UWORLD REVIEW study guide

UWORLD REVIEW • TB and all airborne transmission based precautions (chickenpox, measles) - Use a surgical mask not an N95 for clients. - This helps protect Health care workers and other clients from respiratory secretions, and contain respiratory secretions - The HCWs who transport the clients from a negative pressure room to another location need to wear an N95 mask to protect themselves from infection. • Cirrhosis of the liver. These blood tests would be elevated in the lab results: - Ammonia, bilirubin, prothrombin time - Elevated bilirubin (jaundice) exists due to the decreased inability of the liver to conjugate and excrete bilirubin - Most coagulation factors are produced in the liver. A cirrhotic liver cannot produce the factors essential for blood clotting. As a result, the PT, aPTT, and INR levels are elevated. • Total knee replacement - A recent/current infection is a contraindication to total replacement surgery as a wound infection is more likely to occur in a client with a pre­existing infection. - Burning on urination should be investigated as it could indicate a UTI - Severe knee pain is expected. - Stop taking NSAIDS including selective COX­2 inhibitors (celecoxib) 7 days prior to surgery to decrease the risk of intra and post op bleeding. • Transfusion reaction - Chills, fever, low back pain, flushing, itching) - Stop transfusion immediately, maintain IV line with NS, monitor VS, notify HCP and blood bank, recheck tags numbers and client’s blood type, and return bag to blood bank for further testing. Collect blood and urine sample to evaluate hemolysis, and complete necessary facility paperwork to document the reaction. • Chronic kidney disease with a large plural effusion. Findings : - Decreased fremitus - Diminished lung sounds - A pleural effusion is an abnormal collection of fluid (15­20ml) in the pleural space between the parietal and visceral pleurae that prevents the lung from expanding fully. This results in decreased lung volume, Atelectasis, and ineffective gas exchange. - Other s/s: dyspnea on exertion, non­productive cough, diminished breath sounds, dullness to percussion, and decreased tactile fremitus. If the effusion is large, the trachea is deviated to the opposite side. - Sounds travel faster in solids (consolidation) than in an aerated lung, resulting in increased fremitus in pneumonia. fluid or air outside the lung interrupts the transmission of sound, resulting in decreased fremitus in pleural effusion and Pneumothorax. • Cancer - Unintentional weight loss of greater than 10 percent of usual weight (in nonobese) clients require evaluation and could indicate underlying cancer. N, anorexia, and dysgeusia (altered taste sensation) are also clinical features of cancer and contribute to weight loss. - CAUTION acronym of cancer Change in bowel or bladder habits A sore throat that does not heal Unusual bleeding or discharge from body ...................................continued,......................................