PNC 2 Final Exam V1 Study Guide PDF

Practical Nursing Care 2 Final Exam V1 Study Guide Please note that this guide is meant to help but it is not all inclusive. Some items are not able to be prompted because they are evaluating critical thinking. You will need to review the PPTs and read your online text to have all the information ne...

Practical Nursing Care 2 Final Exam V1 Study Guide Please note that this guide is meant to help but it is not all inclusive. Some items are not able to be prompted because they are evaluating critical thinking. You will need to review the PPTs and read your online text to have all the information needed for the exam. Unit 1 Professional Nursing 1. Review examples of professional comportment. Behavior, bearing Demonstrated through words, actions, and presence 2. Review client teaching in the hospital setting and when this should happen. Client teaching starts on admission till time of discharge 3. Review how to incorporate a client in their plan of care. Client preferences (client’s wishes and values) Involves the client in care planning Information and education Access to care Emotional support Family and friends Continuity and transition Physical comfort Coordination of care Unit 1 Wellness to Illness Continuum 4. Review the key aspect of achieving wellness. Active pursuit of wellness Physically activity Healthy eating habits Stress management Adequate sleep Social connections/ support system Healthy habits on a daily basis to attain better physical and mental health outcomes 5. Review the percentage of social determinants of health that account for health outcomes. 30%-55% Unit 1 Illness 6. Review chronic illnesses that can precede dementia. Vascular Parkinson’s Alzheimer’s Lewy Body HIV infection Huntington’s Disease Atherosclerosis Type 2 diabetes 7. Review planning care for a client trying to stop drinking alcohol. Coping mechanisms Developing relapse prevention strategies Encouraging participation in support groups Promoting healthy lifestyles Provide resources Need to have a viable plan to quit successfully 8. Review medical resources for clients without health insurance. Free or public health clinics Recommend career counseling work with a social worker 9. Review the medical venue that would help a client coordinate chronic illness. Primary care provider 10. Review medication treatment for sickle cell crisis. Hydroxyurea- Makes red blood cells bigger, treats painful episodes IV pain relievers, such as opioids and anti inflammatory medications 11. Review examples of primary prevention. Eating low-fat, low-sugar, low-salt, and exercising Vaccinations 12. Review recommended food as part of the DASH diet. Fruits, vegetables, whole grains, poultry & fish, dry beans, and fat-free dairy products AVOID: Fatty & red meats, high-fat dairy products, sweetened drinks, foods high in sugar, and adding salt or processed foods Unit 2 End of Life 13. Review cultural considerations during end-of-life care. Cultural rituals- assessments Spiritual needs Therapeutic communication Unit 3 Alterations in Endocrine Function 14. Review client education for a client with type 1 diabetes having frequent hypoglycemia. BG monitoring Education on diet Manifestations of hypoglycemia Provide education Treating hypoglycemia 15. Review how hypothyroidism can affect a pregnant client. Hypothyroidism can also affect pregnancy because a developing fetus relies on the pregnant client’s thyroid hormones. Hypothyroidism can affect the infant’s thyroid hormone levels before and after birth, which is related to the infant’s neurological development and function 16. Review precautions for the hyperthyroidism treatment radioactive iodine. All urine and bodily fluids need to be contained and managed at a facility Educate client about flushing multiple times after urinating to protect other household members from exposure Wash hands 17. Review clinical manifestations of diabetic ketoacidosis (DKA). Fruity odor breath Deep rapid Kussmaul respirations Nausea, vomiting, or abdominal pain Acidosis Ketones 18. Review clinical manifestations of hyperglycemia. Polyuria= increased urination  Polydipsia= increased thirst Polyphagia= increase hunger Weight loss Because of dehydration, mucous membranes may be dry Vital signs: low blood pressure and fast heart rate Cognition: confused, lethargic, or comatose Unit 3 Alterations in Gas Exchange 19. Review the pathophysiology of an open pneumothorax. Open pneumothorax- sucking chest wound 20. Review expected O2 saturations for a client with a pneumothorax. Normal O2 saturation 93 to 94 Younger child 94-96 Unit 3 Alterations in Digestion and Bowel Elimination 21. Review the 5-year survival rate of oral cancer. Less than 20% at 5 years 22. Review precautions for a client with end-stage liver disease and ascites. Bleeding precautions (electric razor, a soft bristled brush, and avoid flossing teeth) Avoid using NSAIDs ensure that pressure is applied and held to any broken skin falls and injuries 23. Review client manifestations of GERD. Gastric secretions regurgitate back into esophagus irritation of throat or chest pains occurs 24. Review client teaching to avoid recurrence of pancreatitis. Avoid alcohol Smoking cessation increasing fluid intake Fresh fruits and vegetables Diet modifications- low fat Unit 3 Alterations in Kidney Function and Elimination 25. Review physiologic effects of polycystic kidney disease. Increased risk for depression/anxiety 26. Review laboratory results expected for a client with progressing chronic kidney disease. GFR decrease= less than 15 urine albumin increased creatine and urine albumin to creatinine ratio URA will be ordered 27. Review client manifestations of renal calculi. Severe pain in flank or back Pain during urination Obstruction in urinary tract Nausea, vomiting 28. Review risk factors for urinary retention. Constipation BPH Pelvic organ prolapse Older than 50 Diabetes mellitus Pelvic trauma History of pelvic surgery Unit 3 Disrupted Homeostasis 29. Review client manifestations of respiratory alkalosis. ○ hyperventilation ○ wheezing ○ confusion ○ dizziness ○ dyspnea ○ orthopnea ○ high anxiety ○ fever, weakness, chills ○ numbness, paresthesia (sometimes asymptomatic) 30. Review psychosocial findings for a client with COPD. ○ sleep difficulty ○ anxiety ○ shortness of breath ○ cyanosis ○ increased ICP ○ depression 31. Review abnormalities on a client’s ECG to support the finding of hypokalemia. ECG presence of u waves (usually not prominent on ECG) 32. Review the expected ABG finding for a client who has COPD. Respiratory Acidosis, pH below 7.35 33. Review the indications that treatment has been effective for a client who has dehydration. Mucous membranes will be moist, skin turgor, no longer dizzy, normal urine output, laboratory results and vital signs Unit 3 Alterations in Immunity and Inflammation 34. Review client conditions that increase their risk for sepsis. Those who are immunocompromised Have a had a previous case of sepsis Chronic medical conditions Recent serve illness are also at high risk for fatality Peritonitis- life threatening if left untreated 35. Review body systems that are affected by a diagnosis of lupus. Kidneys Central nervous systems Cardiovascular systems Serositis Unit 3 Cancer 36. Review which type of breast cancer is most common. Ductal breast cancer 37. Review the adverse drug reactions of using opioid medications for pain management. Fatigue constipation respiratory depression decreased activity Psychiatric comorbidities Dietary changes Easily addictive 38. Review client teaching for an angiography. Angiography uses injected dye to evaluate blood vessels. In clients who have cancer, it is helpful to evaluate which blood vessels are supplying the tumor so surgery and other treatments can be safely planned 39. Review ways to relieve nausea in a client undergoing radiation therapy. Eat smaller bites/ meals Ginger Crackers Antiemetics- treat nausea and vomiting Unit 3 Alterations in Mobility 40. Review the physiology behind stretching (muscles). Muscle returns then it returns 41. Review age-related changes in the muscular system. Bone density decreases after age 30. Increased age can lead to decrease in movement due to muscle loss Acceleration in cartilage becomes thinner Joints resilience decreases- more susceptible to damage 42. Review concerns related to open fractures. Fear of falling Quality of life Risk for infection Pressure ulcers Risk of atelectasis or pneumonia 43. Review factors contributing to poor circulation to a limb. Smoking Diabetes Atherosclerosis PAD PVD Unit 3 Alterations in Cognition 44. Review the pathophysiology behind delirium. State of confusion developing over hours to days, causing change in sensorium and behavipor Importance to have established baseline assessment for comparison Symptoms due to lack of oxygen to the brain 45. Review diagnostic information for dementia. Limited in the diagnosis of dementia Must rule out conditions causing dementia-like manifestations Neurological testing for mental health, problem, solving and memory recall 46. Review physiological changes that occur with dementia. Gradual decline in cognitive processes, not level of consciousness Impact quality of life and ability to complete ADLs Dementia should never be a expected change with age Unit 3 Alterations in Neurologic Function 47. Review a risk factor that applies to both tension-type and cluster headaches. Tension- Stress, posture, depression Cluster- Stress, allergens, environment, medications, tobacco/alcohol 48. Review positioning to prevent cerebral aneurysm rupture. Raise HOB 30-45 degrees to prevent ICP and rupture test 49. Review assessment questions that should be included for a client who has a bad headache. Select all the apply ○ History of headaches? ○ Is this the worst headache you have had? ○ Did this headache come on gradually or quickly? ○ How long do your headaches normally last? ○ How many days a month do you experience a headache?  ○ When do you usually get headaches? ○ What things seem to trigger your headaches? ○ Do you experience an aura before your headaches? ○ Where is the headache pain located? ○ What medications do you normally take? 50. Review nursing assessments to be done after a client falls suddenly. Select all that apply ○ Neuro assessment ○ Eyes (PERRLA) ○ Muscle strength ○ Facial symmetry ○ Speech ○ Stroke symptoms (FAST Unit 3 Alterations in Spinal Cord Function 51. Review potential triggers for exacerbation of multiple sclerosis. Temperature sensitivity Hot/humid weather During a fever 52. Review expected findings of cauda equine syndrome. Spinal disc presses nerve roots, cutting off sensation and movement Severe Pain and weakness of one or both legs test Can lose bowel and urinary control and loss of sexual ability 53. Review client manifestations of multiple sclerosis. Select all that apply Vision: monocular or homonymous vision loss, diplopia, optic neuritis Cognitive: difficulty with concentration, memory impairment, executive function impairment Sensory: paresthesia, loss of sensation, dysesthesias Psychiatric: anxiety, depression Vestibular: Vertigo, gait issues Bulbar: dysphagia, dysarthria Motor: fatigue, spasticity, tremor, weakness Urinary and bowel: incontinence, urgency, retention, reflex, diarrhea, constipation Unit 3 Alterations in Sensory Perception 54. Review client manifestations of Meniere’s disease. Vertigo, Tinnitus, Hearing loss 55. Review health conditions that increase the risk for Meniere’s disease. Age Inadequate fluid drainage HX autoimmune disease Migraine headaches Viral infection Genetic disposition Unit 3 Alterations in Cardiovascular Function and Perfusion 56. Review the heart’s activity during atrial fibrillation. Heart electrical signals are rapid and chaotic irregular P-waves replaced by Atrial activities between QRS complexes Ventricular rate can be normal 60-100 or increase (100-200) Rapid heart rate greater than 100/min is referred to as ventricular response 57. Review the pathophysiology of pericarditis. A common cause of chest pain, occurs when the pericardial sac of the heart becomes inflamed They think its caused by respiratory infection, flu like symptoms 58. Review high risk factors for developing atrial flutter. Clients with History of MI with stent replacement Hx of diabetes, hyperthyroidism, obstructive sleep apnea, smoking/alcohol 59. Review client dietary education for heart failure. Reducing dietary intake of sodium (2-3g a day), restricting fluid to 2L a day, and eliminating or decreasing 2-3 grams of sodium per day 2 liters of fluid a day Caffeine 60. Review surgical treatments for mitral valve stenosis. Balloon valvuloplasty- a small catheter with a balloon on the end is threaded into vessel in the groin and advanced to the heart= narrowed valve dilated Valve replace 61. Review the plan of care for a client with peripheral venous disease. Elevation of legs Compression therapy- layered wraps or intermittent pneumatic compression pumps Vein stripping- (diseased vein removed) Ultrasound-guided foam sclerotherapy ( foam injected and causes vein to scar forcing the blood to take another route.) Radio frequency/ laser ablation Medication therapy Unit 3 Alterations in Sexual Function 62. Review risk factors for developing prostatitis. UTI- Urinary tract infection STI- sexually transmitted infection 63. Review the pathophysiology of primary syphilis. Chancres appear, usually painless, go away with treatment 64. Review how a client is tested for gonorrhea. Culture swab from cervix, rectum or mouth Urine specimen Annual screening recommended for sexually active individuals who are having sex with males Unit 3 Alterations in Tissue Integrity 65. Review the cause of moisture-related skin issues. Moisture: Overhydration causes increase susceptibility to shearing and friction; Sweating, moisture, incontinence 66. Review ways to decrease skin tissue injuries in clients in the hospital setting. Turn patient every 2 hours Change and keep them dry Skin care Proper nutrition 67. Review potential complications of chronic wounds. Necrotic tissue Infection Amputation Sepsis Death Psychological impact: depression, anxiety 68. Review the four stages of pressure ulcers, being able to identify a wound in each of the four stages. Stage 1: Intact skin with nonblanchable erythema Stage 2: Partial thickness, loss skin may have blisters Stage 3: Full thickness loss: Loss of skin- exposure adipose tissue Stage 4: Full thickness loss of skin, fascia muscle tendon or bone will be exposed 69. Review the safety concern for a client who had a chemical burn. Decontamination protocols in place to protect the client and the health care team. Decontamination procedures may vary among institutions but should include wearing personal protective equipment (PPE) and removing potentially dangerous chemicals from the client. 70. Review how a hyperbaric chamber is used for wound healing. Hyperbaric oxygen therapy involves placing the client in a pressurized chamber of up to three atmospheres of pressure (ATM). The increased pressure, along with the 100% oxygen being delivered, improves circulation and oxygenation to the wound and has been shown to decrease edema. Hyperbaric oxygen can be applied to the whole body or to specific body parts, like a hyperbaric oxygen boot. Unit 4 Caring for the Surgical Client 71. Review medication education that should be included in postoperative teaching. Continuing medication Medication regimen Teaching proper use of medication New medication 72. Review circulatory assessments done in the post operative period. ABCD framework Cap refill Skin color Temperature and color of skin 73. Review preventative postoperative complications. Getting the client up and moving early (mobility and prevention of DVT) Incentive spirometer Provide fluids and food early Used mild analgesics Managing nausea and vomiting continue education started preoperatively 74. Review what a postoperative patient might experience once anesthesia wears off. Respiratory depression- SOB Pain Nausea and vomiting Cognitive changes 75. Review standards of professional performance for transplant nursing. Assessment of patient data ‘ Education- transplant nurses Attending education regarding best and safe practice Professional practice evaluation- reflect on performance as a member of the care team Unit 5 Introduction to Critical Care and Emergency Nursing 76. Review the parts of SBAR, knowing examples of each. Collaboration and open communication lead to improved client outcomes S- Situation B- Background A- Assessment R- Recommendation 77. Review the facility protocol when the media is requesting information about a disaster. Most facilities have individuals assigned for this ED staff can see facility policies and procedures 78. Review the colored tag system used to communicate regarding patients. The colored tag system communicates to health care providers that patient has been assessed  Green tags: Minor injuries without respiratory distress or signs of hemorrhage Yellow tags: Meet green criteria but have more than minor injuries Red tags: Do not mean green criteria but will survive if treated. Ex: Major burns Black tags: Client has died or is not expected to live even with treatment Unit 5 Critical Alterations in Gas Exchange 79. Review the most common cause of flail chest. Result of blunt trauma to chest Most common: Motor vehicle collision Other: Falls, direct blow to the chest (assault) 80. Review the pathophysiology of flail chest, meaning what is happening to the client. Rib function is impaired inspiration- flail chest segment moves inward Expiration- flail chest segment moves outward 81. Review interventions to prevent further respiratory complications in flail chest. Manage pain Unit 5 Critical Alterations in Perfusion 82. Review the description of an abdominal aortic aneurysm (AAA). Occurs when the aorta wall is weakened and thinning of the layers occur due to the loss of vascular smooth muscle A dilation of the aorta that is greater than 30 83. Review the pathophysiology of distributive shock. A result of a decreased systemic vascular resistance (SVR) and perfusion. Systemic vasodilation 84. Review what happens in Phase 2 of cardiac tamponade. CO is decreased, additional fluid collecting in the pericardial space and SVP decreases 85. Review the manifestations of hypovolemic shock. Decrease in the clients CO Decrease in oxygen transportation 86. Review preventative measures for heart disease. Quit smoking  Stress reduction Exercise Healthy diet Weight management Unit 5 Critical Endocrine Dysfunction 87. Review physical alterations consistent with a diagnosis of SIADH. Body has too much water Hyponatremia Nausea, fatigue, confusion, muscle cramps, water intoxicated, decreased urinary output, headache, mental status changes 88. Review laboratory findings that indicate DKA. ABGs: Clients in DKA will be in metabolic acidosis pH less than 7.3 and HCO3 less than 15 89. Review risk factors for developing HHS. Age 65 and older African american/ Native American or Hispanic Morbid obesity Result of physical stress 90. Review the causes of acquired central DI. Neurosurgery and head trauma Autoimmune and vascular diseases Sarcoidosis and ischemia Infection Decrease in secretion of ADH pituitary gland 91. Review laboratory findings would indicate that a client with SIADH is worsening. Hyponatremia is associated with significant morbidity and mortality in clients with cancer. ○ Sodium levels below 135 ○ Headache and confusion- classic signs