UTA NURS 3561 Adults Final Exam
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| HIV risk factors | show 🗑
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| show | fatigue, headache, low-grade fever, night sweats, persistent generalized lymphadenopathy (PGL)
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| show | persistent fever, frequent drenching night sweats, chronic diarrhea, recurrent headaches, and fatigue severe enough to interrupt normal routines, localized infections, lymphadenopathy, and nervous system manifestations
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| AIDS criteria (vs. HIV) | show 🗑
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| normal CD4 T cell count | show 🗑
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| Antiretroviral therapy (ART) | show 🗑
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| show | signs/symptoms to report (change in LOC, headache, vision changes, SOB, n/v, dehydration, jaundice, bleeding, flank pain, weakness of body part, chest pain, seizures, rash, oral lesions, depression); use of antiretroviral drugs; antibiotic-resistance
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| Fibroadenoma differentiating manifestations | show 🗑
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| show | occurs in older women (Age 50 or over); masses are hard, irregularly shaped, poorly delineated, and nonmobile; nipple discharge and retraction can occur
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| show | assess for lymphedema, administer analgesics, refer to support groups, protect arm/hand/fingers from trauma, take BP in unaffected arm
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| Positioning of arm post mastectomy | show 🗑
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| show | complication of mastectomy; an accumulation of lymph in soft tissue with swelling resulting from inflammation, obstruction, or removal of lymph channels and nodes; can cause too much pressure on the veins leading to nerve damage, cellulitis, and fibrosis
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| show | urinary urgency, decreased force of urination, urinary hesitancy, urine dribbling, urinary retention, incontinence, nocturia, dysuria, feeling as if still has to go, bladder discomfort, and sexual dysfunction
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| BPH management | show 🗑
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| show | decrease caffeine and artificial sweeteners, limit spicy or acidic foods
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| transurethral resection of the prostate (TURP) | show 🗑
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| show | prevent complications (hemorrhage, bladder spasms, urinary incontinence, and infection); irrigate the bladder; administer analgesics; ensure adequate hydration
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| show | decreased metabolism causing weight gain, puffy face (periorbital edema), coarse facial features, dry skin, and dry coarse hair and eyebrows
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| Hypothyroidism management | show 🗑
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| Myxedema coma | show 🗑
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| Myxedema coma management | show 🗑
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| show | increased metabolism, goiter, exophthalmos, weight loss, increased nervousness, tremors, palpitations, angina, bound/rapid pulse, systolic murmurs
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| show | complication of hyperthyroidism; tachycardia, HF, shock, hyperthermia, restlessness, agitation, seizures, abdominal pain, nausea, vomiting diarrhea, delirium, and coma
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| show | Oxygen administered, followed by fluid replacement, administering antipyretics, and treating the stressor
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| show | assess for hemorrhage or tracheal compression; assess for tetany secondary to hypoparathyroidism (hypocalcimia), for Trousseau’s sign or Chvostek’s sign; place in semi-Fowler’s, support head with pillows, and avoid neck flexion and tension on suture lines
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| Hypoparathyroidism manifestations | show 🗑
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| Trousseau's sign | show 🗑
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| Chvostek's sign | show 🗑
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| Hypoparathyroidism management | show 🗑
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| Hyperparathyroidism manifestations | show 🗑
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| show | parathyroidectomy; encourage ambulation to prevent renal calculi
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| show | assess for hemorrhage and fluid electrolyte disturbance, especially Tetany d/t hypocalcemia, Chvostek’s and Trousseau’s signs
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| show | parathyroidectomy post-op sign of hemorrhage, an acute emergency; a harsh, high-pitched sound heard on inspiration and expiration caused by compression of the trachea, leading to respiratory distress.
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| show | regulate metabolism, increase blood glucose levels, and are critical in the physiologic stress response
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| show | regulate sodium and potassium balance
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| show | a metabolic disorder resulting from the chronic and excessive production of cortisol by the adrenal cortex or by the administration of glucocorticoids in large doses for several weeks or longer
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| show | centripetal (truncal) obesity or generalized obesity; “moon facies” (fullness of the face) with facial plethora; purplish red striae on the abdomen, breast, or buttocks; hirsutism and menstrual disorders in women; HTN; and unexplained hypokalemia.
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| Cushing syndrome management | show 🗑
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| Cushing syndrome postoperative risks | show 🗑
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| Cushing syndrome diet | show 🗑
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| show | a metabolic disorder resulting from the reduced excretion of all three adrenal corticosteroids
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| show | very slow (insidious) onset; progressive weakness, fatigue, weight loss, anorexia, hyperpigmentation, orthostatic hypotension, hyponatremia, salt craving, hyperkalemia, nausea and vomiting, diarrhea, irritability and depression.
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| addisonian crisis | show 🗑
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| show | replacement therapy—Daily glucocorticoid replacement; Daily mineralocorticoid; Salt additives for excess heat or humidity; Increased doses of cortisol for stress situations (e.g., surgery, hospitalization)
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| UTI manifestations | show 🗑
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| show | urinary stasis; foreign bodies; anatomic factors (fistula, obesity); immune factors (aging, HIV, DM); functional disorders (constipation, voiding dysfunction); women (pregnancy, multiple sex partners, spermicidals, short urethra); poor hygiene
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| Upper UTI differentiating manifestations | show 🗑
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| show | no systemic manifestations (fever, chills, etc.)
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| UTI management | show 🗑
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| Nitrofurantoin (Furadantin, Macrodantin) drug classification/alert | show 🗑
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| urinary tract calculi risk factors | show 🗑
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| show | important in diagnosing underlying problem
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| show | palpitations, exertional dyspnea, and possibly mild fatigue
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| show | bounding pulse, dyspnea, roaring in ears, and fatigue
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| Severe anemia clinical manifestations | show 🗑
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| anemia acute management | show 🗑
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| CKD effect on hematologic system | show 🗑
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| show | Male: 13.2-17.3 g/dL Female: 11.7-15.5 g/dL (Severe anemia: <6, moderate anemia 6-10)
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| show | Male: 39%-50% Female: 35%-47%
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| show | Male: 4,300,000-5,700,000/μL
Female: 3,800,000-5,100,000/μL
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| show | pallor, glossitis, cheilitis, headache, paresthesias, burning sensation on tongue
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| show | indentify underlying cause, iron supplements, nutritional and diet therapy, and RBC transfusion if symptomic
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| show | chronic health problems and pain; pallor (grayish cast); jaundice; prone to gallstones (cholelithiasis)
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| Sickle cell disease (SCD) management | show 🗑
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| Clostridium difficile (C. difficile) manifestations | show 🗑
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| C. difficile management | show 🗑
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| show | contact precautions (gloves and gowns); disinfect with bleach
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| pancreatitis causes | show 🗑
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| pancreatitis clinical manifestations | show 🗑
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| Cullen’s sign | show 🗑
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| Grey Turner’s spots | show 🗑
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| Pancreatitis complications | show 🗑
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| show | complication of pancreatitis; a cavity continuous with or surrounding the outside of the pancreas
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| pancreatic pseudocyst manifestations | show 🗑
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| show | Internal drainage procedure with an anastomosis between pancreatic duct and the jejunum
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| show | complication of pancreatitis; a large fluid-containing cavity within the pancreas
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| show | upper abdominal pain, abdominal mass, high fever, leukocytosis
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| pancreatic abscess treatment | show 🗑
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| show | NPO status
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| show | fatigue (earliest symptom), dyspnea (orthopnea and paroxysmal nocturnal dyspnea), tachycardia, edema, nocturia, skin changes, behavioral changes, chest pain, weight changes
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| show | development of dependent edema or a sudden weight gain of more than 3 lb (1.4 kg) in 2 days, behavioral changes
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| show | IV vasodilator that reduces preload and afterload, improving myocardial contraction, increasing CO, and reducing pulmonary congestion; complications include hypotension and thiocyanate toxicity—monitor BP frequently (5-10 minutes)
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| show | Monitor IV site for signs of extravasation; Tissue necrosis with sloughing can occur with extravasation of the drug; High dosages may produce ventricular dysrhythmias.
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| show | weight
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| HF teaching | show 🗑
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| show | potentiate effect of opioids and barbiturates (anesthetics)
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| show | predispose to shock when combined with anesthetics
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| Insulin/hypoglycemic agents effect on surgery/healing | show 🗑
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| show | inhibit platelet aggregation, contributing to bleeding problems
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| show | delayed wound healing
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| show | determine physholgoic status, establish baseline, identify site/side, identify medications that may result in interactions, review labs and diagnostic tests, identify cultural and ethnic factors affect surgery, witness consent
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| show | ABGs & pulse ox; glucose; BUN/creatinine (renal function); CBC (anemia, immune status, infection); electrolytes; hCG (pregnancy); LFTs; PT, PTT, INR, platelet count (coagulation status); albumin (nutritional status); urinalysis (renal status)
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| show | establish baseline; allergies; skin integrity; skeletal muscle impairments; perceptual difficulties; LOC; NPO status; pain/discomfort
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| show | monitoring/managing respiratory and circulatory function, pain, temperature, and the surgical site
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| show | Fecal-oral (primarily fecal contamination and oral ingestion)
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| show | Percutaneous (parenteral)/permucosal exposure to blood or blood products; sexual contact; preinatal transmission
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| HCV transmission | show 🗑
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| show | same as HBV: Percutaneous (parenteral)/permucosal exposure to blood or blood products; sexual contact; preinatal transmission
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| HEV transmission | show 🗑
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| Jaundice | show 🗑
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| Asites effect on patient | show 🗑
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| show | 3.5-5.0 mEq/L
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| Elevated Potassium etiology | show 🗑
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| Decreased Potassium etiology | show 🗑
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| Effect of thiazide and loop diuretics on potassium | show 🗑
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| Hyperkalemia manifestations | show 🗑
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| show | fatigue, muscle weakness, leg cramps, n/v, paralytic ileus, soft, flaby muscles, paresthesias, decreased reflexes, weak, irregular pulse, polyuria, hyperglycemia
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| Organ affected by Potassium | show 🗑
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| Normal Calcium | show 🗑
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| show | Acute osteoporosis, hyperparathyroidism, vitamin D intoxication, multiple myeloma
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| Decreased Calcium etiology | show 🗑
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| show | apathy, depression, fatigue, muscle weakness, ECG changes, polyuria and nocturia, anorexia, nausea, and vomiting.
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| show | tetany, Chvostek’s sign, Trousseau’s sign, fatigue, diarrhea
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| show | 135-145 mEq/L
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| show | extreme thirst, decreased urinary output, increased specific gravity
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| Hypernatremia etiology | show 🗑
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| Hyponatremia sodium etiology | show 🗑
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| show | hyperactive bowel sounds, increased urinary output, decreased specific gravity
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| show | 2.4-4.4 mg/dL
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| hyperphosphatemia etiology | show 🗑
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| hypophosphatemia etiology | show 🗑
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| fluid volume deficit etiology | show 🗑
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| show | increased RR and HR, decreased CVP, weight loss, poor skin turgor, dry mucous membranes, decreased urine volume, increased specific gravity of the urine, increased Hct, and altered LOC
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| fluid volume deficit management | show 🗑
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| show | D5, NS, D5 1/2NS, LR
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| show | 1/2NS
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| show | D5NS, D5 1/2NS
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| show | rapid-acting insulin
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| show | rapid-acting insulin
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| show | rapid-acting insulin
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| show | short-acting insulin
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| show | intermediate-acting insulin
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| Glargine (Lantus) classification | show 🗑
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| Detemir (Levemir) classification | show 🗑
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| show | Onset: 15 min; Peak: 60-90 min; Duration: 3-4 hrs
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| Short-acting insulin Onset/Peak/Duration | show 🗑
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| Intermediate-acting insulin Onset/Peak/Duration | show 🗑
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| Long-acting insulin Onset/Peak/Duration | show 🗑
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| Impact of exercise on blood sugar | show 🗑
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| show | monitor blood sugar three or more times a day; watch for complication (infection at insertion site, DKA)
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| Hypoglycemia manifestations | show 🗑
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| Hypoglycemia management | show 🗑
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| show | decreased pH, decreased HCO3, elevated glucose, ketones in blood and urine, polyuria, Kussmaul’s respiration’s; can lead to coma
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| DKA management | show 🗑
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| Electrolyte impacted by DKA | show 🗑
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| Ineffective Breathing pattern characteristics | show 🗑
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| show | Abnormal ABGs, pH; abnormal breathing (rate, rhythm, depth); abnormal skin color (pale, dusky); confusion; cyanosis; decreased CO2; diaphoresis; dyspnea; headache upon awakening; rritability; nasal flaring; restlessness, tachycardia; visual disturbance
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| show | wheezing, cough, dyspnea, and chest tightness after exposure to a precipitating factor or trigger
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| show | Not well controlled: Mild severity (> 2 days/wk); moderate severity (daily), severe (several times per day)
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| show | move indicator to bottom, stand up, take deep breath, place mouthpiece in mouth and close lips around it, and blow as hard and fast as possible; write down number and repeat 2 more times (use best of 3)
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| β2-Adrenergic Agonists (SABA, LABA) drug classification/alert | show 🗑
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| Theophylline drug classification/alert | show 🗑
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| Side effects of inhaled corticosteroids | show 🗑
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| Chronic bronchitis manifestations | show 🗑
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| show | smoking cessation, drug therapy (stepwise fashion: bronchodilator, anticholinergic, ICS), O2 therapy, possible surgical therapy, breathing retraining (pursed-lip and diaphragmatic)
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| Peripheral Artery Disease (PAD) manifestations | show 🗑
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| intermittent claudication | show 🗑
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| show | cardiovascular disease risk factor modification, treatment of claudication,nutritional therapy, proper foot care; worst case: amputation
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| Phlebitis | show 🗑
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| Venous thromboembolism (VTE) risks | show 🗑
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| show | may have unilateral leg edema, extremity pain, a sense of fullness in the thigh or calf, paresthesias, warm skin, erythema, and/or a systemic temperature greater than 100.4° F, positive Homans’ sign; legs, arms, neck, back, or face edematous and cyanotic.
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| show | ambulation, graduated compression stockings, SCDs, anticoagulants
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| show | asymptomatic until severe; fatigue, reduced activity tolerance, dizziness, palpitations, angina, and dyspnea
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| DASH eating plan | show 🗑
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| show | hypokalemia; supplement with potassium-rich foods
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| show | hyperkalemia; avoid potassium
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| Doxazosin (Cardura) classification/alert | show 🗑
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| show | orthostatic hypotension, sexual problems
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| HTN management | show 🗑
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| show | rise slowly, don’t stand still for prolonged periods, do leg exercises (increases venous return), sleep with head of bed raised or on pillows, lie/sit when dizziness occurs
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| Myelosuppression complications | show 🗑
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| Myelosuppression lab monitoring | show 🗑
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| Foods that promote RBC growth | show 🗑
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| Myelosuppression management | show 🗑
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| show | keep dry; no weight bearing for 48 hrs; ice for 24 hrs; elevate above heart for 48 hrs; regular movement of joints above/below cast
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| Signs of cast complications | show 🗑
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| Casting complications | show 🗑
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| show | circulation, sensation and movement
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| Compartment syndrome manifestations | show 🗑
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| Compartment syndrome management | show 🗑
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| Open fracture risk | show 🗑
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| Warfarin (Coumadin) lab monitoring | show 🗑
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| show | aPTT – therapeutic value 46-70 sec (normal 25-35)
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| Signs of bleeding r/t anticoagulant therapy | show 🗑
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| Amputation complications | show 🗑
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| show | appear within 24-48 hrs of traumatic skeletal injury, include chest pain, tachypnea, cyanosis, dyspnea, apprehension, tachycardia, and decreased partial pressure of arterial oxygen (PaO2), changes in mental status, petechiae (distinguishing factor)
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| Fat embolism management | show 🗑
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| Parkinson’s complications | show 🗑
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| Seizure complications | show 🗑
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| show | antiseizure drug therapy, airway management (side-lying, nasotracheal suctioning), seizure safety (loosen clothing, remove harmful objects, padded side rails)
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| Antiseizure medication considerations | show 🗑
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| Lymphadenopathy | show 🗑
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| addisonian crisis triggers | show 🗑
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| emphysema | show 🗑
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| show | Albumin, protein, and daily weights
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| Normal Albumin | show 🗑
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| show | Dehydration
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| Decreased Albumin etiology | show 🗑
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| show | 6.4-8.3 g/dL
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| show | Burns, cirrhosis (globulin fraction), dehydration
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| Decreased Protein etiology | show 🗑
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