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NUR 265 EXAM 4 - QUESTIONS AND ANSWERS
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NUR 265 EXAM 4 Lupus: Hallmark sign Correct Answer: butterfly rash on face Lupus: Indication of flare Correct Answer: Fever and fatigue *also assess BUN function *c reactive protein remains normal Lupus: Interventions Correct Answer: -Falls precautions -treat pain with tylenol and...

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  • July 11, 2022
  • 16
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers

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  • nur 265
  • nur 265 exam 4 questions and answers

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NUR 265 EXAM 4
Lupus: Hallmark sign Correct Answer: butterfly rash on face

Lupus: Indication of flare Correct Answer: Fever and fatigue

*also assess BUN function
*c reactive protein remains normal

Lupus: Interventions Correct Answer: -Falls precautions
-treat pain with tylenol and NSAIDS (monitor kidney function)
-AVOID SUNLIGHT
-REPORT FLARE IMMEDIATELY
-clean skin with mild soap and pat dry and apply lotion

Lupus: medical management Correct Answer: -hydroxychloroquine(anti-malarial) decreases absorption
of UV light

Scleroderma Correct Answer: inflammatory, autoimmune connective tissue disease

Scleroderma: Hallmark Sign Correct Answer: Hard, leather-like edematous skin

Late: esophageal dismotility

Scleroderma: Assess Correct Answer: Swallow safety--esophageal dysmotility (ASPIRATION)
O2
circulation
skin

Scleroderma: Interventions Correct Answer: aspiration precautions (keep HOB at 60 degrees during
meals and after)
skin protection measures
small frequent meals--avoid caffeine and alcohol
-avoid spices, caffeine and pepper

fibromyalgia: S/sx Correct Answer: extreme fatigure
GI symptoms
dysuria
blurred vision
forgetfulness

fibromyalgia: Assess Correct Answer: pain level
extreme fatigue
GI symptoms

,Fibromyalgia: Interventions Correct Answer: NSAIDS
Nuerontin (gabapentin)
Lyrica (pregabalin)
SNRI and tricyclic antidepressants (amitriptyline)

promote sleep and low impact exercise (stretching, walking, swimming, rowing, water exercise)

Lyme Disease: Hallmark sign Correct Answer: stage 1: "bulls eye rash" and flu-like symptoms
Stage 2: facial paralysis, carditis, meningitis

Lyme Disease: Assess Correct Answer: Skin
history of tick bites

Lyme Disease: Interventions Correct Answer: prevention!
Insect repellant with DEET
early stage--doxycycline antibiotics ORAL
late stage--Iv antibiotics (ceftriaxone)
avoid tall grass
wear light colored clothing
have pets wear tick collars

Allergic Reaction Priority Correct Answer: STOP THE INFUSION/ELIMINATE the trigger, then STOP the
immune response

Give Epi
maintain airway

Latex allergy: risks Correct Answer: -frequent use of latex condoms
-healthcare workers
-allergy to avocados, bananas, and some nuts

Anaphylactic shock Correct Answer: AIRWAY--give epi IV or IM STAT and intubate if needed
BREATHING--apply O2; mechanically ventilate
CIRCULATION--monitor for distributive shock; give fluids

Epinephrine Auto-injector teaching Correct Answer: always carry 2 devices
inject by "stabbing" into top of thigh with pants on (AVOID pockets)
call 911 immediately--patient still needs to be monitored
keep epi in cool dark place.

Immunocompromised Patient Correct Answer: -Do not drink anything that has been sitting out
-take temp at least once per day
-clean toothbrush once weekly in diswasher or bleach solution
-do not eat raw foods; salad, cottage cheese
-do not scoop litter boxes
-no plants or soil exposure
-antibacterial soap

, -AVOID reptiles

HIV: Assess Correct Answer: CD4 count
ELISA test once per year for at risk patients

HIV: Interventions Correct Answer: PREVENTION:
-condoms
-PreP (truvada) must take 4 consecutive days in a row before protected; cant miss more than one dose
in a row
-needle safety
-post exposure prophylaxis-start cART within 24-36 hours of exposure

HIV: Nutrition Correct Answer: high calorie
high protein
low fat
small frequent meals
thrush--treat with anitfungal

HIV tx: HAART/cART Correct Answer: DOES NOT CURE
Does not prevent secondary/opportunistic infections
MUST TAKE 90% of the time --otherwise resistance will occur

HIV: complications --- AIDS Correct Answer: CD4 count less than 200mmhg
most likely to experience opportunistic infections
--I.e Pneumocystic jiroveci pneumonia (ASSESS AIRWAY!!)
consult pallative care/hospice

candida albicans Correct Answer: -Hallmark sign-- white patches in the mouth
-"food doesnt taste right"
-If patient wants a coke they can have it! They just have to rinse mouth out with water (fungus loves
sugar)

tuberculosis Correct Answer: hallmark sign-- night sweats, high fever, cough
-airborne isolation
-do not trust TB skin test in client with HIV

Fungal pneumonia Correct Answer: ABC's
monitor ABG--if hypoxemia present
antifungal drugs IV

External Radiation Correct Answer: -teach client to leave markings in place
-use sunscreen
-wash skin with mild soap and use lotion frequently

Breast Cancer: Risks Correct Answer: -BRCA 1&2 genes (preventative mastectomy)
-women age 65-80
-elevated estrogen levels
-alcohol consumption

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