Albumin: protein that when low can cause wounds
Patient comes in and has been starving, is homeless, has sores on the feet, and is
confused how are you going to take care of him according to Maslo's hierarchy of needs?
Physiological needs first (Food and Water FIRST!)
Prevent thrombophlebitis after surgery compression stockings (must be smooth, no
wrinkles)
How to know if patient has AKI? Urine output less than 30 ml/h
What to tell someone who has chronic pain: manage pain when it’s not at its worst, start
with the lowest dose, if someone has arthritis sickle cell, or cancer go to the same
provider.
What is the most common form of cancer: Lung cancer
If patient has GI symptoms, what should they NOT take? Aspirin and NSAIDs
If someone has abdominal surgery, you turn them, and the wound opens, what do you do?
Sterile saline on gauze placed on the wound and call the surgeon.
What is the most painful condition of the musculoskeletal system? Bone cancer.
However, MOST musculoskeletal pain comes from osteoarthritis, may result in joint
replacement as an end result. The patient should not be laid on the affected side. If the
patient had a hip replacement, abductor pillow between the legs is necessary.
If someone has skeletal traction, what are some important considerations? Make sure
weights are hanging freely, and report purulent drainage.
If someone has low levels of albumin, that indicates malnutrition and dehydration (causing
low blood pressure)
Hemolytic anemia S/S: fever, jaundice (accumulation of bilirubin)
Someone in MVA, what is the priority? Airway, neuro, bleeding (PHYSIOLOGICAL FIRST!!!)
Hand hygiene is important for nursing practice and patient education!
Child comes to ED with swollen face and can barely breath (respiratory distress), what is
the likely cause? Anaphylaxis. What should you educate the patient on? Identify the agent
and avoid it.
When young people go to college, they should get a meningitis vaccine due to the close
quarters and lack of hygiene in dorm rooms.
Patient with fever, stiff neck, and headache, what should the nurses suspect? Meningitis
Also recommended to get HPV vaccine to prevent cervical cancer
Kidney function percentage for transplant (20%)
Prevent sepsis by removing tubes (Foley, trach) ASAP
Thiazide diuretics are used for excretion of fluid to reduce blood pressure
If a patient has A-fib, concern for blood clots!
If a blood clot travels to the brain, it causes a stroke. What’s the first sign? LOC and
speech.
Best way to reduce risk of stroke is to manage hypertension
If a patient has a CABG which vein would be used saphenous vein
Blood thinner used during surgery (CABG) to prevent clot formation: heparin (make sure
INR stays within normal range and keep protamine sulfate at bedside)
Warfarin antagonist is vitamin K
Look at dressings to make sure it is not saturated with blood after surgery
If the patient's leg was amputated, a torniquet should be VISIBLE!
Amputee's pain of the removed limb is called phantom pain. It is REAL pain; a specific
medication is used for this type of pain.
Patient had skeletal traction and had a cast on one arm, what is the best cast to have?
Fiberglass cast
Make sure a patient with a fracture does not have compartment syndrome (S/S are the 5
Ps: pain, pallor (pale skin tone), paresthesia (numbness feeling), pulselessness (faint
pulse) and paralysis (weakness with movements))
If a person must have a graft, the skin tone and texture should match and if the graft
becomes purulent, it usually should be thrown away. Ensure the graft is adhered and pink
in color. After the graft has healed education includes ROM, PT compliance, and
stretching.
How often to empty a catheter bag: 8 hours
Catheter is unsuccessful, must use a suprapubic catheter and helps with continuous
irrigation of bladder.
35 year old man present with fever, urinary frequency, and dysuria, what is the likely
diagnosis? Chronic bacterial prostatitis
Person who has breast cancer metastasizes, S/S are stiffness, pain, hepatomegaly.
Metastatic cancer with nothing to do: palliative care
S/S of H. Pylori: repeated vomiting, burning, and epigastric pain (also S/S of peptic ulcer
disease as this bacteria is the main cause)
Patient education for IBS: stay away from irritating substances, take medications 30
minutes before a meal, and reduce stress
ICU patient is having central venous pressure monitored, why? Hypovolemia and
hypotension due to increased accuracy
Someone has a large venous wound in the leg (or any wound that doesn’t heal), eat more
protein and high calorie nutritional intake (And essential vitamins).
For a patient who is bed bound, DVT prophylaxis includes ROM
For CT scan of kidney, use laxative to get a clear scan.
Occult blood: Bleeding is farther up in the digestive tract
Bright red: Nearer to the rectum.
Patient has kidney stones and has had a procedure to break up kidney stones, give the
patient a strainer.
Patient has HIV, what is the outlook? If medication compliant, they can live longer lives.
Side effects of AIDs: Kaposi sarcoma
PSA positive, digital exam to confirm prostate cancer, then a biopsy.
Know how to calculate Glasgow Coma Scale and the rule of 9s for burns
When someone goes for a kidney transplant and they have a fistula, an artery and vein are
connected. What is an appropriate precaution? DO NOT take blood pressure or insert an IV
on that side.
Shock advised -> CLEAR!
GER and GERD are not the same because GER is acute and GERD is chronic
If you were doing a post-op assessment, it should be from head to toe for neuro,
swallowing, pulses, capillary refill, lung sounds, heart sounds, bowel sounds, vitals.
MONA!!! MORPHINE, OXYGEN, NITROGLYCERIN, ASPIRIN
If a person has bone cancer that has metastasized, calcium and phosphate would be
elevated.
If someone has cystic fibrosis, they need pancreatic enzymes daily.
If someone has burns over 20% of the body, monitor fluids
To wean someone off the ventilator ABGs must be continuously checked.
Pneumothorax means collapsed lung.
Baby has cystic fibrosis; mother’s education includes postural drainage.
If someone has TMJ pain and is 40/50 years old, they need to be checked for MS.
If someone comes to the ER, what do we do FIRST? Register and sign an informed consent
If a person is disabled, who can make medical decisions? Power of Attorney
Always treat disabled people with respect and listen to family members about preferences
if the patient cannot communicate them.
Thrombocytopenia = low platelets