Adult Final Exam Paper PDF

adult final Study online at https://quizlet.com/_g9wums 1. Appearance of silvery psoriasis erythema scaly/thick Plaque Psoriasis: Raised, reddish patches covered with silvery scal...

adult final Study online at https://quizlet.com/_g9wums 1. Appearance of silvery psoriasis erythema scaly/thick Plaque Psoriasis: Raised, reddish patches covered with silvery scales, commonly found on the scalp, elbows, knees, and lower back. 2. Treatment for Topical therapies: psoriasis Corticosteroids. Vitamin D analogs (e.g., calcipotriol). Coal tar. Salicylic acid. Phototherapy: Exposure to UV light under medical supervision. Systemic medications (for moderate to severe cases): Oral medications (e.g., methotrexate, cyclosporine). Biologics (e.g., adalimumab, etanercept, infliximab). Lifestyle adjustments: Stress management. Moisturizers to reduce dryness. Avoiding triggers like certain medications, stress, and infections. 3. What are you Physical symptoms: concerned about Pain and discomfort from lesions. for the client with Risk of secondary infections from cracked or open skin. Psoriasis? Quality of life: Visible plaques can lead to self-consciousness or social withdrawal. Itching or pain may disrupt sleep or daily activities. Associated conditions: Psoriatic arthritis, which can cause long-term joint dam- age. Increased risk of cardiovascular disease, obesity, dia- betes, and depression. Psychological impact: Higher prevalence of anxiety and depression due to the visible and chronic nature of the condition. 1 / 31  adult final Study online at https://quizlet.com/_g9wums Medication side effects: Systemic treatments can have significant side effects (e.g., immunosuppression, liver damage). 4. Pressure In- Frequent repositioning:Change positions every 1-2 hours juries: Preven- to reduce prolonged pressure. tion and Treat- Support surfaces:Use pressure-relieving devices like ment specialized mattresses or cushions. Skin care:Keep skin clean and dry to prevent break- down.Apply barrier creams to protect against moisture-re- lated damage. Nutritional support:Ensure adequate protein, vitamins (especially Vitamin C), and hydration to maintain skin integrity. Risk assessment tools:Use scales like the Braden Scale to identify high-risk patients and intervene early. 5. How do you treat Staging the injury:Determine the stage (I-IV) to guide a pressure in- treatment: jury? Stage I: Non-blanchable redness; treat with protective measures. Stage II: Partial-thickness loss; keep the area clean and moist with dressings. Stage III-IV: Full-thickness loss; may involve debridement, infection control, and advanced wound care. Unstageable: Debride necrotic tissue to assess depth. Cleaning and dressing:Use saline or wound cleansers to irrigate.Select appropriate dressings: hydrocolloid, foam, or alginate depending on the injury's characteristics. Infection control:Treat infected wounds with antibiotics if necessary. Advanced therapies:Negative pressure wound therapy (wound vac) or skin grafts for severe injuries. 6. What are the dif- Serous:Clear or light yellow, watery fluid.Indicates normal ferent types of healing. exudate? Sanguineous:Red or bloody drainage.Indicates active bleeding or vascular injury. Serosanguineous:Pink or pale red, watery fluid.Common 2 / 31  adult final Study online at https://quizlet.com/_g9wums in healing wounds. Purulent:Thick, yellow, green, or brown discharge.Indi- cates infection. Fibrinous:Sticky, yellow-white material (fibrin).Often seen in chronic or severe inflammation. 7. Signs of infec- Local signs:Redness, warmth, swelling, and pain around tion in exudate the wound.Increased purulent drainage with a foul odor.Delayed healing or tissue necrosis. Systemic signs:Fever, chills, or increased heart rate.Ele- vated white blood cell count or markers of inflammation (CRP, ESR). 8. What treatment Serous or serosanguineous: Continue regular wound do you anticipate care and protect the area. for a client with Sanguineous:Assess for bleeding and apply pressure if certain types of necessary. Use dressings to promote clotting. exudate? Purulent: Culture the wound to identify causative bac- teria.Initiate antibiotics and use antimicrobial dressings (e.g., silver or iodine-based). Excessive exudate: Manage moisture balance with ab- sorbent dressings (e.g., alginate or foam). 9. What's their sta- severe asthma attack that does not respond to stan- tus (Asthmat- dard treatments like inhaled bronchodilators and corticos- ics)? teroids. Status asthmaticus characteristics: Severe airway ob- struction and inflammation. Unrelenting bronchospasm causing respiratory failure if untreated. Life-threatening condition requiring immediate intervention. 10. pneumothorax's Pneumothorax occurs when air escapes into the pleural in asthmatics space, causing lung collapse. during an Tension pneumothorax, a more severe form, involves air emergency. trapping with each breath, compressing the heart and other lung. 11. Pathophysiolo- Bronchoconstriction: Tightening of the smooth muscles gy of asthma in around the airways. emergencies Inflammation: Swelling of the airway walls, narrowing the 3 / 31  adult final Study online at https://quizlet.com/_g9wums lumen. Mucus hypersecretion: Excess mucus blocks the already narrowed airways. 12. Clinical mani- Severe dyspnea (difficulty breathing). festations and Wheezing (may diminish in severe cases due to little emergency treat- airflow). ment of asthma Use of accessory muscles and nasal flaring. Tachypnea (fast breathing) and tachycardia (fast heart rate). Cyanosis (blue lips or fingertips). Silent chest (ominous sign indicating no airflow). Altered mental status (e.g., confusion, lethargy). 13. Emergency treat- Airway management: ment: for asthma Ensure the airway remains patent. Intubate if respiratory failure occurs. Oxygen therapy: Administer high-flow oxygen to maintain oxygen satura- tion above 92%. Bronchodilators: Nebulized short-acting beta-agonists (e.g., albuterol), of- ten combined with ipratropium. Corticosteroids: IV methylprednisolone or oral prednisone to reduce in- flammation. Magnesium sulfate: IV administration can be used in severe cases to relax airway smooth muscles. Epinephrine: IM epinephrine in cases of anaphylaxis or severe bron- chospasm. Treat pneumothorax (if present): Immediate needle decompression for tension pneumoth- orax, followed by chest tube placement. Continuous monitoring: Monitor oxygen saturation, arterial blood gases (ABGs), and vital signs. 4 / 31  adult final Study online at https://quizlet.com/_g9wums 14. Key interven- Rapid escalation: Involve respiratory therapists, inten- tions: for athsma sivists, and critical care teams. Patient reassessment: Continuous evaluation of re- sponse to treatment, with readiness to intubate if neces- sary. 15. Recognizing pH: 7.35-7.45 Acid-Base PaCO‚: 35-45 mmHg Imbalances HCOƒ{: 22-26 mEq/L 16. Common Respiratory Acidosis (e.g., asthma exacerbation, COPD): Acid-Base Low pH (45 mmHg). Imbalances: Caused by hypoventilation or airway obstruction. Respiratory Alkalosis (e.g., hyperventilation, anxiety): High pH (>7.45), low PaCO‚ (92%. asthma Bronchodilators: Nebulized albuterol (short-acting beta-agonist). Ipratropium can be added for additional bronchodilation. Corticosteroids: Administer IV methylprednisolone or oral prednisone to reduce airway inflammation. Magnesium sulfate: IV administration for severe cases to relax airway mus- cles. Epinephrine: IM epinephrine for severe bronchospasm or anaphylaxis. 22. Advanced in- Intubation: If respiratory failure develops, prepare for me- terventions: for chanical ventilation. asthma Monitor ABGs: Watch for rising PaCO‚ (hypercapnia) or falling pH, indicating worsening acidosis. 6 / 31  adult final Study online at https://quizlet.com/_g9wums 23. Peritonitis key nflammation of the peritoneum due to infection, perfora- features tion, or trauma. Symptoms: Severe abdominal pain, rigidity, rebound ten- derness, fever, nausea/vomiting, tachycardia. 24. Treatment Op- For mild to moderate asthma exacerbations: tions for asthma Inhaled bronchodilators (metered-dose inhaler or nebu- lizer). Oral corticosteroids. For severe exacerbations: Continuous nebulized albuterol. IV corticosteroids and magnesium sulfate. Long-term management: Controller medications (e.g., inhaled corticosteroids, leukotriene modifiers). Asthma action plan to recognize and respond to early symptoms. 25. Plan of care: NPO, isotonic IV fluids, IV antibiotics, possible surgical Peritonitis intervention (e.g., laparotomy). Monitor for sepsis signs. 26. Appendicitis Key Inflammation of the appendix, often due to obstruction. features: Symptoms: Right lower quadrant pain (McBurney's point), rebound tenderness, nausea, fever, elevated WBCs. 27. Plan of care:Ap- Prepare for appendectomy, pain management, IV fluids, pendicitis and antibiotics. Post-op: Advance diet as tolerated, watch for infection signs. 28. Gastroenteritis: Inflammation of the stomach and intestines caused by Key features: infection, toxins, or foodborne illness. Symptoms: Diarrhea, vomiting, abdominal cramps, dehy- dration. 29. gastroenteritis Oral or IV rehydration, electrolyte replacement, antiemet- plan of care ics, and dietary adjustments (bland diet, avoid irritants). 30. 7 / 31  adult final Study online at https://quizlet.com/_g9wums Ulcerative Coli- Chronic inflammation of the colon with continuous le- tis: sions. Key features: Symptoms: Bloody diarrhea, urgency, abdominal pain, weight loss, fatigue. 31. Plan of care: Ul- Medications (aminosalicylates, corticosteroids, immuno- cerative Colitis: suppressants). Monitor for complications (toxic megacolon, perforation). 32. Diverticulitis: Inflammation/infection of diverticula in the colon. Key features: Symptoms: LLQ pain, fever, constipation, bloating, elevat- ed WBCs. 33. Plan of care: Di- Bowel rest (NPO or clear liquids), antibiotics, pain control, verticulitis possible surgery for complications. 34. Nutritional Con- Acute phase: NPO or clear liquid diet to allow bowel rest. siderations for it- Maintenance phase: High-fiber diet (except during diverti- tis culitis flare).Avoid trigger foods (e.g., dairy, caffeine, spicy foods).Adequate hydration. 35. Symptoms of Fever or hypothermia. Sepsis Tachycardia, tachypnea. Altered mental status. Hypotension (late sign). Elevated lactate levels, WBCs. Oliguria (decreased urine output). 36. Isotonic Fluids Isotonic fluids: Restores intravascular volume (e.g., 0.9% and Antibiotics NaCl or lactated Ringer's). Antibiotics: Broad-spectrum initially (e.g., piperacillin-tazobactam) until cultures guide therapy. 37. Education Topics Importance of completing antibiotic therapy. for ITTIS Recognizing signs of infection or complications (fever, abdominal pain, diarrhea). Gradual reintroduction of diet after recovery. Stress management to avoid exacerbations. 38. 8 / 31  adult final Study online at https://quizlet.com/_g9wums Biggest Issues Chronic inflammation that can affect any part of the GI for Crohn's Dis- tract (mouth to anus). ease Key challenges: Strictures, fistulas, abscesses.Malnutri- tion (due to malabsorption). 39. Signs/Symp- Persistent diarrhea (may be bloody). toms of a Abdominal cramping (often RLQ). Crohn's Fatigue, fever. Exacerbation Weight loss and malnutrition. Perianal abscesses or fistulas. 40. Dietary recom- Low-residue diet during flares. mendations: for High-calorie, high-protein diet to address malnutrition. Crohn's Avoid trigger foods (e.g., dairy, spicy foods, alcohol). Monitor complications: Strictures, fistulas, abscesses, anemia. Stress reduction: Encourage stress management techniques (e.g., mindful- ness, counseling). 41. Medications and Aminosalicylates (e.g., mesalamine): Education for Reduces inflammation. crohns Side effects: Nausea, headache, rash. Corticosteroids (e.g., prednisone): Short-term use for flares. Side effects: Weight gain, hyperglycemia, osteoporosis. Immunosuppressants (e.g., azathioprine): Maintains remission. Side effects: Risk of infection, hepatotoxicity. Biologics (e.g., infliximab, adalimumab): Target specific inflammatory pathways. Side effects: Injection site reactions, increased infection risk. Antibiotics (e.g., metronidazole): Treats infections and abscesses. 42. Patient Educa- Medication adherence to prevent flares. tion Topics for Recognizing signs of complications (fever, worsening ab- crohns dominal pain). 9 / 31  adult final Study online at https://quizlet.com/_g9wums Importance of routine follow-ups and lab monitoring. Avoid NSAIDs, which can worsen inflammation. 43. What does Cir- General appearance: rhosis look like Jaundice (yellowing of the skin and eyes). during an exac- Ascites (abdominal swelling from fluid accumulation). erbation? Peripheral edema. Caput medusae (dilated abdominal veins). Muscle wasting. Symptoms: Fatigue and weakness. Abdominal pain or discomfort. Confusion, lethargy (hepatic encephalopathy). Bruising or bleeding tendencies. 44. Important Labo- Liver function tests (LFTs): ratory Values Elevated AST and ALT. Elevated bilirubin. Low albumin. Clotting factors: Prolonged PT/INR (due to impaired clotting). Ammonia: Elevated ammonia levels (associated with encephalopa- thy). Electrolytes: Low sodium (dilutional hyponatremia from ascites). Potassium imbalances (from diuretics or renal dysfunc- tion). CBC: Anemia, thrombocytopenia, leukopenia. Creatinine and BUN: Monitor for hepatorenal syndrome. 45. What will you do Ascites management: to help Cirr Ho- Paracentesis: To remove fluid for comfort. sis? Low-sodium diet to reduce fluid retention. Diuretics (e.g., spironolactone, furosemide). Hepatic encephalopathy management: Administer lactulose to reduce ammonia. 10 / 31  adult final Study online at https://quizlet.com/_g9wums Monitor mental status. Prevent bleeding: Avoid NSAIDs. Monitor PT/INR; consider vitamin K supplementation. Nutrition: High-calorie, low-sodium, moderate-protein diet (to pre- vent worsening encephalopathy). Vitamin supplementation (B vitamins, folic acid). Monitor for complications: Infection (e.g., spontaneous bacterial peritonitis). Variceal bleeding (perform endoscopy as needed). 46. Teaching for Cir- Avoid alcohol completely. rhosis Maintain a low-sodium diet and monitor fluid intake. Recognize signs of encephalopathy (confusion) or infec- tion (fever). Adherence to medications, including lactulose. Importance of follow-ups and routine labs. 47. Medications for Lactulose:Promotes excretion of ammonia through Ammonia Man- stool.Side effects: Diarrhea, bloating (adjust dosage to agement avoid dehydration). 48. Blood Pressure Use beta-blockers (e.g., propranolol) to prevent variceal Management bleeding. Avoid ACE inhibitors or NSAIDs that may worsen renal function. 49. Preventing He- Adequate fluid management to maintain kidney perfu- patorenal Syn- sion. drome Avoid nephrotoxic medications. Treat infections promptly. Monitor closely for renal dysfunction. 50. Hepatitis Trans- Hepatitis A (acute): mission and Spread via fecal-oral route, contaminated food or water. Types Prevention: Hand hygiene, vaccination, avoid high-risk foods. Hepatitis B (acute/chronic): Spread via blood and body fluids (e.g., sexual contact, IV 11 / 31  adult final Study online at https://quizlet.com/_g9wums drug use). Prevention: Vaccination, avoid sharing needles, safe sex practices. Hepatitis C (chronic): Spread via blood (e.g., IV drug use, transfusions before 1992). Prevention: No vaccine; avoid sharing needles or person- al items. Hepatitis D (chronic, co-occurs with Hep B): Spread via blood and body fluids. Prevention: Hep B vaccination (Hep D requires Hep B to infect). Hepatitis E (acute): Spread via fecal-oral route, contaminated water. Prevention: Hand hygiene, avoid contaminated water. 51. Teaching for He- Rest during acute phases to reduce liver strain. patitis Avoid alcohol and hepatotoxic medications. Emphasize vaccination for preventable types (A, B). Safe hygiene practices (e.g., washing hands, safe food preparation). 52. Acute Care for Hepatitis A: Hepatitis Supportive care: Hydration, rest, symptom management (antiemetics for nausea). Hepatitis B and C: Chronic: Antiviral medications (e.g., tenofovir, entecavir for Hep B; direct-acting antivirals for Hep C). Acute: Supportive care; monitor liver function. Hepatitis D: Treat as Hep B with antivirals. Hepatitis E: Supportive care; avoid hepatotoxic substances. 53. Peptic Ulcer Dis- PUD refers to ulcers or sores in the lining of the stomach, ease (PUD) duodenum, or esophagus caused by: H. pylori infection (most common). Chronic NSAID use. Stress or excessive alcohol use. 12 / 31  adult final Study online at https://quizlet.com/_g9wums 54. How am I treat- Lifestyle modifications: ed? PUD Avoid alcohol, smoking, and NSAIDs. Manage stress. Consume smaller, frequent meals to reduce acid produc- tion. Medications: Proton pump inhibitors (PPIs): Omeprazole, pantopra- zole. H2-receptor blockers: Ranitidine, famotidine. Antacids: Neutralize stomach acid. Sucralfate: Coats and protects the ulcer. H. pylori treatment: 55. Approach to H. Triple therapy (14 days): pylori Treatment PPI (e.g., omeprazole). Amoxicillin. Clarithromycin (or metronidazole if allergic to penicillin). Quadruple therapy (14 days, used for resistant cases): PPI. Bismuth subsalicylate. Tetracycline. Metronidazole. 56. How is hemor- Hematemesis (vomiting blood, "coffee grounds"). rhage identified? Melena (black, tarry stools). Fatigue, dizziness, pallor (signs of anemia). Hypotension and tachycardia (shock). 57. How is it man- Stabilize the patient:IV fluids (isotonic solutions).Blood aged in the acute transfusions if needed.Monitor vitals and urine output. setting? hemor- Endoscopic intervention: Cauterization or injection thera- rhage py to stop bleeding. Medications:IV PPIs to reduce acid and stabilize clots. 58. What do you Adhere to medications as prescribed. teach a client Avoid NSAIDs, alcohol, caffeine, and smoking. with PUD? Manage stress and follow a balanced diet (avoid spicy or acidic foods). Recognize signs of complications (bleeding, severe pain). 13 / 31  adult final Study online at https://quizlet.com/_g9wums 59. Irritable Bowel A functional disorder affecting the large intestine, charac- Syndrome (IBS) terized by abdominal pain, bloating, and changes in bowel habits (diarrhea, constipation, or both). Triggers: Stress, certain foods (dairy, gluten, caffeine, spicy foods). 60. Dietary modifica- Low-FODMAP diet. tions: for IBS High-fiber diet for constipation-predominant IBS. Avoid trigger foods. 61. PUD meds Antispasmodics (e.g., dicyclomine). Laxatives for constipation or loperamide for diarrhea. Antidepressants for pain relief and stress management. 62. PUD changes Regular exercise and stress management techniques. 63. Cholecystitis Inflammation of the gallbladder, usually caused by gall- stones blocking the cystic duct. Symptoms:RUQ pain, especially after fatty meals.Nau- sea, vomiting.Fever and jaundice (in severe cases). 64. Acute manage- NPO (to rest the GI tract). ment: of chole- IV fluids, pain management, and antibiotics. cystitis Prepare for surgery if needed (cholecystectomy). Surgical intervention: Laparoscopic cholecystectomy (most common). 65. Diet Considera- During acute phase: NPO or clear liquids. tions for chole- Post-acute phase: Low-fat diet to reduce gallbladder stim- cystitis ulation. Post-cholecystectomy: Gradual reintroduction of normal diet, but limit fatty and greasy foods if symptoms persist. 66. What do you Monitor for signs of infection (fever, redness at incision teach a client site). on discharge af- Gradually increase activity but avoid heavy lifting for 4-6 ter a cholecys- weeks. tectomy? Follow a low-fat diet initially. Expect possible mild diarrhea; notify if severe. Pain management and incision care instructions. 14 / 31  adult final Study online at https://quizlet.com/_g9wums 67. Functions of the Endocrine function:Produces hormones like insulin and Pancreas glucagon to regulate blood sugar. Exocrine function:Secretes digestive enzymes (amylase, lipase, protease) to break down carbohydrates, fats, and proteins. 68. Clinical Symp- Acute pancreatitis: toms of Pancre- Severe epigastric or upper abdominal pain that radiates atitis to the back. Nausea and vomiting. Fever, tachycardia. Abdominal tenderness and distension. Possible jaundice (if bile duct obstruction occurs). Severe signs: Cullen's sign (bluish discoloration around the umbilicus), Grey Turner's sign (flank bruising, indicat- ing retroperitoneal hemorrhage). 69. chronic pancre- Recurrent pain, malabsorption, steatorrhea (fatty stools), atitis weight loss. Diabetes due to progressive loss of endocrine function. 70. Care Goals for Pain Management: Acute Pancreati- Use IV opioids (e.g., morphine, hydromorphone). tis Positioning: Sitting up or leaning forward may reduce pain. Fluids and Nutrition: Fluids: Aggressive IV hydration with isotonic solutions to prevent hypovolemia. Nutrition:NPO initially to rest the pancreas.Consider en- teral feeding (via nasojejunal tube) if prolonged fast- ing.Transition to a low-fat, high-protein, and high-carbo- hydrate diet when symptoms improve. Pulmonary Care: Prevent complications like atelectasis and pleural effu- sions. Monitor respiratory status; encourage incentive spirome- try. Blood Glucose Management: Monitor glucose levels frequently; administer insulin if hyperglycemia occurs. 15 / 31  adult final Study online at https://quizlet.com/_g9wums Hyperglycemia results from decreased insulin production during inflammation. 71. Discharge Edu- Diet: cation for pan- Low-fat, nutrient-dense diet to prevent pancreatic stimu- creatitis lation. Avoid alcohol entirely; it's a major trigger. Eat small, frequent meals to reduce digestive workload. Blood Sugar Management: Monitor blood glucose at home, as diabetes may develop due to pancreatic damage. Teach signs of hypo- and hyperglycemia. Enzyme Replacement: Use pancreatic enzyme supplements (e.g., pancrelipase) with meals to aid digestion. Educate on how to take enzymes properly: Swallow cap- sules whole with water; do not crush or chew. Signs of Complications: Seek immediate care for severe pain, jaundice, fever, or signs of infection. Follow-up: Routine follow-ups to monitor pancreatic function, glu- cose levels, and nutritional status. 72. How do you Key signs: know the kid- Decreased urine output (oliguria