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137 Cards in this Set
- Front
- Back
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Haldol
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A traditional (typical) antipsychotic used for positive symptoms of schizophrenia such as delusions, paranoia, hallucinations and disordered thinking
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Negative symptoms of Schizophrenia include
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Lack of motivation, social withdrawl, flat affect
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Atypical antipsychotics
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Used to treat Negative symptoms of schizophrenia, include clozapine, risperidone and olanzapine.
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What symptoms would the nurse find in a patient w/Neuroleptic Malignant Syndrome
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Hypertension, tachycardia, high fever, muscle rigidity and urinary incontinence
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A person with Borderline personality D/o feels
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fundamentally bad or unworthy, mistreated, bored or empty.
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Threat of rejection to a pt with Borderline Personality D/o may
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cause self distructive behaviors
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A patient w/ PTSD may benefit from
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short term dynamic psychotherapy
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A depressed patient suddenly becomes cheerful. What should the nurse assess for?
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Suicide potential. A change in behavior may mean the pt has a plan.
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A pt on Lithium w/low sodium and dehydration is at risk for
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Lithium retention and toxicity
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A pt on Lithium reports N/V and diarrhea. The pt should
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stop taking the drug
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A child w/ADHD taking a stimulant medication should take their meds
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early in the day and never before bedtime
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An adult who rapidly accelerates at a yellow light may have
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impaired impulse control.
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Elavil (Amitryptaline) should be taken at
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bedtime r/t side effects such as drowsiness and disorientation
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Elavil requires how many days of daily dosage before it starts to work
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10-14 days
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A statement that reflects enmeshed boundaries within a family is
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"you should have known what I meant by that". In enmeshed boundaries, a distinct person fails to emerge.
WTF? |
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Appropriate outcomes for a pt with anorexia nervosa include
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Verbalize that eating behaviors are maladaptive, aknowledge misconception of body image as fat and achieve 80-85 % body weight
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A pt receiving Electroconvulsive therapy may feel
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groggy, disoriented and suffer from amnesia after the procedure
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The pt who is to receive ECT should be placed in a
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supine position
The procedure will take 30 minutes and the pt will be restrained with muscle paralyzing agents |
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General anesthesia is given to a pt prior to
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ECT
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THe three initial nursing dx of a pt with borderline personality d/o include
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1. Risk for self-mutilation *priority*
2. Anxiety 3. Ineffective coping |
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Social isolation (Depersonalization) results in
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numbness and emptiness
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A desirable outcome for a pt with Depersonalization disorder
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expresses satisfaction after interaction with friends
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A child who incorperates self generated standards into his/her personality are have achieved which behavior according to Kohlberg?
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Internalization
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Internalization is
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the developmental change from behavior that is externally controlled to a behavior controlled by internal standards
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Conventional reasoning occurs in
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Kohlberg's 2nd level of moral development
Ex: follows socially sanctioned guidelines when making decisions |
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Symptoms of autism such as lack of social responsiveness may begin to occur as early as
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four months
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A definitive dx of autism can usually by made by
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age 3 yrs
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A manic patient begins jumping up, singing and dancing at a group meeting. The nurse should
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bring this pt to a quieter location to maintain safety and provide control of destructive behaviors
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A pt in a manic state is unable to
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express feelings
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Therapeutic Lithium level
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0.4-1.3 mEq/L
A pt with a therapeutic level should be able to solve problems have modulation of moods |
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Clang associations
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The stringing together of words because they have rhyming sounds, regardless of their meaning
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Flight of ideas
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Continuous flow of accelerated speech with abrupt changes from one topic to the next, themes usually play on words
"Today is a beautiful day. Beauty is in the eye of the beholder" |
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False and fixed beliefs that are not corrected by reasoning
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Delusional thinking
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Loose associations
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Haphazard, confused thinking manifested in jumbled speech
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Withdrawing from once loved activities may be a risk for
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suicide
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Low levels of which neurotransmitter are associated w/depression
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Serotonin
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A decrease in GABA (gamma aminobutyric acid) may be linked to
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anxiety disorders, schizophrenia, and Huntington's disease
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Which diagnostic tool uses radioactive tag to trace physiological and biochemical changes in brain tissue
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PET scan
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Vegetative signs of depression include
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Disinterest in sex, change in bowel habits, sleep disturbance, changes in appetite
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Preoccupation with objects, self stimulating behaviors and absense of attachment are manifestations of
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autism
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Most important nursing measure for a pt in acute episode of mania?
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Prevent exhaustion
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Nurse should evaluate the manic pt's
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nutritional status to prevent dehydration, malnutrition and injury
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A pt with multiple medical complaints and a negative medical work up may be experiencing
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A somatization disorder
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Pt w/somatization disorders most commonly complain of
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chronic pain and problems w/the neuro, respiratory and digestive systems
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A persistent period of worry and anxiety over atleast 6 month period are manifestations of
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generalized anxiety disorder
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A belief that real or imaginary symptoms are a serious illness, regardless of medical reassurance is called
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Hypochondriasis
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Focus of family therapy for a pt w/Anorexia
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improving family communication
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A depressed pt refuses to perform ADLs. The nurse should
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Kindly but firmly help the pt to bathe
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All or nothing thinking
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Extreme reasoning with mutually exclusive black and white terms
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Magnifying the outcome of an event
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Catastrophizing
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When anger is turned inward, it can become
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Depression
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Dissociative symptoms
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Disruptions in conciousness such as identity, memory, and perception of environment
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A pt with chronic acute anxiety should get regular
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physical exercise to help lower anxiety levels
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Effective techniques for acute anxiety include
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progressive muscle relaxtion, music therapy and visualization
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A depressed preschooler may be
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socially withdrawn
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Carbamazapine (Tegretol) serum level in a pt w/bipolar depression should be maintained between
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6-8 mg/L
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Persistent feelings of detachment is a symptom of
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PTSD
The pt relieves a traumatic event though flashbacks, dreams and intrusive recollections |
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Style of coping that contributes to sub stance abuse maintenence
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Denial
Ex: "I can quit drinking whenever I want" |
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An expected outcome of reminiscing therapy is
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increase in self esteem
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What statement should elicit info concerning a pts ability to engage in abstract thinking?
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"What does birds of a feather flock together mean?"
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Questions in the mini mental state examination ask for
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factual information
Ex: "Name the last 5 presidents of the USA" |
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What factor influences increased physical and mental health problems in older adults?
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Low income/limited financial resources
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Confronting a pt w/dementia about their inappropriate behavior may
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escalate conflict
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A pt with dementia should have what type of environment
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structured and consistent
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Which disorder may have genetic involvement?
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Alzheimer's dz. There are atleast four genes involved w/the transmission of Alzheimer's dz
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An elderly pt suddenly becomes confused, withdrawn and resistant. The nurse should first assess the pt for
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signs of physical illness. Cognitive impairment in elderly pts may be caused by a physical problem such as a UTI
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Repetitive behavior such as repeating the same phrase or asking the same question in response to stress is
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perseveration
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Confabulation
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Spontaneous narrative reports of events that never happened, often to fill gaps from memory loss
(the confusion of imagination w/memory) |
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What characteristic should the nurse remember when assessing a patient in early stages of Alzheimer's?
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The pt is aware of their lost abilities and knows that something is wrong.
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A pt with end stage hepatic disease should eat a low Na diet to
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help decrease ascites and ascitic fluid production
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Why should the nurse provide massage to a pt w/impaired liver function
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to mobilize edema
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The pt w/liver disease should avoid using soaps and alcohol based lotion to prevent
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ammonia build up on the skin
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The drug of choice for pancreatitis is
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Morphine
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What drug should be avoided in a pt w/pancreatitis?
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Demerol (can cause spasms, CNS irritability and sz)
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What teaching should the nurse provide to a family of a discharged pt who is recovering from hepatic encephalopathy?
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Obtain a sample of the pt's handwriting on a daily basis, progressive hepatic encephalopathy will be characterized by deterioration in handwriting and inability to draw a simple star
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What test provides the most info when diagnosing chronic pancreatitis?
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ERCP
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An elevated serum amylase would indicate
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acute pancreatitis
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What is the diet for a pt with acute pancreatitis
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NPO
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The nurse should keep the pt with pancreatitis in what position
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Semi-fowler, to decrease pressure on the diaphragm and allow respiratory expansion
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A glycosated hemoglobin (A1C) level provides what?
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A record of the pt's blood glucose control over the past 3 months
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Pancrease is used to treat
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pancreatic enzyme deficiency. It aids in the digestion of protein, starch and fat
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Pts commonly prescribed pancrease
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Cancer of common bile duct, cystic fibrosis, chronic pancreatitis
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During rehydration of the pt with DKA, the nurse should most closely monitor the pt for what
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Hypokalemia, during rapid rehydration, the potassium will reenter the pt's cells
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A pt in acute pancreatitis will usually be
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Hypotensive and Hyperglycemic
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A coexisting problem in acute pancreatitis is often
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Pleural effusion
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A risk of using Glucovance is
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signiifcant hypoglycemic reaction
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The most common side effects of Orinase
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GI upset and dermotological reactions
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Type 2 diabetes is usually diagnosed after age
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30
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A risk factor for type 2 diabetes is
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being overweight
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A pt with hepatic encephalopathy should not receive
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sedatives.
Analgesics should be used sparingly |
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Pts with steatorrhea have problems with
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malabsorption of nutrients, esp fat and protein
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Pts with hepatic cirrhosis should take what kind of vitamins
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water soluble
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What interventions should the nurse perform in a pt w/ascites
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Measure the abdominal girth daily, weigh the pt daily, monitor serum ammonia and electrolyte levels
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What statement indicates that a pt understands what will be done during an ERCP?
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"I will be given a sedative, followed by oral insertion of an endoscope into my GI tract"
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Diabetic coma
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Severe state of hypoglyemia where the pt's blood glucose remains low
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A pt with NIDDM has a glucose level of >500, a normal PH level, dry mucous membranes, elevated BUN, hypotension and tachycardia. These symptoms describe
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HHNKS (hyperglycemic, hyperosmolar, nonketotic syndrome)
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What is the best way to treat shoulder pain in a pt s/p lap chole?
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Heating pad, sitting up, ambulating
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What should the RN monitor for in a pt w/a T-tube s/p open chole?
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Return of pigment to the stool. If pigment does not return, could be a complication
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The earliest sx of hepatic encephalopathy is
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minor mental changes, disorientation
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Jaundice may result from
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impairment of hepatic uptake, conjugation of bilirubin or excretion of bilirubin into biliary system
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What med is given to prevent bleeding esophageal varices in a pt w/cirrhosis?
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Propranolol (Inderal) will reduce portal pressure in this pt w/beta blocking action
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The Amer. Diabetic Association recommends what % of kcals come from carbs
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50-60%
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The pt in the acute stage of liver cirrhosis would show signs of
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fluid volume excess (AEB ascites)
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S/p thyroidectomy, what question should the nurse ask the pt to monitor for bleeding?
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"do you feel fullness at your incision site?"
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The pt w/renal calculi should maintain a high
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fluid intake
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Urinary output should be equivalent to
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intake
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A typical lab finding it pt with adrenal insuffiency is
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hyponatremia, hyperkalemia, hypermagnesemia
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Epoetin alfa
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Used to treat anemia in renal patients, primary effect is to increase Hct
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A pt in thyroid storm should be wrapped in
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a hypothermia blanket to reduce high fever, cold compresses will be inefficient
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Aspirin is contraindicated in
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thyroid storm
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Moon face is a characteristic sign of
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Cushing's dz
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Older pts with hyperthyroidism may present with
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diffuse itching
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A pt with renal stones should be discouraged from taking vitamins and mineral supplements because
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Calcium and Vitamin D can cause more calculi to form
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Exercise is restricted in a pt with acromegaly r/t
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Decrease in bone density
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A nurse may be able to learn about a pt w/acromegaly by assessing
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photos of the pt when they were younger
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Insatiable thirst is characteristic of
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diabetes insipidus
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Dysphagia is associated with
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Thyroiditis
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What is a common nutrition related problem in pts with hypothyroidism?
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Weight gain
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Gross tremors are characteristic of
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Hypoparathyroidism
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One of the most common presenting symptoms in a pt w/Graves Dz is
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Nervousness
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A pt w/hypothryoidism may present w/increased blood
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glucose. Thyroid hormones cause hyperglycemia
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The pt's catecholemine producing a benign tumor describes the pathophysiology of
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pheochromocytoma
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Pheochromocytoma is associated with
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HTN and headache
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Synthroid (Levothyroxine) takes how many days to reach full effect
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10 days
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Hypopituitarism causes what kind of pain
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joint pain
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Due to decreased erythropoetin procuction, a pt in ESRD will usually have
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shortness of breath
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Non cardiac related pain radiating to the shoulder is indicative of
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involvement with the gall bladder
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The most characteristic symptom of acute pyelonephritis
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Flank pain.
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Exopthalmos
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protrusion of the eyes.
Characteristic of Graves DZ (hyperthyroidism) |
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A pt with hyperparathyroidism is at increased risk for
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kidney stones, r/t hyper secretion of calcium
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Hyperparathyroidism typically causes the blood pressure to
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increase
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Pt with hyperparathyroidism should be encouraged to stay active to
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prevent complications from hyper secretion of calcium such as renal calculi and bowel obstruction
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Intake of milk should be limited in a pt with
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kidney stones
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Thyroxine (T4) makes muscles more responsive to
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catecholemines, causing increased neuromuscular response
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Fluids in a pt with diabetes inspidus should be limited to
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an amount equivalent to output
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The loss of volume of extracellular fluids in a pt w/nephrotic syndrome by diuretics may place a pt at risk for
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renal failure 2nd to hypovolemia
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Spironolactone makes what class of meds more effective?
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ACE inhbitors
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