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