Study Guide

Question 1

Pre-Diabetic Blood Sugars

Answer 1

100-125 mg/dl; Nurses must teach about lifestyle changes to lower blood glucose. Oral hypoglycemic is an option at this point

Question 2

How is blood sugar treatment effectiveness evaluated?

Answer 2

Hemoglobin A1C, glycosylated hemoglobin

Question 3

What are normal blood sugars?

Answer 3

70-99 mg/dl

Question 4

What blood sugars will a patient with hypoglycemia present? Why is this important?

Answer 4

Below 70 mg/dl. Hypoglycemia is more of an emergency than hyperglycemia, hypoglycemic patients should receive priority with nursing care

Question 5

What is diabetes insipidus?

Answer 5

Related to lack of ADH; patient will have extremely high urinary output, causing patient to use restroom multiple times a day

Question 6

What are symptoms of Cushings?

Answer 6

Hyperglycemia, elevated blood pressure, mood swings, gastric ulcers and decreased immunity

Question 7

What is the onset of Humalog/lispro insulin?

Answer 7

Starts working in as early as 5-15 minutes

Question 8

What does predinisone require tapering?

Answer 8

Glucocorticoid drug; should be tapered down if needed to stop medication to avoid adrenal insufficient crisis which can lead to circulatory collapse

Question 9

What is the treatment for diabetes insipidus?

Answer 9

Synthetic form of ADH such as desmopressin or vasopressin

Question 10

What is myxedema?

Answer 10

Group of symptoms associated with hypothyroidism, includes fatigue, weakness, muscle cramps, cold intolerance

Question 11

What is Addison’s Disease?

Answer 11

Refers to primary adrenal insufficiency; leads to symptoms such as syncope, weakness, fatigue, and darkness of skin

Question 12

What therapy is used to treat hyperthyroidism?

Answer 12

Iodine 131

Question 13

What is seen with primary hypothyroidism diagnosis?

Answer 13

Low levels of T3 and T4, high levels of TSH

Question 14

What is important patient education regarding migraines?

Answer 14

Choose a quiet and dark place when the headache begins

Question 15

What should a nurse do if a patient is presenting a tonic clonic seizure?

Answer 15

Ensure patient safety, assess patient for injury, observe and note details of seizure and after seizure

Question 16

What is status epilepticus?

Answer 16

Seizures that last greater than 20 minutes, medical emergency; nurses must give one of the abortive medications like gaba potentiator drugs such as Ativan or Valium IV

Question 17

What is an adverse effect of overmedication of antiparkinson drugs?

Answer 17

Uncontrolled head movements (bobbing), must report to provider

Question 18

What is necessary for a patient presenting with uncontrolled tonic clonic seizures?

Answer 18

Padded side rails, must be placed on oxygen mask, must have suction tubing available in the room

Question 19

What is decorticate posturing?

Answer 19

Type of abnormal posturing which can take place in response to stimulation with internal rotation, adduction, and flexion of the arms

Question 20

What is mannitol?

Answer 20

Osmotic diuretic which can be given to patients that require their intercranial pressure to be lowered; ICP must be monitored

Question 21

What should nurses implement first with increased ICP?

Answer 21

Keep head of bed elevated to 30 degrees to improve drainage

Question 22

What is suspected of clear drainage discharge with head injury?

Answer 22

Clear drainage from the nose or ears must be checked for glucose content, indicative of leaking CSF

Question 23

What is the main concern with concussions?

Answer 23

Risk of epidural hematoma; sleeping should be avoided because this is an epidural bleeding and they may not wake up

Question 24

What should patients at risk of increased ICP avoid?

Answer 24

Suctioning unless extremely necessary, coughing or bearing down if constipated will also increase ICP

Question 25

LOC deterioration

Answer 25

REQUIRES IMMEDIATE ACTION, pt is deteriorating

Question 26

Why is viral load checked when patients are started on antiretroviral therapy?

Answer 26

Providers can see the effectiveness of the therapy

Question 27

What should be watched with antibiotic IV?

Answer 27

Pt complains of shortness of breath and itching, discontinue immediately

Question 28

What cross sensitivity is possible with penicillin allergies?

Answer 28

Cephalosporin, question if doctor prescribes for patient with penicillin allergy

Question 29

What do nurses check with insulin IV administration?

Answer 29

Patient potassium levels, potassium is shifted inside the cell

Question 30

What are signs and symptoms of Parkinson's disease?

Answer 30

Stooped posture, slow, shuffling, propulsive gait, slow , monotonous speech, tremors/pill-rolling tremor of fingers, muscle rigidity, bradykinesia/akinesia, masklike expression, difficulty chewing and swallowing, drooling, dryarthria, progressive difficulty with ADLs, mood swings, cognitive impairment

Question 31

What medications are used to treat Parkinson's?

Answer 31

``` dopaminergics (levodopa) to increase dopamine levels, dopamine agonists (bromocriptine [parlodel], ropinirole [requip], and pramipexole [mirapex]) to activate release of dopamine anticholinergics (benztropine [cogentin], trihexyphenidyl [artane]) to control tremors and rigidity COMT inhibitors (entacapone [comtan]) to decrease breakdown of levodopa to make dopamine more available in the brain antivirals (amantadine [symmetrel]) to stimulate release of dopamine, prevent reuptake ```

Question 32

Glasgow Coma Scale

Answer 32

Eye opening 4-1 spontaneous, sound, pain, does not occur Verbal 5-1 coherent/oriented, incoherent/disoriented, spoken words/inappropriate, sounds without words, does not occur Motor 6-1 follows commands, local reaction to pain, general withdrawal to pain, decorticate posture, decerebrate posture, does not occur

Question 33

CDC definition of AIDS

Answer 33

Characterized by life-threatening opportunistic infections, end stage of HIV infection; without treatment, death occurs within 5 years

Question 34

Difference between HIV and AIDS

Answer 34

HIV is retrovirus transmitted through blood and body fluids; AIDS is end stage infection of HIV; all people who have AIDS have HIV but not all people who have HIV have AIDS

Question 35

How is HIV transmitted?

Answer 35

Unprotected sex, multiple sex partners, occupational exposure, perinatal exposure, blood transfusions, IV drug use with a contaminated needle

Question 36

Rifampin

Answer 36

Antibiotic; can interfere with oral contraceptives, may turn urine and other secretions orange; patient should report yellowing of skin, pain or swelling of joints, loss or appetite or malaise immediately

Question 37

HIV initial infection

Answer 37

Viremia for 2-3 weeks; large viral levels in blood make transmission more likely, followed by prolonged period of low viral load

Question 38

HIV acute infection

Answer 38

Flu-like symptoms (fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and joint pain, diarrhea, or a diffuse rash accompanies seroconversion); occurs 2-4 weeks after infection, lasts 1-2 weeks

Question 39

HIV asymptomatic infection

Answer 39

Fatigue, headache, low-grade fever, night sweats, PGL, and other symptoms; most are unaware of infected status, median interval of 11 years between infection and diagnosis of AIDS

Question 40

HIV symptomatic infection

Answer 40

CD4+ T cells drop to 200 to 500 cells/μL, viral load increases, symptoms seen in earlier phases become worse, other problems develop, HIV advances to a more active state

Question 41

Mean arterial pressure

Answer 41

systolic + 2(diastolic)/3

Question 42

What is direct observation therapy for patients receiving TB treatment?

Answer 42

Watching patient take medication to ensure medication adherence

Question 43

Addison's disease

Answer 43

Adrenocortical insufficiency, caused by damage or dysfunction of the adrenal cortex; primary addison's is caused by idiopathic autoimmune dysfunction, tuberculosis, histoplasmosis, adrenalectomy, cancer; secondary addison's is caused by steroid withdrawal, hypophysectomy, pituitary neoplasm

Question 44

What patient teaching is initiated with induction phase of TB therapy?

Answer 44

Complete treatment for TB; four medication regimen includes isoniazid (nydrazid), rifampin (rifadin), pyrazinamide, and ethambutol hydrochloride (myambutol)

Question 45

Clinical manifestations of Addison's disease

Answer 45

Weight loss, craving for salt, hyperpigmentation, weakness and fatigue, nausea and vomiting, dizziness with orthostatic hypotension, severe hypotension, dehydration, hyponatremia, hyperkalemia, hypoglycemia, hypercalcemia