MDC 1 Final exam 2023 with complete solutions

What are some affects of immobility - Answer- Slow peristalsis Decreased appetite Decreased respirations increase workload of heart orthostatic hypotension atelectasis What are some ways to promote therapeutic communication - Answer- Active listening Trusting relationship Being assertive Validating Exploring this issue "tell me more" Silence What is osteoporosis? - Answer- a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D What are some nursing interventions for osteoporosis - Answer- Educate avoiding smoking and alcohol Educate exercise Promote comfort Increase Vitamin D and calcium intake Weight bearing exercises What do we look for in patients with osteoporosis - Answer- Kyphotic posture What do we monitor for in patients with a cast - Answer- Compartment syndrome pressure ulcers infection What is compartment syndrome? - Answer- Damage to nerves and vasculature of an extremity due to compression The 5 Ps to compartment syndrome - Answer- pain, pallor, pulselessness, paralysis, paresthesia Education on cast care - Answer- Report odor, increase pain, numbness Don't stick anything in the cast How do we handle casts - Answer- palm of your hands Diabetes is what? - Answer- Vascular disorder Why do diabetics have poor wound healing - Answer- Poor circulation. The peripheral nerve damage leads to reduced blood flow which increase risk for infection High sugar levels all bacteria to grow and allow infections to develop Diabetes affects what organ - Answer- pancreas Prevention measures for a diabetic - Answer- Monitor blood glucose levels healthy Diet Take medication as prescribed don't share insulin pen Assess FEET Good hygiene Psoriasis is ____ - Answer- chronic inflammatory skin disease, lesions are white scaly patches and red bumpy patches Treatment for psoriasis - Answer- UV light therapy Stress mangement Methotrexate Emollient cream Vitamin A NSAIDS Risk factors for psoriasis are - Answer- Genetics Stressors Smoking Alcohol obesity Pain assessment - Answer- PQRST Atelectasis is - Answer- Collapsed or airless condition of the lungs Signs and symptoms of atelectasis - Answer- SOB Wheezing Chills Night sweats Persistent cough What are some complications that can arise with atelectasis - Answer- Pneumonia hypoxia respiratory failure Nursing interventions for atelectasis - Answer- incentive spirometer coughing and deep breathing Assess O2 Assess lung sounds Use of a cane - Answer- use on stronger side 6 in to front and 6 in to the side What is RA - Answer- Systemic autoimmune disease causing inflammation of connective tissue Signs and symptoms of RA - Answer- Inflammation Stiffness Deformity Tenderness Treatment for RA - Answer- NSAIDS Anti-rheumatic drugs Hot and cold pack Scheduled rest times Corticosteriods Labs for RA - Answer- Elevated ESR and CRP Elevated RH factor osteoarthritis is - Answer- progressive degenerative joint disease Signs and symptoms for osteoarthritis - Answer- Crepitus joint pain stiff and tenderness labs for osteoarthritis - Answer- elevated ESR Treatment for osteoarthritis - Answer- NSAIDS systemic lupus erythematosus - Answer- inflammatory connective tissue disease affecting the whole body Signs and symptoms of SLE - Answer- Butterfly rash Fever Swollen joints Flare ups Chest pain Treatment for SLE - Answer- NO CURE NSAIDS Deep breathing and coughing ROM Corticosteroids Exercise and diet Compartment syndrome risks - Answer- DVT/PE Fat embolism Neurovascular assessment - Answer- Peripheral vascular: -Color and temperature -Capillary refill -Pulses -Edema Peripheral neurologic: -Sensation and motor function -Pain Neurovascular assessment 6Ps - Answer- Pain pallor pulselessness paresthesia paralysis Poikilothermic (cold) OSHA (Occupational Safety and Health Administration) - Answer- Set standards, education and training Makes work environment safe Asthma is - Answer- chronic inflammatory disorder of the airways Signs and symptoms of asthma - Answer- SOB Increased mucus production increase respiration low O2 Wheezing crackles coughing Agitation Treatment for asthma - Answer- bronchodilators and corticosteroids neb treatments O2 Pneumonia is - Answer- infection and inflammation of the lung Treatment for pneumonia - Answer- NSAIDS Antibiotics O2 depending on patient Signs and symptoms of pneumonia - Answer- Wheezing Coughing SOB Low O2 Increased sputum production Nursing preventions for pneumonia - Answer- Deep breathing and coughing O2 high fowlers position Promote gas exchange Ensure airway clearance Nutrtion CRIES scale - Answer- For babies and infants FLACC scale - Answer- face, legs, activity, cry, consolability 2 months to 7 years of age Chain of infection - Answer- infectious agent (Bacteria, virus) reservoir (People, water, food animals) portal of exit (Mouth, cuts, toileting) mode of transmission (Contact, droplet) portal of entry (mouth, cuts, eyes) susceptible host (anyone) Diabetics are at risk for what types of infections - Answer- Feet UTI Yeast Surgical site infections Contact precaution examples - Answer- MRSA C-Diff VRE Shigella Droplet Precaution examples - Answer- Influenza Pertussis RSV Meningitis Rubella Airborne Precaution examples - Answer- COVID Chicken Pox TB Shingles How can you get a UTI - Answer- Sex frequent catheterizations Location of urethra to anus How is nephritis related to UTIs - Answer- When a blockage occurs like a kidney stone, enlarged prostate it can cause back flow of urine which leads to a UTI Signs and symptoms of nephritis - Answer- Pain during urination Frequency urinating pain in pelvis cloudy, or bloody urine What are some aspiration risks - Answer- Seizure coma Mentally disabled patient Loss of consciousness stroke acid reflux Raynaud's phenomenon - Answer- a peripheral arterial occlusive disease in which intermittent attacks are triggered by cold or stress Poor circulation Hip/ knee arthroplasty - Answer- Relieve pain and restore function Cuts away damaged bone and cartilage HIV signs and symptoms - Answer- Fatigue fever headache muscle aches Treatment for HIV - Answer- Antiretroviral therapy (ART) Lab tests for HIV - Answer- Viral load CBC Liver function tests PAP smear Antigen test What are some opportunistic infections to HIV - Answer- Candidiasis Cervical cancer Kaposi sarcoma TB Pneumonia HSV Bucks traction (skin) - Answer- knee immobility; dont adjust weights Boot attached to 5-10 pounds relieves muscle spasm pain Skeletal traction - Answer- a method of immobilization and reduction of a long-bone fracture in which traction is applied by means of pins and wires Pin site care When do you notify PCP if a patient has a skeletal traction - Answer- Increased pain Repositioning doesn't help relieve pain weight is too heavy A DVT is - Answer- blood clot usually found in the legs Signs and symptoms of a DVT - Answer- pain Edema Redness color to skin Warm to touch Risk factors of a DVT - Answer- Immobility Surgery Obesity Smoking Alcohol Blood clotting disorder IBS Family history age Treatment of a DVT - Answer- Blood thinners clot busters Compression socks Preventive measures for a DVT - Answer- Exercise and move the body Healthy diet Avoid smoking and alcohol Lose weight What is a PE - Answer- A blood cot becomes lodged in the pulmonary artery and blocks blood flow to the lungs Signs and symptoms of a PE - Answer- -Dyspnea (difficulty breathing) -Sudden chest pain -cyanosis -Tachycardia -Hypotension -Severe anxiety -pink frothy sputum -Rales -Hypoxemia -Anxiety -SOB Mangement for PE - Answer- Monitor vital signs and lung sounds DX testing Anticoagulants Analgesics Risk factors to a PE - Answer- Heart disease Family history Age Obesity Smoking Clotting disorders Surgery Cancer Lab tests for a PE - Answer- d-dimer X-ray CT Pulmonary angiogram Fall prevention safety measures - Answer- Assess Cognitive state Install handrails and ramps proper use of assistive devices Remove clutter and throw away rugs rubber soler shoes adequate lighting what is a bakers cyst - Answer- Collection of synovial fluid behind the knee What is an excerbation - Answer- worsening of disease Stage IV pressure ulcer - Answer- Full-thickness tissue loss with destruction, tissue necrosis, or damage to muscle,and bone There may be deep pockets of infection, tunneling, undermining, eschar, or slough Deep tissue injury - Answer- Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. Stage II pressure ulcer - Answer- Partial-thickness superficial, skin loss, abrasion, blister, or shallow crater Prevention for pressure ulcers - Answer- Reposition every two hours Nutrition Fluid intake How do you instill Otic medication - Answer- Have patient lie on side Adult: Pull pinna up and back Child: Pull down and back A complete fracture with no injury to skin is - Answer- Closed a complete fracture with injury to skin - Answer- open Greenstick fracture - Answer- is incomplete Transverse fracture - Answer- straight line Oblique fracture - Answer- occurs at an angle across the bone Glaucoma is - Answer- Increased pressure in the anterior chamber of the eye Glaucoma signs and symptoms - Answer- Mild aching or pain in the eyes visual disturbances. halos around lights, or a noticeable loss of peripheral vision Treatment for glaucoma - Answer- drug therapy for underlying cause signs and symptoms of a cataract - Answer- Blurred vision Decreased color perception cloudy lens opacity distorts image Abnormal findings after cataract surgery - Answer- Increased eye redness increased ICP Increased tear production yellow or green discharge Swelling and brusing Weber's Tuning Fork Test - Answer- the a stem of a vibrating tuning fork in the center of the forehead or the top of the head as shown, the loudness of the sound should be equal in both ears if hearing is normal or if there is symmetric hearing loss Red skin over hips - Answer- Pressure ulcer: greater heat production associated with greater pressure Braden scale of 20 how do you as a nurse move forward - Answer- Continue routine assessments types of people at risk for a pressure ulcer - Answer- Obese patients that need help repositioning A thin patient who sits for long periods of time Bedridden patient What do you ask when you are assessing quality of pain - Answer- Is it sharp or dull. Shooting or burning feeling What tools are used to assess ICP - Answer- Tonometry What foods would you recommend to enhance eye health - Answer- Red, green, orange veggies Fruits What diet would you encourage for wound healing - Answer- high protein What is common after a hip fracture or pelvis fracture - Answer- fat embolism If a fracture isn't healed with in 6 months what do you call it - Answer- delayed union Osteomyelitis is - Answer- infection of the bone What changes in mood might you see in a patient who is immoblie - Answer- isolation depression anger anxiety What are four body mechanics - Answer- Balance body alignment coordination joint mobility What are barriers to communication - Answer- Sexism Language Disturbances Racism What is the fifth vital sign - Answer- Pain What are the five characteristics of therapeutic ocmmunication - Answer- empathy respect genuineness concreteness confrontation How can you protect your eyes - Answer- Eye protection Nutrition Regular eye examinations Before touching they eye or instilling eye drops what do you need to do - Answer- Hand hygiene avoid using an ophthalmoscope on what kind of patient - Answer- confused patient If a patient has discharge from one eye which eye do you examine first - Answer- The eye without discharge macular degeneration - Answer- progressive damage to the macula of the retina Risk factors for macular dengenration - Answer- Hypertension female family history smokers poor diet what is hemiparesis - Answer- weakness on one side of the body, partial paraylsis What is purulent drainage - Answer- thick, yell