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ABSN > 305 Exam Final > Flashcards

305 Exam Final Flashcards

1
Q

Key roles of nurse in preparing for and responding to bioterrorist attack?

A

Education
Resources
Diagnosis and treatment
Planning

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2
Q

What category of infectious agents would anthrax, botulism, smallpox, tularemia, viral hemorrhagic fevers, and plague and Ebola be in?

A

Category A.
(Agents easily transmitted individual to individual; cause high mortality, with potential for major public health impact. Public panic.

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3
Q

What category of infectious agents would salmonella, ecoli, viral encephalitis, and water safety threats be in?

A

Category B

(Moderate morbidity and low mortality. )

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4
Q

A patient is overdosing on benzodiazepines, what would the nurse expect to use?

A

Activated charcoal.

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5
Q

What individual would smallpox vaccine be contraindicated for

A

Pregnant patient

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6
Q

Early symptoms of radiation poisoning

A

Nausea, vomiting, diarrhea

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7
Q

A patient experiences a phenobarbital overdose. What would be used to induce alkaline diuresis?

A

Sodium bicarbonate

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8
Q

Atropine can treat what kind of terrorist attack threat

A

Nerve agent exposure

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9
Q

A patient seeks medical attention after a nerve agent is sprayed on the skin. What treatment can the nurse anticipate

A

5% liquid bleach tooically

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10
Q

What is the purpose of the strategic national stockpile ?

A

Provide a repository of medications and medical supplies for emergency use

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11
Q

Lead poisoning can be treated with what

A

Calcium disodium versenate (calcium EDTA)

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12
Q

What derivative of anthrax is responsible for producing inhalation anthrax ?

A

Anthrax spores

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13
Q

What is given to treat gaseous cyanogen chloride?

A

Milk

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14
Q

What is the most common cause of household poisoning

A

Medications

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15
Q

What is done with unused anthrax antitoxin doses?

A

Return them to the cdc

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16
Q

What is the antidote for acetaminophen poisoning

A

Acetylcysteine

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17
Q

After exposure to phosgene gas, the patient should be provided with what?

A

Fresh air.

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18
Q

After skin exposure to mustard-Lewis mixture, how do you treat the patient

A

Flush the area with copious amounts of water

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19
Q

Recommended dietary allowance for vitamin D per age groups

A

Under 1 year- 400IU
1-70 years- 600IU
Over 70 years - 800IU

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20
Q

Recommended dietary allowance of calcium per day for adults

A

800-1200 mg

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21
Q

PTH and Calcitonin influence what 3 targets

A

Bones, kidneys, gastrointestinal

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22
Q

Serum calcium levels exceeding 5.5mEq/L result in what

A

Hypercalcemia.

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23
Q

What is the hypocalcemia serum calcium level ? In mEq/L

A

Below 4.5 mEq/L

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24
Q

High calcium levels lead to what in the cells

A

Decreased sodium permeability across cell membrane. Dangerous state

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25
Q

Hypocalcium levels result in what in the cell

A

Cell membranes can become hyperexcitable and convulsions or muscle spasms occur

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26
Q

Calcium salts are used for what

A

To return serum calcium to normal levels with mild hypocalcemia.
Ex:
Osteoporosis, Paget’s disease, chronic hypothyroidism , rickets, pregnancy, lactation, rapid childhood growth

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27
Q

What are adverse effects of calcium salts

A

Hypercalcemia.
Hypotension, Bradycardia, dysrhythmias, cardiac arrest.

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28
Q

What is the most common metabolic bone disease

A

Osteoporosis

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29
Q

Pharmacotherapy of osteoporosis

A

Calcium and vitamin D therapy
Bisphosphonates
Selective estrogen receptor modulators (Serm)
Calcitonin
Miscellaneous

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30
Q

Osteomalacia in children is

A

Rickets

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31
Q

How to treat osteomalacia

A

Calcium and vitamin D supplements

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32
Q

Alendronate (fosamax) is used for what

A

It is a bisphosphonate. Used for
The prevention and treatment of osteoporosis and Paget’s disease

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33
Q

Raloxifene (evista) is what and used for what

A

Is a SERM and is used to prevent osteoporosis is post menopause women.

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34
Q

Calcijex, and Rocaltrol (calcitriol) is what and used for what

A

An active form of vitamin D
Used for impaired kidney function or hyperparathyroidism— also rickets

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35
Q

What are signs of Hypercalcemia

A

Drowsiness, lethargy, weakness, headache, anorexia, nausea, vomiting, thirst, increased urinating

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36
Q

What are physical assessment signs for hypocalcemia

A

Facial twitching, muscle spasms, parasthesias, seizures

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37
Q

What lab studies should the nurse monitor in regards to gout treatment

A

CBC, platelets
Liver and renal function studies
Uric acid levels, urinalysis

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38
Q

Calcium and cut D are critical for the proper functioning of which systems

A

Nervous
Muscular
Cardiovascular

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39
Q

What is the role of the nurse when treating a patient with gout

A

Obtain thorough health history, including current medications and vitals
Complete a physical examination
Monitor lab studies

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40
Q

What are Lopurin and Zyloprim (allopurinols) used for?

A

Uris acid inhibitors. For gout

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41
Q

Calcium salts are contraindicated for what patients?

A

Patients with ventricular fibrillation,
Metastatic bone cancer, renal calculi, or Hypercalcemia

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42
Q

What is is a general term referring to a cluster of disorders that have in common defects in structure of bone.

A

MBD
Metabolic bone disease

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43
Q

Major risk factors for osteoporosis

A

Menopause
Increased age
Fracture history
Excessive alcohol use
Caucasian or Asian race
Smoking
Low physical activity
Gonadal hormone deficiency
Drugs such as corticosteroids, some anticonvulsants, & immunosuppressants
Low calcium or vitamin d

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44
Q

What is osteomalacia

A

Softening of bones due to demineralization, mostly due to deficient vitamin D and calcium in diet

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45
Q

What are the standards for emergency preparedness for an organizational team

A

-Organizational needs during crisis
-Actions needed to get back to normal
-Efforts to coordinate resources with the community
-responding to the immediate casualties of the crisis

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46
Q

What are the nurses roles in emergency response

A

Planning,
Education,
Diagnosis,
Treatment

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47
Q

Category C infectious agents include

A

Nipah virus,

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48
Q

Signs and symptoms of exposure to nerve agents include

A

Emesis,
Urination
Salivation
Lacrimation
Defecation
Gastric disturbances

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49
Q

What can potassium iodine be used to prevent

A

Thyroid cancer

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50
Q

The nurse is administering calcium EDTA to a client. What lab value needs to be monitored to deter the effectiveness?

A

Lead

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51
Q

Dimercaprol (BAL in oil) is used to treat what poisonings

A

Heavy metals poisoning of
Gold, arsenic, and mercury

52
Q

Symptoms of liquid hydrogen cyanide poisoning are

A

Red eyes
Flushing of skin
Nausea
Headache
Weakness

53
Q

Activated charcoals benefit is greatest when administered within how long after the medication overdose?

A

Within 60 minutes. the effectiveness decreases with time

54
Q

Common symptoms of Ipecac overdose

A

Diarrhea
Lethargy
Sedation

55
Q

Bisphosphates and calcium supplements should be taken how close together ?

A

Bisphosphates are taken 30 min prior to food and 2 hours apart from the calcium supplements

56
Q

How do you measure the effectiveness of the drug Fosamax ?

A

Bone density exam

57
Q

What is the drug of choice for rheumatoid arthritis flare ups

A

NSAID therapy.
Corticosteroids can also be used short term

58
Q

Bisphosphates are used to treat what

A

Paget’s disease and osteoporosis

59
Q

Disease modifying antirheumatic drugs have what potential adverse effect that needs to be reported to healthcare provider if occurs?

A

Significant retinal changes with blurred vision, difficulty reading, photophobia, or blacked out areas of the vision field

60
Q

A patient is prescribed adalimumab (Humira). What finding should case the nurse to withhold the medication?

A

Low WBC, as this drug has adverse effect of neutropenia and serious infections.

61
Q

What needs to be assessed prior to administering the drug Denosumab (Prolia)

A

Serum calcium levels.
This drug can cause severe hypocalcemia

62
Q

What is an unusual effect from bisphosphonate therapy?

A

Osteonecrosis of jaw.
-jaw pain and swelling, loose teeth, infection at lesion site.
Should be immediately reported to HCP

63
Q

Bisphosphates works on Paget’s disease how?

A

Lowering alkaline phosphate levels. And are administered until the patients ALP levels are within normal limits.

64
Q

Which condition occurs when bone loss is faster than bone gain?

A

Osteoporosis

65
Q

When the thyroid gland release’s calcitonin, what physiological response should the nurse expect?

A

Decreased serum calcium level

66
Q

What adverse effects can calcium salts have

A

Dysrhythmias, constipation, nausea. Vomiting, headaches

67
Q

Patients with chronic kidney disease has a positive Chvosteks sign and a decreased serum calcium level.
What medication would be prescribed

A

Vitamin D

68
Q

What should be monitored on a patient with CKD receiving calcitrol (Rocaltrol)

A

Calcium and vitamin D levels as there is a risk for Hypercalcemia

69
Q

Contraindications for calcium salts

A

V-Fib
Metastatic bone cancer
Renal calculi
Hypercalcemia

70
Q

Serum calcium of more than 11mg/dL is what

A

Hypercalcemia

71
Q

Hypocalcemia level in mg/dL

A

9mg/dL

72
Q

Does the amount of calcium consumed control the balance of calcium in the body?

A

No

73
Q

Calcium is an electrolyte and excreted through kidneys
T/f

A

True

74
Q

The parathyroid glands are regulated by a negative feedback loop that is affected by what?

A

activated vitamin D and increased serum calcium. They suppress PTH secretion which lowers serum calcium levels.

75
Q

PTH does what to osteoclast production?

A

Stimulates it

76
Q

Paget’s causes what

A

Bones to enlarge and soften

Headaches,
Facial pain
Hip and femoral pain

77
Q

A client with osteoarthritis asks about increased pain with movement. What response should the nurse provide ?

A

Increased Bone spurs and cysts break off in joint spaces and can cause inflammation

78
Q

Clients with severe malabsorption and decreased serum calcium levels may require how much vitamin D ?

A

50,000- 100,000 units of Vit D daily

79
Q

First line treatment for rheumatoid arthritis is…

A

NSAIDS
Followed by DMARDs to slow damage and modify immune response.

80
Q

What education would the nurse provide to a client taking bisphosphonates?

A

Sit upright for 30 minutes after taking medication.
Take drug on empty stomach with plain water no food
Do Weight bearing exercise 3-5 x week
Eliminate caffeinated sodas
Increase calcium rich foods

81
Q

Corticosteroids can affect blood glucose level how?

A

They can increase them

82
Q

Oxalic acid in spinach, beets, Swiss chard, and rhubarb as well as alcohol, caffeine and zinc rich foods should be avoided when taking what?

A

Calcium carbonate (Rolaids, tums, other)

83
Q

Calcium acetate (PhosLo) needs to be taken with meals. T/f?

A

True

84
Q

Evista (raloxifene) is a SERM used to do what

A

Prevent osteoporosis in post menopausal women and to reduce the risk of breast cancer at high risk

85
Q

Evista (raloxifene) has what black box warning?

A

Increases the risk of venous thromboembolism and death from strokes.

86
Q

The most frequent and serious adverse effects of the drug Zyloprim (allopurinol) used to treat gout would be what?

A

Micropapular rash and toxic epidermal necrolysis

87
Q

How fast can you expect a push package from the SNS?

A

Within 12 hrs

88
Q

What does vendor managed inventory from the SNS include?

A

Specifically targeted emergency response supplies for an identified emergency issue

89
Q

Cutaneous anthrax manifests as what on a person

A

Skin lesions that develop black scabs

90
Q

Emerging pathogens that could be engineered for mass dissemination such as Nipah virus, hantavirus, yellow fever and others are in what category of bioterrorism infectious agent

A

C

91
Q

What does the cdc stockpile consist of

A

Antibiotics
Vaccines
Medical, surgical and patient support supplies

92
Q

How long until a nurse can expect to receive a vender managed inventory package?

A

Within 24-36 hours

93
Q

ciproflaxin has been used as a prophylaxis and treatment for what toxin?

A

Anthrax

94
Q

Glaucoma that is usually unilateral, caused by stress or impact injury, or medications, and progressively develops is what kind.

A

Closed angle

95
Q

What eye disorder is happening When IOP develops over years bilaterally with slow degeneration of optic nerve and gradual vision impairment?

A

Open angle glaucoma

96
Q

Drugs for glaucoma

A

Beta blockers. -decrease aqueous humor with least adverse effects

Prostaglandin analogs (latanoptost- Xaltan). - reduce IOP with side effects of
Eye pain, burning, edema

Brinzolamide (Azopt) - lowers IOP but with systemic adverse effects. Contains sulfur (allergy reaction in some)

97
Q

What are mydriatic drugs

A

Used to dilate pupil for assessment.

98
Q

If a patient is suspected of having glaucoma should a nurse use mydriatics on them?

A

No. They can worsen glaucoma.

99
Q

Lifitegrast (Xiidra) is what drug

A

Enhances Tear production
One drop BID

100
Q

What medication increases the risk of developing glaucoma?

A

Long term Corticosteroids
Antihistamines
Antidepressants
Antihypertensives

101
Q

The median IOP in population is what

A

15-16 mmHg

102
Q

Age, daily activities, and time of day all influence IOP
T/F

A

True

103
Q

IOP greater than what mmHg requires treatment to prevent permanent vision changes

A

30

104
Q

Acute outflow obstruction of aqueous humors produces what symptoms?

A

Headache
Facial pain
Bulging Iris
Seeing colored halos around lights.
Decrease visual acuity
No reactive pupillary response
Reddened eye
Possible nausea and vomiting.

105
Q

Pupil constrictions result from stimulation of what nervous system ?

A

Parasympathetic

106
Q

The malleus, incus and stapes are responsible for what?

A

Transmission of sound waves to inner ear.

107
Q

A client is diagnosed with open angle glaucoma. What treatment would the nurse expect

A

Prostaglandin analog medication

108
Q

Surgical Interventions for closed angle glaucoma would be?

A

Iridectomy, drainage implants, laser trabeculoplasty

109
Q

Mast cell stabilizers and antihistamines are prescribed to treat what?

A

Allergic conjunctivitis

110
Q

Otitis externa is typically treated with what?

A

Topical analgesics
Antibiotics
And corticosteroids

111
Q

Mydriatic medications do what to humor outflow

A

Impair the humor outflow and thereby increase IOP

112
Q

Alpha2-adrenergic medication is used for what

A

Open angle glaucoma

113
Q

Latanoprost (Xalatan) is contraindicated for what?

A

Pregnancy
Intraocular infection
Closed angle glaucoma

(The drug is used to treat open angle glaucoma and ocular hypertension)

114
Q

How do cholinergic agonist decrease IOP?

A

By stretching the trabecular mesh work to allow greater outflow of aqueous humor.

115
Q

Timolol (timoptic) is contraindicated for what?

A

Asthma
Heart failure
Sinus Bradycardia
Copd

(This drug treats hypertension and aphasia glaucoma)

116
Q

A patient taking timolol states they often forget to take their medication. What would you expect the HCP to do

A

Change their prescription to latanoprost. (Xaltan) as it has a longer duration of action

117
Q

Timolol. (Beta adrenergic blocker) has what mechanism of action ?

A

Decreasing the aqueous humor production by the cilary body.

118
Q

Azopt should not be given to patients with what allergies

A

Sulfa.

119
Q

What is the function of vitreous humor in the eye?

A

Keeps retina in place
Maintains shape of eye

120
Q

What is the function of the aqueous humor in the eye

A

Remove wastes, supply eye with nutrients and maintains IOP

121
Q

What happens if the ears semicircular canals and vestibule are disrupted?

A

There would be altered balance and equilibrium.

122
Q

What medication decreases aqueous humor?

A

Timolol.

123
Q

Latanoprost interacts with what preservative

A

Thimerosal

124
Q

With closed angle glaucoma why does the IOP increase?

A

The Iris is pushed over the area where aqueous humor normally drains

125
Q

What is the therapeutic index equation

A

Ld50/md50.
Higher the number -safer the drug

ABSN (9 decks)

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