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Med Surg Final
| Question | Answer |
|---|---|
| Nursing care for clients w/ epistaxis | Monitor bleeding, notifying amount and color of drainage. Monitor VS and hemoglobin levels, excessive swallowing (for bleeding in back of throat), airway obstruction |
| What medications should be avoided in clients w/ COPD | Propranolol |
| Clients w/ lower respiratory tract infection and having difficulty expectorating secretions. What would you do as the nurse? | Encourage coughing and deep breathing,Increase fluid intake, provide oxygen, administer prescribed medication (Bronchodilators,mucolytic,and expectorants) |
| Manifestations of a UTI including what a urinalysis would represent indicating UTI | Voiding urgency, frequency,and burning, , cloudy, foul-smelling urine, hematuria. Urinalysis will show WBc, RBC, casts, bacteria, positive for nitrites. |
| Describe the types of incontinence | Disability-associated incontinence, overflow, stress, urge and total incontinence |
| Effects of aging on the renal system | GFR decreases, urinary bladder decreases in size, tone of detrusor decreases leads to urinating more. Experience more urinary tract infections |
| Diet considerations for clients w/ chronic kidney disease | Given iron, folic acid, vitamins and minerals to supplement restricted diet. |
| Nursing care for client w/ diabetes insipidus | monitor for client I&O, weight, VS, and urine specific gravity. monitor for restlessness or weakness and provide free access to oral fluids |
| Manifestations of hypocalcemia and its treatment (meds) | Changes in heart rate, decreased BP, mental status changes, hyperactive deep tendon reflexes |
| What laboratory data indicates treatment for diabetes insipidus has been effective | urine specific gravity between 1.005 to 1.03 |
| What is SIADH and what electrolyte do you want to closely monitor | too much ADH in the body; serum sodium levels |
| Client has an airway obstruction... what adventitious breath sound is associated and what does it actually sound like? | Diminished or absent lung sounds, fine crackles, coarse crackles, wheezes, stridor, pleural friction rub |
| What is water deprivation test | evaluate the kidney's ability to concentrate urine and help diagnose and differentiate types of diabetes insipidus |
| What is Addison disease and what should be reinforced during times of increased stress following an adrenal crisis | is thought to be an autoimmune disease; that is the gland destroys itself in response to conditions such as tuberculosis, fungal infection, infection related to aids or metastic cancer. During times of stress or illness, doses need to be increased to two |
| Difference between DM type l and type ll | DM type 1 little to no insulin is produced, DM type 2 insulin is produced but body cannot use it effectively |
| Manifestations of emphysema | SOB, activity intolerance, use of accessory muscles |
| Manifestations of Cushing's syndrome | Weight gain, central obesity w/ thin arms and legs, buffalo hump, moon-faced shape, thin skin w/ purple striae, hyperpigmentation |
| Manifestations of hypoglycemia | Hunger, sweating, tremor, blurred vision, headache, irritability, seizures, confusion, coma |
| Manifestation of hyperglycemia | Polyuria, polydipsia, polyphagia, blurred vision, headache, lethargy, abdominal pain, ketonuria, coma |
| Manifestations of airway obstruction | Dyspnea, tachypnea,stridor, wheezing, nasal flaring |
| Manifestations of cystic fibrosis | Range from chronic sinusitis, to thick tenacious sputum. Finger clubbing, infections become more frequent, loss of lung function and respiratory failure. Frequent foul-smelling stools, poor appetite, bowel obstruction, cirrhosis, delayed sexual maturation |
| As a nurse, how would you collect a 24hr urine? | Discard first urine and collect midstream |
| Aging effects on the respiratory system | Decreased cilia, decreased cough reflex, decreased force of cough, decreased gas exchange, increased risk of respiratory infections |
| Nursing care for a client whose chest tube became dislodged | Obtain two padded clamps to keep at the bedside. These are used for clamping the chest tube if the chest drainage system becomes accidentally disconnected from the tubing Ch29 |
| Diagnostic tests that indicate a client has or is suspected of having a pulmonary embolism | pulmonary angiogram CH 31 |
| What is flail chest and its manifestations | (condition of chest wall caused by two or more fractures on each affected rib, resulting in a segment of rib that is not attached on either end). The patient is dyspneic and anxious and may also be tachypneic and tachycardic. CH31 |
| Manifestations of chlamydia | conjuctivitis; in men, urethritis, epididymitis, |
| What is peyronie disease | Peyronie disease gives the penis a curved or crooked look when it is erect. Fibrous bands or plaques form mainly on the dorsal (top) part of the layer of tissue. The plaque may be caused by injury or inflammation of the penile tissue CH43 |
| How does a vasectomy work as a "form" of birth control | Tiny clamps are used to seal off the Vas Defers preventing sperm from reaching outside the body. The man can still ejaculate semen, but it does not contain sperm. A semen sample must be done to confirm success. pg (842) |
| What is priapism | continuous painful erection |
| Manifestations of polycystic ovarian syndrome (PCOS) | Infertility, obesity, and menstrual disturbances. Excess hair growth, increased risk of DM, elevated blood pressure, coronary heart disease, depression and endometrial cancer. |
| Manifestations of diabetic ketoacidosis | Fruity breath, tachycardia, hypotension, shock. Fluid imbalances, flu-like symptoms |
| Client teaching when prescribed prednisone | Administer with food. Monitor for increased blood glucose levels, insomnia, mood swings, and exacerbation of psychotic behaviors. |
| Manifestations of COPD | Chronic cough w/ or w/o sputum, progressive dyspnea on exertion, shortness of breath, activity intolerance. Crackles and wheezing often noted on auscultation |
| Postoperative care to prevent respiratory complications | Monitor breath sounds, encourage deep breathing and coughing hourly, use of incentive spirometer as ordered while awake turning every 2 hours and early ambulation as able |
| Diagnostic tests used to evaluate renal disease | Urinalysis, Bladder ultrasound scan, Renal ultrasonography, kidney-ureter-bladder xray,CT Scan, MRI, |
| Manifestations of hypothyroidism | Fatigue, weight gain, bradycardia, constipation, mental dullness, feeling cold, shortness of breath, decreased sweating, dry skin and hair |
| Postop septoplast | monitor vital signs and bleeding, monitor for excessive swallowing. patient will have nasal packing and "mustache dressing" under the nose to catch drainage. |
| Nursing interventions for sinusitis | Increase water intake by 8-10 glasses a day unless contraindicated, semi-fowler position to relieve pressure |
| Treatment for streptococcal infection | Penicillin. Acetaminophen or throat lozenges may be used to relieve discomfort. Saltwater gargles or honey mixed w warm water help soothe inflamed tissues. Encourage fluid and rest |
| Care for a tracheostomy in the clients home | Regularly monitor pt's respiratory status and tube placement. Auscultate bilaterally, carefully secure tube with tape or velcro to avoid dislodging. |
| Important teaching for pt prescribed w/ Prednisone for COPD | Smoking Cessation, promote healthy diet and physical activity, Bronchodilators, corticosteroids, expectorant, flu and pneumonia vaccinations, supplemental oxygen, breathing excersices, chest physiotherapy, pulmonary rehabilitation |
| Respiratory alkalosis vs. acidosis | Respiratory acidosis is the decreased abilityof lungs to excrete Carbon dioxide and respiratory alkalosis excessive excretion of carbonic acid |
| Location of the body when kidney disease is suspected | Dull heaviness in flank or lumbar region |
| Manifestations of UTI | Voiding urgency, frequency, and burning, cloudy, foul-smelling urine, hematuria |
| Urinary concerns of a client w/ thoracic spinal cord injury | predisposes a client to pneumonia, monitor for urinary retention, urinary catheterization places patients at risk for UTI CH48 |
| Normal pH of urine and what is indicated when values are abnormal | normal pH range of urine is 4.5-8.0. Low: diarrhea, metabolic acidosis, starvation. High: infection, renal disease, vomiting |
| Best indicator of fluid balance | weight is the best indicator of fluid balance |
| Side effects of hemodialysis | muscle cramps, lethargy, weak, fatigue. Drops in BP can cause dizziness and nausea. Fluid and electrolyte levels drop rapidly. cardiac arrythmias, angina CH 35 |
| Nursing interventions for a client w/ urolithiasis | Small stones:Hydration, analgesics, alpha blocker (tamulosin) Large stone: Iv fluids, pain control, thiazide diuretic, allopurinol, lithotripsy. Surgery: percutaneous nephrolithotomy, ureteroscopy, cystoscopy,cys |
| Nursing considerations for a client w/ dialysis access | the nondominant hand should not be used for IV lines , blood draws or blood pressure to avoid damage to the veins |
| Medication for a client status post thyroidectomy | levothyroxine (synthroid) |
| Nursing care for a client in thyrotoxic crisis | Acetaminophen for high fever. Avoid aspirin. IV fluids and cooling blanket, oxygen administered, propranolol to control tachycardia, elevate head of bed |
| What can cause adrenal crisis in a client | Removal of adrenals causes sudden drop in adrenal hormones |
| Teaching a client who has been dx w/ hypoparathyroidism | Importance of long -term diet, medication therapy, and follow - up laboratory testing, understand self care |
| Lab values to be aware of in a client w/ SIADH | Serum and Urine sodium and osmolality, water load test |
| What would indicate a concern upon assessment w/ a client who has a goiter? | thyroid gland is enlarged , and swelling may be apparent at the base of neck |
| Humalin R insulin action, when it takes effect, how long it lasts, when to be aware of client s/s of hypoglycemia | Short acting, it takes effect in 30 mins, it lasts 3-6 hr, be aware of s&s 2-3 hr |
| Hypersmolar hyperglycemia what it is and what nursing interventions are applicable | polyuria causes profound dehydration, producing the hyperosmolar (concentrated) state; look for other signs of dehydration/increase fluid intake, start IV fluids, administer insulin CH40 |
| Long term complications of DM | hypoglycemia, hyperglycemia, diabetic ketoacidosis, hyperosmolar hyperglycemia |
| Education to a client w/ peripheral neuropathy | |
| S/S of DKA | Kussmaul respirations, fruity breath, tachycardia, hypotension, shock, dehydration, hypokalemia, abdominal pain, vomiting CH40 |
| What information would you share w/ a female client who is fibrocystic breast disease support group | Use a supportive bra can help reduce discomfort, herbal remedies like primrose oilor supplemental vitamin E,limit dietary fat and caffeine, and oral contraceptive |
| Nursing considerations of Ribavirin | avoid breastfeeding* |
| Client manifestations of PCOS | infertility, obesity, menstrual disturbances, masculinization (excessive hair growth) |
| Care of client w/ a pessary | Kegel excersice, anterior colporrhaphy, resuspending the bladder |
| Care of client w/ agenesis of the ovaries | may struggle with self-esteem issues, feeling that they are incomplete or have been cheated of something they desire. Show that you are willing to listen if and when the patient wishes to talk, while allowing her as much privacy as she desires CH42 |
| Greater risk of complications of a client taking oral contraceptives | smokers, women with diabetes, hx of thrombophlebitis, and heart disease |
| Client teaching of a client w/ acute prostatitis | Treated with antibiotics. Additional treatments may include anti-inflammatory agents, stool softeners to reduce straining with bowel movements, warm sitz baths, prostatic massage, and dietary changes such as decreasing spicy foods and alcohol CH43 |
| Medication used for BPH that is alpha blocking | Tamsulosin (Flowmax) and Alfuzosin (Uroxatral) pg 868 |
| Care priority of a client w/ priapism | Small veins in the corpora cavernosa spasm, so blood cannot drain back out of the penis as it should. This can cause permanent tissue damage from lack of oxygen. Priority is to restore blood flow and relieve the erection ASAP |
| Considerations of a client post vasectomy | There should be no major change in the way ejaculate looks or feels after the procedure. And a pt should use another birth control method for 3 months after surgery to ensure no sperm is life above the surgical site. |
| S/S of chlamydia | Nausea, vomiting, sharp pain at base of ribs sometimes radiates to right shoulder and arm |
| Care of a pregnant women who is positive for genital herpes simplex virus type 2 | cryosurgery and laser destruction, are forms of removal. all treatments may require multiple applications and result in discomfort as warts degenerate. |
| Teaching clients about gonorrhea | Men may be asymptomatic or may have urethritis with a yellow urethral discharge. Women may have either no noticeable symptoms or have urethritis, MPC, or abnormal menstrual symptoms such as bleeding between periods or during sex. |
| How does PID affect ability to conceive and what confirms dx of PID | Damage to the fallopian tubes affect ability to conceive. To diagnose PID, HCPs obtain a medical history and perform a pelvic exam CH44 |
| How would you explain to a client what pleural effusion is? | Flid has collected in the pleural space and the sac surrounding your lungs |
| Which of the following is not a manifestation of a client w/ COPD? | nonproductive hacking cough |
| Which manifestation does not support a dx of DKA? | Increase in pH |
| D-dimer is a diagnostic test that would be positive in a client suspected of a pulmonary embolism | True |
| Which of the following is not a manifestation of a client w/ Cushing's syndrome | Tremors |
| A client has been diagnosed w/ syndrome of antidiuretic hormone (SIADH), what should be monitored closely? | Sodium/ potassium |
| Client w/ chronic kidney disease should limit their daily intake of what? | Protein |
| Client having difficulty conceiving, they have increased body/facial hair, obese and have acne... what is suspected? | PCOS |
| Client who smokes and is treated for HTN and DM is a great risk for complications from oral contraceptive use | True |
| A client w/ COPD is on long term steroids. What should be vital in client teaching? | Never discontinue abruptly |
Created by:
SamarhaP