Pre/Post-Operative Care
This action should be prioritized when a post-op patient returns with BP 90/50, HR 132, RR 30.
What is... contact the physician!
This medication treats acute pulmonary edema by reducing preload, afterload, and anxiety.
What is morphine
This type of drainage after peritoneal dialysis may indicate peritonitis.
What is cloudy dialysate
This is the most appropriate response to a new colostomy patient passing flatus on day 2 post-op.(think if this is expected or not).
What is this is a normal, expected event.
A client with ascites must do this before a paracentesis.
This is the best position to achieve optimal results when using an incentive spirometer.
What is sitting up or with the head of bed at 45-90 degrees.
This is the most appropriate treatment for second-degree AV block Type I (Mobitz I) with no symptoms.
Call the doctor.
Observe for signs of further heart block.
Epi 1 mg IV push
Immediate insertion of a temporary pacemaker
What is careful observation for signs of further heart block.
This lab result is expected in the oliguric phase of AKI.
What is hyperphosphatemia
This nursing diagnosis is the priority for ulcerative colitis.
What is fluid volume deficit.
This medication is expected for a cirrhosis patient with confusion and musty breath odour.
What is lactulose
This lab value might cause surgery to be postponed.
Hgb 80
Na 145
Creat 70
Platelets 210
What is Hgb 80
A new permanent pacemaker patient should avoid lifting the arm above this height.
This symptom is most associated with lower UTI.
What is urinary frequency and urgency.
This finding in a transverse colostomy requires immediate notification.
*Clue - think of colouration of the stoma
What is purple discolouration of the stoma
A patient with cirrhosis has developed esophageal varices. Which nursing intervention is a priority to prevent life-threatening complications?
a. Encourage oral hydration to maintain mucosal integrity
b. Insert a nasogastric tube to assess for GI bleeding
c. Monitor blood pressure and administer nonselective beta-blockers
d. Position the patient flat to improve hepatic perfusion
What is monitor blood pressure and administer beta-blockers
You would use this type of catheter for continuous bladder irrigation.
What is a triple-lumen catheter
The nurse should prioritize this action for a stable patient with ventricular tachycardia and a pulse.
Clue - Think medication
What is amiodarone
The nurse would expect this dietary order for a patient with nephrotic syndrome.
a. Low carbohydrate potassium
b. Moderate protein
c. Low calcium
d. Increased potassium
What is moderate protein diet.
This is the most frequent complication after an ileostomy.
What is fluid and electrolyte imbalance.
A client on chemo says they’ll take aspirin for a headache. What’s the concern? - Think risks of the medication.
What is risk for bleeding during nadir (bone marrow suppression)
A client who has abdominal sx complains something "gave away". On assessment, there is the presence of a loop bowel protruding through the incision. What interventions would the nurse take (Select all that apply).
Contact the surgeon
Instruct the patient to remain quiet
Prepare the client for wound closure
Document the findings
Place sterile saline dressing over the wound
What is...
a. Contact the surgeon.
c. Prepare the client for wound closure.
d. Document the findings and actions taken.
e. Place a sterile saline dressing over the wound.
This rhythm features ventricular bigeminy and is best managed initially by finding the cause.
a. Performing defibrillation
b. Treatment with intravenous amiodarone
c. Insertion of a temporary pacemaker
d. Continuing to monitor and attempt to determine the underlying cause
What is to continue monitor and determine underlying cause
A client with chronic kidney disease needs more education if they say this.
a. "I should limit foods high in phosphorus like dairy."
b. "I can drink as much water as I want."
c. "I need to monitor my potassium intake."
d. "I should avoid high-protein foods if my BUN is elevated."
What is "I can drink as much water as I want."
The patient has ++ blood stools with U colitis. What MD order would you question?
a. Start IV fluids with electrolyte replacement
b. Place the patient on NPO status
c. Administer an antidiarrheal medication
d. Monitor intake and output every 4 hours
What is administer antidiarrheal medication.
A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply.
a. Diarrhea
b. Black, tarry stools
c. Hyperactive bowel sounds
d. Gray-blue color at the flank
e. Abdominal guarding and tenderness
f. Left upper quadrant pain with radiation to the back
What is
d. Gray-blue color at the flank
e. Abdominal guarding and tenderness
f. Left upper quadrant pain with radiation to the back
BUT IGNORE F