NSG 233 - Medical-Surgical Nursing III
Exam 1
Question:
Triage patients in the ED
Answer:
Use ESI (emergency severity index) tool
Responsibilities of triage nurse:
Assess, reassess, initiate treatment, manage and communicate, educate, sort
patients, transport them
Question:
Meds for managing sexual assault
Answer:
Prophylaxis for gonorrhea
Ceftriaxone + 1% lidocaine
Prophylaxis for syphilis and chlamydia:
Single dose metronidazole
,Single dose azithromycin
7-day oral regimen doxycycline
Anti-pregnancy:
Levonorgestrel and ethinyl estradiol
Give within 12-24 hours, no more than 72 hours post-intercourse
Antiemetic for side effects
Question:
Tension pneumothorax care
Answer:
Immediate needle decompression
Followed by chest tube insertion
S/S: chest pain, dyspnea, tachycardia, anxiety, air hunger, increased use of
accessory muscles, decreased/absent breath sounds on affected side,
deviated trachea to unaffected side
Question:
Subcutaneous emphysema care
Answer:
Leaked air pockets under skin, feels like "rice crispies"
Part of spontaneous pneumothorax
Not usually serious
,Report to provider
Monitor airway
Absorbs once pneumothorax is treated
Question:
Intra-abdominal injury care
Answer:
Risk for hemorrhage - monitor for shock
Liver - right shoulder pain
Spleen - left shoulder pain
If stable --> CT
If unstable --> FAST exam (focused assessment with sonography for trauma)
Management: ABCs, C-spine precautions, NPO, antibiotics/tetanus,
monitoring, surgery PRN
Question:
Pneumothorax assessment
Answer:
Tracheal alignment - midline (simple pneumothorax)
Chest expansion - decreased
Breath sounds - diminished/absent
Chest percussion - normal/hyper-resonant
, Question:
Pneumothorax care
Answer:
Goal: to evacuate air/blood from pleural space
A small chest tube (28 Fr) is inserted near second intercostal space
If hemothorax, large tube (32 Fr or greater) is inserted in fourth or fifth
intercostal space
Suction is applied
Pleural cavity is decompressed (drainage of air/blood)
Question:
Patient-controlled analgesia (PCA)
Answer:
Has programmable settings
Delivers morphine at a preset bolus
Can program a lockout period (control frequency)
HCP gives loading dose to attain therapeutic blood levels quickly (with
continuous IV infusion)
Assess pain scores after initiation, after any change in pump setting, and
periodically
Exam 1
Question:
Triage patients in the ED
Answer:
Use ESI (emergency severity index) tool
Responsibilities of triage nurse:
Assess, reassess, initiate treatment, manage and communicate, educate, sort
patients, transport them
Question:
Meds for managing sexual assault
Answer:
Prophylaxis for gonorrhea
Ceftriaxone + 1% lidocaine
Prophylaxis for syphilis and chlamydia:
Single dose metronidazole
,Single dose azithromycin
7-day oral regimen doxycycline
Anti-pregnancy:
Levonorgestrel and ethinyl estradiol
Give within 12-24 hours, no more than 72 hours post-intercourse
Antiemetic for side effects
Question:
Tension pneumothorax care
Answer:
Immediate needle decompression
Followed by chest tube insertion
S/S: chest pain, dyspnea, tachycardia, anxiety, air hunger, increased use of
accessory muscles, decreased/absent breath sounds on affected side,
deviated trachea to unaffected side
Question:
Subcutaneous emphysema care
Answer:
Leaked air pockets under skin, feels like "rice crispies"
Part of spontaneous pneumothorax
Not usually serious
,Report to provider
Monitor airway
Absorbs once pneumothorax is treated
Question:
Intra-abdominal injury care
Answer:
Risk for hemorrhage - monitor for shock
Liver - right shoulder pain
Spleen - left shoulder pain
If stable --> CT
If unstable --> FAST exam (focused assessment with sonography for trauma)
Management: ABCs, C-spine precautions, NPO, antibiotics/tetanus,
monitoring, surgery PRN
Question:
Pneumothorax assessment
Answer:
Tracheal alignment - midline (simple pneumothorax)
Chest expansion - decreased
Breath sounds - diminished/absent
Chest percussion - normal/hyper-resonant
, Question:
Pneumothorax care
Answer:
Goal: to evacuate air/blood from pleural space
A small chest tube (28 Fr) is inserted near second intercostal space
If hemothorax, large tube (32 Fr or greater) is inserted in fourth or fifth
intercostal space
Suction is applied
Pleural cavity is decompressed (drainage of air/blood)
Question:
Patient-controlled analgesia (PCA)
Answer:
Has programmable settings
Delivers morphine at a preset bolus
Can program a lockout period (control frequency)
HCP gives loading dose to attain therapeutic blood levels quickly (with
continuous IV infusion)
Assess pain scores after initiation, after any change in pump setting, and
periodically
