Questions Flashcards
0
Q
A patient develops diarrhea several days after being treated for a severe respiratory infection. Which information is needed by the nurse to assess the cause of the diarrhea?
A
The medication used for tx of the infection
1
Q
Which behavior is frequently observed in adolescents who have acquired sexually transmitted diseases (std)?
A
Adolescent deny having the disease
2
Q
The nurse is reviewing discharge instructions with a patient with a UTI. Which instructions should be included?
A
Drink 2 -3 liters of fluid daily, void every 2-3 hours
3
Q
Which pathophysiological factor accounts for the increased incidence of opportunistic infections and rumors among patients with AIDS?
A
A decreased number of T-cells
5
Q
The nurse is evaluating a patient who is on warfarin (Coumadin) therapy, which patient behavior indicates the need for further instructions regarding medication?
A
Taking Ibuprofen for a headache (NSAIDS may increase gastric irritation and possible irritation)
6
Q
Why should Tetris toxoid be administered to a patient who has a puncture wound?
A
To stimulate antibody production
7
Q
What is Pulmonary Tuberculosis?
A
A pulmonary disease affecting the lungs parenchyma
8
Q
What other organs can Pulmonary Tuberculosis spread to?
A
Meninges, kidneys, bones, lymph nodes
9
Q
What is the infectious agent (bacteria) in Pulmonary Tuberculosis?
A
Mycobacterium Tuberculosis
10
Q
How is pulmonary tuberculosis transmitted?
A
Droplet nuclei (airborne transmission)
11
Q
What are noted on the lungs that are infected with Pulmonary Tuberculosis?
A
Tubercle lesions (primary lesions)
12
Q
If the Pulmonary Tb enters lymph system, what inflammatory response can occur?
A
granulomatous inflammation
13
Q
What are some signs and symptoms of Pulmonary Tb?
A
Low grade fever, cough, night sweats, fatigue, wt. loss, hemoptysis, lethargy, and chills
14
Q
Elderly patients are know to have_______, symptoms of Tb?
A
decreased symptoms
15
Q
Young patients (youth) are know to have_________, symptoms of TB?
A
Increased symptoms
16
Q
What complications with AIDS patients with Pulmonary TB are usually seen?
A
Extrapulmonary disease
17
Q
Pulmonary Tb is dx by?
A
Tuberculin skin test (Mantoux), CXR, sputum culture, acid fact bacillus smear, quantiferon tb gold test
18
Q
People in foreign countries are given what vaccine to decrease the incidences of Tb?
A
Bacille camette Guerin vaccine (patients will always have positive Tb test)
19
Q
What is Lung Parenchyma?
A
Lung alveolar tissue (bronchioles, bronchi, blood vessels, interstitium, and alveoli
20
Q
What are some medications used to treat Pulmonary TB?
A
INH, rifampin (Rifadine), pyrazinamide, ethambutol (myambutol), rifapentine (Priftin), rifabutin (Myocodentia)
21
Q
Vitamin B (pyridaoxine) with INH is used to prevent?
A
INH associated neuropathy
22
Q
What is Rheumatic Endocarditis (Fever)?
A
Acute rheumatic fever, and exacerbation of strep B throat infection, affects school age children
23
Q
What is the infectious (bacteria) agent that causes Rheumatic Endocarditis (fever)?
A
Group A beta hemolytic streptococcal pharyngitis
24
Q
List some signs and symptoms of Rheumatic Endocarditis (fever)?
A
Fever (101-104F), chills, sore throat, throat redness, enlarged and tender lymph nodes, acute sinusitis and otitis media
25
How can Rheumatic Endocarditis (fever) be prevented?
dx and treat Strep B prior to acute episodes of Rheumatic fever
26
If Strep B is dx and treated, what can it prevent?
Rheumatic Endocarditis (fever)
27
How is Rheumatic Endocarditis spread?
Direct contact with oral or respiratory secretions
28
Rheumatic Endocarditis is dx by?
Throat culture, positive Strep B test (culture)
29
Rheumatic Endocarditis can progress to?
Rheumatic heart disease
30
Rheumatic Heart disease is characterized by which clinical manifestations?
new heart murmurs, cardiomegaly, pericarditis, heart failure, and aschoff body lesions
31
Rheumatic Fever affects which valves?
Mitral valve
32
What is Infective Endocarditis?
microbial infection of endothelial surface of the heart
33
Which types of patients are usually seen with Infective endocarditis?
Prosthetic heart valves, structural cardiac defects, IV drug users, degenerative or calcific valve lesions, pt. with indwelling catheter (dialysis pt.)
34
List some signs and symptoms of Infective Endocarditis:
Fever, heart murmur, petechial clusters, osler nodes, janeway lesions, roth spots, splinter hemorrhages, cardiomegaly, HF, tachycardia, splenomegaly
35
How is Infective endocarditis dx?
Blood cultures, Doppler echocardiography
36
How can Infective endocarditis treated?
IV ABT, debridement or excision of valves, valve replacement
37
List some CNS signs and symptoms displayed with Infective endocarditis?
headache, temporary/transient cerebral ischemia, strokes, embolic PNA, HF, AV block
38
What is Viral Hepatitis A?
RNA virus of enterovirus family, Infectious Hepatitis (HAV)
39
How is the Hepatitis Virus A transmitted?
Oral-Fecal transmission (ingest food or liquids infected by the virus)
40
When children or young adults acquire this infection (HVA) it usually due to?
poor hygiene, hand to mouth contact, or close contact during play
41
List signs and symptoms of Hepatitis A Virus:
Pt. may be asymptomatic; flulike symptoms, headache, malaise, fatigue, anorexia, fever, dark urine, Jaundice (sclera and skin), tender liver, indigestion (GI disturbances), cigarette smoke smell
42
How is Hepatitis A Virus Dx?
Enlarged liver and spleen, Hepatitis A antigen present
43
Describe some tx options for HAV?
(treat symptoms), bed rest, small frequent meals, IV fluids with glucose
44
Hepatitis A Virus patients should avoid which type of drink?
Alcohol
45
The most used resource to decrease the transmission of Hepatitis A virus is?
Hand washing, good personal hygiene, and good environmental sanitation practices.
46
Which vaccine is used for Hep A and B?
Twinrix
47
What is Viral Hepatitis B?
Serum Hepatitis, (HBV), DNA virus, No proteins
48
What type of transmission is usually seen with HBV?
Blood transmission, percutaneous and per mucosal route
49
Other bodily fluid transmission of HBV are?
Blood, saliva, semen, vaginal secretions, and mother to infant, also breast milk
50
HBV has an incubation period of how long?
6 months
51
List some signs and symptoms of HBV:
Pt. may be asymptomatic, arthralgia and rashes, decreased appetite, dyspepsia, abdominal pain, generalized aching, malaise, weakness, jaundice, liver tenderness and enlargement, light colored stools, dark urine, enlarges spleen and lymph nodes
52
How is HBV dx?
HBsAg
53
How Is HBV treated?
decreased liver inflammation: alpha interferon, iamivudine (Epivir), adefovir (Hepsera), oral nucleoside
54
What is Viral Hepatitis C?
HCV,
55
How is HCV transmitted?
through blood, blood products, IV drug use, drug paraphernalia, sex
56
Hepatitis C Virus increased the risk for?
Cirrhosis of the liver and Liver cancer
57
____________increase the progression of the disease?
Alcohol
58
List some signs and symptoms of HCV:
arthragias and rash, decreased appetite, dyspepsia, abdominal pain, aching, malaise, jaundice
59
What Rx treatments are used for Hep C?
interferon (Intron-A), ribavirin (Rebetol)
60
What is non-viral Hepatitis?
Hepatitis that is induced by toxic chemicals or medications. Toxic effect on liver=acute liver necrosis or toxic hepatitis
61
Which chemicals cause non viral hepatitis?
carbon tetrachloride, phosphorous, chloroform, gold compound (hepatotoxins)
62
Which chemical cause non viral hepatitis?
isonizazid (Nydrazid), halothane (Fluthane), acetaminophen, methylodopa (Aldonmet), ABTs
63
What is a urinary tract infection?
Infections caused by pathogenic microorganisms in the urinary tract.
64
List the different types of UTIs:
```
Lower UTIs:
bacterial cystitis (inflammation of the urinary bladder), Bacterial prostatitis (inflammation of the prostate gland), bacterial urethritis (inflammation of the urethra)
```
65
List the different types of upper UTIs:
acute pyelonephritis and chronic pyelonephritis
66
Acute pyelonephritis affects which organs?
the bladder, kidneys, and renal pelvis become infected by bacteria
67
Acute pyelonephritis can cause the kidney's to?
Enlarge
68
What are some signs and symptoms of Acute pyelonephritis?
chills, fever, leukocytosis, bacteriuria, pyuria, low back pain, n/v, headache, malaise, painful urination, tenderness in costovertebral angle, urinarI urgency and frequency
69
How Is Acute pyelonephritis dx?
ultrasound, CT, UA/C&S, IV pyelogram, radionuclide image with gallium citrate and indium-111
70
What are some tx options for Acute pyelonephritis?
Antibiotic therapy and increase fluids
71
What is chronic pyelonephritis?
inflammation of the renal pelvis, interstitial nephritis (inflammation of kidneys)
72
What leads to chronic pyelonephritis?
repeat bouts of Acute pyelonephritis
73
List some signs and symptoms of chronic pyelonephritis:
no symptoms until Acute pyelonephritis exacerbation, fatigue, headache, poor appetite, polyuria, excessive thirst, decreased weight
74
Treatment options for Chronic Pyelonephritis include:
increase intake to 3-4 Liters of fluids, prevent dehydration, antipyretics and antibiotics
75
What is Trichomoniasis?
flagellated protozoan, trichomonas vaginalis, sexually transmitted vaginitis
76
Trichomonas puts a patient at risk for which diseases?
Cervical neoplasia, PID, infertility
77
List some signs and symptoms of Trichomonas:
Vaginal discharge (frothy), yellow to green discharge, malodorous, irritating, burning and itching, vulvitis, vaginal and cervical erythema with multiple small petechial "strawberry spots"
78
Treatment options for Trichomonas are:
metronidazole (Flagyl), tinidzole (Trindamax)
79
A Patient with Trichmonas harbor organism where?
urogenital tract
80
Flagyl may leave and unpleasant taste in a patients mouth that is somewhat of?
A metallic taste
81
If Flagyl is taken with alcohol what symptoms may the patient experience?
Nausea and vomiting, flushed feeling
82
Flagyl is contraindicated for patients with:
blood dyscrasia or CNS diseases, women In the first trimester of pregnancy, and breast feeding women
83
Trinidazole (Trindamax) is not safe for which type of patients?
Patients who are pregnant
84
Candidiasis is also known as?
Yeast Infections, (vulvovaginal candidiasis; funga yeast infections) (cell mediated immunity)
85
What is the infectious organism that causes Candidiasis?
Candida albi and candida glabrata
86
What puts a patient at greater risk for contracting Candidiasis?
Antibiotic use, pregnancy, DM, HIV, oral contraceptive and corticosteroids
87
How is Candidiasis Diagnosed?
Spores and hyphae mixed with K+HO2 slide (pH 4.5 or less)
88
What are the treatment options for Candidiasis?
decrease symptoms
Antifungal agents: miconazole (Monistat)
nystantin (Mycostatin)
clotrimazole (Gyne-Lotrimin)
terconazole (Terazole)
fluconazole (Diflucan)
89
What is Bacterial Vaginosis?
An overgrowth of anaerobic bacteria and gardnerella vaginalis, and an absence of lactobacilli
90
List some signs and symptoms of Bacterial Vaginosis?
Discharge (grey, yellow, and white), Fish like odor
91
How is Bacterial Vaginosis diagnosed?
positive (+) wiff test, discharge pH greater than 4.7, No lactobacilli, slide with vaginal discharge with K+HO2 (clue cells)
92
What are some treatment options for Bacterial Vaginosis?
metronidazole (Flagyl), clindamycin (Cleocin)
93
Bacterial Vaginosis risks are increased by acts such as:
douching after menses, smoking, STDs, and multiple sex partner
94
Bacterial Vaginosis is associated with:
premature labor, premature rupture of membranes, endometritis, and recurrent UTIs
95
What is Human Papillomon Virus (HPV)?
STD, Genital Warts (condylomata), cervical changes (kilocytosis)
96
Human Papillomon Virus (HPV) puts women at increased risk of having?
cervical and anogenital cancers
97
Risk factors the predispose women to HPV are:
being sexually active and multiple sex partners
98
What is the new Vaccine to protect men and women from Human Papillomon Virus (HPV)?
Gardasil
99
What are some signs and symptoms of Human Papillomon Virus (HPV)?
asymptomatic
100
Human Papillomon Virus (HPV) can be diagnose by?
a pap smear and cervical changes
101
Treament options for Human Papillomon Virus (HPV) include:
Topical Trichloroacetic Acid, interferon podofin, podocon (Podophyllin), podofilox (Condylox), imiquimod (Aldara)
102
Patients with Human Papillomon Virus (HPV) should have annual?
Pap smears, condoms decrease risk of HPV, decrease the patients emotional distress
103
What is Pelvic Inflammatory Disease (PID)?
inflammatory condition of the pelvic cavity, begins with cervicitis, endometritis, salpingitis (fallopian tubes), oophoritis (ovaries), pelvic peritoneum, pelvic vascular system
104
PID can be caused by?
Gonorrhea and chlamydia, CMV (bacteria, fungus, or virus)
105
PID puts female patients at risk for:
increased ectopic pregnancies (narrowed fallopian tubes and scarring), infertility, pelvic pain, tubo-ovarian abscess
106
List some signs and symptoms of PID?
Vaginal discharge, dysparenuria, lower abdominal pain, pelvic pain, tenderness after menses, pain increase when voiding or bm, fever, malaise, anorexia, n/v, headache, tenderness=uterus and cervix, leukocytosis
107
Complication that can arise with PID include:
peritonitis, abscess, strictness and fallopian tube obstruction, adhesions, bacteremia with septic shock, thrombophlebitis with embolization
108
What nursing management measures should be taken for a patient with PID?
Semi-Fowlers position (aids in postural drainage) for abdominal distention, sx or intubation, bed rest, analgesics, heating pad, record vaginal discharge
109
List some treatment options for PID:
Antibiotic Therapy: ceftriaxone (Ceftin)
azithromycin (Zithromax)
doxycycline
110
What are the 6 types of Herpes Viruses?
1. Herpes Simplex Type 1 (cold Sores)
2. Herpes Simplex Type 2 (genital herpes)
3. Varicella Zoster (Shingles)
4. Epstein-Barr Virus
5. Cytomegalovirus
6. Human B lymphotrophic Virus
111
What is Herpes Simplex?
- 2 types of skin infections:
* HSV type 1 (mouth sores)
* HSV type 2 (genital sores)
- Seropositive
- True primary infection
112
How can HSV be diagnosed?
Viral culture and rapid assays
113
Herpes Simplex Virus Complications or as follow:
eczema herpeticum, herpetic whitlow and intrauterine neonatal infection (Tx: IV acyclovir)
114
What are some fetal anomalies that are associated with Herpes Simplex Virus?
skin lesions, mircocephaly, encephalitis, intracerebral calcifications
115
Herpes Simplex Virus Type 1 is also known as:
Orolabial Herpes (mouth)
116
Herpes Simplex Virus Type 1 is characterized by which signs and symptoms:
fever blisters, cold sores, erythematous based clusters grouped vesicles on the LIPS, tingling & burning with pain 24hrs before blister appears, flulike symptoms
117
What are some triggers for Herpes Simplex Virus Type 1?
increased stress, sunlight exposure
118
Some complications that may arise with Herpes Simplex Virus Type 1 include:
herpetic gingivostomatitis (high fever, regional lymphadenopathy, generalized malaise), erythema multiforme (acute skin inflammation and mucous membrane lesions that look like "targets")
119
Treatment measures for Herpes Simplex Virus Type 1 include:
- sunscreen
| - acyclovir 200g 5x daily x 5days
120
Herpes Simplex Type 2 is also know as:
Herpes Genitalis (genital)
121
What does Herpes Simplex Virus Type 2 cause?
recurrent, lifelong viral infection that causes herpetic lesions (blisters) on the genitalia, vagina and cervix, rectum, and penis
122
How is Herpes Simplex Virus Type 2 transmitted?
sex, cold sore to genitals, mother to baby during delivery (mother must have C-section) (no scalp electrodes during delivery)
123
What are some signs and symptoms of Herpes Simplex Virus Type 2:
itching and pain at infected area, red and edematous, macules and papules progress to vesicles and ulcers. Blister=coalesces=ulcerates=encrusts. Inguinal lymphadenopathy, increased temp, malaise, myalgia, fever and flulike symptoms, burning and tingling 24hrs before vesicles appear
124
List some treatment option for Herpes Simplex Virus:
-no cure, relieve symptoms of pain, itching and burning, prevent spread, relieve anxiety, increase knowledge about disease
-Rx: acyclovir (Zovirax)
valacyclovir (Valtrex)
famciclovir (Famvir)
125
What is Herpes Zoster (Shingles)?
-Shingles virus affect nerve ganglia, Varicella (chicken pox painful vesicles along the sensory area of distribution of the sensory nerves from on or more posterior ganglia
126
List some signs and symptoms of Herpes Zoster (Shingles):
red rash, fluid filled blisters, painful eruptions that may radiate over an entire region of affected nerves. Pain=burning, lancinating, stabbing, aching. Malaise, vesicles purulent and crust over.
127
The inflammation that Herpes Zoster (Shingles) causes is usually seen where?
unilateral, involving the thorax, cervical and crania nerves in bandlike configurations (eye pain may be present)
128
Herpes Zoster (Shingles) may flare up when?
cellular immunity decreases, with aging natural immunity decreases and the virus reactivates itself
129
What is a complication of Herpes Zoster (Shingles)?
Postherapetic Neuraglia (persistent pain of affected nerve after healing)
130
If Herpes Zoster (Shingles) is in the eye it is referred to as?
Ophthalmic Herpes Zoster; (ophthalmic emergency) refer to ophthalmologist immediately, prevent keratitis, uveitis, ulcerations
131
What are some treatment options for Herpes Zoster (Shingles)?
-relieve pain, decrease complications (ophthalmic HZ)
-oral antivirals within 24hrs: acyclovir (Zovirax)
valacyclovir (Valtrex)
Famciclovir (Famvir)
-Corticosteroids: Triminolone (aristocort, kenacort, kenalog)
132
What is the name of the vaccine use to prevent Herpes Zoster (Shingles)
Varicella Vaccine
133
Nursing management for Herpes Zoster (Shingles) include:
- ensure antiviral are taken
- wet to dry dressing to lesions or topical ointment applied
- diversionary techniques and relaxation to alleviate discomfort and ensure sleep
134
What Is Impetigo?
- superficial skin infection caused by streptococci, staphylococci
- bullous impetigo (S. aureus (infectious agent)=lg fluid filled blisters that rupture and leave raw areas)
135
What are some causes of Impetigo?
poor hygiene, malnutrition, excessive use of antibacterial soap (increases resistance to bacteria)
136
What parts of the body is Impetigo seen at?
face, hands, neck and extremities
137
List some signs and symptoms of Impetigo:
- small red macules that rupture, have a honey yellow crust (ringworm in the scalp)
- very contagious, follows: pediculosis capitis (head lice), scabies (itch mite), herpes simplex, insect bites, poison ivy, and eczema
138
Treatment measures use for Impetigo include:
-prevent acute glomerulonephritis (kidney infection that leads to streptococcal skin infection disease)
-RX: Penicillin (PCN)
benzathine Penicillin
cloxacillin (Cloxapen)
dicloxacillin (Dycill)
mupirocin (Bactroban)
*when applying topical crèmes, remove crust before applying
139
What is Pediculosis?
Lice infestation
140
List the 3 types of pediculosis:
1. Pediculus humanus capitit (Head Lice)
2. Pediculus humanus corporis (Body Louse)
3. Phthirus Pubis (Pubic Louse, Crab Louse)
141
What role does the Lice play when attached to the body?
They feed on human blood, inject digestive juices and excrement into skin which produces severe itching
142
What are some complications of Pediculosis?
epidermic rickettsial disease
143
Pediculosis Capitis is also known as?
Head Louse, infestation of scalp by head louse, nits (eggs)=female louse
144
How is Pediculosis Capitis transmitted?
direct physical contact, combs, brushes, wigs, hats, and bedding
145
What are some signs and symptoms of Pediculosis Capitis?
- Head lice is found along the back of the head and behind the ears. Eggs (nits) look like silvery glistening oval bodies.
- severe pruritus and scratching leads to secondary bacterial infections (impetigo)
146
List some treatment options for Pediculosis Capitis:
- antipruritic, systemic antibiotics, topical corticosteroids
- lindane (Kwell) (TOXIC TO CNS)
- pyrethrin compound with piper butoxide (Rid or R&C shampoo)
- after washing, comb hair with vinegar dipped comb
147
Pediculosis Corporis is also referred to as?
Body Louse, infestation of body by louse
148
People who do not wash, and do not change clothes may have?
Pediculosis corporis (body louse)
149
Which parts of the body is usually associated with Pediculosis Corporis?
Neck, trunk, and thighs (Louse live in seams of underwear)
150
Signs and symptoms of Pediculosis Capitis include:
pruritus, minute hemorrhagic points, excoriation d/t scratching, linear scratches
151
Treatment options for Pediculosis Capitis are as follows:
bathe with soap and water with scabicide (Lindane), permethrin (Elimitel), petrolatum to lashes
152
Pediculosis Pubis is also know as:
Pubic Louse, infestation of genital region by louse (transmitted by sexual contact)
153
Signs and symptoms of Pediculosis Pubis are:
pruritus at night, reddish brown dust in underwear, grey blue macules
154
Treatment for Pediculosis Pubis include:
washing genitals with Lindane, scabicide
155
What is scabies?
Infestation of skin by "itch mite," Sarcoptes Scabiei
156
List signs and symptoms of Scabies:
severe itching, red eruptions, increased itch at night, burrows (straight, wavy, brown or black, threadlike lesions) and papules.
157
Scabies usually affects which part of the body?
fingers and writs, hands, elbows, knees, edges of feet, around nipples, axillary folds, beneath pendulous breast, groin, gluteal folds, penis and scrotum
158
How is Scabies diagnosed?
recovering S. Scabiei mite, epidermis scrapping into slide and view under microscope
159
What are some treatment options for Scabies?
- warm soapy bath
| - scabicide Lindane, crotamiton (Eurax), 5% Permethrin
160
What Nursing management techniques should be used to aid with Scabies treatment?
- clean laundered clothing and bedding, dry cleaning advised.
- topical corticosteroid, antihistamine
- apply scabicide immediately after bathing before skin dries and cools. Scabicide absorption can cause CNS abnormalities such as seizures
