CANCER
Life expectancy of 6 months or less confirmed by 2 physicians
A patient who starts taking tolterodine asks why they are taking a respiratory medication to treat their incontinence. What teaching does the nurse provide?
Teach the patient that tolterodine is an anticholinergic meaning that although it can be used to relax the smooth muscle of the bronchioles it also causes the patient to be unable to pee which can treat incontinence.
What is the cause of a goiter?
Lack of iodine
What is the order of assessment of the abdomen?
How should you position a patient who is about to receive tube feedings?
30-45 degrees (keep up for 30 minutes after feeding)
What should the nurse teach a patient who is experiencing thrombocytopenia secondary to chemo?
Teach patient to avoid invasive procedures, no injections, use soft bristle toothbrush, use an electric razor, and avoid activities that may cause injury/bleeding
Overflow incontinence
What is the ideal diet for a patient with hyperthyroidism?
High-calorie, high protein, high carb (frequent meals and snacks)
Avoid high fiber, caffeine, and spicy foods (already having diarrhea)
Salt restriction with severe exophthalmos
What are some things that can cause GERD exacerbations?
You are caring for a post-op patient following a colostomy. The nurse checks the ostomy bags and notes 200mL of bright red drainage. What should the nurse do?
Call the surgeon
This is not a normal finding. There should be little to no output in the first few postoperative days.
A patient is prescribed epoetin alfa, when should the nurse hold the drug?
How do you differentiate an upper UTI and a lower UTI?
Upper UTIs will have flank pain and systemic flu-like symptoms
Lower UTIs will have local symptoms like burning and urgency (not systemic symptoms)
What causes a patient with hypoparathyroidism to have painful muscle spasms, aches, and seizures?
Hypocalcemia (low calcium)
When should a patient experiencing pyrosis take an antiacid?
1-3 hours after meals/bedtime
What route must TPN be administered?
Through a central line because it is harsh on peripheral veins.
A cancer patient is being palliatively and using morphine to control their pain. The family is concerned about addiction because the dose keeps getting increased. What can the nurse teach the family about opioid pain management?
Prolonged use of morphine will cause the patient to build a tolerance. They need to increase the dose to achieve the same level of pain relief, therefore addiction would not be suspected.
What medication does the female nurse need to wear gloves with when handling the tablet?
5-alpha-reductase inhibitors (finasteride, dutasteride)
What are some indications that a patient's Levothyroxine dose needs to be lowered?
Tachycardia, agitation, weight loss, sweating, hyperactivity, exophthalmos, insomnia, hyperactivity (s/s of hyperthyroidism)
What is the action of metoclopramide?
It is a prokinetic drug that promotes gastric emptying, reducing the risk of gastric acid reflux.
After placing an NG tube you are checking for placement by aspirating gastric contents. What pH would indicate it is in the right place?
<6 would mean it is in the stomach
Steven Johns Syndrome
You are caring for a post-op TURP patient with a 3-way Foley catheter. What are the guidelines for irrigation of this patient?
Light pink clear output- normal
Bloody output with clots- increase irrigation
Clear output (no color)- decrease irrigation
What are the symptoms of hyperparathyroidism?
Kidney stones, fractured bones, constipation (hypercalcemia)
What are the long-term complications of pantoprazole (PPI)?
Decreased bone density, kidney disease, and vitamin b12 deficiency
What are some ways to prevent central-line blood stream infections?
Hand hygiene, sterile insertion, clean dressing changes, chlorhexidine solution, and removal when unneeded