DAANCE: all modules Ch with Complete Solutions 2023 Latest Update., Exams of Nursing

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Complete Solutions 2023

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Pulmonary artery - Correct Answer: One of two arteries that carry venous (oxygen poor) blood from heart to lungs What type of intubation is preferred with emesis with aspiration? - Correct Answer: ETT. LMA or combitube acceptable. What emergency would a cricothyrotomy typically be performed? - Correct Answer: Airway obstruction Atropine would be given in which emergency? - Correct Answer: Symptomatic bradycardia Adenosine would be given in which emergency? - Correct Answer: SVT

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Amiodarone would be given in which emergency? - Correct Answer: V. Tach What medications can be given for a sever case of hyperventilation? - Correct Answer: Versed, Valium, or Propofol PVC's are treated with which medicine? - Correct Answer: Lidocaine Epi is given in which two emergencies? - Correct Answer: V. Fib and asystole Max dose of epi for cardiovascular disease pt - Correct Answer: .04mg A beta blocker would be given in which emergency? - Correct Answer: Hypertension

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A fluid bolus of NS and ephedrine can be given with what emergency? - Correct Answer: Hypotension What medications are used to treat malignant hypothermia? - Correct Answer: Dantrolene, IV cold saline (not Ringer's) Nasopharyngeal airway - Correct Answer: When tongue is obstructing airway. Tube is lubricated and passed through the nose into nasal cavity. Sits in oropharynx behind tongue. Well tolerated and can be used on awake pts. Oropharyngeal airway - Correct Answer: Also placed to position tongue in more anterior position. Often interfere with intra oral procedures. Not tolerated well with awake pts.

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Laryngeal mask airway (LMA) - Correct Answer: Device that sits over top of larynx. Can be placed blindly. Does not protect against aspiration. Inflated with 30cc to create seal. Endotracheal intubation - Correct Answer: End of tube passes through vocal cords and terminates half way between vocal cords and bifurcation of trachea. Important to listen to both lungs after placement. May or May not be cuffed. Combitube - Correct Answer: Generally used for specific emergencies. Both cuffs inflated. Pts predisposed to bronchospasm - Correct Answer: Allergies, asthma, copd, bronchitis

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Bronchospasm - Correct Answer: Generalized contraction of smooth muscles of small bronchi and bronchioles in lungs causing restriction of air flow of air to and from lungs. Maximum dose of epi for healthy pt - Correct Answer: .2mg Liver - Correct Answer: Protein and lipid synthesis, bio transformation, detoxification and storage of vitamin A, E, D, K, and B12. Causes of seizures - Correct Answer: Liver failure, renal failure, sickle cell disease, brain tumor, meningitis, previous stroke and hypo- hyperglycemia. Medications to treat seizures - Correct Answer: Tegretol, Klonopin, Neurontin, luminal, Dilantin, depacon

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Main function of kidneys - Correct Answer: Maintain volume and composition of body fluids. Body's main source of filtration and excrete metabolic end products and toxins. Islets of langerhans - Correct Answer: Located in pancreas. Secrete insulin and glucagon. Insulin helps the body store sugar to keep glucose levels in a steady state. Adrenal glands - Correct Answer: Secretes epinephrine and norepinephrine. Controls electrolyte balance and carb metabolism. Thyroid - Correct Answer: Regulates body's basal metabolic rate. Pterygoid plexus - Correct Answer: Network of veins corresponding to 2nd and 3rd parts of maxillary artery

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Olfactory nerve - Correct Answer: 1st cranial nerve that controls smell Optic nerve - Correct Answer: 2nd cranial nerve that controls sight Internal jugular vein - Correct Answer: Drains much of blood from head and neck Purkinje fiber system - Correct Answer: Causes muscles of heart to contract. Spreads impulse rapidly along heart muscle. Brachiocephalic artery - Correct Answer: Branches into right common carotid in neck and right subclavian artery in arm.

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Hematocrit - Correct Answer: % blood volume made up of red blood cells. Men: 42-52% women: 37-48%. Anything below 35% considered anemic. Mental artery - Correct Answer: Supplies blood to chin. Ischemia - Correct Answer: Reduced blood flow in coronary arteries. Lack of oxygen to heart cells weakens, but does not kill them. Maxillary artery - Correct Answer: Supplies blood to maxilla, teeth, sinuses, and portion of nose. Medulla oblongata - Correct Answer: Coordinating region for impulses. The seat of many autonomic centers.

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Normal levels of hemoglobin - Correct Answer: Males: 13-18 mg/dL Females: 14-16 mg/dL Oropharynx - Correct Answer: Located between soft palate and epiglottis. Facial nerve - Correct Answer: 7th cranial nerve. Supplies motor fibers to muscles of facial expression. Trigeminal nerve - Correct Answer: 5th cranial nerve. Supplies sensation to teeth and jaws. Vagus nerve - Correct Answer: 10th cranial nerve. Supplies fibers to many parts of body. (Ears, tongue, pharynx, larynx, thoracic/abdominal viscera).

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Pulmonary veins - Correct Answer: Return oxygenated blood to left atrium from lungs. Only veins that carry oxygenated blood. Superior vena cava - Correct Answer: Drains head, neck, and upper extremities into right atrium. Adrenal glad - Correct Answer: Secretes epinephrine, norepinephrine, and corticosteroids. Ectopic focus - Correct Answer: Displaced central point of origin for cardiac dysrhythmias. Inferior alveolar artery - Correct Answer: Supplies blood to teeth, mandible, lower lip, and chin.

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Inferior vena cava - Correct Answer: Drains lower extremities and abdominal viscera into right atrium. Brachial artery - Correct Answer: Supplies blood to shoulder, arm, forearm, and hand. Facial artery - Correct Answer: Supplies blood to face, tonsil, palate, and submandibular gland. T's of pulseleas electrical activity - Correct Answer: Toxins, trauma, thrombosis, tension pneumothorax, tamponade H's of pulseless electrical activity - Correct Answer: Hydrogen ion, hypoxia, hypovolemia, hypoglycemia, hypo/hyperkalemia, hypothermia.

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Pulseless electrical activity (PEA) - Correct Answer: Normal appearing tracing, but patient has no pulse. Asystole - Correct Answer: Cessation of all contractions. "Flat line" usually follows v. fib or v. tach. Treated with CPR. Ventricular fibrillation v. fib - Correct Answer: Course v. fib with prominent, erratic baseline or fine v. fib with far less pronounced vacillations. No p, qrs, or t. Often precedes asystole. Class III - Correct Answer: Pt has severe systemic disturbance or disease. Class IV - Correct Answer: Patient has a severe, life threatening systemic disorder.

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Class V - Correct Answer: Patient is moribund with little chance of survival. Surgery is done in desperation. Class II - Correct Answer: Patient has mild to no systemic disturbance. Smokers included. Class I - Correct Answer: Patient has no organic, biochemical, psychiatric, or physiological disturbance. Beta blockers - Correct Answer: Reduce the rate and force of contraction of the heart. (Atenolol) Vasodilators - Correct Answer: Reduce the pressure vasculature. (Norvasc, lisinopril, diovan)

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Diuretics - Correct Answer: Reduce the volume of fluid in system. Used to treat coronary artery disease. (HCTZ, Lasix) Hypertension - Correct Answer: Blood pressure of 140/90 or greater. (Hx of nosebleeds, headaches, and dizziness) Rate of ventricles - Correct Answer: 20- Rate of AV node - Correct Answer: 40- Rate of atria - Correct Answer: 60- Arrest rhythms - Correct Answer: Ventricular dysrhythmias

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Rate of SA node - Correct Answer: 60- Social history review of systems - Correct Answer: Patients smoking and alcohol history/current use should be noted along with illegal drug use. Ventricular foci - Correct Answer: Located in ventricles Supraventricular foci - Correct Answer: Located above level of ventricles in atria. Antibiotic prophylaxis for total joint replacement patients - Correct Answer: Previous joint infection, 2 yrs following joint replacement, malnourishment, hemophilia, diabetes type I, immunosuppressed or immunocompromised patients.

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AV blocks - Correct Answer: PR length is prolonged or varies in length due to impulse being partially or completely blocked as it attempts to travel from atria to ventricles via AV node. Patients who need antibiotic prophylaxis - Correct Answer: Previous infective endocarditis, prosthetic valves, cardiac transplant patients who develop valvulopathy, congenital heart disease. Congestive heart failure - Correct Answer: Condition caused by the heart is unable to handle blood volume coming back to it from either the lungs or peripheral circulation. 3 characteristics of normal heart rhythms - Correct Answer: Rate, regularity, and rhythm.

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MVP (mitral valve prolapse) - Correct Answer: One or more of valve flaps don't close completely allowing redundancy of valve leaflets into left atrium. Rheumatic heart diseases - Correct Answer: Condition caused secondary to rheumatic fever (beta hemolytic streptococci) which damages the heart valves, primarily the mitral valve, and causes heart murmur. MI (myocardial infarction) - Correct Answer: Heart attack. Six should be performed on patient until 6 months after. Right sided heart failure - Correct Answer: Increased pressure of fluid in blood vessels causes fluid to leak into body's tissues causing peripheral edema and ascites

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Left sided heart failure - Correct Answer: Increased pressure of fluid in blood vessels causes fluid to leak into lungs. Patients often present with shortness of breath. Review of systems musculoskeletal - Correct Answer: Weakness of extremities, atrophy of muscles, frequent cramping of muscles. Review of systems neurologic - Correct Answer: Weakness of extremities, hx of projectile vomiting, headaches, visual disturbances, any unexplained pain or numbness in body. Review of systems pulmonary - Correct Answer: Shortness of breath, dizziness, chronic cough, wheezing, productive cough. Review of systems genitourinary - Correct Answer: Painful urination, blood in urine, frequent urination, incontinence, discharge in urine.

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Review of systems gastrointestinal - Correct Answer: Loss of appetite, swallowing, change in taste, nausea, vomiting, diarrhea, constipation. Review of systems skin - Correct Answer: Bruising, bleeding, discoloration. Review of systems cardiovascular - Correct Answer: Headaches, dizziness, nosebleeds, shortness of breath, chest or arm pain, edema. Review of systems general - Correct Answer: Weight loss, loss of appetite, weakness, fatigue. 4 key questions to ask patient in evaluation - Correct Answer: Are they currently under physicians care, do they take any meds, do they have any allergies and reactions they have, review of systems.

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Asthma - Correct Answer: Usually associated with allergies. Increased secretions in the muscles membranes lining bronchioles. Mucus plugs block smaller bronchi making movement of air in and out if lungs difficult. More difficulty with expiration. Focus (foci) - Correct Answer: Site in atria or ventricles which is center for generation of impulse. Cushing's disease - Correct Answer: Non life threatening. Hyper secretion of glucocorticoids. Glucocorticoids - Correct Answer: Allow the body to respond to stress. Addison's disease - Correct Answer: Life threatening. Hypo secretion of glucocorticoids.

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Cirrhosis - Correct Answer: Fibrosis or scar tissue in liver. Patients with cirrhosis may have difficulty metabolizing medications and may have prolonged effects of medications. Risks of liver cirrhosis - Correct Answer: Prolonged effects of medications, prolonged mental depression can cause hepatic coma, trouble clotting, peripheral edema, ascites. Dyspnea - Correct Answer: Difficulty breathing or breathlessness. Bronchitis - Correct Answer: Inflammation of the mucous membranes lining the bronchial tubes. Sx should be delayed. Smoking - Correct Answer: Predisposes patients to laryngospasm and bronchospasm.

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Upper respiratory infection (URI) - Correct Answer: Common cold or cough which produces increased secretions in airway. Best to delay surgery. Involves sinuses, nasal passages, pharynx, and larynx. Diabetes mellitus - Correct Answer: Metabolic impairment where the body is unable to metabolize glucose properly causing increased blood glucose levels. This prevents the body from metabolizing carbs properly. Type I - Correct Answer: Insulin dependent diabetes. Type II diabetes - Correct Answer: Non insulin dependent Considerations for diabetic patients - Correct Answer: Patients with diabetes do not heal as quickly and are more prone to infection. Often placed on antibiotics.

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Fasting blood sugar (FBS) - Correct Answer: 125 mg/dL normal or in control Insulin overdose - Correct Answer: Give patient sugar, candy, or sugar containing beverage. Glucose IV or glucagon IM if patient is sedated. Emphysema - Correct Answer: Enlargement of alveolar sac in lungs along with destruction and scarring of alveoli which makes less surface area available for exchange of O2 and CO2. Smokers. Risks of kidney disease - Correct Answer: Patients with kidney disease may have difficulty eliminating medications from their body. Sx should not be scheduled on same day as dialysis.

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Epilepsy - Correct Answer: Seizures. If an incident occurs during anesthesia Valium IV can be given. TIA (transient ischemic attack) - Correct Answer: Mini stoke. Sudden neurological loss of function with full recovery in 24 hrs. Cerebrovascular accidents (CVA/stroke) - Correct Answer: Neurological impairment caused by disruption of blood supply to area of brain. Ischemic stroke - Correct Answer: 85% caused by occluded blood vessel. Hemorrhagic stroke - Correct Answer: 15% caused by ruptured artery (aneurysm)

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Trimester to best perform surgery - Correct Answer: 2nd trimester. Most risk to fetus in 1st trimester. Obesity - Correct Answer: 20 % above ideal body weight [(wt in lbs/height in inches)2] x 703 Modifiable risk factors of stroke - Correct Answer: High blood pressure, diabetes, heart disease, smoking, TIA, increased red blood cells, sickle cell disorder. Unmodifiable risk factors for stroke - Correct Answer: Male, age 55 or older, two times African American, previous stroke, heredity. Considerations for obese patients - Correct Answer: Use of a large blood pressure cuff, difficult venous access, patients should be treated in upright or semi fowler position.