185 Exam 1

Front 1

A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told by the health care provider that hemodialysis is necessary. Which clinical manifestation indicates the need for hemodialysis?

Back 1

Hyperkalemia Protein breakdown liberates cellular potassium ions, leading to hyperkalemia, which can cause a cardiac dysrhythmia and standstill. The failure of the kidneys to maintain a balance of potassium is one of the main indications for dialysis

Front 2

A nurse obtains daily stool specimens for a client with chronic bowel inflammation. The nurse concludes that these stool examinations were prescribed to determine:

Back 2

Occult blood.Occult blood in the stool may indicate active bleeding

Front 3

The nurse is providing postoperative care eight hours after a client had a total cystectomy and the formation of an ileal conduit. What assessment finding should be reported immediately?

Back 3

Dusky-colored stoma. Dusky-colored stoma may denote a compromised blood supply to the stoma and impending necrosis.

Front 4

The nurse reviews a client's medication history, which includes a cholinergic medication. The client states, "I take that for some kind of urinary problem." The nurse recalls that cholinergic medications are prescribed primarily for what type of urinary condition?

Back 4

Flaccid bladder Cholinergics intensify and prolong the action of acetylcholine, which increases the tone in the genitourinary tract, preventing urinary retention

Front 5

During history taking, a client reports experiencing black, tarry stools. The nurse recognizes that this may be an indication of:

Back 5

Upper gastrointestinal bleeding. Black, tarry stool (also known as melena) is indicative of an upper GI bleed. The black, tarry appearance and consistency are related to digestive effects on blood caused by breakdown of red blood cells (RBCs). Upper GI bleeding also presents with a distinctive foul smell that is not found with lower GI bleeding.

Front 6

A 40-year-old client scheduled for a hemi-colectomy because of ulcerative colitis asks if having a hemi-colectomy means wearing a pouch and having bowel movements in an abnormal way. Which is the best response by the nurse?

Back 6

"No, only part of the colon is removed and the rest reattached."Hemi-colectomy is removal of part of the colon with an anastomosis between the ileum and transverse colon; a colostomy is not necessary. With a colostomy the intestine opens on the abdomen, whereas in a hemi-colectomy a portion of the intestine is resected and the ends reconnected.

Front 7

The mother of a 17-year-old adolescent who is going to be a foreign exchange student asks the nurse why her child must have a tetanus toxoid immunization instead of the immune globulin. The nurse responds that the tetanus toxoid immunization provides:

Back 7

Longer-lasting active immunityToxoids are modified toxins that stimulate the body to form antibodies that can last up to 10 years against the specific disease; because the adolescent will be in a foreign country, the toxoid is given prophylactically. The tetanus toxoid provides active, not passive, immunity; all passive immunity is short acting. Only by having the disease can someone gain natural immunity. Toxoids confer active, not temporary passive, immunity.

Front 8

A nurse is caring for a client after surgical creation of a conduit diversion. What is the major disadvantage of a conduit diversion that the nurse should consider when caring for this client?

Back 8

Urine continuously drains from it The ureters are implanted in a segment of the ileum, and urine drains continually because there is no sphincter; continent catheterizable stomal reservoirs do not continually drain but are accessed with a catheter approximately every four hours. Ileal conduits are not neurologically innervated; therefore, no peristalsis exists. No feces are present in an ileal conduit. Absorption of nutrients is not affected by an ileal conduit

Front 9

A nurse is providing postoperative care to a client who had a kidney transplant. What assessment is the best indicator of the functioning of the newly transplanted kidney?

Back 9

Serum creatinine Serum creatinine, a test of renal function, measures the kidneys' ability to excrete metabolic wastes; creatinine, a nitrogenous product of protein breakdown, is increased with kidney insufficiency Normal levels of creatinine in the blood are approximately 0.6 to 1.2

Front 10

The nurse assesses a male client with a preliminary diagnosis of cancer of the urinary bladder. The nurse recalls that which sign or symptom is a common early sign of cancer of the urinary system:

Back 10

Hematuria Research statistics indicate that hematuria is the most common early sign of cancer of the urinary system, probably because of the urinary system's rich vascular network.

Front 11

During discharge teaching, a client with an ileal conduit asks how frequently the urine pouch should be emptied. The best reply by the nurse is:

Back 11

"To prevent leakage and pulling of the pouch from the skin, it should be emptied every few hours." The weight of a full bag can pull the appliance from the skin and cause leakage; it should be emptied approximately every two to three hours or when half full

Front 12

Theophylline (asthma inhaler) used

Back 12

to prevent and treat wheezing, shortness of breath, and chest tightness caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air passages in the lungs, making it easier to breathe.

Front 13

Theophylline (asthma inhaler) side effects

Back 13

Side effects seizures, insomnia, cardiac dysrhythmias.

Front 14

Midazolam (Benzodiazepine) is used

Back 14

to produce sleepiness or drowsiness and to relieve anxiety before surgery or certain procedures. Midazolam is also given to produce amnesia (loss of memory) so that the patient will not remember any discomfort or undesirable effects that may occur after a surgery or procedure.

Front 15

Acetylcysteine is used

Back 15

When inhaled by mouth is used to help thin and loosen mucus in the airways due to certain lung diseases (such as emphysema, bronchitis, cystic fibrosis, pneumonia). This effect helps you to clear the mucus from your lungs so that you can breathe easier. Its topical form can treat rash and other skin problems. Its oral form can prevent liver damage caused by an overdose of acetaminophen.

Front 16

Ipratropium bromide and albuterol sulfate are

Back 16

an inhaler that is a combination of an anticholinergic bronchodilator and a selective beta2-adrenergic bronchodilator

Front 17

Ipratropium bromide and albuterol sulfate are used

Back 17

to treat and prevent symptoms (wheezing and shortness of breath) caused by ongoing lung disease (chronic obstructive pulmonary disease-COPD and asthma.

Front 18

Vancomycin is used

Back 18

to treat an infection of the intestines causedby Clostridium difficile, which can cause watery or bloody diarrhea. It is also used to treat staph infections that cancause inflammation of the colon and small intestines. Oto and Nephrotoxic

Front 19

Diphenoxylate and atropine (lomotil) is used

Back 19

to treat acute diarrhea (diarrhea of limitedduration).

Front 20

Diphenoxylate is

Back 20

a man-made narcotic chemically related tomeperidine (Demerol) like Imodium anti-diarrhea, for IBS.

Front 21

Diphenoxylate and atropine (lomotil) side effects are

Back 21

seizures, constipation, and Oliguria (the medical term for a decreased output ofurine.

Front 22

Phenazopyridine is used to

Back 22

treat pain, burning, increased urination, andincreased urge to urinate. These symptoms are usually caused by infection,injury, surgery, catheter, or other conditions that irritate the lower urinarytract. Oliguria and Jaunice

Front 23

Metronidazole is

Back 23

an antibiotic. It fights bacteria in your body.

Front 24

Metronidazole is used

Back 24

to treatbacterial infections of the vagina, stomach, skin, joints, and respiratorytract. This medication will not treat a vaginal yeast infection.

Front 25

Metronidazole side effect

Back 25

Can cause a metallic taste in your mouth.

Front 26

GoLYTELY solution (jug) isused for

Back 26

Cleaning out the bowel before surgery or otherprocedures. It may also be used for other conditions as determined by yourdoctor.

Front 27

GoLYTELY solution (jug) is

Back 27

a bowel cleansing solution. It works by causing the colon to produce awatery stool and empty the bowel.

Front 28

PEG (polyethylene glycol) with electrolyte isused

Back 28

to clean out the intestines before certain bowelexam procedures such as colonoscopy or barium enema X-rays

Front 29

PEG (polyethylene glycol) with electrolyte is

Back 29

a laxative that works by drawing large amounts of water into thecolon.

Front 30

Warfarin (brand names Coumadinand Jantoven) is

Back 30

a prescription medication used to prevent harmful bloodclots from forming or growing larger. Beneficial blood clots prevent or stop bleeding,but harmful blood clots can cause a heart attack, stroke, deep vein thrombosisor pulmonary embolism.

Front 31

Warfarin can cause

Back 31

and life- threateningbleeding, Such patients may require fresh frozen plasma or prothrombin complexconcentrates to replenish their stores of vitamin K-dependent clotting factors

Front 32

Heparin is

Back 32

an anticoagulant (blood thinner) that preventsthe formation of blood clots.

Front 33

Heparin is used

Back 33

to treat and prevent blood clots in the veins,arteries, or lung. It is also used before surgery to reduce the risk of bloodclots.

Notifydoctor if sudden numbness or weakness, especially on one side of the body,sudden severe headache, confusion,problems with vision, speech, or balance, chest pain, sudden cough, wheezing,rapid breathing, fast heart rate, pain, swelling, warmth, or redness in one orboth legs, trouble breathing (in an infant) extreme drowsiness, weakness, orgasping for breath; or fever, chills, runny nose, or watery eyes.

Front 34

Epoetin alfa is

Back 34

a human erythropoietin produced in cell cultureusing recombinant DNA technology. Stimulates RBC production

Front 35

Filgrastim injection is used

Back 35

to treat neutropenia (low white blood cells) that is caused by cancermedicines.

Front 36

Filgrastim injection is

Back 36

a synthetic (man-made) form of a substance that is naturally produced inyour body called a colony stimulating factor. Filgrastim helpsthe bone marrow to make new white blood cells.

Front 37

Lisinopril is

Back 37

an angiotensin converting enzyme (ACE) inhibitor used for treating high blood pressure,heart failure and for preventing kidney failure due to high blood pressure anddiabetes.

Front 38

Lisinopril side effect

Back 38

Low BP

Front 39

Hydrocodoneand acetaminophen combination is

Back 39

used to relieve moderate to moderately severe pain.

Front 40

Hydrocodone and acetaminophen combination can cause

Back 40

High risk for addiction and dependence. respiratory distress and death when taken inhigh doses or when combined with other substances, especially alcohol.

Front 41

APAP N-Acetyl-Para-Amino-Phenol(acetaminophen)Tylenol Acetaminophen belongs to a class of drugs

Back 41

analgesics (pain relievers) and antipyretics(fever reducers).

The exact mechanism of action of acetaminophen is notknown. It may reduce the production of prostaglandins in the brain.

Front 42

Ibuprofen works well for

Back 42

mild to moderate painand inflammation, but it doesn't last as long as other NSAIDs.

Front 43

Norco is a good option to treat

Back 43

pain as needed when over-the-counter medicines can't controlthe symptoms, but must make sure you don't take too much acetaminophen(Tylenol) to avoid liver problems or death.

Front 44

Acetaminophen is used

Back 44

relieve pain and reduce fever in patients.

Front 45

acetaminophen does not become habit-forming when taken for a long time. But acetaminophen may cause

Back 45

other unwanted effects when taken in large doses, including liver damage.

Front 46

Oxycodone narcotic it is

Back 46

a moderately potent opioid analgesic generallyindicated for relief of moderate to severe pain.

Front 47

Oxycodone narcotic Can cause

Back 47

High risk for addiction and dependence. Can cause respiratory distress and death whentaken in high doses or when combined with other substances, especially alcohol.

Front 48

Morphinenarcotic cantreat

Back 48

moderate to severe pain.

Front 49

Tramadol is used

Back 49

to relieve moderate to moderately severe pain

Front 50

Tramadol extended-releasetablets and capsules are only used

Back 50

by people who are expected to need medication to relieve pain around-the-clock.

Front 51

Tramadol is in a class of medications

Back 51

called opiate (narcotic) analgesics

Front 52

Tramadol may cause

Back 52

feelings of anxiousness, itching,sweating, flushing