Hondros Nur 176 exam 1 Questions and Answers 100% correct

Hondros Nur 176 exam 1 Questions and Answers 100% correct Interventions to prevent diabetes Maintain healthy weight, diet and exercise Signs of type 1 diabetes 3 polys, blurred vision, cold feet, numbness, shiny thin skin w/ no hair, age 30 and under, sudden onset, underweight, Signs of type 2 diabetes No symptoms at first , later develop the 3 polys, obesity, Nigricans (black line on back of neck) skin tags S/S of hypoglycemia Fatigue, weakness, irritability, reduce cognition, tremors, seizures, diaphoresis( sweating) S/S of hyperglycemia 3 polys, fruity breath S/S of diabetic ketoacidosis and treatment High BS, high HR, restlessness, weight loss, fruity breath, kussmaul(fast deep RR) -- treatments; IV regular insulin First intervention if a pt. Presents with s/s of hypo/hyperglycemia Check blood sugar Prevention of long term complications of diabetes Takes meds, daily feet care, yearly renal test, eye exams every 6 months, LDL less than 150 Dietary teaching for a diabetic patient Meals at the same time every day, decrease saturated fats, increase exercise , refer pt. To MyPlate learning tool, Diabetic Pt. should never increase carbs unless... Sugar is low before exercising Discharge teaching for diabetic pt. Know hypo/hyperglycemia s/s, know that stress and illness increase BS , see a diabetic educator, know what the effect of Exercise can have on Bs Diabetic foot care Clean w/ soap and warm water, clean socks everyday, cut toe nails straight across, keep feet dry, no powder or lotion b/t toes , wear shoes , inspect feet daily, no gardners Lipid analysis LDL-less than 100 HDL- more than 40 Triglycerides- more than 150 What are low and high levels of HDL indicative of High- insulin resistance, low- insulin sensitivity What insulins can not be mixed? Levemir and Lantus ( detemir and glargine ) How to mix insulin Short acting to long acting, regular to NPH, Clear to cloudy Should a nurse hold a patients insulin before consulting a dr? No No insulin, beta cells are destroyed is a result of ? Diabetes type 1 Beta cells exhaustion , insulin resistance is a result of ? Diabetes type 2 Rapid acting insulin Lispro(Humalog) aspart(Novolog) glulisine(Apidra) Onset, peak and duration of Novolog and Apidra Onset-15-30, Peak-1-3hr, duration-3-5hr onset, peak and duration of humalog Onset-15-30, Peak-1-2hr, duration-3-4hr Short acting insulin( regular) Humulin R, Novolin R, ReliOn R, Onset-30-60 , Peak-2-4hr, duration-6-8hr Intermediate insulin (NPH) Humulin N, Novolin N, ReliOn N, Onset-1-4hr Peak-4-12hr, duration-12-16hr Long acting insulin Lantus and levemir Onset-1-2hr, Peak- none, duration-24hr Which insulin is the only one that can be given through IV ? Regular What is glucagon used for? Makes glucose. Received if BS is low If a pt. Is lethargic, what form of glucose should be administered? Glucagon gel in cheek What is Lipohypotrophy and the prevention ? Lump under subcut tissue due to repeated injections at the same site. Rotate sites S/s of brain tumor Vision changes, confusion and headache S/S of traumatic brain injury Blurred vision, personality changes, altered level of consciousness, slurred speech, confusion, headache, uncoordinated, weakness / numbness of legs and arms If someone hit their head, which test should be completed? CT scan to make sure there's no head bleeding Early signs of IICP Altered levels of consciousness Nursing interventions for mannitol & lasix Monitor I&O and electrolytes Nursing interventions for prednisone Monitor blood glucose and daily weight Glasgow coma scale measures .. Eye opening, verbal and motor response. A score less than 8 is considered in a coma S/S of Ischemic strokes 80% have these, trouble talking, Face droop? Arm drift, Slurred speech S/S of hemorrhagic stroke Serve headache, aneurysm rupture from hypertension , *never administer TPA for these strokes What is Aphasia Trouble speaking, expressive, receptive and global Dysphagia precautions No straws , thicken liquids, Steps before administering TPA Do CT scan to verify Ischemic stroke, neurological assessment, make sure they aren't on blood thinners, history of blood disorders Side effects of Lovenox (enoxaparin) Bruising at injection site, dark loose stools , GI bleeding Is Delirium a disease of the CNS ? No S/S of early stage dementia Gradual onset of memory loss, difficulty focusing attention, depression Main goal for dementia patients Maintain self care abilities and prevent injuries Nursing interventions for dementia patients Large clock and calendar, decreased distractions during meals, decreased stimuli, monitor weight How many pain assess menus are done for pt with dementia? 2 Interventions for an agitated dementia pt. Move pt. To a calm environment Reality orientation for dementia pts Be honest, call by preferred name, eye contact, set a routine , simple tasks and directions, familiar objects Safety interventions in the Alzheimer's pt. Calm environment, encourage supervision, allow social and physical activity Med for multiple sclerosis Copaxone Generalized tonic-clonic seizures (grand mal) Most common, stiffening of body for 10-20 sec. then jerking extremities for another 30-40 secs Absence seizures ( petit mal) Occurs during childhood, stares off with little to no tonic-clonic movement Psychomotor (partial seizures) Occurs at any age, pt. Behaves in a drunk manner, doesn't remember Jacksonian-focal seizures ( local or partial) Occur in pts. With structural brain disease, starts in the hands or feet, can turn into tonic-clonic Myoclonic seizures Sudden jerking of body Akinetic seizures Not common, falls in flaccid state, unconscious for 1 or 2 minutes What med will a pt get with new onset seizures? Broad spectrum anti-seizure med Pt education related to seizures Keep long and recorded time and duration, any drowsiness , nausea and vomiting. Discharge education for a pt taking Dilantin Mouth care, avoid alcohol, no driving, use soft tooth brush Seizure disorder interventions Stay with them while they seize, lower them to floor, observe and record, keep them safe, don't force mouth open , turn on side if excessive sputum accumulates What should be determined when assessing meningitis? Viral or bacterial, the specific organism that caused it Bacterial meningitis labs Increase protein, increase WBC , decrease glucose Isolation for meningitis Respiratory droplet, 24 hour isolation after first treatment Age of onset for type 1 diabetes 30 years or younger Age of onset for type 2 diabetes 35 years or older but increasing in children Hyperglycemia Blood glucose levels Higher than 100-140mg/dl Hypoglycemia blood glucose levels Less than 70mg/dl Euglycemia blood glucose level ( normal) 70-100mg/dl Level of Consciousness oriented to 1. Person 2. Person and Place 3. Person Place and Time. 4. Person Place Time and Purpose S/S Intracranial Pressure Increase in systolic b/p widening pulse pressure, bradycardia, irregular breathing pattern page 302 (cooper) Insulin Peptide hormone commonly absorb into patients blood stream. Given subcutaneously. (Also IV mixed with NS) When giving Insulin be careful to only inject into Subcutaneous tissue (between fat and muscle layer) page 1758 (cooper) Intractable Pain that is described as unbearable and does not respond to treatment. Diplopia Double vision NIHSS Stroke scale Characteristics of Parkinson's Disease Blank facial expression, Forward tilt to posture, slow monotonous slurred speech, tremor, short shuffle gait Ischemic Stroke Deficient blood flow to the brain from a partial or complete occlusion of an artery. Either thrombotic or embolic account for 90% of all strokes (cooper 1938) Postictal Period Rest period of a seizures varies in length Epilepsy Chronic two or more unprovoked seizures Seizure A disorder in which nerve cell activity in the brain is disturbed, causing seizures. What is the action of glucagon? Increases blood sugar (blood glucose) What does the nurse record after a seizure? Duration and time, degree of drowsiness afterward, SE of N/V Can we restrain a pt having a seizure? No Can we place something in a pt's mouth to protect their airway? No Phenytoin and pt teaching? Avoid alcohol, good oral hygiene, may have driving restrictions, pt needs to take meds even when seizures stop Why is it important to find pathogen that caused Meningitis? So it can be treated properly meningitis Inflammation of brain and spinal cord membranes, typically caused by an infection. What test is usually done to determine the type of organism in Meningitis? Lumbar puncture Pt teaching about Meningitis? Vaccinations are important; bacterial treated with antibiotics, viral treated with comfort measures If there is suspected bacterial meningitis? Respiratory isolation (droplet) until antibiotic runs for 24 hours Alzheimer's pt and safety Offer social or physical activity as distraction, encourage family and staff supervision, do Not restrain - physically or chemically, maintain calm environment Dementia pt and reality orientation Wall clock and calendar, do not overstimulate, decrees distraction during meals, do NOT put up rails as restraints, monitor weight for changes What do we monitor while pt on Mannitol (osmitrol)? I/O electrolytes