RN Comprehensive Predictor Study Guide

RN Comprehensive Predictor Study Guide Testing for TB ---CORRECT ANSWER--- A Mantoux skin test is the most accurate and valuable screening tool available for TB. A positive result means only that the client has been exposed to TB; it does not meant that the client has active TB. Testing for TB continue ---CORRECT ANSWER--- A sputum culture for acid fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB after a screening test and chest x-ray come back positive. Teaching instructions for the use of a cane: ---CORRECT ANSWER--(1) The cane is moved forward about 12 inches. (2) Then, the weak leg is moved even with the cane. (3) Finally, the strong leg is brought forward and ahead of the cane and weak leg. - Cane is held on stronger side. - The gripper of the cane should be level with the trochanter of the femur. Meningococcal vaccine ---CORRECT ANSWER--- Recommended that this vaccine be given to children who are 11 through 12 years of age and then given a booster dose at age 16. When should the single dose of Herpes zoster vaccine be given? ---CORRECT ANSWER--- To adults 60 years or older whether or not they report a previous episode of herpes zoster. Rotavirus should be given at what age? ---CORRECT ANSWER--- During the child's first year of life. Alendronate (Fosamax) ---CORRECT ANSWER--- This medication is used to prevent and treat postmenopausal osteoporosis and Paget's Disease. - Alendronate-taken in morning on an empty stomach. - The patient must be instructed to wait at least 30 minutes after taking Alendronate before eating, drinking, or taking other medications. What to expect with a patient having a chest tube? ---CORRECT ANSWER--- Continuous gentle bubbling in the suction control chamber. - Crepitus (with a pneumothorax, this will persist for several hours depending) - Oscillations-tidaling in the water seal chamber upon respiration are expected. What is a potential complication of a thyroidectomy? ---CORRECT ANSWER--- Hypocalcemia: numbness and tingling in the hands, soles of the feet and around the lips. What is Chvostek's sign? And how is it done? ---CORRECT ANSWER--Tap on the pt's face at a point just anterior to the ear and just below the zygomatic bone. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggestive of neuromuscular excitability caused by hypocalcemia. Brudzinski's sign ---CORRECT ANSWER--- Is an indication of meningeal irritation, which may be positive in patient's with meningitis. - To perform this, the client needs to be supine. The nurse: -places one hand behind patient's head. -places the other hand on the client's chest. Kernig's sign ---CORRECT ANSWER--- Is an indication of meningeal irritation. The maneuver is usually performed with the client supine with hips and knees in flexion. Extension of the knees is attempted and the inability to extend the clients knee beyond 135 degrees w/out causing pain constitutes a positive test. Babinski sign ---CORRECT ANSWER--- This is used to test for brain damage or upper motor neuron damage. It is considered positive if the toes flare up upon stroking the plantar aspect of the foot. Cataract surgery discharge instructions ---CORRECT ANSWER--- Do not lift anything heavier than 10lbs for at least one week - Sleep on your back or unaffected side to lessen the pressure. - Need to report any pain, decrease in vision or increase in discharge in the eye. Cataract continue ---CORRECT ANSWER--- It is normal to feel itching and mild discomfort after surgery, but the pt should be instructed not to rub or place pressure on the eye. Exposure or possible exposure to anthrax ---CORRECT ANSWER--- Administer an antibiotic prophylaxis to all pt's newly exposed **Those exposed to anthrax do not require decontamination and are not considered contagious** Botulism treatment ---CORRECT ANSWER--- Give an antitoxin Why would lidocaine (Xylocaine) be given to someone following cardiac arrest? --- CORRECT ANSWER--- Lidocaine is an antiarrhythmic med that is commonly used to restore a regular heartbeat in a client who has arrhythmia. This effect is produced by delaying abnormal nerve pulses to the heart and reducing irritability of the heart tissue. What diagnostic test would help the nurse monitor and evaluate the effectiveness of the aspirin medication for an Rhematoid arthritis patient? ---CORRECT ANSWER--- Erythrocyte sedimentation rate (ESR) ** RA is a chronic inflammatory disease. ESR is useful in detecting and monitoring tissue inflammation in clients with RA.** Antinuclear antibody (ANA) ---CORRECT ANSWER--- ANAs are frequently present in pts who have autoimmune disorders such as systemic lupus erythematosus, RA, and scleroderma Rheumatoid factor (RF) diagnostic test ---CORRECT ANSWER--Helpful in diagnosing RA, but the levels do not always correlate with the severity of the disease Cheyne-Stokes Respirations ---CORRECT ANSWER--- Is characterized by a rhythmic increase (to the point of hyperventilation) and decrease (to the point of apnea) in the rate and depth of respirations. - It is commonly seen in pts who are unconscious, comatose or moribund (approaching death).