Medical Surgical Proctored Final Exam With
Complete Solutions
Prophylactic DVT Care - ANSWER -Assess and compare peripheral pulses
-Caused by dehydreation, obesity, trauma, malignacy, Hx of thrombosis, hormones, and
use of indwelling cath
-Nursing actions: prevention, avaoid dangling pt for long periods, anticoagulants,
provide adequate hydration
Cardiac cath postoperative care - ANSWER -Apply an initial dressing of gauze and
replace with transparent dressing w/i 24 hr
-x ray to ensure placement
-assess q8hr
- Use 10mL or < syringe to flush
-Clean port for 3 seconds and allow to dry
-flush before, between, and after meds
- no BP on arm with PICC
Ventricular fibrillation - ANSWER -can cause cardiogenic shock
-Dx- ECG, Ech, CT, Cardiac cath, chest x ray
-Tx- Cardiac cath, Anticoagulants, defib shock to fix rythem
Assessing arterial line - ANSWER -check placement
-keep pressure
-flush before between and after meds
-watch for clotting
,Eval. pt understanding of digoxin administration - ANSWER -Hold if apical HR is
<60bpm per min
-Watch for N&V
-Monitor ECG, BP
-Take same time each day
-take 2 hr before or after antacids
- If you miss dose take it as soon as you remember
Expected findings following administering Narcan - ANSWER -Increase Resp.
-Pain returns
-increase HR
-increase BP
Allergic blood transfusion reactions - ANSWER Mild- Itching, urticaria, flushing-
Administer benadryl
Anaphylactic- wheezing, dyspnea, chest tightness, cyanosis, hypotension
-maintain airway, admin. 02, IV fluids, antihistamines, corticosteroids, and vasopressors
Acute and Chromic Kidney: Planning Dietary Restrictions - ANSWER - Possible fluid
restrictions
-Restrict K+, phosphate, & magnesium
- Potassium and sodium regulated
-High pretine and possible TPN
Acute and chronic kidney: Evaluating pt understanding - ANSWER -Encourage pt to
drink 2-3L daily
-Promote smoking cessation, weight loss, and use of NSAIDs
-Instruct pt to take ALL perscribed meds and ATB
, -Decreased dietary potass, phosphate, and mag.
-Increase protein, possible TPN
Cardio: ECG abnormalities following myocardial infarction - ANSWER Q waves and ST
elevation
Inflammatory Bowel: Dietary recommendations - ANSWER low fiber
increased protein
decreased calories
Pt. teaching about Dilantin - ANSWER -If one med doesn't work dose is increased or
another med is added
-Therapeutic lvl determined by blood test
-Med taken same time each day
-Oral contraception/warfarin
A and C kidney: Med Adverse effects - ANSWER -Avoid antimicrobial, NSAIDs, ACE
inhibitors, IV contrast dye
-Monitor Digoxin lvl & administer post dialysis
-kayexalate to increase elemination of serum potassium
-epogen, procrit, to increase RBS stimulation
-Iron supplement
-Lasix
-Amphojel- taken to stop phsophate absorption
-take 2 hr before or after digoxin
Preventing complications after a transurethral resection of the prostate - ANSWER
-Urine should be light pink. If red increase irrigation
-If cath becomes obstructed turn of CBI and irrigate with 50mL
-Record amt. of irrigation and sub. from total to get true output
Complete Solutions
Prophylactic DVT Care - ANSWER -Assess and compare peripheral pulses
-Caused by dehydreation, obesity, trauma, malignacy, Hx of thrombosis, hormones, and
use of indwelling cath
-Nursing actions: prevention, avaoid dangling pt for long periods, anticoagulants,
provide adequate hydration
Cardiac cath postoperative care - ANSWER -Apply an initial dressing of gauze and
replace with transparent dressing w/i 24 hr
-x ray to ensure placement
-assess q8hr
- Use 10mL or < syringe to flush
-Clean port for 3 seconds and allow to dry
-flush before, between, and after meds
- no BP on arm with PICC
Ventricular fibrillation - ANSWER -can cause cardiogenic shock
-Dx- ECG, Ech, CT, Cardiac cath, chest x ray
-Tx- Cardiac cath, Anticoagulants, defib shock to fix rythem
Assessing arterial line - ANSWER -check placement
-keep pressure
-flush before between and after meds
-watch for clotting
,Eval. pt understanding of digoxin administration - ANSWER -Hold if apical HR is
<60bpm per min
-Watch for N&V
-Monitor ECG, BP
-Take same time each day
-take 2 hr before or after antacids
- If you miss dose take it as soon as you remember
Expected findings following administering Narcan - ANSWER -Increase Resp.
-Pain returns
-increase HR
-increase BP
Allergic blood transfusion reactions - ANSWER Mild- Itching, urticaria, flushing-
Administer benadryl
Anaphylactic- wheezing, dyspnea, chest tightness, cyanosis, hypotension
-maintain airway, admin. 02, IV fluids, antihistamines, corticosteroids, and vasopressors
Acute and Chromic Kidney: Planning Dietary Restrictions - ANSWER - Possible fluid
restrictions
-Restrict K+, phosphate, & magnesium
- Potassium and sodium regulated
-High pretine and possible TPN
Acute and chronic kidney: Evaluating pt understanding - ANSWER -Encourage pt to
drink 2-3L daily
-Promote smoking cessation, weight loss, and use of NSAIDs
-Instruct pt to take ALL perscribed meds and ATB
, -Decreased dietary potass, phosphate, and mag.
-Increase protein, possible TPN
Cardio: ECG abnormalities following myocardial infarction - ANSWER Q waves and ST
elevation
Inflammatory Bowel: Dietary recommendations - ANSWER low fiber
increased protein
decreased calories
Pt. teaching about Dilantin - ANSWER -If one med doesn't work dose is increased or
another med is added
-Therapeutic lvl determined by blood test
-Med taken same time each day
-Oral contraception/warfarin
A and C kidney: Med Adverse effects - ANSWER -Avoid antimicrobial, NSAIDs, ACE
inhibitors, IV contrast dye
-Monitor Digoxin lvl & administer post dialysis
-kayexalate to increase elemination of serum potassium
-epogen, procrit, to increase RBS stimulation
-Iron supplement
-Lasix
-Amphojel- taken to stop phsophate absorption
-take 2 hr before or after digoxin
Preventing complications after a transurethral resection of the prostate - ANSWER
-Urine should be light pink. If red increase irrigation
-If cath becomes obstructed turn of CBI and irrigate with 50mL
-Record amt. of irrigation and sub. from total to get true output
