241 Review Questions F25 | Baamboozle - Baamboozle

What are 2 complications of cardiopulmonary bypass?

air embolis, decreased plt= high risk for bleeding, hypothermia

You are caring for a patient who presents with high RR, arrythmia, hypoxia, and pinky frothy sputum, what do you think is happening to your patient?

they are experiencing s/s of ACUTE PULMONARY EDEMA

What is a common complication for OHS/CABG that results in vasoconstriction, and hypoxia?

hypothermia

What are the top 2 manifestions seen with pulmonary edema and require immediate intervention?

Hypoxia, and Arrythmias

What is the complicaiton called when Blood accumulates around the heart pushing against the heart, preventing appropriate contraction?

CARDIAC TAMPONADE

What is the machine called that is used during OHS to divert blood from the heart, and allow heart to be still during surgery?

Cardiopulmonary bypass (CPB)

What Medication that works by Increasing diuresis & Vasodilator but needs its own IV site?

Synthetic BNP (Nesiritide or Natrecor)

How do you know if someone has improvement in heart failure?

Decreased crackles upon auscultation s/p treatment indicates improvement

What is the Main Goal of heart failure treatment?

DECREASE WORK LOAD TO INCREASE HEART FUNCTION

What is the Procedure that Provides information regarding the heart structure and function?

Cardiac Cath

What are the signs and symptoms for left sided heart failure?

Inspiratory Crackles, confusion, dizziness, and SOB

Your patient presents with right sided heart failure which is not a typical sign of right sided failure?

Rales

JVD

Ascites

Peripheral Edema

What is the role of medication in Parkinson's Disease and Parkinson's Disease Dementia if there's no cure?

Medications can help manage the symptoms of Parkinson's and improve quality of life.

What are some ways that dressing can be made easier for someone with Parkinson's?

Pull on clothing (elastic waist), Velcro closures instead of zippers and buttons.

What is facial masking?

Decreased expression/emotion visible on the face of someone with Parkinson's due to the disease's effect on the muscles.

What are some secondary Parkinson's symptoms?

Anxiety, Confusion, Dementia, Constipation, Depression, Diminished sense of smell, Skin problems, Urinary frequency, Slow/Quiet speech and more

What are the primary symptoms of Parkinson's?

Tremor, Rigidity, Bradykinesia (slowness of movement), Postural Instability (impaired balance and coordination)

What bodily functions does dopamine help regulate?

Motivation, Reward, Movement, Memory, Mood, Attention, Sleep, Immunity

Loss of which neurotransmitter (brain chemical) is part of the Parkinson's Disease process?

Dopamine

What is Parkinson's Disease?

A chronic, progressive movement disorder

A patient has lab work drawn and it shows a positive HBsAg. What education will you provide to the patient?

avoid sexual intervourse or intimacy until negative test

The pt is less likely to develop a chronic infection

Pt is now recovered from a previous hep B infection

Pt is not a candidate for antiviral or interferon meds

A patient with Hepatitis A asks you about the treatment options for this condition. Your response is?

Supportive Care

A patient has completed the Hepatitis B vaccine series. What blood result below would demonstrate the vaccine series was successful at providing immunity to Hepatitis B?

Positive anti-HBs

What is the most effective practice to prevent Hepatitis A transmission?

Washing hands with soap and water

These types of hepatitis are transmitted via blood and body fluids.

Hep B, C, & D

Which medication would the nurse exepect to administer to a patient with serum ammonia of 164 mcmol/L(15–55 mcmol/L)

Lactulose

A patient with end stage liver disease admitted to the medical surgical floor, keeps trying to crawl out of bed, and is actively hallucinating. What is the most likely reason for his behavior?

Hepatic encephalopathy secondary to elevated ammonia level.

What is the purpose of oral pancreatic enzymes in chronic pancreatitis?

Aids in digestion of carbs, fats, and proteins

What are the primary interventions for a patient with acute pancreatitis?

NPO, IVF, pain management

Breakdown of pancreatic and surrounding tissue by pancreatic enzymes is a complication of acute pancreatitis associated with high mortality. What is this complication called?

Necrotizing Pancreatitis

These lab values are elevated in acute pancreatitis

Amylase and Lipase

These types of hepatitis are transmitted via the fecal oral route?

Hep A& E

You want to avoid milk products with what group of abx?

flouroquinolones

Why can't you use Tetracyclines with children under 8 or lactating women?

If binds to calcium, causes tooth discoloration, and bone malformation

What is the most common drug used for UTI's?

Sulfonamides

What happens if you take PCN with oral contraceptives?

It makes them less effective

What is the black box warning for the quinolones like Cipro or Levaquin?

tendonitis and/or tendon rupture

What happens when you take antacids with quinolones like Levaquin or Cipro?

It reduces absorption

What drug allergy is concerning to the nurse if they know the patient is ordered a cephalosporin?

PCN - they are related

Do you need to draw a blood level before administering the third dose of vancomycin?

YES

What are the 2 toxicities you need to worry about with aminoglycosides?

nephrotoxicity and ototoxicity

Does bactericidal therapy kill bacteria or inhibit the growth of susceptible bacteria?

Kills bacteria

What lab test would be elevated before abx and then expected to go down after abx?

WBC

What infection can be caused if a patient is on long term antibiotics?

Clostridium difficile (C-diff)

Name any 3 signs and symptoms of a hypersensitivity reaction.

itching, wheezing, SOB, tongue swelling

Which antibiotic therapy would be used before a patient goes to OR to prevent an infection?

prophylactic therapy

What test needs to be done before an antibiotic is given to any patient?

Culture

What is the most common Health Care Associated Infection?

MRSA

Most common treatment for Thyroid Cancer?

Total thyroidectomy

What symptoms may be seen with thyrotoxicosis?

Increased HR, Increased BP and atrial fibrillation

True of False: When the metabolic rate falls, the hypothalamus stimulates the pituitary gland to secrete TSH

True

Which classification of drugs could precipitate a potentially fatal myxedema (hypothyroidism) coma in a person with severe hypothyroidism? (Select all that apply.)

Opioids, sedatives, Tranquilizers

Which priority intervention will the nurse implement when on the second postoperative day after a subtotal thyroidectomy, the patient tells the nurse that they feel numbness and tingling around their mouth?

Attempt to elicit Chvostek sign

Which priority intervention should be implemented when 12 hours after a total thyroidectomy, the patient develops dyspnea and respiratory distress?

Prepare for an emergency tracheotomy!

A patient scheduled for a partial thyroidectomy asks the nurse why they are being given an iodine preparation before surgery. Which response by the nurse is the best response?

"It will decrease the release of thyroid hormones before surgery."

A patient with a history of hyperthyroidism returns to the unit 12 hours after a thyroidectomy. The nurse notes tachycardia, cardiac dysrhythmias, vomiting, and fever. Which diagnosis does the nurse suspect the patient is experiencing based

Thyroid Storm

Several hours after a thyroidectomy, a patient is transferred from a stretcher to a bed. Which position would the nurse place the patient in after checking the bandage?

Semi-Fowler

What is a reliable parameter to measure volume overload and changes in fluid retention in patients?

Daily weight and urine output

Which common OTC medications would you want to avoid administering to a heart failure patient?

NSAIDs, OTC meds with sodium content, nasal and ocular decongestants

What types of lifestyle modifications can improve outcomes for heart failure patients?

Sodium restriction, smoking cessation, weight loss, avoiding/limiting alcohol, avoiding/limiting caffeine, physical activity, heart-healthy diet

T or F? Lasix (furosemide) can be dosed PRN for fluid overload in heart failure

TRUE

What medication class should be used for patients with symptoms of volume overload?

diuretics

What’s the dosing strategy when initiating patients on heart failure medications?

start at low doses and slowly titrate up to the highest tolerable dose

What are the first line treatment options for heart failure (3)

ACEIs, beta blockers, diuretics

What diagnostic tool is used to differentiate between different types of heart failure?

Echocardiogram

What ejection fraction percentage is considered “reduced?”

< 40%

What are the different types of heart failure?

Left-sided (systolic and diastolic), right-sided, and congestive

What are some common symptoms that heart failure patients usually present with?

dyspnea, fatigue, palpitations, edema

What are the 2 leading causes of heart failure?

Coronary artery disease (CAD) & hypertension

Why is it useful to have a patients creatine levels when you suscept they may have liver failure?

This is an indicator of multi organ failure

If the liver is not functioning properly this can lead to a build up of ammonia. What can this lead to?

hepatic encephalopathy and cerebral edema

What causes portal hypertension?

Reduced blood flow through the sinusoids from fibrosis causes release of angiogenic factors and vasodilators (systemic circulation), hypovolaemia and RAAS

What causes varices to develop in liver cirrhosis?

Reduced blood flow to the liver via the portal vein due to stenosis of the sinusoids from fibrosis results in enlargement of submucosal and oesophageal arteries

Why is hepatic encephalopathy exacerbated in decompensated liver cirrhosis?

Ammonia is formed due to increased glutaminase in other organs due to hyperdynamic circulation and increase sodium levels.

Cirrhosis causes the following coagulation complications:

increased bleeding time,thrombocytopenia,decreased vitamin K

decreased bleeding time,thrombocythemia, increased vitamin K

increased bleeding time, thrombocythemia,increased vitamin K

decreased bleeding time,thrombocytopenia,decreased vitamin K

What are the two most common causes of pancreatitis?

gallstones and alcohol consumption

alcohol consumption and drug use

fatty food and alcohol consumption

pancreatic cancer and alcohol consumption

Nursing interventions for Acute Pancreatitis include:

GI Rest

high fiber diet

avoiding antibiotics

daily laxatives

Why is Clostridium Difficile typically treated with oral medication instead of IV medication?

The oral medications target and work in the intestines.

Your patient has been diagnosed with esophageal varices. What items should the patient avoid moving forward?

spicy food, aspirin, alcohol, potato chips

bland food

non-carbonated drinks

soft diet

What does a HIDA scan diagnose?

problems of the liver, gallbladder and bile ducts

inflammation in the large colon

esophageal varices

colon cancer

muscle twitching, tetany, numbness and tingling is a key sign of what condition?

hypocalcemia

hyponatremia

hypokalemia

hypervolemia

pts ABG results are as follows: pH-7.61, PACO2 -22 mmHg, HCO3-25 mEq/L. what do you interpret these results as?

respiratory alkalosis

pt's ABG results are as follows: PH-7.57, PACO2 37 mmHg, HCO3 30 meq/L, what do you intrepret these results as?

metabolic alkalosis

the pt's ABG results are as follows: PH-7.10, PACO2- 70 mmHg, HCO3-24 meq/L. what do you interpret these results as?

respiratory acidosis

respiratory alkalosis

metabolic alkalosis

metabolic acidosis

pts ABG's results are: PH- 7.6, PACO2- 31 mmHg, HCO3-25, what should the nurse intrepret the results as?

Respiratory Alkalosis

Respiratory Acidosis

Metabolic Alkalosis

Metabolic Acidosis

pt has ABG's results of PH-7.3, PaCO2-68 mmHg, HCO3- 28,

Respiratory Acidosis

Respiratory Alkalosis

Metabolic alkalosis

Metabolic acidosis

A nurse is caring for a pt who has respiratory acidosis. which of the following medications should the nurse prepare to administer?

bronchodilator

inhaled steroid

antacid

antidiarrheals

nurse is assessing a pt who has acute alcohol intoxication. the nurse should identify that the client is at risk for which of the following acid-balance imbalances?

METABOLIC ACIDOSIS

pt's ABG results are PH-7.30, PAC02 32 mmHg, HCO3 19 meq/l. the nurse should identify that the pt has which of the following acid base imbalances?

metabolic ACIDOSIS

pt has a high fever/hyperventilating. ABG results are PH 7.51, PACo2 28 mmHG, and HCO3 24 meq/L

RESPIRATORY ALKALOSIS