determine may be occurring with this patient?
answer
The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide.
question
A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse?
answer
"Your hair will grow back, but the new hair may be a different color or texture."
question
Which agent would the nurse expect to be administered orally?
answer
Methotrexate
question
Anemia from chemotherapy treatment is the result of bone marrow suppression.
answer
True
question
A client is experiencing intense nausea while being treated with chemotherapeutics. What actions should the nurse perform? Select all that apply.
answer
> Ensure that the client has had a dietician consult > Administer antiemetics as prescribed > Provide the client with small, frequent meals
question
A female client is receiving L-asparaginase. She is at the end of her chemotherapeutic course and is concerned because her liver function tests are abnormal. What is an appropriate response by the nurse?
answer
"Liver impairment usually subsides when chemotherapy is complete."
question
A nurse is caring for a patient being treated with antineoplastic drugs. The patient is at risk for thrombocytopenia due to bone marrow suppression. What should the nurse monitor for in this patient?
answer
Bloody urine
question
A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug?
answer
Tamoxifen
question
A patient has been prescribed melphalan, an alkylating agent, for the treatment of an ovarian tumor. The patient wants to know the action of the drug in treating the tumor. Which of the following should the nurse inform the patient?
answer
Changes the cell to a more alkaline environment.
question
The client receiving a first infusion of paclitaxel reports chills and dyspnea. The oncology nurse assesses the client and observes facial flushing, wheezing, and extreme anxiety. What is the priority intervention by the nurse?
answer
Stop the infusion.
question
An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which characteristic of this patient's current health status may preclude the use of imatinib?
answer
The patient has chronic heart failure resulting in significant peripheral edema.
question
A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?
answer
Risk for Infection related to suppressed bone marrow function
question
Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by
answer
slowing the infusion.
question
A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to:
answer
drink a lot of water.
Acute Urinary Retention
Fluid And Electrolyte Balance
Health Assessment
Nursing
Urology
Pathoma- Female GU (Vulva) – Flashcards 21 terms

Pedro Huang
21 terms
Preview
Pathoma- Female GU (Vulva) – Flashcards
question
vulva, vagina, and cervix
answer
three components of the female GU that comprise the lower GU tract
question
squamous cells
answer
type of epithelial cells that comprise the vulva
question
inflammation
answer
this immune response causes Bartholin's cysts
question
Bartholin's cyst
answer
typically presents as a unilateral, painful cystic lesion at the lower vestibule
question
reproductive age
answer
age during which Batholin's cysts are most common
question
6 and 11
answer
types of HPV that are considered low-risk and result in condyloma
question
koilocytes
answer
cells that exhibit a raisin-esque nucleus in response to HPV infection (high risk or low risk)
question
lichen sclerosis
answer
condition characterized by thinning of the epidermis and fibrosis of the dermis over the vulva. Vulvar skin is considered "parchment-like"
question
leukoplakia
answer
lichen sclerosis, lichen simplex chronicus, and vulvar carcinoma all have this common presentation
question
postmenopausal
answer
age group most at risk of lichen sclerosis
question
squamous cell carcinoma
answer
potential cancer that could result from long-standing lichen sclerosis
question
lichen simplex chronicus
answer
characterized by hyperplasia of the vulvar squamous epithelium. Vulvar skin is considered "leathery"
question
false
answer
true or false: lichen simplex chronicus is associated with increased risk of squamous cell carcinoma
question
HPV and lichen sclerosis
answer
two conditions that can result in rare vulvar carcinoma
question
16, 18, 31, and 33
answer
four high-risk HPV subtypes that are associated with dysplasia and progression to vulvar carcinoma
question
age
answer
demographic feature that differentiates women with vulvar carcinoma from HPV from women with vulvar carcinoma from lichen sclerosis
question
extramammary paget's disease
answer
condition characterized by malignant epithelial cells in the epidermis that represents carcinoma in-situ (no underlying carcinoma) that presents as erythematous, pruritic, and ulcerated vulvar skin
question
nipple
answer
this particular type of Paget's disease is associated with underlying carcinoma, but not in the vulvar region
question
PAS +, keratin +, and S-100 -
answer
three cell markers that would be indicative of extramammary paget's disease
question
PAS -, keratin -, and S-100 +
answer
three cell markers that would be indicative of melanoma of the vulvar
question
melanoma
answer
specific cancer that must be ruled-out when extrammary paget's disease is considered
Fluid And Electrolyte Balance
Indications For Use
Nutrition
Total Energy Expenditure
Medical Nutrition Therapy Final Exam – Flashcards 117 terms

Bernice Cooper
117 terms
Preview
Medical Nutrition Therapy Final Exam – Flashcards
question
Resting Energy Expenditure
answer
Also expressed as RMR and BMR, it is the energy required to maintain all body functions. A significant amount of energy is used to maintain metabolic activities. It is 60-75% of TEE.
question
Thermic Effect of Food
answer
The energy spent on the digestion, absorption and metabolism of food. It is 5-10% of TEE. This component is largely ignored in sick people.
question
What components are used to compute TEE?
answer
REE, Thermic effect of food, physical activity (15-30%), and illness or injury
question
What factors increase REE
answer
LBM, hormones (thyroid), pregnancy/lactation, environment/cold exposure, drugs/stimulants, stress, temperature/fever.
question
Direct Calorimetry
answer
Heat production parallels energy expenditure
question
Indirect Calorimetry
answer
Oxygen consumption parallels energy expenditure, clinical measure of TEE
question
Doubly labeled water
answer
Ingest water labelled with isotopes of oxygen and hydrogen; measures O2 and H disappearance from the body; Easier in free-living; Research studies as a measure of TEE.
question
Mifflin-St. Jeor Equation
answer
Energy expenditure estimation used more commonly for healthy and non-stressed individuals. Would need to multiply by a stress factor if used for sick individuals.
question
Sources of fluids in PN/EN pt
answer
Maintenance IV fluids; medications given via IV drip, Water flushes given with crushed medications; water flushes to keep tubes patent; water contained in EN or PN
question
Sources of fluid loss in pt
answer
chest tubes, percutaneous drains (biliary/pancreatic), wound drainage, ostomies/stool/urine, NG tube suction, excessive drooling, fistulas, increased insensible losses (burns, tracheostomies, fever, kinder beds)
question
Clinical or physical signs of nutritional deficiency
answer
Dehydration, edema, muscle wasting, decreased subcutaneous fat, clinical symptoms of vitamin/mineral deficiencies
question
When can you use Albumin, Pre-albumin, and transferrin to assess protein status?
answer
In stable patients, with good renal function. If pt is stress/inflammed the levels will not reflect protein status. TYN and UUN do not account for wound losses.
question
General Characteristics of EN
answer
Fed into GI track; Fed enterally; mimics the composition of normal diet in liquid form (polymeric, hydrolyzed)
question
General Characteristics of PN
answer
Fed outside GI tract; fed parenterally (intravenous, large or small veins, central or peripheral); concentrated monomeric formulas: glucose, free amino acids, lipids)
question
Oral Liquid Supplements
answer
Used when nutritional needs are not met by standard diet alone, often used to supplement a normal diet, commercially available, lactose and gluten free, high protein, high calorie nutrient dense foods and liquids.
question
Indications for EN support
answer
Cancer of the head and neck; radical surgery to the upper GI tract neck, oral pharynx, or upper respiratory track; esophageal cancer; dysphagia; gastroparesis; gastric outlet obstruction; mild malabsorptive disease (Crohn's disease, SBS, pancreatitis); inability to meet nutrient needs by intake alone (as with burn, trauma, sepsis and chemo pts); depressed mental status; neurological impairment; paralysis; P.O. intake less than cooler and protein needs (often d/t cancer and anorexia); correction of malnutrition d/t chronic disease.
question
Indications for EN support in children
answer
Congenital abnormalities of the mouth, esophagus, stomach or intestines; malabsorption as with cystic fibrosis, Crohn's, fat malabsorption; sucking and swallowing disorders (premature); brain injury; developmental delay; neuromuscular disorders; cerebral palsy; failure to thrive.
question
Indications and notes for NGT (nasogastric)
answer
Inadequate oral intake; high needs; Intubated/sedated; relatively functional GI tract; normally used short term
question
Indications and notes for nasoduodenal or nasojejunal
answer
Functional lower GI tract (proximal injury/surgery); inadequate gastric motility (high residuals); esophageal reflux. These routes require continuous drip feeding d/t bypassing gastric emptying
question
Indications and notes for gastrostomy
answer
Esophageal injury or obstruction; inability to swallow; anticipate EN needed for > 4 weeks. Long term usage. Caution: GERD and intractable vomiting
question
Indications and notes for Jejunostomy
answer
Obstruction/surgery proximal to jejunum; UGI stricture or fistula; inadequate gastric motility. Use long term transpyloric continuous drip
question
Continuous Drip EN
answer
Used in ICU settings; better tolerated in sick in-patient; less N, D, cramping, and bloating; may reduce risk of aspiration pneumonia; generally requires infusion pump (intestine); can by cycled in homecare puts with good tolerance to EN.
question
Bolus EN
answer
Gastric feeding (cannot be used post-pyloric); appropriate for long-term feedings; allows mobility for pt; allows mealtime feedings that mimics normal eating patterns; usually 50-500cc/feeding
question
Intermittent EN
answer
Given "drip" method; gravity garage or pump; feeding bag; may give same volume as bolus but over a longer time period; can be given nocturnally at increased rate to allow daytime mobility; used to transition to oral feedings; used for intestine feedings to increase mobility.
question
Indications for use of standard EN formula
answer
normal GI function with mild/moderate stress
question
Indications for use of high protein, high Kcal EN formula
answer
hypermetabolic, volume restrictions, high protein
question
Indications for use of elemental/partially hydrolyzed EN formula
answer
Malabsorption, bowel rest, pancreatitis
question
What does low residue mean?
answer
Only a small amount of the EN is getting to the colon.
question
Complications of EN
answer
Diarrhea, Constipation, Bloating, Nausea/vomiting, high residuals, aspiration, naso-pharyngeal irritation, clogged tube, hyperglycemia, hypoglycemia, dehydration, hypokalemia, hypophosphatemia
question
Complications of overfeeding on EN
answer
hyperglycemia, lipogenesis, fluid and fat gain vs LBM, immunosuppression (XS lipid and linoleic acid), excess CO2 production, increased minute ventilation.
question
Complications of underfeeding on EN
answer
loss of lean tissue, skin breakdown, poor wound healing, immundysfunction. Intake is often <75% of order
question
What is the most serious life-threatening complication of enteral therapy?
answer
Aspiration/Pneumonia
question
Benefits of EN
answer
Stimulates immune barrier function at GI; attenuates bacterial translocation; physiologic presentation of nutrients; maintains gut mucosal integrity; attenuates hypermetabolic response; simplifies fluid/electrolyte management; more "complete" nutrition that PN; provides iron, fiber, glutamine, phytochemicals that are not found in PN; less infectious complications; stimulates return of bowel function; less expensive.
question
MNT for flatulence
answer
Low fructose diet, reduce gas forming foods, increase physical activity
question
Causes of flatulence
answer
Swallowed air, distention, cramping, high fiber (raffinose), high fructose diets.
question
Constipation is defined as
answer
low stool caliber, hard stool, no BM for 3 days
question
Causes of constipation (systemic etiology)
answer
Side effect of medication (narcotics, NSAIDs); metabolic endocrine abnormalities, such as hypothyroidism, uremia (renal failure), hypercalcemia, systemic neuromuscular disease (ALS), spina bifida, Parkinson's disease, lack of exercise, bedridden hospitalized or LTC (any sedentary lifestyle); ignoring the urge to defecate; vascular disease of the large bowel; poor diet low in fiber; pregnancy
question
Causes of constipation (gastrointestinal etiology)
answer
cancer; diseases of the upper GIT; Diseases of the large bowl resulting in failure of propulsion along the colon (colonic inertia) and/or failure of passage through anorectal structures (outlet obstruction); IBS; anal fissures or hemorrhoids; laxative abuse; stimulants; patients of opioids.
question
Constipation: Nutrition-related contributing factors
answer
Low intake of fruits, vegetables and whole grains; consumption of the typical refined American diet; decreased fluid intake, water; increased consumption of caffeinated beverages; dairy products (milk and hard cheese); laxative abuse (senna, castor, phenylphthalenin)
question
Laxatives
answer
senna, castor, phenylphthalein
question
Constipation MNT
answer
High (non-soluble) fiber diet; increase intake of whole grain cereals; increase intake of f&v (raw or cooked w/ skins and hull), and legumes; increase water to 8 cups of water per day; OTC fiber supplements of fermentable fibers (psyllium, methylcellulose)
question
Types of diarrhea
answer
Osmotic, secretory, exudative, medication induced, malabsorptive
question
Osmotic diarrhea is caused by
answer
overconsumption of sugars (fructose, lactose intolerance)
question
Secretory diarrhea is caused by
answer
bacteria, viruses, toxins
question
Exudative diarrhea is caused by
answer
HFD, mucus, fluid, electrolytes, blood, plasma proteins, Crohn's, UC, radiation
question
What medications can cause diarrhea
answer
antibiotics (AAD)
question
Malabsorptive diarrhea is caused by
answer
decreased absorptive surface (celiac) or low bile or pancreatic enzymes (steatorrhea)
question
What electrolytes are lost with excess fluid loss
answer
sodium and potassium
question
What is the leading cause of nosocomial diarrhea
answer
Clostridium difficile
question
Clostridium difficile
answer
leading cause of nosocomial diarrhea; opportunistic proliferation of pathogenic organisms associated with antibiotic therapy and chronic use of PPIs; spore forming and spread via tube feedings from pt to pt. Causes colitis, secretory diarrhea, colon dilation (magacolon), peritonitis, can be fatal; diagnosed by still sample, tx w/ antibiotics
question
Diarrhea MNT
answer
Oral fluids/electrolytes (carbonated beverages, sports drinks-potassium, soups, vegetable juice, isotonic liquids); avoid-sugar alcohol, fructose, lactose; w/ servere acute vomiting use IV hydration; with chronic diarrhea check zinc status; do not need to with hold food.
question
BRAT Diet
answer
not evidence based to treat diarrhea, high CHO and fructose, bananas, rice, applesauce and toast.
question
Tropical spruce
answer
Infectious diarrhea d/t bacterial overgrowth d/t mucosa atrophied/inflamed d/t decreased absorption. Can result in multiple vitamin and mineral deficiencies (low HCl and IF)-folic acid, B12
question
Irritable bowel syndrome nutrion-related presenting features
answer
Alternating diarrhea and constipation, dyspepsia, bloating, distention, incomplete evacuation, mucus in stool, discomfort after eating. R/o lactose intolerance or other GI dx. IBS is a diagnosis of exclusion
question
IBS-MNT
answer
Soluble fiber (normalize transit time), eliminate offending foods, low FODMAP (?), individualized to pt d/t variability in food tolerances. Probiotics (bifidobacterium infantis)
question
What is not allowed on a low FODMAP diet
answer
fructose, lactose, oligosaccharides (fructans or galactans), polyols.
question
Small Intestine Bacterial Overgrowth (SIBO)
answer
Bacterial overgrowth from stasis in the intestine, obstruction, radiation enteritis, fistula, IBD, IBS, or removal of ileocecal valve, surgical repair. Bacterial will cause a loss of bile salt function resulting in steatorrhea, bacteria use B12 resulting in def.
question
SIBO Tx
answer
antibiotics for bacterial overgrowth, probiotics and probiotics to regain normal cultures. Limit refined CHO *increase whole grains, veggies and oligosaccharides. May use MCT, Low FODMAP, B12 supplement
question
Common tests for malabsorption
answer
Direct stool examination; fecal fat test; C-xylose absorption test; breath test; pancreatic exocrine deficiency; schilling test (B12 malabsorption, protein losing enteropathy); Intestinal biopsy looking for celiac, eosinophilic enteritis, giardiasis, Crohn's disease.
question
Primary lactose intolerance
answer
deficiency in lactase brought on by gradual decline in lactase production
question
Secondary lactose intolerance
answer
intestinal infection or destruction of mucosal cells, intractable diarrhea, Crohn's and gluten sensitive enteropathy
question
Tests used to diagnose lactose intolerance
answer
Breath Hydrogen test or lactose tolerance test
question
Lactose intolerance MNT
answer
decrease consumption of lactose containing foods/milk; lactase enzyme replacements and treated milk products added to diet; calcium and vitamin D supplements; Identify hidden sources of lactose (milk solids, whey, casein)
question
Nutritional concerns with steatorrhea
answer
loss of energy/wt loss; loss of fat soluble vitamins; loss of ca and mg; increased absorption of oxylate (urolithiasis)
question
MNT for steatorrhea
answer
low fat diet; MCT supplements; water forms of fat soluble vitamins
question
Etiologies of celiac disease
answer
genes (familial or HLA class II), immune (antigliadin Ab), gliadin intolerance, damaged mucosa (decrease absorptive surface)
question
Gold standard for diagnosis of celiac disease
answer
endoscopic tissue biopsy
question
MNT for celiac disease
answer
Gluten free diet
question
Dermatitis Herpetiformis
answer
Red, raised, small or large blisters that burn and itch intensely, not unique to celiac disease.
question
Ulcerative colitis
answer
is a mucosal disease of the large intestine, including the rectum
question
Crohn's disease
answer
may involve any part of the GIT; most in distal ileum and colon; segments of inflamed bowel.
question
Ulcerative Colitis nutrition-related presenting features
answer
Chronic diarrhea, frequent watery stools; up at night; bloody diarrhea; fever; anorexia; wt loss; low hgb, hct, albumin, and potassium; elevated ESR and CRP
question
Ulcerative Colitis - MNT
answer
oral fluids and electrolytes; low fiber, low residue (acute phases); may add soluble bulking agent to prevent constipation and diarrhea; monitor zn levels w/ chronic persistent diarrhea; monitor Hgb, HCT, f/u with Fe studies indicated with anemia, etiology is GI bleed depletes iron.
question
Crohn's Disease - MNT
answer
Crohn's disease can lead to severe malnutrition. May require complete bowel rest (PN or EN hydrolyzed/elemental, low fat formulas); nutrition must be individualized and monitored (electrolytes, fluid status, wt, growth in children, anemia, fat soluble vitamins, pre-albumin, CRP-inflammation, zinc). Tropic feeds. Similar to UC, low fiber; low residue. High protein, high calorie; may benefit from MCT, vitamin and mineral supplementation, lactose restriction prn.
question
Fistula
answer
Abnormal opening between organs. Caused by birth defects, trauma, inflammatory disease, malignant disease, enterocutaneous post surgery
question
Fistula MNT
answer
Restore fluid and electrolyte balance, PN may be necessary and depends on location of the fistula, enteral nutrition may be possible using predigested formulas, oral diets
question
Short bowel syndrome
answer
Loss of 70-75% of the small bowel (100-120 cm of small bowel w/o colon or 50 cm of small bowel with colon). Results in wt loss, diarrhea, decreased transit time, malabsorption, dehydration, loss of electrolytes, hypokalemia; steatorrhea; B12 def; loss of fat soluble vitamins; fatty acid mineral soaps with ca, zn, and mg.
question
SBS MNT
answer
1) PN, 2) slow introduction of EN, focus on glutamine, nucleotides, SCFAs first (tropic feeds); MCT for fat soluble vitamins; evaluate narcotics. Eventually the remaining bowel will increase its absorptive surface.
question
MNT for Ileostomy or Colostomy
answer
Nutrition needs very; avoid gas and odor forming foods; fluid and electrolyte needs; B12 supplement
question
Diverticulosis nutrition-related issues
answer
High refined carbohydrate, high fat low fiber "western" diet contributes to disease
question
Diverticulosis MNT
answer
High fiber, low fat. Special focus on soluble fibers
question
Soluble fiber supplements
answer
metamucil, fibercon, citrucel, psyllium
question
Colorectal Cancer Nutrition-related contributing factors
answer
High fat, low fiber, refined "western" diet; low ca and FA intake; high alcohol (beer) intake; high meat intake; obesity; tobacco.
question
Colorectal cancer nutrition-related protective factors
answer
whole grain, FA, ca, vit D, multivitamin, PA and NSAIDs
question
Screening for GI disease: What is the most important indicator
answer
unintentional wt loss
question
Screening for GI disease: "flags" in diet hx
answer
Changes in appetite; N, V, & D; chewing/swallowing problems; food intolerances; supplements; pre and probiotics; typical intake/ability to take fluids
question
Screening for GI disease: "flags" in lab values
answer
Vit B12, FA, Ferritin, vitamin D
question
Achalasia
answer
Failure of esophageal neurons, in ability to relax the LES, MNT- Liquids not tolerated
question
Odynophagia
answer
Painful swallowing, as with the canker sores as a result of oral and esophageal cancers. MNT-liquids better tolerated than solids
question
Nutrition-related presenting characteristics for dysphagia
answer
Pt c/o food sticking in throat; aspiration pneumonia; wt loss; PEM
question
Dysphagia MNT
answer
Modify texture and consistency of pets diets per recommendations of swallow study. Avoid acidic foods and alcohol to help with symptoms. Correct nutritional deficiencies, prevent further wt loss, utilize high protein, high calorie food choices, oral supplements and EN
question
EGD
answer
Esophagogastroduodenoscopy, used to evaluate GERD
question
GERD
answer
Backward flow of the stomach or duodenal contents into the esophagus, result of competency of the LES
question
Esophagitis
answer
Inflammation, ulceration, erosions, scarring of the esophagus. D/t reflux, ingestion of corrosive agent, infection, intubation, radiation, eosinophilic infiltration, NSAIDs,
question
Barrett's Esophagus
answer
Precancerous condition; risk factors: prolonged GERD, mae gender, >50 yo, family hx
question
Hiatal hernia
answer
out-pouching of a portion of the stomach into the chest through esophageal hiatus of the diaphragm
question
Hiatal Hernia MNT
answer
wt reduction and decreasing meal size. May require surgery
question
GERD/Hiatal hernia nutrition-related presenting characteristics
answer
S exacerbated by fried foods, spicy foods, large meals, over-eating, alcohol, caffeine, and dietary indiscretion. pt c/o heart burn after large meals; chronic GERD may cause dysphagia, dental erosions
question
MNT for GERD
answer
Prevent pain and chemical irritation of esophageal mucosa (avoid acidic foods, alcohol, spiced foods); Prevent reflux (avoid foods that lower LES pressure i.e. high fat, greasy, alcohol, carminatives, chocolate. Avoid eating 2-4 hrs before bed; raise head of bed; avoid PA immediately following meals; avoid wearing tight fitting clothing; avoid overeating. Reduce Acidity of Gastric Contents (proton pump inhibitors, H2 receptor antagonist, antacids)
question
Omeprazole/prilosec
answer
Proton pump inhibitors, decrease Mg.
question
H2 receptor Antagonists
answer
cimetidine (Tagamet); Ranitidine (Zantac)
question
Antacids
answer
Magnesium and Aluminum hydroxide, calcium carbonate, magnesium phosphate
question
Ingesting too many magnesium based antacids can
answer
cause diarrhea and deplete phosphorus.
question
MNT for cancers of the oral cavity, pharynx and esophagus
answer
Modify texture and consistency of pets diets per recommendations of swallow study. Avoid acidic foods and alcohol to help with symptoms. Correct nutritional deficiencies, prevent further wt loss, utilize high protein, high calorie food choices, oral supplements and EN; f/u with nutritional plan. Tx of cancer may cause nutritional issues (decreased saliva production, tooth decay, swallowing difficulties, tooth extractions).
question
Esophagectomy MNT
answer
individualized NTRI plan and f/u, nutritional support (TF), slow progression to oral feedings. Monitor dumping syndrome, nutrient malabsorption, recommend liquid multivitamins and B12
question
What is required for normal RBC synthesis
answer
Functional bone marrow, EPO, protein, iron, B12, FA, Vit C, B6
question
What lab measures RBC size
answer
MCV
question
What lab measures RBC production
answer
Reticulocytes
question
Anemia
answer
decrease in the oxygen-carrying capacity of blood d/t decreased hemoglobin
question
Which anemias are affected by alcohol consumption
answer
Folic acid, B12, GI bleeding, Immune suppression, liver disease, impaired biosynthetic processes
question
What medications can result in anemia
answer
NSAIDS, Steroids, antacids, H2 blockers, anticoagulants, myelosuppressive drugs, vitamin antagonists
question
Microcytic Anemias
answer
IDA, ACD, Thalassemia, Sideroblastic
question
Causes of macrocytic anemia
answer
B12 and FA deficiencies, pernicious anemia, liver disease, hypothyroidism, drugs (FA and B12 antagonists, antivirals)
question
Normocytic anemias
answer
ACD/AI, pregnancy, bleeding, renal failure, cirrhosis, CLL, CML
question
What medications can result in anemia
answer
NSAIDS, Steriods, antacids, H2 blockers
question
What anemia patients my responds well to EPO tx
answer
pt with renal disease, rheumatoid arthritis, HIV, multiple myeloma
question
What anemias should not be tx with iron?
answer
blood loss, ACD/AI, thalassemia, sideroblastic, lead toxicity, sickle cell (?)
Fluid And Electrolyte Balance
Foundations Of Professional Nursing
Normal Blood Glucose
Nursing
Surgery
Med Surg: Nutritional Needs – Flashcards 79 terms

David Dunn
79 terms
Preview
Med Surg: Nutritional Needs – Flashcards
question
What is TPN
answer
a method of providing all the nutrients that a client will need for a 24 hour period through an IV
question
What type of vein must TPN run through
answer
central
question
What type of vein can PPN run through
answer
peripheral
question
Why must TPN run through a central vein
answer
because it is a vesicant and running it through a large vein will allow it to be diluted
question
Where are the central lines located
answer
in the trunk of the body, subclavian, internal jugular, PICC
question
How is TPN administered
answer
on an infusion pump
question
What are the goals of TPN
answer
improve nutritional status establish a positive nitrogen balance maintain muscle mass promote weight maintenance/ gain enhance wound healing
question
Who decides what is in a TPN solution
answer
the entire health team based on labs, physical assesment, and underlying disease process
question
Why can traditional IV fluids not be used for TPN
answer
does not provide sufficient calories
question
How many calories are in D5W
answer
4 cal/g
question
What are the clinical indications for using TPN
answer
multiplicity of problems 10% loss of pre-illness body weight NPO NPO sevan days after surgery enternal nutrition not an option hyper-catabolic situation (hyperthyroidism, severe burns) major illness (cancer)
question
what is cacexia
answer
severve malnutrition
question
what is one sign of cacexia
answer
temporal wasting
question
What is TPN composed of
answer
amino acids-protein (wound healing) glucose or dextrose ( energy) fat (maintain body temp, increase caloric consumption) insulin
question
Where does the glucose in TPN come from
answer
beet pulp becuase it has a lower glycemic index which helps reduce the risk of hyperglycemia
question
What electrolytes are in TPN
answer
K+ (muscle function) 3.5-5.3 mEq Ca++ (bone growth and maintenance, muscle contraction, neuromuscular interaction) Mg ++ (muscle and neurological fxn) Na + (muscle contraction) Cl - and PO4 ( acid/ base balance, muscle fxn)
question
What trace elements are included in TPN
answer
micro-nutrients zinc (wound healing, collogen strength) copper (promote tissue profusion) selenium (muscle mass) iodinw fluoride cobalt nickle iron
question
Which vitamins are fat soluable
answer
ADEK
question
which vitamins are water soluable
answer
B complex and C
question
When is thiamine added to a TPN solution
answer
when there is suspected ETOH abuse or impaired liver fxn
question
What type of soultion is TPN
answer
hyperglycemic
question
What type of insulin can be added to TPN
answer
REGULAR
question
What is the #1 way to seeif TPN solution is beneficuual
answer
weight assesment
question
What should be assesed to determine need for TPN
answer
electrolyte status caloric intake protein loss (decreased skin tugor and muscle mass) - pre-albumin labs
question
Nursing Dx associated with the need for TPN
answer
imbalanced nutrition less than body requirements r/t inadequate oral intake of nutrients AMB muscle waisting, low albumin leves, decreases levels of pre-albumin, weight loss, and poor tissue healing
question
Examples of nursing goals while on TPN
answer
balanced nutrition gain 3lbs within a week labs within normal limits
question
What are some complications that can occur with TPN
answer
infection hyperglycemia hypoclycemia (shaking, sweating, irritablity) fluid volume overload air embolism
question
Nursing Dx for client who has infection in TPN lin
answer
Risk for overwhelming baterial infection
question
Signs/ symptoms of infection
answer
fever chills swelling and erythemia at catheter site purulent drainage tachycardia tachypnea change in LOC hypotention increased WBC septic shock
question
how to prevent CRBI
answer
strick aseptic tecnique change solution per hos. protocol change tubing q 12 hrs change dressign per hos. protocol bag and tubing should not hang longer than infusion time
question
What should be done if CRBI occurs
answer
pull cath and send to lab for culture admin abx as ordered
question
causes of hypergylcemia durring TPN therpay
answer
blood gluscose levels > 200mg/ dl too rapid infusion of TPN stress of illness
question
Sign and symptoms of hyoerglycemia
answer
excessive thirst, fatigue, polyuria, restlessness, confusion, weakness, diuresis, hyperglycemic coma
question
Nursing interventions to prevent hyperglycemia durring TPN
answer
assess BG as ordered sliding scale insulin maintain BG < 200 mg/dl
question
What would put a client at risk for hypoglycemia durring TPN therapy
answer
TPN being abruptly discontinue toomuch insulin via TPN or sliding scale
question
Signs and symptoms of hypoglycemia
answer
shaky, weak, diaphoretic, may be hungry, BG < 70 mg/dl
question
nursing implementations for prevent hypoglycemia
answer
monitor BG gradually decrease TPN flow rate always use infusion pump never stop TPN abruptly infuse D10W infusion or D50 IVP restart additional IV
question
Signs and symptoms of an air embolism
answer
resp distress, restlessness, chest pain, hypertension, weak pulse, tachycardia
question
what should be done if air embolism is suspected
answer
place pt in trendelenburg and place on left side
question
prevention of air embolism
answer
valsalva maneuver durring tube change prime tubing check connections
question
What does CRBI stand for
answer
catheter related bloodstream infection
question
signs and symptoms of fluid volume overload
answer
restlessness, resp distress, change in LOC, tachypnea, tachycardia, bounding pulse, increased BP, JVD, wet lung sounds, decreased 02 stats, excessive weight gain
question
fluid overload prevention
answer
use pump dont play catch up
question
what should be done is fluid volume overload is suspected
answer
don't leave pt sit bed up anticipate giving 2-4 lt o2 via cannula diruetics
question
rules regarding rate of TPN
answer
start low, go slow 50 ml/hr if rate is not writtin in order increase gradually over 24hr period until rate is reached
question
additional complications
answer
venous thrombus movement clot or thrombosus in cath electrolyte imbalance excessive weight gain increased lipid levels fatty liver (monitor trigycerides, glucose) refeeding syndrome
question
signs of refeeding syndrome
answer
acute decrease in K+, Mg++, PO4 hypoglycemia
question
who is at risk for refeeding syndrome
answer
severly malnurished pt beginning on TPN
question
TPN nursing interventions
answer
know facility protocols maticulously care for TPN site accurate I&Os daily weights
question
what is always the # intervention
answer
assesment
question
what is tube feeding
answer
enteral nutrition administration of nutritionally balanced liquefied food through tube inserted into stomach, duodenum, or jejunum
question
advantages of enteral feeding over TPN
answer
easily administered, safer, more physiologicallu effcient, less expensive
question
how is tube placement varified
answer
x-ray ausculation of air aspiration of stomach fluids ( pH around 5)
question
how often should placement be assesed
answer
q8hr
question
what are the advantages of using a dobb-hoff
answer
more flexible and comfortable less mucosal damage
question
indications for enteral feedings
answer
anorexia orofacial fractures head/ neck cancer burns nurtitional deficiencies neurological conditions phychiatric conditions chemotherapy radiation therapy
question
tube feeding delivery options
answer
continuous infusion by pump intermmittent by gravity intermittent bolus by syringe cyclic feeding by infusion pump
question
Nursing Dx with enteral feedings
answer
Risk for aspiration r/ t reflux
question
complcations related to nasogastric and nasointestinal tubes
answer
can become silodge by vomiting or coughing tube can end up in trachea increases resk for aspiration can become knotted/ kinked in GI tract
question
when would a gastrostomy or jejunostomy tube be used
answer
for long-term feedings when GI tract is intact and unobstructed
question
how are gastrostomy or jejunostomy tubes placed
answer
surgically, radiologically or endoscopically
question
what is a PEG tube
answer
Percutaneous Endoscopic Gastrostomy
question
how is a PEG tube placed
answer
via percutaneous endoscopy through esophagus into stomach andthen pulled through a stab wound made in abdominal wall
question
how should pt being positioned durring enteral feeding administration
answer
sitting or lying with HOB at 30-45 degrees HOB should remain elevated for 30 -60 minutes after intermittent delivery
question
what should be done to help keep tube patent
answer
by administering water before/ after each feeding, drug admin, and residual checks
question
when should placement be checked
answer
prior to intial feeding prior to irrigation prior to med admin prior to fluid admin q shift
question
what should be done before begining a feeding
answer
aspirate gastric contents and measure amount
question
when should a feeding be held and why
answer
if more than 150 ml is aspirated b/c it can be a sign of clinical intolerance
question
what is done with residual stomach contents
answer
put back through tube
question
what is the appropriate tempurature for formula and why
answer
room/ body temp prevents cramping and abdominal distension overall GI comfort
question
standard volume for intermittent feedings
answer
200 to 500 ml
question
what will help to decrease tube feeding diarrehea
answer
administration of "free water"
question
general nursing considerations with enteral feedings
answer
daily weights BMI skin turgor assess bowl sounds before feedings accurate I&Os initial glucose checks label with date and time feeding was started feeding infusions older than 8 hrs should be discarded tubing changed q 24 hr
question
nursing considerations with enteral feedings
answer
verify tube placement position pt safely correct formula aseptic technique admin feeding according to order maintain tube patency assess tube feeding residuals admin free water as ordered
question
enteral complications
answer
aspiration vomiting diarrhea constipation dehydration
question
when is a high protein formula contraindicated
answer
in pts with renal failure
question
aspiration prevention
answer
elevate HOB check residuals assess lung sounds and respiratory status
question
diarrhea prevention
answer
start feedings slow dilute initial feedings perineal care assess fluid and electrolyte status
question
gerontologic considerations
answer
fluid and electrolyte balanaces glucose intolerance decreased ablity to handle large volumes increased risk of aspiration
Fluid And Electrolyte Balance
Injuries
Nursing
Adult 1- FINAL- ch. 59 Care of pts w/problems of the Biliary system & Pancreas – Flashcards 28 terms

Chad Lipe
28 terms
Preview
Adult 1- FINAL- ch. 59 Care of pts w/problems of the Biliary system & Pancreas – Flashcards
question
A patient is admitted to the patient care unit with obstructive jaundice. Which sign/ symptom does the nurse expect to find upon assessment of the patient?
answer
pruritus
question
the daughter of a patient with cholelithiasis has heard that there is a genetic disposition for cholelithiasis. The daughter asks the nurse about the risk factors. how does the nurse respond?
answer
Hormone replacement therapy has been associated with increased risk for cholecystitis.
question
which patient is at low risk for development of gallbladder disorders?
answer
Patient who is 20 years old and male.
question
the nurse on a medical surgical unit is caring for several patients with acute cholecystitis. Which task is best to delegate to the UAP?
answer
Obtain the patient's vital signs.
question
The nurse is assessing a patient with acute cholecystitis whose abdominal pain is severe. The patient has a heart rate of 118 a minute, is pale, diaphragmatic, and describes extreme fatigue. What is the nurse's priority action at this time?
answer
Notify the patient's healthcare provider.
question
The healthcare provider has assessed a patient's abdomen and found rebound tenderness on deep palpitation. What does the nurse recognize?
answer
Blumberg's sign.
question
a patient is scheduled for tests to verify the medical diagnosis of cholecystitis. For which diagnostic test does the nurse provide patient teaching?
answer
Ultrasonography of the right upper quadrant.
question
which type of drug is used to treat acute severe biliary pain?
answer
opioids, morphine.
question
The nurse is administering ketorolac, Toradol, to a 78-year-old patient for mild to moderate pain management. Which assessment finding indicates the patient is experiencing a side effect of this drug?
answer
Abdominal bloating and cramping.
question
The nurse is caring for an older adult patient with acute biliary pain. Which drug order does the nurse question?
answer
Meperidine, Demerol.
question
Which factor renders the patient the least likely to benefit from ESWL for the treatment of gallbladder stones?
answer
Height 5'10", 325 pounds
question
which statement about the care of a patient with a Jackson Pratt, JP, drain after a traditional cholecystectomy is true?
answer
serosanguineous draninage stained with bile is expected for 24 hours.
question
The female patient is to have her gallbladder removed by natural orifice transluminal endoscopic surgery. What does the nurse teach about the surgery?
answer
The surgeon will use a vaginal approach to remove your gallbladder.
question
After removal of the gallbladder, a patient experiences abdominal pain with vomiting for several weeks. What does the nurse recognize?
answer
Postcholecystectomy syndrome
question
patient with acute cholecystitis has a pacemaker. Which diagnostic test is contraindicated?
answer
Magnetic resonance cholangiopancreatography, MRCP
question
the nurse is evaluating electrolyte values for a patient with acute pancreatitis and notes that the serum calcium is 6.8 mEq/L. how does the nurse interpret this finding?
answer
A result of the body not been able to use bound calcium.
question
Disseminated intravascular coagulation, DIC, is a complication of pancreatitis. What pathophysiology leads to this complication?
answer
Consumption of clotting factors in micro thrombi formation.
question
the patient with acute pancreatitis experiences of abdominal pain. What is the best intervention to begin management of this pain?
answer
IV opioids by means of patient controlled analgesia, PCA.
question
the patient comes to the emergency department with severe abdominal pain and the mid-epigastric area. The patient states that the pain began suddenly, is continuous, radiates to his back, and it is worst when he lies flat on his back. What conditions is the nurse suspect?
answer
Acute pancreatitis.
question
Which diagnostic test is the most accurate in verifying a diagnosis of acute pancreatitis?
answer
Lipase.
question
A patient with acute pancreatitis is at risk for the development of paralytic, a dynamic, ileus. Which option provides the nurse with the best indication of bowel function?
answer
Asking the patient if he or she has passed flatus or had a stool.
question
which condition is most likely to be treated with antibiotics?
answer
Acute necrotizing pancreatitis.
question
The nurse has instructed a patient in the recovery phase of acute pancreatitis about diet therapy. Which statement by the patient indicates the teaching has been successful?
answer
I will avoid eating chocolate and drinking coffee.
question
The nursing student is caring for a patient with chronic pancreatitis who is receiving pancreatic enzyme replacement therapy. Which statement by the student indicates the need for further study concerning this therapy?
answer
If the patient has difficulty swallowing the enzyme preparation, I will crush it and mix it with foods.
question
The nurse detects an epigastric mass while assessing a patient with acute pancreatitis. The patient describes epigastric pain that radiates to his back. What does the nurse suspect?
answer
Pancreatic pseudocyst
question
what is the most common and serious complication after a Whipple procedure?
answer
Fistula development
question
the nurse is teaching a patient and family how to prevent exacerbations of chronic pancreatitis. which teaching point does the nurse include?
answer
Avoidance of alcohol and nicotine.
question
The patient is to continue pancreatic enzyme replacement therapy, PERT, after discharge. Which statement indicates that the patient understands teaching about this therapy?
answer
I will take the enzymes after I take my ranitidine, Zantac.
End Stage Kidney Disease
End Stage Renal Disease
Fluid And Electrolyte Balance
Nursing
Specific Gravity Of Urine
Surgery
Acute Renal Injury & CKD – NCLEX – Flashcards 26 terms

Jessica Forbes
26 terms
Preview
Acute Renal Injury & CKD – NCLEX – Flashcards
question
How do you determine that a patient's oliguria is associated with acute renal failure (ARF)? A. Specific gravity of urine at 3 different times is 1.010. B. The serum creatinine level is normal. C. The blood urea nitrogen (BUN) level is normal or below. D. Hypokalemia is identified.
answer
A. Specific gravity of urine at 3 different times is 1.010. A urinalysis may show casts, red blood cells (RBCs), white blood cells (WBCs), a specific gravity fixed at about 1.010, and urine osmolality at about 300 mOsm/kg.
question
When caring for a patient during the oliguric phase of acute kidney injury, what would be an appropriate nursing intervention? A. Weigh patient three times weekly B. Increase dietary sodium and potassium C. Provide a low-protein, high-carbohydrate diet D. Restrict fluids according to the previous day's fluid loss
answer
D. Restrict fluids according to the previous day's fluid loss Patients in the oliguric phase of acute kidney injury have fluid volume excess with potassium and sodium retention. They will need to have dietary sodium, potassium, and fluids restricted. Daily fluid intake is based on the previous 24-hour fluid loss (measured output plus 600 mL for insensible loss). The diet also needs to provide adequate, not low, protein intake to prevent catabolism. The patient should also be weighed daily, not just three times per week.
question
Which assessment finding is commonly found in the oliguric phase of acute kidney injury (AKI)? A. Hypovolemia B. Hyperkalemia C. Hypernatremia D. Thrombocytopenia
answer
B. Hyperkalemia In AKI, the serum potassium levels increase because the normal ability of the kidneys to excrete potassium is impaired. Sodium levels are typically normal or diminished, whereas fluid volume is normally increased due to decreased urine output. Thrombocytopenia is not a consequence of AKI, although altered platelet function may occur in AKI.
question
Which patient has the greatest risk for prerenal AKI? A. The patient is hypovolemic because of hemorrhage. B. The patient relates a history of chronic urinary tract obstruction. C. The patient has vascular changes related to coagulopathies. D. The patient is receiving antibiotics such as gentamicin.
answer
A. The patient is hypovolemic because of hemorrhage. Prerenal causes of AKI are factors external to the kidneys. These factors reduce systemic circulation, causing a reduction in renal blood flow, and they lead to decreased glomerular perfusion and filtration of the kidneys.
question
The patient admitted to the intensive care unit after a motor vehicle accident has been diagnosed with AKI. Which finding indicates the onset of oliguria resulting from AKI? A. Urine output less than 1000 mL for the past 24 hours B. Urine output less than 800 mL for the past 24 hours C. Urine output less than 600 mL for the past 24 hours D. Urine output less than 400 mL for the past 24 hours
answer
D. Urine output less than 400 mL for the past 24 hours The most common initial manifestation of AKI is oliguria, a reduction to urine output to less than 400 mL/day.
question
The patient in the oliguric phase of AKI excreted 300 mL of urine in addition to 100 mL of other losses during the past 24 hours. With appropriate calculations, you determine that for the next 24 hours the patient's fluid allocation is A. 600 mL. B. 800 mL. C. 1000 mL. D. 1200 mL.
answer
C. 1000 mL. Fluid intake must be closely monitored during the oliguric phase. The rule for calculating the fluid restriction is to add all losses for the previous 24 hours to 600 mL for insensible losses.
question
Your plan for care of a patient with AKI includes which goal of dietary management? A. Provide sufficient calories while preventing nitrogen excess. B. Deliver adequate calories while restricting fat and protein intake. C. Replace protein intake with enough fat intake to sustain metabolism. D. Restrict fluids, increase potassium intake, and regulate sodium intake.
answer
A. Provide sufficient calories while preventing nitrogen excess. The challenge of nutrition management in AKI is to provide adequate calories to prevent catabolism despite the restrictions required to prevent electrolyte and fluid disorders and azotemia (accumulation of nitrogen and wastes in blood).
question
For the patient with AKI, which laboratory result would cause you the greatest concern? A. Potassium level of 5.9 mEq/L B. BUN level of 25 mg/dL C. Sodium level of 144 mEq/L D. pH of 7.5
answer
A. Potassium level of 5.9 mEq/L Hyperkalemia is one of the most serious complications in AKI because it can cause life-threatening cardiac dysrhythmias.
question
Important nursing interventions for the patient with AKI are (select all that apply) A. careful monitoring of intake and output. B. daily patient weights. C. meticulous aseptic technique. D. increase intake of vitamin A and D. E. frequent mouth care.
answer
A. careful monitoring of intake and output. B. daily patient weights. C. meticulous aseptic technique. E. frequent mouth care. You have an important role in managing fluid and electrolyte balance during the oliguric and diuretic phases of AKI. Observing and recording accurate intake and output are essential. Measure daily weights with the same scale at the same time each day to assess excessive gains or losses of body fluids. Mouth care is important to prevent stomatitis, which develops when ammonia (produced by bacterial breakdown of urea) in saliva irritates the mucous membrane.
question
What characterizes AKI (select all that apply)? A. Primary cause of death is infection. B. It usually affects older people. C. The disease course is potentially reversible. D. The most common cause is diabetic nephropathy. E. Cardiovascular disease is the most common cause of death.
answer
A. Primary cause of death is infection. C. The disease course is potentially reversible. AKI is potentially reversible. It has a high mortality rate, and the primary cause of death is infection; the primary cause of death for chronic kidney failure is cardiovascular disease. AKI commonly follows severe, prolonged hypotension or hypovolemia or exposure to a nephrotoxic agent. Although it can occur at any age, the older adult is more susceptible to AKI because the number of functioning nephrons decreases with age.
question
During the oliguric phase of AKI, you monitor the patient for (select all that apply) A. hypertension. B. electrocardiographic (ECG) changes. C. hypernatremia. D. pulmonary edema. E. urine with high specific gravity.
answer
A. hypertension. B. electrocardiographic (ECG) changes. D. pulmonary edema. You monitor the patient in the oliguric phase of AKI for hypertension and pulmonary edema. When urinary output decreases, fluid retention occurs. The severity of the symptoms depends on the extent of the fluid overload. In the case of reduced urine output (anuria and oliguria), the neck veins may become distended and have a bounding pulse. Edema and hypertension may develop. Fluid overload can eventually lead to heart failure, pulmonary edema, and pericardial and pleural effusions. The patient is monitored for hyponatremia. Damaged tubules cannot conserve sodium, and the urinary excretion of sodium may increase, resulting in normal or below-normal levels of serum sodium. Monitoring may reveal ECG changes and hyperkalemia. Initially, clinical signs of hyperkalemia are apparent on electrocardiogram, which demonstrate peaked T waves, widening of the QRS complex, and ST-segment depression. Urinary specific gravity is fixed at about 1.010.
question
If a patient is in the diuretic phase of AKI, you must monitor for which serum electrolyte imbalances? A. Hyperkalemia and hyponatremia B. Hyperkalemia and hypernatremia C. Hypokalemia and hyponatremia D. Hypokalemia and hypernatremia
answer
C. Hypokalemia and hyponatremia In the diuretic phase of AKI, the kidneys have recovered their ability to excrete wastes but not to concentrate the urine. Hypovolemia and hypotension can result from massive fluid losses. Because of the large losses of fluid and electrolytes, the patient must be monitored for hyponatremia, hypokalemia, and dehydration.
question
You are preparing to administer a dose of PhosLo to a patient with chronic kidney disease (CKD). This medication should have a beneficial effect on which laboratory value? A. Sodium B. Potassium C. Magnesium D. Phosphorus
answer
D. Phosphorus Phosphorus and calcium have inverse or reciprocal relationships, meaning that when phosphorus levels are high, calcium levels tend to be low. Administration of calcium should help to reduce a patient's abnormally high phosphorus level, as seen in CKD.
question
A patient is admitted to the hospital with CKD. You understand that this condition is characterized by A. Progressive irreversible destruction of the kidneys B. A rapid decrease in urinary output with an elevated BUN level C. Increasing creatinine clearance with a decrease in urinary output D. Prostration, somnolence, and confusion with coma and imminent death
answer
A. Progressive irreversible destruction of the kidneys CKD involves progressive, irreversible loss of kidney function.
question
Nurses need to educate patients at risk for CKD. Which individuals are considered to be at increased risk (select all that apply)? A. Older African Americans B. Individuals older than 60 years C. Those with a history of pancreatitis D. Those with a history of hypertension E. Those with a history of type 2 diabetes
answer
A. Older African Americans B. Individuals older than 60 years D. Those with a history of hypertension E. Those with a history of type 2 diabetes Risk factors for CKD include diabetes mellitus, hypertension, age older than 60 years, cardiovascular disease, family history of CKD, exposure to nephrotoxic drugs, and ethnic minorities (e.g., African American, Native American).
question
Patients with CKD have an increased incidence of cardiovascular disease related to (select all that apply) A. hypertension. B. vascular calcifications. C. a genetic predisposition. D. hyperinsulinemia causing dyslipidemia. E. increased high-density lipoproteins levels.
answer
A. hypertension. B. vascular calcifications. D. hyperinsulinemia causing dyslipidemia. Traditional cardiovascular risk factors, such as hypertension and elevated lipid levels, are common in CKD patients. Hyperinsulinemia stimulates hepatic production of triglycerides. Most patients with uremia develop dyslipidemia. Much of the cardiovascular disease may be related to nontraditional risk factors such as vascular calcification and arterial stiffness. Vascular calcification and arterial stiffness are major contributors to cardiovascular disease in CKD. Calcium deposits in the vascular medial layer are associated with stiffening of the blood vessels. The mechanisms involved are multifactorial and incompletely understood, but they include (1) vascular smooth muscle cells that change into a chondrocyte or osteoblast-like cell, (2) high total body calcium and phosphate levels due to abnormal bone metabolism, (3) impaired renal excretion, and (4) drug therapies to treat the bone disease (e.g., calcium phosphate binders).
question
Measures indicated in the conservative therapy of CKD include A. decreased fluid intake, carbohydrate intake, and protein intake. B. increased fluid intake; decreased carbohydrate intake and protein intake. C. decreased fluid intake and protein intake; increased carbohydrate intake. D. decreased fluid intake and carbohydrate intake; increased protein intake.
answer
C. decreased fluid intake and protein intake; increased carbohydrate intake. Water and any other fluids are not routinely restricted in the pre-end-stage renal disease (ESRD) stages. Patients on hemodialysis have a more restricted diet than patients receiving peritoneal dialysis. For those receiving hemodialysis, as their urinary output diminishes, fluid restrictions are enhanced. Intake depends on the daily urine output. Generally, 600 mL (from insensible loss) plus an amount equal to the previous day's urine output is allowed for a patient receiving hemodialysis. Patients are advised to limit fluid intake so that weight gains are no more than 1 to 3 kg between dialyses (interdialytic weight gain). For the patient who is undergoing dialysis, protein is not routinely restricted. The beneficial role of protein restriction in CKD stages 1 through 4 as a means to reduce the decline in kidney function is being studied. Historically, dietary counseling often encouraged restriction of protein for CKD patients. Although there is some evidence that protein restriction has benefits, many patients find these diets difficult to adhere to. For CKD stages 1 through 4, many clinicians encourage a diet with normal protein intake. However, you should teach patients to avoid high-protein diets and supplements because they may overstress the diseased kidneys.
question
The advantage of continuous replacement therapy over hemodialysis is its ability to A. remove fluid without the use of a dialysate. B. remove fluid in less than 24 hours. C. allow the patient to receive the therapy at the work site. D. be administered through a peripheral line.
answer
A. remove fluid without the use of a dialysate. Several features of continuous replacement therapy are different from those of hemodialysis. Solute removal can occur by convection (no dialysate required) in addition to osmosis and diffusion. The process can take days or weeks. The patient cannot receive the therapy at work and a vascular access device is required.
question
You are caring for a patient receiving continuous replacement therapy and notice that the filtrate is blood tinged. What is your priority action? A. Place the patient in Trendelenburg position. B. Initiate a peripheral intravenous line. C. Suspend treatment immediately. D. Administer vitamin K (Aquamephyton) per order.
answer
C. Suspend treatment immediately. The ultrafiltrate should be clear yellow, and specimens may be obtained for evaluation of serum chemistries. If the ultrafiltrate becomes bloody or blood tinged, a possible rupture in the filter membrane should be suspected, and treatment is suspended immediately to prevent blood loss and infection.
question
A patient with a history of end-stage renal disease (ESRD) resulting from diabetes mellitus has presented to the outpatient dialysis unit for his scheduled hemodialysis. Which assessment should you prioritize before, during, and after his treatment? A. Level of consciousness B. Blood pressure and fluid balance C. Temperature, heart rate, and blood pressure D. Assessment for signs and symptoms of infection
answer
B. Blood pressure and fluid balance Although all of the assessments are relevant to the care of a patient receiving hemodialysis, the nature of the procedure indicates a particular need to monitor blood pressure and fluid balance.
question
Which statement regarding continuous ambulatory peritoneal dialysis (CAPD) is of highest priority when teaching a patient new to this procedure? A. "It is essential that you maintain aseptic technique to prevent peritonitis." B. "You will be allowed a more liberal protein diet after you complete CAPD." C. "It is important for you to maintain a daily written record of blood pressure and weight." D. "You must continue regular medical and nursing follow-up visits while performing CAPD."
answer
A. "It is essential that you maintain aseptic technique to prevent peritonitis." Peritonitis is a potentially fatal complication of peritoneal dialysis, and it is imperative to teach the patient methods to prevent it from occurring. Although the other teaching statements are accurate, they do not address the potential for mortality by peritonitis, making that nursing action the highest priority.
question
How should you assess the patency of a newly placed arteriovenous graft for dialysis? A. Irrigate the graft daily with low-dose heparin. B. Monitor for any increase in blood pressure in the affected arm. C. Listen with a stethoscope over the graft for presence of a bruit. D. Frequently monitor the pulses and neurovascular status distal to the graft.
answer
C. Listen with a stethoscope over the graft for presence of a bruit. A thrill can be felt by palpating the area of anastomosis of the arteriovenous graft, and a bruit can be heard with a stethoscope. The bruit and thrill are created by arterial blood rushing into the vein.
question
What are the main advantages of peritoneal dialysis compared to hemodialysis? A. No medications are required because of the enhanced efficiency of the peritoneal membrane in removing toxins. B. The diet is less restricted and dialysis can be performed at home. C. The dialysate is biocompatible and causes no long-term consequences. D. High glucose concentrations of the dialysate cause a reduction in appetite, promoting weight loss.
answer
B. The diet is less restricted and dialysis can be performed at home. Advantages of peritoneal dialysis include fewer dietary restrictions and home dialysis is possible.
question
A patient is recovering in the intensive care unit (ICU) after receiving a kidney transplant approximately 24 hours earlier. What is an expected assessment finding for this patient during the early stage of recovery? A. Hypokalemia B. Hyponatremia C. Large urine output D. Leukocytosis with cloudy urine output
answer
C. Large urine output Patients frequently experience diuresis in the hours and days immediately after kidney transplantation. Electrolyte imbalances and signs of infection are unexpected findings that warrant prompt intervention.
question
An ESRD patient receiving hemodialysis is considering asking a relative to donate a kidney for transplantation. In assisting the patient to make a decision about treatment, what do you tell the patient? A. Successful transplantation usually provides better quality of life than that offered by dialysis. B. If rejection of the transplanted kidney occurs, no further treatment for the renal failure is available. C. The immunosuppressive therapy that is required after transplantation causes fatal malignancies in many patients. D. Hemodialysis replaces the normal functions of the kidneys, and patients do not have to live with the continual fear of rejection.
answer
A. Successful transplantation usually provides better quality of life than that offered by dialysis. Kidney transplantation is extremely successful, with 1-year graft survival rates of about 90% for deceased donor transplants and 95% for live donor transplants. An advantage of kidney transplantation compared with dialysis is that it reverses many of the pathophysiologic changes associated with renal failure when normal kidney function is restored. It also eliminates the dependence on dialysis and the accompanying dietary and lifestyle restrictions. Transplantation is also less expensive than dialysis after the first year.
question
A kidney transplant recipient complains of fever, chills, and dysuria over the past 2 days. What is the first action that you should take? A. Assess temperature and initiate a workup to rule out infection. B. Provide warm covers for the patient and give 1 gram of acetaminophen orally. C. Reassure the patient and let him know this is common after transplantation. D. Notify the nephrologist that the patient has developed symptoms of acute rejection.
answer
A. Assess temperature and initiate a workup to rule out infection. You must be astute in the observation and assessment of kidney transplant recipients, because prompt diagnosis and treatment of infections can improve patient outcomes. Fever, chills, and dysuria indicate a possible infection. The temperature should be assessed, and the patient should have diagnostic tests to identify or rule out an infection.
Fluid And Electrolyte Balance
Nursing
Nursing-LPN
Patient Self Determination Act
Rasmussen Nursing 1 – Test 2 – Flashcards 272 terms

Deloris Connelly
272 terms
Preview
Rasmussen Nursing 1 – Test 2 – Flashcards
question
Urge incontinence
answer
The involuntary loss of larger amounts of urine accompanied by a strong urge to void. It is often referred to as OVERACTIVE BLADDER.
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Stress incontinence
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An involuntary loss of small amounts of urine with increased intra-abdominal pressure. Activities that produce leakage of urine include exercise, laughing, sneezing, coughing, and lifting.
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Functional incontinence
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The untimely loss of urine when no urinary or neurological cause is involved. This type of incontinence occurs because of physical disability, immobility, pain, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.
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Mixed incontinence
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A combination of urge and stress incontinence.
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Transient incontinence
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Short-term incontinence that is expected to resolve spontaneously. Causes include UTI and medications, especially diuretics.
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Overflow incontinence
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The loss of urine in combination with a distended bladder. Causes of Overflow Incontinence include fecal impaction, neurological disorders, and enlarged prostate.
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Unconscious (reflex) incontinence
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Loss of urine when the person does not realize the bladder is full and has no urge to void. Central nervous system disorders and multi-system problems are common causes.
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Enuresis
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Bed-wetting. Unintentional passage of urine.
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Presentations of enuresis
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Wet sheets Wet clothes Room smells of urine
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Nursing interventions for enuresis
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Bladder training Estabish toileting schedule Monitor and increase fluid in AM, decrease in PM Teach Kegel exercises Teach incontinence diary Avoid caffeine and alcohol Provide incontinence care
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Urinary retention
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An inability to empty the bladder completely. Etiologies include obstruction (BPH), inflammation and swelling, neurological problems, medications (anesthesia & opiods), and anxiety. Treatments: Urinary catheterization.
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Nursing interventions for urinary retention
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Prevent UTI's Prevent backflow of urine Encourage fluids Perineal hygiene
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Urinary tract infection (UTI)
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An infection involving the kidneys, ureters, bladder, or urethra. Often caused by E.Coli. A UTI is labeled according to the region of infection. In general terms, reference is made to lower urinary tract (e.g., urethra, bladder, or prostate) and upper urinary tract infections (e.g., ureters or kidney).
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Symptoms of upper UTI
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-Fairly high fever (higher than 38.3° C [101° F]) -Shaking chills -Nausea -Vomiting -Flank pain
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Symptoms of lower UTI
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Dysuria Frequency Urgency Hesitancy Cloudy, foul smelling urine Hematuria Bladder spasms Lower abdominal pain Mild fever (less than 38.3° C [101° F]) Chills Not feeling well (malaise) OLDER ADULTS will appear confused, have a loss of appetite, (hypotension, tachycardia, tachypnea, and fever are symptoms of urpsepsis)
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Nursing interventions for UTI
answer
Promote fluid intake up to 3 liters daily Administer antibiotics as prescribed Encourage to urinate every 3-4 hours Encourage to shower daily Recommend warm sitz bath for comfort Avoid use of indwelling catheters Advise to urinate before and after sex Advise to drink cranberry juice to reduce risk
question
Interstitial cystitis
answer
Presentations of I.C. include: Urgency Frequency Nocturia Dysuria Hematuria may be present All of these with no evidence of infection! Pain: Pain ranges from mild to severe. Pain is most prominent as the bladder fills between voiding. Suprapubic pain is a common finding, but a person may also feel pain in the bladder, the urethra, the area below the umbilicus, the lower back, or the area around the vagina. Men may also feel pain in the scrotum, testes, or penis. Pain can come and go or it can be constant. It can increase during sex, and some women find that it is worse when they are having their period.
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Pyelonephritis
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An infection of the UPPER urinary tract. It may involve the ureters, renal pelvis, and papillary tips of the collecting ducts. Unchecked, it can extend into the tubules of the nephron, creating a potential for renal failure. Filtration, re absorption and secretion are impaired.
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Symptoms of pyelonephritis
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-Bacteruria -Flank pain at the costovertebral angle (CVA) -Fever -Chills -Colicky abdominal pain -Nausea -Vomiting -Dysuria -Frequency -Nocturia
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Diagnostic tests for pyelonephritis
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Urinalysis and urine culture may be sufficient in mild, initial cases of pyelonephritis in an uncomplicated presentation. Computed tomography (CT) is the standard diagnostic tool for pyelonephritis unresponsive to 72 hours of antibiotic therapy. Ultrasound is used when CT scanning is contraindicated, such as in pregnancy or in pre-existing renal compromise.
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Nursing interventions for pyelonephritis
answer
Assess and monitor: Nutritional status I&O Fluid & Electrolytes BUN/Creatnine WBC's Temp Pain Increase fluid intake to at least 2L/day Administer acetaminophen for fever Administer opiods for pain Assist with hygiene
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Glomerulonephritis
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Inflammation of the glomerular capillaries. In patients with glomerulonephritis, the glomeruli become inflamed and impair the kidney's ability to filter urine. Eventually, the glomeruli become inflamed and scarred, and slowly lose their ability to remove waste and excess water from the blood to make urine. Immune complex disease - NOT AN INFECTION
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Symptoms of glomerulonephritis
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Anorexia Oliguria Brown, tea, or cola-colored urine Proteinuria Dysuria SOB Orthopnea Crackles S3 heart sound Periorbital edema Mild hypertension Changes in LOC Weight gain Flank pain --This cluster of symptoms—hematuria, edema, and hypertension—is known as nephritic syndrome. Approximately 95% of patients with post-streptococcal glomerulonephritis have at least two of these symptoms; 40% have all three.
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Diagnostics for glomerulonephritis
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-Laboratory tests include: -CBC -Electrolytes -BUN & creatinine (will be elevated) -GFR (will be decreased) -Urinalysis -Cultures of the throat and skin to rule out Streptococcus
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Nursing interventions for glomerulonephritis
answer
Administer antibiotics as prescribed Monitor blood pressure Monitor fluid and electrolytes Maintain low sodium diet (2g per day) Fluid restrictions (1L per day) Monitor I&O Possible loop diuretics with severe edema Possible ACE inhibitor or calcium channel blocker
question
Nephrotic syndrome
answer
Not a single disease but a group of symptoms. Symptoms include heavy proteinuria, hypoalbuminemia, edema, hypercholesterolemia, and normal renal function. Nephrotic syndrome can be primary or secondary. Primary nephrotic syndrome occurs as part of a recognized systemic disease. Nephrotic syndrome is often described as a disease of children and is relatively rare. It is 15 times more common in children than in adults.
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Manifestations of nephrotic syndrome
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Pitting edema (ankles & legs) Periorbital edema Pleural effusion or ascites Foamy urine Anorexia Irritability Fatigue Abdominal discomfort Diarrhea
question
Renal calculi
answer
Kidney stones. Cause is unknown, but greater incidence in males. Most stones are calcium oxalate but can also be composed of calcium phosphate, uric acid, struvite, and cystine.
question
Manifestations of renal calculi
answer
-Severe pain (renal colic). Pain intensifies as the stone moves through the ureter. Flank pain suggests the stone is located in the kidney or ureter. Flank pain that radiates to the abdomen, scrotum, testes, or vulva suggest the stone is in the ureter or bladder. -Frequency -Fever -Diaphoresis -Pallor -Nausea -Vomiting -Tachycardia, tachypnea, increased BP (pain) -Decreased BP (shock) -Hematuria -Oliguira/anuria occurs with stones that obstruct urinary flow. This is a medical emergency and needs to be treated to preserve kidney function.
question
Nursing interventions for renal calculi
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-Increase fluid intake to 3L/day -Administer IV fluids, analgesics and antibiotics as prescribed -Strain all urine to check for passage of stone, and save to send to lab for analysis -Monitor pain, I&O, urinary pH
question
Acute renal failure
answer
Sudden loss of kidney function caused by failure of renal circulation or damage to the tubules or glomeruli. Usually reversible, with spontaneous recovery in a few days to weeks Ischemia is primary cause; it produces irreversible damage to tubules if continues for more than 2 hours.
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Nursing interventions for acute renal failure
answer
Monitor labs and dialysis Potassium restrictions Fluid reduction Accurate I&O Daily weights Check for edema and lung sounds Energy conservation
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Oliguria
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Urine output of less than 400 mL in 24 hours. For pediatric patients, oliguria is < 0.5-1.0 mL/kg per hour.
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Anuria
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The absence of urine, often associated with kidney failure or congestive heart failure. This term is used when urine output is less than 100 mL in 24 hours.
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Chronic renal failure
answer
A progressive and irreversible decline in renal function ranging from mild with nearly normal function to ESRD requiring renal replacement therapy. Characterized by a glomerular filtration rate (GFR) less than 20% of normal. Diabetes mellitus and hypertension are the two most common causes of CRF in the United States. The common underlying cause of progression to CRF is glomerulosclerosis. Regardless of the initial insult, glomerulosclerosis is the end result. As the level of glomerular function declines, need for intervention increases.
question
Clinical presentations of chronic renal failure
answer
1. Early: nausea, apathy, weakness, and fatigue; declining urine output 2. Late: possibly frequent vomiting, increasing weakness, lethargy, and confusion 3. Client may report "restless leg syndrome," paresthesia, and sensory loss 4. Personality changes, such as anxiety, irritability, and hallucinations; seizures and coma posible in late stages 5. Respirations may change to Kussmaul pattern, with deep coma following 6. Skin becomes pale and dry, with yellowish hue; metabolic wastes cause itching and uremic frost (crystallized deposits of urea on skin) 7. Urinalysis shows fixed specific gravity approximately 1.010, equivalent to plasma; abnormal proteins, blood cells, and casts are present. 8. Elevated creatinine and BUN and decreased creatinine clearance 9. Abnormal electrolyte values as noted above 10. Moderate anemia 11. Decreased platelets 12. Decreased renal size by ultrasonography 13. Positive renal biopsy if damage caused by cancer
question
Nursing management of chronic renal failure
answer
1. Provide diet low in protein (such as 60 grams protein) with supplemented amino acids; restrict fluids as ordered 2. Provide electrolyte replacement or restriction -Na+ restriction (such as 2 grams daily) -K+ restriction (such as 2 grams daily) -Replacement of bicarbonate stores to treat acidosis 3. Monitor and plan nursing care for hypertension and heart failure 4. Prepare client for dialysis or kidney transplant 5. Monitor I&O and vital signs 6. Monitor laboratory results: BUN and serum creatinine, pH, electrolytes, and CBC 7. Provide symptomatic relief for nausea and vomiting 8. Observe for signs of infection 9. Provide rest periods to combat fatigue, which is chronic in nature 10. Help client learn about and adjust to diagnosis; support coping strategies and work with client to develop realistic goals 11. Medication therapy: limited by kidneys' inability to excrete -Diuretics to reduce volume of extracellular fluid -ACE inhibitors to maintain normal BP -Electrolyte replacement -Phosphate binding agents, such as calcium carbonate -Kayexalate to reduce serum K+ levels
question
Uremia
answer
Excess urea and other nitrogenous waste products in blood.
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Diarrhea
answer
Increased frequency of bowel movements (more than 3 times a day) as well as liquid consistency and increased amount; accompanied by urgency, discomfort, and possibly incontinence.
question
Fecal incontinence
answer
Involuntary elimination of feces, often caused by diarrhea.
question
Nursing interventions for fecal incontinence
answer
Determine cause. Such as medications, infections, or impaction. Provide perineal care after each stool, and apply moisture barrier. Provider can prescribe anal bag or other bowel management system to collect stool and prevent it from coming in contact with the skin.
question
Constipation
answer
A bowel pattern of difficult and infrequent evacuation of hard, dry feces. The number of bowel movements a patient has is individual, but if a patient has fewer than three bowel movements per week or must vigorously strain, the patient is considered to have constipation. It is due to sedentary lifestyle, poor diets (low in dietary fiber and fluid), frequent use of laxatives, pregnancy, and some medications.
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Fecal impaction
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The presence of a hardened fecal mass in the rectum. The impaction often blocks the passage of normal stool and sets up a vicious cycle of furthering hardening.
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Manifestations of fecal impaction
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Liquid stool may leak, seeping around the hardened mass, and the patient may report feelings of fullness, bloating, constipation, diminished appetite, and a change in bowel habits. You can detect fecal impaction by digital examination of the rectum.
question
Bowel obstruction
answer
Significant mechanical impairment or complete arrest of the passage of contents through the intestine. Can be either mechanical (physical or structural) or functional. Most obstructions occur in the small intestine. Most commonly due to postoperative adhesions, fibrous bands within the peritoneum, which may compress the bowel and cause obstruction, or be a focus for a volvulus (a twisting of the bowel on itself that causes obstruction). Prior abdominal surgery or sepsis (e.g., pelvic inflammatory disease, appendicitis) may cause adhesions.
question
Clinical presentation of bowel obstruction
answer
Colicky, mid-abdominal pain often over a period of days. Vomiting occurs early in the course, especially with proximal simple obstruction. A change in the character of the pain (continuous, increasing severity) suggests the development of more ominous ischemic complications. Pain lasting several days, with progressive distension, suggests a more distal obstruction. Patients may report reduced to absent flatus for days preceding presentation and distension. Auscultation typically reveals increased bowel sounds and high-pitched tinkling in early obstruction.
question
Nursing interventions for bowel obstruction
answer
Careful abdominal examination is necessary in suspected obstruction. Palpation should follow percussion, and severe pain is unusual, unless strangulation, ischemia or infarction, or perforation have occurred. In that case, there may be signs suggestive of peritonitis and acute abdomen, including guarding and rebound tenderness. A careful search for inguinal hernias, a rectal exam for masses, and analysis of stool for occult blood conclude the abdominal assessment. Strict bowel rest and careful attention to fluid replacement for loss as well as maintenance, with appropriate laboratory guided electrolyte supplementation (especially potassium), are indicated.
question
Irritable bowel syndrome (IBS)
answer
A relatively common functional disorder characterized by abdominal pain and altered bowel habits in the absence of structural or biochemical explanations for the symptoms. The cause of IBS is unknown, although there may be a genetic propensity to the disorder. In addition, stress exacerbates the manifestations, as does a diet high in fat, irritating foods, alcohol, and smoking.
question
Symptoms of IBS
answer
Recurrent abdominal pain or discomfort at least three days per month in the last three months associated with two or more of the following: 1. Improvement with defecation 2. Onset associated with a change in frequency of stool 3. Onset associated with a change in form (appearance) of stool
question
Health promotion and disease prevention for IBS
answer
Avoid foods that trigger exacerbation, such as dairy, wheat, corn, fried foods, alcohol, spicy foods, and aspertame. Avoid alcoholic and caffeinated beverages, and other fluids containing fructose and sorbitol. Consume 2-3L/day from food and fluid sources Increase fiber intake (approx 30-40g/day)
question
Ulcerative colitis
answer
Edema and inflammation that begins in the rectum and can progress proximally, but is usually limited to sigmoid colon and rectum. Cause is unknown but may be related to stress, genetics, infection, dietary factors (low fiber intake), or antibody formation.
question
Symptoms of ulcerative colitis
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Abdominal pain/cramping (LLQ) Anorexia Weight loss Fever Diarrhea Abdominal distention Abdominal tenderness & firmness High pitched bowel sounds Rectal bleeding
question
Nursing interventions for ulcerative colitis
answer
Rest is required to decrease intestinal activity. Diet therapy may include a low-residue, high-protein, high-calorie diet with vitamins and iron; in severe cases NPO to rest bowel; TPN will be ordered in severe cases. Assess dehydration, fluid and electrolytes.
question
Appendicitis
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An inflammation of the appendix, which is a small finger-like appendage just below the ileocecal valve. Treatment: Appendectomy is the most common emergency abdominal surgery in the United States.
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Diverticulitis
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Inflamed sac-like pouches of mucosa through the muscular layer of the bowel that may occur anywhere along the GI tract. Can lead to bleeding (5%), abscess and fistula formation, perforation, and/or obstruction.
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Crohn's disease
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Chronic inflammatory bowel disorder with a relapsing and remitting course. Once remission is achieved, the main aim of the management of Crohn's disease is maintenance of that remission. Usually begins with a small inflammatory lesion of the intestinal mucosa. Eventually, the inflammation continues and progression through all layers of tissue is seen. Deeper ulcerations, fissures, and granulomatous lesions persist into the deeper layers of the bowel wall. As the disease progresses, the inflammation causes the bowel wall to thicken and become fibrotic, and a narrowing of the intestinal lumen occurs. Fistulas are common between loops of bowel, as are adhesions of the diseased bowel areas. The absorption of nutrients is impaired as the jejunum and ileum are affected.
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Clinical presentations of Crohn's disease
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Typically, abdominal pain (RLQ) and tenderness accompanies the disorder. Often the pain is relieved temporarily with defecation. In addition, eating can initiate the abdominal discomfort, and patients may consequently limit their food intake. This lends them to have nutritional deficits, and weight loss, and experience malnutrition and even secondary conditions. Diarrhea is common and not necessarily positive for occult bleeding. There may be a palpable mass in the RLQ. Steatorrhea is also a common finding with the stool (pale appearance, presence of fat and mucous)
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Nursing interventions for Crohn's disease
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Provide prescribed diet: usually high-calorie, high-protein; involve client in making appropriate menu choices. Weigh daily, maintain calorie count, and monitor I&O. TPN may be ordered during periods of severe exacerbation to provide total bowel rest.
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Gastroenteritis
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An increase in the frequency and water content of stools and vomiting as a result of inflammation of the mucous membranes of the stomach and intestines, primarily affecting the small bowel. May be viral or bacterial in origin.
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Symptoms of gastroenteritis
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Onset of diarrhea w/ accompanying abdominal cramping or pain Nausea and vomiting Bloody, mucous, or watery, foul smelling stool Possible fever Dehydration Positive stool sample for bacteria
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Treatment for gastroenteritis
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Fluid replacement Diet therapy Drug therapy (antiemetics or anticholinergics) Antimicrobials are given if it is caused by an infecting organism susceptible to therapy
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Patient education for gastroenteritis
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Replace fluids Follow recommended diet Wash hands Do not share utensils Maintain clean bathroom
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Consequences of fecal or urinary incontinence
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Skin breakdown Changes in daily activities Changes in social relationships
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Elimination
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Excretion of waste from the body
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Bowel elimination
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Passage and dispelling of stool through the intestinal tract by means of intestinal smooth muscle contraction.
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Urinary elimination
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Passage of urine out of the urinary tract through the urinary sphincter and urethra.
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Populations at greatest risk for problems with bowel and urinary elimination
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Children Pregnant women Older adults
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Renal ultrasound (kidney scan)
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A renal ultrasound visualizes the parenchyma and associated structures, including the renal blood vessels, using sound waves to produce an image. The nurse's role during a renal ultrasound is to primarily make sure the patient has received the proper education and is prepared for the procedure guidelines for patient education.
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Patient education for renal ultrasound
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The nurse can assist and educate the patient undergoing a renal ultrasound by providing the following information: -You will be positioned in a supine position. Your flank will be exposed and appropriately draped. -Your abdomen will be lubricated with an acoustic gel. -You will be asked to take a deep breath and hold it. This is done so that various parts of the kidney can be visualized. -The technician will use a transducer to visualize various regions of the kidney and surrounding areas.
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Renal biopsy
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Removal of a piece of kidney tissue for microscopic evaluation. The least intrusive method to obtain samples of the renal cortex. Pre-procedure, the patient will be instructed not to eat or drink for four to six hours. The patient should be forewarned of the approximate two-hour period of bedrest required for transplant graft biopsy and the four to six hours of bedrest for native kidney (one's own kidney as opposed to a transplant graft) biopsy. Less bed rest is required for transplant biopsy due to less strain on the renal capsule with the graft located in a lower abdominal quadrant.
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Post-procedure patient education for renal biopsy
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Frequent vital signs and inspection of the biopsy site for hematoma. Typical frequency is every 15 minutes during the first hour. Then, gradually the interval is increased if no bleeding occurs. Monitor for any evidence of bleeding. Signs and symptoms include significant change in blood pressure, tachycardia, nausea or vomiting (often associated with hypotension), or a reduction in hematocrit. Anything more than minimal pain is a warning symptom and the patient should be thoroughly assessed. Ureteral colic could signal a clot occluding the ureter. Back pain may indicate a retroperitoneal or intrarenal bleed. Monitor the urine for hematuria or clots. Serial samples of urine are saved in urinalysis tubes, dated, timed, and placed in a rack for color comparison. Educate the patient to avoid heavy lifting for approximately of two weeks and to notify the health care provider of flank pain, light-headedness or dizziness, rapid pulse, dysuria, or hematuria.
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Cystoscopy
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Direct visualization of the urethra, bladder, and ureteral orifices by insertion of a scope. May be used to obtain biopsies and treat pathology of visualized areas.
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Nursing management for cystoscopy
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The patient must avoid food and fluids for four to eight hours prior to the procedure if receiving general anesthesia. Postprocedural care includes monitoring the patient for urinary obstruction secondary to swelling and hematuria related to biopsy or inadvertent injury to urinary structures. Light hematuria and pain during the first void may not be abnormal depending on the extensiveness of the procedure. The patient should be educated to notify the nurse for problems voiding, gross hematuria, excessive pain, fever or chills, and continued dysuria.
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Intravenous pyelogram (IVP)
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Evaluates renal function by analyzing flow of contrast over time. A radiopaque contrast agent is injected intravenously. This renders the urine radiopaque as the contract agent is excreted in the urine. Abnormalities of the lumen, calculi, and masses can be detected. It is imperative to check for dye allergies and to hydrate the patient for posttest dye excretion to avoid nephrotoxicity.
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KUB (Xray of kidneys, ureters, and bladder)
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The KUB shows kidney size, shape, and position and the presence of calculi. Hydronephrosis, cysts, and tumors may be visualized. Constipation can interfere with the viewing field.
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Colonoscopy
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Provides direct visualization of the rectum, colon, entire large intestine, and distal small bowel. A flexible scope is inserted through the rectum and advanced to the cecum. Useful in detecting lower GI disease. Positioning: LT side with knees to chest Anesthesia: Moderate sedation (Midazolam, fentanyl, and/or propofol)
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Nursing management for colonoscopy (Prep)
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-Bowel Prep (laxatives, such as bisacodyl and polyethyline glycol) -Polyethyline glycol isn't recommended for older adults as it can cause fluid and electrolyte imbalances -Polyethyline glycol can also inhibit the absorption of some medications. Review medications and consult with doctor. -Clear liquid diet, NPO after midnight -Patient must avoid medications such as aspirin, anticoagulants, and antiplatelets.
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Nursing management for colonoscpy (Post-procedure)
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-Notify provider of severe pain (possible perforation) -Monitor for rectal bleeding -Monitor vitals & respiratory status. Maintain open airway until patient is awake -Resume normal diet as prescribed -Encourage increased fluid intake -Instruct that there can be some flatulence due to air instillation during the procedure -Do not drive or use equipment for 12-18 hrs after
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Esophagogastroduodenoscopy (EGD)
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Insertion of endoscope through the mouth into the esophagus, stomach, and duodenum to identify or treat areas of bleeding, dilate an esophageal stricture, and diagnose gastric lesions or celiac disease. Position: LT side laying with head of bed elevated Anesthesia: Moderate sedation per IV access. Topical anesthetic to depress gag reflex, atropine to decrease secretions. Prep: NPO 6-8 hrs.
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Nursing management for EGD (Post-procedure)
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-Monitor vitals and respiratory status. Maintain open airway until patient is awake -Notify provider of any bleeding, abdominal or chest pain, and any evidence of infection -Withhold fluids until return of gag reflex -D/C IV therapy when patient tolerates oral fluids w/o nausea and vomiting -Do not drive or use equipment for 12-18 hrs after -Use throat lozenges if sore throat or hoarse voice persists following procedure
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Barium swallow (esophagraphy)
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A fluoroscopic visualization of the esophagus following the ingestion of barium sulfate. The results of barium studies can reveal congenital abnormalities; lesions; spasm; reflux, stricture, and obstruction; inflammation; ulceration; varices; and fistula.
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Patient prep for barium studies
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-Patient should not smoke for 24 hours prior to the procedure (smoking causes an increased production of gastric juices) -Placing the patient on NPO status after midnight -Administering a laxative the evening before and enemas the morning of the test -Educate patient that during the procedure (which will last approximately two hours), pictures will be taken at 30-minute intervals with the patient in different positions -Post-procedure barium will be expelled in the stool, making it milky white. Fluids are forced to help with the excretion of barium. If the barium is not completely excreted, it can cause intestinal obstruction. -Follow up two to three days post-procedure to ensure the patient has had a normal brown stool
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Barium enema
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A rectal infusion of barium sulfate. Is the roentgenographic study of the lower intestinal tract. The colon should be free of all fecal material to allow for maximum visualization
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Clinical management: Primary prevention
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Hydration Adequate dietary fiber Regular toileting practices Regular exercise Avoidance of environmental contamination
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Clinical management: Collaborative interventions
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Treatment strategies depend on the underlying condition The most common strategies include: Pharmacotherapy Incontinence management Invasive procedures and surgery
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Process of micturition (voiding of urine)
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Filling of bladder --> 200-450 mL of urine Activation of stretch receptors in bladder wall Signaling to the voiding reflex center Contraction of detrusor muscle Conscious relaxation of external urethral sphincter
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Lifespan considerations related to urination (infants)
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15-60 mL per kg Produce 8-10 wet diapers per day No voluntary control
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Lifespan considerations related to urination (children)
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Toilet training requires: -Mature neuromuscular system -Adequate communication skills Problems include: -Enuresis -Nocturnal enuresis
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Lifespan considerations related to urination (older adults)
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Kidney function decreases Urgency and frequency common Loss of bladder elasticity and muscle tone leads to: -Nocturia -Incomplete emptying
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Factors Affecting Urinary Elimination
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Personal Sociocultural Environmental Nutrition Hydration Activity level Medications Surgery and anesthesia
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Pathological conditions affecting urinary elimination
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Bladder/kidney infections Kidney stones Hypertrophy of the prostate (male) Mobility problems Decreased blood flow through glomeruli Neurological conditions Communication problems Alteration in cognition
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Nursing management for urinary incontinence
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Prevent skin breakdown Encourage/teach lifestyle modifications Implement bladder training Encourage client to perform Kegel's exercises Use anti-incontinence devices as needed Strategies to promote independent urination Pharmacological interventions Surgical interventions Parental teaching for enuresis
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Consequences: Urinary retention
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Cause: External sphincter does not open for release of urine or blockage of urethra -Leads to increased urine volume and bladder distention -Backflow to the upper urinary tract -Dilation of the ureters and renal pelvis -Pyelonephritis and renal atrophy
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Managing urinary retention
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Urinary Catheterization: Introduction of a sterile tube into the bladder -Straight catheter -Indwelling catheter: Foley -Suprapubic catheter
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Nursing care for urinary catheter
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Prevent urinary tract infection Prevent backflow of urine Encourage fluids Perineal hygiene
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Process of defecation
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Defecation: process of elimination of waste Feces: semisolid mass of fiber, undigested food, inorganic material, etc. -Fecal material reaches rectum -Stretch receptors initiate contraction of sigmoid colon/rectal muscles -Internal anal sphincter relaxes -Sensory impulses cause voluntary "bearing down" -External sphincter relaxes
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Factors affecting bowel elimination
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Developmental stage Personal factors Sociocultural factors Nutrition/hydration Medications Procedures Pregnancy Pathological conditions Bowel diversions -Ileostomy -Colostomy
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Nursing management of diarrhea
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-Monitor stools to quantify diarrhea -Assess and monitor for fluid imbalance -Monitor for alterations in perineal skin integrity -Proper dietary teaching *Clear liquid *Bananas, rice, applesauce, toast (BRAT) *Foods to avoid -Antidiarrheal medications ***Not recommended for acute diarrhea Lomotil, immodium -Teach clients about over-the-counter aids
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Nursing management of constipation
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-Increase intake of high-fiber foods -Increase fluid intake -Increase activity/exercise -Provide privacy -Help client to a position that facilitates defecation -Allow uninterrupted time -Offer laxatives when lifestyle changes are ineffective
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Nursing management of fecal impaction
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-Prevention is the best treatment -Determine presence: digital examination -Enemas *Oil retention to soften *Tap water or Fleet enemas to remove and cleanse -Manual/digital removal: dysimpacting -Establish bowel program to prevent recurrence
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Establishing a bowel training program
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-Plan program with the client -Increase fiber in diet gradually -Increase fluid intake to 8 glasses water per day -Establish a designated time for defecation -Provide privacy for the client -Treatment plan should be staged -Treatment may include stool softener -Modify the plan based on client results
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Nursing management of an ileostomy/colostomy
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-Stoma assessment and care -Strict attention to skin care/peristomal skin assessment -Monitor amount and type of effluent -Be attentive to client's psychosocial needs -Be professional; show acceptance -Attend to odor control -Address client participation in ostomy care ` -Client teaching for home care
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Colostomy
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Brings a portion of the colon through a surgical opening in the abdomen. The location of the colostomy determines the consistency of the feces eliminated, as well as the need to wear an ostomy appliance. The closer the colostomy is to the ascending colon and the ileocecal valve (between the small and large intestine), the more liquid and continuous the drainage will be. In contrast, a colostomy close to the sigmoid colon will produce solid feces.
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Double-barreled colostomy
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Has two separate stomas that externalize the bowel on both sides of the portion that has been removed. The proximal and distal loops are sutured together and both ends are brought out through the abdominal wall. The proximal stoma is the functioning end that drains fecal material. The distal stoma may drain mucus and is sometimes called a mucous fistula.
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Loop colostomy
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Usually performed as an emergency procedure and situated often in the right transverse colon. Consists of a segment of bowel brought out to the abdominal wall. The posterior wall of the bowel remains intact, but a plastic rod is wedged under the bowel to keep it from slipping back into the abdomen. The anterior wall is incised, and the mucosal surface is left visible and open to air. It, too, has a functioning proximal end and limited drainage from the distal end.
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Ileostomy
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Brings a portion of the ileum through a surgical opening in the abdomen, bypassing the large intestine entirely. Drainage at this level is liquid and continuous. The patient must wear an ostomy appliance at all times to collect the drainage.
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Pharmacotherapy for bowel elimination
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-Laxatives *Bulk-forming agents *Bowel stimulants *Lubricants *Saline laxatives -Stool softeners -Antibiotics -Antispasmodics -Analgesics
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Clinical judgement
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An interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response. Related terms: Inference Interpretation Decision Clinical reasoning Critical thinking
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Attributes of clinical judgment
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Involves a holistic view of the patient situation. Is a process orientation (a circular process). Requires reasoning and the interpretation of data.
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Clinical judgment process - Noticing
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A nurse notices things about a patient in the context of the nurse's background and experience, context of environment, and knowing the patient. A nurse is looking for patterns that are consistent with previous experiences and uses that information to guide care.
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Clinical judgment process - Interpreting
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Interpreting is the process of assembling information to make sense of it. Types of reasoning patterns tend to vary with the experience of the nurse: -Novice nurses tend to rely on analytic reasoning. -Expert nurses draw from a variety of reasoning patterns; analytic, intuitive, and narrative.
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Clinical judgment process - Responding
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Responding is the implementation of actions and interventions, based on patient needs. Depending on the level of expertise, the nurse may or may not be able to judge the effectiveness of the intervention before initiating it.
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Clinical judgment process - Reflecting
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Reflecting is the process of thinking and learning from experiences. -Reflection-in-action happens in real time while care is occurring. -Reflection-on-action happens after the patient care occurs. Reflecting is critical for development of knowledge and improvement in reasoning.
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Ethics
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-The study or examination of morality through a variety of different approaches. -How you respond to an ethical situation is a reflection of the core values, beliefs, and character that make you the person who you are and, ultimately, the professional who you will become. -Systematic study of right and wrong conduct. -Formal process for making consistent moral decisions.
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Bioethics
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Ethical questions surrounding biological sciences and technology.
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Clinical ethics
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Decisions made at the bedside.
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Research ethics
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Conduct of research using humans and animals.
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Societal ethics
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Society provides a normative basis for ethical behavior with laws and regulations. Law is the minimum standard of behavior to which all members of society are held.
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Organizational ethics
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Formal and informal principles and values guide the behavior, decisions, and actions taken by members of an organization. Directs all aspects of an organization.
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Professional ethics
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Ethical standards and expectations of a particular profession Held to a higher standard because of privileged role in society Code of conduct Aimed at the highest ideals of practice
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Personal ethics
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Continuously intersect with other categories of ethics. Do not overlap perfectly; consequently, a potential for conflict exists. Sources of ethics are not static and change over time.
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Ethical theory
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Ethics of Duty -Is the right thing to do. Ethics of Consequence -Is the greatest good for the greatest number. Ethics of Character -Is based on life experiences and a willingness to reflect on our actions. Ethics of Relationship -Is the nature and obligation inherent in human relationships.
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Nursing ethics
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Ethical questions that arise out of nursing practice -What will your level of participation be in a given ethically challenging situation? -Can you support clients'decisions based on their ethical beliefs? -What are your feelings about the results of decisions made by others?
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Failure to act or respond in an ethically appropriate way has been linked to:
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Serious and potentially dangerous errors Personal stress Professional burnout
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Ethical decision making
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Health care decisions that present an ethical dilemma are not made by individuals alone. Health care organization's compliance officer and compliance committee are charged with the responsibility of ensuring that ethical standards are met. Institutions have reporting mechanisms for unethical behaviors.
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Ethical issues in nursing
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Protecting patients' rights and human dignity Not respecting informed consent treatment Providing care with risk to the health of the nurse Using or not using chemical or physical restraints Understaffing Prolonging the living and dying process with inappropriate measures Policies that could threaten the quality of care Working with unethical or impaired colleagues
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Morals
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Private, personal, or group standards of right and wrong Moral behavior; in accordance with custom; reflects personal moral beliefs
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Moral distress
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Occurs when the nurse is aware of the right and moral action to take in a given patient situation but is unable to carry out that action because of external constraints. Perceived constraints : -Physicians; nurse administrators; other nurses -The law; threat of lawsuit
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Moral outrage
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Belief that others are acting immorally. Similar to moral distress, except that in cases of moral outrage, nurses do not participate in the act. Therefore, they do not believe that they are responsible for doing wrong, but that they are powerless to prevent the wrongdoing. Powerlessness Cannot prevent a "wrong" Respond with "whistleblowing"
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Whistleblowing
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Identification of an unethical or illegal situation Can involve one person or an entire organization Reporting such an action to someone in authority Need accurate information Be aware of the consequences ANA working to protect whistleblowers
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Factors in moral decision making
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Values -Belief about the worth of something -Highly prized ideals, customs, conduct, goals -Freely chosen -Learned through observation and experience -Vary from person to person Attitudes -Feelings toward person, object, idea -Includes thinking and feeling component -What a person thinks Beliefs -Something that one accepts as true -Not always based on fact
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Consequentialism
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The rightness or wrongness of an action depends on the consequences of the act rather than on the act itself. Theories of this type are also called: Teleology- from the Greek word telos, meaning "end" or the study of ends (also called final causes) . Utilitarianism- the most familiar consequentialist theory, takes the position that the value of an action is determined by its usefulness. The principle of utility states that an act must result in the greatest good (positive benefit) for the greatest number of people.
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Deontology
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Unlike the utilitarian model, considers an action to be right or wrong regardless of its consequences.
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Formalism
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Defines morals based off of logic and reason which says that if something is defined as wrong or right, it is defined as wrong or right all the time.
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The categorical imperative
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One should act only if the action is based on a principle that is universal—or in other words, if you believe that everyone should act in the same way in a similar situation.
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Feminist ethics
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Based on the belief that traditional ethical models provide a mostly masculine perspective, and that they devalue the moral experience of women. Uses relationships and stories rather than universal principles. Addresses female perspective of issues.
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Ethics of care
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Nursing's responsibility to care in ethical situations. Using an ethics of care perspective, nurses include a responsibility to care as a part of their professional behavior. Some aspects of care include the ability and duty to appreciate, understand, and even share the patient's pain or condition.
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Professional guidelines for ethical decision making
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Nursing Codes of Ethics International Council of Nurses American Nurses Association Standards of Care Patient Care Partnership
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Autonomy
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Patients have the freedom to make decisions for themselves.
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Non-maleficence
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To do no harm, either intentional or unintentional
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Beneficence
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To act in the best interest of others; to benefit others
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Fidelity
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Duty to keeping commitments and promises
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Veracity
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To tell the truth, which has an added benefit of promoting trust between client and nurse.
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Justice
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Fair, equitable, and appropriate treatment; resources are distributed equally to all.
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Evidence based practice
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Knowledge bases for clinical decisions Definition: -Research evidence -Clinical expertise -Patient preference Sociopolitical forces in quality of care EBP is using the best research and proven assessments and treatments in our day-to-day clinical care and service delivery. Why it is important to patient care: The patient gets up-to-date care that has already been done in studies.
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Major features of EBP
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Interdisciplinary Evidence summary Translation to clinical practice guidelines Provider and organizational factors guide integration Evaluation
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ACE Star Model of Knowledge Transformation
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The core concept of the ACE Star Model is knowledge transformation; this is defined as the conversion of research findings from primary research results through a series of stages and forms to have an impact on health outcomes by way of evidence-based care. Each of the five points of the star focuses on a sequential cognitive activity. In the model the stages progress clockwise from discovery to evaluation.
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Star point 1: Discovery
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Primary research. It is the approach with which nurses are familiar, i.e., single reports of research studies.
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Star point 2: Evidence summary
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All primary research on a given clinical topic is gathered and summarized into a single statement about the state of the science.
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Star point 3: Translation
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Experts are called on to consider the evidence summary, fill in gaps, and merge research knowledge with expertise to produce clinical practice guidelines (CPGs). Clinical practice guidelines are commonly produced and sponsored by a clinical specialty organization. The aim of translation is to provide a useful and relevant package of screened, summarized, and interpreted evidence to clinicians and patients in a form that suits the time, cost, and care standard.
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Star point 4: Integration
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Perhaps the most familiar stage of knowledge transformation in health care because of society's longstanding expectation that health care be based on the most current knowledge, thus requiring implementation of innovations. Once guidelines are produced, implementation plans are put into action to change the individual clinician practices, organizational practices, and environmental policies.
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Star point 5: Evaluation
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A broad array of endpoints and outcomes are evaluated. These include evaluation of the impact of EBP on patient health outcomes, provider and patient satisfaction, efficacy, efficiency, economic analysis, and the health status of a population. As new knowledge is transformed through the five stages, the final outcome is evidence-based quality improvement of health care.
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Steps in conducting a systematic review
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Formulate question Locate relevant studies Select and appraise studies Summarize and synthesize results Interpret findings Update regularly
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Laws
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Established to protect society Nursing practice guided by legal principles Purpose of laws: -Protect clients/society -Define scope of nursing practice -Identify minimum level of care to be provided
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Health care law
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The collection of laws that have a direct impact on the delivery of health care or on the relationships among those in the business of health care or between the providers and the recipients of health care.
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Legislation
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The process of introducing, adopting, changing, or repealing law.
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Regulation
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The process of putting laws into action through the establishment of rules.
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Litigation
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The process of seeking help through the courts to address a perceived wrong.
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Five traditional legal disciplines:
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Tort law Contract law Property law Constitutional law Criminal law **All legal disciplines have shaped health care law to some degree, but most health care laws are derived from constitutional law and tort law.
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Criminal law
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Federal or state government prosecutes Offense against society Can lead to a fine, imprisonment, or death -Misdemeanor **Minor crime; DUI -Felony **Homicide
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Civil law
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Allows for resolution of dispute between private parties May result in monetary compensation Plaintiff: person bringing suit Defendant: person being sued
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Types of civil law
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Contract law -Dealing with agreements between individuals Explicit or implicit Tort law -Dealing with duties and rights among individuals Involves claims for damages
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State board of nursing
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A state board of nursing holds the legal authority for nursing practice and regulates nursing practice through: Establishing the requirements to obtain a nursing license Issuing nursing licenses Determining the scope of practice Setting minimum education standards Managing disciplinary procedures
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Professional nursing practice
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Is regulated by the states; nurses must hold a state-issued license to practice nursing. Details of the practice of nursing are found in the scope of practice for each state. Practice can vary from state to state; for this reason, nurses should be familiar with the nursing practice act and scope of practice in the state in which they work.
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Quasi-Intentional Torts: Slander
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Oral defamatory statements
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Quasi-Intentional Torts: Defamation
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False communication to a third person
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Quasi-Intentional Torts: Libel
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Written defamatory statements
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Intentional Torts: Assault and battery
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Performing a procedure without consent.
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Intentional Torts: False imprisonment
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Restraining a client against her/his will
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Intentional Torts: Fraud
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Failing to provide essential information for informed consent
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Intentional Torts: Invasion of privacy
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Breach of confidentiality (HIPAA)
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Negligence
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Failure to perform as a reasonable, prudent person would Failure to follow standards of practice No intent to harm is present
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Malpractice
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Tort law or law of medical liability is the legal discipline for malpractice. Four elements must be satisfied: duty, breach, causation, and harm. Is a failure to "follow the standard of care" and is the direct cause of harm. The profession establishes the standard, making this a unique characteristic of medical malpractice.
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Common malpractice claims
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Failure to assess and diagnose Failure to plan Failure to implement a plan of care Failure to evaluate
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Minimizing malpractice risk
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Observe mandatory standards of care Use nursing process; follow professional standards Avoid medication and treatment errors Report and document accurately Obtain informed consent Attend to client safety Maintain client confidentiality Provide education and counseling Delegate, assign, and supervise properly Accept appropriate assignments Participate in continuing education Observe professional boundaries Observe mandatory reporting regulations Be aware of legal safeguards for nurses
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Employer/employee liability
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Vicarious liability Employer liable for the acts of its employee if the employee was acting as an agent of the employer and the actions resulted in injury within that scope of employment.
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Federal laws
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Bill of Rights Social Security Act of 1965 Consolidated Omnibus Budget Reconciliation Act Emergency Medical Treatment and Active Labor Act of 1986 American with Disabilities Act Patient Self-Determination Act of 1991 Health Insurance Portability and Accountability Act of 1996 Patient Protection and Affordable Care Act of 2010
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State laws
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Licensing of professionals—scope of practice -Credentialing -Discipline Licensing of health care institutions Laws relating to public health and disease prevention and control (mandatory reporting laws) -Communicable disease -Abuse Consent Advanced directives Physician-assisted suicide
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HIPAA
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The Health Insurance Portability and Accountability Act (HIPAA) was passed by Congress in 1996 to protect patients: â– Protect health insurance benefits for workers who lose or change their jobs. â– Protect coverage to persons with preexisting medical conditions. â– Establish standards to protect the privacy of personal health information.
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Mandatory reporting laws
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The law in various states requires healthcare workers to report communicable diseases. You also have a duty to report physical, sexual, or emotional abuse or neglect of children, older adults, or the mentally ill, whether you suspect it or have actual evidence of it.
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Advanced directives
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Two common forms of advance directives are a living will or health care proxy (POA) -Living will outlines medical treatment client wishes to refuse (ex: intubation) if client unable to communicate wishes at that time -Health care proxy (also called durable power of attorney for health care) appoints someone (usually family or trusted friend) to make health care decisions if client unable to do so
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Safe and effective care environment - Surgery
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Differentiate among the various types and purposes of surgery. Examine individual patient factors for potential threats to safety, especially for older adults. Use appropriate patient identifiers when providing instruction, administering drugs, marking surgical sites, and performing any procedure. Verify that the patient has given informed consent for the surgical procedure and that the presurgical checklist is complete and accurate. Identify patient conditions or issues that need to be communicated to other members of the surgical and postoperative teams.
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Psychosocial integrity - Surgery
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Use effective communication when teaching patients and family members about what to expect during the surgical experience. Act as a patient advocate with regard to patients' rights, informed consent, and advance directives. Identify learning needs for the patient preparing for surgery.
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Physiological integrity - Surgery
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Use knowledge of physiology and behavioral principles to describe an accurate and complete preoperative assessment. Evaluate personal factors that increase the patient's risk for complications during and immediately after surgery. Evaluate laboratory values for changes that may affect the patient's response to drugs, anesthesia, and surgery. Explain the purposes and techniques commonly used for patient preoperative preparation. Apply anti-embolic stockings, sequential compression boots, or other devices to reduce or prevent vascular complications.
question
Teamwork and collaboration
answer
Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care
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Pre-operative period
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Begins when patient is scheduled for surgery; ends at time of transfer to surgical suite Nurse functions as educator, advocate, promoter of health and safety
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Surgical settings
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Inpatient -Same day admission Outpatient -Same day surgery Ambulatory -Free standing centers -Physician offices -Ambulatory care centers
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Pre-op assessment includes:
answer
Current medications - complementary or alternative -herbs -OTC meds Medical history & Family history -Cardiovascular -Pulmonary Previous surgical procedures and anesthesia -Pain control -Management of nausea / vomiting Blood donation Discharge planning - support system
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Older adults: Changes of aging as surgical risk factors
answer
Decreased: -Cardiac output, peripheral circulation -Vital capacity, blood oxygenation -Blood flow to kidneys, glomerular filtration rate Increased: -Blood pressure -Risk for skin damage, infection -Sensory deficits -Deformities related to osteoporosis/arthritis
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Pre-op system assessment - Cardiovascular
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Affect the ability of the heart to work as an efficient pump. Coronary Artery Disease MI within 6 months before surgery Angina Hypertension Dysrhythmias
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Pre-op system assessment - Respiratory
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Decrease pulmonary function, increase the risk of respiratory infection, and may be exacerbated by general anesthesia. Chronic respiratory problems -Emphysema -Asthma -Bronchitis Smoking -Increases carboxyhemoglobin blood level and deceases oxygen delivery
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Pre-op system assessment - Renal/urinary
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Renal disease/impairment affects the patient's ability to excrete many medications, including anesthetic agents. It also affects the body's ability to regulate fluid and electrolytes.
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Pre-op system assessment - Neurological
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-Determine baseline LOC -Note presence of sensory or perceptual deficits -Assess range of motion and ability to perform activities of daily living
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Pre-op system assessment - Nutrition status
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Patients who are malnourished or obese are at risk for delayed wound healing, infection, and fatigue. Obese clients are also more prone to cardiovascular disorders and impaired pulmonary function.
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Prevention of cardiovascular complications
answer
-Be aware of patients at greater risk for DVT -Antiembolism stockings -Pneumatic compression devices -Leg exercises -Mobility
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Pre-op Labs
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Urinalysis Blood type and crossmatch CBC or hemoglobin level and hematocrit Clotting studies (PT, INR, aPTT) Electrolyte levels Serum creatinine level Pregnancy test
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Pre-op Diagnostics
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Chest x-ray - Assesses respiratory status and heart size ECG - Assesses preexisting cardiac disease or rhythm abnormalities
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Nursing Diagnoses - Surgery
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Knowledge deficit (surgical experience) related to unfamiliarity with surgical procedures and preparation. Anxiety related to new or unknown experiences, possibility pain, and possible surgical outcomes.
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Knowledge deficit: Goals & outcomes
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The patient will: Verbalize -in own words purpose and expected results of surgery -understanding of preoperative preparations Ask -questions when terms or procedure is not known Adhere -to NPO requirements Demonstrate -correct use of exercises and techniques to be used after surgery to prevent complications
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Knowledge deficit: Interventions
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*Preoperative teaching *Informed consent: -Surgeon obtains signed consent before sedation and/or surgery -Nurse clarifies facts and dispels myths about surgery -Nurse not responsible for providing detailed information about procedure!
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Informed consent
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Patients may sign with "X" In emergency, telephone authorization is acceptable Special permits required for some procedures
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NPSG's and informed consent
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Ensure correct site is selected and wrong site is avoided Licensed independent practitioner marks site, involving patient if possible "Time out" procedure adopted by most facilities
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Self-determination
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Pt has the right to have or initiate: -Advance directives -Living wills -Durable power of attorney Mandated by the Patient Self-Determination Act Provide legal instructions to healthcare providers ***Surgery does not provide an exception to the patient's advance directives or living will.
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Implementing dietary restrictions
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NPO - Patient not to ingest anything by mouth for 6 to 8 hours before surgery: -Decreases risk for aspiration -Give patients written/oral directions to stress adherence -Surgery can be canceled if instructions not followed
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Administering regularly scheduled medications
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Consult with physician and anesthesia provider for instructions Drugs for certain conditions often allowed with a sip of water: -Cardiac disease -Respiratory disease -Seizures -Hypertension
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Medications that may affect surgery, therefore are a risk
answer
-Antibiotics - may potentiate the action of anesthetic agents -Anticoagulants - increase risk for bleeding -Antidysrhythmics - may impair cardiac function during anesthesia -Antihypertensives - increase the risk for hypotension during surgery; may interact with anesthetic agents to cause bradycardia and impaired circulation -Aspirin - increase risk for bleeding -Corticosteroids - delay wound healing and increase risk for infection -Diuretics - alter fluid and electrolyte balance (especially potassium balance) -Opiods - increase the risk of respiratory depression -NSAID's - inhibit platelet aggregation, increasing the risk for bleeding -Tranquilizers - increase the risk of respiratory depression
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Intestinal preparation
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Performed to prevent injury to colon; reduce number of intestinal bacteria -Enema or laxative
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Skin preparation
answer
Skin is first line of defense - break in barrier can lead to infection 1st step in reducing surgical site infection -Can start 1-2 days before surgery with -Antiseptic solutions with shower Removal of hair -DO NOT SHAVE! Clip instead
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Patient and family teaching
answer
Tubes -Urinary catheter -NG Drains -Penrose -JP -Hemovac Vascular access -PIV -Central Line
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Prevention of respiratory complications
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Breathing exercises -Deep (diaphragmatic) -Expansion Incentive spirometry Coughing and splinting
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Patients at risk for VTE
answer
Obese patients Age 40 or older History of cancer Decreased mobility or immobile Spinal cord injury Smoking History of VTE, PE, varicose veins, edema Oral contraceptives History of decreased cardiac output Hip fracture, total hip/knee surgery
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Pre-operative chart review
answer
-Ensure all documentation, preoperative procedures, orders are complete -Check surgical consent form and others for completeness -Inform patient that area will be marked before procedure begins -Document allergies, height, and weight -Ensure all laboratory and diagnostic test results are in chart -Document/report any abnormal results -Report special needs and concerns
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Pre-operative patient preparation
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Remove most clothing; provide gown Leave valuables with family member or lock up Tape rings in place if cannot be removed Ensure patient is wearing ID band Remove: -Dentures -Prosthetic devices -Hearing aids -Contact lenses -Fingernail polish -Artificial nails -Pierced jewelry
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Pre-operative Medications
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Sedatives/Antihistamines - provide sedation and antiemetic effects -hydroxyzine (Vistaril) -diphenhydramine (Benadryl) Hypnotics - provide sedation and increase the duration of sleep -lorazepam (Ativan) -temazapam (Restoril) Anxiolytics - control anxiety, calming -midazolam (Versed) -diazepam (Valium) Opioid analgesics - provide pain relief and sedation; induce anesthesia -morphine (Duramorph) -fentanyl (Sublimaze) Anticholinergic agents - reduce oral and pulmonary secretions, prevent laryngospasms, prevent bradycardia -atropine (Atropisol) -scopolamine (Maldemar) H2 histamine blockers - reduce gastric acidity and reflux -ranitidine (Zantac) -cimetidine (Tagamet)
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Members of the surgical team
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Sterile team: -Surgeon and surgical assistant or RNFA -Scrub nurse -Surgical technologist Clean team: -Anesthesia providers -Circulating nurse -ORTs/surgical technologists may be used in addition to nursing staff -Holding area nurse -Specialty nurses
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Scrub nurse
answer
Sets up the sterile field Prepares the surgical instruments Assists with the sterile draping of the patient Anticipates and responds to the surgeon's needs Maintains the integrity of the sterile field
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Registered nurse first assistant (RNFA)
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An RN with additional education and training in surgical technique. The RNFA serves as an assistant to the surgeon to perform the surgical procedure, a role that has historically been filled by physicians.
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Anesthesiologist or a nurse anesthetist (CRNA)
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Induces amnesia, analgesia, and muscle relaxation or paralysis with anesthesia. Their role is to continuously monitor and evaluate the patient's responses to the anesthetic agent and the surgical procedure. CRNAs administer more than half of all anesthetics in the United States.
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Circulating nurse
answer
An RN who applies the nursing process to coordinate all activities in the operating room. She is a client advocate who continuously monitors the client and the sterile field maintains a safe, comfortable environment; communicates with appropriate personnel outside the operating room; responds to emergencies; and, in some cases, administers sedation to the patient. An important aspect of the circulating nurse's role is to attend to the patient during the induction of anesthesia.
question
Time out
answer
The circulating nurse, in the role of patient advocate, is usually the team member who initiates the time out. A correctly performed time out includes verifying the correct: -patient -procedure -site -side (laterality) -surgeon -position As well as that proper equipment, instrumentation, and implants are available.
question
What to do if a doctor becomes hypoglycemic during a procedure?
answer
Nurse has the duty to report impaired practice.
question
Minimally invasive and robotic surgery (MIS)
answer
Now common practice Preferred technique for many surgery types, including: Cholecystectomy Joint surgery Cardiac surgery Splenectomy Spinal surgery Potential injury Mechanical trauma Thermal injury
question
Environment of the surgical team
answer
Preparation of surgical suite, team safety Layout Health and hygiene of surgical team Surgical attire Surgical scrub Remember!!! People are a source of bacteria in the surgical setting! Special health care standards, dress are needed Watch for nosocomial infections, identify source of pathogens
question
Surgical scrubbing
answer
Broad-spectrum, surgical antimicrobial solution Vigorous rubbing that creates friction used from fingertips to elbow Scrub continues for 3 to 5 min
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Anesthesia
answer
Induced state of partial or total loss of sensation, occurring with or without loss of consciousness Used to block nerve impulse transmission, suppress reflexes, promote muscle relaxation, achieve controlled level of unconsciousness (in some cases)
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General anesthesia
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Reversible loss of consciousness induced by inhibiting neuronal impulses in several areas of CNS Involves single or combination of agents Depresses CNS, resulting in analgesia, amnesia, and unconsciousness with loss of muscle tone and reflexes
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Stages of general anesthesia
answer
Stage 1—Beginning of anesthesia; client is drowsy and dizzy; pain sensation is depressed Stage 2—Excitement stage; client has irregular breathing, involuntary motor movements; avoid stimulating client, which can trigger vomiting, holding the breath, and increased activity; ensure client safety by proper use of safety straps Stage 3—Stage of anesthesia appropriate for surgical procedures; client has skeletal muscle relaxation, constricted pupils, absence of eyelid reflex Stage 4—medullary depression; client is NEAR DEATH; pupils are fixed and dilated, respirations are weak, pulse is rapid and thready Emergence—recovery from anesthesia
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Administration of general anesthesia
answer
Inhalation IV injection Balanced anesthesia Adjuncts to general anesthetic agents: -Hypnotics -Opioid analgesics -Neuromuscular blocking agents
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Balanced anesthesia
answer
Combination of IV drugs and inhalation agents used to obtain specific effects Example: -thiopental for induction -nitrous oxide for amnesia -morphine for analgesia -pancuronium for muscle relaxation
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Complications of general anesthesia
answer
Malignant hyperthermia Overdose Unrecognized hypoventilation Problems with specific anesthetic agents Intubation problems
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Malignant hyperthermia
answer
Acute, life-threatening complication May be genetic Begins with skeletal muscle exposed to specific agent Causes increased metabolism, calcium levels in muscle cells Leads to acidosis, high temperatures, dysrhythmias
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Clinical presentations of malignant hyperthermia
answer
-Tachycardia -Tachypnea -Skin initially appears flushed, then becomes mottled and cyanotic -Myoglobinuria -Rise in end tidal carbon dioxide -Rapid rise in body temperature -Respiratory and metabolic acidosis
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Regional anesthesia
answer
Blocks multiple peripheral nerves in specific body region: Field Nerve Spinal Epidural
question
Regional - Local anesthetic
answer
Briefly disrupts sensory nerve impulse transmission from specific body area/region Delivered topically and by local infiltration Patient remains conscious, able to follow instructions Injected in a specific area for minor surgical procedures, such as lidocaine for suturing a small wound
question
Regional - Field block
answer
Injection of anesthetic around the operative field.
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Regional - Nerve block
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Anesthetic agent is injected into and around a nerve or group of nerves, such as a pudendal block used to numb perineum for an episiotomy.
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Regional - Spinal block
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Anesthesia is injected through a lumbar puncture into subarachnoid space, such as for hernia repairs or cesarean section deliveries Patient is conscious but has no sensation or movement of lower extremities up to a specific area.
question
Regional - Epidural block
answer
Anesthetic agent injected into epidural space to anesthetize larger areas, such as in vaginal childbirth; Patient is awake and aware of surroundings but feels no pain
question
Complications of regional and local anesthesia
answer
Anaphylaxis Incorrect delivery technique Systemic absorption Overdose Local complications
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Treatment of complications of anesthesia
answer
Establish open airway Give oxygen Notify surgeon Fast-acting barbiturate is usual treatment Epinephrine for unexplained bradycardia
question
Moderate sedation
answer
IV delivery of sedative, hypnotic, opioid drugs to reduce level of consciousness Patient maintains patent airway, can respond to verbal commands Amnesia action is short
question
Potential for injury
answer
Interventions: Proper body position Prevent pressure ulcer formation Prevent obstruction of circulation, respiration, nerve conduction
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Potential for infection
answer
Interventions include: Plastic adhesive drape Skin closures, sutures and staples, nonabsorbable sutures Insertion of drains Application of dressing Patient transfer from OR table to stretcher
question
Potential for hypoventilation
answer
Continuous monitoring of: -Breathing -Circulation -Cardiac rhythms -Blood pressure and heart rate Continuous presence of anesthesia provider
question
Potential for hypoxemia
answer
Highest incidence occurs on 2nd postoperative day Interventions: -Airway maintenance -Monitor (Spo2) -Semi-Fowler's position -Oxygen therapy, breathing exercises -Mobilization as soon as possible
question
Potential for wound infection and delayed healing
answer
Interventions: Nursing assessment of surgical area Dressings—first change usually done by surgeon Drains—provide exit route for air, blood, bile; help prevent deep infections, abscess formation during healing Drug therapy, irrigation to treat wound infection Débridement Surgical management required for wound opening
question
Post-operative period
answer
Begins with completion of surgery and transfer to PACU, ambulatory care unit, or ICU
question
PACU recovery room
answer
During this period, the client is at high risk for respiratory and cardiovascular compromise. As a precaution, the anesthetist and the circulating nurse accompany the client and attend to his needs during transport to the PACU. Ongoing evaluation and stabilization of patients to anticipate, prevent, manage complications after surgery The Joint Commission's NPSGs require circulating nurses and anesthesia providers give PACU nurses verbal hand-off reports including surgical procedure, anesthesia, drugs and IV fluids administered, and estimated blood loss
question
Functions of the PACU nurse
answer
Respiratory LOC, TPR, O2 Sat, BP Examine surgical area Discharge from PACU
question
What to do if patient is confused in the PACU
answer
Orient the patient. Let them know where they are, how they got there, the time, day, etc.
question
Post-op: Respiratory system assessment
answer
-Patent airway, adequate gas exchange -Note artificial airway when applicable -Rate, pattern, depth of breathing -Breath sounds -Accessory muscle use -Snoring and stridor -Respiratory depression or hypoxemia
question
Post-op: Cardiovascular assessment
answer
Vital signs every 15 mins until stable Heart sounds Cardiac monitoring Peripheral vascular assessment -Monitor for VTE
question
Post-op: Neurological assessment
answer
Cerebral functioning Motor and sensory assessment after epidural or spinal anesthesia
question
Post-op: Fluid, electrolyte & acid-base balance assessment
answer
I & O Hydration status IV fluids Vomitus Urine Wound drainage NG tube drainage Acid-base balance
question
Post-op: Renal/urinary system assessment
answer
Check for urine retention Consider other sources of output (e.g., sweat, vomitus, diarrhea stools) Report urine output of < 30 mL/hr
question
Post-op: Gastrointestinal assessment
answer
Postoperative nausea/vomiting common 30% of patients experience nausea or vomiting after general anesthesia Peristalsis may be delayed up to 24 hours Monitor for bowel sounds **Absent bowel sounds common due to meds that decrease peristalsis, not a big concern immediately after surgery
question
Post-op: Drug therapy to reduce nausea/vomiting
answer
Ondansetron (Zofran) Meclizine (Antivert, Dramamine)
question
Post-op: NG tube drainage
answer
Inserted during surgery to: Decompress and drain stomach Promote GI rest Allow lower GI tract to heal Provide enteral feeding route Monitor any gastric bleeding Prevent intestinal obstruction **Assess drained material every 8 hr
question
Post-op: Skin/incision assessment
answer
Normal wound healing **draining wound does not mean infected wound** Impaired wound healing - seen most often between 5th and 10th days after surgery -Dehiscence -Evisceration Marking post op drainage: How: Any drainage is on the dressing, the nurse circles the area and marks it with a time and date. Provides a gauge how much seepage is occurring. When to notify surgeon: When excessive bleeding or hematoma formation has occurred, the surgeon should be notified right away so that the wound site assessment can be performed.
question
Post-op: Management of nicotine withdrawal
answer
Transdermal nicotine patch
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Gravity drains
answer
Gravity drains: -Penrose: Short-term drain to give fluids under the wound a channel to drain to the surface; prevents pressure on suture lines -T-tube: Drain directly through a tube from the surgical area
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Closed-wound drainage systems
answer
Jackson-Pratt Hemovac: drainage collects in a collecting vessel by means of compression and re-expansion of the system.
question
Montgomery straps
answer
Used when frequent dressing changes are anticipated. They help prevent skin irritation from frequent tape removal.
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Application of skin staples
answer
The stapler is lightly positioned over everted skin edges. It is not necessary to press the staple, or stapler anvil, into the skin to get a proper "bite" (just "kiss" the skin). Center the staples over the incision line, using the locating arrow or guideline, and place staples approximately ÂĽ inch apart.
question
Post-op: Discomfort/pain assessment
answer
Pain/discomfort is expected after surgery Physical and emotional signs of pain Consider type, extent, length of surgical procedure in assessing patient's discomfort, need for medication
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Physical and emotional signs of acute pain
answer
Increased pulse and blood pressure Increased respiratory rate Profuse sweating Restlessness Confusion (older adults) Wincing, moaning, crying
question
Pain interventions
answer
Drug therapy Complementary & alternative therapies: -Positioning -Massage -Relaxation/diversion techniques
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Post-op: Laboratory assessment
answer
Analysis of electrolytes CBC "Left-shift" (bandemia) Specimens for C&S ABGs Urine and renal laboratory tests Other (e.g., serum amylase, blood glucose)
question
Incentive spirometry
answer
Encourage incentive spirometer, deep breathing and coughing exercises every 2 hours while awake to prevent atelectasis and pneumonia.
question
Post-surgical patient education: Diet
answer
Drink at least 6 to 8 glasses of fluid daily unless otherwise ordered (water is beneficial) Adhere to any diet restrictions (provide individualized instruction according to diet) Eat well-balanced meals that are high in vitamin C and protein to aid wound healing
question
Post-surgical patient education: Activity
answer
Maintain activity restriction if ordered by surgeon Resume activities gradually (all clients) Avoid heavy lifting for 6 weeks after major surgery Avoid lifting more than 10 pounds or performing activities involving pushing or pulling with an abdominal incision Often may return to work in 6 to 8 weeks (depending on surgery and client status preoperatively)
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Post-surgical patient education: Wound care
answer
Take care of incision and/or change dressing as taught (specific information is individualized to client and surgery; provide 1 to 2 days of dressing materials or according to hospital policy) Cover incision with plastic wrap before showering (if allowed) Sutures or staples are often removed in surgeon's office 7 to 14 days post operatively Steri-Strips will fall off by themselves (if used instead of sutures or if applied for support when sutures are removed before discharge) Keep wound clean, dry, and intact
End Stage Renal Disease
Fluid And Electrolyte Balance
Nursing
Short Bowel Syndrome
Short Term Therapy
TPN – Flashcard 72 terms

Jill Lopez
72 terms
Preview
TPN – Flashcard
question
What is the primary purpose of TPN?
answer
- To meet the patient's nutritional needs - To allow growth of new body tissue (protein)
question
What materials are used to administer TPN?
answer
A central line, such as a tunneled triple lumen catheter or a single- or double-lumen peripherally inserted central (PICC) line
question
TPN contains complete nutrition, this includes...
answer
- Calories (in a high concentration [20% to 50%] of dextrose) - Lipids/essential fatty acids - Protein - Electrolytes - Vitamins - Trace elements.
question
TPN standard IV bolus therapy is typically less than or equal to _____ calories/day.
answer
700
question
Total parenteral nutrition (TPN) is a _______ , __ ______ solution.
answer
- Hypertonic - IV Bolus
question
What are some reasons for administering parenteral nutrition?
answer
- Client's GI tract does not function - Client cannot consume sufficient nutrients via GI tract
question
Partial Parenteral Nutrition (PPN) is: Hypertonic or Isotonic?
answer
Isotonic
question
Partial Parenteral Nutrition (PPN) is: Intended for long or short term use?
answer
Short-Term
question
Partial Parenteral Nutrition (PPN) is: Administered into a large or small peripheral vein?
answer
Large
question
Potential indications for TPN include any condition that: (name two)
answer
- Affects the ability to absorb nutrition. - Has a prolonged recovery. - Creates a hypermetabolic state. - Creates a chronic malnutrition.
question
There are two basic guidelines regarding when to initiate TPN. What are they?
answer
- A weight loss of 7% body weight and NPO for 5 days or more - A hypermetabolic state
question
A nurse is planning care for a client who has a new prescription for total parenteral nutrition (TPN). Which of the following interventions should be included in the plan of care? (Select all that apply.) A. Obtain a capillary blood glucose four times daily. B. Administer prescribed medications through a secondary port on the TPN IV tubing. C. Monitor vital signs three times during the 12-hr shift. D. Change the TPN IV tubing every 24 hr. E. Ensure a daily aPTT is obtained.
answer
A. CORRECT: The client is at risk for hyperglycemia during the administration of TPN and may require supplemental insulin. C. CORRECT: Vital signs are recommended every 4 to 8 hr to assess for fluid volume excess and infection. D. CORRECT: It is recommended to change the IV tubing that is used to administer TPN every 24 hr.
question
A nurse is caring for a client who is receiving TPN solution. It has been 24 hr since the current bag of solution was hung, and 400 mL remains to infuse. Which of the following is the appropriate action for the nurse to take? A. Remove the current bag and hang a new bag. B. Infuse the remaining solution at the current rate and then hang a new bag. C. Increase the infusion rate so the remaining solution is administered within the hour and hang a new bag. D. Remove the current bag and hang a bag of lactated Ringer's solution.
answer
A. CORRECT: The current bag of TPN should not hang more than 24 hr due to the risk of infection.
question
What are the benefits to having a PICC line route for TPN? (name two)
answer
- Access to central vein - Can accommodate hypertonic fluids - Lower risk of phlebitis than PPN - Easier to insert than central line
question
PPN is appropriate for caloric needs that are no more than how many calories per day?
answer
2000 - 2500
question
TPN administration regime whereby nutrients are infused at night, but not during the day.
answer
Cyclic TPN
question
This kind of solution is one with a higher concentration of solutes outside the cell than inside the cell. It has a higher osmolality than the comparison solution.
answer
Hypertonic Hyp*e*rtonic *e*nters the vessel *I*sotonic stays where *I* put it Hyp*o*tonic goes *o*ut of the vessel
question
This kind of solution has a lower concentration of solutes outside the cell than inside the cell. It has a lower osmolality than the comparison solution.
answer
Hypotonic Hyp*o*tonic goes *o*ut of the vessel *I*sotonic stays where *I* put it Hyp*e*rtonic *e*nters the vessel
question
This kind of solution is one in which its effective osmole concentration is the same as the solute concentration of a cell. It has approximately the same osmolality of the comparison solution.
answer
Isotonic *I*sotonic stays where *I* put it Hyp*o*tonic goes *o*ut of the vessel Hyp*e*rtonic *e*nters the vessel
question
Parenteral nutrition is administered A. intramuscularly. B. into the stomach. C. into the small intestine. D. into the circulatory system.
answer
D. Into the circulatory system
question
The digestive tract is used as the route for nutrient delivery whenever possible to prevent: A. thrombosis and cardiac arrest. B. diarrhea and sepsis. C. hunger and constipation. D. GI atrophy and sepsis.
answer
D. GI atrophy and sepsis.
question
3. Medical conditions for which TPN may be indicated include: A. AIDS-related enteropathy. B. cardiovascular disease. C. acute pancreatitis D. bowel infarction E. all of the above. F. A, C and D only.
answer
F. A, C and D only.
question
True or False? With PPN, nutrients are supplied to the superior vena cava.
answer
False!
question
True or False? When nutrient needs are high and the patient must be on parenteral nutrition for a long period of time, TPN is the appropriate choice.
answer
True!
question
True or False? IV lipids are hypertonic.
answer
False!
question
True or False? The maximum kcalories tolerated with PPN is about 1000 kcal/day?
answer
False!
question
True or False? Up to about 90 g/day of protein can be supplied via PPN.
answer
True!
question
True or False? Protein, carbohydrates, and vitamin/minerals contribute to solution osmolarity.
answer
True!
question
The complication that can arise when a hypertonic solution is introduced to a small vein is: A. infarction. B. thrombosis. C. sepsis. D. dehydration.
answer
B. thrombosis.
question
The purpose(s) of lipid emulsion in PN therapy is/are to: A. Provide kcalories. B. provide essential fatty acids. C. provide essential amino acids. D. two of the above. E. all of the above.
answer
D. two of the above. - Provide kcalories. - provide essential fatty acids.
question
Contraindications for lipid emulsions include: A. Diabetes mellitus. B. Acute pancreatitis with hyperlipidemia. C. Severe egg allergy. D. Hyperlipidemia. E. B and D only. F. B, C and D only.
answer
F. B, C and D only.
question
True or False? The PN patient should receive lipid emulsions every day.
answer
False!
question
Why is the TPN infusion started slowly? A. To prevent fluid overload. B. So the body has time to adapt to the glucose load. C. So the body has time to adapt to the hypotonic solution. D. So the body has time to adapt to the protein load. E. A and B only. F. A, B and D only.
answer
E. A and B only.
question
True or False? With cyclic TPN, the patient receives the infusion 24 hours a day.
answer
False!
question
True or False? If, for some reason, the infusion must be stopped for a period of time, the rate should be increased upon commencement of the infusion to "catch up" so that the day's kcalorie and protein needs can be met.
answer
False!
question
What should the nurse observe for when a patient switches from continuous TPN to cyclic TPN?
answer
Signs of: Glucose Overload Fluid Imbalance
question
True or False? Cyclic TPN reduces the risk of hepatotoxicity and allows essential fatty acids to be released from body stores.
answer
True!
question
With TPN infusion initiation, _______ liter(s) of solution is/are infused the first day, then the infusion is increased by _______ liter(s) a day until the desired volume is reached. A. 1; 1. B. 1; 2. C. 2; 1 D. 0.5; 0.5
answer
A. 1; 1.
question
True or False? Pneumothorax is caused by a sudden cessation of TPN infusion.
answer
False!
question
True or False? In monitoring the TPN patient, fluid input/output should be recorded every day.
answer
True!
question
A weight gain of greater than _______ lb(s). per day indicates fluid retention. A. 0.5 B. 1.0 B. 1.5 D. 2.0
answer
A. 0.5
question
A potential complication associated with the sudden cessation of the TPN infusion is: A. rebound hypoglycemia B. pneumothorax C. kidney failure D. nutritional recovery syndrome
answer
A. rebound hypoglycemia
question
250 mL of a 10% lipid emulsion provides _______ kcalories. A. 250 kcals. B. 275 kcals. C. 500 kcals. D. 550 kcals.
answer
B. 275 kcals 10% solution = 1.1 kcal / mL 250 x 1.1 = 275
question
250 mL of a 20% lipid emulsion provides _______ kcalories. A. 250 kcals. B. 275 kcals. C. 500 kcals. D. 550 kcals.
answer
C. 500 kcals. 20% solution = 2 kcal / mL 250 x 2 = 500
question
What is the maximum lipid tolerance (in grams) for a patient who weighs 70 kg? A. 125 g B. 175 g C. 250 g D. 375 g
answer
B. 175 g Maximum fat-emulsion amount should not exceed a dose of 2.5g/kg/day and should be administered slowly over 12 hours 2.5 x 70 = 175
question
A nurse is caring for a cient who is receiving enteral tube feedings. The client requires 2000 cal / day to meet his caloric needs. The tube feeding prescribed provides 2 cal / mL. How many mL/hr should the nurse set the pump to administer the tube feeding within 24 hr? (round to nearest whole number)
answer
42 mL 2000 calories / 2 calories per mL = 1000 calories 1000 / 24 = 41.66
question
Excessive lipid administration may suppress which body system? A. Digestive B. Respiratory C. Immune D. Endocrine
answer
C. Immune
question
True or False? Lipids are often hung separately, or piggyback into EN?
answer
True!
question
Lipid solutions could be a potential source of Vitamin K. In which pharmacological therapy could that be contraindicated?
answer
Could pose a problem in the patient on anticoagulants.
question
You need at least ____% of kcals from lipids to prevent Essential Fatty Acid Deficiency.
answer
10%
question
To decrease the risk of overfeeding, an energy intake of how many kcals/kg/day are recommended in a non-obese patient?
answer
25 - 30
question
Is it okay to put additives into lipid solutions?
answer
No - do not mix!
question
The nurse is reviewing the laboratory test results for a 70-year-old patient with lung cancer. The patient was admitted with a diagnosis of malnutrition. Serum albumin level is 4.0 g/dl and prealbumin is 10 mg/dl. The nurse should draw which of the following conclusions? A. The albumin level is normal, and therefore the patient does not have protein malnutrition. B. The albumin level is increased, which is a common finding in patients with cancer who have malnutrition. C. Both the serum albumin and prealbumin levels are reduced, consistent with the admitting diagnosis of malnutrition. D. Although the serum albumin level is normal, the prealbumin level more accurately reflects the patient's nutritional status.
answer
D. Although the serum albumin level is normal, the prealbumin level more accurately reflects the patient's nutritional status. Serum albumin has a half-life of approximately 20 to 22 days; therefore the serum level may lag behind actual protein changes by more than 2 weeks and is therefore not a good indicator of acute changes in nutritional status. Prealbumin has a half-life of 2 days and is a better indicator of recent or current nutritional status.
question
The nurse is caring for a patient admitted to the hospital for asthma who weighs 186 lb (84.5 kg). During dietary counseling, the patient asks the nurse how much protein he should ingest each day. How many grams of protein does the nurse recommend should be included in the diet based on the patient's current weight? A. 24 B. 41 C. 68 D. 93
answer
C. 68 Correct The daily intake of protein should be between 0.8 and 1 g/kg of body weight. Thus this patient should take in between 68 and 84 g of protein per day in the diet. **From PPT notes: Protein should be provided at the rate of 1 to 1.5 g/kg/day depending on the patient's needs.**
question
A patient with dysphagia from a stroke is receiving enteral feedings through a percutaneous endoscopic gastrostomy (PEG). Which of the following interventions should the nurse integrate into this patient's care? A. Flush the tube with 30 ml of normal saline every 4 hours. B. Flush the tube before and after feedings if the patient's feedings are intermittent. C. Flush the PEG with 100 ml of sterile water before and after medication administration. D. To prevent fluid overload, avoid flushing when the patient is receiving continuous feeding.
answer
B. Flush the tube before and after feedings if the patient's feedings are intermittent. The nurse should flush feeding tubes with 30 ml of water (not normal saline) every 4 hours during continuous feeding or before and after intermittent feeding. Flushes of 100 ml are excessive and may cause fluid overload in the patient.
question
Which of the following methods should be used to confirm the placement of a patient's newly-inserted nasogastric (NG) feeding tube? A. X-ray B. Aspiration C. Air auscultation D. Measurement of external length
answer
A. X-ray It is imperative to ensure that an NG tube is situated in the GI tract rather than the patient's lungs. When an NG tube has been recently inserted, it is important to confirm this placement with an x-ray that will identify the tube's radiopaque tip.
question
The nurse recognizes that the majority of patients' caloric needs should come from which of the following sources? A. Fats B. Proteins C. Polysaccharides D. Monosaccharides
answer
C. Polysaccharides Polysaccharides are the complex carbohydrates that are contained in the breads and grains that form the base of the food pyramid. - Carbs should constitute between 45% and 65% of caloric needs - 20% to 35% from fats - 10% to 35% from proteins.
question
A patient who has suffered severe burns in a motor vehicle accident will soon be started on parenteral nutrition (PN). Which of the following principles should guide the nurse's administration of the patient's nutrition? A. Administration of PN requires clean technique. B. Central PN requires rapid dilution in a large volume of blood. C. Peripheral PN delivery is preferred over the use of a central line. D. Only water-soluble medications may be added to the PN by the nurse.
answer
B. Central PN requires rapid dilution in a large volume of blood. Central PN is hypertonic and requires rapid dilution in a large volume of blood. Because PN is an excellent medium for microbial growth, aseptic technique is necessary during administration. Administration through a central line is preferred over the use of peripheral PN and no medications may be added to PN by the nurse.
question
Which of the following assessments is considered priority in the care of a patient who has recently begun receiving parenteral nutrition (PN)? A. Skin integrity and bowel sounds B. Electrolyte levels and daily weights C. Auscultation of the chest and tests of blood coagulability D. Peripheral vascular assessment and level of consciousness
answer
B. Electrolyte levels and daily weights The use of PN necessitates frequent and thorough assessments. Key focuses of these assessments include daily weights and close monitoring of electrolyte levels. Assessments of bowel sounds, integument, peripheral vascular system, LOC, chest sounds, and blood coagulation may be variously performed, but close monitoring of fluid and electrolyte balance supersedes these in importance.
question
Which needs to be tapered slowly, TPN or PPN?
answer
TPN
question
PPN does not need to be tapered off. Why?
answer
It uses more dilute solution with less dextrose.
question
TPN does need to be tapered off. Why?
answer
To prevent hypoglycemia
question
The nurse is responsible to ensure that PN solution is discontinued and replaced with a new solution if that bag is not empty after how long?
answer
24 hours
question
If fat emulsions are infused separately from PN solution, is it delivered rapidly or slowly?
answer
Slowly
question
How long should a fat emulsion infusion run for?
answer
Slowly over 12 hours
question
A nurse is planning care for a client who has a new prescription for TPN. Which of the following interventions should be included? (select all that apply) A. Obtain CBS 4xday B. Give meds through secondary port on TPN tubing C. Monitor VS three times during 12 hr shift D. Change TPN tubing every 24 hrs E. Ensure a daily aPTT is obtained
answer
A, C, D - Client is at risk of hyperglycemia - VS recommended to assess for fluid overload - Tubing in TPN should be changed every 24hrs.
question
A nurse is caring for a client who is receiving TPN solution. It has been 24hrs since the current bag of solution was hung, and 400 mL remains to infuse. Which of the following is the appropriate nursing action to take? A. Remove current bag, hang new one B. Infuse remaining solution at current rate and hang new bag C. Increase infusion rate so remaining solution is administered within the hour and hang a new bag D. Remove the current bag and hang a bag of lactated ringer's solution
answer
A. The current bag of TPN should not hang more than 24 hrs due to the risk of infection
question
Potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally).
answer
Refeeding Syndrome
question
What is the hallmark biochemical feature of refeeding syndrome?
answer
Hypophosphataemia
question
What lab values do you want to monitor in the patient who may have refeeding syndrome?
answer
- Phosphorous - Magnesium - Potassium - Glucose
question
Pt receiving IV Fat Emulsion therapy should have which levels monitored?
answer
Serum Triglycerides
question
Patients receiving PN
answer
...
Fluid And Electrolyte Balance
Fluid Volume Excess
Nursing
Nursing-LPN
HESI Patient Review Susan Wilson (2) – Flashcards 42 terms

Rae Jordan
42 terms
Preview
HESI Patient Review Susan Wilson (2) – Flashcards
question
Based on Susan's assessment data and history, you identify which of the following as a priority nursing diagnosis for Susan at this time?
answer
Deficient fluid volume related to inadequate intake of fluids.
question
With regard to rupture of membranes, which questions are important?
answer
A. "What time did your 'water break'?" C. "What was the color of the fluid?"
question
Based on your assessment, you determine that the fetus is in a/an ____ presentation
answer
Cephalic/vertex/occiput
question
Based on your assessment, you position the ultrasound transducer on Susan's abdomen at the:
answer
right lower quadrant
question
Fetal heart rate increases can be associated with a variety of factors. These include:
answer
the mother receiving the drug Brethine (terbutaline) The mother receiving the drug Yutopar (ritodrine) Maternal fever or infection Fetal anemia Also, Maternal Dehydration Maternal Hyperthyroidism
question
Susan has been monitored for 15 min. Which of the following actions on your part is indicated?
answer
Continue to monitor the fetal heart rate
question
To measure the frequency contractions you examine a 10-minute strip and:
answer
determine the time from the beginning of one contraction to the beginning of the next
question
You perform a vaginal exam to check for shortening and thinning of cervix. This is called
answer
effacement / effacing
question
You also determine that the fetus is at zero station....Your response is based on the knowledge that zero station means that:
answer
the baby's presenting part is at the level of the mother's ischial spines
question
zero station means that
answer
the baby's presenting part is at the level of the mother's ischial spines
question
Based on your assessment of Susan (3 cm dilated, 80% effaced, fetus at zero station) and your interpretation of her data, you determine that she is now in which stage of labor?
answer
Stage one (until cervix is fully dilated)
question
Susan decides to rest in bed. Which of the following positions are acceptable?
answer
right lateral left lateral
question
You remind Susan that it is important for her to try to urinate every two hours. The rationale for this is that a distended bladder can:
answer
interfere with fetal descent cause difficulty in voiding after delivery increase the pain associated with uterine contractions
question
In response to the order for Stradol (butorphanol tartrate), which of the following is indicated?
answer
Administer the Stradol as ordered
question
You determine that Susan is now in which phase of stage one labor?
answer
Active phase
question
A number of factors may affect the length of time a woman's labor will last. These include:
answer
maternal activity and position the parity of the mother fetal position and size
question
What is the best nursing action to take at this time?
answer
Suggest that John take a short break and have another family member coach Susan temporarily
question
You identify this as a/an________ deceleration
answer
Early
question
Early deceleration is caused by
answer
compression of the head
question
The anesthesiologist performs the epidural procedure and Susan begins to feel almost immediate relief from painful contractions. You know that a priority nursing intervention is to:
answer
frequently monitor Susan's blood pressure for hypotension
question
Because Susan had an epidural she has not exhibited some of the signs/behaviors that otherwise characterize the transition phase. These include:
answer
amnesia between contractions diaphoresis reluctance to be touched physical shaking
question
You examine a recent strip from the fetal monitor. The abnormal fetal heart rate pattern you observe is interpreted as a ___ deceleration
answer
late
question
In response to the occurrence of a late deceleration, which of the following actions should be carried out FIRST?
answer
Turn on left side
question
At this point, which of the following would be appropriate advice for Susan?
answer
Let me help you assume the knee-chest position if the urge to push is uncomfortable Don't push yet. Pant through contractions if you need to
question
Based on your assessment of this male neonate, you determine that his 1-minute Apgar score is
answer
9
question
As Susan and John admire their new son, you notice a sudden gush of blood from Susan's perineum and an apparent lengthening of the umbilical cord. You recognize that these signs indicate
answer
separation of the placenta
question
After the placenta has been expelled, Dr. Cooper asks you to start a Pitocin (oxytocin) drip, at a concentration of 10 units in 1000 mL Lactated Ringer's. You know that Pitocin (oxytocin) is administered at this time to:
answer
stimulate uterine contractions
question
Susan's pitocin drip is infusing with an infusion pump at a rate of 60 mL per hour ___ milliunit of drug is infusing per minute
answer
10
question
The correct term for the cone shape of a vaginally-delivered infant's head is
answer
molded
question
The newborn is prone to hypothermia because:
answer
Newborns have a large body surface to body weight ratio Blood vessels are close to the skin surface There is minimal subcutaneous fat
question
John asks "Why does he need to have a shot already?" Your explanation to John is based on the knowledge that:
answer
Vitamin K is needed to prevent bleeding problems in the early neonatal period Newborns are unable to synthesize vitamin K due to absence of intestinal flora at birth
question
apply erythromycin ophthalmic ointment to the newborn's eyes to:
answer
protect the infant from gonorrheal or chlamydial infection
question
Which of the following assessments would be considered normal at this time?
answer
Fundus is firm, at the midline, and two fingerbreadths below the umbilicus
question
At the next assessment, Susan's uterus is midline. The fundus feel boggy at one fingerbreadth below the umbilicus, what should you do first?
answer
Massage Susan's uterus
question
the vaginal discharge that occurs during the postpartum period (puerperium), which and consists of blood, tissue, and mucous, is called
answer
lochia
question
Which of the following is the expected progression of lochial changes during the puerperium?
answer
Rubra, serosa, alba
question
The term that describes the expected gradual reduction in size of the uterus after delivery as it contracts to return to normal size is
answer
involution
question
When John describes to you the advantages he sees in breastfeeding, you agree when he says:
answer
breastfed babies experience fewer respiratory illnesses than formula-fed babies breastfed babies are not likely to have allergies to their mother's breast milk breastfeeding is more economical
question
Which of the following statements would indicate that Susan understands correct information on breastfeeding?
answer
To break suction, I will insert my finger into the corner of Jason's mouth before removing him from the breast When Jason has a growth spurt, he will want to nurse more often which will increase my milk supply
question
After delivery, a declining level of estrogen allows for rising levels of the hormone responsible for milk production. You know that the hormone that stimulates milk production is
answer
prolactin
question
The hormone responsible for milk ejection is
answer
oxytocin
question
Susan expresses concern about engorged breasts. Some of her friends have told her that it's painful. You discuss engorgement with Susan and suggest:
answer
to help avoid engorgement, feed Jason at least every 2-3 hours around the clock to help avoid engorgement, make sure Jason is positioned for good milk transfer during feedings if engorgement occurs, express some milk prior to feedings to facilitate latching-on
Fluid And Electrolyte Balance
Nursing
Chapter 1: Concepts Basic to Perioperative Nursing – Flashcards 18 terms

Misty Porter
18 terms
Preview
Chapter 1: Concepts Basic to Perioperative Nursing – Flashcards
question
What is the nursing model created by the Association of periOperative Registererd Nurses (AORN) featuring domains that are in continuous interaction with the health system and encircling the focus of perioperative nursing practice—the patient?
answer
The Perioperative Patient-Focused Model.
question
What is the expanded perioperative role characterized by handling and cutting tissue, using instruments and medical devices, providing exposure and hemostasis, and suturing, all as components of assisting-at-surgery behaviors?
answer
The registered nurse first assistant (RNFA) is an example of an expanded perioperative nursing role.
question
The AORN publication, Standards of Perioperative Nursing, is an example of what kind of standard?
answer
The AORN Standards are an example of process-based standards.
question
What standards are based on and describe the application of the nursing process in perioperative nursing?
answer
They include the collection and analysis of data, identification of expected outcomes, planning and implementation of care, and evaluation of outcomes.
question
Institutional standards are usually directive about specific actions in specific circumstances within a facility or system. What type of standards typically provide generalized authoritative statements that can be implemented in all settings?
answer
National standards provide generalized authoritative statements that can be implemented in all settings.
question
List the types of advanced practice nurses who may practice in the perioperative environment.
answer
Nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialists (CNSs) are examples of nurses who may practice in the advanced role in the perioperative environment.
question
Define the phase of the nursing process concerned with the collection of relevant data about the patient.
answer
The assessment phase.
question
Define the phase of the nursing process that focuses on identifying and classifying data collected in the assessment in a way that provides a focus to plan nursing care.
answer
The nursing diagnosis phase.
question
What is the act of transferring the authority for a selected nursing task or tasks in a selected situation(s) to a competent person?
answer
Delegation.
question
What is the initiative that encompasses improvements in quality and effectiveness, based on ethical and economic perspectives?
answer
Performance improvement is the initiative that encompasses improvements in quality and effectiveness, based on ethical and economic perspectives.
question
Define the phase of the nursing process typically associated with describing the desired or favorable patient condition that can be achieved through nursing interventions.
answer
The outcome identification phase.
question
Define the phase of the nursing process characterized by preparation for what will or may happen and determining the priorities for care.
answer
The planning phase.
question
Define the phase of the nursing process characterized by performing the nursing care activities and interventions that were planned, and responding with critical thinking and orderly action.
answer
The implementation phase.
question
Define the phase of the nursing process that focuses on the patient's progress in attaining identified outcomes.
answer
The evaluation phase.
question
What is the specialty nursing language that provides a uniform and systematic method to collect and document the basic elements of perioperative nursing care?
answer
Perioperative Nursing Data Set (PNDS).
question
What certification is available to perioperative nurses that demonstrates proficiency in support of quality patient care and sets a standard of commitment to the profession of OR nursing?
answer
Certified Nurse, Operating Room (CNOR).
question
Describe the minimal level of education required for an advanced practice nurse.
answer
A Master's degree is required for advanced practice nursing.
question
What are some examples of emerging roles in the OR?
answer
Emerging roles include care coordinator, family liaison, robotics coordinator, and informatics specialist.
Fluid And Electrolyte Balance
National League For Nursing
Nurse Practice Acts
Nursing Fundamentals ATC Farmer Exam 1 Davis Plus Questions – Flashcards 180 terms

Jessica Forbes
180 terms
Preview
Nursing Fundamentals ATC Farmer Exam 1 Davis Plus Questions – Flashcards
question
Which of the following are responsibilities of each state's board of nursing? Select All That Apply 1) Determining the salaries of nurses working in the state 2) Approving nursing education programs 3) Establishing criteria that allow a person to be licensed as a registered nurse 4) Hiring instructors for schools of nursing in the state 5) Developing rules and regulations for guidance to nurses 6) Enforcing the rules that govern nursing
answer
2) Approving nursing education programs 3) Establishing criteria that allow a person to be licensed as a registered nurse 5) Developing rules and regulations for guidance to nurses 6) Enforcing the rules that govern nursing
question
A friend recently graduated from high school and is planning to start a program to become a registered nurse, which will include 2 years of nursing classes plus many liberal arts and science classes. Whoch of the following educational routes is your friend taking to become a nurse? 1) Diploma program 2) Associate degree program 3) Baccalaureate degree program 4) Master's entry program
answer
2) Associate degree program
question
Which of the following trends in the United States is most likely to increase the demand for nurses and other healthcare professionals? 1) Increased access to health and medical information among healthcare consumers 2) Growing proportion of older adults 3) Collective bargaining 4) The women's movement
answer
2) Growing proportion of older adults
question
You work as a labor and delivery nurse in the birthing center of a large hospital. Your hospital follows a model of care in which during a single shift, you are assigned to provide all aspects of care for just one patient. This is an example of which model for nursing care? 1) Case method 2) Functional nursing 3) Team nursing 4) Primary nursing
answer
1) Case method
question
You are currently a registered nurse but would like to become an advanced practical nurse. In particular, you would like to work with patients with cardiovascular disease in the coronary care unit of a hospital. Which advanced practice nursing certification should you pursue? 1) Nurse practitioner 2) Certified registered nurse anesthetist 3) Clinical nurse specialist 4) Certified nurse midwife
answer
3) Clinical nurse specialist
question
In your career as a nurse, you have provided primary, secondary, and tertiary care to a wide variety of patients. Which of the following is an example of primary care? 1) Administering pneumonia immunizations to older adults in a community clinic 2) Administering an antibiotic to a child with strep throat in an ambulatory care center 3) Caring for a patient who is learning to walk again after a traumatic injury in a rehabilitation center 4) Providing in-home hospice care for a patient who is dying of brain cancer
answer
1) Administering pneumonia immunizations to older adults in a community clinic
question
You have received unexpected blood test results for a patient and would like to confirm that there were no errors in the processing of the specimen. Which of the following healthcare professionals should you contact to address this concern? 1) Nursing assistant 2) Physical therapist 3) Physician's assistant 4) Laboratory technologist
answer
4) Laboratory technologist
question
Which of the following is a recommendation for healthcare reform that the American Nurses Association (ANA) published in 2008? 1) Provide universal access to essential healthcare services for all citizens and residents 2) Privatize the entire healthcare system 3) Shift the priority from health promotion to illness care 4) Established a three-payer system for financing healthcare
answer
1) Provide universal access to essential healthcare services for all citizens and residents
question
You are providing care for a 20-year-old who is currently unemployed, has no health insurance, and is struggling financially. Which of the following would it be most appropriate to provide information on? 1) Medicare 2) Medicaid 3) CHIP 4) Individual private insurance
answer
2) Medicaid
question
The following each describes one of five of the stages in Benner's model of the process by which a nurse acquires clinical skills and judgement: novice, advanced beginner, competence, proficient, expert. Put the descriptions in the correct order according to the their corresponding stages. - Can handle patient load and prioritize situations - Can recognize problems in the absence of classic signs and symptoms - Has a more sophisticated use of rules; recognition of abnormal findings but not of significance - Is task oriented and focuses on "learning the rules" - Can see the "big picture," coordinate services, and forecast needs
answer
1) Has a more sophisticated use of rules; recognition of abnormal findings but not the significance 2) Can recognize problems in the absence of classic signs and symptoms 3) Can handle patient load and prioritize situations 4) Is task oriented and focuses on "learning the rules" 5) Can see the "big picture," coordinate services, and forecast needs
question
In the hospital where you work as a registered nurse, nursing tasks are specialized. You are responsible for performing ordered treatments, such as giving injections, taking blood draws, and taking vital signs. A licensed practical nurse distributes medications to patients. A nursing assistant gives bed baths and makes the beds. This is an example of which model of nursing care? 1) Case method 2) Functional nursing 3) Team nursing 4) Primary nursing
answer
2) Functional nursing
question
Which of the following were acknowledged by the American Nurses Association (ANA) in 2010 as key characteristics of registered nursing? Select All That Apply 1) Nursing practice is the same for every nurse 2) Nurses coordinate care by establishing partnerships 3) Care is central to the practice of the registered nurse 4) Registered nurses use a corporate process to plan and provide care to their healthcare consumers 5) A strong link exists between the work environment and the nurse's ability to achieve optimal outcomes 6) The profitability of the healthcare facility is central to the practice of the registered nurse
answer
2) Nurses coordinate care by establishing partnerships 3) Care is central to the practice of the registered nurse 5) A strong link exists between the work environment and the nurse's ability to achieve optimal outcomes
question
Your uncle, who is 56, recently has a heart attack and was in the hospital for emergency coronary bypass surgery. After his stay in the hospital, he was moved to a facility for inpatient, multidisciplinary care for 6 weeks to help him recover and regain function. In which type of care facility was your uncle most likely treated? 1) Ambulatory care center 2) Nursing home 3) Rehabilitation center 4) Assisted living facility
answer
3) Rehabilitation center
question
You are interested in joining a nursing organization that has as one of its primary goals the improvement of working conditions for nurses throughout the world. Which of the following organizations would be best for you to join? 1) American Nurses Association 2) National League for Nursing 3) International Council of Nursing 4) Sigma Theta Tau International
answer
3) International Council of Nursing
question
Which of the following are factors that has a strong influence on the evolution of professional nursing? Select All That Apply 1) Buddhism 2) Societal beliefs 3) Architecture 4) Christianity 5) The marketplace 6) The military
answer
2) Social beliefs 4) Christianity 6) The military
question
You perform a blood draw on a patient and afterward the patient says, "Nobody has ever done such a good job finding my vein and taking a blood sample. You really now what you're doing." What type of knowledge is the patient referring to in this situation? 1) Theoretical knowledge 2) Practical knowledge 3) Self-knowledge 4) Ethical knowledge
answer
2) Practical knowledge
question
What are the two components of "doing" in the full-spectrum nursing concepts? 1) Critical thinking and theoretical knowledge 2) Practical knowledge and the nursing process 3) Self-knowledge and ethical knowledge 4) Patient data and patient preferences and context
answer
2) Practical knowledge and the nursing process
question
Which of the following are examples of critical-thinking attitudes? Select All That Apply 1) Independent thinking 2) Intellectual curiosity 3) Intellectual empathy 4) Intellectual pride 5) Intellectual safety 6) Intellectual perseverance
answer
1) Independent thinking 2) Intellectual curiosity 3) Intellectual empathy 6) Intellectual perseverance
question
While caring for a 6-year-old boy who is adjusting to being in the hospital for the first time, you suggest to his father that he bring in the boy's special blanket and favorite stuffed animal to help ease the transition. Which component of caring are you demonstrating by this action? 1) Knowing 2) Being with 3) Doing for 4) Enabling
answer
4) Enabling
question
You are working with a patient who is in severe pain following a traumatic accident. The patient's religious beliefs prevent her from taking any kind of medication for pain. After experimenting with several different nonpharmacological methods of pain management, you discover that a combination of distractions works: the patient views a television program while receiving a shoulder massage, which is reasonably effective in providing her with relief from pain. Which of the following types of complex thinking is this best an example of? 1) Clinical reasoning 2) Diagnostic reasoning 3) Decision making 4) Problem-solving
answer
4) Problem-solving
question
What are the two components of "caring" in the full-spectrum nursing concepts? 1) Critical thinking and theoretical knowledge 2) Practical knowledge and the nursing process 3) Self-knowledge and ethical knowledge 4) Patient data and patient preferences and context
answer
3) Self-knowledge and ethical knowledge
question
Which of the following are examples of critical-thinking skills? Select All That Apply 1) Subjectively gathering information about a problem or issue 2) Recognizing the need for more information 3) Assuming the credibility and usefulness of sources of information 4) Recognizing gaps in one's knowledge 5) Speaking carefully 6) Separating relevant from irrelevant data
answer
2) Recognizing the need for more information 4) Recognizing gaps in one's knowledge 6) Separating relevant from irrelevant data
question
A hospital administrator calls and asks you to prioritize treatment of a patient who is related to the administrator. This request bothers you, and you decide to report it to your supervisor. Which type of nursing knowledge are you acting on in this situation? 1) Theoretical knowledge 2) Practical knowledge 3) Self-knowledge 4) Ethical knowledge
answer
4) Ethical knowledge
question
After assessing a client, you determine that the client has the following problem: imbalanced nutrition: less that body requirements. At which phase in the nursing process are you? 1) Assessment 2) Diagnosis 3) Planning 4) Implementation
answer
2) Diagnosis
question
Which of the following are components of the definition of critical thinking? Select All That Apply 1) Reasoned thinking 2) Openness to alternatives 3) Adherence to established guidelines 4) Ability to reflect 5) Loyalty to traditional approaches 6) Desire to seek the truth
answer
1) Reasoned thinking 2) Openness to alternatives 4) Ability to reflect 6) Desire to seek the truth
question
You are in the process of assessing a patient who is of another race and religion than yours. As you perform the assessment, you begin to wonder what factors—including the patient's race and religion—may be influencing your behavior in this situation. Which thinking process in the critical-thinking model are you demonstrating? 1) Contextual awareness 2) Inquiry 3) Considering alternatives 4) Reflecting skeptically and deciding what to do
answer
1) Contextual awareness
question
In the course of a day, you encounter many different types of patients. Which of the following patients would most require you to use the most complex critical thinking skills in your care of him or her? 1) An 18-year-old football player who has broken his leg 2) A 60-year-old school teacher who has strep throat 3) A 45-year-old attorney who has developed high blood pressure 4) An 80-year-old woman with diabetes who has broken her hip
answer
4) An 80-year-old woman with diabetes who has broken her hip
question
You have just finished a physical examination of an 8-year-old girl and discovered bruises on her body in places that make you suspect that she has been physically abused. Before you investigate that line of reasoning, however, you stop and think about all the other likely ways that a child her age could obtain bruises in those locations. Which thinking process in the critical-thinking model are you demonstrating? 1) Contextual awareness 2) Inquiry 3) Considering alternatives 4) Reflecting skeptically and deciding what to do
answer
3) Considering alternatives
question
Place the following six phases of the nursing process in correct order. - Evaluation - Planning outcomes - Implementation - Assessment - Planning Interventions - Diagnosis
answer
1) Assessment 2) Diagnosis 3) Planning Outcomes 4) Planning Interventions 5) Implementation 6) Evaluation
question
Which of the following is an example of a nurse who is using critical thinking? 1) Following the hospital's new policy to require a photo ID for all visitors to the birthing center 2) Questioning a medication order from a physician that doubles the patient's dosage when the patient exhibited no changes in a recent office visit 3) Recording the patient's vital signs once an hour, per the physician's request 4) Calculating the proper dosage of a child's oral medication based on established height/weight charts
answer
2) Questioning a medication order from a physician that doubles the patient's dosage when the patient exhibited no changed in a recent office visit
question
You are conducting an initial assessment of a new client. The client does not have time today for a comprehensive assessment, so you will be doing that at the client's next visit. Which of the following types of data should you collect as part of this assessment? Select All That Apply 1) Status of a healing laceration 2) Emotional status 3) Phone number 4) Blood pressure 5) Marital status 6) Occupation
answer
3) Phone number 5) Marital status 6) Occupation
question
A patient is in the examination room waiting to be assessed. You are the registered nurse assigned to assess the patient. You also have a nurse aide assisting you. Which aspects of the patient's assessment would be appropriate for you to delegate to the nurse aide? 1) Take the patient's temperature 2) Weigh the patient 3) Validate the data collected 4) Measure the patient's height 5) Conduct the patient interview 6) Complete the physical assessment
answer
1) Take the patient's temperature 2) Weigh the patient 4) Measure the patient's height
question
As you perform a detailed assessment of a 10-year-old client, the client asks, "Why are you taking so long to check me out?" What is your most appropriate response to this patient? 1) "I have to figure out what's wrong with you." 2) "I have to get enough information so that I can help you." 3) "I have to decide what kind of treatment to give you." 4) "I have to help you feel better."
answer
2) I have to get enough information so that I can help you."
question
During a physical examination, you gather much data on a client. Which of the following are data findings that you should validate? Select All That Apply. 1) A report of a height of 6 feet, 6 inches in a client who appears very tall 2) A blood pressure reading of 80/60 mm Hg in a client with hypertension who is not on medication 3) A heart rate of 40 beats/min in a moderately active 45-year-old 4) A denial of illicit drug use in conjunction with the observation of needle track marks on the client's arm 5) An oral temperature of 98.2*F 6) A total cholesterol score of 245
answer
2) A blood pressure reading of 8-/60 mm Hg in a client with hypertension who is not on medication 3) A heart rate of 40 beats/min in a moderately active 45-year-old 4) A denial of illicit drug use in conjunction with the observation of needle track marks on the client's arm
question
As you perform an assessment of a client, which of the following actions are required by The Joint Commission? Select All That Apply 1) Record findings of the assessment in writing or on a computer tablet 2) Delegate taking the patient's biometric measures to a nurse aide 3) Include evaluation of the client's physical, psychological, and social status in the assessment 4) Follow agency policy regarding when the client is to be reassessed 5) Assess the client for possible physical abuse 6) Assess the client for pain
answer
1) Record findings of the assessment in writing or on a computer tablet 3) Include evaluation of the client's physical, psychological, and social status in the assessment 4) Follow agency policy regarding when the client is to be reassessed 6) Assess the client for pain
question
Which phase of the nursing process uses the data gathered during assessment to identify the client's health problems and strengths? 1) Planning Interventions 2) Implementation 3) Diagnosis 4) Evaluation
answer
3) Diagnosis
question
You are assessing a child with sickle cell disease who is experiencing an acute pain crisis. You are concerned that the child's spleen may be enlarged, which is a serious complication of this disease. You don't see any signs of enlargement in the patient's abdomen but you know that the condition may still be present. You decide to examine the patient's abdomen by feel. Which of the following physical assessment techniques are you using? 1) Inspection 2) Palpation 3) Percussion 4) Auscultation
answer
2) Palpation
question
You are documenting the assessment data of a client. Which of the following is the most appropriate documentation? 1) Patient is angry over a long wait in the waiting room 2) Client is intoxicated 3) Child has bruises from being spanked 4) Patient has a cluster of three clear vesicles on the upper lip
answer
4) Patient has a cluster of three clear vesicles on the upper lip
question
As a new nurse, you are interviewing a 15-year-old client as part of a comprehensive assessment and come to the portion of the health history that relates to her sexual health. You are embarrassed to ask someone her age about her sex life and you fear what her reaction will be. Which of the following actions should you take? 1) Skip this section and assume that the client will mention any problem she has in this area 2) Ask a more experienced nurse to complete the interview 3) Ask to speak to the client's mother about this topic 4) Explain that you will keep all information confidential and then ask the necessary questions
answer
4) Explain that you will keep all information confidential and then ask the necessary questions
question
You are interviewing a client to obtain information about his health history. Because he appears nervous, you begin by using directive interviewing. Which of the following is an example of a question you might ask when using this type of interviewing? 1) "How has your weight loss program been going?" 2) "When was your last physical examination?" 3) "What signs or symptoms have you experienced related to your diabetes?" 4) "How would you describe your work environment?"
answer
2) "When was your last physical examination?"
question
In your interview with a new client, you learn that she drinks six beers a day. In which section of the nursing health history would you record this information? 1) Biographical data 2) Chief complaint 3) Family health history 4) Social history
answer
4) Social history
question
You are assessing the functional abilities of a client who is in hospice care and nearing the end of life. Which of the following special needs assessments would be most appropriate to use with this client? 1) Katz Index of Activities of Daily Living (ADL) scale 2) Lawton Instrumental Activities of Daily Living (IADL) scale 3) Karnofsky Performance scale 4) Wellness assessment
answer
3) Karnofsky Performance scale
question
You have just completed a client assessment and need to record the data you have gathered. Which of the following guidelines should you observe as you complete this task? Select All That Apply. 1) Wait at least 24 hours before recording 2) If recording on paper, write only with pencils 3) Write the patient's own words, when possible, in quotation marks 4) Record only the most important patient words 5) Record inferences, not cues 6) Use concrete, specific information rather than vague generalities
answer
3) Write the patient's own words, when possible, in quotation marks 4) Record only the most important patient words 6) use concrete, specific information rather than vague generalities
question
You are preparing for an interview with a client and deciding how to incorporate directive and nondirective interviewing techniques. Which of the following is a disadvantage of directive interviewing? 1) It may cause you to miss topics important to the patient 2) It is ineffective 3) It can produce much irrelevant data 4) It is not effective for clients who are anxious
answer
1) It may cause you to miss topics important to the patient
question
A patient arrives at the clinic where you work complaining of pain in her temples. She describes the pain as throbbing and intense. This is an example of which type of data? 1) Primary subjective 2) Primary objective 3) Secondary subjective 4) Secondary objective
answer
1) Primary subjective
question
As you are weighing a client and calculating her body mass index, you begin to think that a diagnosis of "Imbalanced nutrition: more than body requirements" would be appropriate for this client. Which of the following is true of this guess? 1) It illustrates that nursing diagnosis actually begins during assessment 2) It is an example of a nurse not properly following the nursing process 3) It is an example of the nurse making a medical diagnosis, which should not be done 4) It proves that the nursing process need not be followed
answer
1) It illustrates that nursing diagnosis actually begins during assessment.
question
You have written your diagnostic statements for a client. Which of the following criteria should you use to judge their quality? Select All That Apply 1) In choosing a NANDA-I label, do not rely on the label definition alone 2) Include both problem and etiology, with cause and effect stated correctly 3) Be sure that the etiology restates the problem 4) Use medical diagnosis and treatments as etiological factors 5) Write the statement concisely 6) Be sure the statement is descriptive and specific
answer
1) In choosing a NANDA-I label, do not rely on the label definition alone. 2) Include both problem and etiology, with cause and effect stated correctly. 5) Write the statement concisely. 6) Be sure the statement is descriptive and specific.
question
You are in the process of selecting a diagnostic label for a health problem of a client. Which of the following is the first step you should take in this process? 1) Narrow your search to the class or most likely labels 2) Identify the domain that seems to fit the cue cluster 3) Consult a nursing diagnosis handbook 4) Compare definitions and defining characteristics of the diagnostic labels to your cue cluster
answer
2) Identify the domain that seems to fit the cue cluster.
question
You are caring for a client who complains of having hard stool and of not having had a bowel movement in 3 or 4 days. You suspect that the client has constipation. Moreover, after seeing his intake and output measures, you believe that the constipation is caused by inadequate intake of fluids and fiber-rich foods. Which of the following would be an appropriate nursing diagnosis based on these findings? 1) Hard stool and bowel movement every 3 or 4 days r/t constipation AMB inadequate intake of fluids and fiber-rich foods 2) Inadequate intake of fluids and fiber-rich foods r/t constipation AMB painful, hard tool and bowel movement every 3 or 4 days 3) Constipation r/t inadequate intake of fluids and fiber-rich foods AMB painful, hard tool and bowel movement every 3 or 4 days 4) Hard stool and bowel movement every 3 or 4 days r/t inadequate intake of fluids and fiber-rich foods AMB constipation
answer
3) Constipation r/t inadequate intake of fluids and fiber-rich foods AMB painful, hard tool and bowel movement every 3 or 4 days
question
Which of the following is an example of an actual nursing diagnosis? 1) Risk for infection related to surgery 2) Impaired walking related to a diabetic ulcer 3) Possible risk for imbalanced nutrition: less than body requirements 4) Readiness for enhanced nutrition
answer
2) Impaired walking related to a diabetic ulcer
question
While caring for a patient in the hospital, you note ulcers on the patient's feet. You recall that the patient's laboratory test results indicated a high blood glucose level. Which of the following is an appropriate nursing diagnosis that you could make in this situation? 1) Advanced type 2 diabetes mellitus 2) Staphylococcus infection of the feet 3) Impaired tissue integrity 4) Potential complication of type 2 diabetes mellitus: hyperglycemia
answer
3) Impaired tissue integrity
question
You are reflecting critically on your diagnostic reasoning after formulating a nursing diagnosis. Which of the following questions should you ask yourself to evaluate your self-knowledge? Select All That Apply. 1) Is this diagnosis based on sound knowledge? 2) What biases and stereotypes may have influenced my interpretation of the data? 3) Did I rely too much on past experiences? 4) Do I feel reasonably sure I have interpreted the data correctly? 5) Did I rely too much on the client's medical diagnosis, the setting, or what others say about the client instead of on the data? 6) Am I qualified to make this diagnosis, or should I consult with a more experienced nurse or other member of the collaborative healthcare team?
answer
2) What biases and stereotypes may have influenced my interpretation of the data?3) Did I rely too much on past experiences? 6) Am I qualified to make this diagnosis, or should I consult with a more experienced nurse or other member of the collaborative healthcare team?
question
Which of the following is the first step in the process of analyzing and interpreting data? 1) Cluster cues 2) Identify data gaps 3) Identify significant data 4) Identify data inconsistencies
answer
3) Identify significant data
question
Which of the following is the best definition of health problem? 1) Any condition that requires intervention to promote wellness or to prevent or treat disease or illness 2) A statement of client health status that nurses can identify, prevent, or treat independently 3) A description of a disease, illness, or injury developed so that appropriate medical treatment can be given 4) A complication related to a disease that a nurse monitors to detect a change in status
answer
1) Any condition that requires intervention to promote wellness or to prevent or treat disease or illness
question
You are preparing to write a collaborative problem diagnosis. Which of the following elements is typically left out of a collaborative problem? 1) Complication 2) Disease 3) Etiology 4) The word potential
answer
3) Etiology
question
Which of the following is an example of a wellness nursing diagnosis? 1) Risk for infection related to surgery 2) Impaired walking related to a diabetic ulcer 3) Possible risk for imbalanced nutrition: less than body requirements 4) Readiness for enhanced nutrition
answer
4) Readiness for enhanced nutrition
question
You are working with a client in the hospital who has lost 5 pounds since being admitted. You recognize that this client is probably experiencing imbalanced nutrition: less than body requirements. Which of the following are likely etiologies related to this diagnosis? Select All That Apply. 1) Excessive fear of weight gain 2) Self-induced vomiting related to self-starvation 3) Diet high in fat 4) Inability to ingest food 5) Lack of physical activity 6) Depression
answer
1) Excessive fear of weight gain 2) Self-induced vomiting related to self-starvation 4) Inability to ingest food 6) Depression
question
Put the following steps of the diagnostic reasoning process in the correct order. - Verify problems with the patient. - Analyze and interpret data. - Record the diagnostic statements. - Draw conclusions about the patient's health status. - Prioritize the problems.
answer
1) Analyze and interpret data 2) Verify problems with the patient 3) Draw conclusions about the patient's health status 4) Record the diagnostic statements 5) Prioritize the problems
question
Which of the following is an accurate statement regarding the relationship of the nursing diagnosis to outcomes and interventions? 1) The problem suggests the goals. 2) The etiology suggests the problem. 3) The goals suggest the etiology. 4) The interventions suggest the etiology.
answer
1) The problem suggests the goals.
question
You are preparing to prioritize the health problems that you have identified for a patient. You have decided to prioritize them based on the problems that relate to the client's most basic human needs. Which theoretical framework are you using? 1) Problem urgency 2) Future consequences 3) Patient preference 4) Maslow's hierarchy
answer
4) Maslow's hierarchy
question
You are creating a comprehensive care plan for a patient. Which of the following are examples of appropriate information to include in this plan? Select All That Apply. 1) Assistance the patient will require with bathing 2) Prescriptions for an antibiotic and an analgesic 3) A detailed family health history 4) A nursing diagnosis of "Impaired mobility related to fractured toe" 5) Information on the patient's insurance plan 6) Special teaching on care of an ostomy pouch
answer
1) Assistance the patient will require with bathing 2) Prescriptions for an antibiotic and an analgesic 4) A nursing diagnosis of "Impaired mobility related to fractured toe" 6) Special teaching on care of an ostomy pouch
question
You are caring for a patient who is experiencing significant pain following surgery. You have been administering acetaminophen by mouth for the past 24 hours but can clearly see that the patient's pain level is high. You add a note to the patient's care plan and notify the patient's provider about the pain, recommending a change in medication. Which type of planning is this? 1) Initial, formal 2) Initial, informal 3) Ongoing, formal 4) Ongoing, informal
answer
3) Ongoing, formal
question
Your hospital has recently implemented a new electronic health record system that includes computer-generated care plans. Which of the following are advantages of computerized planning? Select All That Apply. 1) Increases the use of intuition 2) Ensures consideration of a variety of actions 3) Prevents overlooking common and important interventions4) Increases the use of insight 5) Reduces time spent on paperwork 6) Enhances nursing expertise
answer
2) Ensures consideration of a variety of actions 3) Prevents overlooking common and important interventions 5) Reduces time spent on paperwork
question
You are using the standardized Nursing Outcomes Classification (NOC) vocabulary to develop patient outcomes. In NOC vocabulary, the observable behaviors and states you can use to evaluate patient status are which of the following? 1) Indicators 2) Outcomes 3) Measurement scales 4) Outcome labels
answer
1) Indicators
question
You are formulating a goal for a patient who is experiencing a disturbed sleep pattern related to anxiety about finances. Which of the following would be specific and concrete performance criteria for such a goal? Select All That Apply. 1) Will return to a normal sleep pattern 2) Will sleep at least 8 hours each night 3) Will fall asleep within 1 hour of going to bed 4) Will get enough sleep at night 5) Will report feeling rested in the morning 6) Will sleep more
answer
2) Will sleep at least 8 hours each night 3) Will fall asleep within 1 hour of going to bed 5) Will report feeling rested in the morning
question
You are preparing to discharge a client and are deciding whether you need to create a comprehensive, formal discharge plan. Which of the following client characteristics or situations would tend to necessitate a formal discharge plan? Select All That Apply. 1) Mental illness 2) Medication continued at home 3) Complicated major surgery 4) Inadequate financial resources 5) A significant other to help provide care 6) Malnutrition
answer
1) Mental illness 3) Complicated major surgery 4) Inadequate financial resources 6) Malnutrition
question
You have given a client the following nursing diagnosis: Ineffective Airway Clearance related to ineffective cough secondary to incisional pain. Which of the following is an example of an essential patient goal related to this diagnosis? 1) Coughs forcefully/effectively 2) Rates pain as < 3 on a scale of 1 to 10 scale 3) Splints incision while coughing 4) Lungs clear to auscultation
answer
4) Lungs clear to auscultation
question
Below are the steps in the process for writing an individualized patient care plan. Put them in the correct order. - Transcribe medical orders to appropriate documents - Write activities of daily living and basic care needs in special sections of the Kardex, care plan, or computer - Make a working problem list - Develop individualized care plans for problems not addressed by standardized documents - Decide which problems can be managed with standardized care plans or critical pathways - Individualize the standardized plan as needed
answer
1) Individualize the standardized plan as needed 2) Write activities of daily living and basic care needs in special sections of the Kardex, care plan, or computer 3) Make a working problem list 4) Transcribe medical orders to appropriate documents 5) Decide which problems can be managed with standardized care plans or critical pathways 6) Develop individualized care plans for problems not addressed by standardized documents
question
You have diagnosed a patient with the following nursing diagnosis: Possible Constipation related to suspected inadequate intake of fiber and fluids. Which of the following is the appropriate patient goal to address this diagnosis? 1) Will have normal, formed bowel movement within 24 hours after receiving stool softener 2) Will have bowel function within normal limits for patient 3) There is no patient goal. 4) Reports increased intake of dietary fiber and fluids
answer
3) There is no patient goal.
question
You have given a client you are working with a nursing diagnosis of "Impaired Mobility related to atrophied muscles from confinement to bed." Which of the following states an appropriate long-term goal that addresses that problem? 1) Walk three steps using a walker 2) Walk down the hall and back unassisted 3) Perform exercises daily to strengthen legs 4) Client resists efforts at rehabilitating his legs
answer
2) Walk down the hall and back unassisted
question
In preparing a care plan for a patient, you decide to use a preprinted plan. The plan you choose groups patients according to diagnosis, describes the minimal standard of care required to meet the recommended length of stay, and specifies patient outcomes and broad interventions for each day and each hour. Which type of plan have you chosen? 1) Unit standards of care 2) Critical pathway 3) Standardized patient care plan 4) Integrated plans of care
answer
2) Critical pathway
question
A new nurse you are training asks why you have to write down the patient care plan. She tells you that at her last job, she didn't have to write anything down. Which of the following reasons would you tell her? Select All That Apply. 1) To ensure that care is complete 2) To help instill confidence in patients 3) To provide continuity of care 4) To promote efficient use of nursing efforts 5) To provide a guide for assessments and charting 6) To meet the requirements of accrediting agencies
answer
1) To ensure that care is complete 3) To provide continuity of care 4) To promote efficient use of nursing efforts 5) To provide a guide for assessments and charting 6) To meet the requirements of accrediting agencies
question
During your physical examination of a new client, you observe that she appears underweight and you make a mental note that she may require counseling related to disordered eating. Which type of planning is this? 1) Initial, formal 2) Initial, informal 3) Ongoing, formal 4) Ongoing, informal
answer
2) Initial, informal
question
You are formulating goals as part of creating an individualized care plan for a client. Which of the following is a goal or expected outcome, as opposed to just an outcome? 1) Constipation relieved 2) Pain level unchanged 3) Anxiety related to pending surgery 4) Allergic reaction to penicillin
answer
1) Constipation relieved
question
A patient is becoming discouraged because she is struggling to relearn how to brush her teeth after a stroke. You decide to have her first attempt to grasp her modified toothbrush handle and hold it up for 10 seconds. This is an example of which of the following? 1) Short-term goal 2) Long-term goal 3) Short-term outcome 4) Long-term outcome
answer
1) Short-term goal
question
Nursing interventions are actions based on clinical judgment and nursing knowledge that nurses perform to achieve client outcomes. Interventions are also referred to as which of the following? Select All That Apply. 1) Goals 2) Outcomes 3) Nursing actions 4) Measures 5) Strategies 6) Activities
answer
3) Nursing actions 4) Measures 5) Strategies 6) Activities
question
Put the following steps in the evidence-based practice process in correct order. - Formulating an answerable question about prevention, diagnosis, prognosis (likely outcome), and interventions - Evaluating or grading the quality of the evidence obtained - "Translating" the evidence into guidelines for practice - Integrating the guidelines and evidence with clinical expertise and the patient's preferences and characteristics - Compiling and analyzing the data to prepare a structured report of the review - Conducting a systematic review of published evidence (research) to find studies that shed light on the desired topic
answer
1) Formulating an answerable question about prevention, diagnosis, prognosis (likely outcome), and interventions 2) Evaluating or grading the quality of the evidence obtained 3) Integrating the guidelines and evidence with clinical expertise and the patient's preferences and characteristics. 4) Compiling and analyzing the data to prepare a structured report of the review 5) "Translating" the evidence into guidelines for practice 6) Conducting a systematic review of published evidence (research) to find studies that shed light on the desired topic
question
You are reflecting critically about a nursing order you have just composed for a client. You should make sure that the order is which of the following? Select All That Apply. 1) Complete, addressing all aspects of the problem 2) Generic, able to be used for a wide variety of clients 3) Clear, specific, and precise, avoiding vague language 4) Long and complex, including the details of all procedures 5) Technically complete, including all required components 6) Prioritized, indicating which orders must be implemented immediately
answer
1) Complete, addressing all aspects of the problem 3) Clear, specific, and precise, avoiding vague language 5) Technically complete, including all required components 6) Prioritized, indicating which orders must be implemented immediately
question
In caring for a patient who is confined to bed in the hospital for many weeks, you are seeking interventions to help prevent decubitus ulcers, or pressure sores. You decide to conduct a systematic review of published research to find studies that shed light on this topic. This action is an example primarily of which of the following? 1) Theory 2) Critical pathway 3) Evidence-based practice 4) Protocol
answer
3) Evidence-based practice
question
You are preparing to perform a blood draw on a client who is seated in a phlebotomy chair. The client appears pale and confesses that he "gets squeamish" at the sight of blood. Which of the following responses best illustrates the use of the critical-thinking skill of predicting to help generate an intervention in this situation? 1) With other clients who were squeamish, I have successfully distracted them by making small talk; maybe that will work for this client. 2) Because the client is squeamish, he may faint during the blood draw, so I should have him lie down. 3) I learned in a music therapy workshop that music can help calm anxious clients; perhaps I should play some soft music. 4) This client is experiencing a vasovagal response, in which the parasympathetic nervous system is triggered by a threat in the environment.
answer
2) Because the client is squeamish, he may faint during the blood draw, so I should have him lie down.
question
Below are the steps for selecting the best nursing intervention for each patient. Put them in the correct order. - Identify several interventions or actions - Review the nursing diagnosis - Choose the best interventions for the patient - Review the desired patient outcomes - Individualize standardized interventions
answer
1) Review the desired patient outcomes 2) Individualize standardized interventions 3) Identify several interventions or actions 4) Review the nursing diagnosis 5) Choose the best interventions for the patient
question
You are providing wellness teaching to a client who frequently experiences constipation. Which of the following interventions would be most appropriate in this situation? 1) Recommend an over-the-counter laxative 2) Administer a prescribed stool softener 3) Obtain more data to confirm or rule out constipation 4) Provide the patient with a daily fluid intake guide to promote optimal health
answer
4) Provide the patient with a daily fluid intake guide to promote optimal health
question
You are researching standardized intervention classification systems to find spiritual care interventions to use with your clients. Which of the following are some spiritual care interventions you might consider? Select All That Apply 1) Spiritual growth facilitation 2) Religious ritual enhancement 3) Decision-making support 4) Health screening 5) Spiritual support 6) Bereavement support
answer
1) Spiritual growth facilitation 2) Religious ritual enhancement 5) Spiritual support 6) Bereavement support
question
You are writing up a nursing order for a client. Which of the following components should you include in it? Select All That Apply. 1) Date 2) Subject 3) Prescribed medications 4) Action verbs 5) Times and limits 6) Signature
answer
1) Date 2) Subject 4) Action verbs 5) Times and limits 6) Signature
question
Which of the following is an example of an interdependent intervention? 1) Assisting the client in performing leg exercises and reporting results to the physical therapist 2) Administering a prescribed antibiotic 3) Collecting a stool sample per orders 4) Encouraging the client to increase fluid intake to prevent dehydration
answer
1) Assisting the client in performing leg exercises and reporting results to the physical therapist
question
While caring for a patient one day, you perform many interventions, both direct care and indirect care. Which of the following is an example of an indirect-care intervention? 1) Teaching a patient how to care for an incision site 2) Administering an injection 3) Listening to the patient explain fears related to death 4) Making a referral for the patient to see a speech pathologist
answer
4) Making a referral for the patient to see a speech pathologist
question
You are a home health nurse and are planning interventions for a client who is recovering from a stroke. You would like to use an intervention classification system that is especially designed to meet the needs of home health nursing. Which of the following systems should you choose? 1) North American Nursing Diagnosis Association—International (NANDA-I) 2) Nursing Interventions Classification (NIC) 3) Clinical Care Classification (CCC) 4) Omaha System
answer
3) Clinical Care Classification (CCC)
question
You are caring for a patient for whom you have given the actual nursing diagnosis of constipation. Based on the status of this problem, which of the following interventions should take priority? 1) Encourage the patient to drink more fluids 2) Administer a prescribed stool softener 3) Obtain more data to confirm or rule out the constipation 4) Provide the patient with a daily fluid intake guide to promote optimal health
answer
2) Administer a prescribed stool softener
question
You are counseling a client on potential lifestyle changes to optimize her health. Which of the following is an appropriate wellness intervention for the client? 1) "The client will spend at least 15 minutes per day meditating for the next week." 2) "I will walk at least 1 mile every day at lunch time with a coworker for the next month." 3) "The client will take all prescribed medications at the right time for the next 3 months." 4) "I will perform hand exercises daily to regain strength lost following carpal tunnel surgery."
answer
2) "I will walk at least 1 mile every day at lunch time with a coworker for the next month."
question
Throughout your day as a nurse, you make many interventions, both independent and dependent. Which of the following is an example of an independent intervention? 1) Administering a prescribed analgesic 2) Delegating the bathing of a patient to a nurse aide 3) Drawing blood for an ordered complete blood count 4) Starting IV therapy
answer
2) Delegating the bathing of a patient to a nurse aide
question
You are preparing to discharge a client and have concerns about his ability to adhere to the diabetic diet that you and the nutritionist have developed for him. Which of the following are effective ways to promote cooperation with the diet? Select That All Apply. 1) Assess the client's knowledge of diabetes. 2) Ask the client what concerns he has about going on the diet. 3) Provide teaching on what foods to avoid and what foods will help keep his blood glucose level steady. 4) Talk openly and regularly about adherence. 5) Be determined to change any of the client's attitudes that contribute to resistance to the diet. 6) Help the client set ambitious, challenging goals.
answer
1) Assess the client's knowledge of diabetes. 2) Ask the client what concerns he has about going on the diet. 3) Provide teaching on what foods to avoid and what foods will help keep his blood glucose level steady. 4) Talk openly and regularly about adherence.
question
You are critically reflecting on variables that could have affected the results of an intervention. Which of the following should you consider? Select All The Apply. 1) Client's ability and motivation to follow directions for treatment 2) Effectiveness of the same treatment in clients in other regions 3) Availability and support from family and significant others 4) Client's family history 5) Client's lack of experience, knowledge, or ability 6) Staffing in the institution
answer
1) Client's ability and motivation to follow directions for treatment 3) Availability and support from family and significant others 5) Client's lack of experience, knowledge, or ability 6) Staffing in the institution
question
Which of the following are key components of the implementation phase? Select All That Apply. 1) Diagnosing 2) Data gathering 3) Doing 4) Documenting 5) Decision making 6) Delegating
answer
3) Doing 4) Documenting 6) Delegating
question
You are evaluating a client's collaborative problem of Potential Complication of myocardial infarction: congestive heart failure (CHF). Which of the following should be your primary goal in such evaluation? 1) Client reports no pain. 2) Client's reassessment data are within normal range. 3) Client achieves activities of daily living. 4) Client does not have another heart attack.
answer
2) Client's reassessment data are within normal range.
question
As you are preparing to implement your nursing plan for applying dressings to a client who has sustained third-degree burns, you decide that it would be best to include times during each intervention that you will stop and check in with the client before continuing. This action is known as which of the following? 1) Checking your knowledge and abilities 2) Preparing supplies and equipment 3) Establishing feedback points 4) Preparing the patient
answer
3) Establishing feedback points
question
A scale is reliable if it does which of the following? 1) Functions for many years 2) Yields consistent results time after time 3) Is accurately measuring a person's mass or weight 4) Is achieving expected or accepted levels of performance
answer
2) Yields consistent results time after time
question
You are preparing to delegate several tasks to a licensed vocational nurse. Which of the following "rights" of delegation should you keep in mind as you do this? Select All That Apply. 1) Right task 2) Right circumstance 3) Right dosage 4) Right person 5) Right communication 6) Right supervision
answer
1) Right task 2) Right circumstance 4) Right person 5) Right communication 6) Right supervision
question
You are now entering the implementation phase of the nursing process with a client. Which of the following are actions that would be appropriate to take in the implementation phase? Select All That Apply. 1) Write up a nursing order for the client. 2) Reposition a pregnant patient to her side to prevent compression of the inferior vena cava vein. 3) Develop expected outcomes related to a patient's progress with feeding himself. 4) Document a patient's anaphylactic response to a medication. 5) Delegate the application of cold compresses to the patient's forehead to a nurse aide. 6) Interview the patient to obtain a detailed health history.
answer
2) Reposition a pregnant patient to her side to prevent compression of the inferior vena cava vein. 4) Document a patient's anaphylactic response to a medication. 5) Delegate the application of cold compresses to the patient's forehead to a nurse aide.
question
One of your patients needs to be transported via wheelchair to radiology for a chest x-ray. You have a nurse aide perform this task. This is an example of which of the following? 1) Assigning 2) Delegating 3) Collaborating 4) Coordinating
answer
2) Delegating
question
Which of the following is a program designed to promote excellence in nursing? 1) Quality assurance 2) Reliability 3) Validity 4) Collaboration
answer
1) Quality assurance
question
A client has been on cholesterol medication for 6 months now and recently had her cholesterol level checked. Although greatly improved, the cholesterol level is still above normal. The client will return in another 6 months to have her cholesterol checked again. Which type of evaluation is this? 1) Initial evaluation 2) Ongoing evaluation 3) Intermittent evaluation 4) Terminal evaluation
answer
3) Intermittent evaluation
question
After evaluating a care plan, you determine that some goals have been met but others have not. Which of the following would be the most appropriate actions to take at this point? Select All That Apply. 1) Discontinue the care plan. 2) Examine the entire plan. 3) Revise the care plan only in the areas of the unmet goals. 4) Review all steps of the nursing process. 5) Revise the entire plan. 6) Continue with the same plan but allow more time for goal achievement.
answer
3) Revise the care plan only in the areas of the unmet goals. 6) Continue with the same plan but allow more time for goal achievement.
question
You are performing an evaluation of the adequacy of your facility's radiography equipment to meet the imaging demands of patients. Which type of evaluation are you conducting? 1) Structure 2) Process 3) Outcomes 4) Reliability
answer
1) Structure
question
You are training a new nurse on the evaluation phase of the nursing process. The nurse asks why evaluation is important. Which of the following are correct rationales for evaluation that you should tell the nurse? Select All That Apply. 1) To identify incompetent nurses so that they may be terminated 2) To ensure positive outcomes for patients 3) To conserve scarce resources 4) To validate established nursing practices 5) To satisfy professional standards of practice 6) To help ensure nursing's survival
answer
2) To ensure positive outcomes for patients 3) To conserve scarce resources 5) To satisfy professional standards of practice 6) To help ensure nursing's survival
question
Below are the steps for evaluating patient progress. Put them in the correct order. - Record the evaluative statement - Judge goal achievement - Review outcomes - Collect reassessment data
answer
1) Record the evaluative statement 2) Judge goal achievement 3) Collect reassessment data 4) Review outcomes
question
Which of the following are the four essential concepts of a nursing theory? 1) Nurse, context, patient, and health 2) Caring, person, theory, and nursing 3) Health, setting, patient, and treatment 4) Person, environment, health, and nursing
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4) Person, environment, health, and nursing
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You decide to conduct a qualitative study of asthma. Which of the following might be characteristics of such a study? Select All That Apply. 1) Goal of generalizing results to a similar population 2) Large numbers of subjects 3) Focus on the lived experience of a 12-year-old girl with asthma 4) Use of words and quotations from people interviewed 5) Controlled data collection 6) Purpose of sharing the experience of people in the study
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3) Focus on the lived experience of a 12-year-old girl with asthma 4) Use of words and quotations from people interviewed 6) Purpose of sharing the experience of people in the study
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You decide to develop your own theory of nursing. You begin by taking it for granted that all nurses have an impulse to serve those who are in need. This idea is an example of which of the following? 1) Phenomenon 2) Assumption 3) Concept 4) Definition
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2) Assumption
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Which of the following are true of theory? Select All That Apply. 1) A theory is a fact. 2) A theory is based on observations of facts. 3) A theory is a collection of random and unrelated ideas and concepts. 4) A theory helps us find meaning in our experiences. 5) A theory is a way of viewing reality. 6) A theory answers the question "Who am I?"
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2) A theory is based on observations of facts. 4) A theory helps us find meaning in our experiences. 5) A theory is a way of viewing reality.
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You have located a dozen research articles that directly address your research question and are preparing to read them. What questions should you ask yourself during reading so that you can best analyze the value of each article? Select All That Apply. 1) What is the book, journal, or article about as a whole? 2) What is being said in detail, and how? 3) How many pages does the article contain? 4) Is the book, journal, or article "true" in whole or part? 5) How long will it take to read the article? 6) Is it of any significance?
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1) What is the book, journal, or article about as a whole? 2) What is being said in detail, and how? 4) Is the book, journal, or article "true" in whole or part? 6) Is it of any significance?
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Which of the following accurately describe nursing research? Select All That Apply. 1) Requires a master's degree in nursing for one to participate in it 2) Is systematic 3) Is subjective 4) Involves analysis of phenomena 5) Encompasses all clinical practice areas 6) Provides evidence on which to base nursing care
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2) Is systematic 4) Involves analysis of phenomena 5) Encompasses all clinical practice areas 6) Provides evidence on which to base nursing care
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You are interested in researching the unique role or function that nurses perform and the basic needs of patients that they address. You should investigate the theory of which of the following nursing theorists? 1) Florence Nightingale 2) Virginia Henderson 3) Hildegard Peplau 4) Nola Pender
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2) Virginia Henderson
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You are formulating a searchable research question that considers the effectiveness of nonpharmacological methods of pain management with the use of analgesics. You are at the point now at which you are deciding which nonpharmacological methods to research. At which point in the acronym PICO is this question addressed? 1) P 2) I 3) C 4) O
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2) I
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Below are six basic human needs that make up Maslow's Hierarchy of Needs. Put them in the correct order, from the most basic need to the least basic need. - Self-esteem needs - Self-actualization needs - Physiological needs - Safety and security needs - Transcendence of self - Love and belonging needs
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1) Safety and security needs 2) Transcendence of self 3) Self-esteem needs 4) Self-actualization needs 5) Love and belonging needs 6) Physiological needs
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After consulting with many nursing colleagues, you are surprised at how many do not use research as the basis for their practice. Which of the following are common barriers to using research? Select All That Apply. 1) Negative attitudes toward research 2) Lack of research conducted in areas relevant to the field of nursing 3) Lack of knowledge of nursing research 4) Inadequate forums for disseminating research 5) Lack of support from the employing institution 6) Study findings that are not ready for the clinical environment
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1) Negative attitudes toward research 3) Lack of knowledge of nursing research 4) Inadequate forums for disseminating research 5) Lack of support from the employing institution 6) Study findings that are not ready for the clinical environment
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After working in a new job at a hospital for several months, you observe that the method in place for administering patient medications seems inefficient. With the permission of your charge nurse, you implement a new approach to administration of medications, using it for 1 week and then reverting to the established method the following week. You follow this plan for a month and record the time it takes each shift to administer the regular medications. You find in the end that the hospital's approach was actually faster. What method of gaining knowledge did you employ in this case? 1) Authority and tradition 2) Scientific method 3) Logical reasoning 4) Trial and error plus common sense
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2) Scientific method
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You are looking for a narrowly focused nursing construct that will specifically guide how you approach teaching patients self-care just before discharge from the hospital. Which of the following should you consider? 1) Grand theories 2) Clinical practice theories 3) Conceptual frameworks 4) Conceptual models
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2) Clinical practice theories
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You are assisting a nurse researcher in conducting a research study on the sleep quality of inpatients in a large metropolitan hospital. Halfway through the study, one of your subjects informs you that he no longer wants to participate in the study. You recognize his right to leave the study and thank him for participating. Which right has this subject exercised? 1) Right to full disclosure 2) Right to self-determination 3) Right not to be harmed 4) Right to privacy
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2) Right to self-determination
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Below are the phases of the research process. Put them in the correct order. - Select a research design - Analyze data - Collect data - Use the research findings - Select and define the problem
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1) Use the research findings 2) Collect data 3) Select a research design 4) Analyze data 5) Select and define the problem
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During a late shift in the emergency room, you see a patient arrive limping and supported on either side by a friend. When you examine the patient's leg, you see that the ankle is swollen and red. The patient describes the pain as severe, especially when he puts any weight on the leg. You determine from these findings that the ankle is likely fractured. Which of the following processes did you use to arrive at this conclusion? 1) Deductive reasoning 2) Conceptual framework 3) Inductive reasoning 4) Conceptual model
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3) Inductive reasoning
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You are teaching a group of older adults in a senior center on factors that increase their susceptibility to infection. Which of the following should you mention? Select All That Apply. 1) Living alone 2) Smoking cigarettes 3) Obesity 4) Immune-suppressing agents 5) Retirement 6) Urinary catheterization
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2) Smoking cigarettes 4) Immune-suppressing agents 6) Urinary catheterization
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You are providing teaching to a client who frequently develops upper respiratory infections. Which of the following lifestyle practices should you encourage her to adopt to support her immune defenses? Select All That Apply. 1) Drink more water than usual when you have a fever. 2) Maintain a healthy intake of protein during illness. 3) Sleep at least 5 hours per day. 4) Wash your hands frequently. 5) Exercise moderately. 6) Laugh often.
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1) Drink more water than usual when you have a fever. 2) Maintain a healthy intake of protein during illness. 4) Wash your hands frequently. 5) Exercise moderately. 6) Laugh often.
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You are caring for a client with tuberculosis. The pathogen associated with this disease is very small and remains infectious over long distances when suspended in the air. It is easily transmitted through ventilating systems. Which type of precautions should be used with a client with this disease? 1) Standard 2) Contact 3) Droplet 4) Airborne
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4) Airborne
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You are providing training on infection control to healthcare workers at your hospital. Which of the following should you mention as primary defenses of the body against infectious disease? Select All That Apply. 1) Phagocytic white blood cells 2) Fever 3) The skin 4) B lymphocytes 5) Mucous membranes of the trachea 6) Acid in the stomach
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3) The skin 5) Mucous membranes of the trachea 6) Acid in the stomach
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You are donning your personal protective equipment using sterile technique. Put the following steps in correct order. - Perform the surgical scrub. - Put on shoe covers, hair covers, and a mask. - Don gloves using the closed method. - Secure the waist tie on your gown. - Keep your hands within your field of vision at all times. - Don the gown, with assistance from a coworker.
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1) Put on shoe covers, hair covers, and a mask 2) Perform the surgical scrub 3) Don the gown, with assistance from a coworker. 4) Don gloves using the closed method 5)Secure the waist tie on your gown 6) Keep your hands within your field of vision at all times.
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You are preparing to perform a physical examination of a healthy, young student athlete. Which type of precautions should be used with this client? 1) No precautions required 2) Standard 3) Contact 4) Droplet
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2) Standard
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You are caring for a client who has developed methicillin-resistant Staphylococcus aureus (MRSA). Which of the following risk factors related to this infection should you most suspect in this client? 1) Employment in a preschool 2) Multiple sexual partners 3) Multiple stays in the intensive care unit 4) Smoking
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3) Multiple stays in the intensive care unit
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Below are steps to take in the event of a biological epidemic. Put them in the correct order. - Institute the appropriate level of standard precautions. - Recognize an outbreak. - Prepare clients for a pandemic. - Notify the safety officer.
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1) Recognize an outbreak 2) Notify the safety officer 3) Institute the appropriate level of standard precautions 4) Prepare clients for a pandemic
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As a nurse in the intensive care unit, you realize that you are at high risk of transmitting multidrug-resistant organisms (MDROs) to patients. Given what you know about how these organisms are usually transmitted, which of the following infection prevention measures is most important for you to implement? 1) Wearing a mask 2) Wearing a gown 3) Performing hand hygiene 4) Following airborne precautions
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3) Performing hand hygiene
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Which of the following are examples of emerging infectious diseases? Select All That Apply. 1) Microorganisms in humans that extend their host range to begin infecting animals 2) Newly identified diseases caused by an unrecognized microorganism 3) Diseases occurring in new geographical areas 4) Microbes that evolve to become more virulent 5) Known diseases that dramatically decrease in incidence 6) Organisms that are deliberately altered for bioterrorism
answer
2) Newly identified diseases caused by an unrecognized microorganism 3) Diseases occurring in new geographical areas 4) Microbes that evolve to become more virulent