Exam (elaborations) NURSG 200

1. A nurse is teaching a client about hypothyroidism and is asking the client to verbalize the teaching to ensure the client’s understanding. Which of the following would indicate a proper understanding by the client regarding hypothyroidism? (Select all that apply.) Intolerance to cold Heightened reflexes (hyperreflexia with hyper) Hair loss Joint and/or muscle pain Elevated T3 (for hyper) Decreased libido 2. A client is admitted to the recovery room following a thyroidectomy. Which of the following actions by the nurse indicates an understanding of care of the client with a thyroidectomy? A. The nurse offers extra blankets. (Nursing consideration for hypo: provide extra clothing and blankets for decreased cold tolerance) B. The nurse places a tracheostomy tube at the beside. (In the comprehensive ati book and what we learned in school was to have a trach kit, o2, suctioning and calcium gluconate readily available after a thyroidectomy) C. The nurse insists that the client refrain from talking. D. The nurse administers pain medication every 4 hr. COPD 1. A nurse is providing an educational session on COPD. What risk factors for COPD should the nurse include in the teaching? Risk factors for COPD is advanced age because older adult clients have a decreased pulmonary reserve due to normal lung changes, cigarette smoking, alpha 1 antitrypsin deficiency, and exposure to environmental factors such as air pollution. 2. A nurse is caring for a client who has COPD. What breathing techniques should be taught to help control dyspneic episodes? Breathing techniques to control dyspneic episodes include diaphragmatic breathing and pursed­lip breathing. Inflammatory Bowel Disease Match the following signs & symptoms to the correct disease process: A. Crohn’s Disease B. Diverticulitis C. Ulcerative Colitis CROHN’S: diarrhea, bloody stools, abdominal pain, weight loss ULCERATIVE COLITIS: chronic diarrhea, abdominal pain, nausea, cramping, flatulence DIVERTICULITIS: intermittent LLQ pain, abdominal cramping, nausea and vomiting, abdominal distention MECHANICAL VENTILATION 1. What should you do if the ventilator’s high pressure alarm sounds? High pressure alarms indicate an obstruction meaning it can indicated increased pressure from things like excessive secretions, client biting ETT, kinks in the ventilator tubing, coughing, and pneumothorax. 2. Why should the nurse provide oral care every 2 hours for the client on a ventilator? A nurse should provide oral care every 2 hours for the client on ventilator in order to decrease the risk of aspiration due to increased secretions and enteral feedings. COMPREHENSIVE PRACTICE B ASSESSMENT CONCEPTS 1. For communicable diseases mumps, pertussis, rubella, measles and varicella are all spread by contact and droplet. Antibiotics and antitoxins are used to decrease the severity of complications. In the ATI comprehensive book, measles, tb and varicella are under airborne precautions. 2. There are many unexpected medical conditions such as cervical insufficiency, hyperemesis gravidarum, anemia, gestational DM and gestational HTN that if detected early enough, interventions can be taken to ensure that the fetal well being and maternal health are taken care of. 3. Compartment syndrome can affect the extremities and happen when pressure happens within one or more of the muscle compartments. It is important to remember the 5 P’s which are pain, paralysis, paresthesia, pallor and pulselessness. If untreated, necrosis can occur. 4. Risk factor for osteoporosis include female gender, family history, thin, and lean body build because they are precursors for low bone density. Other risk factors include low calcium intake, diet deficient or excessive in protein, history of smoking, excessive caffeine, gastric bypass surgery, sedentary lifestyle or immobility. 5. A mental status examination focuses on level of consciousness, physical appearance, behavior, and cognitive and intellectual abilities. The Glasgow Coma Scale is used to obtain a baseline assessment of a client’s LOC and neurological status.