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2360 final
Nursing
| Question | Answer |
|---|---|
| Bacteriostatic = inhibits growth (e.g., macrolides, tetracyclines, sulfonamides); relies on immune system. Bactericidal = kills bacteria (e.g., penicillins, cephalosporins, fluoroquinolones)." | |
| Macrolides—Prototype, | "Erythromycin (think also azithromycin)." |
| Macrolides— | Uses,"Respiratory infections; STIs; Helicobacter pylori." |
| Macrolides—Key Adverse Effects, | "QTc prolongation; GI pain/N/V; liver toxicity; injection-site reactions; diarrhea; ototoxicity." |
| Macrolides—Nursing Implications | 1,"Avoid grapefruit and St. John’s wort." |
| Macrolides—Nursing Implications " | 2,"Take with 8 oz water; take erythromycin on an empty stomach; around-the-clock dosing. |
| Macrolides—Nursing Implications 3, | "Avoid antacids & dairy within 2 hours of erythromycin." |
| Macrolides—Nursing Implications 4," | Oral contraception effectiveness may decrease—use backup." |
| Macrolides—When to Call Provider | ,"Watery diarrhea, dark urine, yellow skin/eyes, or hearing loss." |
| Clindamycin—Class/Relation | ,"Lincosamide (similar clinical niche to macrolides)." |
| Clindamycin—Uses | ,"Intra-abdominal, wound, and gynecological infections." |
| Clindamycin—Key Adverse,"C. difficile diarrhea; ↑ AST/ALT; N/V, abdominal pain." | |
| Clindamycin—Nursing,"Take with 8 oz water; infuse over ≥20 minutes (too fast → cardiac risk); complete full course." | |
| Clindamycin—Call Provider,"Jaundice, severe diarrhea, or abdominal pain." | |
| Linezolid—Class,"Oxazolidinone (Zyvox)." | |
| Linezolid—Uses,"HCAP/CAP; skin infections; VRE & MRSA." | |
| Linezolid—Key Adverse,"Serotonin syndrome; myelosuppression; C. difficile colitis; hypoglycemia (oral)." | |
| Linezolid—Nursing 1,"Avoid tyramine-rich foods (hypertensive risk)." | |
| Linezolid—Nursing 2,"Assess for SSRI/serotonergic drugs (serotonin syndrome)." | |
| Linezolid—Nursing 3,"Infuse over 30–120 minutes; report diarrhea or bloody stool." | |
| Metronidazole—MOA,"Forms toxic intermediates that disrupt DNA/protein synthesis." | |
| Metronidazole—Uses,"Pseudomembranous colitis (oral); H. pylori regimens." | |
| Metronidazole—Key Adverse,"Neuro symptoms; disulfiram-like reaction with alcohol; metallic taste; GI upset." | |
| Metronidazole—Nursing 1,"No alcohol during therapy and for 3 days after (even mouthwash)." | |
| Metronidazole—Nursing 2,"Dark/red-brown urine may occur; report neuro symptoms." | |
| Metronidazole—Nursing 3,"Avoid with warfarin—↑ bleeding risk." | |
| Vancomycin—MOA,"Inhibits peptidoglycan synthesis → cell wall disruption and bacterial death." | |
| Vancomycin—Uses,"Oral for pseudomembranous colitis; MRSA risk; severe infections." | |
| Vancomycin—Key Adverse,"Thrombophlebitis; Red Man syndrome (infused too fast); nephrotoxicity; neutropenia." | |
| Vancomycin—Nursing 1,"Infuse over at least 60 minutes (slower if needed to prevent Red Man)." | |
| Vancomycin—Nursing 2,"Monitor hearing with prolonged therapy; check IV site before/ during infusion; report IV site pain." | |
| Vancomycin—Nursing 3,"Monitor CBC (neutrophils); assess renal function (BUN/Creatinine)."Term,Definition | |
| Inflammation—core definition,"Complex nonspecific response to tissue injury that limits damage, removes debris, and facilitates healing. Distinct from specific “immunity.” :contentReference[oaicite:0]{index=0}" | |
| Nursing focus with inflammation,"Know active vs passive immunity, recognize alterations in immune function, and link patho → assessment → interventions. :contentReference[oaicite:1]{index=1}" | |
| Acute cholecystitis—patho snapshot,"Obstructed bile outflow → chemical irritation, edema, vascular compression → pain RUQ ± radiation; risks: empyema, gangrene, perforation. :contentReference[oaicite:2]{index=2}" | |
| Acute cholecystitis—priority care,"NPO, pain control, NG suction PRN, IVFs, lithotripsy or cholecystectomy/T-tube as indicated. :contentReference[oaicite:3]{index=3}" | |
| Acute pancreatitis—patho snapshot,"Autodigestion from prematurely activated enzymes → local damage + possible systemic inflammatory response/multiorgan failure; often gallstones or alcohol. :contentReference[oaicite:4]{index=4}" | |
| Acute pancreatitis—priority care,"NPO, analgesia, NG suction, IVFs, insulin PRN, H2/PPI, antiemetics, early enteral feeds as tolerated; surgical biliary interventions if needed. :contentReference[oaicite:5]{index=5}" | |
| Inflammation labs to trend,"ALP, cholesterol, lipase/amylase, bilirubin, AST/ALT, CBC/CMP; imaging: US, CT, MRI, ERCP, XR. :contentReference[oaicite:6]{index=6}" | |
| Hypersensitivity—Type I,"IgE-mediated; spectrum from rhinitis/asthma to anaphylaxis (mass histamine release → vasodilation, hypotension, hypoxia, airway edema). :contentReference[oaicite:7]{index=7}" | |
| Anaphylaxis—first actions,"Call for help, airway/100% O2, IM epinephrine, large-bore IVFs, adjuncts (H1/H2 blockers, steroids), continuous monitoring. Rationale: prevent hypoxia/shock. :contentReference[oaicite:8]{index=8}" | |
| Necessity of early recognition,"Untreated severe inflammatory sequelae can progress to distributive shock—monitor vitals, perfusion, LOC closely. :contentReference[oaicite:9]{index=9}" | |
| Perioperative phases,"Pre-operative, Intra-operative, Post-operative (PACU → unit or discharge)—nursing optimizes outcomes across all three. :contentReference[oaicite:10]{index=10}" | |
| Pre-op assessment—key buckets,"History/physical; meds/allergies; nutrition/fluids; dentition; substance use; resp & cardiac status; hepatic/renal/endocrine/immune function; psychosocial. :contentReference[oaicite:11]{index=11}" | |
| Pre-op teaching essentials,"Deep breathing/coughing/IS, mobility/ambulation, pain plan, coping strategies, safety, NPO/skin/bowel prep per procedure. :contentReference[oaicite:12]{index=12}" | |
| Immediate pre-op interventions,"Complete checklist, give ordered antibiotics/benzodiazepine, VTE prophylaxis, warming, support patient/family. :contentReference[oaicite:13]{index=13}" | |
| Intra-op team—who’s who,"Anesthesia (MD/CRNA), surgeon, RNs, surg techs, RNFA; scrub role (sterile field supply), circulator (coordination, consent, positioning, prep, documentation, safety). :contentReference[oaicite:14]{index=14}" | |
| Intra-op safety basics,"Time-out & fire risk check; asepsis/sterility; skin prep; zone attire; OR ventilation & temp; sterile field vigilance. :contentReference[oaicite:15]{index=15}" | |
| Anesthesia exemplars,"General (inhalation isoflurane; IV propofol); NMB (vecuronium—requires airway/ventilation); adjuncts (midazolam, fentanyl, dexmedetomidine). :contentReference[oaicite:16]{index=16}" | |
| Malignant hyperthermia—risk & trigger,"Autosomal dominant; triggered by volatile anesthetics and some NMBs; uncontrolled Ca²⁺ release → hypermetabolic crisis. :contentReference[oaicite:17]{index=17}" | |
| Malignant hyperthermia—red flags,"Rapid rise ETCO₂/HR/temp, rigidity, acidosis, hyperK; treat with **dantrolene**, 100% O₂, active cooling, manage dysrhythmias and electrolytes. :contentReference[oaicite:18]{index=18}" | |
| PACU priorities,"Airway/oxygenation (obstruction risk), LOC (post-anesthesia score), perfusion (hypotension/bleeding/shock), pain, PONV, wound/tubes. :contentReference[oaicite:19]{index=19}" | |
| Common post-op problems,"Resp (depression, atelectasis, pneumonia, hypoxemia); perfusion (hemorrhage, shock, VTE); pain; thermoregulation; GI (PONV, ileus/NG); urinary retention; skin/wound/drains. :contentReference[oaicite:20]{index=20}" | |
| Post-op pulmonary prevention bundle,"TCDB, IS at least q2h, early ambulation, adequate pain control to enable deep breaths and mobility. :contentReference[oaicite:21]{index=21}" | |
| Surgical drains—examples,"Penrose, Jackson-Pratt (JP), Hemovac, wound VAC—know expected output/appearance and keep suction systems functioning. :contentReference[oaicite:22]{index=22}" | |
| TPN—what it is,"Complete IV nutrition delivered into the bloodstream via central line, bypassing the GI tract; provides calories, protein, carbs, fat, vitamins, minerals. :contentReference[oaicite:23]{index=23}" | |
| TPN—indications (examples),"When oral/enteral isn’t adequate/possible: short bowel, obstruction, severe acute pancreatitis, IBD, malabsorption, fistulas (to rest gut). :contentReference[oaicite:24]{index=24}" | |
| TPN—macro/micronutrients,"Macros: amino acids, dextrose, lipids (often hung separately). | Micros: electrolytes (Na, K, Ca, Mg, Phos, Cl), trace elements (Zn, Cu, Mn), vitamins; additives may include insulin, folate, thiamine. :contentReference[oaicite:25]{index=25}" |
| TPN—common complications,"Hyperglycemia; hepatic cholestasis/↑AST/ALT/bili; hypertriglyceridemia; hypervolemia; **refeeding syndrome** (↓K, Mg, Phos + fluid overload). :contentReference[oaicite:26]{index=26}" | |
| TPN—nursing setup,"Central line only; 1.2-micron filter; verify bag/label/rate with MAR; no co-infusions through the same lumen unless ordered. :contentReference[oaicite:27]{index=27}" | |
| TPN—monitoring bundle,"FSBG q6h; daily weights; vitals; lung sounds/edema; labs: BMP/electrolytes, trace elements, triglycerides, LFTs; meticulous line care—high infection risk. :contentReference[oaicite:28]{index=28}" | |
| Refeeding syndrome—nursing watch,"After malnutrition, rapid nutrition → insulin surge drives **K⁺/Mg²⁺/Phos** into cells → arrhythmias/CHF risk; start low, go slow, replace electrolytes. :contentReference[oaicite:29]{index=29}" | |
| Periop consent & documentation,"Verify informed consent, site marking, pre-op checklist completeness before transport; circulating RN documents intra-op events and safety checks. :contentReference[oaicite:30]{index=30}" | |
| VTE prevention post-op,"Assess risk; TEDS/SCDs; early ambulation; prophylactic anticoagulation per order; monitor for calf pain/swelling, SOB. :contentReference[oaicite:31]{index=31}" | |
| PONV management pearls,"Risk assess; early non-pharm (slow position change, aromatherapy if allowed) + pharm prophylaxis/treatment (per protocol). :contentReference[oaicite:32]{index=32}" | |
| Skin integrity in inflammation,"Document size (cm), warmth, erythema; elevate edematous limb; trend photos per policy; treat entry sources (e.g., tinea pedis). :contentReference[oaicite:33]{index=33}" | |
| When to escalate—abdominal inflammation,"Worsening pain, persistent tachycardia/fever, guarding, jaundice, peritonitis signs, hypotension—possible progression/complications; notify provider stat. :contentReference[oaicite:34]{index=34}" | |
| Pre-op medication pearls,"Antibiotic timing (on-time before incision), benzo safety (fall/resp risk), VTE prophylaxis initiated; maintain normothermia pre-induction. :contentReference[oaicite:35]{index=35}" | |
| Airway risk in PACU, | "Most are extubated before arrival; monitor O₂ sat, RR, breath sounds; watch for hypopharyngeal obstruction and intervene promptly. :conten |
| TPN line infection prevention," | Strict hand hygiene, scrub the hub, dedicated TPN lumen if possible, change tubing/filters per policy; report fever/chills or line site changes. :contentReference[oaicite:37]{index=37}" |
Created by:
Anmag002