Med surg Final

What medication cannot be given with Viagra?

What medication cannot be given with Viagra?

Nitroglycerin

Pt. with HHS expected findings is

 Urine that is negative for ketones

Glaucoma Teaching to pt. is that

Glaucoma can cause blindness

Client behavior that would not promote healthy eyes and ears?

High volume music and Planned pregnancy after receiving MMR vaccine

Safety risk for Glaucoma patient?

Scattered rugs

Health promotion for family history of prostate cancer is?

Annual DRE and PSA starting at age 45

Cataract extraction what action would be needed to call physician?

Severe pain and nausea post-op

Signs and symptoms of Macular degeneration? 

Darkened vision, Scotomas (Blind spots)

Metamorphopsia (distortion of vision)

Open angle glaucoma with treatment drops instructions would be?

administer 5 min. apart

hold pressure for 2mm, do not touch eye with dropper

Instructions after cataract surgery? 

Keep head straight and up

Elevated PSA (Prostate specific antigen means?

Prostate cancer

RN preparing daily weight for CRD pt. what should she do? 

You want to weigh the patient on the same scale daily in the morning

Vancomycin can potentially cause what?

Nephrotoxicity

Pre-operative instructions for repair of retinal detachment is?

Restrict head movement

What should you do if pt. has K+ to give and Lab work is 3.0?

You would give the medication

What medication do you give for BPH?

Finasteride (Proscar)

Teaching for urge incontinence is?

Limit fluids in the evening, Restrict caffeine intake, Wear extra padding in underwear

Food that is good for exacerbation of inflammatory bowel is?

Soy milk

What findings do you commonly see with BPH?

Difficulty starting flow of urine

What should you do for skin breakdown?

Apply moisture barrier ointment to skin

What actions do you give for C diff?

Use soap and water to wash hands

Instructions to follow when having Hiatal Hernia? 

Not to gain weight and not to lift heavy items

Why do we assess client's vitals pre-operatively? 

To establish a baseline

Discharge instructions for Cataract surgical post-op are?

Wear sunglasses while outside, Wear patch over eye while asleep, and Avoid lifting anything heavier than 10 pounds

Findings that would require you to notify a doctor postop would be what? 

Difficulty passing stool and constipation

Which person is at highest risk of contracting HIV in the hospital?

Phlebotomist

Manifestations of teaching for a pt. with Hemophilia A are?

Disabling joint pain

A risk factor that can be recognized as a UTI pt. is?

Diabetes Mellitus

What findings would you see in a pt. with excessive blood loss? 

Tachycardia, Hypotension, Cold/clammy skin, and Unconscious

What type of anemia would a female be at risk for who has menstrual cycle and low HGB? 

Iron-deficiency anemia.

What interventions are given for a DKA pt?

Administer isotonic saline for fluid resuscitation

Instructions and teaching for a sickle cell anemia pt. is a crisis is what?

Offer fluids, oxygen and pain medications

Pt. with thrombocytopenia instructions would be what?

Brush teeth with soft toothbrush

Blow nose gently

What is important to tell pt. about taking garlic and ginkgo biloba? 

Increase risk for bleeding

If platelets are low what are they at risk for?

Prolonged bleeding

HIV/Aids pt. is at risk for developing what?

Candidiasis

What electrolyte imbalance would you see in an Acute Kidney Injury Pt.?

Hyperkalemia

Aplastic anemia you watch for?

Bleeding tendencies

What type of foods should you increase if you have iron-deficiency anemia?

Red meat and organ meat

Which lab result indicates therapeutic effect for epoetin alfa? 

Hematocrit (Hct)

What signs and symptoms should the RN teach pt related to RBC deficiency? 

Fatigue

Shortness of breath

Discharge instructions for a UTI pt. are what? 

Signs and symptoms are: Wipe front to back and Consume at least 200 ml of H2O

You implement what to decrease ammonia levels in ESLD?

Reduces the clients intake of protein

Abnormal result for a child with hemophilia is? 

Partial thromboplastin time

Signs and symptoms of UTI are? 

Cloudy urine, Frequency and urgency with urinating

Discharge instructions for a UTI pt. are what?

To help prevent UTI is to Wipe front to back. Consume at least 2000-3000 mL of H2O daily

When would you notify a provider with a pt. that has impaired renal function?

Urine output of 175 in the past 8 hour

Which actions should the nurse include in the plan for a cirrhosis pt. with ascites? 

Low-sodium diet, Give furosemide, and measure abdominal girth

Lactulose is given for what?

Decrease ammonia levels in cirrhosis pt.

Which interventions are used for a pt. with pneumonia?

Assess lung sounds, Give O2, Cough and deep breathing, and Monitor pulse ox

Manifestations of advanced cirrhosis is what?

Jaundice

Discharge for pt. with Esophageal varices is what?

Coughing and sneezing increases hemorrhage Avoid aspirin and NSAIDS, Avoid straining, and Abstinence from Alcohol

Who do you contact if potassium level comes back at 5.0? 

Contact provider

You want to decrease what in a pt. with cirrhosis with ascites? 

Decrease fluid intake

Plan to prevent pulmonary complications postoperatively is? 

Encourage incentive spirometer use

What should you do if Magnesium level comes back at 1.0? 

 Give order to replace Mg+ or notify provider to get orders

Primary cause of liver cirrhosis is what? 

 Alcohol

With informed consent you need to make sure you have what?

A witness to clients’ signature

Symptoms of hyperkalemia are? 

Positive Chvostek's sign

What do you do for a potassium of 3.0 and you have Lasix ordered?

Hold the Lasix (diuretic)

Hyperventilating leads to what type of Acid Base imbalance?

Respiratory alkalosis

Type of issues that show up on the skin with a pt. that has cirrhosis are?

Ascites,

Spider angiomas, and Caput Medusae

Sign of cataract is what?

Blurred vision

End stage renal failure can lead to what types of acid base?

Metabolic acidosis

When caring for a cirrhosis pt. what would you report to the provider?

An increase in abdominal girth of two inches

What do you tell a pt. with kidney stones due to hypercalcemia?

Increase weight bearing activity,

diet low in calcium, increase fluid intake to 3000-4000 qday

Using an NG tube can lead to what type of acid base imbalance?

Metabolic Alkalosis

What instructions is given for a pt. getting an EEG?

Remove all hairpin due to being metal

What is sickle cell disease?

Sickle cell make cells unable to flow to easy through microvasculature due to clumping of obstructed blood flow.

Unresponsive pt. could have what type of acid base imbalance?

Respiratory acidosis

What does Basal cell carcinoma look like?

raised lesion, flesh-colored with pearly white borders.

Ways to prevent skin cancer are?

Check skin months, avoid tanning booths, and apply sunscreen daily even on cloudy days

Following instructions for a pt. with home oxygen would be? 

Do not adjust the flow rate yourself