MED SURG NURS 371 EXAM 1 2025

Past health hx, health/current (heart, lung, diabetes, surgeries), family hx, reaction problems to anesthesia (pt/fam) current medications, allergies, recreational drug use, latex screen and a comprehensive body system review is all a part of a ______________ assessment? - -pre-op Meds (prescriptions, otc, herbal, dietary supplements, nsaid/antiplatelets can effect bleeding/coumadin, warfarin/take off before surgery) Can interact with anesthesia What medications should the nurse document for a pre-op patient? - -prescription, otc, herbal, recreational, antiplatelets, nsaid, dietary supplements The priority nursing interventions for a pre-op pt is to get baseline vitals/labs, ___________ access, npo, prep the site, and the most important is _______________ which the dr is responsible for informing the pt of the procedure and risks. The nurse is responsible for making sure that it is completed before surgery. - -iv, informed consent Pre-op teaching is important. Teach the client about tcdb/is, tubes/drains, pain control, and forms to be signed and placed in chart such as ________, _________, ______, ______? - -informed consent, blood transfusions, advance directives, power of attorney Good to know. Post-op interventions. Vs, airway patency, o2sat, tcdb/is, repositions q2, hydrate, lung sounds, pain control, dvt prevention (teds, scd, site care, discharge education - - Case management begins on admission and it is a collaborative process of assessment , facilitation, and advocacy options/services to meet the clients needs to promote? A. Quality and cost effective outcomes B. Consumer demands and profit C. Communication D. Independence - -a Changes in reimbursement systems, people living longer, increase in complex chronic diseases (mult), consumer demans, expense r/t technology, more people needing access to diminishing dr and advanced technology are the ____________ behind case management and is why it is needed in todays healthcare system? - -driving forces The primary goal of case management is to avoid __________________ and ________________? - -fragmentation of care and control cost MED SURG MED SURG True of false, case management begins at admission and end at discharge? - -true Which of the following is the nurses role in case management? A. Admission, transfer, discharge, post discharge orders B. Initiation, revision, evaluation of plan of care C. Report clients status to team D. Coordinate discharge plan, facilitate referrals and utilization of community resources - -a, b, c, d Good to know different types of insurance providers Medicare (elderly), medicaid (low income), kchip (for kids), tri-care (military insurance), individual, employer - - What are the four causative agents of infections? - -1. Bacterial (, staph) 2. Viral (hiv, herpes) 3. Fungal (candida, aspergillus) 4. Protozoa/parasites (malaria) Match the following to it correct term. (droplet, contact, airborne, vector borne) A. __________ animals or insects as intermediaries (malaria, lymes disease, rocky mountain spotted fever) B. ___________ sneezing, coughing, talkinging (flu, pertussis, steptococcalpneumonia ) C. ____________direct physical contact or indirect contact with an inanimate object (c diff, herpes simplex virus, impetigo) D. ____________ sneezing, coughing (measles, varicella, tb) - -a. Vector borne B. Droplet C. Contact D. Airborne Which of the following pre-dispose someone to develop an infection? A. Medication therapy, immunocompromised, glucocosteriod, chemo B. Chronic diseases (diabetes, renal/hepatic, lung,resp) C. Environmental D. Health care worker - -a, b, c Which of the following are reasons to avoid immunizations (red flag)? A. Bad reaction/allergies to eggs B. Women ages 30-40 C. Pregnant/lactating D. Fever within 24 hrs MED SURG MED SURG E. Immunocompromised F. Age 65-75 - -a, c, d, e General s/s of an infection include which of the following? A. Fever, chills, increase wbc B. Loss of consciousness, pallor, decrease in bp C. Fever, chills, decrease in wbc D. Hyperemia, inflammation - -a Which of the following would a nurse typically see change with an infection affecting the brain? A. Nausea, vomiting, anorexia B. Nuchal rigidity (painful stiff neck) C.photophobia D. Sob, change loc E. Heachach, change in loc - -b,c, e The purpose for performing a wbc with differential is that it provides information about the ________________________ . The normal wbc level is __________ to ___________. Can be slightly lower in the elderly. If its decreased (leukopenia below 4,300) may be an immune problem/immunocompromised. - -type of infection. 5,0000-10,000 If neutrophils are elevated, it is a sign that the infection is _________ related. If lymphocytes are elevated, it is a sign that the infection is _________ related. If eosinophils are elevated, it is a sign that the infection is __________ related. - bacterial Viral Parasite/allergen A ____________________ is done to determine what pathogen is growing and what effect antimicrobials have on the microorganism (what meds you can treat it with). - c&s Which of the following are ways to collect a specimen to run a c&s? A. Urine B. Sputum C. Semen D. Blood E. Wound drainage F. Abscess fluids G.sweat H. Peritoneal fluid I. Tears - -a, b, d, e, f, h MED SURG MED SURG The sensitization portion of the c&s can take up to ___________ hours. In the meantime, pt will be treated with an antibiotic based on the hospitals ___________. The final report is to be given to the pcp whom will make decisions based on the results and what to use to treat the infection if its no sensitive. - -48-72hrs Antibiogram An esr is the rate at which settle out of plasma. Normal for adults is _____to_______mm/hr. If this is increased, it can indicate an active ____________. - 15to20mm/hr Inflammation/infection The main difference between an antibody screening test and an antibody test is? A. An antibody screen detects the presence of of antibodies against specific against. Has been exposed to a pathogen. An antibody test detects a specific pathogen, identifies certain infectious disorders. B. There is no difference, they are the same - -a Antibody scree test checks for positive antibodies. Antibody test detects the specific pathogen Sepsis is diagnosed by a _____________. People that are most at risk are the very young and the very old, weakened immune system, and trauma pt. - -blood culture (2 anaerobic, 2 aerobic cultures drawn) The west nile virus is spread through by _________________. 80% of people will have no symptoms but ones that do may experience symptoms in ______ days to _______weeks. Mild symptoms can include rash on chest, back, stomach, fever, and nv. Severe symptoms can include an high fever, ______________ rigidity, tremors, coma, convulsions, numbness, and paralysis. - -infected mosquito bite 3days to 2 weeks Nuchal rigidity (painful stiff neck) Fyi, there is no specific treatment for west nile. Prevention measures include bug spray, wearing long sleeves, and staying away from still/standing bod