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Med surg trainwreck!

Med surg

This can cause infective endocarditis. Wisdom teeth extraction.
The tearm vegetations in someone with infective endocarditis means.. Inflammatory debris of the heart valve.
What does infective endocarditis alter the structure of? The valves.
If a client is anxious and breathless what should we as nurses due? Raise the head of the bed and stay with client.
If a lower leg blood clot becomes mobile what symptoms are most likely to occur? Sudden chest pain and or dyspnea
What signs and symptoms are consistant due to tissue ischemia in a client with peripheral arterial disease? Brown discoloration to the skin on the legs.
Which sign is most important to tell the physician because it suggests thrombolitis in a lower extremity? Calf pain on dorsiflection of the foot.
What should a nurse plan to teach someone with thromboangitis obliterans? Buerger-Allen exercises.
What will be heard in the chest of a client with pericarditis? Friction rub
When someone with pericarditis experiances pain what will help the client relieve the pain? Instruct them to sit up and lean forward.
If someone is on a low sodium diet due to aortic stenosis. What should the client avoid? canned soup
What is a ballon valvuloplasty? A stretching of a narrowed valve
What does an asprin a day reduce the potential for? forming blood clots
What is incouraged for a patient with aortic stenosis to prevent the need for the valsalva maneuver? Encourage foods high in fiber
Pulsus paradoxus can be noted in a client with. Cardiac tamponade
What is a commissurotomy? When a surgeon digitally stretches or incises thickened cardiac valvular leaflets.
How do you relieve chest pain in a client with mitral valve prolapse? Have the client lay flat with legs elevated at 90 degrees for several minutes.
Most common cardiomyopathy. Dialated cardiomyopathy
The priority of a nurse to due to someone in the acute phase of rheumatic fever is.. Assess for early signs of endocarditis
Inflammation of this cardiac structure can accumulate fluid and can cause acute compression of the heart. The pericardium.
When discharging a client with mitral regurgitation what is the most important symptom for the client to report to the physician? Symptoms of heart failure
When the left ventrical overfills and the pressure backs up in the lungs it creates. Pulmanary hypertension
A valvular disorder that is caused by dammaged by rheumatic heart disease, congenital malformation, and degenerative thickening and calcification is... Mitral stenosis
A noninvasive test that evaluates the heart structure. Echocardiogram
When the heart valve cusps enlarge, become floppy and bulge back into the left atrium this is called. Mitral Valve prolapse
Indications a client may have cardiac disease. Chest pain on exertion
Ultrasound waves that are used in a ecocardiogram are. Sound waves which are beyond the upper range of audible sound.
The desired effect of atropine during a cardiac cath is to.. Treat bradycardia
Teaching for heart valve disorder patients might include Taking antibiotics for a short time before dental procedures.
Someone with the diagnosis of a myocardial infarction should be able to tell the nurse that this is when.. arteries are hard and narrowed by fatty deposits
What effect does nitroglycerine tablets have? Dialates blood vessels.
What is the cheif complaint during a myocardial infarction? Chest pain, will be severe.
What supports the diagnosis of myocardial infarction. Nauseated and diaphoretic.
What lab test if elevated can determine a myocardial infarction. Creatine kinase (ck-mb)
What occurs with a myocardial infarction? A portion of the heart muscle dies
In someone with coronary artery disease as the supply of oxygen to myocardial cells is reduced, the heart my be protected from damaged by. The development of collateral circulation
What consequences may occur with atherosclerosis? Can lead to heart attacks.
Artherosclerotic process is accelerated by: Chronic cigarette smoking
In atherosclerosis the blood vessels become hard an inelastic. What causes this? Eating to much saturated fat.
The difference between angina and a myocardial infarction is in angina.. The heart muscle does not die.
When a clients myocardium is ischemic there is a manifestation of chest pain
With CAD laboratory test will show. Elevated cholesterol.
What lab results will show a client has been compliant with their low fat diet? LDL level is reduced.
What is recomended to healthy adults to help develop collateral circulation? Performing regular aerobic exercise.
In a treadmill stress test the technician will stop the test if the client? Exhibits a serious arrhythmia.
The type of cholesterol that is most benificial is? HDL
What is it called when a ballon tiped catheter is inserted into a diseased coronary artery? Percutaneous transluminal coronary angioplasty or (PTCA)
After a coronary arteriography, what is a sigh that there is a clot w/in the artery at the vascular access site? Distal leg pulses are absent.
After a MI a nurse should look for complications such as.. Arrhythmias and heart failure.
A patient askes about a stress test procedure the nurse would inform her that? A blood pressure cuff and electrocardiogram leads are used during the test.
Why is a client with a MI prescribed a diuretic? To regulate fluid balance.
A clent is admitted into the ER due to chest pain and nausea that started several hrs ago. The nurse notes the tropin levels are high, but LDH and CK-MB are normal. What is a possible explanation? The patient may have had a MI, but it is too early to see changes in all the labs.
What intervention is appropriate to add to a client with a MI to avoid developing venous thrombosis. Apply antiembolism stockings and remove q8h for 20 min.
Term used to reflect the unknown etiology of Raynaud's disease is? Idiopathic
Skin colors observed in areas affected by Raynauds disease are? Cyonotic to flushed
Education for Raynauds would include? Measures to avoid cold exposure.
What should you discourage in a female client with vericose veins? Knee high nylon stockings.
A indication someone might hav a aneurysm in the descending aorta is? A pulsating abdominal mass.
The tissue responsible for initiating a normal heart beat is? SA node.
What is the meaning of the term dysrhythmia? Heart rhythm or rate, or both
What is sinus bradycardia? The heart rate is less than 60 and regular.
A clients heart rate is 54 beats a min, in who is this considered to be acceptable? A 20yr old who jogs 5 miles a day. Young athletic people may normally have a pulse below 60.
In a client with sinus tachycardia, the clients heart rate is reg and beating at a rate of. between 100-150 bpm
During an atrial fibrillation the atria? Quiver rapidly.
Someone in ventrical fibrillation needs? Immediate defibrillation.
When talking to a client their monitor displays flatline the first thing we should do is? Assess the client and check the leads.
Occasional PVCs are? Virtually harmless.
What is concerning in a client being monitored by cardiac telemetry. A monitor showing atrial fibrillation with a rate of 90.
A client experiencing frequent PVCs needs to be? Evaluated by a physician.
A physical assessment a nurse will detect in someone experiancing ventricular fibrillation is? No palpable peripheral pulses.
A patient collapses and becomes unresponsive then starts to shake. After yelling for help a nurse should? Open the patients airway.
When rescue breathing is being performed effectively you will see? The client's chest will rise and fall.
The correct placement of your hands during cardiac compressions is? Over the lower half of the sternum about 1 1/2 inches above the tip of the xiphoid process.
Where will a permanent pacemaker be placed? Below the right or left clavical.
What is not needed for a client returning from a cardiac cath? Temp every 15 min x3
Someone with a permanent pacemaker should? maintain atleast 6 in between digital cell and pacemaker.
Personnel should be aware a client has a pacemaker when? A client is scheduled for a MRI
Betty is schedualed for a hysterectomy. She will be NPO at midnight to reduce the risk for? vomiting and aspiration.
Why is a Foley catheter inserted before surgery? If the bladder is empty there is less chance of it being injured due to the surgery.
Why is nail polish removed before surgery? So that the oxygen saturation can be checked accuratly.
Mrs. P refused her post op sleeping medication at bedtime. At 2 in the morning she was found crying in her room. The most helpfull approach would be? "You seem upset Mrs P"
This is not true concerning surgical "Prep". It steralizes the skin for surgery.
After surgery a patient is put in what position? So vomit and secretions are not aspirated into the tracheobronchial passages.
When someone is moved from the OR to the post anesthesia unit when does the nurse remove the oral airway? When the patients gag reflex returns.
When you do not change the position of the client and remind them to deep breath and cough they are at risk for pneumonia. What type is this? Hypostatic
Ambulation after surgery helps? Get over problems that contribute to abdominal distension.
Why is a post op patient at risk for pnemonia? Failure to expand lungs sufficiently, non productive cough and lying in one position.
Post up pnemonia can be prevented by? Assisting patient to turn frequently, encouraging cough and deep breathing and early ambulation.
What will the nurse do when the patient is in post anesthesia recovery? Turn the patient,assess the blood pressure and pulse and check their temp every 15 min.
Vomiting and nausea post op is often caused by? anesthesia
The most important thing to do to a patient following surgery is? Assure patency of airway.
An indication of an internal hemmorrhage can be? Restlessness
An accumulation of gas after surgery is caused by? Lack of peristalsis.
How do you tell a patient's peristalsis has returned after surgery? Bowel sounds.
What are symptoms of a paralytic ileus during the post op period? Abdominal distention and pain, vomiting and absence of bowel sounds.
How can abdominal distention be relieved post op? Ambulation.
Lots of protine in the diet post op helps? Promote healing.
What do nurses due when a post op patient complains of pain? Assess and determine the level of pain.
What is it important to due when assessing a surgical dressing after surgery. Report any signs of excessive drainage or bright red blood.
Between the 7th and 10th day post op what is most likely to occur? Wound dehiscence and evisceration.
If wound disruption has occured or is suspected the client is placed in? Complete rest in a position that creates the least strain on the incision.
A inappropriate action to due to a client recovering from general anesthesia would be? Maintaining a supine position.
When a physician orders a patient controlled analgesia the nurse will let the patient know. Pain releif should occur shortly after pushing the button.
A charge nurse draws up medication for the student nurse. What is the most appropriate action. Refuse to give the injection.
When an endotracheal tube is used to administer general anesthesia the patient often comlains of? A sore throat.
An oropharyngeal airway helps? Maintain a patent airway.
What is done first when treating a patient for shock? A intravenous line.
During the compensatory shock phase, low blood volume stimulates the pituitary gland to secrete: Antidiuretic hormone
What will the nurse due if a post op patient has a crystalloid IV fluid running? Assess the amount remaining and fate of flow, assess needle site for infiltrationn and note whether the patient is to continure recieving the fluids.
Why do we assess the capilary refill? To assess the arterial blood flow in an extremity.
When assessing for neurogenic shock the most prominant feature of this type of distributive shock is? Peripheral vasodialation and hypotension.
Some of the first signs of shock are: Tachycardia hypotension anxiety or restlessness
A person is considered to be pre-hypertensive when systolic blood pressure is equal or above 120mm Hg and Distolic is equal to or higher than? 80 mm Hg
The cause of essential hypertension is? unknown
What is the most important lifestyle change for someone with hypertension? Eliminate smoking cigarettes.
What lab tests are used to check for renal complications related to hypertension? BUN and creatinine
What sign and symptom is connected to hypertension? Spontaneous nosebleeds
What do you observe with a client with sudden acute hypertension? A flushed face
To accuratly diagnose hypertension the best place to check the blood pressure is? Have the patient check their blood pressure in their own environment.
A sign that atherosclerosis is a contributing cause of hypertension is? Their cholesterol is elevated
The first measures used to treat hypertensive clients. dietary modifications weight reduction and increasing exercise
Too small of a blood preassure will cause? High blood pressure reading
The action of the calcium channel blocker dilitazem (Cardizem) for hypertension is? It dialates arterioles and arteries
If there is hemorrage and significant blood loss in a patient the nurse should? Place the patient supine
Secondary hypertension is due too? A known cause.
Accelerated hypertension causes? hemorrhages and exudates in the eye
What body chemical elevates blood pressure? Catechomamines
Hypertensive disease can cause damage too? The heart, brain, and kidneys.
What are you most likely too observe in a clients inner eye with elevated blood pressure? Papilledema
A sign of renal failure in a client with hypertension is when? Less than 30 mL of urine per hour is excreated
A beverage someone with hypertension can have is? Orange juice
Hypertension is a chronic condition that requires? Lifelong attention
A hypertensive client needs additional teaching when they state? "I will take an extra dose when I feel tense"
In planing the care of a client w/ accelerated hypertension it is appropriate to do what? Measuring VS every 15 min.
The term conjestive in heart failure means when the heart fails as a pump... an accumulation of blood and fluids in organs and tissues.
When the left side of the heart fails the client will have symptoms affecting... The lungs and breathing
People with heart failure usually have a history of.. chronic hypertension
What reason should a nurse demonstrate competence in front of somone going in for cardiac surgery? To relieve anxiety in a client.
What is a inotropic action? Heart strength
Right sided heart failure enlarges? The liver
In heart failure an echocardiography is done too... Show the size of the heart chambers.
What findings should be reported to the doctor before giving dig? An apical heart rate of 55 bpm
A person with right sided heart failure usually has? Chronic lung disease.
A sign related to cor pulmonale is? Dyspnea when sitting
The abdomen in someone with right-sided heart failure is usually? Distended
A possible outcome when giving CHF paitents O2 is? The heart rate will be reduced to the normal range.
In someone taking digoxin we should offer the client food high in? Pottassium
Somone developing left sided heart failure will usually half to? Sleep in a reclining chair.
When a heart has to pump against elevated pressure in the pulmanary vascular system patients tend to develop? Right ventricular hypertrophy
A daily assessment in a client with heart failure is? Weight
In someone experiancing paroxysmal dyspnea we will use? Several pillows to support head and thorax.
Why is a client with pulmonary edema given morphine sulfate? To vasodialate the vascular bed.
Complications of coronary artery bypass dysrhythmias stroke renal failure decline in mental function
A mitral valve commissurotomy is The repair of adhesions on the cusps of the valve.
A patient experiancing wheezing, restlessness, moist lung sounds, and coughing up pink frothy sputum is showing signs of... Pulmanary edema
Somone with CHF taking digitalis and Lasix should include what in their diet? potatoes, milk, and orange juice
A BNP level is? A hormone that indicates the severity of heart failure.
A serous membrane covering the lungs? Parietal pleura
What part of the bronchi is a foreign object most likely to lodge in a choking incident? Right bronchus
Lung inflation is dependent on? Negative pressure
What should be reported immediatly after a bronchoscopy and biopsy? Laryngeal stridor
Wheezes in the lower lung feilds is a sign of? Narrowed airways
Normal values for an arterial blood gas PaO2 in an adult is? 80-100 mm Hg
A tracheal deviation to the unaffected side of someone suffering from a pneumothorax is from? Dangerously high preassure inside the thoracic cavity
A possible dangerouse complication associated w/ a bronchoscopy is? laryngeal edema
A client that has undergone sinus surgey you should assess for? visual acuity
You should document what in a client with laryngitis that has complete loss of voice? aphonia
Nursing interventions for epistaxis? Applying external preassure Packing the nares Applying an ice pack
A nurse should assess clear drainage in a nasal fracture for? Glucose
Following surgery for a nasal fracture a nurse should assess? Airway petency
If diagnosed early a person with laryngeal cancer they would expect what kind of surgery? Partialy laryngectomy
How long should a client with a tracheotomy be suctioned? No longer than 10 seconds at a time.
To prevent atelectasis in a patient that is intubated the nurse should? Turn the patient every 2 hrs
Collapse of a lung due to air entering the pleural space is a? Pneumothorax
When respirations gradually increase and decrease in a reg pattern with periods of apnea is called? CHEYNE-STOKES RESPIRATIONS
Nasal polyps Tend to be in people allergic to asprin are usually benign
Chest radiographs are used to identify Pneumonia atelectasis Pneumothorax
When ausculatating someone with a lung abscess what will you hear over that area. Lung sounds will be absent
A nursing diagnoses in someone with an O2 sat of 80% that has viral pneumonia is? Impaired gas exchange
Sign of sleep apnea? loud snoring
People with Cystic fibrosis do this treatment several times a day? Perform postural drainage
Assessments for a client with a water seal chest drainage system. Inspect skin around dressing for sub Q emphysema. Check the clients resp. status, heart rate, and neurological status. Make sure water seal drainage system is intact.
One of the treatments for someone with bronchiectasis is? Postural drainage
The primary cause of emphysema is? Smoking
The best nursing intervention for someone suffering from an acute asthma attack is? Provide oxygen per mask
Severe,progressive, and prolonged acute asthma attacks are called? Status asthmaticus
Air escaping from the chest into the sub Q tissue is called? Subcutaneous emphysema
The most appropriate nursing intervention for cardiac irregularities during suctioning of a endotracheal tube would be? Stop the procedure and reoxygenate the patient
A sign of lung cancer? hemoptysis
Flail chest could occurin someone with Fractured ribs
Someone with a total laryngectomy due to cancer will have a? Permanant tracheostomy
Difficulty breathing and hemoptysis in a post surgical client may indicate? Pulmanary embolus
The cause of pulmanary edema is caused by fluid in the? Alveoli
If someone is breathing 40 times a min a nursing diagnosis is? Ineffective breathing pattern
Pleural effusion is: Pus and fluid between the parietal and visceral pleurae
The route of transmission of tuberculosis is? Airborne
The signs of a pneumothorax in someone that has sustained a blunt injury to the chest. Shortness of breath
Which test results will confirm Tuberculosis? A sputum culture
When treating severe epistaxis a nurse can make available what? Topical epinephrine
Preventing deep vein thrombosis and pulmonary emboli in someone on strict bed rest would be? Active range of motion excercises
Most common cause of acute bronchitis A virus
Someone with acute bronchitis should? expectorate rather than swallow sputum
To loosen bronchial secretions in someone with bronchitis the nurse may recomend? Humidification of room air
While performing postural drainage to help loosen secretions a nurse can do? Gental percussion over the segment being drained.
Adequate oxygenation in someone with pneumonia may be accomplished by? Placing the client in a semi-Fowlers position
A nurse encourages deep breathing in a patient with pleurisy by? Assisting the client to splint the chest wall
A client is observed for what following a thoracentesis? Respiratory distress
When assessing a Mantoux skin test the site has no induration and a 1mm area of ecchymosis, the results would be? Negative
The effectiveness of coughing and deep breathing can be determined by? Auscultation of the lungs
You can encourage coughing and deep breathing by? An Incentive spirometer
Primary teaching of someone with TB is? Adhearing to the prescribed medical regimen
Shortness of breath while performing small tasks is called? exertional dyspnea
The O2 flow rate for a client with emphysema No more than 2-3 L/min
The nurse would insure what on a chest tube attached to a water seal drainage sys? The connection is taped between the chest tube and drainage system, the dressing is maintained at the insertion site.
The purpose of a water seal drainage system is to? Prevent air from re-entering the chest
The nurse should imediatly do what if a chest drainage bottle becomes disconected from the tubing? Reconnect and document the occurance
What pathological condition do you hear stridor during respiration? An airway obstruction
Most characteristic finding in pulmanary edema? pink frothy sputum
Early signs of hypoxemia? Restlessness Yawning Tachycardia
What is the outcome expected for a client experiancing an acute asthma attack? The client will maintain an open airway with adequate gas exchange
When turning a client with a chest tube connected to a pleur-evac should? Keep pleura-vac below the level of the wound.
Collection of pus in the pleural cavity? Empyema
Red blood cells Erythrocytes
When macrophages ingest bacteria and foreign substances. Phagocytosis
After a bone marrow aspiration on a patient with leukemia as nurses what should we do as nurses? Apply preassure at the site to stop the bleeding.
A test to distinguish pernicious animia and folic acid deficiency? Schilling Test
Condition that makes a patient bleed easy? Thrombocytopenia
In order for a child to be born with sickle cell what needs to happen? The mother and father must both carry the defective gene.
When injecting iron by z track what angle does she insert the needle? 90 degrees
When a patient has activity intolerance due to animia, what should the nurse do? Space interventions and encourage rest periods.
What causes joints to ache in someone with polycythemia vera? Uric acid
Acute lymphocytic leukemia affects what age group? Younger than 5
Common cause of agranulocytosis. Toxicity from drugs.
Safe foods for a client with aplastic anemia. Cooked oatmeal with milk
What should someone with hemophillia avoid? Contact sports
Cause of lymphangitis? Streptococcus
Cause of mononucleosis? Epstein-barr virus
If a patient has a lymph node biopsy and it states they have Hodgking lymphoma the report will also have? Reed-sternberg cells
A client is admitted with aplatic anemia. What is the best room to put them in? A private isolation room with a negative airflow.
A symptom of non-Hodgkin's lymphoma. Diffuse lymph node enlargement
What is the primary role of platelets? Play a roll in homeostasis
Even though someone has a elevated white blood cells we would still observe for infection because? Many of the wbc's will be immature
The best plase to observe pallor in a dark skinned person is? Mucous membranes
What should be done if a client refuses a blood transfusion due to religion? Notify the physician of the clients refusal
Depression of bone marrow is a side effect of chemotherapy. We would look for signs of infection and anemia. We would also look for? Bleeding
What intervention would be done for a client in a sickle cell crisis? Pain assessment every 4 hours
Proper route and site for parenteral iron? Intramuscular, z-track, gluteus
S&S of chronic lymphocytic leukemia Anemia, weakness, fatigue, epistaxis, splenomegaly, lymph node enlargement
Created by: Dawn Hoehne Dawn Hoehne on 2011-11-30

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