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Cardiovascular
You’re caring for a patient prescribeddigoxin. What are your nursingconsiderations?
Therapeutic range is 0.5-2 S/S of toxicity: vision changes, N/V Antidote: Immune Fab
The patient is in ventricular tachycardiawith no pulse. What is you priorityintervention?
Defibrillate! Give amiodarone or lidocaine
You’re caring for a patient prescribed abeta blocker. For what reasons wouldyou not administer the medication?
Systolic BP below 90 HR below 50 History of asthma or COPD
Your patient with hypertension isprescribed the DASH diet. Whateducation would you include?
Eating vegetables, fruits, whole grains Fat-free or low-fat dairy products Fish, poultry, beans, nuts, and vegetable oils Limit red meats.
You’re caring for a patient with congestiveheart failure. What education will you include?
A low-salt diet, fluid restriction and weight daily.
Your patient is having a myocardialinfarction. What medications would youexpect to give?
Morphine, nitroglycerin, aspirin and oxygen
Your patient is having a AAA. What typeof symptoms would you expect?
Often asymptomatic, but patients mayfeel their heart beating, or back and/orabdominal pain.
Your patient is prescribed furosemide for heart failure. What is your priority actionprior to giving?
Check serum electrolytes, especially potassium!
Gastrointestinal
Your patient with GERD is prescribedomeprazole, what would you educatethem about?
Do not crush or chew the tablet. Take onan empty stomach. Increases risk ofinfection!
You are caring for a patient experiencingan ulcerative colitis exacerbation, whatare you MOST worried about?
Fluid and electrolyte imbalances due to the diarrhea.
What is a differentiating symptombetween ulcerative colitis and crohn’sdisease?
Blood in the stool with UC
Your patient with end stage liver cirrhosishas a sengstaken-blakemore tube. Whatare you nursing considerations?
If the patient has difficulty breathing, usescissors to cut the sangstaken-blakemoretube and remove it immediately!
Your patient is receiving TPN. The baghas finished, but the new TPN bag has notbeen delivered to the unit. What wouldyou do?
Administer 10% dextrose to preventhypoglycemia
What are the symptoms of a rupturedappendix?
Severe abdominal pain, fever & chills. If the appendix ruptures, the pain candisappear until symptoms of the infection(peritonitis) begin.
Cullen’s sign and Grey Turner signcorrelate with which medical condition?
Pancreatitis
Musculoskeletal
What will you teach a patient withosteoarthritis about pain control?
Ice or heat therapy Acetaminophen or NSAIDs Assistive devices, if needed
What is an early symptom of rheumatoid arthritis?
Fatigue, weakness, anorexia and weightloss are also early symptoms. Morning stiffness and warmth andredness of the joints are late symptoms.
For acetaminophen (tylenol), what is themax daily dose and what is the antidote?
The max daily dose is 4 grams If overdose, the antidote is acetylcysteine
Which side of the body should the patient hold the cane?
The cane is used on the stronger side
What is the most common sign of goutand what medication would you anticipatethe patient being prescribed?
Pain - most commonly in the big toe Colchicine or Allopurinol
What assessment is really important to dofor someone who has a fracture?
CSM: circulation, sensation, movement
You patient has a HALO vest, what areyou safety considerations?
Pin site care Taping a wrench to the vest - in case youneed to take it off for CPR
Your patient has a fracture. A cast isplaced while there is still a lot swellinghappening, what is the patient at risk for?
Compartment Syndrome
Hematologic
Name three facts you know foradministering a blood transfusion.
2 RNs to check bloodStay for the first 15 minutes4 hours max to infuseNS and Y tubing usedNo other meds administered with it20 gauge or larger IV/ central lineIf transfusion reaction suspected stop infusion
What are the symptoms of a hemolytictransfusion reaction?
Flank/lower back pain, hematuria, fever,tachycardia, hypotension
What symptoms and lab values would youexpect to see in the anemic patient?
Pallor, fatigue, hypotension, tachycardia, dyspnea Low hemoglobin (<10), hematocrit (<36)and RBC (<4) Possibly, pica
What instructions would you give yourpatient about taking iron?
Iron should be taken with vitamin C, suchas citrus juice or tomato juice forincreased absorption. Also, it is best absorbed when taken onan empty stomach.
What is the treatment for hemolytic andaplastic anemia?
Epoetin alfa - this injection stimulates thebone marrow to produce red blood cells.
What foods would you recommend foryour patient with iron deficiency anemia?
Meat, whole wheat and leafy greens
What is the cause of DIC?
Tissue Trauma (examples include severeinfections and cancer)
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