These types of hepatitis are transmitted via the fecal oral route?
Hep A& E
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!
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
T or F? Lasix (furosemide) can be dosed PRN for fluid overload in heart failure
TRUE
What is the most common drug used for UTI's?
Sulfonamides
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
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."
What is Parkinson's Disease?
A chronic, progressive movement disorder
What are the primary symptoms of Parkinson's?
Tremor, Rigidity, Bradykinesia (slowness of movement), Postural Instability (impaired balance and coordination)
What is the Main Goal of heart failure treatment?
DECREASE WORK LOAD TO INCREASE HEART FUNCTION
What are the signs and symptoms for left sided heart failure?
Inspiratory Crackles, confusion, dizziness, and SOB
What are 2 complications of cardiopulmonary bypass?
air embolis, decreased plt= high risk for bleeding, hypothermia
You want to avoid milk products with what group of abx?
flouroquinolones
Loss of which neurotransmitter (brain chemical) is part of the Parkinson's Disease process?
Dopamine
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
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
What are some common symptoms that heart failure patients usually present with?
dyspnea, fatigue, palpitations, edema
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 medication class should be used for patients with symptoms of volume overload?
diuretics
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
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 causes portal hypertension?
Reduced blood flow through the sinusoids from fibrosis causes release of angiogenic factors and vasodilators (systemic circulation), hypovolaemia and RAAS
What test needs to be done before an antibiotic is given to any patient?
Culture
A nurse is caring for a pt who has respiratory acidosis. which of the following medications should the nurse prepare to administer?
antidiarrheals
bronchodilator
antacid
inhaled steroid
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.
Cirrhosis causes the following coagulation complications:
increased bleeding time, thrombocythemia,increased vitamin K
decreased bleeding time,thrombocythemia, increased vitamin K
decreased bleeding time,thrombocytopenia,decreased vitamin K
increased bleeding time,thrombocytopenia,decreased vitamin K
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.
A patient with Hepatitis A asks you about the treatment options for this condition. Your response is?
Supportive Care
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
Your patient presents with right sided heart failure which is not a typical sign of right sided failure?
JVD
Ascites
Rales
Peripheral Edema
What are the 2 leading causes of heart failure?
Coronary artery disease (CAD) & hypertension
Name any 3 signs and symptoms of a hypersensitivity reaction.
itching, wheezing, SOB, tongue swelling
pt has a high fever/hyperventilating. ABG results are PH 7.51, PACo2 28 mmHG, and HCO3 24 meq/L
RESPIRATORY ALKALOSIS
These types of hepatitis are transmitted via blood and body fluids.
Hep B, C, & D
What does a HIDA scan diagnose?
colon cancer
esophageal varices
inflammation in the large colon
problems of the liver, gallbladder and bile ducts
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
A patient has lab work drawn and it shows a positive HBsAg. What education will you provide to the patient?
Pt is now recovered from a previous hep B infection
The pt is less likely to develop a chronic infection
avoid sexual intervourse or intimacy until negative test
Pt is not a candidate for antiviral or interferon meds
What is the complicaiton called when Blood accumulates around the heart pushing against the heart, preventing appropriate contraction?
CARDIAC TAMPONADE
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
Which medication would the nurse exepect to administer to a patient with serum ammonia of 164 mcmol/L(15–55 mcmol/L)
Lactulose
Which antibiotic therapy would be used before a patient goes to OR to prevent an infection?
prophylactic therapy
Why is Clostridium Difficile typically treated with oral medication instead of IV medication?
The oral medications target and work in the intestines.
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
What is the Procedure that Provides information regarding the heart structure and function?
Cardiac Cath
What lab test would be elevated before abx and then expected to go down after abx?
WBC
What are the primary interventions for a patient with acute pancreatitis?
NPO, IVF, pain management
What bodily functions does dopamine help regulate?
Motivation, Reward, Movement, Memory, Mood, Attention, Sleep, Immunity
What infection can be caused if a patient is on long term antibiotics?
Clostridium difficile (C-diff)
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
pt has ABG's results of PH-7.3, PaCO2-68 mmHg, HCO3- 28,
Respiratory Alkalosis
Metabolic acidosis
Respiratory Acidosis
Metabolic alkalosis
What are the first line treatment options for heart failure (3)
ACEIs, beta blockers, diuretics
Nursing interventions for Acute Pancreatitis include:
avoiding antibiotics
daily laxatives
high fiber diet
GI Rest
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 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
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
True of False: When the metabolic rate falls, the hypothalamus stimulates the pituitary gland to secrete TSH
True
What is the most effective practice to prevent Hepatitis A transmission?
Washing hands with soap and water
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 ejection fraction percentage is considered “reduced?”
< 40%
What are the 2 toxicities you need to worry about with aminoglycosides?
nephrotoxicity and ototoxicity
These lab values are elevated in acute pancreatitis
Amylase and Lipase
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)
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 Medication that works by Increasing diuresis & Vasodilator but needs its own IV site?
Synthetic BNP (Nesiritide or Natrecor)
What symptoms may be seen with thyrotoxicosis?
Increased HR, Increased BP and atrial fibrillation
What happens if you take PCN with oral contraceptives?
It makes them less effective
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?
metabolic acidosis
respiratory acidosis
respiratory alkalosis
metabolic alkalosis
What is the purpose of oral pancreatic enzymes in chronic pancreatitis?
Aids in digestion of carbs, fats, and proteins
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
Does bactericidal therapy kill bacteria or inhibit the growth of susceptible bacteria?
Kills bacteria
What are the top 2 manifestions seen with pulmonary edema and require immediate intervention?
Hypoxia, and Arrythmias
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 the different types of heart failure?
Left-sided (systolic and diastolic), right-sided, and congestive
Most common treatment for Thyroid Cancer?
Total thyroidectomy
Why can't you use Tetracyclines with children under 8 or lactating women?
If binds to calcium, causes tooth discoloration, and bone malformation
pts ABG's results are: PH- 7.6, PACO2- 31 mmHg, HCO3-25, what should the nurse intrepret the results as?
Metabolic Acidosis
Respiratory Alkalosis
Respiratory Acidosis
Metabolic Alkalosis
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
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
Your patient has been diagnosed with esophageal varices. What items should the patient avoid moving forward?
spicy food, aspirin, alcohol, potato chips
non-carbonated drinks
bland food
soft diet
What diagnostic tool is used to differentiate between different types of heart failure?
Echocardiogram
What is a common complication for OHS/CABG that results in vasoconstriction, and hypoxia?
hypothermia
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
What is the most common Health Care Associated Infection?
MRSA
What is the black box warning for the quinolones like Cipro or Levaquin?
tendonitis and/or tendon rupture
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 is a reliable parameter to measure volume overload and changes in fluid retention in patients?
Daily weight and urine output
muscle twitching, tetany, numbness and tingling is a key sign of what condition?
hypocalcemia
hyponatremia
hypervolemia
hypokalemia
How do you know if someone has improvement in heart failure?
Decreased crackles upon auscultation s/p treatment indicates improvement
What happens when you take antacids with quinolones like Levaquin or Cipro?
It reduces absorption