Miscellaneous
Describe what a "shift to the left" in a CBC means?
Increased bands (immature neutrophils) as the body responds to an infection.
What dietary restrictions are necessary for a client who is prescribed cyclosporine?
No grapefruit juice!
Guillain-Barre Syndrome is usually prompted by a ____________
Viral infection
Identify the MOST important measure the nurse should take to prevent infection transmission.
HANDWASHING!
The HIV virus can be transmitted during all of the following EXCEPT:
A. Unprotected intercourse
B. Sharing needles with someone infected with HIV
C. Casual contact with someone infected with HIV
D. In utero from mom to baby during delivery
C
Identify 3 iron-rich foods for a client experiencing iron-deficiency anemia.
Beans
Leafy green vegetables
(Avoid dairy products due to the interaction with ferrous sulfate supplements).
Interferon is used to treat what diagnosis? What side effects are common with this medication?
MS
Flu-like symptoms
Identify how the nurse would assess the effectiveness of levothyroxine.
Monitor T3 and T4 levels - should increase
Monitor TSH levels - should decrease
Patient should show improvement in hypothyroid symptoms (hair loss, fatigue, weight gain).
Identify the appropriate vancomycin trough level.
5-15 mcg/mL
What are the initial symptoms of an HIV infection?
Flu-like symptoms and night sweats
Identify 3 clinical manifestations of atopic dermatitis.
Dry skin
Pruritis
Redness
Thickened skin (lichenification)
Identify side effects and patient education related to the use of methotrexate.
Bone marrow suppression, risk of infection, liver and kidney damage.
Takes 3-6 weeks to work (corticosteroids as a bridge), avoid alcohol, interact with NSAIDs, DC 3 months before pregnancy. Avoid crowds, avoid contact with anyone who is sick.
What can exacerbate lupus?
Sunlight (11am-3pm), pregnancy, infection, stress
Not washing hands or using alcohol-based hand sanitizer instead of soap and water, living in a SNF, medications that affect gastric pH, antibiotic usage
Identify the diagnostic criteria for AIDS.
Describe manifestations of a hemolytic transfusion reaction. Identify nursing interventions.
Tachycardia, HA, back pain, hemoglobinuria
Stop the infusion. Don't flush the IV. Notify the provider. Send the blood and tubing back to the blood bank. Collect the next patient void. Start infusing NS in a different IV.
Identify side effects of NSAIDs (naproxen).
You are caring for a client with MS who is prescribed IV methylprednisolone 160mg. You have available methylprednisolone 1gm/250mL. How many mL should you administer?
40mL
Identify the appropriate type of precautions/isolation for the following disease processes:
TB
MRSA
Influenza
Client 2 days p/o stem cell transplant
Airborne
Contact
Droplet
Reverse
What should you do if you experience a needlestick while at work?
Wash the area with soap and water vigorously!
Call Employee Health / go to the ER.
The patient will be tested for infectious diseases (with their consent).
Start PEP within 72 hours.
Complete continued monitoring for HIV infection.
Identify 3 live-attenuated vaccinations and explain contraindications and patient education related to these types of vaccines.
MMR, varicella, smallpox, nasal influenza.
NO immunosuppressed patients. Shouldn't even be around anyone who has received this type of vaccine.
What stipulations must be met in order for a client to continue to be prescribed PrEP?
•Must be HIV negative
•Must not miss any doses
•Must still use a condom
•Check HIV status q3mos
Describe clinical manifestations of myasthenia gravis. Identify 3 nursing interventions for this disease.
Weakness of voluntary muscles that worsens with continued activity.
Eat large meals in the morning.
Risk of falls
Aspiration risk
Mechanical ventilation required in myasthenic crisis.
Outline the steps in the Sepsis Bundle.
Temp > 38.5, Lactate, WBC high or low, CRP/ESR, hypotension, tachycardia, tachypnea
Lactate, blood cultures, broad-spectrum antibiotics, 30mL/kg NS bolus, vasopressors if needed to maintain MAP >65mmHg.
DAILY DOUBLE: WAGER IN MULTIPLES OF 500
Identify signs and symptoms related to rejection in a client s/p kidney transplant. Must name 5 to get the points!
HTN
Pain at the incision site
Elevated BUN/Cr
Edema
Decreased UOP