UTA NURS 3561 Adults Final Exam
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| HIV risk factors | show 🗑
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| show | fatigue, headache, low-grade fever, night sweats, persistent generalized lymphadenopathy (PGL)
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| show | persistent fever, frequent drenching night sweats, chronic diarrhea, recurrent headaches, and fatigue severe enough to interrupt normal routines, localized infections, lymphadenopathy, and nervous system manifestations
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| show | one of the following: CD4 < 200; one opportunistic infections (e.g., candidiasis and PCP) or cancer (e.g., cervical cancer, KS, lymphoma); wasting syndrome (looses 10% or more of ideal body mass); AIDS dementia complex
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| normal CD4 T cell count | show 🗑
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| Antiretroviral therapy (ART) | show 🗑
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| HIV teaching | show 🗑
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| show | occurs in young women (Ages 15-40); masses are small, round, well-delineated, and mobile; absense of nipple discharge and retraction
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| show | occurs in older women (Age 50 or over); masses are hard, irregularly shaped, poorly delineated, and nonmobile; nipple discharge and retraction can occur
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| Mastectomy postoperative care considerations | show 🗑
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| show | elevated on a pillow not exceeding shoulder elevation
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| show | complication of mastectomy; an accumulation of lymph in soft tissue with swelling resulting from inflammation, obstruction, or removal of lymph channels and nodes; can cause too much pressure on the veins leading to nerve damage, cellulitis, and fibrosis
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| show | urinary urgency, decreased force of urination, urinary hesitancy, urine dribbling, urinary retention, incontinence, nocturia, dysuria, feeling as if still has to go, bladder discomfort, and sexual dysfunction
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| show | “watchful waiting”, dietary changes, avoid decongestants and anticholinergics, restrict evening fluid intake, voiding schedule; drug therapy (5α-reductase inhibitors and α-adrenergic receptor blockers); minimally invasive therapy (TURP)
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| BPH diet | show 🗑
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| show | a surgical procedure involving the removal of prostate tissue with the use of a resectoscope inserted through the urethra
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| TURP postoperative care | show 🗑
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| show | decreased metabolism causing weight gain, puffy face (periorbital edema), coarse facial features, dry skin, and dry coarse hair and eyebrows
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| Hypothyroidism management | show 🗑
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| show | complication of hypothyroidism; manifestations include hypothermia, hypotension, and hypoventilation
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| Myxedema coma management | show 🗑
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| show | increased metabolism, goiter, exophthalmos, weight loss, increased nervousness, tremors, palpitations, angina, bound/rapid pulse, systolic murmurs
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| show | complication of hyperthyroidism; tachycardia, HF, shock, hyperthermia, restlessness, agitation, seizures, abdominal pain, nausea, vomiting diarrhea, delirium, and coma
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| show | Oxygen administered, followed by fluid replacement, administering antipyretics, and treating the stressor
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| Thyroidectomy postoperative management | show 🗑
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| Hypoparathyroidism manifestations | show 🗑
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| Trousseau's sign | show 🗑
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| show | contraction of facial muscles in response to a light tap over the facial nerve in front of the ear
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| Hypoparathyroidism management | show 🗑
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| Hyperparathyroidism manifestations | show 🗑
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| show | parathyroidectomy; encourage ambulation to prevent renal calculi
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| Parathyroidectomy postoperative management | show 🗑
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| show | parathyroidectomy post-op sign of hemorrhage, an acute emergency; a harsh, high-pitched sound heard on inspiration and expiration caused by compression of the trachea, leading to respiratory distress.
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| Glucocorticoid (cortisol) action | show 🗑
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| Mineralocorticoid (aldosterone) action | show 🗑
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| Cushing syndrome | show 🗑
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| show | centripetal (truncal) obesity or generalized obesity; “moon facies” (fullness of the face) with facial plethora; purplish red striae on the abdomen, breast, or buttocks; hirsutism and menstrual disorders in women; HTN; and unexplained hypokalemia.
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| show | treat underlying cause—transsphenoidal resection and radiation therapy (pituitary adenoma) OR adrenalectomy and ketoconazole (Nizoral) and aminoglutethimide (Cytadren) (adrenocorical adenoma, carcinoma, or hyperplasia)
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| show | increased risk for hemorrhage (rapid or significant changes in BP, respirations, or HR), increased susceptibility to infection, delayed wound healing
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| show | low-carb, low-sodium, high-protein, high-potassium
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| show | a metabolic disorder resulting from the reduced excretion of all three adrenal corticosteroids
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| show | very slow (insidious) onset; progressive weakness, fatigue, weight loss, anorexia, hyperpigmentation, orthostatic hypotension, hyponatremia, salt craving, hyperkalemia, nausea and vomiting, diarrhea, irritability and depression.
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| show | life-threatening emergency caused by insufficient adrenocortical hormones or a sudden sharp decrease in these hormones
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| Addison’s disease management | show 🗑
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| UTI manifestations | show 🗑
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| UTI risk factors | show 🗑
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| show | fever, chills, and flank pain
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| Lower UTI differentiating manifestations | show 🗑
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| show | antibiotic therapy, usually Trimethoprim/sulfamethoxazole (TMP/SMX) (Bactrim, Septra) or nitrofurantoin (Macrodantin), adequate fluid intake
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| Nitrofurantoin (Furadantin, Macrodantin) drug classification/alert | show 🗑
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| show | increased urine calcium, oxaluric, uric, or citric acid levels; warm climates; large intake of proteins, tea/fruit juice, calcium and oxalate, and low fluid intake; family hx, cystinuria, gout, or renal acidosis; sedentary occupation, immobility
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| show | important in diagnosing underlying problem
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| show | palpitations, exertional dyspnea, and possibly mild fatigue
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| show | bounding pulse, dyspnea, roaring in ears, and fatigue
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| show | dyspnea at rest, pallor, jaundice, pruritus, tachycardia, systolic murmurs/bruits, angina, MI, HF, cardiomegaly, pulmonary and systemic congestion, ascites, and peripheral edema
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| show | blood or blood product transfusions, drug therapy (e.g., erythropoietin, vitamin supplements), volume replacement, and oxygen therapy to stabilize the patient.
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| show | anemia due to decreased production of the hormone erythropoietin by the kidneys; may require oral iron supplements
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| show | Male: 13.2-17.3 g/dL Female: 11.7-15.5 g/dL (Severe anemia: <6, moderate anemia 6-10)
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| Hct normal levels | show 🗑
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| RBC normal levels | show 🗑
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| Iron-deficiency differentiating manifestations | show 🗑
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| show | indentify underlying cause, iron supplements, nutritional and diet therapy, and RBC transfusion if symptomic
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| show | chronic health problems and pain; pallor (grayish cast); jaundice; prone to gallstones (cholelithiasis)
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| show | alleviating the symptoms from the complications of the disease, minimizing end-organ damage, and promptly treating serious sequelae
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| Clostridium difficile (C. difficile) manifestations | show 🗑
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| C. difficile management | show 🗑
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| show | contact precautions (gloves and gowns); disinfect with bleach
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| pancreatitis causes | show 🗑
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| show | Epigastric pain, N/V, Abdominal tenderness, Low-grade fever, Leukocytosis, Hypotension, Tachycardia, Jaundice, ↓ or absent BS, Hypovolemia, Grey Turner’s spots & Cullen's sign
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| Cullen’s sign | show 🗑
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| show | bluish flank discoloration caused by seepage of blood-stained exudate from the pancreas
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| Pancreatitis complications | show 🗑
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| show | complication of pancreatitis; a cavity continuous with or surrounding the outside of the pancreas
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| pancreatic pseudocyst manifestations | show 🗑
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| pancreatic pseudocyst treatment | show 🗑
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| show | complication of pancreatitis; a large fluid-containing cavity within the pancreas
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| show | upper abdominal pain, abdominal mass, high fever, leukocytosis
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| pancreatic abscess treatment | show 🗑
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| Most effective means of relieving pain associated with acute pancreatitis | show 🗑
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| show | fatigue (earliest symptom), dyspnea (orthopnea and paroxysmal nocturnal dyspnea), tachycardia, edema, nocturia, skin changes, behavioral changes, chest pain, weight changes
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| HF exacerbation manifestations | show 🗑
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| show | IV vasodilator that reduces preload and afterload, improving myocardial contraction, increasing CO, and reducing pulmonary congestion; complications include hypotension and thiocyanate toxicity—monitor BP frequently (5-10 minutes)
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| show | Monitor IV site for signs of extravasation; Tissue necrosis with sloughing can occur with extravasation of the drug; High dosages may produce ventricular dysrhythmias.
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| show | weight
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| HF teaching | show 🗑
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| show | potentiate effect of opioids and barbiturates (anesthetics)
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| Antihypertensive effect on surgery/healing | show 🗑
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| Insulin/hypoglycemic agents effect on surgery/healing | show 🗑
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| Aspirin, Plavix, & NSAID effect on surgery/healing | show 🗑
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| Corticosteroid effect on surgery/healing | show 🗑
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| show | determine physholgoic status, establish baseline, identify site/side, identify medications that may result in interactions, review labs and diagnostic tests, identify cultural and ethnic factors affect surgery, witness consent
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| Preop labs | show 🗑
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| show | establish baseline; allergies; skin integrity; skeletal muscle impairments; perceptual difficulties; LOC; NPO status; pain/discomfort
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| show | monitoring/managing respiratory and circulatory function, pain, temperature, and the surgical site
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| show | Fecal-oral (primarily fecal contamination and oral ingestion)
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| HBV transmission | show 🗑
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| HCV transmission | show 🗑
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| show | same as HBV: Percutaneous (parenteral)/permucosal exposure to blood or blood products; sexual contact; preinatal transmission
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| HEV transmission | show 🗑
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| show | symptom of yellowish discoloration of body tissues that results from an increased concentration of bilirubin in the blood
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| Asites effect on patient | show 🗑
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| Normal Potassium | show 🗑
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| show | Addison's disease, diabetic ketosis, massive tissue destruction (e.g., burn patients), renal failure
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| show | hyperaldosteronism, Cushing syndrome, diarrhea (severe), diuretic therapy, gastrointestinal fistula (colitis), pyloric obstruction, starvation, vomiting
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| Effect of thiazide and loop diuretics on potassium | show 🗑
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| show | irritability, anxiety, abdominal cramping, diarrhea, weekness of lower extremities, parathesias, irregular pulse, cardiac arrest if sudden or severe
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| show | fatigue, muscle weakness, leg cramps, n/v, paralytic ileus, soft, flaby muscles, paresthesias, decreased reflexes, weak, irregular pulse, polyuria, hyperglycemia
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| show | Heart
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| Normal Calcium | show 🗑
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| Elevated Calcium etiology | show 🗑
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| Decreased Calcium etiology | show 🗑
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| Hypercalcemia manifestations | show 🗑
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| show | tetany, Chvostek’s sign, Trousseau’s sign, fatigue, diarrhea
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| show | 135-145 mEq/L
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| Hypernatremia manifestations | show 🗑
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| Hypernatremia etiology | show 🗑
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| Hyponatremia sodium etiology | show 🗑
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| show | hyperactive bowel sounds, increased urinary output, decreased specific gravity
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| Normal phosphorus | show 🗑
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| hyperphosphatemia etiology | show 🗑
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| show | malnutrition/starvation (alcoholism), antacid use, Diabetes mellitus, hyperparathyroidism, vitamin D deficiency
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| show | vomiting, diarrhea, conditions that cause increased respirations or increased urinary output, insufficient IV fluid replacement, draining fistulas, and the presence of an ileostomy or colostomy
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| show | increased RR and HR, decreased CVP, weight loss, poor skin turgor, dry mucous membranes, decreased urine volume, increased specific gravity of the urine, increased Hct, and altered LOC
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| fluid volume deficit management | show 🗑
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| isotonic solutions | show 🗑
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| hypotonic solutions | show 🗑
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| hypertonic solutions | show 🗑
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| show | rapid-acting insulin
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| Aspart (Novolog) classification | show 🗑
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| Glulisine (Apidra) classification | show 🗑
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| Regular (Humulin R, Novolin R, ReliOn R) classification | show 🗑
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| NPH (Humulin N, Novolin N, ReliOn N) classification | show 🗑
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| Glargine (Lantus) classification | show 🗑
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| show | long-acting insulin
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| Rapid-acting insulin Onset/Peak/Duration | show 🗑
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| Short-acting insulin Onset/Peak/Duration | show 🗑
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| show | Onset: 2-4 hrs; Peak: 4-10 hrs; Duration: 10-16 hrs
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| Long-acting insulin Onset/Peak/Duration | show 🗑
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| show | potentiates effect of insulin, putting patient at risk for hypoglycemia up to 48 hrs after; don’t exercise at time of peak drug action, do exercise 1hr after meals or after carb snack and glucose monitoring, carb snacks every 30 minutes during exercise
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| Insulin pump teaching | show 🗑
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| Hypoglycemia manifestations | show 🗑
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| show | food or glucose (D50)
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| show | decreased pH, decreased HCO3, elevated glucose, ketones in blood and urine, polyuria, Kussmaul’s respiration’s; can lead to coma
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| DKA management | show 🗑
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| Electrolyte impacted by DKA | show 🗑
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| Ineffective Breathing pattern characteristics | show 🗑
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| show | Abnormal ABGs, pH; abnormal breathing (rate, rhythm, depth); abnormal skin color (pale, dusky); confusion; cyanosis; decreased CO2; diaphoresis; dyspnea; headache upon awakening; rritability; nasal flaring; restlessness, tachycardia; visual disturbance
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| show | wheezing, cough, dyspnea, and chest tightness after exposure to a precipitating factor or trigger
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| Frequent use of rescue inhalers | show 🗑
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| Use of Peak Flow Meter | show 🗑
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| β2-Adrenergic Agonists (SABA, LABA) drug classification/alert | show 🗑
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| show | bronchodilator used for alternative therapy for step 2 care in mild persistent asthma; Instruct patient to report signs of toxicity: nausea, vomiting, seizures, insomnia; Avoid caffeine to prevent intensifying adverse effects.
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| Side effects of inhaled corticosteroids | show 🗑
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| show | “blue bloater”, form of COPD characterized by excessive production of mucus and chronic inflammatory changes in the bronchi
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| show | smoking cessation, drug therapy (stepwise fashion: bronchodilator, anticholinergic, ICS), O2 therapy, possible surgical therapy, breathing retraining (pursed-lip and diaphragmatic)
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| Peripheral Artery Disease (PAD) manifestations | show 🗑
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| intermittent claudication | show 🗑
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| show | cardiovascular disease risk factor modification, treatment of claudication,nutritional therapy, proper foot care; worst case: amputation
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| Phlebitis | show 🗑
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| show | Virchow’s triad: venous stasis, damage to inner lining of vein, and hypercoagulability of the blood
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| show | may have unilateral leg edema, extremity pain, a sense of fullness in the thigh or calf, paresthesias, warm skin, erythema, and/or a systemic temperature greater than 100.4° F, positive Homans’ sign; legs, arms, neck, back, or face edematous and cyanotic.
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| show | ambulation, graduated compression stockings, SCDs, anticoagulants
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| show | asymptomatic until severe; fatigue, reduced activity tolerance, dizziness, palpitations, angina, and dyspnea
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| DASH eating plan | show 🗑
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| Thiazide and loop diuretic adverse effects | show 🗑
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| show | hyperkalemia; avoid potassium
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| Doxazosin (Cardura) classification/alert | show 🗑
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| show | orthostatic hypotension, sexual problems
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| HTN management | show 🗑
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| show | rise slowly, don’t stand still for prolonged periods, do leg exercises (increases venous return), sleep with head of bed raised or on pillows, lie/sit when dizziness occurs
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| Myelosuppression complications | show 🗑
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| Myelosuppression lab monitoring | show 🗑
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| Foods that promote RBC growth | show 🗑
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| show | infection prevention (including monitoring temperature); WBC growth factor administration
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| Care of cast | show 🗑
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| Signs of cast complications | show 🗑
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| show | skin irritation/breakdown, neurovascular damage, cast syndrome (body cast too tight)
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| show | circulation, sensation and movement
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| Compartment syndrome manifestations | show 🗑
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| show | don’t elevate above heart; don’t apply cold compresses; remove/loosen bandage or split the cast; reduce traction weight; surgical decompression; apputation
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| Open fracture risk | show 🗑
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| Warfarin (Coumadin) lab monitoring | show 🗑
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| show | aPTT – therapeutic value 46-70 sec (normal 25-35)
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| show | hypotension, tachycardia, hematuria (bloody urine), melena (black or bloody stools), hematemesis (coffee-ground or bloody vomit), petechiae, ecchymosis, nosebleeds
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| show | hemorrhage, infection, flexion contractures
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| show | appear within 24-48 hrs of traumatic skeletal injury, include chest pain, tachypnea, cyanosis, dyspnea, apprehension, tachycardia, and decreased partial pressure of arterial oxygen (PaO2), changes in mental status, petechiae (distinguishing factor)
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| Fat embolism management | show 🗑
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| Parkinson’s complications | show 🗑
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| show | status epilepticus (continuous seizure activity); injury/death from trauma suffered during a seizure
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| show | antiseizure drug therapy, airway management (side-lying, nasotracheal suctioning), seizure safety (loosen clothing, remove harmful objects, padded side rails)
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| show | titrate up; monitor serum levels; abrupt withdrawal may precipitate seizures
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| show | Lymph nodes are enlarged (>1 cm); may be tender to touch
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| addisonian crisis triggers | show 🗑
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| show | "pink puffer", a form of COPD characterized by overinflation and destructive changes in alveolar walls
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| show | Albumin, protein, and daily weights
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| Normal Albumin | show 🗑
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| Elevated Albumin etiology | show 🗑
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| Decreased Albumin etiology | show 🗑
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| show | 6.4-8.3 g/dL
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| Elevated Protein etiology | show 🗑
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| Decreased Protein etiology | show 🗑
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