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