Final Exam
What are the risk factors post Paracentesis?
Bleeding
F & E imbalance
Infection
BUN value
Creatinine
pH of urine
minimum urine output
5-20
0.6 – 1.2
4.6-8.0
30ml/hr
Avoid caffeine and chocolate
Do not lie 2-3 hours after eating
Elevate the head while sleeping
Small frequent meals
What are interventions for GERD?
Fever, Hyperventilation, Hypoxia, Hysteria, Overventilation, Pain
Causes of respiratory alkalosis?
Rifampin
Isoniazid (INH)
Pyrazinamide (PZA)
Ethambutol (EMB)
Treatment for Hyperthyroidism?
PTU
Surgical removal of thyroid
1. Hepatic Encephalopathy treatment
2. Esophageal Varices complication
3. Pancreatitis treatment
4. Cholecystitis
1. Lactulose
2. Bleeding
3. NPO, NG tube
4. Pain meds, surgical removal and low fat diet
What are nursing interventions for seizures?
Protect the head from injury
Put the client on their side
Have the suction set ready
pH elevated, HC03 elevated, PaCo2 normal
What is metabolic alkalosis?
Patients with osteoporosis needs to do the following? SATA
Take calcium supplements
Take prescribed meds ( Alendronate)Avoid coffee, chocolate and smoking.
Maintain fall risk precautions to prevent fractures.
1. Appropriate diet for client retaining fluid (due to HF, Kidney Failure, Liver failure)
2. What is the standard treatment for HF, Kidney Failure, Liver failure?
1. Low sodium diet
2. Diuretics
1. Hep A
2. Hep B
3. Hep C
4. Hep D
1. Oral fecal route
2. Bodily fluids
3. Bodily fluids.
4. Needs Hep B to replicate
What are S/S of ICP?
Headache, N/V and Papilledema
Seizures
Asthma, atelectasis, brain trauma, bronchiectasis, bronchitis, central nervous system depressants, emphysema, COPD, Administering high O2 levels, pneumonia, pulmonary edema, pulmonary emboli
What are causes of respiratory acidosis?
pH 7.30 CO2 50 HCO3 26 indicates respiratory acidosis.
HF patients (both right & left) need the following medications?
B. Blockers
Ace Inhibitors
Diuretics
Digoxin
What are nursing responsibilities r/t blood transfusion?
Stop the flow of the transfusion and flush the line with 0.9% normal saline solution.
If needed, the line must be disconnected from the set-up, and a new tubing must be used to ensure that the line is kept patent
Take the patient’s vital signs, document together with all the reactions seen and complained by the patient.
Notify the physician immediately of the event.
Inform the blood bank of the event.
Be prepared to administer medications to the patient to combat any reaction that must be addressed:
Fill in the blanks:
Clients who have ______have an increased amount of antidiuretic hormone, which results in excess fluid volume. This excess fluid dilutes the sodium level in the blood, causing dilutional hyponatremia. Oral fluids are restricted in an attempt to restore the fluid balance and the sodium level in the blood. The nurse should offer this client frequent oral care to prevent discomfort and breakdown of the oral mucosa.
What is SIADH?
What are your nursing interventions for ICP?
Fowler's position
Stool softner
No sneezing, no coughing, no bending, no shivering
Initiate seizure precautions
Renal Failure, Diabetes/DKA, Acetylsalicylic acid (asprin), high fat diet, severe diarrhea, malnutrition
What are some causes of metabolic acidosis?
MONA stands for ????
Morphine
Oxygen
Nitro
Aspirin
What are nursing responsibilities r/t Tracheostomy?
Suction should be given for no more than 10 seconds to reduce the risk of hypoxia, cardiac arrhythmia and bronchospasm/constriction.
It should only be applied on withdrawal of the suction catheter to reduce the risk of mucosal irritation and damage
Suction catheters are a sterile, invasive piece of equipment and should therefore be discarded after single use
1. Complications of any surgery
2. Post ortho procedures do -------------
1. Hemorrhage in the first 2 days
Infections usually post 2 days
2. Neurovascular checks
1. Monitor Amylase, Lipase and Protease.
Keep patient NPO, insert NG tube, initiate IV fluids and antibiotics
2. Manifestations of Crohn's Disease
1. What is pancreatitis?
2. Persistent diarrhea. Rectal bleeding. Urgent need to move bowels. Abdominal cramps and pain.
Sensation of incomplete bowel evacuation
Excessive vomiting or GI suctioning, hyperaldosteronism, excessive sodium bicarbonate, massive whole blood transfusion
What are causes of metabolic alkalosis?
1. Sickle Cell Anemia patients should do the following to prevent Sickle Cell Crisis?
REMEMBER FOR ANY DISORDER ENDING WITH "ITIS" GIVE ANTIBIOTICS
1. Hydration, Avoid high altitudes. Prevent infections.
Pancreatitis give antibiotics
Appendicitis give antibiotics
For all patients do the following assessment?
LOC
PERRLA
Reflexes
Cranial nerves
For chronically ill patients (COPD, Cirrhosis) do the following______
For GI patients do the following____
For chronically ill patients (COPD, Cirrhosis) provide frequent rest periods.
For GI patient hold fluids and food. Initiate IV fluids
Diet for patient with Hepatic Encephalopathy?
Diet for patient with Cholecystitis
Low protein
Low fat and low cholesterol
pH decreased, HC03 normal, Pa02 decreased PaC02 elevated
Respiratory acidosis
Medications that cause Osteoporosis
What is prednisone or hydrocortisone
Anastrozole
-------------?
What are risk factors for TURP (A transurethral resection of the prostate)
Client with BHP will have risk of bleeding (first couple of days) incontinence, urinary retention and Erectile Dysfunction.
S/S of Ovarian Cancer
Vague discomfort in the abdomen or pelvis
bloating, change in bowel habits, indigestion, or nausea
Abdominal fullness, fluid in the abdomen, or lump in the abdomen
Cancer-related fatigue or loss of appetite
1. Treatment of Chlamydia and Gonorrhea
2. Treatment for Herpes
Gonorrhea can be cured with the right treatment. CDC recommends a single dose of 500 mg of intramuscular ceftriaxone
A single dose of azithromycin or taking doxycycline twice daily for 7 to 14 days are the most common treatments
2. Acyclovir
increased pH, normal HC03, decreased PaCO2
pH 7.50 CO2 30 HCO3 24
What is respiratory alkalosis?
1. Treatment of Heart Failure
2. Treatment of Liver Failure
1. Digoxin. Diuretics. Ace Inhibitors
2. Treatment of symptoms. Treatment is supportive
For HE give Lactulose
1. Interventions for Anemia
2. Interventions for thrombocytopenia
3. Leukopenia
1. Blood transfusion if Hgb less than 8. (Procrit)
2. Electric razor, decrease invasive procedures as much as possible
3. Monitor temperature. Limit visitors. No fresh fruits or flowers. Private room
Interventions for Lymphedema?
Elevate the affected arm
No BP/ IV/ Blood draws
1. Pap smear screens ___________?
2. Risk factors for Cervical Cancer?
3. Diagnostics for HIV______
1. Only cervical cancer.
2. HPV. Smoking. Multiple sexual Partners
3. ELISA. Western blot. Viral load
Decreased pH, HCO3 decreased, PaCo2 normal
What is metabolic acidosis?
For Iron Deficiency Anemia the client should receive the following?
What is Ferrous Gluconate or Ferrous Sulfate?