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54 Cards in this Set

  • Front
  • Back
Recognize behaviors than increase and decrease a person’s risk for developing cancer.
Eliminate tobacco, alcohol beverages
Reduce fats
Increase fiber in diet
Use sun protection
Woman have Mammograms
Men have Digital Rectal Prostate exam.
Fecal Occult Blood test
Woman have a Pap test
Self examine for abnormal lumps and skin lesions
Recognize laboratory data that would indicate canceling the treatment of a client who is receiving clyclophosphamide (Cytoxan) (a chemo drug) (Know normal white cell count, platelet count and normal hemoglobin).
Normal white blood cell count (WBC)is 4,300-10,800.
Normal platelet count is 150,000 to 450,000.
Normal hemoglobin is 12-18
Normal BUN ( Blood Urea Nitrogenis ) 10-20. or 7-20
Recognize the best way to prevent or decrease chemo-induced nausea and vomiting
Administer antiemetics 30 to 45 minutes prior to antineoplastic administration or at the first sign of nausea.
What is the most dangerous adverse effect of most chemotherapy agents?
Bone marrow suppression, anemia
What are the clinical symptoms closely associated with a duodenal ulcer?
The characteristic symptom of duodenal ulcer is a gnawing or burning , upper abdominal pain that occurs 1 to 3 hours after meal. the pain disappears upon ingestion of food, and nighttime pain, nausea, and vomiting are uncommon. If erosion progresses deeper into the mucosa, bleeding occurs and may be evident as either bright red blood in vomit or black, tarry stools
What are important discharge teaching points related to risk factors associated with peptic ulcer disease?
Explain need for lifestyle changes. Smoking and certain foods increase gastric acid secretion.
What should the client being treated for peptic ulcer disease with H2 receptor antagonists be aware of in terms of immediately notifying the healthcare provider?
If using OTC formulations, patients should be advised to seek medical attention if symptoms persist or reoccur.
Why is combination therapy necessary in the treatment of peptic ulcer disease?
To increase the effectiveness of drug therapy, and lower the potential for bacterial resistance
Recognize important instructions for the client who experiences frequent constipation.
Tell the patient to increase insoluble dietary fiber and fluid intake or take a medi-cation regimen that includes drugs that reduces intestinal motility. Lifestyle modifications that incorporate positive dietary changes and physical activity should be considered before drugs are utilized. Avoid alcohol beverages, products with a high content of refined white flour, dairy products, and chocolate.
With the pt. receiving orlistat (Xenical) what adverse effect can be used to monitor compliance with therapy?
Xenical blocks the lipid absorption in the GI tract. Unfortunately orlistat may also decrease absorption of other substances, including fat soluble vitamins and war-farin (coumadin). Severe GI effects such as flatus with discharge, oily stool, abdominal pain, and discomfort.
Recognize all medication/treatments that could be used as part of a “bowel prep” for clients going for bowel surgeries?
Bulk- forming agents Stool softeners or surfactants Stimulants irritate the bowels to increase peristalsis Saline or osmotic laxatives Miscellaneous agents include mineral oil Drugs, in conjunction with enemas ( The injection of liquid into the rectum through the anus for cleansing, for stimulating evacuation of the bowels, or for other therapeutic or diagnostic purposes) are often given to cleanse the bowel prior diagnostic or surgical procedures of the colon or genitourinary tract.
Cathartics are usually the drug of choice preceding diagnostic procedures of the colon, such as colonoscopy or barium enema. “stimulant laxatives, osmotic laxatives and enemas.
What is important knowledge for the client placed on iron therapy (ferrous sulfate) to know related to changes in his/her stool?
Patient should be advised that iron preparations may darken stools, but this is harmless side effect.
The nurse should inform the patient that these effects will diminish over time, and that iron will turn stools a harmless dark green or black color, and that constipation is also a side effect.
Recognize clients at highest risk for developing vitamin deficiencies.
Infancy and childhood are at times of potential deficiency due to the high growth demands placed on the body.
Also during lactation and pregnancy.
Patients having a low or unbalanced diatery itake, those who are pregnant, or those experiencing a chronic disease may benefit from a vitamin therapy.
What clinical conditions (vitamin deficiency diseases) are most likely associated with a client who has a history of alcoholism?
Alcohol abuse is the most common cause of thiamine deficiency in the US.
Alcohol is known for its ability to inhibit the absorption of thiamine and folic acid.
What are expected consequences of being treated with radioactive iodine (Iodine-131) therapy for a thyroid disorder?
Iodide 131 is a radioisotope used to destroy overactive thyroid glands by emiting ionizing radiation. Shortly after oral administration, I-131 accumulates in the thy-roid gland, where it destroys follicular cells. The nurse should instruct the patient in signs and symptoms of hypothyroidism because many patients treated with this medication will need “thyroid hormone replacement therapy”. Patient should not be in close contact with children or pregnant women for 1 week following administration of the drug, because the patient will be emiting small amounts of radiation.Physical distance should be increased for a few days to limit the possibility of exposing others to radiation.
What types of foods should be limited in a client diagnosed with hyperthyroidism?
....Avoid foods that are high in saturated fat, such as fatty cuts of beef, bacon, processed meats such as salami, and full-fat cheese. Eat plenty of...
...Avoid refined carbohydrates such as white bread, cake, candy, white rice, and other processed foods that are high in sugar and often high in fat as...

Caffeinated drinks and dairy products should be avoided.
What are some adverse effects of glucocorticoid therapy?
Cushing syndrome, insmnia, anxiety, headache, vertigo, confusion and depres-sion. cardiovascular effects my include hypertension and tachycardia. Long term may result in peptic ulcer disease.

Suppression of the normal function of the adrenal gland (adrenal insufficiency) hyperglycemia, mood changes cataracts, peptic ulcers, electrolyte imbalances, and osteoporosis.
What are important teaching points for the client on glucocorticoid therapy related to increases in the blood sugar?
Blood glucose should be monitored frequently because these drugs increase blood sugar. (Glucocorticoids cause an increase in gluconeogenesis and reduce glucose utilization.)
What is the immediate treatment for the diabetic client in the hospital who is unresponsive?
When in doubt treat for Hypoglysemia, emergency treatment will typically consist of administration of sugar in the form of IV dextrose solution. Continuous IV infusions may be required. Glucagon may be given by injection if IV access is difficult to obtain or if hypoglycemia continues despite dextrose treatment In severe, unresponsive cases, insulin may also be necessary for type 2 diabetics or it may be required temporarily during times of stress such as illness or loss.
What is important regarding the storage of insulin?
Keep insulin vials that are currently in use at room temperature, as it is less irritating to the skin. When not needed, refrigerate insulin to keep it stable.
What should a nurse do when a diabetic pt. who takes oral anti-diabetic medication is ordered to be NPO before a diagnostic test.
Call the doctor and verify the order.
Describe the pathophysiology of type 2 diabetes (what happens at the cellular level over time?).
Patients are capable of segregating insulin, although in relatively deficient amounts, insulin receptors in the target tissues have become insensitive or resistant to the hormone. Thus, a small amount of insulin secreted does not bind to its receptor as efficiently, and less effect is achieved.
Tell a client why he cannot take insulin by mouth.
Insulin is a protein and if taken by mouth,it will be destroyed it would be digested in the body.
Why are opioids not used for treating acute pancreatitis?
May cause severe breathing depression.
What symptoms would cause you to stop the infusion of oxytocin (Pitocin) to induce labor?
Increased blood pressure would cause “headache”.
What advice would you give a client who has missed taking several doses of her oral contraceptives?
Extra protection, such condom or spermicide should be used, begin using on the next cycle
What would you tell a pre-menopausal pt who asks if she is a candidate for hormone replacement therapy?
Give information and educate HRT. Find other alternatives.
What additional information would help you determine the problem your male client with nocturia and a feeling of fullness in the lower pelvic region is having.
Age and Benign Prostatic Hyperplasia ( BPH )
What are specific guidelines the pt. who has been prescribed Viagra should know related to how often it can be given safely?
Do not take more than once a day 1x a day ( take one hour before sexual activity )
Know some of the adverse effects that young athletes should be aware of regarding the use of anabolic steriods.
Increased cholesterol level, low sperm count, impotence, liver damage, behavioural changes eg: aggression, and psychological dependence.
After administering the first dose of doxazosin Cardura) to your male pt, what action is of critical importance?
It will cause orthostatic hypotension.
Advise patient to make positional changes slowly and in stages.
What points are important when teaching your pt. who has been prescribed pironolactone (Aldactone) regarding salt substitutes?
Avoid salt substitute (this medicine is a potassium-sparing diurectics)
Hyperkalcemia may develop, potassium level can raise up.
What should you have the pt on Lasix do who is experiencing a feeling of gaining weight?
Ask him to go to the doctor for evaluation.
What are some instructions for the 38 year old client who is prescribed a diuretic related to when the medication should be given?
This medication should be taken in the morning.
What is necessary to do when your client is placed on an IV solution containing 10 mEq of potassium chloride in the clinical setting?
Monitor fluid intake and output.
Regarding a pt’s acid/base balance, what information is important for the pt to give to the healthcare worker if MI is suspected?
The patient should report any ymptoms that may relate to fluid overload durin infusion of hypertonic saline solutions such as shortness of breath, palpitations, headache, and restlessness.

Report to emergency room doctor, needs IV infused sodium bicarbonate.
What information is important to give adolescent athletes regarding fluid replacement during a track event?
Give some nutritional supplement to hold onto the fluid, and natural substitute of electrolites
Know the lab work critical to monitor in a pt. on dantrolene (Dantrium).
Liver function test, the patient.
Identify a drug when administered with an antispasmodic that will increase the risk of respiratory depression.
Benzodiapezine, opioids, and antihistamine and alcohol.
Recognize good advice to give a woman who complains of waking frequently with leg and foot cramps.
Take calcium supplements or take quinamm (Quinine sulfate).
Name the best treatment for restoring a pt with osteomalacia’s calcium balance.
Calcium supplement and vitamin D
Recognize important instruction for the pt given colchicine (Novocholchicine) for gout.
Should increase fluid intake 8-12 glasses. Tell patient to monitor urine output. If urine output goes down then call the doctor.
How should calcium supplements be taken?
Should be taken with food, avoid zink rich foods
What is the most important action when administering lindane (Kwell)?
Leave it on for a long period of time 8-12 hours before washing it off.
Use all over the skin, It should be used as specifically as directed.
Recognize the need for more instruction of the mother of a teenager taking isotretinoin (Accutane) for acne.
May cause depression since medication would take longer.
What should the pt with psoriasis know regarding the condition and treatment.?
This condition cannot be cured, but medication can reduce discomfort, it is not contagious.
What should the pt with glaucoma understand about his condition and treatment?
He/she will always have this disease, but it preventable. He/she can prevent
blindness by taking medication as directed. (eg. putting eyedrops everyday).
Describe how to tell the pt how to administer her eye drops.
It should be administered in the conjuctival sac, or bottom sac on the eye.
Describe how to tell the pt how to administer his ear drops.
Lay on the unaffected side, put drops in the ear. Stay put for few minutes so that medication won’t drain out.
How is the proper/safe way to remove cerumen from the ear?
This procedure usually involves instillation of an ear wax softener and then a gentle lavage of the wax-impacted ear with tepid water using an asepto-type syringe to gently insert the water.
Normal white blood cell count is
(WBC)is 4,300-10,800.
Normal platelet count is
150,000 to 450,000.platelet
Normal hemoglobin is
Normal BUN is