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AdultCare1-Cook > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are unilateral leg pain, calf tenderness, and swelling manifestations of?

A

deep vein thrombosis

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2
Q

How can the risk for coronary artery disease be reduced?

A

-decreasing LDL level (weight loss program)
- regular exercise (increases HDL)
- increase omega-3 fatty acid intake

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3
Q

What does troponin test indicate?

A

troponin appears in the bloodstream when there is damage to the heart (myocardial infarction)

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4
Q

Which diagnostic tests could the nurse suspect in the confirmation of DVT diagnosis?

A

venous duplex ultrasound and d-dimer

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5
Q

What post-surgical complication is a client at risk for following a hip arthroplasty?

A

deep-vein thrombosis (this may also occur from gynecological and urological procedures)

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6
Q

Which portion of the ECG strip would represent the time it takes for ventricular depolarization and repolarization combined (ventricular cycle)?

A

QT interval

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7
Q

What tests should the nurse prepare to obtain for a client that reports chest pressure and SOB?

A

troponin (MI)

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8
Q

Why should massaging be avoided in those at risk for VTE (venous thromboembolism)?

A

blood clot could detach and become an embolus

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9
Q

If a patient has a confirmed case of sepsis and is hypotensive, how much fluid should the nurse administer IV?

A

30 mL/kg

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10
Q

Is medicating the client for pain part of the 1hr bundle in sepsis treatment?

A

No, but drawing lactate, admin ABX, IV fluids, blood cultures, and vasopressors if needed all are

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11
Q

What lab is indicative of sepsis?

A

increased lactate

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12
Q

What are the hallmarks of sepsis?

A

increased serum lactate and increased bands
- inc. procalcitonin (in response to inflammatory cytokines)
- abnormal WBC

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13
Q

What is a priority for the nurse to ensure when administering ABX in a patient who has sepsis?

A

drawing blood cultures

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14
Q

If a patient has a urinary output of 15 mL/hr what may be indicated?

A

organ dysfunction
(renal dysfunction r/t poor perfusion in septic clients)

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15
Q

When is an example of a time that the nurse should notify the provider in regards to assessing surgical incision/site?

A

redness at surgical site, as this may indicate infection

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16
Q

what are examples of modifiable risk factors for cardiovascular disease?

A

personal lifestyle, smoking, physical inactivity, obesity, and psychological variables (stress, anger, etc)

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17
Q

What are some factors that may contribute to the likelihood of cardiovascular disease that cannot be changed?

A

pts age, gender, ethnic origin, family hx of CVD

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18
Q

What does the P- wave on an EKG represent?

A

atrial depolarization (contraction)

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19
Q

What represents the combination of ventricular depolarization (contraction) and atrial repolarization (relaxation)?

A

QRS complex

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20
Q

What does the T- wave represent on an EKG?

A

ventricular repolarization

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21
Q

What is considered a normal cholesterol level?

A

less than 200 mg/dL

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22
Q

What are the four steps of the electrical conduction in the heart?

A
  1. SA node
  2. AV node
  3. bundle of HIS
  4. purkinje fibers
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23
Q

What is the preferred diagnostic test for DVT?

A

venous duplex ultrasound

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24
Q

The nurse should monitor for which lab while a patient is receiving IV heparin?

A

aPTT

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25
Q

When and how often should aPTT be monitored while patient is receiving IV heparin?

A

6 hr after initiation, 6 hr after ANY dose changes, and at least daily

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26
Q

Which medication should PT/INR be evaluated while administering?

A

warfarin

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27
Q

What is the antidote for warfarin?

A

Vitamin K

27
Q

What may early ambulation prevent in post-surgical patients?

A

DVTs

27
Q

What is the benefit of novel (direct) oral anticoagulants?
ex. dabigatran, rivaroxaban, apixaban, and edoxaban

A

fixed dosing without the need for frequent lab monitoring

27
Q

In case of a heparin overdose, the nurse should have what available?

A

protamine sulfate (antidote)

28
Q

How does the onset of pain usually occur for DVTs?

A

sudden

29
Q

Name an example of a gram + bacteria.

A

staphylococcus

30
Q

What is considered a therapeutic INR while taking warfarin?

A

< 2

31
Q

What body temp indicates SIRS?

A

> 100.5 or < 96.8 F

32
Q

What respiratory rate indicates positive SIRS?

A

> 20 BPM or < 32 mmHg PaCO2

32
Q

What HR parameter is given for SIRS criteria?

A

90 bpm

33
Q

What is considered shock in a patient with sepsis?

A

hypotension regardless of administration of vasopressors

34
Q

Which wave represents atrial depolarization (contraction)?

A

P-wave

35
Q

What type of medications cause the heart to beat more slowly and with less force?

A

beta-blockers

36
Q

What are some symptoms that a patient may have with a PE (pulmonary embolism)?

A

-dyspnea, tachypnea and chest pain
-acute confusion, restlessness
-crackles
- decrease SpO2

37
Q

What may be used as drug therapy for DVT prevention?

A

heparin, warfarin, enoxaparin

38
Q

What is the therapeutic INR for a patient with a DVT?

A

1.5-2

39
Q

What should the nurse do if the output of a chest tube is > 70mL/ hr?

A

contact the provider

40
Q

What is important for positioning the chest tube drainage system?

A

keep the system below the level of the chest

41
Q

What are 2 supplies that should always be at the bedside in case of an emergency with a chest tube?

A

sterile water and occlusive dressing

42
Q

Why should sterile water be kept at the bedside of a patient with a chest tube?

A

if the tube disconnects, place tip into 2 in of water to create a seal, preventing air from entering the patient

43
Q

How would Vaseline gauze be used for a chest tube emergency?

A

tubing disconnects from patient

44
Q

When would NPPV (like CPAP and BiPAP) be contraindicated/used with great caution?

A

patients with nausea, thick secretions, or emesis. If the throw up it’ll likely be blown back into their airway (aspiration)

45
Q

What consumption instructions should be given prior to a PFT (pulmonary function test)?

A

no smoking 6-8 hr before and
no bronchodilators 4-6 hr before

46
Q

How long should a patient be NPO prior to a scheduled bronchoscopy?

A

4-8 hr before

47
Q

What is the normal time for the PR interval?

A

0.12-0.2 secs

48
Q

What is the normal time for the QRS compex?

A

0.6- 0.10 sec (<0.10 secs)

49
Q

what is normal for the normal time for the QT interval?

A

<0.44 sec

50
Q

What drug may given to a patient with sinus bradycardia?

A

atropine

51
Q

What are the 3 components of Virchow’s triad that increase the risk for a patient developing a VTE?

A

hypercoagulable state
stasis of blood
endothelial blood

52
Q

What are some factors that may cause stasis of blood

A

immobility, atrial fibrillation, venous insufficiency, venous obstruction, heart failure

53
Q

What may be some causes of endothelial injuries?

A

surgery (hip, knee, and prostate)
trauma
atherosclerosis
smoking
catheter

54
Q

What is Homan’s sign?

A

pain with dorsiflex that may indicate DVT
(this often has false positives)

55
Q

What may be indicated by elevated lactate levels in a septic client?

A

poor perfusion and/or oxygenation to tissues

56
Q

What interventions should the nurse implement to prevent atelectasis?

A

turn, cough, deep breathe
incentive spirometry use

57
Q

How often should an incentive spirometer be utilized?

A

10 times per hour

58
Q

What is a serious complication that patients receiving benzocaine for a bronchoscopy should be monitored for?

A

methemoglobinemia

59
Q

If methemoglobinemia is recognized, what should the nurse do?

A

call rapid response and prepare to admin methylene blue

60
Q

What may a patient with methemoglobinemia present with?

A

chocolate-colored blood and hypoxia that does not respond to O2 therapy

61
Q

What difference may the nurse note while percussing the chest wall of a client with a pleural effusion?

A

dullness with percussion

62
Q

How may the trachea appear with a tension pneumothorax?

A

deviation to unaffected side

63
Q

What can the nurse offer to a client experiencing a sore throat following a bronchoscopy?

A

gargle salt water and lozenges

AdultCare1-Cook (8 decks)

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