HURST EVALUATION TEST QUESTIONS AND
ANSWERS SET A+
✔✔when a patient is having GI problems and ulcers wy do you think a PCP wants the
client to be NPO and have a NG tube hooked up to suction ? - ✔✔- because they can
develop a paralytic ileus
✔✔why could a pt develop a paralytic ileus? - ✔✔- decreased vascular volume
- decreased GI motility
- hyperkalemia
✔✔if a client doesn't have bowel sounds, what will happen to the abdominal girth ? -
✔✔- INCREASE
✔✔the Ng tube will be removed when you hear what in the GI system? - ✔✔- bowel
sounds
✔✔when you start GI feedings what should you measure to ensure that the supplement
is moving through the GI tract? - ✔✔- residuals
- return residuals back to client!!!!!
✔✔since a client has partial thickness and ful-thickness burns, is it possible they could
have problems with contractures? - ✔✔- yes
✔✔if a pt has burns on their hands , what are some specific measure that may be taken
when wrapping? - ✔✔- wrap each finger seperately
- use splints to prevent contractures
✔✔what is it called when the head is back ? - ✔✔- hyperextending the neck
tip: no pillows it helps promotoe chin to chest contractures
✔✔with a perineal burn, what is the #1 complication ? - ✔✔- infection
,✔✔what is eschar? - ✔✔dead tissue
✔✔does eschar have to be removed? - ✔✔- yes
✔✔if eschar is not removed can new tissue regenerate? - ✔✔- NO
✔✔what likes to grow in eschar? - ✔✔- bacteria
✔✔if a pt is suffering from a chemical burn what should you do ? - ✔✔- remove the
client from the chemical and begin FLUSHING
- flush with water 15-30 minutes ( cool water or sterile saline)
- BRUSH POWDER CHECMICALS OFF FIRST, THEN FLUSH
✔✔how many wounds does electrical burns have ? - ✔✔2
✔✔what are the two wounds a electrical burn have ? - ✔✔- entrance and exit
* DO NOT FORGET INTERNAL DAMAGE
✔✔what is the first thing you do for an electrical injury? - ✔✔- contionuous heart
monitoring for 24 hrs
✔✔what arrythmia is a electrical burn pt at high risk for ? - ✔✔- V_FIB
✔✔with electrical burns, myoglobin and hemoglobin can build uo and cause what ? -
✔✔- kidney damage
✔✔a electrical client may be placed on a spine board with a c- collar why? - ✔✔-
electrical injuries occur in HIGH PLACES
- muscle contractions can cause fractures and the force of the electricity can actually
throw the victim forcefully
✔✔are amputations common in electrical burns ? and why? - ✔✔- yes
- the circulatory system is DESTROYED
✔✔what are some other electrical complications do electrical wounds or injuries
include? - ✔✔- cataracts, gait problems, and neuro deficit
✔✔they thyroid gland produces how many hormones? and what are they? - ✔✔- 3
- T3, T4, Calcitonin
✔✔what does calcitonin do to the serum calcium ? - ✔✔- decreases by taking calcium
out of the blood and pushing it back into the bone
,✔✔what does one need to make hormones? - ✔✔- iodine
✔✔what does thyroid hormone give us ? - ✔✔- energy
✔✔what is another name for HYPERthyroidism ( too much energy) ? - ✔✔- GRAVES
DISEASE
✔✔what are some S/S of graves disease? - ✔✔- attention span DECREASE
- appetite INCREASES
- weight DECREASES
- gi FAST
- BP and Pulse INCREASES FAST
- thyroid size GROWS
✔✔if you drew a serum thyroxine ( T4) level on this client, would it be increased or
decreased? - ✔✔- INCREASE
- TSH DECREASES!!
✔✔client must discontinue any iodine containing medication ___ week prior to the
thyroid scan and must wait _____ weeks to restart medications - ✔✔-1
-6
✔✔Amiodarone ( Cordarone) is what type of drug ? - ✔✔- antiarrythmic drug that
contains high levels of iodine and may affect thyroid function
✔✔what is the treatment for hyperthyroidism ( graves disease) ? - ✔✔- 1. anti-thyroids
- 2. iodine compounds
- 3. beta blockers ( supportive therapy )
- 4. radioactive iodine therapy ( ONE TIME DOSE)
✔✔what are some anti thyroid medications and what do they do ? - ✔✔- methimazole (
tapazole)
- propylthiouracil ( PTU)
- stops the thyroid from making thyroid HORMONE
- its used PRE- OP to stun the thyroid
- we want this client to become euthyroid ( eu= normal)
✔✔what are some iodine compound drugs and what do they do ? - ✔✔- potassium
iodine ( sski and lugols solution )
- DECREASE the size and the vascularity of the gland
- ALL endocrine glands are VERY VASCULAR
- give in milk or juice and use a straw. why? STAINS THE TEETH
✔✔what are some beta blockers and what do they do ? - ✔✔- propranolol ( inderal)
, - decreases myocardial contractility
- decreases HR, BP
- DECREASES anxiety
✔✔what does radioactive iodine therapy do ? - ✔✔- given PO ( liquid or tablet form) *
rule out pregnancy first *
- destroys thyroid cells ----> decreases thyroid ( hypothyroid)
- follow radioactive precautions - stay away from babies for 1 week ...... - dont kiss
anyone for 1 week
✔✔DO NOT GIVE BETA BLOCKJERS TO WHAT KIND OF PTS? - ✔✔- asthmatics
- diabetes
✔✔what are some post op and rules for after a thyroidectomy ( partial/complete) -
✔✔PRIORITY: HEMORRHAGE!!!!!!!!
- report feelings of PRESSURE
- check for bleeding where? - at the incision site, behind the neck
- assess for recurrent laryngeal nerve damage by listening for HOARSENESS
✔✔can thyroidectomy lead to vocal cord paralysis ? - ✔✔- yes
✔✔when there is paralysis of both cords ______________ obstruction will occur
requiring immediate ___________ - ✔✔- airway
- trach
✔✔trach at bedside watch for what? - ✔✔- swelling
- recurrent laryngeal nerve damage ( vocal cord paralysis)
- hypocalcemia
✔✔what to assess for when watching for hypocalcemia? - ✔✔- assess for
PARATHYROID removal
- how ? s/s of HYPOCALCEMIA ( muscle rigidity spasms)
- sedate or not sedated? NOT sedated
✔✔what should you do as a nurse when a patient goes through a thyroidectomy? - ✔✔-
teach how to support the neck
- put personal items REALLY CLOSE to them
- positioning the HOB elevated helps edema DECREASE
- nutrition ( pre-post op) : client needs MORE calories
✔✔what are the s/s of HYPOthyroid? - ✔✔- no ENERGY
- speech SLOW & SLURRED
- weight INCREASED
- GI SLOW
- hot or cold? COLD
ANSWERS SET A+
✔✔when a patient is having GI problems and ulcers wy do you think a PCP wants the
client to be NPO and have a NG tube hooked up to suction ? - ✔✔- because they can
develop a paralytic ileus
✔✔why could a pt develop a paralytic ileus? - ✔✔- decreased vascular volume
- decreased GI motility
- hyperkalemia
✔✔if a client doesn't have bowel sounds, what will happen to the abdominal girth ? -
✔✔- INCREASE
✔✔the Ng tube will be removed when you hear what in the GI system? - ✔✔- bowel
sounds
✔✔when you start GI feedings what should you measure to ensure that the supplement
is moving through the GI tract? - ✔✔- residuals
- return residuals back to client!!!!!
✔✔since a client has partial thickness and ful-thickness burns, is it possible they could
have problems with contractures? - ✔✔- yes
✔✔if a pt has burns on their hands , what are some specific measure that may be taken
when wrapping? - ✔✔- wrap each finger seperately
- use splints to prevent contractures
✔✔what is it called when the head is back ? - ✔✔- hyperextending the neck
tip: no pillows it helps promotoe chin to chest contractures
✔✔with a perineal burn, what is the #1 complication ? - ✔✔- infection
,✔✔what is eschar? - ✔✔dead tissue
✔✔does eschar have to be removed? - ✔✔- yes
✔✔if eschar is not removed can new tissue regenerate? - ✔✔- NO
✔✔what likes to grow in eschar? - ✔✔- bacteria
✔✔if a pt is suffering from a chemical burn what should you do ? - ✔✔- remove the
client from the chemical and begin FLUSHING
- flush with water 15-30 minutes ( cool water or sterile saline)
- BRUSH POWDER CHECMICALS OFF FIRST, THEN FLUSH
✔✔how many wounds does electrical burns have ? - ✔✔2
✔✔what are the two wounds a electrical burn have ? - ✔✔- entrance and exit
* DO NOT FORGET INTERNAL DAMAGE
✔✔what is the first thing you do for an electrical injury? - ✔✔- contionuous heart
monitoring for 24 hrs
✔✔what arrythmia is a electrical burn pt at high risk for ? - ✔✔- V_FIB
✔✔with electrical burns, myoglobin and hemoglobin can build uo and cause what ? -
✔✔- kidney damage
✔✔a electrical client may be placed on a spine board with a c- collar why? - ✔✔-
electrical injuries occur in HIGH PLACES
- muscle contractions can cause fractures and the force of the electricity can actually
throw the victim forcefully
✔✔are amputations common in electrical burns ? and why? - ✔✔- yes
- the circulatory system is DESTROYED
✔✔what are some other electrical complications do electrical wounds or injuries
include? - ✔✔- cataracts, gait problems, and neuro deficit
✔✔they thyroid gland produces how many hormones? and what are they? - ✔✔- 3
- T3, T4, Calcitonin
✔✔what does calcitonin do to the serum calcium ? - ✔✔- decreases by taking calcium
out of the blood and pushing it back into the bone
,✔✔what does one need to make hormones? - ✔✔- iodine
✔✔what does thyroid hormone give us ? - ✔✔- energy
✔✔what is another name for HYPERthyroidism ( too much energy) ? - ✔✔- GRAVES
DISEASE
✔✔what are some S/S of graves disease? - ✔✔- attention span DECREASE
- appetite INCREASES
- weight DECREASES
- gi FAST
- BP and Pulse INCREASES FAST
- thyroid size GROWS
✔✔if you drew a serum thyroxine ( T4) level on this client, would it be increased or
decreased? - ✔✔- INCREASE
- TSH DECREASES!!
✔✔client must discontinue any iodine containing medication ___ week prior to the
thyroid scan and must wait _____ weeks to restart medications - ✔✔-1
-6
✔✔Amiodarone ( Cordarone) is what type of drug ? - ✔✔- antiarrythmic drug that
contains high levels of iodine and may affect thyroid function
✔✔what is the treatment for hyperthyroidism ( graves disease) ? - ✔✔- 1. anti-thyroids
- 2. iodine compounds
- 3. beta blockers ( supportive therapy )
- 4. radioactive iodine therapy ( ONE TIME DOSE)
✔✔what are some anti thyroid medications and what do they do ? - ✔✔- methimazole (
tapazole)
- propylthiouracil ( PTU)
- stops the thyroid from making thyroid HORMONE
- its used PRE- OP to stun the thyroid
- we want this client to become euthyroid ( eu= normal)
✔✔what are some iodine compound drugs and what do they do ? - ✔✔- potassium
iodine ( sski and lugols solution )
- DECREASE the size and the vascularity of the gland
- ALL endocrine glands are VERY VASCULAR
- give in milk or juice and use a straw. why? STAINS THE TEETH
✔✔what are some beta blockers and what do they do ? - ✔✔- propranolol ( inderal)
, - decreases myocardial contractility
- decreases HR, BP
- DECREASES anxiety
✔✔what does radioactive iodine therapy do ? - ✔✔- given PO ( liquid or tablet form) *
rule out pregnancy first *
- destroys thyroid cells ----> decreases thyroid ( hypothyroid)
- follow radioactive precautions - stay away from babies for 1 week ...... - dont kiss
anyone for 1 week
✔✔DO NOT GIVE BETA BLOCKJERS TO WHAT KIND OF PTS? - ✔✔- asthmatics
- diabetes
✔✔what are some post op and rules for after a thyroidectomy ( partial/complete) -
✔✔PRIORITY: HEMORRHAGE!!!!!!!!
- report feelings of PRESSURE
- check for bleeding where? - at the incision site, behind the neck
- assess for recurrent laryngeal nerve damage by listening for HOARSENESS
✔✔can thyroidectomy lead to vocal cord paralysis ? - ✔✔- yes
✔✔when there is paralysis of both cords ______________ obstruction will occur
requiring immediate ___________ - ✔✔- airway
- trach
✔✔trach at bedside watch for what? - ✔✔- swelling
- recurrent laryngeal nerve damage ( vocal cord paralysis)
- hypocalcemia
✔✔what to assess for when watching for hypocalcemia? - ✔✔- assess for
PARATHYROID removal
- how ? s/s of HYPOCALCEMIA ( muscle rigidity spasms)
- sedate or not sedated? NOT sedated
✔✔what should you do as a nurse when a patient goes through a thyroidectomy? - ✔✔-
teach how to support the neck
- put personal items REALLY CLOSE to them
- positioning the HOB elevated helps edema DECREASE
- nutrition ( pre-post op) : client needs MORE calories
✔✔what are the s/s of HYPOthyroid? - ✔✔- no ENERGY
- speech SLOW & SLURRED
- weight INCREASED
- GI SLOW
- hot or cold? COLD
