NR-324 Adult Health I
NR324 Final Exam Review
What is seen with lower GI bleeds?
Bright red blood in poop or black/tar stools
- Vomiting blood, fainting, passing out on toilet
An elderly patient presents with altered mental status, what is most likely the two
common causes?
Pneumonia and UTI (infection)
A 50-year-old patient who has COPD is admitted with acute COPD exacerbation.
What are some of the appropriate interventions that the HCP would order?
Vitals: T 100.2, O2 92%, HR 87, BP 120/80, RR 16
Azithromycin 500mg IV q24
Ambulate as tolerated
PRN ipratropium/albuteral for wheezing
O2 therapy to maintain O2 between 90-95%
Patient took a recent trip to Latin America and develops a cough, hemoptysis, low
grade fever, and night sweats. What is most likely the cause for these symptoms?
TB
What interventions are needed for a bowel obstruction?
NPO and NG tube
,Patient CBC is the following:
Hemoglobin - 9.7
Hematocrit - 38
MCV - 65.7
Platelets - 300,00
What type of anemia?
Iron-deficiency anemia
Patient awaiting surgery for a closed femur fracture. Develops symptoms of
dyspnea, tachypnea, and becomes anxious. Which possible complication the nurse
recognizes this as?
Fat Emboli
Management for GERD/Meds are what?
PPI and H2RA
A patient with HIV has a CD4 count of less than 200 for 3 months. What is most
likely the problem?
The patient has progressed to AIDs
An HIV patient reports yellow film and patches on the tongue and the roof of the
mouth. What is the problem and treatment?
Oral Candidiasis
- Nystatin swish and swallow QID x 10 days
What are the 4 types of hypersensitivity reactions?
1. Allergic
2. Cytotoxic
3. Antibody Complex Accumulation
4. Cell-mediated Cytotoxicity
,What is a type 1 hypersensitivity reaction?
Allergic reaction (asthma, anaphylaxis)
- IgE mediated - bind to mast cells and basophils (granulocytes)
Systemic - Anaphylaxis Reaction = worst case scenario
What are the chemical mediators for type 1 hypersensitivity reactions?
Histamine - itching, constricts muscles in lungs, anaphylaxis
4ht
Leukotrienes - tighten airway muscle
Bradykinin - increase vascular permeability and vasodilation (hypotension)
What is a type 2 hypersensitivity reaction?
Cytotoxic - body cells directly attacked by antibodies (hemolytic anemia)
- Antigen - cell surface of RBC
- Can occur in minutes to hours
Transfusion Reaction
- Binding of IgM/IgG AB to antigen surface
Ex. ABO incompatability, hemolytic anemia, leukopenia, ALL THE PENIAS, Good
Pasture Syndrome
What is good pasture syndrome in regards to type 2 hypersensitivity reactions?
AB attacks lungs
- Body attacks itself (basement membrane of glomerulus and pulmonary alveoli)
What is a type 3 hypersensitivity reaction?
Antibody complex accumulation
- Leading to destruction
- Antigen - antibody complexes float through blood and accumulate in tissues (joint,
glomerulus, blood vessels)
, What is a type 4 hypersensitivity reaction?
Cell-mediated Cytotoxicity (ex. organ rejection)
- T-Cell mediated
- Responding to tissues and organs
- Activates monocytes and lymphocytes
- E.g. contact dermatitis, chronic transplant rejection
Recognize the problem (TB, fungi) and stimulated CD4 releases cytokines -
activates macrophage phagocytosis
A patient has a lower leg bone fracture. It is NOT protruding through the skin and
is shattered into multiple pieces. It is known as?
Closed comminuted fracture of the tibia/fibula
What type of anemia results from heavy menses or chronic blood loss?
Iron deficiency anemia
What medications for GERD cause an increased risk of pneumonia and C. diff?
Proton Pump Inhibitors (PPI)
- Pantoprazole (Protonix)
- Lansoprazole (Prevaci)
Appendicitis manifests with what symptoms?
- Peri-umbilical pain and tenderness that migrates to the RLQ
- Fever, leukocytosis, and rebound tenderness
What blood tests are associated with HIV?
CBC, blood cultures, CD4 (800-1200), CD4 T cell (<200), and type/screen
NR324 Final Exam Review
What is seen with lower GI bleeds?
Bright red blood in poop or black/tar stools
- Vomiting blood, fainting, passing out on toilet
An elderly patient presents with altered mental status, what is most likely the two
common causes?
Pneumonia and UTI (infection)
A 50-year-old patient who has COPD is admitted with acute COPD exacerbation.
What are some of the appropriate interventions that the HCP would order?
Vitals: T 100.2, O2 92%, HR 87, BP 120/80, RR 16
Azithromycin 500mg IV q24
Ambulate as tolerated
PRN ipratropium/albuteral for wheezing
O2 therapy to maintain O2 between 90-95%
Patient took a recent trip to Latin America and develops a cough, hemoptysis, low
grade fever, and night sweats. What is most likely the cause for these symptoms?
TB
What interventions are needed for a bowel obstruction?
NPO and NG tube
,Patient CBC is the following:
Hemoglobin - 9.7
Hematocrit - 38
MCV - 65.7
Platelets - 300,00
What type of anemia?
Iron-deficiency anemia
Patient awaiting surgery for a closed femur fracture. Develops symptoms of
dyspnea, tachypnea, and becomes anxious. Which possible complication the nurse
recognizes this as?
Fat Emboli
Management for GERD/Meds are what?
PPI and H2RA
A patient with HIV has a CD4 count of less than 200 for 3 months. What is most
likely the problem?
The patient has progressed to AIDs
An HIV patient reports yellow film and patches on the tongue and the roof of the
mouth. What is the problem and treatment?
Oral Candidiasis
- Nystatin swish and swallow QID x 10 days
What are the 4 types of hypersensitivity reactions?
1. Allergic
2. Cytotoxic
3. Antibody Complex Accumulation
4. Cell-mediated Cytotoxicity
,What is a type 1 hypersensitivity reaction?
Allergic reaction (asthma, anaphylaxis)
- IgE mediated - bind to mast cells and basophils (granulocytes)
Systemic - Anaphylaxis Reaction = worst case scenario
What are the chemical mediators for type 1 hypersensitivity reactions?
Histamine - itching, constricts muscles in lungs, anaphylaxis
4ht
Leukotrienes - tighten airway muscle
Bradykinin - increase vascular permeability and vasodilation (hypotension)
What is a type 2 hypersensitivity reaction?
Cytotoxic - body cells directly attacked by antibodies (hemolytic anemia)
- Antigen - cell surface of RBC
- Can occur in minutes to hours
Transfusion Reaction
- Binding of IgM/IgG AB to antigen surface
Ex. ABO incompatability, hemolytic anemia, leukopenia, ALL THE PENIAS, Good
Pasture Syndrome
What is good pasture syndrome in regards to type 2 hypersensitivity reactions?
AB attacks lungs
- Body attacks itself (basement membrane of glomerulus and pulmonary alveoli)
What is a type 3 hypersensitivity reaction?
Antibody complex accumulation
- Leading to destruction
- Antigen - antibody complexes float through blood and accumulate in tissues (joint,
glomerulus, blood vessels)
, What is a type 4 hypersensitivity reaction?
Cell-mediated Cytotoxicity (ex. organ rejection)
- T-Cell mediated
- Responding to tissues and organs
- Activates monocytes and lymphocytes
- E.g. contact dermatitis, chronic transplant rejection
Recognize the problem (TB, fungi) and stimulated CD4 releases cytokines -
activates macrophage phagocytosis
A patient has a lower leg bone fracture. It is NOT protruding through the skin and
is shattered into multiple pieces. It is known as?
Closed comminuted fracture of the tibia/fibula
What type of anemia results from heavy menses or chronic blood loss?
Iron deficiency anemia
What medications for GERD cause an increased risk of pneumonia and C. diff?
Proton Pump Inhibitors (PPI)
- Pantoprazole (Protonix)
- Lansoprazole (Prevaci)
Appendicitis manifests with what symptoms?
- Peri-umbilical pain and tenderness that migrates to the RLQ
- Fever, leukocytosis, and rebound tenderness
What blood tests are associated with HIV?
CBC, blood cultures, CD4 (800-1200), CD4 T cell (<200), and type/screen
