Nsg260 Exam One

Front 1

identify the stages seen in all chronic conditions.

Back 1

•Prediagnostic stage
•Diagnostic stage
•Chronic Illness
•Terminal stage

Front 2

Prediagnostic stage of chronic illness

Back 2

Person has no disease, may have risk factors, no s&s (lifestyle, family history)

Front 3

Diagnostic Stage of chronic illness

Back 3

Confirmed by tests, studies and with S&S

Front 4

Chronic Illness Stage

Back 4

Experiencing illness, management critical

Front 5

Terminal stage of chronic illness

Back 5

Body system failure (transplant, dialysis)

Front 6

List the 8 phases in the trajectory framework of chronic illness

Back 6

1 pre-trajectory phase
2 trajectory phase
3 crisis phase
4 acute phase
5 stable phase
6 unstable phase
7 downward phase
8 dying phase

Front 7

describe the pre-trajectory phase of chronic illness

Back 7

risk factors are present

Front 8

describe the trajectory phase of chronic illness

Back 8

signs & symptoms present

Front 9

describe the crisis phase of chronic illness

Back 9

diagnostic phase - pt may be in shock, surprised

Front 10

describe the acute phase of chronic illness

Back 10

hospitalization required to manage

Front 11

describe the stable phase of chronic illness

Back 11

symptoms managed (breathing better, blood sugar controlled)

Front 12

describe the unstable phase of chronic illness

Back 12

have to make lifestyle changes to manage illness

Front 13

describe the downward phase of chronic illness

Back 13

some body system failure is evident

Front 14

describe the dying phase of chronic illness

Back 14

terminal stage

Front 15

4 parts to pattern of psychological adaptation to chronic illness

Back 15

disbelief
developing awareness of illness
integration into life
coping

Front 16

Explain who can be covered under Medicare and Medicaid

Back 16

Medicare – health insurance program for people at least 65 yrs old, or under age 65 & disabled. Also for people w/end stage renal disease requiring dialysis or transplant.
Medicaid - For indigent persons under age 65 and some poor elderly

Front 17

Describe the purpose of hospice

Back 17

• Hospice is a means of support and care for people in the last phases of incurable disease to make life as full and comfortable as possible.

Front 18

Describe the advantages of hospice

Back 18

Only if patient wants it
One physician leads the team
24/7 access to nurse
Covered by Medicare/ Medicaid
No unwanted treatments will happen
All equipment & therapy is paid for 100%

Front 19

Describe the disadvantages of hospice

Back 19

Certain care may be rejected (x-ray, blood transfusion)
Experimental therapies not allowed (feeding tube)
Hospitalizations discouraged

Front 20

What are advance directives?

Back 20

a written plan stating what health care treatments you would or would not want if you could not speak for yourself

Front 21

Advantages of advance directives

Back 21

Don’t need attorney
Describes what patients wants
Document can be changed at any time
Document can make it easier to express your thoughts
Free

Front 22

Disadvantages of advance directives

Back 22

Not always readily available
May not be specific enough
Can be overridden by physician
Physician must order
Nurse alone cannot follow living will

Front 23

Humoral Immunity
Cells involved?
Products?
Memory cells where?
Protect against?
common reactions?

Back 23

Cells involved? B lymphocytes
Products? antibodies
Memory cells where? outside cell
Protect against? bacteria, extracellular viruses, respiratory & GI pathogens
common reactions? anaphylactic shock, blood transfusion reactions

Front 24

Cell-mediated immunity
Cells involved?
Products?
Memory cells where?
Protect against?
common reactions?

Back 24

Cells involved? t lymphocytes & macrophages
Products? sensitized T cells & cytokines
Memory cells where? inside cell
Protect against? fungus, intracellular viruses, chronic infectious agents, tumor cells
common reactions? cancer, graft rejections, contact dermititis

Front 25

type of immunity that is lifelong (or may need a booster) by creating memory cells

Back 25

active acquired immunity

Front 26

examples of active acquired immunity

Back 26

exposure to infection
immunizations

Front 27

type of immunity that is immediate but not long lasting

Back 27

passive acquired immunity

Front 28

examples of passive acquired immunity

Back 28

mom to baby
immunoglobulins

Front 29

a state in which an individual is at risk for deterioration of body systems as a result of prescribed or unavoidable musculoskeletal inactivity

Back 29

disuse syndrome

Front 30

symptoms of disuse syndrome

Back 30

Symptoms include constipation, altered respiratory patterns, lose strength in extremities, will get powerlessness if they do not try. They will have injury, activity intolerance, body image problems. Entire ...current health status must be considered because most patients will have a comorbidity such as patients with strokes. There is a balance you have to reach.

Front 31

proper sequence of immune systems response to an invader?

Back 31

inflammation - neutrophils first to arrive
monocytes engulf bacteria
lymphocytes remove bacteria
eosinophils/basophils attack allergens

Front 32

Diagnostic studies performed for a pt w/hypersensitivities

Back 32

skin tests
RAST
CBC Diff
PFT

Front 33

Nursing mgmt for anaphylaxis

Back 33

ensure airway - epi
O2 non-rebreather mask
admin meds benadryl, histamine blockers, maintain BP
thorough history for allergies

Front 34

Medications used to treat MS, their side effects & pt education related to them?

Back 34

steroids-weight gain-restrict salt intake
Immunosuppressives-cardiotoxic-lifetime limit
muscle relaxers-drowsiness-no driving
CNS stimulants-insomnia-stop caffeine
anticholinergics-dry mouth, constipation-
antidepressants
antiseizures

Front 35

S&S exacerbation of SLE

Back 35

fever, weight loss, arthralgia, excessive fatigue

Front 36

S&S exacerbation of GB

Back 36

pain
respiratory failure
usually 1-3wks after URI or UTI
weakness lower extremities

Front 37

describe cause of GB

Back 37

Unknown etiology but is believed to be cell-mediated immunologic reaction directed at peripheral nerves. Often preceded by viral infection, trauma, surgery, or HIV

Front 38

what causes MG?

Back 38

an autoimmune process in which antibodies attack ACh receptors, which prevents ACh molecules from attaching & stimulating muscle contraction.

Front 39

S&S of MG

Back 39

fluctuating weakness, restored after period of rest
facial muscles often involved incl eyes, mouth, throat & resp

Front 40

Crises of MG

Back 40

myasthenic crisis is an acute exacerbation of muscle weakness triggered by infection, surgery, emotional distress, drug overdose or inadequate drugs. major complications result from muscle weakness in swallowing & breathing

Front 41

Treatments for MG

Back 41

plasmapheresis
thymectomy

Front 42

Side effects of glucocorticoids/
cortcosteroids

Back 42

weight gain
moon face
redistribution of body fat

Front 43

5 points necessary to teach pt/family about MS

Back 43

drug therapy & s/e
proper nutrition (standard-hi protein diet)
how to reduce exacerbations & build general resistance to illness
avoid exposure to cold
balance exercise & rest
avoid immobility hazards (contractures, ulcers)

Front 44

5 points to teach pt/family about SLE

Back 44

pace activities to save energy
restrict exposure to sun & use sunscreen
s/e of meds
plan activities later in day if bothered in am

Front 45

3 meds for SLE and 2 s/e each

Back 45

steroids - moon face, weight gain
NSAIDs-bleeding, hepatotoxicity
Antimalarials-toxicity, vision problems

Front 46

Diagnostics tests to confirm SLE

Back 46

+ANA
+Smith
anti-DNA

Front 47

what can you teach a patient about the causes of SLE

Back 47

Etiology unknown
Environmental triggers such as sun exposure & sunburns
Production of antibodies against your own nucleic acids, RBCs, WBCs