Nur 242 Exam 1 | Medical-Surgical
Nursing Exam Guide Rated A+ | Latest
2024
Tuberculosis - Correct Answer - A contagious disease that generally affects the lungs, but may affect other parts of the body
Offending agent/organism: Mycobacterium Tuberculosis
Transmitted through aerosolization (airborne route); respiratory droplets become airborne and may be inhaled
Tuberculosis: Risk Factors - Correct Answer - Alcoholics, Immigrants, HCW's, NH patients, HIV/AIDS, homeless, patients using immunosuppressive drugs
Tuberculosis Symptoms - Correct Answer - Fever, sputum production, productive cough, anorexia, fatigue, malaise, weight loss, DRENCHING night sweats, hemoptysis; has pt been exposed to someone with TB? Tuberculosis Dx - Correct Answer - DX: CXR—presence of apical cavitations and infiltrates
Sputum for AFB and culture
Tuberculosis Treatment - Correct Answer - TB is usually curative; about 10% of cases are fatal. Four drug therapy. Pneumonic RIPE
All TB drugs are somewhat hepatotoxic
Tuberculosis Treatment: Pyrazinamide and Ethambutol - Correct Answer - Pyrazinamide: Do not give to Pregnant women!
Ethambutol: Major adverse effect is optic neuritis. Eye. Patient will
have difficulty distinguishing colors.
Two months: Give all four drugs.
Four months: Two drugs, INH and Rifampin
Finally: Repeat CXR and AFB to ensure eradication.
Tuberculosis Treatment Rifampin: - Correct Answer - Causes Red
secretions. These are harmless. Red urine, tears, etc (appear more orange). Tuberculosis: Treatment Isoniazid (INH): - Correct Answer - Reduces B6 levels, therefore B6 supplementation(pyridoxine) is indicated. B6 deficiency causes neurological problems (numbness, tingling). "Injures Neurons and Hepatocytes."
Tuberculosis Skin Test - Correct Answer - Intradermal injection: Performed by injecting 0.1ml of Purified Protein Derivative into the
inner surface of the forearm. When performed correctly, it should produce a wheal.
PPD should be read 48-72 hours after administration
Should be read in mm of induration (not redness)
Tuberculosis Skin test Results - Correct Answer - > 5mm is positive in persons with decreased immunity
>10mm is positive in recent immigrants from high prevalence countries, IDU's, live in population within close proximity to people
might be infected (homeless shelter, prison), >15mm is positive in any person, even those without risk factors for TB If PPD is positive should have CXR/sputum test
What are the three main types of headaches? - Correct Answer - Migraine, Tension, Cluster
Steps to Pain Assessment - Correct Answer - Provoking
Quality
Radiation
Severity Time
Provoking - Correct Answer - has anything made it better or worse
Quality - Correct Answer - Sharp, dull, achy, throbbing
Radiation - Correct Answer - Does it radiate to another part of the body
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