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Nclex II-- Endocrine

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Question
Answer
show Nervous, decrease weight, hot, sweaty, increase appt, fast GI, Increase BP, irritable, decrease attention spam.  
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show Graves Disease  
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Why does the patient develop the symptoms of hyperthyroidism?   show
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show Increase the pulse and BP. When the pulse and BP is increase it increase the workload of the heart.  
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show Iodine  
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show Stops Thyroid From working. Propacil, PTU, Tapazol.  
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show Propacil, PTU, Tapazol.  
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show B/C they stain teeth.  
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show Decrease HR/BP, decrease anxiety.  
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show Destroys thyroid cells  
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What is one of the major complications of radioactive iodine?   show
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show Decreases  
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When a patient has been placed on an antithyroid, what do you except to happen to theis thyroid hormone level?   show
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show Decrease vascularity, decrease chance of hemorrhage.  
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When a patient has had a thyroidectomy, why is it so important for them to have neck support.   show
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How do you want a thyroidectomy patient to be position. Explain   show
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Why do we check for bleeding behind the neck with a thyroidectomy patient?   show
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Why do we keep a trach set at the bedside with a thyroidectomy patient?   show
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show Listen for horseness.  
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show B/C they are close to the thyroid, could have been accidentally removed.  
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show Watch for muscle rigidity-- tight muscles, tetany. Look for S/S of Hypocalcemia.  
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What are the S/S of parathyroid removal?   show
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What is another name for hypothyroidism.   show
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show Decrease.  
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show Fatigue, GI slow, increase weight, slow speech, cold.  
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What is cretinism?   show
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show Give thyriod hormones-- synthroid, proloid, cytomel.  
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show Permanent  
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When someone is hyperparathyroid, what is the major electrolyte imbalance they have?   show
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Why do you have to worry about the bones of a patient with hyperparathyroidism?   show
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Why does the hyperparathyroid patient have kidney stones?   show
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What is the major eletrolytes imbalance a hypoparathyroid patient will have.   show
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What type of symptoms will they exhibits   show
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show To reduce stimuli-- they are at risk for seizures.  
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Why does a hypoparathyroid patient need a trach tray next to the bed.   show
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show Serum phosporus is high already.  
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Explain how amphojel works for the hypoparathyroid patient   show
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show Problem with the adrenal medulla-- benign tumor that secrete norepinephine that maks blood pressure increase and heart rate increase.  
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What happes to thier blood pressure and Pulse. (pheochromcytoma)   show
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What is the major diagonostic test for the pheochromocytoma? Explain?   show
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show Changes in mood, breakdown proteint and fat, alter defense mechanism. (suppress immune system), inhibits insulin.  
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When you hear the word mineralocorticoid, what is the major word you need to think of?   show
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show Makes you retain Na and H2O  
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show steroids. adrenocorticotropin hormones (ACTH) cortisol.  
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Why do steroids drive your blood sugar up?   show
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If a patient is making to much aldosterone, what is going to happen to the vascular space? Explain Why?   show
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show Body does not have enough steriods (aldosterone) -- Na and H2O is lost -- K+ is retained (think about shock and hyperkalemia)  
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show Aldosterone  
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show Hyperkalemia  
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show Muscle weakness, decrease bowel sounds, anorexia, GI upset, arrythmias  
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Could the addison's disease patient also have a life threating arrthmia? if so why?   show
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show Not enough  
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Why does Addison diease patient have trouble with shock?   show
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Why does the Addison's disease patient need more sodium in thier diet.   show
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show Because the patient has severe fluid volume problems.  
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show Deficit  
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What happens to the Addison's disease patient's blood pressure.   show
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When a patient has Cushing's syndrome, explain briefly, in your own words, what they will look like?   show
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When a patient has cushing's syndrome, do they have too many steroids or not enough.   show
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show to much glococoricoids.....  
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is the cushing syndrome patient in a fluid volume deficit or excess.   show
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Why does the cushing's syndrome patient develop high blood pressure.   show
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Why does the cushing syndome patient develop Congestive heart failure?   show
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show Because they have to much aldesterone. (retain to much NA and H2O and lose k+  
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show Because steriods decease serum calcium level by making you excrete it through the GI tract.  
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Why does the cushing's syndrome patient have ketones in their urine and glucose in their urine.   show
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Does th cushings syndrome patient need to be low-soduim diet or a high sodium diet? Explain?   show
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Why does the cushing's syndrome patient not have protein in their urine? Is it normal to have Protein in the urine.   show
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In a diabetic patient, what is absent that makes their blood sugar go up?   show
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What is the normal action of insulin? (how does it work)   show
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show Because their is no insulin  
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show The cells are starving for energy, so we try to get energy forother places.  
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Anytime you break down fat, you are going to get production of what.   show
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show Acid  
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show Metabolic acidosis. B/C fats are being broken down for energy, which makes ketones, which make the blood more acid.  
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show A. Kidneys are trying to get rid of excess glucos. b. Losing lots of fluids. C. they have excessive thirst from FV lose.D. thy are hungr, bc brain cells are hungry.  
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Explain how oral hypoglycemia agent work and give examples.   show
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show Because they dont prduce insulin, not een with a stimulation. Pancreas is not working. TYPE 1  
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show Blood suga are high and bacteria can grom rapidly.  
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show Diet and exercise Oral Agents Insulin  
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In treatment of a diabetic, why do we have to limit the protein in their diet.   show
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Why are diabetrics prone to Coronary Artery Disase.   show
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How can a highfiber diet benefit a diabetic patient?   show
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show Exercise lowers blood sugar, eat fruit , low fat milk.  
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show To prevent hypoglycemia.  
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show Decrease.  
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show B/C insulin should lower BS. Therefore there shouldnt be any excess to spill into the urine. Also insulin should prevent fat being broken down.  
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If you are giving somebody insulin and they do have glucose and ketones in their urine, what needs to be done to the dose of the insulin.   show
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show Draw up the clear regular insulin up first to prevent contamination of the regular insulin with the med. or long acting insulin (cloudy). REMEMBER CLear/Regular insulin is the only insulin tht can be given IV.  
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What is the only typ of insulin that can be give IV?   show
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Explain the peaks of the three different classes of Insuin?   show
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show Decreas~~ Risk for hypogycemia  
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show Hypoglycemia.  
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show Inform patient to eat, take regular insulin, and eat healthy snacks.  
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show To prevent tissue damage, lipodystrophy decrease absorptions.  
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show Increase.  
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show Increase.  
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show DKA  
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show No~~~ Tissue damage.  
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show Shaking, weak, decrease LOC, cool clammy skin, nervousness, Increase pulse, nausea, sweating, HA..... Simple Sugar.  
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After a patient has experienced hypoglycemia and they have drank a coke or eaten some candy or whatever, what do they need to do next? Explain Why?   show
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show Brain can die  
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show Temporary.  
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show Hypo.  
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YOu give an unconscious patient an amp of D50W B/C you think they are HYPO. The patient should start to wake up. When they are awake, what should you get tem to do.   show
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Why is it so important that a diabetic patient eat regulatly and take their insulin Regularly.   show
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Why does the diabetic patient sometimes develop Kussmaul's respirations?   show
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show Not enough insulin-- blood suger increases- polyuria, polydypsia, polypahgia-- fat breakdown (acidosis) -- Kussmauls resp.  
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When a patient has diabetic ketoacidosis, why is it so important that we measure the blood sugar and the potassium hourly?   show
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When you give somebody insulin, what do you except it to do to their blood sugar? Explain Why?   show
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When you give someone insulin, what do you except it to do to theirserum potassium level. Explain why   show
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Why is it so important that we montior the diabetic ketoacidotice patient's EKG so Closely.   show
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show B/C polyuria could turn to oliguria then anuria (renal failure)  
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show Polyuria- tring to get rid of sugar in the body. Polyuria cause vascular volume to decrease. Kidneys aren't being perfused as well so Oliguria occurs and possibly anuria could occur.  
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When a patient has Oliguria and Anuria, what do you really have to start to worry about and why?   show
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When a DKA patient presents to the emergency room, are they in a fluid volume deficit or a fluid volume excess? Explain Why?   show
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show Patient is in fluid volume deficit.  
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How does normal saline work?   show
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What could the patients blood sugar be with DKA   show
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When you get the DKA patient into the emergency room, you are going to see the doctor order IV push insulin, therefore, what is going to start happening to the blood sugar rapidly?   show
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show To prevent throwing the patient into hypovolemic state.  
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show By decreasing the blood sugar rapidly with insulin.  
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show They have pood circulation everywhere due to sugar deposition. Sugar deposits like fat (retinopathy, kidney problems, nerve damage, amputation)  
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show Clip nail straight across, be careful with lotion, inspect feet each day, dry inbetween toes very well, wear leather shoes all the time.  
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show The amount of blood being pumped out of the LV  
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show NO  
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If you are taking care of a patient with decrease cardiac output, what is going to happen to their level of consciousness.   show
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show Yes  
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show Because there is no perfusion. (perpheral vasoconstriction in an effort to shunt blood to vital organs)  
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When you are taking care of a patient what has decrease cardiac output, why do they get short of breath and have wet lung sounds?   show
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When you are taking care of a patient who has decrease cardiac output, why do their peripheral pulses diminish?   show
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What is going to happen to the urine output when you have a patient who has decrease CO?   show
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When you have a patient with decrease CO, why does their blood pressure drop?   show
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show Decrease, B/C heart is not pumping out much volume, heart is pumping slowly.  
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show Decrease ventricles cant fill up; dont have time to fill b/c heart is beating to fast.  
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show CO decrease, Dead mucsle doesnt pump well.  
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If my blood pressure is really high, how will this affect cardiac output and why.   show
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What is preload.   show
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show Increase  
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List some ways preload can be increase.   show
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show Standing upright, hypovolemia, less volume, lower legs, raise HOB  
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show Amount of pressure in the aorta that the ventricle has to pump against.  
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If you increase afterload, what do you do to cardiac output.   show
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show Lungs  
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What is angina?   show
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explain the pain a patient has with angina?   show
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show to relieve the pain-- vasodilates which increase blood/ O2 to heart.  
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When you give somebody nitroglycerine, more ___________ is going to get to the heart.   show
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How do you teach a patient to take their nitroglycerine?   show
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Why should nitroglycerine burn.   show
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What is a common and expected side effect of nitroglycerine.   show
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show Vasodilate--- Decrease  
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Why do patients with angine need a beta blocker? List several example?   show
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show Decrease blood pressure, decrease workload of heart. Verapamil, Calon, Procardia. These drugs also dilate CA which enhances blood flow to the heart.  
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show Balloon to open coronary arteries to enhance blood flow__ MI  
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Why is it so important that the angina patient avoid isometric exercise, overeating, caffeine, or any drugs that increase the heart rate and avoid cold weather.   show
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Why is it so important that the angina patient rest frequently.   show
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show Yes.  
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show Sit down, nitroglycerin makes them dizzy; they may faint.  
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With a MI, why does the patient have necrosis?   show
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Will rest or nitroglycerine relieve MI pain?   show
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show Severe, non-stop pain; chest pressure; radiation to the left arm and jaw.  
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Why does an MI patient get cold, clammy, and their BP drop.   show
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show Inflammatory response.  
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show Inflammatory response  
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show A. Determine if heart mucsle, skeletal or brain affected. B. CPK- increase 4-6 peaks 18-24 LDH- detects 48-72 hours back C. high specificity for MI cell injury; always normal in non-cardiac muscle diseases, elevate sooner and stays elevated.  
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When a patient has had a MI, what is the drug of choice?   show
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show V-fib V tec  
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When a pateitn goes into V-fib, what is the priority nursing action?   show
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What drug is sometimes started IV on a MI patient to prevent things like PVC or V tach or V fib?   show
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show TOXICITY  
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show Vagus  
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If you stimulate the Vagus nerve long enough, what is going to hjappen to the heart rate?   show
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What happens to the size of the complex when the vagus nerve is stimulated.   show
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When a patient goes into a thuird-degree block, what are the major drugs that are used.   show
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show They dissolve the clot that is blocking blood flow to the heart muscle. They decrease size on the infarction. Streptokinase, TPA, Eminase  
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show Hemorrhage.  
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show Any past bleeding problems, stroke, pregnancy, surgery, bleeding ulcers.  
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After someone has received a thrombolytic, why is it so important that we decrease puncture sites.   show
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show Because contrast dye is used and it contain iodine.  
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show Warm/flushing/ sweating  
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show Femoral/ brachial  
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show Bleeding and hematoma.  
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When a patient has had a heart cath, you have a pertinent nursing assessment you need to do distal to the insertion site. Explain.   show
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show SA node.  
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show Yes, but not for long.  
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Explain the diffecrence between a demand and a fixed pacemaker.   show
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You really need to get worried about a pacemaker malfunctioning when the rate of the pacemaker does what?   show
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show The wires need time to embed in the heart; if the arm is moving too much the wires (leads) could pull out  
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Why does the patient need to check their pulse everyday?   show
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show Can alter or damage pacemaker.  
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What are the major symptoms of Left sided failure and explain why?   show
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show Because they become hypoxic  
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Why does a patient with left sided failure have nocturnal dyspnea?   show
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show Blood is backing up into the lungs.  
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What is the other name for left sided failure?   show
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What are the major symptoms of right sided failure.   show
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show Venous  
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What does a Swan Ganz cath measure inside the heart   show
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show Any pressure reading on the right side of the heart. More volume= More pressure.  
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What is the wedge pressure?   show
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show PRessure in left side of heart.  
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If a patient's wedge pressure is increasing, that means volume is building up in the left side of the heart. when volume is building up in the left side of the heart, that puts the patient at risk for developing what?   show
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show Arterial line-- in artery-- measures cont BP on a monitor.  
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What is an Allen's test?   show
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show Skin temp, color, pulse, cap refills. these need to be checked because the A-line could decrease heart perfusion so the line is normally placed in the radial artery.  
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if an A-line is accidently pulled out, what is the first thing that needs to be done.   show
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show To prevent backflow of the arterial blood. If you didnt place pressure on the flush bag, the high pressure of the artery would force blood back up through the tubing and fill the flush bag with blood  
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Why does the patient in heart failure develop cardiomegaly?   show
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show slows down the heart rate which give the ventricles more time to fill with blood. then the heart can squeese down with the stronger contraction on more blood; therfore is increase cardiac output.  
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When you slow down someone';s heart rate, you give the ventricvles more time to do what?   show
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show CO increase. Kidney Increase.  
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Anytime you increase kidney perfusion, what is going to happen to urine output?   show
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show UP  
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show more blood is being ejected for the left ventricles to the systemic circulation.  
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show better oxygenates.  
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When you start giving somebody Dig, we expect their card output to increase; therefore, what happen to their. LOC, lung sounds, uring output, skin, peripheral pulse, BP.   show
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Why does a CHF patient need Lasix.   show
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show Diuresis may occur  
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Why do we give diuretics in the morning?   show
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show To monitor themselves for Fuild retention.  
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show Pulmonary edema.  
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What is pulmonary edema.   show
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show The left ventricle is failing so the blood is not being pumped forward into the systemic circulation; therefore, the blood backs up into the lungs.  
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What are the major S/S of pulmonary edema?   show
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show at night- because lying down preload icreases so we are dumping more blood into the right side of the heart and into the lungs.  
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show Hypoxia.  
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show Becuase they cant handle the volume of blood in there lungs.  
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show Given to strenthen the contraction more and increase cardiac output.  
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When a patient is in pulmonary edema, why do we give them Aminophylline?   show
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show Nervousness and Thachycardia.  
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show To vasodilate; therefore decreasing preload and afterload; and to decrease anxiety.  
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How much morphine do we give them?   show
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show To decrease venous return  
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What is one quick check you can do on patients to see if they are going into pulmonary edema?   show
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show To enhance pooling of blood in lower extremities; decrease of venous return.  
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show B/C there patient may not have the ability to pump extra fluid or to excrete extra fluid.  
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What is intermittent claudiction?   show
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show When oxygenated blood cannot get to an area, the patient is going to switch in that extremity from aerobic metabolism to anaerobic metabolism. the product of anaerobic metabolism is a buildup of lactic acit. the lactic acid is what promotes the pain.  
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When a patient has as arterial problems, that means the oxygen/blood are having a hard time getting to the tissue, so therefore different S/S develop. Explain ?   show
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show Yes-- B/C oxygenatated blood is not getting to an area.  
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show will restore oxygenated blood flow to an area. (opens up the artery)  
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show Vasoconstriction  
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In buerger's and raynard's, there is significant vasoconstriction. What type of things bring on the vasoconstiction in Buerger and raynards?   show
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show Buerger- excellent foot care- avoid cause. Raynards- avoid cause.  
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show Cause  
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Why does Buergers patient have to do such excellent foot care?   show
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When a patient has a venous disorder, are they having trouble with oxygenation of the affected extremity?   show
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show Phlebitis, thrombophlebitis, DVT  
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Do you elevate venous disorders or lower venous disorders (such as affected extremity)   show
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Explain the pathophysiology behind venous disorder?   show
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Why does a patient with a venous disorder need heparin?   show
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How do TED hose help venous disorder?   show
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show Warm moist heat to decrease imflammation  
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What is a thoracentesis?   show
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When a patient is having a thoracentesis, where is the fluid being removed from.   show
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show It is the potential space between the visceral and parietal pleural  
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show Collapse  
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show Fluid volume deficit anytime you pull fluid from the body the vascular space could deplete.  
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show B/C the doctor could puncture all the way into the lungs.  
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What has happened when a patient needs a chest tube?   show
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Chest tube have a water seal., first of all, what is the purpose of the water seal and what would happen if there was no water seal? Also in chest tubes, the chest bottle will have an air vent at the top os the bottle. what ist he purpose of the air vent   show
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When a patient has a chest tube, you should see fluctuation of the fluid in the water seal tubing. what does this fluctuation mean.   show
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When a patient has a chest tubes, hopefully the lung should do what?   show
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show Hook it back up unless you happen to have a sterile connector in the room. Then you would use the brand new sterile connector  
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show Air from the outside environment would rush into the pleural space and re-collapse the lung.  
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If a break in the chest system occurs, air from the outside can rush into the pleural space and cause what life threatening complication.   show
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show Place your hand over the insertion site.  
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show Blood becomes thck and could form a clot.  
🗑
show B/C a thrombus can from and dislodge and go to the lungs.  
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How can birth control pills promote a pulmonary embolus.   show
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When a patient has a pulmonary embolus, why does their pulse go up.   show
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When a patient has a pulmonary embolus, describe their chest pain.   show
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When a patient has a pulmonary embolus, the blood pressure is going to go up in their lungs. What effect will that have on the right side of the heart.   show
🗑
show inflammation  
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Why does the PO2 go down with a pulmonary embolus?   show
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show Swan-Ganz Cath  
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show Will decrease the formation of new clots and keep the clot that has already developed from getting any larger.  
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show Blood in the pleural space.  
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What is a pneumothorax.   show
🗑
show Collapse  
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show Leave it in place.  
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show The pressure has accumulated in the pleural apce and has collasped the lungs and pushed everything to the opposite side.  
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show Tracheal Deviation.  
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show Three- The fouth side acts as a air vent. There is a chance there is some air that will need to come out so you will have to leave a way for it to come out.  
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When a patient has a fractured sternum or ribs, why are the respirations so shallow? what acid base imbalance will this put them at risk for?   show
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With a fractured sternum or ribs, why do we give non-narcotic analgesics.   show
🗑
show To expend the chest to realign ribs.  
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show Positive and Expiratory pressure.  
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What is CPAP   show
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What is the major difference between the two (PEEP and CPAP)   show
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show Multiple rin fractures  
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What is paradoxical chest wall movement?   show
🗑
show Because of the broken ribs.  
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show When fluid is accumulating in the pericardial sac.  
🗑
show Blood pressure goes down because of hemorhaging. CVP goes up b/c as the sac fills around the heart, this puts pressure on the heart, squeezing the heart. Therefore the pressure inside the heart goes up making CVP go up  
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Why do the heart sounds sound muffled with cardiac tamponade.   show
🗑
show B/c of the hemorrhaging.  
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show Mycobacterium Tuberculosis  
🗑
show Ultraviolet light  
🗑
Explain the skin test for TB?   show
🗑
show It means the patient has been exposed.  
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One of the major drugs used for TB in INH (isoniazid). What is the major side effect? and what vitamin can be given to prevent that major side effect?   show
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When a patient is on INH, what lab work has to be monitored.   show
🗑
show Alcohol  
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What are the major side effect of Rifampin.   show
🗑
show Liver enzymes  
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When a patient is on streptomycin, what are two possible side effects.   show
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How would you monitor for these side effects.   show
🗑
show Streptococcus  
🗑
show Fluid volume Excess  
🗑
When a patient has glomerrulonephritis, why do they develop malaise and headache?   show
🗑
show Because the kidneys are failing  
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When a patient has glumerulonephritis, why does their BUN and Creatinis go up?   show
🗑
When a patient had glomerulonephritis, why do they get protein in the urine?   show
🗑
Explain CVA tenderness.   show
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In glomerulonephritis, why doe sthe blood pressure go up?   show
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And what will happen to the urine specific gravity?   show
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In glomerulonephritis, why are the patient's red blood cells affected?   show
🗑
show Because protein makes your urea level in your blood go up.  
🗑
show Increase.  
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Why does the glomerulonephritis patient need bed rest.   show
🗑
When determining fluid replacement for a renal disease patient (glomeronephritis), you always give them what they lost in a 24 hour period, plus 500cc. WHta is the purpose of adding 500cc.   show
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show FVD.  
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When a patient is in the acute stages of glomerulonephritis, do you think their serum potassium level will be increased or decreased? what about the Magnesium? What about the phosphorus level?   show
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When a patient had nephorotic syndrome, what is the major element that is leaking out into their urine?   show
🗑
show Fluid  
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If a patient does nto have protein a=or albumin in their vascular space (blood) what is going to happen to all the fluid that is supposed to stay in their vascular system?   show
🗑
show Decrease the volume in the vascular space.  
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Therefore, will the nephrotic syndrome patient (in the acute stages) be in a FVD of FVE   show
🗑
When a patient has nephrotic syndrome, they develop total body edema. what is the proper term for total body edema.   show
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When a patient has nephrotic syndrome, it is not uncommon for them to be placed on prednisone. WHy?   show
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Does the nephrotic syndrome patient need a high sodium diet ot a low sodium diet?   show
🗑
Does the nephrotic syndrome patient need a high protein diet or a low protien diet. Explain?   show
🗑
How can brady cause renal failure.   show
🗑
How can hypovolemia cause reanl failure.   show
🗑
show Decrease perfusion  
🗑
How can decrease cardis output cause renal failure.   show
🗑
How can glomerulonephritis, nephrotic, or diabetes cause renal failure.   show
🗑
How can the kidney stone cause renal failure   show
🗑
show urine can be trapped in the kidney  
🗑
show Urine can be trapped in the kidney  
🗑
When a patient is in renal failure, why does the BUN and creatinine go up?   show
🗑
show It usually goes up, but it can also become fixed. when is becomes fixed this means that the patient's urine specific gravity doe nto respond to high volumes of fluids or restriction of fluids. It stays the same.  
🗑
show B/C erythropoietin can be altered.  
🗑
show B/C they are retaining fluids.  
🗑
show B/C they are retaining fluids.  
🗑
Why does the renal failure patient develop anorexia, Nausea and Vomiting?   show
🗑
show Urea builds up in the blood and eventually accumulates on the skin  
🗑
Why does a renal failure patinet have to worry about osteoporosis?   show
🗑
There are two phases of renal failure. the first phse is an oliguric phase. if a patient is oliguric, what has happened to the urine output.   show
🗑
Why does the oliguric patient go into a FVE   show
🗑
show unable to excrete potassium  
🗑
The second phae of renal failure is called the diuretic phase. When a patient is diuresing, what has happened to their urine utput.   show
🗑
show Losing Volume  
🗑
If a patient goes into a fluid volume deficit, what will happen to theis blood pressure.   show
🗑
show Increase- trying to compensate for the decrease in volume  
🗑
When a patient is diuresing, their serum potassium level goes doen (hypokalemia) Explain Why   show
🗑
if a patient is allergia to Heparin, they cannot be hemodialyzed.   show
🗑
Is hemodialysis done everyday?   show
🗑
Does the patient who is being hemodialyzed have to watch what they eat and drink in between treatments?   show
🗑
show No BP , no punctures in that extremity, do not wear a watch on that extermity, check it for adequate crculation  
🗑
show Fluid is instilled into the abdomen. Fluid stays in for a period of time, the it is drained out of the abdomen, along with the excess electrolytes and toxins.  
🗑
When a patient is having peritoneal dialysis, where is the fluid goin into?   show
🗑
What wuld you do if you instilled 1000 cc of fluid into the peritoneal dialysis pt and only 700 cc came back.   show
🗑
show Clear or straw color.  
🗑
What are the S/S of infections with the peritoneal dialysis.   show
🗑
When a patient has capd for their renal failure, why do they have to increase protein and fiber in their diet.   show
🗑
show The dialysate tha is used is a high glucose content  
🗑
show Hematuria and pain  
🗑
show Fluids Fluids Fluids  
🗑
show Discard the first voiding, keep all urine for the next 24 hours in a specal sontainer and save the last void.  
🗑
show 24 hour urine.  
🗑
Do thy use dye with a KUB   show
🗑
When a patient has an IVP (intravenos Pyelgram), exactly wht is this x-ray looking at?   show
🗑
Does an IVP use dye? if so, what had you better ask the pt if they are allergic to?   show
🗑
Wha does a cystoscopy look at specifically.   show
🗑
Wht is the normal pre-procedue activities for a cytoscopy.   show
🗑
show Watch for urine retention, burning in common for a couple of days due to urethra irritation, and blood tinged urine is okay for a day or so.  
🗑
Why is the serum creatinine not affected by what we eat?   show
🗑
show Blood  
🗑
show Yes.  
🗑
Why cant a patinet with CHF or Poor kidney have whole blood.   show
🗑
Why do we have to agitate platelets when we are administering them.   show
🗑
Why do we give albumin or dextran in shock? Howd these work?   show
🗑
What should yo do if your patinet begins o have a transfusion reations.   show
🗑
Once you get the blood from the blood bank, how long do you have to get it hanging?   show
🗑
show 4 hours  
🗑
Explain themajor symptoms of febrile or septic blood transfusion reaction.   show
🗑
Explain the major S/S of an allergic reaction with a blood transfusion   show
🗑
show Back pain is number one, Chills, fever, flusing, increase pusle,increase RR, BP decrease.  
🗑
show Incopatible blood. Stop the blood, start the saline, get a urine specimen, save the blood, call the dr, call he bld bank, get vitalsigns and prepare to flush out the kidneys with mannitol.  
🗑
Why do we give mannitol when a patient is having a hemolytic reaction?   show
🗑
show Urine  
🗑
show Te shape of the red blood cell is changing doe to hypoxia.  
🗑
Are patinet who have sickle cell hypoxic   show
🗑
show Due to the shape, they start hanging together.  
🗑
show B/C their red blood cells sickle. so their red blood count decrase.  
🗑
show Jaundice develope when th overabundance of sickle cells ae fragile and rapidly destroyed in circulation releasing the bilirubin.  
🗑
Why does a sickle cell ptient develop heart problems.   show
🗑
Why does a sickle cell patient develop ischemia or infarction in extremities.   show
🗑
show B/C the cell can cut off circulation to an area.  
🗑
Why does the sickle cell patient have to be on folic acid.   show
🗑
show Any type of stress which increase oxygen demand; decrease O2 concentration causes the sickle process.  
🗑
What should be done duig a crisis?   show
🗑
show Infection.  
🗑
What is anemia?   show
🗑
show There's not enough RBC's to carry the oxygen  
🗑
How can hemorrhage cause anemia.   show
🗑
How can poor nutrition cause anemia?   show
🗑
show With out erthropoietin, immature RBC cannot mature.  
🗑
When a patient is anemic, why does their heart beat faster. Tachy   show
🗑
When a patient is anemic, why do theyget short of breath.   show
🗑
show They do not have enough RBC.  
🗑
show Heart is always stressed due to chronic hypoxia  
🗑
show hypoxia  
🗑
Patient with iron deficient anemia develop poor red blood cells (anemia) due to the fact that they do not have enough iron in their diet. what are some foods tht are high in iron.   show
🗑
What can be given with iron to increase the absorption?   show
🗑
show GI upset & constipation  
🗑
show Stain  
🗑
show Makes stool very dark  
🗑
Whydo we give iron IM Z-track method.   show
🗑
When a patient has had pernicious anemia, what vitamin are thy deficit in?   show
🗑
Afte wha surery can a patient develop pernicious anemia?   show
🗑
show Red swallow tongue and neuro changes.  
🗑
show Schilling test.  
🗑
show No  
🗑
Whyare IM injections of b-12 effective wit pernicious anemia. why does oral b-12 not work in thi patient.   show
🗑
What is the first thing you need to think of when you thinkof leukemia?   show
🗑
When a patient has leukemia, they are at high risk for infection. Why.   show
🗑
show B/C there are so many immature WBC, there's no room for RBC.  
🗑
Why does the leukemic patient develop thrombocytopenia?   show
🗑
show B/C they dont have enoug platlets; therefore they will bleed int he muscle.  
🗑
show You wont want to give anythin to them that woul promote moe bleeding.  
🗑
show Bed rest is needed due to decreased RBC (hypoxia) and also to prevent trauma.  
🗑
show to replace RBC- to fight anemia.  
🗑
Why does the leukemia patien need platelets?   show
🗑
show Hypoxia.  
🗑
show Decrease platelets.  
🗑
show Males.  
🗑
Who is the carrier and the transmitter of hemophilia.   show
🗑
Hemophiliacs aresometimes called "free bleeders". Explain the major syptoms a hemophiliac will have.   show
🗑
show Hemarthrosis  
🗑
show They dont need anything that is ging to increase their bleeding episodes.  
🗑
show They dont need to have freq dental work due to the chances of hemorrhage.  
🗑
show Avod trauma; ibuprofen is fine for minor aches and pains; avoid forceful nose blowing; coughing and straining; use electric razor and soft toothbrushes.  
🗑
Why is it so important tha fractures be immobilized as soon as possible.   show
🗑
What tye of emboli do yu worry about with a fractue.   show
🗑
What would you do if patient came in with an open fracture.   show
🗑
show Check pulses, color, movement, sensaion, capillary refills, skin temperature.  
🗑
show A. movement and sensatin. B. Vascular- cap refills, skin temp, color pulse  
🗑
Give S/S of a fat embolus?   show
🗑
show When circulation is being cut off to an extermity.  
🗑
If you suspect a compartment syndrome, what should you do first.   show
🗑
show We dont want to indent the cast.  
🗑
show Could cause pressure sores unde the cast.  
🗑
show To prevent indentions  
🗑
Cast care: Keep uncovered and dry   show
🗑
show To derease indentations or damage to the cast  
🗑
Cast care: Cover cast close to thegroin with plastic.   show
🗑
show Elevate to decrease edema  
🗑
When a patient with an orthopedic injury complains of pain, what is the first thing you should do?   show
🗑
show To realign bones; to decrease muscle spasms and to immobilize  
🗑
show If the Wts are not hanging freely then th amount of traction bein applied is not what the dr has ordered.  
🗑
show the skin has not been penetrated. bucks traction and russell traction are examples.  
🗑
show Skin, because the skin is being pulled on.  
🗑
What is skeletal traction? Explain   show
🗑
Explain how to do pin care.   show
🗑
When a patient has a total hip replacement, there are some important things to remember about positioning. A Neutral rotation B. Limit flexion C. extension D. Abducton   show
🗑
show Assess the degree of flexion the machine is exerting ; assess the patient pain level and tolerance of the machine.  
🗑
What are some good exercises for the total hip replacement patient?   show
🗑
Why is it so important that the total hip replacement patient avoid flexion?   show
🗑
Give examples of things a total hip replacement patient should avoid specifically relate to flexion?   show
🗑
Why is it important that we keep a tourniquet at the bedside with amputation?   show
🗑
Why is elevation so important with an amputation?   show
🗑
show Extend the joint-- prone position is a good position to extend the hip and knee.  
🗑
show Pain that is experrienced in the amputated extremity. the pain is real.  
🗑
show Diversional activity and pain meds are given.  
🗑
show Swollen joints, fatigued, increase WBC, reddened fingers dur inflammatio, morning stiffness. (lasting longer then 30 mins) and a low grade temp.  
🗑
With rheumatoid arthritis, what happens to the pain with stress?   show
🗑
Is rheumatoid arthritis seen more in males or females?   show
🗑
List the S/S separately and explain why the patient develops each symptom.   show
🗑
Why are rheumatoid artritis patient places on aspirin, prednisone, or NSAID's?   show
🗑
show B/C the joints tend to contract with inflammation.  
🗑
Why is rheumatoid arthritis pt placed on Chemotherpy?   show
🗑
Why is wt loss so important with the osteoarthritis patient?   show
🗑
What is the difference in rheumatoid arthritis and osteoartritis?   show
🗑
What is the genetal treatment forosteoarthritis? Explain why   show
🗑
What is gout?   show
🗑
What are S/S of gout?   show
🗑
show Colchicine to decrease pain and swelling; Zyloprim to decrease uric acid levels and probenecide to decrease uric acid level.  
🗑
What diet change chould thegout pateint make.   show
🗑
show To flush out the uric acid crystals. Alco hol promotes diurese and when you become dehydrated uric acid crystals ten to accumulate and promote an attack.  
🗑
When performing an assessment on theneuro patient, what is most important.   show
🗑
show Difference in systolic and diastolic blood pressure.  
🗑
show It widens  
🗑
I a neuro patiet complains of a headache, what would this man.   show
🗑
show When the eye move the opposite way that the head is turned. Assesses brain stem funtions.  
🗑
Explain the ice watr calorics test.   show
🗑
show When the bottom of te foot is stroked yo and you watch to see what the toes are going to do. in child less that 1 yr a positive Babinski is ok. + toes fan out, over 1 we want toes to curl in.  
🗑
When a patient is having a CT of the head, is it okay for them to talk?   show
🗑
show Yes.  
🗑
Can a patient become claustrophobic with a CT scan.   show
🗑
What type of patient cannot tolerate an MRI scan.   show
🗑
show They will be in a closed space; need to lie still, they will hear a clanging sound, they can talk to others while they are in the tube, no metal object are allowed in the tube.  
🗑
What is cerebral angiography?   show
🗑
When a ptient is having cerebral angiography, what artey do hey go through.   show
🗑
show Heart cath.  
🗑
show to help the patiet excrete the dye throhg the kidneys.  
🗑
show Post-procedure we will be needing to check the circulation in the extremity tomake sure clots didnt form distal to the punture sight. so baseline data should be collected pre-procedure.  
🗑
show the dye causes a flushed feeling.  
🗑
It is important that you ask this patient who is about to have cerebral angiography if they are allegic to something. What is it.   show
🗑
Explain the post procedue care for the cerebral angiography patient and explain why?   show
🗑
show B/C clots could form and go to the brain. WEre lookingfor change in LO and any motor or sensory deficits and one sided weakness or paralysis.  
🗑
show An xray of the sub-arachnoids space.  
🗑
show yes.  
🗑
What is the pre-procedure care for a patiet who is about to have a nyelogram.   show
🗑
Why is it so imporant in myelogram patient that we increase the fluids.   show
🗑
What are some gereral symptoms of meningitis.   show
🗑
Why is the patient who has had a myelogram or any procudure where you have gotten into ceebrospina fluid at risk for meningitis.   show
🗑
show Electroencephalogram.  
🗑
What is the preprocedure care for a patient who is going to have an EEG   show
🗑
show They will be asked to lie quietly, first; then they may be asked to do such things as hyperventilate during the procedure.  
🗑
When a patient shaving a lumbar puncture, do we get into cerebrospinal fluid.   show
🗑
show to check for lood, to measure pressure and to obtain a specimen.  
🗑
How do you positin a patient for a lumbar punctur?   show
🗑
Why doyou put athem in this position?   show
🗑
What sould cerebrospinal fluid look like.   show
🗑
show We want the patient to be on bed rest, lying flat so a seal can form at the puncture sight. patient should drink many fluids. we should check the dressing to make sure it is not wet.  
🗑
Wha is the most common complication of a lumbar puncture.   show
🗑
show Bed rest, fluids, pain meds, and blood patch may need to be dne.  
🗑
show Herniation.  
🗑
If a patiet has an epidural hematoma, explain the sequence of event that will occur and why thepatient has these changes.   show
🗑
show Stop the bleeding; control the ICP  
🗑
show subdural hematoma, it can be acute and choronic. Acute = rapid bleeding. Choronic= my look like a storke.  
🗑
What is one of th emost important things you need to rememer with a scalp injury   show
🗑
What is n open head injury.   show
🗑
show Meninges have not been broken.  
🗑
WIth which fracture is thepatient most at risk forinfection?   show
🗑
show Bleeding in the eyes, ears, nose, and throat.  
🗑
When a patient has a basal skull fracture. Where isthe fracture.   show
🗑
What is battle sign.   show
🗑
show Bruises around the eyes.  
🗑
show Leakage os CSF from the nose.  
🗑
Explain the S/S of a concussion.   show
🗑
If a patiet has been diagnosed with a concussion, what things should you teach before the go home.   show
🗑
IS it okay for a concussion patient to go home alone?   show
🗑
What a trauma ptient comes into the emergency roo, why do we have to assume a C-spine injury is present.   show
🗑
show to protect the cerical spine and spinal cord.  
🗑
How do you tell CSF from other drainage.   show
🗑
show to decrease the stimuli which could initiate seizures.  
🗑
When yo have a head injured patient, why do we have to pad the side rails?   show
🗑
What a neuro patient, why do we want to avoid narcotics?   show
🗑
Wht happens to ICP when the patient sits up and lies down?   show
🗑
show A sign of severe nuero damage.  
🗑
Explain the two different types of postering.   show
🗑
When a patient is posturing, what happens to their caloric needs.   show
🗑
Why are osmotic diuretice used in the treatment of ICP? Explain exactly how they work.   show
🗑
When a patient is on an osmotic diuretic,they better have teo organs that are working perfectly. What are they?   show
🗑
show Potential for fluid volume deficit.  
🗑
Why are patient with ICP given steroids.   show
🗑
How can hypeventilation decrease ICP.   show
🗑
show ICP would go up  
🗑
When taking care of ahead injured patient with ICP why is it so important that you space yur nursing interventions?   show
🗑
What is the purpose of a barbiturate induced coma.   show
🗑
Why is it so important to restrict the fluids in a head injured patient?   show
🗑
What should you restrict the fluids to? (how many CC per day)   show
🗑
show all these things increase ICP  
🗑
If a patient were t become bradycardic, wha would happen to cerebral perfusion? Explain why?   show
🗑
show The higher the blood pressure is, cardiac output goes down; therefore not as much blood would make it to the brain.  
🗑
What is a major risk whe a patient has an ICP monitoring device.   show
🗑
show To decrease chace for infection  
🗑
Wha is Myasthenia gravis.   show
🗑
show Muscle tone decrease.  
🗑
Explain the s/s og myasthenia and explain why the patient develops these symptoms.   show
🗑
show Tensilon increase nerve impulse. the patient will be injected with tensilon and if they have Myasthenia they wil improve immediately.  
🗑
Why are prostigmin ad mestinon used to treat myasthenia gravis?   show
🗑
show Myasthenia is thought to be an autoimmune problem, therefore steroids are given t decrase the immune reasponse.  
🗑
Why do we have to worry abot aspiration with the mysthenia gravis patient?   show
🗑
Why do we need to worry about airway with myasthenia gravis patient?   show
🗑
If a patient with myasthenia gets too tired or takes an over the counter medicine, what cold happen.   show
🗑
show MG has no had enough meds. CHO has had to much. inject Tensilon, improves it is MG, worst it is CHO  
🗑
When a patient is in a crisis with Myasthenia,why would you prepare them for a ventilator?   show
🗑
show The patiet will be NPO past midnight. No smoking.  
🗑
Yo are taking care of a patient who is going t have an upper GI. Explain what is going to happen to the ptient.   show
🗑
show Clear liquids, laxatives or enemas until clear, somethines they have to drink a large volume of fluids to flush ot the GI tract.  
🗑
Hw would you describe a barium enema to a patient   show
🗑
show B/C we dont want the bariu to stay in the body.  
🗑
show NPO- pre, they will besedated; a tube wiull be placed in the thraot and through the esophagus into the stomach.  
🗑
When a patient has a gastroscopy, they have to be NPO until their gag reflux returns. Why   show
🗑
Wha would be a major sign of perforation post gasteoscopy?   show
🗑
show PT PTT- one of the main funtions of te liver isto help with clotting. fter puncturing into theliver there is a chance our blood may not clot as quickly as it should.  
🗑
Why is it so important that vital signs be checked pre-liver biopsy?   show
🗑
How is a patient positioned during a liver biopsy.   show
🗑
Ho is a patint post liver biopsy? Explain Why   show
🗑
Why dos the patient have to exhale and hold while the physician is puncturing into te liver.   show
🗑
What is a paracentesis?   show
🗑
show Sit them up.  
🗑
show dont want to puncture the bladder.  
🗑
Why is it so important to monitor the vital signs pre and post paracentisis?   show
🗑
During a paracentesis, the patient could be thrown into a FD or FVE   show
🗑
What are two major functions of the pancrease   show
🗑
show Gall bladder disease and alcoholism.  
🗑
show A gallstone can block the pancreatic duct trapping the enzymes inside the pancrease.  
🗑
Pancreatitis: Abdominal Distentin and ascites   show
🗑
show Possible hemorrhage.  
🗑
Pancreatitis: Jaundice   show
🗑
show Inflammation  
🗑
Pancreatitis: Hypotension   show
🗑
show All will increase.  
🗑
show Polonged.  
🗑
Pancreatitis: Serum bilirubin (u or D)   show
🗑
Pancreatitis: H/H (up or down)   show
🗑
Why do we give the pancreatitis patient steroids.   show
🗑
show TO dry secretions  
🗑
show to decrease acid in the stomach.  
🗑
show Yes, because the pancrease is altered.  
🗑
show Because, the ascites could be pressing up on the diaphragm.  
🗑
What is a peitoneal lavage and how does the pancreatitis patient can get into? Explain?   show
🗑
show Hypocalcemia- te pancreas is filled with calcium, but when is starts digesting itself we lose our calcium; therefor the serum calcium goes down.  
🗑
show Clear liq, increase food slowly, no stimulating foods. freq small meals, high carbohydrates for energy  
🗑
Wht is cirrhosis?   show
🗑
show Increase-- Portal hypertension  
🗑
show Firm, nodular liver. abdomnal pain, chronica dyspepsia. Changes in bowel habit, ascites.  
🗑
Why does the cirrhosis patient sometimes develop hepatic encephalopathy and come.   show
🗑
Why are we worried abut I and O and daily wts wit the cirrhosis patient?   show
🗑
show To rest the liver.  
🗑
Why are we worried about prevention of bleeding in the cirrhosis patient.   show
🗑
Why do we measure the abdominal girth in the cirrhosis patient and what will it tell us?   show
🗑
Where is the first place a cirrhosis patient might develop jaundice.   show
🗑
show Alteration in skin integrity.  
🗑
show B/C the liver cannot metabolize narcotics.  
🗑
When a patinet has a liver disease, what should be done with protein in the diet.   show
🗑
Why does the liver patinet need a low-sodium diet.   show
🗑
show Ammonia.  
🗑
show B/C the liver is unable to convert ammonia to urea.  
🗑
show Minor mental changes. Decrease LOC, Asterixis, Decrease reflexes.  
🗑
show Neomucin and Lactualose b/c they decrease Ammonia.  
🗑
show Increase b/c the liver cannot convert ammonia to urea.  
🗑
show Protruding vessels in the esophagus waiting to rupture.  
🗑
show The back pressure in the liver forces the vessels in the esophagus to protrude.  
🗑
show Because the patient is anemic and we want what few red blood cells they have to be hyper-oxygenated.  
🗑
show It decrease the blood pressure in the liver and hopefully the bleeding will subside.  
🗑
show Cause vasoconstriction in other parts of the body.  
🗑
show Pitressin  
🗑
show To hold pressure on the bleeding varices.  
🗑
What is the nursing care associated with a Sengstaken Blakemore tube.   show
🗑
show Ulcerative colitis is a LG intestine disease. Chron'e disease is a small intestine disease.  
🗑
show Diarrhea, rectal bleeding, wt loss, vomitting, cramping, dehydration, blood in stool, anemia, rebound tenderness and fever.  
🗑
show Regional Enteritis  
🗑
show Low fiber diet b/c a high fiber diet would increase motility  
🗑
Why does the patient with ulcerative colitis or chorn's need to avoid cold foods, and smoking?   show
🗑
show Gantrisin which is a sulfonamide (antibiotic) to decrease infecton and inflammation.  
🗑
show To decrease inflammation  
🗑
Why does the patient with ulcerative colitis or Crohns disease possibly need psychotherapy?   show
🗑
What is the surgical treatment for ulcerative colitis?   show
🗑
What is the surgical treatmn fo Crohn's Disease?   show
🗑
show Continuous liquid drainage.  
🗑
show These will increas motility and therefore make the patient lose even more water.  
🗑
Why does the ileostomy patient need Gatorade.   show
🗑
Why is the ileostomy patient at risk for kidney stones.   show
🗑
show Potassium.  
🗑
show Bowel training and irrigation will be needed.  
🗑
show B/C the appendix fills with bowel conent and becomes inflamed and can rupture.  
🗑
show Right lowe quadrant pain and an elevated WBC; may have some nausea and vomiting and rebound tenderness.  
🗑
Why do we avod giving an enema to a patient twho has appendicitis?   show
🗑
When a patient has had anyabdominal sugery, what is the postion of choice and why?   show
🗑
show Burning pain in th mid- epigastic area. The pain may go all the way through to the back.  
🗑
Why do we give the peptic ulcer patient anatacids. What type of antacids would be best-- Liquid or tablet.   show
🗑
show To decrase acid -- Tagamet, pepcid, zantac.  
🗑
Why do we give the peptic ulcer patient Carafate?   show
🗑
Why is it important that the peptic ulcer patient decrease stress.   show
🗑
Why is it important that the peptic ulcer patient stop smoking.   show
🗑
Explain what you would teacha paptic ulcer patient about diet?   show
🗑
What is the difference in a pepotic ulce and a duodenal ulcer.   show
🗑
show When the stomach empties too rapidly after a gastrectomy gastic bypass.  
🗑
show Gastrectomy, Gatic Bypass.  
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show Fullness, palpitations, faintness, weakness cramping and diarrhea.  
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show Lie back when eating the lie flt after meals; drink fluids between meals; do not drink fluids with meals.  
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Wht is a hiatel hernia?   show
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What are the major symptoms of a hiatal hernia   show
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What are the major nursing interventions for a patiet who has a hiatal hernia?   show
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What is another nae for hyperalimentation?   show
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Why does a ptien whois receiving hyperalimentation need a centralline.   show
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show To avoid throwing the patie tinto hypoglycemia. Hyperalimintation solutios are packed with glucose.  
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Why is it so important that we monitor daily WT in the hyperal patient?   show
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The hyperal ptient may have to start taking insulin. WHY?   show
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show Checking urine fr glucose and ketones.  
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Why is it so important that we not mix hyperal ahead of time.   show
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show B/C it s full of eletrolytes.  
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show To prevent infection.  
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show We need to get some fluids spiked and primed and ready to go.  
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show The patient is placed in trendelenburg positin (to Distend the jugula and subclavian veins.  
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Where does the central line go?   show
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If air gets into your central line, what is going to happen? What position should you place the patient in?   show
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show Placement and Pneumothorax.  
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