BSN 7000 FINAL QUESTIONS WITH VERIFIED
ACCURATE ANSWERS
What are the important symptoms of case study 1 (Alf)? - Answers - CHF, venous ulcer
on fire and throbbing, cap refill 4+, 3+ pitting edema
What are the diagnoses of case study 1 (Alf)? - Answers - CHF exacerbation and CVI
Chronic venous insufficiency - Answers - veins cannot move blood back to the heart,
causing blood to pool into the legs, increasing pressure in the veins and causes swelling
and ulcers
What does CVI increase risk of? - Answers - DVT
Signs and symptoms of CVI - Answers - edema, dull pain, heaviness, varicose veins,
yellow ankles, itchy/flaky skin, venous ulcers, leathery skin
Treatment of CVI - Answers - elevate legs, compression stockings, avoid prolonged
sitting, maintain good skin patency
Education for CVI - Answers - careful with temperatures, foot trauma, avoid crossing
legs, no dangling legs, no caffeine, hydrate
Congestive heart failure - Answers - inability of the heart to provide the body with an
adequate amount of blood, either a pumping or filling issue
Left sided heart failure - Answers - lungs = dyspnea, SOB, tachypnea, cough, crackles,
cyanosis, decreased O2, confusion, weight gain, increased HR
Right sided heart failure - Answers - rest of body = ascites, enlarged liver and spleen,
JVD, edema
Priority problems for case study 1 - Answers - 1. Improve venous circulation and
decrease edema
2. Treat wound
3. Manage pain
How do we improve venous circulation and decrease edema? - Answers - elevate legs,
increase dose of Lasix, daily weights, I/O, cap refill
How do we treat the venous ulcer wound? - Answers - keep clean, prevent infection,
collab with wound specialist
, What's the concern with Lasix and Digoxin? - Answers - decreased potassium increases
the risk of digoxin toxicity
What is digoxin's therapeutic range? - Answers - 0.5-2.0
What's wrong with the dose of Lasix (20mg)? - Answers - it's too low and not getting rid
of enough fluid, causing CHF exacerbation with fluid overload. We need to increase to
40mg
Why do we want to monitor weight gain? - Answers - anything more than 2-3lbs/week of
weight gain from fluid overload = report to HCP
Why is it important to monitor kidney function with furosemide? - Answers - nephrotoxic
Digoxin toxicity signs and symptoms - Answers - vision changes, dizzy, N/V, irregular
pulse, confusion
Why is it important to monitor liver function with simvastatin? - Answers - hepatotoxic
What might Bisoprolol mask? - Answers - signs of hypoglycaemia
What are the important symptoms for case study 2 (Barb)? - Answers - diabetes type 2,
osteoporosis, bipolar type 2, thyroidectomy, alcohol/substance use, cirrhosis, current
admission for femoral fracture for unwitnessed falls
Priority problems for case study 2 (Barb) - Answers - 1. Risk of falls due to medications,
multiple chronic conditions, alcohol use
2. Risk of polypharmacy
3. Risk of medications not being taken properly
How do we improve the risk of falls? - Answers - OT/PT/home health, mobilize safely at
home, pain relief
How do we improve risk of polypharmacy? - Answers - involve pharmacist, use blister
packs, assess side effects (orthostatic hypotension, serotonin syndrome), assess
environment, assess mental health
What's the concern with risperidone? - Answers - causes orthostatic hypotension
What do we do to teach the client about orthostatic hypotension? - Answers - teach
client to get up and change positions slowly, regularly check BP in different positions to
track changes and effectiveness of management
What's the concern with venlafaxine? - Answers - monitor for serotonin syndrome and
patient is on the maximum dose (225mg)
ACCURATE ANSWERS
What are the important symptoms of case study 1 (Alf)? - Answers - CHF, venous ulcer
on fire and throbbing, cap refill 4+, 3+ pitting edema
What are the diagnoses of case study 1 (Alf)? - Answers - CHF exacerbation and CVI
Chronic venous insufficiency - Answers - veins cannot move blood back to the heart,
causing blood to pool into the legs, increasing pressure in the veins and causes swelling
and ulcers
What does CVI increase risk of? - Answers - DVT
Signs and symptoms of CVI - Answers - edema, dull pain, heaviness, varicose veins,
yellow ankles, itchy/flaky skin, venous ulcers, leathery skin
Treatment of CVI - Answers - elevate legs, compression stockings, avoid prolonged
sitting, maintain good skin patency
Education for CVI - Answers - careful with temperatures, foot trauma, avoid crossing
legs, no dangling legs, no caffeine, hydrate
Congestive heart failure - Answers - inability of the heart to provide the body with an
adequate amount of blood, either a pumping or filling issue
Left sided heart failure - Answers - lungs = dyspnea, SOB, tachypnea, cough, crackles,
cyanosis, decreased O2, confusion, weight gain, increased HR
Right sided heart failure - Answers - rest of body = ascites, enlarged liver and spleen,
JVD, edema
Priority problems for case study 1 - Answers - 1. Improve venous circulation and
decrease edema
2. Treat wound
3. Manage pain
How do we improve venous circulation and decrease edema? - Answers - elevate legs,
increase dose of Lasix, daily weights, I/O, cap refill
How do we treat the venous ulcer wound? - Answers - keep clean, prevent infection,
collab with wound specialist
, What's the concern with Lasix and Digoxin? - Answers - decreased potassium increases
the risk of digoxin toxicity
What is digoxin's therapeutic range? - Answers - 0.5-2.0
What's wrong with the dose of Lasix (20mg)? - Answers - it's too low and not getting rid
of enough fluid, causing CHF exacerbation with fluid overload. We need to increase to
40mg
Why do we want to monitor weight gain? - Answers - anything more than 2-3lbs/week of
weight gain from fluid overload = report to HCP
Why is it important to monitor kidney function with furosemide? - Answers - nephrotoxic
Digoxin toxicity signs and symptoms - Answers - vision changes, dizzy, N/V, irregular
pulse, confusion
Why is it important to monitor liver function with simvastatin? - Answers - hepatotoxic
What might Bisoprolol mask? - Answers - signs of hypoglycaemia
What are the important symptoms for case study 2 (Barb)? - Answers - diabetes type 2,
osteoporosis, bipolar type 2, thyroidectomy, alcohol/substance use, cirrhosis, current
admission for femoral fracture for unwitnessed falls
Priority problems for case study 2 (Barb) - Answers - 1. Risk of falls due to medications,
multiple chronic conditions, alcohol use
2. Risk of polypharmacy
3. Risk of medications not being taken properly
How do we improve the risk of falls? - Answers - OT/PT/home health, mobilize safely at
home, pain relief
How do we improve risk of polypharmacy? - Answers - involve pharmacist, use blister
packs, assess side effects (orthostatic hypotension, serotonin syndrome), assess
environment, assess mental health
What's the concern with risperidone? - Answers - causes orthostatic hypotension
What do we do to teach the client about orthostatic hypotension? - Answers - teach
client to get up and change positions slowly, regularly check BP in different positions to
track changes and effectiveness of management
What's the concern with venlafaxine? - Answers - monitor for serotonin syndrome and
patient is on the maximum dose (225mg)
