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2010-06-29 18:25:36
Misc questions

Misc questions for NCLEX review
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  1. Burns:

    Formally called first degree burn
    Superficial thickness
  2. Formally called second degree burn
    Partial thickness
  3. Formally called third degree burn
    Full thickness
  4. What type of isolation do you use with a burn patient?
    Reverse isolation or Protective
  5. DO NOT use Santyl...
    On face

    If pregnant

    Over large nerves

    If area is opened to a body cavity
  6. Hydrotherapy is used to
  7. Silvadene
    Soothing, apply directly, if rubs off apply more, can lower WBC, can cause a rash
  8. Sulfamylon
    can cause acid base problems, stings, if it rubs off apply more
  9. Silver nitrate
    keep these dressings wet; can cause electrolyte problems
  10. Betadine
    Stings, stains, allergies, acid-base problems
  11. Why should burn drugs/cremes be rotated?
    Different types of bacteria
  12. In burn patients, broad spectrum antibiotics are avoided to prevent?

    -Broad spectrum antibiotics will be used until the wound cultures have returned
  13. If skin graft becomes blue or cool what would this mean?
    No circulation
  14. Sometimes the MD will order you to roll sterile Q-tips over a graft with steady, gentle pressure from the center of the graft out to the edges. Why?
    Smooths it down to touch the wound bed so it can adhere and gain circulation
  15. electrical burn-- 2 exits. Which is worse?
  16. What is important with an electrical injury?
    Heart monitor
  17. Electrical injury-- what arrythmia is patient at high risk for?
  18. With electrical burns ____ can build up and cause ______ ______.
    Toxins build up and cause kidney damage
  19. Amputations are common in burns because_____
    The circulatory system can be destroyed
  20. Complications of electrical wounds include:
    cataracts, gait problems, and just about any type of neuro deficit.

    Electricity loves blood!
  21. No aces on ___
  22. Alcohol + tobacco =

  23. CAUTION stands for?
    • Change in bowel/bladder habits
    • A sore that does not heal
    • Unusual bleeding/discharge
    • Thickening or lump in breast or elsewhere
    • Indigestion or difficulty swallowing
    • Obvious change in wart or mole
    • Nagging cough or hoarseness
  24. When cancer invades bone marrow it causes _____ and _______
    Anemia and thrombocytopenia
  25. What is another name for internal radiation?
  26. With all brachytherapy, the radioactive source is inside the patient; radiation is being emitted.

    What is the difference between Unsealed and Sealed or Solid?
    • Unsealed: patient and body fluids emit radiation
    • - isotope is given IV or PO
    • - usually out of system in 48 hrs.

    • Sealed or solid: patient emits radiation; body fluids are not radioactive
    • - implanted close or in the tumor
  27. Radiation (brachytherapy) precautions
    • -private room
    • -restrict visitors
    • -no visitors under 16
    • -no pregnant visitors/nurses
    • -mark the room
    • -wear a film badge at all times
    • -limit each visitor to 30 min per day
    • -visitors must stay at least 6 feet from source
  28. How can you help prevent dislodgment of a radioactive implant?
    • keep patient on bedrest
    • prevent bladder distention
    • decrease fiber in diet
  29. other names for External radiation are?
    • teletherapy
    • beam radiation
  30. Usual side effects of external radiation
    • erythema
    • shedding of skin
    • altered taste
    • fatigue
    • Pancytopenia (all blood components are decreased)

    • many signs and symptoms are location and dose related
  31. Protect an external radiation site from sun for how long after completion of therapy?
    1 year
  32. Usual side effects of chemo
    • aopecia,
    • N/V
    • mucositis
    • immunosuppression
    • anemia
    • thrombocytopenia
  33. Patient's WBC count must be at least ____ before they can receive chemo
  34. A vesicant is a type of chemo drug that if it infiltrates (extravasates) will cause tissue ______.

    When giving a vesicant the nurse must _______.

    Stay with patient the whole time drug is being given
  35. Chemo works on the ___________

    -usually schedualed every __________
    Cell cycle

    3-4 weeks
  36. Signs and symptoms of extravasation
    • Pain
    • redness
    • swelling
    • no blood return
  37. What do you do with extravasation?
    • STOP infusion
    • Ice packs
    • Call MD
  38. What lab value is most important in preventing infection for an immunocomprimised patient?
    Absolute Neutrophil count
  39. Classic symptom of invasive cervical cancer
    painless vaginal bleeding
  40. general s/s of cervical cancer
    • watery, blood tinged vaginal discharge
    • leg pain along sciatic nerve
    • back/flank pain
  41. Major symptom of uterine cancer
    Post menopausal bleeding
  42. Diagnostic for uterine cancer to rule out ovarian involvment
    CA-125 blood test
  43. Uterus and cervix only removed
    Total abdominal hysterectomy
  44. may remove all of the pelvic organs
    Patient may have colostomy, ileal conduit
    Radical hysterectomy
  45. The greatest time for hemorrhage following a hysterectomy is
    During the first 24 hrs

    Why? Pelvic congestion of blood
  46. major complication with abdominal hysterectomy is _______

    major complication with vaginal hysterectomy is ________
    abd hemorrhage

    vag infection
  47. bilateral oophorectomy =
  48. bilateral salpingectomy =
  49. why do you want to prevent abd distention after abd surgery?
    • Do not want tension on the suture line
    • dehiscence and evisceration
  50. avoid high fowlers in post op abd surgery because
    blood pools to suture
  51. S/S of lung cancer
    • hemoptysis
    • dyspnea
    • hoarseness
    • cough
    • change in endurance
    • chest pain
    • pleuritic pain on inspiration
    • displaced trach

    *may metastasize to bone
  52. major difference between the S/S of lung cancer and that of tuberculosis
    TB has night sweats too!
  53. After a bronchoscopy, watch for:
    • resp. depression
    • hoarseness
    • dysphagia
    • SQ emphysema (air in the tissues) Sounds like rice krispies
  54. Is it normal to have resp. depression after a bronchoscopy?
  55. Sputum specimen:

    Best time to obtain?

    Is this sterile?

    What should patient do first?
    First thing in the morning

    yes it is sterile

    patient should rinse mouth with water to decrease bacteria in mouth
  56. Diagnostic tests for lung cancer
    • Bronchoscopy
    • sputum specimen
    • CT
    • MRI
  57. Lobectomy

    what is it?

    How do you position pt after?
    Part of the lung is removed

    chest tubes and surgical side up
  58. Pneumonectomy:

    What is it?

    Pt care after?
    total removal of lung

    • Good lung up!
    • position on affected side
    • No chest tubes because there's no lung

    Avoid severe lateral positioning becuase this could lead to a mediastinal shift!

    • RR should always be perfect!!