Clots
What is the purpose of teaching leg exercises to a post-MI client on bed rest.
To prevent venous stasis and clot formation
What is the highest priority intervention for a patient receiving alteplase
Monitoring for signs of bleeding
What are 2 ways immunity is acquired?
passive: breastmilk, placental transfer, or IGG infusion
active: an illness or immunization
S/S you might expect to see if someone is thrombocytopenic
bruising, prolonged bleeding, blood in urine, stool, heavy periods, fatigue, weakness
This adverse effect may occur in a client who takes ibuprofen regularly.
What is a gastrointestinal bleed?
Which type of shock: A client with DVT suddenly becomes dizzy, short of breath, and hypotensive.
PE - Obstructive shock
What should you do if you notice flushing, pruritus, or redness during vancomycin administration?
Stop the infusion, prepare to administer diphenhydramine and acetaminophen
If a patient has A-Fib, what are 2 concerns we need to monitor?
clotting (stagnate blood in atrium), lower cardiac output
What are the s/s of a DVT
redness/warmth, pain, swelling
This is the reason heparin is administered to a patient experiencing a myocardial infarction.
To prevent new clots
HIV exposure prophylaxis is called:
PEP - 28 day course of meds started immediately
These foods are recommended for a patient with vitamin K deficiency.
What are green leafy vegetables like kale, broccoli and spinach?
This is the physiological rationale for prescribing 81 mg of aspirin daily to a client with coronary artery disease.
What is preventing platelet aggregation/agglutination?
S/S of anaphylaxis is: --
When does it become anaphylactic shock?
Wheezing
Vasodilating = low BP, poor perfusion s/s
You notice that your pt has been ordered ceftriaxone and they have a h/o penicillin allergy. Why should you be concerned or more aware?
cross-sensitivity with PCN, may have allergic reaction to cephalosporins
Common SE for RAAS medications include:
ACE: first dose hypotension, cough
ACE, ARB: hyperkalemia
Rare angioedema
Alteplase must be administered quickly after an MI for this purpose.
What is re-perfusing the blocked coronary artery?
You should question giving a pt which med if they have an INR of 4.0.
Warfarin/coumadin
Immunity present at birth
Innate immunity
This medication is given before chemotherapy begins to prevent nausea.
What is ondansetron?
This PRN home medication should be questioned for a client being discharged after hospitalization for a GI ulcer.
What is ibuprofen for headaches?
Pt in hypovolemic shock receives an IV fluid bolus, what are indicators of improved perfusion
improved: cap refill, LOC, BP, UOP
MD ordered abx, cultures, IVF. What order do you complete these? And why?
cultures, IVF and abx
You think your pt may have a PE: c/o CP and trouble breathing. After assessing VS (stable) and LOC (no change), what should you do next before calling MD?
elevate HOB
What are some teaching points for a pt starting clopidogrel.
Expect some bruising, bleeding gums
Notify PCP if there is unexpected bleeding, or bleeding won't stop
A PTT value that is above the provider's ordered therapeutic range is called what?
Supratherapeutic
Tell me 1 live virus vaccine and 1 inactivated virus vaccine
Live: MMR, Chicken Pox, Rotavirus
Inactivated: Hep A, Flu, Polio
Why would a pt get chemo after surgical to remove a tumor.
To kill left over cancer cells
A concerning assessment finding in a client who frequently uses acetaminophen.
What is jaundice?
S/S of a pt with a spinal cord injury indicate possible neurogenic shock.
flushed skin, hypotension, decreased urinary output, and altered mental status
When giving an antibiotic, what questions (3) should you ask the patient?
any allergies? PMH? other medications?
Your patient has CP, ST elevation and elevated CKMB. what is the priority for your patient's heart?
increase perfusion/oxygenation
What do you tell your pt is the reason for getting low molecular weight heparin after their ischemic stroke.
To help prevent a new clot from forming
What does it mean when a pt continues to have CP after alteplase?
It means the thrombolytic therapy was unsuccessful
Flu positive pts may receive: ?
Covid positive pts may receive: ?
Oseltamivir
Paxlovid
A biopsy of a breast lump is performed for this purpose.
What is determining whether the lump is cancerous?
4 side effects of corticosteroids are:
•Sodium and water retention, potassium loss
•Central obesity
•Hyperglycemia
•Increased risk of bone fracture (osteoporosis) •Thinning of the skin and striae
•Mood/personality changes
S/S of hypovolemic shock after a client loses 15-20% of their blood volume. 5L - 750ml-1000ml
decreased LOC, deceased BP, pale, clammy, elevated HR, low UOP, cyanosis, weak pulses
15lb baby = 510ml total blood volume, 75ml = 15%
A pt taking an antibiotic develops watery, mucus-filled diarrhea after several days. What is this and what should you tell the pt?
possible SE and hold dose and notify the provider
(c.diff)
Your patient was just prescribed nitroglycerine for angina. What are 3 teaching points you want to tell them?
HA common
keep from temp, light, oxygen;
interactions (sildenafil, alcohol)
if angina not resolved within 5 min, call 911. take no more than 3 pills 5 min apart