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76 Cards in this Set

  • Front
  • Back
A degenerative brain disorder caused by a deficiency of thiamine (vitamin B1) from chronic alcohol abuse, vomitting, eating disorder, or chemo. S/S confusion, vision impairment, ataxia, unsteady walking, loss of memory. Late stage may result in coma, stupor, or death.
Loss of muscle coordination
Librium (chlordiazepoxide)
Antianxiety Agent - used to prevent withdrawal
Antabuse (disulfiram)
Makes drinking painful
ReVia (naltrexone)
Decreases drinking pleasure
Campral (acamprosate)
Restores chemical balance in brain
Anorexia Nervosa
*weight loss through restriction of food
*purging behaviors
*reject mature appearing body
*perfectionist behavior
Bulimia Nervosa
*eating binges w/ diet/purging
*impulsive/chaotic behavior
*outgoing, sensitive to others
*Issue: control self/enviorn thru eating
*drive for thinness
False perception of something that is not real
Incorrect interpretation of external stimuli
Absence or impairment of the ability to communicate through speech, writing, or signs because of brain dysfunction.
Inability to recognize or comprehend sights, sounds, words, or other sensory information
Confusion or disorientation that increases in the afternoon or evening.
Trusting Relationship between nurse and patient involves
respect, honesty, consistency, faith and caring
Pregnancy needs
Add: 300 mg calories
15 mg iron
30 g protein
400 g calcium
200 mcg folic acid (0.2 mg)
Lactation: add 500 calories
Negative Nitrogen balance occurs with
infection, burns, fever, starvation, and injury
Fat soluble Vitamins
A,D,E,K, - can be stored in body but is not excreted in excess, risk of toxicity
Low levels of salt < 125 =
mental confusion, hostility, hallucinations
High levels of salt >135 =
HTN, edema, aka. anasarca
Hypocalcemia caused by
rickets, Vit D deficiency, renal failure, pancreatitis, hypoparathyroidism

S/S muscle tingling, twitching, tetany
Hypercalcemia caused by
hyperparathyroidism, metatasis of cancer, Paget's disease of bone, prolonged immobilization

S/S weakness, paralysis, decreased deep tendon reflexes
Hypermagnesium caused by
chronic renal disease, overuse of antacids, Addison's disease, uncontrolled DM

S/S lethargy, N/V, slurred speech, muscle weakness, paralysis, decreased deep tendon reflexes, slowinf of cardiac conduction
Hypomagnesium caused by
malnutrition, toxemia in pregnancy, malabsorption, alcoholism, diabetic acidosis

S/S mood irritability, muscle tingling/twitching/tetany, delirium, convuslions
Magnesium Norms
1.5 to 2.5 mEq/L
Calcium Norms
8.5 to 10.5 mEq/L
Potassium Norms
3.5 to 5 mEq/L
Sodium Norms
135-145 mEq/L
Phosphate Norms
2.8 to 4.5 mg/dL
Chloride Norms
95 to 105 mEq/L
When calcium is high
Phosphorus is low
When calcium is low
Phosphorus is high
Pancreas produces Insulin
which aids the transport of glucose (broken down carbs) into cells and provides the energy one needs
Four Point Crutch Walking

(able to bear some weight on each leg)
move right crutch then left foot, move left crutch then right crutch
Three Point Crutch Walking

(non-weight bearing)
move both crutches with affected leg forward then move unaffected leg forward
Cane held on
stronger side with client moving cane at same time as weaker leg
Gout calls for a
Low-Purine Diet (no gland meats, gravies, fowl, or fish; low meat) because purines are turned into uric acid, which activates gout.
In diabetes, the proportions should
5:2:1 carbohydrate:fat:protein.
Immobilized clients risk
pneumonia, atelectasis, loss of muscle tone and joint mobility, and decubitus (pressure) ulcers.
Bruxism is
grinding of the teeth.
Signs of hearing loss include
silence, indifference, suspicion and social withdrawal, as well as unclear speech and a tendency to dominate the conversations that the person does join.
Clients with stroke that immobilizes one side should be approached from
"good" side, encouraged to turn toward the "blind" side to compensate for the loss in visual field. In addition, the nurse should make eye contact, speak clearly and simply, announce the subject of discussion, repeat instructions, and keep all objects stably placed, familiar, and visible to the client.
The seven major minerals
calcium, magnesium, sodium, potassium, phosphorus, sulfur, and chlorine. Iron is a trace mineral, along with copper, iodine, manganese, cobalt, zinc, and molybdenum.
A nurse should have knowledge to monitor blood pressure in clients who receive antipsychotic medications for what reason?
orthostatic hypotension is a common side effect
Clients should be made aware of the possibility of dizziness and syncope from postural hypotension for about
an hour or two after ingestion of this type of medication.
A client who is receiving a blood transfusion reports generalized raised red itchy bumps 30 minutes after the transfusion has begun. The first action the nurse should take is which intervention?
stop the infusion and notify the registered nurse (RN) immediately
A nurse should caution clients about which common side effects of nonsteroidal anti-inflammatory medications?
occult bleeding
A client has received two units of whole blood today after an episode of gastrointestinal (GI) bleeding. Which
laboratory report should a nurse monitor most frequently?
hemoglobin and hematocrit

The post-transfusion hematocrit provides immediate information about red cell replacement and about continued blood loss. Commonly it is ordered at one hour after an infusion of blood is complete. If the serumlevels continue to drop, the thought is that bleeding has continued to be active.
A client is being maintained on heparin therapy. A nurse must closely monitor which laboratory value?
activated PTT
Which statement by the client diagnosed with type 1 diabetes mellitus is incorrect and indicates a need for further
reinforcement of information?
"I always make sure to shake the NPH bottle hard to mix it well."

The bottle should by rolled gently, not shaken. Shaking the bottle results in small air bubbles, which may end in errors of measurement for the insulin dosage.
A home health nurse received a call about an older adult client who had a sudden onset of confusion. The nurse should immediately check the client’s medications for which of these classifications?

Many antihistamines often cause sudden confusion in older adults. Other common medication groups that may result in sudden confusion in this group are anticholinergics, benzodiazepines, NSAIDs, histamine 2 blockers (especially Tagamet) and antihypertensives.
While providing home care to a client with heart failure, a nurse is asked how long diuretics must be taken. What is the best response by the nurse to this client?
"The medication must be continued so the fluid problem is controlled."
A client is admitted to the hospital with a diagnosis of liver failure with ascites. A health care provider orders spironolactone (Aldactone). A nurse should care for the client based on knowldge that this medication has what effect?
promotes sodium and chloride excretion

Spironolactone promotes sodium and chloride excretion while sparing potassium and decreasing aldosterone levels. This medication assists to decrease the fluid accumulation in the abdomen, ascites.
A client diagnosed with anemia has a new prescription for ferrous sulfate. In helping to develop a teaching plan for
the client about
tomato juice

Ascorbic acid as in citrus juice enhances absorption of iron. Tea and coffee are to be avoided since they decrease iron absorption if the iron is taken at the same time they are ingested.
A nurse has reinforced discharge instructions to the parents of a child on phenytoin (Dilantin). Which statement by a
parent suggests that the teaching was effective?
Our child should brush and floss carefully after every meal."

Phenytoin causes lymphoid hyperplasia that is most noticeable in the gums (as an overgrowth of the gums).
Frequent gum massage and careful attention to good oral hygiene may reduce the gingival hyperplasia. More frequent dental check-ups may be required.
A nurse is reinforcing information about the application of a pediculicide to parents for their child's head lice. Which
of these instructions indicate proper application? Apply the shampoo
to the head, may repeat in one week and no sooner

Treatment of head lice consists of applying the shampoo to the head only and repeating the treatment in oneweek if nits are still present. If the shampoo is left on longer than directed there is a risk of neurological deterioration. In addition to the shampooing of the head, the hair will need to be combed with a specal nit comb to get the eggs off of the hair shafts.
A nurse is assigned to a client with clinical depression who is receiving an MAO inhibitor. During reinforcement of instructions about precautions with this medication, the nurse should remind the client to avoid which actions?
ingestion of chocolate and cheese

Foods high in tryptophan, tyramine and caffeine, such as chocolate and cheese may precipitate a
hypertensive crisis. They also need to avoid aged meats and foods such as anchovies. The two types of cheeses these clients can eat are cream cheese and cottage cheese, which are not aged cheeses.
A client is started on atenolol (Tenormin). A nurse should emphasize to the client to immediately report which
slow, bounding pulse

Atenolol (Tenormin) is a beta-blocker that can cause side effects including bradycardia and hypotension. A tip to recognize this group of medication is that they end in “lol.” They are also give cautiously in clients diagnosed with asthma since they may stimulate bronchospasm as a side effect.
A nurse is discussing the precautions necessary while on Coumadin therapy with a client. The nurse should remind
the client to avoid which over-the-counter (OTC) medication?
non-steroidal anti-inflammatory medications

Medications with NSAIDS such as ibuprophen (Motrin) may increase the response to warfarin (Coumadin)
with an increased risk for bleeding.
When reinforcing discharge instructions to a client who takes alprazolam (Xanax), a nurse should include which piece of information?
sudden cessation of alprazolam (Xanax) can cause rebound insomnia and nightmares

Sudden cessation of alprazolam can cause rebound insomnia and nightmares. Other withdrawl findings are:
nervousness, irritability, sweating, light-headedness, abdominal and muscle cramps, tremors and seizures.
Medications in this antianxiety or benzodiazepine classification require to decrease the dose or wean off instead of stopping abruptly.
Which over-the-counter (OTC) medication should a nurse recognize as having the most elemental calcium per tablet?
calcium carbonate

Calcium carbonate contains 400mg of elemental calcium in 1 gram of calcium carbonate. Thus, this is the
recommended type for persons who need calcium replacement.
loss or impairment of the power to use or comprehend words usually resulting from brain
the presence of pus in the urine
repetitive, brief, jerky, rapid involuntary movements that start in one part of the body and move abruptly, unpredictably, and often continuously to another part.
Clues suggesting "silent" MI (acute or sudden)
-heart failure, change in mental status, unexplained abdominal pain, dyspnea, fatigue

-women may experience fatigue and/or GI symptoms
Angina appears with
nausea, vomiting, fainting, sweating, and cool extremities
Cytotec (G: Misoprostol)
used to prevent stomach ulcers while you take NSAIDs and complications of bleeding associated with ulcers
an examination of the inside of the bladder and urethra
used to help treat alcoholism

**Drinking alcohol while on this medication can cause serious effects that can last from 30 minutes to several hours. It produces an unpleasant reaction of flushing, headache, nausea, vomiting, dizziness, sweating, pounding heart (palpitations), blurred vision or weakness
Tagamet (Cimetidine) Histamine H2 antagonist
stimulates stomach cells to produce acid (tx: GERD, ulcers, etc)
Carafate (sucralfate)
used for the treatment of peptic ulcer disease and to prevent recurrent ulcers after healing of the ulcer has been achieved.
*Taken on empty stomach and one-two hours before other meds
DDVAP (desmopressin)
nasal spray used to treat diabetes insipidus or in surgery, injury, or other conditions where reduced urination is necessary
Pregnancy Induced Hypertension
is a rare tumor of the adrenal gland that causes too
much release of epinephrine and norepinephrine
Zyprexa (G:olanzapine)
a drug that is licensed to treat schizophrenia and bipolar disorder
Use of crutches with one affected leg
UP: Move Good leg , bad leg, crutches

DOWN: crutches, bad leg, good leg
Patients with spinal cord injury should avoid
caffeine to prevent bladder spasms an incontinence