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ATI Med-Surg
ATI study material
| Question | Answer |
|---|---|
| Aphasia | language use or comprehension difficulty |
| Alexia | reading difficulty |
| Agraphia | writing difficulty |
| what portion of the brain is responsible for language, mathematics, and analytic thinking? | left cerebral hemisphere |
| the right portion of the brain is responsible for??? | visual and spatial awareness and proprioception |
| If you pt has a stroke where will you place the food? | back of mouth on unaffected side |
| what should you check on a stroke pt before feeding? | swallowing, gag, cough |
| If you are caring for a stroke pt what kind of liquids would you give and why? | thickened liquids, risk for aspiration |
| An Rn would provide systemic/catheter thrombolytic therapy to pts except? | pts with hemorrhagic stroke or increased risk of bleeding |
| how would you rule out a hemorrhagic stroke? | MRI |
| what are risk factors for stroke? | HTN, Atherosclerosis, hyperlipidemia, DM, Cocaine, A Fib, smoking, oral contraceptives, obesity, hypercoagulability, cerebral aneurysm, and arteriovenous malformation |
| the pt has infarction/ischemia on the right side of the brain, which side should the nurse approach and place the pts dinner? | The right side. |
| what are the three layers of the meninges? | dura mater, arachnoid mater, and pia mater. (from outer to inner) |
| the pt has infarction/ischemia on the right side of the brain, which side should the nurse approach and place the pts dinner? | The right side. |
| what are the three layers of the meninges? | dura mater, arachnoid mater, and pia mater. (from outer to inner) |
| which meningitis is aseptic, most common and resolves without treatment? | viral |
| Bacterial Meningitis Is??? | septic, contagious, occurs in overcrowded living areas |
| what is the most definitive test for meningitis? | CSF analysis |
| what results indicate meningitis? | cloudy(bacterial)/clear(viral), elevated WBC, protein, CSF pressure, decreased glucose(bacterial) |
| Kernig and Brudzinski signs indicate what? | bacterial meningitis |
| 20/200 or less with corrective lenses constitutes what? | legal blindness |
| how is intraocular pressure measured and what determines the drainage angle of the anterior chamber of the eyes? | tonometry and gonioscopy |
| tonometry normal values??? | 10-21 mm Hg |
| what food is recommended for preventing reduced vision? | green leafy vegetables, an antioxidant |
| What is mydriasis? | dilation of the pupil (anticholinergics are given) |
| what is cycloplegia? | ciliary paralysis (anticholinergics are given) |
| what is miosis? | constriction of the pupil (cholinergic given; angle-closure glaucoma) |
| what do you give for open-angle glaucoma and decreased in aqueous humor production? | beta-blocker (timolol(timoptic)) |
| at what age should annual eye exams with IOP measurement be encouraged? | 40+ |
| when and how is scleral buckling performed? | rest eye before procedure, general anesthesia, insert silicone and encircling band, infiltration of gas to push retina back, eye patch/shield, avoid rapid movement |
| bright flashes of light, floating dark spots, partial-curtain drawing over visual field, loss of vision are S/S of ? | retinal detachment |
| what activities increase IOP? | bending at the waist, sneezing, coughing, straining, vomiting, head hyperflexion, restrictive clothing, sexual intercourse |
| what is myopia? | nearsightedness |
| what is the most common surgery for people over 65yo? | cataract surgery. 95% successful |
| what are some rick factors of cataracts? | advanced age, diabetes, heredity, trauma, excessive sun exposure, chronic steroid use |
| Final best vision is not expected until? | 4-6 weeks post-op |
| progressive and painless loss of vision, decreased visual acuity, glare/light sensitivity, blurred vision, visible opacity, absent red reflex, and diplopia are S/S of ? | cataracts |
| what is the leading cause of blindness? | glaucoma, early diagnosis and treament to prevent vision loss |
| what is the most common form of glaucoma? | open-angle glaucoma (angle between iris and sclera)S/S: loss peripheral vision, decreased accommodation, elevated IOP) |
| what is the least common form of glaucoma? | angle-closure (IOP rises suddenly, angle between iris and sclera is decreased)S/S:elevated IOP rapid, decreased/blurred vision, halos around lights, pupils nonreactive to light, severe pain, photophobia |
| what med is used as an emergency treatment for angle-closure glaucoma to quickly decrease IOP? | IV Mannitol |
| which eye disease is not curible or irreversible? | glaucoma, its a chronic disease |
| how far should the Snellen chart be from the pt? | 20 ft |
| what test identifies if hearing loss is conductive or sensorineural? | Audiometry |
| what are the characteristics of inner ear problems? | tinnitus, vertigo, and dizziness |
| what is closed reduction? | when a pulling force is applied manually to realign the displaced fractured bone fragment |
| what is used to ensure fracture alignment? | radiographs |
| when applying a cast was is placed underneath to maintain skin integrity? | tubular cotton web rolls |
| should the cast be elevated and if so when? | yes, during the first 24-48hrs to prevent swelling |
| It is ok to use a metal hanger to scratch an itch under the cast? | no, no foreign objects should be placed under the cast |
| what do splints prevent? | unsupported fractured/injured areas and joint contracture |
| How is countertraction provided in straight/running traction? | by the clients body |
| How is countertraction provided in balanced suspension traction? | devices such as slings or splints |
| what is the essential assessment when a pt is immobilized? | neurovascular |
| which joints are most commonly replaced? | knee and hip |
| if your pt has joint replacement what side of the bed do you tranfer from? | unaffected side |
| what motion is promoted in the knee and to prevent scar tissue? | continuous passive motion (CPM) |
| how many grades of open fractures are there and what are they? | 3. I)minimal skin damage II)damage includes skin and muscles contusions III)damage to skin,muscles,nerves,blood vessels |
| what is crepitus? | grating sound created by the rubbing of bone fragments |
| what are early signs in neurovascular assessment that a problem is developing? | pain, paresthesia, pallor(increased cap refill, cyanosis) |
| what are late signs in neurovascular problems? | paralysis,polar-cold, weak/unpalpable pulses |
| A pt presents to the ER with an closed fracture and receives appropriate treatment, what type of shock is pt at risk for? | Hypovolemic (ex:pelvic fracture-assess abdomen, bladder for bleeding) |
| what is normal compartmental pressure? | 0-8 mm HG; >8=fasciotomy |
| what type of embolism might occur 48hrs following a long bone fracture? | Fat embolism (alt LOC, resp distress, tachy-cardia/pnea, fever, cutaneous petechiae) |
| when might bone pain increase with movement? | osteomyelitis |
| A fracture that has not healed within 6 months is called? | delayed union |
| a fracture that never heals is called? | nonunion |
| Fractures that heal incorrectly are known as? | malunion |
| what nutrients are essential in the production of new bone? | calcium, phosphorous, protein, vitamin D |
| what type of surgery is becoming the most common surgical procedure for people over 85yo? | surgical hip fracture repairs |
| what is a disarticulation? | amputation through the joint |
| how much and how long do you inflate an air splint? | 20-22 mm HG for 22 of 24hr/day |
| what is the precursor to osteoporosis? | osteopenia-low bone mineral density for pts age/sex |
| what is DEXA or dual energy x-ray absorptiometry? | screen for early changes in bone density, measures mineral density in wrist,hip,vertebral column |
| what labs rule out metabolic bone diseases other than osteoporosis? | serum calcium, vit d, phosphorus, alkaline phosphate |
| what causes progressive deterioration of the articular cartilagde? | osteoarthritis |
| when is osteoarthritis inflammatory and nonsystemic? | It can be inflammed if localized, and it is always nonsystemic |
| what labs are elevated when a pt has osteoarthritis? | ESR-erythrocyte sedimentation rate, high sensitivity C-reactive protein |
| does joint pain/stiffness resolve with rest? | Yes, rest or inactivity (chief report) |
| what med rebuilds cartilage? | glucosamine |
| what does heat/cold therapy do? | heat alleviated pain, cold reduces inflammation |
| OA is normal part of what process? | aging |
| when is osteoarthritis inflammatory and nonsystemic? | It can be inflammed if localized, and it is always nonsystemic |
| what labs are elevated when a pt has osteoarthritis? | ESR-erythrocyte sedimentation rate, high sensitivity C-reactive protein |
| does joint pain/stiffness resolve with rest? | Yes, rest or inactivity (chief report) |
| what med rebuilds cartilage? | glucosamine |
| what does heat/cold therapy do? | heat alleviated pain, cold reduces inflammation |
| OA is normal part of what process? | aging |
| what are the organs of the immune system? | bone marrow, thymus gland, lymph nodes, spleen, mucosal lymphatic tissue |
| which immunity is inherited and involves inflammatory response? | natural |
| which immunity is acheived by active/passive processes? | acquired |
| active immunity occurs when? | when the body responds to presence of pathologic organism and produces antibodies, and response to vaccines |
| what is passive immuntiy? | mother-fetus, breast milk-infant, and antibody injections |
| when are snesitized t cells produced? | cell mediated immunity |
| antibodies are produced in response to pathogen when? | humoral immunity |
| what are the organs of the immune system? | bone marrow, thymus gland, lymph nodes, spleen, mucosal lymphatic tissue |
| which immunity is inherited and involves inflammatory response? | natural |
| which immunity is acheived by active/passive processes? | acquired |
| active immunity occurs when? | when the body responds to presence of pathologic organism and produces antibodies, and response to vaccines |
| what is passive immuntiy? | mother-fetus, breast milk-infant, and antibody injections |
| when are snesitized t cells produced? | cell mediated immunity |
| antibodies are produced in response to pathogen when? | humoral immunity |
| what are the organs of the immune system? | bone marrow, thymus gland, lymph nodes, spleen, mucosal lymphatic tissue |
| which immunity is inherited and involves inflammatory response? | natural |
| which immunity is acheived by active/passive processes? | acquired |
| active immunity occurs when? | when the body responds to presence of pathologic organism and produces antibodies, and response to vaccines |
| what is passive immuntiy? | mother-fetus, breast milk-infant, and antibody injections |
| when are snesitized t cells produced? | cell mediated immunity |
| antibodies are produced in response to pathogen when? | humoral immunity |
| what are the organs of the immune system? | bone marrow, thymus gland, lymph nodes, spleen, mucosal lymphatic tissue |
| which immunity is inherited and involves inflammatory response? | natural |
| which immunity is acheived by active/passive processes? | acquired |
| active immunity occurs when? | when the body responds to presence of pathologic organism and produces antibodies, and response to vaccines |
| what is passive immuntiy? | mother-fetus, breast milk-infant, and antibody injections |
| when are snesitized t cells produced? | cell mediated immunity |
| antibodies are produced in response to pathogen when? | humoral immunity |
| what are the organs of the immune system? | bone marrow, thymus gland, lymph nodes, spleen, mucosal lymphatic tissue |
| which immunity is inherited and involves inflammatory response? | natural |
| which immunity is acheived by active/passive processes? | acquired |
| active immunity occurs when? | when the body responds to presence of pathologic organism and produces antibodies, and response to vaccines |
| what is passive immuntiy? | mother-fetus, breast milk-infant, and antibody injections |
| when are snesitized t cells produced? | cell mediated immunity |
| antibodies are produced in response to pathogen when? | humoral immunity |
| how often is the tetanus/diphtheria(Td) vaccination given? | q 10 yrs |
| pneumococcal vaccines are given how often? | a dose with one time revac in 5 yrs |
| name three infections that have emerged over the last few decades? | lyme disease (Borrelia burgdorferi), HIV, ans SARS (Coronavirus) |
| what is the chain of infection? | causative agent, reservoir, portal of exit from host, mode of transmission, portal of entry to the host, susceptible host |
| what is leukopenia? | a WBC count below 4300, compromised inflamm response or viral infection |
| WBC greater that 10000? | inflammatory response to a pathogen or disease process |
| what does a 70% increase in neutrophils indicate? | bacterial infection; shift to the left |
| what type of infection do lymphocytes usually react to? | viral infections; second most commonly occuring WBC |
| What is elevated in the WBC count with allergic rxns and parasitic infection? | eosinophils |
| what is the normal value for ESR? | 15-20 mm/hr; increase indicates an active inflammatory process and infection |
| what test can be used to detect hypersensitivity, autoimmune disorders, chronic viral infections, immunodifficiency, mult..., and immunoglobulin presence/quantity? | immunoglobulin electrophoresis |
| what does HIV target? | CD4+ lymphocytes, or T-cells |
| what stage of HIV has flu like symptoms, s/s within 2-4wks, icreased viral load, decreased CD4+ cells, and increased CD8 cells, with lymphadenopathy? | Primary HIV-1 infection |
| which HIV stage is prolonged/clinically silent (up to 10yrs), anti-HIV antibodies present, and has active replication occuring? | Chronic asymptomatic infection, stage II |
| Stage III-HIV is called? What are the characteristics? | AIDS; life-threatening opportunistic infections, end stage of HIV infection, death 3-5yrs without treatment |
| what are the three classifications of SLE? | Discoid-skin, butterfly rash nose/cheeks, self-limiting; systemic-connective tissues, major organ failure;drug-induced-resolve with drug discontinuation, no renal/neuro disease |
| what are the risk factors of SLE? | female 15-40, AA, Asian, Nat.Amer; incidence drops after menapause, but remains steady for men |
| what are precancerous skin lesions called? | actinic keratoses |
| what are the three types of skin cancer? | squamous cell carcinoma, basal cell carcinoma, malignant melanoma |
Created by:
queencamb