Nursing Basics
In ADOPIE the P is for Planning. What acronym is used in Planning Goals, and what does each letter stand for?
SMART
Specific, Measurable, Achievable, Realistic, Time Bound
Pt will walk 10 ft with assistance within 24 hours.
I have pink skin, a barrel chest, and cachexia. What type of COPD do I have?
COPD secondary to Emphysema. My symptoms are known as the "Pink Puffer."
Give 3 examples of diseases that would require Airborne Precautions (N95, negative pressure room).
TB, Measles, Varicella (chicken pox)
A patient is prescribed fluoxetine for OCD what should the patient be informed of regarding possible side effects?
A- drowsiness
B- loss of appetite
C- decreased sexual desire
D- Urinary retention
fluoxetine (Prozac) is commonly known to decrease sexual desire
A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment requires immediate action before proceeding?
A. BP of 136/88 mmHg
B. Apical pulse of 52 bpm
C. RR of 16 breaths/min
D. Potassium level of 4.2 mEq/L
Apical pulse of 52 bpm
Digoxin slows the heart rate; it must be held and the provider notified if the apical pulse is less than 60.
Which patient would benefit most from being placed in Trendelenburg position?
A. A patient with increased intracranial pressure
B. A patient in hypovolemic shock
C. A patient with GERD
D. A patient with a fractured femur
Trendelenburg Position
Improves venous return during hypotensive states such as shock.
I am on ACE Inhibitors, Beta Blockers, Digoxin, Calcium Channel Blockers, Vasodilators and Diuretics. What disease do I have?
Heart Failure
Meds to lower BP, Decrease workload of heart, Increase contractility of heart, and drain excess fluid from heart.
Which situation requires the nurse to don gloves according to standard precautions?
A. Administering oral medications
B. Checking capillary refill
C. Inserting a urinary catheter
D. Auscultating lung sounds
A- administering meds per JACHO requires the nurse to wear gloves as protection.
Sterile gloves are used to insert a urinary catheter. Checking cap refill and lung sounds does not require gloves.
Critical withdrawal symptoms from ETOH start at what time period?
48-72 hours
Hallucinations, delirium, delusions, seizures
Less critical start 6 hours after the last drink. Shaky hands, anxiety, headache, Tachycardia, N/V, Sweating
Which of the following medications requires a second nurse to verify before
administration?
A. Furosemide IV
B. Morphine PO
C. Potassium chloride IV
D. Metoprolol PO
IV potassium is high-alert and must be double-checked to avoid life-threatening errors. IV potassium is never given without dilution!
The fastest team to provide a nursing diagnosis and a medication used to treat a DVT.....GO!
Nursing dx examples;
Impaired tissue perfusion, risk for injury, risk for PE, acute pain.
Medications- anticoagulants (apixaban, rivaroxaban, dabigatran, heparin, warfarin)
The 1st line of treatment for TB is PERI. What does each letter stand for?
Pyrazinamide-think liver damage, NO ETOH, monitor for jaundice
Ethambutol-think optic neuritis, req eye exams
Rifampin- turns urine and secretions orange, monitor liver
Isoniazid- lowers B6, can cause peripheral neuropathy, monitor liver
Name at least 3 drug classes that would alert the nurse to put the patient at risk of falls.
Sedatives, Opioids, Antihypertensives, Diuretics, Laxatives
What is a somatoform disorder?
BONUS 100 Points, Give an example of a somatoform disorder.
Psychological stress is expressed through physical symptoms. They can't be medically explained or diagnosed.
Non-epileptic seizures, fibromyalgia (debatable), conversion disorder, body dysmorphia
The provider orders ampicillin 250 mg IV every 6 hours. The vial reads 500 mg/2 mL.
How many mL will the nurse administer per dose?
A. 0.5 mL
B. 1 mL
C. 2 mL
D. 1.5 mL
1ml
Dose/Hand/Quantity
250/500/2=1ml per dose
What is a nursing diagnosis based on?
The patient's response to a health problem.
If you got this wrong you can hear me screaming all the way from Italy!
What illness is known as the "silent killer."
HTN
Many times HTN can be asymptomatic.
Headache, blurred vision, dizziness, chest pain, SOB
Restraints require a provider's renewal every ______hours. Restraints placed for medical surgical reasons the nurse documents/assesses these 3 things every 2 hours ___________,_____________,____________.
And rounds are done every ________hour.
24 hours
Circulation, skin, behavior (2-hour assessment/doc must be done by a nurse)
Hourly rounds are completed, but can be delegated to a CNA (just checking in for safety, not assessing)
What are the 5 types of hallucinations? In medical terms!
Auditory, Visual, Olfactory, Somatic, Gustatory
If a patient is prescribed opioids, what other medication should the patient be prescribed?
Stool softeners or Laxatives
Opioids can cause constipation- Think "low and slow" vitals, high risk for falls, orthostatic hypotension, low and slow GI tract
Which medications would a nurse expect to increase a patient's infection risk. Hint 3 classes
Corticosteroids, Chemotherapy, Antibiotics
What is the most common cause of a pulmonary embolism?
A blood clot (DVT) forms in one of the lower extremities and gets dislodged and travels up the vascular system and becomes lodged in the lungs.
Which medication should alert the nurse to a higher fall risk in a 78-year-old client?
A. Metoprolol
B. Omeprazole
C. Warfarin
D. Lisinopril
Lisinopril can cause orthostatic hypotension, increasing falls in elderly clients.
"Prils" cause "Spills."
Metoprolol can also cause falls associated with unsteadiness, but Lisinopril has a higher risk as it causes orthostatic hypotension.
Name at least 5 signs of Lithium Toxicity
BONUS- Name all 6 signs and the toxic level amount.
Toxic level of Lithium is >2
Signs include: diarrhea, tremors, muscle weakness, lack of coordination, blurred vision.
What is the medication used for an opioid reversal?
Naloxone
Narcan is naloxone, but in a nasal spray form.
Patients usually need multiple doses as the med has a short half-life.