Exam 4: NSG223/ NSG 223 (Latest 2024/ 2025 Update) Med Surg 2 Exam| Guide Questions and Verified Answers| 100% Correct| Grade A- Herzing

Exam 4: NSG223/ NSG 223 (Latest 2024/ 2025 Update) Med Surg 2 Exam| Guide Questions and Verified Answers| 100% Correct| Grade A- Herzing Q: Loss of Proprioception Answer: Loss of proprioception: ability to perceive the position of your body in space Q: Ischemic Stroke Symptoms Answer: Hemiplegia Hemiparesis Dysarthria Apraxia Dysphasia Dysphagia Aphasia: difficulty communicating Expressive: Cannot answer, knows answer but cannot get it out Receptive: Do not understand what you are saying Global: Both Loss of proprioception: ability to perceive the position of your body in space Facial Droop Q: Hemorrhagic Stroke Nursing Assessment Answer: CT MRI to determine extent of damage Under 40- Drug Screen No Lumbar Puncture Aneurysm Precautions: bed rest laying down, dim lights, SCD (leg squeezers), need them to turn still, stool softeners Environment: Quiet, head of bed 30 degrees Bowel/Bladder Lighting Prevention Bed Rest Sedation If INR high, use Vitamin K and plasma Q: Hemorrhagic Pharmacological Treatment Answer: If caused by elevated INR due to Warfarin Reverse INR with FFP and Vitamin K If caused by NOACs: Idarucizumab (Praxbind) reverses dabigatran (Pradaxa) Seizures: phenytoin (Dilantin) (more likely for seizures) Anti-hypertensives (ACE favored) Analgesics for pain Acetaminophen for fever Antidepressants Q: Ischemic Pharmacological Treatment Answer: Anticoagulants: Warfarin INR Goal 2-3 NOACs: do not have to check INR or APTT often Dabigatran (Pradaxa) (only one with reversal) Apixaban (Eliquis) & Edoxaban (Savaysa) & Rivaroxaban (Xarelto) Antiplatelet: Plavix & Aspirin Statins: Helpful in reducing risk of ischemic stroke (even in those who do not need their cholesterol decreased) Antihypertensives: (ACE preferred with or without a diuretic) Oxygen THROMBOLYTICS (tPA, Alteplase) Clot Buster- ISCHEMIC ONLY, symptoms started less than 3 hours ago. Q: Cataract Discharge Teaching Answer: An eye shield is usually worn at night for the first week to avoid injury. The nurse also explains that there should be minimal discomfort after surgery and educates the patient about taking a mild analgesic agent, such as acetaminophen, as needed. Antibiotic, anti-inflammatory, and corticosteroid eye drops or ointments are prescribed postoperatively. Patients prescribed anti-inflammatory or corticosteroid eye drops are monitored for possible increases in IOP Q: Macular Degeneration Patient Education Answer: Amsler grids are given to patients to use in their homes to monitor for a sudden onset or distortion of vision. These may provide the earliest sign that macular degeneration is getting worse. Patients should be encouraged to look at these grids, one eye at a time, several times each week with glasses on if needed for corrected near vision. If there is a change in the way the grid appears to the patient (e.g., if the lines or squares appear distorted or faded), the patient should notify the ophthalmologist immediately and should arrange to be seen promptly Q: Nursing Assessment of Cataracts Answer: Decreased visual acuity is directly proportionate to cataract density. The Snellen visual acuity test, ophthalmoscopy, and slit-lamp biomicroscopic examination are used to establish the degree of cataract formation. The degree of lens opacity does not always correlate with the patient's functional status. Some patients can perform normal activities despite clinically significant cataracts. Others with less lens opacification have a disproportionate decrease in visual acuity; hence, visual acuity is an imperfect measure of visual impairment. Q: Glaucoma Cholinergic Medications Answer: Cholinergic (Miotics) (Pilocarpine & Carbachol): Increase aqueous fluid outflow by contracting the ciliary muscle and causing constriction of pupil and opening up meshwork. Side Effects: Periorbital pain, blurry vision, difficulty seeing in dark. Implications: Caution patients about