NURS 242 (Med/Surg) FINAL EXAM
STUDY GUIDE COMPLETE AND LATEST
UPDATED
What are the risk factors for pulmonary hypertension?
Obstructive sleep apnea
Emphysema (greater risk factor)
Chronic bronchitis
What are some indications of a chest tube
Pneumothorax
Lung collapses due to the presence of air or gas in the cavity between
the lungs and the chest wall
What can happen in thoracic surgery that will collapse the lung?
Pneumothorax
Hemathorax - bleeding into the thoracic cavity
What causes tidaling in a chest tube?
Inspiration and expiration
What do bubbles indicate in a chest tube?
Air leak
Few bubbles after insertion may be normal but they should go away
Output for chest tube drainage
Every 8 hours
100ml in 30 minutes call the provider
,What symptoms/manifestations indicate the patient needs to be
reintubated?
Dyspnea
ABG compared to baseline before extubated
An increase in PCO2 indicates the need for possible intubation
What is the most common complications post bronchoscopy?
Bronchospasm
What should you do as a nurse when the high pressure alarm goes off?
Assess the breath sounds
What is the #1 cause of a High pressure alarm?
Possible pneumothorax
E/T tube could have slipped up and only right side was getting air
What are the nursing responsibilities of a low pressure alarm?
Check tubing for kinks
Check o2 sat
What happens if you are unsuccessful in determining the cause of a low-
pressure alarm?
Ambu patient
Call for help
What things on the ventilator should you correlate to the physicians
orders?
PEEP - amount of positive pressure that keeps alveoli open for gaseous
exchange
FIO2 - oxygen setting
,Tidal Volume
Rate - how many times should the ventilator breathe for the patient
What is appropriate post-pneumonectomy positioning of the patient
Hourly from back to operative side
Review positioning for all thoracic surgeries
What lab do we assess in the gallbladder?
Bilirubin
What do we call gallstones?
Cholelithiasis
What is the term for inflamed or infected gallbladder?
Cholecystitis
What manifestations may tell you that a patient needs pain meds after a
cholecystectomy?
Grimacing
Shallow breathing
What is the Pre Op teaching for an ERCP?
Remain perfectly still during the procedure
What are the manifestations of cholecystitis?
Indigestion
Fever
RUQ pain radiating toward the back
Within 30 minutes of eating fatty meal
May or may not have emesis
What might you see on the abdomen with cholecystitis?
, Cullen's sign/Bruising around the umbilicus
What is the drug we give for gallstones (ReVIEW)
Ursodiol - it dissolves the gallstones
What type of diet would you teach the person with history of gallstones
High unsaturated/low saturated fats
Low carbohydrates
Avoid fried food
What is the patient teaching post-liver biopsy?
Position patient on the right side
Don't bear down
Why do we do a complete neurological check on someone with liver
disease?
Looking for encephalopathy due to increase in ammonia
How does the liver take care of ammonia when it's functioning properly?
Converts to urea so it can be put into circulation
What are kupffer cells responsible for?
Phagocytosis
Cleansing portal blood
What do you teach a patient with chronic hepatitis C?
Don't donate blood
No needle sharing
Safe sex
What are the manifestations of hepatitis A?
STUDY GUIDE COMPLETE AND LATEST
UPDATED
What are the risk factors for pulmonary hypertension?
Obstructive sleep apnea
Emphysema (greater risk factor)
Chronic bronchitis
What are some indications of a chest tube
Pneumothorax
Lung collapses due to the presence of air or gas in the cavity between
the lungs and the chest wall
What can happen in thoracic surgery that will collapse the lung?
Pneumothorax
Hemathorax - bleeding into the thoracic cavity
What causes tidaling in a chest tube?
Inspiration and expiration
What do bubbles indicate in a chest tube?
Air leak
Few bubbles after insertion may be normal but they should go away
Output for chest tube drainage
Every 8 hours
100ml in 30 minutes call the provider
,What symptoms/manifestations indicate the patient needs to be
reintubated?
Dyspnea
ABG compared to baseline before extubated
An increase in PCO2 indicates the need for possible intubation
What is the most common complications post bronchoscopy?
Bronchospasm
What should you do as a nurse when the high pressure alarm goes off?
Assess the breath sounds
What is the #1 cause of a High pressure alarm?
Possible pneumothorax
E/T tube could have slipped up and only right side was getting air
What are the nursing responsibilities of a low pressure alarm?
Check tubing for kinks
Check o2 sat
What happens if you are unsuccessful in determining the cause of a low-
pressure alarm?
Ambu patient
Call for help
What things on the ventilator should you correlate to the physicians
orders?
PEEP - amount of positive pressure that keeps alveoli open for gaseous
exchange
FIO2 - oxygen setting
,Tidal Volume
Rate - how many times should the ventilator breathe for the patient
What is appropriate post-pneumonectomy positioning of the patient
Hourly from back to operative side
Review positioning for all thoracic surgeries
What lab do we assess in the gallbladder?
Bilirubin
What do we call gallstones?
Cholelithiasis
What is the term for inflamed or infected gallbladder?
Cholecystitis
What manifestations may tell you that a patient needs pain meds after a
cholecystectomy?
Grimacing
Shallow breathing
What is the Pre Op teaching for an ERCP?
Remain perfectly still during the procedure
What are the manifestations of cholecystitis?
Indigestion
Fever
RUQ pain radiating toward the back
Within 30 minutes of eating fatty meal
May or may not have emesis
What might you see on the abdomen with cholecystitis?
, Cullen's sign/Bruising around the umbilicus
What is the drug we give for gallstones (ReVIEW)
Ursodiol - it dissolves the gallstones
What type of diet would you teach the person with history of gallstones
High unsaturated/low saturated fats
Low carbohydrates
Avoid fried food
What is the patient teaching post-liver biopsy?
Position patient on the right side
Don't bear down
Why do we do a complete neurological check on someone with liver
disease?
Looking for encephalopathy due to increase in ammonia
How does the liver take care of ammonia when it's functioning properly?
Converts to urea so it can be put into circulation
What are kupffer cells responsible for?
Phagocytosis
Cleansing portal blood
What do you teach a patient with chronic hepatitis C?
Don't donate blood
No needle sharing
Safe sex
What are the manifestations of hepatitis A?
