Bleed It Out
What causes a sickle cell crisis?
What is hypoxia?
What is the classic breath sound associated with asthma?
What is wheezing?
What is the most common complication for a s/p MI pt?
What is a dysrhythmia (afib, VT, VF)?
Name 2 types/classes of medication used to treat afib.
What is CCB, BB, antidysrhythmics, anticoagulants, adenosine?
What is antibiotics?
The nurse should monitor this assessment finding closely in a patient diagnosed with rhabdomyolysis as this could indicate deterioration of their condition.
What is UOP?
What are s/sx of compartment syndrome?
pain not relieved by meds and out of proportion, pressure, paresthesia, pallor, paralysis, pulselessness
How is leukemia diagnosed?
What is a bone marrow biopsy?
Name 2 specific signs or symptoms and 2 diagnostics of pneumonia.
What is fever, confusion, chills, diaphoresis, dyspnea, tachypnea, crackles and wheezes, cough, decreased O2, purulent and/or blood-tinged and/or rust colored sputum; CBC, ABG, blood cultures, sputum culture and sensitivity, serum electrolytes, CXR?
What are 2 examples of symptomatic hypertension?
What is chest pain, headache, nose bleeds, dizziness, palpitations, dyspnea, SOB?
Right CHF symptoms are this and left CHF symptoms are this.
What is systemic and respiratory?
What is the characteristic 'red flag' symptom of systemic lupus erythematous (SLE)? What system is usually noted to be damaged within the first 5 years following diagnosis?
What is malar rash; renal?
What is the common diagnostic lab?
What may cause a flare?
Fatigue, sun exposure, emotional stress, infection, drugs, surgery
What pneumonic is the treatment for sprains and strains and what does it stand for?
What is RICE - rest, ice, compression, elevation?
This anemia may be seen in young adult women with a heavy menstrual flow.
What is iron deficiency anemia?
Name 2 specific signs or symptoms and 2 diagnostics of COPD.
What is dyspnea on exertion, productive cough, crackles and wheezing, tripod positioning, right HF, finger clubbing, pale/cyanotic nail beds; pulse ox, ETCO2, ABG, sputum culture, CBC, CMP, serum alpha-1 antitrypsin?
An EKG notes no p-wave, irregular rhythm, normal QRS interval. What rhythm is it?
What is a-fib?
What is the red flag symptom of cardiac tamponade?
May also see JVD, decreased CO, narrowing pulse pressure.
This issue is caused by too much uric acid in the body. Name an ACUTE flare medication that may be prescribed.
What is gout; colchicine, NSAIDs, steroids?
How can patients prevent flares?
Dietary monitoring - avoid red meat, organ meats, wine, beer, shellfish, fructose drinks
Who is most at risk for osteoporosis?
What is the older, thin, white female?
Parathesias of the hands and feet is characteristic of this anemia.
What is B12 anemia?
Patients diagnosed with Tb must be followed closely by the health dept due to this problem with their treatment.
What is noncompliance due to the length of antibiotic treatments?
What are some s/sx of Tb?
fatigue, lethargy, anorexia, weight loss, low grade fever, chills, night sweats, persistent, productive cough >3wks
This EKG change may be noted during an MI and it means this.
What is ST elevation; 100% blockage?
PAD legs vs. PVD legs
What is thin, shiny, taut vs. brown, thick/leathery, edema?
What are the 2 post op focuses for a total knee arthroplasty?
What is pain management and PT?
A patient with a lower extremity amputation needs to start doing this to help accommodate mobilization post op.
What is exercising the upper body?
What lab values should be monitored for a client on epoetin alfa (Epogen)? Filgrastim (Neupogen)?
What is hgb/hct; WBC and/or neutrophil count?
Name at least 3 risk factors for OSA.
What is obesity (BMI>30), >65y.o., neck circumference >17cm, craniofacial abnormalities, acromegaly, smoking, male?
An EKG notes a wide QRS complex, no discernible P waves, HR>200. What rhythm is it and what is the nurses first action?
What is v-tach; start CPR, call a code blue?
A patient presents with a third degree heart block. What procedure should the nurse prepare for immediately?
What is trancutaneous pacing?
Scleroderma is a problem of too much _____. Doing ______ regularly can help prevent contractures of skin and joints. Difficulty _____ could result in decreased intake and weight loss and requires prompt notification to the provider.
What is collagen; exercise; swallowing?
Osteoarthritis is usually ____ sided, may cause joint pain and/or stiffness upon awakening but resolves ______, and has no _____ symptoms.
What is one; within 30 minutes; systemic?
Name at least 2 steps required for a blood transfusion.
What is 2 RN verification; admin within 30 minutes of receiving with from the blood bank; VS before admin and 15 min after starting; inspect blood bag for abnormalities and/or clots; run in <4hr; only admin with NS?
A patient comes in to the ER with sudden onset chest pain and dyspnea that just started. The patient is coughing up pink, frothy sputum and has a history of afib. The nurse would expect this diagnostic to be ordered to confirm the problem.
What is a CTA?
What access is used for PCI? Name 2 post op assessments.
What is artery access at the radial or femoral; bleeding and bruising at insertion site, NV assessment, monitor for dysrhythmias,
Name 3 patient discharge education points regarding pacemaker placement.
What is attend follow up appointments as scheduled; monitor incision for signs of infection and clean as ordered; do not raise arm over head until provider instructs safe to do; avoid direct chest blows; avoid MRIs unless pacer approved; carry pacemaker card with you at all times; wear a medic alert bracelet?
Name the two common hand deformities of RA. What lab is often used to determine the presence of RA?
What is swan neck deformity and boutonniere deformity; RF?
Name 2 preventative measures for CTS.
What is wrist splints, ergonomic keyboard pads and mouse pads, workstation changes, frequent breaks from repetitive activities, resting hand splints at night?
What is the treatment (generic) for DIC?
What is supportive care; fluids, anticoagulants, and blood transfusions (pRBCs, cryo) as needed?
Name the red flag symptom for flail chest, pneumo, tension pneumo.
What is paradoxical chest movement; asymmetric chest movement and absent breath sounds on affected side; deviated trachea?
A patient with a history of HTN comes in to the ER complaining of chest pain. What does the RN anticipate the provider to order? Name 3 orders.
What is start an IV, gets labs (specifically a troponin), 12 lead EKG, CXR, O2, nitro (if appropriate), 324mg ASA?
Name 3 postop assessments the RN should do following a femoral popliteal bypass.
What is pain, pulses, paresthesias, compare extremities color/swelling/pulses, VS?
Name at least 3 diagnostics and/or treatments for septic arthritis.
What is joint aspiration, synovial fluid culture, blood cultures, xray, aspiration with surgical debridement, broad spectrum antibiotics, pain management, artificial joint removal if indicated?
Antibiotics for how long?
What usually causes fat embolism syndrome (FES)? Name 2 symptoms associated with FES.
What is a long bone fracture; chest pain, tachypnea, cyanosis, dyspnea, tachycardia, hypoxemia, change in mental status; petechiae on neck, anterior chest wall, axilla, head?
Name at least 2 critical assessments and/or diagnostics for patients with thrombocytopenia.
What is skin assessment, fall risk assessment, VS, labs?
What would be a critical assessment component for neutropenia?
Temperature monitoring
Name at least 2 other body systems affected by cystic fibrosis and give at least 1 intervention for that body system OR explain how the body system is affected.
What is reproductive (thick secretions can cause fertility issues); integumentary (salty skin; make sure to stay hydrated), GI (decreased fat absorption, increased risk for obstruction, malnutrition due to malabsorption, diabetes related to CF, decreased absorption of fat soluble vitamins; pancreatic enzymes; high calorie, high protein well-balanced diet; insulin if diabetic; fat soluble vitamins - A, D, E, K)
Name at least 2 post op assessments for a CABG?
What is incision assessment (midsternal and wherever the harvested vessel was taken); chest tubes; ETT and ventilator; Foley; IVs; possibly central line; arterial line; continuous EKGs?
Name 3 teaching points for discharge of a CHF patient.
What is fluid restriction, sodium restriction (usually 2g), daily weights, smaller more frequent meals, medication compliance, f/u appointment compliance?
The RN is caring for a client in skeletal traction. Name 3 nursing interventions/assessments that should be happening during shift.
What is keep weights off floor and hanging freely; prevent or reduce pain and muscle spasms, monitor pins closely for infection and clean as ordered (could be every 4 hr or even daily), NV assessments as ordered?
Does an RN ever reposition the pins? NO
Name 3 discharge instructions or education points the nurse should address for a patient with a cast.
What is assess NV status daily at home, monitor skin integrity closely, do not stick anything in the cast, use a hair dryer on cool setting for itching, apply ice for first 24 hr (but not directly to cast, don't want to get wet), elevate above level of the heart for first 48hr, exercise joints above and below level of fracture, know when to call provider (increasing pain despite elevation, ice, analgesia; swelling with pain and discoloration of distal extremity; pain during movement; burning or tingling under cast; sores or foul odor under cast), educate on skin changes at cast removal, and education about going to follow up appointments?