NR I224 IFinal IExam IReview
• Bulimia INervosa
• Recurrent Iepisodes Iof Ibinge Ieating I(rapid Iconsumption Iof Ia Ilarge Iamount
I ofIfood I in Ia Idiscrete Iperiod Iof I time)
• A Ifeeling Iof I lack Iof Icontrol Iover Ieating Ibehavior Iduring Ieating Ibinges
• Recurrent I inappropriate Icompensatory Ibehaviors Ito Iprevent Iweight Igain, Isuch
IasIs elf-induced I vomiting, I use I of I laxatives I or Idiuretics, I strict I dieting I or Ifasting,
I orIvigorous I exercise
• Binge Ieating Iand I inappropriate Icompensatory Ibehaviors Ithat Iboth Ioccur,
IonIa verage, Iat I least I once I a I week I for I 3 I months
• Self-evaluation I unduly I influenced Iby Ibody Ishape Iand Iweight
• To Iprevent Ihypoglycemia, Ido Inot Iabruptly Idiscontinue ITPN Ibut Itaper
Irate Idown I to Iwithin I10% Iof I infusion Irate I1 I to I 2 I hours I before Istopping.
• Assess Ifor Isigns Iof I medical Itoxicity Iin Iolder Iadult Ibecause: I re duced
I glomerularIf iltration
• Majority Iof Iabsorption: Ismall Iintestine
• Indicate Ithe Iuse Iof I z-track: Ilast Ishot Iturned Iskin Ito Icolors
• GI Itract
o mouth, Iesophagus, Istomach, Ismall Iintestine, Ilarge Iintestine,
I rectum,Ia nus
o small Iintestine: Iduodenum, I jejunum, Iileum
o large Iintestine: Icecum, Iascending Icolon, Itransverse Icolon,
I descendingIcolon, I sigmoid I colon, I and I rectum
• Dose Iis Iincorrectly Iinte rpreted: INURSE Iis Iat I fault
• if Ipt. Irefuses Imedication: Iexplain Ipurpose/ Ieducate Iwhy Ithey Iare
I gettingIit/ I ask I why I they I don’t I want I to I take I it
• excrete Igaseous Imedication: Icough Iand Itake Ideep Ibreaths
• expired Imedication: Icall Iphysician
• Nurse I is I going Ito Iadminister Ipain I medication I for Ipt I with Ipe ripheral
I IV.IN otices I red I streak, I warm I and I tender I to I touch I = I Phlebitis-iv I site I that I is
I blown/bust, I and I the I fluid I just I starts I to I puddle: I DO INOT Igive Ipain I medication.
• Nurse I is Ipreparing I medication Ito Ipatients Iwith Isame Ilast Iname Iand
I didIN OT I check I identification I before I administering I medication: I return I to
I room I to I check I and I assess I pt.
• Pt Idid Inot Itake Idaily Iallergy Imedication Iin I the I morning Ibc I felt
ItooIdrowsy: Ichange I time I to I 9PM I so Idrowsiness Ioccurs Iwhen Ipt I is Isleeping
• Successful Igoal Iof Iconstipation: Isoft Istool
• Pt Iasks I if I she Iwill Ibe I needing Ito I have I the Ibag I(ostomy) Ion Iat Iall Itime:
I yesIbc I it I by-passes I the I large I intestine I and I constantly I oozes I liquid
• Concerned Iif Istoma Iis Iblue/purple/black
• REE: Iconsumed Iover I24 Ihour I period I for Ibody Ito I maintain Iall Iof I its
internal I working
• Pain I meds. ICause Iconstipation. I3 Idays Iwithout
I bowelImovement=constipated
• MajorIsource Iof Ienergy: Icarbohydrates
• Black Istool: Iiron Iingestion-women Itake Iiron Isupps. IAIlot
,• Meet Inutritional Ineeds: Ido Inot Igain Ior Ilose Iweight I- Initrogen Ibalance-
Inegative I is I malnutrition, I positive-healing
• Breastfeeding Iis I necessary I for Ithe I first I4-6 Imonths Iof Ilife Cow’s Imilk
I can I be I drank I after I 1 I year
• PoorInutrition: Ishort Iattention Ispan; Idry, Ibrittle Ihair; Idry, Irough
I andIpale I skin
• Colorectal Icancer
o African-americans Iare Iat Ihighest Irisk
o Risk Ifactors: Ihigh Ianimal Ifats Iand Ired Imeat; Iobesity, Itype I2
I diabetes,Is moking, I and I heavy I alcohol
o Causes Iof Igyno ----obesity, Ialcohol, IliverIcirrhosis
o Warning Isigns: Ichange Iin Ibowel Ihabits; Irectal Ibleeding;
I incomplete Ie vacuation I and I unexplained I abdominal I or I back I pain
o Colonoscopy: Ievery I10 Iyears Iafter I50 Iyears
o Sigmoidoscopy: Ievery I5 Iyears IafterI50
o Pap Ismears: Iwomen Iget Ithis Itest Ievery Iyear
• C. Idiff: I wash Ihands Iwith Isoap Iand I water
• Infectious Iagent, Ireservoir, Iportal Iof Iexit, Imode Iof Itrans mission, Iportal
I ofIe ntry, I susceptible I host
• Measure Ifor ING Itube: Itip Iof Inose, Iearlobe, Ixiphoid Iprocess
• AdministerIeardrops
o Children: Ipull Iauricle Idown Iand Iback
o Adult: Ipull Iauricle Iupward Iand Ioutward
o Cotton
o Apply Igentle Ipressure Ito Itragus Iof Iear
• Toxicity: Ikidney Ifailure
• BMI Iof I28: Ioverweight
• Opioids: Iconstipation
• Alcohol I with Iopioids Iwould Imake Ithe Ieffect Iwork
I faster=synergisticIaffect
• Deltoid Ineedle: I22-25 Iand I1-1 Iand Ia Ihalf I in
• Valsalva Imaneuver: Idon’t Ihave IaIaging Iadult Ido Ithis
I becauseIintracranial I pressure
• Inserting Ia Isuppository: ILeft-side Iwith I(right) Iknee Ibent
• Feeding:
• Too I many Imedications, Iconcerned Iwith Iclogging: I(what Idoes Inurse Ido?)
o use Iliquid Iforms Iof Imedication, I if Ipossible
o flush Itube I with I30 Ito I50 ImL Iof Iwater Ior I normal Isaline Ibefore Iand
IafterImedication Iadministration Iand Ibefore Iand Iafter Ibolus I feeding
o flush Iwith I water Ievery I4 Ihours I for Icontinuous I feeding
o answer: Icall I the Ipharmacy Iand Iask Ithem I to Isend I you I liquid I form
IofImedications
• TPN Itotal Iparenteral I nutrition-through Ithe Icentral I line
• HTN I medication Iand Iorange Istool: Iquestion: I what I medications Ihave
IyouItaken Irecently
, • Laxative: Ilong-term Ican Icause Iconstipation
• Older Iadult: Icalcium Iand Ivitamin ID
• Candidate I for Itube: I throat Icancer
• nurse Ineeds I further Iteaching: I(always Iprepare I the Iregular I insulin I first)
o Draw IRegular I insulin I first, Ithen Ithe INPH I in Ithe Isyringe
o NPH Iis I intermediate
o insulin I garglane I(Lantis) I- Ialways Idrawn I in I its Iown Isyringe I(drawn Ialone)
o Regular Iinsulin I is Ithe IONLY Iinsulin I that’s Igiven IIV
• IV Iis Ithe Ifastest Iabsorption
• Topical Iis Ithe Islowest
• Enteral Ifeeding: Icannot Iingest Ifood Ibut Ican Idigest Iand
I absorbInutrients
• Stop Iusing IET Iwhen I75% Iof Ibody Ineeds Iare Imet, Itapering I method
• Inserted Iright Iinto Ithe Idigestive Itract Ilike Ia IJ-tube, IG-tube, ING Itube
o Candidates: Ifunctioning IGI
• Parenteral Ifeeding: Icannot Idigest, Iabsorb ----- proble m Iwith Ithe IGI Iso
you Ihave Ito Iget Ia Icentral Iline Iclose Ito Ithe Iheart
o Candidates: I NON Ifunctioning IGI
• Side Ieffect: Iunavoidable, Ipredictable
• Idiosyncratic Ieffect: Iover/under-reactionIorIdifferent Ireaction
IfromInormal, I unpredictable Iex: I like I if I CNS Istimulator I and I instead I of
I becoming I restless I and I have Ienergy I the I patient I falls I asleep
• At Irisk: I motorcycle Iaccident Ivictim
• Surgery: Iprimary I intention, Iclean I incisions, Iapproximated Iedges
• Burn: Isecondary Iintention, Iburns, Ipressure Iulcers, ISCARRING
• Tertiary Iintention: I left Iopen I for I7 Idays I until I necrotic Istuff I is I gone, Iand Ithen
I itIc loses- Ibecause I you Idon’t I want Ito I trap Ibacteria I in Ithe I wound
• Shallow Iopening: IStage III
• Nonblanchable: IStage II
• Nectrotic: IUnstageable, I need Ito Iremove I(debridement)
• Wound Ican’t Ibe Istaged Iuntil Iit’s Idebrided
• Classification Iof IPressure IUlcers
o Stage II: I intact Iskin I with Inonblanchable Iredness
o Stage III: Ipartial-thickness Iskin I loss I(epidermis, Idermis, Ior Iboth)
o Stage IIII: I full-thickness Itissue I loss Iwith I visible I fat
o Stage IIV: I full- thickness Itissue Iloss Iwith Iexposed Ibone, I muscle, Ior
Itendon,IEschar
• First Isign Iof I hypoxia: Irestlessness
• the I last Isign Iof I hypoxia I is: Icyanosis I (turning Iof Ithe Iskin Iblue)
• Administer Ianalgesic Iwithin I30 Ito I60 I minutes
o Dressing Ichange: Iprovide Ianalgesic I meds
• Acute Idistress Isyndrome: I give Ibronchodilator
• Atelectasis: Ibreathing Iexercises I- Ievery I1-2 Ihours I make I them Icough
IandIdeep Ibreath Iand I incentive Ispirometer I is I10 Iper I hour Iand I make Isure I to I inspire
Inot Iexpire I(use Iaccessory I muscles)
• Bulimia INervosa
• Recurrent Iepisodes Iof Ibinge Ieating I(rapid Iconsumption Iof Ia Ilarge Iamount
I ofIfood I in Ia Idiscrete Iperiod Iof I time)
• A Ifeeling Iof I lack Iof Icontrol Iover Ieating Ibehavior Iduring Ieating Ibinges
• Recurrent I inappropriate Icompensatory Ibehaviors Ito Iprevent Iweight Igain, Isuch
IasIs elf-induced I vomiting, I use I of I laxatives I or Idiuretics, I strict I dieting I or Ifasting,
I orIvigorous I exercise
• Binge Ieating Iand I inappropriate Icompensatory Ibehaviors Ithat Iboth Ioccur,
IonIa verage, Iat I least I once I a I week I for I 3 I months
• Self-evaluation I unduly I influenced Iby Ibody Ishape Iand Iweight
• To Iprevent Ihypoglycemia, Ido Inot Iabruptly Idiscontinue ITPN Ibut Itaper
Irate Idown I to Iwithin I10% Iof I infusion Irate I1 I to I 2 I hours I before Istopping.
• Assess Ifor Isigns Iof I medical Itoxicity Iin Iolder Iadult Ibecause: I re duced
I glomerularIf iltration
• Majority Iof Iabsorption: Ismall Iintestine
• Indicate Ithe Iuse Iof I z-track: Ilast Ishot Iturned Iskin Ito Icolors
• GI Itract
o mouth, Iesophagus, Istomach, Ismall Iintestine, Ilarge Iintestine,
I rectum,Ia nus
o small Iintestine: Iduodenum, I jejunum, Iileum
o large Iintestine: Icecum, Iascending Icolon, Itransverse Icolon,
I descendingIcolon, I sigmoid I colon, I and I rectum
• Dose Iis Iincorrectly Iinte rpreted: INURSE Iis Iat I fault
• if Ipt. Irefuses Imedication: Iexplain Ipurpose/ Ieducate Iwhy Ithey Iare
I gettingIit/ I ask I why I they I don’t I want I to I take I it
• excrete Igaseous Imedication: Icough Iand Itake Ideep Ibreaths
• expired Imedication: Icall Iphysician
• Nurse I is I going Ito Iadminister Ipain I medication I for Ipt I with Ipe ripheral
I IV.IN otices I red I streak, I warm I and I tender I to I touch I = I Phlebitis-iv I site I that I is
I blown/bust, I and I the I fluid I just I starts I to I puddle: I DO INOT Igive Ipain I medication.
• Nurse I is Ipreparing I medication Ito Ipatients Iwith Isame Ilast Iname Iand
I didIN OT I check I identification I before I administering I medication: I return I to
I room I to I check I and I assess I pt.
• Pt Idid Inot Itake Idaily Iallergy Imedication Iin I the I morning Ibc I felt
ItooIdrowsy: Ichange I time I to I 9PM I so Idrowsiness Ioccurs Iwhen Ipt I is Isleeping
• Successful Igoal Iof Iconstipation: Isoft Istool
• Pt Iasks I if I she Iwill Ibe I needing Ito I have I the Ibag I(ostomy) Ion Iat Iall Itime:
I yesIbc I it I by-passes I the I large I intestine I and I constantly I oozes I liquid
• Concerned Iif Istoma Iis Iblue/purple/black
• REE: Iconsumed Iover I24 Ihour I period I for Ibody Ito I maintain Iall Iof I its
internal I working
• Pain I meds. ICause Iconstipation. I3 Idays Iwithout
I bowelImovement=constipated
• MajorIsource Iof Ienergy: Icarbohydrates
• Black Istool: Iiron Iingestion-women Itake Iiron Isupps. IAIlot
,• Meet Inutritional Ineeds: Ido Inot Igain Ior Ilose Iweight I- Initrogen Ibalance-
Inegative I is I malnutrition, I positive-healing
• Breastfeeding Iis I necessary I for Ithe I first I4-6 Imonths Iof Ilife Cow’s Imilk
I can I be I drank I after I 1 I year
• PoorInutrition: Ishort Iattention Ispan; Idry, Ibrittle Ihair; Idry, Irough
I andIpale I skin
• Colorectal Icancer
o African-americans Iare Iat Ihighest Irisk
o Risk Ifactors: Ihigh Ianimal Ifats Iand Ired Imeat; Iobesity, Itype I2
I diabetes,Is moking, I and I heavy I alcohol
o Causes Iof Igyno ----obesity, Ialcohol, IliverIcirrhosis
o Warning Isigns: Ichange Iin Ibowel Ihabits; Irectal Ibleeding;
I incomplete Ie vacuation I and I unexplained I abdominal I or I back I pain
o Colonoscopy: Ievery I10 Iyears Iafter I50 Iyears
o Sigmoidoscopy: Ievery I5 Iyears IafterI50
o Pap Ismears: Iwomen Iget Ithis Itest Ievery Iyear
• C. Idiff: I wash Ihands Iwith Isoap Iand I water
• Infectious Iagent, Ireservoir, Iportal Iof Iexit, Imode Iof Itrans mission, Iportal
I ofIe ntry, I susceptible I host
• Measure Ifor ING Itube: Itip Iof Inose, Iearlobe, Ixiphoid Iprocess
• AdministerIeardrops
o Children: Ipull Iauricle Idown Iand Iback
o Adult: Ipull Iauricle Iupward Iand Ioutward
o Cotton
o Apply Igentle Ipressure Ito Itragus Iof Iear
• Toxicity: Ikidney Ifailure
• BMI Iof I28: Ioverweight
• Opioids: Iconstipation
• Alcohol I with Iopioids Iwould Imake Ithe Ieffect Iwork
I faster=synergisticIaffect
• Deltoid Ineedle: I22-25 Iand I1-1 Iand Ia Ihalf I in
• Valsalva Imaneuver: Idon’t Ihave IaIaging Iadult Ido Ithis
I becauseIintracranial I pressure
• Inserting Ia Isuppository: ILeft-side Iwith I(right) Iknee Ibent
• Feeding:
• Too I many Imedications, Iconcerned Iwith Iclogging: I(what Idoes Inurse Ido?)
o use Iliquid Iforms Iof Imedication, I if Ipossible
o flush Itube I with I30 Ito I50 ImL Iof Iwater Ior I normal Isaline Ibefore Iand
IafterImedication Iadministration Iand Ibefore Iand Iafter Ibolus I feeding
o flush Iwith I water Ievery I4 Ihours I for Icontinuous I feeding
o answer: Icall I the Ipharmacy Iand Iask Ithem I to Isend I you I liquid I form
IofImedications
• TPN Itotal Iparenteral I nutrition-through Ithe Icentral I line
• HTN I medication Iand Iorange Istool: Iquestion: I what I medications Ihave
IyouItaken Irecently
, • Laxative: Ilong-term Ican Icause Iconstipation
• Older Iadult: Icalcium Iand Ivitamin ID
• Candidate I for Itube: I throat Icancer
• nurse Ineeds I further Iteaching: I(always Iprepare I the Iregular I insulin I first)
o Draw IRegular I insulin I first, Ithen Ithe INPH I in Ithe Isyringe
o NPH Iis I intermediate
o insulin I garglane I(Lantis) I- Ialways Idrawn I in I its Iown Isyringe I(drawn Ialone)
o Regular Iinsulin I is Ithe IONLY Iinsulin I that’s Igiven IIV
• IV Iis Ithe Ifastest Iabsorption
• Topical Iis Ithe Islowest
• Enteral Ifeeding: Icannot Iingest Ifood Ibut Ican Idigest Iand
I absorbInutrients
• Stop Iusing IET Iwhen I75% Iof Ibody Ineeds Iare Imet, Itapering I method
• Inserted Iright Iinto Ithe Idigestive Itract Ilike Ia IJ-tube, IG-tube, ING Itube
o Candidates: Ifunctioning IGI
• Parenteral Ifeeding: Icannot Idigest, Iabsorb ----- proble m Iwith Ithe IGI Iso
you Ihave Ito Iget Ia Icentral Iline Iclose Ito Ithe Iheart
o Candidates: I NON Ifunctioning IGI
• Side Ieffect: Iunavoidable, Ipredictable
• Idiosyncratic Ieffect: Iover/under-reactionIorIdifferent Ireaction
IfromInormal, I unpredictable Iex: I like I if I CNS Istimulator I and I instead I of
I becoming I restless I and I have Ienergy I the I patient I falls I asleep
• At Irisk: I motorcycle Iaccident Ivictim
• Surgery: Iprimary I intention, Iclean I incisions, Iapproximated Iedges
• Burn: Isecondary Iintention, Iburns, Ipressure Iulcers, ISCARRING
• Tertiary Iintention: I left Iopen I for I7 Idays I until I necrotic Istuff I is I gone, Iand Ithen
I itIc loses- Ibecause I you Idon’t I want Ito I trap Ibacteria I in Ithe I wound
• Shallow Iopening: IStage III
• Nonblanchable: IStage II
• Nectrotic: IUnstageable, I need Ito Iremove I(debridement)
• Wound Ican’t Ibe Istaged Iuntil Iit’s Idebrided
• Classification Iof IPressure IUlcers
o Stage II: I intact Iskin I with Inonblanchable Iredness
o Stage III: Ipartial-thickness Iskin I loss I(epidermis, Idermis, Ior Iboth)
o Stage IIII: I full-thickness Itissue I loss Iwith I visible I fat
o Stage IIV: I full- thickness Itissue Iloss Iwith Iexposed Ibone, I muscle, Ior
Itendon,IEschar
• First Isign Iof I hypoxia: Irestlessness
• the I last Isign Iof I hypoxia I is: Icyanosis I (turning Iof Ithe Iskin Iblue)
• Administer Ianalgesic Iwithin I30 Ito I60 I minutes
o Dressing Ichange: Iprovide Ianalgesic I meds
• Acute Idistress Isyndrome: I give Ibronchodilator
• Atelectasis: Ibreathing Iexercises I- Ievery I1-2 Ihours I make I them Icough
IandIdeep Ibreath Iand I incentive Ispirometer I is I10 Iper I hour Iand I make Isure I to I inspire
Inot Iexpire I(use Iaccessory I muscles)
