Med-Surg Exam 6 NURS 121

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Common Lab Test(s) Used to Diagnose Gout? (P.770): - Based on Serum Uric Acid Levels
- Joint Fluid Aspiration Analysis Can Identify Uric Acid in Synovial Fluid
- BUN and Serum Creatinine to Assess Kidney Damage
Signs/Symptoms of RA? (P.767): - Divided Into Early and Late Manifestations
- Typical Pattern is Bilateral and Symmetrical
- Begins in Upper Extremeties and Progresses to Other Joints
- Sjogrenâ€™ Syndrome â€“ Inflammation of Tear Ducts
- Feltyâ€™s Syndrome â€“ Characterized by Enlarged Liver and Spleen
Lab Findings in Presence of Bone Cancer? (P.797): - Elevated ALP Level and Erythrocyte Sedimentation Rate
Key Components of Neurovascular Assessment? (P.756): - Color â€“ Pallor, Cyanosis, Redness, or Discoloration
- Temperature, Pain, Movement
- Sensation, Pulse (Pedal, Radial)
- Strength and Equality of Hand Grip
- Capillary Refill
Signs/Symptoms/Treatment and Prevention Strategies of Fat Emboli? (P.792): - Altered Mental Status from Low Arterial Oxygen Level
- SOB, Tachycardia, Tachypnea, Fever, High Blood Pressure
- Sm. Fat Globules are Released from Yellow Bone Marrow to Blood
- Pt. w/ Multiple Fractures
- Monitor Neurovascular Status
Post Operative Positioning of Total Hip Replacement Patient to Decrease Risk of Dislocation? (P.775): - Correct Positioning of the Surgical Leg is Critical
- Main Goal Prevent Hip Adduction (Across Body Midline)
- Trapezoid-Shaped Abduction Pillow is Used Between Legs
- Patient is Turned with Hip Adduction Avoided
- Turn Hips and Legs Simultaneously to Minimize Dislocation
S/S of Dislocation in Hip Replacement Patient? (P.775): - Subluxation (Partial Dislocation) or Total Dislocation
- Femoral Component Becomes Dislodged from Acetabular Cup
- Pt Feels Increased Hip Pain, Shortening of Surgical Leg
- Possible Rotation of Surgical Leg
Traction Care Guidelines? (P.786): - Monitor Neurovascular Status for Impaired Blood Flow
- Monitor Skin Conditions for Pressure Points or Irritations
- Traction Must be Maintained for Fractures
- Inspect Ropes, Weights, Pulleys every 8 to 12 hrs
Indication and Pharmacological Action of Allopurinol? (P.770): - Chronic Gout
- Decreases Uric Acid Production
Desired Outcome(s) for a Patient in Buckâ€™s Traction? (P.786): - Indicated for Pt. with Hip Fractures
- Typically 5-10lbs
- Reduced Pain, Muscle Spasms
Define Phantom Pain? (P.780): - Occurs in 80% of Amputees
- Pt. Complains of Pain where Body Part was Located
- Triggered by Touching Limb, Feeling Fatigued, or Emotional Stress
- Treat with Medications and Complementary Therapies
Purpose of CPM? (P.778): - Pt. having Total Knee Replacement or Total Hip Replacement
- Continuous Passive Motion
- To Prevent Deep Vein Thrombosis
- Motorized Flexible Extremity Rest
S/S and Common Conservative Treatment(s) for Carpal Tunnel Syndrome? (P.781): - Finger, Hand, and Arm Pain and Numbness
- Painful Tingling and Paresthesias
- Fine Motor Deficits and Muscle Weakness may Develop
- Ergonomics, Splints, NSAID, Aspirin, Cortisone
Risk Factors/Signs/Symptoms and Complications of Osteoporosis? (P.794): - Caucasian or Asian; Sedentary Lifestyle; Decreased Calcium/Vitamin D
- Alcoholism, Smoking, Caffeine
- Petite Body

- Typically Realized with Broken Bone
- â€œDowageâ€ Hump or Kyphosis of Spine
- Decrease in Height, Back Pain
- Patholigical Fracture â€“ Bone Breaks Before Fall
Medications Used to Control Symptoms of RA? (P.768): - Disease Modifying Antirheumatic Drugs
- NSAIDS, and Corticosteroids
Complication of Abruptly Discontinuing Cortisol Therapy?: - Higher Levels Needed During Periods of Stress
Strategies to Help Post Op Pt Relieve Gas Pain? (P.169): - NG or GI Tube Used to Remove Secretions until Peristalsis Returns
Order for 50 mg/ml Meperidine. Ampule reads 100mg/ml. How much will You Give?: - Question Makes No Sense; Assume Order is 50mg
- Give 0.5ml of Medicine
Most Common Human Response to Stress? (P.147): - Fear & Anxiety
Give Examples of each Surgical Category: Exploratory, Curative, Pallitative, Diagnostic? (P.146): - Exploratory â€“ Confirmation or Measurement of Extent of Condition
- Curative â€“ Removal of Disease or Abnormal Tissue
- Palliative â€“ Alleviation of Symptoms without Curing Disease
- Diagnostic â€“ Obtain Tissue Samples, to Make Diagnoses
Differentiate Between Spinal, Local, and General Anesthesia? (P.158): Local:
- Loss of Sensation to a Region of the Body
- No Loss of Consciousness
- Block Nerve Impulse Along Nerve where it was Injected
Spinal: (Spinal & Epidural are a Form of Local)
- Injection of a Local Agent into Subarchnoid Space
- Used in Lower Extremity and Lower Abdominal Surgery
- Both Sensory and Motor Function Blocked
General:
- Patients are Very Anxious
- Surgical Procedure will Take Long Time
- Muscle Relaxation, Pt. Unable to Cooperate
Nursing Care and Considerations of Patient Post Spinal Anesthesia? (P.159): - Headaches Due to Leak of CSF, Photophobia
- Lying Flat on Abdomen May Help Relieve Pain
Differentiate Between Primary and Secondary Intention. Which Type of Wound Heals more Rapidly? (P.167): - Primary â€“ Wound Edges well Approximated, Little Tissue Loss
- Secondary â€“ Large Tissue Loss, Granulation Tissue Fills Over Time
S/S of a Postoperative Ileus? (P.170): - Ileus â€“ Obstruction of the Bowel
- Abdominal Distention, Absent Bowel Sounds, Pain May Result
- NG Tube Can be Used to Decompress GI Tract
Requirements Surrounding Surgical Consent: Who When, Where etc? (P.153): - Physicianâ€™s Responsibility to Obtain Voluntary, Written, Informed Consent
Intraoperative Outcome(s) in the Care Plan of a Surgical Patient? (P.157): - Free From Injury
- Skin Integrity is Maintained
- Maintains Blood Pressure, Pulse, Urine Output within Normal Limits
- Free of Infection
- Reports Pain Relieved to Satisfactory Level
Nursing Priority Responsibility of a Patient in PACU? (P.160): - Airway Maintenance, Vital Signs
- Respiratory Assessment, Neurological Assessment
- Surgical Site Status, General Assessment, Patient Safety
S/S of Evisceration and Emergency Nursing Management? (P.169): - Place Pt. In Low Fowlerâ€™s Position
- Cover Wound with Sterile Dressing or Towels
- Notify Physician Immediately
- Apply Gentle Pressure Over Wound
- Monitor Vital Signs and Evidence of Shock
Rationale for and Proper Use of Incentive Spirometry? (P.153): - Encourage Deep Breathing in Pt. Risk for Lung Collapse (Atelectasis)
- 45Â°; 2 Reg. Breaths; Use Spiro, InhaleÃžTarget; Hold 3-5sec; Exhale;10xhr
Perioperative Risk Factors Associated with Infants?: - No Clue, Unable to Find
Post-Op Complications COPD are at Risk For? (P.148): - Thickens Lung Secretions & Reduces Action of Cilia
- Cessation Allows more Hemoglobinto Carry O2 During Surgery
Individual in OR Responsible for Oxygenation, Gas Exchange and Vital Signs of Patient? (P.157): - Registered Nurse
- Patient Advocate, Planning Care, Protecting Patient, Safety
- Too Many Read P.157
Definition of Scoliosis, Kyphosis? (P.795): - Scoliosis â€“ Sideways Curve of Spine
- Kyphoisis â€“ Downage Hump of Spine (Osteoporosis)
Definition of Osteoarthritis? (P.763): - Articular Cartilage and Bone Ends of Joints Slowly Detriorate
- Joint Space Narrows, Bone Spurs Develop, Inflammation
Differences Between OA and RA? (P.763): OA: -Joints Become Inflamed
- Cause Unknown
- Risk Factors: Age, Obesity, Trauma, Sepsis

RA: - Synovium Becomes Thick, and Fluid Accumulates Causing Swelling
- Autoimmune Disease
- Family History Possible
Normal Capillary Filling Findings? (P.176): - Used to Determine Arterial Circulation to Extremity
- Compress Nail Bed and Release
- Color Should Return to Normal within 3sec.
Rationale for Palming a Cast? (P.785): - To Prevent Indentations that may become Pressure Points
Rationale Periodic Prone Positioning for an AKA Patient? (P.780): - Prone (On Stomach) for 30min 4x Day
- Prevent Contracture
Necessary Treatment for a Severed Achilleâ€™s Tendon?: - Unable to Find
Rationale and Examples of Skin Traction? (P.786): - Provides Pulling Force to Provide Fracture Reduction, Alignment
- Typically Skin or Skeletal Type
- Velcro Boot â€“ Bucks Traction; Russelâ€™s Traction â€“ Knee Sling
Foods/Beverages/Meds to Avoid in Gout Patients? (P.769): - Diuretic Therapy, Chemotherapeutic Agents
- Stress (Physical/Emotional), Alcohol, Asprin
- High Protein Foods (Liver)
Recommended Protocol for Caring for a Severed Body Part? (P.779): - Wrap it Cool, Slightly Moist Cloth
- Place in Sealed Plastic Bag, Submerged in Cold Water
Point in Life that Bone Renewal Stops⬦⬦ (P.794): - Bone Density Peaks Between 30 and 35 years
- After which Bone Breakdown Exceeds Rate of Building
Indication for a Fasciotomy? (P.792): - Incision into Fascia that Encloses the Compartment
- Allows Compartment Tissue Room to Expand and Relieves Pressure
Signs/Symptoms of Carpal Tunnel Syndrome? (P.781): - Slow-Onset Finger, Hand and Arm Pain and Numbness
- Painful Tingling and Paresthesias (Abnormal Sensation w/o Stimulus)
- Fine Motor Deficits the Muscle Weakness May Develop
Rationale for Immediate Attention of Dislocation? (P.774): - Femoral Component Becomes Dislodged from Acetabular Cup
- Vascular Damage, Tissue Perfusion
Pathophysiology of Avascular Necrosis? (P.774): - Long Term Use of Steroids, and Complications with Joint Replacement
- Bone Tissue Dies (Typically Femoral Head)
- Due to Impaired Blood Supply
Describe to Client what to Expect and Indications for Arthrocentesis, EMG and Dexa Scan? (P.760): Arthrocentesis:
- Diagnostic Test where Synovial Fluid is Aspirated in Joint for Analysis
- After Local Anesthetic, Needle is Used Aspirate Content of Joint Space
- Anti-Inflammatory Such as Corticosteroid Injected
Electromyography:
- Measures Muscleâ€™s Electrical Impulses
- Aids in Diagnosis of Muscle Disease or Nerve Damage
- Discomfort at Site of Study May Occur; Use Mild Analgesic
Dexa Scan:
- Unable to Find
You find Skeletal Weights on the Floor Next to Bed. What Should You Do? (P.786): - Reposition Patient in Bed
- Assistance Should be Obtained to Prevent Lifting Injuries
What is the Indication for Windowing a Cast? (P.785): - Wound is Present or Odor is Detected, Physician Cuts Opening
- Underlying Skin is then Treated
- Tape is Applied so Skin does not â€œpop upâ€ from Window
- Essentialy a way to "Peek In"
What is the Indication for Bivalving a Cast? (P.792): - Acute Compartment Syndrome
- Method of Removing Pressure
What is the Indication for a Sequestrectomy?: - Excision of a Necrosed Piece of Bone
Define Crepitation? (P.755): - Grating Sound as Joint or Bones Move
Discharge Criterion from the PACU for a Patient Following Surgery? (P.163): Post Anesthesia Care Unit
- Typical Stay 1hr
- Scale Used to Determine Readiness to Discharge
- Factors Include Respiration, O2 Sat, LOC, Activity, Circulation

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