Med surg final

  1. What is the treatment for V-tach? With a pulse and with no pulse.
    • Pulse: O2, amiodarone, lidocaine, cardioversion
    • No pulse: CPR and DEFIBRILLATION
  2. What is the treatment for F-vib?
    • CPR
    • Defibrillation
    • Epinephrine
    • Shock
    • Amiodarone
  3. What are 3 symptoms associated with cardiac tamponade?
    • JVD
    • muffled heart tones
    • Hypotension
  4. What is the main presenting symptom of pancreatitis?
    Abdominal pain!!
  5. What disorder is suspected in a client who presents with pain, jaundice, and clay-colored stools?
  6. What can you teach the client to do to prevent dumping syndrome?
    • Avoid sugar, salt, and milk
    • Eat a high protein, high fat, low card diet
    • Eat small meals and avoid consuming fluids with meals
    • Lie down after meals
    • Take antispasmodic medications
  7. Which disease would u suspect in a client that expierences dull, gnawing pain in the mid-epigastrum or radiating pain to the back that is relieved by eating or taking antacids?
  8. Bloody diarrhea, abdominal pain and tenderness are signs of what?
    Ulcerative colitis
  9. Cobblestone granuloma, diarrhea 3-5x a day is indicative of what?
    Crohn's disease (regional enteritis)
  10. What do you hang when you run out of TPN?
    10% dextrose
  11. Which type of nutrtion is preferred?
    Enteral (maintains gut, fewer complications)
  12. What are the signs of bowel perforation and peritonitis?
    • Guarding of the abdomen
    • Increased fever and chills
    • Pallor
    • Progressive abdominal distention and abdominal pain
    • Restlessness
    • Tachycardia and tachypnea
  13. The client with chronic pancreatitis needs to limit which item in the diet?
  14. Dysfunction of the lower motor neuron pathways result in:
  15. Hyperventilation is recommended if there is any indication of increased ICP. This intervention decreases ICP by:
    lowering CO2, which results in vasoconstriction
  16. What type of solution would you likely hang in a patient with brain trauma?
  17. What are the 3 signs/symptoms of cushing's triad?
    Hypertension, bradycardia, bradypnea
  18. You are caring for a patient with a brainstem injury, what is your priority assessment?
    Respiratory rate and rhythm
  19. Client with laryngeal cancer has undergone radiation to the head and neck, what adverse effects of external radiation would you monitor for?
    • Xerostoma (dry mouth)
    • Stomatitis
    • Dysgeusia (distortion of taste)
  20. What is allopurinal used for?
    Reduces the amount of uric acid hte bdoy makes (chemo)
  21. Myelosuppression (bone marrow suppression) includes what 3 problems? And what are you at risk for?
    • Anemia (decreased RBC's)
    • Thrombocytopenia (decreased PLT's)
    • Neutropenia (decreased production of granulocytes)

    Risk for --> Infection and bleeding
  22. What are neutropenic precautions?
    • Use of gloves!
    • No fresh fruit or flowers
  23. How do we assess thrombocytopenia?
    Decreased PLT count
  24. What are two electrolyte involved oncologic emergencies?
    • Hyponatremia
    • Hypercalcemia
  25. Patient with thrombocytopenia is at risk for what?
  26. What ulcer is a common complication in burn injuries?
    • Culring's Ulcer
    • Curling's ulcer is a common complication secondary to hypersecretion of gastric acid--look for pain, occult bleeding, hematemesis
  27. Tracheal deviation, unilateral absence of breath sounds, and neck vein distension are symptoms associated with:
    Tension pneumothorax
  28. Tumor lysis syndrome is manifested by what finding?
    elevated uric acid
  29. A client with multiple sclerosis is prescribed Balcofen for what reason?
    relieve muscle spasms
  30. What is the best choice of airway maintenance in an unconsious trauma victim?
    Oropharyngeal airway
  31. Which sign/ symptom alerts the nurse to a serious complication of a pelvic fracture?
    Gross Hematuria
  32. The primary nursing goal for a myasthnia gravis patient is
    maintaining respiratory function
  33. What is cranial nerve 9? What does it do?
    Glossopharyngeal- gag reflex- risk for aspiration
  34. The nurse is planning care for an adult man who is admitted with severe flame burns. Nursing care planning is based on the knowledge that the first 24-48 hours post-burn care is characterized by:
    fluid shift from plasma to interstitial spaces
  35. Which classification of medications is used most often to combat the most frequent side effect of chemotherapy?
  36. Which nursing actions assists the client to have adequate ABG values after a head injury?
    Manually hyperventilating with 100% oxygen for 60 seconds before suctioning
  37. To detect a common adverse (potentially life-threatening) effect of chemotherapy the nurse should assess the client for the development of which symptom?
  38. What vital sign changes are seen with increased ICP?
    • Increased temp and BP
    • Decreased pulse and respirations
  39. A client's platelet count is 95,000/ul. The nurse concludes that the client understands instructions to avoid potential complications when the client states to do what?
    Avoid aspirin and aspirin (salicylate)-containing products
  40. A nurse is caring for a client with metastatic bone disease. The client complains to the nurse of irritability, confusion, and weight gain. The nurse determines that these findings are indicative of:
    • SIADH
    • (SIADH causes water retention)
  41. A long term goal for a client with multiple sclerosis is to prevent:
    • Contractures!
    • (Major complications associated with MS include contractures, decubitus ulcers, and respiratory complications)
  42. The nurse should assess a client in the emergent phase of a burn injury for:
  43. The major stimulus to acute glomerulonephritis is:
    Group A streptococcal infection
  44. A patient presents with difficulty starting urination and voiding several times during the night, which disease is the pt most likely suffering from?
  45. UTI and Pyelonephritis are usually caused by which organism?
    E. coli
  46. The major manifestation of nephrotic syndrome is:
  47. A clinical diagnosis of nephrotic syndrome is consistent with an exceedingly high level of:
    Protein in the urine
  48. What is the leading cause of ESRD?
    Diabetes mellitus
  49. Female reports loss of urine when she jogs, what type of incontinence is this?
    Stress incontinence
  50. The nurse would assess the client with urolithiasis for what symptom?
    Flank pain
  51. Which type of incontinence occurs from a sudden increase in intra-abdominal pressure?
    Stress incontinence
  52. Type of incontinence that occurs from loss of sensation (paraplegia)
    Reflex incontinence
  53. Type of incontinence preceded by UTI, tumors, or neurologic dysfunction
    Urge incontinence
  54. What side effects do clients often experience from dialysis?
    Hypotension and muscle cramping
  55. What is the first most common clinical manifestation of acute renal failure?
  56. Clients with acute glomerulonephritis exhibit what clinical manifestations? (3)
    • Hematuria
    • Proteinuria
    • Tea colored urine
  57. What is the purpose of intestinal decompression?
    remove fluid and gas build up above level of obstruction, to prevent nausea/vomiting and decrease risk of aspiration.
  58. Client has been prescribed a renal diet, which selection would indicate understanding of the prescribed diet?
    • Toast, grits, eggs, coffee.
    • *High in carbs, low in protein*
  59. A client with Ulcerative Colitis should follow what sort of diet?
    High in protein, low in residue.
  60. The function of the three lumens in a triple lumen catheter is:
    continuous inflow and outflow of the irrigation solution
  61. What is the most life threatening effect of renal failure?
    Retention of potassium
  62. What are the signs of a UTI in an elderly client?
    Fatigue and observable cognitive changes
  63. The nurse is teaching a client that is about to undergo a fistula creation, what should the nurse tell the client?
    a vein and an artery in your arm will be attached surgically
  64. What nursing intervention is important when monitoring a patient with BPH?
    Assess for bladder distention after voiding
  65. The nurse teaching a client about chronic renal failure, should instruct the client to restrict what foods?
    Potatoes, tomato sauce, and dried figs (foods high in potassium)
  66. What is kayexalate used for?
    To lower potassium levels (exchanges potassium ions with sodium ions)
  67. What dialysis therapy is best for a hemodynamically unstable client?
    Continuous venovenous hemodialysis (CWHD)
  68. Before hypertonic glucose, insulin infusion, and sodium bicarb are administered, the nurse should:
    Assess lab data (these meds are given for high potassium levels)
  69. To reduce to the risk of infection in a client with a transplanted kidney, it is imperative that the nurse:
    wash hands frequently
  70. What would be most beneficial for a client who has ulcerative colitis and has lost 12 pounds?
  71. A client with BPH has a distended bladder and experiences involuntary loss of urine, what type of inctontinence is he experiencing?
    Overflow incontinence
  72. Why are steroids prescribed to the client with ulcerative colitis?
    Steroids are used in acute flare ups b/c they can decrease the incidence of bleeding (steroids decrease inflammation which decerase the bleeding from ulcerations)
  73. An elemental diet is prescribed to a client with inflammatory bowel to promote:
    nutrient absorption within the upper GI tract
  74. When should prevacid be taken?
    Before meals
  75. What clinical finding should the nurse look for in a client with chronic renal failure?
  76. Are grafts or fistulas able to be used sooner?
    • Grafts
    • AV graft 2-3 weeks, fistual 4-6 weeks
  77. The client has developed peritonitis r/t a perforated ulcer. During the nusing assessment, what would the nurse most likely find?
    Rigid abdomen
  78. What is needed after a gastrectomy for gastric cancer?
    Monthly B12 injections
  79. What assessment findings would be present in a client with a small bowel obstruction?
    • Projectile vomiting
    • Hyperactive bowel sounds
    • Tachycardia, hypotension, and dehydration
  80. When teaching a client about the purpose of cimethidine, an H2 antagonist, the nurse should explain that it will:
    inhibit gastric acid formation
  81. The nurse suspects upper GI bleed, when she observes stool that is:
    tarry and black
  82. TPN is tapered before discontinuing to prevent what complication?
    Rebound hypoglycemia
  83. Clients experiencing malabsorption will exhibit what manifestations?
    • Easy bruising
    • Prolonged INR when taking coumadin
    • Anemia
    • Osteoporosis
  84. Which foods need to be avoided with GERD and esophagitis?
    Caffiene, alcohol, and chocolate
  85. A client has undergone a radical neck dissection, post-op what needs to be assessed?
    • Breath sounds!
    • (assess for stridor!!)
  86. In preparing a client for a barium enema, the nurse can expect that the client will be:
    placed on a low residue diet 1-2 days before the test
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Med surg final