NUR3171-Adult Nursing (Exam #2)

For a patient who recently just had chemotherapy and transplant. If they have what type of condition do they need to go to the hospital?

-If they have fever

What type of things do you need to tell a neutropenic and cancer patient to avoid?

-No flowers in the room

-No uncooked foods or veggies

-No crowded places (wear a mask)

-No pregnant women nor children can visit

-No animals

-Visitors should not stay more than 30 minutes in the room

-Visitors must stay 6 feet away

When your patient just had a liver biopsy, what position are you going to put your patient in?

-Laying down on their right side (remain laying down for a few hours)

What are the bleeding precautions in a patient who has chemo induced thrombocytopenia

(What are you going to tell them to avoid?)

-Protect skin from cuts

-Scrapes

-Sharp objects

-Use a soft toothbrush

What are you monitoring for in a neutropenic patient?

-Monitoring for fever

-Sweats

-Abdominal pain

-CBC and leukocytes differential counts

What kind of medication should a patient with thrombocytopenia take if they have a headache?

-Tylenol (Acetaminophen)

How is Hepatitis A transmitted?

-Fecal & Oral

-Hand to mouth contact

-Close contact

-Food

-Fluids (Contaminated water)

(Advise patient to have good hand washing and drink safe water)

What types of people are prone to have Hepatitis A?

-Children and people who work at a daycare

Patient with hepatic dysfunction and they are prone to bleeding and anemia, what disorder is causing that?

-Clotting factor

(They have a coagulation disorder)

What are the labs we check for anemia?

-CBC (complete blood cell count

-H&H (Hemoglobin and Hemocratic)

What is Hepatitis A?

-A virus that spreads from contaminated food, water, or someone who is infected

What is the difference between a duodenal ulcer and a gastric ulcer?

-Duodenal Ulcer: Have pain 2-4 hours after eating (they have diarrhea and have a bowel movement 10-15 times a day)

-Gastric Ulcer: Have pain immediately or 10-15 minutes after eating

What are the clinical manifestations for a patient with peptic ulcer disease and what are they going to be complaining of?

-Manifestations: a dull gnawing pain or burning in the mid-epigastric

-Patient will complain of: Heartburn and vomiting

Why should we put patients with peptic ulcer disease on NPO?

-To rest the gut

What is the clinical manifestation for a patient with peritonitis?

-Elevated WBC (Fever, Tachycardia, Hypotension)

-Diffuse pain/pain aggravated by movement

-Anorexia

-Nausea/Vomiting

-Distended abdomen/Rigid muscles

-Rebound Tenderness

-Low H&H

-Low Bowel Sound

What are the labs and vitals for a patient with peritonitis?

-Tachycardia

-Hypotension

-Fever (Elevated WBC)

How would the abdomen of a patient with peritonitis appear to you?

-Distended Abdomen

-Rigid Muscles (Board-like abdomen)

What are the precautions you should advice for people who travel outside of the country?

-Good hand hygiene

-Avoid contaminated water and food

How would the stool appear in ulcerative colitis?

-Bloody stool (15-20 liquids stools)

-Loose, watery stool

What hepatitis virus runs along with hepatitis D?

-Hepatitis B

If a patient has any type of obstruction is that something that can be delayed or should it be addressed right away?

-Right away

What are the vital signs for a patient in unstable condition?

Anything that is not a normal vital sign

-Normal Heart Rate=60-100

-Normal BP=120/80

-Normal Respiratory Rate= 12-20

-Normal Oxygen= 95-100

-Normal Temperature= 97.8F-99.1F

36.5C-37.3C

What is the sign that correlates with appendicitis?

-Rovsing Sign (pain in the right lower quadrant)

After your patient has had a gastric surgery and they go out to eat and start feeling uncomfortable, what is the condition called?

-Dumping Syndrome

What is the purpose of putting your patient on NG tube to suction?

-To empty the stomach to prevent aspiration

What are the tasks you can delegate to a UAP?

-Take vital signs

-I&O's

-Patient cleaning

-Collect urine specimens

-Feedings/Dressing

What are the clinical manifestations for rheumatoid arthritis?

-Symmetric joint pain

-Morning joint stiffness

-Symmetric swelling/warmth/erythema

-Spongy, boggy tissue

-Deformities of hands and feet

-Rheumatoid nodules

-Weight loss

What is the therapeutic outcome that you want to achieve for a patient that is experiencing a rheumatoid arthritis?

-Tell patient to increase calcium in their diet

-Manage their joint pain

What is a patient with rheumatoid arthritis going to complain of?

-Joint pain

-Joint swelling

-Swans neck deformity

What type of advice would you give to a rheumatoid arthritis patient that works out 5-6 time a week?

-Take pain medication 30 minutes to 1 hour prior before exercising

What should a patient with lupus avoid?

-They need to avoid sunlight and use sunscreen

How can lupus patient have another exacerbation of flare up?

-If they don't take their medications as prescribed

What causes gallbladder perforation and what is a common thing found with perforations?

-Gallstones

What is the normal color of the stool in a patient with cholecystitis or gallbladder?

-Clay-colored stools

What are some of the things we could do to prevent pulmonary and respiratory infection for patient post operatively?

-Splint the incision with a pillow

What are the labs for pancreatitis?

-Elevated Amylase & Lipase

-Hypocalcemia

-Hyperglycemia (elevated bilirubin)

-Elevated WBC'S (fever)

What labs are you checking for patients with HIV that have been on antiviral medications?

-CD4 and viral load

If a nurse is stuck by a needle of a patient with HIV, what treatment will the nurse be in?

-PEP

What does PEP stand for?

-Post Exposure Prophylaxis (PEP starts as soon as possible after exposure, nurse must wait 6 months to see if they are HIV positive)

What are the signs and symptoms of infection when you are assessing a central line?

-Pain

-Swelling

-Dischage from the site

-Redness

What are the clinical manifestations and patient teaching for GERD?

-Dyspepsia (Indigestion)

-Dysphagia

-Acid reflux

-Throat Irritation

-Hypersalivation

-Eructation

-Flatulence

-Bitter taste in mouth

-Chest pain

What position does a patient with hiatal hernia need to stay in after eating?

-High Fowlers Position (sit up)

Convert pounds to kilograms:

-2.2 lb = 1kg (120lb/2.2=54kg (1.5g) = 81g)