Med-Surg (NR325) Adult Health II Final Exam 3Questions AND Correct
Answers
Alzheimer's client education - ✔✔-refer to social services/case
managers to prevent role strain, as alzheimer's is permanent and only
gets worse
-educate family about illness, care, meds, adaptation of home
environment
-provide info about seizure care (can happen later in disease)
-remove scatter rugs/clutter, install safety locks
-provide good lighting
-shower chair
-have patient wear med. ID bracelet
-place mattress on floor
Alzheimer's disease patient care - ✔✔-assess cognitive status,
memory, judgement, personality
-bowel/bladder schedule
-encourage client/fam to join in support group
-SAFETY (remove obstacles, frequent monitoring)
-frequent walks w client to reduce wandering
-sleep schedule
-verbal/nonverbal communication
-check skin weekly for brkdown
,-cognitive stimulation (activities, structure, calendar, consistency)
-memory training (reminisce abt past with them, rehearsing memory
facts)
-promote self-care ALAP
Alzheimer's medications - ✔✔-most meds target
behavioral/emotional issues
-Donepezil (prevents breakdown of acetylcholine) which increases
nerve impulses @ site
-Memantine: blocks nerve cell damage * reduces deterioration
-Cholinesterase inhibitors slow degeneration
-Ginkgo biloba can increase memory/blood circulation but shouldn't
be taken with these meds
-observe for frequent stools/upset stomach
-monitor for dizziness/headache
-use caution when giving this med. to clients with asthma/COPD
Anemia d/t chemotherapy - nursing actions - ✔✔-monitor for
fatigue/pallor/dizziness/ SOB
-schedule rest periods in btwn activities
-administer erythropoietic meds (darbepoetin alfa, epoetin alfa) and
antianemic meds (feroous sulfate)
-monitor H/H to determine response to meds
,-be prepared to admin blood
BPH & s/s - ✔✔-benign prostatic hyperplasia
-enlargening of prostate that causes urinary dysfunction
*risk factors*
-increased age, smoking, chronic alcohol use, sedentary lifestyle,
western diet, DM, heart disease
*s/s*
-urinary frequency, dribbling, nocturia, weak stream, hematuria,
incomplete bladder emptying, urgency, urgency, incontinence, UTI's
due to urinary issues, kidney damage if urine backflows to ureters and
kidneys
BPH drugs/patient education - ✔✔*drugs*
-Dihydrotestosterone (DHT)-lowering meds (*finasteride*) - to
decrease prod. of testosterone in prostate/reduce size
-this can take up to 6 mo. to work, impotence/libido decrease =
adverse effects, report breast enlargement to HCP
-PREGNANT WOMEN AVOID CONTACT WITH THIS DRUG
-alpha-blocking agents: *tamsulosin*
--causes relaxation of bladder outlet/prostate gland
-decreases pressure on urethra, allowing for stronger urine flow
--tachycardia, syncope, postural hypotension can occur, change
positions slowly
, -cimetidine use can increase hypotensive effect
BPH lab tests/diagnostics - ✔✔*labs*
-WBC's elevated, hematuria, bacteria in UTI
-RBC's may be decreased d/t hematuria
-BUN/Creatinine elevated indicating kidney damage
*diagnostics*
-DRE
-Transrectal ultrasound with needle aspiration biopsy to rule out
cancer
-EPCA blood test instead of biopsy to rule out prostate cancer
Carbamazepine definition and s/s of toxicity - ✔✔-antiepileptic drug
also used for neuropathic pain, schizophrenia, Bipolar
-normal therapeutic range: 4-12 mcg/mL
-levels > 15 mcg/mL considered toxic
*s/s in order of severity*
-disorientation/ataxia
-aggression/hallucinations
-seizures/comas
Answers
Alzheimer's client education - ✔✔-refer to social services/case
managers to prevent role strain, as alzheimer's is permanent and only
gets worse
-educate family about illness, care, meds, adaptation of home
environment
-provide info about seizure care (can happen later in disease)
-remove scatter rugs/clutter, install safety locks
-provide good lighting
-shower chair
-have patient wear med. ID bracelet
-place mattress on floor
Alzheimer's disease patient care - ✔✔-assess cognitive status,
memory, judgement, personality
-bowel/bladder schedule
-encourage client/fam to join in support group
-SAFETY (remove obstacles, frequent monitoring)
-frequent walks w client to reduce wandering
-sleep schedule
-verbal/nonverbal communication
-check skin weekly for brkdown
,-cognitive stimulation (activities, structure, calendar, consistency)
-memory training (reminisce abt past with them, rehearsing memory
facts)
-promote self-care ALAP
Alzheimer's medications - ✔✔-most meds target
behavioral/emotional issues
-Donepezil (prevents breakdown of acetylcholine) which increases
nerve impulses @ site
-Memantine: blocks nerve cell damage * reduces deterioration
-Cholinesterase inhibitors slow degeneration
-Ginkgo biloba can increase memory/blood circulation but shouldn't
be taken with these meds
-observe for frequent stools/upset stomach
-monitor for dizziness/headache
-use caution when giving this med. to clients with asthma/COPD
Anemia d/t chemotherapy - nursing actions - ✔✔-monitor for
fatigue/pallor/dizziness/ SOB
-schedule rest periods in btwn activities
-administer erythropoietic meds (darbepoetin alfa, epoetin alfa) and
antianemic meds (feroous sulfate)
-monitor H/H to determine response to meds
,-be prepared to admin blood
BPH & s/s - ✔✔-benign prostatic hyperplasia
-enlargening of prostate that causes urinary dysfunction
*risk factors*
-increased age, smoking, chronic alcohol use, sedentary lifestyle,
western diet, DM, heart disease
*s/s*
-urinary frequency, dribbling, nocturia, weak stream, hematuria,
incomplete bladder emptying, urgency, urgency, incontinence, UTI's
due to urinary issues, kidney damage if urine backflows to ureters and
kidneys
BPH drugs/patient education - ✔✔*drugs*
-Dihydrotestosterone (DHT)-lowering meds (*finasteride*) - to
decrease prod. of testosterone in prostate/reduce size
-this can take up to 6 mo. to work, impotence/libido decrease =
adverse effects, report breast enlargement to HCP
-PREGNANT WOMEN AVOID CONTACT WITH THIS DRUG
-alpha-blocking agents: *tamsulosin*
--causes relaxation of bladder outlet/prostate gland
-decreases pressure on urethra, allowing for stronger urine flow
--tachycardia, syncope, postural hypotension can occur, change
positions slowly
, -cimetidine use can increase hypotensive effect
BPH lab tests/diagnostics - ✔✔*labs*
-WBC's elevated, hematuria, bacteria in UTI
-RBC's may be decreased d/t hematuria
-BUN/Creatinine elevated indicating kidney damage
*diagnostics*
-DRE
-Transrectal ultrasound with needle aspiration biopsy to rule out
cancer
-EPCA blood test instead of biopsy to rule out prostate cancer
Carbamazepine definition and s/s of toxicity - ✔✔-antiepileptic drug
also used for neuropathic pain, schizophrenia, Bipolar
-normal therapeutic range: 4-12 mcg/mL
-levels > 15 mcg/mL considered toxic
*s/s in order of severity*
-disorientation/ataxia
-aggression/hallucinations
-seizures/comas
