Flashcards in Exam 2 Deck (34):
Which nursing action should be done first with a patient diagnosed with hepatitis C?
Schedule HCV genotype testing.
The first things you want to know about the patient is the viral load and genotype.
A nurse is administering alpha-interferon ribavirin (Rebetol) to a patient with chronic hepatitis C. What will the nurse monitor for?
What information given by a patient's health history indicates that the nurse should screen them for hepatitis C?
Use of IV drugs.
What is the main reason someone gets hepatitis B instead of hepatitis C?
Hepatitis B is received through sexual contact. Hepatitis C is more likely contracted due to IV drug use.
Which goal has the highest priority for homeless with hepatitis who has severe anorexia and fatigue?
Nutrition and fluid levels.
Someone that is unimmunized came into the ER exposed to hepatitis B by a needle stick. What should be the first reaction?
Administer hepatitis B vaccine, test for antibodies, give immunoglobulin.
A patient is admitted with an abrupt onset of jaundice and nausea, abnormal liver functions, negative for viral causes of hepatitis. Which nursing question is most appropriate? What levels are you going to want to see in their chart?
"Do you take any OTC drugs?". Tylenol.
AST, ALT, protein (albumin).
What kind of mattress would you give a patient with cirrhosis and 4+ pitting edema in feet and legs?
Pressure mattress. Prevents sores.
What nursing intervention should you do concerning a patient with cirrhosis and a potassium level of 3.2 with scheduled doses of aldactone and lasix?
Hold the lasix. It is potassium wasting and will lower already low potassium levels.
You have an alcoholic trying to go through treatment and rehab and comes to the ER and something is off. What do you ask the patient?
"Have you had a drink?"
You have a patient with severe cirrhosis with esophageal varices. What is the most important lab you would look for?
Ammonia. The level would be high for an alcoholic.
A patient as ascites. What do you want the patient to do before you begin the procedure?
Empty their bladder.
Kayexalate is ordered for a patient with hyperkalemia. What must be done before administration?
Listen to bowel sounds to make sure they are present and unblocked.
What is the most important information to communicate with the doctor about a patient with a liver transplant?
A temperature of 100.8. Most susceptible to contracting an infection after a transplant.
A patient with testicular cancer is admitted after first chemo treatment, receiving cisplatin chemo, what is an appropriate nursing diagnosis?
Potential alteration in sexual functioning. ED.
Which assessment finding may indicate adverse effects of corticosteroid after a kidney transplant?
Knee and hip joint pain. Most inflammation pain is found in joints.
The nurse is assessing a patient 4 hours after a kidney transplant. Which information is most important to communicate to the health care provider?
CVP (central venous pressure) is decreased. This can be evidence of bleeding. Other information such as good urine output, BUN/Cre levels elevated can be expected from a transplant.
At which point in time should sexuality be discussed with a patient with cancer?
During diagnosis, treatment, recovery, and every visit if they feel comfortable.
What is the number one reason for getting pancreatitis?
What are signs and symptoms of hypocalcemia?
Muscles tensing up, twitching, and finger numbness.
What medication would you give for hypocalcemia?
What action should an ER nurse take if someone comes in vomiting blood?
Take their vitals. Ensure they are not tachycardia or hypovolemia.
What question should you ask a patient with pancreatitis?
"Do you drink?"
What is the difference between peritoneal dialysis and hemodialysis?
Peritoneal dialysis: fluid is inserted and filtered in abdomen.
Hemodialysis: blood is drained from vein and filtered through a machine outside of the body.
After insertion of an arteriovenous graft, the dialysis patient complains about coldness in fingers. What is the appropriate nursing action?
Which menu choice for hemodialysis patient indicates successful teaching?
Apple juice (low in K), poached eggs (high in protein), and wheat.
You want LOW sodium, phosphate, and potassium and HIGH protein. More protein is allowed because urea and creatinine (proteins) are removed by dialysis.
Patient needs vascular access for dialysis. What is an advantage of a fistula over a graft?
Fistula is less likely to clot.
Which patient is not an appropriate candidate for a kidney transplant?
A cancer patient.
What should you know about handling an acute kidney injury patient with temporary vascular access in left femoral vein?
The patient should not move.
What are some nephrotoxic drugs?
Metformin and NSAIDS. Monitor adverse effects, toxicity, and creatinine level.
A patient with end stage kidney disease is going to receive procrit (epoetin alfa - man-made form of a protein). What is one thing you need to tell the provider?
High hemoglobin levels (> 12), if dehydrated, and if hyperkalemia (put on EKG).
Which information should be included in patient education on peritoneal dialysis?
Eat high in protein, avoid salt, and take a phosphate binder with each meal.
What are unloading statements?
Statements that let patients know that others have similar concerns and that any questions they might have are within the "norm".