Nursing Care
Name and describe one breathing technique for patients with COPD.
What is huff coughing or pursed lip breathing?
List the two potential complications that can result from group A beta-hemolytic streptococcus.
What are rheumatic heart disease and glomerulonephritis?
Name the most sensitive indicator of kidney function and its normal parameters.
What is creatinine Clearance 70-135 ml/min?
Name the treatment for latent TB.
What is isoniazid for 6-9 months?
A patient calls their primary care office with symptoms of the common cold. The patient informs the nurse that they have been taking an intranasal decongestant for over a week and are no longer receiving relief. What patient education should the nurse give to the patient?
Intranasal decongestants should only be used for 3-5 days at a time. The nurse should instruct the patient to discontinue the nasal decongestant as they are more than likely experiencing rebound congestion.
A patient is in the hospital for a COPD exacerbation. What would their meals look like? (frequency of meals, high/low ___, etc).
What is 5-6 small meals (high calorie, high protein)?
You have a patient who has an unstable chest due to multiple rib fractures. List 2 expected assessment cues you expect to see.
What are rapid and shallow respirations; tachycardia, abnormal respiratory movement (paradoxical movement)
What is painless hematuria?
Name three interventions for xerostomia.
What are pilocarpine hydrochloride (Salagen), increase fluids, chew gum or candy, nonalcoholic mouthwash, artificial saliva, carry water?
What education point would you give a patient using a nettie pot for sinusitis?
What is instruct the patient to use distilled or boiled (and fully cooled) water?
You have a patient with an acute kidney injury. The patient's urinary output over the past 24 hours has been 400 mL. Calculate their fluid intake for the next day.
What is 1000 mL?
600 mL + 400 mL (UO for past 24 hours) = 1000 mL
List three risk factors/ predisposing factors for head and neck cancer.
What is smoking, alcohol use, long-term exposure to harmful chemicals, and HPV?
explain nutrition therapy for AKI.
What is low protein, 30-40% total calories from fat, sodium restriction, calcium supplements?
What is CBIG K drop, dialysis, kayexalate, dietary restriction?
List three education points for a patient with cystitis.
what is take meds as prescribed, empty bladder every 2-4 hours and after intercourse, hydration, avoid tight clothes, follow-up if recurrent symptoms?
List 5 nursing care points for a lithotripsy.
•Pain management
•Watch for obstructions à want at least 30 ml/hr
•Bed rest and hydration
•Turning q 2 hours to help move stone
•Strain urine to see if it passed
•Patient education about diet and urine pH testing
•Some patients may require regular urinalysis
List the asthma triad.
what is mucosal edema, bronchoconstriction, excessive secretion production?
List two treatment options for Goodpasture's?
What are corticosteroids, immunosuppressants, and plasmapheresis?
List 3 therapeutic interventions for uric acid kidney stones.
What is hydration, K citrate, allopurinol, reduce red and organ meats in diet?
You have a patient who underwent lithotripsy 15 hours ago for a kidney stone. The patient reports that there is blood when they urinate. How would you respond to this patient's concern?
Educate the patient that blood in their urine is common up to 24 hours after their procedure. The blood will begin as bright red and turn dark and smokey over time and should clear in 24 hours.
List five nursing interventions or nursing care for a patient with pneumonia.
•Elevate HOB: prevent aspiration
•Monitor ABGs, oximetry, O2
•Fever? antipyretics
•Turn, cough, deep breathe
•Push fluids!!! (3L of fluids daily)
•Small frequent meals à high calorie/protein
•ABX if needed
•Pneumovax recommendation (every 5 years)
You have a patient in the emergency department who was just diagnosed with pneumonia. The patient is a 64 year old male with a respiratory rate of 34, BUN of 23, blood pressure of 96/65, and shows signs of new onset confusion. Give his CURB 65 score.
What is 3?
C- 1 because the patient had new onset confusion
U- 1 because his BUN >20
R- 1 because his RR is >30
B- 0 because his BP is >90/60
65- 0 because he is 64
List five possible causes of urinary retention. Name at least 3 medication classes.
What are BPH, diabetes, alcoholism, sacral neurological disorder. Meds – antihypertensives, anti-parknisonian, antihistamines, anticholinergics, antispasmodics, sedatives, anesthetics?
List the 3 reasons a patient could not get the flu vaccine.
What is being < 6 months, serious reaction to previous vaccine, Guillain barre syndrome within previous 6 weeks, recent illness/ fever, possible egg allergy (not a big problem anymore)
List four patient education points for a patient with a Surgically created fistula (TEF).
Daily clean area around the stoma
Home trach care and G tube care
Stoma shield: scarf, shirt, handkerchief à cover stoma is coughing or any activity that might lead to inhalation of foreign body
ABSOLUTELY NO SWIMMING
Humidified hospital air, bedside humidifier and home and fluids
Medical alert bracelet** à neck breather
Carbon monoxide/ smoke detectors (smell lost)
Nutritious/ caloric meals