Exam (elaborations)
NUR 265 EXAM 4 with correct answers
- Course
- NUR265 / NUR 265
- Institution
- Galen College Of Nursing
NUR 265 EXAM 4 with correct answers
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NUR 265 EXAM 4 with correct answersLupus: Hallmark sign - ** VERIFIED ANSWERS **✔✔butterfly rash on face
Lupus: Indication of flare - ** VERIFIED ANSWERS **✔✔Fever and fatigue
*also assess BUN function
*c reactive protein remains normal
Lupus: Interventions - ** VERIFIED ANSWERS **✔✔-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 - ** VERIFIED ANSWERS **✔✔-hydroxychloroquine(anti-malarial)
decreases absorption of UV light
Scleroderma - ** VERIFIED ANSWERS **✔✔inflammatory, autoimmune connective tissue disease
Scleroderma: Hallmark Sign - ** VERIFIED ANSWERS **✔✔Hard, leather-like edematous skin
Late: esophageal dismotility
Scleroderma: Assess - ** VERIFIED ANSWERS **✔✔Swallow safety--esophageal dysmotility
(ASPIRATION)
O2
,circulation
skin
Scleroderma: Interventions - ** VERIFIED ANSWERS **✔✔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 - ** VERIFIED ANSWERS **✔✔extreme fatigure
GI symptoms
dysuria
blurred vision
forgetfulness
fibromyalgia: Assess - ** VERIFIED ANSWERS **✔✔pain level
extreme fatigue
GI symptoms
Fibromyalgia: Interventions - ** VERIFIED ANSWERS **✔✔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 - ** VERIFIED ANSWERS **✔✔stage 1: "bulls eye rash" and flu-like
symptoms
Stage 2: facial paralysis, carditis, meningitis
, Lyme Disease: Assess - ** VERIFIED ANSWERS **✔✔Skin
history of tick bites
Lyme Disease: Interventions - ** VERIFIED ANSWERS **✔✔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 - ** VERIFIED ANSWERS **✔✔STOP THE INFUSION/ELIMINATE the
trigger, then STOP the immune response
Give Epi
maintain airway
Latex allergy: risks - ** VERIFIED ANSWERS **✔✔-frequent use of latex condoms
-healthcare workers
-allergy to avocados, bananas, and some nuts
Anaphylactic shock - ** VERIFIED ANSWERS **✔✔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 - ** VERIFIED ANSWERS **✔✔always carry 2 devices
inject by "stabbing" into top of thigh with pants on (AVOID pockets)
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