Show:
Cardiac Alterations
Care of the Surgical Patient
End of Life Care
Fluid & Electrolytes
Oxygenation
100
What are three symptoms you may see in a patient with iron deficiency anemia?
moderate: increased palpitations, bounding pulse, dyspnea, roaring in the ears, fatigue -pallor -pruritus -jaundice -increased HR -increased stroke volume -sensitivity to cold -weight loss -lethargy -systolic murmurs and bruits -HF -cardiomegaly -MI -ascites -peripheral edema
100
True or False : The nurse's responsibilities for informed consent include obtaining informed consent and answering questions or concerns regarding the procedure
False Witnesses informed consent Ensure that the provider gave the client necessary information. Ensure that the client understood the information and is competent to give informed consent Notify the provider if the client has more questions or appears not to understand any of the information.
100
Give an example of a situation in which a someone may experience complicated grief.
Some people do not experience a normal grief process. In complicated grief a person has a prolonged or significantly difficult time moving forward after a loss. He or she experiences a chronic and disruptive yearning for the deceased; has trouble accepting the death and trusting others; and/or feels excessively bitter, emotionally numb, or anxious about the future. Com- plicated grief occurs more often when a person had a conflicted relationship with the deceased, prior or multiple losses or stressors, mental health issues, or lack of social support. Loss associated with homicide, suicide, sudden accidents, or the death of a child has the potential to become complicated. (Potter&Perry)
100
Name the 2 main electrolytes in your body and where they are found?
Sodium-ECF Potassium-ICF
100
What factors affect normal oxygenation?
Decreased oxygen carrying capacity Decreased Inspired oxygen concentration Hypovolemia Increased Metabolic rate Conditions affecting chest wall movement
200
True or false: blood pressure is primarily a function of cardiac output and systemic vascular resistance.
True blood pressure - the force exerted by the blood against the walls of the blood vessel. It must be adequate to maintain tissue perfusion during activity and rest. cardiac output - CO is the total blood flow through the systemic or pulmonary circulation per minute. It is described as the stroke volume (amount of blood pumped out of the left ventricle per beat [approximately 70 mL]) multiplied by the heart rate (HR) for 1 minute. Systemic vascular resistance (SVR) is the force opposing the movement of blood within the blood vessels. The radius of the small arteries and arterioles is the principal factor determining vascular resistance. A small change in the radius of the arterioles creates a major change in the SVR. If SVR is increased and CO remains constant or increases, arterial BP will increase.
200
Name 3 things on the Pre-op checklist
Hygiene Hair & cosmetics Prosthesis Removal valuables Bowel and bladder prep Vital Signs Documentation Pre-op meds Eliminating wrong site/wrong procedure Diagnostic results
200
What are three nursing interventions you can implement for a dying patient (and their family) that is experiencing excess secretions?
-Suctioning the patient is not recommended, as it is ineffective and often uncomfortable for the patient -Turn the patient on his/her side -Elevate the head of the bed -Reassure the family of the patient’s comfort -Educate the family about the etiology of the breathing -Anticholinergics, such as scopolomine, glycopyrrolate and hyoscyamine can be useful in reducing secretions
200
Fill in the blank If a patient has gained weight since the previous day of _____lbs they may be experiencing_____
2.2, fluid retention
200
What are some signs and symptoms of Hypoxia?
Apprehension, restlessness Confusion, inability to concentrate Declining level of consciousness Cyanosis is a late sign
300
What are two possible causes of iron deficiency anemia?
-inadequate dietary intake -malabsorption (GI surgery) -blood loss -hemolysis
300
True or False: The circulating nurse helps maintain the sterile field during surgery.
False The scrub nurse maintains a sterile field during the surgical procedure, assists with applying sterile drapes, hands instruments and other sterile supplies to surgeons, and counts the sponges and instruments.
300
Define bereavement. The definition should include two key concepts.
The term bereavement encompasses both grief (emotional response to a loss) and mourning (outward, social expressions of grief) and includes the emotional responses and outward behaviors of a person experiencing loss. (Potter&Perry)
300
True or False: It is okay to give a patient with hypernatremia a hypotonic solution 0.45% saline
True
300
True or False: It is acceptable to use a nasal cannula to administer 8L of oxygen.
False Nasal cannula is used for low flow rates, up to 4 L
400
What are two nonmodifiable and two modifiable risk factors for hypertension?
modifiable: tobacco use, alcohol use, high dietary sodium intake, obesity, sedentary lifestyle, stress nonmodifiable: age, gender, ethnicity, family history
400
What is the purpose of the "Time out"?
Is used to verify right patient, right procedure, right site and any implants. Performed right before procedure has started.
400
Name three factors that can influence loss and grief.
-Stage of development (ex: toddler vs. adult) -The quality of the relationship -The nature of the loss (ex: a private miscarriage vs. a sudden car accident vs. a terminal illness) -Coping strategies -Socioeconomic status (When people lack financial, educational, or occupational resources, the burdens of loss multiply) -Culture and ethnicity -Spiritual and religious beliefs (Potter & Perry)
400
Fill in the Blank Abdominal Distention can be a sign of_____ and ____.
Hypokalemia and third spacing
400
Name 3 risk factors associated with pneumonia
Advanced age Compromised immunity Underlying lung disease Alcoholism Endotracheal intubation Malnutrition Altered consciousness Impaired swallowing Smoking Immobilization Underlying cardiac or liver disease
500
You are teaching a patient who has just been diagnosed with primary hypertension about the DASH diet. What are three foods you recommend increasing intake of and two you tell the patient to restrict intake of?
The DASH eating plan emphasizes fruits, vegetables, fat-free or low-fat milk and milk products, whole grains, fish, poultry, beans, seeds, and nuts. The plan contains less red meat, salt, sweets, added sugars, and sugar-containing beverages than the average American diet. • Restrict salt and sodium • Restrict cholesterol and saturated fats • Maintain adequate intake of potassium • Maintain adequate intake of calcium and magnesium There is some evidence that greater levels of dietary potassium, calcium, vitamin D, and omega-3 fatty acids are associated with lower BP in the general popula- tion and in those with hypertension. People with hypertension should maintain adequate potassium, calcium, and vitamin D intake from food sources. Calcium supplements are not recom- mended to lower BP. Omega-3 fatty acids found in certain fish oils can contribute to a reduction in BP and triglycerides
500
If you are a PACU nurse receiving a patient what would you include in your assessment in the first few minutes of PACU care?
Vital signs Respiratory adequacy Postoperative cardiac status Peripheral circulation Postoperative neurological status Level of consciousness, alertness, lucidity Orientation Intravenous patency Pain level Motor abilities Return of sensory and motor control Skin integrity Temperature regulation Positioning Surgical wound condition Presence of nausea and vomiting
500
What is the main difference between hospice and palliative care? Within what time frame is hospice care implemented?
Hospice today refers to a concept of comprehensive end of life care for those patients in the final stages of a life limiting illness, not necessarily a place. For patients in the final stages of any disease- diagnosed as having a life expectancy of six months or less. Palliative care refers to methods of treatment intended to sooth the symptoms of a disease or disorder without effecting a cure. The ultimate goal of palliative care is to improve the quality of the patient's life. It is appropriate for any age, any diagnosis, at any time, or in any setting Powerpoint slides 7, 12, 13
500
You have patient come in confused with distended neck veins, bounding pulse, Blood pressure 190/80, who says they have gained 2 pounds since yesterday. What is the possible diagnosis?
Fluid volume excess-these are all manifestations of FVE other manifestations are crackles decreased HCT ascites tachypnea confusion muscle weakness
500
What nursing interventions can the nurse do to help promote ventilation? Name 3
Reposition regularly Teach patient to cough, deep breathe Ambulate patient Increase fluid intake Utilize incentive spirometry