Download NUR 176 Exam 2 Review with 100% Verified Solution and more Exams Nursing in PDF only on Docsity!
NUR 176 Exam 2 Review with 100% Verified
Solution
Recording #1: 1.If a patient is overweight, smokes and has a history of coronary artery disease, what are you going to recommend? ● Stop smoking. ● Weight managing regime. If they are overweight 2.If a pt tells you they cannot walk on a Treadmill for a stress test. What are you going to do? ● Ask the patient why they cannot walk on the treadmill 3.What is the discharge teaching on coumadin? ● Avoid Vitamin K foods (broccoli & asparagus) ● Dose depends on PT value ● Teach them what a therapeutic INR is (2-3) ● And chose 1 other 4.Pt comes in the ER with cool clammy skin, shortness of breath, indigestion and pain. What do we do? ● MONA. Start with Nitro, Morphine, baby aspirin and oxygen. See if it helps. ● Connect to heart monitor 5.If you have a patient stating they have heavy pressure in the middle of their chest: ● This is an EMERGENCY ● They are probably having an MI 6.Signs and Symptoms for right sided Heart failure (peripheral):
● Peripheral edema - these are the only 2 she mentioned at the very end when answering it again but she was all over the place so the other 2 could be possible answers too. ● Weight gain ● Poor circulation ● Slow cap refill 7.Left Side heart failure (pulmonary/ lungs/ respiratory): ● Wheezes ● Crackles ● Pink frothy sputum ● Pulmonary edema ● Shortness of breath
8. When a patient has Angina. We give 81 mg baby aspirin. Why? ● It allows blood to flow easier. It makes the blood thin. **Recording # 2:
- What is a PTCA?** ● Percutaneous transluminal coronary angioplasty ● The patient goes in and the doctor will do a heart cath through the femoral up to the heart and they will put a stent in that spreads the vessel out and then when they take the stent out, the vessel stays open. (it opens up a blocked coronary artery) 2.What should you educate the patient on if they have a PTCA? Further education question. ● Tell the pt that they will not be asleep for the procedure but they will be consciously sedated. (they will be in a twilight sleep)
3.Patient complains of sharp stabbing pain when they are walking. What should you do? ● Doppler of lower extremity ● Measure circumference of both legs ● Ultrasound of bilateral lower extremities ● Know the location and characteristics of the pain 4.DIC (Disseminated Intravascular Coagulation). What would you assess immediately? ● Pulmonary edema is a big concern -(pink frothy sputum) 5.Cystitis= Inflammation of the bladder. ● They have a tendency to have future UTIs 6.A patient returns from surgery and only had 150 ml of urine after 8 hours. What are we going to do? ● Assess vital signs and the patient’s status (it is a little low because they were NPO all night which is normal) Recording #4:
1. What are you going to teach patients that have frequent UTI’s? ● Encourage lots of fluids ● Empty your bladder all the way 2.What are some foods that you would educate to eat for someone on a renal diet? ● Broccoli ● Asparagus ● Low sodium ● Low potassium
3.You have an older patient that was alert and oriented on day shit and now it is 11 o'clock at night and he is totally off the wall. What do suspect is going on? ● UTI 4.What lab values determine our renal status? ● BUN (10-20) ● Creatinine (0.6-1.2) ● Check complete blood count (CBC) 5.If someone has too high of potassium, what is the medication that we give them? ● Kayexalate 6.If you have a pt complaining of itchy, dusty, yellow, tan, and slightly grey bilateral lower extremities. What do you suspect they have? ● Chronic Renal Failure (because they are itchy from all the crystals) 7.You have a female patient that just had a urinalysis done and they come in because they had e coli in their urine and a UTI. What are you going to tell them? ● Proper peri care ○ Wipe front to back 8.What happens with BPH? ● They can’t urinate because the prostate enlarges and constricts the urethra. ○ Assess if they have difficulty with starting their stream. ○ Assess if they cannot completely empty 9.What is the purpose of the continuous bladder irrigation (CBI)?
1.Pernicious Anemia. What do you teach them? ● Might need Vitamin B12 injections for life. They don’t have intrinsic factor 2.When signs of ABCs. ● Not breathing is number one 3.Discharge instructions for colostomy (I’m not sure this is complete. She got distracted, so review on your notes) ● Well fitted wafer ● Educate the family or spouse how to take care of the colostomy 4.Pt comes in to the ER with signs Rovsing's sign (rebound pain). What do you suspect the pt has? ● Appendicitis 5.Crohn's disease. Patient with soft stool has a small amount of mucous and a little blood. ● Normal 6.Celiac disease. What to teach them: ● Gluten free diet 7.Diabetes 8.To Prevent Peripheral Vascular disease. What should we teach the patient? ● Stop smoking ● Heart healthy diet ● Exercise ● A1c Below 7
9. What can you delegate to the UAP. ● Empty the foley and record the amount 10. Common to the aging process: ● Nocturia ● Urinary frequency ● Urgency ○ CAREFUL Cystitis or UTI are NOT 11. What is MONA? (used when someone comes into the ER with chest pain): ● Morphine ● Oxygen ● Nitroglycerin ● Aspirin 12. Endoscopy: ● They cannot drink immediately. They need a gag reflex tested before 13. What to teach for a patient with a renal angiogram. Or any gram study: ● Increase fluids 14. What do we check a femoral heart cath site for? ● Check for bleeding ○ Glued down 15. Barium swallow study, what interventions do we teach? ● Increase fluids 16. Do we ever allow someone with a pacemaker to have an MRI? ● NO, there is metal in the pacemaker
for?
● Feel for the thrill ● Listen for the bruit
25. You have a patient here with peritoneal dialysis but you notice that this dialysate fluid starts running kind of slowly into your patients peritoneal space. What should you do? ● Reposition your patient 26. You have a transfer patient with chronic renal failure, they are on hemodialysis. What interventions should you monitor during dialysis? ● Monitor Vital signs before and after dialysis (BP) ● Check weight before and after dialysis ● Monitor electrolytes 27. If you have a patient with chronic renal failure, what diet should we put them on? ● Decreased protein ● Decreased potassium ● Low sodium ● Low phosphorus ● Increase calories ● Fruits and veggies 28. If they are sending you for a colonoscopy, and you are concerned about that because you know there are risks of something going wrong that could cause further complications, what would that be? ● There is a chance of perforating the valve which could cause bleeding 29. You are monitoring your patient while they are getting hemodialysis. What is your priority assessment?
B. Checking respiratory rate C. Checking urinary output D. Checking blood pressure
30. You have a patient that is having a barium swallow study done, pre-procedure, what intervention should we teach the patient? A. Decrease fiber in the diet B. Increase fluids - because you want to get all of the barium out C. Prescribe a laxative D. Put them on strict bed rest 31. What are some signs and symptoms of a chronic renal failure patient? ● Low urine output or no urine ● Jaundice (yellowing of skin) ● Lack of appetite ● Lethargic ● Itchy ● Swelling in abdomen or legs 32. You have a patient that you are sending home on lasix (furosemide), which side effect should you tell the patient to report immediately to the health care provider? A. Diarrhea and thirst B. Lightheadedness and headache C. Rapid heartbeat and low urine output - b/c they should be peeing more D. Constipation and dry skin 33. What are some common signs and symptoms of cystitis and UTI? ● Burning ● Frequency ● Urgency
● Pain ● Odor ● Confusion ● Fever ● Urinalysis show bacteria ● Increase WBC
34. What will you see for a patient with BPH? ● Hard to start flow of urine ● Little amount of urine ● Bladder doesn't empty fully ● Stream starts and stops- b/c its putting pressure against urethra 35. What medication do you give to help with BPH (the prostate)? ● Proscar - helps decrease inflammation 36. What surgery will a patient with BPH go through? ● TURP ○ Hook up to continuous bladder irrigation- gets rid of blood clots You know they are assessing correctly if they are Not percusing for the thrill (palpating Choose 1. Ascites Weight gain Peripheral edema Uurine specific gravity (1.03)- normal Need further education if pt says they need b12 for rest of life for sickle cell- perniscious
Cath site check for bleeding Appendicitis- give pain meds as an LPN Nocturia, frequency and urgency Endo- have a gag reflex first Urokenesis- blood thinner (clot busting) UAP- accompany pt to dining room and empty foley and report findings or record amount
