Final Exam - Summary Set Flashcards
1
Q
primary OA is caused by
A
(1) aging
(2) genetic factors
2
Q
___ is the #1 drug of choice for treating OA
A
acetaminophen
3
Q
PAC stands for ___ and is used to prevent ___
A
Pharmacologic, ambulation, compression; prevent clots
4
Q
Sjogren syndrome is associated with ___
A
RA
5
Q
low-grade fever and bilateral swelling of the joints is characteristic of ___
A
RA
6
Q
___ is the #1 drug of choice for treating RA
A
methotrexate
7
Q
T/F: Oral chemo is just as toxic as IV chemo
A
T
8
Q
Rituximab is an example of ___
A
monoclonal antibodies for cancer
9
Q
side effects of radiation include
A
radiation dermatitis, reduced immunity, increased photosensitivity
10
Q
describe neutropenic precautions
A
(1) no planted / potted flowers in the room
(2) HH
(3) aseptic technique
(4) screen family members for illness
(5) avoid large crowds
(6) clean pt room at least 1x/day
(7) VS q4h
(8) daily WBC
(9) educate family
11
Q
___ is the definitive diagnostic test for CRC
A
colonoscopy
12
Q
hematochezia is ___
A
bleeding from the rectum
13
Q
dehydration - blood osmlality and Na levels
A
increased blood osmolality
increased Na
14
Q
give ___ solution for dehydration
A
isotonic
15
Q
diuretics overuse, blood losses, and lack of aldosterone can all lead to ____
A
fluid volume deficit (FVD)
16
Q
best indicator of fluid overload is ___
A
weight gain
17
Q
Diphenoxylate hydrochloride is not safe in ____
A
older adults (can cause drowsiness and fall risk)
18
Q
Tissue / skin integrity nursing considerations
A
(1) clean (peri) area with warm water and mild soap
(2) keep area as dry as possible
(3) use barrier creams to reduce irritation
19
Q
DKA is associated with which acid-base imbalance?
A
metabolic acidosis
20
Q
Kussmaul respirations, hyperkalemia, decreased reflexes, and decreased LOC are associated with which acid-base imbalance?
A
metabolic acidosis
21
Q
muscle weakness, opioids, COPD, and atelectasis are all associated with ____ acid-base imbalance
A
respiratory acidosis
22
Q
massive blood transfusion is associated with ____ acid-base imbalance
A
metabolic alkalosis
23
Q
in metabolic alkalosis what will K and Ca levels be?
A
LOW - hypokalemia, hypocalcemia
24
Q
you will see positive Chvostek and positive Trousseau in ____
A
respiratory alkalosis
25
____ can lead to cerebral edema
hyponatremia
26
the biggest things to monitor for hyponatremia are
(1) neuro status
(2) seizure precautions
(3) fall prevention
27
s/s of hypernatremia
(1) jumpy / twitchy
(2) increased HR
(3) distended neck veins
(4) increased excitability
28
Cushing syndrome is associated with which two electrolyte imbalances?
hypernatremia and hypokalemia
29
NEVER PUSH IV ____
K (potassium)
30
what are the nursing considerations for hypokalemia?
(1) monitor RR and breathing patterns
(2) monitor dysrhythmias and cardiac changes
(3) fall prevention (muscle weakness)
(4) monitor UO
31
inverted T wave and a depressed ST is associated with ____
hypokalemia
32
ECG changes in hyperkalemia
(1) peaked T wave
(2) ST depression
(3) widened QRS
33
you can give diuretics, dialysis, and ___ to pull off K in hyperkalemia
Ca gluconate
34
you will see Positive Chvostek and Positive Trousseau in which two electrolyte imbalances?
hypocalcemia
hypomagnesemia
35
laxative misuse can lead to ___
hypomagenesemia
36
monitor cardiac and bone fractures in ____
hypercalcemia
37
Mg replacement can cause ____
diarrhea
38
the antidote for too much Mg is ___
Ca gluconate
39
diabetes diagnosis
A1C > 6.5% OR
Fasting blood glucose > 126 mg/dL…
2-hr GTT > 200 mg/dL OR…
Classic s/of hyperglycemia and random BG > 200 mg/dL
40
Rule of 15
If blood sugar < 70 mg/dL, eat 15g of simple CHO
Wait 15 minutes
Retest BS
If still < 70, repeat
Once within 70-100, eat another snack of a complex carb and protein to help with maintaining blood sugar increase
41
the key differences of HHS, compared to DKA
(1) BG > 600
(2) osmolarity >320
(3) neuro symptoms
42
Examples of simple CHO include
4 oz of juice or regular soda
5 hard candies
3-4 glucose tablets or gels
43
the severe version of hypothyroidism is ___
myxedema coma
44
the severe version of hyperthyroidism is ___
thyroid storm
45
Levothyroxine education
administer 1hr before meals and other medications
46
methimazole can be used in ___
hyperthyroidism
47
craving for salt is characteristic of ____
Addison's disease
48
what are the 2 main priority actions for acute adrenal insufficiency?
(1) start IV bolus of hydrocortisone
(2) monitor for hyperkalemia with peaked T waves
49
the primary goal of care for Addison's disease is to prevent ____
circulatory shock
50
will BP be high or low in Addison's disease?
low
51
thinning bones, weight gain, truncal obesity, and thinning hair are s/s of ___
Cushing syndrome
52
Mitotane and Ketoconazole are used to treat ____
Cushing syndrome
53
describe at least 3 s/s of early stage AD
(1) difficulty finding new places
(2) should not travel alone
(3) forgets name
(4) independent in ADLs
(5) difficulty recalling new info
(6) subtle changes in behavior and personality
54
name at least 3 s/s of moderate stage AD
(1) more dependence in ADLs
(2) only oriented to self
(3) problems with money
(4) speech and language deficits
(5) depression / agitation
(6) wandering
(7) delusions / hallucinations
55
name at least 3 s/s of late stage AD
(1) completely dependent for ADLs
(2) bowel and bladder incontinence
(3) completely bedridden
(4) loss of mobility and verbal skills
(5) agnosia (can't recognize people, objects, etc.)
56
____ and ____ are last resort for hallucinations in patients with AD
diazepam; haloperidol
57
how often should you toilet a patient with AD that is dependent on ADLs?
q2h
58
what are the side effects of phenytoin?
(1) headache
(2) drowsiness
(3) can lead to gingival hyperplasia
59
do not use phenytoins with ___
warfarin
60
name at least 4 seizures precautions during a seizure
(1) loosen restrictive clothing
(2) remove pillow
(3) raise padded side rails
(4) side-lying position
(5) provide privacy
(6) have O2 and suction ready
61
what does BEFAST stand for?
Balance
Eye and vision changes
Facial drooping
Arm weakness
Speech changes
Time since onset of symptoms
62
the main priority for stroke patients is to ____
restore perfusion to the brain
63
alteplase is given ___ (route)
IV
64
how do we dose alteplase?
by weight
65
do not give alteplase within 24-48 hours of ___
aspirin
66
before giving alteplase, check ___ and ___
blood glucose; hypoxia
67
BP should be at least ____ before administering alteplase
<180/110
68
name at least 3 safety considerations with strokes
(1) aspiration risk b/c of impaired swallowing
(2) fall risk
(3) blood glucose / hyperglycemia
(4) bleeding risk (alteplase)
69
hemorrhagic strokes are characterized by what two things?
(1) severe headache
(2) increased intracranial pressure
70
name at least 4 interventions when working with someone with delirium
(1) maintain sleep/wake cycles
(2) use a calm voice
(3) play soothing music
(4) use a stuffed animal to soothe patient
(5) reorient if no h/o AD
71
the 4 cardinal signs of PD are
(1) tremors
(2) muscle rigidity
(3) bradykinesia
(4) postural instability
72
name at least 3 safety considerations for PD
(1) aspiration risk
(2) fall risk
(3) depression
(4) infection (UTI, skin breakdown)
73
loss of lung elastic tissue, leading to hyperinflation and air trapping
emphysema
74
inflammation of the bronchi and bronchioles + thick mucus
chronic bronchitis
75
name at least 3 s/s of early hypoxia
(1) tachycardia
(2) tachypnea
(3) elevated BP
(4) pale skin
(5) confusion
76
name at least 3 s/s of late hypoxia
(1) stupor
(2) cyanosis
(3) bradycardia
(4) bradypnea
(5) hypotension
77
name at least 3 s/s of chronic hypoxia
(1) nail clubbing
(2) cyanosis
(3) barrel chest
(4) pursed lip breathing
(5) delayed cap refill
78
name the traits of a COPD exacerbation
(1) RR 40-50
(2) O2 80-85%
(3) accessory muscle use
(4) abnormal lung sounds
79
salmeterol is an example of a ____
LABA
80
Ipratroprium is an example of a ____
inhaled anticholinergic
81
side effect of ipratropium is
dry mouth
82
what should you do after administering fluticasone?
rinse mouth to prevent thrush
83
acetylcysteine can smell like ____
rotten eggs
84
acetylcysteine side effect
hepatotoxicity
85
explain how to properly use a MDI
(1) shake inhaler
(2) full inhale/exhale
(3) give a puff and inhale over 3-5 seconds
(4) hold breath for 10 seconds
(5) exhale
(6) wait 5 minutes between doses
(7) rinse mouth afterwards
86
the two meds used to treat pneumonia are
(1) cephalosporins (ceftriaxone)
(2) fluoroquinolone (levofloxacin)
87
what are the side effects of levofloxacin?
(1) c. diff
(2) yeast infection
(3) N/V
(4) tendon rupture
88
levofloxacin teaching
(1) take with food
(2) avoid sun exposure
(3) complete the full dose
89
PAD usually occurs on the ___
toes
90
PAD pedal pulses
weak or absent
91
PAD pain
intermittent claudication
92
PAD skin
hairless, shiny, dry, cool to touch
93
PAD on elevation
pallor
94
PAD in dependent position
rubor
95
2 ways to promote vasodilation are
(1) wear socks and keep feet warm
(2) avoid smoking, caffeine, and nicotine
96
elevating the legs in PAD will cause ____
more pain
97
what are the meds used to treat PAD?
(1) aspirin
(2) clopidogrel
98
prolonged venous HTN that stretches the veins and damages the valves
venous insufficiency
99
name at least 3 s/s of venous insufficiency
(1) pitting edema
(2) eczema / dermatitis
(3) ulcers
(4) hyperpigmentation
(5) pedal pulses present and palpable
100
name at least 3 treatment options for venous insufficiency
(1) Teds / Jobst
(2) SCDs
(3) avoid constricting clothing
(4) avoid crossing legs
(5) unna boots
101
asymmetric lung expansion, decreased or absent breath sounds, and tachycardia are s/s of ___
pneumothorax
102
what does excessive bubbling in a chest tube mean?
leak in the system
103
what does intermittent bubbling in a chest tube mean?
normal! system is working
104
do we want to see fluctuations in the chamber of a chest tube?
yes - it means there is still air coming into the system
105
nursing priorities for chest tube
(1) 2 cm min of water for water seal
(2) monitor for infection
(3) fluctuating bubbling is good
(4) no bubbles either means full done OR an issue with the system
106
virchow's triad is
(1) reduced blood flow
(2) blood vessel injury
(3) increased coagulability
107
what is an important lab test in VTE/DVT?
d-dimer
108
name at least 3 ways to prevent clots
(1) passive and active ROM
(2) ambulate AMAP
(3) utilize compression devices
(4) reposition q2h
(5) no pillows under the knees
(6) smoking cessation
(7) don't cross legs
109
what is the antidote for heparin?
protamine suulfate
110
what is the antidote for warfarin?
vitamin K
111
PE is diagnosed with ___ and ___
D-dimer; CTPA
112
___ can tell is if the cause of chest pain is respiratory or cardiac
BNP
113
name 4 ways to prevent bleeding risk
(1) use electric not manual razors
(2) avoid needle pokes
(3) use small / thin needles
(4) prevent falls / injury
(5) no aspirin
114
the two biggest risk factors for A fib are
(1) HTN
(2) CV disease
115
key ECG characteristics of a fib
(1) HR can vary (normal or high)
(2) irregular R to R
(3) no clear P wave
116
2 major risks associated with a fib are
(1) embolus formation
(2) heart failure
117
what are the 3 antidysrhythmics that can be used with A Fib?
(1) Diltiazem (Ca channel blocker)
(2) Metoprolol (Beta blocker)
(3) Digoxin (cardiac glycoside)
118
which drug can cause bronchospasms?
metoprolol / beta blockers
119
herbals like ginseng or ginger can interfere with ___
warfarin / coumadin
120
in later sinus tachycardia, what happens to BP?
decreases - hypotension
121
what drug can be used to SPEED up HR?
atropine
122
repetitive firing or irritable ventricular focus
ventricular tachycardia (VT)
123
what will we see on an ECG with VT?
(1) widened QRS
(2) absence of visible P waves
124
in VT, we can administer what drug?
amiodarone
125
if VT is pulseless, what do we do?
(1) call for help
(2) start CPR
(3) delegate to get defibrillator
126
if VT has a pulse / stable, what do we do?
(1) give O2
(2) confirm with 12-lead ecg
(3) give amiodarone
(4) cardioversion
127
which arrhythmia is life-threatening?
Ventricular fibrillation (V Fib)
128
the biggest risk factor for VF is ___
MI
129
V Fib is always ___
apneic and pulseless
130
what do we do in the case of V Fib?
(1) call for help
(2) CPR
(3) delegate for defibrillator
131
complete absence of any ventricular rhythm is ____
ventricular asystole
132
what is the Med / Surg nursing role during CPR for ventricular asystole?
(1) provide support, medical hx
(2) report initial cardiac rhythm
(3) answer Qs
(4) comfort family
133
CPR should be ___ compressions per __ breaths
30 compressions to 2 breaths
134
explain s/s of stable angina
(1) chest pain relieved by nitro or rest
(2) less than 15 minutes
(3) no nausea, diaphoresis, etc.
135
name s/s of unstable angina
(1) occurs at rest or w/ exertion
(2) lasts >15 minutes
(3) poorly relieved by nitro
(4) may have ST changes
(5) no changes in troponin levels
(6) ischemia but no damage
136
the main factor for ACS is ___
atherosclerosis
137
how can angina present in females?
(1) back pain
(2) pain between the shoulder blades
(3) epigastric pain
(4) indigestion
(5) flu-like symptoms
(6) aching jaw
138
describe key attributes of a STEMI
(1) ST elevation on 2 contiguous leads
(2) elevated troponin levels
(3) associated s/s (chest pain, SOB, nausea, impending doom, etc.)
139
describe key attributes of a NSTEMI
(1) ST depression
(2) T inversion
(3) troponin levels start normal; then elevate
(4) associated s/s (chest pain, SOB, nausea, diaphoresis)
140
if you are assessing a patient and they have chest pain, what do you do?
(1) stop assessment and assess pain quickly
(2) VS
(3) ensure IV access
(4) notify provider / call rapid
(5) pain relief
(6) semi-fowler's
(7) calm environment
141
what is used for pain relief in angina / NSTEMI / STEMI?
(1) IV morphine
(2) nitroglycerin
142
before giving nitroglycerin, ask if a patient is taking ___
ED medications
143
why is it risky to give nitro when someone is on ED medications?
because they are both vasodilators and could lead to severe hypotension
144
when do we hold nitro?
(1) if on ED meds
(2) if BP <100 mmHg
145
how many doses of nitro can we give?
every 5 minutes, up to 3 total
146
guidelines for nitro
(1) risk of hypotension
(2) sublingual
(3) 3 total doses
(4) keep in light-resistant container
(5) needs to be replaced every 3-5 months
147
treat a NSTEMI within ___ of symptoms
4-6 hours
148
treat a STEMI within ___ of symptoms
90 minutes
149
name the meds that can be given for NSTEMI / STEMI
(1) aspirin chewable 325 mg at ED
(2) clopidogrel
(3) beta blocker w/in 1-2 hours after MI and when BP/HR are stable
(4) ACEI/ARB within 24 hours
(5) statin therapy - for abnormal lipid panel
150
a patient must be able to climb 2 flights of stairs without symptoms before ___
returning to sexual activity
151
statins are most effective when taken ___
in the evening
152
when to call provider after a MI
(1) HR <50
(2) dyspnea
(3) weight gain (3 lbs/week or 1-2 lbs/day)
(4) activity intolerance
153
when to call 911 after a MI
(2) chest pain not relieved with 1 dose of nitro
(2) severe pain + associated s/s
154
restrict Na to ___ to help manage hypertension
<1.5 g
155
what are the 2 main drugs used to help manage HTN?
(1) thiazide diuretics
(2) Ca channel blockers
156
thiazide diuretics can lead to ____ so we should monitor cardiac symptoms
hypokalemia
157
avoid grapefruit juice when taking ___
ca channel blockers, like amlodipine
158
___ can cause a dry, persistent cough
ACEIs
159
why should you never abruptly stop taking antihypertensives?
it can lead to rebound hypertension
160
hypertensive crisis is defined as
systolic >180; diastolic >120
161
the 3 interventions in a hypertensive crisis are:
(1) semi-fowler's
(2) give O2 to maintain >90
(3) call rapid
162
patient education when taking ferrous sulfate
(1) check Hgb q4-6 weeks
(2) vitamin C to increase absorption
(3) take between meals to increase absorption
(4) avoid taking with calcium
(5) stools can be dark green, black, tarry
163
the most common secondary cause of HTN is
kidney disease
164
name at least 3 s/s of right-sided HF
(1) weight gain
(2) nausea / anorexia
(3) nocturia
(4) ascites
(5) JVD
(6) peripheral edema
165
name at least 3 s/s of left-sided HF
(1) decreased CO - fatigue, weakness, dizziness, confusion, oliguria
(2) pulmonary congestion - cough, dyspnea, crackles, frothy sputum, tachypnea
166
in HF, BNP will be ___
elevated
167
ejection fraction <___ is concerning for heart failure
<50%
168
name 3 interventions to help with gas exchange in HF
(1) high Fowler's
(2) supplemental O2
(3) loop diuretics (Furosemide)
169
why do we give IV Push furosemide over 1-2 minutes?
to avoid ototoxicity
170
first-line treatment for perfusion treatment of HF is
ACEI or ARB (never at the same time)
171
name 4 signs of digoxin toxicity
(1) fatigue
(2) weakness
(3) bradycardia
(4) loss of P wave
172
blurry vision with halos around light and loss of peripheral vision are s/s of
glaucoma
173
alpha agonists and carbonic anhydrase inhibitors are used to treat
glaucoma
174
what are the education points for treatment of glaucoma?
(1) tearing and blurred vision are normal after eye drop admin
(2) punctal occlusion to avoid drop going to lacrimal duct
(3) wait 5-10 minutes between drops
(4) don't touch dropper to the eye
175
name at least 3 safety measures for someone with glaucoma / vision loss
(1) remove rugs and clutter
(2) add handrails
(3) non-skid mats
(4) adequate / bright light
(5) announce self upon entry
(6) do not move items without their permission
(7) clock face for food on plate
(8) use a normal voice
(9) offer an arm when walking with the pt
176
sensorineural is ____ hearing loss, while conductive is ____ hearing loss
permanent; temporary
177
tinnitus, dizziness, and difficulty following conversations are s/s of ____
sensorineural hearing loss
178
name at least 4 points of hearing aid care
(1) keep aid dry
(2) clean ear mold with mild soap and water
(3) use soft toothbrush to clean debris
(4) turn off when not in use
(5) check and replace batteries
(6) keep aid in safe place
(7) adjust volume to lowest setting and ramp up
179
you can use a ___ voice to help with hearing loss
lower-octave
180
partial or complete airway collapse is ____
obstructive sleep apnea (OSA)
181
name at least 3 s/s of OSA
(1) daytime sleepiness
(2) waking up gasping
(3) headache
(4) irritability
(5) memory problems
(6) overweight
182
post-op care main priority is
preventing infection
183
the main priority of pre-op is
safety
184
what data collection should you do to prep for surgery?
(1) health history
(2) allergies
(3) H2T
(4) vitals
(5) diagnostics as indicated
185
what are the steps to prepare for surgery (outside of data collection)?
(1) NPO
(2) skin prep - CHG, clippers
(3) med administration
(4) infection prevention
(5) remove dentures, aids, etc. before surgery
(6) psychological support
186
name at least 3 age-related risks of post-op complications
(1) skin - delayed healing
(2) decreased kidney function
(3) neuro - delirium
(4) CV - HTN, hypotension
(5) respiratory - decreased lung capacity
(6) MSK - mobility issues
187
after anesthesia, what are the priorities?
airway and breathing
188
____ and ____ can lead to impaired perfusion after anesthesia
hypotension; low respirations
189
how do we detect acute urinary retention?
bladder scan
190
who is at higher risk for dehiscence and evisceration?
(1) abdominal surgery
(2) c-section
(3) obesity
191
what are the VS requirements following surgery?
(1) every 5-15 minutes for first hour
(2) q1h for 4 hours
(3) q4h for 24 hours
192
dantrolene sodium is the treatment for ____
malignant hyperthermia
193
evisceration is an emergency. what should you do?
(1) call rapid
(2) HOB at 20 deg and knees bent
(3) sterile dressing with saline
(4) notify surgeon
194
when doing neurovascular checks the main priority is to ____
compare perfusion bilaterally
195
name at least 3 s/s of malignant hyperthermia
(1) decreased O2
(2) tachycardia
(3) muscle rigidity
(4) hypotension
(5) elevated T (late sign)
196
CD4+ cells begin to create ____
new HIV virus particles
197
what are the leading causes of death in HIV/AIDS?
(1) opportunistic infections
(2) cancer
198
T/F: Antibodies that are produced in HIV/AIDS are incomplete and do not function well
T
199
name at least 3 s/s of acute HIV Infection
(1) fever
(2) night sweats
(3) rash
(4) sore throat
(5) head and muscle aches
200
AIDS criteria is
CD4+ count <200 or opportunistic infection w/ HIV diagnosis
201
name at least 3 ART complications
(1) kidney function
(2) activity intolerance
(3) neuropathies
(4) nutritional impacts
(5) N/V/D
202
the 6 priorities for cirrhosis are
(1) fluid overload
(2) hemorrhage
(3) confusion
(4) pruritus
(5) avoid alcohol
(6) avoid hepatotoxic meds
203
3 s/s of early cirrhosis include
(1) anorexia
(2) vomiting
(3) weight changes
(4) abdominal pain
(5) fatigue
(general/nonspecific)
204
3 s/s of late cirrhosis include
(1) jaundice
(2) GI bleeding
(3) bruising
(4) ascites
(5) pruritus
205
albumin levels in cirrhosis will be ____
low
206
how do we prevent hemorrhage in cirrhosis?
beta blockers like propranolol
207
2 nephrotoxic drugs are
NSAIDs and acetaminophen
208
we use ____ to reduce ammonia levels via the stool
lactulose
209
when does COVID-19 require immediate attention?
(1) dyspnea
(2) tachypnea
(3) hypoxemia
(4) chest pain
(5) confusion
(6) cyanosis
210
4 ways to prevent ventilator-associated pneumonia include
(1) HOB >30
(2) oral care
(3) HH
(4) sterile suctioning
211
older adults may exhibit ____ with pneumonia
confusion
212
the 2 meds used to support breathing with pneumonia are
(1) bronchodilators
(2) methylprednisolone (IV to PO)
213
describe the hour-1 bundle for sepsis
(1) obtain lactate levels
(2) obtain blood sample
(3) administer broad-spectrum abx
(4) administer fluids
(5) apply vasopressors if still hypotensive
214
we can administer corticosteroids for sepsis to ____
manage adrenal insufficiency
215
SIRS criteria
at least 2 of the following:
- T <36 or >38
- HR >90
- RR >20 or PaCO2 <32
- WBC <4 or >12
216
Severe sepsis criteria
- requires vasopressor to keep MAP >65 or
- serum lactate >2 despite fluids
217
____ is the primary cause of chronic pancreatitis
alcohol use
218
sudden onset of severe, boring, epigastric pain with N/V, and abdominal distention
pancreatitis
219
will blood glucose levels be high or low in pancreatitis?
high
220
what is the treatment for pancreatitis?
(1) NPO until pain free
(2) bland, high-protein, low fat diet when resumed
(3) no stimulants
(4) NGT for decompression if needed
(5) position in side-lying or fetal (whatever is comfortable)
221
name at least 3 s/s of a small bowel obstruction
(1) mid-abdominal pain or cramping
(2) upper abdominal distention
(3) N/V
(4) metabolic alkalosis
222
name at least 3 s/s of a large bowel obstruction
(1) lower abdominal pain / distention
(2) minimal vomiting
(3) constipation/obstipation
(4) ribbon stools
(5) metabolic acidosis
223
what signs may indicate a perforation?
(1) severe pain followed by relief
(2) fever
(3) tachycardia
(4) hypotension
(5) rigidity
224
how do we treat a bowel obstruction?
(1) NPO - bowel rest
(2) NGT for decompression
(3) IVF and electrolytes
(4) oral care
(5) pain management
225
name the 4 key nephrotoxic drugs
(1) NSAIDs
(2) abx
(3) metformin
(4) CT contrast
226
3 signs of decreased perfusion in a patient with AKI include
(1) MAP <65
(2) increased HR
(3) weak peripheral pulses
227
which electrolyte imbalance will occur in AKI?
metabolic acidosis
228
what are the indications for temporary dialysis?
(1) symptomatic uremia
(2) K >6.5
(3) pH <7.1
(4) fluid overload
229
the 2 most common causes of CKD are
(1) DM
(2) HTN
230
name at least 3 signs of progression of CKD
(1) increased BUN
(2) increased creatinine
(3) decreased UO
(4) fluid overload
(5) electrolyte buildup
(6) uremia
231
kidney complications r/t CKD
fluid overload - weight gain, edema, bounding pulse, JVD, etc.
232
metabolic complications r/t CKD
(1) increased K
(2) increased Phos
(3) decreased Ca
(4) metabolic acidosis
233
cardiac complications r/t CKD
(1) HTN
(2) HLD
(3) HF
(4) pericarditis
234
hematologic complications r/t CKD
anemia, bruising, bleeding
235
immunity complications r/t CKD
increased risk of infection
236
GI complications r/t CKD
anorexia, nausea, foul breath, metallic taste
237
cognitive complications r/t CKD
changes in cognition
238
skin complications r/t CKD
pruritus, dry skin, yellowing skin
239
we want to restrict ___, ___, ___, and ___ in CKD
protein, Na, K, and Phos
240
Epoetin alfa is used to ___
treat / prevent anemia in CKD
241
Ca acetate is a ____
phosphate binder
242
what are the side effects / considerations of phenazopyridine?
(1) take with food
(2) may turn urine orange or red
243
s/s of infection in PD
(1) cloudy, opaque effluent
(2) fever
(3) abdominal pain
(4) malaise
(5) nausea
244
AVF safety precautions:
(1) no BP cuff on that extremity
(2) no IVs or blood draws
(3) check for bleeding
(4) check for infection
(5) don't compress extremity
(6) assess bruit & thrill; distal pulses
245
green loose stool; odorless; very irritating to skin. which ostomy does this describe?
ileostomy
246
describe a healthy stoma
(1) red/pink
(2) moist
(3) protrudes 1-3 cm
247
describe a post-op stoma
(1) edematous
(2) small amount of bleeding
(3) stool in 2-3 days
248
describe an unhealthy stoma
(1) dark red / purple / black
(2) dry - ischemic
(3) heavy bleeding
249
describe an unhealthy peristomal
(1) reddened
(2) painful
(3) itchy
250
describe the DOPE pneumonic for assessing patients with mechanical ventilation
Dislodgement
Obstructions
Pneumothorax
Equipment
251
____ injection can be used to treat hyperkalemia
insulin
252
acidosis is associated with which electrolyte imbalance?
hyperkalemia
253
alkalosis is associated with ___ potassium levels
low - hypokalemia
254
glargine is what type of insulin?
long-acting
255
when should you stop and notify the provider prior to a surgery?
(1) surgical site discrepancy
(2) patient does not understand what they've consented to
256
steps to enhance recovery in post-op patients
(1) early mobility
(2) early intake
(3) manage N/V
(4) discontinue IVF
(5) mild analgesics
(6) education
