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442 Cards in this Set
- Front
- Back
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IN DIABETES INSIPIDUS THE URINE SPECIFIC GRAVITY IS
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1.001 - 1.005
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BULIMIA IS
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BINGE EATING
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WHAT SHOULD YOU KEEP HANDY IN THE PATIENT'S ROOM FOR 48 HRS. AFTER A THYROIDECTOMY?
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TRACHEOSTOMY SET
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IN CORTICOSTEROIDS THERAPY, THE PLAN OF CARE IS TO
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PREVENT INFECTION
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PRIOR TO AN IVP, WHAT DOES THE NURSE NEED TO ASK THE PATIENT?
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DO YOU HAVE ANY ALLERGIES?
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BUFFALO HUMP IS AN ABNORMAL ADIPOSE TISSUE DISTRIBUTION IN WHAT DISEASE?
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CUSHING'S SYNDROME
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WHAT MEDICATION SERVES AS REPLACEMENT THERAPY IN HYPOTHYROIDISM?
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SYNTHROID
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A HORMONAL CHANGE OF ADOLESCENCE FROM ANDROGENIC STIMULATION OF SEBUM PRODUCTION IS A PREDISPOSING FACTOR FOR WHAT?
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ACNE VULGARIS
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WHY SHOULD SYNTHROID NOT BE TAKEN WITH FOOD?
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FOOD INTERFERES WITH ABSORPTION.
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TOFRANIL WITH CONCOMITANT USE MAY LEAD TO
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GI COMPLICATIONS
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A PATIENT ON SYNTHROID THERAPY SHOULD REPORT WHAT SIDE EFFECT?
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TACHYCARDIA
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S/S OF HYPERKALEMIA ARE
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MUSCLE WEAKNESS, HYPOTENSION, SHALLOW RESPIRATIONS, APATHY, AND ANOREXIA.
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A PATIENT WHO HAS GOOD CONTROL OF DIABETES MAY SHOW WHAT?
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A 2 HR. POST-PRANDIAL BLOOD SUGAR RESULT OF 139 MG/DL
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A PATIENT WITH HYPOTHYROIDISM HAS WHAT TYPE OF INTOLERANCE?
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COLD INTOLERANCE; GIVE BLANKET
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IN DIABETES MELLITUS, THE PATIENT SHOULD DO WHAT TO THEIR FEET?
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BATHE FEET DAILY IN WARM WATER AND DRY FEET CAREFULLY, ESPECIALLY BETWEEN THE TOES.
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A 21 YR. OLD GETTING MARRIED IN 3 WEEKS STATED, "I'M NOT SURE IF I WANT TO GO THROUGH WITH IT". WHAT IS THIS CALLED?
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INTIMACY VS. ISOLATION
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THE PSYCHOSOCIAL STAGE OF DEVELOPMENT IN ALCOHOLISM IS
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ORAL
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CLINICAL MANIFESTATION OF ACUTE PANCREATITIS IS
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A CONSTANT EPIGASTRIC ABDOMINAL PAIN RADIATING TO THE BACK, AND FLANK PAIN, WHICH IS MORE INTENSE IN THE SUPINE POSITION.
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IF A PATIENT HAS A POSITIVE OUTLOOK ON SURGERY, WHAT DOES IT MEAN?
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THE GOAL HAS BEEN MET, WHICH IS SELF-ACTUALIZATION.
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WHAT SIDE EFFECTS SHOULD BE REPORTED IMMEDIATELY TO THE PHYSICIAN ON A PATIENT IN LITHIUM THERAPY?
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DIARRHEA, VOMITING, DROWSINESS, MUSCULAR WEAKNESS, AND LACK OF COORDINATION
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THE THERAPEUTIC SERUM LEVEL FOR LITHIUM MAINTENANCE IS
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0.6 - 1.2 MEQ/L
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OCD IS WHAT TYPE OF DISORDER?
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ANXIETY-RELATED
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ALANON IS A SELF-HELP GROUP FOR
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FAMILIES OF ALCOHOLICS
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THE TREATMENT FOR PHOBIA (IRRATIONAL FEAR) IS CALLED
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DESENSITIZATION
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AFTER ECT TREATMENT, WHICH WAY SHOULD THE PATIENT BE POSITIONED?
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SIDE OR HEAD TURNED TO THE SIDE
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DELUSION IS
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A FIXED FALSE BELIEF
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GIVING AWAY PERSONAL POSSESSIONS IS ONE OF THE TELL-TELL SIGNS OF WHAT?
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SUICIDE IDEATION
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WHAT IS AGORAPHOBIA?
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THE FEAR OF OPEN, CROWDED SPACES.
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A PERSONALITY DISORDER THAT MANIFESTS HOSTILITIES INTO OTHERS IS
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PARANOID
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WHAT IS A LONG TERM COMPLICATION OF DM?
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DIABETIC NEUROPATHY
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WHAT IS ONE WAY TO ASSESS PATIENT JUDGEMENT?
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ASK THE PATIENT WHAT TO DO IF HE FOUND A STAMPED ENVELOPE (THE PATIENT SHOULD RESPOND THAT HE WOULD DROP IT IN THE MAIL
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AFTER ECT, THE PATIENT SHOULD BE MONITORED FOR WHAT POST SHOCK
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AMNESIA
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A PATIENT ON LITHIUM THERAPY SHOULD HAVE WHAT TYPE OF DIET?
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ADEQUATE SODIUM DIET AND INTAKE OF FLUIDS (2500-3000ML)
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THE DOCTOR PRONOUNCED THE CHILD DEAD, AND THE MOTHER IS STILL PERFORMING CPR. THE MOTHER IS SHOWING WHAT?
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DENIAL
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WHAT IS TRANSVESTITISM?
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THE DESIRE TO WEAR CLOTHES OF THE OPPOSITE SEX.
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PORTAL VEIN HTN IS ASSOCIATED
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LIVER CIRRHOSIS.
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AFTER A THYROIDECTOMY, ASSESS FOR
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LARYNGEAL DAMAGE THAT IS MANIFESTED BY HOARSENESS
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A PATIENT WITH HYPOPARATHYROIDISM HAS
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HYPOCALCERUTA.
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EXCESSIVE BLINKING, VERMIFORM TONGUE MOVEMENT, ABNORMAL INVOLUNTARY SUCKING, CHEWING, LICKING, AND PURSING MOVEMENTS OF TONGUE AND MOUTH ARE ALL SIGNS OF
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TARDIVE DYSKINESIA.
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WHAT MEDS ARE GIVEN TO COUNTERACT EXTRAPYRAMIDAL SIDE EFFECTS?
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ARTANE AND COGENTIN
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IN ORDER TO PREVENT A HYPERTENSIVE CRISIS, WHAT TYPE OF FOODS SHOULD A PATIENT ON MAOIS AVOID?
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AGED CHEESE, CAFFEINE, BEER, YEAST, CHOCOLATE, LIVER, PROCESSED FOODS, AND MSG
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WHAT ARE EXTRAPYRAMIDAL SX?
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PARKINSONISM, DYSTONIA, AKATHISIA (ANTS IN PANTS), AND TARDIVE DYSKINESIA
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A MANIC DEPRESSIVE SHOULD BE GIVEN WHAT TO SUPPLY ADEQUATE NUTRITION?
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FINGER FOODS
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WHAT DIET SHOULD A PATIENT WITH CHRONIC PANCREATITIS HAVE?
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LOW FAT, BLAND DIET
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HEPATITIS A SHOULD BE ON WHAT PRECAUTION?
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ENTERIC
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ASSOCIATED WITH LIVER DISORDER, THERE WILL BE A SIGN OF
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JAUNDICE
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ONE OF THE SIDE EFFECTS OF DILANTIN IS
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GUM HYPERLPASIA
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WHAT SHOULD YOU WATCH FOR IN PHENYLKETONURIA
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PROTEIN
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WHAT HAPPENS IN DIABETIC KETOACIDOSIS?
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THE FATTY ACIDS ARE BROKEN DOWN
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PATIENT WITH RENAL CALCULI SHOULD INCREASE FLUID INTAKE TO MORE THAN
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2500CC/DAY
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WHY USE LUGOL'S SOLUTION BEFORE THRYOIDECTOMY?
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DEVASCULARIZE THE GLAND
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ANTIDEPRESSANT IS A MOOD
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ELEVAOTR
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WAYS TO PREVENT ICU PSYCHOSIS IS
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HAVE THE PATIENT TOUR THE ICU
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WHAT HAPPENS WHEN YOU TAKE THORAZINE WITH ALCOHOL?
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YOU GET INTOXICATED QUICKER
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WHY SHOULD STEROID THERAPY BE TAPERED?
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TO PREVENT ADDISON'S EFFECT.
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CLOZARIL IS CONTRAINDICATED ON A PATIENT WITH
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SEVERE GRANULOCYTOPENIA, SEVERE CNS DEPRESSION, AND PREGNANCY.
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CLINICAL MANIFESTATIONS OF CHOLECYSTITIS ARE
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N/V, LOW-GRADE FEVER, BILIARY COLIC PAIN, AND RIGHT UPPER QUADRANT GUARDING; PAIN RADIATES TO THE RIGHT SCAPULA.
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EARLY COMPLAINTS OF LIVER CIRRHOSIS ARE
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FATIGUE, ANOREXIA, EDEMA OF THE ANIDES IN THE EVENING, EPISTAXIS AND BLEEDING GUMS.
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___ IS USED WHEN THE INDIVIDUAL IS UNABLE TO RECALL PAINFUL OR UNPLEASANT FEELINGS BECAUSE THEY HAVE BEEN INVOLUNTARILY PUSHED INTO THE UNCONSCIOUSNESS.
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REPRESSION
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____ IS SEEN IN THE SITUATION IN WHICH UNWANTED CHARACTERISTICS OR SHORTCOMINGS ARE SHIFTED TO OTHERS.
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PROJECTION
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____ IS A HYPERFUNCTION OF THE ADRENAL MEDULLA
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PHEOCHROMOCYTOMA
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CLINICAL MANIFESTATIONS OF DIABETES INSIPIDUS ARE
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POLYDIPSIA, POLYURIA, SG 1.000-1.005, AND HIGH SERUM OSMOLALITY.
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TREATMENT FOR PSYCHOGENIC AMNESIA IS
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HYPNOSIS
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A PATIENT WITH GALACTOSEMIA SHOULD NOT HAVE
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DAIRY PRODUCTS
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A SIGN OF TRANSPLANT REJECTION IS
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HTN
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IF A PATIENT IS WANDERING, WHAT CAN YOU DO
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PROVIDE A BRACELET WITH INFORMATION.
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AN INDICATION THAT LACTULOSE IS EFFECTIVE IS THE PATIENT HAS
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INCREASED ALERTNESS
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A CHILD FAILS TO GROW ABOVE 3RD PERCENTILE IN 2 YEARS. WHAT IS THE CLINICAL MANIFESTATION?
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HYPOPITUITARISM
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BEFORE PARACENTESIS PROCEDURE, PATIENT SHOULD
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VOID FIRST
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DEPRESSED PATIENT WITH NUTRITIONAL PROBLEM - NURSE SHOULD
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STAY WITH PATIENT DURING MEAL
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ANTABUSE IS ADMINISTERED ORALLY IN TREATMENT OF
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ALCOHOLISM
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IN ACUTE PANCREATITIS, LAB VALUES WOULD SHOW
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INCREASE GLUCOSE AND LIPIDS, DECREASED CALCIUM AND POTASSIUM
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HOW DO YOU CHECK FOR PATENCY OF ATRIOVENOUS SHUNT IN HEMODIALYSIS?
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PRESENCE OF BRUIT
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REACTIONS TO EATING RESTRICTED FOODS WHILE ON MAOI DIET ARE
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HAS AND HYPERTENSIVE CRISIS
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WHAT ARE CLINICAL MANIFESTATIONS OF DIABETIC KETOACIDOSIS?
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KUSSMAUL'S BREATHING AND ACETONE BREATH
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WHAT DOES THE NURSE NEED TO ASK THE FAMILY OF A CHILD DIAGNOSED WITH DIABETES?
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THE CHILD'S DIET
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AFTER A THYROIDECTOMY, THE NURSE SHOULD CHECK FOR SIGNS OF HEMORRHAGE BY
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ROLLING PATIENT TO THE SIDE AND CHECKING THE BACK OF THE NECK.
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WHAT IS THE USUAL REACTION OF A WOMAN DIAGNOSED WITH CANCER?
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DENIAL
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THE HUSBAND HAD A PROBLEM AT WORK, AND CAME HOME AND HIT HIS WIFE.
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THE DEFENSE MECHANISM IS DISPLACEMENT
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HOW DO YOU KNOW IF A SCHIZOPHRENIC PATIENT IS IMPROVING IN HIS SOCIAL ACTIVITY?
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HE ATTENDS GROUP ACTIVITY, BUT DOESN'T TALK.
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IN ORIENTATION PHASE, WHAT IS DEVELOPED BASED ON ERIK ERICKSON THEORY?
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TRUST
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FOR A MANIC PATIENT, WHICH S/S NEEDS INTERVENTION?
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PATIENT LOOSING WEIGHT.
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CLINICAL MANIFESTATION OF THYROID STORM OR CRISIS IS
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HYPERPYREXIA
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KORSAKOFF'S SYNDROME IS DUE TO THE DEFICIENCY OF
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VIT. B1 (THIAMINE)
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TO PREVENT LIPODYSTROPHY IN GIVING INSULIN TO A DIABETIC PATIENT, WHAT SHOULD THE NURSE DO?
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CHANGE SITE OF INJECTIONS.
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PATIENT RECEIVING LEVODOPA FOR THE TREATMENT OF PARKINSONISM DEVELOPS
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A CONTROLLED SHUFFLING GAIT
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A CLINICAL SIGN OF ESOPHAGEAL VARICES IS
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HEMATEMESIS
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IN DEALING WITH A PATIENT HAVING ANXIETY, WHAT SHOULD YOU DO?
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REDUCE STIMULI
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HOW CAN PERIPHERAL PROBLEMS IN DIABETIC PATIENTS BE PREVENTED?
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EXAMINE THE SKIN DAILY FOR LESIONS.
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DEFINITIVE DIAGNOSTIC TEST FOR DIABETES IS
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GTT (GLUCOSE TOLERANCE TEST)
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A FATHER LOST HIS JOB AND IS VERY UPSET. WHAT SHOULD BE ASSESSED FIRST?
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PREVIOUS COPING MECHANISM
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WHEN TAKING MAOIS, FOODS CONTAINING WHAT ARE CONTRAINDICATED?
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TYRAMINE
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WHAT SHOULD YOU CHECK FOR IN A PATIENT WITH ESOPHAGEAL VARICES?
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PORTAL HTN
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DRUG OF CHOICE FOR MANIC-DEPRESSIVE IS
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LITHIUM
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WHAT SHOULD YOU CHECK FOR BEFORE A LIVER BIOPSY?
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PT AND PLATELETS
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WHAT SHOULD YOU KEEP HANDY IN THE ROOM OF A PATIENT WITH AN ESOPHAGEAL BALLOON TAMPONADE?
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SCISSORS AT THE BEDSIDE TO CUT THE TIP
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A PATIENT WHO JUST HAD THEIR GALLBLADDER REMOVED IS AT RISK FOR WHAT POST OPERATIVE CONDITION?
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ATELECTASIS AND DEHISCENCE
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AFTER A LIVER BIOPSY, THE PATIENT SHOULD BE POSITIONED
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ON THE RIGHT SIDE WITH A PILLOW UNDERNEATH
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THE FIRST PRIORITY FOR THE NURSE IN HELPING A BATTERED WIFE IS
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THE PHYSICAL SAFETY
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EXPECTED OUTCOME OF KAYEXALATE THERAPY IS
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DECREASED POTASSIUM LEVEL
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WHAT SHOULD YOU SUSPECT WHEN THE MOTHER REPORTS THAT HER BABY SLEEPS ALL THE TIME AND DOES NOT CRY?
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CRETINISM
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AFTER A THYROIDECTOMY, WHAT SIGNS SHOULD YOU REPORT TO THE DOCTOR?
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TINGLING OF FINGERS AND EXTREMITIES BECAUSE OF THE DAMAGE TO THE PARATHYROID GLAND.
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WHAT HORMONE IS DEFICIENT IN DIABETES INSIPIDUS?
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ADH
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WHAT IS THE CLINICAL SIGN OF INCREASED AMMONIA LEVEL?
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DECREASED CONSCIOUSNESS
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WHAT IS THE MEDICATION USED IN ACUTE PANCREATITIS?
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DEMEROL
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CORTISOL IS GIVEN IN PATIENT WITH WHAT DISEASE?
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ADDISON'S DISEASE
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MEDICATION FOR N/V DUE TO CHOLECYSTITIS
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COMPAZINE, MECLAZINE, AND TIGAN
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LITHIUM CARBONATE INDICATES THAT IT IS STARTING TO WORK IF
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THE PATIENT CONCENTRATION IMPROVES
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A MANIC PATIENT UNDER MILIEU THERAPY: IT HAS ACHIEVED THE GOAL IF THE PATIENT
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GETS ALONG WITH THE STAFF
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PATIENT STATES "I'M SURE SURGERY WILL BE ALRIGHT". THE MASLOW'S HIERARCHY OF NEEDS IS
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SELF-ACTUALIZATION
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IDIOPATHIC NEPHROTIC SYNDROME CLINICAL MANIFESTATIONS ARE
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DOUBLE THE WEIGHT (PROTEINURIA OR ALBUMINURIA)
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IN HYPERTHYROIDISM, THE PRIMARY NURSING ACTION IS TO LET THE PATIENT EAT
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IN A QUIET ENVIRONMENT
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MYELOMENINGOCELE CAUSES FLACCID PARALYSIS OF THE
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LOWER EXTREMITIES
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CHILD HOSPITALIZED WITH DX OF CHRONIC RENAL FAILURE. THE FATHER NEEDS HEALTH TEACHING IF HE GIVES
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PEANUT BUTTER SANDWICH AND MILK TO THE CHILD.
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WHAT CAN YOU EXPECT IN HYPERPARATHYROIDISM?
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RENAL CALCULI
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IN BIPOLAR DISORDER, THE PRIMARY NURSING ACTION IS TO
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PREVENT INJURY
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IN BILE DUCT OBSTRUCTION CAN'T ABSORB
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FAT AND VIT. K
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IN AN ACUTE PANIC EPISODE, WHAT SHOULD YOU DO?
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ASSURE PATIENT THAT THE ENVIRONMENT IS SAFE.
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THE PURPOSE OF AEROSOL SPRAY IS TO
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LIQUIFY SECRETIONS
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THE BEST WAY TO DEAL WITH A DEPRESSED PATIENT IS TO
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INITIATE COMMUNICATION WITH THEM
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DIET FOR PATIENT WITH GLOMERULONEPHRITIS IS
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LOW PROTEIN
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FOLLOWING ECT, WHAT SHOULD THE NURSE DO WITH THE PATIENT?
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ORIENT TO PERSON, PLACE, AND TIME
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FOLLOWING ECT, SX THAT SHOULD BE REPORTED TO THE DOCTOR IS
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BACK PAIN
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PATIENT WITH ACUTE RENAL FAILURE,THE NURSE WILL SEE POSSIBLE CLINICAL SIGNS OF
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MATABOLIC ACIDOSIS
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PRIMARY NURSING ACTION FOR PATIENT WITH ANOREXIA NERVOSA
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GIVE SUPPORT AT MEALTIME AND RECORD AMOUNT EATEN
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PATIENT AFTER THYROIDECTOMY, MONITOR FOR
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HYPOCALCEMIA
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NURSE IS LEAVING FOR VACATION AND THE PATIENT RESPONDS "YOU NEVER CARE ABOUT ME". YOU KNOW THIS IS PATIENT RESPONSE TO
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EARLY TERMINATION OF THERAPEUTIC RELATIONSHIP
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YOU WILL FIND A LOW SPECIFIC GRAVITY OF URINE IN WHAT DISEASE?
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DIABETES INSIPIDUS
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CLINICAL MANIFESTATIONS OF GUSHING'S SYNDROME
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EDEMA (KIDNEY PROBLEM)
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CLINICAL SIGNS OF HYPOGLYCEMIA
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DIAPHORESIS, TACHYCARDIA, AND HYPOTENSION
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ANOREXIA NERVOSA: PRIMARY NURSING DX IS
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NUTRITION LESS THAN BODY REQUIREMENTS
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WHAT LAB VALUE IS ELEVATED IN THE END STAGE OF CIRRHOSIS OF THE LIVER?
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AMMONIA
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EXCESSIVE INTAKE OF WHICH FLUID IN RENAL CALCULI?
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MILK
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A NURSE TOLD THE PATIENT "YOU ARE IN A FINE HOSPITAL, SO YOU WILL BE WELL SOON." THE NURSE'S NON-THERAPEUTIC TECHNIQUE IS
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FALSE REASSURANCE
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A POST-OP PATIENT TOLD THE NURSE, "I DIDN'T KNOW THAT THE SCAR IS AS BAD AS THIS." THE NURSE RESPONDS
|
TELL ME ABOUT WHAT YOU KNOW.
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AN OBESE PATIENT IS AT RISK FOR
|
GALLSTONES
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WHAT NEEDS TO BE MEASURED IN A PATIENT WITH LIVER CIRRHOSIS?
|
ABDOMINAL GIRTH
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IN GLOMERULONEPHRITIS, A DECREASE IN ESR INDICATES
|
IMPROVEMENT
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BODY IMAGE DISTURBANCE OF PATIENT WITH CUSHING'S SYNDROME
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TOOTHPICK EXTREMITIES
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A SIGN OF POTENTIAL EMOTIONAL PROBLEMS IN AN ADOLESCENT IS IF HE MAKES THE FWG. STATEMENT:
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I DON'T HAVE ANY FRIENDS
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THE ONSET OF ALZHEIMER'S DISEASE SX MAY BE DESCRIBED AS
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INSIDIOUS
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ANTABUSE TX IS TO PREVENT
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SPORADIC DRINKING IMPULSES
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A WOMAN WHO HAS BEEN PHYSICALLY ABUSED BY HER HUSBAND, WHAT WOULD BE AN APPROPRIATE NURSING INTERVENTION?
|
HAVE THE WOMAN TAKE RESPONSIBILITY FOR SEEKING ADDITIONAL THERAPY
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A 47 Y/O CLIENT HAS BEEN ADMITTED TO THE HOSPITAL WITH A MEDICAL DX OF BPH. WHICH SX WOULD BE INDICATIVE OF A COMPLICATION IN THE PRE-OP PHASE OF HIS CARE?
|
INFECTION
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HALDOL, AN ANTISYCHOTIC DRUG HAS BEEN GIVEN TO A CLIENT. WHAT SIDE EFFECT CAN THE NURSE EXPECT?
|
URINARY FREQUENCY
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WHICH OF THE FWG. NURSING DX SHOULD BE GIVEN PRIORITY IN THE CARE PLAN OF A PT WHO HAS CHRONIC PANCREATITIS?
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ALTERATION IN NUTRITION, LESS THAN BODY REQUIREMENTS, R/T ALTERED ABILITY TO DIGEST NUTRIENTS.
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WHICH OTC MED SHOULD THE PT AVOID WHO IS TAKING ORAL ANTICOAGULANTS?
|
ASA
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A CLIENT IS RECEIVING THE ANTIPSYCHOTIC MED CLOZARIL. WHICH SIGNIFICANT TOXIC RISK MUST BE ASSESSED?
|
BLOOD DYSCRASIA, MONITOR WBC COUNT
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A PT INVOLVED IN AN MVA SUSTAINED A SKULL FX THAT INVOLVED THE CEREBELLUM AREA OF THE BRAIN. WHICH SX MIGHT THE NURSE EXPECT TO OBSERVE?
|
ATAXIA - INABILITY TO COORDINATE MOVEMENT
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WHAT STATE FOLLOWS MANIC STATE?
|
DEPRESSED STATE
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IF A DEMENTIA PT LIVES AT HOME, WHAT TO THEY NEED TO WEAR?
|
ID BRACELET
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ALCOHOLIC PT IS DEFICIENT IN
|
THIAMINE
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WHY IS ATELECTASIS A COMPLICATION AFTER GALL BLADDER SURGERY?
|
INCISION IS CLOSE TO DIAPHRAGM AND CAUSE PAIN WHEN THE PT BREATHES
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DRUG USED TO DRY SECRETIONS BEFORE SURGERY IS
|
ATROPINE SULFATE
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MY TONGUE DOESN'T FEEL AS THICK, AS STATED CLEARLY BY THE PATIENT, INDICATES EPS MEDS
|
ARE WORKING
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WHAT IS A CAUSE OF PANCREATITIS?
|
ALCOHOL
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TO ASSESS FOR HEP. A, THE NURSE MAY NEED TO NOTE ON THE CHART IF THE PATIENT HAS EATEN WHAT?
|
SHELLFISH
|
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SIDE EFFECTS OF HALDOL ARE
|
DROWSINESS, INSOMNIA, WEAKNESS, HA, EXTRAPYRAMIDAL SX, AKATHISIA, TARDIVE DYSKINESIA, DYSTONIA
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LAB TEST GIVING THE MOST SPECIFIC INDICATION OF KIDNEY DISEASE IS
|
SERUM
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AN IDEAL DONOR WOULD BE
|
AN IDENTICAL TWIN OR SIBLING
|
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BILATERAL ADRENALECTOMY NEEDS TO TAKE WHAT FOR LIFE?
|
CORTISONE
|
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ALCOHOLIC MAN STATES HE DRINKS BECAUSE NO ONE UNDERSTANDS HOW HE WORKS SO HARD, HE IS USING WHAT DEFENSE MECHANISM?
|
RATIONALIZATION
|
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PT WITH LIVER CIRRHOSIS, DISCHARGE INSTRUCTION
|
USE SOFT BRISTLE TOOTHBRUSH FOR GOOD ORAL HYGIENE
|
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PYLORIC STENOSIS CLINICAL MANIFESTATION
|
EPIGASTRIC NODULE
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PRIORITY FOR PT WITH PSYCHOSIS
|
DO NOT LET THEM HARM THEMSELVES OR OTHERS
|
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IN ACUTE PANCREATITIS, WHAT LAB VALUE IS ELEVATED?
|
SERUM AMYLASE
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TO CHECK THE NEUROLOGIC STATUS OF HYDROCEPHALUS PT ASK PT ABOUT
|
PLACE, PERSON, AND TIME
|
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WHAT IS THE SIGN OF OBSTRUCTIVE JAUNDICE
|
EXCESSIVE ITCHING OF THE SKIN
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NPH INSULIN GIVEN AND PATIENT EXPERIENCED SX OF LOW BLOOD SUGAR IN
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10 HOURS
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S/S OF OCD (OBSESSIVE COMPULSIVE DISORDER)
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REPEATED RITUALS, ANXIETY OCCURS IF OBSESSIONS OR COMPULSIONS ARE RESISTED,
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N/I OF OCD
|
• IDENTIFY PROBLEMS
• DO NOT INTERRUPT COMPULSIVE BEHAVIORS, ALLOW PT TO PERFORM RITUALS UNLESS CAUSE HARM TO ONESELF, MAKE SCHEDULE TO DISTRACT • ENCOURAGE VERBALIZATION OF COMPULSIVE DISORDER. |
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S/S OF PHOBIC DISORDER
|
IRRATIONAL FEAR OF OBJECT OR SITUATION THAT A PERSON RECOGNIZES AS UNREASONABLE, PANIC LEVEL ANXIETY IF OBJECT OR SITUATION CANNOT BE AVOIDED, DEFENSE MECHANISM ARE REPRESSION AND DISPLACEMENT
|
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N/I OF PHOBIC DISORDER
|
STAY WITH CLIENT WHILE ANXIETY IS HIGH, IDENTIFY THE ANXIETY ALLOW CLIENT TO SPEAK ABOUT THE OBJECT OR SITUATION DESENSITIZE BY GRADUALLY INTRODUCING FEARED OBJECT OR SITUATION,
DO NOT FORCE CONTACT WITH OBJECT OR SITUATION |
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WHAT IS AGORAPHOBIA
|
FEAR OF BEING ALONE IN A PUBLIC PLACE WHERE ESCAPE MAYBE DIFFICULT
|
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WHAT IS SOCIAL PHOBIA I
|
FEAR OF SITUATION IN WHICH ONE MIGHT BE EMBARRASSED OR CRITICIZED, AND FEAR OF MAKING A FOOL OUT OF ONESELF
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S/S OF PTSD (POST TRAUMATIC STRESS DISORDER)
|
AFTER EXPERIENCING A PSYCHOLOGICAL TRAUMATIC EVENT, THE INDIVIDUAL RE-EXPIERENCES THE EVENT VIA RECURRENT DREAMS OR FLASHBACKS,
EMOTIONAL NUMBNESS, DETACHMENT, ANXIETY, SLEEP DISTURBANCE, HYPERVILIGENCE, GUILT, POOR CONCENTRATION |
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N/I OF PTSD
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DESENSITATION THROUGH GRADUAL EXPOSURE,
INSTRUCT PT IN RELAXATION TECHNIQUES, PROVIDE INDIVIDUAL THERAPY THAT ADDRESS LOSS OF CONTROL ISSUE OR ANGER ISSUE, SUPPORT GROUPS, HYPNOTHERAPY |
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S/S OF DISSOCIATIVE DISORDER
|
- DISRUPTION IN INTEGRATIVE FUNCTION OF MEMORY, CONSCIOUSNESS OR IDENTITY.
- ASSOCIATED TO EXPOSURE TO A TRAUMATIC EVENT |
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N/I OF DISSOCIATIVE DISORDER
|
DEVELOP A TRUSTING RELATIONSHIP WITH CLIENT
- ENCOURAGE VERBAL EXPRESSION OF PAINFUL EXPOSURE, ANXIETIES OR CONCERNS - EXPLAIN METHODS OF COPING - IDENTIFY SOURCES OF CONFLICT - FOCUS ON CLIENTS STRENGTHS AND SKILLS PROVIDE NONDEMANDING SIMPLE ROUTINES |
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TYPES OF DISSOCIATIVE DISORDERS
|
MULTIPLE PERSONALITY, AMNESIA, FUGUE, DEPERSONALIZATION DISORDER
|
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WHAT IS MULTIPLE PERSONALITY
|
2 OR MORE FULLY DEVELOPED DISTINCT AND UNIQUE PERSONALITY WITHIN THE PERSON
- PERSONALITIES MAY TAKE FULL CONTROL OF THE CLIENT ONE AT A TIME - PERSONALITIES MAY OR MAY NOT BE AWARE OF EACH OTHER. |
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WHAT IS AMNESIA
|
INABILITY TO RECALL IMPORTANT PERSONAL INFORMATION BECAUSE IT IS ANXIETY PROVOKING
- MEMORY IMPAIRMENT MAY BE PARTIAL OR ALMOST COMPLETE |
|
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WHAT IS FUGUE
|
ASSUMPTION OF A NEW IDENTITY IN A NEW ENVIRONMENT
- DISORDER MAY OCCUR SUDDENLY |
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WHAT IS DEPERSONALIZATION DISORDER
|
ALTERED SELF PERCEPTION IN WHICH ONE'S OWN REALITY IS LOST OR CHANGED
|
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S/S OF ULCERATIVE COLITIS
|
ANOREXIA, WT LOSS, MALAISE, ABD TENDER AND CRAMPING, SEVERE DIARRHEA MAY CONTAIN BLOOD AND MUCUS, DEHYDRATION AND ELECTROLYTE IMBALANCE, ANEMIA, VIT K DEFICIENCY, INCREASED BOWEL SOUNDS
|
|
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N/I OF ULCERATIVE COLITIS
|
ACUTE PHASE: NPO STATUS, IV AND ELECTROLYTE POSSIBLY TPN
- RESTRICT PT ACTIVITY TO REDUCE INTESTINAL ACTIVITY - MONITOR BOWEL SOUNDS - AFTER ACUTE PHASE DIET PROGRESS FROM CLEAR LIQUID TO LOW RESIDUE DIET - AVOID GAS FORMING FOODS - ADMINISTER BULK FORMING AGENTS TODECREASE DIARRHEA - ADMINISTER DRUGS TO PREVENT INFECTION AND REDUCE INFLAMMATION |
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WHAT IS ULCERATIVE COLITIS
|
INFLAMMATORY DISEASE OF BOWEL THAT RESULTS IN POOR ABSORPTION OF NUTRIENTS
- COLON BECOMES EDEMATOUS AND MAY DEVELOP BLEEDING LESIONS AND ULCERS - SCAR TISSUE DEVELOPS AND CAUSES LOSS OF ELASTICITY |
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WHAT IS GASTRIC ULCER?
|
ULCERATION IN MUCOSAL WALL OF THE STOMACH, THAT IS ACCESSIBLE TO GASTRIC SECRETIONS EROSION MAY EXTEND THROUGH THE MUSCLE
- PREDISPOSING FACTORS ARE STRESS, SMOKING, USE OF CORTICOSTEROIDS, NSAIDS, ALCOHOL, HX OF GASTRITIS - COMPLAINTS OF HEMORRHAGE, PERFORATION AND PYLORIC OBSTRUCTION |
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S/S OF GASTRIC ULCER
|
GNAWING SHARP PAIN ON OR LEFT OF THE MIDEPIGASTRIC REGION 1-2 HOURS AFTER EATING.
- NAUSEA AND VOMITING - HEMATEMESIS |
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N/I OF GASTRIC ULCER
|
MONITOR VITAL SIGNS AND FOR SIGNS OF BLEEDING
- ADMINISTER SMALL FREQUENT BLAND FEEDINGS - ADMIN. HISTAMINES TO REDUCE SECRETION OF GASTRIC ACID - ADMIN. ANTACIDS - ADMIN ANTICHOLINERGENICS TO REDUCE GASTRIC MOTILITY - ADMIN. MUCOSAL BARRIER PROTECTANTS AS PRESCRIBED 1 HOUR BEFORE MEAL |
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WHAT IS ANOREXIA NERVOSA
|
ONSET IS OFTEN ASSOCIATED WITH STRESSFUL LIFE EVENT.
- PT. INTENSELY FEARS OBESITY - BODY IMAGE IS DISTORTED HAS A DISRUPTED SELF CONCEPT - PREOCCUPIED WITH FOODS THAT PREVENT WEIGHT GAIN - CAN BE LIFE THEATNING, - SELF INDUCED WT. LOSS GREATER THAN 15% OF NORMAL WEIGHT FOR AGE AND HT. |
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S/S OF ANOREXIA NERVOSA
|
VARY DEPENDING ON SEVERITY OF ILLNESS
- WT LOSS GREATER THAN 15% OF NORMAL WEIGHT - BRADYCARDIA, HYPOTENSION, COLD INTOLERANCE, HYPOTHERMIA, DRY SKIN, CONSTIPATION, ABD PAIN - PSYCHOLOGICAL MANIFESTATIONS INCLUDE PERFECTIONIST AND OCD WITH HIGH PERFORMANCE EXPECTATIONS - ANXIETY INCREASED EXERCISE ACTIVITY, INHIBITED OR DESTRUCTIVE SOCIAL INTERACTIONS |
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N/I OF ANOREXIA NERVOSA
|
ASSES PT. NUTRITIONAL STATUS
- ESTABLISH CONTRACT CONCERNING THE DIET PLAN - ASSIST PT. IN IDENTIFYING PRECEPTORS OF THE EATING DISORDER - ENCOURAGE BEHAVIOR MODIFICATIONS TECHNIQUE - RECORD I & O - SET TIME LIMIT ON MEAL TIME, - WEIGHT PT DAILY - ASSES AND LIMIT PT ACTIVITY LEVEL |
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WHAT IS BULIMIA NERVOSA
|
PT INDULGES IN EATING BINGES FOLLOWED BY PURGING BEHAVIOR
- MOST PTS REMAIN WITHIN NORMAL WT LIMITS BUT ARE DOMINATED BY EATING RELATED CONFLICT - USE OF SELF INDUCED VOMITING, EXCESSIVE LAXATIVES, DIURETICS, FASTING, EXCESSIVE EXERCISE |
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S/S OF BULIMIA NERVOSA
|
PREOCCUPIED WITH BODY WEIGHT
_ CONSUMES HIGH CALORIE FOOD IN SECRET - BINGE PURSE SYNDROME - LOWER SELF ESTEEM - POOR INTERPERSONAL RELATIONSHIP - MOOD SWINGS |
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N/I OF BULIMIA NERVOSA
|
- SAME AS ANOREXIA
- NUTRITIONAL PLAN - BALANCED DIET |
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WHAT IS SCHIZOPHRENIA
|
GROUP OF MENTAL DISORDERS CHARACTERIZED BY PSYCHOTIC FACTORS, INABILITY TO TRUST OTHERS, DISORDERED THOUGHT PROCESS, AND DISRUPTED INTERPERSONAL RELATIONSHIPS
- DISTURBANCE IN AFFECT, MOOD, BEHAVIOR, AND THOUGHT PROCESS |
|
|
FACTORS RELATED TO SCHIZOPHRENIA
|
GENETIC - IF ONE PARENT IS AFFECTED 19% CHILD WILL, IF BOTH PARENTS AFFECTED 39% CHILD WILL
- BIOCHEMICAL , DOPAMINE, NOREPI, SEROTONIN MAY HAVE A ROLE - PSYCHOSOCIAL FACTORS , INTERPERSONAL THEORY PROPOSES LACK OF A WARM NURTURING RELATIONSHIP IN EARLY YEARS OF LIFE |
|
|
S/S OF SCHIZOPHRENIA
|
DISHEVELED APPEARANCE, BODY IMAGE DISTURBANCE, PREOCCUPIED WITH SOMATIC COMPLAINTS
- CATATONIC POSTURING, CATATONIC EXCITEMENT, MOVEMENTS MAY BE REPETITIVE, MOTOR ACTIVITY INCREASE - MISTRUST, VIEW WORLD AS UNSAFE AND THREATENING DISPLAY FEELINGS OF HELPLESSNESS, ANXIETY, ANGER- COMPULSIVE RITUALS, ABNORMAL THOUGHT PROCESS |
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NURSING DIAGNOSIS FOR SCHIZOPHRENIA
|
ALTERED THOUGHT PROCESS RELATED TO PERCEPTUAL AND COGNITIVE DISTORTIONS
- SOCIAL ISOLATION RELATED TO INABILITY TO TRUST - RISK FOR ACTIVITY INTOLERANCE RELATED TO ADVERSE REACTIONS TO MEDSRISK FOR VIOLENCE SELF DIRECTED OR TOWARD OTHERS |
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|
N/I OF SCHIZOPHRENIA
|
PROVIDE PT WITH HONEST AND CONSISTENT FEEDBACK
- AVOID CHALLENGING THE CONTENT OF PTS BEHAVIOR - FOCUS ON PTS BEHAVIOR - ADMINISTER MEDS |
|
|
EVALUATE OUTCOME CRITERIA FOR PTS WITH SCHIZOPHRENIA
|
EXHIBITS IMPROVED REALITY ORIENTATION, CONCENTRATION AND ATTENTION SPAN
- COMMUNICATES WITH FAMILY AND SHIFT IN A CLEAR MANNER WITHOUT EVIDENCE OF LOOSE THINKING - MAINTAIN PERSONAL HYGIENE |
|
|
WHAT IS AUTISM
|
SEVERE MENTAL DISORDER BEFORE THE AGE OF 3
- IMPAIRMENT IN RECIPROCAL SOCIAL INTERACTION, AND IN VERBAL AND NON VERBAL COMMUNICATION - CAUSE UNKNOWN AND PROGNOSIS IS POOR |
|
|
S/S OF AUTISM
|
DISTURBANCE IN THE RATE AND APPEARANCE OF PHYSICAL AND SOCIAL AND LANGUAGE
- ABNORMAL RESPONSE TO BODY SENSATIONS - ABNORMAL WAYS OF RELATING TO PEOPLE OR OBJECTS - CHILD MAY PLAY HAPPY ALONE FOR HOURS BUT DISTURB HIM AND HE WILL THROW A TEMPER TANTRUM - LANGUAGE DISTURBANCE OFTEN INCLUDES REPETITION OF PREVIOUSLY HEARD WORDS |
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N/I OF AUTISTIC CHILD
|
DETERMINE CHILD’S ROUTINE AND HABITS AND PREFERENCES AND MAINTAIN
- FACILITATE COMMUNICATION THROUGH PICTURE BOARD - EVALUATE FOR SAFETY - MONITOR FOR STRESS AND ANXIETY - INITIATE REFERRALS TO SPECIAL PROGRAMS |
|
|
S/S OF PARANOID DISORDER
|
SUSPICIOUS AND MISTRUSTFUL
- EMOTIONALLY DISTANT - DISTORTS REALITY - POOR INSIGHT - HYPERVILIGENCE - LOW SELF ESTEEM - EVASIVE |
|
|
NURSING DIAGNOSIS FOR PTS WITH PARANOID DISORDER
|
ALTERED THOUGHT PROCESS TO PERCEPTUAL AND COGNITIVE DISTORTIONS
- SOCIAL ISOLATION RELATED TO INABILITY TO TRUST - RISK FOR ACTIVITY INTOLERANCE RELATED TO ADVERSE REACTIONS - INEFFECTIVE INDIVIDUAL COPING RELATED TO MISINTERPRETATION - RISK FOR VIOLENCE |
|
|
N/I FOR PARANOIA PTS
|
ASSESS SUICIDE RISK
- DIMINISH SUSPICIOUS BEHAVIOR - ESTABLISH TRUSTING RELATIONSHIP - PROMOTE INCREASED SELF ESTEEM - FOLLOW THROUGH ON COMMITMENT MADE TO PT |
|
|
S/S OF HOSTILITY
|
HX OF VIOLENCE OR SELF HARM
- POOR IMPULSE CONTROL AND LOW TOLERANCE OF FRUSTRATION - DEFIANT ARGUMENTATION - VERBAL THREATS - INCREASE IN PACING AND AGITATED - MUSCLE RIGIDITY - FLUSHED FACE - GLARING - LOUD VOICE |
|
|
N/I OF HOSTILITY
|
- ACKNOWLEDGE ANGER
- SET LIMITS ON BEHAVIOR - LISTEN ACTIVELY AND ASSIST PT TO DEAL WITH CONSEQUENCES OF ANGER - PROVIDE SAFETY FOR EXPRESSING ANGER AND TO SAFETY OF OTHERS |
|
|
CLUES FOR SUICIDAL REACTION
|
GIVING AWAY PERSONNEL, SPECIAL OR PRIZED POSSESSIONS
- CANCELING SOCIAL ENGAGEMENTS - TAKING OUT OR CHANGING INSURANCE POLICIES |
|
|
ASSESSMENT OF SUICIDAL REACTION
|
DOES PT HAVE A PLAN
- PT OF HX OF ATTEMPTS, - PSYCHOSOCIAL |
|
|
N/I OF SUICIDAL REACTION
|
INITIATE SUICIDE PRECAUTIONS
- REMOVE HARMFUL OBJECT - DO NOT LEAVE PT ALONE - PROVIDE NONJUDGMENTAL ATTITUDE - PROVIDE CONTRACT - KEEP PT ACTIVE |
|
|
4 TYPES OF CIRRHOSIS
|
ALCOHOLIC
POST NECROTIC BILIARY CIRRHOSIS CARDIAC CIRRHOSIS |
|
|
LATE S/SX OF CIRRHOSIS
(DECREASED LIVER SIZE SCAR TISSUE) |
ASCITES D/T DECREASED ALBUMIN
JAUNDICE SPIDER ANGIOMA GASTROINTESTINAL. VARICES EDEMA ANEMIA CLOTTING DYSFUNCTION. PRURITUS D/T ACCUMULATION OF BILE SALTS HEPATIC ENCEPHALOPHY OR COMA |
|
|
WHAT ARE SOME CLINICAL MANIFESTATIONS OF HEPATIC COMA
|
NEURO: DISORIENTED,CONFUSION,PERSONALITY CHANGES, MEMORY LOSS, DEC.LOC,DEC. MOTOR ACTIVITY,
POSITIVE BABINSKI REFLEX SEIZURES ASTERIXIS OR FLAPPING TREMOR OF THE HANDS. EEG SLOWING BRAIN WAVES BREATH ODOR SULFUR |
|
|
WHAT IS GIVEN TO DEC. AMMONIA LEVEL
|
LACTULOSE
THE LACTULOSE TRAPS THE AMMONIA IN THE INTESTINE. |
|
|
DIET FOR HEPATIC COMA (IF PT CAN EAT)
|
HIGH-CARB,LOW-PROTEIN,LOW FAT
|
|
|
WHAT IS THE BEST POSITION FOR PT W/ HEPATIC COMA
|
SEMI-FOWLER'S OR FOWLER'S SUPPORTING ARMS W/ PILLOWS.
|
|
|
IF PT. IS ON LACTULOSE WHAT LABS SHOULD BE MONITORED.
|
SODIUM AND POTASSIUM
|
|
|
CHOLECYSTITIS
|
ACUTE INFLAMMATION AND INFECTION OF THE GALLBLADDER
|
|
|
WHEN EATING FATTY FOODS WHAT HORMONE IS SECRETED BY THE SMALL INTESTINES?
|
CHOLECYSTOKININ
|
|
|
WHAT IS THE TIME PERIOD (AGE) FOR FREUD'S ANAL STAGE?
|
18 MONTHS TO 3 YEARS
|
|
|
WHAT IS THE TIME PERIOD (AGE) FOR FREUD'S ORAL STAGE?
|
BIRTH TO 18 MONTHS
|
|
|
WHAT IS THE TIME PERIOD (AGE) FOR FREUD'S PHALLIC STAGE?
|
3 YEARS TO 6 YEARS
|
|
|
WHAT IS THE TIME PERIOD (AGE) FOR FREUD'S LATENCY STAGE?
|
6 YEARS TO PUBERTY
|
|
|
WHAT IS THE TIME PERIOD (AGE) FOR FREUD'S GENITAL STAGE ?
|
PUBERTY – ON
|
|
|
WHAT WOULD BE CHARACTERISTIC OF SOMEONE WHO HAD UNRESOLVED ISSUES FROM FREUD'S ANAL STAGE?
|
TOO CLEAN AND ORDERLY OR TOO MESSY
|
|
|
WHAT WOULD BE CHARACTERISTIC OF SOMEONE WHO HAD UNRESOLVED ISSUES FROM FREUD'S ORAL STAGE?
|
EATING, BITING NAILS, SMOKING
|
|
|
WHAT WOULD BE CHARACTERISTIC OF SOMEONE WHO HAD UNRESOLVED ISSUES FROM FREUD'S PHALLIC STAGE?
|
CONFUSED SEXUAL IDENTITY
|
|
|
WHAT IS THE OEDIPUS COMPLEX?
|
PSYCHOLOGICAL THEORY WHERE MALES ARE ATTRACTED TO WOMEN LIKE THEIR MOTHER
|
|
|
WHAT IS THE ELECTRA COMPLEX?
|
PSYCHOLOGICAL THEORY WHERE FEMALES ARE ATTRACTED TO MEN LIKE THEIR FATHER
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF TRUST VS. MISTRUST OCCUR?
|
BIRTH TO AGE 1
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF IDENTITY VS. ROLE CONFUSION OCCUR?
|
ADOLESCENSE
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF INITIATIVE VS. GUILT OCCUR?
|
3 TO 6 YEARS
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF INTIMACY VS. ISOLATION OCCUR
|
YOUNG ADULTHOOD
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF GENERATIVITY VS. STAGNATION OCCUR?
|
MIDDLE ADULTHOOD
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF EGO INTEGRITY VS. DESPAIR OCCUR?
|
SENIOR CITIZEN AGE
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF INDUSTRY VS. INFERIORITY OCCUR?
|
6 TO PUBERTY
|
|
|
AT WHAT AGE DOES ERICKSON’S STRUGGLE OF AUTONOMY VS. SHAME/DOUBT OCCUR?
|
1 TO 3 YEARS
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF AUTONOMY VS. SHAME/DOUBT WOULD RESULT IN?
|
OVERLY DEPENDENT, LOW SELF-ESTEEM
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF TRUST VS. MISTRUST WOULD RESULT IN?
|
OVERLY DEPENDENT, LOW SELF-ESTEEM
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF TRUST VS. MISTRUST WOULD RESULT IN?
|
SUSPICIOUS AND MISTRUSTING
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF INITIATIVE VS. GUILT WOULD RESULT IN?
|
BEING FOLLOWERS, SELF-LIMITING
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF INDUSTRY VS. INFERIORITY WOULD RESULT IN?
|
SELF-DOUBT, INFERIORITY
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF IDENTITY VS. ROLE CONFUSION WOULD RESULT IN?
|
CONFUSION ABOUT SELG
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF INTIMACY VS. ISOLATION WOULD RESULT IN?
|
LONELINESS AND DEPRESSION
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF GENERATIVITY VS. STAGNATION WOULD RESULT IN?
|
UNPRODUCTIVE FEELINGS
|
|
|
UNRESOLVED ISSUES DURING ERICKSON’S STAGE OF EGO INTEGRITY VS. DESPAIR WOULD RESULT IN
|
DESPAIR/DEPRESSION
|
|
|
ANTIDIURETIC HORMONE (ADH)
|
AKA VASOPRESSIN
SYNTHESIZED IN HYPOTHALAMUS STORED & SECRETED BY POSTERIOR PITUITARY DECREASE = DIABETES INSIPIDUS INCREASE = SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (SIADH) |
|
|
DIABETES INSIPIDUS
|
CAUSED BY ADH DEFICIENCY USUALLY DUE TO TUMORS/TRAUMA TO PITUITARY GLAND
OCCASIONALLY CAUSED BY PT DRINKING LARGE AMOUNTS OF WATER IN ABSENCE OF TRUE DISEASE S/S: POLYURIA - NOCTURIA - HIGH SERUM OSMOLALITY - LOW URINE OSMOLALITY - DECREASED URINE SPECIFIC GRAVITY – POLYDIPSIA |
|
|
HYPOPHYSECTOMY
|
SURGICAL REMOVAL OF PITUITARY GLAND
|
|
|
SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (SIADH)
|
RESULTS FROM TOO MUCH ADH IN BODY CAUSING EXCESS WATER TO BE REABSORBED BY KIDNEY TUBULES & COLLECTING DUCTS
*RESULTS IN DECREASED URINE OUTPUT & FLUID OVERLOAD *CERTAIN CANCERS, SEVERAL DRUGS, AND HEAD TRAUMA OR SURGERY CAN CAUSE SIADH *S/S: WEIGHT GAIN - SERUM OSMOLALITY LESS THAN 275 MOSM/KG - CONCENTRATED URINE - MUSCLE CRAMPS & WEAKNESS - LETHARGY - SEIZURES – COMA |
|
|
GROWTH HORMONE (GH)
|
AKA SOMATOTROPIN
RESPONSIBLE FOR NORMAL GROWTH OF BONES, CARTILAGE, & SOFT TISSUE SYNTHESIZED & SECRETED BY ANTERIOR PITUITARY EXCESS = ACROMEGALY DEFICIT = DWARFISM |
|
|
DWARFISM
|
AKA SHORT STATURE OCCURS WHEN GH IS DEFICIENT IN CHILDHOOD
*MAY BE DUE TO PITUITARY TUMOR/FAILURE TO DEVELOP, INFECTION, TRAUMA, & EXTREME STRESS *S/S CHILDREN: GROWTH MAY REACH 3-4 FEET MAX W/NORM BODY PROPORTIONS - SEXUAL MATURATION SLOWED - SOMETIMES ACCOMPANIED BY MENTAL RETARDATION *S/S ADULTS: WEAKNESS - HYPOGLYCEMIA - SEXUAL DYSFUNCTION - SKIN CHANGES - HEADACHES - MENTAL SLOWNESS - VISUAL DISTURBANCES |
|
|
ACROMEGALY
|
EXCESS OF GH THAT AFFECTS ADULTS (USUALLY IN 30S OR 40S)
IF GH EXCESS OCCURS AS CHILD, RESULT IS GIGANTISM CAUSED BY OVERSECRETION OF GH S/S: NOSE/JAW/BROW/HANDS/FEET ENLARGE - TEETH MAY BE DISPLACED - TONGUE THICKENS - KYPHOSIS DUE TO VERTEBRAL CHANGES - HEADACHES - DIABETES MELLITUS - OSTEOPOROSIS & ARTHRITIS MAY OCCUR |
|
|
HYPERPLASIA
|
ABNORMAL INCREASE IN NUMBER OF CELLS IN TISSUE/ORGAN
IS NOT A TUMOR |
|
|
HYPOPHYSECTOMY
|
SURGICAL REMOVAL OF PITUITARY GLAND
CHECK POSTOP PT FOR DI & CSF LEAKAGE (CONTAINS GLUCOSE UNLIKE SURGICAL DISCHARGE) |
|
|
TRIIODOTHYRONINE (1____) AND THYROXINE (2_____) ARE SECRETED BY THE 3_____ GLAND. THESE HORMONES MAY BE COLLECTIVELY REFERRED TO AS 4_____ 4_____ (TH). DEFICIENT SECRETION OF THESE HORMONES RESULTS IN 5_____; EXCESS TH RESULTS IN 6_____.
|
1 T3
2 T4 3 THYROID 4 THYROID HORMONE 5 HYPOTHYROIDISM 6 HYPERTHYROIDISM |
|
|
CRETINISM
|
HYPOTHYROIDISM OCCURRING IN INFANCY
|
|
|
MYXEDEMA
|
HYPOTHYROIDISM THAT DEVELOPS IN AN ADULT
|
|
|
HYPOTHYROIDISM
|
OCCURS WHEN THYROID GLAND FAILS TO PRODUCE ENOUGH TH DESPITE ENOUGH TSH BEING SECRETED
CAUSE CAN BE DUE TO CONGENITAL DEFECT, INFLAMMATION, IODINE DEFICIENCY, AUTOIMMUNE DX, POSTPARTUM PITUITARY NECROSIS S/S: REDUCED METABOLISM - FATIGUE - WEIGHT GAIN - BRADYCARDIA - CONSTIPATION - MENTAL DULLNESS - FEELING COLD - SOB - DRY SKIN & HAIR - WATER RETENTION |
|
|
HYPERTHYROIDISM
|
EXCESSIVE AMOUNTS OF CIRCULATING THYROID HORMONE
INCREASES METABOLISM, NUMBER OF BETA-ADRENERGIC RECEPTOR SITES & ACTIVITY OF NE RESULTING IN 'FIGHT-OR-FLIGHT' RESPONSE S/S: HEAT INTOLERANCE - INCREASED APPETITE W/WEIGHT LOSS - INCREASED BOWEL MOVEMENTS - NERVOUSNESS - TREMOR – TACHYCARDIA |
|
|
THYROTOXIC CRISIS
|
AKA THYROID STORM
SEVERE HYPERTHYROID STATE THAT CAN OCCUR IN HYPERTHYROID PTS WHO ARE UNTREATED OR WHO ARE EXPERIENCING ANOTHER ILLNESS OR STRESSOR CAN RESULT IN DEATH IN AS LITTLE AS 2 HRS IF UNTREATED |
|
|
GOITER
|
ENLARGEMENT OF THYROID GLAND
MAY BE DUE TO INCREASED TSH LEVELS, IODINE DEFICIENCY, ENVIRONMENTAL FACTORS, OR FOOD/MEDICATIONS S/S: THYROID GLAND ENLARGED - INTERFERENCE W/SWALLOWING OR BREATHING - S/S OF HYPO OR HYPERTHYROIDISM MAY BE PRESENT |
|
|
GOITROGENS
|
FOODS/MEDICATIONS THAT BLOCK BODY'S USE OF IODINE & RESULT IN GOITER
|
|
|
CANCER OF THE THYROID GLAND
|
POSSIBLE CAUSES INCLUDE THYROID HYPERPLASIA, RADIATION EXPOSURE, IODINE DEFICIENCY, & PROLONGED EXPOSURE TO GOITROGENS
S/S: HARD, PAINLESS NODULE ON THYROID GLAND DIFFICULTY BREATHING OR SWALLOWING - VOICE MAY CHANGE ** MANY PTS HAVE NORMAL TH LEVELS |
|
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HYPOPARATHYROIDISM
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DECREASED PTH ACTIVITY
MOST COMMON CAUSES ARE HEREDITY & ACCIDENTAL REMOVAL DURING THYROIDECTOMY S/S: HYPOCALCEMIA - NUMBNESS/TINGLING OF FINGERS - MUSCLE SPASMS/TWITCHING - +CHVOSTEK'S SIGN - +TROUSSEAU'S SIGN – LETHARGY |
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CHVOSTEK'S SIGN
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METHOD FOR ASSESSING PT FOR HYPOCALCEMIA
TAP ON PT'S FACIAL NERVE JUST IN FRONT OF EAR - SPASM OF FACE = + HYPOCALCEMIA |
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TROUSSEAU'S SIGN
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METHOD FOR ASSESSING PT FOR HYPOCALCEMIA
PLACE SPHYGMOMANOMETER ON PT'S ARM & PUMP TO ABOVE PT'S SYSTOLIC PRESSURE - SPASM OF THUMB & FINGERS OCCURS W/I 3 MIN IF PT HAS HYPOCALCEMIA |
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HYPERPARATHYROIDISM
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OVERACTIVITY OF ONE OR MORE PARATHYROID GLANDS CAUSING INCREASE IN PTH
USUALLY RESULT OF HYPERPLASIA, BENIGN TUMOR, HEREDITY, OR CANCER S/S: HYPERCALCEMIA - FATIGUE - DEPRESSION - CONFUSION - POLYURIA - ANOREXIA - N/V - PEPTIC ULCERS - JOINT PAIN - PATHOLOGICAL FRACTURES |
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ENDOCRINE SYSTEM
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CONSISTS OF DUCTLESS GLANDS WHICH SECRETE HORMONES
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NEGATIVE FEEDBACK MECHANISM
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EFFECTS OF HORMONE REVERSE THE STIMULUS WHICH ULTIMATELY LEADS TO DECREASED SECRETION OF THE HORMONE
MANY HORMONES REGULATED THIS WAY |
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ANTIDIURETIC HORMONE (ADH)
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INCREASES AMOUNT OF WATER REABSORBED BY KIDNEY TUBULES & DECREASES URINE OUTPUT
STORED IN POSTERIOR PITUITARY SECRETED DUE TO DEHYDRATION AND EXTREME FLUID LOSS |
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OXYTOCIN
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CAUSES CONTRACTION OF SMOOTH MUSCLE IN UTERUS & MAMMARY GLANDS
STORED IN POSTERIOR PITUITARY |
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ANTERIOR PITUITARY GLAND
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SECRETES: GROWTH HORMONE - TSH - ADRENOCORTICOTROPIC HORMONE - PROLACTIN - FOLLICLE-STIMULATING HORMONE - LUTEINIZING HORMONE
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POSTERIOR PITUITARY GLAND
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STORES ADH AND OXYTOCIN
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GROWTH HORMONE (GH)
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AKA SOMATOTROPIN
INCREASES CELL DIVISION IN TISSUES CAPABLE OF MITOSIS INCREASES TRANSPORT OF AMINO ACIDS INTO CELLS & THEIR USE IN PROTEIN SYNTHESIS INCREASES RELEASE OF FAT FROM ADIPOSE TISSUE & USE OF FATS FOR ENERGY PRODUCTION SECRETION IS REGULATED BY GHRH AND GHIH IN HYPOTHALAMUS |
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THYROID-STIMULATING HORMONE (TSH)
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AKA THYROTROPIN
STIMULATES GROWTH OF THYROID & SECRETION OF TWO OF ITS HORMONES (T4 & T3) SECRETION STIMULATED BY THYROTROPIN-RELEASING HORMONE (TRH) FROM HYPOTHALAMUS WHEN METABOLIC RATE DECREASES |
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ADRENOCORTICOTROPIC HORMONE (ACTH)
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STIMULATES SECRETION OF CORTISOL & RELATED HORMONES FROM ADRENAL CORTEX
STIMULATED BY CORTICOTROPIN-RELEASING HORMONE (CRH) FROM HYPOTHALAMUS WHICH IS PRODUCED DURING PHYSIOLOGICAL STRESS |
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WHAT ARE THE THREE HORMONES PRODUCED BY THE THYROID GLAND?
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T4
T3 CALCITONIN |
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PARATHYROID HORMONE (PTH)
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PRODUCED BY FOUR GLANDS LOCATED ON THE THYROID
INCREASES REABSORPTION OF CALCIUM & PHOSPHATE FROM BONES TO BLOOD RESULTING IN HIGHER BLOOD CALCIUM LEVEL & LOWER BLOOD PHOSPHATE LEVEL SECRETION OF PTH STIMULATED BY HYPOCALCEMIA & INHIBITED BY HYPERCALCEMIA |
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ADRENAL GLANDS
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AKA SUPRARENAL
LOCATED ON TOP OF EACH KIDNEY CONSISTS OF INNER ADRENAL MEDULLA & OUTER ADRENAL CORTEX |
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ADRENAL MEDULLA
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PART OF ADRENAL GLAND
SECRETE EPINEPHRINE & NOREPHINEPHRINE SECRETION STIMULATED BY SYMPATHETIC IMPULSES FROM HYPOTHALAMUS DURING STRESS |
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ADRENAL CORTEX
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PART OF ADRENAL GLAND
SECRETES THREE TYPES OF STEROID HORMONES: SEX HORMONES - MINERALOCORTICOIDS – GLUCOCORTICOIDS |
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ALDOSTERONE
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PRODUCED IN ADRENAL CORTEX
MOST ABUNDANT OF MINERALOCORTICOIDS INCREASES REABSORPTION OF SODIUM IONS & EXCRETION OF POTASSIUM IONS BY KIDNEY TUBULES |
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CORTISOL
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PRODUCED IN ADRENAL CORTEX
MOST ABUNDANT OF GLUCOCORTICOIDS STIMULATES LIVER TO CHANGE GLUCOSE TO GLYCOGEN - INCREASES CONVERSION OF EXCESS AMINO ACIDS TO CARBS - INCREASES USE OF FATS FOR ENERGY - HAS ANTI-INFLAMMATORY EFFECT BY BLOCKING HISTAMINE & STABILIZING LYSOSOMES IN CELLS STIMULUS FOR SECRETION IS ACTH FROM ANTERIOR PITUITARY GLAND (BROUGHT ON BY STRESS) |
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ISLETS OF LANGERHANDS
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PANCREATIC ISLETS
ENDOCRINE PORTIONS OF THE PANCREAS CONTAIN ALPHA CELLS (PRODUCE GLUCAGON) - BETA CELLS (PRODUCE INSULIN) - DELTA CELLS (SECRETE SOMATOSTATIN |
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GLUCAGONS
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PRODUCED BY ALPHA CELLS WITHIN ISLET OF LANGERHANS WITHIN PANCREAS
STIMULATES LIVER TO CHANGE GLYCOGEN TO GLUCOSE INCREASES USE OF FATS & EXCESS AMINO ACIDS FOR ENERGY PRODUCTION RESULT IS INCREASE IN BLOOD GLUCOSE LEVELSECRETION STIMULATED BY HYPOGLYCEMIA |
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HEPATITIS
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INFLAMMATION OF CELLS OF LIVER
USUALLY CAUSED BY VIRUS BUT MAY ALSO BE CAUSED BY DRUGS OR BACTERIA S/S: MALAISE - HEADACHE - ANOREXIA - FEVER - RUQ PAIN - FATIGUE - VOMITING – JAUNDICE |
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FULMINANT LIVER FAILURE
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AKA ACUTE LIVER FAILURE
UNCOMMON BUT SERIOUS COMPLICATION OF LIVER DISEASE UP TO 50% MORTALITY RATE S/S: CNS DYSFUNCTION - RAPID REDUCTION IN LIVER SIZE - MARKED ELEVATION IN PROTHROMBIN TIME |
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CIRRHOSIS
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CHRONIC DX OF LIVER ASSOCIATED W/FAT INFILTRATION & FIBROTIC TISSUE
S/S: MALAISE - ANOREXIA - DIARRHEA - RUQ PAIN - ICTERUS – JAUNDICE |
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HEPATORENAL SYNDROME
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COMPLICATION OF LIVER FAILURE
S/S: OLIGURIA W/O DETECTABLE KIDNEY DAMAGE - REDUCED GFR - URINE OUTPUT 200 ML OR LESS DAILY - NEARLY TOTAL SODIUM RETENTION |
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POSTNECROTIC LIVER FAILURE
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RESULTS FROM MASSIVE EXPOSURE TO HEPATOTOXINS OR VIRAL HEPATITIS
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BILIARY LIVER FAILURE
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CAUSED BY CHRONIC INFLAMMATION & OBSTRUCTION OF THE GALLBLADDER & BILE DUCTS
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CARDIAC LIVER FAILURE
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CAUSED BY CHRONIC SEVERE CONGESTION OF LIVER FROM HEART FAILURE
LIVER CONGESTION CAUSES DEATH OF LIVER CELLS FROM LACK OF NUTRIENTS & OXYGEN |
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ASCITES
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ACCUMULATION OF SEROUS FLUID IN ABDOMINAL CAVITY
ACCUMULATES PRIMARILY DUE TO LOW PRODUCTION OF ALBUMIN BY FAILING LIVER |
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PORTAL HYPERTENSION
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PERSISTENT BP ELEVATION IN PORTAL CIRCULATION OF ABD
MOST SERIOUS RESULT IS BLEEDING ESOPHAGEAL VARICES (DILATED VEINS) |
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HEPATIC ENCEPHALOPATHY
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CAUSED BY ACCUMULATION OF NOXIOUS SUBSTANCES IN CIRCULATION
FAILING LIVER UNABLE TO MAKE TOXIC SUBSTANCES WATER SOLUBLE FOR EXCRETION S/S: PROGRESSIVE CONFUSION - ASTERIXIS - FETOR HEPATICUS - FATIGUE - HANDWRITING CHANGES |
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ASTERIXIS
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FLAPPING TREMORS IN HANDS CAUSED BY TOXINS AT PERIPHERAL NERVES
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TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT (TIPS)
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SHUNT PLACED BETWEEN PORTAL AND SYSTEMIC VENOUS SYSTEMS
DIVERTS VENOUS BLOOD AROUND LIVER TO VENA CAVA |
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WHAT ARE THE MEDICAL GOALS FOR MANAGING BLEEDING FROM ESOPHAGEAL VARICES? (FOUR LISTED)
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1 STOP BLEEDING
2 TREAT FLUID VOLUME DEFICIT CAUSED BY BLEEDING 3 PREVENT FURTHER FLUID LOSS 4 MAINTAIN FLUID & ELECTROLYTE BALANCE |
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WHAT TYPES OF DRUGS ARE USED TO TREAT BLEEDING VARICES?
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VASOCONSTRICTORS
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LIST SOME DIETARY CONSIDERATIONS FOR A PT W/LIVER FAILURE.
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1 RESTRICT PROTEIN INTAKE
2 HOMOGENIZED MILK & EGGS RECOMMENDED 3 ADEQUATE CARB INTAKE NECESSARY 4 FLUID & SODIUM RESTRICTED IF ASCITES PRESENT |
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THE PT W/CHRONIC LIVER FAILURE IS AT RISK FOR 1_____ FROM BLEEDING ESOPHAGEAL VARICES, GASTROINTESTINAL BLEEDING, & LACK OF 2_____ _____ _____.
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1 HEMORRHAGE
2 BLOOD CLOTTING FACTORS |
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SIGNS OF POSSIBLE ORGAN TRANSPLANT REJECTION INCLUDE: (FIVE)
|
1 PULSE GREATER THAN 100 BPM
2 TEMP GREATER THAN 101F 3 C/O OF RUQ PAIN 4 INCREASED JAUNDICE 5 DECREASE IN BILE FROM T-TUBE OR CHANGE IN BILE COLOR |
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SYMPTOMS OF ACUTE TISSUE REJECTION USUALLY DEVELOP BETWEEN THE 1_____ AND 2_____ POSTOPERATIVE DAYS.
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1 FOURTH
2 TENTH |
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CANCER OF THE LIVER
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USUALLY RESULT OF METASTASIS FROM PRIMARY CANCER AT DISTANT LOCATION
INCREASED RISK FOR PTS W/HX OF CHRONIC HBV, NUTRITIONAL DEFICIENCIES, OR EXPOSURE TO HEPATOTOXINS S/S: ENCEPHALOPATHY - ABNORMAL BLEEDING - JAUNDICE - ASCITES - ELEVATED SERUM ALKALINE PHOSPHATASE |
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PANCREATITIS
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PANCREATITIS
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ACUTE PANCREATITIS
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CAUSED BY AUTODIGESTION
MOST COMMONLY ASSOCIATED W/EXCESSIVE ALCOHOL CONSUMPTION S/S: DULL ABD PAIN - RIGID ABD - HYPOTENSION - RESPIRATORY DISTRESS - FEVER - DRY MUCOUS MEMBRANES – TACHYCARDIA |
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CHRONIC PANCREATITIS
|
CHRONIC DX THAT REPLACES FUNCTIONING PANCREATIC TISSUE W/FIBROTIC TISSUE DUE TO INFLAMMATION
S/S: PATTERN OF REMISSIONS /EXACERBATIONS OVER YEARS - EPIGASTRIC OR LUQ PAIN - WEIGHT LOSS – ANOREXIA DRY, SCALY SKIN OR CHANGES IN SKIN PIGMENT MAY INDICATE A DEFICIENCY IN: |
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CANCER OF THE PANCREAS
|
SPREAD RAPIDLY BY DIRECT EXTENSION TO STOMACH, GALLBLADDER, & DUODENUM
ASSOCIATED W/HI-FAT DIETS, CIGARETTES, DIABETES, ALCOHOL, & CHRONIC PANCREATITIS S/S: WEIGHT LOSS - ABDOMINAL PAIN (WORSE AT NIGHT) - ANOREXIA - VOMITING - WEAKNESS - FEELING BLOATED AFTER EATING |
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PANCREATECTOMY
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SURGICAL REMOVAL OF ALL OR PART OF PANCREAS
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RELIEF OF BILIARY OBSTRUCTION CAN SOMETIMES BE ACCOMPLISHED BY IMPLANTING A _____ OR PLASTIC TUBE IN THE COMMON BILE DUCT.
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STENT
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CHOLECYSTITIS
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INFLAMMATION OF THE GALLBLADDER
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CHOLELITHIASIS
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GALLSTONES
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CHOLANGITIS
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INFLAMMATION OF THE BILE DUCTS
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CHOLEDOCHOLITHIASIS
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GALLSTONES IN THE COMMON BILE DUCT
S/S: SUDDEN BILIARY COLIC ONSET - LASTS 1 TO 3 HRS - FEVER - NAUSEA/VOMITING |
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MEDICAL MANAGEMENT FOR AN ACUTE EPISODE OF CHOLECYSTITIS CENTERS ON 1____ 1_____, PREVENTION OF 2_____, AND MAINTENANCE OF FLUID AND ELECTROLYTE BALANCE. THE ANALGESIC AGENT MOST OFTEN ORDERED IS MEPERIDINE HYDROCHLORIDE BECAUSE 3_____ _____ IS BELIEVED TO CAUSE SPASMS OF THEGALLBLADDER, BILIARY DUCTS, AND THE SPHINCTER OF ODDI.
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1 PAIN CONTROL
2 INFECTION 3 MORPHINE SULFATE |
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CHOLEDOCHOSCOPY
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USE OF ENDOSCOPE TO EXPLORE COMMON BILE DUCT & POSSIBLY REMOVE STONES FOUND
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EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY (ESWL)
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USE OF SHOCK WAVES AS A NONINVASIVE METHOD TO DESTROY STONES IN GALLBLADDER OR BILIARY DUCTS
USUALLY USED W/PTS CONSIDERED POOR SURGICAL CANDIDATES |
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THE PT W/ALTERED THOUGHT PROCESSES R/T LIVER FAILURE MOST LIKELY HAS WHICH OF THE FOLLOWING LABORATORY FINDINGS?
A. LOW BILIRUBIN B. LOW AMYLASE C. HIGH HEMATOCRIT D. HIGH AMMONIA |
D. HIGH AMMONIA
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JACK, A PT W/CHRONIC LIVER FAILURE, HAS AN EPISODE OF BLEEDING. WHICH OF THE FOLLOWING CONDITIONS PLACED JACK AT RISK FOR BLEEDING?
A. PORTAL HYPERTENSION B. LOW VITAMIN K C. ELEVATED LIVER ENZYMES D. HIGH-FIBER DIET |
B. LOW VITAMIN K
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MOST GALLSTONES ARE COMPOSED OF WHICH OF THE FOLLOWING?
A. LIPASE B. CHOLESTEROL C. SODIUM D. POTASSIUM |
B. CHOLESTEROL
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JOHN DEVELOPS JAUNDICE & DARK, AMBER-COLORED URINE. WHICH OF THE FOLLOWING IS THE MOST LIKELY CAUSE?
A. ENCEPHALOPATHY B. PANCREATITIS C. BILE DUCT OBSTRUCTION D. CHOLECYSTITIS |
C. BILE DUCT OBSTRUCTION
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JEFF IS A 26-YR-OLD HEALTH CARE WORKER WHO IS DIAGNOSED W/HCV. WHICH OF THE FOLLOWING QUESTIONS IS MOST IMPORTANT TO ASK JEFF?
A. "HAVE YOU EATEN ANY RAW SEAFOOD RECENTLY?" B. "HAVE YOU EXPERIENCED A NEEDLE STICK?" C. "HAVE YOU MADE BEDS OR HANDLED CLOTHING SUCH AS SLIPPERS W/O GLOVING?"D. HAS ANYONE COUGHED INTO YOUR FACE WHEN YOU WEREN'T WEARING A MASK?" |
B. "HAVE YOU EXPERIENCED A NEEDLE STICK?"
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JIM, AGE 43, IS ADMITTED TO YOUR UNIT W/CHRONIC PANCREATITIS. YOU RECOGNIZE THAT AN ELEVATION IN WHICH DIAGNOSTIC TEST INDICATES CHRONIC PANCREATITIS?
A. SERUM BILIRUBIN B. SERUM CALCIUM C. SERUM ALBUMIN D. SERUM AMYLASE |
D. SERUM AMYLASE
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IN PLANNING CARE FOR THE NEWLY ADMITTED PT W/ACUTE PANCREATITIS, YOU ASSIGN THE HIGHEST PRIORITY TO WHICH PT OUTCOME?
A. PT EXPRESSES SATISFACTION W/PAIN CONTROL B. PT VERBALIZES UNDERSTANDING OF MEDS FOR HOME C. PT INCREASES ACTIVITY TOLERANCE D. PT MAINTAINS NORMAL BOWEL FUNCTIONS |
A. PT EXPRESSES SATISFACTION W/PAIN CONTROL
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WHICH OF THE FOLLOWING IS A FUNCTION OF THE LIVER?
A. SYNTHESIS OF PLASMA PROTEINS B. ELIMINATION OF CARBOHYDRATES C. CONCENTRATION OF BILE D. SECRETION OF CHOLECYSTOKININ |
A. SYNTHESIS OF PLASMA PROTEINS
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WHICH FOOD IS MOST LIKELY TO STIMULATE THE RELEASE OF BILE?
A. GREEN BEANS B. FRENCH FRIES C. COFFEE D. POACHED EGG |
B. FRENCH FRIES
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THE ENZYMES OF THE PANCREAS ARE INVOLVED IN THE DIGESTION OF WHICH FOODS?
A. STARCH AND FAT B. STARCH, FAT, AND PROTEIN C. FAT AND PROTEIN D. STARCH AND PROTEIN |
B. STARCH, FAT, AND PROTEIN
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WHICH OF THE FOLLOWING COMPLICATIONS SHOULD THE NURSE MONITOR FOR AFTER A LIVER BIOPSY?
A. NAUSEA B. MUSCLE TWITCHING C. BLEEDING D. HYPOVENTILATION |
C. BLEEDING
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WHICH OF THE FOLLOWING NURSING MEASURES IS MOST IMPORTANT AFTER AN UPPER OR LOWER GI SERIES?
A. OFFER A LAXATIVE AS ORDERED B. PLACE PRESSURE ON THE PUNCTURE SITE C. CHECK FOR RETURN OF THE GAG REFLEX D. KEEP THE PATIENT IN THE SEMI-FOWLER'S POSITION |
A. OFFER A LAXATIVE AS ORDERED
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MR. SIKMILLER RETURNED AN HOUR AGO FROM AN EGD AND IS ASKING FOR A GLASS OF WATER. WHICH OF THE FOLLOWING RESPONSES IS BEST?
A. "I'M SORRY, BUT YOU WILL NEED TO WAIT 4 HOURS BEFORE DRINKING ANYTHING." B. "I CAN'T GIVE YOU ANY WATER; WOULD YOU LIKE SOME ICE CHIPS?" C. "I WILL BRING YOU SOME WATER AND A LAXATIVE." D. "LET ME CHECK YOUR GAG REFLEX FIRST TO MAKE SURE IT IS SAFE TO DRINK WATER." |
D. "LET ME CHECK YOUR GAG REFLEX FIRST TO MAKE SURE IT IS SAFE TO DRINK WATER."
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THE LIVER FILLS THE 1_____ AND CENTER OF THE UPPER ABDOMINAL CAVITY JUST BELOW THE 2_____. THE TWO MAIN LOBES OF THE LIVER ARE CALLED THE 3_____ AND 4_____ LOBES.
|
1 RIGHT
2 DIAPHRAGM 3 RIGHT 4 LEFT |
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|
THERE ARE THREE DIGESTIVE FUNCTIONS OF THE LIVER.
TRUE OR FALSE |
FALSE
THE ONLY DIGESTIVE FUNCTION OF THE LIVER IS THE PRODUCTION OF BILE BY THE HEPATOCYTES (LIVER CELLS). P 535 |
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BILE IS MOSTLY 1_____ AND HAS AN EXCRETORY FUNCTION IN THAT IT CARRIES 2_____ AND EXCESS 3_____ TO THE INTESTINES FOR ELIMINATION IN 4_____--.
|
1 WATER
2 BILIRUBIN 3 CHOLESTEROL 4 FECES |
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HOW DOES THE LIVER REGULATE BLOOD GLUCOSE LEVELS?
|
LIVER STORES EXCESS GLUCOSE AS GLYCOGEN -> BLOOD GLUCOSE LEVEL BECOMES LOW -> LIVER CHANGES GLYCOGEN BACK TO GLUCOSE
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OF THE 1_____ AMINO ACIDS NEEDED FOR THE PRODUCTION OF HUMAN 2_____, THE LIVER IS ABLE TO SYNTHESIZE 12, CALLED THE 3_____ AMINO ACIDS, BY THE PROCESS OF TRANSAMINATION. THE OTHER 4_____ AMINO ACIDS, WHICH THE LIVER CANNOT SYNTHESIZE, ARE CALLED THE 5_____ AMINO ACIDS. THESE AMINO ACIDS ARE REQUIRED IN THE DIET
|
1 TWENTY
2 PROTEINS 3 NONESSENTIAL 4 EIGHT 5 ESSENTIAL |
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THE FUNCTIONS OF THE LIVER INCLUDE:
(EIGHT POSSIBLE) |
1 CARBOHYDRATE METABOLISM
2 AMINO ACID METABOLISM 3 LIPID METABOLISM 4 SYNTHESIS OF PLASMA PROTEINS 5 PHAGOCYTOSIS BY KUPFFER CELLS 6 FORMATION OF BILIRUBIN 7 STORAGE 8 DETOXIFICATION |
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KUPFFER CELLS
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FIXED MACROPHAGES OF LIVER
PHAGOCYTIZE PATHOGENS CIRCULATING IN LIVER |
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THE FIXED MACROPHAGES OF THE LIVER PHAGOCYTIZE OLD WBCS & FORM BILIRUBIN FROM THE HEME PORTION OF THEIR HEMOGLOBIN.
TRUE OR FALSE |
FALSE
THE FIXED MACROPHAGES OF THE LIVER PHAGOCYTIZE OLD RED BLOOD CELLS & FORM BILIRUBIN FROM THE HEME PORTION OF THEIR HEMOGLOBIN. P 537 |
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THE LIVER STORES THE MINERALS IRON AND 1_____; THE FAT-SOLUBLE VITAMINS A, 2_____, E, AND 3_____; AND THE WATER-SOLUBLE VITAMIN 4_____.
|
1 COPPER
2 D 3 K 4 B12 |
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THE GALLBLADDER IS A 1_____ SAC ABOUT 3 TO 4 INCHES LONG LOCATED ON THE UNDERSURFACE OF THE LEFT LOBE OF THE 2_____. BILE IN THE 3_____ 3_____ FROM THE LIVER FLOWS THROUGH THE CYSTIC DUCT INTO THE GALLBLADDER, WHICH STORES BILE UNTIL IT IS NEEDED IN THE 4_____ 4_____.
|
1 MUSCULAR
2 LIVER 3 HEPATIC DUCT 4 SMALL INTESTINE |
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THE PANCREATIC ENZYME AMYLASE DIGESTS STARCH TO _____.
|
MALTOSE
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LIPASE (PANCREATIC ENZYME) CONVERTS _____ _____ TO FATTY ACIDS AND GLYCEROL.
|
EMULSIFIED FATS
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_____ DIGESTS POLYPEPTIDES TO SHORTER CHAINS OF AMINO ACIDS.
|
TRIPSIN
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ALANINE AMINOTRANSFERASE (ALT)
NORMAL RANGE: 5-35 IU/DL ------------------------------ AN INCREASE INDICATES . . . |
36 IU/DL OR HIGHER
POSSIBLE CHRONIC LIVER FAILURE OR HEPATITIS |
|
|
ASPARTATE AMINOTRANSFERASE (AST)
NORMAL RANGE: 8-20 UNITS/L ------------------------------ AN INCREASE INDICATES . . . |
21 UNITS/L OR HIGHER
POSSIBLE CHRONIC LIVER FAILURE, VIRAL HEPATITIS, OR ACUTE PANCREATITIS |
|
|
LACTIC DEHYDROGENASE (LDH)
NORMAL RANGE: 110-250 IU/L ------------------------------ AN INCREASE INDICATES . . . |
251 IU/L OR HIGHER
LIVER DISEASE POSSIBLE |
|
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IN PREPARATION FOR AN ORAL CHOLECYSTOGRAM (GALLBLADDER SERIES), THE PT IS ASKED TO EAT A 1_____ 1_____ DIET FOR 2 DAYS BEFORE THE TEST, THEN A 2_____ 2_____ DIET THE DAY 3_____ THE EXAMINATION
|
1 HIGH FAT
2 LOW FAT 3 BEFORE |
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HOW LONG SHOULD A PT REMAIN ON BEDREST FOLLOWING A PERCUTANEOUS LIVER BIOPSY?
A. 2 DAYS B. 36 HOURS C. 24 HOURS D. 12 HOURS |
C. 24 HOURS
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HYPERTHYROIDISM IS ALSO KNOW AS
|
GRAVES' DISEASE
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RATIONALE FOR USING PROPRANOLOL HYDROCHLORIDE (INDERAL) IN MANAGEMENT OF PATIENTS WITH CIRRHOSIS OF THE LIVER?
|
TO PREVENT BLEEDING FROM ESOPHAGEAL VARICES
|
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S/S MOST CHARACTERISTIC OF ACUTE PYELONEPHRITIS
|
FLANK PAIN
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A PATIENT WITH HYPOTHYROIDISM WHO IS TAKING HORMONE REPLACEMENT THERAPY MAY BE AT RISK FOR WHAT?
|
HYPERGLYCEMIA
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FOLLOWING A THYROIDECTOMY, IT IS MOST IMPORTANT TO ASK THE PATIENT WHAT QUESTION TO ASSESS FOR BLEEDING?
|
DO YOU HAVE A FEELING OF FULLNESS AT YOUR INCISION SITE?
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PRIORITY INTERVENTION FOR A PATIENT WITH HYPERTHYROIDISM WHO IS STARTED ON INDERAL?
|
MONITOR PULSE AND PULSE PRESSURE.
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PATIENT TAKING SYNTHROID FOR HYPOTHYROIDISM. HOW LONG TO ACHIEVE FULL EFFECT?
|
10 DAYS
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NURSING INTERVENTION TO IMPROVE NUTRITIONAL STATUS OF A PATIENT WITH GRAVES' DISEASE?
|
PROVIDE THE PATIENT WITH A QUIET ATMOSPHERE DURING MEALS.
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PHYSIOLOGICAL EFFECT T4?
|
INCREASED NEUROMUSCULAR RESPONSE
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FINDING EXPECTED IN PATIENT WITH HYPERPARATHYROIDISM?
|
FATIGUE
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WHAT CAUSES FATIGUE IN PATIENT WITH HYPERPARATHYROIDISM
|
CALCIUM IS CONCENTRATING IN BLOODSTREAM.
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PRIORITY INTERVENTION FOR A PATIENT WITH THYROID STORM AND A NURSING DIAGNOSIS OF ALTERED BODY TEMPERATURE?
|
APPLY HYPOTHERMIA BLANKET.
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WHAT IS THE CAUSE OF PHEOCHROMOCYTOMA?
|
CATECHOLAMINE PRODUCING TUMOR.
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OLDER PATIENTS WITH HYPERTHYROIDISM COMMONLY PRESENT WITH WHAT?
|
DIFFUSE PRURITUS.
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INTERVENTION MOST LIKELY TO ENHANCE COMFORT OF A PATIENT WITH HYPERTHYROIDISM?
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PROVIDE COOL ENVIRONMENT
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DECREASED ERYTHROPOETIN SECONDARY TO END-STAGE RENAL DISEASE (ESRD) CAUSES WHAT?
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SHORTNESS OF BREATH
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PATIENT WITH ADRENAL INSUFFICIENCY IS DIZZY AND EXPERIENCING NEUROMUSCULAR IRRITABILITY AND CONFUSUSION. WHAT LABORATORY FINDING WOULD YOU EXPECT?
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HYPONATREMIA
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WHAT CLINICAL MANIFESTATION WOULD YOU EXPECT IN PATIENT WITH GRAVES' DISEASE?
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NERVOUSNESS
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WHAT TYPE OF PATIENT IS AT RISK FOR GALLSTONES?
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OBESE
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PATIENT WITH CIRRHOSIS OF THE LIVER AT END STAGE SHOULD BE MONITORED FOR WHAT?
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ASCITIES
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WHAT LAB VALUE IS ELEVATED IN THE END STAGE OF CIRRHOSIS OF THE LIVER?
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AMONIA
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PRIMARY NURSING DIAGNOSIS FOR PATIENT WITH ANOREXIA?
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ALTERED NUTRITION: LESS THAN BODY REQUIREMENTS
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DIAPHORESIS, TACHYCARDIA, AND HYPOTENTION ARE CLINCIAL SIGNS OF WHAT?
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HYPOGLYCEMIA
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CLINCIAL MANIFESTION OF CUSHING'S SYNROME?
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EDEMA (KIDNEY PROBLEMS)
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FOOD RESTRICTIONS WHILE ON MAO INHIBITORS?
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MSG (MONOSODIUM GLUTAMATE)
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AFTER THYROIDECTOMY, MONITOR FOR?
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HYPOGLYCEMIA
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MOST IMPORTANT NURINSG INTERVENTION OF PATIENT WITH ACUTE PANCREATITIS?
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MAINTAIN FLUID AND ELECTROYTE BALANCE
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PRIMARY NURSING ACTIONS FOR PATIENT WITH ANOREXIA?
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GIVE SUPPORT AT MEALTIME AND RECORD AMOUNT EATEN.
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PATIENT WITH ACUTE RENAL FAILURE. POSSIBLE CLINICAL MANIFESTION IS:
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METABOLIC ACIDOSIS
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ERICKSON PSYCHOSOCIAL DEVELOPMENTAL STAGE FOR A 10 YEAR OLD?
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INDUSTRY VS. INFERIORITY
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SIGNS FOUND IN PATIENT WITH HEPATITS A?
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DARK URINE, CLAY-COLORED STOOLS, YELLOW SKIN
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WHAT SHOULD BE RESTRICTED BEFORE A 24-HOUR VMA URINE TEST COLLECTION?
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COFFEE, TEA, COLA (CAFFEINE)
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DIET FOR PATIENT WITH GLOMERULONEPHRITIS?
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LOW PROTEIN
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WHAT IS THE BEST WAY FOR THE NURSE TO DEAL WITH A DEPRESSED PATIENT?
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TO INITIATE COMMUNICATION.
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WHAT IS THE CAUSE WHEN THE BODY CAN'T ABSORB FAT AND VITAMIN K?
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BILE DUCT OBSTRUCTION
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PRIMARY NURSING ACTION IN PATIENT WITH BIPOLAR DISORDER?
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TO PREVENT INJURY
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PATIENT HAS INTRAPERITONEAL SHUNT. WHAT ASSESSMENT FINDING SHOULD THE NURSE REPORT?
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INCREASED ABDOMINAL GIRTH
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A MAN IS DIAGNOSED WITH HAVING PARANOID DELUSIONS. ACCORDING TO ERIKSON, THIS MAN FAILED WHAT DEVELOPMENTAL TASK?
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TRUST VS MISTRUST
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A SYMPTOM OF AUTISM CHILDHOOD ONSET (2 YEARS OLD) IS:
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UNABLE TO FOCUS DUE TO IMPULSIVENESS AND INATTENTION
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THE BLOOD LEVEL IN HYPOPARATHYROIDISM WILL SHOW WHAT?
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DECREASE IN CALCIUM
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WHAT CLINICAL SIGN DO YOU EXPECT TO SEE IN A PATIENT WHO HAS A HIGH LEVEL OF VASOPRESSIN?
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EDEMA
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NON-PHARMACOLOGICAL PAIN MANAGEMENT FOR SICKLE CELL CRISIS
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APPLY LOCAL HEAT TO THE JOIN AND ANTICIPATE PAIN.
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WHAT DRUG IS USED TO DRY SECRETIONS BEFORE SURGERY
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ATROPINE SULFATE
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LAB TEST GIVING THE MOST SPECIFIC INDICATION OF KIDNEY DISEASE?
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SERUM CREATININE
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WHY WOULD A PATIENT'S PROLIXIN BE DISCONTINUED?
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IF SERUM CREATININE AND/OR IS ABNORMAL AND WBC ARE DEPRESSED
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WHAT S/S WILL BE EVIDENT IN THE OLIGURIC PHASE OF RENAL FAILURE?
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HYPERNATREMIA
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WHAT LAB TESTS SHOULD BE DRAWN FOR A PATIENT ABOUT TO START LITHIUM THERAPY?
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BEST ANSWER IS LIVER FUNCTION TEST; ALSO, CARDIAC ENZYMES
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ABRUPT WITHDRAWAL OF STEROID TREATMENT CAUSES WHAT?
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ADDISON'S DISEASE
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IMPROVEMENT IS INDICATED IN PATIENT WITH GLOMERULONEPHRITIS WHEN THERE IS A DECREASED IN WHAT?
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ESR
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WHAT MED IS GIVEN TO PATIENT WITH ADDISON'S DISEASE
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IV CORTISOL
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WHY IS IV CORTISOL GIVEN TO PATIENT WITH ADDISON'S DISEASE?
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FOR PROFOUND HYPOTENSION
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WHAT HORMONE IS DEFICIENT IN PATIENT WITH DIABETES INSIPIDUS
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ANTIDIURETIC HORMONE (ADH)
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WHY WOULD TINGLING OF THE FINGERS AND EXTREMITIES BE REPORTED AFTER A THYROIDECTOMY
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DAMAGE TO THE PARATHYROID GLAND
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EXPECTED OUTCOME OF KAYEXALATE THERAPY
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DECREASED POTASSIUM LEVEL
TEST TIP: DO NOT SELECT HYPOKALEMIA |
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WHAT IS THE MEDICAL DIAGNOSIS FOR A PATIENT WITH PROTEIN ABSORPTION PROBLEMS?
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LIVER DISORDER
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ACUTE PANCREATITIS LAB VALUES WOULD INDICATE WHAT?
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INCREASED GLUCOSE AND LIPIDS AND DECREASED CALCIUM AND POTASSIUM
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NURSING ACTION FOR PATIENT BEFORE PARACENTESIS
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LET PATIENT VOID FIRST
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SIGN OF TRANSPLANT REJECTION?
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HYPERTENSION
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WHY USE LUGOL'S SOLUTION BEFORE A THYROIDECTOMY?
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TO DEVASCULARIZE THE GLAND
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POST-OP CONDITION AT RISK FOR AFTER REMOVAL OF GALLBLADDER?
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ATELECTASIS
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WHAT IS THE CHEMICAL PROCESS THAT OCCURS TO CAUSE KETONES TO APPEAR IN URINE?
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FAT DESTRUCTION
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A FIXED FALSE BELIEF
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A DELUSION
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THE TREATMENT FOR PHOBIA IS CALLED?
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DESENSITIZATION
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S/S OF ACUTE PANCREATITIS
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CONSTANT EPIGASTRIC ABDOMINAL PAIN RADIATING TO THE BACK AND FLANK WHICH IS MORE INTENSE IN SUPINE POSITION
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COMPLICATION OF RENAL DIALYSIS
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DESTRUCTION OF RBC'S
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WHAT IS THE SIGN OF OBSTRUCTIV JAUNDICE?
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EXCESSIVE ITCHING OF THE SKIN
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MUSCLE WEAKNESS, FLACCID PARALYSIS, BRADYCARDIA, OLIGURIA, AND MUSCLE CRAMPS ARE S/S OF WHAT ELECTROLYTE IMBALANCE?
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HYPOKALEMIA
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MUSCLE WEAKNESS, HYPOTENSION, SHALLOW RESPIRATIONS, APATHY, AND ANOREXIA ARE S/S OF WHAT ELECTROLYTE IMBALANCE?
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HYPERKCLEMIA
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WHAT S/S SHOULD A PATIENT ON SYNTHROID THERAPY REPORT
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TACHYCARDIA
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DIET RECOMMENDED FOR ACUTE RENAL FAILURE PATIENT?
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LOW-PROTEIN DIET WITH ESSENTIAL AMINO ACIDS AND VITAMINS
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A NURSE CAN EXPECT TO SEE WHAT IN A CHILD WITH NEPHROTIC SYNDROM?
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WEIGHT GAIN AND EDEMA
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WHY IS THE URINE SPECIFIC GRAVITY LOW IN PATIENT WITH DIABETES INSIPIDUS?
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THE HYPOTHALAMUS DOESN'T PRODUCE ENOUGH ADH OR VASOPRESSIN FOR THE KIDNEYS TO RESPOND TO ADH
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POSSIBLE PRE-RENAL CAUSES OF ACUTE RENAL FAILURE?
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CONDITIONS THAT DECREASE BLOOD FLOW SUCH AS HYPOVOLEMIA, SHOCK, BURNS AND DIURETIC THERAPY
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BEST CANDIDATE FOR SHORT-TERM DYNAMIC PSYCHOTHERAPY?
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PATIENT WITH POST-TRAUMATIC STRESS DISORDER
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WHAT S/S WOULD THE NURSE EXPECT TO FIND IN A PATIENT WITH NEUROLEPTIC MALIGNANT SYNDROME?
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HIGH FEVER AND MUSCLE RIGIDITY
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WHICH IS MOST IMPORTANT TO CONSIDER IN DEVELOPING A PLAN OF CARE FOR A PERSON EXPERIENCING UNRESOLVED ANGER?
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WHEN ANGER IS TURNED INWARDS, IT CAN BECOME DEPRESSION
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A CHILD WHO HAS AN AUTISTIC DISORDER IS LIKELY TO DISPLAY SYMPTOMS BY WHAT AGE?
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4 MONTHS
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WHICH S/S IS ASSOCIATE WITH POST-TRAUMATIC STRESS DISORDER?
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PERSISTANT FEELINGS OF DETACHMENT FROM OTHERS
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A STANDARD ANTIPSYCHOTIC MED SUCH AS HALDOL IS MOST EFFECTIVE IN MODIFYING WHICH SYMPTOM OF SCHIZOPHRENIA?
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DELUSIONS OF PERSECUTION
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A PATIENT PRESENTS WITH A HISTORY OF UNEXPLAINED PAIN IN 6 DIFFERENT BODY AREAS. ALL TESTS ARE NEGATIVE. THIS IS CALLED WHAT?
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SOMATIZATION DISORDER
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AN 18 MONTH-OLD EXHIBITS PREOCCUPATION WITH OBJECTS, SELF-STIMULATING BEHAVIORS, AND ABSENSE OF ATTACHMENT. THESE ARE S/S OF WHAT?
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AUTISM
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ACCORDING TO KOHLBERG'S THEORY OF MORAL DEVELOPMENT, WHAT BEHAVIOR IS MOST DESCRIPTIVE OF A CHILD WHO HAS ACHIEVED INTERNALIZATION?
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THE CHILD INCORPORATES SELF-GENERATED STANDARDS INTO HIS/HER PERSONALITY.
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WHICH LAB TEST SHOULD THE NURSE MONITOR DURING TREATMENT OF DIABETIC KETOACIDOSIS TO AVOID SERIOUS COMPLICATONS OF RAPID FLUID INFUSION/
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SERUM POTASSIUM
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APPROXIMATELY WHAT PERCENTAGE OF A DIET FOR A PATIENT WITH DIABETES MELLITUS SHOULD BE CARBS?
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50-60%
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WHICH TEST PROVIDES THE MOST IMPORTANT INFORMATION WHEN DIAGNOSISNG CHRONIC PANCREATITIS?
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ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)
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NARCOTIC ANALGESIC CONTRAINDICATED FOR PANCREATITIS?
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MORPHINE
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WHAT IS A PLAN OF CARE FOR A PT W/A DX OF GRAVE'S DISEASE?
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CALM, COOL RESTFULL ENVIRONMENT
*AVOID HIGH FIBER FOODS |
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WHAT DISEASE IS CHARACTERIZED BY AN OVERSECRETION OF GLUCOCORTICOID HORMONES?
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CUSHING'S DISEASE
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OF THE FOLLOWING NURSING DIAGNOSIS FOR A PT. WITH A DX OF MYXEDEMA, WHICH IS MOST APPROPRIATE?
ALTERED NUTRITION, MORE THAN BODY REQUIREMENTS ALTERED NUTRITION, LESS THAN BODY REQUIREMENTS RISK FOR HYPERTHERMIA FLUID VOL. EXCESS |
ALTERED NUTRITION, MORE THAN BODY REQUIREMENTS
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WHAT KIND OF DIET SHOULD A PT WITH NEPHROTIC SYNDROME BE ENCOURAGED TO EAT?
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HIGH PROTEIN
*TO REPLACE THE PROTEIN LOST THROUGH THE KIDNEYS AND TO CORRECT HYPOALBUMINEMIA |
