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Future RN 2015
| Question | Answer |
|---|---|
| Abnormal Platelets?: | High at risk for clotting Low at risk for bleeding |
| Abnormal WBC numbers mean? | Patient either has an infection if its high and at risk for infection if low |
| African Americans are more at risk for? | hypertension |
| After surgery you should?: | Assess surgical incision, respiratory and signs of bleeding. |
| ALS | Respiratory complications, respiratory complications A progressive neurologial degeneration, short life expectancy after diagnosis. Palliative care for quality of life |
| Alzheimer's disease: | Toilet them often. Reorient often. Be aware of symptoms of infection if they are unable to tell you, Be aware of sundowning, keep environment consistent and free of unnecessary distractions. |
| Antibiotics | take the whole course |
| Appendicitis | REBOUND TENDERNESS!!! Usually in younger people Right lower quadrant pain |
| Arterial Insufficiency | Color changes, pale skin, decreased pulses, hair absence, poor tissue perfusion, usually have pain with exercise and the pain is relieved by rest Dry wounds, like black toe (I think this is the question |
| Assess for risks for hepatitis: | A & E: Traveling BC: Unprotected sex, needle drug use |
| Braden score: | 15-16 mild risk 12-14 moderate risk <11 severe risk |
| Cardiac landmarks | aortic pulmonic, Erb's (S1 and S2), tricuspid, mitral |
| Catheter considerations: | really good care for catheter and skin. Take it out as soon as you can |
| Catheterization: | Lean in as short of a time as possible because it is a portal for infection;Usually long term only for people who are sedated or paralyzed |
| Caucasian Women are more at risk for??? | Coronary Artery disease? I think? indigestion, heart burn as symptoms |
| Check temp every day with | Chemo, also check left shift often |
| Colon cancer | Genetic risk Dietary risk, lots of processed foods, diets high in meat; Psychosocial with cancer |
| Community acquired Pneumonia: | People with underlying issues in the community, like substance abuse. What does this even mean? that people with substance abuse issues are more likely to get pneumonia? I have no idea. Maybe ignore this one. |
| COPD | Hyper inflated lungs Increased CO2 Hypoxia O2 sats Elevated heart rate Elevated hemoglobin |
| COPD Patients | Often on inhalers and steroids, more at risk for infection. Thrush Need to use inhaler correctly, |
| Crush injuries | Compare sides for vascular compromise, check the 5 p's |
| Cushings Disease: | Diets, high calorie, lots of protein and nourishment |
| Cystic Fibrosis | Lots of mucous, Physiotherapy, Percussion. Focus is to prevents respiratory complications. nutritional issues, supplement pancreatic enzymes. |
| Delegation | ONLY RNS CAN: Assess, educate. LPNS can: Reinforce education and give meds; Make sure you do things first for a patient: feeding a person who just had a stroke. |
| Duchennes Muscular Dystrophy: | Genetic, mother is the carrier, sons get the disease. Usually wheelchair bound(she said this multiple times) Short life expectancy weakness |
| Dignostics for GI | EGD Colonoscopy Occult Blood |
| Esophageal Cancer: | Increased risk: Smoking and drinking, barrets esophagus: chronic acid causes cellular changes |
| . food Poisoning | don't take antidiarrheal Don't become dehydrates, get enough fluids, seek medical attention if it is severe |
| Food Poisoning assessment questions: | Have you traveled anywhere out of country? Have you eaten something you do not normally eat? |
| Gal Bladder | Affects females more, obese, older pregnancy. |
| Hearing Difficulties: | Minimize distractions face them directly focus on visual Modify alarms and phones for flashing lights |
| Heart Failure | Left: Lung issues Right: Edemas Lasix Pillow under the arms Dietary modifications: Avoid salt, canned foods, processed foods, usually on fluid restriction. DAILY WEIGHTS!!!!! Sate time, same scale, same clothes |
| Heart Failure 2 | Make sure they take their meds as prescribes Be aware of potassium ACE inhibitors increase potassium low Na+ diet, check labs K+ |
| Hepatitis | B& C: Blood or body fluids A & E are fecal oral D only can exist with b |
| hypersensitivity reactions | anaphylactic reactions usually are: peanuts, latex, bees |
| hip replacement precautions | do not cross legs, elevated toilet seat |
| How can you tell the difference between cardiac friction rum and pulmonary friction rub? | have the person hold their breath and if you still hear the rub its cardiac if it stops its pulmonary. |
| How is HIV Spread | Using dirty needles or unprotected sex. Healthcare workers are at minimal risk. Treat everyone with precaution, carry gloves all the time |
| how to diagnose leukemia | bone marrow biopsy |
| How to take samples from catheters | you know this so i am not putting it |
| Hyperthyroid assessment | warm, energetic, lost weight |
| Hypothyroid | less calories due to less metabolic demand |
| Hypothyroidism assessment | fatigue, gaining weight, constipation |
| patient is fatigued | rest and space out care |
| dark skin/check for jaundice? | mucous membranes |
| Intrarenal failure | inside the kidney, causes: medications, antibiotics, diabetes, hypertension |
| Kidney biopsy | usually done with ultrasound. In the hospital. kidneys are highly vascular so watch for bleeding. 14 gauge needle |
| kidneys | filter, manage blood pressure, and stimulate red blood cell production. |
| Lab matching CBC | WBC:5000 to 10000 Hgb F:12-16 Hgb M: 14-18 HCT: F35-45% HVT M: 42 to 52% PLT: 150000-400000 BUN: 10-20 Creatinine: 0.5-1.1 |
| Labs | Potassium: 3.5 to 5 be aware of cardiac issues Sodium: 135-145 if its super really low can cause coma seizure and death |
| Labs Electrolytes | k: 3.5 to 5 MG+: 1.1-2.1 CL-: 90-106 Ca+: 9-10.5 Sodium: 135-145 |
| Lactulose concerns | Hypokalemia, losing sodium, skincare |
| Left shift | body is putting out white blood cells that are immature (neutrophil bands). Due to infection or cancer. find out the cause, check temps, do a urinalysis, look for wounds |
| Left shift 2 | Immature white blood cells increased, infection wounds and temp, left shift with sepsis TX: antibiotics |
| Liver Assessment Cirrhosis | Skin tone, check for jaundice yellowing eyes, ascites, peripheral edema, malnutrition |
| Liver Failure Cirrhosis | Stop drinking alcohol or doing drugs. Take lactulose to keep ammonia levels down |
| Liver Labs | AST 5-40 ALT: 3-35 Albumin: 3.5-5.0 Amonia: 15 to 110 |
| Low hemoglobin | Anemia |
| Lumbar Puncture | side lying, not agitated or restless. Be aware of the site for clear fluid draining which could be cerebral spinal fluid. Remember the yellow ring when it dries means it is CSF and not just normal fluid. |
| Matching Question Peripheral artery disease VS Peripheral Venous Disease | PAD: Less hair, reduced pedal pulses, cool temp PVD Discoloration Edema |
| Native Americans Are More at risk for | Diabetes |
| Neurological Assessment | PERRLA Pupils Equal, Round, Reactive to Light and Accommodating, LOC |
| NG tube | check placement; pH etc. Med admin need to flush before and after and between |
| NG tube feeding | sit high fowlers; check residuals before each feeing to ensure digestion. |
| Obstructive sleep apnea: | Obesity, Excessive Daytime Sleepiness, fall asleep a lot, neck circumference |
| Occult Blood Test | people should avoid: aspirin, vitamin C, and red meat for 48 hours before giving a stool specimen |
| Oxygen Education | No smoking Precaution |
| Paget's disease | a chronic disorder where bone is broken down by osteoclasts. reformed by osteoblasts and results in bone deformation. More common in people with a family history |
| Pancreatitis | Lots of pain, lots and lots of pain, give pain meds NPO because eating stimulates the pancreas At risk for shock because enzymes go places they shouldn't and eat things they shouldn't Sometimes they get an nj tube to decompress the stomach |
| postsurgical complications risks | Obese, smokers, previous complications from other surgeries |
| kidney failure | poorly controlled; anemic due to not enough red blood cells |
| High risk for Latex allergies | spinabifida and healthcare workers, people with fruit allergies |
| thyroid issues | usually assessed for infertility issues |
| Pericarditis | inflammation, very painful. You can hear pericardial friction rub. |
| Polycystic kidney disease | Genetic Edema Peri-orbital Edema Pulmonary Edema Usually kidney transplant- Medication compliance important |
| Postoperative considerations | RESPIRATORY Slow Gi: hypo-active bowel sounds Sleepy groggy, |
| Postrenal failure | urine cannot get out, stone, obstruction; usually in ureter; after kidney |
| Preop Planning | identity,Consent, Bathroom, VS, Assess for food/ med allergies and administer Preop Meds time out |
| Preoperative consent | signed inform consent; bilateral surgeries correct marking |
| Prerenal failure | Shock, CHF, Stricture in renal artery, Dehydration (dessert walkers) causes also inadequate blood perfusions |
| Reglan helps with what postop? | induce bowel movement after surgery |
| Respiratory Assessment: | auscultate to lungs; inspect chest diameter; assess Clubbing fingernails; inquire about occupational exposure assess if SOB |
| SIADH | Syndrome of inappropriate antidiuretic syndrome Low serum sodium. Fluid restriction, sodium restriction |
| Sinus Rhythm | look at pic |
| Skin issues in the hospital | can be caused by: bedrest, immobility |
| Spinal Cord injury | autonomic dysreflexia (From urine retention) can result in hypertensive crisis put them on a catheterization schedule. Psychosocial considerations SKIN INTEGRITY!!! |
| Suctioning | Have to be hyper oxygenated before Only suction on the way out intermittent assess before and after: O2 sats, lung sounds |
| Cardiac symptoms | Chest pain, fatigue, tachycardia, hypertension, shortness of breath |
| Thyroidectomy assessment | low calcium, check airway, check calcium reflexes. Chvostek's and Trousseau's sign |
| Thyroidectomy Intervention | Usually take it out for cancer, hyperthyroidism and need to control symptoms. supplementation synthroid. Interacts with a lot of meds, given early in the morning to avoid interactions w/ food or meds. interacts w/ Ca+, soybean flour |
| total hip replacement Post surgical | DVT, leg-leg comparison; edema, pulses. Anticoagulant, mobilize, Coumadin, implement bleeding precautions. |
| Traction | pin site for infection, check order and weights, educate pts. and family to leave weights alone. Weights cannot be on floor |
| abdominal trauma | Do not palpate, check for distention, guarding, rigid abdomen Seatbelts are a common cause of abdominal trauma |
| Urinalysis | Check for infection Also checks for other issues GLUCOSE AND PROTEIN MEAN DIABETES |
| UTI prevention | education, front-back, voiding post-sex, estrogen changes, increase fluids. |
| Venous insufficiency | Edema, discolorations. Wounds are wet and oozy |
| skin Interventions | repositioning q 2 hrs or more, mobilizing patient and high protein diet |
| thrush medication | Nystatin |
| GI concern | Hypoactive bowel sounds Rebound tenderness |
| Paget's disease Intervention Priority | Control pain; usually severe bone pain |
| Confusion demonstrated by pt. | find cause; infection, UTI, electrolyte imbalance; neurological issue or medication. Reorient pt. |
| GI emergency symptom | rigid board like abdomen |
| Fluid overload risks | Heart failure, kidney failure, trauma, too much iv fluids |
| Pressure Ulcers Stages I-V | I-redness skin, intact skin II- not intact skin, blister open/close III-sore invades sub q tissues, IV- full skin loss muscle, tendon or bone V-unstageable |
| Pressure ulcer risks | change in mental status, immobility, malnutrition, incontinence |
| Pressure ulcer Interventions | repositioning q 2 hr or more, nutrition (high protein), skin care, skin cleaning and barrier protection |
| Complication of fractures | issues with tissue perfusion, check pedal pulses at same time for comparison and 5 P's, Pain, Pulse, Pallor, Paresthesia, Paralysis |
| postoperative complications | respiratory distress or other issues, cardiac issues due to advanced age, previous hx of complications, comorbidities |
| postoperative assessment | respiratory, incision, bleeding, gag reflex, bowel sounds |
| total hip precautions | don't cross legs, don't allow more than 90 degree elevation with affected leg. use accommodation devices elevated toilet seat, reaching arm etc. |
Created by:
Future RN 2015
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