NURSING 220 MIDTERM EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS

NURSING 220 MIDTERM EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS Preoperative nursing assessment - Answer-CSM, pain, skin integrity, preparation for surgery, hydration, NPO. Postoperative nursing assessment - Answer-Vitals, dressing changes, drainage, ambulation, medications, pain, hydration, bowels and bladder, referrals, patient education. Compartment syndrome - Answer-Increased tissue pressure within a limited space. Symptoms include: pain, pallor, paralysis, pulselessness, poikilothermia, parathesia. Symptoms of infection - Answer--Tenderness -Pain -Redness -Swelling -Warmth -Purulent -Delayed union -Elevated temperature Deep vein thrombosis - Answer-Large blood clot in the calf. Symptoms include: swelling, warmth, and tenderness of the area. Hip fracture - Answer-Femoral, neck, intertrochanteric, or subtrochanteric. Head and neck fractures are treated with insertion of a femoral head prosthesis. Trochanteric fractures are treated with compression screws. Total hip arthroplasty - Answer-Results from severe trauma, osteoarthritis, or a previous failed surgery. Hip must remain at <90 degrees of flexion during recovery. Hypertension - Answer-Persistent elevation of systolic 140mmHg and diastolic 90mmHg. Primary hypertension - Answer-Elevated blood pressure without an identified cause, 90-95% of clients. Secondary hypertension - Answer-Elevated blood pressure with a specific cause that can be identified and corrected, 5-10% of patients. Target organ damage - Answer-Cardiac disease, cerebrovascular disease, peripheral vascular disease, renal damange, or retinal damage. Drug therapy for hypertension - Answer-Aim to reduce CO and decrease circulating blood volume with a BP of 130/80 or lower. Initial drug therapy: thiazide diuretic, ACE-I, ARB, long-acting CCB, Beta blockers. Secondary drug therapy: dual, triple, quadruple combos. Coronary artery disease - Answer-Arterial blood flow is under higher pressure. Progressive narrowing of coronary arteries. Collateral circulation - Answer-Develops to compensate for low output states, such as heart failure, and provides an alternate route for blood and oxygen to myocardial tissues when arteries are occluded. Cardiac arteries - Answer-1. Right coronary artery 2. Left anterior descending coronary artery 3. Left circumflex coronary artery 4. Left main coronary artery Atherosclerosis - Answer-Endothelial lining of the arteries reacts to hyperlipidemia and hypertension, inflammatory response. Platelets are activated, adhering to blood vessel walls. Stable plaque - Answer-Impedes blood flow to myocardial tissues. No occlusion. Unstable plaque - Answer-Plaque rupture, platelet aggregation precipitates an acute coronary event. High density lipoprotein - Answer-Transport cholesterol to liver for excretion, beneficial effect on arterial wall. Low density lipoprotein - Answer-Harmful effects including increased inflammation of artery walls. Metabolic syndrome - Answer-Precursors include: abdominal obesity, blood fat disorders, elevated BP, insulin resistance or glucose intolerance, proinflammatory state. Impaired myocardial perfusion - Answer-Symptoms include: angina, chest pain, usually precipitated by exercise. Stable: relieved at rest. Unstable: no pattern. Silent ischemia: no pain, often in women. Angina - Answer-Heaviness or chest pressure caused by an increase in myocardial oxygen demand. Medications include statins, ASA, antihypertensives, CCB, vasodilators, insulin, Beta blockers, ACE-I. Acute coronary syndrome - Answer-Most common cause of coronary artery disease: coronary atherosclerosis. Bolus - Answer-Introduction of concentrated doses of medications directly into the patient's systemic circulation. The most dangerous method because there is not time to correct an error. Large-volume infusions - Answer-500mL - 1000mL dilutions, the safest and easiest.