Download 420 EXAM 2 AND QUESTION WITH VERIFIED SOLUTIONS. and more Exams Advanced Education in PDF only on Docsity!
420 EXAM 2 AND
QUESTION WITH
VERIFIED SOLUTIONS
Hemoglobinb-bcorrectbanswer-femaleb12- maleb13- Hemocritb-bcorrectbanswer-40% Plateletsb-bcorrectbanswer-150,000-450, PTTb(partialbthromboplastinbtime)b-bcorrectbanswer-60-70bseconds aPTTb(activatedbpartialbthromboplastinbtime)b-bcorrectbanswer-25-40bseconds* (commonlybused:b 25 b-b 35 bseconds) PTb-bcorrectbanswer-11-13bseconds INRb(internationalbnormalizedbratio)b-bcorrectbanswer-1- 2 b-b 3 bdesiredbtherapeuticblevelbwithbCoumadin SepsisbLabsb-bcorrectbanswer-CBC, Lactatebacidb> BloodbCx CRPbelevated
Procalcitoninb> WBCb5,000-10, ESR Liverbfunctionblabsb-bcorrectbanswer-ASTb5- ALTb0- increasedblabbvaluesbequalbliverbfailure Kidneybfunctionb-bcorrectbanswer-BUNb5- creatinineblessbthanb 1 increasedblabbvaluesbequalbkidneybfailure Clottingblabsb-bcorrectbanswer-INR PT PTT aPTT Plt BEFASTb-bcorrectbanswer-Balance Eyes Face Arms Speech Time Ischemicbstrokeb-bcorrectbanswer- abtypebofbstrokebthatboccursbwhenbthebflowbofbbloodbtobthebbrainbisbblocked absuddenblossbofbfunctionbresultingbfrombdisruptionbofbthebbloodbsupplybtobabpartbofb thebbrainb(causedbbybabbloodbclot)ThrombolicborbEmbolicAlsobknownbasbbrainbattac k Hemorrhagicbstrokeb-bcorrectbanswer- occursbwhenbabbloodbvesselbinbthebbrainbleaksborbruptures;balsobknownbasbabbleed (Aneurysm,bAVMs,bIntracerebralbHemorrhagebduebtobHTN) Ischemicbstrokebpathophysiologyb-bcorrectbanswer--Occlusionbofbcerebralbartery -DecreasedbATP -IncreasebextracellularbK+,bintracellularbNa+,bwaterb-->blysis -IncreasedbintracellularbCa+ -Inflammationbandbapoptosis Thebbloodbentersbthebbrainbthoughb-bcorrectbanswer-- Carotidbarteriesb(2):btheybspitbintobthebexternalbcarotidb(2)bandbinternalbcarotidb(2)bar teriesor-Vertebralbarteriesb(2)AllbthebarteriesbmixbbloodbatbthebcirclebofbWillis LeftbHemisphericbStrokeb-bcorrectbanswer-- Paralysisborbweaknessbonbrightbsidebofbbody -Rightbvisualbfieldbdeficit -Aphasiab(expressive,breceptive,borbglobal) -Alteredbintellectualbability
Maturational/Developmentalblossb-bcorrectbanswer- expectedblossesbthatbhappenbasbabpersonbmovesbthroughbdevelopmentalbstagesbof blife Loss,busuallybofbanbaspectbofbself,bresultingbfrombthebnormalbchangesbofbgrowthban dbdevelopment.bExperiencedbasbabresultbofbnaturalbdevelopmentalbprocesses Example:bsendbchildboffbtobschool mouringb-bcorrectbanswer- statebofbsorrowboverbthebdeathborbdeparturebofbablovedbone Berveavementb-bcorrectbanswer-statebofbgrievingborbgoingbthroughbthebgriefbprocess Prolongedbgriefb-bcorrectbanswer- griefbthatbinvolvesbenduringbdespairbandbisbstillbunresolvedboverbanbextendedbperiod bofbtime 5 bstagesbofbgriefb-bcorrectbanswer-1.bDenial 2.bAnger 3.bBargaining 4.bDepression 5.bAcceptance Dysfunctional/complicatedbgriefb-bcorrectbanswer- griefbthatbisbcomplicatedbandbprolongedbbeyondbwhatbisbnormallybexpected abnormalborbdistortedbgriefbthatbmaybbebeitherbunresolvedborbinhibited unresolvedbgriefb-bcorrectbanswer- griefbthatbcontinuesbbeyondbwhatbisbconsideredbabreasonablebperiodbofbtime;bmayba ffectbthebperson'sbabilitybtobfunction abpersonbmaybhavebtroublebexpressingbfeelingsbofblossborbmaybdenybthem;bunresol vedbgriefbalsobdescribesbabstatebofbbereavementbthatbextendsboverbablengthybperiod Chronicbgriefb-bcorrectbanswer- anbingrained,bpathologicalbmourningbprocessbinbwhichbthebpersonbneverbovercomes bthebgrief childbthatbwasbbornbwithbdisabilitiesbandbsomebofbthebparentsbneverbacceptbit Inhibitedbgriefb-bcorrectbanswer- personbsuppressesbfeelingsbofbgriefbandbmaybinsteadbmanifestbsomaticb(body)bsym ptoms,bsuchbasbabdominalbpainborbheartbpalpitations Manybofbthebnormalbsymptomsbofbgriefbarebsuppressedbandbotherbeffects,bincluding bsomatic,barebexperiencedbinstead. Maladaptiveb-bcorrectbanswer- anythingbthatbdoesbnotballowbabpersonbtobfunctionbwithinborbadaptbtobthebstressesba ndbeverydaybdemandsbofblife
Physicalbsignsbandbsymptomsbofbgriefb-bcorrectbanswer- notbsleeping,bdepression,bheadache,bheartbpalpitations,bweightbgain Emotionalbsignsbandbsymptomsbofbgriefb-bcorrectbanswer- guilt,bhatred,blossbofbcontrol Socialbsignsbandbsymptomsbofbgriefb-bcorrectbanswer- Mournedblossbandbendedbupbcryingbandbsadness.bSomebfamiliesbarebverybquiet Spiritualbsignsbandbsymptomsbofbgriefb-bcorrectbanswer- askbforbprayers,bprayingbwithbfamily/friends Resourcesbforbgrievingb-bcorrectbanswer- griefbcounselors,bhopebfosteringbcategories,bupliftingbmemories Nursingbinterventionsbinbhopebforbindividuals:b-bcorrectbanswer- Listeningbtobthem,btherapeuticbsilence,bmorebonebonbonebwithbpatient,bmakingbsureb theybarebinbabquiet,bprivatebenvironment,bsocialbworker,bcounselors,btherapeuticbco mmunicationbwithbpatientbandbfamily.bTakebabminutebandbbreathebatbthebendbofbtheb day.bNeverbprovidebwithbfalsebhope.bGivebthembextrabtime.bEncouragebtobsharebfeel ings.bProvidebwithbaccuratebinformation.bItbisbokaybtobencouragebpatientbtoblookbinto btheirblives.bBringbabdogbforbthatbpersonbasbtheybpassbaway. Deathbexpectedbinbshortbtimeb-bcorrectbanswer- Informbpatientbofbdiagnosisbandbprognosis.bThebdoctorbisbtellingbthebpatientbwhatbisb happeningbandbwhybtheybarebdying Signsbandbsymptomsbofbterminalbillnessb-bcorrectbanswer- Dependsbonbillnessbandbtreatmentb Mottling Terminalbillnessbeffectbonbthebpatientb-bcorrectbanswer- Howbarebwebgoingbtobtakebcarebofbthebpatientbonbtheirblastbdays.bAssessingbthem,b meaningbofbthesebsymptoms,btreatingbappropriately.bTurnbpatientsbwhenbdying.bExp lainingbtobfamily.bGoalsbforbliving.GrievingbprocessLossbofbindependenceDyingbpers on'sbbillbofbrights Terminalbillnessbeffectbonbthebfamilyb-bcorrectbanswer-Funeralbarrangements.b Letbthembtakebtheirbtime. Grievingbprocess Funeralbarrangements Caregivingbroles Palliativebcareb-bcorrectbanswer- Carebdesignedbnotbtobtreatbanbillnessbbutbtobprovidebphysicalbandbemotionalbcomfor tbtobthebpatientbandbsupportbandbguidancebtobhisborbherbfamily. HospicebCareb-bcorrectbanswer- carebprovidedbforbthebdyingbinbinstitutionsbdevotedbtobthosebwhobarebterminallybill
Diuretics-interventionsb-bcorrectbanswer- Observebforborthostaticbhypertension,bdelirium,bchangesbinbmentalbfunction. Explainbreasonsbforbtakingbinbthebmorning Observebforbhypokalemia Withbdaily RecordbI&O Kidneybfunctionblabs Digoxinb(Lanoxin)b-bcorrectbanswer-cardiacbglycoside treatsbabnormalbheartbrhythmsbandbheartbfailure. Controlsbheartbrate cardiacbglycosideb-bcorrectbanswer-increasesbthebforcebofbcontractionbofbthebheart Digoxinbinterventionsb-bcorrectbanswer- Assessbapicalbpulsebforb 1 bminbpriorbtobadministration.bNotifybHCPbifbHRblessbthanb 6 0 b(adult),blessbthanb 70 b(child),blessbthanb 90 b(infant),bmonitorbforbsignsbofbdigoxinbtox icity,bhypokalemia,bandbhypomagnesemia,bnotifybproviderbofbanybsuddenbincreasebi nbpulsebratebthatbpreviouslybnormalborblow,bmaintainbtherapeuticblevel Digoxinbtoxicitybs/sb-bcorrectbanswer-GIbeffectsb- banorexia,bnausea,bvomiting,babdominalbpain;bCNSbeffectsb- bfatigue,bweakness,bdiplopia,bblurredbvision,byellow- greenborbwhitebhalosbaroundbobjects Confusion. Irregularbpulse. arrhythmiasb Bradycardia DVTb(deepbveinbthrombosis)b-bcorrectbanswer- formationbofbabbloodbclotbinbabdeepbveinbofbthebbody,boccurringbmostbcommonlybinbt heblegsborbthighs DVTbpreventionb-bcorrectbanswer-•SCDs/TEDbhose, •Earlyb/oftenbambulation •Heparin/lovenox weightbloss Adequatebhydration DVTbriskbfactorsb-bcorrectbanswer- PMHxbofbDVTborbPE,bFHx,bRecentbSurgery,bCancer,bImmobility,bPregnancy,bBCP,b Smoking,bLEbTrauma,bLEbCasts DVTbinbpregnancyb-bcorrectbanswer- PregnantbwomenbhavebabhigherbriskbinbdevelopingbDVTsb Naturalbchangesbinbabwoman'sbbodybduringbpregnancy,bchildbirth,bandbtheb3- monthbperiodbafterbdeliverybcanbputbwomenbatbhigherbriskbforbabbloodbclot.bDuringbp
regnancy,babwoman'sbbloodbclotsbmorebeasilybtoblessenbbloodblossbduringblaborban dbdelivery. WhatbdobyoubusebtobtreatbDVTbinbpregnantbwomen?b-bcorrectbanswer- Heparinborblow-molecular-weightbheparinsb(LMWHs)busuallybarebthebfirst- linebmedications. Whatbanticoagulantbcanbbebusedbinbpregnancy?b-bcorrectbanswer- Warfarin,bthebmostbcommonlybprescribedbanticoagulant,borbthebnewboralbanticoagul antsb(dabigatran,brivaroxabanbandbapixaban),barebconvenientbtobtakebbecausebtheyb dobnotbhavebtobbebinjected,bbutbtheybarebnotbconsideredbsafebforbunbornbbabies. PostbDiagnosisbDVTsbCareb-bcorrectbanswer-Be Extra Thorough And Don't Touch BedbRest Elevate Thrombolytics Anticoagulants DobNotbMassage TEDbHose supplements/herbalsbthatbinteractbwithbwarfarin/Coumadinb-bcorrectbanswer- GreenbTea Garlic VitaminbE Canbpatientsbtakingbwarfarin/Coumadinbeatbsalads?bWhy?b-bcorrectbanswer- Eatingbsaladsbcanbbebworrisomebbecausebmanyblettucesbandbtrendybgreensbarebric hbinbvitaminbK,bwhichbcanbinterferebwithbthisbmedication Heparinbinducedbthrombocytopeniab-bcorrectbanswer- Heparinbcausesbabdecreasebinbplateletbcountbbecausebofbthebformationbofbabcomple xbwithbplateletbfactorb4,bIgGbantibodiesbagainstbplatelet- heparinbcomplexbthatbthebspleenbproceedsbtobdestroy atorvastatin/ Lipitorb-bcorrectbanswer-Antihyperlipidemic Use:bTreatbhighbcholesterolbandbtriglycerideblevels.bThisbmaybreducebthebriskbofbang ina,bstroke,bheartbattack,bandbheartbandbbloodbvesselbproblems. Avoid:bAlcoholbandbGrapefruitbjuice Labs:bALT AST rosuvastatin/bCrestorb-bcorrectbanswer-hyperlipidemia
Ageb> AlteredbCoagulationb-bcorrectbanswer- Thrombocytopeniab(plateletbcountb<b140,000)b- breducedbnumberbofbthrombocytesbleadingbtobimpairedbclottingbability. AlteredbCoagulationbexamplesb-bcorrectbanswer-cancer pregnancy oralbcontraceptivebuse ProteinbCbdeficiency ProteinbSbdeficiency Antiphospholipidbantibodybsyndrome FactorbVbLeidenbdefect ProthrombinbG20210Abdefect Hyperhomocysteubemia Polycythemia Septicemia Whatbarebexamplesbofbanbantiplateletbdrugs?b-bcorrectbanswer-a.bAspirin b.bClopidogrenb(Plavix) c.bPrasugrelb(Effient) Ticagrelorb(Brilinta) 1Whatbarebexamplesbofbanbanticoagulants?b-bcorrectbanswer- a.Warfarinb(Coumadin) b.bEnoxaparinb(Lovenox) c.bRivaroxabanb(Xarelto) d.bHeparin e.bApixabanb(Eliquis) Danogatramb(Pradaxa Whatbphysicalbfindingsbwouldbpromptbyoubtobevaluatebthembforbincreasedbbleedingbt endenciesbwithbabpatientbonbheparin?b-bcorrectbanswer-a.bBruising b.bPetechiae c.bBackbpain d.bBleedingbgums Abpatientbisbonbanticoagulantbtherapy,bwhatbinterventionsbwouldbyoubimplementbtobd ecreasebbleedingbrisk?b-bcorrectbanswer- a.bElectricbrazorbusebinsteadbofbrazorbblade b.bApplybextrabpressurebtobvenipuncturebsites c.bSoftbtoothbrush d.bDon'tbwalkbbarefootbwearbshoesborbslippers e.bWearbprotectivebglovesbwhenbgardening,borbdoingbthebdishes f.bWearbresistantbfootwear g.bDon'tbforcefullybblowbnose h.bStoolbsofteners i.bNobenemas,bsuppositories,borbtampons j.bBebcautiousbwhenbusingbsharpbobjectsblikebscissorsborbblades k.bAvoidbalcohol
l.bNobnailbclippers m.bAvoidbdentalbflossbandbtoothbpicks DVTbprophylaxisbHeparinb-bcorrectbanswer-Dose:b5,000bunitsb Route:bSubQbeveryb8-12bhoursbdependingbonbweight DVTbprophylaxisbLovenoxb-bcorrectbanswer-Dose:b30-40mg Route:bSubQbdaily VentralbSeptalbDefectb(VSD)b-bcorrectbanswer- anbabnormalbopeningbbetweenbthebrightbandbleftbventricles bloodbisbshuntedbfrombthebleftbtobthebrightbsidebduebtobhighbpressurebinbleftbventricle thebcharacteristicbmurmurbofbVSDbisbdescribedbasbharshbandbholosystolic clinicalbfeaturesbincludebfailurebtobgainbweight,brestlessness,birritability,bsweatingbwh enbeating,bincreasedbheartbratebandbrespirations atrialbseptalbdefectb(ASD)b-bcorrectbanswer- anbopeningbinbthebseptumbseparatingbthebatria Frequentbrespiratoryborblungbinfections. Difficultybbreathing. Tiringbwhenbfeedingb(infants) Shortnessbofbbreathbwhenbbeingbactiveborbexercising. Skippedbheartbeatsborbabsensebofbfeelingbthebheartbeat heartbfailureb(HF)bchildrenb-bcorrectbanswer-canboccurbwithbASDbandbVSD Differentbfrombadultsbandbmanybcasesbarebduebtobcongenitalbmalformationsbwhichbu suallybresultbinbhighboutputbcardiacbfailure.bSomebchildrenbsufferbfromblowboutputbca rdiacbfailurebsuchbasbcardiomyopathy patentbductusbarteriosusb(PDA)b-bcorrectbanswer- passagewayb(ductusbarteriosus)bbetweenbthebaortabandbthebpulmonarybarterybremai nsbopenb(patent)bafterbbirth Patentbductusbarteriosusb(treatment)b-bcorrectbanswer- Closebwithbindomethacin;bopenborbmaintainbwithbPGEbanalogs PDAb(PatentbDuctusbArteriosus,bSYSbandbDIAbsound)b-bcorrectbanswer- Whatbcausesbabcontinuousbmurmurbwithbsilentbintervalblatebinbdiastole;bheardbbestbi nbL2ICS,bharshbmachinery-likebandbusuallybwithbabthrill? Pulmonarybstenosisb-bcorrectbanswer-narrowingbofbthebpulmonarybvalve AorticbStenosisb(AS)b-bcorrectbanswer- narrowingbofbthebaorticbvalve,bwhichbmaybbebacquiredborbcongenital coarctationbofbthebaortab-bcorrectbanswer- congenitalbcardiacbconditionbcharacterizedbbybabnarrowingbofbthebaorta
