Hondros NUR 212 Exam 1 (2023 – 2024) Questions With 100% Correct Answers What should be done when there is an obstruction in a chest tube and why? - Milk the tube, never strip due to pressure changes When is it normal to find bleeding in a chest tube? - Only with a hemothorax Is tidaling normal with a chest tube? - Yes, on respirations What does it mean when there is no longer tidaling with a chest tube? - That the tube is ready to be taken out Is constant bubbling with a chest tube good or bad? - Bad Is crepidous supposed to be at the chest tube site? - No, but usually resolves back into the body What is crepidous? - Air bubbles in the subcutaneous tissue surrounding chest tube site How should a chest tube be observed for any issues? - From the patient to the machine What is the first thing the nurse should do if she suspects any issues with a patient’s chest tube? - Make sure the chest tube connections are secure What are the steps to a self br east exam? - Step 1: Lie down and place left arm behind head (lying down spreads breast tissue evenly) Step 2: Use finger pads of 3 middle fingers on your right hand to feel for lumps in the left breast. Use overlapping dime -sized circular motions to feel breast tissue. Light, medium, and firm pressure to feel each layers. (A firm ridge on the curve of each breast is normal) Step 3: Move around breast in a vertical pattern at an imaginary straight line down your side from the underarm. Respect for right breast. Step 4: Stand in front of mirror and tighten pectoral muscles for any redness, lumps, shapes, or scaliness near nipples. Step 5: Examine each underarm for and knot, or thickening tissue What prevents lymphedema? - Exercise, healthy diet (health maintenance) Treatment for lymphedema? - Healthy diet, exercise, compression stockings, good skin/nail care, decongestive therapy, elevate extremity, isometric exercises What are neutropenic precautions? - Avoid fresh fruits/veggies, no fresh flowers, good hand hygiene (infection prevention) Signs and symptoms of thrombocytopenia? - Most patients are asymptomatic, but s \s include bleeding (mucosal or cutaneous), bruising, petechiae, purpura, and s \s of hemmorhaging. Adverse affects of chemo/radiation? - Nausea, vomiting, anorexia, diarrhea, skin breakdown, reproductive dysfunction, nephrotoxicity, neuropathy, anemia Fatigue management for chemo? - Encourage moderate exercise as tolerated, encourage rest when fatigued but to continue to maintain lifestyle patterns as much as possible while pacing activities to energy level, and reassure that fatigue is a common side affect Stages of cancer? - 1-Initiation 2-Promotion -Can be reversed with lifestyle changes. 3-Latent 4-Progression Initiation stage - Injury to DNA, genetic changes. Promotion stage - Proliferation, reversible (lifestyle changes can reduce risk) Latent stage - Tumor present, no evidence of cancer Progression stage - Tumor has own blood supply, increased growth rate, i nvading surrounding cells, metastases Are all side effects of chemo instant? - No, can be latent for a few days to a week Proper PPE for nurse administering chemo? - Gloves, gown, and mask Proper skin care for a patient on radiation therapy? - Aloe or lotion without perfume, metal, alcohol, or additives. No heating pads or ice packs. Frequent skin assessments. S\S of adverse affects of IV chemo? - Painful, red, swollen, or blistered IV site. Primary prevention for cancer? - Lifestyle change s, healthy diet, exercise, smoking cessation. Secondary prevention for cancer? - Screenings (breast/testicle self exam, Pap smear, PSA) What is an important nursing intervention for a patient with a mastectomy - No BP or injections on the side with maste ctomy, and elevate arm to help with flow of lymph due to the risk of lymphedema