How can interventions for postoperative cardiac complications

Change position slowly, SCDs, TEDS, Heparin sq or lovenox, Ambulation, Proper hydration

We taper steroids to prevent

Secondary adrenal insufficiency

Nursing interventions for post op integumentary complications

Splint when coughing, Ambulate, Use binder, q2hs Turns, Sterile dressing changes as ordered

What are 3 home safety interventions for a client with a visual deficit?

Paint edges of stairs with bright color, No extension cords, Watch out for small animals, No rugs, No chairs with wheels, Good lighting

What nursing interventions are important for a patient receiving thoracentesis?

Change in vitals before and after, Look for changes in respiratory statues, CXR post procedure, Hold anticoagulants per provider order, Review labs

What are some post op complications of integumentary?

Pressure Ulcers, Eviscerate, Wound infection, Dehiscence

What are the nursing responsibilities for clients receiving TPN?

Use micro filter preferred central line, Monitor VS/labs, Monitor infection, Change tubing/fluids q24hrs, Check glucose levels

Veracity in nursing practice requires:

Providing honest and truthful information

How are crutches measured?

2-3 fingerbreadths below axillary

Hypercalcemia Symptoms

Slowed reflexes, Kidney Stones, Constipation

Action of Metoprolol?

Decrease workload by slowing HR, Decreasing BP, and reducing contractility

What are the nursing considerations for Metoprolol?

Check blood glucose more frequently for diabetics, Change positions slowly

Hypocalcemia s/s include:

Diarrhea, Positive Chvostek's/ Trousseau sign, Tetany

What should the nurse do before the cardiac catheter procedure?

Ensure consent is signed and on file, Check for allergies, Trim hair, don’t shave, NPO 4-6 hours

Where is the location of an ileostomy?

Ileocecal (right lower quadrant)

NSAID, Antiplatelet, Antipyretic

A client is prescribed diltiazem(cardizem) to manage HTN. The nurse should tell the client this med will?

decrease HR and B/P, Move positions slowly, Prolong QT interval

What is the peak of long acting glargine insulin?

Less defined or no pronounced peak

What should the nurse instruct the CNA to do when feeding a client at risk for aspiration?

90 degrees, Chin tuck, Speech and swallow, No straws

Which of the following are postoperative cardiac complications?

PE, Orthostatic hypotension, DVT

What are 2 nursing considerations when communicating with a client who is hearing impaired?

Hearing aids in if they have them, Lighting, Face them, Quiet environment, Patience- take time to communicate

Furosemide nursing interventions

S/S electrolyte imbalance, Kidney Function (BUN, Creatinine), Monitor I&O, Daily weights, Monitor serum electrolyte levels

How is an ABG procedure in nursing interventions ?

By inserting a needle into an artery to collect a blood sample, By applying a bandage to a wound, Review patient chart labs and hx

What should a nurse do for CT scan with contrast?

Check for allergies-shellfish or iodine, Hold metformin per provider orders., Explain the procedure to the patient, Provide bonus per provider order

Which of the following symptoms may be associated with high bilirubin levels?

Abdominal pain, Jaundice, Increased risk of bleeding, Icterus, Clay stools, dark urine

Aspirin Teaching Points

Hypersensitivity, No one under 18-Reye Syndrome, Patients that have ulcer disease or asthma, Take with food, Tinnitus sign of toxicity

What should be checked when taking Accupril?

Blood pressure, Potassium levels

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Questions 113

Answers

1
What affects the BUN level?
fluid balance and diet
acidotic states
change in neuro status
alkalotic states
2
Simple Face Mask
8L/ 30-50%
24-50%
5-12L / 35-50%
10-15L/ 60-90%
3
How can interventions for postoperative cardiac complications
Change position slowly
SCDs
TEDS
Heparin sq or lovenox
Ambulation
Proper hydration
4
Do high platelet levels increase the risk of blood clotting?
True
False
5
We taper steroids to prevent
Secondary adrenal insufficiency
Primary adrenal insufficiency
Adrenal androgen excess
Thyroid storm
6
Nursing interventions for post op integumentary complications
Splint when coughing
Ambulate
Use binder
q2hs Turns
Sterile dressing changes as ordered
7
What are 3 home safety interventions for a client with a visual deficit?
Paint edges of stairs with bright color
No extension cords
Watch out for small animals
No rugs
No chairs with wheels
Good lighting
8
Lorazepam classification
Benzodiazepines antidepressant
Barbiturates cns depressant
Barbiturates antidepressants
Benzodiazepines cns depressant
9
What is beneficence in nursing?
Being honest
Doing good
Avoiding harm
Respecting autonomy
10
Which of the following is a common effect of both hypokalemia and hyperkalemia?
Skeletal muscle twitch and cramps
Elevated serum pH
Oliguria
Cardiac arrhythmias
11
What nursing interventions are important for a patient receiving thoracentesis?
position client in prone position.
Change in vitals before and after
Look for changes in respiratory statues
CXR post procedure
Hold anticoagulants per provider order
Review labs
12
Normal lab value for hematocrit
35-48%
100-120%
25-35%
15-25%
13
What are some post op complications of integumentary?
Pressure Ulcers
Eviscerate
Wound infection
Dehiscence
14
What is the level for therapeutic range digoxin and lithium?
70-110 mg/dL
3.5-5 mEq/L
135-145 mEq/L
10-20 mg/dL
15
What is the consistency of output in an colostomy?
Watery, continuous output
More formed, not continuous
Ileocecal (right lower quadrant)
Ascending, transverse, descending
16
What are the nursing responsibilities for clients receiving TPN?
Use micro filter preferred central line
Monitor VS/labs
Monitor infection
Change tubing/fluids q24hrs
Check residuals q4h
Check glucose levels
17
Veracity in nursing practice requires:
Making decisions for patients
Acting with fairness
Keeping patient information confidential
Providing honest and truthful information
18
What should be avoided in clients with COPD and asthma when it comes to beta-blockers?
Selective B-blockers
Non-selective B-blockers
Midodrine
Mirabegron
19
How are crutches measured?
4-5 fingerbreadths below axillary
1 inch below auxiliary
2-3 fingerbreadths below axillary
Eyeball it
20
Hypercalcemia Symptoms
Slowed reflexes
Tetany
Kidney Stones
Constipation
21
Action of Metoprolol?
inhibit influx of calcium through its channels, causing a slower conduction
Decrease workload by slowing HR, Decreasing BP, and reducing contractility
Vasodilator which relaxes the smooth muscle in blood vessel walls.
Causes: Venous, Coronary Artery, arteriole dilation
22
Benzodiazepine antidote
Vitamin K
Warfarin
Flumazenil
Acetylcystine
23
What are the nursing considerations for Metoprolol?
Check blood glucose more frequently for diabetics
Report excessive bleeding or bruising
Do not drastically change your diet
Change positions slowly
24
Hypocalcemia s/s include:
Diarrhea
Positive Chvostek's/ Trousseau sign
Diminished reflexes
Tetany
25
What is the recommended flow rate for using a nasal cannula?
6-7L
0.5-6L
5-6L
3-4L
26
What is the normal value for Lab Glucose?
135-145 mEq/L
70-110 mg/dL
8.5-10.5
3.5-5 mEq/L
27
What precautions should be taken for a patient with low platelets?
Airborne precautions
Bleeding precautions
Contact precautions
Standard precautions
28
What should the nurse do before the cardiac catheter procedure?
Ensure consent is signed and on file
Check for allergies
Trim hair, don’t shave
NPO 4-6 hours
29
Where is the location of an ileostomy?
Sigmoid colon
Rectum
Ileocecal (right lower quadrant)
Ascending, transverse, descending
30
Long-acting insulin can be mixed
True
False
31
What are the potential complications of untreated hyperglycemia?
Coma
Seizure
DEATH
DKA
32
Aspirin Class
NSAID
Antihistamine
Antiplatelet
Antipyretic
33
When to empty ostomy bag?
Once per shift
Completely full
Every hour
1/3 full
34
A client is prescribed diltiazem(cardizem) to manage HTN. The nurse should tell the client this med will?
decrease HR and B/P
only decrease b/p
Move positions slowly
Prolong QT interval
35
What is the peak of long acting glargine insulin?
2-5 hr
Less defined or no pronounced peak
4-12 hr
30 min-3 hr
36
What should the nurse instruct the CNA to do when feeding a client at risk for aspiration?
90 degrees
Chin tuck
Speech and swallow
No straws
37
Which of the following are postoperative cardiac complications?
PE
Orthostatic hypotension
DVT
Stress management
38
What are 2 nursing considerations when communicating with a client who is hearing impaired?
Hearing aids in if they have them
Lighting
Face them
Quiet environment
Patience- take time to communicate
39
Furosemide nursing interventions
Rate, rhythm, quality of respirations
S/S electrolyte imbalance
Kidney Function (BUN, Creatinine)
Monitor I&O
Daily weights
Monitor serum electrolyte levels
40
How is an ABG procedure in nursing interventions ?
By inserting a needle into an artery to collect a blood sample
By applying a bandage to a wound
By taking a urine sample from the patient
Review patient chart labs and hx
41
What is a possible symptom of Hypernatremia & Hyponatremia?
Rapid heartbeat
Excessive sweating
Numbness or tingling
Confusion
42
simvastatin classification
antihyperlipidemic
anti-diabetic
gastrointestinal agent
antihypertensive
43
What should be checked before administering Digoxin?
Auscultation of lungs
Apical pulse
Decreased edema
Potassium level
44
What does the Creatinine level indicate?
therapeutic drug range for dilantin
specific to kidney function
fluid balance and diet
kidney function but not specific
45
What should a nurse do for CT scan with contrast?
Check for allergies-shellfish or iodine
Interpret the scan results
Hold metformin per provider orders.
Explain the procedure to the patient
Provide bonus per provider order
46
Which of the following symptoms may be associated with high bilirubin levels?
Abdominal pain
Jaundice
Increased risk of bleeding
Icterus
Clay stools, dark urine
Muscle pain
47
Aspirin Teaching Points
Hypersensitivity
Intracranial hemorrhage with normal BGL
No one under 18-Reye Syndrome
Patients that have ulcer disease or asthma
Take with food
Tinnitus sign of toxicity
48
Which are signs and symptoms for hyperkalemia?
Cardiac symptoms (Peaked T wave, MI)
Muscle symptoms (Weakness, cramping, paralysis, paresthesia)
All of the above
GI Symptoms (Nausea & Vomiting)
49
The HOB for tube feedings should be…
50-90 degrees
25-30 degrees
30-45 degrees
15-25 degrees
50
What should be checked when taking Accupril?
Blood pressure
Vitamin D levels
Potassium levels
Blood sugar levels
51
What is Lasix / furosemide
antianxiety
heart medication
diuretic
antibiotic
52
Is respiratory atelectasis a post-operative complication?
False
True
53
You must inflate the reservoir bag on a nonrebreather with oxygen before placing it on a patient
False
True
54
How often should the tube feed set be changed?
Q24H
Q12H
Q4H
Q6H
55
What are the effects of high glucose?
diarrhea, cramping
seizure, coma and death
confusion, irritability, diaphoresis
3 p's (polydipsia, polyuria, polyphagia)
56
What are the effects of low glucose?
diarrhea, cramping
confusion, irritability, diaphoresis
3 p's (polydipsia, polyuria, polyphagia)
seizure, coma and death
57
What should be reported if experienced while on Warfarin?
Excessive bleeding or bruising
Diet changes
Contact sports
58
Morphine Class
NSAID
Urinary antispasmodic
Muscle relaxant
Opioid
59
What drug class is diltiazem (Cardizem) in?
calcium channel blocker
potassium channel blocker
sodium channel blocker
beta blocker
60
What is an important nursing interventions for an MRI?
Applying EKG leads
Removing metal objects from the patient
Hold Metformin per provider order if contrast dye indicated
Claustrophobic- Request Benzodiazepines
Monitor renal function- may administer bonus if contrast was used.
Check for allergies-shellfish/iodine
61
Opioid antidote
Phenelzine
Acetylcysteine
Naloxone
Phenytoin
62
What can be delegated to an LPN?
Unstable patients
Stable patients
Acute patients
Chronic conditions
63
What is the best response by the nurse if a client has no output from their ileostomy for 2 hours?
Hot liquids and Massage
Knee chest and Ambulate
Change the wafer and Warm shower
Suspected blockage notify provider
64
Lorazepam adverse reactions
Hypertension/tachycarida
Hypotension
Bradycardia
Resp depression
Tolerance/withdrawal
65
What is the recommended suction gauge range for a nasogastric tube?
30 mm Hg
20-60 mmHg
Near 20
Near 60
66
Dexamethasone Class
beta blocker
Corticosteroid
antihistamine
sympathomimetic
67
NG placement confirmation?
Listening for gurgling
Chest x-ray
Taking a guess
Pulling residual
68
What is a side effect of Phenytoin?
Pink urine normal finding
Drowsiness
Gingival hyperplasia
Fatigue
69
Nonmaleficence is to cause no harm or hurt
True
False
70
Long-term steroid side effects?
Osteoporosis
Skin thinning
Increased infection risk
Mood changes
71
What is autonomy in nursing?
Fidelity
Justice
Beneficence
Self-governance
72
which are interventions for GU complications of post op
increased fluids oral and IV as ordered
pathological fractures
administer stool softeners or enemas as ordered
Ambulation
73
What should be done if there is vomiting or ileus?
Gravity
Ambulation
Nasogastric tube
Fluids
74
What are the risks of post op complications of urinary system?
Stones
CAUTI
Stroke
Urinary retention
75
Nursing Assessment post cardiac cath?
Check distal pulses in both legs
HOB less than 30 degrees
Monitor VS
Have the patient urinate as soon as possible
Check for bleeding at the site q15minutes
Promote hydration
76
normal lab value for WBCs
1.000 to 5,000
45,000 to 70,000
10,000 to 12,000
5,000 to 10,000
77
What is the most common symptom of anemia?
Pallor
Shortness of breath
Boost of energy
Fatigue
78
Which of the following is an appropriate GI surgery post-op nursing intervention
Assess VS, bowel sounds, flatus
Early ambulation
Inspect dressings, & monitor for S/Sx of infection
NG if indicated
NPO to slowly progress diet
IV Fluids, Monitor I&O
79
What is the normal value for Creatinine?
3.5-5 mEq/L
70-110 mg/dL
135-145 mEq/L
0.5-1.5 mg/dL
80
What is an appropriate reason to clamp a client's chest tube?
Looking for leak
While changing the chest drainage system
Per provider order in transition to remove. See patient tolerance.
If the client develops sudden dyspnea
81
What is an example of rapid-acting insulin?
Glargine, Detemir
Lispro, Aspart
Toujeo
Regular
82
What is the onset, peak, and duration of rapid acting lispro insulin?
1.5-4 hr, 4-12 hr, 12-18 hr
5-15 min, 1.5 hr, 3hr
30 min-1 hr, 2-5 hr, 5-8 hr
0.8-4 hr, Less defined or no pronounced peak, 16-24 hr
83
What are 3 factors that increase a client's risk for falls?
Medication
Uses equipment to ambulate (walker/cane)
Lines, Tubes, or drains
Age
Gender
Previous fall
84
Accupril is an ACE inhibitor.
True
False
85
What is the normal value for Ca+?
3.5-5 mEq/L
8.5-10.5
135-145 mEq/L
70-110 mg/dL
86
What is the therapeutic range for phenytoin levels?
30-40 mcg/mL
20-30 mcg/mL
5-10 mcg/mL
10-20 mcg/mL
87
Normal Serum Bilirubin is ??
0.3 to 1.0mg/dL
2.5 to 3.0 mg/dL
3.5 to 5.0 mg/dL
1.2 to 2.8 mg/dL
88
What is the role of the nurse during an EEG?
Hold Seizure Medication if indicated
No CNS Stimulants/Depressants
Sleep deprivation of patient if indicated
89
What "hip precaution" teaching will you provide to a client being discharged home after hip surgery?
Do not bend over 90 degrees
Raised toilet seat
Do not cross legs
Chair height with arms
90
Is it important to take bleeding precautions (low platelets) when using an electric razor and toothbrush?
False
True
91
NPH Insulin Onset & Peak and special considerations
O: 30-60 mins, P: 14 hours, Eat meal prior
O: 45 mins, P: 6-14 hours, cannot mix either our insulins
O: 30-60mins, P: 0.5-0.25 hours, D: give with food
O: 60 mins, P: 6 hours, roll don’t shake
92
What is the classification of Metoprolol?
Beta blocker
Anticoagulant
Cardiac glycoside
Ace inhibitor
93
Phenytoin is a medication used to treat which condition?
Diabetes
Depression
Hypertension
Epilepsy
94
What is the onset and peak short acting insulin?
1 hr, 2hr, 5-8 hr
0.8-4 hr, Less defined or no pronounced peak, 16-24 hr
30 minutes, 3 hours, only medicine given via intravenous
1.5-4 hr, 4-12 hr, 12-18 hr
95
How often should an ostomy pouch/wafer be changed?
Once a week
Every 2-3 days
7-10 days or prn if there is a leak
Only when it's dirty
96
What do nurses need to know about traction (e.g. bucks or cervical)?
Rest weights on floor
Continuous never release weights
Rest weights on bed if patient is uncomfortable
Never change weights
97
How can respiratory atelectasis/pneumonia be prevented after surgery?
Hydration to thin secretions
TCDB q2h, ISE 10x hour while awake
Ambulate or sit up in chair
Chest physiotherapy
98
Simvastatin Nursing considerations
Risk of rhabdomyolysis-look for signs ofmyalgias
Do not take with grapefruit juice
Report abd pain, jaundice, icterus, dark urine, clay stool
Monitor liver panel before and during treatment
Take at night due to liver activity
99
What are the possible complications of GI post op complications?
Illeus
Constipation
N/V
Heart attack
100
What is the normal value for NA+?
8.5-10.5
135-145 mEq/L
70-110 mg/dL
3.5-5 mEq/L
101
What is the normal value for K+?
3.5-5 mEq/L
70-110 mg/dL
135-145 mEq/L
8.5-10.5
102
Can phenytoin affect the effectiveness of birth control?
False
True
103
Is it necessary to humidify if the oxygen delivery is 3-4L or higher?
True
False
104
Normal hemoglobin lab range for adults? Referenced ATI***
12-18g/dL
11-20g/dL
9-18g/dL
11-18g/dL
105
What is the normal value for BUN?
70-110 mg/dL
3.5-5 mEq/L
135-145 mEq/L
10-20 mg/dL
106
What should be checked with Endoscopy?
NPO 4-6 hours
Consent in on file
Check Gag reflex
Trim site of hair
107
What is the function of Digoxin?
Clears lungs
Increases contractility
Improves breathing
Decreases heart rate
108
What is the consistency of output in an ileostomy?
Formed, not continuous
Thick, intermittent
Watery, continuous
Solid, constant
109
What is an adverse reaction of Accupril?
Dry non productive cough
Decrease BC
Bleeding
Angioedema
110
Fidelity in nursing means?
justice
Keeping the promises you make
respect patient decisions
If you cant do good ,dont do harm
111
Is it necessary to check residuals q4h per provider order?
True
False
112
Symptoms of hypokalemia?
Leg cramps, constipation, alkalosis, heart palpitations
Jason Mamoa’s love
Nausea, vomitting diarhea
shortness of breath, agitation, restlessness
113
During an EEG, the nurse should ensure that the patient is in a state of:
Pain
Sleep
Anxiety
Wakefulness

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