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MedSurg II ATI
ATI study guide
| Question | Answer |
|---|---|
| Cushing’s Syndrome Physical Symptoms (increased cortisol and androgens), lifelong therapy, eat high calcium/Vit D, avoid infection | thin, fragile skin, bruising and petechiae, hypertension, tachycardia, weight gain, moon face, truncal obesity, buffalo hump, fractures, muscle wasting in extremities, Hirsutism, acne, red cheeks, striae, fever, swelling |
| Abnormal lab values revealing possibility of Cushing’s Syndrome | hyperglycemia, hypernatremia, hypocalcemia, hypokalemia (also lymphocytopenia) |
| proper use of quad cane, which leg | use on same side as affected leg |
| HF management, report weight gain of ___ pounds per ___ to HCP | 2, day |
| a trach/intubated patient needs suction when an assessment of breath sounds is ___ and there is a presence of ___ | abnormal, rhonchi |
| PICC line location | into superior vena cava |
| PICC line dressing change schedule: opaque - change every ___ days; transparent - change every ___ | 3 days, 24 hours |
| PICC line patient teaching – port used for long-term ___ ___ | administration (antibiotic) |
| Nitro patient teaching – position, tablet placement, details of timing of use | sit down, nitroglycerin tablet under tongue, If pain is unrelieved in 5 minutes, client should call 911 or be driven to ER, take up to 2 more doses at 5 minute intervals |
| Patient has a chest tube and the water seal chamber is low on water, nursing action? | refill water |
| Family teaching of patient with conscious sedation | NPO ā 6hrs, do not walk around, no driving, sign informed consent |
| expected side effect and a complication of dialysis | hypotension is an expected side effect; hyperglycemia is a complication |
| contraindication of heparin use | low platelet count (thrombocytopenia) |
| Accutane contraindicated in a client with a ___ | rash |
| Nurse's role during seizure | protect from injury, patent airway, prepare suction of oral secretions, turn client on side, loosen clothing, do not attempt to restrain client, do not open jaw or insert airway during seizure activity, do not use tongue blades, document onset, duration |
| Signs of digoxin toxicity | muscle cramps, weakness (hypocalcemia) |
| COPD patient experiencing SOB, nursing action | check ABC’s, check O2 saturation |
| First action when patient experiences VFIB | shock first |
| patient on Lasik, sign that its working | urine output >30mL/hr |
| How would you position a patient post liver biopsy? | lie on right side (liver side) to allow for pressure on incision |
| sign treatment is effective for myxedema coma | increase in O2 saturation, able to breathe |
| unexpected drainage color in NG tube | red-blood |
| reason for compression wrap on below the knee amputation | reduce swelling |
| Crohn's disease dietary recommendation | ↑ fiber,↓ fat,↓ sugar |
| sign/symptom of retinal detachment – acute ___ ___ | vision loss |
| ART line, arm at ___ ___, tube pressure must remain at same pressure as ___ ___ | heart level, heart pressure |
| What color should the fluid exiting the bag during peritoneal dialysis be? | clear |
| peritoneal dialysis bag placement | Keep outflow bag lower than client’s abdomen (drain by gravity, prevent reflux) |
| patient has a positive Mantoux skin test, next action is to perform what diagnostic procedure | chest x-ray |
| signs that patient has hearing difficulty | loud TV, turning head when listening, asking to repeat |
| meningitis assessment finding | nuchal rigidity |
| colostomy education, empty bag when? | at 1/4-1/2 full |
| skin ulcer care | rotate patient to relieve pressure |
| post-pacemaker implant precautions | don’t lift arm up, keep arm in sling |
| sign of hypocalcemia | muscle weakness |
| sign of circulation issue - decrease in? (2) | decrease in pulses, decrease in capillary refill |
| patient receiving RBC transfusing, becomes flushed, first nursing action | slow down infusion |
| signs, symptoms of hypervolemia | pink frothy sputum, HTN, crackles |
| effective Epogen treatment will result in increased | activity, RBC (used to treat anemia) |
| when to hold digoxin | low heart rate (<60bpm), teach patient to check HR and hold medication if necessary |
| ABG's post surgery, check for increase in ___ | CO2 (caused by not breathing enough, holding in carbon dioxide) |
| regular intervention for patients on TPN | finger sticks for glucose (can cause hyperglycemia because they are NPO) |
| patient teaching for oxycontin | long acting medication, do not crush |
| patient has esophageal varices, how are they fed? | PEG tube |
| MI initial treatment | MONA (morphine, oxygen, nitro, aspirin) |
| gastric bypass nutrition education | 1 cup per meal, 2 servings of protein per day |
| best way to check placement of ET tube | chest x-ray |
| gout is an excess of ___ ___ | uric acid |
| What is hypervolemia? | fluid overload |
| how to assess pain | pain scale |
| identify STEMI on a ECG | baseline elevated on S-T interval |
| total hip replacement, can never ___ ___ again | cross legs |
| IV medication administration through PICC line, flush with ___ ___ | normal saline |
| nursing actions with fractures (4) | check pulses, capillary refill, pain, risk for compartment syndrome |
| an ostomy should appear ___, ___, ___ | red, beefy, moist |
| actions for hemorrhagic shock | stop bleeding, then administer isotonic fluid bolus |
| hormone replacement therapy side effect | hypercalcemia |
| signs that fluid replacement is working | no HTN, normal capillary refill, normal pulses |
| HF patients should avoid | salt |
| post bronchoscopy important assessment | oxygen saturation |
| (3) signs, symptoms of a perforated ulcer | increased temperature, increased WBC, dark stools |
| lab value - hematocrit | male 42-52, female 35-47 |
| lab value - sodium | 135-145 |
| lab value - BUN | 10-20 |
| lab value - glucose | 60-100 |
| patient treated for DVT, you suspect PE because of increase in work required to breathe and SOB, nursing action (3) | assess, ABC’s, treat with O2 |
| priority assessment after endoscopic retrograde cholangiopancreatography (ERCP) | gag reflex |
| teach patients with SLE to use | sunblock |
| mucositis interventions | examine mouth several times a day, document lesion location/size, avoid glycerin-based mouthwash, topical anesthetic prior to meals, discourage salty/acidic/spicy food, mouth care before/after meals, rinse-half 0.9% NaCl/peroxide, soft bristle toothbrush |
Created by:
BrandiLynn
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