week 4 midterm

Question 1

The nurse should instruct the client to take hydrochlorothiazide

Answer 1

early in the day to avoid nocturia.

Question 2

If a client’s potassium level is above the expected reference range of 3.5-5.0 mEq/L..

Answer 2

nurse should obtain a 12-lead ECG to monitor for cardiac changes.

*dysrhythmia’s

Question 3

adverse effects of ACE inhibitors

*treated with

Answer 3

angioedema (tongue/pharynx swelling)
cough
giant wheals

*subcutaneous epinephrine

Question 4

Atenolol & considerations

Answer 4

Beta-Blocker

lowers blood pressure & heart rate

*adv effect = bradycardia (monitor pulse rate)
*contraindicated in asthma, COPD, & heart failure
*masks hypoglycemia

Question 5

digoxin toxicity

Answer 5

vision changes (green halos)
n/v
abdominal pain
bradycardia

*call provider if heart rate is less than 60 bpm

Question 6

spironolactone

Answer 6

potassium sparing diuretic — loss of sodium & water

adv effects = hyponatremia & hyperkalemia

Question 7

carvedilol

Answer 7

*beta blocker = lowers heart rate and blood pressure

contraindicated in asthma
masks hypoglycemia
adv effect = bradycardia

Question 8

s/s of left sided heart failure

Answer 8

hacking cough
frothy sputum
wheezing
weakness
fatigue

Question 9

tramadol patch considerations

Answer 9

1. new patch each morning
2. hairless & rotate sites
3. remove for 10 to 12 hr daily

Question 10

client should limit cheese intake due to

Answer 10

high levels of fat & sodium

Question 11

s/s of hypokalemia

Answer 11

muscle weakness
n/v
fatigue

Question 12

full liquid diet includes

Answer 12

*skim milk
milk & milk products

Question 13

test for digoxin toxicity

Answer 13

fab antibody fragments

Question 14

applying nitro patches

Answer 14

*angina pain

in the morning & off at night
rotate areas
hairless sites
10 to 12 hrs w/o it

Question 15

s/s of blood transfusion reactions

Answer 15

uticaria
fever / chills
bronchospasm
** take baseline temperature

Question 16

teach a patient how to use albuterol

Answer 16

retain in the lungs for a min of 10 sec so the max amount of the dosage can be delivered properly to the airways.

To use the inhaler, the
1.client exhales normally just prior to releasing the medication
2. inhales deeply as the medication is released
3. then holds the medication in the lungs for approx 10 seconds prior to exhaling.

Question 17

occupational therapist role

Answer 17

fine motor skills & coordination

• improving hand strength/movements - self-management of ADLs- eating, hygiene, and dressing.
• independent living skills - cooking & shopping.

Question 18

combination drugs for TB

Answer 18

1. Rifampin - orange urine
2. Isoniazid - empty stomach & *liver
3. Pyrazinamide - assess gout & drink water
4. Ethambutol - ocular toxicity

Question 19

pulmonary tuberculosis manifestations

Answer 19

*lethargy & fatigue

fever
night sweats
cough

Question 20

ABC approach w lungs

Answer 20

auscultate lung fields to provide knowledge of which lung areas are most affected and would be the focus of the procedure.

Question 21

chest pain of 6/10 and takes 1 sublingual nitro. Pain is now 2/10

Answer 21

admin another nitro
*can have a sip of water

Question 22

to prevent vasoconstriction

Answer 22

WARMTH

keeping the environment WARM

Wearing gloves, warm clothes, and socks

exercising indoors

*extra socks

Question 23

Intermittent claudication

Answer 23

ischemic pain that is precipitated by EXERCISE & RESOLVES W REST & is reproducible. (O2 demand exceeds supply)

**Initial reason clients who have PAD seek medical attention.

Question 24

iron-rich diet

Answer 24

*red & organ meat
fish
poultry
grains
legumes
veggies
spinach
beef

Question 25

when diet fails to improve the anemia

Answer 25

nurse should administer vitamin B12 injections to treat pernicious anemia — poor absorption

Question 26

ABC w anemia

Answer 26

1. O2 saturation
2. hypotension
   hgb
   hct

Question 27

thrombocytopenia teaching

Answer 27

*bleeding risk

soft tooth brush
electric razor
avoid dental work - tooth extraction

Question 28

Lubricate lips with

Answer 28

water-soluble ointment.

Question 29

central venous catheter risk & priority action

Answer 29

*air entering = highest risk

first action the nurse should take is to CLAMP the catheter

Question 30

increase in venous hydrostatic pressure

Answer 30

develops when fluid accumulates in the veins, causes fluid to leak out into the tissues = edema.

Question 31

treatment for venous insufficiency

Answer 31

Elastic or compression stockings
elevating legs
avoid crossing legs

Question 32

s/s of chronic venous insufficiency

Answer 32

*varicose veins – lack of perfusion = priority

*shoes feel tighter at end of day

• edema
• heaviness in the legs
• prolonged capillary refill
• venous stasis ulcers (irregular, shallow w drainage on ankle

Question 33

A client who has an elevated sodium level and is NPO requires

Answer 33

hypotonic IV solution, such as 0.45% sodium chloride or 0.225% sodium chloride.

Question 34

s/s of infiltration

Answer 34

Edema
pallor
coolness around the insertion site
collection of fluid leaking into subcutaneous tissue

Question 35

immune thrombocytopenic purpura (ITP)

Answer 35

*destruction of platelets by antibodies;

expect a platelet level below the expected reference range. (<150k)

Question 36

history of allergic reactions to blood transfusions

Answer 36

administering an antihistamine such as diphenhydramine prior to the transfusion might prevent future reactions.

*slower rate over 2 to 4 hrs

Question 37

s/s of fluid overload & heart failure

Answer 37

tachycardia / bounding pulse / HTN / tachypnea / increased central venous pressure / weakness / vision changes / altered LOC
ascites
CRACKLES
cough
dyspnea
edema
weight gain
JVD
pallor
increased urine output

Question 38

patient has type A blood an recieved type O…next step?

Answer 38

administer as ordered

Question 39

steps to take in a blood transfusion reaction

Answer 39

1. stop infusion
2. Request a prescription for an antipyretic medication
3. Begin infusing 0.9% sodium chloride solution is correct

Question 40

How to use an MDI

Answer 40

1) Inhale deeply and then exhale completely.
2) Place her lips firmly around the mouthpiece.
3) Breathe in deeply over 2 to 3 seconds while pushing down on the canister.
4) Hold her breath for 10 seconds.
5) Exhale slowly through pursed lips.
6) Wait 60 seconds between each puff

Question 41

To decrease the risk for renal calculi

Answer 41

client would have to increase fluid intake of 3-4L daily.

Question 42

Hypomagnesemia is associated with

Answer 42

alcohol use

*n/v/w/fatigue/tremors

Question 43

Patients with COPD

Answer 43

• sitting up in the “tripod” position.
• O2 sat of 90% indicates adequate blood oxygen level w/o danger of suppressing the respiratory drive.

Question 44

diagnosing COPD

Answer 44

*Bronchodilators b4 spirometry so that a baseline assessment of airway function can be determined.

Testing is repeated after bronchodilator use to determine whether the decrease in lung function is reversible.

Question 45

all patients with PAD must maintain

Answer 45

aggressive lipid management
-statins

Question 46

to reduce the risk for amputation in patients with Buerger’s disease

Answer 46

Absolute cessation of nicotine use is needed

Question 47

new onset dyspnea with DVT

Answer 47

indicates pulmonary embolism – rapid O2 administration

Question 48

aplastic anemia considerations

Answer 48

low WBC = risk for infection

avoid other sick patients

Question 49

hypocalcemia s/s

Answer 49

tingling and numbness of the lips, tongue, fingers and feet,

muscle cramps,

twitching of the facial muscles

bone pain.