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can a pt give consent if he has been drinking or is pre-medicated?

no

When, if at all, is 5th disease contagious?

Yes, but only before a rash develops when pt usually has cold-like symptoms.

what signs can indicate morphine toxicity?

pin-point pupils and/or resp < 13

what's the primary physiological effect of Narcan?

reverses resp depression

who is responsible for communicating medical diagnosis to a pt?

physician

why is it better to lock up medications rather than place child-proof caps?

children can still open "child-proof" caps;
most common cause of poisoning is improper storage

infants should sit in rear-facing car seats until ____

1 yo and 20 lbs

the function of a booster seat is to ___ and they are indicated when a child is ____

allow the seat belt to be properly positioned over the child's chest and pelvis;
shorter than 4' 9" and weight >40 lbs

children can sit in a regular adult seat in a car once they are ____

> 4' 9" in height

neostigmine (Prostigmin) is used to tx ____ and causes ____

myasthenia gravis;
bronchoconstriction

why might you place a patch over an eye injury?

to minimize eye movt until a surgeon is available

what special steps are needed when administering iron dextran IM?

dorso-gluteal
Z-track method
aspirate 0.2ml of air after drawing up, then change needle
do NOT massage site after

what might RQ pain in pregnant woman indicate?

impaired liver function from pre-eclampsia

pre-eclampsia Sx

hypertension, 4+ proteinuria and edema; severe: BP > 150/100, headache, epigastric pain

who has the highest incidence of cleft lip & palate?

Native Americans, then Asians.
Boys > girls

what is the purpose of an amniocentesis? is a prior miscarriage a CI (contra-indication)?

to determine possible birth defects; no

meconium-stained amniotic fluid indicates ____

infant has likely experienced a recent episode of hypoxia

RN priority upon assessing meconium-stained amniotic fluid?

assess fetal heart rate

furosemide (Lasix) can cause ____ (esp. in elderly)

postural (orthostatic) hypotension

prolapse of the umbilical cord indicates what pt positioning?

Trendelenburg

what is the diff between a spinal anaesthetic and an epidural?

spinal anaesthetic injects into the intravertebral space BEYOND the dura mater (into the subarachnoid space) and blocks PAIN AND MOVT; whereas an epidural injects into the intravertebral space ABOVE the dura mater and blocks PAIN ONLY

if hypoTN occurs as a result of an epidural, what position is best?

side-lying, NOT supine as will compress maternal vena cava

if pt has internal radiation tx, what is nursing priority?

RN should wear individual dosimeter badge to measure radiation exposure

myelogram

insertion of contrast dye into the sub-arachnoid space (via lumbar puncture) to visualize the vertebral column

RN priority pre-myelogram?

encourage fluids, withhold phenothiazines and CNS depressants for 48 hrs (which lower seizure threshold) and check allergies

certain food allergies (i.e. bananas) may indicate an allergy to ___. The list includes ...

latex (commonly used in surgery); grapes, cherries, apricots, passion fruits, avocados, chestnuts, peaches and tomatoes

Bryant's traction

aortic & pulmonic areas are found at the ____ intercostal space

2nd

Erb's point is found at the ____ intercostal space

3rd

tri-cuspid soudns are best heard at the ____ intercostal space

4th

the mitral valve is best heard at the ____ intercostal space

5th

PMI is best found at the ____ intercostal space

5th

the most critical factor post-amputation in any extremity is ____

resulting circulation. Most LE amputations are the result of poor peripheral circulation (i.e. PVD) from diabetes or cardiac disease.

a figure-8 bandage on a residual limb (post-amputation) helps to ____

reduce post-op swelling

in prep for toilet training, the toddler needs to ____

be able to control anal and urethral sphincter, recognize urge to void/defecate and communicate this to parent(s)

during an anxiety attack, is the pt's sensory input incr or decr?

decr (since pt is unable to see hear, or function)

benztropine (Cogentin): class & use

anti-Parkinsonian that manages extra-pyramidal Sx

when might benztropine (Cogentin) be used other than to tx Parkinson's disease?

to counter Parkinsonian-like SE of antipsychotics/anti-depressants (recall antipsychotics/anti-depressants (i.e. Thorazine) can cause extra-pyramidal Sx, and benztropine (Cogentin) can help to reverse these)

Imipramime (Tofranil): class & indication

TCA used to tx panic attack

are phobias symbolic of unresolved conflicts from the past?

yes

how does nifedipine (Procardia) work?

decr myocardial O2 demand

is coughing post liver biopsy a concern?

Yes... coughing or straining may cause hemorrhage

during CPR, depress the sternum ____

1.5" - 2"

post bleeding into joint for a hemophiliac pt, the RN should recommend ____

active ROM exercises (to prevent crippling effects of bleeding; note that passive ROM contraindicated as pt's pain level should dictate level of activity/stretching)

what is the opposite of Diabetes Insipidus?

SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone), an EXCESS of ADH (from pituitary) causes water intoxication

Lasix is a ____ diuretic that inhibits ____ reabsorption

loop; Na & Cl

ecchymosis

bruise

petechiae

pin-point hemorrhages

melena

black, tarry stool

neomycin sulfate (Neo-fradin): class & use

Abx to suppress intestinal bacteria (E. coli & Psuedomonas) pre-operatively

CPR rescue breathing rate

12 bpm

voncristine sulfate (Oncovin): class & Tx

antineoplastic to treat cancer

pt w/ a sensitivity to penicillins should take caution when using ____ due to a cross-allergy

cephalosporins (i.e. Cephalexine (Keflex))

when using crutches, allow ___ inches clearance from the side of the feet

8-10"

when using crutches, follow the crutches w/ the weak|strong leg

strong (so that if you falter, the strong leg is already in motion to help regain balance)

vecuronium bromide (Norcuron): class and use

neuromuscular blocking agent used to promote skeletal relaxation while pt under mechanical ventilation

vecuronium bromide (Norcuron): common SE and RN priority

inability to blink, requiring eye care to avoid corneal abrasion

stapedectomy

removal of the stapes bone of the middle ear to improve hearing (i.e. for pt w/ osteoclerosis, an abnormal mineralization of the temporal bone)

Warfarin sodium (Coumadin) thins the blood by ____

inhibits vit K clotting factors (i.e. inhibits the synthesis of prothrombin)

why might hypovolemic shock occur w/ bone fracture? what solution should be used to replace fluids?

since bone is highly vascularized; LR or 0.9% NS

what's the difference between rheumatoid arthritis and osteoarthritis?

RA is a chronic systemic inflammatory disease of the joints, whereas O is non-systemic and a degenerative disease of the synovial joint

presbycusis

age related changes to hearing that causes loss in higher frequencies

appropriate intervention for pt w/ presbycusis

face pt and speak slowly w/ a slightly lower voice

name a harmless SE of phenytoin (Dilantin)

pink, red or brown urine

for the following eye exam procedures, briefly explain the procedure and its purpose:
doll's eye oculocephalic reflex

turn pt's head side-to-side quickly and eyes should move in opposite direction; establishes intact reflex

direct light response

in darkened room w/ other eye covered, move bright light towards the midline of the face and into the open eye: pupil should shrink immediately; establishes intact reflex

conjugate gaze

move two fingers in "cross-figure" in front of pt's face, asking to follow fingertips; establishes conjugate gaze intact

corneal reflex

touch cotton ball to cornea, pt should blink immediately; establishes normal reflex

when might doll's eye oculocephalic reflex be contra-indicated?

spinal injury

levodopa (Levopa) treats ____ by ____

Parkinson's Disease; restoring dopamine levels in extrapyramidal centers

milk, celery and fish are naturally high in sodium

T

CRF diet

avoid excessive protein and use HBV (high biological value) proteins, low sodium & potassium and incr carbs

uretolithotomy

removal of calculi (stone) from ureter

uretolithotomy: should the RN irrigate post-op?

NO! urine should drain clear (after initially a small amount of blood-tinged urine)

during pain, what VS changes occur?

incr HR, BP, respirations
decr skin temp
other: pupils dilate

Crohn's disease is a form of regional ____ causing ____ and is characterized by ____

IBS;
restriction in absorption of nutrients (esp. proximal colon);
weightloss, diarrhea and RLQ abdominal pain

Crohn's disease diet

hi calorie, hi protein, low fat, low residue

for an Abx to remain effective, what must be maintained?

consistent blood level, therefore dosages should be equally spaced

verapamil (Calan): class, important SE and instructions

CCB (Ca Channel Blocker);
transient hypotension, incr liver enzymes;
take with meals

propantheline (Pro-Banthine): class, effect

anticholinergic that inhibits gastric secretions and decr GI motility

thrombocytopenia

low platelet levels (i.e. below 100)

thrombocytopenia: major causes

vit B12 or folic acid deficiency, leukemia, sepsis, liver failure (deficiency in thrombopoeitin)

thrombocytopenia: sx

petechiae or ecchymoses, large blood filled bullae in mouth

which is more important in determining premature labor: REGULAR contractions or cervical effacement and dilation?

REGULAR contractions

enuresis

bed-wetting

early sx of glomerulonephritis

oliguria

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