Mark Klimek Blue Book questions 2024 with correct answers, Exams of Nursing

Download Mark Klimek Blue Book questions 2024 with correct answers and more Exams Nursing in PDF only on Docsity! Mark Klimek Blue Book questions 2024 with correct answers Water acounts for __________ to _________% of an infant's total weight? - ANSWERS✔✔ 70 to 75% What temperature is appropriate for the water used to bathe an infant? - ANSWERS✔✔ 100 to 105 What cranial nerve is affected in Bell's Palsy? - ANSWERS✔✔ #7, facial nerve Give three eye interventions for the client with Bell's Palsy. - ANSWERS✔✔ Dark glasses, artificial tears, cover eye at night The man with BPH has a _________-stream of urine - ANSWERS✔✔ forked The most radical prostate surgery is the ____________ prostatectomy. - ANSWERS✔✔ Perineal Acid Ash diet - ANSWERS✔✔ Decrease pH (makes urine acid) Chz, eggs, Meat, fish, oysters, poultry, Bread, Cereal, Whole Grains, Pastries, Cranberries, Prunes, Plums, Tomatoes, Peas, Corn, Legumes. What drug is use to treat bladder spasm? - ANSWERS✔✔ B&O suppositories (Belladonna & Opiates) If you see an increase in blood content of urine coming out of the catheter, you would first ___________. if - ANSWERS✔✔ Pull carefully on the catheter to apply local pressure on the prostate with the Foley balloon. How often should the drainage bag be emptied? - ANSWERS✔✔ Every 8 hours Name foods that make acid urine - ANSWERS✔✔ Cranberry juice, apple juice (avoid citrus juices- they make alkaline urine) Increased intracranial pressure will _________ the pulse pressure. - ANSWERS✔✔ Increase or Widen If a unit of blood is infused through a central line it must be__________. - ANSWERS✔✔ Warmed Which of the following are signs of transfusion reaction? Bradycardia, Fever, Hives, Wheezing, Increased Blood Pressure, Low Back Pain - ANSWERS✔✔ Low back pain, wheezing, fever, hives What are the signs and symptoms of a hemolytic transfusion reaction? - ANSWERS✔✔ Shivering, HA, low back pain, increased pulse & respirations, decreasing BP, oliguria, hematuria What are the signs and symptoms of a febrile transfusion reaction? - ANSWERS✔✔ Low back pain, shaking HA, increasing temperature, confusion, hemoptysis What are the signs of symptoms of an allergic reaction to a transfusion? - ANSWERS✔✔ Hives- uticaria, wheezing, pruritus, joint pain, (arthralgia) When are hemolytic transfusion reactions likely to occur? - ANSWERS✔✔ In the first 10 to 15 minutes When is a febrile reaction likely to occur? - ANSWERS✔✔ Within 30 minutes of beginning the transfusion What would you do if the client had an increasing temperature and was to get blood? - ANSWERS✔✔ Call the MD because blood is often held with an elevated temperature How long should it take for one unit of blood to infuse? - ANSWERS✔✔ From one hour to three hours What is the routine for vital sign measurement with a transfusion? - ANSWERS✔✔ Once before administration Q15 x 2 after administration is begun They prevent viral replication. NRTI (nucleoside reverse transcriptease inhibitors) - ANSWERS✔✔ an antiviral drug used against HIV (is incorporated into the DNA of the virus and stops the building process; results in incomplete DNA that cannot create a new virus; often used in combination with other drugs) PI's (Protease inhibitors) - ANSWERS✔✔ most potent of antiviral meds, inhibit cell protein synthesis that interferes with viral replication, does not cure but slows progression of AIDS and prolongs life, used prophylactically, used in AIDS to decrease viral load and opportunistic infections What do NRTI's and PI's do? - ANSWERS✔✔ They prevent viral replication What does the physician hope to achieve with NRTI's and PI's for HIV? - ANSWERS✔✔ A delayed onset of AIDS for as long as possible (usually can delay onset for 10-15 years) What is the most common NRTI used? - ANSWERS✔✔ AZT (zidovudine) What is the most challenging aspect of combination of drug therapy for HIV disease? - ANSWERS✔✔ The number of pills that must be taken in 24 hours can be overwhelming. The frequency also makes it hard to remember-an alarm wristwatch is used. What lab findings are present in AIDS? - ANSWERS✔✔ Decreased RBC's, WBC's and platelets What is the most important intervention in treating AGN? - ANSWERS✔✔ Bedrest - they can walk if hematuria, edema and hypertension are gone. What is the most common dietary restriction for AGN? - ANSWERS✔✔ Moderate sodium restriction. Fluid restriction is #2 if edema is severe. What are the urinaysis findings on AGN? - ANSWERS✔✔ Hematuria Proteinuria +3 to +4 Specific gravity Up How do you assess fluid excess in the child with AGN? - ANSWERS✔✔ Daily weight What happens to the kidney in AGN? - ANSWERS✔✔ It becomes clogged with antigen-antibody complexes which then cause inflammation and loss of function. What are the first signs of AGN? - ANSWERS✔✔ Puffiness of face, dark urine What will prevent hip flexion contracture after AKA? - ANSWERS✔✔ Lying prone several times a day How long should the stump be elevated to prevent post op swelling? - ANSWERS✔✔ 12-24 hours How often should a stump be washed? - ANSWERS✔✔ daily When a stump is wrapped, the bandage should be tightest _____________ and loosest _____________. - ANSWERS✔✔ distally (far from the center), proximally (neareast to the point) What artery is widened in a thoracic aneurysm? - ANSWERS✔✔ the aorta An aneurysm can result from an _____________ and from ____________. - ANSWERS✔✔ infection, syphilis An aneurysm will most affect which of the following, the blood pressure or the pusle? - ANSWERS✔✔ the pulse (many times the aneurysm will rupture and much blood will be lost before the blood pressure starts to change. What class of drugs is the client with an aneurysm most likely to be on? - ANSWERS✔✔ Antihypertensives Is there anything that can be done for the client with a ruptured aneurysm before they get to the operating room? - ANSWERS✔✔ Yes, if available you can get them into antishock trousers but not if this causes a delay in getting them to the operating room The post op abdominal aneurysm repair client is most likely to have which type of tube? - ANSWERS✔✔ NG tube for decompression of bowel Describe the pain of angina pectoris - ANSWERS✔✔ crushing substernal chest pain that may radiate What are the top 2 side effects of nitro? - ANSWERS✔✔ headache and hypotension The diagnosis is made when there is a weight loss of _______% or more of body weight. - ANSWERS✔✔ 15 (weigh < 85% of normal body weight), hospitalize if 30% weight loss The pulse rate of anorexics is tachycardic or bradycardic? - ANSWERS✔✔ Bradycardic What is the apgar scale? - ANSWERS✔✔ quick objective way to evaluate the vital functions of the newborn Name the 5 criteria that are recorded on an apgar scale - ANSWERS✔✔ Appearance, Pulse, Grimace, Activity, and Respiration On heart rate or cardiac status, a 2 means that the HR is above _______ BPM. - ANSWERS✔✔ 100 In order to score a 0 on HR the infant must have a rate of _________. - ANSWERS✔✔ Zero A high score of 2 is given for respiratory effort if the newborn_____________. - ANSWERS✔✔ Cries vigorously An infant is given a score of 1 if their respirations are _______ or ________. - ANSWERS✔✔ Slow or irregular What is the primary dietary prescription for calcium nephrolithiasis? - ANSWERS✔✔ Low calcium diet For the client with calcium nephrolithiasis the diet should be _________ash. - ANSWERS✔✔ Acid If the kidney stone is calcium phosphate the diet must be low in _____ too. - ANSWERS✔✔ Phosphorous The primary diet treatment for uric acid nephrolithiasis is _________ -________. - ANSWERS✔✔ Low purine The client with uric acid nephrolithiasis should have a diet low in ___________. - ANSWERS✔✔ Methionine What is methionine? - ANSWERS✔✔ The precursor of the amino acid cystine (precursor = material out of which something is made) Name two foods high in methionine. - ANSWERS✔✔ Milk, eggs Clients with cystine nephrolithiasis should have a (n) _________ ash diet. - ANSWERS✔✔ Alkaline Increasing fluids to over 3000 cc per day is more effective in treating renal calculi ( kidney stones) than any dietary modification. (T/F) - ANSWERS✔✔ True. It's more important to flush the urinary tract than worry about what you're eating. In general, cancer drugs have side effects in which three body systems? - ANSWERS✔✔ GI Hematologic (blood) Integumentary What are the 3 most common chemotherapeutic GI side effects? - ANSWERS✔✔ N/V Diarrhea Stomatitis (oral sores) With what solution should the client with chemotherapeutic stomatitis rinse pc (after meals)? - ANSWERS✔✔ H2O2 - hydrogen peroxide What lubricant can safely be applied to the cracked lips of chemotherapy stomatitis? - ANSWERS✔✔ K-Y Jelly Name the 3 hematologic side effects of chemotherapy. - ANSWERS✔✔ Thrombocytopenia Leukopenia Anemia What are the 3 objective symptoms/signs of thrombocytopenia? Hint: P.E.E. - ANSWERS✔✔ Petechiae Epistaxis Ecchymosis When the Absolute Neutrophil Count ANC is below________ the person on chemotherapy will be placed on reverse isolation. - ANSWERS✔✔ 500 CD ranks ________ among the leading cause of maternal death. - ANSWERS✔✔ Fourth What is the #1 cause of CD of pregnancy? - ANSWERS✔✔ Rheumatic heart disease Pregnancy requires a __________ increase in the cardiac output. - ANSWERS✔✔ 30-50% What is the #1 cause of maternal death in CD of pregnancy? - ANSWERS✔✔ Decompensation What is meant by decompensation? - ANSWERS✔✔ Failure of the heart to maintain adequate circulation. What will you see when you observe the neck of a client with CD of pregnancy? - ANSWERS✔✔ Distended neck veins -JVD What will you hear when you auscultate the heart of the client with CD of pregnancy? - ANSWERS✔✔ Murmurs What will you hear when you auscultate the lungs of the client with CD of pregnancy? - ANSWERS✔✔ Crackles-rales If the client with CD of pregnancy experiences sudden heart failure what is the MOST common thing you will see? - ANSWERS✔✔ Sudden onset of SOB (dyspnea). What is the #1 treatment of CD during pregnancy? - ANSWERS✔✔ Rest What are the three most common drugs given to women with CD in pregnancy? - ANSWERS✔✔ Diuretics Heparin Digitalis Why are diuretics given to women with CD of pregnancy? - ANSWERS✔✔ To promote diuresis which will: -lower circulating blood volume -decrease preload -decrease the amount of blood the heart pumps. Why are anticoagulants (heparin only) given to women with CD of pregnancy? - ANSWERS✔✔ To prevent thrombophlebitis due to venous congestion, usually in legs. Why is digitalis given to women with CD of pregnancy? - ANSWERS✔✔ To increase the strength of the heart and to decrease the rate, rest the heart while making it more efficient Can morphine be given to a woman with CD during labor? - ANSWERS✔✔ Yes, even though it negatively affects the fetus, remember morphine decreases preload and pain which rests the heart. Upon what do you support a cast while it dries? - ANSWERS✔✔ Pillows (no plastic covers) How long does it take a cast to dry? - ANSWERS✔✔ 24 hours Should you cover a wet cast? - ANSWERS✔✔ No Should you use a heat lamp or hair dryer or fan to help dry a cast? - ANSWERS✔✔ No heat lamp and hair dryer Yes fan What type of cast causes cast syndrome? - ANSWERS✔✔ A body cast What causes cast syndrome? - ANSWERS✔✔ Anxiety and stress leading to sympathoadrenal shut-down of the bowel What is the #1 symptom of cast syndrome? - ANSWERS✔✔ Nausea and vomiting due to bowel obstruction What is the #1 treatment of cast syndrome? - ANSWERS✔✔ NPO and NG tube for decompression Traction is used to _______ and _______ a fracture, relieve ________ _______ and prevent ________. - ANSWERS✔✔ Reduce and immobilize, muscle spasm; deformities Can skin traction be removed for skin care? - ANSWERS✔✔ Yes Can the client be removed from skeletal traction? - ANSWERS✔✔ No Name 3 types of skin traction - ANSWERS✔✔ Bucks Bryants Pelvic Name 3 types of skeletal traction - ANSWERS✔✔ Cranial tongs Thomas splints with Peason attachments 90 degrees to 90 degrees What type of traction is most commonly used for hip fracture in adults? - ANSWERS✔✔ Bucks What type of traction is most commonly used for hip fractures in children? - ANSWERS✔✔ Bryants In what position should the bed be if the patient is in pelvic traction? - ANSWERS✔✔ Semi-fowlers with knee gatched To insure that Bryant's traction is working the child's hip/sacrum should be _________ - ANSWERS✔✔ Off the bed enough to slip a hand between the sacrum and the bed. What is the advantage of balanced counteraction? - ANSWERS✔✔ You can easily move the patient around in bed Patients in Russell's traction are particularly prone to ____________. - ANSWERS✔✔ Thrombophlebitis When a patient is in a Buck's traction they may turn to the _________ side. - ANSWERS✔✔ Unaffected Define cataract - ANSWERS✔✔ Opacity of the crystalline lens Is surgery done immediately upon diagnosis of cataract? - ANSWERS✔✔ No, they usually wait until it interferes with ADLs . What three most common visual defects occur with cataract? - ANSWERS✔✔ Cloudiness Diplopia (double vision) Photophobia (sensitivity to light) What are the two common treatments of cataract? - ANSWERS✔✔ Laser, surgical removal. Surgery called intraocular or extraocular lens extraction What will the client be wearing after cataract surgery? - ANSWERS✔✔ A protective patch/shield on the operative eye for 24 hours, then a metal shield (AT NIGHT only) for 3 weeks When the client asks about the use of glassess or contacts after cataract surgery what would you say? - ANSWERS✔✔ If an introcular lens is implanted they will NOT need glasses. If no lens is implanted, then contacts will be fitted for 3 months post-op, temporary thick glasses given immediately but will get a different prescription in 2 to 3 months What will be a high priority nursing diagnosis for a client post cataract surgery? - ANSWERS✔✔ Safety Should the client ambulate independently after cataract surgery? - ANSWERS✔✔ No the patient should not ambulate independently, depth perception is altered. What positions are to be avoided after cataract surgery? - ANSWERS✔✔ Lying face down. Also, do not lie on operative side for a month. What are the post-operative signs of hemorrhage into the eye? - ANSWERS✔✔ Severe pain Restlessness What movements are to be avoided after cataract surgery? - ANSWERS✔✔ Coughing Sneezing Bending at the waist Straining at stool Rubbing or touching eyes Rapid head movements The patient with a recent CVA is most likely to have fluids restricted or forced? - ANSWERS✔✔ Restricted How far should the HOB be up after CVA? - ANSWERS✔✔ 30 degrees Can the stroke victim be turned side-to-side? - ANSWERS✔✔ Yes The CVA patient should be turned onto his paralyzed side no longer than 2 hours. (T/F) - ANSWERS✔✔ False, the patient should not be on their paralyzed side for more than 20 minutes. ROM exercises should occur every 2 hours in CVA patients. (T/F) - ANSWERS✔✔ False-- every 4 hours or 3 times a day is enough If the client has right homonymous hemaniopsia, the food on the ____ side of the tray may be ignored. - ANSWERS✔✔ Right After meals, the nurse must always check _______ of the CVA client for _________. - ANSWERS✔✔ Mouth (cheek), food Aphasia is most common if the stroke occurred in the (dominant/non-dominant) hemisphere of the brain. - ANSWERS✔✔ Dominant How do you tell which side of the person's brain is dominant? - ANSWERS✔✔ It is the side that controls their dominant hand, ie, a left handed person has a dominant right hemisphere and conversely a right hand person has a dominant left hemisphere Cytoxan cyclophosphamide - ANSWERS✔✔ Hemorrhagic cystitis Cisplatin - ANSWERS✔✔ Peripheral neuropathy, constipation, ototoxicity Bleomycin - ANSWERS✔✔ Pulmonary fibrosis Adriamycin - ANSWERS✔✔ Cardiotoxicity Vincristine - ANSWERS✔✔ Peripheral neuropathy (foot drop, numbness and tingling, hoarseness, jaw pain) constipation (adynamic ileus due to neurotoxicity) DTIC- dome - ANSWERS✔✔ Flu-like symptoms Chemo-therapeutic Agent Toxicities Methotrexate - ANSWERS✔✔ Toxic to just about every organ except to heart, toxicity made worse with aspirin The infant fears _________ most when hospitalized. - ANSWERS✔✔ Separation from love object The toddler fears _______ most when hospitalized. - ANSWERS✔✔ Separation from family The preschooler fears separation as well as _________ when hospitalized. - ANSWERS✔✔ Mutilation- remember preschoolers have vivid imaginations...fantasy The toddler and preschooler will think that illness is caused by_____________. - ANSWERS✔✔ Something they did wrong. The school-aged hospitalized child is afraid of separation from ___________. - ANSWERS✔✔ Age group The school-aged child perceives the cause of illness to to be external or internal? - ANSWERS✔✔ External, she knows that illness is not a result of bad behavior. Which age group engages in stalling tactics before painful procedures most? - ANSWERS✔✔ School-Age Which age groups are most likely to physically resist the nurse during procedures? - ANSWERS✔✔ School-age, adolescents The meats that are highest in cholesterol are _________ meats. - ANSWERS✔✔ Organ meats liver, heart, brains, kidneys The meats that are second highest in cholesterol are the ___________ - ANSWERS✔✔ Shell seafood- shrimp, crab, lobster The three meats lowest in cholesterol are _________, _________ and __________. - ANSWERS✔✔ Chicken, pork, mutton What is the most severe complication of otitis media? - ANSWERS✔✔ Meningitis or mastoiditis What is cholesteatoma? - ANSWERS✔✔ An epidemial cyst in the ear highly associated with otitis media. What are the restrictions to be followed when tubes are in a child's ear? - ANSWERS✔✔ No swimming, no showering, no diving What is cleft lip? - ANSWERS✔✔ The lip is open to the nares What is cleft palate? - ANSWERS✔✔ The roof of the mouth is open to the nasopharynx. When will the cleft lip be repaired? - ANSWERS✔✔ Between 10 weeks and 6 months When is cleft palate repaired? - ANSWERS✔✔ Between 1 and 5 years of age Describe the nipples on bottles used to feed babies with cleft lip? - ANSWERS✔✔ Large-holed, soft nipples What is the classic motor manifestation of Parkinson's? - ANSWERS✔✔ Pill-rolling and tremors What type of rigidity is typical of Parkinson's? - ANSWERS✔✔ Cogwheel Parkinson's patients move fast or slow? - ANSWERS✔✔ Slow What type of gait is seen in Parkinson's? - ANSWERS✔✔ Shuffling slow gait Patient's with Parkinson's have ______ speech. - ANSWERS✔✔ Monotone Patients with Parkinson's tend to have constipation or diarrhea? - ANSWERS✔✔ Constipation Name four drugs used to treat Parkinson's. - ANSWERS✔✔ Levodopa, benztropine, trihexyphenidyl, bromocriptine In what type of chair should Parkinson's patients sit? - ANSWERS✔✔ Firm, hard-backed What time of day can be particularly dangerous for the Parkinson's patient? - ANSWERS✔✔ Mealtime, due to choking When a patient is taking Levodopa he should have assistance getting out of bed because... - ANSWERS✔✔ Of orthostatic hypotension What vitamin should patients on Levodopa avoid? - ANSWERS✔✔ B6 pyridoxine Levodopa should be given with or without food? - ANSWERS✔✔ With What might Levodopa do to patients urine? - ANSWERS✔✔ Make it very dark The tremors of Parkinson's will get better or worse when they purposefully move or perform a task? - ANSWERS✔✔ Better, they tremor more when not performing an action Clients with COPD are not good candidates for PCA pumps. (T/F) - ANSWERS✔✔ True, due to the effects of narcotics on central respiratory control Name the three most common uses of PCA techniques. - ANSWERS✔✔ Post-operative pain, cancer pain, sickle-cell crisis pain PCA pumps allow a more constant level of serum drug than conventional analgesia. (T/F) - ANSWERS✔✔ True A major disadvantage of PCA pump is that the client can take too much medication. (T/F) - ANSWERS✔✔ False, it is not possible for the client to overdose due to the lock-out feature Clients on PCA pumps use more medication than those receiving IM injections. (T/F) - ANSWERS✔✔ False, they use less A disadvantage of PCA pumps is that the client does not ambulate as early due to the machine. (T/F) - ANSWERS✔✔ False, PCA clients ambulate earlier and they pull their machine with them. When discontinuing a PCA infusion it is acceptable to discard the drug cartridge. (T/F) - ANSWERS✔✔ False, the whole cartridge system must be returned to the pharmacy due to federal narcotic control laws. Comfort range or relative humidity is... - ANSWERS✔✔ 30-60% Which patients should be forbidden to smoke? Smoke alone? - ANSWERS✔✔ Those with oxygen in the room, confused, sleepy, drugged clients When applying restraints remember to... - ANSWERS✔✔ Avoid bruising skin, cutting off circulation, accidental entangling What is the common finding with pediculosis pubis? - ANSWERS✔✔ Reddish-brown dust in the underwear After treatment how long do you have to inspect for lice? - ANSWERS✔✔ Inspect for 2 weeks to be sure that they are all gone What is the most dangerous toxicity of Kwell? - ANSWERS✔✔ CNS toxicity What is the typical of the lesions of pemphigus? - ANSWERS✔✔ Foul-smelling, blisters break easily, seen in the elderly, cause unknown What is the characteristic lesion of pemphigus? - ANSWERS✔✔ Large vesicular bullae What chemical is added to the bath water of a client with pemphigus? - ANSWERS✔✔ Potassium permanganate What precaution must be taken with potassium permanganate? - ANSWERS✔✔ Be careful that no undissolved crystals touch the client; it will burn the skin What is the typical skin care of pemphigus? - ANSWERS✔✔ Cool wet dressing What unusual nursing diagnosis is high priority in pemphigus? - ANSWERS✔✔ Alteration in fluid and electrolyte balance What are the top three nursing interventions in pemphigus? - ANSWERS✔✔ Oral care, protection from infection, encouraging high fluid intake What kinds of fluids will clients with pemphigus drink best? - ANSWERS✔✔ Cold fluids What drugs are most commonly used? - ANSWERS✔✔ Steroids What is meant by "cardiac decompensation"? - ANSWERS✔✔ It means that the compensatory mechanisms - hypertrophy, dilation, tachycardia are not working and the heart has failed. Name the three groups of drugs used to treat CHF? - ANSWERS✔✔ Diuretics Vasodilators Digitalis What is the activity order for clients with CHF? - ANSWERS✔✔ Bed Rest What special item do clients with CHF have to wear to decrease venous stasis in the legs? - ANSWERS✔✔ TED hose If the adult client's apical pulse is below 60, what should you do? - ANSWERS✔✔ Do not give digitalis For a child don't give for a pulse under 70 For an infant don't give for a pulse under 90 What complication is common in CHF? - ANSWERS✔✔ Pulmonary edema When the client is taking diuretics, what mineral is the CHF client most likely to lose? - ANSWERS✔✔ Potassium--K+ You should tell the client with CHF to immediately report to his/her doctor if he/she gains _____pounds in one week. - ANSWERS✔✔ Three Name the four most common toxic effects of digitalis. - ANSWERS✔✔ Anorexia N&V-- very common Yellow vision Arrythmia Some women experience discomfort when wearing contact lenses during pregnancy or menstrual periods. (T/F) - ANSWERS✔✔ True What is the most common complication of malpositioned lenses in the comatose or confused patient? - ANSWERS✔✔ Corneal ulceration 1 gr - ANSWERS✔✔ 60 mg Cushings syndrome is __________ secretion of _______, _______ and _______ _______ by the _______ _______. - ANSWERS✔✔ Oversecretion; glucocorticoids, mineralocorticoids, androgenic hormones; adrenal gland In Cushings the blood sugar is (increased/decreased). - ANSWERS✔✔ Increased In Cushings the sodium level is (increased/decreased) - ANSWERS✔✔ Increased In Cushings syndrome, the client develops __________ face. - ANSWERS✔✔ Moon In Cushings syndrome, the trunk is ________ and the extremities are _________. - ANSWERS✔✔ Obese, thin What is seen on the abdomen of the patient with Cushings? - ANSWERS✔✔ Striae--purple horizontal lines Men with Cushings develop______________. - ANSWERS✔✔ Gynecomastia Women with Cushings develop? - ANSWERS✔✔ Hirsutism Amenorrhea The Cushings syndrome patient will have a _________ on their upper back. - ANSWERS✔✔ Buffalo hump The patient with Cushings Syndrome will have (increased/decreased) blood pressure. - ANSWERS✔✔ Increased, remember retaining water and sodium The Cushings syndrome patient will have ________ natremia, _________kalemia and _______glycemia. - ANSWERS✔✔ Hyper; hypo; hyper Cushings Man aka Cush Man - ANSWERS✔✔ moon face with infection buffalo hump on back big trunk thin extremities loses potassium keeps glucose and salt has striations on abdomen and breasts Is CF hereditary? - ANSWERS✔✔ Yes What glands are affected in CF? - ANSWERS✔✔ Exocrine glands What is the appearance of the stool in a client with CF? *remember the 4 Fs* - ANSWERS✔✔ Fat Frothy Foul-smelling Floating Steatorrhea What are the top 2 nursing diagnoses for a client with CF? - ANSWERS✔✔ Decreased airway clearance Alteration in nutrition or absorption What is the classic test for CF? - ANSWERS✔✔ Iontophoresis - sweat test In which two systems/organs are the most problems in CF? - ANSWERS✔✔ Lungs What would you do if you noticed a small amount of blood come out in the first few bottles that were infused? - ANSWERS✔✔ Nothing, this is normal: the blood is due to the initial puncture of the abdomen What precautions are important in the care of the client receiving PD? - ANSWERS✔✔ Safety, because they get dizzy. Is I&O important to record during PD? - ANSWERS✔✔ Yes How high should the dialysate bag be when its infused? - ANSWERS✔✔ Shoulder height What vitamin is not absorbed in a patient with pernicious anemia? - ANSWERS✔✔ Vitamin B-12 What is another name for Vitamin B-12? - ANSWERS✔✔ Extrinsic factor What happens when patients with pernicious anemia don't absorb Vitamin B-12? - ANSWERS✔✔ Their RBC's do not mature and they become seriously anemic. What other disease can be confused with pernicious anemia? - ANSWERS✔✔ Angina pectoris What are some classic and unique signs of pernicious anemia? - ANSWERS✔✔ Beefy red tongue Numbness and tingling of the hands Sores in the mouth Chest pain Can we cure pernicious anemia? - ANSWERS✔✔ No, just treat the symptoms. What unique urine test is done to diagnose pernicious anemia? - ANSWERS✔✔ The Schilling test What neurologic test do they do for this anemia? - ANSWERS✔✔ The Romberg test (a test for balance), in normal people this test is negative, in the client with pernicious anemia this test becomes positive What is conservation? In what stage does it develop? - ANSWERS✔✔ When the child realized that number, weight, volume remain the same even when outward appearances change; Concrete Operational What is the age range of formal operation thinking? - ANSWERS✔✔ 12-15 What is the sensori-motor stage of intellectual development? - ANSWERS✔✔ It is the intellectual stage of children from birth to 2 years What is the age range of concrete operational thinking? - ANSWERS✔✔ 7-11 What is the age range of pre-operational thinking? Hint: Think of PRE-schoolers. - ANSWERS✔✔ 3-6 What is the classic pattern in formal operational thinking? - ANSWERS✔✔ Abstract reasoning What is egocentricity? In what stage is it found? - ANSWERS✔✔ The child views everything from his frame of reference, common in pre-operational thinking In whom is Placenta Previa most likely to occur? Primigravida's or multigravida's? - ANSWERS✔✔ Multigravidas What are the 3 complications of placenta previa? - ANSWERS✔✔ Shock Maternal death Fetal death What is the best and safest way to confirm placenta previa? - ANSWERS✔✔ Ultrasound Should a woman with placenta previa be hospitalized? - ANSWERS✔✔ Yes, always if bleeding If a surgeon delays doing a C-section for Placenta Previa it is due to: (reason for delay). - ANSWERS✔✔ Immaturity of the fetus (they will want the child to mature) If a woman is admitted with active bleeding with Placenta Previa you should monitor fetal heart tones _________. - ANSWERS✔✔ Continuously via fetal monitor It is not necessary to use electronic fetal monitoring when there is active bleeding in Placenta Previa. (T/F) - ANSWERS✔✔ False, infant must always be monitored Will a woman with active bleeding in Placenta Previa be given any systemic pain relief during labor? - ANSWERS✔✔ No, they don't want to depress the fetus Which blood gas disorder is most common in pneumonia? - ANSWERS✔✔ Respiratory alkalosis, because the hyperventilation blows off more CO2, than the consolidation traps in the blood What is polycythemia vera? - ANSWERS✔✔ A blood disease in which there is an increase in erythrocytes, leukocytes and platelets What is the typical complexion of a client with polycythemia vera? - ANSWERS✔✔ Ruddy red, almost purple What procedure is done to relieve symptoms in polycythemia vera? - ANSWERS✔✔ Phlebotomy What is phlebotomy? - ANSWERS✔✔ Drain off 200-500 cc of blood from body (opposite of transfusion). What type of diet will people with polycythemia vera be on? - ANSWERS✔✔ Low iron What are three signs of polycythemia vera? - ANSWERS✔✔ Headache Weakness Itching A sign of gestational diabetes is excessive (weight gain/weight loss) - ANSWERS✔✔ Weight gain (Obese/very thin) women are most likely to become diabetic during pregnancy. - ANSWERS✔✔ Obese In gestational diabetes the client experiences a (decrease/increase) in thirst - ANSWERS✔✔ Increase (polydipsia) In gestational diabetes the client experiences a (decrease/increase) in urine output. - ANSWERS✔✔ Increase (polyuria) Gestational diabetes is associated with what OB history? - ANSWERS✔✔ Previous large baby (over 9 lbs), unexplained stillbirth, miscarriage, congenital anomalies Gestational diabetics tend to get ________ infections. - ANSWERS✔✔ Monilial (yeast) What test confirms the diagnoses of gestational diabetes? - ANSWERS✔✔ 3 hour glucose tolerance test What are the two main treatment methods in gestational diabetes? - ANSWERS✔✔ Diet, insulin How often should a woman visit the doctor prenatally if diabetes is present? - ANSWERS✔✔ Twice a month, then once per week in the 3rd trimester How many pounds per week is the diabetic allowed to gain the 2nd and 3rd trimesters? - ANSWERS✔✔ 1 pound a week Is severe carbohydrate restriction required in gestational diabetics? - ANSWERS✔✔ No, it could lead to ketosis Of protein, fat, and carbohydrates, which ones (percent-wise) increase in the diet of gestational diabetics? - ANSWERS✔✔ Protein, fat When is insulin used in the treatment of gestatinal diabetes? - ANSWERS✔✔ When dietary control does not keep the blood sugar within normal limits If insulin is used, the dose is the same in all 3 trimesters. (T/F) - ANSWERS✔✔ False, it varies Oral hypoglycemics should never be used during pregnancy. (T/F) - ANSWERS✔✔ True, they cause birth defects (teratogenic) When should a diabetic be delivered? - ANSWERS✔✔ Between 37 and 39 weeks What IV solution is used during labor for the diabetic? - ANSWERS✔✔ D5W The mother's insulin requirements will (fall/rise) markedly after delivery. - ANSWERS✔✔ Fall During pregnancy what complications is most dangerous for the fetus of a diabetic? - ANSWERS✔✔ ketosis If ketosis is a big problem for the baby during pregnancy what the big problem after delivery? - ANSWERS✔✔ Hypoglycemia Why is hypoglycemia such a dangerous problem? - ANSWERS✔✔ Brain cells die without glucose, brain damage (Multi/prima) gravida clients are most likely to get PIH. - ANSWERS✔✔ Primagravida Which age group(s) are most likely to experience PIH? - ANSWERS✔✔ Patients under 18 and over 35 When does pre-eclampsia usually begin in pregnancy (week)? - ANSWERS✔✔ After 20 weeks Name the three symptoms of PIH. - ANSWERS✔✔ Hypertension, weight gain (edema), proteinuria If pre-eclampsia is mild will the woman be hospitalized? - ANSWERS✔✔ No, just rest at home What type of diet is indicated for a woman with pre-eclampsia? - ANSWERS✔✔ Increased protein/normal salt intake (no restriction typically) What measurement must the woman with pre-eclampsia make every day? - ANSWERS✔✔ She must weigh herself What is the activity order for a woman with severe pre-eclampsia? - ANSWERS✔✔ Left side lying What is the dietary order for the woman with severe pre-eclampsia? - ANSWERS✔✔ Low salt, high protein Are diuretics used for women with pre-eclampsia? - ANSWERS✔✔ Yes When a woman is hospitalized for severe pre-eclampsia the nurse should test... - ANSWERS✔✔ #1 reflexes, the urine for protein When pre-eclampsia gets worse the deep tendon reflexes will be (hyper/hypo) reflexia. - ANSWERS✔✔ Hyper-reflexia What types of precautions will be in effect for a woman with severe pre-eclampsia? - ANSWERS✔✔ Seizure precautions Name 5 things included in seizure precations. - ANSWERS✔✔ Suction machine in room O2 in room Padded rails up X 4 Must stay on unit Ambulation with supervision only No More than 1 pillow What drug is used to increase ventilation in clients with pulmonary edema? - ANSWERS✔✔ Aminophylline (bronchodilator) Since pulmonary edema is caused by left ventricular failure what drug is given? - ANSWERS✔✔ Digitalis Why is morphine given to clients with pulmonary edema? - ANSWERS✔✔ To decrease apprehension and decrease preload, this rests the heart If your client suddenly goes into pulmonary edema what would you do first? - ANSWERS✔✔ Elevate the HOB, then increase O2, then call the MD Besides a thrombus what else can cause an embolus in the lung? - ANSWERS✔✔ Air, fat, tumor cells What class of drugs can lead to pulmonary embolus? - ANSWERS✔✔ Oral contraceptives What heart problem can lead to pulmonary embolus? - ANSWERS✔✔ Atrial fibrillation (RIGHT atrial fibrillation casues pulmonary embolus; LEFT atrial fibrillation causes cerebral embolus) What genetic disorder can lead to pulmonary embolus? - ANSWERS✔✔ Sickle cell anemia What is the first sign of pulmonary embolus? - ANSWERS✔✔ Dyspnea The dyspnea of pulmonary embolus is accompanied by ____ _____. - ANSWERS✔✔ Pleuritic pain With severe pulmonary embolus the client will look as though they are __________. - ANSWERS✔✔ In Shock What are the two major treatments of pulmonary embolus? - ANSWERS✔✔ O2, anticoagulants Name the anitcoagulant given for immediate anticoagulation by IV or SQ route. - ANSWERS✔✔ Heparin A drug for long term anticoagulation in any disorder would be? - ANSWERS✔✔ Coumadin What two lab tests monitor coumadin therapy? - ANSWERS✔✔ Prothrombin time (PT) and the INR When coumadin is therapeutic, the INR should be between _______ and _______. - ANSWERS✔✔ 2.0 and 3.0 What is lovenox? - ANSWERS✔✔ It is a low-dose Heparin used for anticoagulation in POST-OP THROMBOPHLEBITIS PREVENTION NOT USED FOR PULMONARY EMBOLUS Effective heparin therapy rises the PTT to approximately _______ times normal. - ANSWERS✔✔ 2.5 Heparin is used in the acute phase of pulmonary embolus. What drug is used for 6 months after pulmonary embolus? - ANSWERS✔✔ Coumadin Coumadin therapy is monitored by what daily test? - ANSWERS✔✔ PT (prothrombin time) What is pyelonephritis? - ANSWERS✔✔ A bacterial infection of the kidneys Which organism causes pyelonephritis? - ANSWERS✔✔ E. Coli Name the symptoms that pyelonephritis and cystitis have in common? - ANSWERS✔✔ Frequency, urgency, burning, cloudy, foul smelling urine What medical intervention is necessary in pyelonephritis? - ANSWERS✔✔ IV antibiotics for one to two weeks, must get urine culture 2 weeks after antibiotic therapy is over How does pyelonephritis differ from cystitis in meaning? - ANSWERS✔✔ Cystitis means bladder infection; pyelonephritis means an infection of kidney pelvis What causes or precedes pyelonephritis? - ANSWERS✔✔ Cystitis always does Will the client with pyelonephritis have daily weights? - ANSWERS✔✔ Yes, as would any client with kidney problem Name the five signs/symptoms that pyelonephritis has that cystitis does not have? - ANSWERS✔✔ Fever, flank pain, chills, increased WBC, malaise What is the BIG danger with pyelonephritis? - ANSWERS✔✔ Permanent scarring and kidney damage How is pyelonephritis prevented? - ANSWERS✔✔ By preventing or treating all cystitis (UTI's) Will the client with pyelonephritis have hematuria? - ANSWERS✔✔ It is common but not always present The patient with pyelonephritis will have (hypertension/hypotention)? - ANSWERS✔✔ Hypertension Where is the pyloric sphincter? - ANSWERS✔✔ At the distal (duodenal) end of the stomach What is done to correct pyloric stenosis? - ANSWERS✔✔ Surgery (pyloromyotomy) In what position should the child with Pyloric Stenosis be during feeding? - ANSWERS✔✔ High fowlers The feedings for an infant with pyloric stenosis should be thick or thin? - ANSWERS✔✔ Thickened What test is done to confirm a diagnosis of pyloric stenosis? - ANSWERS✔✔ Upper GI series (barium swallow) These infants are prone to develop ______ and failure to ______. - ANSWERS✔✔ Dehydration, thrive Why does the pyloric valve become stenosed in pyloric stenosis? - ANSWERS✔✔ It hypertrophies scoliosis? - ANSWERS✔✔ Young teens What are the 3 subjective complaints of clients with scoliosis? - ANSWERS✔✔ Back pain, dyspnea, fatigue What test/exam CONFIRMS the diagnosis of scoliosis? - ANSWERS✔✔ X-rays of the spine What type of brace is most commonly used for scoliosis? - ANSWERS✔✔ Milwaukee Name 4 exercises used to treat mild scoliosis. - ANSWERS✔✔ Heel lifts; sit-ups; hyperextension of the spine; breathing exercises What kind of treatment is done for severe scoliosis? - ANSWERS✔✔ Surgical fusion with rod insertion What type of cast is used post-operatively? - ANSWERS✔✔ Risser cast What kind of rod is used to "fix" curvature? - ANSWERS✔✔ Harrington Rod Scoliosis MOST commonly affects _____ _____ (type of clients). - ANSWERS✔✔ Teenage females How many hours a day should the client wear a Milkwaukee brace? - ANSWERS✔✔ 23 What solution should be used on the skin where the brace rubs? - ANSWERS✔✔ Tincture of benzoin or alcohol,no lotions of ointments-you want to toughen the skin not soften it Clients with a Milwaukee brace should avoid vigorous exercise. (T/F) - ANSWERS✔✔ True After corrective SURGERY how is the client turned? - ANSWERS✔✔ Log rolled (in a body cast) How often should the neurovascular status of the extremities of a client in a Risser cast be measured? Fresh post-operatively? - ANSWERS✔✔ Every 2 hours What is a common complication of a client in a body cast (like a Risser cast)? - ANSWERS✔✔ Cast syndrome What is cast syndrome? - ANSWERS✔✔ Nausea, vomiting and abdominal distention that can result in intestinal obstruction What group of people get cast syndrome? - ANSWERS✔✔ ANYONE in a body cast What is the treatment of for cast syndrome? - ANSWERS✔✔ Removal of the cast, NG tube to decompress, NPO How would you, the nurse, assess for developing cast syndrome? - ANSWERS✔✔ Ask the client if they are experiencing any abdominal symptoms-keep track of bowel movements & passing flatus (if not having BMs or passing flatus, cast syndrome is suspected) What causes cast syndrome, specifically in a Risser cast? - ANSWERS✔✔ Hyperextension of the spine by a body cast: the hyperextension interrupts the nerve & blood supply to the gut The inheritance pattern of sickle-cell anemia is _____ _____. - ANSWERS✔✔ Autosomal recessive What does heterozygous mean? - ANSWERS✔✔ It means you only have 1 defective gene from 1 parent. People with sickle cell TRAIT only carry the disease, they DO NOT have symptoms. (T/F) - ANSWERS✔✔ True-usually it has occurred that in times of SEVERE stress, the TRAIT does cause some symptoms but not usually. What are the #1 and #2 causes of sickle cell crisis? - ANSWERS✔✔ Hypoxia, dehydration The most common type of crisis that occurs is a ______-______ crisis. - ANSWERS✔✔ Vaso-occlusive What are the top 3 priorities in care of the client with sickle-cell crisis? - ANSWERS✔✔ Oxygenation, hydration, and PAIN control What activity order will the client with sickle cell CRISIS have? - ANSWERS✔✔ Bed rest Or Tylenol, Morphine, Demoral, Aspirin which is NEVER given to a sickle-cell patient? - ANSWERS✔✔ Aspirin-it can cause acidosis which makes the crisis and sickling worse At what age is death most likely in sickle cell anemia? - ANSWERS✔✔ Young adulthood Sickle-cell anemia symptoms do not appear before the age of ____ months due to the presence of _____ ______. - ANSWERS✔✔ 6; fetal hemoglobin In what age range is spinal cord injury most common? - ANSWERS✔✔ 15 to 25 dysreflexia? - ANSWERS✔✔ No, only call the doctor if draining the bladder & removing impaction does not work What is the #1 treatment for autonomic dysreflexia? - ANSWERS✔✔ Drain the bladder, empty the bowel What is the purpose of restricting activity after spinal tap? - ANSWERS✔✔ To prevent headache due to CSF loss Should the client drink after a spinal tap? - ANSWERS✔✔ Yes, encourage fluids to replace CSF Does the client have to be NPO before a spinal tap? - ANSWERS✔✔ No Into what space is the needle inserted during a spinal tap? - ANSWERS✔✔ Subarachnoid space Can the client turn side-to-side after a spinal tap? - ANSWERS✔✔ Yes In what position should the client be during a spinal tap? - ANSWERS✔✔ Lateral decubitus (on their side) position and knees to chest Identify the activity restriction necessary after lumbar puncture? - ANSWERS✔✔ Lie flat for 6 to 12 hours What are the 2 purposes of a spinal tap? - ANSWERS✔✔ To measure or relieve pressure and obtain a CSF sample Which hand should hold the suction catheter? Which should hold the connecting tube? - ANSWERS✔✔ The dominant, the non-dominant The nurse should use (medical/surgical) asepsis during airway suction? - ANSWERS✔✔ Surgical asepsis (sterile technique) What kind of lubricant should be used on the suction catheter? - ANSWERS✔✔ Sterile water-soluble Should the suction be continuous or intermittent? - ANSWERS✔✔ Intermittent to prevent mucosal damage For how long should suction be applied during any one entry of the catheter? - ANSWERS✔✔ 10 seconds How often should the nurse clear the tubing during suctioning? - ANSWERS✔✔ After each pass/entry/removal Which way would you turn the client hear to suction the right mainstem bronchus? The left mainstem bronchus? - ANSWERS✔✔ To the left, to the right The best client position during airway suctioning is _______. - ANSWERS✔✔ Semi-fowlers How often should the client's airway be suctioned? - ANSWERS✔✔ When it needs to be, for example moist lung sounds, tachycardia, restlessness (hypoxia), ineffective cough The unconscious client should assume what position during suctioning? - ANSWERS✔✔ Side-lying, facing nurse If not contraindicated, what action by the nursing before suctioning would most likely reduce hypoxia during suctioning? - ANSWERS✔✔ Administer a few breaths at 100% oxygen before beginning With what size catheter should an adult's airway be suctioned? - ANSWERS✔✔ 12 to 16 French How much suction should be used for an infant? - ANSWERS✔✔ Less than 80 mm Hg How much suction should be used for a child? - ANSWERS✔✔ 80 to 100 mm Hg How much suction should be used for an adult? - ANSWERS✔✔ 120 to 150 mm Hg What are the four classic suicide precautions? - ANSWERS✔✔ Search personal belongings for drugs & alcohol, remove any sharp objects, remove any device for hanging or strangling; must be on constant one-to-one observation (NEVER out of sight) Once the patient is admitted for attempted suicide should you ever discuss the attempt with them? - ANSWERS✔✔ No, you should not focus on the attempt, focus on the present and future. -cele - ANSWERS✔✔ Combining form meaning a tumor or swelling or a cavity -cis - ANSWERS✔✔ Cut, kill -rhapy; -rrhapy - ANSWERS✔✔ Joining in a seam, suturation Syphilis first infects the _____ ______. - ANSWERS✔✔ Mucous membranes What are the stages of syphilis? - ANSWERS✔✔ Primary, secondary, latent, late What organism causes syphilis? - ANSWERS✔✔ Treponema palladium What is the lesion like in primary syphilis? - ANSWERS✔✔ The chancre (pronounced shanker) The chancres of syphilis are (painful/painless). - ANSWERS✔✔ Painless What unusual post-operative complication can result from mastoidectomy? - ANSWERS✔✔ Facial nerve paralysis due to accidental damage during surgery (law suit time!) What should you do to assess for facial nerve paralysis post-mastoidectomy? - ANSWERS✔✔ Have the patient smile and wrinkle forehead. What is the medical treatment for mastoiditis? - ANSWERS✔✔ Systemic antibitoics What is the surgery for mastoiditis called? - ANSWERS✔✔ Simple or radical mastoidectomy Will a simple mastoidectomy worsen hearing? - ANSWERS✔✔ No, a radical mastoidectomy may Should the nurse change the post-mastoidectomy dressing? - ANSWERS✔✔ No, reinforce it. Physician changes first post op dressing What is a common side effect of mastoidectomy? - ANSWERS✔✔ Dizziness (vertigo) What is a major nursing diagnosis post-mastoidectomy? - ANSWERS✔✔ Safety When putting on the second of a set of sterile gloves, you should grasp the cuff. (T/F) - ANSWERS✔✔ False, reach under the cuff with the tip of the gloved fingers. When putting on the first glove of a set of sterile gloves, you should grasp the cuff. (T/F) - ANSWERS✔✔ True When putting on the second glove of a set of sterile gloves, you must not use the thumb of the first hand. (T/F) - ANSWERS✔✔ True When pouring liquid onto a sterile field you should pour from a height of _____ to _____ inches above sterile field. - ANSWERS✔✔ 6 to 8 Name the four most common parenteral routes of administrations. - ANSWERS✔✔ SQ, IM, IV, ID (intradermal) You can administer up to ____ cc of a drug per site by IM injection in adults. - ANSWERS✔✔ 3 cc Children should receive no more than _______ cc per site by IM injection. - ANSWERS✔✔ 2 cc Why is the dorsogluteal site not recommended for IM injection the children less than 3 years of age? - ANSWERS✔✔ Because the muscle is not well developed yet. Can 3 cc of fluid be administered per IM into the deltoid of an adult? - ANSWERS✔✔ No, maximum of 1 cc The #1 danger when using the dorsogluteal site for IM injection is___________. - ANSWERS✔✔ Damage to the sciatic nerve The preferred length of needle to administer an IM injection is... - ANSWERS✔✔ 1 to 2 inch The preferred gauge of needle for IM injection is... - ANSWERS✔✔ 21 to 22 gauge How long is the needle kept inserted during Z-track injection? - ANSWERS✔✔ 10 seconds What must be done to the equipment before injecting by Z-track method? - ANSWERS✔✔ Change the needle When giving a Z-track injection, the overlying skin is pulled (up/down/medially/laterally). - ANSWERS✔✔ Laterally The preferred gauge of needle for injection for SQ injection___________. - ANSWERS✔✔ 25 gauge The preferred length of needle for SQ injection is_________. - ANSWERS✔✔ 5/8 inch The intradermal route is primarily used for ________ _________. - ANSWERS✔✔ Skin testing Name the two sites used for intradermal injection. - ANSWERS✔✔ Inner forearm Upper back After using nose drops, the client should remain ______ for _______ minutes. - ANSWERS✔✔ Supine, 5 After administration of a vaginal durg the client should remain _____ for______ minutes. - ANSWERS✔✔ Supine, 10 Rectal suppositories with an oil base should be kept refrigerated. (T/F) - ANSWERS✔✔ True The best way to ensure effectiveness of a rectal suppository is to... - ANSWERS✔✔ Push the suppository against the wall of the rectum A rectal suppository is inserted ______ inches in an adult and ________ inches in a child. - ANSWERS✔✔ 4,2 The client should remain supine for 5 minutes after having received a rectal suppository. (T/F) - ANSWERS✔✔ False-- they should be lying on their side for 5 minutes, not supine Eye medications can be given directly over the cornea. (T/F) - ANSWERS✔✔ False, into the conjunctival sac, never the cornea; hold the dropper 1/2 inch above the sac To prevent eye medications from getting into the systemic circulation you apply pressure to the _______ for ______ seconds. - ANSWERS✔✔ Nasolacrimal sac, 10 (press between the inner canthus and the bridge of the nose) If ear medications are not given at room temperature the client may experience... - ANSWERS✔✔ Dizziness, nausea Colchicine - ANSWERS✔✔ Give with meals -- anti gout, remember if diarrhea develops, stop the drug Thorazine - ANSWERS✔✔ Take with LOTS OF WATER regardless of meals to prevent constipation. All drugs that end in "-zine" are major tranquilizers that also cause Psuedo Parkinson's or extra- pyramidal effects. Carafate and sulcrafate - ANSWERS✔✔ Give on empty stomach 1 hour before meals and at bedtime -- remember these coat the GI tract and interfere with the absorption of other medications (give them by themselves) Allopurinol - ANSWERS✔✔ Give with meals and give with lots of water--anti uric acid--- used to treat gout and the purine build up seen in chemotherapy for cancer Define Meniere's Disease - ANSWERS✔✔ An increase in endolymph in the inner ear, causing severe vertigo. What is the famous triad of symptoms in Meniere's? - ANSWERS✔✔ Paroxysmal whirling vertigo -- sensorineural hearing loss--tinnitus (ringing in the ears) Does Meniere's occur more in men or women? - ANSWERS✔✔ Women What should the client do if they get an attack? - ANSWERS✔✔ Bed Rest What safety measures should be followed with Meniere's? - ANSWERS✔✔ Side rails up x 4, ambulate only with assistance What age group in Meniere's highest in? - ANSWERS✔✔ 40 to 60 What can PREVENT the attacks of Meniere's? - ANSWERS✔✔ Avoid sudden movements What electrolyte is given to people with Meniere's? - ANSWERS✔✔ Ammonium chloride What is the surgery done for Meniere's? - ANSWERS✔✔ Labyrinthectomy What disease often follows labyrinthectomy? - ANSWERS✔✔ Bell's palsy-- facial paralysis, will go away in a few months What is the activity order after labyrinthectomy? - ANSWERS✔✔ Bed rest When surgery is performed for Meniere's, what are the consequences? - ANSWERS✔✔ Hearing is totally lost in the surgical ear What should the client avoid after labyrinectomy? - ANSWERS✔✔ Sudden movements and increased Na food What type of diet is the client with Meniere's on? - ANSWERS✔✔ Low salt What two classes of drugs are given in Meniere's? - ANSWERS✔✔ Antihistamines and diuretics (Diamox) Meningitis is an inflammation of the _______ of the _______ and spinal ___________. - ANSWERS✔✔ Linings, brain , cord Meningitis can be caused by _______, _____, and _____. - ANSWERS✔✔ Viruses, bacteria, chemicals The four most common organisms that cause meningitis are... - ANSWERS✔✔ Pneumococcus Meningococcus Streptococcus H. influenza The child with meningitis is most likely to be (lethargic/irritable) at first. - ANSWERS✔✔ Irritable What visual symptom will the patient with meningitis have? - ANSWERS✔✔ Photophobia (over- sensitivity to light) What is the most common musculo-skeletal symptom of meningitis? - ANSWERS✔✔ Stiff neck- nuchal rigidity Will the patient with meningitis have a headache? - ANSWERS✔✔ Yes Kernig's sign is positive when there is pain in the _____ when attempting to straighten the leg with ____ flexed. - ANSWERS✔✔ Knee; hip What type of vomiting is present in meningitis? - ANSWERS✔✔ Projectile What is the definitive diagnostic test for meningitis? - ANSWERS✔✔ Lumbar puncture with culture of CSF (cerebro-spinal fluid) If the patient has meningitis, the CSF shows _______ pressure, _____ WBC, ______ protein, ______ glucose. - ANSWERS✔✔ Increased, increased, increased, decreased On what type of isolation will the patient with meningitis be? - ANSWERS✔✔ Contact and respiratory precautions How long will the patient with meningitis be on these precautions? - ANSWERS✔✔ Until they have been on an antibiotic for 48 hours The room of a patient with meningitis should be _______ and ______. - ANSWERS✔✔ Dark and quiet What is opisthotonos? - ANSWERS✔✔ Arching of back (entire body) from hyperextension of the neck and ankles, due to severe meningeal irritation. If a patient has opisthotonos, in what position would you place them? - ANSWERS✔✔ Side-lying MS can lead to urinary incontinence. (T/F) - ANSWERS✔✔ True MS can lead to impotence in males. (T/F) - ANSWERS✔✔ True Patients with MS should be taught to walk with a ____-____ gait. - ANSWERS✔✔ Wide based Why are Adrenocorticotropic Hormone (ACTH) and prednisone given during acute MS? - ANSWERS✔✔ To decrease edema in the demyelination process For acute exacerbations of MS _______ per IV is often used. - ANSWERS✔✔ ACTH (Corticotropin) What drug can be given to treat urinary retention in MS? - ANSWERS✔✔ Urecholine, Bethanocol Will the muscles of MS clients be spastic or flaccid? - ANSWERS✔✔ Spastic What three drugs can be given for muscle spasms? - ANSWERS✔✔ Diazepam, Baclofen (Lioresal), Dantrium Baclofen causes (constipation/diarrhea) - ANSWERS✔✔ Constipation Dantrium causes (constipation/diarrhea) - ANSWERS✔✔ Diarrhea (hint: D's go together, Dantrium and Diarrhea) Patient's with MS should have (increased/restricted) fluids. - ANSWERS✔✔ Increased to dilute urine and reduce incidence of UTI. The diet of a patient with MS should be ____--ash. - ANSWERS✔✔ Acid What major sense is affected most in MS (besides vision)? - ANSWERS✔✔ Tactile (touch)-- they burn themselves easily Which will bring on a MS exacerbation: over-heating or chilling? - ANSWERS✔✔ Both will; but they tend to do better in cool weather (summer will always be a bad time for MS patients) In Myasthenia Gravis (MG) there is a disturbance in transmission of impulses at the _____ _____. - ANSWERS✔✔ Neuromuscular junction The #1 sign of MG is ______ ______ _____. - ANSWERS✔✔ Severe muscle weakness What is the unique adjective given to describe the early signs of MG? - ANSWERS✔✔ The early signs (difficulty swallowing, visual problems) are referred to a BULBAR signs. MG affects men more than women. (T/F) - ANSWERS✔✔ False, affects women more than men When women get MG they are usually old or young? - ANSWERS✔✔ Young When men get MG they are usually old or young? - ANSWERS✔✔ Old What neurotransmitter is problematic in MG? - ANSWERS✔✔ Acetylcholine What class of drugs is used to treat MG? - ANSWERS✔✔ Anticholinesterases What ending do anticholinesterases have? - ANSWERS✔✔ -stigmine Are anticholinesterases sympathetic or parasympathetic? - ANSWERS✔✔ Parasympathetic Anticholestinesterases will have (sympathetic/cholinergic) side effects. - ANSWERS✔✔ Cholinergic (they will mimic the parasympathetic nervous system) What surgery CAN be done for MG? - ANSWERS✔✔ Thymectomy (removal of thymus) The severe muscle weakness of MG gets better with exercise. (T/F) - ANSWERS✔✔ False, it is worse with activity What will the facial appearance of a patient with MG look like? - ANSWERS✔✔ Mast-like with a snarling smile (called a myasthenic smile) If a patient has MG, what will be the results of the Tensilon Test? - ANSWERS✔✔ The patient will show a dramatic sudden increase in muscle strength Besides the Tensilon Test, what other diagnostic tests confirm a diagnosis of MG? - ANSWERS✔✔ Electromylogram (EMG) What is the most important thing to remember about giving Mestinon and other anticholestinerases? - ANSWERS✔✔ They must be given EXACTLY ON TIME; at home, they might need to set their alarm Do you give anticholestinerases with or without food? - ANSWERS✔✔ With food, about 1/2 hour ac; giving ac helps strengthen muscles of swallowing What type of diet should the patient with MG be on? - ANSWERS✔✔ Soft What equipment should be at the bedside of an MG patient? - ANSWERS✔✔ Suction apparatus (for meals), tracheostomy/endotube (for ventilation) Name the two types of crises that a MG patient can have. - ANSWERS✔✔ Cholinergic (too much Mestinon) Myasthenic (not enough Mestinon) The #1 danger in both Myasthenic and Cholinergic crisis is _____ ______. - ANSWERS✔✔ Respiratory arrest In general, males have a higher risk of heart disease than females. (T/F) - ANSWERS✔✔ True Post-menopausal females have a lower risk of heart disease than males aged 25-40. (T/F) - ANSWERS✔✔ False. They have a higher risk. Family history of diabetes increases the risk fo heart disease. (T/F) - ANSWERS✔✔ True Family history of liver disease increases the risk of heart disease. (T/F) - ANSWERS✔✔ False Cigarette smoking increases the risk of heart disease. (T/F) - ANSWERS✔✔ True Oral contraceptives decrease the risk of heart disease. (T/F) - ANSWERS✔✔ False, use increases the risk Who is the most likely to receive a graft for dialysis? - ANSWERS✔✔ People with diabetes mellitus. How often do clients with renal failure undergo dialysis? - ANSWERS✔✔ 3 times per week Is hemodialysis short term or long term? - ANSWERS✔✔ Both- but most short term dialysis is achieved by hemodialysis How long does the average dialysis last? - ANSWERS✔✔ 4 to 6 hours What are 3 ways to gain access to the circulation in hemodialysis? - ANSWERS✔✔ AV shunt AV fistula AV graft What is the most common site for an AV shunt? - ANSWERS✔✔ Radial artery to radial vein What should be avoided in the arm of the client with an AV shunt? - ANSWERS✔✔ No venipuncture or blood pressure allowed in the arm with a shunt, graft or fistula. What syndrome results when too much fluid is exchanged during hemodialysis too quickly? - ANSWERS✔✔ Disequilibrium syndrome What are the symptoms of disequilibrium syndrome? - ANSWERS✔✔ Change in LOC N/V Headache Twitching Does anything exit the skin in an AV shunt? - ANSWERS✔✔ Yes, the plastic tube that connects the artery and vein outside the arm How long can AV shunt be used? - ANSWERS✔✔ Just for a few weeks Hemophilia A is a deficiency of Factor # __________. - ANSWERS✔✔ VIII During an acute bleeding episode, you should apply________ for 15 minutes and apply________. - ANSWERS✔✔ Pressure, ice The inheritance patterns for hemophilia is: - ANSWERS✔✔ Sex linked recessive In hemophilia, the PTT is (up/down), the coagulation or clotting time is (up/down) and the platelet count is (up/down). - ANSWERS✔✔ Up (increased or longer) Up (increased or longer) Neither (hemophilia does not affect platelets) What does hemarthrosis mean? - ANSWERS✔✔ Bleeding into the joints During bleeding into the joints you should (mobilize/immobilize) the extremity. - ANSWERS✔✔ Immobilize to prevent dislodging the clots that do form. To treat hemarthrosis you should _______ the extremity above the __________. - ANSWERS✔✔ Elevate, heart What is the name of frozen factor VIII given to hemophiliacs? - ANSWERS✔✔ Cryoprecipitate Once you have stopped the bleeding into the joint, how long should the hemarthrosis patient wait before bearing weight or doing range of motion? - ANSWERS✔✔ 48 hours What drug can you apply topically to stop bleeding? - ANSWERS✔✔ Epinephrine, or topical fibrin foam Which of these symptoms are NOT seen in hemophilia? Prolonged bleeding, petechiae, ecchymosis or hematoma? - ANSWERS✔✔ Petechiae Hepatitis is an _____, ______ disease of the _______. - ANSWERS✔✔ Acute, inflammatory, liver Hepatitis A,B,C and D are all (bacterial/viral) diseases. - ANSWERS✔✔ Viral An early sign of hepatitis A is ________. - ANSWERS✔✔ Anorexia or fatigue Early stage hepatitis often looks like the _______. - ANSWERS✔✔ Flu In later stages of hepatitis, the ______ turns dark. - ANSWERS✔✔ Urine What does pre-icteric mean? - ANSWERS✔✔ The stage BEFORE the patient exhibits jaundice. What skin symptoms do you see in hepatitis? (Give 2) - ANSWERS✔✔ Pruritis (itching) Jaundice (Both are due to bilirubin accumulation) Which disease has more severe symptoms-- Hepatitis A or B? - ANSWERS✔✔ Hepatitis B What is sordes? - ANSWERS✔✔ Crusts on the tongue and gums due to improper oral hygiene What action will facilitate the trimming of brittle toenails? - ANSWERS✔✔ Soaking in warm water Should the client roll the elastic stocking down to wash legs? Why or why not? - ANSWERS✔✔ No, it can cause a constricting band around the ankle/foot. When should a patient put on TED hose? - ANSWERS✔✔ Before getting out of bed (before the swelling occurs). Hyperemesis Gravidarum is ______ and ________ vomiting that persists into the _____ trimester. - ANSWERS✔✔ Severe and prolonged; 2nd trimester (normal vomiting should be gone before 2nd trimester) Give three possible causes of hyperemesis gravidarum. - ANSWERS✔✔ Pancreatitis Multiple pregnancies Hydatidiform mole Has hyperemesis gravidarum ever been associated with mixed feelings about pregnancy? - ANSWERS✔✔ Yes, increased incidence of it in women who are ambivalent about pregnancy What are the two most common complications of hyperemesis gravidarum? - ANSWERS✔✔ Electrolyte imbalance (dehydration) Starvation What is the initial diet order for clients with hyperemesis gravidarum? - ANSWERS✔✔ NPO Why are doctors cautious in using antiemetics to treat hyperemesis gravidarum? - ANSWERS✔✔ They don't want to harm the fetus What are the instructions given to clients recovering from hyperemesis gravidarum in relation to mealtime? - ANSWERS✔✔ Remain seated upright for 45 minutes after each meal What is the biggest challenge in nursing care of the client with hyperemesis gravidarum? - ANSWERS✔✔ Getting them to eat Hypertension is an ________ or sustained elevation in the (systolic/diastolic) __________. - ANSWERS✔✔ Intermittent, diastolic blood pressure Hypertension is often fatal if untreated. (T/F) - ANSWERS✔✔ True Oral contraceptives (increase/decrease/do not effect) the blood pressure. - ANSWERS✔✔ Increase What four organs does hypertension affect the most? - ANSWERS✔✔ Brain (stroke) Eyes (blindness) Heart (MI) Kidney (renal failure) How many measurements must be made before you can say a person has hypertension? - ANSWERS✔✔ At least three What blood pressure is considered to be hypertension? - ANSWERS✔✔ Anything greater than 140/90 mm Hg Which pressure is most damaging, an increased (systolic/diastolic)? - ANSWERS✔✔ An increased diastolic When a doctor takes three different blood pressure readings at different times, how far apart must the measurements be made? - ANSWERS✔✔ At least one week Can hypertension be cured? - ANSWERS✔✔ No, just treated What class of drugs is used to first treat hypertension? - ANSWERS✔✔ Diuretics Name the two most common dietary prescriptions used to treat hypertension? - ANSWERS✔✔ Calorie reduction for weight loss Sodium restriction What two non-dietary lifestyle changes are used commonly to treat hypertension? - ANSWERS✔✔ Decreases stress Increase activity When you take the blood pressure of the client with hypertension you would measure _____- _______, with the client _____, _______ and _______. - ANSWERS✔✔ Both arms; lying, sitting and standing What gauge catheter would you use to start an IV in hypovolemic shock? - ANSWERS✔✔ 16 or larger What is the #1 cause of hypovolemic shock? - ANSWERS✔✔ Acute blood loss What happens to the pulse pressure in hypovolemic shock? - ANSWERS✔✔ It narrows (becomes a smaller number) How do you calculate the pulse pressure? - ANSWERS✔✔ You subtract the diastolic from systolic What is the normal pulse pressure? - ANSWERS✔✔ 40 (+ or -10) In hypovolemic shock the output of urine will be less than _______cc per hour. - ANSWERS✔✔ 25 to 30 cc The client's skin will be _____, ______, and ________. - ANSWERS✔✔ Cool, pale, clammy (due to arterial constriction to shunt blood from skin to vital organs) The first sign that a fallopian ectopic pregnancy had ruptured is... - ANSWERS✔✔ Sharp abdominal pain Name the surgery performed for an ectopic pregnancy. - ANSWERS✔✔ Exploratory laparotomy What is ECT? - ANSWERS✔✔ The use of electrical shock current delivered to the brain to induce a seizure that treats depression. The client is (awake/under local anesthesia/under general anesthesia) during ECT? - ANSWERS✔✔ Under general anesthesia -- must be artificially ventilated What conditions does ECT treat? - ANSWERS✔✔ Depression primarily Is an informed consent necessary for ECT? - ANSWERS✔✔ Yes Name the three most common complications of ECT? - ANSWERS✔✔ Aspiration of emesis (most common) into the lung Dislocations of joints Fractures due to convulsion-- rare today What class of drugs is given with ECT? - ANSWERS✔✔ Muscle relaxant -- succinylcholine What intellectual ability is impaired after ECT? - ANSWERS✔✔ Memory How long will a client's memory be impaired after ECT? - ANSWERS✔✔ 2 to 3 weeks Immediately after ECT, how will the client normally act? - ANSWERS✔✔ Drowsy Dull Apathetic In what position should the client be immediately after ECT? - ANSWERS✔✔ On their side-- to prevent aspiration What typical pre-operative type of orders will be ordered before ECT? - ANSWERS✔✔ NPO after midnight Remove dentures Client to void before surgery Side rails up What does an EEG measure? - ANSWERS✔✔ Measures electrical activity generated by the brain When are there activity restrictions after an EEG? - ANSWERS✔✔ ONLY when sedatives are used, and then it's only necessary to keep side rails up. Should the client wash his hair before an EEG? - ANSWERS✔✔ Yes What would you tell a client who says what if I get shocked during my EEG? - ANSWERS✔✔ That is impossible since the test measures electrical activity coming FROM him, never to him. Does a client have to be NPO before an EEG? - ANSWERS✔✔ No, they should never be NPO, it could cause hypoglycemia and alter the EEG results. What instructions are MOST important to give a client during an EEG? - ANSWERS✔✔ Try not to move What should the client do after an EEG? - ANSWERS✔✔ Wash their hair Should sedatives be given before an EEG? - ANSWERS✔✔ Only if ordered as a pre-test medication. How much sleep should the client get the night before an EEG? - ANSWERS✔✔ At least 4 to 5 hours-- unless it is a sleep deprivation EEG Do you need a signed informed consent for an EEG? - ANSWERS✔✔ No Should caffeine be limited before an EEG? - ANSWERS✔✔ Yes. It should be eliminated for 24 hours before the test. What will excessively fatty stool be like? - ANSWERS✔✔ Large, pale, foul smelling, greasy Name the three types of parasites abnormally found in stool. - ANSWERS✔✔ Roundworm Tapeworm Pinworm Are fats a normal constituent of feces? - ANSWERS✔✔ Yes but it should be WNL A decrease in urobilin in stool results in stool that is______ ________. - ANSWERS✔✔ Clay-colored Name two things for which stool specimens are tested. - ANSWERS✔✔ Occult blood, fat, ova and parasites What position is best for clients with emphysema under normal circumstances? - ANSWERS✔✔ Semi- fowlers or higher What flow rates of O2 are appropriate for the client with emphysema? - ANSWERS✔✔ Low flow -- <2.5 L/min; never exceed 2.5L in COPD In emphysema, the alveoli are over-_____ and under-______. - ANSWERS✔✔ Over-enlarged, under- ventilated so that air is trapped in alveoli In emphysema, the appetite________ the weight ______ and the anterior-post diameter of the chest________. - ANSWERS✔✔ Decreases, decreases, increases What is the increase in anterior-posterior diameter of emphysema called? - ANSWERS✔✔ Barrel chest Drooling Stridor Will a child with epiglottitis cough? - ANSWERS✔✔ No, there will be a lack of spontaneous cough. How will the child with epiglottitis breathe? - ANSWERS✔✔ Leaned forward with flaring nostrils If epiglottitis is suspected, what should the parents be told? - ANSWERS✔✔ To take the child to the ER as soon as possible. What drug is used to fight epiglottitis? - ANSWERS✔✔ Penicillin, ampicillin Children with epiglottitis often need a tracheotomy. What behavior would indicate the need for a tracheotomy? - ANSWERS✔✔ Restlessness Increased HR Retractions What is recommended for the prevention of epiglottitis? - ANSWERS✔✔ All children two months and over should receive an H. influenza B vaccine. Autonomy vs Shame and Doubt - ANSWERS✔✔ Toddler Industry vs Inferiority - ANSWERS✔✔ School Age 18 to 25 years - ANSWERS✔✔ Young Adult Says "no" - ANSWERS✔✔ Toddler Encourage creativity and collecting things - ANSWERS✔✔ School Age Give choices - ANSWERS✔✔ Toddler Centers on having basic needs met - ANSWERS✔✔ Infancy 18 months to 3 years - ANSWERS✔✔ Toddler 3 to 6 years - ANSWERS✔✔ Pre-schooler 12 to 20 years - ANSWERS✔✔ Adolescent Initiative vs Guilt - ANSWERS✔✔ Pre-schooler 6 to 12 years - ANSWERS✔✔ School age Trust vs Mistrust - ANSWERS✔✔ Infancy Peer group important - ANSWERS✔✔ Adolescent Encourage fantasy - ANSWERS✔✔ Pre-schooler Identity vs Role confrontation - ANSWERS✔✔ Adolescent Intimacy vs Isolation - ANSWERS✔✔ Young adult Birth to 18 months - ANSWERS✔✔ Infancy Define EGD - ANSWERS✔✔ Insertion of a fiber optic scope to visualize the esophagus, stomach and duodenum What can be done during an EGD besides visualization? - ANSWERS✔✔ Remove polyps Take specimens Coagulate bleeding vessels Can EGD be done on an uncooperative client? - ANSWERS✔✔ No Does client need to have side rails up after EGD? - ANSWERS✔✔ Yes, until sedative effects of diazepam have worn off Can an EGD be done on clients with GI bleeding? - ANSWERS✔✔ Yes Is the client sedated before EGD? - ANSWERS✔✔ Yes, with valium (diazepam) or another sedative What pre-test activities must be performed before the EGD? - ANSWERS✔✔ Remove dentures and eyeglasses Sign consent NPO after midnight When can an EGD client begin to eat after the test? - ANSWERS✔✔ When gagg reflex returns (knocked out with xylocaine) Is an EGD a fasting procedure? - ANSWERS✔✔ Yes, after midnight What drug is given to anesthetize the pharynx? - ANSWERS✔✔ Xylocaine (a local anesthetic) What are the complications of EGD? - ANSWERS✔✔ Perforation of gut Aspiration secondary to emesis Respiratory arrest (due to valium) What two discomforts are common during an EGD? - ANSWERS✔✔ Vomiting Gagging How should eye ointments be given? - ANSWERS✔✔ Placed on the lower inner eye lid, then have client close eyes Name two anticholinergics used in the eye. - ANSWERS✔✔ Cyclopentolate, atropine Name one carbonic anhydrase inhibitor - ANSWERS✔✔ Diamox How should the eye drops be given? - ANSWERS✔✔ Place drops into the lower conjunctival sac How is the flow of eye irrigational fluid directed? - ANSWERS✔✔ From inner canthus to outer canthus Name two miotics - ANSWERS✔✔ Pilocarpine, Timpotic (or any drug ending in -lol) Define nuclear family - ANSWERS✔✔ A family of parents and their offspring When does a nuclear family become an extended family? - ANSWERS✔✔ When aunts or uncles or grandparents live with the family In America, the family is the basic unit of society. (T/F) - ANSWERS✔✔ True Give the 2 major roles of the family in society - ANSWERS✔✔ To protect and socialize What percentage of North American families are single-parent? - ANSWERS✔✔ 50% 90% of single-parent families are headed by a ___________. - ANSWERS✔✔ Female In what step of the nursing process does the nurse ask the family about their beliefs on illness? - ANSWERS✔✔ Assessment phase What is the first thing a nurse must do to help families in crisis? - ANSWERS✔✔ Nurse must first examine her own values Anxiety-producing thoughts are called_____. - ANSWERS✔✔ Obsessions Repetitive actions designed to reduce anxiety are called_____. - ANSWERS✔✔ Compulsions -- such as washing hands over and over, dusting furniture 3 hours per day, refusing to turn your back to anyone Which defense mechanism is most closely associated with obsessive-compulsive disorder? - ANSWERS✔✔ Displacement Should you allow an obsessive-compulsive person perform their compulsive behavior? - ANSWERS✔✔ Yes, give them time to do their ritual and try to set limit and redirect Should you ever make an obsessive-compulsive person stop their compulsive behavior? - ANSWERS✔✔ No, they will become very anxious Is the patient with obsessive-compulsive disorder neurotic or psychotic? - ANSWERS✔✔ Neurotic-- they know reality Should you confront the obsessive-compulsive patient with the absurdity of their behavior? - ANSWERS✔✔ No, just say things like :You washed your hands for so long you must have been very anxious." What should you do if an obsessive-compulsive patient is always late due to their rituals? - ANSWERS✔✔ Get them started earlier-- for example if they wash their hands for 1/2 hours before meals and are always late for breakfast, just get them started 1/2 hour earlier. What are the two types of oral contraceptives? - ANSWERS✔✔ Progestin only and combination progesterone and estrogen How many days of the menstrual cycle do you take the progestin only pill? - ANSWERS✔✔ All 28 days How many days of the menstrual cycle do you take the combination pill? - ANSWERS✔✔ You take it on days 5-24, but not on days 24-28 and 1-4 (8 days off) How long before surgery must you discontinue oral contraceptives? - ANSWERS✔✔ One week before surgery If a women forgets to take pill one day, what should she do? - ANSWERS✔✔ Take it as soon as she remembers it, and take next pill at regular time. What if a woman forgets to take the pill for two days in a row? What should she do? - ANSWERS✔✔ Take 2 pills a day for two days in a row and then resume normal schedule. What should a woman do if she forgets to take her pill for 3 days or more? - ANSWERS✔✔ Throw away pack and start new pack same day. use back-up contraceptive method for 7 days If a woman doesn't stop oral contraceptives one week before surgery she is at risk for developing______. - ANSWERS✔✔ Thrombophlebitis People who smoke more than ______ cigarettes per day should not be on oral contraceptives. - ANSWERS✔✔ 15, because if you smoke you have constriction of vessels and this potentates the chances that a woman on oral contraceptives will get thrombophlebitis If a women on oral contraceptives misses a period, should she still take pills? - ANSWERS✔✔ Yes, however, if 2 missed periods occur,stop and have a pregnancy test. Will breakthrough bleeding, nausea and vomiting and breast tenderness go away when a woman is on oral contraceptives? - ANSWERS✔✔ Yes, after about 3-6 months of treatment. Osteoarthritis is a ________ disease of the ______. - ANSWERS✔✔ Degenerative, joint Osteoarthritis is most commonly caused by the wear and tear of life. (T/F) - ANSWERS✔✔ True