NR341 EXAM 1 (COMPLEX HEALTH) EXAM WITH QUESTIONS AND CORRECT DETAILED ANSWERS WIT
RATIONALE GRADED A+|BRAND NEW!!
1. Delirium: an acute brain dysfunction; reversible; can lead to cognitive decline if
not fixed @#$%^&*(
Risk factors:
- UTI in older adults
- Sleep deprivation
- Sensory deprivation (normal stuff like glasses or hearing aids)
- Immobility
- Sepsis
- Increased age
- Hx of substance abuse
Nursing interventions:
- Screening tools
- Assessing LOC
- Reorient
- Adjust alarms and noises/dim lights/take nap
- Family interaction
2. Increased anxiety
And vice versa.. Increased anxiety = increased pain: What does increased pain
cause?
3. Benzodiazepines: - midazolam (Versed)
- Lorazepam (Ativan)
Used for anxiety
Side effects:
- Respiratory depression
- Syncope/orthostatic hypotension
- Ataxia
- Paradoxical agitation
- Delirium/confusion
Reversal = flumazenil
4. Opioids
** Narcan has a shorter half life.. They can become sedated again.. That's why
some people are put on a Narcan drip until opioid is out of their system: -
, NR341 EXAM 1 (COMPLEX HEALTH) EXAM WITH QUESTIONS AND CORRECT DETAILED ANSWERS WIT
RATIONALE GRADED A+|BRAND NEW!!
Fentanyl
- Morphine sulfate @#$%^&*(
- Hydromorphon
e used for pain
- Respiratory depression
- Constipation
- Urinary retention
- N/V
- Orthostatic hypotension
- Pruritus
Reversal = nalaxone (Narcan)
5. Sedation medications: commonly given to patients on a ventilator
Dexmedetomidine (Precedex) side effects:
- Hypotension
- Bradycardia
- Sinus arrest
- Reversal = atipamezole
Diprivan (Propofol) side effects:
- Hypotension
- Respiratory depression
- Irregular heartbeat
- Hyperlipidemia
- May cause death
- Change iv tubing every 12 hours because there is high risk for infection
6. ABCDEF bundle: A = have patient describe in their own terms what kind of pain
and anxiety and how much; non pharmacological and pharmacological
B = patient's aren't intended to be on ventilators for very long; weaning trial
C = increase patient's comfort level; don't want to overuse drugs because it can
cause delirium
D = delirium is an acute cognitive problem; every shift do an assessment; know
things that increase risk; know how to decrease risk —> promote early mobility,
, NR341 EXAM 1 (COMPLEX HEALTH) EXAM WITH QUESTIONS AND CORRECT DETAILED ANSWERS WIT
RATIONALE GRADED A+|BRAND NEW!!
Encourage sleep, encourage family members to engage, clock and calendar in room
@#$%^&*(
E = get them up and moving
F = physical and psychological benefits with family engagement; have them bring in
personal items
7. Advanced directive (living will): document that specifies a client's wishes for
what kind of medical care they do or do not want when they cannot make medical
decisions on their own
8. DNR: physician's order which states no measures will be taken to resuscitate the
patient
- If document is not available and the client cannot confirm wishes, resuscitative care
will be provided
-If active DNR is discovered during resuscitative measures, it needs to be validated
then measures are stopped
9. Rapid response team: prevents arrest by bringing rapid care to unstable
patients in non-critical settings; reduces mortality rates
10. - confusion
- VS changes (increased RR/HR) 6-8 hours before respiratory/cardiac arrest: -
What are some signs of early deterioration?
11. At end stage organ failure: When are client's put on a organ donation list?
12. Living donor: healthy individuals that offer organs to clients with end stage
organ disease (kidney, lung lobe, part of liver or pancreas
13. Brain death/circulatory death donor: organ given by a patient that has cessa-
tion of all brain function/organ given when no brain damage was done but injury
happened where no recovery is suspected (both need to be determined by a
physician)
14. Organ procurement organization (OPO): Who gets consent and arranges for
removal of donated organs?
15. - rejection
- Infection
- Post-transplant malignancies (due to suppression of immune system from
meds): What are the complications or organ donation?
16. Early s/s of respiratory distress: - tachycardia, tachypnea, hypertension
- Low SPO2
- Dyspnea on exertion
- Nasal flaring
- Agitation, restlessness
- Pale skin
RATIONALE GRADED A+|BRAND NEW!!
1. Delirium: an acute brain dysfunction; reversible; can lead to cognitive decline if
not fixed @#$%^&*(
Risk factors:
- UTI in older adults
- Sleep deprivation
- Sensory deprivation (normal stuff like glasses or hearing aids)
- Immobility
- Sepsis
- Increased age
- Hx of substance abuse
Nursing interventions:
- Screening tools
- Assessing LOC
- Reorient
- Adjust alarms and noises/dim lights/take nap
- Family interaction
2. Increased anxiety
And vice versa.. Increased anxiety = increased pain: What does increased pain
cause?
3. Benzodiazepines: - midazolam (Versed)
- Lorazepam (Ativan)
Used for anxiety
Side effects:
- Respiratory depression
- Syncope/orthostatic hypotension
- Ataxia
- Paradoxical agitation
- Delirium/confusion
Reversal = flumazenil
4. Opioids
** Narcan has a shorter half life.. They can become sedated again.. That's why
some people are put on a Narcan drip until opioid is out of their system: -
, NR341 EXAM 1 (COMPLEX HEALTH) EXAM WITH QUESTIONS AND CORRECT DETAILED ANSWERS WIT
RATIONALE GRADED A+|BRAND NEW!!
Fentanyl
- Morphine sulfate @#$%^&*(
- Hydromorphon
e used for pain
- Respiratory depression
- Constipation
- Urinary retention
- N/V
- Orthostatic hypotension
- Pruritus
Reversal = nalaxone (Narcan)
5. Sedation medications: commonly given to patients on a ventilator
Dexmedetomidine (Precedex) side effects:
- Hypotension
- Bradycardia
- Sinus arrest
- Reversal = atipamezole
Diprivan (Propofol) side effects:
- Hypotension
- Respiratory depression
- Irregular heartbeat
- Hyperlipidemia
- May cause death
- Change iv tubing every 12 hours because there is high risk for infection
6. ABCDEF bundle: A = have patient describe in their own terms what kind of pain
and anxiety and how much; non pharmacological and pharmacological
B = patient's aren't intended to be on ventilators for very long; weaning trial
C = increase patient's comfort level; don't want to overuse drugs because it can
cause delirium
D = delirium is an acute cognitive problem; every shift do an assessment; know
things that increase risk; know how to decrease risk —> promote early mobility,
, NR341 EXAM 1 (COMPLEX HEALTH) EXAM WITH QUESTIONS AND CORRECT DETAILED ANSWERS WIT
RATIONALE GRADED A+|BRAND NEW!!
Encourage sleep, encourage family members to engage, clock and calendar in room
@#$%^&*(
E = get them up and moving
F = physical and psychological benefits with family engagement; have them bring in
personal items
7. Advanced directive (living will): document that specifies a client's wishes for
what kind of medical care they do or do not want when they cannot make medical
decisions on their own
8. DNR: physician's order which states no measures will be taken to resuscitate the
patient
- If document is not available and the client cannot confirm wishes, resuscitative care
will be provided
-If active DNR is discovered during resuscitative measures, it needs to be validated
then measures are stopped
9. Rapid response team: prevents arrest by bringing rapid care to unstable
patients in non-critical settings; reduces mortality rates
10. - confusion
- VS changes (increased RR/HR) 6-8 hours before respiratory/cardiac arrest: -
What are some signs of early deterioration?
11. At end stage organ failure: When are client's put on a organ donation list?
12. Living donor: healthy individuals that offer organs to clients with end stage
organ disease (kidney, lung lobe, part of liver or pancreas
13. Brain death/circulatory death donor: organ given by a patient that has cessa-
tion of all brain function/organ given when no brain damage was done but injury
happened where no recovery is suspected (both need to be determined by a
physician)
14. Organ procurement organization (OPO): Who gets consent and arranges for
removal of donated organs?
15. - rejection
- Infection
- Post-transplant malignancies (due to suppression of immune system from
meds): What are the complications or organ donation?
16. Early s/s of respiratory distress: - tachycardia, tachypnea, hypertension
- Low SPO2
- Dyspnea on exertion
- Nasal flaring
- Agitation, restlessness
- Pale skin
