NUR 198 ADULT HEALTH NURSING EXAM 1:
HIGH-YIELD REVIEW AND KEY CONCEPTS
An older adult comes in with new onset of Confusion. What should you do first?
Labs, to check for UTI or Pneumonia. Electrolytes issue like HypoNatremia. This is because symptoms of
disease in the very old frequently manifest as incontinence, falls, weakness and lethargy, confusion,
changes in sleep or level of alertness and loss of appetite or weight loss.
Define tolerance.
Tolerance is the diminishing effect with regular use of the same dose of a drug, requiring the user to
take larger and larger doses before experiencing the drug's effect
Define dependence
Dependence is A state in which there is a compulsive or chronic need, as for a drug
What is the first symptom of Acidosis?
Hyperventilation, increased Respiration Rate
action of 3% sodium
hyperosmolar agent
used in patients with severe hyponatremic encephalopathy, traumatic brain injury, and cerebral edema
pain scales
numeric rating scale: numbers
visual analog scale: faces
categorical scale: words, numbers, colors, locations on the body
nonverbal cues of pain
Decreased activity, grimacing, frowning, crying, moaning, and irritability.
Priority assessment in the PACU
,breathing, circulation, and respiratory adequacy
ABCs: airway, breathing, circulation
malignant hyperthermia
a genetic severe reaction to certain drugs used for anesthesia
What are Symptoms of Malignant Hyperthermia ?
(Hyper: Over or Excess, Thermia: Heat )
Symptoms of Malignant Hyperthermia are a Dangerously high body temperature, Rigid Muscles or
Spasms, a rapid Heart Rate(Tachycardia), Tachypnea (High Breath Rate) and High Fever
What Medications Can cause Malignant Hyperthermia?
These Anesthesia drugs Can Cause Malignant Hyperthermia:
Halothane: Used to Induce or Maintain Anesthesia
Sevoflurane: Inhaled and used to Maintain a loss of Consciousness during Surgery
Desflurane: Used to Induce or Maintain Anesthesia
Succinylcholine: Is a Depolarizing Skeletal Muscle Relaxant and used Adjuncty to Anesthesia, and during
Intubation.
What is the Treatment for Malignant hyperthermia ?
The treatment is the Administration of Dantrolene. This
Limits the activation of calcium receptor and preventing the response of the muscle to move.
What are the Appropriate medications for low-moderate pain?
acetaminophen (tylenol)
NSAIDs: Ibuprofen (Advil, Motrin),Naproxen (Aleve)
Acetylsalicylic: Aspirin
non-opioid
Post-Op teaching should include
wound care
pain management or pain goals
activity restrictions
dietary guidelines
medication management or adherence
signs of complications
ambulation to prevent DVT
follow up appointments
Most common form of elder abuse
Financial abuse
, role of the nurse in elder abuse
mandatory reporter and documentation
- dementia or Alzheimer's are the most at risk(also parkinsons, immobile clients)
- neurological or degenerative diseases
most common affective disorder in elderly
depression
risk of suicide is increased from losses, isolation, and illness
delirium
- Acute
- Fluctuating state of confusion
- Onset: fast
- Duration: hours to less than 1 month
- Causes: multiple, such as surgery, infection (sepsis, stoke, UTI's), drugs
- Management: remove or treat the cause
- Nursing interventions: reorient the client to reality; provide a safe environment
possible causes of delirium
○ Dehydration
○ Electrolyte imbalance/ emotional stress
○ Lung, liver, heart, kidney, brain disorders
○ Infection (sepsis, stroke, UTI's)
○ Rx Drugs
○ Immobility
○ Untreated pain, unfamiliar environment
○ Metabolic disorders
if delirium is left untreated what are possible outcomes
changes in level of consciousness, irreversible brain damage, and sometimes death
what assessments are performed on patients when they are in a state of acute confusion with
alterations in attention and cognition? (delirium is suspected)
CAM, confusion assessment method
healthcare team's primary goals for delirium patients
§ Improve oxygen
§ Reorient the client to reality; provide a safe environment
§ Supporting cognitive function
§ Reducing anxiety and agitation
§ Improve communication
dementia
HIGH-YIELD REVIEW AND KEY CONCEPTS
An older adult comes in with new onset of Confusion. What should you do first?
Labs, to check for UTI or Pneumonia. Electrolytes issue like HypoNatremia. This is because symptoms of
disease in the very old frequently manifest as incontinence, falls, weakness and lethargy, confusion,
changes in sleep or level of alertness and loss of appetite or weight loss.
Define tolerance.
Tolerance is the diminishing effect with regular use of the same dose of a drug, requiring the user to
take larger and larger doses before experiencing the drug's effect
Define dependence
Dependence is A state in which there is a compulsive or chronic need, as for a drug
What is the first symptom of Acidosis?
Hyperventilation, increased Respiration Rate
action of 3% sodium
hyperosmolar agent
used in patients with severe hyponatremic encephalopathy, traumatic brain injury, and cerebral edema
pain scales
numeric rating scale: numbers
visual analog scale: faces
categorical scale: words, numbers, colors, locations on the body
nonverbal cues of pain
Decreased activity, grimacing, frowning, crying, moaning, and irritability.
Priority assessment in the PACU
,breathing, circulation, and respiratory adequacy
ABCs: airway, breathing, circulation
malignant hyperthermia
a genetic severe reaction to certain drugs used for anesthesia
What are Symptoms of Malignant Hyperthermia ?
(Hyper: Over or Excess, Thermia: Heat )
Symptoms of Malignant Hyperthermia are a Dangerously high body temperature, Rigid Muscles or
Spasms, a rapid Heart Rate(Tachycardia), Tachypnea (High Breath Rate) and High Fever
What Medications Can cause Malignant Hyperthermia?
These Anesthesia drugs Can Cause Malignant Hyperthermia:
Halothane: Used to Induce or Maintain Anesthesia
Sevoflurane: Inhaled and used to Maintain a loss of Consciousness during Surgery
Desflurane: Used to Induce or Maintain Anesthesia
Succinylcholine: Is a Depolarizing Skeletal Muscle Relaxant and used Adjuncty to Anesthesia, and during
Intubation.
What is the Treatment for Malignant hyperthermia ?
The treatment is the Administration of Dantrolene. This
Limits the activation of calcium receptor and preventing the response of the muscle to move.
What are the Appropriate medications for low-moderate pain?
acetaminophen (tylenol)
NSAIDs: Ibuprofen (Advil, Motrin),Naproxen (Aleve)
Acetylsalicylic: Aspirin
non-opioid
Post-Op teaching should include
wound care
pain management or pain goals
activity restrictions
dietary guidelines
medication management or adherence
signs of complications
ambulation to prevent DVT
follow up appointments
Most common form of elder abuse
Financial abuse
, role of the nurse in elder abuse
mandatory reporter and documentation
- dementia or Alzheimer's are the most at risk(also parkinsons, immobile clients)
- neurological or degenerative diseases
most common affective disorder in elderly
depression
risk of suicide is increased from losses, isolation, and illness
delirium
- Acute
- Fluctuating state of confusion
- Onset: fast
- Duration: hours to less than 1 month
- Causes: multiple, such as surgery, infection (sepsis, stoke, UTI's), drugs
- Management: remove or treat the cause
- Nursing interventions: reorient the client to reality; provide a safe environment
possible causes of delirium
○ Dehydration
○ Electrolyte imbalance/ emotional stress
○ Lung, liver, heart, kidney, brain disorders
○ Infection (sepsis, stroke, UTI's)
○ Rx Drugs
○ Immobility
○ Untreated pain, unfamiliar environment
○ Metabolic disorders
if delirium is left untreated what are possible outcomes
changes in level of consciousness, irreversible brain damage, and sometimes death
what assessments are performed on patients when they are in a state of acute confusion with
alterations in attention and cognition? (delirium is suspected)
CAM, confusion assessment method
healthcare team's primary goals for delirium patients
§ Improve oxygen
§ Reorient the client to reality; provide a safe environment
§ Supporting cognitive function
§ Reducing anxiety and agitation
§ Improve communication
dementia
