Stroke and ACE Inhibitors Quiz

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Questions and Answers

What precaution should patients taking ACE inhibitors take to reduce the risk of infections?

Practice good hand hygiene (correct)

Increase physical activity levels

Take vitamin supplements

Limit fluid intake

Which of the following is NOT recommended for patients on a sodium-restricted diet?

Using potassium chloride as a salt substitute

Using herbs and spices

Using lemon juice for flavoring

Incorporating regular table salt (correct)

Which lifestyle change can support immune function in patients taking ACE inhibitors?

Maintaining a healthy diet (correct)

Reducing sleep hours

Taking immune-boosting supplements

Practicing yoga daily

Why should patients with kidney disease be cautious when using potassium chloride salt substitutes?

It can result in potassium retention Signup and view all the answers

When should white blood cell counts be monitored for patients on ACE inhibitors?

Periodically as advised Signup and view all the answers

What symptom most likely indicates an injury to the cerebellum?

Loss of balance Signup and view all the answers

Which characteristic distinguishes a TIA from a CVA?

Symptoms resolve within minutes Signup and view all the answers

What is the priority nursing consideration immediately after a CVA?

Maintaining airway Signup and view all the answers

Which type of stroke is characterized by bleeding in the brain?

Hemorrhagic stroke Signup and view all the answers

What is the rationale for prescribing warfarin after a CVA?

To prevent further clot formation Signup and view all the answers

What defines the end of the acute phase of a stroke?

Return to normal vital signs Signup and view all the answers

Which of the following is a true statement regarding intravenous tPA administration?

Must be given within 3 hours of symptom onset Signup and view all the answers

Which of these symptoms indicates injury to the brain's language areas?

Trouble speaking or understanding speech Signup and view all the answers

What is a common sign of dehydration in a patient with severe diarrhea?

Dry mouth and lips Signup and view all the answers

What is the primary purpose of an ileostomy?

To divert intestinal contents outside the body Signup and view all the answers

Which dietary modification is essential for preventing diverticulosis in older adults?

High-fiber diet Signup and view all the answers

What type of incision is NOT typically required for an abdominoperineal resection surgery?

Thoracic incision Signup and view all the answers

What is a recommended post-surgical care practice for a patient recovering from hemorrhoid treatment?

Use cold packs to reduce swelling Signup and view all the answers

Which intervention can a nurse implement to prevent complications from extended bed rest?

Encourage passive range-of-motion exercises Signup and view all the answers

What condition suggests that a patient with hepatic disorder might benefit from fluid restrictions?

Ascites Signup and view all the answers

Which factor is a primary risk for developing diverticulosis in aged men?

Low-fiber diet Signup and view all the answers

How frequently should the pouch of an ileostomy be changed?

Every 3-5 days Signup and view all the answers

What fluid recommendation is typically made to help prevent constipation?

8 glasses of water per day Signup and view all the answers

What is a potential complication from an ileostomy?

Dehydration Signup and view all the answers

What is an important aspect of patient education for stoma care?

Use mild soap and water for cleaning Signup and view all the answers

Which symptom indicates the need for prompt medical evaluation in cases of severe diarrhea?

Persistent dizziness and lightheadedness Signup and view all the answers

What is the primary purpose of administering nimodipine after an aneurysmal subarachnoid hemorrhage?

To prevent cerebral vasospasm Signup and view all the answers

What is a significant contraindication for interventions in patients with a hemorrhagic stroke?

Performing suctioning procedures Signup and view all the answers

Which symptom is NOT typically associated with fluid volume excess?

Increased thirst Signup and view all the answers

Which type of range-of-motion exercise allows the patient to move their joint independently?

Active range-of-motion Signup and view all the answers

What is a key nursing consideration for a patient with homonymous hemianopsia in the acute phase?

Arrange the environment within their visual field Signup and view all the answers

What is an appropriate outcome criterion for a patient with inadequate nutrition related to dysphagia?

Patient consumes recommended dietary intake without aspiration Signup and view all the answers

Which intervention helps prevent pressure injuries in immobilized patients during the rehabilitation phase?

Regular turning and positioning Signup and view all the answers

How does hyperglycemia negatively impact stroke recovery?

Exacerbates brain damage and inflammation Signup and view all the answers

What is arterial embolism primarily caused by?

A blood clot blocking an artery Signup and view all the answers

Which type of aphasia is characterized by difficulty producing speech but relatively preserved comprehension?

Broca's aphasia Signup and view all the answers

What is a common sign of fluid volume excess related to pulmonary status?

Crackles or gurgling sounds on respiration Signup and view all the answers

Which lifestyle modification is recommended for a patient diagnosed with a blood clot?

Manage diabetes effectively Signup and view all the answers

What bonding issue might arise due to a patient's inability to eat normally following a stroke?

Inadequate nutrition Signup and view all the answers

What is the main goal of a bowel regimen?

To promote regular and complete bowel evacuation Signup and view all the answers

What is the most appropriate way to monitor a patient's fluid volume status?

Tracking daily weight gain and urine output Signup and view all the answers

What dietary change is suggested for patients with dysphagia?

Incorporate thickened liquids Signup and view all the answers

What sign should a patient with achalasia be taught to recognize that requires medical attention?

Worsening trouble swallowing Signup and view all the answers

What is an important technique for preventing contractures in immobilized stroke patients?

Consistent range-of-motion exercises Signup and view all the answers

What type of medication can be contraindicated for patients on blood thinners?

Ginger supplements Signup and view all the answers

What activity is recommended for patients with irritable bowel syndrome (IBS)?

Increased hydration Signup and view all the answers

Which of the following is a sign of aspiration a patient should recognize?

Coughing or choking Signup and view all the answers

What symptom is commonly associated with gastric ulcers?

Burning pain occurring 1-2 hours after meals Signup and view all the answers

What is an appropriate position for feeding patients at risk of aspiration?

Head elevated Signup and view all the answers

For a patient with dysphagia, what practice should be avoided during meals?

Engaging in conversation Signup and view all the answers

What type of food is most beneficial for someone with achalasia?

Soft, pureed foods Signup and view all the answers

Which symptom would indicate a medical emergency for a patient with arterial embolism?

Severe and worsening pain Signup and view all the answers

What is an essential component of follow-up care for patients prescribed long-term anticoagulants?

Regular blood monitoring Signup and view all the answers

What characterizes global aphasia?

Severe impairment in both expression and comprehension Signup and view all the answers

Which type of aphasia is characterized by difficulty naming objects while maintaining good fluency?

Anomic aphasia Signup and view all the answers

Which statement is true regarding arterial ulcers compared to venous ulcers?

Arterial ulcers are painful and occur on toes/feet. Signup and view all the answers

What is a common complication to monitor for after abdominal surgery?

Wound infection Signup and view all the answers

Which of the following is a preventative measure for varicose veins?

Maintaining a healthy weight Signup and view all the answers

What distinguishes venous PVD from arterial PVD in terms of limb characteristics?

Venous limbs are warm and edematous. Signup and view all the answers

What should a patient with Raynaud's syndrome be advised to avoid?

Cold temperatures and stress Signup and view all the answers

Which treatment option is considered a minimally invasive procedure for varicose veins?

Sclerotherapy Signup and view all the answers

What is an essential question to ask a patient with a history of DVT?

Do you experience pain or swelling in the affected limb? Signup and view all the answers

How can claudication be best characterized in arterial PVD?

Pain occurs with exercise and is relieved by rest. Signup and view all the answers

What lifestyle modification is recommended for patients with Raynaud's syndrome?

Practice stress management techniques. Signup and view all the answers

What is a key nursing consideration when administering aminoglycosides intravenously?

Observe the IV site for phlebitis or extravasation. Signup and view all the answers

Which of the following interventions is NOT typically advised for patients recovering from abdominal surgery?

Avoiding deep breathing exercises Signup and view all the answers

After an endovenous laser ablation procedure, which post-care instruction is important?

Wearing compression stockings. Signup and view all the answers

Which risk is associated with acute attacks of Ménière's disease?

High risk for injury due to severe vertigo. Signup and view all the answers

What is the primary goal for managing Raynaud's syndrome?

Preventing attacks and minimizing tissue damage. Signup and view all the answers

What patient teaching can help manage symptoms of Ménière's disease?

Lying down at the first signs of dizziness can be beneficial. Signup and view all the answers

What condition is characterized by inherited hearing loss that often worsens during pregnancy?

Alport syndrome. Signup and view all the answers

What defines presbycusis?

Age-related hearing loss that occurs gradually. Signup and view all the answers

What does myringotomy involve?

Surgical incision in the tympanic membrane. Signup and view all the answers

What can untreated cholesteatomas lead to?

Hearing loss and possibly brain abscess. Signup and view all the answers

What blood pressure reading indicates Stage 1 Hypertension?

Systolic BP 130-139 mmHg. Signup and view all the answers

What dietary adjustments can help manage the adverse effects of loop diuretics?

Increased intake of potassium-rich foods. Signup and view all the answers

What symptom can beta-adrenergic blockers mask in diabetic patients?

Tremors. Signup and view all the answers

Which condition is a potential side effect of verapamil?

Constipation. Signup and view all the answers

What should be monitored when administering ACE inhibitors?

Reduced immunity. Signup and view all the answers

What dietary modification is recommended for managing hyponatremia?

Increase sodium intake. Signup and view all the answers

What is an important teaching point regarding peripheral edema from verapamil?

Monitor for ankle swelling and elevate legs. Signup and view all the answers

Which symptom is NOT related to the need for fluid restrictions in patients?

Increased appetite Signup and view all the answers

What is the primary method used to assess for ascites?

Percussion of the abdomen Signup and view all the answers

What transmission method is associated with Hepatitis C?

Contact with infected body fluids Signup and view all the answers

Which of the following is NOT a warning sign of cancer represented by the acronym 'CAUTION'?

Unexplained weight loss Signup and view all the answers

What is a significant risk factor for cancer reflected in many scenarios?

Genetic predisposition Signup and view all the answers

Which of the following is NOT a common adverse effect of the 'mycins' antibiotics?

Drowsiness Signup and view all the answers

What primary purpose does a Pap test serve?

Identifying precancerous changes in the cervix Signup and view all the answers

Which instruction is NOT recommended for patients preparing for a colonoscopy?

Eat a high-fiber diet before the procedure Signup and view all the answers

What is a primary nursing consideration for a patient with an internal radiation implant?

Limit time spent near the patient Signup and view all the answers

What condition could ascites lead to in liver disease patients if not monitored closely?

Respiratory compromise Signup and view all the answers

Which hepatitis virus is only transmissible in individuals already infected with Hepatitis B?

Hepatitis D Signup and view all the answers

Which of these is a common gastrointestinal effect of 'mycins' antibiotics?

Nausea Signup and view all the answers

What is a common environmental risk factor for cancer?

Exposure to carcinogens like chemicals Signup and view all the answers

Which intervention is necessary after patient education regarding internal radiation safety?

Consult with a radiation safety officer Signup and view all the answers

What should a nurse do immediately after an intravenous vesicant cancer drug has extravasated?

Stop the infusion but keep the IV line in place. Signup and view all the answers

What is the classic sign associated with systemic lupus erythematosus (SLE)?

Butterfly-shaped rash across the cheeks and nose. Signup and view all the answers

Which statement about the stages of HIV infection is true?

Advanced HIV/AIDS includes a significant decline in immune function. Signup and view all the answers

What is the primary use of gentamicin sulfate (Garamycin)?

To treat serious bacterial infections. Signup and view all the answers

Which type of glaucoma is considered more dangerous and requires immediate treatment?

Angle-closure glaucoma. Signup and view all the answers

What happens to the viral genome during the action of reverse transcriptase in HIV?

It transcribes RNA into DNA. Signup and view all the answers

What is a primary nursing intervention for a patient experiencing neutropenia?

Instruct the patient to avoid raw foods. Signup and view all the answers

Which of the following symptoms is NOT typically associated with cataracts?

Severe eye pain. Signup and view all the answers

How does neutropenia affect a patient's risk of infection?

It increases the risk of infection. Signup and view all the answers

What is the best nursing action to take if a patient with leukemia shows signs of infection?

Promptly report symptoms and treat as an emergency. Signup and view all the answers

Which of the following symptoms is an early sign of open-angle glaucoma?

Loss of peripheral vision. Signup and view all the answers

What should be included in the nursing documentation after extravasation of a vesicant drug?

A thorough account of the extravasation event. Signup and view all the answers

What are common signs and symptoms of Pseudomonas aeruginosa infections?

Respiratory symptoms and pneumonia. Signup and view all the answers

What type of visual impairment is typically caused by central cataracts?

Blurriness in straight-ahead vision. Signup and view all the answers

What is a potential adverse effect of gentamicin sulfate that must be monitored?

Nephrotoxicity. Signup and view all the answers

Study Notes

Cerebrovascular Accident (CVA) and Transient Ischemic Attack (TIA)

CVA Location by Symptoms: Numbness/weakness on one side of the body (face, arm, leg) indicates injury to the opposite brain side. Confusion/speech issues point to language areas. Vision problems (blindness) suggest occipital lobe or optic nerve damage. Balance/coordination issues imply cerebellum injury. Severe headache may indicate brain stem hemorrhage.
TIA vs. CVA: TIA symptoms are temporary, do not cause permanent damage, and resolve within minutes to under 24 hours. They arise from temporary blood flow deprivation to the brain, not resulting in tissue death or infarction. TIAs are warning signs of potential stroke and require urgent evaluation.
Warfarin (Coumadin) in CVA: Prescribed to prevent further clot formation and reduce subsequent stroke risk following a CVA.
CVA Types: Hemorrhagic (bleeding in the brain), ischemic (blocked blood flow).
Complete Stroke: No further neurological symptoms, vital signs return to normal.
Priority Post-Stroke Nursing Care: Maintaining a patent airway.

Stroke Stages

Stroke completion criteria: Not in an acute phase.

Thrombolytic Therapy (tPA)

Intravenous tPA Administration: Given within 3 hours of symptom onset, or 3-4.5 hours for selected patients.
Intra-arterial tPA: Can be given up to 6 hours after symptom onset. Close monitoring is critical due to bleeding risk.

Calcium Channel Blocker (Nimodipine)

Administration: Typically oral every 4 hours for 21 days after aneurysmal subarachnoid hemorrhage. Administer within 96 hours of hemorrhage to prevent cerebral vasospasm.

Hemorrhagic CVA Interventions

Interventions increasing intracranial pressure (suctioning, coughing) are contraindicated. Focus on maintaining a patent airway while minimizing pressure-increasing actions.

Fluid Volume Excess

Signs/Symptoms: Edema (extremities, abdomen), shortness of breath (dyspnea), cough, crackles, frothy sputum, sudden weight gain, shiny/taut skin, decreased urine output, restlessness, anxiety. Elevated blood pressure, bounding pulse, and decreased hematocrit are also possible.

Joint Mobility Promotion

Range-of-Motion (ROM) Exercises: Active (patient moves joint independently), active assisted (patient moves with support), or passive (joint moved by someone else). Regular ROM exercises prevent stiffness, contractures and mobility loss.

Homonymous Hemianopsia

Description: Visual field defect – same half of vision lost in both eyes. Associated with stroke impacting optic tract, radiation, or occipital lobe.
Acute Phase Nursing: Arrange environment to patient's remaining visual field (food trays).
Later Phase Nursing: Teach compensatory techniques (scanning the affected visual field). Assess for safety risks related to visual neglect (falls). Protect weak limbs. Monitor for other problems (diplopia, ptosis). Facilitate mobility as required given the patient's deficits.

Inadequate Nutrition (Dysphagia) Outcome

Expected outcome: Patient consuming the recommended diet via prescribed texture/consistency without signs of aspiration over 3 days. This outcome is specific, measurable, attainable, relevant, and time-bound.

CVA Rehabilitation (Family Teaching)

Positioning/Turning: Techniques to prevent pressure injuries and contractures. Demonstrate proper positioning, assistive devices, turning schedule.
Range-of-Motion (ROM): Teach families how to conduct active, active-assisted, and passive ROM.
Bowel/Bladder Training: Explain timed voiding schedules, bowel routines, regain continence.
Swallowing Techniques: Demonstrate safe feeding strategies with proper food/fluid consistencies if dysphagia exists.
Mobility/Transfers: Instructions on proper body mechanics, equipment use to improve independence.
Medication Management: Especially for new medications during rehabilitation.
Home Environment Modifications: Safety and accessibility upon discharge.
Emotional Support: Celebrate small achievements and emphasize patience.

Hyperglycemia in CVA

Association: Hyperglycemia (high blood glucose) exacerbates brain damage during acute stroke, which impacts recovery.
Reasons: Stress response (cortisol/epinephrine increasing glucose), previously undiagnosed diabetes, and increased oxidative stress/inflammation.
Treatment: Current guidelines recommend insulin treatment if blood glucose exceeds 200 mg/dL.
Impact: Worsens brain damage, poorer patient outcomes.

Different Types of Aphasia

Broca's (Expressive): Difficulty speaking, forming words, relatively preserved comprehension, non-fluent speech, effortful.
Wernicke's (Receptive): Difficulty comprehending language, possibly fluent but nonsensical speech.
Global: Severe impairment in both expression and comprehension.
Anomic: Difficulty retrieving words/naming items, relatively preserved fluency and comprehension.
Conduction: Impaired word/sentence repetition despite comprehension.
Transcortical: Rare, involve connections between areas; may present as pure or mixed.

Deep Vein Thrombosis (DVT) Questions

Last DVT episode, affected limb, risk factors (surgery, immobility, cancer), current anticoagulant medications, residual swelling/pain/discoloration, prevention instructions, family/personal history of blood clotting disorders, physical activity level, recent events (surgery, immobility).

Peripheral Vascular Disease (PVD) Types

Arterial PVD: Pain during walking (claudication), relieved by rest, ulcers over bony prominences, pale/painful ulcers, coolness, diminished pulses, affects multiple areas.
Venous PVD: Painless unless ulcers are present, ulcers around ankles, shallow/painless ulcers, warmth, edema, prominent superficial veins, localized.

Varicose Veins Treatment/Teaching

Conservative: Compression stockings, leg elevation, weight loss, avoid prolonged sitting/standing.
Minimally Invasive: Sclerotherapy, endovenous laser/radiofrequency ablation.
Surgical: Ligation and stripping, post-op instructions about compression stockings, activity limitations, monitoring for complications, leg elevation.

Raynaud's Syndrome Patient Teaching

Avoid triggers (cold, stress, vasoconstrictors). Dress warmly. Stress management techniques. Gentle warming measures, exercise. Quit smoking. Wear medical alert jewelry. Recognize concerning signs (circulation problems, infection). Adjust lifestyle (avoiding vibrating tools).

Post-Abdominal Surgery Assessments

Monitor for wound infection (fever, pain/tenderness, drainage), dehiscence, bleeding, ileus (distention, no bowel sounds), adequate urinary output. Assess incision site, drainage (amount/characteristics). Palpate for tenderness/swelling. Auscultate bowel sounds, measure abdominal girth, monitor tube patency (if present), assess/monitor pain/analgesics, closely monitor intake/output, encourage early ambulation/deep breathing, provide instructions.

Arterial Embolism Patient Teaching

Explain condition - clot blocking artery.
Treatments - anticoagulants, thrombolytics, possible surgery.
Medication instructions - dosing, side effects, ongoing monitoring.
Risk factor modification - stop smoking; manage underlying conditions.
Symptoms to report - worsening pain, numbness, discoloration.
Lifestyle guidance - activity restrictions, allowable exercises, compression use. . Monitor for complications.

Regurgitation Avoidance

Positioning: Upright or head-of-bed elevated.
Liquid Thickening: For dysphagia.
Enteral Feedings: Head of bed elevated during and 30 minutes post.
Residuals: Check and hold feedings as per protocol.
Oral Hygiene: Frequent.
Positioning: Avoid flat position (right side preferred).
Continuous Feedings: Temporarily stop before lowering head.
Tube Positioning/Patency: Maintain.

Bowel Regimen Goal

Regular, complete bowel evacuation, and prevention of complications like constipation.

Dysphagia (Swallowing) Teaching

Swallowing therapy techniques (chin tuck, head turn, double swallow).
Dietary modifications (thickened liquids, pureed/soft foods).
Positioning (head elevated).
Proper eating (small bites, thorough chewing, alternate solids/liquids).
Distraction avoidance.
Oral hygiene.
Recognize warning signs for aspiration, seek help if symptoms worsen.
Use adaptive equipment (weighted utensils).
Swallowing exercises with speech therapy.

Ginger Contraindications

Bleeding Risk: Increased risk with blood thinners (Coumadin, Plavix, aspirin).
Blood Sugar Levels: Could lower blood sugar in diabetics.

Peptic Ulcer Pain

Gastric Ulcer: Burning/gaseous epigastric pain 1-2 hours after meals; food worsens pain.
Duodenal Ulcer: Intermittent, burning/cramping midepigastric pain, 2-5 hours after meals when stomach is empty, relieved by food or antacids; some patients may present with bloating, nausea, vomiting, and early fullness instead of or in addition to pain.

Achalasia

Esophageal muscle failure to relax, prevents food passage.
Teaching: Soft/pureed foods. Avoid tough meats, raw veggies and hard bread. Small bites, thorough chewing. Liquids with meals. Stay upright after eating.. Monitor for worsening swallowing difficulty, or lung issues from aspiration. Emphasize that treatments help provide relief.

Irritable Bowel Syndrome (IBS) Patient Teaching

Individual food triggers (dairy, caffeine, fatty foods, alcohol).
Increased fiber gradually (whole grains, fruits, vegetables).
Hydration (plenty of fluids).
Physical activity and stress management.
Regular meal/bowel habits.
Symptom management (gas, bloating, diarrhea, constipation).
Seek medical care if symptoms worsen or new ones develop.
Medications for symptom relief.
Probiotics/peppermint oil are also useful for some patients, and adjust fiber based on predominant symptoms (less for diarrhea, more for constipation)

Severe Diarrhea (2 weeks) Symptoms

Decreased urine output, dark urine.
Dry mouth/lips/mucous membranes
Sunken eyes
Dizziness, fatigue
Headache, muscle cramps
Rapid heart rate, low blood pressure,
Confusion/irritability, especially elderly.

Ileostomy

Description: Surgical opening to ileum (small intestine) for diversion of bowel contents.
Output: Liquid fecal effluent.
Stoma Appearance: Pink/red, moist.
Skin Care: Gentle soap/water and skin barriers.
Appliance: Pouch changes every 3-5 days
Initial Output: Initially liquid, thickens as the body adapts. Diet modifications.
Emptying: Frequent at first, routine lengthens.

Diverticulosis Risk Factors

Low-fiber diet, weakening colon wall, increased pressure from constipation/straining, especially in the sigmoid colon.
Lack of exercise, obesity, smoking, certain meds (NSAIDs, opioids). Family history

Abdominoperineal Resection Surgery Incisions

Abdominal, colostomy, perineal.

Hemorrhoid Post-Surgery Teaching

Sitz baths: 2-3 times daily, 15-20 minutes, promote healing/pain relief.
Pain management: Prescribed meds as needed, cold compresses.
Bowel habits: Fluids, high-fiber foods, stool softeners if recommended; avoid straining.
Hygiene: Gentle anal area care with fragrance-free wipes.
Activity: Avoid prolonged sitting/standing, moderate activity, avoid heavy lifting until healed.
Wound care: Instruct on wound care and report infection signs.
Gradual return to normal activities.

Constipation Avoidance Teaching

Increase fiber in diet (fruits, vegetables, whole grains, beans).
Drink sufficient fluids (at least 8 glasses).
Regular exercise.
Respond to bowel urges promptly.
Establish a regular bowel schedule (e.g., after breakfast).
Use bedpans/commodes for those confined to bed.
Stool softeners/laxatives if constipation persists.

Extended Bed Rest Complications Avoidance

ROM exercises, turning every 2 hours, sufficient nutrition/fluids (at least 3000 mL/day), pressure relief devices and skin care, frequent skin assessments, stool softeners/laxatives. Encourage movement of unaffected limbs. Isometric exercises, comfort measures (massage, hygiene, eliminate irritants).

Hepatic Disorder and Fluid Restrictions

Indications: Ascites (fluid buildup in abdomen), peripheral edema, shortness of breath, rapid weight gain, distended abdomen. Liver's impaired fluid regulation.

Ascites Monitoring

Assessment: Abdominal inspection, auscultation (bowel sounds), percussion (distension, flank dullness), palpation (tenderness). Monitor abdominal girth. Assess shifting dullness (percuss at different points to assess fluid shift with position changes).
Daily Weight: Monitor for rapid weight gain.
Other Indicators: Shortness of breath, ankle edema, tense abdominal skin.
Diagnostic Tests: Abdominal ultrasound, CT scans, paracentesis results.

Hepatitis Types and Transmission

Hepatitis A: Ingestion of contaminated food/water; Close personal contact.
Hepatitis B: Infected blood, semen, other bodily fluids. Sexual contact, needle sharing, mother-to-child.
Hepatitis C: Primarily through infected blood, less commonly sexual.
Hepatitis D: Only with Hep B; same transmission methods.
Hepatitis E: Contaminated food/water.

CAUTION Acronym (Cancer Warning Signs)

Change in bowel habits.
Sore that doesn't heal.
Unusual bleeding/discharge.
Thickening/lump in breast.
Indigestion.
Obvious change in warts/moles.
Nagging cough.

Recognizing Cancer Risk Factors

Identify genetic/family history of cancer.
Evaluate environmental exposures (carcinogens).
Assess lifestyle factors (tobacco use, diet, obesity).
Note patient age.
Consider hormonal factors.
Evaluate relevant medical conditions or treatments.

Adverse Effects of "Mycins" (Antibiotics)

Gastrointestinal issues (nausea, vomiting, pain, diarrhea)
Hepatotoxicity (liver enzyme elevation, hepatitis, jaundice).
Cardiac effects (prolonged QT interval, arrhythmias like torsades de pointes).
Ototoxicity (hearing loss, tinnitus, vertigo).
Allergic reactions (rash, fever, anaphylaxis)
Bacterial overgrowth.

Pap Test

Screening for cervical precancerous changes. Cells are collected and examined for abnormalities.

Pre-Colonoscopy Patient Teaching

Procedure explanation, clear liquid diet prep (24-48 hours), bowel preparation regimen (laxatives, cathartics, enemas), stopping specific medications (iron, aspirin, anti-inflammatories) 3 days prior. Inform patient will need a ride home.

Internal Radiation Implant Nursing Considerations

Radiation safety (time, distance, shielding).
Patient/visitor education.
Coordinated care with radiation safety officer.
Visitor restrictions (pregant women, children).
Ongoing monitoring.

Intravenous Vesicant Cancer Drug Extravasation

Stop infusion, keep IV line in place.
Aspirate remaining drug.
Get physician order for antidote via IV in affected area.
Apply warm compresses and elevate limb.
Monitor site and provide supportive care.
Thoroughly document.

Enzyme Reverse Transcriptase

Transcribes HIV's RNA genome to double stranded DNA, allowing integration into host cell DNA to enable HIV replication.

HIV Infection Stages

Acute: 2-4 weeks after infection; flu-like symptoms, high viral load; most infectious
Clinical Latency: Virus dormant/inactive; no major symptoms, CD4 count gradually declines (2-12 years).
AIDS: CD4 count <200 cells/mm3, severe immune impairment; opportunistic infections/cancers.
Advanced/Late Stage AIDS: More severe opportunistic illnesses, wasting syndrome, increased mortality risk.

Systemic Lupus Erythematosus (SLE)

Classic Sign: Butterfly-shaped rash on cheeks and nose.
Symptoms: Fatigue, fever, joint/muscle pain, photosensitivity rashes, oral/nasal ulcers, hair loss, anemia, low platelet and white blood cell counts, potential kidney, heart, lung, or eye involvement. Symptoms fluctuate.

Low Neutrophil Count (Neutropenia) Precautions

Hand hygiene, avoid infections (crowds, sick people, raw foods). Infections require prompt treatment, possibly use of medications (filgrastim) to boost neutrophil production. Closely monitor temperature, instruct patient on avoidance and prompt reporting of symptoms.

Pseudomonas aeruginosa in Leukemia Patients

Opportunistic germ, causes serious infections (pneumonia, bloodstream, skin/soft tissue). Leukemia patients are at high risk due to chemotherapy-induced neutropenia.

Cataracts

Signs/symptoms: Cloudy/blurry vision, faded colors, poor night vision, halos around lights, double vision, spots/ghost images, floaters.

Glaucoma Types and Dangers

Open-angle: More common; increased intraocular pressure (IOP) due to impaired aqueous humor drainage, gradual peripheral vision loss.
Angle-closure: Less common, but more acute and dangerous; iris blocks drainage angle, rapid IOP increase, severe symptoms (eye pain, nausea, halos, sudden vision loss). Urgent medical attention is critical.

Gentamicin Sulfate (Garamycin)

Medication: Aminoglycoside antibiotic for serious bacterial infections.
Adverse Effects: Nephrotoxicity, ototoxicity, neuromuscular blockade.
IV Administration: Monitor IV site for phlebitis/extravasation (tissue damage).
Monitor for any signs of potential issues.

Meniere's Disease

Description: Inner ear disorder with vertigo, tinnitus, hearing loss, ear fullness/pressure. Risk for injury during attacks (vertigo, nausea, possible falls).
Patient Teaching: Sit/lie down at first dizziness signals. Avoid activities until vertigo subsides. Make home environment safe (remove tripping hazards). Adhere to vestibular exercises for better long-term balance.

Inherited Hearing Disorder Affecting Young Women During Pregnancy

Alport Syndrome: Inherited disorder causing progressive hearing loss, often worsening during pregnancy. Impacted by collagen production, effects ears, kidneys, and eyes.

Presbycusis

Age-related hearing loss, high frequency hearing difficulty, speech understanding problems in noisy settings. Degenerative changes in inner ear and auditory nerve.

Tympanic Membrane Tube Placement

Myringotomy: Incision in eardrum to drain fluid from middle ear. Tympanostomy tubes often inserted to maintain aeration.

Cholesteatoma

Abnormal, non-cancerous skin cyst in the middle ear, behind the eardrum. Can cause hearing loss, vertigo, facial nerve damage, brain abscess if untreated. Requires surgical removal.

Hypertension (HTN) Diagnosis

Stage 1: Systolic 130-139 mmHg or Diastolic 80-89 mmHg
Stage 2: Systolic ≥140 mmHg or Diastolic ≥90 mmHg. Average of two or more elevated readings from two or more office visits is used after the initial assessment.

Loop Diuretics and Diet

Adverse effects: Hypokalemia (low potassium) and hyponatremia (low sodium).
Dietary management: Potassium-rich foods (bananas, oranges, tomatoes, spinach, potatoes). Sodium-rich foods (broths, soups, crackers) can restore sodium levels. Monitor electrolyte levels and adjust diuretic dosage as needed.

Beta-Adrenergic Blockers and Adverse Effects

Hypoglycemia Masking: Can mask hypoglycemia symptoms, increasing severe hypoglycemia risk in diabetics.
Increased Fall Risk: Dizziness, fatigue, and orthostatic hypotension increase fall risk in elderly patients.

Verapamil (Calcium Channel Blocker) Teaching

Constipation: Increase fluids/fiber.
Dizziness/Lightheadedness: Slow position changes, use assistance when rising.
Peripheral Edema: Monitor for swelling, elevate legs.
Bradycardia: Report significant fatigue, dizziness or fainting.
Gingival Hyperplasia: Good oral hygiene practice. Monitor for possible side effects.

ACE Inhibitors and Reduced Immunity

Potential decrease in substances for WBC activation and activation in white blood cells. Manage by practicing good hand hygiene; avoiding crowds, and getting necessary vaccinations. Monitoring needed of WBC counts, and maintaining a balanced lifestyle.

Salt Substitutes in Sodium-Restricted Diet

Potassium Chloride substitutes may be used, but cautiously in kidney disease, and certain medications, Consider alternatives (herbs, spices, lemon juice, salt-free Seasoning blends). Consult physician or dietitian.

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Description

Test your knowledge on the precautions for patients taking ACE inhibitors and the nursing considerations following a cerebrovascular accident (CVA). This quiz covers symptoms related to stroke, immune function support, and the use of medications post-stroke. Make sure you understand the key differences between TIA and CVA as well.