MED SURG EXAM REVIEW

1.When listening to the lungs sounds what's the most important thing to check for. The airway is clear, patent, and no obstruction. 2.What is giving to prevent pneumonia (medical management)? The pneumonia vaccine 3.How to know if a patient is positive for PPD? PPD test induration is more than 10. Immunocompromised patient induration is 5. 4.Risk factors for developing aspiration pneumonia? Immobility, remain NPO to prevent backflow, NG tube (elevated HOB to prevent aspiration) 5.Priority nursing diagnosis for a patient with pneumonia? Ineffective airway clearance (alveoli sac will be filled with fluid causing airway to be blocked) 6.Pt. with high risk of pneumonia always reinforce hand hygiene. 7.Which medication should be given first. Bronchodilator (short acting) or corticosteroid (long acting)? Bronchodilator should be given first because it opens the airway passage right away. The best short acting bronchodilator is albuterol. 8.Best way to prevent asthma and allergy concerns? Not exposing patients to the allergen. (same things that trigger allergy symptoms such as pollen, dust mites, and pet dander may also cause asthma sign and symptoms) In some cases, skin and food allergies can also cause asthma symptoms. 9.Labs to check for low blood (anemia). ? HCT and HGb 10.How is sickle cell acquired? Both parents must be carriers of the trait or defective gene. 11.What are nursing interventions to prevent respiratory complications? Early ambulation, turn patient every 2 hours, give 1-3 liters of oxygen.' 12.What's the best way to confirm TB? Sputum collection (positive PPD means you have been exposed to the bacteria but doesn't mean its active) More tests must be done to check whether its active) 13.What does that mean if there's continuous bubbling in the water seal chamber? A leakage 14.What if there is fluctuation in the water seal? Normal 15.What is S & S of asthma? Wheezing, chest pain, respiratory distress, nasal flaring 16.What are S & S of iron deficiency patients? Crave ice, extreme fatigue, pale skin, SOB, pallor 17.What type of anemia will a patient get after a gastrectomy? Risk for pernicious anemia 18.What is pernicious anemia? decrease in RBC that occurs when the intestine cannot absorb vitamin B12 (patient will need B12 shots for the rest of their lives) 19.Pt. has MI and doctor order a beta blocker what does this medication do the HR? (metoprolol) This medication will lower HR and pulse. This medication also lowers BP. 20.What are signs of bleeding in the skin of a patient with low platelet level? Bruises, petechiae, and ecchymosis. 21.What is bad cholesterol? LDL 100 optimal 22.How can you tell if a patient is at risk for CAD? Bad cholesterol (LDL) will be higher than good cholesterol (HDL) 23.How can you tell if a patient is not at risk for CAD? HDL will be higher than LDL (LDL<100, total cholesterol <200, and triglycerides <150) 24.What is the drug of choice to decrease the cardiac workload and anxiety for MI? Morphine 25.How often do you give nitroglycerin for Angina? Up to 3 pills every 5 minutes sublingual. 26.If nitroglycerin doesn't help with MI, what medications can be given? Morphine 27.What type of fat or oil can a patient have with CAD? Patient needs unsaturated fat (it dissolves at room temperature. 28.What is the best method to give nitroglycerin to a patient? Patient needs to be sitting or lying down. 29.If you do not control hypertension, what can it lead to? Stroke (CVA) 30.If a patient develops a right-side stroke where will the paralysis be at? Left side. 31.If a patient develops a left side stroke where will the paralysis be at? Right side 32.Left side stroke what is affected? Speech 33.Right side stroke what is affected? Vision 34.What are signs of digoxin toxicity? Blurred vision, nausea, anorexia (antidote Digibind) 35.What teaching to the patient for a loop diuretic? Its going to lower the BP 36.What is the cell that determines Hodgkin's lymphoma? Reed-Sternberg cell 37.What is some S & S to let you know someone has Hodgkin lymphoma? Night sweats, fatigue, lump in the throat, large and swollen lymph nodes. 38.What is the difference between left sided HF and right sided HF? Left(lungs) pulmonary edema, congestion in lungs, dyspnea. Right side=JVD, peripheral edema, pitted edema, ascites 39.What could be some of the contributing factors of angina pectoris? Smoking, sedentary lifestyle, obesity 40.Diet for cardiac patients? Low sodium diet, low fat, and high protein 41.What lab to determine why blood is in the urine? Platelet count 42.Difference between benign and malignant? Benign don't spread, have borders, 43.Best way to confirm cancer? Biopsy 44.What would you teach a patient with hypertension? To reduce salt intake 45.Major side effect of chemotherapy regarding bone marrow suppression. Neutropenia, fatigue, nausea, pale skin and lips, anorexia, weight loss, constipation, and sores in mouth and tongue