Primary dietary prescription for calcium

Low calcium diet

nephrolithiasis (kidney stones) ? PG. 85

For client with nephrolithiasis the diet

Acid
should be ___ ash

If kidney stone is calcium phosphate the

Phosphorus
diet must be low in ___ too

Primary diet tx for uric acid nephrolithiasis

Low purine
is __ ____

Client with uric acid nephrolithiasis should

Methionine
have a diet low in ____

What is methionine? Precursor of the amino acid cystine

2 foods high in methionine? Eggs, milk

Clients with cystine nephrolithiasis should

Alkaline
have an ____ ash diet

Inc. fluids over 3000 cc /day is more

True. Want to flush tract than worry about
effective in treating renal calculi than ANY
diet
dietary modification, T/F?

What is the common name for

Croup
Laryngotracheobronchitis - LTB
 What is the typical temp elevation in Low grade, usually below 102, but can go
croup? up to 104.

Are ATBs helpful for croup? For epiglottits? For croup, no. Epiglottitis, yes

Is croup viral or bacterial? Viral

With which condition is croup most often

Epiglottitis
confused?

Can croup be managed at home? Can

Yes. No, epiglottitis is a 911 emergency
epiglottitis be managed at home?

No, bc this would mask the signs of

Are sedatives used for kids with croup?
respiratory distress

What causes epiglottitis? A virus or

H. influenza BACTERIA
bacteria?

What is the best tx for croup? Cool moist air

What should never be done to a child with Never put anything in the child's mouth, ie,
epiglottitis? a tongue blade can lead to obstruction

What are the typical signs and symptoms Barking cough, inspiratory stridor, labored
of croup? resp. pattern
 What 3 signs tell you that the child has
Muffled voice, drooling, increased fever
epiglottitis instead of croup?

When is croup bad enough to be evaluated When retractions, and high pitched stridor
by a doc? are present

What lead level needs intervention? 50-60 micrograms/ dl

With which class of drugs will a child with

Chelating agents
lead poisoning be treated?

They increase the excretion of heavy

What do chelating drugs do?
metals

The most freq. cause of lead poisoning is... Ingestion of lead-based paint chips

Name 3 common chelating agents for lead

EDTA, desferal, BAL in oil
poisoning

Drowsiness, clumsiness, ataxia, seizures,

S&S of lead poisoning
coma, resp. arrest

Sx of lead poisoning show up in the ____

Neuro
system

Leukemia is cancer of the ___ forming

Blood
tissues
The type of cell that is most common and
Immature WBC
problematic in leukemia is ____

Low, bc the bone marrow is going "wild"

In leukemia the RBC count is ... producing all those immature WBC - no
energy or nutrients to make platelets

Low, bc the bone marrow is going "wild"

In leukemia, the platelet count is ... producing all those immature WBC - no
energy or nutrients to make platelets

Bc the RBCs are low, the pt will exhibit ___

Pallor and fatigue
and ___

Bc of the immature WBCs, the pt is at risk

Infection
for ___

Bc of low platelets, the pt is at risk for ___,

Bruising, ecchymosis, bleeding, petechiae
___, and ___

What causes lymph gland enlargement in All those small immature WBC clog the
leukemia? lymph system

Should you take a rectal temp on a child

No
with leukemia?

Yes, as long as they are over 4 years old,

Should you take an oral temp on a child
in remission, and have no sores in their
with leukemia?
mouth

Should the child with active leukemia use

NO straws, NO forks, YES cups
straws, forks, cups?
 RN's priority in tx a child with newly
Dec. risk of infection
diagnosed leukemia is...

When the leukemia child's platelets and

Limited
WBC's are low, his activities should be ...

When the platelet and WBCs are low the

Suppository
nurse should not insert a..

When labs are low IMs avoided and IVs

Are IM injections and IV sticks permitted on
limited; only done when absolutely necessary
a child with leukemia?
(to give chemo or measure blood counts)

To prevent uric acid kidney stones (remember

Why are kids on chemo also on allopurinol when chemo kills cancer cells, purines and uric
acid build up and could cause kidney stones

Why do some kids with leukemia have joint The immature WBCs infiltrate the joint and
pain? cause inflammation

Why is a child with leukemia at risk for The immature WBCs infiltrate the brain and
neuro sx due to ICP cause inflammation

What is alopecia? Hair loss

If the platelet count is low what drug should

Aspirin
the child not take?

No. It will grow back. (Alopecia of radiation

Is the alopecia from chemo permanent? therapy is permanent bc the follicle is
destroyed)
 What does ANC mean? Absolute Neutrophil Count

If ANC <500, then pt will be on protective

What is the ANC used for in leukemia?
isolation

Which is used more commonly to decide if

ANC is more reliable and valid
the pt should be on isolation: WBC or ANC

By the end of the 1st 6 months of life an

Double
infants birthweight should ____

By the end of the first year of life an infants

Triple
birthweight should ___

Ideal food for infants is ___ Breast milk

Breast milk contains substances that

True
increase immunities T/F?

Bottle-fed infants dont bond well with their

False
moms T/F?

The 1 nutrient that commercial formulas

Fe
are typically low in is ___

False. However, it does not contain enough

Breast milk does not contain iron T/F? iron- so they should be fed iron fortified
cereal starting at 6 months
 At what age should the infant be fed
Not before 12 months
cows/goats milk?

They dont get enough calories and dont

What is the major problem with feeding an
grow. Dehydration from excessive solute
infant skim milk?
load and inability to concentrate urine

When should the infant be introduced to

4-6 months
textured solid foods?

What is the first food that an infant should

Iron fortified rice cereal
be introduced to?

When forced to eat, the preschool child

Rebel
will...

Parents of preschool children should be taught that as

long as the child eats ___ good nutritious meal per day, One
they should not make eating food an issue

Refusal to eat is common in preschoolers

True, but still offer a variety
T/F?

Youngsters develop food preferences by.. Observing significant ppl in their environ

School-age kids grow at a slower rate than

True
infants, toddlers, or adolescents T/F?

What dietary strategy is most appropriate Wholesome snacks, bc they are often too
for the industrious school-age child? busy too eat
 Girls in adolescence need more calories
False, boys need more cals
than adolescent boys T/F?

Adolescents should take vitamin

True
supplements T/F? PG. 90

Mastitis and breast engorgement are more

Primipara
likely to occur in...

Where does the organism that causes

The INFANTS nose or mouth
mastitis come from?

Which organism most commonly causes

Staph
mastitis

Prolonged intervals between breast-

Increase
feeding (dec/inc) the incidence of mastitis

Cant too-tight bras lead to mastitis? Yes, by preventing emptying of ducts

Mastitis usually occurs at least ___ days

10
after delivery

When mastitis is present the breasts are

Hard, swollen, warm
___, ____, and ____

Mastitis is accompanied with a fever over

102
___
 Temporary increase in vascular & lymph
If mastitis is caused by an organism , what
supply to the breast in preparation for milk
causes breast engorgement
production

If mastitis occurs 1+ weeks after delivery,

2-5 days after delivery
when does breast engorgement occur?

Does breast engorgement interfere with Yes, the infant has a difficult time latching
nursing? on

What class of drugs is used to treat

ATBs
mastitis?

ATBs are used to treat breast

False
engorgement (T/F)?

Application of (warm H2O compresses/ice

packs) is the preferred tx for breast Ice packs to dec swelling
engorgement

The mother with mastitis should stop False. The mother must keep breast
breast feeding (T/F)? feeding. (Offer unaffected breast first).

If the mother has an open abscess on her

True
breast, she must not breastfeed (T/F)?

For breast engorgement, the non- No, that would increase milk production and would
breastfeeding mother should be told to make the problem worse (warm compresses or a
express milk (T/F) warm shower to let milk "leak" is okay - Ice is best

What is the best tx for breast Breast feeding - it will balance supply and
engorgement? demand
 Inflammation / infection of the mastoid
What is mastoiditis?
process

What is the most common cause of

Chronic otitis media
mastoiditis?

Drainage from ear, high fever, HA, and ear

What are the 4 S&S of mastoiditis?
pain, tenderness over mastoid process

What unusual post-op complication can Facial nerve paralysis d/t accidental
result from mastoidectomy? damage during surgery

What should you do to assess for facial Have the patient smile and wrinkle
nerve paralysis post-mastoidectomy? forehead

What is the medical tx of mastoiditis? Systemic ATBs

What is the surgery for mastoiditis called? Simple or radical mastoidectomy

Will a simple mastoidectomy worsen

No, a radical mastoidectomy may
hearing?

Should the nurse change the post- No, reinforce it. Physician changes first
mastoidectomy dressing? post-op dressing

What is a common side effect of

Dizziness (vertigo)
mastoidectomy?
 What is a major nursing diagnosis post-
Safety
mastoidectomy ? PG 92

An increase in endolymph in the inner ear

Define Menieres diease
causing severe vertigo

What's the famous triad of S&S in Paroxysmal whirling vertigo - sensorineural

Meniere's? hearing loss - tinnitus (ringing in the ears)

Does Meniere's occur more in men or

Women
women?

What should the client do if they have an

Bedrest
attack?

What safety measures should be followed Side rails up x4, ambulate only with
with Meniere's? assistance

What age group in Meniere's highest in? 40-60

What can prevent the attacks of

Avoid sudden movements
Meniere's?

What electrolyte is given to ppl with

Ammonium chloride
Meniere's?

What surgery is done for Meniere's? Labyrinthectomy

 What disease often follows Bell's palsy - facial paralysis, will go away in
labyrinthectomy? a few month

What is the activity order after

Bed rest
labyrinthectomy?

When surgery is preformed for Meniere's,

Hearing is totally lost in surgical ear
what are the consequences?

What should the client avoid after

Sudden movements and increase Na foods
labyrinthectomy?

What type of diet is the client with

Low salt
Meniere's on?

What two classes of drugs are given in

Antihistamines and diuretics (Diamox)
Meniere's?

Meningitis is an inflammation of the ___ of

Linings, brain, cord
the ___ and spinal ___

Meningitis can be caused by ___, ___, and

Viruses, bacteria, and chemicals
____.

The 4 most common organisms that cause Pneumococcus, meningococcus,

meningitis are... streptococcus, H. Influenza

Child with meningitis is most likely to be

Irritable
(lethargic, irritable) at first.
What visual S&S will the pt with meningitis
Photophobia (over-sensitivity to light)
have?

What is the most common musculo-

Stiff neck - nuchal rigidity
skeletal S&S of meningitis?

Will the pt with meningitis have a HA? Yes

Kernig's sign is positive when there is pain

in the ___ when attempting to straighten Knee; hip
the leg with the ___ flexed

What type of vomiting is present in

Projectile
meningitis?

What is the definitive diagnostic test for

Lumbar puncture with culture of CSF
meningitis?

If the pt has meningitis, the CSF shows

___ pressure, ___ WBC, and ____ protein, Inc., inc., inc., dec
___ glucose

On what type of isolation will the patient

Contact and respiratory precaution
with meningitis be?

How long will the patient with meningitis be

Until they have been on an ATB for 48h
on these precautions?

The room of a pt with meningitis should be

Dark and quiet
___ and ___
The client with meningitis can develop ___ Seizures

Arching of back (entire body) from

What is opisthotonos? hyperextension of the neck and ankles, d/t
severe meningeal irritation

If a patient has opisthotonos, in what

Side-lying
position would you place them?

Average duration of menstrual flow is ___.

5 days, 3-6
The normal range is ___ to ___ days.

Average blood loss during menstruation is

50-60 cc.
____ cc

Follicular phase (first 14 days), luteal

Name the two phases of the ovarian cycle
phase (second 14 days)

In the menstrual cycle, day 1 is the day on

Menstrual discharge begins
which...

How long does an ovarian cycle last? 28d

How many days after ovulation does

14 days
menstruation begin?

What hormones are active during the

FSH and Estrogen
follicular phase?
 To develop and maintain the corpus luteum
What is the major function of the luteal
which produces progesterone to maintain
phase of the ovarian cycle?
pregnancy until placenta is est.

If an ovum is fertilized during the luteal

HCG (human chorionic gonadotropin)
phase what hormone will be secreted?

During menstruation, the average daily

0.5 to 1.0 mg
loss of iron is ___ mg.

What occurs during the follicular phase of It accomplishes maturation of the graafian
the ovarian cycle? follicle which results in ovulation

What type of environmental modification is

Dark, quiet, environment
best for a migraine?

The long term tx of migraine focuses Assessing things that bring on stress and
upon... then planning to avoid them

What type of pain is typical of migraines? Throbbing

Are migraines more or less common in

Less
men?

Besides pain, ppl with migraines complain

N&V, and visual disturbances
of what other S&S?

What are the processes occurring in Reflex constriction then dilation of cerebral
migraines? arteries
Where is the pain of migraines most likely
Temporal, supraorbital
located?

Sansert (methsergide), Cafergot

Name a drug given to tx migraine?
(prophylaxis: Imipramine)

Are migraine HAs usually unilateral or

Unilateral
bilateral?

When Inderal is given in migraine

headache, is it used to prevent or treat an To prevent. It does not treat
attack?

MS is a progressive ____ disease of the

Demyelinating
CNS.

Myelin promotes ___, ___ ___ of nerve

Fast, smooth conduction
impulses.

With demyelination the nerve impulses

Slow, uncoordinated
become ___ and ____.

MS affects men more than women (T/F) False, affects women more than men

What age group usually gets MS? 20-40

MS usually occurs in (hot/cool) climates Cool

 What is the 1st sign of MS? Blurred or double vision

MS can lead to urinary incontinence (T/F) True

MS can lead to impotence in males (T/F) True

Patients with MS should be taught to walk

Wide-based
with a ___ -___ gait

Why are Adrenocorticotropic Hormone

To dec. edema in the demyelination
(ACTH) and prednisone given during acute
process
MS?

For acute exacerbations of MS ___ per IV

ACTH (Corticotropin)
is often used

What drug can be given to treat urinary

Urecholine, Bethanocol
retention in MS?

Will the muscles of MS clients be spastic or

Spastic
flaccid

What 3 drugs can be given for muscle

Valium, Baclofen (Lioresal), Dantrium
spasms?

Baclofen causes (constipation/ diarrhea) Constipation

 Diarrhea (Hint: the D's go together,
Dantrium causes (constipation/ diarrhea)
Dantrium and Diarrhea)

Patients with MS should have Increased to dilute urine and reduce

(inc/restricted) fluids incidence of UTI

The diet of a patient with MS should be

Acid
___ -ash

What major sense is affected most in MS Tactile (touch) - they burn themselves
(besides vision)? easily

Both will; but they tend to do better in cool

Which will bring on a MS exacerbation:
weather (summer will always be a bad time
over-heating or chilling?
for MS patients)

In Myasthenia Gravis (MG) there is a

disturbance in transmission of impulses at Neuromuscular junction
the ___ ____.

The #1 sign of MG is ____ ____ ___ Severe muscle weakness

The early signs (difficulty swallowing, visual

What is the unique adj. given to describe
problems) are referred to as BULBAR
the early signs of MG?
signs.

MG affects men more than women (T/F) False, affects women more than men

When women get MG they are usually old

Old
or young?
 What neurotransmitter is problematic in
Acetycholine
MG?

What class of drug is used to tx MG? Anticholinesterases

What ending do anticholinesterases have? -stigmine

Are anticholinesterases sympathetic or

Parasympathetic
parasympathetic?

Anticholinesterases will have Cholinergic (they will mimic the

(sympathetic/cholinergic) side effects parasympathetic nervous system)

What surgery CAN be done for MG? Thymectomy (removal of thymus)

The severe muscle weakness of MG gets

False, it is worse with activity
better with exercises (T/F)

What will the facial appearance of a patient Mask-like with a snarling smile (called a
with MG look like? myasthenic smile)

If a patient has MG, what will be the results The patient will show a dramatic sudden
of the Tensilon Test? increase in muscle strength

Besides the Tensilon Test, what other

diagnostic tests confirm a diagnosis of Electromylogram (EMG)
MG?
 What is the most important thing to
They must be given EXACTLY ON TIME; at
remember about giving Mestinon and other
home, they might need to set an alarm
anticholinesterases?

Do you give anticholinesterases with or With food, about 1/2 hour ac; giving ac
without food? helps strengthen muscles of swallowing

What type of diet should the pt with MG be

Soft
on?

What equipment should be at the bedside Suction apparatus (for meals),

of an MG patient? Tracheostomy/ endotube (for ventilation)

Name the two types of crises that a MG pt Cholinergic (too much Mestinon);
can have Myasthenic (not enough Mestinon)

The #1 danger in Myasthenic and

Respiratory arrest
Cholinergic crisis is ___ ___.

What words will the client use to describe Crushing, heavy, squeezing, radiating to
the pain of an MI? left arm, neck, jaw, shoulder

Either a clot, spasm, or plaque, that blocks the

What is an MI? coronary arteries causing loss of blood supply
to the heart and myocardial cell death

Severe chest pain unrelieved by rest and

What is the #1 S&S of an MI?
nitroglycerine

Males are more likely to get an MI than

True
females (T/F)
 Death d/t MI occurs within ___ hour of
1
symptom onset in 50% of all patients

What pain medication is given for the pain

Morphine, Demerol, Nitroglycerine
of a MI (give three)?

What is the reason for giving post MI To prevent platelets from forming clots in
patients ASA? the coronary arteries

Name a new drug with anti-platelet activity Plavix

The 3 most common complications after MI

Cardiogenic shock, arrhythmia, CHF
are ___, ___, and ____.

Give another name for an MI Heart attack

What will the activity order be for the post-

Bed rest with bedside commode
MI client?

What is the most common arrhythmia after

PVCs
an MI?

What cardiac enzymes indicate an MI? Elevated CPK, LDH, SGOT

What serum protein rises soonest after

Troponin
myocardial cell injury?
 Do people without cell damage have No, troponin is only present when
troponin in their blood? myocardial cells are damaged

How soon after cell damage does troponin As soon as 3 hours (can remain elevated
increase? for 7 days)

When will the client with an MI be allowed

6 weeks after discharge
to engage in sexual activities after an MI?

Will fluid resuscitaion (administering large

No, you must use cardiac drugs (giving IVs
amounts of IV fluid) treat cardiogenic
and blood will not help this kind of shock)
shock?

Will the client with an MI be nauseated?...

Yes, Yes
diaphoretic?

What will the extremities of the client with

Cold, clammy
an MI feel like?

What is the permanent EKG change seen

ST wave changes
post MI?

Of CPK and LDH which rises earliest? CPK

What drug will be used to treat PVCs of

Lidocaine
MI?

Will the client with an MI need 100% O2 for No, just moderate flow (42% or 3-6L for
their entire stay in the hospital? first 48h)
 Vegetables highest in Na are ___ Canned veggies

The fruit food that is highest in Na is ____ Tomato sauce

As a rule, fresh meats are ____ in Na Low

As a rule, canned meats are ___ in Na Very high

As a rule, smoked foods are ___ in Na Very high

As a rule, fruits are ___ in Na Low

As a rule, vegetables are ___ in Na Low

As a rule, which are higher in sodium...

Vegetables
vegetables or fruit?

As a rule, which are higher in sugars..

Fruits
vegetables or fruits?

As a rule, breads/cereals are ___ in Na Moderately high

 As a rule, processed meats and cheeses
Very high
are ___ in Na

Margarine is much lower in Na than butter False, it is the same

Salt substitutes contain Potassium (T/F) True, so beware

An NG tube is inserted into the ____ via

Stomach, nares
the ____.

You can feed a client through a NG tube

True
(T/F)

When an NG tube is being used for The stomach is being emptied of its
decompression what is happening? contents by suction

NG tubes are used to pump the stomach of

True
drug overdose clients (T/F)

What does gavage mean? Feed a client with a tube

To continuously irrigate the stomach via

What does lavage mean?
NG tube

When an NG tube is used to stop gastric

Iced tap water
hemorrhage, it is irrigated with ____
How long do you irrigate an NG with iced Until the irrigating solution comes back out
tap water when the stomach is bleeding? clear

What is the maximum suction level used to

25 mmHg
decompress the GI tract via a NG?

Why are salem sump tubes best suited for Because they have vents that prevent
safe gastric suctioning? damage to the gastric mucosa

When a NG tube is in for a long time it

2-3
must be replaced every ___ to ___ weeks

People with a NG tube will breathe through

Mouth (mouth care is important)
their ___

To aspirate gastric contents; auscultating

The best way that the nurse can check if
the gastric air bubble is the second best
the NG is in the stomach is...
way

Before you put anything down the NG you You must check the see if the NG
must do what? placement is in the stomach

Sitting up with head slightly extended until the tube

In what position should the client be when
reaches the back of the throat then have them
a NG is being inserted? mildly flex the neck to push the tube in all the way

How do you determine how far to put an Measure from the tip of the nose to the
NG tube in? back of the ear then to the xiphoid process

In what position should the client be during HOB must be elevated 30 degrees (semi-
a continuous NG tube feeding? fowler's would be acceptable)
 No, it is not a specific disease, it is a group
Is nephrotic syndrome a disease?
of S&S that can result from many diseases

No, there is no hematuria in the -oses, but

Is there any hematuria in nephrosis?
there is hematuria in the -itis's

What are the dietary modifications for

High carbs, moderate proteins, low sodium
nephrosis ?

What is #1 nursing dx in nephrosis? Alteration in fluid volume, excess

What are the 2 pathophysiologic processes

Glomerular inflammation, loss of protein
in nephrotic syndrome?

What S&S are MOST common in

Generalized severe edema
nephrosis?

What 2 classes of drugs are given for

Steroids, diuretics
nephrosis?

It is occasionally done, but not nearly as common

Is bed rest common in treating nephrosis? as in acute glomerulo-nephritis, it is usually is most
appropriate when edema is severe

Hypertensive: remember in acute

In nephrotic syndrome, the BP will be most
glomerulonephritis, the BP is hypertensive
likely (hypotensive / hypertensive)
as well

In nephrotic syndrome, the urine is

Frothy. Remember in AGN, it is tea-colored
(frothy/very dark or tea-colored)?
Is scrotal edema common in nephrosis? Yes

Elevate the scrotum on a scrotal sling and

What is done for scrotal edema? PG. 110
apply ice

Name the 3 sub-scales in the Glasgow Best eye opening (E), Best verbal response
coma scale (GCS) (V), and best motor response (M)

Whats max score on GCS? 15

What is the minimum score on the GCS? 3

A score equal to or below ____ on the

7
GCS is considered coma

Pupillary reaction test cranial nerve ___ #3

A respiratory pattern in which there is

alternation between apnea and Cheyenne-Stokes
hyperventilation is known as..

A value of 20/80 on visual acuity means

that the patient can see at ___ feet what 20, 80
normal people see at ___ feet

Babiniski's reflex is tested by stroking the

Bottom lateral surface of the foot
___
 False, non-walking infants normally have a positive
It is always pathologic if a Babinski is
Babinski, walking infants, toddlers, and all other people
negative (T/F) should normally have a negative Babinski

When a Babinski is positive the ___ ___

Great toe dorsiflexes, toes
___ flexes and the other ___ fan out

In decorticate posturing, the legs are ____

and the neck and arms are ___ and ___ extended, flexed, internally
rotated

In decerebrate posturing, the legs are ___

Extended, extended (pronated)
and the arms, neck and back are ____

A score of 4 for a reflex means that it is

Hyperactive
____

Cerebellar function is evaluated by testing Posture, gait, balance, coordination (ie

for ____, ____, ____, ____ Pg. 110 Romberg's sign)

A threat or an attempt to make bodily

Assault contact with another person without that
person's consent

Battery An assault that is carried out

Law resulting from court division that is

Common law then followed when other cases involving
similar circumstances arise

An act of negligence- commonly used when speaking of

Malpractice negligent acts committed by a person working in a
certain profession, such as medicine or nursing
 A system that defines actions with respect
Ethics
to their being judged right or wrong

Unjustifiable restraint or prevention of the

False imprisonment movement of a person without proper
consent

Misdemeanor A wrong of less seriousness than a felony

Law that gives certain persons legal

Good Samaritan Law protection when giving aid to someone in
an emergency

Felony A wrong of serious nature

Performing an act that a reasonable and comparable

person under similar circumstances would not do, or failing
Negligence to perform an act that a reasonable and comparable
person under similar circumstances would do

A wrongful act that violates the right of a

Invasion of privacy
person to be let alone

Being accountable, responsible, or

Liable
answerable for an act

A written untruthful statement about a

Libel person that subjects him/her to ridicule or
contempt

A spoken untruthful statement about a

Slander person that subjects him/him to ridicule or
contempt
 If the client perceives that the nurse
How could a nurse be convicted of
intends to do a procedure without consent
assault?
or justification

If the nurse willfully touched a client in any

How could a nurse be convicted of battery?
manner that is wrong in some way

Clients have a right to refuse nursing

True
interventions (T/F)

If a nurse uses restraints to keep a client, who is a False, you can detain/restrain a person
danger to himself, in bed, the nurse is likely to be against their will if they are: 1) a threat to
convicted of false imprisonment (T/F) self; 2) a threat to others

In order to legally sign as a witness to informed consent, False. You are only witnessing that the
the nurse must have been present when the physician patient was the one who signed the
and client discussed the procedure (T/F) consent

It is NOT necessary for the nurse to determine

if the client understands what the physician is True. You are only witnessing a signature
said in order to witness an informed consent

Can a patient legally sign an informed No. The patient would be considered to be
consent after they have received the under the influence of a mind-altering drug.
premedication analgesic for a procedure? The consent would be invalid

Name 3 groups of ppl who cannot give Minor, unconscious client (even under
legal consent influence of CNS drugs), mentally ill

In an emergency situation, when client and

family cannot give consent, consent is True
assumed and tx proceeds (T/F)

False- no definitive policy in the courts

The legality of no code or slow code orders
exists at this time- dealt with on a case-by-
is well-est. in the courts
case basis
 Anxiety-producing thoughts are called
Obsessions
____

Compulsions - such as washing hands over

Repetitive actions designed to reduce
and over, dusting furniture 3 hour per day,
anxiety are called _____
refusing to turn your back to anyone

Which defense mechanism is most closely

Displacement
associated with OCD

Should you allow an OCD person to Yes, give them time to do their ritual and
perform their compulsive behavior? try to set a limit and redirect

Should you ever make an OCD person

No, they will become very anxious
stop their compulsive behavior?

Is the patient with OCD neurotic or

Neurotic- they know reality
psychotic?

No, just say things like "You washed your

Should you confront the OCD patient with
hands for so long you must have been very
the absurdity of their behavior?
anxious."

What should you do if an obsessive- Get them started earlier - for ex. if they wash their hands
complusive person is always late due to for 1/2 hour before meals and are always late for
their rituals? breakfast, just get them started 1/2 hour earlier

What are the two typer of oral Progestin only & combination progesterone
contraceptives? and estrogen

How many days of the menstrual cycle do

All 28 days
you take the progestin only pill?
How many days of the menstrual cycle do You take it on days 5-24, but not on days
you take the combo pill? 24-28 and 1-4 (8 days off)

How log before surgery must you d/c PO

One week before surgery
contraceptives

If a woman forgets to take the pill one day, Take it as soon as she remembers it, and
what should she do? take next pill at regular time.

What if a woman forgets to take the pill for Take 2 pills a day for 2 days in a row and
two days in a row? What should she do? then resume normal schedule

Throw away pack & start new pack same

What should a woman do if she forgets to
day. Use back-up contraceptive method for
take her pill for 3 days or more?
7 days

If a woman doesn't stop oral

contraceptives one week before surgery Thrombophlebitis
she is at risk for developing ___

15, bc if you smoke you have constriction of vessels

People who smoke more than ___ cigs per
and this potentates the chances that a woman on oral
day should not be on an oral contraceptive contraceptives will get thrombophlebitis

If a woman on oral contraceptives misses a Yes, however, if 2 missed periods occur,

period, should she still take pills? stop and have a pregnancy test.

Will breakthrough bleeding, N&V, and

breast tenderness go away when a woman Yes, after about 3-6 months of tx
is on oral contraceptives?

Osteoarthritis is a ____ disease of the ___ Degenerative, joint

Osteoarthritis is most commonly caused by
True
the wear and tear of life (T/F)

The most common symptom of

Joint pain
osteoarthritis is ____ _____

What 2 joints are most commonly affected

Knee and hip
in osteoarthritis?

To control the pain of osteoarthritis one

Heat
should use heat or cold?

What 3 meds are used in osteoarthritis? Aspirin, NSAIDs, steroids

What do you observe on the fingers of the

Heberden's nodes
client with osteoarthritis?

Not in the beginning, can be later as

Are Heberden's nodes painful?
swelling occurs

Are rest periods and ROM exercises Yes, rest is probably the most effective
appropriate in the care of osteoarthritis? thing they can do.

The pain of osteoarthritis is usually better

Better with rest, worse with activity
or worse with rest? With activity?

What age group gets osteoarthritis? 60-80 years old

Osteoarthritis is more common in females
False, it occurs in equal frequency
(T/F)

For cervical osteoarthritis the client should

A cervical collar
wear..

What is arthroplasty? Joint replacement

What is arthrodesis? Joint fusion

Overgrowth of the spongy bone in the

What is otosclerosis? middle ear that doesn't allow the bones of
the middle ear to vibrate

What will the client with otosclerosis

Buzzing or ringing in the ears (tinnitus)
complain of besides hearing loss?

Do ppl have a loss of hearing with

Yes
otosclerosis?

What is a corrective surgery for Stapedectomy - removing the stapes bone

otosclerosis called? and replacing it with a micro prosthesis

Should side rails be up after

Yes, client may feel dizzy
stapedectomy?

What should the client avoid post- Coughing, sneezing, blowing nose,
stapedectomy? swimming, showers, flying
 What warning should you give the client
Get up slowly
about getting up after stapedectomy?

What should the client expect regarding An initial decrease with the benefits of
hearing post-stapedectomy? surgery noticeable in 6 weeks

What should the client do if he must Open his mouth, this de-pressurizes the
sneeze? middle ear

What type of hearing loss is associated

Conductive
with otosclerosis?

Which sex has a higher incidence of

Women
otosclerosis?

Do hearing aids help hearing in

Yes
otosclerosis?

What will be the results of the Rinne test in Bone conduction will be better than air
otosclerosis? conduction

Is stapedectomy done under general or

Local
local anesthesia?

If the client complains of dec. hearing after It is normal d/t edema. The hearing will
stapedectomy what would you say? start to improve within 6 weeks

Depends on MD: operative side promotes drainage, un-

Which side will the client be allowed to lie
operative side prevents graft dislodgment. Dont make a
upon post-stapedectomy big deal of position post-op
 What 2 drugs are commonly given post- Codeine/Demerol for pain, Dramamine for
stapedectomy dizziness

Cysts on the ovaries are usually malignant

False, usually benign
(T/F)?

What is the #1 reasons why MD's remove Remove before they transform into
ovarian cysts? malignant

Do small ovarian cysts cause S&S? No, only large ones

Low back pain, pelvic pain, abnormal

Common signs of large ovarian cysts are..
bleeding

What does torsion of an ovarian cyst Twisting of cyst with interruption of its blood
mean? supply

What is the big danger from torsion? Necrosis and rupture of ovary

What other disorders resemble rupture of Appendicitis, rupture of a fallopian tube

ovarian cysts? pregnancy

What affect do oral contraceptives have on They cause it to stop growing and
ovarian cysts? decrease in size

What are the 3 most common signs of

Pain, abd distention, abd rigidity
ovarian cyst rupture?
 Compare signs of non-ruptured ovarian Non-ruptured= low back pain, dull pelvic pain, abnormal
uterine bleeding esp. with mensturation
cysts with the signs of a ruptured ovarian
cyst Ruptured: acute pain, abd distention, and abd rigidity

After surgery to remove an ovarian cyst the

woman can return to normal activities 4-6 weeks
between ___ to ___ weeks

How soon after removal of an ovarian cyst

4-6 weeks
can a woman resume sexual intercourse?

No, it is not good to douche on a regular

Should a woman douche after surgery to
basis, it destroys the natural protective
remove an ovarian cyst?
vaginal flora

When the fetal head descends into the

What does lightening mean?
pelvis

When does it occur in pregnancy? 2-3 weeks before birth for primipara

What is the most common positive effect of After it occurs the woman can breathe
lightening? much easier

Name the 2 earliest signs that a woman is Low back pain and show (blood-tinged
likely in labor mucous plug has passed)

The onset of regular contractions that

What is the most RELIABLE or VALID
result in progressive dilatation/effacement
indication that a woman is in labor?
of the cervix

What are the 2 processes that occur to the

Effacement and dilation
cervix during labor?
 What is the meaning of cervical
The cervix thins
effacement?

Into how many stages is labor and delivery

4
divided?

What is accomplished during the first stage

Full effacement and dilation
of L&D?

How long is the first stage of labor and

delivery for a primagravida? For a 12 hours, 6 hours
multigravida?

The cervix is fully dilated when it is ___ cm 10

The 2nd stage of L&B accomplishes.. Delivery of infant

The 2nd stage of L&D begins with ___ and

Full dilation, delivery, infant
ends with ___ of the ___

The 2nd stage of labor and delivery lasts

___ hours for a primagravida and ___ 1.5, .5
hours for a multigravida

The 3rd stage of L&D accomplishes... Expulsion of the placenta

The 3rd stage of the L&D lasts... Less than one hour
What occurs during the 4th stage of L&D? Recovery

When does 4th stage of L&D end? 2 hours after expulsion of the placenta

What is the average blood loss during

500 cc
labor?

If the statement refers to PHASES of labor, it means the

When the terminology "the 3 phases of
3-step process of latency, followed by active and
labor" is used, what does it mean? transitional. (LAT order - just as its spelled in LATency)

Normal length of pregnancy is ____ to

240, 300
____ days

Pregnancy is divided into ____ trimesters 3

During the 1st trimester the woman

experiences decreased or increased Increased
vaginal secretions?

When are urine pregnancy tests positive? At the time of the first missed period

Pregnancy tests test for the presence of HCG (human chorionic gonadotropin
what hormone? hormone)

Urine and blood pregnancy tests are

enough evidence to be certain of False, these tests only suggest pregnancy
pregnancy (T/F)?
 What is Hegar's sign? Uterine softening

What is Chadwick's sign? Blue-tint to the cervix

The first trimester goes from week ___ to

1 - 13
week __

The second trimester goes from week ___

14-27
to week ___

Which week can mother first feel the fetus 16th-20th week, (the end of the 4th month
move? into the 5th month)

What is the word used to ID the feeling that

the mother experiences when the fetus Quickening
moves?

The 3rd trimester goes from week ___ to

28 - 40
week ___

In which trimester does the women most

Third
feel backache?

Which trimester is the fetus most

First
susceptible to effects of outside agents?

What is the name of the process in which

outside agents cause birth defects in the Teratogenesis
fetus?
 Which trimester is N&V most common? First

Which trimester do Braxton-Hicks

Third
contractions begin?

Usually painless contractions that

What are Braxton-Hicks?
strengthen the uterus for labor

Which trimester does quickening occur? 2nd

Which trimester does venous congestion in

Third
the legs occur?

Which trimester does linea nigra appear? Second

What is linea nigra? Single dark vertical line on the abdomen

Which trimester do striations occur? Second

What are striations? Horizontal pigmented lines on abd

Mask of pregnancy- pigmented area on

What is chloasma?
face
 Which trimester is constipation most
Third
common?

In addition to the nares, where else should

the nurse assess for skin irritation when Behind and on top of the ears
nasal cannulae are in use?

What are two signs of hypoxia? Restlessness and tachycardia

What is the highest flow rate appropriate

6 L/min
for nasal cannulae?

How often should the nares of a client with

O2 by nasal cannulae be assessed for skin Q 6-8 hours
breakdown?

What is the maximal O2 flow rate for the

2 L/min
client with COPD?

What are the signs of O2 toxicity? Confusion, HA

What can happen if the client with COPD is

They may stop breathing
given a high flow rate of O2

What is the problem with giving high flow

Dries the mucous membranes
rates of O2 by nasal cannulae?

No, the O2 delivery device must be

Can a client smoke in the room when the
removed from the wall or the tank out of
O2 is turned off?
the room before a client can smoke
 When O2 is administered, it must be ... Humidified

Masks deliver higher or lower

Higher
concentrations of O2 than nasal cannulae?

How often should the nurse check the flow

At least once per shift
rate of the O2?

False, it does not explode- it supports

O2 is an explosive (T/F)?
combustion

What structures in the brain are most

Basal ganglia
affected in Parkinson's

The neurotransmitter imbalance that

causes Parkinson's is a ___ in _____ Decrease, dopamine activity
______

What drugs can cause a Parkinson-like Haldol, major tranquilizers - drugs that end
syndrome? in "-azine"

What is the classic motor manifestation of

Pill-rolling and tremors
Parkinson's?

Cogwheel - Cogwheel' rigidity is a combination of

What type of rigidity is typical of leadpipe rigidity and tremor which presents as a jerky
Parkinson's? resistance to passive movement as muscles tense and
relax

Parkinson's patients move fast or slow? Slow

 What type of gait is seen in Parkinson's? Shuffling slow gait

Patients with Parkinson's have ___ speech Monotone

Patients with Parkinon's tend to have

Constipation
constipation or diarrhea?

Levodopa, Sinement, Symmetrol,

Name 4 drugs used to treat Parkinson's
Cogentin, Artane, Parlodel

In what type of chair should Parkinson's

Firm, hard-backed
patients sit?

What time of day can be particularly

Mealtime, d/t choking
dangerous for the Parkinson's patient?

When a patient is taking Levodopa he

should have assistance getting out of bed Of orthostatic hypotension
because...

What vitamin should patients on Levodopa B6, pyridoxine - Vitamin B6 reduces the
avoid? effectiveness of levodopa

Levodopa should be given with or without

With food
food?

What might Levodopa do to patients urine? Make it very dark

The tremors of Parkinson's will get better
Better, they tremor more when not
or worse when they purposefully move or
performing an action
perform a task?

The client on a PCA pump is less likely to True, b/c the comfortable pt moves around more
have post-op complications than the client and is less likely to get thrombophlebitis,
w/o a PCA pump (T/F)? pulmonary embolus, fatigue, ileus and pneumonia

Clients with COPD are not good candidates True, d/t the effects of narcotics on central
for PCA pumps (T/F)? respiratory control

Name the 3 most common uses of PCA Post-op pain, cancer pain, sickle-cell crisis
techniques pain

PCA pumps allow a more constant level of

serum drug than conventional analgesia True
(T/F)?

A major disadvantage of PCA pump is that

False. It is not possible for a client to OD
the client can take too much medication
d/t the lock-out feature
(T/F)?

Clients on PCA pumps use more

medication than those receiving IM False, they use less
injections (T/F)

A disadvantage of PCA pumps is that the

False, PCA clients ambulate earlier and
client does not ambulate as early d/t the
they pull their machine with them
machine (T/F)

False, the whole cartridge system must be

When d/c a PCA infusion it is acceptable to
returned to the pharmacy d/t federal
discard the drug cartridge (T/F)
narcotic control laws

Comfort range of relative humidity is... 30-60%

 Which patients should be forbidden to Those with oxygen in the room, confused,
smoke? Smoke alone? sleepy, drugged patients

Avoid bruising the skin, cutting off

When applying restraints remember to...
circulation, and accidental entangling

Use drapes and screens during care in

List ways to ensure privacy...
semi-private rooms

Plastic pillow cases are _____

Hot and slippery
(disadvantage)

When using restraints with clients who

False imprisonment
object, dont forget about ____ ______

Individuals who are ill are ____ sensitive to

More
noise than individuals who are well

When you are not at the bedside the bed

In the lowest position
should always be...

Can nurses be held liable for an accident

resulting from a client not being told how to Yes
use the call light?

Circulation of micro-organisms on air

Dangers associated with drafts are...
currents

The first thing a nurse should do when a

Explain why they are being used
client objects to side rails is...
 The comfort range of temperature is ... 68-74

Is having the client verbally ID himself

No, only ID bands are acceptable
considered adequate for safety?

Bed side rails should be up for the Elderly clients, unconscious, babies, young
following individuals... children, restless, confused

The S&S of sensory overload and sensory Fear, panic, depression, inability to
deprivation are... concentrate, restlessness, agitation

If a family member asks to have the side Remember that you are responsible for the
rails down while they are in the room you client's safety - not his family, it might be
should... unwise to permit this

Pillows are sterilized between uses (T/F) False

What is the common name for pediculosis? Lice

What is a common finding with pediculosis

Reddish-brown dust in the underwear
pubis?

What common household solution is used Vinegar. Nits are the eggs of lice that
to remove nits? adhere to the hair shaft

What shampoo is used for lice? Kwell

 Where are head lice most commonly At the back of the head and behind the
found? ears

On what do lice feed? Blood

After tx how long do you have to inspect for Inspect for 2 weeks to be sure that they are
lice? all gone

What is the most common symptom of

Itching
lice?

What is the most dangerous toxicity of

CNS toxicity
Kwell?

What is the typical of the lesions of Foul-smelling, blisters break easily, seen in
pemphigus the elderly, cause is unknown

What is the characteristic lesion of

Large vesicular bullae
pemphigus?

What are bullae? Large blisters

What chemical is added to the bath water

Potassium permanganate
of a client with pemphigus?

What precaution must be taken with Be careful that no undissolved crystals

potassium permanganate? touch the client; it will burn the skin
What is the typical skin care of pemphigus?
What unusual nursing dx is high priority in
pemphigus?
What are the top 3 nursing interventions in
pemphigus?
What kinds of fluids will clients with
pemphigus drink best?
What drugs are most commonly used?
Should steroids be given with meals?
What is the #1 cause of death of
pemphigus?
Define pemphigus
Define peritoneal dialysis
When PD is being used the client must be
on heparin (T/F)
Cool, wet dressings
Alteration in F&E balances - Because you may have lost bodily
fluids due to oozing of the sores, you may receive fluids through a
vein (intravenously), as well as electrolytes — minerals such as
sodium, potassium and calcium that maintain the balance of fluids
in your body — and protei
Oral care, protection from infection,
encouraging high fluid intake
Cold fluids
Steroids
Always
Overwhelming infection
An acute or chronic disease of adults, characterized by occurrence of successive crops of bullae that
appear suddenly on apparently normal skin and disappear, leaving pigmented spots. It may be attended by
itching and burning and constitutional disturbance. The disease if untreated is usually fatal. A characteristic
finding is a positive Nikolsky sign: When pressure is applied tangential to the surface of affected skin, the
outer layer of epidermis will detach from the lower layer (probably autoimmune)
The removal of wastes, electrolytes and
fluids from the body using the peritoneum
as a dialyzing membrane
False, you don't need to be heparinized for
peritoneal, but you do need to be
heparinized for hemodialysis
How long does one episode /course of PD
Could be 10 hours
last?

With PD there is a high/low risk of

peritonitis? High
PG 125

When fluid accumulates in the abd during

Dyspnea- SOB or difficulty breathing, d/t
PD what problem does the client
the inability of the diaphragm to descend
experience first?

What nutrient is lost in highest amounts

Protein
during PD?

Can a client who had recent bowel surgery

No
get PD?

Should a client who is having breathing

No
problems receive PD?

What body surface must be punctured to

The abd
administer PD?

The solution introduced into the

Dialysate
peritoneum during PD is called...

Before allowing the dialysate to flow into

the peritoneal cavity it must be ___ to ____ Warmed, body
temperature

Before PD it is important the client be... Weighed, to assess water loss or gain
 What force is used to introduce the
Gravity only, no pumps
dialysate into the peritoneum

How fast does the dialysate usually flow

In 10 minutes
into the peritoneum?

How long is the dialysate allowed to remain

15-30 minutes
in the peritoneum before it is drained out?

10 minutes (10 minutes flow in, 30 minutes

How long does it usually take for the
in abd cavity, 10 minutes out = total of 50
dialysate to drain out of the perineum?
minutes)

If the dialysate does not drain out well, you

Have them turn side to side
would first...

What color is the dialysate when it comes

Straw colored- clear
out?

Should you raise the HOB to increase

Yes
drainage of the dialysate?

How often do you measure vital signs Q15min during the first cycle and qhour
during PD? thereafter

Can a client on PD: Sit in a chair? Eat?

Yes to all
Urinate? Defecate?

If too much fluid is removed during PD, the

Decreased BP (hypotension)
client will experience...
 If the client absorbs too much of the
Increased BP (circulatory overload)
dialysate the client will experience...

If the client complains of dyspnea during

Slow the flow, elevate HOB
PD you would first ___, then ____

Cloudy drainage in the dialysate most

Peritonitis, (Not good, call MD)
commonly means...

What would you do if you noticed a small

Nothing, this is normal; the blood is due to
amount of blood come out in the first few
the initial puncture of the abd
bottles that were infused?

What precautions are important in the care

Safety, bc they get dizzy
of the client receiving PD?

Is it I&O important to record during PD? Yes

How high should the diasylate bag be

Shoulder height
when its being infused?

What factor do clients with pernicious

Intrinsic factor. It has no other name
anemia lack?

What vitamin is not absorbed in a patient

Vit B-12
with pernicious anemia?

What is another name for Vitamin B-12 Extrinsic factor

 Why isn't Vitamin B-12 (extrinsic factor)
Bc these patients lack intrinsic factor
absorbed in pernicious anemia?

What happens when patients with

Their RBC's do not mature and they
pernicious anemia don't absorb Vitamin B-
become seriously anemic
12?

What other disease can be confused with

Angina pectoris
pernicious anemia?

Beefy red tongue, numbness, and tingling

What are some classic and unique signs of
of the hands, sores in the mouth, chest
pernicious anemia?
pain

What is the medical treatment for

IM injections of Vitamin B-12
pernicious anemia?

How long must the client receive this

For the rest of their life
medical treatment?

Can we cure pernicious anemia? No, just treat the symptoms

What unique urine test is done to diagnose

The Schilling test
pernicious anemia?

Is it okay to give B-12 orally to a client with No, it will never be absorbed d/t a lack of
pernicious anemia? intrinsic factor

The Romberg test (a test for balance); in normal people

What neurologic test do they do for this this test is negative, in the client with pernicious anemia
anemia? this test becomes positive (A loss of balance is
interpreted as a positive Romberg's test)
 When the child realizes that number, weight,
What is conservation? In what stage does
volume remain the same even when outward
it develop?
appearances change; Concrete Operational

What is the age range of formal operation

12-15
thinking?

What is the sensori-motor stage of It is the intellectual stage of children from

intellectual development? birth to 2 years

What is the age range of concrete

7-11
operational thinking?

What is the age range of pre-operational

3-6
thinking?

What is the classic pattern in formal

Abstract reasoning
operational thinking?

The child views everything from his frame

What is egocentricity? In what stage is it
of reference, common in pre-operational
found?
thinking

In Placenta Previa the placenta is

implanted ___ than it should be and lays Lower, cervical os
over the ____ ____.

What is the classic symptom of Placenta Painless 3rd trimester bleeding (hint:
Previa? Painless Placenta Previa)

In whom is Placenta Previa most likely to

Multigravida's
occur? Prima or multi
What is meant when the physician/nurse use Total or complete: placenta covers whole cervical opening

the terms total (complete) or partial Partial or incomplete: placenta covers only part of the
(incomplete) in reference to placenta previa? cervical opening

What are 3 complications of placenta

Shock, maternal death, fetal death
previa?

What is the best and safest way to confirm

Ultrasound
placenta previa?

Should a woman with placenta previa be

Yes, always if bleeding
hospitalized?

If a surgeon delays doing a C-section for Immaturity of the fetus (they will want the
placenta previa it is d/t: (reason for delay) child to mature)

As soon as placenta previa is diagnosed,

most pregnancies will be terminated via C- True
section if the fetus is mature (T/F)

If a woman is admitted with active bleeding

with Placenta Previa you should monitor Continuously via fetal monitor
fetal heart tones ____

It is not necessary to use electronic fetal

monitoring when there is active bleeding in False, infant must always be monitored
Placenta Previa (T/F)?

Will a woman with active bleeding in

Placenta Previa be given any systemic pain No, they don't want to suppress the fetus
relief during labor?

If you were told to start the IV on the

18 gauge, or any other one large enough
woman admitted for Placenta Previa, what
to administer blood
gauge need would you use?
Pneumonia is an ____ in the ____ __ ____ Infection, alveoli of lungs

Respiratory alkalosis, bc the

Which blood gas disorder is most common
hyperventilation blows off more CO2, than
in pneumonia?
the consolidation traps in the blood

A blood disease in which there is an

What is polycythemia vera increase in erythrocytes, leukocytes, and
platelets

What is the typical complexion of a client

Ruddy red, almost purple
with polycythemia vera?

What procedure is done to relieve S&S in

Phlebotomy
polycythemia vera?

Drain off 200-500 cc of blood from body

What is phlebotomy?
(opposite of transfusion)

What type of diet will ppl with polycythemia

Low iron
vera be on?

What are the 3 signs of this disease? HA, weakness, itching

Is hemoglobin inc. or dec. in this disease? Increased

What oral problem will people with

Bleeding mucous membranes
polycythemia vera have?
 What organ will be enlarged in The spleen, bc it is destroying the
polycythemia vera? excessive RBCs

D/t enlarged destruction of RBCs seen in Uric acid levels will be high (remember- uric acid levels
polycythemia vera what blood level will be are always high when cells are being destroyed as in
increased? hemolysis, chemotherapy or radiation therapy)

What drug is most commonly used in Myleran (this is usually used for bone
polycythemia vera? marrow cancer)

How often should the client cough and

q2h
deep breath post-op

How often should the post-op patient turn? q2h

How often should the pt use the incentive

Q1-2H
spirometer?

How often should the nurse auscultate the

Q4h
lung sounds post-op?

How often should the bedridden post-op

Q2h
patient do leg exercises?

The post-op pt should void by ___ hours

6-8
post-op or you must call the MD

Will the typical post-op client have lung Lung-yes; bowel sounds- no; Low grade
sounds? Bowel sounds? Increased temp? temp- yes
Unless contraindicated the pt should be out
24h
of bed no later than ___ hours post-op

DVT is most common in what kinda

Low abd or pelvic
surgery?

The most common complication of DVT is

Pulmonary embolism
____ ______

The best way to prevent thrombophlebitis False, ambulation /exercise are the best
is TED hose (T/F) way

Paralysis of the bowel d/t surgery

What is a paralytic ileus?
(common- especially in abd surgery)

If a post-op pt complains of gas and

Assess then ambulate
cramping you should first ____ then ____

2nd or 3rd, never before that (remember

The onset of post-op infection is on the
elevated temperatures earlier than the 2nd
___ or ____ day post-op day
post-op is NOT an infection)

Define dehiscence Separation of the incisional edges

Protrusion of abd contents through a

Define evisceration
dehiscence

Dec HOB (but not flat; can steri strip, then

What do you do for dehiscence?
call MD
 Dec HOB (but not flat); cover with sterile
What do you do, in order, for evisceration? gauze moistened with sterile saline, call
MD

Pregnancy (dec/inc) the body's insulin

Increases
requirements

Can pregnancy convert a non-diabetic

Yes
woman into a diabetic?

What name is given to diabetes that is

Gestational diabetes
brought on by pregnancy?

Diabetes with pregnancy is (more/less)

More
common as the woman ages

What is the #1 cause of infant illnesses

Hypoglycemia
when the mother has diabetes?

When is infant hypoglycemia most likely to

In the hours immediately following delivery
occur during L&D?

Hormones of pregnancy work against

True
insulin (T/F)

A sign of gestational diabetes is excessive

Weight gain
weight (loss/gain)

(Obese/ very thin) women are most likely

Obese
to become diabetic during pregnancy
 In gestational diabetes the client
Increase (polydipsia)
experiences a (dec/inc) in thirst

In gestational diabetes the client

Increase (polyuria)
experiences a (dec/inc) in urine output

Gestational diabetes is ass w/

Htn
(htn/hypotension)

Gestational diabetes is ass w/ what OB Prev. large baby (over 9lb.), unexplained
history? stillbirth, miscarriage, congenital anomalies

Women who have gestational diabetes

Large for gestational age
tend to deliver infants who are (small/large)

Gestational diabetics tend to get ____

Monilial (yeast) infections
infections

3 hr glucose tolerance test A blood sample will be collected when you arrive. This is your fasting blood
glucose value. It provides a baseline for comparing other glucose values.
What test confirms the diagnoses of You will be asked to drink a sweet liquid containing a measured amount of glucose. It is best to drink the
liquid quickly. For the standard glucose tolerance test, you will drink 75 grams or 100 grams.

gestational diabetes? Blood samples will be collected at timed intervals of 1, 2, and sometimes 3 hours after you drink the
glucose. Blood samples may also be taken as soon as 30 minutes to more than 3 hours after you drink the
glucose.

What are the 2 main tx methods in

Diet, insulin
gestational diabetes?

How often should a woman visit the doctor Twice a month, then once per week in the
prenatally if diabetes is present? 3rd trimester

How many lbs/week is the diabetic allowed

1 lb a week (same as non-diabetic)
to gain the 2nd and 3rd trimesters?
 Is severe carbs restriction required in
No, it could lead to ketosis
gestational diabetes?

Of protein, fat, and carbs, which ones

(percent wise) inc in the diet of gestational Protein, fat
diabetes?

When is insulin used in tx of gestational When dietary control does not keep the
diabetes? blood sugar within normal limits

If insulin is used, the dose is the same in all

False, it varies
3 trimesters (T/F)

Oral hypoglycemics should never be used

True, they cause birth defects (teratogenic)
during pregnancy (T/F)

When should a diabetic be delivered? Btwn 37-39 weeks

What IV solution is used during labor for

D5W
the diabetic

The mothers insulin requirements will

Fall
(fall/rise) markedly after delivery

During pregnancy what complication is

Ketosis
most dangerous for the fetus of a diabetic?

If ketosis is a big problem for the baby

during pregnancy what is the big problem Hypoglycemia
after delivery?
 Why is hypoglycemia such a dangerous
Brain cells die w/t glucose, brain damage
problem?

(Multi/prima) gravida clients are most likely

Primagravida
to get PIH

Which age group(s) are most likely to

Pts under 18 or over 35
experience PIH?

When does pre-eclampsia usually begin in

After 20 weeks
pregnancy (wk)?

Hypertension, weight gain (edema),

Name the 3 symptoms of PIH
proteinuria

If pre-eclampsia is mild will the woman be

No, just rest at home
hospitalized?

What is the best position for the client with

Left-side lying
severe pre-eclampsia?

What is the dietary order for the woman

Low salt, high protein
with severe pre-eclampsia?

Are diuretics used for woman with pre-

Yes
eclampsia?

When a woman is hospitalized for severe

#1- reflexes, the urine for protein
pre-eclampsia the nurse should test the...
When pre-eclampsia gets worse the deep
tendon reflexes will be (hypo/hyper)- Hyper-reflexia
reflexia

Pre-eclampsia makes the neuromuscular

More
system more or less irritable?

What vision problem do women with pre-

Blurred vision
eclampsia have?

What type of precautions will be in effect

Seizure precautions
for a woman with severe pre-eclampsia?

Suction machine in room, O2 in room, padded

Name 5 things included in seizure
rails upx4, must stay on unit, ambulation with
precautions
supervision only, no more than 1 pillow

When is pre-eclampsia called eclampsia? Once convulsions have occurred

In eclamptic patients what ominous sign

Severe epigastric pain
almost always precedes a seizure?

What are the 3 major tx objectives in

Dec BP, control convulsions, diuresis
eclampsia?

The urine output of the eclamptic client will

Decrease
(inc./dec.)

Place the hand flat on the abd over the

How would you palpate the uterus to see if
fundus with the fingers apart and press
eclamptic woman was having contractions
lightly
Premature rupture of membranes (PROM)
is a ____ break in the amniotic sac ___ the Spontaneous, before, onset
____ of the contractions

Usually labor starts within ____ hours of

24
rupture of membranes

What is the danger with PROM? Infection

How would you tell if the woman with Maternal fever, fetal tachy, foul smelling
PROM had an infection? discharge

To test for amniotic fluid the nurse should

pH
check the ___ of the fluid

Amniotic fluid is (acidic/alkaline) Alkaline

Being alkaline means having a (high/low)

High
pH?

Amniotic fluid turns nitrazine paper deep

Blue
____

When PROM occurs, the age of the fetus must

be determined. The best way to assess lung L/S (lecithin/sphingomyelin)
maturity is to check the ____ ratio

An L/S ratio greater than ___ indicates

2.0
lung maturity
 If labor does not begin within ___ hours
24
after PROM, labor will likely be induced

If PROM occurs before viability, what is the

Termination of pregnancy
typical management?

If PROM occurs after viability but before 36 Hospitalize, watch for infection, try to gain
weeks, what is the typical management? time for the infant to mature

If there are any signs of infection after

Delivery of fetus
PROM, what must occur immediately?

PROM always occurs in a gush of fluid

False
(T/F)?

The woman must avoid sexual intercourse

True
if PROM has occurred (T/F)

When the nurse tells the patient personal

What is self-disclosure?
information about self

No, you can self-disclose as long as you do

Is it always bad for the nurse to self-
it cautiously and you are 100% sure it is
disclose?
therapeutic

If the nurse uses self-disclosure it should Short, quickly re-focused back on the
be ____ and the conversation should be... patient

Insight means the ability of the pt to ____

Understand
his own problems
 During what phase should the nurse
Pre-interaction phase
examine his/her own feelings

Flight of ideas is when the patient changes

Rapidly
topics of conversation ____

The basis for a therapeutic nurse/patient

relationship begins with the ___, self-____ Nurses, awareness, self-understanding
and ____ _____

What are the steps of the nurse/patient Pre-interaction phase, orientation phase,
therapeutic relationship? working phase, termination phase

Should the nurse self-disclose if the patient

No, not unless it is specifically therapeutic
asks the nurse to?

The nurse should introduce information

about the end of the nurse/patient Orientation
relationship during the ____ phase

Termination phase begins in the ____

Orientation
phase

Pulmonary edema is accumulation of ___

Fluid
in the lung

Pulmonary edema is a common

Cardiovascular
complication of ___ disorders

Pulmonary edema usually results from

Left ventricular
_____ ____ failure
 What force causes pulmonary edema in Increased hydrostatic pressure in the
left ventricular failure? pulmonary capillaries

Can letting IVs run in too fast cause Yes, in the client with poor cardiovascular
pulmonary edema? function

What are the 4 classic signs of pulmonary Dyspnea on exertion, paroxysmal nocturnal
edema? dyspnea, orthopnea, coughing

What is meant by dyspnea on exertion? Sudden episodes of difficulty breathing

What is meant by orthopnea? SOB when lying flat

Is heart rate fast or slow in pulmonary

Fast, tachy
edema?

What will the nurse auscultate over the

Crackles
lungs when pulmonary edema occurs?

When pulmonary edema is severe what

Bloody and frothy
does the sputum look like?

What drug is used in pulmonary edema to

A diuretic (Lasix)
reduce the fluid in the lungs?

What drug is used to increase ventilation in

Aminophylline (bronchodilator)
clients with pulmonary edema?
 Is O2 given in pulmonary edema? Yes

Since pulmonary edema is caused by left

Digitalis
ventricular failure what drug is given?

Why is morphine given to clients with To dec apprehension and dec preload, this
pulmonary edema? rests the heart

If your client suddenly goes into pulmonary Elevate the HOB, then increase oxygen,
edema what would you do first? then call MD

Pulmonary embolus is an obstruction of the

pulmonary ____ bed by a dislodged ___ or Capillary, thrombus
foreign substance

Where do the emboli that cause pulmonary

The legs
embolus usually come from?

Besides a thrombus what else can cause

Air, fat, tumor cells
an embolus in the lungs?

What tx modality can lead to pulmonary

Bed rest
embolus?

What class of drugs can lead to pulmonary

Oral contraceptives
embolus?

Afib (RIGHT afib causes pulmonary

What heart problem can lead to pulmonary
embolus; LEFT afib causes cerebral
embolus?
embolus)
 What genetic disorder can lead to
Sickle cell anemia
pulmonary embolus?

What is the first sign of pulmonary

Dyspnea
embolism?

The dyspnea of pulmonary embolus is

Pleuritic pain
accompanied by ___ _____

Does the heart rate inc or dec in

Increase
pulmonary embolus?

With severe pulmonary embolus the client

In shock
will look as though they are ____

What are the 2 major tx of pulmonary

O2, anticoagulants
embolus?

Name the anticoagulant given for

immediate anticoagulation by IV or SQ Heparin
route

A drug for long term anticoagulation in any

Coumadin
disorder would be?

What 2 lab tests monitor coumadin

PT and INR
therapy?

When Coumadin is therapeutic, the INR

2.0 and 3.0
should be between ___ and ____
 It is low-dose Heparin used for anticoagulation in
What is lovenox? POST-OP THROMBOPHLEBITIS PREVENTION
NOT USED FOR PULMONARY EMBOLUS

Heparin therapy is monitored by daily

PTT (partial thromboplastin time)
measurement of the _____

Effective heparin therapy raises the PTT to

2.5
approximately ____ times normal

Clients on heparin should use an electric

Electric
razor or a safety razor?

What is the best way to prevent pulmonary

Early ambulation
embolus in post-op patients?

Is it appropriate to massage the legs of the

No, never
client to prevent pulmonary embolus?

Heparin is used in the acute phase of

pulmonary embolus. What drug is used for Coumadin
6 months after pulmonary embolus?

Coumadin therapy is monitored by what

PT (prothrombin time)
daily test?

What is pyelonephritis? A bacterial infection of the kidneys

Which organism causes most

E. Coli
pyelonephritis?
 Name the S&S that pyelonephritis and Frequency, urgency, burning, cloudy, foul
cystitis have in common? smelling urine

What medical intervention is necessary in IV ATBs for 1-2 weeks, must get urine
pyelonephritis? culture 2 weeks after ATBs therapy over

Cystitis means a bladder infection;

How does pyelonephritis differ from Cystitis
pyelonephritis means an infection of kidney
in meaning?
pelvis

What causes or precedes pyelonephritis? Cystitis always does

Will the client with pyelonephritis have daily Yes, as would any client with a kidney
weight? problem

Name the 5 S&S that pyelonephritis has

Fever, flank pain, chills, inc WBC, malaise
that cystitis does not have?

What is the BIG danger with

Permanent scarring and kidney damage
pyelonephritis?

How is pyelonephritis prevented? By preventing or treating all cystitis (UTIs)

Will the pt with pyelonephritis have

It is common but not always present
hematuria?

The patient with pyelonephritis will have

Hypertension
(hypertension/hypotension)
 Where is the pyloric sphincter? At the distal (duodenal) end of stomach

What does stenosis mean? Narrowed

What is done to correct pyloric stenosis? Surgery (pyloromyotomy)

In what position should the child with PS be

High Fowler's
during feeding?

The feedings for an infant with pyloric

Thickened
stenosis should be thick or thin?

What test is done to confirm a diagnosis of

Upper GI series (Barium swallow)
pyloric stenosis?

These infants are prone to develop ____

Dehydration, thrive
and failure to _____

Why does the pyloric valve become

It hypertrophies
stenosed in this disease?

In what position should a child be after a

Right side with HOB up
feeding?

The infant appears ___ even after vomiting Hungry

What do you see during and after feeding? Peristaltic waves from L to R

Is the vomiting projectile or non-projectile?

Is the vomiting bile-stained or not bile- Projectile, not bile-stained
stained?

What assessment finding is found under An olive-sized bulge (the hypertrophied

the right rib cage? pylorus)

The symptoms of pyloric stenosis most

4 to 6 weeks
commonly appear at age __ to ___

Describe the typical child with pyloric

Firstborn, full term, white, boys
stenosis.

Both are internal forms of radiotherapy however, in

What is the #1 difference between sealed sealed, a solid object is placed in a body cavity; in
and unsealed radiation? unsealed a radioactive substance is injected in liquid
form into a vein

What are the 3 principles the nurse uses to

protect self when caring for a client with a Time, distance, shielding
sealed radioactive implant?

What is another name for external

Beam or X-Rays
radiation therapy?

In external the tumor is bombarded with Xrays and

What is the difference between external
nothing is placed in the body; in internal there is some
radiation tx and internal radiation tx? radioactive substance introduced into the body

Of sealed internal, unsealed internal, and Sealed internal then unsealed internal, external
external radiation tx, which is MOST radiation tx is of no danger to the RN unless
dangerous for the nurse? the RN is in the radiation tx room during the tx
 Should prego nurses care for a patient
Never (Lawsuit time!)
receiving sealed internal radiotherapy?

Should prego nurses provide care for a

Maybe, as along as they don't contact body
patient receiving unsealed internal
secretions
radiotherapy?

What skin products should the pt receiving No ointments with metals like zinc oxide, no
external radiotherapy AVOID? talcum powder

Describe the hygiene measures that you

Use plain water only; no soaps, pat dry,
teach the pt receiving external
can use cornstarch for itch
radiotherapy?

Pruritis, erythema, burning, sloughing of

What are the major side effects of
skin, anorexia, N&V, diarrhea, bone
radiotherapy?
marrow depression

Wear gloves while in possible contact with

When the pt is receiving radioactive iodine
urine, special precautions taken to dispose
what precautions is/are most important?
of the urine

Rape is a crime of passion (T/F)? False, it is a violent act

Most rapes occur involving 2 people of diff

False, usually the same race
races (T/F)?

When must psychological care of the rape

In the ER
victim begin?

Name the 2 phases of Rape Trauma Disorganization Phase, re-organization

Syndrome? phase
 Immediately after rape, a woman who is False, calmness and a composed attitude are S&S
calm and composed is adjusting well of Rape Trauma syndrome (calm person is just as
(T/F)? disorganized as the crying and upset lady)

GI irritability, itching or burning on

Name 3 physical sx of Rape Trauma
urination, skeletal muscle tensions, *don't
syndrome
forget PAIN

Victims of rape often blame ____ Themselves

In the long term reorganization phase the

Residence and/or telephone number
woman is likely to change _____

In the long term re-organization phase the

woman is likely to experience _____ during Nightmares
sleep.

1) Indoors or outdoors (depending on where the rape occurred)

In the long-term re-organization phase the 2) Being along or in crowds
3) Sexual fears
woman has 4 common fears. Name them... 4) People being behind them

Before evidence from the woman's body

can be gathered for rape, _____ ____ Consent forms
must be completed

Should a female staff member be present

Always
when the rape victim is being examined?

The rape victim requires only a pelvic

False, the exam is a very long, invasive
exam and a head to toe exam so the pt is
head-to-toe exam
not stressed (T/F)?

During vaginal speculum is lubricated

False, lubrication could alter the evidence
before it is placed in the vagina (T/F)?
 What drug is often used to prevent Kits approved by FDA: Preven of Plan B
pregnancy after rape? (less N&V)

When working with a rape victim they

Dignity and respect
should be tx with ___ and ____

After rape, a woman needs follow-up

STIs
exam/test for ____ ____ _____

After discharge contact with the rape victim

Telephone
is maintained via the _____

Raynaud's is an arterial or venous

Arterial disease characterized by spasms
disease?

What part of the body is most affect in

The fingers
Raynaud's

Raynaud's affects males or females

Females (young)
mostly?

What 3 things in precipitate a Raynaud's Exposure to cold, emotional stress,

attack? tobacco use

The digits in Raynaud's are hot or cold? Cold

What will the fingers look like? Pales, sometimes blue

 What will you find when you assess the Weak/absent pulse, cool, pale, loss of hair,
legs of these patients? shiny thin skin

What 3 sensations will the client

Pain, numbness, tingling
experience?

What should the client with Raynaud's

Cold weather (wear gloves, stop smoking)
avoid?

In the recovery room (PACU) the patient

On either side
should be positioned...

What reflex is commonly routinely tested in

Gag reflex
the recovery room?

When will the artificial airway be removed

When the gag reflex returns
in the recovery room?

Vital signs are measured ____ in the

Q15 minutes
recovery room

To the side with the cheek and neck

In the recovery room the head should be...
extended slightly down

In the recovery room the neck should be... Slightly extended

Can post-op pain meds be given in the

Yes
recovery room?
 Give three stages of ARF Oliguric, diuretic, recovery

Inability of the kidney to excrete wastes

Define ARF and maintain fluid and electrolyte
imbalances

What is the BIG danger in ARF? Hyperkalemia and it's effect on the heart

What is anuria? Less than 50cc of urine out in 24hrs

What is oliguria? Less than 500cc of urine out in 24hrs

What are the dietary modifications for the Increased carbs, decreased protein, dec.
oliguric phase of ARF? sodium, dec. potassium, dec. water

Increased carbs, inc. protein. Moderate K

What are the dietary modifications for the
and Na (may need to inc. fluids diuresis
diuretic phase of ARF?
results in dehydration)

What are the dietary modifications for the

Increased carbs and proteins
recovery phase of ARF?

Accumulation of wastes in the blood and

What causes the itching seen in ARF? the associated signs. This occurs in end
stage renal failure

What is the first phase in ARF? The oliguric phase

In the oliguric phase, blood volume is ___,
High, high, high
sodium is ____, and potassium is ____

How long does the oliguric phase last? 7-10 days

In the diuretic phase: blood volume is

____, sodium is ____, and potassium is Low, low, low
_____

How long does the diuretic phase usually

3-4 days, maximum time is 2-3 weeks
last?

In the diuretic phase: urine output = ____

4-5 liters per 24 hours
to ____ liters/ 24 hours

Oliguria, because since you are losing

Which is more dangerous, oliguria or
more fluids you are actually hemo-
anuria? Why?
concentrating the hyperkalemia more

Respiratory Distress Syndrome occurs in

False, it occurs in premature infants
full-term infants (T/F)?

Respiratory Distress Syndrome hardly ever

37
occurs after week ____ of gestation

Respiratory Distress Syndrome is also

Hyaline Membrane Disease (HMD)
known as...

The cause of RDS is a lack of ____ Surfactant

Surfactant prevents the ____ of the alveoli Collapse

Lack of surfactant causes the neonate to

Breath
lose lung capacity with each ___

Death from Respiratory Distress Syndrome

most commonly occurs within ___ hours of 96
birth

Within minutes of birth, what 3 respiratory

Retractions, nasal flaring, and grunting
difficulties occur?

Survants (Surfactant) via ET tube. Repeat

What medication is given? By what route?
doses are often required

What acid/base disorder is seen in

Respiratory acidosis (CO2 retained)
Respiratory Distress Syndrome?

What will you auscultate over the lungs of

the neonate with Respiratory Distress Decreased lung sounds with crackles
Syndrome?

What lab test assess the risk of Respiratory

L/S ratio (Lecithin/Sphingomylein ratio)
Distress Syndrome?

What L/S ratio confirms fetal lung maturity? 2/1

What other test is used to confirm fetal Amniotic fluid is analyzed for presence of
lung maturity? PG
 PEEP (positive end expiratory pressure) and CPAP
Severe cases of Respiratory Distress (continuous positive airway pressure), to keep the
Syndrome requires ventilation with ____ alveoli open while on the ventilator. High frequency jet
ventilation is sometimes used.

What may be added to the IV to correct the

Bicarbonate
acidosis?

High flow rates of O2 delivered in

Respiratory Distress can cause ___ Retrolental fibroplasia (an eye problem)
______

Retrolental fibroplasia can result in ____ Blindness from retinal damage

High ventilatory pressures can result in

Broncho-pulmonary dysplasia
what chronic lung problem?

At what time of year does rheumatoid

Spring
arthritis flare up?

As with any inflammatory disease clients

Grade fever
with rheumatoid arthritis have a low-____

What factor is present in the blood when

The rheumatoid factor
the client has rheumatoid arthritis?

As in most inflammatory diseases the client

has an ____ erythrocyte sedimentation Increased
rate

During an exacerbation (flare-up) of

rheumatoid arthritis you should splint the Extension
joints in (extension/flexion)
 As in most inflammatory disorders, the
Elevated; leukocytosis
WBC count is ___. This is called ____

What type of chair should be used for A chair with a high seat, armrests, and one
rheumatoid arthritis clients? in which the knees are lower than hips

In rheumatoid arthritis the client should

avoid positions 0f ____ and assume Flexion; extension
positions of ___

When the client with rheumatoid arthritis is

in remission you should apply (heat/cold) Heat
to the joint

During an exacerbation of rheumatoid

Ice
arthritis you should apply (heat/Ice)

True, unlike osteoarthritis, rheumatoid

Rheumatoid arthritis is more common in
arthritis occurs 3x's more commonly in
females than in males (T/F)
women

People with rheumatoid arthritis

(usually/never) experience remission of Usually
S&S

Rheumatoid arthritis is a ____, ____

Chronic, inflammatory
disease

Rheumatoid arthritis attacks the ___, ___, Joint, muscles, tendons, ligaments, blood
____, ___, and ____. vessels

Where are the nodules of rheumatoid The nodes of rheumatoid arthritis are subcutaneous
arthritis found in contrast to the Heberdens nodules usually on the elbows (ventral forearm);
nodes of osteoarthritis? Herberden's nodes of osteroarthritis are on the fingers
 Which joints of the fingers are most
The proximal interphalangeal joint (PIP)
effected by rheumatoid arthritis?

Clients with rheumatoid arthritis have a

Swan-neck deformity
deformity of the wrist/hand called ____

The mainstay of rheumatoid arthritis

Aspirin
therapy is the drug ___

Decreases (This is opposite of

Activity (inc./dec.) the pain of rheumatoid
osteoarthritis where activity increases the
arthritis
pain)

False, they usually have recurrence and

Remissions of rheumatoid arthritis last for
when it re-occurs it usually comes back
the rest of the patients life (T/F)
worse

CHF CHF

Scoliosis is a ___ curvature of the ____ Lateral, spine

Scoliosis is MOST common in the ____ Thoracic and lumbar (2nd and 3rd section/
and ____ sections of the spinal column 5 sections)

Scoliosis in the thoracic spine is usually

Right
convex to the (left/right)

Scoliosis in the lumbar spine is usually

Left (*hint: curve Left in Lumbar)
convex to the (left/right)
 With which other two spine deformities is Lordosis (swayback)
scoliosis associated? Kyphosis (humpback)

What is kyphosis? Humpback in the thoracic area

Swayback in the lumbar area (Lumbar,

What is lordosis?
Lordosis)

What is the difference between structural Structural - you are born with it
and functional scoliosis? Functional - you get from bad posture

What age group should be routinely

Young teens
screened for scoliosis?

What are the 3 subjective complaints of

Back pain, fatigue, dyspnea
clients with scoliosis?

What test/exam confirms the diagnosis of

X-Rays of the spine
scoliosis?

What type of brace is most commonly used

Milwaukee
for scoliosis?

Name 4 exercises used to treat mild Heel lifts; sit ups; hyperextension of the
scoliosis? spine; breathing exercises

What kind of treatment is done for severe

Surgical fusion with rod insertion
scoliosis?
 What type of cast is used post-op? Risser cast

What kind of rod is used to "fix" curvature? Harrington rod

Scoliosis MOST commonly affects ___ ___ Teenage females

How many hours a day should the client

23 hours
wear a Milwaukee brace?

Tincture of benzoin or alcohol, no lotions or

What solution should be used on the skin
ointments - you want to toughen the skin
where the brace rubs?
not soften it

Clients with a Milwaukee brace should

True
avoid vigorous exercise (T/F)

After corrective surgery how is a patient

Log rolled (in a body cast)
turned?

How often should the neurovascular status

of the extremities of the client in a Risser q2h
cast be measured? Fresh post-op?

What is a common complication of a client

Cast syndrome
in a body cast (like the Risser cast)?

N&V, and abd distention that can result in

What is cast syndrome?
intestinal obstruction
What group of people get cast syndrome? ANYONE in a body cast

Removal of the cast, NG tube for

What is the tx for cast syndrome?
decompression, NPO

Ask the client if they are experiencing any abd

How would you, the nurse, asses for symptoms - keep track of BM and passing flatus (if not
developing cast syndrome? having BMs or passing flatus, cast syndrome is
suspected)

Hyperextension of the spine by a body

What causes cast syndrome, especially in
cast: the hyperextension interrupts the
a Risser cast?
nerve and blood supply to the gut

The inheritance pattern of sickle cell

Autosomal recessive
anemia is ____ ____

It means you only have ONE defective

What does heterozygous mean?
gene from only ONE parent

People who are (hetero/homo)zygous have

Heterozygous
sickle cell TRAIT

It means you have the defective gene from

What does homozygous mean?
both parents

People who are (hetero/homo)zygous have

Homozygous
sickle cell DISEASE

True- usually is has occurred in times of

People with sickle cell trait only carry the
severe stress, the trait does cause some
disease, they do not have symptoms
symptoms but not usually
 What are the #1 and #2 causes of sickle
Hypoxia, dehydration
cell crisis?

The most common type of crisis that

Vaso-occlusive
occurs is a ____-_____ crisis

In vaso-occlusive crisis the vessels

Abnormal RBCs
become occluded with ____ _____

The abnormal hemoglobin produced by

people with sickle cell anemia is called Hgb Hgb S - it "sickles"
____

What shape does Hgb S make the RBCs? Crescent-shaped

Why do the cresent-shaped RBCs cause

They clump together and create sludge
occlusion of the vessels?

What are the top 3 priorities in care of a

Oxygenation, hydration, and pain control
client with sickle-cell crisis?

What activity order will the client with sickle

Bedrest
cell crisis have?

Of Tylenol, Morphine, Demerol, Aspirin,

Aspirin- it can cause acidosis which makes
which is NEVER given to sickle-cell
the crisis and sickling worse
patients?

At what age is death most likely in sickle

Young adulthood
cell anemia?
 Sickle-cell anemia symptoms do not
appear before the age of ___ months d/t 6; fetal hemoglobin
the precense of ____ ____

Sickle cell anemia is most commonly seen

Blacks
in (blacks/whites)

Should a child in sickle-cell crisis wear tight

No, it can occlude vessels even more
clothes

Spinal cord injuries are more common in

True
males (T/F)?

In what age range is spinal cord injury

15-25
most common?

The #1 goal in emergency treatment of

Immobilization of the spine
spinal cord injury is...

When halo traction is being used to

immobilize the spinal cord the client is Ambulate
allowed to ____

When the patient with spinal cord injury is

in tongs or on a stryker frame or on a Absolute bed rest
circoelectric bed they are on...

The two most common surgeries used to

treat spinal cord injury are ____ and ___ Laminectomy and spinal fusion
____

It is a common occurrence in spinal cord

What is spinal shock? injury in which the spinal cord swells above
and below the level of injury
 When does spinal shock occur? Immediately or within 2 hours of injury

How long does spinal shock last? 5 days - 3 months

When the spinal cord injury is at level of

C1-C8
___ to ___ the patient will be quadriplegic

When spinal cord injury is between ___

and ___, there is permanent respiratory C1-C4
paralysis

Yes, bc even though his injury was below C4, spinal

Can the patient with spinal cord injury at shock can lead to loss of function above the level,
C7 level have respiratory arrest? however he will not be permanently ventilator dependent
- he will breathe on own once spinal shock goes away

Spinal cord injury in the thoracic/lumbar

Paraplegia
regions result in ____plegia

If airway obstruction occurs at the accident

site and you suspect spinal cord injury, Modified jaw thrust
what maneuver is used to open airway?

In spinal cord injury never ___ the neck Move, hyperextend

How should you change the position of the

Slowly, bc of severe orthostatic
spinal cord injury patient after he has an
hypotension (they use a tilt table)
order to be up? Why?

For the pt with a neurogenic bladder you

Q6H
should straight cath every ___ hours
The patient with spinal cord injury will have
Spastic
(flaccid/spastic) muscles

Name 3 drugs used to treat spasms? Valium, Baclofen, Dantrium

What is autonomic dysreflexia or A common complication of quadriplegics in

hyperreflexia? response to a full bladder or bowel

What are the vital sign changes seen in Sweating, HA, N&V, gooseflesh, and
autonomic dysreflexia? severe HYPERtension

What do you do first for the client

Raise HOB
experiencing autonomic dysreflexia?

What do you do second in the patient

Check the bladder, check the bowel
experiencing autonomic dysreflexia?

No, only call the doctor if draining the

Do you need to call the doctor for
bladder and removing impaction does not
autonomic dysreflexia?
work

What is the #1 treatment for autonomic

Drain the bladder, empty the bowel
dysreflexia?

What is the purpose of restricting activity

To prevent HA d/t CSF loss
after spinal tap?

Should the client drink after a spinal tap? Yes, encourage fluids to replace CSF
Do need an informed consent for a spinal
Yes
tap?

Should CSF contain blood? No

Does the client have to be NPO before a

No
spinal tap?

What is the normal color of CSF? Clear, colorless

Into what space is the needle inserted

Subarachnoid space
during a spinal tap?

Can the client turn side-to-side after a

Yes
spinal tap?

In what position should the client be during Lateral decubitus (on their side) position
a spinal tap? and knees to chest

ID the activity restriction necessary after

Lie flat for 6-12 hours
lumbar puncture?

To measure or relieve pressure and obtain

What are the 2 purposes of a spinal tap?
a CSF sample

Does the client have to be sedated before

No
a spinal tap?
 Which hand should hold the suction
catheter? Which should hold the The dominant, the non-dominant hang
connecting tube?

Surgical asepsis (sterile technique) - Practices that

The nurse should use (medical/surgical)
render and keep objects and areas free from all
asepsis during airway suction? micro-organisms

What kind of lubricant should be used on

Sterile water-soluble
the suction catheter?

Should the suction be continuous or

Intermittent to prevent mucosal damage
intermittent?

For how long should suction be applied

10 seconds
during any one entry of the catheter?

How often should the nurse clear the

After each pass/entry/removal
tubing during suctioning?

Which way would you turn the clients head

to suction the right mainstem bronchus? To the left, to the right
The left mainstem bronchus?

The best client position during airway

Semi-Fowlers
suctioning is ____

The suction should be delivered while

Removing
(inserting/removing) the catheter

What outcomes would indicate that

Clear even lung sounds, normal vital signs
suctioning was effective?
 When its needs to be, for ex. moist lung
How often should the client's airway be
sounds, tachy, restlessness (hypoxia),
suctioned?
ineffective cough

The unconscious client should assume

Side-lying facing nurse (aspiration)
what position during suctioning?

If not contraindicated, what action by the

Administer a few breaths at 100% oxygen
nurse before suctioning would most likely
before beginning
reduce hypoxia during suctioning?

What solution should be used to clear the

Sterile saline
tubing during suctioning?

With what size catheter should an adult's

12-16 French
airway be suctioned?

How much suction should be used for an

Less than 80 mmHg
infant?

How much suction should be used for a

80-120 mmHg
child?

How much suction should be used for an

120-150 mmHg
adult?

Do you assess for suicide potential Yes, in fact whenever a patient makes a statement about
wishing or wanting to die or kill self you must ALWAYS
whenever a pt makes any statement about AND FIRST assess suicide potential - stop everything
wanting to die or kill self? and assess for suicide patient (except CPR, of course)

Children are at ____ risk for suicide Low

Adolescents are (low/high) risk for suicide High

Young adults are (low/high) risk for suicide High to moderate

People between 25 and 50 years are

Low to moderate
(low/moderate/high) risk for suicide

The pt who has a definite plan is (low/high) Moderate to high, depends upon feasibility
risk for suicide and ease of plan

The use of pills makes the patient

Moderate
(low/moderate/high) risk for suicide

The patient who has NO definite plan is

Low
(low/high) risk for suicide)

The use of ___, ___, and ____ to kill self,

Guns, ropes, knives
make high risk suicide

Who is at higher risk for suicide, a man or

A man
a woman?

Of married, divorced, and separated, which

Highest- separated then divorced
marital status is highest risk for suicide?
Lowest- married
Lowest risk for suicide?

The goal of action while the suicidal patient Another person on the scene (this
is still on the phone is to get ___ person immediately decreases risk). Remember:
___ the ____. ppl who are alone are always at high risk
 Search personal belongings for drugs and alcohol,
remove any sharp objects, remove any device for
What are the 4 classic suicide precautions? hanging or strangling; must be on constant one-to-one
observation (NEVER out of sight)

Once the patient is admitted for attempted

No, you should not focus on the attempt,
suicide should you ever discuss the
focus on the present and future
attempt with them?

Syphilis is sexually transmitted (T/F)? True

Syphilis first infects the ___ ____ Mucous membranes (mouth, vulvar)

What are the stages of syphilis? Primary, secondary, latent, late

Syphilis is a fatal disease if untreated

True
(T/F)?

What organism causes syphilis? Treponema palladium

What is the lesion like in primary syphilis? The chancre (pronounced shanker)

The chancres of syphilis are

Painless
(painful/painless)

Chancres disappear without treatment

True
(T/F)
Late syphilis attacks which 3 body organs? Liver, heart, brain

What test confirms the presence of Dark-field illumination of the treponema

syphilis? palladium

What is the tx of choice for syphilis? Penicillin

Procaine makes the shot less painful;

Why is penicillin administered with
Probenecid blocks the excretion of
Procaine? With probenecid?
penicillin

What is the most common sign of

Ataxia (gait problems)
neurosyphilis?

What does TENS stand for? Transcutaneous electrical nerve stimulator

Is it an invasive procedure? No, the skin is never broken

Can it be used for acute or chronic pain? Both

TENS use is based upon the ___ ____ of

Gate control
pain relief

TENS electrodes stimulate (large/small) Large - this is the basis of the gate control
diameter fibers theory
 TENS electrodes are placed onto the... Skin

Can TENS units be placed over an incision

Never
to decrease incisional pain?

Pts with what other mechanic device in use

Cardiac pacemaker
cannot use TENS

How often should the pt be taught to

Every day
change the TENS electrodes?

Dorsal column stimulation electrodes are surgically

How is a dorsal-column stimulator different
implanted by the spinal cord; the pt has to undergo a
than a TENS unit? laminectomy to place the DCS electrodes

In what group of clothes is thoracentesis

Uncooperative, bleeding disorders
contraindicated?

What instruction is most important to give

Don't move or cough
the client undergoing thoracentesis?

The pleural space is entered by puncture and fluid

What is thoracentesis? is drained by gravity into bottles - allows the lungs
to re-expand

If a client has a cough, what should be

Give him a cough suppressant
done before thoracentesis?

Does thoracentesis require a signed

Yes, it invades a body cavity
informed consent?
 Describe the position the client should Upright with arms and shoulders elevated,
assume during a thoracentesis? slightly leaning forward

What is exophthalmos? Bulging outward of eyes

To care for the pt with exophthalmos the pt

should wear ____ _____ and use ____ Dark sunglasses, artificial tears
_____.

Radioactive iodine is given to hyperthyroid

pts bc it ___ ___ plus dec. production of Destroys tissue, thyroid hormone
____ ____.

The #1 problem with using Propylthiouracil

Agranulocytosis
is ____

What do you teach to all patients on drugs

which have agranulocytosis as a side Report any sore throat immediately
effect?

Lugols solution decreases the ___ of the

Vascularity
thyroid gland

Lugols solution should be given __ a ___

Through a straw; teeth
to prevent staining of the ____

SSKI should be given with ___ ___ to dec. Fruit juices; bitter taste (SSKI - super
the ___ ____ saturated solution of potassium iodide)

Pts with either hypo or hyper thyroid can

True
go into thyroid storm (T/F)
 Give another name for thyroid storm Thyrotoxicosis, thyroid crisis

In thyrotoxicosis, the temp ____ : the heart Increases (106); increases;

rate ___ and the pt becomes ____ delirious/comatose

What is the first thing a nurse does when

Give oxygen
thyroid storm occurs?

What is the second thing a nurse does Call MD, can pack in ice or use
when thyroid crisis occurs? hypothermia blanket

What are the side effects of thyroid Tachy, palpitations and other signs seen in
replacement drugs? hyperthyroidism

Why is Lugols solution given pre-op To dec. the vascularity of the gland and
thyroidectomy minimize blood loss

After thyroidectomy you check for wound Slipping your hand under the neck and
hemorrhage by... shoulders

The #1 complication of thyroidectomy in

Hemorrhage - or maybe airway
the first 8-12 hours is ____

When moving the fresh post-op

thyroidectomy pt you must take care to Move the neck
never ___ ____ ____

Post-op thyroidectomy pts will have sand

Neck
bags on either side of the ___
 *Why do you assess the post-op Bc during surgery the surgeon may have
thyroidectomy pt voice for hoarseness nicked the recurrent laryngeal nerve (this
periodically? nerve is tested on state boards)

Will the post-op thyroidectomy pt be He is on voice rest unless you are

allowed to talk? assessing his voice

In what position should the post-op Semi-fowlers with neck supported in

thyroidectomy pt be? midline

What 3 pieces of emergency equipment

Suction, trach set, O2
must be in the room after thyroid storm?

What Ca imbalance is common in the post- Hypocalcemia- d/t accidental removal of

op thyroidectomy pt? the parathyroids

When is hypocalcemia most likely to occur The 2nd and 3rd post-op day- bc it takes
after thyroidectomy? Why? awhile for the level to drop

Hypocalcemia will cause (tetany/severe

Tetany
muscle weakness)

What drug is used to treat dec. calcium? Calcium gluconate

A sign of hypocalcemia, it is when you tap

What is Chvostek's sign? the cheek, the patient puffs out the cheeks.
(CHvostek and CHeeks)

It is a sign of hypocalcemia - it is when you get

What is Trousseau's sign? a carpopedal spasm of the hand when you
apply a BP cuff to the lower arm
 Tremors/ tingling
What is the earliest sign of hypocalcemia?
(muscles weakness/ numbness)

Should you palpate the thyroid of the

No, it could send them into thyroid storm
hyperthyroid pt after ectomy?

Can dental work send a hyperthyroid client

Yes, any stress can
into thyroid storm?

Give another name for TPN Hyperalimentation

Hyperalimentation contains hypertonic Glucose, amino acids, water, minerals,

____, ___ acids, ____, ____, and ____. vitamins

TPN can be safely given via a central IV

Yes, this is the preferred route
line (T/F)

TPN can be safely infused via a peripheral It can, but only for a very short period - 48
IV line (T/F) to 72 hours maximum

If a TPN infusion runs in too fast it creates

Hyperosmolar - because of all the solutes
a ____ osmolar imbalance

If a TPN solution is running too slow and is

two hours behind you can increase the rate No, never ever speed up the rate
20% (T/F)

It is okay however to slow the rate down if False, never slow the rate down - it could
the client leaves the unit (T/F) cause hypoglycemia
 What tests must the nurse perform q6h
#1 accu check, #2 urine glucose/acetone
when a patient is on TPN?

IV lipid emulsions can be given either

True
central or peripheral (T/F)

Be certain to shake a lipid emulsion before False, never shake it, shaking damages
administration (T/F) the molecules

The port closest to the insertion catheter site. More

Into which port of a peripheral IV line can a
recently, lipids are included are in the hyperalimentation
lipid infusion be piggybacked? bag and there is no separate administration of the lipids.

These are a group of congenital birth

What is meant by tracheo-esophageal
defects in which the esophagus and
malformation?
trachea are malformed

How many types of tracheo-esophageal

4
malformations are there?

1) Esophageal atrasia - EA
What are the 3 most common tracheo- 2) Tracheo-esophageal fistula - TEF
esophageal malformations? 3) Tracheo-esophageal fistula with esophageal atresia -
TEF w/ EA

An opening between the esophagus and

What is the defect called esophageal
trachea but the esophagus is connected to the
fistula?
stomach and trachea is connected to the lungs

The esophagus ends in a blind pouch and there

What is the defect called tracheo-
is no connection to the stomach and there is a
esophageal atresia with fistula?
fistula between the esophagus and trachea

Of tracheo-esophageal fistula, esophageal

Tracheo-esophageal fistula with
atresia, and tracheo-esophageal atresia
esophageal atresia
with fistula, which one is most common?
 Name - a blind end esophagus: the
Simple esophageal atresia
trachea is connected to the lungs

What is the most common cleansing

Hydrogen peroxide
solution used during trach care?

Cut the old trach ties (before/after) you

After
have secured the new ties in place

Is is acceptable to scrub the inside of the

trach cannula with a brush during trach Yes, it is desirable
care?

What are the 2 major reasons for To keep the airway patent, and to keep the
performing trach care? stoma site clean (decrease infection)

Tie the ends of the trach ties in a (bow

Double knot
knot/ double knot)

Trach care is performed by (sterile/clean

Sterile
technique)

What must you do before performing trach

Suction the airway
care (besides wash hands)

A properly snug set of trach ties allows ___

finger(s) to be placed between the neck 1
and ties

Both hands must be kept sterile throughout False, only the dominant hand remains
the entire trach care procedure (T/F) sterile
 When trach suctioning and care is
performed by the client at home, sterile False, clean technique is adequate
technique must be followed (T/F)

What is another name for trigeminal

Tic doulourex
neuralgia?

Which cranial nerve is affected in

Cranial nerve 5
trigeminal neuralgia?

What is the #1 S&S of trigeminal

Episodic, severe one-sided facial pain
neuraglia?

What drug treats the trigeminal neuraglia? Tegretol

Breezes, cold or hot foods/fluids, tooth

What triggers attacks of trigeminal
brushing, chewing, touching the face,
neuralgia?
talking

Is surgery done for trigeminal neuraglia? Yes, nerve avulsion (destroying the nerve)

What environmental modifications are

necessary in care of the patient with Prevent drafts or temp extremes
trigeminal neuraglia?

What dietary modifications are necessary

in the care of the patient with trigeminal Lukewarm, small freq semi-solids
neuraglia?

After surgery for trigeminal neuraglia, the

patients affected eye will be _____ and the Protected; unaffected
pt should chew food on the ____ side
 What organism causes pulmonary TB? Mycobacterium tuberculosis

The mode of transmission of the

Droplet nuclei
mycobacterium tb organism is by ___ ____

What living conditions predispose you to

Crowded, poorly ventilated
TB?

The incubation period of TB is... 4-8 weeks

What is the typical lung lesion of TB called? Tubercle

In TB, the appetite is ____, the client ___

Decreased, loses, elevates, afternoon
weight and the temp ___ in the ____

An intradermal skin test to screen for TB -

What is a Mantoux test?
called PPD

When should a Mantoux test be read? 48-72 hours after test injection

More than 10mm induration (hardness),

What qualifies as a positive Mantoux? remember redness has nothing to do with
the test being positive

Name 3 drugs given to treat TB Isonizad, Rifampin, Ethambutol

How often and when during the day should
Isonizad, Rifampin, and Ethambutol be Every day, all together
given?

Peripheral neuritis- take Vitamin B6 to

What is the #1 side effect Isoniazid?
prevent

After how many weeks of drug therapy is

the client considered NO LONGER 2-4 weeks
contagious?

What isolation techniques are required for

Masks
TB?

Which test is most diagnostic for TB? Sputum for acid-fast bacilli

What does the sputum look like in TB? Purulent (pus) or hemoptysis (blood)

When should you obtain a sputum

Early AM
specimen for acid fast bacilli TB?

Clear liquid diet UC diet

Bed rest UC

Women mostly UC
One-layer ulceration's with edema of bowel UC

Steroids UC and Crohn's

I&O UC and Crohn's

Rectum and sigmoid colon UC

Bloody diarrhea UC

Young adults UC

Surgery w/ ileostomy UC and Crohn's

Ileostomy UC and Crohn's

Jewish clients UC and Crohn's

Lesion through all layers of the bowel Crohn's

Terminal-distal-small intestine Crohn's

Regional enteritis Crohn's

Adults, up to 4o Crohn's

Lesions form patches Crohn's

Sulfa drug Crohn's

Granulomas Crohn's- hint: "gran"ny Crohn

"String sign" on barium enema Crohn's

Diarrhea Crohn's

Pain and cramping Crohn's

Steroids (Prednisone) UC and Crohn's

 The purpose of an upper GI series is to
Ulcerations
detect ____

What 3 structures does an upper GI series

Esophagus, stomach, duodenum
visualize?

Does barium come in different flavors? Yes

What is the most uncomfortable aspect of

Lying and turning on a hard, flat X-ray table
an upper GI series?

Is fasting required before an upper GI

Yes, usually NPO after midnight
series?

How much barium is to be swallowed? 8 oz

Barium is ___ in consistency Chalky - bitter taste

If an ulceration does not reduce by 50% on

upper GI in 3 weeks of mediation tx then Malignancy
___ is suspected

Normal rectal temp... 99.6 degree

Normal axillary temp... 97.6 degree

 If your client is 4 years old or younger,
No
should you take an oral temp?

Can you measure an oral temp on an

No
unconscious client?

Can you measure an oral temp on

No
someone with an NG tube in place?

If the client is found smoking, eating, or

drinking when you are about to take a 15 min
temp you should wait ___ (at least).

Ppl on seizure precaution should have their

Rectal or axillary, tympanic or temporal
temp measured by which route?

Ppl with facial trauma should have their

Rectal or axillary or tympanic
temp measured by which route?

Ppl with heart blocks or conduction

Rectum - vagal stimulation causes more
problems should not have their temp taken
heart block
per ____ . Why?

When using a glass thermometer it should

3-10
remain in the mouth for ___ minutes

When using a glass thermometer it should

2-3
remain in the rectum for ___ minutes

When using a glass thermometer it should

8-11
remain in the axilla for ___ minutes
 In the normal adult, which is longer,
Expiration
inspiration or expiration

Which finger should never be used to

The thumb
determine a pulse?

It is a series of X-rays taken as the person with a full

bladder is asked to void. The X-rays shown any reflux of
What is a voiding cystogram? urine back up the ureters (a dye was injected prior to
this)

Does the client need to have a catheter

Yes
inserted for a voiding cystogram?

Is the client sedated for a voiding

No
cystogram?

Is the client NPO for a voiding cystogram? No, just clear liquid breakfast

What problems does a voiding cystogram Bladder filling problems, vesicoureteral

diagnose best? reflex

What precautions are necessary for males

Shielding the testicles from the X-rays
during a voiding cystogram?

Is there a bowel evacuation prep for

No
voiding cystogram?

Permit you to remove and replace

For what reasons are Montgomery straps
dressings without using tape (protects the
used?
skin)
Sutures in general are removed by the ___
7th
day

Leaving a wound open to air decreases

infection by eliminating what 3 Dark, warm, moist
environmental conditions?

To remove tape always pull (toward/away) Toward (this way you don't put pressure/
from the wound pull on the suture line)

Define contusion Internal bruise

Define debridement Removal of necrotic tissue from a wound

Remove secretions from the area so

What is the purpose of a wound drain?
healing occurs

To prevent germs from getting into or out

of a wound you should use what type of An occlusive dressing
dressing?

What solution is put onto the skin to protect

Tincture of benzoin
it from the irritating effects of the tape?

With what is a wound closed in first

Sutures, or steri-strips, staples
intention?

What is another name for second

Granulation
intention?
 When swabbing an incision you should
start at the incision or 1 inch away from the Start at the incision and move outward
incision?

After you remove soiled dressings and

before you put on the sterile dressing you Wash your hands and put on sterile gloves
must...

What is meant by the phrase "advance the

You pull the drain out 1 inch
drain 1 inch"

After adv a Penrose drain you

(should/should not) cut off the excess Should
drain?

When a dressing is saturated, germs can

True, by a process called capillary action
enter the wound from the outside (T/F)

When is a bad time to change dressings? Mealtime

Define laceration Cut

In Abruptio Placenta, the placenta ____

Separates, prematurely
from the uterine wall ____

Abruptio Placenta usually occurs in

Multigravida, 35 (HTN, trauma, cocaine)
(prima/multi) gravida over the age of ___

Usually with pain in Abruptio but not in

How is the bleeding of Abruptio Placentia
placenta previa, bleeding more voluminous
different from that in placenta previa?
in previa
If you are the nurse starting the IV on the
client with Abruptio Placenta, what gauge 18 gauge - to give blood if necessary
needle should you use?

How often should you measure the vital q5-15min for bleeding and maternal VS -
signs, vaginal bleeding, fetal heart rate continuous fetal monitoring, deliver at
during Abruptio Placenta? earliest sign of fetal distress

How is an infant delivered when Abruptio

Usually a C-Section
Placenta is present?

Is there a higher or lower incidence of fetal

death with Abruptio Placenta compared to Higher
Placenta Previa?

In what trimester does Abruptio Placenta

Third
most commonly occur?

Should vomiting be induced after ingestion

No
of cleaning products?

At what age are accidental poisonings

2 years old
most common?

If a child swallows a potentially poisonous

Call medical help
substance, what should be done first?

Should vomiting be induced after ingestion No - not for gas or any other petroleum
of gasoline? products

When taking a child to the ER after

accidental poisoning has occurred what The suspected poison
must accompany the child to the ER?
 An elderly client is a (high/low) risk for
High - d/t poor eyesight
accidental poisoning?

What is the causative organism of acne? P. acnes (propionibacterium acnes)

What structures are involved in acne

The sebaceous glands
vulgaris?

Name 3 drugs given for acne Vitamin A, Atbs, Retinoids

Dietary indiscretions are a cause of acne

False
(T/F)

What are the 3 causative factors in Acne

Heredity, Bacterial, Hormonal
Vulgaris?

Uncleanliness is a cause of acne (T/F) False

What is the most common retinoid given to

Accutane
ppl with acne?

Accutane is an analog of which vitamin? Vitamin A

What is the most common side effect of

Inflammation of the lips
accutane?
 What side effects is MOST important in
health teaching in accutane It can cause birth defects
administration?

What is the atb most commonly given to

Tetracycline
clients with acne?

How long will it take for the person to see

4-6 weeks
results when acne is being treated?

Does stress make acne worse? Yes

How often should the client with acne wash

Twice
their face each day?

What instructions do you give a client Take it on an empty stomach and avoid the
taking tetracycline? sunlight (photosensitivity)

What are comedones? Blackheads and white heads

What virus causes AIDS? HIV - human immunodeficiency virus

The AIDS virus invades helper ___ ____ T-lymphocytes (CD4 cells)

AIDS is transmitted through what four Blood, sexual contact, breast feeding,
routes? across placenta in utero
 True, but not transmitted by all - only
HIV is present in all body fluids (T/F)
blood, semen, and breast milk

Homosexual/bisexual men, IV drug users, hemophiliacs,

Name the 5 risk groups for AIDS heterosexual partners of infected people, newborn children
of infected mother

What is the first test for HIV atbs? ELISA

What test confirms the ELISA? Western Blot

Which test is the best indicator of the

The CD4 count
progress of HIV disease?

A CD4 count of under ___ is associated

500
with the onset of AIDS- related symptoms

A CD4 count of under ___ is associated

200
with the onset of opportunistic infections

Anorexia, fatigue, weakness, night sweats,

Give 6 S&S of HIV disease
fever, diarrhea

Which 2 classes of drugs are given in NRTI's (nucleoside reverse transcriptease

combo for HIV sero-positivity? inhibitors) and PI's (protease inhibitors)

What do these drugs do? They prevent viral replication

 A delayed onset of AIDS for as long as
What does the physician hope to achieve
possible. (Usually can delay onset for 10-
with these drugs?
15 years)

What is the most common NRTI used? AZT (zidovudine)

The number of pills that must be taken in 24 hours

What is the most challenging aspect of
an be overwhelming. The frequency also makes it
combo of drug therapy for HIV disease? hard to remember- an alarm wristwatch is used

Clients with AIDS (gain/lose) weight? Lose

The typical pneumonia of AIDS is caused

Pneumocystic carinii
by ____ _____

What type of oral/esophageal infectious do

Candida
AIDS patients get?

What is the #1 cancer that AIDS patients

Kaposi's sarcoma
get?

Kaposi's sarcoma is a cancer of the ____ Skin

Can AIDS pts also get lymphomas? Yes

What lab findings are present in AIDS? Decreased RBC, WBC, platelets
If the AIDS pt has leukopenia (dec. WBC) a
Protective isolation
they will be on ___ ____

W/o leukopenia the AIDS pt will be on ___ Standard precautions or blood and body
precautions fluid precautions

When the AIDS pt has a low platelet count, Bleeding precautions: No IM's, no rectal
what is indicated? temps, etc.

Does AIDS require a single room? Yes - if WBC low

If you are going to be working with

When do you need a gown with AIDS?
secretions

Not usually unless they have an infection

When do you need a mask with AIDS?
caused by an airborne bug

Suctioning, central line start, arterial

When do you need goggles with AIDS?
procedures

If an AIDS pt blood contaminants a counter

1:10 solution of bleach and water
top, with what do you clean?

Are all articles used by AIDS pts double No - only those contaminated with
bagged? secretions

Can AIDS pt leave the floor? Yes, unless WBC very low
 Not usually - however if there is severe azotemia then it
Is dietary protein limited in AGN? may be restricted -- azotemia means nitrogenous
wastes in the blood - increased creatinine, BUN

What is the best indicator of renal function? The serum creatinine

False. The vast majority of all clients

AGN has a poor prognosis (T/F)
recover completely from it

By having all sore throats cultured for strep

How can AGN be prevented?
and treating any strep infections

What is the most important intervention in Bedrest - they can walk if hematuria,
treating AGN? edema, and hypertension are gone

What is the common dietary restriction for Moderate sodium restriction. Fluid
AGN? restriction is #2 if edema is severe.

Hematuria, usually found only in diseases ending in -itis

What are the urinalysis findings in AGN? Proteinuria +3 and +4
Specific gravity up

How long after strep infection does AGN

2-3 weeks after initial infection
develop?

How do you assess fluid excess in the child

Daily weights
with AGN?

What organism causes AGN? Group A beta hemolytic strep

 It becomes clogged with antigen-antibody
What happens to the kidney in AGN? complexes which then cause inflammation
and loss of function

How often are vital sign measurements

Q4H w BP
taken in AGN?

Will the client have hypo or hyper tension

Hypertension, bc of fluid retention
with AGN? Why?

What are the first signs of AGN? Puffiness of face, dark urine

What does AKA mean? Above the knee amputation

What does BKA mean? Below the knee amputation

If the patient had an AKA they should lie

Prone - to prevent flexion contracture
____ several times a day

The #1 contracture problem in AKA is ___

Flexion of the hip
of the ____

What will prevent hip flexion contracture

Lying prone several times a day
after AKA?

What is the #1 contracture problem after

Flexion of the knee
BKA?
How do you prevent flexion contracture of Remind the patient to straighten their knee
the knee after BKA? constantly while standing

To prevent post-op swelling, the stump

Elevated, 12-24
should be ___ for ___ to ___ hours

How often should the stump be washed? Daily

When a stump is wrapped, the bandage

Distally, proximally
should be tightest __ and loosest ____

If after a right BKA, the client c/o pain in his

Phantom limb sensation
right toe, he is experiencing ___

Phantom limb sensation is normal (T/F) True

Will phantom limb sensation subside? In a few months

Yes, this is one way to toughen a stump so it will

Is it acceptable for the patient to push the
not breakdown d/t the wear of the prosthetic leg;
stump against the wall? hitting it with pillows is another good method

An aneurysm is an abnormal ___ of the

Widening (it is also weakening), artery
wall of a(n) (artery or vein)

What artery is widened in a thoracic

The aorta
aneurysm?
Can an aneurysm result from an infection?
Yes, yes
From syphilis?

The most common symptom of abdominal

A pulsating mass above the umbilicus
aneurysm is ___

Which aneurysm is most likely to have NO

The abd is most often "silent"
symptoms... abd or thoracic?

Which vital signs are most important to

The pulse or BP
measure in clients with aneurysm?

Dec. blood supply to myocardium, resulting

What causes angina pectoris?
in ischemia and pain

Crushing substernal chest pain that may

Describe the pain of angina pectoris
radiate

What drug treats angina pectoris? Nitroglycerine

The pain of the two is very similar; the way to tell the
How do you tell if the client has angina or difference is if nitroglycerine and rest relieve the pain, its
an MI? angina. If nitroglycerine and rest do not relieve the pain,
it's probably an MI.

How many nitroglycerine tabs can you take

3 tablets
before you call the doctor?

How many minutes should lapse between 5 minutes, remember you can take up to 3
the nitroglycerine pills you take? tablets 5 minutes apart. If no relief, call MD.
By what route do you take nitroglycerine? Sublingual

Dilates coronary arteries to increase blood

What is the action of nitroglycerine?
supply and reduces preload

What are the top 2 side effects of

Headache and hypotension
nitroglycerine?

What precaution must the nurse take when Wear gloves - nurse may get a dose of the
administering topical nitroglycerine paste? medicine

Everyone with angina needs bypass

False
surgery (T/F)

Anorexics are usually ___ under the age of

Females, 25
___

The diagnosis is made when there is a

15% (Weight <85% of normal body wt.)
weight loss of ___ % or more of body
Hospitalize if 30% wt loss
weight

A major mental/ emotional nursing

Altered body image
diagnosis seen in anorexia nervosa is ___

The pulse rate of anorexics is tachy or

Brady
brady?

List the most common gynecologic S&S of

Amenorrhea
anorexia nervosa
What is found over the body of the client
Lanugo- soft downy hair
with anorexia nervosa?

What is the top priority in the care of the Intake of enough food to keep them alive,
client with anorexia nervosa? have them gain weight

The best goal to evaluate the progress of

An adequate weight gain
the client with anorexia nervosa is ___

It is a quick objective method to

What is the APGAR scale? comparatively evaluate the VITAL
FUNCTIONS of the newborn

When is APGAR scoring performed on At one minute and again at 5 minutes after
infants? birth

Cardiac status, respiratory effot, muscle

Name the 5 criteria that are recorded on
tone, neuromuscular irritability (reflexes),
an APGAR scale
and color

The total APGAR score can range from

0-10
___ to ____

The max score an infant can receive on

2
any one of the 5 criteria is ___

The lowest score an infant can receive on

0
any one criterion of the APGAR is ___

A 10 on the APGAR means the baby is in

Terrific health
___
 A 0 on the APGAR is ____ (bad/good) Bad, the baby is stillborn

On heart rate or cardiac status, a 2 means

that the HR is (above/below) ___ beats per Above, 100
minute

On the heart rate criteria an infant scores a

"1" if their HR is (greater/lesser) than 0 but Greater, 100
less than ___

In order to score a 0 on HR the infant must

Zero
have a rate of ___

A high score of 2 is given for respiratory

Cries vigorously
effort if the newborn ___ ___

An infant is given a score of 1 if their

Slow, irregular
respirations are ___ or ___

An infant is given a score of 0 for

They do not breathe
respiratory effort if ___

In order to get a score of 2 on muscle tone

Move spontaneously (actively)
the infant must ___ ___

To get a score of 1 on the APGAR for

muscle tone the newborn must place their Flexion
extremities in ___

A newborn receives a score of 0 on muscle

No movement
tone when there is ___ ___
 To score the max of 2 pts on
neuromuscular reflex irritability the infant Cry
must ___

If the neonate ___ , they will score a 1 on

Grimaces
neuromuscular irritability

To receive a 0 on reflex (neuromuscular)

No response
irritability the neonate must exhibit ___ ___

To score a max score of 2 on color the

Totally pink
child must be ___ ____

If the child's ___ are ____ and the trunk-

face abdomen are ___, the child scores 1 Extremities are blue (cyanotic), pink
on color

To get a 0 on color the infant is __/___ Totally blue, pale

Color, most healthy babies have

When a healthy child receives a 9 on the
acrocyanosis on the 1 minutes APGAR but
APGAR they most likely get a 1 on ___
get a 10 on the 5 minute.

Appendicitis is an ___ of the appendix d/t

Inflammation, obstruction
____

Appendicitis occurs most in what age

15-35
group?

What is the most common complication of

Peritonitis
appendicitis?
 What is the 1st sign of appendicitis? Right upper quadrant pain

What follows the right upper quadrant

N&V
(RUQ) abd pain of appendicitis?

Where does the pain of appendicitis finally

Right lower quadrant
end up?

What is the name of the right lower

quadrant (RLQ) abd pain where McBirney's point
appendicitis pain finally localizes?

What is present when rebound tenderness

Peritoneal inflammation
is present?

When the pain of appendicitis goes away

False - rupture has occurred
the client is improving (T/F)?

What is the highest that the temp will be in

102
appendicitis?

What blood count is elevated in

WBC
appendicitis?

What is the name for an elevated WBC? Leukocytosis

What is the only tx recommended for

Surgery - appendectomy
appendicitis?
 Before the client with suspected
No pain meds, NO enemas or laxatives, no
appendicitis sees the physician what
food
should be avoided?

To lessen the pain place the client in ___

Fowlers (Use post-op also)
position

Never apply ___ to the area of the

Heat, it ruptures
appendix

Carbs, fats, proteins, vitamins, minerals,

Name the 5/6 essential nutrients
water

The major source of energy for the body is

Carbs
___

Carbs provide ___ K cals per 1 gram 4

Sucrose is a sugar found in ___ and ____ Fruits and veggies

NO! It is a stored formed of glucose

Is glycogen eaten in foods?
MANUFACTURED by the liver

What is glycogen? A stored form of glucose/energy

Lactose is a sugar found in ___ Milk

 When the body does not receive enough
Protein and fats
carbs it burns ___ and ___

The most concentrated source of energy

Fats
for the body is ___

Fats provide ___ Kcals per 1 gram 9

Fats carry vitamins ___, ___, ___, and ___ A, D, E, K

The nutrient needed most for growth and

Protein (2nd is Vitamin C)
repair of tissues is ____

Vitamins and minerals provide energy for False- they are necessary for a body's
the body (T/F)? chemical reactions

Water is present in ALL body tissues

True (even bone)
(T/F)?

Water accounts for ___ to ___ of an adult's

50-60%
total weight

Milk & cheese; meat & legumes; veggies &

Name 4 basic food groups
fruits; bread & cereal

Water accounts for ___ to ____ of an

70-75%
infant's total weight
An individual is overweight if they are ___%
10%
above the ideal weight

An individual is obese if they weigh ___%

20%
above the ideal weight

What solution and material are used to

Plain water, cotton balls, washcloths
cleanse the eyes of an infant?

Can you use cotton swabs to clean the

No, this is dangerous
eyes, nares of ears of an infant?

Can you use the same cotton

No, it would cross contaminate
ball/washcloth edge for both eyes?

Should you cover an unhealed umbilical

No, fold the diaper down
site with the diaper?

What temperature is appropriate for the

100-105
water used to bathe an infant?

What is the #1 purpose of a tepid sponge

Lower body temp during fever
bath?

How should the temp of the water be Dropping water on inside surface of your
tested if no thermometer is available? forearms

With which body part do you begin when

Eyes, always
bathing an infant?
 When cleansing an infant's eye, cleanse
No, inner to outer
from outer to inner canthus?

Should you retract the foreskin of a 5 week No, not until foreskin retracts naturally and
old male, uncircumcised infant to cleanse without resistance - then it should be
the area? retracted, cleansed, and replaced

When sponge-bathing with tepid water the

98.6F
correct temp is ___

How many days does it take for the

7-14 days
umbilical stump to fall off?

The primary reason why an infant is

False - the primary purpose of draping is to
draped during the bath is to provide
prevent chilling
privacy (T/F)

You may use friction to remove vernix

False, it causes damage/ bruising
caseosa from an infant's skin (T/F)

What solution is commonly used for care of 70% alcohol to promote drying (trend is
the umbilical cord? toward soap & water)

What cranial nerve is affected in Bell's

#7, Facial nerve
Palsy?

What is the #1 S&S of Bell's Palsy? One-sided (unilateral) facial paralysis

Complete recovery from the paralysis of

Bell's Palsy should occur in ___ to ___ 4-6 months
months
In addition to the facial paralysis, the sense
Taste
of ___ is also affected

Will the patient be able to close their eye

No
on the affected side?

Give 3 eye interventions for the client with Dark glasses, artificial tears, cover eye at
Bell's Palsy night

As the prostate enlarges it compresses the

Urethra, retention
___ and causes urinary ___

At what age does BPH occur? Men over 50 years of age

What does BPH stand for? Benign Prostatic Hypertrophy

In BPH the man has (increased/decreased)

Increased
frequency of urination

In BPH the force of the urinary stream is

Decreased
(increased/decreased)

The man with BPH has a ___-stream of

Forked
urine

The man with BPH has hesitancy. What

Difficulty starting to void
does this mean?
 Will the man with BPH have enuresis, Enuresis (unable to control pee) - no,
nocturia, or hematuria? nocturia - yes, and hematuria - maybe

What is the best way to screen men for

Digital rectal exam
BPH?

Should fluids be forced or restricted in

Forced
BPH?

What does TURP stand for? Transurethral resection of the prostate

The most radical prostate surgery is the

Perineal
____ prostatectomy

What type of diet is used in BPH? Acid Ash

What is the primary purpose of a 3-way

To keep the catheter clear of clots and to
continuous bladder irrigation (CBI) after
drain urine
TURP?

What solution is used for CBI? Normal saline (0.9 NaCl)

At whatever rate it takes to keep the urine

How fast do you run the CBI?
flowing and free of clots

What drug is used to treat bladder

B&O suppositories
spasms?
 Should you take a rectal temp after
No rectal temps, yes stool softeners
prostatectomy? Give stool softeners?

You should call the MD after TURP when Bright thick blood, persistent clots,
you see ___ thick ____ , ___ clots, and persistent urine on dressing (don't call MD
___ urine drainage on the dressing for transitory clots and urine on dressing)

If you see an increase in the blood content Pull carefully on the catheter to apply local
of urine coming out of the catheter, you pressure on the prostate with the Foley
would first ____ balloon

If you see clots in the tubing you would first

Increase the flow-rate
___

What exercises should the post- Perineal exercises, start and stop stream of
prostectomy patient do upon discharge? urine, bc dribbling is a common but temp.
Why? problem post-op

Will the post-prostatectomy patient be If TURP, no impotence; if perineal

impotent? prostatectomy, yes impotence

How often should the urinary drainage bag

Every 8 hours
be emptied?

What is the most common problem d/t

UTI
catheterization?

What is the most common organism to

E. Coli
cause UTI with catheterization?

What urinary pH prevents UTI? Acidity, low pH

 Is it okay to routinely irrigate indwelling
No
catheters?

What agents are best for catheter care? Soap and water

What is the most effective way to dec. UTI Keep the drainage system closed, do not
with catheters? disconnect junctions of the tubing

Give some signs of infection in a Foley

Cloudy urine, foul smelling urine, hematuria
catheter

Is urinary incontinence an indication for

No
catheterization?

Give 3 appropriate indications for bladder Urinary retention, to check for residual, to
catheterization? monitor hourly output

What are the top 2 diagnoses for a client #1 - Potential for infection; Potential
with a catheter? Which is #1? impairment of urethral tissue integrity

What is systole? The maximal force of blood on artery walls

What is diastole? The lowest force of blood on artery walls

Accurate BP is obtained by using a cuff

Two-thirds
that has a width of ___ of the arm
 The difference between the systolic and
What is the pulse pressure?
the diastolic BP

If you deflate a cuff TOO SLOWLY, the High, venous congestion makes the arterial
reading will be too high or low? Why? pressure higher (increases resistance)

If you use too narrow of a cuff the reading

High
will be too high or low?

Vasoconstriction will ___ BP Increase

Vasodilation will ____ BP Decrease

Shock will ___ BP Decrease

Increase or widen (high systolic, low

IICP will ___ the pulse pressure
diastolic)

If my BP is 190/110, what is my pulse

80 mmHG
pressure?

What blood test must be done before a

Type and cross match
transfusion?

What does a type and cross match Whether the client's blood and donor blood
indicate? are compatible
 What should the nurse measure before
Vital signs
starting a transfusion?

With what solution should blood be

0.9 normal saline
transfused?

How many nurses are required to check

2
the blood?

What happens when blood is administered The cells clump together and don't flow
with dextrose IVs? well

If a transfusion reaction occurs what First, stop the blood flow and start running
should the nurse do first? the saline

How long can a unit of blood be on the unit

Less than 1/2 hour
before it must be started?

What should the nurse do with the IV line if

Keep it open with saline
transfusion reaction is suspected?

If a transfusion reaction is suspected, what

2 samples are collected and sent to the Urine and blood
lab?

If a unit of blood is transfused through a

Warmed
central line it must be ___

Which of the following are signs of

transfusion reaction? Brady, fever, hives, Low back pain, fever, wheezing, hives
wheezing, inc BP, low back pain
 What are the 3 types of transfusion
Allergic, hemolytic, febrile
reactions that can occur?

What would you do first is you suspected

Stop the blood and start the saline
transfusion reaction?

Shivering, HA, low back pain, increased

What are the signs and symptoms of a
pulse and resp., decreasing BP, oliguria,
hemolytic transfusion reaction?
hematuria

What are the S&S of a febrile transfusion Low back pain, HA - same as hemolytic
reaction? Increasing temp, confusion, hemoptysis

What are the S&S of an allergic reaction to Hives (uticaria), wheezing, pruritus, joint
a transfusion? pain (arthralgia)

Restore blood volume secondary to

Give three reasons for a blood
hemorrhage, maintain hemoglobin in
transfusion?
anemia, replace specific blood components

What does blood typing mean? Check for surface antigen on the RBC

When does typing and cross matching Whenever a client is to get a blood product.
need to be done? It is only good for 24 hours

Mixing a little of the client's blood with the

What does blood cross matching mean?
donor blood and looking for agglutination

When are hemolytic transfusion reactions

In the first 10-15 minutes
likely to occur?
 Within 30 minutes of the beginning of the
When is a febrile reaction likely to occur?
transfusion

What test IDs Rh factor? Coombs test detects antibodies to Rh

What is the difference between whole Packed cells don't have nearly as much
blood and packed cells? plasma or volume as whole blood does

What would you do if the client had an Call the MD because blood is often held
increasing temp and was to get blood? with an elevated temperature

How long should it take for one unit of

From 1-3 hours
blood to infuse?

How long should you stay with the patient

At least 15-30 minutes
after beginning a transfusion?

What blood type is the universal recipient? AB

What blood type is the universal donor? O

What is the routine for vital sign Once before admin and q15min x2 after admin has
measurements with a transfusion? begun, then q hour x1 after transfusion has stopped

What IV solution is hung with a blood

0.9 normal saline, NO glucose
transfusion?
 What gauge needle is used with a blood
Large gauge, 18 gauge
transfusion?

What other things are appropriate to do Call MD, get a blood sample, get urine
after a reaction? sample, monitor vitals, send blood to lab

Can blood be given immediately after No, it has to be warmed first for only about
removal from refrigeration? 20-30min

With what solution and when should a

Plain water, before and after each feeding
breast feeding mother cleanse the areola?

For a woman who doesn't have retracted

Air drying of the nipples is best
nipples, is towel drying or air drying better?

The goal is for the infant to breast-feed for

20 minutes
____ minutes per side

How does the mother break the suction of She inserts her little finger into the side of
the breast feeding infant? the infants mouth

When should the breast feeding infant be

After feeding from each breast
burped?

Assuming no mastitis, on which side should Begin nursing on the side that the baby
breast feeding begin? finished on the last feeding

How long can breast milk be refrigerated? 24 hours

 How long can breast milk be frozen? 6 months

In what type of container should breast

Sealed plastic bags
milk be stored?

Can you microwave frozen breast milk in

Never
order to warm/thaw it?

Which 2 nutrients is breast milk lower in? Fluoride and iron

What should you tell a breast feeding Milk should come in by postpartum day 3.
mother about her milk supply when she Breastfeed q2-3 hours to est. good milk
goes home from the hospital? supply

Should not use OCP during first 6 weeks after birth bc the
Can a woman on oral contraceptives hormones may dec. milk supply. Estrogen is not
breastfeed? recommended. Non-hormonal methods are recommended.
Remember breastfeeding is an unreliable contraceptive

Thromboangiitis obliterans - caused by small blood

What is another name for Buerger's vessels that become inflamed and swollen. The blood
disease? vessels then narrow or become completely blocked by
blood clots (thrombosis)

Which extremities are affected by it? Lower

Which sex does it affect most often? Men

The group with the highest incidence of

Smokers
Buerger's disease is ____
 Upon walking the pt with Buerger's
Intermittent Claudication
experiences ____

What is intermittent claudication? Pain in calf upon walking

A first degree burn is pale or red? Red

A first degree burn has vesicles (T/F)? False

A second-degree burn is pale or red? Red

A second-degree burn is dull or shiny? Shiny

A second-degree burn has vesicles (T/F) True

A second-degree burn is wet or dry? Wet

A third-degree burn is white or red? White

A third-degree burn is hard or soft? Hard

 A third-degree burn is wet or dry? Dry

Of first, second, and third degree burns Third degree burns, nerve damage has
which has less pain? Why? occurred

For what purpose do you use the rule of To estimate the percentage of body
nines? surface burned; is NOT used for children

In the rule of nines, the head and neck

9%, 9%
receive ___ ; each arm receives ___.

In the rule of nines, the front trunk gets

___, the posterior trunk gets ___, each leg 18%, 18%, 18%, 1%
gets ___, and the genitalia gets ____.

Tetanus toxoid - if they had a previous immunization;

What is the only IM given to a burn
Tetanus antitoxin - if they have never been immunized
patient? before (or immune globulin)

In the emergent phase do you cover

Yes, with anything clean and dry
burns? (in the field)

Should you remove adhered clothing? No

Name the 3 phases of burn Shock, diuretic, recovery

Fluid moves from the ___ to the ___ ___ in

Bloodstream, interstitial space
the shock phase
 The shock phase lasts for the first ___ to
24-48 hours
___ hours after a burn

Increased, because of all the cells

During shock phase of a burn is K inc or
damaged- the K is released from damaged
dec? Why?
cells

What acid-base disorder is seen in the

Metabolic acidosis
shock phase of a burn?

What is the #1 therapy in the shock phase? Fluid replacement/ resuscitation

What is the simple formula for calculating 3 cc x Kg x % burned per day

fluid replacement needs in the first 24 ie: 70 Kg with 50% burn
hours after a burn? 3 x 70 x 50 = 10,500 cc

If the MD orders 2800 cc of fluid in the first

24 hours after a burn, one-___ of it must Half (or 1400cc)
be infused in the first 8 hours.

The hematocrit - The hematocrit is an

What blood value will dictate IV flow rate? accurate method to measure exact
dehydration % of a patient.

How will you know the pt has entered the

The urine output will increase
fluid mobilization or diuretic phase?

How long does the fluid mobilization or

2-5 days
diuretic phase of a burn last?

Fall - remember diuresis always causes

In the diuretic phase, K+ levels fall or rise?
hypokalemia
 If the nurse accidently runs the IVs at the
shock phase rate during diuretic phase the Pulmonary edema
pt will experience ___ ____

The burn pt will be on ___ urine output and

Hourly, weight
daily ___

Sulfamyon cream ___ Burns

Silver Nitrate cream ___ the ____ Stains, skin

Pain meds should admin ___ min before

30min, wound care
___ care

When using silver nitrate, the dressings

Wet
must be kept ___

What is Curlings ulcer? Why is it a problem
in a burn patients? What drug prevents it?
It is a stress GI ulcer, you get these with any severe physical stress. Tagament,
Zantac, Pepcid, (any H2 receptor antagonist), Protonix Prilosec
-Acute peptic ulcer of the duodenum resulting as a complication from severe burns
when reduced plasma volume leads to ischemia and cell necrosis (sloughing) of the
gastric mucosa

Neoplasm refers to benign and malignant

True
rumors (T/F)

Which type of tumor is more malignant? Undifferentiated is worse to have (Highly

Differentiated or undifferentiated? differentiated is better to have)

When cancer spreads to a distant sit it is

Metastasis
called ___
 The cause of cancer is known (T/F) False

A person should have a yearly work up

exam for cancer detection over the age of 40
___

In general, cancer drugs have side effects

GI, hematologic (blood), integumentary
in which 3 body systems?

What are the 3 most common chemo GI

N&V, diarrhea, stomatitis (oral sore)
side effects?

Clients receiving chemo must be NPO

False
(T/F)

It is permissible to give lidocaine viscous ac

True
if the pt has chemo stomatosis (T/F)

With what solution should the client with

H2O2 - hydrogen peroxide
chemo stomatitis rinse pc (after meals)

What lubricant can safely be applied to the

K-Y Jelly
cracked lips of chemo stomatitis?

Name the 3 hematologic side effects of

Thrombocytopenia, leukopenia, anemia
chemo

Which cells are low in thrombocytopenia? Platelets

 What drug should NOT be given to the
ASA - aspirin
patient with chemo thrombocytopenia?

When should the nurse withhold IM

Only when their platelet count is down
injections in the client on chemo?

What are the 3 objective S&S of

Epistaxis, ecchymosis, petechiae
thrombocytopenia?

What is epistaxis? Nose bleeds

What is ecchymosis? Bruising

Small dot-like pinpoint hemorrhages on the

What is petechiae?
skin

What blood cell is low in leukopenia? WBC

When the ANC is below ___ the person on

500
chemo will be placed on reverse isolation

What is the #1 integumentary side effect of

Alopecia
chemo?

The hair loss d/t chemo is usually

True
temporary (T/F)
 Can scalp tourniquets prevent chemo
In some cases, yes
alopecia?

Can ice packs to the scalp prevent chemo

In some cases, yes
alopecia?

Cardiovascular diseases ranks ___ among

Fourth
the leading causes of maternal death

What is the #1 cause of CD of pregnancy? Rheumatic heart disease

Pregnancy requires a ___ increase in the

30-50%
cardiac output

What is the #1 cause of maternal death in

Decompensation
CD of pregnancy?

Failure of the heart to maintain adequate

What is meant by decompensation?
circulation

What will you see when you observe the

Distended neck veins - JVD
neck of a client with CD of pregnancy?

What will you hear when you auscultate the

Crackles - rales
heart of the client with CD of pregnancy?

If the client with CD of pregnancy

experiences sudden heart failure what is Sudden onset of SOB - dyspnea
the MOST common thing you will see?
What is the #1 tx of CD during pregnancy? Rest

What are the 3 most common drugs given

Diuretics, Heparin, Digitalis
to women with CD in pregnancy?

To promote diuresis, which will lower circulation

Why are diuretics given to women with CD
blood volume, decrease preload, dec the
of pregnancy?
amount of blood the heart pumps

Why are anticoags (hep only) given to To prevent thrombophlebitis d/t venous
women with CD of pregnancy? congestion, usually in legs

To inc. the strength of the heart and to dec

Why is dig given to women with CD of
the rate, rests the heart while making it
pregnancy?
more efficient

Yes, in fact they should be given

Can a woman with CD of pregnancy be
analgesics, may get too anxious which is
given analgesics during labor?
bad for the heart

Yes, even though it neg affects the fetus,

Can morphine be given to a woman with
remember morphine dec preload and pain
CD during labor?
which rests the heart

What is the most common dietary

modification for the woman with CD who Dec Na, dec water (restriction)
shows signs of decompensation?

Is a C-section mandatory for delivery of a

No
woman with CD of pregnancy?

Second to rest, what is very important tx

Weight control
for CD of pregnancy?
 How long must the woman with CD of
At least one week
pregnancy be on bed rest after delivery?

What nutrients should be supplied in the Iron, folic acid, prevent anemia (anemia
diet of this woman? always makes the heart work more)

What are the 2 most common subjective

complaints of a the woman who is SOB, palpitations
decompensating during labor?

In addition to the things you assess for in every

woman during labor, what additional assessment You must assess lung sounds frequently
must you make for a woman with CD?

How often must you assess the lung sounds

during the 1st stage of labor? During active Every 10-30 minutes
labor? During transition labor?

In which position should a woman with CD

Semi recumbent, HOB up
labor be?

The nurse should limit the client's efforts to

Bear down
___ ___ during labor when CD is present

What is the big danger to staff when caring

Radiation hazard
for a client with cesium implant?

What are the 3 principles to protect

Time, distance, shielding
yourself from radiation hazard?

Will the woman with the cesium implant

Yes
have a Foley?
From where should the nurse provide care
The head of the bed
to the client with cesium implant?

How can the woman with cesium implant

Only from side to side
move in bed?

Profuse vaginal discharge, elevated temp,

What 4 S&S should be reported to the
N&V (these indicate infection and
physician?
perforation)

Should pregnant staff care for a client with

No
a cesium implant?

Can the woman with a cesium implant

Yes, only 45 max
have the HOB elevated?

From where should the nurse talk to the

The entrance to the room
patient with a cesium implant?

Is bed rest necessary when a woman has

Yes, absolute bed rest
cesium implant in place?

What type of diet is this woman on ? Low residue

No nurse should attend the client more

One half hour
than ____ hours per day

Pick it up with the forceps only - never

What would you do if the implant came
touch with hand even if you're wearing
out?
gloves
Should the nurse provide perineal care for
No, risk of radiation hazard
the client an implant?

What part of your hand do you use to

The palm
handle a wet cast?

Upon what do you support a cast while it

Pillows (no plastic covers)
dries?

How long does it take a cast to dry? 24 hours

Should you cover a wet cast? No

Should you use a heat lamp or hair dryer NO- heat lamp and hair dryer
or fan to help dry a cast? YES- fan

Numbness, tingling, burning, pallor,

What S&S would you report if they were
unequal or absent pulses, unequal
present after cast application?
coolness

If there is inflammation under a cast, it will

"Hot"
be evident in a ___ spot

To prevent irritation of the skin near the

Petaled
edges of a cast the edges should be ___

What type of cast causes cast syndrome? A body cast

 Anxiety and stress leading to
What causes cast syndrome?
sympathoadrenal shut-down of the bowel

What is the #1 symptom of cast syndrome? N&V d/t bowel obstruction

What is the #1 tx of cast syndrome? NPO, and NG tube for decompression

A dry cast is gray or white? White

A dry cast is dull or shiny? Shiny

A dry cast is dull or resonant to

Resonant
percussion?

Traction is used to ___ a fracture, relieve Reduce and immobilize; muscle spasm;
___ ____ and prevent de-____ deformities

Can skin tractions be removed for skin

Yes
care?

Can the client be removed from skeletal

No
traction?

Name 3 types of skin traction Bucks, Bryants, Pelvic

 Cranial tongs, Thomas splints with Peason
Name 3 types of skeletal traction
attachments, 90 - 90

What type of traction is MOST commonly

Bucks
used for hip fracture in adults?

What type of traction is MOST commonly

Bryants
used for hip fracture in children?

In what position should the bed be if the

Semi-fowlers with knee gatched
patient is in pelvic traction?

To insure that Bryant's traction is working Off the bed enough to slip a hand between
the child's hip/sacrum should be ____ the sacrum and the bed

You can easily move the pt around in the

What is the adv of balanced counteraction?
bed

Patients in Russell's traction are

Thrombophlebitis
particularly prone to ____

When a pt is in Buck's traction they may

Unaffected
turn to the ____ side

Opacity of the crystalline lens d/t dec.

Define cataract
hydration and inc. density

Is surgery done immediately upon No, they usually wait until it interferes with
diagnosis of cataract? activities of daily living
 What three most common visual defects Cloudiness, diplopia (double vision),
occur with cataract? photophobia (sensitivity to light)

Laser, surgical removal. Surgery called

What are the two common tx of cataract?
intraocular or extraocular lens extraction

What does the eye look like when a client

Cloudy, milky-white pupil
has cataracts?

A protective shield/patch on the operative

What will the client be wearing after
eye for 24h, then a metal shield (AT NIGHT
cataract removal?
only) for 3 weeks

When the client asks about the use of If an intraocular lense is implanted they will NOT need
glasses. If no lense is implanted, then contacts will be
glasses or contacts after surgery what fitted 3m post-op, temporary thick glasses given
would you say? immediately but will get a diff prescription in 2-3m

What will be a high priority nursing

diagnosis for a client post cataract Safety
surgery?

Should the client ambulate independently

No, depth perception is altered
after cataract surgery?

What positions are to be avoided after Lying face down. Also, do not lie on
cataract surgery? operative side for a month

What are the post-op signs of hemorrhage

Severe pain, restlessness
into the eye?

Coughing, sneezing, bending at the waist,

What movements are to be avoided after
straining at stool, rubbing or touching eyes,
cataract surgery?
rapid head movements
 What positions are okay after cataract
Do not lie on operative side; DO lie on back
surgery?

Should you use talcum powder with a post- No, may cause sneezing; also should avoid
op cataract client? pepper

What are the 3 signs of intraocular Pain (mod. to severe), restlessness,

pressure? increased pulse rate

What is a major objective in caring for a

To prevent pressure in or on the eyes
client after surgical cataract removal?

When the lens is to be extracted for

Mydriatics, dilators, ATBs drugs
cataract what drugs are given pre-op?

Injury, congenital, exposure to heat,

Give 5 causes of cataract?
heredity, age

Celiac's disease is a ___ disease Malabsorption

The client with celiacs cannot tolerate ___ Gluten

Gluten is a ___ Protein

What does gluten do to the intestines of

It destroys the lining of the intestine
the client with celiac's disease?
The stools of a client with celiacs disease
Large, greasy, foul-smelling
are ___, ____, and ___ ____

Clients with celiac's disease do not absorb

Iron
what mineral?

Clients with celiac's disease don't absorb

fats; therefore they don't absorb ___ ____ Fat soluble vitamins
____.

What are the four fat-soluble vitamins? A, D, E, K (w/o K = bleeding disorder)

Malabsorption of which vitamin leads to

Vit K, remember do not mix up K with vit K
bleeding disorder?

What will the abd of clients with celiac's

Distended with flatus
disease look like?

What is the #1 tx of celiac's disease? Gluten-free diet

Celiac's: Veggies are allowed or not

Allowed
allowed?

Celiac's: Fruits are allowed or not allowed? Allowed

Grains of all kinds are prohibited (T/F) False

 What grains are allowed in a gluten-free
Rice and corn
diet?

What grains are not allowed in a gluten-

Wheats, oats, rye, barley, alfalfa
free diet?

Are foods made with wheat, oat or rye flour

No
allowed?

Is milk allowed on a gluten-free diet? Yes

Yes, but watch for breaded meats and hot

Are meats allowed on a gluten-free diet? dogs/ lunch meats- may have grain in them
and are not allowed

Are eggs allowed on a gluten-free diet? Yes

Is commercial ice cream allowed on a No, even though it is a milk product,

gluten-free diet? commercial ice cream has grain in it

Are puddings allowed on a gluten-free

No, for the same reason ice cream isn't
diet?

Which soups are not allowed on a gluten-

Creamed soups - these often have flour
free diet?

The #1 problem with a central line is ____ Infection

How often should central line dressings be
QOD - every other day
changed?

What type of dressing is applied to a

Sterile occlusive
central line insertion site?

Can drugs be piggybacked into central -

No, use another lumen
TPN?

Turn his head away from the site, hold

When changing central line tubing the
breath, and perform the Valsalva
patient should be told to ___
maneuver

If a central line is found accidentally open

Left side
the pt should be positioned on his ___ ___

A CVA is a ___ of brain cells d/t dec ___

Destruction; blood flow and oxygen
___ and ____

Women have a (higher/lower) incidence of

Lower
stroke than men?

Name the 3 types of CVA Embolus, thrombus, hemorrhage

Use of oral contraceptives increases the

True
risk of CVA (T/F)

Chronic abuse of alcohol increases the risk

False
of CVA (T/F)
 Obesity increases risk of CVA (T/F) True

Smoking increases risk of CVA (T/F) True

A fib inc the risk of CVA (T/F) True, emboli particularly

Transient ischemic attack, warning sign of

What is a TIA? impending CVA (transient neuro deficits of
any kind can last 30 seconds to 24 hours)

Do pts experiencing a CVA have a HA? Yes

The first sign of CVA is usually a ___ Change in LOC

The activity order in early management of

Absolute bed rest
CVA is ___

The pt with a recent CVA is most likely the

Restricted
have fluids restricted or forced?

How far should the HOB be up after CVA? 30

Can the stroke victim be turned side-to-

Yes
side
 How often should the CVA pt be turned
Q2H
and repositioned?

The CVA pt should be turned onto his

False, the pt should not be on their
paralyzed side no longer than 2 hours
paralyzed side for more than 20 min
(T/F)

ROM exercises should occur every 2 hours False - every 4 hours or 3 times a day is
(T/F) enough

To prevent urinary incontinence, the CVA False - remember incontinence will never
pt should be catheterized (T/F) be allowed as a reason for catheterization

What type of paralysis is typical of CVA -

Hemiplegia
paraplegia, hemiplegia, quadriplegia?

What anatomical fact accounts for the left

The motor-pyramidal-tracts cross over to
side of the body being controlled by the
the other side (decussate in the medulla)
right brain?

If the pt has right hemiplegia, he cannot

move his ___ and ___ the stroke was on Right arm, right leg, left
the ___ side of the brain.

Not being able to see 1/2 of the field of

What is hemianopsia?
vision

The client with hemianopsia should be

Scan
taught to ___

Moving the head from side to side to see

What is scanning?
the whole field of vision
 If the client has right homonymous
hemianopsia, the food on the ___ side of Right
the tray may be ignored

After meals the nurse must always check

Mouth (or cheek); food
__ of the CVA client for ___

Should a CVA pt have all 4 side rails up at Side rails yes. Restraints no - unless they
all times? Should they be restricted? are a danger to self or others

When a pt doesn't understand incoming

Receptive
language he is said to have ___ aphasia

When the CVA client understands your

question but can't respond verbally Expressive
correctly, he is said to have ___ aphasia?

What is global aphasia? Both receptive and expressive

Aphasia is most common if the stroke

occurred in the (dominant/non-dominant) Dominant
hemisphere of the brain

It is the side that controls their dominant hand.

How do you tell which side of the person's IE a left handed person has a dominant right hemisphere
brain is dominant? and conversely a right hand person has a dominant left
hemisphere

For which type of aphasia are slow, short,

Receptive
simple directions most useful?

For which type of aphasia is careful

listening and needs anticipation most Expressive
useful?
 The loss of the ability to perform
purposeful, skilled acts, ie, brushing teeth, Apraxia
is called ____

Cytoxan cyclophosphamide Hemorrhagic cystitis

Peripheral neuropathy, constipation,

Cisplastin
ototoxicity

Bleomycin Pulmonary fibrosis

The infant fears __ most when hospitalized Separation from love object

The toddler fears ___ most when

Separation from family
hospitalized

The preschooler fears separation as well Mutilation - remember preschoolers have

as ___ when hospitalized vivid imaginations... fantasy

The toddler and preschooler will think that

Something they did wrong
illness is caused by ___

The school-aged hospitalized child is afraid

Age group
of separation from ____.

The school-aged child perceives the cause External, she knows that illness is not a
of illness to be external or internal? result of bad behavior
 The adolescent who is hospitalized fears
Peers, independence
separation from ___ and loss of ___

Preschoolers may require physical restraint

True
during painful procedures (T/F)

Which age group engages in stalling tactics

School-age
before painful procedures most?

Which age groups are most likely to

physically resist the nurse during School-age, adolescents
procedure?

Toddlers may require physical restraint for

True
painful procedures (T/F)

The meats that are highest in cholesterol

Organ meats, liver, heart, brains, kidneys
are ___ meats

The meats that are second highest in

Shell seafood- shrimp, crab, lobster
cholesterol are the ___

Egg white is (high/low) in cholesterol? Low

Egg yolk is (high/low) in cholesterol? High

The 3 meats lowest in cholesterol are ___,

Chicken, pork, mutton
___, and ___.
 Milk is (high/low) in cholesterol Low

Is cheese high in cholesterol? Only moderate, not really that high

Which oils are high in cholesterol? Animal oils

Is cholesterol a triglyceride? No

Do plant foods contain any cholesterol? No, not many

Chronic infectious/inflammatory disease of

What is otitis media?
the middle ear

Is otitis a disease of the adult or child? Usually the child

What part of the ear is involved in otitis

Middle ear
media?

What are the 2 common subjective signs of

Hearing loss, feeling of fullness in the ear
otitis media?

What are the 2 common objective signs of Fever (hyperpyrexia), drainage from the
otitis media? ear
What commonly happens secondary to
Perforation of the ear drum
otitis media?

Do all the children with otitis media need

No
tubes in their ears?

What are the 2 most common medical tx

Systemic ATBs, ATB ear drops
for otitis media?

What is the most severe complication of

Meningitis or mastoiditis
otitis media?

An epidemial cyst in the ear highly

What is cholesteatoma?
associated with otitis media

What are the restrictions to be followed

No swimming, no showering, no diving
when tubes are in a child's ear?

What is cleft lip?

The lip is open to the nares

What is cleft palate?

The roof of the mouth is open to the nas ophary nx

Is it possible to have only one: cleft lip or

Yes, you can have one or the other or both
cleft palate?

When will the cleft lip be repaired? Between 10 weeks - 6 months

 When is the cleft palate repaired? Between 1-5 years of age

Feeding is easier after repair and

Why is cleft lip repaired early? (2 reasons) appearance after repair is more acceptable
to parents

Describe the nipple on bottles used to feed

Large-holed, soft nipples
babies with cleft lip

The infant with cleft lip/ cleft palate needs

Bubbling/ burping
more frequent ___

Children with cleft lip/palate should be fed

An almost upright position
in what position?

What is the #1 complication of cleft

Aspiration
lip/palate?

Hearing, speech, teeth

Children with cleft lip and cleft palate have Hearing - the middle ear must be full of air, which gets there from the back of the
long-term problems with ___, ___, and nose via a tube (the eustachian tube). Eustachian tubes are normally closed but
are opened by the palate muscles on swallowing allowing air to enter the middle-
____. ear cavities.

In how many surgeries is cleft palate 2 surgeries - one at 12 -18m, the last at 4-
repaired? 5y

Why is final repair of the palate delayed Earlier surgery would interfere with tooth
until 4-5 years? development

How are cleft lip /palate primarily treated? Surgical repair

 Is the infant restrained before repair? No, just after repair

Yes, they can cry; may breast-feed with

Should children with cleft palate before
simple cleft lip however palate interferes
surgery be allowed to cry? To breast-feed?
with feeding

No, the infant should be held to prevent

After repair of cleft lip is the infant allowed
crying; the infant is not allowed to breast-
to cry? To breast-feed?
feed bc sucking is not good after lip repair

After cleft lip repair, what device will the

baby wear?
A logan bow

What is the purpose of a Logan bow? To prevent stress on the suture line

With what device will the infant be

restrained after repair?
Elbow res traints

Remove the gauze before feeding and

How do you care for an infant with a Logan
cleanse after feeding with peroxide and
bow?
saline

Can cleft lip/palate babies sleep on their

Yes
backs?

What position is contraindicated after cleft

NEVER lie on their abd
lip repair?

What will be used to feed the infant after A dropper/syringe with rubber top to
cleft lip repair? discourage sucking
What must the mother do after feeding the
Rinse the infant's/child's mouth with water
baby who has had cleft lip/palate repair?

A surgically created opening of the colon

What is a colostomy?
out onto the abd wall

Name the 3 most common reasons for a

UC, diverticulitis, cancer
colostomy

A colostomy that is not intended to be

What is meant by the term "temp"
permanent - the bowel will be reconnected at a
colostomy?
later date and the client will defecate normally

What is meant by the term "double-barrel" A procedure where the colon is cut and
colostomy? both ends are brought out onto the abd

Colostomies performed for cancer tend to

Permanent
be (temp/permanent)

Colostomies performed for a gunshot tend

Temp
to be (temp/permanent)

In a double barrel colostomy, from which

Proximal
stoma (barrel) will the stool come out of?

A fresh new stoma is ___, ___, and ____ Large, red, and noisy

When a client voices embarrassment over

The noise will go away in a few days to a
the noises that their colostomy makes on
week
the first day post-op, what would you say?
 What behavior on the part of the client is
the BEST indicator that they have accepted When they do their own stoma care
their stoma?

By what day post-op should the client By the 3rd and 4th day. They should be
begin to take care of their own stoma? looking at it and asking questions by day 2

The MORE colon is removed the MORE

Liquid
___ the stool

What technique is used to remove feces

and flatus from the bowel through a
colostomy? Colos tomy irrigation

How many times per day will the client

Once
irrigate his colostomy?

Which solution is used to irrigate a

Tap water
colostomy?

How warm should the irrigation solution

Warmer than body temp, ie, 99-100F
be?

In what position should the client be when

Sitting
they irrigate their colostomy?

Define ileostomy characteristics

Liquid s tool, odor mild, s tool v ery damaging to s k in, c ont. drainage, high ris k for F&E imbalanc es , inc ontinent, nev er
irrigate
-Your ileum is the end part of y our s mall intes tine (bowel).

Define transverse colostomy

characteristics Soft s tool, ty pic al s tool odor, s tool damages the s k in, empties s ev eral times per day may be or may not be at ris k for F&E
imbalanc es , may irrigate
 Define descending colostomy
characteristics Formed s tool, ty pic al s tool odor, s tool does n't irritate unles s diarrhea, predic table 2-3 times per day empty ing, lowes t ris k
for F&E imbalanc es , c ontinent, do irrigate

CHF can be right-sided, left-sided or both-

True- left sided usually comes first
sided (T/F)

What does right-sided CHF mean? Right ventricle decomp

What does left-sided CHF mean? Left ventricle decomp

CHF can result from MI (T/F) True

When CO fails, name 3 ways the heart will Ventricular hypertrophy, dilate and heart
try to compensate rate will increase

It means that the compensatory

What is meant by cardiac
mechanisms - hypertrophy, dilation, tachy
decompensation?
are not working and the heart has failed

Name the 3 groups of drugs used to treat

Digitalis, diuretics, vasodilators
CHF?

What is the activity order for clients with

Bed rest
CHF?

What special item do clients with CHF have

to wear to dec venous stasis in the legs?
TED hos e
 How often should anti-embolism hose be
Daily
removed? (TED)

When during the day should TED hose be

Before the client gets out of bed
applied?

Is it okay to use powder with TED hose? Yes

Should you massage the calves of the

Never
client with CHF?

Before you give dig, what action must you

Measure the apical pulse
take?

Do not give dig- for a child don't give if

If the adult client's apical pulse is below 60,
pulse under 70; for an infant don't give for
what should you do?
a pulse under 90

What daily measurement best indicates the

Daily weights
amount of fluid the client is retaining?

Should clients with CHF have a foley Yes, on diuretics and fluid balance is
catheter? important

What complication is common in CHF? Pulmonary edema

When the client is taking diuretics what

mineral is the CHF client most likely to Potassium - K+
lose?
 You should tell the client with CHF to
immediately report to the doctor if he gains 3 pounds
___ lb in one week

Name the 4 most common toxic effects of Anorexia, N&V - very common, yellow
dig vision, arrhythmia

Should hearing aids be removed before

Yes, but just before surgery
going for surgery?

Conductive - sounds become quieter, although not usually distorted.

Hearing aids are more useful in sensory or
(Sensorineural hearing loss not only changes our ability to hear quiet sounds, but it
conductive hearing loss? also reduces the quality of the sound that is heard, meaning that individuals with
this type of hearing loss will often struggle to understand speech.)

Some women experience discomfort when

wearing contact lenses during pregnancy
or menstrual period (T/F) True - d/t c hange of s hape of c ornea - the trans parent front portion of the ey e.

Should a client sleep with the hearing aid in

No
place?

What are the 2 most-common causes of

Loose ear mold, low battery
whistling and squealing of a hearing aid?

What solution should be used to clean a

Water and soap
hearing aid?

What solution is best to use if you intend to

Sterile saline
remove a client's contact lenses?

Hearing aids make sounds more distinct False- they only amplify - make it louder,
and clear (T/F) they do not clarify
Can you use alcohol on the ear mold of a
No, it will dry and crack
hearing aid?

The connecting tube of a hearing aid can

A pipe cleaner
be cleansed with ____

What is the most common complication of

malpositioned lenses in the comatose or
confused pt? Corneal ulc eration - infec tion of the v arious lay ers of the c ornea. Corneal ulc ers dev elop when a break of the c orneal
epithelium res ults in mic robial ac c es s to the underly ing c orneal s troma.

In a 911 situation when hard contact

Slide the lends entirely over the sclera - get
lenses are unable to be removed what
it off the cornea
should the nurse do?

Cushings syndrome is an ____ secretion of Over, glucocorticoids, mineralocorticoids,

___, ___ and ___ ____ by the ___ ____. androgenic hormones, adrenal gland

In Cushings the blood sugar is (inc/dec) Increased

In Cushings the sodium level is (inc/dec) Increased

In Cushing syndrome, the trunk is ___ and

Obese, thin
the extremities are ____

What is seen on the abd of the pt with

Cushings?
Striae- purple horiz ontal lines

Men with Cushings develop ___ Gynecomastia

 What is gynecomastia?
Female-ty pe breas ts

Women with Cushings develop ___ Hirsutism, amenorrhea

What is hirsutism?
Hair where y ou don't want it

The Cushings syndrome pt will have a

____ ____ on their upper back
Buffalo hump

The pt. with Cushings will have (inc/dec)

Increased, remember retaining water Na
BP

The Cushings syndrome pt will have

Hyper; hypo; hyper
___natremia, ___kalemia, ___glycemia

Cushings client will have

(increased/decreased) resistance to Decreased
infection

Chronic ___ therapy imitates Cushings Steroid

Cushings man - moon face with infection and buffalo

hump on back, big trunk, thin extremities, loses K, keeps
glucose, salt, has striations on abd, and breasts (T/F) True

Is CF hereditary? Yes
 What glands are affected in CF? Exocrine glands

Fat, frothy, foul-smelling, floating,

What is the appearance of the stool in a
steatorrhea (presence of excess fat in
client with CF?
feces)

What are the top 2 nursing diagnoses for a Dec airway clearance; alteration in nutrition
client with CF? or alteration in absorption

In which two systems/organs are the most

Lungs, pancreas
problems in CF?

How does the client evaluate the activity of

Observe stools for steatorrhea
their pancreas?

What is the typical diet for the CF client? High cal, high protein, modified fat

Increased viscosity of the secretions of

The major problem in CF is ____
exocrine glands lead to obstruction

The most common intervention for CF

clients with a diagnosis of decreased
airway clearance is ____ Pos tural drainage - trac hea is inc lined downward and below the affec ted c hes t area.

Fat soluble in water soluble form - A, D, E,

What vitamins need to be replaced in CF?
K

What do CF clients need to do (ingest) in

Take NaCl tablets
hot weather?
The child with a diagnosis of CF probably Meconium ileus - bowel obstruction d/t the
had a hx of ___ ___ at birth thickness of the stool

Why is the child with CF receiving They are enzymes which aid absorption of
pancreas/ viokase/ pancreatin? nutrients

With meals, so it is in the gut while food is

When should the child with CF take his
present, the whole purpose it to inc
pancreatin/ viokase/ pancreas?
absorption of ingested food

Direct visualization of the urethra and

Define cystoscopy
bladder through a cystoscope

What would you do if the client had any

one of the following after cystoscopy: Record it but no need to call the MD
bladder spasm, burning, frequency?

What would you do if the client's urine had

Call the MD!
red blood in it after cystoscopy?

What would you do if the clients urine was Record it in the notes, no need to call the
pink-tinged after cystoscopy? MD

No, not unless a child with a general

Is the client NPO before cystoscopy? anesthetic - in fact with adults you should
encourage fluids

Are enemas required before cystoscopy? No, but may be ordered

Should you encourage fluids after

Yes
cystoscopy?
 Is a signed consent required for
Yes
cystoscopy?

What vital sign changes are most ominous A fall in BP and increase in pulse -
after cystoscopy? increasing hemorrhage

It is done under local anesthesia. General

Is the client sedated for a cystoscopy?
anesthesia may be used for a child

What drugs are most commonly given

Valium or demerol
before cystoscopy?

The goal of nursing intervention in the care

of the violent client is to prevent loss of Control, control
____ or to restore ___

Use of alcohol and/or drugs (inc./dec.) risk

Increases
of violent behavior

Pacing can be a warning sign of potential True, as it any other form of increased
violence (T/F) motor activity

If the client is not yet out of control, what is

Decrease environmental stimuli
the #1 strategy to treat beginning violence?

When a client is becoming violent you

False, allow them space or else they can
should move in close to them to provide a
get worse
sense of security (T/F)

When approaching a violent client the first

My name is ___ and I am a nurse
thing you say is...
 What are you going to do and ask if there
After IDing yourself what do you say next?
are any questions

When the client is having an overt violent

outburst you should NEVER be alone with True
them (T/F)

When you seek assistance to deal with the

violent client, you should obtain ___ Trained
personnel

Should you ever ask family or other

patients to help you physically overcome a NEVER
violent client?

When a client is overtly and actively violent, True, once enough trained personnel are
they are given a chance to calm down present the client is told that if they don't
themselves before being subdued (T/F) control themselves they will be controlled by us

To promote efficient and safe

accomplishment of physically-controlling a Only one person talk during the procedure
violent client it is extremely important that...

When a client is losing control it is very

Fear
frightening to them if the nurse shows ___

The best staff approach to control

Setting limits and doing it consistently
impulsive outbreaks of violence is...

Purpose of defense mechanism is to

Anxiety
reduce ___

When a person is consciously choosing to

Denial
disbelieve the truth, they are using ___
 False, in fact defense mechanisms are
Defense mechanism are always unhealthy
often and most always healthy bc they
(T/F)
reduce anxiety

When a pt hates someone but then Reaction formation - you form the opposite reaction, ie,
expresses the opposite emotion, it is called you love a person and that makes you anxious so you
____ form the opposite reaction and you ignore them

When an angry pt says "I am not mad, he

Projection
is"; they are using ____

When a person is unconsciously choosing

Repression
to disbelieve the truth, they are using ____

When the pt makes an excuse about

something bad that happened, they are Rationalizing
____

When a pt becomes demanding and self-

centered and attention-seeking, the Regression
defense mechanism used is ____

Defense mechanisms are ways to lie to

True, they all involve self-deception
yourself (T/F)

When a pt tells all kinds of details about

very upsetting events but acts very cool Intellectualization
and calm, they are using ____

When a pt expresses their emotions

Displacement
toward another object they are using ___

The defense mechanism most suspected

Repression
of causing psychosomatic illness is ____
 What is the most important thing to do
immediately when retinal detachment is Bedrest
suspected?

Define detached retina

Separation of the retina from the bac k of the ey e - the c horoid

Vitreous (c lear gel) pulls hard enough to tear the retina in one or more plac es . Fluid may pas s through a retinal tear, lifting
the retina off the bac k of the ey e

What is the most common complication of

Hemorrhage
retinal reattachment?

What group of drugs are given to people

Tranquilizers
with retinal detachment?

What is the most common visual defect

A veil or curtain in the line of sight
with retinal detachment?

Give 3 common causes of retinal

Trauma, aging, cataract surgery
detachment

Does the client always need surgery for No, lasers can be used, as can freezing
retinal detachment? probes

Will the clients eyes be bandaged after

Both will be, also before surgery as well
retinal surgery?

Can the client return to work after retinal Not for 3 weeks - and may not be able to
surgery? go back to active jobs 6-8w after that

What environmental change is most

appropriate for clients after retinal Dimmed lighting
reattachment?
 What are the 2 non-surgical tx done for Laser photo coagulation cryosurgery -
retinal detachment? freezing

Give 2 odd visual sensations that these

Flashes of light- floaters
clients have

Name a surgical procedure done for retinal

detachment Sc leral buc k ling - After s ealing break s and tears in the retina with either las er or c ry oporbe treatment, the s c leral buc k le
is applied. This c ons is ts of a s ilic one patc h wrapped around the ey e, c ompres s ing the globe and elongating it s lightly ,
thus pus hing the retina up agains t the pos terior as pec t of the ey e, and s ealing the detac hment. The s ilic one patc h is
us ually left in plac e permanently , unles s it c aus es problems later, s uc h as infec tion.

When does anterior fontanel close?

18-24m

Infant's birthweight should ___ in 6m Double

Infant's birthweight should ___ in 1year Triple

Infant's resp rate is ___ to ____ BPM 30-60

Infant's HR is ___ to ___ BPM 110-160

Which are the first teeth to erupt? Lower central incisors

When does infant's teeth first erupt? 4-6 months

What age can infant follow an object with
2m
its head?

What age are children first afraid of

6-7m
strangers?

What age does an infant walk alone? 14-15m

What age does an infant have a pincer

12-13m
grasp?

What age can an infant roll over? 4-5 months

What age can an infant sit up unassisted? 6-8m

What age does an infant stand alone? 12-13m

What age does an infant crawl? 8-9m

What age does an infant walk holding onto

10-11m
furniture?

What visual experiences will pt with dig

Yellow/ green halos around lights
toxicity have?
 The signs of lithium toxicity are ___
(muscle symptom), ___, (abd sign), and Tremor, N&V
thirst

Lithium carbonate is given for ___ disorder Bipolar (manic-depressive)

When a pt is on lithium you must watch for

Sodium
a dec in ____

Theophylline is a broncho-___ used to

Dilator, asthma
treat ___

Dig toxicity exists when blood levels

2.0 ng/dl
exceeds ___

The earliest sign of dig toxicity is... N&V with HA

Is theophylline toxicity life-threatening? Yes

Lithium toxicity occurs when blood levels

2.0
are higher than ___ mEq/L

The signs of theophylline toxicity are ___

N&V (coffe ground emesis), tachy, tremors
(GI), ___ (heart), ____ (muscle)

What is the therapeutic blood level of

10-20
theophylline?
 Dig is a cardiac ___, used to ___ the
Glycoside, increase
contraction of cardiac muscle

Theophylline toxicity exists when the blood

20
level is above ___

Ectopic pregnancy is implantation of a

fertilized ovum ___ the ___
Outs ide, uterus

The most common site for ectopic

Fallopian tubes (90%)
pregnancy is in the ___ ____

Have intrauterine devices to prevent

pregnancy ever been linked to ectopic Yes, so have pelvic infections
pregnancies?

What is the most common sign of fallopian

Unilateral pelvic pain
tube ectopic pregnancy?

What is the most dangerous side effect/

complication of fallopian tube ectopic Rupture of the fallopian tube
pregnancy?

If the fallopian tube ruptures d/t ectopic

pregnancy, nursing care is the same as Shock and peritonitis
that for ____

The uterus feels ____ after rupture of a

Boggy - tender, also
fallopian ectopic pregnancy

The first sign that a fallopian ectopic

Sharp abd pain
pregnancy had ruptured is...
 Ectopic pregnancy is (usually/almost
Almost never
never) carried to term

The most common med-surg tx for ectopic Surgical removal of fetus and some
pregnancy is ___ surrounding tissue

Exploratory laparotomy - midline incision is carried down

Name the surgery performed for ectopic to the linea alba and the fascia is incised. The
pregnancy peritoneum is entered and any immediate, life-
threatening bleeding is identified and controlled.

What is ECT?
The us e of elec tric al s hoc k c urrent deliv ered to the brain to induc e a s eiz ure that treats depres s ion

The client is (awake/under local

Under general anesthesia - must be
anesthesia/ under general anesthesia)
artificially ventilated
during ECT

What conditions does ECT treat? Depression primarily

Is an informed consent necessary for

Yes
ECT?

Aspiration of emesis (most common) into

Name the 3 most common complications of
the lung, dislocation of joints, fractures d/t
ECT?
convulsion - rarely

What class of drugs is given with ECT? Muscle relaxant - succinylcholine

What intellectual ability is impaired with

Memory
ECT?
 How long will a client's memory be
2-3 weeks
impaired after ECT?

Immediately after ECT, how will the client

Drowsy, dull, apathetic
normally act?

In what position should the client be On their side - to prevent aspiration of

immediately after ECT? emesis

NPO after midnight - remove dentures,

What typical pre-op type of orders will be
client to void before procedure, side rails
ordered before ECT?
up

The convulsion (seizure) that the electrical False, it used to be, but it isn't any more
current produced is violent (T/F) with the use of muscle relaxants

What does an EEG measure?

Meas ures elec tric al ac tiv ity generated by the brain

When are there activity restrictions after an ONLY when sedatives are used, and then
EEG? it's only necessary to keep side rails up

Should the client wash his hair before an

Yes
EEG?

That is impossible since the test measures

What would you tell a client who says what
electrical activity coming FROM him, never
if I get shocked during my EEG?
to him

No, they should never be NPO, it could

Does a client have to be NPO before an
cause hypoglycemia and alter the EEG
EEG?
results
 What instructions are MOST important to
Try not to move
give a client during an EEG?

What should the client do after an EEG? Wash their hair

Should sedatives be given before an EEG? Only if ordered as a pre-test medication

How much sleep should the client get the 4-5 hours - unless it is a sleep deprivation
night before an EEG? EEG

Do you need a signed informed consent for

No
an EEG?

Yes. It should be eliminated for 24hrs

Should caffeine be limited before an EEG?
before the test

What will excessively fatty stool be like? Large, pale, foul-smelling, greasy

What are large, pale, foul-smelling, greasy,

Steatorrhea
stools called?

Name the 3 types of parasites abnormally

Roundworm, tapeworm, pinworm
found in stool

What does occult blood in feces mean? Bleeding somewhere in the GI tract
 Are fats a normal constituent of feces? Yes, but it should be WDL

A decrease in urobilin in stool results in a

Clay-colored
stool that is ____ ___

Name the 2 things for which stool

Occult blood, fat, ova, and parasites
specimens are tested

Is blood a normal constituent of feces? No

What is melena? A black, tarry stool indicating GI bleed

What position is best for clients with

Semi-fowlers or higher
emphysema under normal circumstances?

What flow rates of O2 are appropriate for Low flow - <2.5L/min; NEVER exceed 2.5L
the client with emphysema? in COPD

If a client with emphysema has a severe Sitting upright with arms folded on the over
dyspneic episode what position is best? bed table

What will you observe on the hands of the

Clubbing of the fingernail beds
client with emphysema?

In emphysema, the alveoli are over- ___ Enlarged, ventilated so that air is trapped in
and under-____ alveoli
 The development of emphysema is most
Smoking
ass. with a history of ___

In emphysema, the appetite ___ the weight

___ and the anterior-post diameter of the Dec., dec., inc.
chest ___

What is the increase in anterior-posterior

Barrel chest
diameter of emphysema called?

The persons with emphysema have ___,

Grunting, pursed, rapid
___ lip and (slow/rapid) breathing

What dietary prescription is most

Freq. small meals to prevent tiring
appropriate for the client with emphysema?

What fluid order should the emphysema

3L/day (this is an increase)
client have?

The client with emphysema is (ruddy/pale /

Cyanotic
cyanotic)

Another name for hyperthyroidism

Grav e's dis eas e (y ou're going to run y ours elf into the grav e)

Another name for high growth hormone in

Gigantism
a child

Another name for over-secretion of

Conn's disease
mineralcorticoids only
 Another name for low growth hormone
Pituitary dwarfis m

Another name for high growth is an adult Acromegaly

Another name for undersecretion of

adrenal cortex
Addis on's dis eas e

Another name for hypothyroidism in an

adult
My x edema

Another name for over secretion of adrenal

cortex
Cus hing's s y ndrome

Another name for over secretion adrenal

Pheochromocytoma
medulla

Another name of hypothyroidism in child Cretinism

Another name for over secretion of ACTH Cushing's syndrome

Growth of endometrial tissue outside of

What is endometriosis?
uterus

Endometriosis most commonly occurs in

25-40
women between ages of ___ and ____
After menopause, endometriosis (dec/inc) Dec.

What is the MOST common side effect of

Dysmenorrhea (painful menstruation )
endometriosis?

What is the major complication of

Infertility
endometriosis?

What diagnostic procedure confirms the

Laparoscopy
diagnosis endometriosis?

What class of drug is used to

Androgens
conservatively treat endometriosis?

Which androgen drug is most commonly

Danazol
used to tx endometriosis?

Women with endometriosis should be

counseled to use (tampons/pads) during Pads only
menstruation

Will client die of endometriosis? What

Not life-threatening
would you say?

What advice is best for women with Do not postpone pregnancy, may not be
endometriosis who want to have kids? able to have children

What is the #1 danger of epiglottitis? Airway obstruction

 Epiglottitis most commonly occurs in
1-8y
children from age ___ to ____

What organism causes epiglottitis? Hemophilus influenza B

What level of fever is present in epiglottitis? Over 102

What S&S are classic epiglottitis? Muffled voice, drooling, stridor

No, there will be a lack of spontaneous

Will a child with epiglottitis cough?
cough

How will the child with epiglottitis breathe? Leaned forward with flaring nostrils

If a child is suspected having epiglottitis NO, never put any instrument in the child's
should you put a tongue depressor in their mouth unless you are prepared to do an
mouth look? immediate intubation

Would you do a throat culture? NO, never put anything in their mouth

If epiglottitis is suspected, what should the To take the child to the ER as soon as
parents be told? possible

Children with epiglottitis often need a

Restlessness, increased heart rate, and
tracheotomy, what behavior would indicate
retractions
the need for a tracheotomy?
 What is recommended for prevention of All children 2 months and over should
epiglottitis? receive an H. Influenza B vaccine

Insertion of a fiber optic scope to visualize

Define EGD the esophagus, stomach, and duodenum -
Left side, 5-20min

What can be done during an EGD besides

visualization?
Remov e poly ps , tak e s pec imens , c oagulate bleeding v es s els

Can EGD be done on an uncooperative

No
client?

Does client need to have the side rails up Yes, until sedative effects of valium have
after EGD? worn off (meds in vein)

Can an EGD be done on clients with GI

Yes
bleeding?

Yes, with valium (diazepam) - or another

Is the client sedated before EGD?
sedative

What pre-test activities must be performed Remove dentures, eyeglasses, sign

before the EGD? consent, NPO after midnight

When can an EGD client begin to eat after When gag reflex returns (knocked out with
the test? lidocaine)

Is an EGD a fasting procedure? Yes, after midnight

 What drug is given to anesthetize the
Lidocaine- a local anesthetic
pharynx?

Perforation of gut, aspiration secondary to

What are complications of EGD?
emesis, respiratory arrest (d/t valium)

What 2 discomforts are common during an

Vomiting and gagging
EGD?

What is the most dangerous complication

Secondary respiratory arrest (valium)
of an EGD?

What is the most common complaint after

Sore throat
an EGD?

Treat glaucoma, decreases aqueous

Eyes - Carbonic Anhydrase inhibitors
humor production, diuresis. Ex. Diamox

Dilates pupil, causes photophobia, used

Eyes - Anticholinergic pre-op for cataract removal, don't use in
glaucoma. Ex. Atropine

Eyes - Miotic Constricts pupil. Ex. Timoptic, Pilocarpine

Tachy, photophobia, dilates pupil, do not

Mydriatic
use in glaucoma. Ex. Neo-synephrine

Dec. production of aqueous humor and

What do carbonic anhydrase inhibitors do
thus decrease intraocular pressure (tx
to the eye?
gluacoma)
 Name the most common side effect of
Diuresis
carbonic anhydrase inhibitors

Which 2 groups of these drugs cause

Anticholinergics & Mydriatics
photophobia?

Which of these classes of drugs causes

Miotics
contact dermatitis?

What do mydriatics do for the eye? Dilate the pupil (My"D"riatic - "D" for dilate)

What do miotics do for the eye? Constrict the pupil

Name one Mydriatic Atropine & Neo synephrine

Dilate the pupil, cycloplegia, paralyzes

What do anticholinergics do for the eye?
accommodation

Paralysis of pupil/iris -Because of the paralysis of the ciliary

muscle, the curvature of the lens can no longer be adjusted to
What is cycloplegia? focus on nearby objects

(what's done during eye exam)

Which 2 of these classes of drugs cause MyDriatics, anticholinergics (sympathetic

tachycardia? effects)

What is the most common use for To cause cycloplegia (dilation), allowing
anticholinergics in the eye? eye exam
 Placed on lower inner eye lid, then have
How should eye ointments be given?
client close eyes

Name 2 anticholinergic used in the eye. Cyclogel, atropine

Name one carbonic anhydrase inhibitor. Diamox

How should eye drops be given? Place drops into the lower conjunctival sac

How is the flow of eye irrigational fluid

From inner canthus to outer canthus
directed?

Pilocarpine, Timpotic (or any drug ending

Name two miotics
in "lol")

Increasing dietary fiber intake lowers the

Cancer, colon
risk of ___ of the ___

Foods lose some or all of their fiber when

Processed, cooked, peeled, refined
they are ___, ____, ____, or ____.

Whole grain and grain products are

High
(high/low) in fiber

Fruits are (low/high) in fiber High

 Veggies are (low/high) in fiber High

Milk and milk products are (high/low) in

Low
fiber

Meats are (high/low) in fiber Low

Nuts, seeds, and legumes are (high/low) in

Low
fiber

Which has highest fiber? Grains, fruits,

Grains - esp bran
veggies, nuts

When a person increases fiber in the diet

Slowly
they should do so ____

Side effects of a high fiber diet include

Gas (flatus), minerals
____ and the malabsorption of ___

Of milled bread, enriched bread, fortified

bread & whole grain bread; which is Whole grain
highest in fibers?

What type of herpes virus causes genital

Herpes simplex II
herpes

Name the 2 most common ways genital

Sexual intercourse/contact; through birth
herpes is transmitted
How long is the incubation period of genital
3-7 days (about the same for gonorrhea)
herpes?

What do lesions of herpes look like?

Fluid filled v es ic les

What are the 2 most common sites for

On the genitals and the mouth
herpes?

Acyclovir (or Gancyclovir, Famciclovir,

What drug is used to treat herpes?
Penciclovir, Valacyclovir)

The client should keep the lesions

Dry
(dry/wet)

What precautions should the person with

No intercourse while the vesicles are
herpes take in regard to sexual
evident
intercourse?

When is C-section delivery indicated if the If the vesicles are present, then C-section
mother is infected with herpes? is indicated

How long will it take for the vesicles to

2-4 weeks
heal?

Glaucoma is an eye disorder in which there

is ___ intraocular pressure in the ___ Increased, anterior
chamber