NCLEX 5 Mark klimek ABC's and lecture
outline
In Abruptio Placenta, the placenta ____________ from the uterine wall ____________.
- ANS-Separates, prematurely
Abruptio Placenta usually occurs in (prima/multi) gravida over the age of
____________. - ANS-Multigravida, 35 (HTN, trauma, cocaine)
How is the bleeding of Abruptio Placenta different from that in Placenta Previa? -
ANS-Usually painful; bleeding is more voluminous in placenta previa
If you are the nurse starting the IV on the client with Abruptia Placenta, what guage
needle should you use? - ANS-18 (in preparation to give blood if necessary)
How often should you measure the VS, vaginal bleeding, fetal HR during Abruptio
Placenta? - ANS-Q5-15 minutes for bleeding, maternal VS and continuous fetal
monitoring
Deliver baby at earliest sign of fetal distress
How is an infant delivered when Abruptio Placenta is present? - ANS-Usually C-section
Is there a higher or lower incidence of fetal death with Abruptio Placenta compared to
Placenta Previa? - ANS-Higher
In what trimester does Abruptio Placenta most commonly occur? - ANS-Third
At what age are accidental poisonings most common? - ANS-2 years old
If a child swallows a potentially poisonous substance, what should be done first? -
ANS-Call for medical help
Should vomiting be induced after ingestion of gasoline? - ANS-No- not for gas or any
other petroleum products
When taking a child to the ER after accidental poisoning has occurred what must
accompany the child to the ER? - ANS-the suspected poison
,An elderly client is a (high/low) risk for accidental poisoning? What about a school age
child? - ANS-high - due to poor eyesight, high
What types of chemicals cause burns to oral mucosa when ingested? - ANS-Lye,
caustic cleaners
Children at highest risk for seizure activity after ingestion are those who have swallowed
_____________ and ______________. - ANS-drugs, insecticides
Can impaired skin integrity ever be an appropriate nursing diagnosis when poisoning
has occurred? - ANS-Yes, when lye or caustic agents have been ingested
What is the causative organism of acne? - ANS-P. acnes (propionibacterium acnes)
What structures are involved in acne vulgaris? - ANS-The sebaceous glands
Name 3 drugs given for acne? - ANS-Vitamin A, Antibiotics, Retinoids
Dietary indiscretions and uncleanliness are causes of acne? - ANS-False
What are the 3 causative factors in acne vulgaris? - ANS-Hereditary, Bacterial,
Hormonal
Uncleanliness is a cause of acne? - ANS-False
What is the most common retinoid given to people with acne? - ANS-Accutane
Accutane is an analog of which vitamin? - ANS-Vitamin A
What is the most common side effect of accutane? And what is most important in health
teaching in adminstration? - ANS-Inflammation of the lips; Causes birth defects
What is the antibiotic most commonly given to clients with acne? - ANS-Tetracycline
How long will it take for the person to see results when acne is being treated? - ANS-4
to 6 weeks
Does stress make acne worse? - ANS-yes
,How often should the client with acne wash his face each day? - ANS-Twice a day
What instructions do you give to a client taking tetracycline? - ANS-Take it on an empty
stomach and avoid the sunlight (photosensitivity)
What are comedones? - ANS-Blackheads and white heads
What virus causes AIDS? - ANS-HIV - Human immunodeficiency virus
The AIDS virus invades helper ____________. - ANS-T-lymphocytes (or CD4 cells)
AIDS is transmissible through what four routes? - ANS-blood
sexual contact
breast feeding
across placenta in utero
HIV is present in all body fluids? - ANS-Yes, but it is not transmitted by all, only blood,
semen and breast milk
Name the 5 risk groups for AIDS - ANS-Homosexual/bisexual men
IV drug users
Hemophiliacs
Heterosexual partners of infected people
Newborn children of infected women
What is the first test for HIV antibodies? - ANS-ELISA
What test confirms the ELISA? - ANS-Western Blot
Which test is the best indicator of the PROGRESS of HIV disease? - ANS-CD4 count
A CD4 count of under __________ is associated with the onset of AIDS-related
symptoms. - ANS-500
A CD4 count of under _______ is associated with the onset of OPPORTUNISTIC
INFECTIONS. - ANS-200
Give 6 symptoms of HIV disease. - ANS-anorexia
fatigue
weakness
, diarrhea
night sweats
fever
Which 2 classes of drugs are given in combination for HIV sero-positivity? - ANS-NRTI's
(Nucleoside Reverse Transcriptease Inhibitors) and PI's (Protease Inhibitors)
They prevent viral replication.
NRTI (nucleoside reverse transcriptease inhibitors) - ANS-An antiviral drug used against
HIV
Is incorporated into the DNA of the virus and stops the building process
Results in incomplete DNA that cannot create a new virus
Often used in combination with other drugs
PI's (Protease inhibitors) - ANS-Most potent of antiviral meds
Inhibit cell protein synthesis that interferes with viral replication. Does not cure but slows
progression of AIDS. Prolongs life, used prophylactically and used in AIDS to decrease
viral load and opportunistic infections.
What do NRTI's and PI's do? - ANS-They prevent viral replication.
What does the physician hope to achieve with NRTI's and PI's for HIV? - ANS-A
delayed onset of AIDS for as long as possible (usually can delay onset for 10-15 years)
What is the most common NRTI used? - ANS-AZT (zidovudine)
What is the most challenging aspect of combination of drug therapy for HIV disease? -
ANS-The number of pills that must be taken in 24 hours can be overwhelming. The
frequency also makes it hard to remember-an alarm wristwatch is used.
Clients with AIDS (gain/lose) weight? - ANS-Lose weight
The typical pneumonia of AIDS is caused by ___________ ____________. -
ANS-Pneumocystic carinii
What type of oral/esophageal infections do AIDS patients get? - ANS-Candida
What is the #1 cancer that AIDS patients get? - ANS-Kaposi's sarcoma
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