PT 1
What fluid is contraindicated in babies and patients with head trauma?
D5W (5% Dextrose in Water)
Can cause cerebral edema
How do we treat a patient dx w/ heparin induced thrombocytopenia?
Stop the heparin and start the pt on another anticoagulant such as a direct thrombin inhibitor (DTI).
What lab values would indicate that treatment to manage HIV is successful?
BONUS 100
What lab value would indicate an AIDS in an HIV patient?
If the viral load falls to undetectable levels, it is considered untransmitable. This is the goal for all HIV treatment.
CD4 count of under 200
Where do the first signs of MS usually occur? Name at least one s/s.
Ocular problems are usually the first s/s that present for MS; they can include blurred/ double vision, red-green color distortion, or even blindness in one eye.
What kind of anemia is genetic?
Sickle Cell Anemia
How should you take a patient off of TPN?
Decrease TPN by half, slowly wean off, then switch to a replacement fluid with a DEXTROSE base
What is a wedge resection?
A small, wedge shaped portion of a lung to excise a tumor while also taking a portion of healthy tissue (to be absolutely sure all the cancer is removed).
What med will not work on patients with heart transplants who are experiencing bradycardia?
Atropine
What is the difference between positive and negative symptoms in a schizophrenic patient?
Positive symptoms add something to a person's experience, while negative symptoms take something away
What is the difference between hospice and palliative care?
Hospice care is a type of palliative care that focuses on the comfort and quality of life of people who are near the end of their life, while palliative care can be provided at any time during a serious illness.
What level of prevention is this? A patient attending a flu vaccine clinic at the start of the school year.
Secondary prevention (Getting a flu shot during flu season is considered secondary prevention)
What is happening to blood cells in the spleen with splenomegaly? How does this affect the patient?
The spleen is overfiltering the blood, causing it to trap and destroy an excessive amount of healthy red blood cells, platelets, white blood cells, leading to a reduction in their numbers within the bloodstream.
This can lead to anemia symptoms, increased risk of infection, increased bleeding, and it increases the risk of the spleen rupturing.
What are the 5 rights of delegation?
Right task, circumstance, person, supervision, feedback/ communication
What are 3 ways to manage aggression in a mental health patient?
Set firm limits on behavior, clearly outline consequences for inappropriate behavior and follow through, remain calm and role model ways to express anger
What type of genetic disorder is Huntingtons?
Inherited, autosomal dominant genetic disorder
What are 5 steps to take before starting a blood transfusion?
Ensure informed consent is received
Ensure premeds are ordered/ administered
Prime/ set up blood tubing
2 RNs verify pts name, DOB, blood type, and blood band if necessary.
2 RNs verify blood unit number, donor type, expiration date, product type
What are the treatment steps for polycythemia?
Eliminate the cause
Phlebotomy (to reduce number of cells)
Hydration
Myelosuppression
Hydroxyurea
ASA
What tasks are LPNs not allowed to perform as opposed to RNs?
LPNs cannot do admission assessments or develop/ change comprehensive care plans, or initiate patient teaching.
What is an edrophonium test?
It is a medication test used to diagnoses myasthenia gravis; it involves injecting endrophonium and then observing for any improvement in muscle strength.
What is the difference between PTSD and ASD?
PTSD is diagnosed after the s/s of ASD have lasted longer than 1 month
When should the nurse infuse blood after retrieving a unit from the lab and what are the steps to initiating/ maintaining the transfusion?
The nurse has 30 mins to begin the transfusion after blood is received.
Start the rate slow (25-50ml/hr), watch for s/s of a reaction, obtain first set of VS, continue to monitor based of clients condition
List 4 s/s of multiple myeloma
Fatigue/ weakness, bone pain/ fractures, frequent infections, constipation, increased thirst/ urination, confusion/ decreased alertness, kidney damage, numbness/ tingling in extremities.
What are 5 considerations for determining how donor organs are distributed?
Clinical status- preexisting conditions, labs, age, functional status of the patient
Nutritional status- malnourished patients are more likely to experience rejection
Psychosocial status- hx of poor adherence to treatment plan
Financial status- ability to pay for treatment and consequent therapy (life long anti-rejection meds)
UNOS waiting list placement- how long the patient has been on the waiting list/ how rare the organ they need is
What are two major differences between characteristics of MS as opposed to other neurodegenerative disorders?
MS is autoimmune in nature, as opposed to other neurodegenerative disorders which are generally caused by either a mutation, neurodegenerative processes, or vascular issues that damage brain cells directly.
MS symptoms also generally fluctuate with episodes of relapse and remission.
MS symptoms can fluctuate depending on what parts of the brain are damaged by lesions.
What steps should you take when hanging lipids as a secondary for a patient on TPN?