ADULT HEALTH ONE FINAL

What symptoms are commonly indicate and MS relapse

Fatigue, blurred vision, and weakness

What is the priority assessment for a patient with suspected MS exacerbation?

A focused neuro exam looking for new or worsening deficits across motor, sensory, visual, and coordination pathways

What is the priority nursing action when MS relapse symptoms appear?

Notify the provider immediately.

What medication class is commonly used during MS exacerbations, and what is the major risk?

Corticosteroids (e.g., prednisone); major risk is infection.

What interventions reduce infection risk in MS patients taking steroids?

Avoid crowds, Hand hygiene, Monitor temperature, Report fever immediately

What are the classic symptoms of Parkinson’s disease?

Tremor, rigidity, and bradykinesia

What is the underlying pathophysiology of Parkinson’s disease?

Degeneration of dopamine‑producing neurons in the substantia nigra = decreased dopamine which causes imbalance between dopamine and acetylcholine this impairing movement regulation

What is the priority nursing concern for a patient with Parkinson’s?

Fall risk and gait assessment.

What is an early sign of Huntington’s disease?

Psychiatric symptoms such as depression, irritability, and personality changes.

What are the later signs of Huntington’s disease?

Chorea or involuntary movement

What safety teaching should be provided to families caring for a patient with dementia?

Remove hazards, use door alarms, provide structured routines, ensure supervision during wandering risk

What communication techniques help when caring for a patient with dementia?

Use simple, short sentences, maintain eye contact, provide one-step instructions, avoid arguing

What is a hallmark symptom of rheumatoid arthritis?

Morning stiffness lasting longer than 30 minutes

What are common symptoms of rheumatoid arthritis?

Symmetrical joint pain, swelling, warmth, fatigue, decreased ROM

What is important to teach patients about RA medications?

RA medications are lifelong and help prevent joint destruction.

What is ankylosing spondylitis?

A chronic inflammatory disease-causing fusion of the spine and decreased mobility.

What is the priority treatment for ankylosing spondylitis?

NSAIDs and maintaining mobility through exercise.

What activity should patients with ankylosing spondylitis avoid?

Bedrest

What is the priority assessment after an amputation?

Hemorrhage.

What are signs of hemorrhage after an amputation?

Tachycardia, hypotension, saturated dressings, cool, pale skin

What infection‑prevention measures are required after an amputation?

Sterile dressing changes, monitor for redness, warmth, drainage, hand hygiene and report fever

What are the signs of a Stage I pressure injury

Intact skin and non‑blanchable redness

What are the signs of a Stage II pressure injury?

Partial‑thickness skin loss, pink/red wound bed, may appear as a blister

What are the signs of a Stage III pressure injury?

full‑thickness + fat visible, but no bone/tendon/muscle

What are the signs of a Stage IV pressure injury?

full‑thickness + bone/tendon/muscle visible.

How is Type 2 Diabetes diagnosed?

A fasting blood glucose >126 mg/dL on two separate occasions.

Why can’t diabetes be diagnosed from a single elevated glucose reading?

Because glucose levels can be temporarily elevated by stress, illness, or medications; confirmation is required.

What long‑term complications are associated with Type 2 Diabetes?

Vision changes (retinopathy), neuropathy, poor wound healing, renal impairment

What is sliding‑scale insulin based on?

The patient’s current blood glucose level.

What teaching is essential for sliding‑scale insulin?

Never skip blood glucose monitoring; dose changes depend on the reading.

What are common symptoms of hypoglycemia?

Sweating, confusion, tachycardia

What is the first‑line treatment for hypoglycemia if the patient is awake and can swallow?

5–20 g of fast‑acting carbohydrates (juice, glucose tabs)

When is IV dextrose indicated for hypoglycemia?

When is IV dextrose indicated for hypoglycemia?

When is IM glucagon indicated?

When IV access is not available and the patient is unconscious.

How often should blood glucose be reassessed after giving glucose?

Every 15 minutes until stable.

What is the major risk associated with metformin?

Lactic acidosis

What symptoms of lactic acidosis should be reported immediately?

Muscle pain, rapid breathing, fatigue, and abdominal discomfort

What organ function must be monitored while taking metformin?

Kidney function

Who is most at risk for DKA?

patients with Type 1 Diabetes.

What are common signs and symptoms of DKA?

Kussmaul respirations, fruity breath, hyperglycemia, dehydration and abdominal pain

What is the priority treatment for DKA?

IV fluids.

What treatment follows fluids in DKA management?

IV insulin infusion

Why is potassium monitoring essential during DKA treatment?

Insulin drives potassium into cells increasing the risk of hypokalemia.

What is the key difference between chronic bronchitis and emphysema?

• Chronic bronchitis: airway inflammation + mucus production

• Emphysema: alveolar destruction + air trapping

What is the #1 priority intervention for COPD patients?

Smoking cessation.

What breathing technique should be taught to emphysema patients?

Pursed‑lip breathing to improve CO₂ elimination.

What is the priority intervention for a symptomatic pneumonia patient?

Oxygen therapy

When should blood cultures be collected in pneumonia?

Before starting antibiotics

What are signs of an asthma exacerbation?

Wheezing, dyspnea, chest tightness and cough

What is the priority medication during an asthma attack?

A SABA (albuterol).

What does a SABA (albuterol) do?

Rapid bronchodilation of the airway smooth muscle

What should be reassessed after giving albuterol?

Lung sounds and respiratory status.

What medication is added for status asthmaticus?

Corticosteroids to reduce inflammation.

What ABG pattern indicates respiratory acidosis?

Low pH + high CO₂.

What ABG pattern indicates metabolic acidosis?

Low pH + low HCO₃.

What ABG pattern indicates metabolic Alkalosis

High pH + high HCO₃.

What ABG pattern indicates respiratory alkalosis

High pH + low CO₂.

Metabolic Alkalosis think

Vomiting, NG suction, antacids

Metabolic acidosis think

DKA, diarrhea, renal failure

Respiratory Acidosis think

Slow and sleepy, hypoventilation

Respiratory Alkalosis think

Fast and frantic, hyperventilation

What does an elevated BNP indicate?

Heart failure exacerbation.

What is BNP and why is it elevated in heart failure?

BNP is a hormone released when the ventricles stretch due to fluid overload; elevation indicates worsening HF.

TTE is an

Transthoracic Echocardiogram which is a non‑invasive ultrasound performed on the chest wall.

TEE is an

Transesophageal Echocardiogram, which is an invasive ultrasound, performed via the esophagus for clearer images

What pre‑medication may be used before a TEE to reduce post‑procedure throat pain?

A topical anesthetic (e.g., viscous lidocaine).

Why are ACE inhibitors used in heart failure?

They reduce afterload and prevent ventricular remodeling.

What is the major adverse reaction of ACE inhibitors?

Angioedema — an airway emergency.

Why is digoxin given in heart failure?

It increases contractility and slows heart rate.

When should digoxin be held?

When HR < 60 bpm.

What are signs of digoxin toxicity?

Bradycardia and visual halos

What is the underlying pathophysiology of PAD?

Narrowing of peripheral arteries which cause decreased blood flow to extremities.

What are common signs and symptoms of PAD?

Claudication, cool, pale extremities, weak pulses and delayed cap refill

What lab value is the most important indicator of kidney function?

Creatinine

What does an elevated creatinine level indicate?

Impaired kidney function and decreased ability to filter waste.

What are expected findings in CKD

increase creatinine, decrease GFR, hypertension, and electrolyte imbalances

What is the significance of a low GFR

It indicates reduced kidney filtration and progression of kidney failure.

Why does CKD cause hypertension?

Fluid retention and activation of the renin‑angiotensin system.

What is the priority assessment before and after hemodialysis?

Blood pressure.

Why is blood pressure monitoring essential during dialysis?

Rapid fluid shifts can cause hypotension.

What assessments confirm AV fistula patency

bruit which is loud murmur on auscultation and thrill vibrating pulse on palpation

What should NEVER be done on an arm with an AV fistula?

No blood pressure, no IVs, no blood draws

Why are BP, IVs, and labs avoided in a fistula arm?

They can damage the fistula and cause loss of access.

What is a major complication of hemodialysis?

Hypotension due to rapid fluid removal

What is a major complication of peritoneal dialysis

Peritonitis (cloudy effluent, fever, abdominal pain)

What are priority complications after a kidney transplant

Bleeding and infection

What is the most important patient teaching after a kidney transplant

Report any signs of infection immediately

What is the most concerning complication of BPH

Urinary retention

Why is urinary retention dangerous?

It can cause bladder distention, infection, and kidney damage

Why does cholecystitis cause RUQ pain after fatty meals?

Fatty foods trigger gallbladder contraction; if the cystic duct is inflamed or blocked, this causes pain

What is the classic symptom of cholecystitis?

RUQ pain that may radiate to the right shoulder.

What are common causes of ascites?

Liver cirrhosis, portal hypertension, low albumin, fluid shifts into the peritoneal cavity

What is the priority assessment for ascites?

Measuring abdominal girth

What medication is used for peptic ulcer diseases (PUD) prophylaxis?

Proton pump inhibitors (PPIs) or H2 blockers to reduce acid

What are signs of GI bleeding in PUD?

Melena (black, tarry stools), hematemesis, dizziness

What finding indicates a perforated ulcer

A rigid, board‑like abdomen.

What is the priority assessment after a new colostomy?

Stoma appearance (color, moisture, perfusion).

What does a healthy stoma look like?

Pink to red, moist, and protruding slightly.

What is the classic symptom of glaucoma?

Seeing halos around lights.

What is the priority goal in glaucoma management?

Reduce intraocular pressure (IOP).