Med Surg Capstone Review
What are three (3) risk factors for testicular cancer? List three (3) subjective
and objective findings in the client with testicular cancer?
• Risk Factors
1) HIV infection
2) Undescended testis
3) Genetic disposition
o Also Metastases, Age 20-54 (occur at any age)
• Subjective Findings
1) Lumps/swelling of testes
2) Feeling of heaviness in testicles
3) Evidence of metastasis (i.e. abdominal masses, gynecomastia, back
pain)
• Objective Findings
1) Enlarged testes without pain
2) Palpable lump (assessed by provider)
3) Swelling of lymph nodes in groin
What are the recommendations for vaccinations in the adult population?
• Td booster
o Give booster every 10 years. For adults 19-64 y/o who didn’t receive
Tdap
o Adults >65 y/o who haven’t received Tdap
o Pregnant women after 20 weeks GA may receive vaccine
• MMR vaccine
o 1-2 doses at 19-49 y/o & 1 dose at >50 y/o
• Varicella vaccine
o 2 doses to adults who don’t have evidence of previous infection
• PPSV
o Adults who are immunocompromised who have chronic disease,
smoking cigarettes, who life in long-term facilty
• Hep A vaccine
o 2 doses for high-risk individuals
• Hep B vaccine
o 3 doses for high-risk individuals
o Recommended for adults 60 y/o or younger
• Influenza vaccine
o Recommended for all adults annually
• Herpes Zoster vaccine
o Recommended for >60 y/o
A nurse is caring for a client receiving gastric tube feeding. What are nursing
actions should be taken to prevent overfeeding?
• Check residual every 4-6 hr during feedings
, • Follow protocol for withholding excess residual volume as directed (100-200
mL)
• Withhold feeding as prescribed & resume at reduce rate as prescribed
A nurse is caring for a client with multiple risk factors for peripheral vascular
disease. List four (4) risk factors associated with peripheral vascular disease.
1) Hypertension
2) Hyperlipidemia
3) Diabetes mellitus
4) Cigarette smoking
• Also obesity, sedentary lifestyle, family predisposition, & age
A nurse is caring for a client who has herpes zoster. Which of the following
alterations in integument should the nurse expect to find?
A. Generalized pink body rash
B. Red circles with white centers
C. Red edematous rash on cheeks bilaterally
D. Linear clusters of fluid-containing vesicles with some crusting
A nurse is caring for a client post-laryngectomy. What three (3) postoperative
interventions should be provided?
1) Monitor VS frequently for risk of hemorrhage & respiratory compromise
2) Enable patient use of communication (i.e. dry-erase board)
3) Assess stoma hourly & provide care frequently
A nurse is caring for a client with hyponatremia. List five (5) clinical
manifestations the client may exhibit with this electrolyte imbalance
1) Headache
2) Tachycardia with Rapid Thready Pulse
3) Hyperactive Bowel Sounds
4) Lethargy
5) Muscle Weakness
• Also Decreased DTRs, Hypotension, & Seizures
A nurse is caring for a client admitted to the hospital with a diagnosis of severe
hypothyroidism. What nursing interventions should be instituted for this
client?
• Monitor for cardio changes (i.e. low BP, bradycardia, dysrhythmias)
• If mental status compromised, orient periodically, & provide safety measures
• Increase activity level gradually & provide frequent rest periods
• Apply antiembolism stockings & elevate legs to assist venous return
• Encourage coughing & deep breathing
• Consult with dietitian & provide low-calorie, high-bulk diet
• Provide meticulous skin care
What are three (3) risk factors for testicular cancer? List three (3) subjective
and objective findings in the client with testicular cancer?
• Risk Factors
1) HIV infection
2) Undescended testis
3) Genetic disposition
o Also Metastases, Age 20-54 (occur at any age)
• Subjective Findings
1) Lumps/swelling of testes
2) Feeling of heaviness in testicles
3) Evidence of metastasis (i.e. abdominal masses, gynecomastia, back
pain)
• Objective Findings
1) Enlarged testes without pain
2) Palpable lump (assessed by provider)
3) Swelling of lymph nodes in groin
What are the recommendations for vaccinations in the adult population?
• Td booster
o Give booster every 10 years. For adults 19-64 y/o who didn’t receive
Tdap
o Adults >65 y/o who haven’t received Tdap
o Pregnant women after 20 weeks GA may receive vaccine
• MMR vaccine
o 1-2 doses at 19-49 y/o & 1 dose at >50 y/o
• Varicella vaccine
o 2 doses to adults who don’t have evidence of previous infection
• PPSV
o Adults who are immunocompromised who have chronic disease,
smoking cigarettes, who life in long-term facilty
• Hep A vaccine
o 2 doses for high-risk individuals
• Hep B vaccine
o 3 doses for high-risk individuals
o Recommended for adults 60 y/o or younger
• Influenza vaccine
o Recommended for all adults annually
• Herpes Zoster vaccine
o Recommended for >60 y/o
A nurse is caring for a client receiving gastric tube feeding. What are nursing
actions should be taken to prevent overfeeding?
• Check residual every 4-6 hr during feedings
, • Follow protocol for withholding excess residual volume as directed (100-200
mL)
• Withhold feeding as prescribed & resume at reduce rate as prescribed
A nurse is caring for a client with multiple risk factors for peripheral vascular
disease. List four (4) risk factors associated with peripheral vascular disease.
1) Hypertension
2) Hyperlipidemia
3) Diabetes mellitus
4) Cigarette smoking
• Also obesity, sedentary lifestyle, family predisposition, & age
A nurse is caring for a client who has herpes zoster. Which of the following
alterations in integument should the nurse expect to find?
A. Generalized pink body rash
B. Red circles with white centers
C. Red edematous rash on cheeks bilaterally
D. Linear clusters of fluid-containing vesicles with some crusting
A nurse is caring for a client post-laryngectomy. What three (3) postoperative
interventions should be provided?
1) Monitor VS frequently for risk of hemorrhage & respiratory compromise
2) Enable patient use of communication (i.e. dry-erase board)
3) Assess stoma hourly & provide care frequently
A nurse is caring for a client with hyponatremia. List five (5) clinical
manifestations the client may exhibit with this electrolyte imbalance
1) Headache
2) Tachycardia with Rapid Thready Pulse
3) Hyperactive Bowel Sounds
4) Lethargy
5) Muscle Weakness
• Also Decreased DTRs, Hypotension, & Seizures
A nurse is caring for a client admitted to the hospital with a diagnosis of severe
hypothyroidism. What nursing interventions should be instituted for this
client?
• Monitor for cardio changes (i.e. low BP, bradycardia, dysrhythmias)
• If mental status compromised, orient periodically, & provide safety measures
• Increase activity level gradually & provide frequent rest periods
• Apply antiembolism stockings & elevate legs to assist venous return
• Encourage coughing & deep breathing
• Consult with dietitian & provide low-calorie, high-bulk diet
• Provide meticulous skin care
