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ADN 420 EXAM 2
QUESTIONS WITH
100% CORRECT
ANSWERS
NecessaryvLossv-vcorrectvanswer- Avlossvrelatedvtovchangevthatvisvpartvofvthevcyclevofvlifevthatvisvanticipatedvbutvcanvsti llvbevintenselyvfelt.vThisvtypevofvlossvcanvbevreplacedvbyvsomethingvbetter. ActualvLossv-vcorrectvanswer- Anyvlossvofvavvaluedvperson,vitem,vstatus,vorvjobvthatvcanvbevrecognizedvbyvothers. PerceivedvLossv-vcorrectvanswer- Anyvlossvdefinedvbyvthevclientvthatvisvnotvobviousvorvverifiablevtovothers. MaturationalvorvDevelopmentalvLossv-vcorrectvanswer- anyvlossvnormallyvexpectedvduevtovthevdevelopmentalvprocessingvofvlife.vThesevloss esvarevassociatedvwithvnormalvlifevtransitionsvandvhelpvtovdevelopvcopingvskillsv(e.g., vchildvleavingvhomevforvcollege.)
SituationalvLossv-vcorrectvanswer- anyvunanticipatedvlossvcausedvbyvanvexternalvevent.v(Familyvlosesvhomevtovavtorna do.) AnticipatoryvLossv-vcorrectvanswer-Experiencedvbeforevthevlossvhappens. Kubler-RossvModelvStagesvofvGriefv-vcorrectvanswer- Denial,vanger,vbargaining,vdepression,vacceptance. Factorsvinfluencingvloss,vgrief,vandvcopingvability.v-vcorrectvanswer- Indvcurrentvstagevofvdevelopment,vgender,vinterpersonalvrelationshipvandvsocialvsup port,vtypevandvsignificancevofvthevloss,vculturevandvethnicity,vspiritualvandvreligiousvb eliefs/practices,vpriorvexperiencevwithvloss,vsocioeconomicvstatus, Factorsvthatvincreasevriskvofvcomplicated/dysfunctionalvgrievingv-vcorrectvanswer- Beingvexceptionalvdependentvonvthevdeceasedvind.,vavpersonvdyingvunexpectedlyvat vavyoungvagevthroughvviolencevorvinvavsociallyvunacceptablevmanner,vinadequatevco pingvskills,vlackvofvsocialvsupport. NursingvInterventionsvforvGrievingvProcessv-vcorrectvanswer- Facilitatevmourningv(grantvtimevforvgrievingvprocess),vtherapeuticvcommunicationvrel atedvtovclientsvstagevofvgrief,vactivevlistening,vsilencevandvpersonalvpresence,vsumm arizingvwhatvthevclientvisvfeeling,vavoidvfalsevreassurance,vassessvforvineffectivevcop ing,vencouragevsupportvgroupvattendance,vspiritualvadvisorvifvappropriate,vmentalvhe althvcounselors. PalliativevCarev-vcorrectvanswer- Carevdesignedvnotvtovtreatvanvillnessvbutvtovprovidevphysicalvandvemotionalvcomfortv tovthevpatientvandvsupportvandvguidancevtovhisvorvhervfamily. HospicevCarev-vcorrectvanswer- Medicalvcarevisvstoppedvandvqualityvofvlifevandvsupportingvthevclientvtovavpeacefulva ndvdignifiedvdeath.vLifevexpectancyvunderv 6 vmonths. CharacteristicsvofvDiscomfortv-vcorrectvanswer- pain,vanxiety,vrestlnessness,vdyspnea,vnauseavorvvomiting,vdehydration,vdiarrhea,vc onstipation,vurinaryvincontinence,vinabilityvtovperformvADLs Manifestationsvofvapproachingvdeathv-vcorrectvanswer- LOCvdecreases,vmusclevrelaxationvofvthevface,vlaboredvbreathingv(dyspnea,vapnea,v cheyne- stokes),vdeathvrattle,vhearingvisvnotvdiminished,vtouchvdiminishedvbutvcanvfeelvpress urevofvtouch,vmucousvcollectingvinvairways,vmottling,vincontinence,vpupilsvnovlongerv reactivevtovlight,vpulsevslowvandvweak,vBPvdrops,vcoolvextrems,vdecreasedvurinevout put,vinabilityvtovswallow. NursingvInterventionsvforvEndvofvLifevPhysicalvCare:v-vcorrectvanswer- Givevpriorityvtovcontrollingvfindings,vadminvmedsvthatvmanagevpain,vairvhungervandva nxiety,vongoingvassessment,vrepositionvforvairwayvandvcomfort,vmaintainvintegrityvorv
HFvs/ sx,vfrequentvrespvinfections,vfatigue,vpoorvgrowth,vtachycardia,vtachypnea,vhypotensi on.vWidevpulsevpressure,vboundingvpulse. Administrationvofvindomethacin,vcoilsvduringvCC. PulmonaryvStenosisv-vcorrectvanswer- Obstructive.vNarrowingvofvthevpulmonaryvvalvevorvpulmonaryvarteryvthatvresultsvinvo bstructvofvbloodvflowvfromvthevventricle. Systolicvejectionvmurmur,vthrill,vdyspnea,vcyanosisvwithvexertion,vtiredness. Balloonvangioplasty,vpulmonaryvvalvotomy. AorticvStenosisv-vcorrectvanswer-Obstructive.vAvnarrowingvofvthevaorticvvalve. Infants:vFaintvpulse,vhypotension,vtachycardia,vpoorvfeeding,vtolerance. Children:vIntolerancevtovexercise,vdizziness,vchestvpain,vpossiblevejectionvmurmur. Balloon,vsurgicalvrepair. CoarctationvofvthevAortav-vcorrectvanswer- Obstructive.vAvnarrowingvofvthevlumenvofvthevaorta,vusuallyvatvorvnearvthevductusvart erioles,vthatvresultsvinvobstructionvbloodvflowvfromvthevventricle. Elevatedvbpvinvarms Lowvbpvinvlegs,vcoolvlowervextrems,vandvweakervpulses. Heartvfailurevinvinfants. Dizziness,vheadaches,vfainting,vorvnosebleedsvinvoldervchildren. TricuspidvAtresiav-vcorrectvanswer- Decreasedvp.vbloodvflow.vCompletevclosurevofvthevtricuspidvvalvevthatvresultsvinvmix edvbloodvflow. Cyanosis!,vrapidvrespirations,vdiff.vfeeding,vpalevgrayvcolor,voveractivevapicalvpulse. Infants:vcyanosis,vdyspnea,vtachycardia. OldervChildren:vHypoxemia,vclubbingvofvfingers. Surgeryvinv 3 vstages. TetralogyvofvFallotv-vcorrectvanswer- Decreasedvp.vbloodvflow.vFourvdefectsvthatvresultvinvmixedvbloodvflow:vp.vstenosis,v VSD,voverridingvaorta,vrightvventricularvhypertrophy. Murmur,vcyanosis,vpoorvfeeding,vnotvstrongvcry,vdyspnea,vagitation,vTETvSPELLS!! Kneevtovchestvforvinfantsvandvbabies--vsquattingvforvoldervchildren. Surgicalvrepair,vShuntvplacement. CardiacvCatheterizationv-vcorrectvanswer- Anvinvasivevtestvusedvforvdiagnosing,vrepairingvsomevdefects,vandvevaluatingvdysrhy thmias. CongenitalvHeartvDiseasevNursingvCarev-vcorrectvanswer- RemainvCalmvwhenvprovidingvcare Keepvthevchildvwellvhydrated,vconservevenergyvbyvclusteringvcares,vsmallvfrequentv meals,vdailyvweightvIvandvOs,vmonitorvHRvBPvbloodvelectrolytesvandvkidneyvfunction ,vmaintainvbedvrest,vfeedvinfantveveryv 3 vhrvtakingv 30 vminsvtovfeedvsovinfantvcanvrest, vincreasevcalvofvformulavgraduallyvfromv20-30vkcal.vProvidevO2vandvmonitorvsats.
HeartvDiagramv-vcorrectvanswer- PulmonaryvEmbolismvRiskvFactorsv-vcorrectvanswer-Long- termvimmobility,vpregnancy,voralvcontraceptives,vtabaccovuse,vhypercoagulabilty,vob esity,vsurgery,vcentralvvenousvcaths,vheartvfailurevorvavfib,vautoimmunevhemolyticvan emiav(sicklevcellvdisease),vlongvbonevfractures,vcancer,vtrauma,vadvancedvage. PulmonaryvEmbolismvExpectedvFindingsv-vcorrectvanswer- Anxiety,vfeelingsvofvimpendingvdoom,vsuddenvonsetvofvchestvpressure,vpainvuponvin spiration,vdyspneavorvairvhunger,vcough,vhemoptysis. PhysicalvFindings:vPleurisy,vpleuralvfrictionvrub,vtachycardia,vhypotension,vtachypne a,vcracklesvandvcough,vheartvmurmurvS3vandvS4,vdiaphoresis,vlow- gradevfever,vdecreasedvSPO2vlevels,vpetechia,vdistendedvneckvveins,vsyncope,vand vcyanosis. PulmonaryvEmbolismvNursingvCarev-vcorrectvanswer-O2,vhigh- fowlers,vmaintainvIVvaccess,vmedsvasvprescribed,vassessvrespvstatusvevv 30 vmins,va ssessvcardiacvstatus,vprovidevemotionalvsupportvandvcomfortvtovcontrolvanxiety,vmon itorvchangesvinvLOCvandvmentalvstatus. DVTvNursingvCarev-vcorrectvanswer- Encouragevambulation,vwarmvmoistvcompressesvasvprescribed,vdovnotvmassagevaff ectedvlimbs,vprovidevthigh-highvcompressionvorvanti- embolismvstockings,vpreparevthevclientvforvanvInferiorvVenavCavavFilter. Left-CerebralvHemispherevStrokevS/SXv-vcorrectvanswer-Affectsvrightvsidevofvbody.v Expressivevandvreceptivevaphasiav(inabilityvtovspeakvandvunderstandvlanguage.) Agnosiav(unablevtovrecognizevfamiliarvobjects.) Alexiav(readingvdifficulty.) Agraphiav(writingvdifficulty.)v Rightvextremityvhemiplegiavorvhemiparesis. Slow,vcautiousvbehavior. Depression,vanger,vandvquickvtovbecomevfrustrated. Visualvchangesv(hemianopsia.) Right-CerebralvHemispherevStrokevS/SXv-vcorrectvanswer-AffectsvLeftvsidevofvbody. Alteredvperceptionvofvdeficits. Unilateralvneglect-vneglectvofvleftvsidevofvbody. Lossvofvdepthvperception. Poorvimpulsevcontrolvandvjudgement. Leftvhemiplegiavorvhemiparesis. Visualvchangesv(hemianopsia.) StrokevNursingvCarev-vcorrectvanswer-MonitorvVSveveryv1- 2 vhours,vnotifyvprovidervifvBPvsysvgreatervthanv 180 vandvdysvgreatervthanv110.vMonit orvtemp,vprovidevO2,vcardiacvassessment,vchangesvinvLOCv(ICP),vavoidvextremevfle xionvorvextensionvofvthevneck,vseizurevprecautions,vassistvwithvcommunicationvskills, vassistvwithvsafevfeedingv(SLPvreferral.),vpreventvcomplicationsvofvimmobility,vencour agevROMvevv 2 vhr,vmaintainvsafevenvironmentvtovreducevfalls,vifvvisualvchangesvusev
