A Metabolic syndrome includes which risk factors?

Central obesity hyperlipidemia uncontrolled hypertension and hyperglycemia describe what syndrome?

Intermediate-acting insulin covers insulin needs for how long?

A About half the day or overnight

Hyperglycemia dehydration symptoms?

Tachycardia, nausea ,vomiting, abdominal cramps fatigue, blurred vision

Hyperglycemia classic symptoms 3 ps ?

A Polyphagia, polydipsia, polyuria

Prevent diabetes complications nursing includes what?

A Daily foot inspection, monitor wounds, proper footwear, fall precautions

Help

Options

focusNode

Didn't know it?
click below

Knew it?
click below

Don't Know

Remaining cards (0)

Know

retry

shuffle

restart

0:00

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

Normal Size Small Size show me how

Concept Exam 2


Which diabetes is caused by autoimmune destruction of pancreatic beta cells?	Type 1 Diabetes
Which diabetes is caused by insulin resistance where insulin is present but cells do not respond?	Type 2 Diabetes
In which diabetes is insulin production minimal or completely absent?	Type 1 Diabetes
In which diabetes does the pancreas eventually fail to keep up leading to insufficient insulin production?	Type 2 Diabetes
Which diabetes is most commonly diagnosed under age 30?	Type 1 Diabetes
Which diabetes is most commonly diagnosed over age 50 but increasing in younger patients?	Type 2 Diabetes
Which diabetes symptoms appear suddenly and dramatically?	Type 1 Diabetes
Which diabetes symptoms develop gradually?	Type 2 Diabetes
Which diabetes is associated with unintentional weight loss?	Type 1 Diabetes
Which diabetes is associated with obesity?	Type 2 Diabetes
Which diabetes may initially be managed with lifestyle changes or oral medications?	Type 2 Diabetes
Which diabetes often presents in the ED with glucose sometimes 600+?	Type 1 Diabetes
Fruity breath indicates what complication strongly associated with which diabetes?	DKA Type 1 Diabetes
Gestational diabetes increases risk for developing which diabetes later in life?	Type 2 Diabetes
A Metabolic syndrome includes which risk factors?	Central obesity hyperlipidemia uncontrolled hypertension and hyperglycemia describe what syndrome?
Rapid-acting insulin onset time?	15 minutes
Rapid-acting insulin peak time?	30 minutes to 1.5 hours
Rapid-acting insulin hypoglycemia risk is highest when?	If meal is delayed
Short-acting insulin example?	Regular insulin
Short-acting insulin onset?	30 minutes
Short-acting insulin peak?	2 to 5 hours
Which insulin is the ONLY insulin that can be given IV?	A Regular insulin
Intermediate-acting insulin onset?	1.5 hours
Intermediate-acting insulin peak?	4 to 12 hours
Intermediate-acting insulin covers insulin needs for how long?	A About half the day or overnight
Long-acting insulin peak?	No true peak
Long-acting insulin provides what coverage?	Basal coverage over 24 hours
Which insulin should NEVER be mixed?	Long-acting insulin
Hypoglycemia risk is greatest at what time?	Peak of insulin
Why rotate insulin sites?	to Prevent complications
Repeated injections in same spot cause what?	Lipoatrophy
Lipoatrophy causes what physical change?	Indentation in skin
Lipohypertrophy causes what?	Fatty lumps
Insulin is given via which route?	Subcutaneous
Common injection sites?	Thighs, abdomen, fatty areas
When giving insulin what must nurse assess for?	Hypoglycemia
Oral anti-diabetics will NOT work in which diabetes?	Type 1 Diabetes
Metformin major adverse effect?	Lactic acidosis
Metformin must be held before what procedures?	Surgery and contrast studies
Sulfonylureas major adverse effect?	Hypoglycemia
Sweating, tremors, palpitations, nervousness, hunger Cold clammy, pale, tachycardic describes what?	Hypoglycemia
Late hypoglycemia signs?	Seizure confusion
First action for suspected hypoglycemia?	Check blood glucose
Professor emphasis what must you assess first in hypoglycemia?	Level of consciousness
Hyperglycemia dehydration symptoms?	Tachycardia, nausea ,vomiting, abdominal cramps fatigue, blurred vision
Hyperglycemia classic symptoms 3 ps ?	A Polyphagia, polydipsia, polyuria
Kussmaul respirations indicate what?	A DKA metabolic acidosis
Prevent diabetes complications nursing includes what?	A Daily foot inspection, monitor wounds, proper footwear, fall precautions
BMP showing high glucose suggests what?	Diabetes
Urinalysis showing glucose indicates what?	Blood sugar too high
Urinalysis showing ketones suggests which diabetes?	Type 1 Diabetes
When looking at Fasting plasma glucose what number indicates diabetes	126 mg/dL
Fasting plasma glucose is done after how many hrs of fasting?	8
Oral Glucose Tolerance Test (OGTT) is commonly used during what?	pregnancy
For Oral Glucose Tolerance Test (OGTT) which number indicates diabetes?	200
For Random glucose test is fasting needed?	No
For Random glucose test which number indicates diabetes?	200
HbA1c reflects blood glucose over how long?	90 days
If HbA1c is over what number it indicated diabetes? ?	6.5
Why foot care is critical in diabetes?	Decreased sensation from neuropathy
Avoid walking how with diabetes?	Barefoot
Trim nails how with diabetes?	Straight across
Should diabetes Pt wear well-fitted shoes?	Yes
Can diabetes Pt wear open-toe shoes?	No
During exercise diabetic patients should do what?	Eat before exercise carry snack check glucose
Sick day rule insulin?	Never stop insulin without provider guidance
Insulin in use may be kept at ?	room temperature
Never do what to insulin?	Freeze
Heat exposure does what to insulin?	Makes it ineffective
What to do to blood sugar before and after exercise?	Check blood sugar
Avoid injecting into muscle just exercised T/F?	True
Blood glucose fingerstick correct technique?	A Alcohol wipe air dry wipe first drop use second drop
If a patient says, “My sugars are all over the place,” one of the first things to assess is ?	where they are injecting.
Impaired glucose regulation risk if insulin given but meal skipped?	Hypoglycemia
Peripheral neuropathy pain is commonly described as what type of pain?	A Burning or stabbing pain
Gabapentin is used to treat what condition in diabetic patients?	Neuropathic pain
Nephropathy may progress to what?	Dialysis
DKA risk includes what imbalance?	Acid-base imbalance
High blood glucose impairs what body system leading to infection risk?	A Immune function
Slow wound healing in diabetic patients increases risk for what?	Infection
Elevated blood glucose places patients at risk for which nursing diagnosis?	Risk for Infection
What body areas should be closely monitored in diabetic patients to prevent infection?	Skin and feet
Hypoglycemia treatment if awake?	A Simple carbohydrates
Reassess after simple carbs how long?	15 minutes
If unconscious hypoglycemia with iv access treat with?	1 amp (50 ml) dextrose 50% IV push
If unconscious hypoglycemia with no iv access treat with?	1 mg glucagon SQ
Tachycardia, nausea, vomiting, abdominal cramps, fatigue, blurred vision, polyphagia, polydipsia, and Kussmaul respirations are clinical manifestations of what acute complication?	Hyperglycemia
What should be assessed in a patient with peripheral neuropathy to prevent falls?	Gait and balance
TPN is used when what cannot be used?	GI tract
TPN is given through?	A Central line
TPN must not be stopped abruptly because?	Rebound hypoglycemia
A patient with extensive burn injuries and severe metabolic demand may require what type of nutritional support if oral or enteral intake is inadequate?	Parenteral nutrition
Poor wound healing despite adequate oral intake may require escalation to what form of nutritional therapy?	TPN
Which gastrointestinal conditions may require parenteral nutrition due to impaired absorption or fistula formation?	Ulcerative colitis, Crohn’s disease, GI fistula
Why might pancreatitis require temporary use of parenteral nutrition?	To rest the pancreas and avoid GI stimulation
Which route of nutrition bypasses the gastrointestinal tract entirely?	Parenteral nutrition
Administration of TPN requires what type of technique to prevent infection?	Strict sterile technique
TPN contains high amounts of dextrose which increases risk for what complication?	Hyperglycemia
Patients receiving TPN require scheduled monitoring of what lab value?	Blood glucose
Central line must be assessed how often in patients receiving TPN?	Every shift
Why must TPN be tapered gradually instead of stopped suddenly?	To prevent hypoglycemia
If TPN is stopped unexpectedly what solution may be given to prevent hypoglycemia?	Dextrose
Electrolytes must be monitored during TPN to assess what?	Metabolic balance
Albumin and prealbumin are monitored during TPN to evaluate what?	Nutritional status
Monitoring intake and output during TPN evaluates what?	Fluid balance
Tachypnea, tachycardia, accessory muscle use, pursed-lip breathing, pale skin, adventitious breath sounds, and mucus/secretions are signs of what type of impaired gas exchange?	Acute
Cyanosis, clubbing of nails, barrel chest, and orthopneic positioning are signs of what type of impaired gas exchange?	Chronic
Which diagnostic tests are used to evaluate a patient with Impaired Gas Exchange by assessing lung structure?	Chest X-ray and CT scan
Which diagnostic study evaluates airflow in a patient with Impaired Gas Exchange?	Pulmonary function studies (FVC, FEV, PEFR)
Which lab helps determine if anemia or infection is contributing to Impaired Gas Exchange?	CBC
Which test evaluates oxygenation, ventilation, and acid-base balance in a patient with Impaired Gas Exchange?	ABG
Which specimen may help identify an infectious cause of Impaired Gas Exchange?	Sputum culture
Before allowing a patient to resume oral intake following a bronchoscopy, which assessment must be completed to prevent aspiration?	Check for return of gag reflex
Frequent vital sign monitoring immediately following an airway procedure is primarily to detect what complication?	Hypoxemia
Maintaining a patent airway following a bronchoscopy prevents which priority complication?	Hypoxemia
Light blood-streaked sputum following bronchoscopy is considered what type of finding?	Expected
Coughing up large amounts of bright red blood following bronchoscopy indicates what?	Emergency
When bleeding occurs after bronchoscopy, what two things must be documented?	Amount and time of onset
Suction should be available following bronchoscopy to prevent which complication?	Aspiration
If oxygen saturation decreases or hypoxemia is suspected, what intervention should the nurse implement as prescribed?	Administer oxygen as ordered
Following Bronchoscopy procedure, what complication should the nurse monitor for by assessing signs and symptoms such as fever, increased WBC, or purulent sputum?	Infection
Is COPD reversible?	No
What is the number one cause of COPD?	Smoking
What genetic deficiency is associated with COPD?	Alpha-1 antitrypsin deficiency
Chronic bronchitis is primarily a problem affecting what part of the respiratory system?	Airways
Pulmonary emphysema is primarily a problem affecting what structure of the lungs?	Alveoli
Chronic bronchitis and pulmonary emphysema both lead to what chronic respiratory disease?	COPD
Patients with chronic bronchitis feel most comfortable breathing in what position?	Tripod position
Airway constriction and wheezing are characteristic findings of which COPD condition?	Chronic bronchitis
In a patient with chronic bronchitis, when should the provider be notified regarding weight gain?	1 lb overnight or 2–3 lbs in a week
Difficulty breathing while lying flat in a bronchitis patient is described as what?	Orthopnea
Which diagnostic tests are commonly used to evaluate chronic bronchitis?	Chest X-ray, ABG, pulmonary function studies
Fever, productive cough, and heavy accessory muscle use suggest an exacerbation of which condition?	Chronic bronchitis
Weight gain in a patient with chronic bronchitis may indicate what underlying issue?	Fluid retention
Progressive dyspnea and shortness of breath with barrel chest are characteristic findings of which COPD condition?	Emphysema
Unintentional weight loss is more commonly associated with which COPD condition?	Emphysema
A patient who prefers to sleep sitting upright in a chair is most likely experiencing symptoms of which condition?	Emphysema
Which breathing technique is commonly used by patients with emphysema to prevent air trapping?	Pursed-lip breathing
In a patient with emphysema, an increase in sputum production should prompt what action?	Notify the provider
Barrel chest in emphysema develops in what manner?	Over time
What is the first step in MDI inhaler teaching before use?	Shake inhaler
Before pressing an MDI inhaler, what should the patient do with their breath?	Breathe out all the way
During MDI use, what action should occur at the same time as inhalation?	Press inhaler while breathing in
After inhaling medication from an MDI, how long should the patient hold their breath?	10 seconds
After holding the breath for 10 seconds with an MDI, how should the patient exhale?	Breathe out slowly
If the patient uses a steroid inhaler, what should they do after use to prevent thrush?	Rinse mouth
How long should the patient wait between puffs of an inhaler?	1 minute
When using both a bronchodilator and a steroid inhaler, which is used first?	Bronchodilator
When using both a bronchodilator and a steroid inhaler, which is used second?	Steroid
Which short-acting beta₂-agonist is an inhaled rescue medication for sudden shortness of breath?	Albuterol
Short-acting beta₂-agonists like albuterol are used for what type of symptom?	Sudden shortness of breath
Which long-acting beta₂-agonist is used daily for maintenance control?	Arformoterol
Which anticholinergic medication helps improve the airway in COPD?	Ipratropium
What effect do anticholinergics like ipratropium have on secretions?	Dries secretions
Anticholinergics help improve breathing by doing what to the airway?	Relax airway
What is the purpose of mucolytics in COPD care?	Thin secretions
Mucolytics help break up what in the airway?	Mucus
Hydration helps thin what respiratory problem?	Secretions
What is the purpose of anti-inflammatories (steroids) in gas exchange issues?	Decrease inflammation
Which corticosteroid is inhaled for airway inflammation?	Beclomethasone
Which corticosteroid is oral for airway inflammation?	Prednisone
Which oxygen device is best for precise oxygen control in COPD?	Venturi mask
COPD patients often breathe based on what drive?	Carbon dioxide drive
Too much oxygen in COPD can cause what problem?	Suppress respiratory drive
What target oxygen saturation is often appropriate for COPD patients?	88–92%
When evaluating O2 sat in COPD, what comparison is most important?	Their baseline
Why might a patient with fluid overload or HF contributing to SOB receive diuretics?	To pull fluid off
Which vaccines are important for COPD prevention/maintenance?	Flu and pneumonia vaccines
What is a key goal of COPD maintenance care?	Prevent exacerbations
What is the number one intervention for COPD?	Smoking cessation
In priority nursing care for COPD, what is the priority focus?	Airway and breathing first
What is the priority sequence emphasized for COPD management?	Airway, breathing, oxygenation, medications, reassess
When assessing breath sounds, wheezing indicates what?	Airway narrowing
When assessing breath sounds, crackles indicate what?	Fluid
When evaluating oxygen delivery, what lab value should be checked for RBCs?	Hemoglobin
Why is hemoglobin important for oxygen delivery?	Oxygen rides on hemoglobin
A patient can have normal lungs but low oxygen delivery if what is low?	Hemoglobin
ABG tells you what three things?	Oxygenation, ventilation, acid-base balance
On ABG interpretation, what oxygen measures must always be checked?	PaO2 and O2 saturation
Does a chest X-ray tell how well lungs are working?	No
Pulse oximetry measures what?	Oxygen saturation
Bronchodilators help impaired gas exchange by doing what?	Open airway
Steroids help impaired gas exchange by doing what?	Decrease inflammation
Antibiotics are used in gas exchange problems when what is present?	Infection
After giving respiratory medication, what must the nurse do?	Reassess
Oxygen should be treated as what in nursing care?	A drug
Why should the nurse not apply oxygen and walk away?	Must monitor response and safety
What position improves lung expansion for impaired gas exchange?	High Fowler’s
Pursed-lip breathing helps do what for COPD patients?	Slow breathing and empty trapped air
How do you inhale during pursed-lip breathing?	Inhale through nose
How do you exhale during pursed-lip breathing?	Exhale slowly through pursed lips
Why are small frequent meals recommended in COPD?	Large meals make breathing harder
Small frequent meals help prevent what?	Fatigue
Hydration makes sputum easier to do what?	Cough up
Why are COPD patients high risk for infections?	Impaired respiratory defenses/illness risk
What safety rule is very testable with oxygen therapy?	No smoking with oxygen
Why can too much oxygen be dangerous in COPD?	Suppresses CO2 drive
A pleural chest tube may be needed for what problem?	Fluid buildup to expand lung
Chest tubes drain what from pleural space?	Air, blood, fluid
Chest tubes improve what physiologic process?	Gas exchange
Excessive bubbling in the water-seal chamber suggests what?	Air leak
What patient supplies must be at bedside for chest tube safety?	Emergency supplies
What should the nurse assess at the insertion site?	Site condition and dressing
The dressing over a chest tube site must be what?	Intact
Why encourage cough and deep breathing with a chest tube?	Promote lung expansion
What device supports lung expansion post chest tube?	Incentive spirometry
What bedside actions were emphasized for chest tube care?	Assess respiratory status, inspect site, ensure dressing intact, circle drainage, reassess lung sounds/O2
What should the nurse check for in the chest tube tubing?	Kinks, occlusions, loose connections
Should the nurse strip or milk the tubing?	No
What is Chamber A in a chest tube drainage system?	Suction control
What is Chamber B in a chest tube drainage system?	Water seal chamber
What is Chamber C in a chest tube drainage system?	Water seal chamber
What is Chamber D in a chest tube drainage system?	Fluid collection chamber
Tracheal deviation indicates airway is what?	No longer patent
With tracheal deviation, what is the immediate nursing response?	Assess airway and Call Rapid Response
With tracheal deviation, should the nurse leave the patient?	No, stay with patient
With tracheal deviation, what must be assessed first?	Airway and breathing
Sudden onset increased dyspnea with chest tube suggests what?	Lung collapse/pneumothorax
What should the nurse assess with sudden increased dyspnea?	Assess lung sounds Check O₂ saturation Check tubing for kinks Notify provider if worsening
What should be checked immediately with sudden dyspnea?	O2 saturation
What equipment check is priority with sudden dyspnea?	Tubing for kinks
If dyspnea worsens after checks, what is next?	Notify provider
For most patients, O2 saturation below what is an emergency?	90%
If O2 saturation is low, what should the nurse do immediately?	Assess respiratory status
After applying oxygen, what must the nurse do?	Reassess
Drainage greater than what amount per hour is concerning?	70 mL/hr
With high drainage, what should be monitored closely?	Vital signs
With suspected hemorrhage, assess for signs of what?	Shock
If drainage stops, what is the first action?	Check tubing for kinks
If drainage stops, what positioning rule must be confirmed?	System below chest level
If still no drainage after checks, what is next?	Notify provider
If tubing falls out, what should the nurse do to the site?	Cover with sterile gauze
Should the nurse attempt to reinsert the tube?	No
If tubing disconnects from drainage system, what should the nurse do immediately to the end of tube?	Place end of tube in sterile water
When multiple problems occur, what is priority order?	Airway first, oxygenation, equipment
Why is bedside assessment critical per lecture?	Determines life or death
TB requires what type of isolation?	Airborne precautions
What PPE is required for TB isolation?	Gown, gloves, N95
TB patients should be placed in what room type?	Negative pressure
For TB, what should be done with the door?	Keep closed
What organism causes TB?	Mycobacterium tuberculosis
How is TB transmitted?	Aerosolization airborne
Secondary TB means what?	Reactivation later
Examples of immunosuppression risks for secondary TB?	HIV, smoking, weakened immune system
Secondary TB can reactivate from what?	Primary lesion
TB is highly communicable in what environments?	Close-contact environments like Prisons, nursing homes, close contact settings
Homelessness increases TB risk due to what?	Poor access, delayed treatment, crowded shelters
Immunocompromised patients are high risk for what TB type?	Reactivation/secondary TB
TB is a public health issue and is what kind of disease?	Reportable
TB symptoms are usually what speed of onset?	Gradual
A patient saying “I feel tired all the time” should raise concern for what?	TB
Purulent sputum suggests what?	Infection including TB
Crackles may be heard where in TB?	Upper lobes
Cough lasting longer than how many weeks is suspicious for TB?	3 weeks
Weight loss, night sweats, and hemoptysis together suggest what diagnosis?	TB
After exposure/positive skin test, what is required?	Chest X-ray
What TB test is called the Mantoux skin test?	PPD
PPD is read at what time?	72 hours
PPD positive threshold (per notes) is greater than what?	10 mm induration
PPD positive indicates what?	Exposure
What confirms active TB definitively?	Sputum cultures
How many sputum samples are usually needed for TB?	3 early-morning samples
Why may HIV patients have weaker PPD reactions?	Immunosuppression
TB medications are hard on what organ?	Liver
Which labs must be monitored due to TB drug hepatotoxicity?	LFTs (AST, ALT)
What substance use must be assessed with TB meds?	Alcohol use
RIPE therapy stands for what meds?	Isoniazid, Rifampin, Pyrazinamide, Ethambutol
INH requires monitoring for what signs?	Dark urine, jaundice
INH may require what vitamin to prevent neuropathy?	Vitamin B6 (pyridoxine)
TB antibiotic therapy may last up to how long?	6 months
TB treatment often uses what approach?	Combination medications
TIA is defined as what type of deficit?	Reversible ischemic neurologic deficit
TIA symptoms resolve within what time range?	30–60 minutes
After TIA, the patient returns to what?	Baseline function
TIA is a warning sign for what?	Future stroke days–weeks
Should TIA be dismissed if symptoms resolve?	No, still emergency
Stroke is defined as interruption of perfusion long enough to cause what?	Permanent neurologic damage
Do stroke symptoms reliably resolve?	No
Are both TIA and stroke emergencies?	Yes
Thrombotic stroke occurs when what happens?	Clot forms in brain vessel
Thrombotic stroke is associated with what vascular disease?	Atherosclerosis
Thrombotic stroke onset is typically what?	Slow and gradual
Thrombotic deficits progress over what time?	Hours to days
Thrombotic stroke risk factors emphasized?	HTN, diabetes, hyperlipidemia
Embolic stroke occurs when what happens?	Clot travels from elsewhere to brain
Embolic stroke onset is typically what?	Sudden immediate severe deficit
Embolic stroke is strongly associated with what rhythm?	Atrial fibrillation
Hemorrhagic stroke occurs when what happens?	Vessel ruptures bleeding in/around brain
Hemorrhagic stroke locations include what?	Intracerebral, subarachnoid, subdural
Hemorrhagic stroke is usually caused by what?	Uncontrolled hypertension
Hemorrhagic stroke often presents with what major sign?	Decreased LOC with increased ICP
In hemorrhagic stroke, are tPA and anticoagulants given?	No
In hemorrhagic stroke, what is the priority?	Stop bleed, control BP, manage ICP, protect perfusion
Non-modifiable stroke risk factors include what?	Age, family history, prior stroke/TIA
What is the number one clinical risk factor for stroke?	Hypertension
Major stroke risk factors include what?	Atherosclerosis, hyperlipidemia, diabetes, A-fib, hypercoagulability
Most common modifiable stroke risk factors include what?	Smoking, heavy alcohol, cocaine, oral contraceptives, obesity
Sudden confusion or trouble speaking is a sign of what emergency?	Stroke
Sudden one-sided weakness/numbness of face/arm/leg suggests what?	Stroke
Severe headache with no known cause is especially concerning for what stroke type?	Hemorrhagic
FAST facial droop assessment is done by asking the patient to do what?	Smile
FAST arm weakness assessment is done by asking the patient to do what?	Raise both arms
FAST speech difficulty is assessed by noting what?	Slurred/wrong words/unable
FAST time means what action?	Call 911/activate stroke alert
Why call EMS for stroke instead of driving?	EMS begins care en route
If a change is noted in hospital suggesting stroke, what should be activated?	Code Stroke/Stroke Alert
NIHSS is used for what purpose?	Assess stroke deficits/severity and trend
Lower GCS score indicates what?	Decreased LOC sudden drop in GCS = emergency
GCS test what?	Neuro
First imaging test for suspected stroke is what?	Non-contrast CT
Why is CT first in stroke?	Rule out hemorrhage
MRI is more sensitive for what?	Early/small ischemic injury
Cerebral angiography is used to look for what?	Occlusion/aneurysm/vascular abnormalities
PT/INR monitors what medication?	Warfarin
PTT monitors what medication?	Heparin infusion
Alteplase (tPA) is only used for what stroke type?	Ischemic
If stroke onset is greater than about what time, tPA is not given per lecture?	~4 hours
Major nursing concern with tPA is what?	Bleeding
Internal bleeding clue after tPA includes what vitals change?	Decreased BP and increased HR
What is important about a heparin infusion per lecture?	Do not let it stop/run dry
Expressive aphasia means what?	Understands but cannot get words out
Receptive aphasia means what?	Can speak but cannot understand
Aphasia is a language problem, not what?	Intelligence
What must be ensured for patients with aphasia?	A way to communicate
Communication strategies include what style?	Short simple sentences one idea at a time
Why avoid yes/no questions with aphasia?	Can be inaccurate
Tools to support communication include what?	Picture boards gestures writing tools
Which service should be consulted for aphasia?	Speech-language pathology
Stroke deficits appear on what side relative to brain injury?	Opposite side
Left hemisphere stroke causes weakness on which side?	Right
Right hemisphere stroke causes weakness on which side?	Left
Quadriparesis means what?	Total paralysis/weakness in all four (per notes)
Dysarthria means what?	Slurred speech
Mobility priorities after stroke include assessing what?	Strength bilaterally
Stroke patients are at risk for what two issues with mobility?	Falls and skin breakdown
How should nurses promote independence after stroke?	Let them do what’s safe assist what’s not
Why support the affected limb after stroke?	Prevent injury and improve positioning
PT focuses on what for stroke patients?	Gait training devices
OT focuses on what for stroke patients?	ADLs retraining
Early mobilization helps prevent what complication?	DVT/VTE
Mechanical DVT prevention includes what?	SCDs
Medication DVT prophylaxis examples include what?	Heparin/lovenox unless contraindicated
Swallowing impairment post-stroke increases risk for what?	Aspiration
Stroke swallowing impairment increases risk for what nutrition issue?	Imbalanced nutrition
Where should the nurse check for swallow evaluation status?	EMR
Should food/drink be given before swallow eval is cleared?	No
Post-stroke, a swallow study is required before what?	PO intake
Position for feeding stroke patient to reduce aspiration?	Upright
Diet types after stroke may include what?	Mechanical soft, thickened liquids, puree
To reduce pocketing in cheek, food should be placed where?	Toward back of mouth
If coughing/choking during feeding, what should happen?	Stop feeding
Swallow/diet coordination requires which disciplines?	SLP, OT, dietitian
Diet/swallow status must be communicated to who?	Unlicensed personnel
Unilateral neglect means what?	Ignores one side
Unilateral neglect increases risk for what?	Skin breakdown
Decreased LOC is a major sign of what complication?	Increased ICP
Projectile vomiting is a sign of what?	Increased ICP
Very high BP (SBP>180/DBP>110) in this context suggests what?	Increased ICP/ICU level care
To help reduce ICP, HOB should be at what angle?	30 degrees
To reduce ICP, head should be positioned how?	Midline
To reduce ICP, what should be avoided?	Overstimulation/clustering too many activities
For increased ICP, what environment is recommended?	Quiet dim lights reduce noise
Care transitions are high risk for what?	Communication breakdowns
Discharge planning must focus on what status?	Functional status/safe mobility
What process ensures meds are correct at discharge?	Medication reconciliation
Rehab intensity inpatient rehab is about how many hours/day?	4–5 hours/day
SNF rehab is appropriate when patient cannot do what?	Tolerate long therapy days
Home health/outpatient is what intensity?	Lowest intensity
Discharge needs include teaching safe what?	Mobility/transfers
Family education must include what stroke recognition tool?	FAST and call 911
Anticoagulant/antiplatelet teaching must include what precaution?	Bleeding precautions
After stroke, emotional health assessment includes screening for what?	Depression
Joint Commission core measures include DVT prophylaxis unless what?	Contraindicated
Discharge on antithrombotic and what other med class?	Statin
Stroke education must be what?	Provided/documented
Seizure is defined as what?	Sudden uncontrolled electrical discharge in brain neurons
Epilepsy is defined as what?	Two or more unprovoked seizures
Stroke patients are at increased risk for what complication?	Seizures
Generalized seizures involve what?	Both hemispheres
Tonic-clonic seizure includes what phases?	Tonic stiffening then clonic jerking
During tonic-clonic seizure, does the patient lose consciousness?	Yes
Postictal phase commonly includes what?	Confusion/fatigue
Myoclonic seizures look like what?	Brief jerky movements
Simple focal seizure includes what consciousness status?	still have LOC
Complex focal seizure includes what behavior example?	Lip smacking with lose of LOC
Partial/Focal seizures can spread to become what?	Generalized
Aura occurs when?	Right before seizure
Aura examples include what?	Visual flashes odd smell/taste dizziness déjà vu anxiety restlessness mood changes
After seizure, patient may not remember what?	The event
Generalized seizures may include what elimination issue?	Incontinence
Postictal phase usually lasts how long?	Minutes to ~30 minutes
Idiopathic epilepsy means what?	No identifiable cause/unknown
Mainstay of epilepsy treatment is what?	Drug therapy (AEDs)
Abruptly stopping antiseizure meds can trigger what dangerous complication?	Status epilepticus
Alcohol should be avoided in epilepsy because it does what?	Lowers seizure threshold and affects meds
Some AEDs may require monitoring of what?	Serum levels
Secondary seizures mean what?	Known cause/trigger
Treatment of secondary seizures focuses on what?	Treat the cause
If seizure not witnessed, what is the most important assessment?	Patient history
History questions should include what pre-seizure warning?	Aura
A long postictal phase suggests what seizure type?	Generalized
During a seizure, what is the nursing priority?	Airway
During a seizure, the patient should be turned to what position?	Side
During a seizure, what should be protected?	Head
During a seizure, what should be loosened?	Tight clothing
During a seizure, should you restrain the patient?	No
During a seizure, should you put anything in the mouth?	No
Seizure precautions include what bed safety measure?	Pad bed rails
Seizure precautions include bed in what position?	Lowest position
Primary diagnostic test for seizures is what?	EEG
PET scan evaluates what?	Metabolic activity in brain
Are these Active of Long-term seizures meds examples include phenytoin, carbamazepine, valproic acid, gabapentin, and Levetiracetam?	Longterm
Nonadherence is a top cause of what?	Breakthrough seizures
Serum levels tell us what about AED therapy?	med Adherence
Epilepsy teaching includes avoiding alcohol and wearing what?	Medical alert bracelet
Seizure precautions include maintaining what if ordered?	IV access
What should never be inserted into a patient’s mouth during seizure precautions?	Tongue blade
PRN acute seizure meds should be what?	Ordered
Are these long-term or active seizures meds such as diazepam lorazepam?	Active
If a seizure starts while you are in the room, what must you do?	Stay with the patient
If a seizure starts, should you leave to get medication?	No
During a seizure, how do you get help?	Press call light/call for help
Increased oxygen demand during seizure puts patient at risk for what?	Hypoxia
During a seizure, turning patient side-lying helps with what?	Airway and secretion drainage
Benzodiazepines are used for what purpose in seizures?	Stop active seizures
After a seizure, what must be observed and documented?	Appearance, body parts involved,
If restraints are present when seizure occurs, what should be done?	Remove restraints
Status epilepticus is defined as seizure lasting greater than what?	5 minutes
Status epilepticus can also be repeated seizures over what time without return to baseline?	30 minutes
Why is status epilepticus dangerous?	Severe hypoxia brain damage respiratory failure risk
Immediate actions for status epilepticus include administer what?	Oxygen
For status epilepticus, prepare for what airway need?	Advanced airway/protect airway
For status epilepticus, what team must be activated immediately?	Rapid Response Team
For status epilepticus, what type of IV medication is typically first-line?	IV benzodiazepine
Most common cause of status epilepticus (exam favorite) is what?	Stopping antiseizure medications
5 minutes of seizure means what?	Emergency
in status epilepticus, what is priority?	Airway and oxygen
The nurse is taking care of a pt. that had a thrombotic stoke, what does the pt. report?	Gradual onset of weakness before admission
The nurse looking at the EMR notices which medication is the probable cause for the embolic stroke?	Digoxin for a-fib
The nurse noticed the patient had a right sided brain attack and ate only one side of their plate. This is an indication of	Hemianopsia
The nurse found the patient coughing, lying flat, with food particles around their mouth. What is the nurses first action?	Place the patient upright
The nurse has received a hand-off report. Which patient should the nurse see first?	The patient whose GCS is 8 from a 10
What do ABGs assess in a patient with respiratory compromise?	Gas exchange and oxygen perfusion
If a provider writes an order for routine suctioning every 2 hours, what should the nurse do?	Question the order because suctioning is PRN
Why should an order that states “continuous suction for 2–3 hours” be questioned?	Suctioning is only done as needed (PRN)
In a properly functioning chest tube system, what is expected in the water-seal chamber with breathing?	Rise with inhalation and fall with exhalation
To prevent aspiration, what equipment must always be available in the patient’s room?	Suction setup
If a patient begins vomiting, how should the nurse position the patient?	Turn the patient on their side
Before resuming a diet after decreased LOC or airway procedure, what must be checked?	Gag reflex
What serious complication can diabetic retinopathy lead to?	Blindness
What is the nursing recommendation for preventing diabetic retinopathy complications?	Yearly eye exam by an ophthalmologist
What is the initial oxygen therapy method recommended for most patients?	2–4 L/min via nasal cannula
A Type 1 diabetic patient is confused, diaphoretic, and clammy. What should the nurse administer first?	4 oz of 2% milk

Created by: fsanoe

"Know" box contains:
Time elapsed:
Retries: