MED SURG ATI QUESTION AND ANSWER

MED SURG ATI QUESTION AND ANSWER Right Sided Stroke - CORRECT ANSWER-impulsive behavior, poor judgement Left Sided Stroke - CORRECT ANSWER-Aphasia Priority for autonomic dysreflexia - CORRECT ANSWER-Elevate HOB then empty bladder/bowels Osteoarthritis - CORRECT ANSWER-Normal wear and tear of joints involving crepitus, decreased ROM, resolves with rest Craniotomy wound drainage - CORRECT ANSWER-Should be < 50mL/8 hrs Meds for primary angle closure glaucoma - CORRECT ANSWER-osmotic diuretics (Mannitol) Greatest risk after thoracentesis - CORRECT ANSWER-Pneumothorax Suctioning - CORRECT ANSWER-Increases ICP! TB is what kind of precautions - CORRECT ANSWER-Airborne Normal pH, CO2, HCO3 - CORRECT ANSWER-pH: 7.35-7.45 CO2: 35-45 HCO3: 22-26 Chest tube chambers - CORRECT ANSWER-1st chamber: drainage, should be <70mL, report if cloudy or red 2nd chamber: water seal, tidaling is normal 3rd chamber: suction control, gentle bubbling normal Continuous bubbling in water seal chamber - CORRECT ANSWER-Air leak S/S of hypoxemia (early and late) - CORRECT ANSWER-Early: restlessness, tachycardia, tachypnea, pale skin, increased BP, nasal flaring Late: confusion, bradycardia, decreased BP S/S of O2 toxicity - CORRECT ANSWER-substernal pain, stuffiness, N/V, sore throat, hypoventilation TB meds - CORRECT ANSWER-1. Isoniazid (Nydrazid) or INH 2. Rifampin 3. Pyrazinamide 4. Ethambutol take for 6-12 months, sputum samples q 4 weeks Isoniazid (INH) - CORRECT ANSWER-Watch for tingling in hands and feet (neurotox) and take with Vit B6 Rifamipin - CORRECT ANSWER-Can create orange secretions, interferes with hormonal BC Ethambutol - CORRECT ANSWER-test visual acuity and color tests Thrombolytics - CORRECT ANSWER-altepase (Activase) and streptokinase give slowly to prevent hypotension ARDS - CORRECT ANSWER-dyspnea, bilateral pulmonary edema, decreased lung compliance, diffuse infiltrates, orthopnea, rapid, shallow breathing caused by near drowning, OD, dysphasia, CABG Cholesterol - CORRECT ANSWER-<200 HDL - CORRECT ANSWER-35-80 LDL - CORRECT ANSWER-<130 Triglycerides - CORRECT ANSWER-40-160 S/S of cardiac tamponade - CORRECT ANSWER-hypotension, JVD, muffled heart sounds ECG lead placement - CORRECT ANSWERCABG - CORRECT ANSWER-diuretics stopped 2-3 days before aspirin stopped 1 week before compartment syndrome - CORRECT ANSWER-tingling, numbness, pain on passive movement Peripheral arterial disease - CORRECT ANSWER-decreased pulses in lower extremities, thick toenails, rubor in dependent position, intermittent claudication Myglobin - CORRECT ANSWER-earliest marker for injury to cardiac or skeletal muscle CKMB - CORRECT ANSWER-peaks 24 hrs (most indicative of MI) Troponin I - CORRECT ANSWER-detectable up to 1 week Troponin T - CORRECT ANSWER-detectable 14-21 days angina ecg - CORRECT ANSWER-ST depression and T wave inversion MI ecg - CORRECT ANSWER-ST elevation, abnormal q Treatment for angina/MI - CORRECT ANSWER-1. O2 2. Nitro 3. Aspirin 4. Morphine nitro - CORRECT ANSWER-vasodilator, can cause hypotension take 1 q 5 mins, up to 3 times headache common Metoprolol (Lopressor) - CORRECT ANSWER-slows HR, hold if <60 streptokinase - CORRECT ANSWER-give within 6 hours, contraindicated in active bleeding, PUD, CVA eptifibatide (Integrilin) - CORRECT ANSWER-prevent binding of fibrinogen, used in combo with aspirin therapy L sided HF - CORRECT ANSWER-Risk factors: HTN, CAD, MI, valve d/o SS: dyspnea, orthopnea, fatigue, S3, crackles, frothy sputum, change LOC, oliguria R sided HF - CORRECT ANSWER-Risk factors: L sided HF, MI, COPD S/S: JVD, ascending edema, fatigue, nausea, weight gn, hepatomegaly Cardiomyopathy - CORRECT ANSWER-weakness, dysrhythmias, S3, cardiomegaly, angina BNP elevated Meds for HF - CORRECT ANSWER-diuretics to decrease preload ACE Inhibitors Angiotensin blockers Calcium channel blockers Digoxin Dopamine Diuretics - CORRECT ANSWER-Loop- lasix K sparing- aldactone Thiazide- hydrochlorothiazide