TRAINERS Flashcards

Terms Definitions
abdominal perineal resection with complaints of chills may indicate what?
peritonitis
S/S of hypoglycemia ___
Diaphoresis and trembling.
nifedipine (Procardia):
Pt has HR of 50, give?
NO
piperacillin (Pipracil) is what class of drugs?
penicillin
S/S of amphetamine withdrawal:
Depression, disturbed sleep, restlessness, disorientation.
S/S of hyponatremia:
Headache, apprehension, and lethargy, muscle twitching, convulsions, diarrhea, fingerprinting of skin
S/S of hypernatremia
Sticky mucous membranes; decreased urinary output; and firm, rubbery tissues, restlessness, weakness, coma, tachycardia, flushed skin, oliguria, fever
Do "personal effects" need to be decontaminated for those who are dx with TB?
No
expalin wound irrigation
warm solution to 90-95ºF (32.2-35ºC). Remove the soiled dressing and discard it in a plastic trash bag along with the gloves. Position the patient to allow for gravity drainage. Establish a sterile field. Pour the irrigating solution into the sterile container. Put on the sterile gloves. Fill the syringe with solution. Connect the rubber catheter to the syringe to reduce the force of the solution. Instill a slow, steady stream of solution into the wound. Make sure the solution flows away from the wound to prevent contamination of clean tissues. Withdraw the catheter without aspirating. Refill the syringe and repeat the irrigation. Continue until the solution is clear or the prescribed amount has been used.

CORRECT ANSWER–(3) This would require an intervention. Multiple pairs of sterile gloves ar
pt develops severe, crushing chest pain radiating to the left shoulder and arm.
what do you expect to give?
MS IV
what is a common s/e of bactrim?
uticaria
S/S of cocaine withdrawal:
Severe cravings, depression, fatigue, hypersomnia.
When does the posterior fontanelle close?
By third month
What kind of drug is tranylcypromine sulfate (Parnate)?
How long does it take to work?
MAOI
3-4 weeks
what is normal CLoride level
normal Cl-: 95-105 mEq/L.
pt taking Carafate--you should instruct pt to do what?
take on empty stomach
to avoid dizziness with ear irrigation, what should you do?
warm the solution
Prochlorperazine maleate (Compazine) 10 mg IM is ordered for a client. The client is also to receive butorphanol (Stadol) 2 mg IM. Before administering these medications, the nurse should take which of the following actions?
Draw the medications in separate syringes.
Also monitor BP and HR (but not as high of a priority as separate syringes)
Hormonal interference in glucose metabolism during pregnancy causes insulin requirements to ___ then ___ after delivery
increase
decrease
(Bg will fall because of sudden decrease in insulin requirements)
A client is admitted diagnosed with a subdural hematoma and cerebral edema after a motorcycle accident. Which of the following symptoms should the nurse expect to see INITIALLY?
Decreased LOC
A male nurse who is CMV-negative is ____ (at risk or NOT at risk) for developing CMV.
at risk
Best way to take prenatal vitamins?
At night with oj
Sengstaken-Blakemore tube:
Priority equip at bedside?
If in resp distress... do what?
Scissors
Cut balloon ports and remove the tube (it goes all the way down to a balloon in the stomach)
Teaching for someone who is having a spont abortion
Save/count pads
when adminstering a suppository, what should you tell pt to do?
breathe...do not hold breath
s/s of cocaine abuse? (3)
1. Complaints of insomnia
2. rhinorrhea
3. facial pain.
s/s of dig toxicity? (6)
1. anorexia
2. nausea
3. vomiting
4. diarrhea
5. confusion
6. and visual disturbances
for a pt with SIADH, what would you anticipate giving?
lasix
What is sucralfate (Carafate)?
It treats ulcers. Take on empty stomach. Forms a barrier on the GI mucosa and decreases absorption of other meds so they should be taken 2 hours afterwards.
Need to assess ___ for someone on gemfibrozil (Lopid)
Liver function (AST)
glipizide (Glucotrol) is effective for diabetics who ___
Produce minimal amounts of insulin.
(Type 2 Diabetics- non insulin dependent)
Guaiac stool samples:
___ container.
How to get the sample ___
Order is for guaiac x 3, how is this done?
What can cause a false pos?
Clean ok... sterile not needed
Use a tongue blade to collect a sm amount
Once sample each day (So no more than one each day)
Recent ingestion of red meat
risperidone (Risperdal) teaching:
____ wt
_____ temp
_____ sun
_____ bp
May cause increase in wt
Avoid extreme temps (impairs bods regulation)
Wear sunscreen (photosensitivity)
Orthostatic hypotension may occur
Umbilical cord care:
Clean several times a day (Uh... not sure with what) and expose to air frequently.
The nurse administers sublingual nitroglycerin (Nitrostat) to a client complaining of chest pain. Which of the following observations is MOST important for the nurse to report to the next shift?
Blood pressure has decreased from 140/80 to 90/60.
OR
Respir
Blood pressure has decreased from 140/80 to 90/60.
(Don't be tricked by ABC's...hypotension is a sig SE of nitroglycerin... needs to be monitored closely)
teaching for myasthenia gravis? (3)
1. avoid extreme emotions
2. avoid crowds
3. avoid heat
when restraining pt, it is important to consider what?
use least restricting first
what med do you anticipate giving for a pt with DI?
Desmopressin DDAVP (Vasopressin)
what is important to assess with Buerger’s disease? (2)
ulcer formation and gangrene
what is the normal intraocular pressure?
10 to 21 mm Hg
What size needle is used for Haldol?
2 inc 21 gauge (IM)
Which of the following nursing actions is important for safe administration of oxytocin?
1.Assess respirations and urine output.
2.Administer oxytocin parenterally as the primary IV.
3.Have calcium gluconate available as an antidote.
4.Palpate the uterus
4.Palpate the uterus frequently. (Assessing for prolonged tetanic contractions, which can lead to rupture of uterus)
hydrochloride (Zantac) is best taken ___
Just before bed (once a day)
S/S of strabismus?
The child closes one eye to see a poster on the wall. (Brain receives two images)
An extremely agitated client receives haloperidol (Haldol) IM every 30 minutes.... what to do?
Monitor blood pressure every 30 minutes (lowers bp and causes postural hypotension)
drug of choice for treatment of candidiasis:____
Ketoconazole (Nizoral) 200 mg daily.
evisceration is treated immediately by ___
applying sterile gauze soaked in normal saline.
Drug abuser....The nursing diagnosis is ineffective individual coping:
Goal for the "working stage" of the nurse/pt relationship would be to ____
Meet individually with the client to discuss the consequences of drug-using behavior and examine other options.
The nurse cares for a client complaining of moderate pain. Which of the following nursing actions is MOST important to provide the patient with effective pain relief?
1.Teach the patient about the pain.
2.Establish a trusting relationship with the patient
2.Establish a trusting relationship with the patient. (why this is specific to pain, I'm not sure... DUMB question)
Do walkers need to have rubber caps on all four legs?
Yes- prevents accidents
apnea monitor: can the parents "leave our baby for brief periods of time"?
Yes... appropriate because they monitor will alarm if infant stops breathing
What two conditions commonly cause ARF?
Hypovolemia and HF
*they cause renal ischemia
intravenous pyelogram (IVP)..nurse should tell pt that?
may experience a hot feeling, and my skin may become flushed
what is rhe average circumference of the chest for a neonate
Chest circumference of 32 cm
what 3 s/s may indicate paralytic ileus which should be notified to the MD
1. Nausea
2. vomiting
3. increased abdominal distention.
explain characteristic of a toddler (15-30months) (4)
1. curiosity and negativism
2. can builds 2-7 block towers
3. vocabulary increases from 10 words to 200 words
4. Fears: separation
how to position a pt after a thryoidectomy?
Position the patient semi-Fowler's.
if someone who was choking became unconscious, waht should you do?
straddle victim’s thighs, place hands one over other with heel of bottom hand just above the victim’s navel, quickly thrust inward and upward
what is considered preterm labor
2 contractions lasting at least 30 seconds in a 15-minute period
IV site is reddened and warm, what should you do?
remove iv and restart
When admin. a salem sump NG tube to r/o intestinal obstruction, it is best to position the pt ___
with HOB 60-90 degrees
Buck's traction:
Very important to ___
HOB ___
___ bedrest?
Footboard?
Turn pt to unaffected side (with fx... I think you can turn both sides if they don't have a fx)
Should be between 15-20 degrees
YES, strict
NO, interferes with traction
Sickle cell anemia should not take which meds?
Aspirin (can cause hemorrhage during sickle crisis)
Overweight pt:
What is a good bfast for them?
Applesauce, cream of wheat, toast.
OR
Scrambled eggs and toast, one slice of bacon.
Applesauce, cream of wheat, toast
(I wasn't sure this had enough protein in it. The other has to much fat)
what is seen in the early stages of alzheimers?
short term memory loss
how is the diet for cystic fibrosis? (5)
1. increased salt
2. pancreatic enzymes
3. high cal
4. high fluid
5. high fat
explain the use of soapsuds enema? (4)
1. put irrigation 12–18 inches above
2. insert enema 3-4 inches
3. place pt in sims position
4. and warm water to 105 degrees
how often change ostomy bag
ostomy bags should be changed at least once a wee
how to palpate uterine contraction?
places one hand on the abdomen over the fundus, and with the fingertips, presses gently
At what age is "stormy" behavior expected?
11 or so (not beginning school aged)
Buck's traction... pt keeps sliding down in bed... what to do?
Elevate the foot of the bed on blocks.
(Keeps leg strait and counters the pull of the weights)
Kaopectate and other meds ordered. What to do?
Wait an hour before taking the other meds if Kao is taken
A postoperative client is returned to the assigned room from the surgical recovery area. The client is sleeping, and the nurse notes that the client is disoriented when aroused. Which of the following actions, if taken by the nurse, is BEST?
Stay with the
Elevate the side rails until the client is fully awake.
Side rails should always be elevated for any disoriented client
A primigravida woman at five weeks’ gestation comes in the clinic having vaginal spotting and some cramping. what should you do?
tell her to reduce her activity

(its a sign of threatened abortion)
what should you remember about kayexalate?
dont give with other meds (wait at least 1 hr after before admin po meds b/c kayexalate absorbs po meds
infant postrepair of a cleft lip and palate has congested lungs and slightly labored respirations, what position should you put them in?
Position the infant on one side.
s/s of lithium toxicity? 6 early, 3 advanced, 1 severe?
1. n/v
2. slurred speech
3. muscle weakness
4. polyuria
5. fine tremors
6. mild thirst

7. GI upset
8. confusion
9. incoordination

10. ataxia
explain to pt with lice?
put kwell on one time then may repeat in 7 days
Person with hep A who is incontinent or diapered has ___ precautions.
Contact (will need their own room too)
Which of the following is a correct instruction by the nurse to the parent of a 4-year-old client regarding collecting a specimen to be tested for pinworms?
(When and how to collect)
Collect the specimen in the early morning with a piece of Scotch tape touched to the child's anus.
(inworms crawl outside the anus early in the morning to lay their eggs)
Normal head circ of newborn ___
Chest circ ___
32-36 cm (so 40 would be of concern)
32 is normal
What precautions is a pt with Haemophilus influenzae meningitis on?
Droplet (for at least 24 hours after abx therapy started)
The nurse cares for clients on the psychiatric unit. Suddenly, a male client's behavior begins to escalate into aggressive behavior. It is MOST important for the nurse to take which of the following actions?
1.Utilize an organized team to place the client
4.Assist the client to identify and express his feelings of increasing anxiety, frustration, and anger.
(He is too pissed off to do a quiet activity.... having him try to id and express feelings should be done before seclusion)
when should trach cuff be inflated
any time the patient is in danger of aspiration
where do you put a Jackson-Pratt drain in place?
on the patient's gown or pajamas, never to the sheet or mattress
if pt is manic, what is important for the nurse to do?
Distract the patient, and redirect behaviors.
it is important to report what if pt has hyperparathyroid? why?
hematuria b/c indicate renal injury from stones
what should the nurse tell pt undergoing cardiac catheterization?
they may may feel a fluttery sensation when the catheter is inserted
interventions for deep vein thrombosis (DVT?) (4)
1. Warm, moist packs to the affected leg.
2. Elevate the foot of the bed 6 inches.
3. Elastic stockings on unaffected leg
4. bedrest for 5-7 days (no bedside commode)
does heparin pass into breast milk?
no, so mom on heparin is safe to breastfeed
for a pt with sczema (rough wheeping scaling dry lesions, what should you teach pt to avoid? (3)
1. avoid eggs, wheat, milk,, citrus fruits, tomatoes
2. avoid wool. irritating clothes (perhaps cotton=good)
3. avoid hot showers and soap
Meds given to woman before c-section compared to that for general surgery.
___ amounts of narcotics
Dosage of sedatives and hypnotics ____
Lower (So baby isn't put at risk for resp depression)
Will be similar
Why is it not good to "milk" the finger when checking BG?
Forces interstitial fl out and dilutes sample
Which of the following plans would be a priority for an infant with a positive PKU blood test?
Give them Lofenalac formula. It is low in phenylalanine but contains minerals and vitamins to provide balanced nutrition.
tell pt taking INH to report what to the doctor..why?
tingling of fingers and toes b/c represents peripheral neuropathy
A multigravida woman at six weeks’ gestation comes in the clinic reporting frank, red vaginal bleeding with moderate cramps.
what should you do?
tell her to count pads b/c they are s/s of spontaneous abortion
how to obtain a sterile urine specimen from a foley
To obtain a urine specimen apply a clamp to the drainage tubing distal to the injection port. Clean the injection port with an antiseptic, and insert a sterile needle and syringe into the port. Aspirate the quantity of urine that is needed, and inject the urine into a sterile specimen container. Then remove the clamp.
The nurse performs a routine IV tubing change on a patient with a central line. Fifteen minutes later, the nurse re-enters the patient's room to find the patient cyanotic, short of breath, and complaining of pain. The patient's vital signs are BP 84/62, p
2.Lower the head of the bed and place the patient on the left side.
(Will cause air to rise to R atrium, minimizes chance of air bubbles entering cerebral circulation)
While checking the patency of a Salem sump tube, the nurse finds stomach contents draining from the air vent. Which of the following nursing actions is MOST appropriate?
Insert 30 ml of air through the air vent
When would a nurse wear a lead apron while caring for a pt with internal radiation?
When the nurse has to spend any length of time at a close distance, not just for routine care
if next container of TPN is not avail for pt who has been recieving TPN, what should you give?
Hang a container of 10% D/W until the new solution is available. (HYPERTONIC SOLUTION)
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