Miscellaneous
Name 2 nonpharmacologic ways to prevent Deep Vein Thrombosis.
Ankle Pumps, Quad Sets, Gluteal Tightening, Straight Leg Raises, SCDs, Ted Hose, Turning and Ambulation
What is the name for the amount of blood ejected by the left ventricle during each systole?
What is Stroke Volume?
Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?
a. Protamine sulfate
b. Potassium chloride
c. Aminocaproic acid (amicar)
d. Vitamin K
What is a. Protamine Sulfate?
Rationale: The antidote to heparin is protamine sulfate; it should be readily available for use if excessive bleeding or hemorrhage should occur. Vitamin K is an antidote for warfarin sodium. Amniocaproic acid is the antidote for thrombolytic therapy. Potassium chloride is administered for a potassium diet.
What is the primary function of the GI system?
to convert ingested nutrients and fluids into a form that can be used by the cells of the body
While turning your bedridden patient, you note the skin over the bony prominence of his coccyx to be intact but it is redder, warmer, and softer than the surrounding skin and it is non-blanchable.
You document this as what type of wound?
What is a stage 1 pressure injury?
In a stage 1 pressure injury, the skin is not broken, but it may be redder, warmer, firmer, or softer than the surrounding area, and it does not blanche (turn white/lighter) when pressed.
The skin may also be painful or have changes in sensation.
Which two conditions are under the umbrella diagnosis of COPD?
Chronic Bronchitis and Emphysema
Which two heart valves close to make the S2 sound?
What are the Pulmonic and Aortic Valves?
A client with peptic ulcer disease is taking ranitidine (Zantac). What is the expected outcome of this drug?
A. Heal the ulcer
B. Protect the ulcer surface from acids
C. Reduce acid concentration
D. Limit gastric acid secretion
D. Limit gastric acid secretion
Rationale: Ranitidine is a Histamine-2 receptor antagonist, meaning that is reduces gastric acid secretion. Anti-secretory or proton-pump inhibitors such as Prilosec, help ulcers heal quickly in 4-8 weeks. Cytoprotective drugs such as Carafate protect the ulcer surface against acid, bile and pepsin. Antacids are responsible for reducing acid concentration and helping to reduce symptoms.
On TOH acute care wards, you are expected to document use of this tool to assess patient's risk for pressure sores on admission, every 48 hours, and when there has been a change in health condition:
What is the Braden Scale?
Developed in 1987 by nurses Barbara Braden and Nancy Bergstrom, the scale evaluates six areas: sensory perception, moisture, activity, mobility, friction and shear, and nutritional status. Each area is scored on a scale of 1–4, except for friction and shear which is scored on a scale of 1–3. The total score is the sum of the six scores, with a lower score indicating a higher risk of skin breakdown.
Name the 3 classic signs of diabetes mellitus:
What is polyuria, polydipsia, and polyphagia
Your patient's heart rate is 42. Should you administer or hold their beta blocker?
What is hold?
Which of the following comments indicates that a client understands the nurse’s teaching about sertraline (Zoloft)?
a. “Zoloft will probably cause me to gain weight”
b. “This medication can cause delayed ejaculations”
c. “Dry mouth is a permanent side effect of Zoloft”
d. “I can take my medicine with St. John’s wort”
What is b. “This medication can cause delayed ejaculations”?
Rationale: Sertraline is an SSRI which can cause decreased libido and sexual dysfunction. SSRI’s do not cause weight gain, but can cause decreased appetite and weight loss. Dry mouth is a possible side effect, but is temporary. St. John’s wort should not be taken with SSRI's because it can cause serotonin syndrome.
If your patient has this condition, you may need to continue to administer lactulose even if they are having watery diarrhea:
What is hepatic encephalopathy?
Hepatic encephalopathy is a condition that occurs when the lover can't clear toxins (ammonia) from the body.
Lactulose is a non-absorbable sugar composed of galactose and glucose was first made in 1929. Lactulose reduces the intestinal production/absorption of ammonia (Colonic breakdown of lactulose to lactic acid leads to acidification of the gut which favors the formation of nonabsorbable NH4+ from NH3, thereby trapping NH4+ in the colon and reducing plasma ammonia concentrations).
Name 1 way you can decrease your patient's risk of incontinence associated dermatitis (diaper rash)?
What is:
-change patient frequently
-clean skin thoroughly at each change with mild cleanser and pat dry gently
-apply a skin protectant barrier cream
Which type of diabetes is due to the development of resistance to endogenous insulin?
What is Diabetes Mellitus Type 2?
What does MAP stand for?
What is Mean Arterial Pressure?
A formula you can use to calculate MAP is 2 times diastolic plus systolic over 3.
A 66-year-old client complaining of not feeling well is seen in a clinic. The client is taking several meds for the control of heart disease and hypertension. These medications include atenolol, digoxin, and chlorothiazide. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?
a. Dypsnea, edema, and palpitations
b. Chest pain, hypotension, and paresthesia
c. Double vision, loss of appetite, and nausea
d. Constipation, dry mouth, and sleep disorder
What is c. Double vision, loss of appetite, and nausea?
Rationale: These are early signs of toxicity. Additional signs of toxicity are bradycardia, difficulty reading, other visual alterations such as green and yellow vision or seeing spots or halos, confusion, vomiting, diarrhea, and decreased libido and impotence.
Stage this pressure injury:
The sore extends into deeper tissue and fat, but it doesn't reach muscle, tendon, or bone. The sore may form a small crater, and fat may be visible.
What is stage 3?
The symptom that refers to swelling caused by fluid leaking into surrounding tissues.
What is edema?
True of false: a dose of 81mg of aspirin daily is used to treat chronic pain?
Low dose daily aspirin is given for it's antiplatelet action.
This star-shaped tropical fruit should not be consumed by patients with renal failure, especially those on dialysis, because it contains a toxin that can affect the brain and cause neurological disorders.
What is star fruit?
Patients with chronic kidney disease cannot process and pass the toxins (oxalate) from star fruit (averrhoa carambola) the way healthy kidneys can.
Star fruit may be found in beverages as well.
True or false: Smoking positively impacts wound healing.
What is FALSE?
Smoking NEGATIVELY impacts wound healing by:
-Decreasing oxygen
Smoking reduces the amount of oxygen in the blood and the body's ability to transport oxygen to wounds.
-Damaging blood vessels
Smoking can damage blood vessels, making it harder for blood to flow to wounds. Nicotine, a chemical in tobacco, can cause arteries to narrow.
-Thickening blood
Smoking can thicken blood, making it harder for it to flow through narrowed blood vessels. This can increase the risk of blood clots.
-Limiting infection-fighting cells
Chemicals in cigarette smoke can reduce the effectiveness of neutrophils, which are cells that fight infection.
-Increasing inflammation
Smoking can increase inflammation, which can make wounds more painful.
-Smoking can also decrease the strength of scar tissue and reduces the success of skin grafts