NURS PHARM ATI EXIT EXAM: THINGS TO REMEMBER

NURS PHARM ATI EXIT EXAM: THINGS TO REMEMBER What are some expected findings of theophylline toxicity? Anorexia, Tachycardia, Albuminuria, and Hypotension How is breast engorgement treated? Cold therapy (ice packs on breasts for 15 minutes, 3-4 times per day). What do you do if your patient experiences bowel protrusion? 1. Stay with client and call for help. 2. Place saline-soaked gauze on wound. 3. Position client supine with knees bent. 4. Take vital signs. What are the side effects of estradiol? Headache, Hypertension. What should you NOT do when ambulating with a quad cane? Place can on affected side (canes should ALWAYS be placed on the UNaffected side!) What statement should the client make if they understand teaching related to warfarin therapy? "I should report a change in the color of my stools." (Blood in the stool indicates bleeding) What are some expected findings in a client with increased ICP? Altered mental status, memory loss (nuchal rigidity is a sign of bacterial meningitis, NOT increased ICP!) What should you teach a client regarding preeclampsia? 1. Report swelling of hands and face. 2. Rest in side-lying position. When performing CPR on an infant, where should you check for the pulse? Brachial site. What electrolyte changes will occur with dehydration? Serum sodium 130 Potassium 5.0 Chloride 95 Glucose 70 BUN 25 Creatinine 1.5 Urine Specific Gravity 1.030 How should a client climb the stairs using crutches? 1. Tripod position. 2. Place body weight on crutches. 3. Advance unaffected leg. 4. Advance crutches and affected leg. What should you AVOID regarding nutrition following a tonsillectomy? Do not give ice cream! It will make the client cough. What are the major manifestations of a hemolytic blood transfusion reaction? Tachycardia and LOW BACK PAIN For pregnant women, why would a bead be placed on the P6 meridian of the wrist? This is an alternative medical technique that aids in alleviation of nausea/vomiting. What are some normal findings during the newborn assessment that are usually thought to be abnormal? Apnea for up to 10 seconds Acrocyanosis (hands and feet are blue) What should you teach a client with home oxygen therapy? Always wear COTTON clothing to reduce static electricity. Check oxygen tank/equipment function daily. Why should drinking grapefruit juice be avoided when taking verapamil, a calcium channel blocker? It will cause a dangerous drop in BP. What is flumazenil the antidote for? Benzodiazepines, such as lorazepam and diazepam What should you use to clean up Hepatitis A? 1:1000 chlorine solution How long does treatment for TB last? Greater than 6 months. What should you teach parents of a newborn NOT to do when monitoring for apnea? DO NOT adjust the monitor to decrease incidence of alarms. What is the major side-effect of clozapine? Weight gain. Can an LPN insert an NG tube? Yes, it is within the scope of practice for LPNs. When planning discharge for a client with CVA, what is designated to the home health nurse only? Only the home health nurse conducts home safety assessments. For patients with increased uric acid, what should they include in their diet? Oranges AVOID: liver, red wine, and chicken How do you know when it is time to intervene with a client who shows aggressive behavior? When they start showing signs of hyperactivity, such as pacing around the room. What should a nurse case manager do when discharging a client with mental health issues? Arrange for transportation to health care appointments (the nurse case manager acts as a client advocate) What are some foods that can be given to toddlers as snacks? Steamed carrots (and anything soft). Celery, popcorn and marshmallows are BAD!! What is the primary finding in a patient with cardiac tamponade? Pulsus paradoxus. What is the major adverse effect of fluoxetine? Headaches What is the major adverse effect of oxygen toxicity? Bradypnea How should a patient at risk for decubitus ulcers be positioned in bed? 30* angle to decrease sacral pressure. How should a PICC line placement be confirmed initially? X-ray What should the nurse do prior to obtaining a FSBS? Wash client's hands in warm water. This increases blood flow and decreases infection. How should a parent collect a pin worm specimen from their child? Use a plastic bag for collection. What is the major adverse effect of propranolol? Coughing at night. Atrial fibrillation presents with... No visible P waves and an irregular ventricular response. When performing enteral feeding of an infant... DO NOT allow the rate to exceed 10 mL/min If a client is refusing to ambulate, what is the first thing you should assess for? Pain. For vacuum-assisted birth, what should the nurse monitor for? Perineal, cervical, and vaginal laceration. When assessing a mother during the immediate postpartum period, what should you report to the HCP? Boggy uterus. If your client has two different eye drops prescribed, what should you teach the client to do? Close eyes for 1 minute following administration of each medication to allow for absorption. Wait 10-15 minutes between each med. Immediately after delivery, if the nurse notes heavy lochia and boggy fundus, what medication should the nurse administer? Pitocin (stimulates uterine contractions and prevents bleeding) Why would magnesium sulfate be given during pregnancy? To relax smooth muscle and decrease contractions during preterm labor. What should you teach your patient to do when taking thorazine? Sip fluids throughout the day to relieve dry mouth. What should you teach your patient to do when taking Cytoxan? Maintain hydration with liberal fluid intake (should consume 1-1.5 times more than then recommended daily fluid intake). If a child comes to you from the ER with fever and fluid-filled vesicles on trunk and extremities, what should you do first? Implement transmission-based precautions. If a patient is in active labor and receiving Pitocin, and is showing FHR variability with accelerations, what should you do? Document and continue to monitor (variable accelerations are a reassuring FHR pattern indicating intact fetal CNS and a healthy placental/fetal exchange of oxygen. How should you verify NG tube placement? Aspirate contents of stomach and test for pH. What are the characteristics of a stage 2 pressure ulcer? Partial thickness skin loss. What should you promote for a child who has been discharged home with a large wound? Diet high in protein. A client is receiving Pitocin for labor induction and notes frequent decelerations. What should you do? Turn client on to left side to relieve cord compression. How should you treat pain associated with rheumatoid arthritis? Apply cold therapy to edematous joints. What lab studies should be done for a client taking valproic acid (Depakote)? Due to hepatotoxicity, serum liver enzyme levels (AST, ALT) should be monitored. For clients in a CPM machine... Affected extremity should remain in neutral alignment. Turn off machine during meals to promote comfort and dietary intake. What should be included in the plan of care for a patient with failure to thrive (FTT)? Develop a structured routine. What is the primary adverse effect of Dig. toxicity? Nausea. What should be documented in the medical record for an accident report of a medication error? Time medication was given. Using Naegelle's Rule, if a client's last menstrual period was on July 7, what is her approximate due date? April 14th. Subtract 3 months and add 7 days to last missed period. What should you do for a patient with peripheral artery disease? Apply lubricating lotion to feet. If a patient has a VP shunt, what should be reported to the HCP? Irritability while being held (sign of increased ICP). Who should receive RhoGAM shots? An O- woman following spontaneous abortion. Also, Rh- women should be given RhoGAM. How should a male go about detecting prostate cancer early on? Annual measurement of PSA levels for men over 50. A person with AIDS... Should not work in the garden (contact with soil may cause infection) What is an expected finding in a child with autism? Lack of response. If a client is to receive an IV pyelogram, what should the nurse encourage the client to do? Take a laxative to remove feces, liquid, and air from system. What should a client with thrombocytopenia avoid? Blowing their nose (will lead to increased risk for bleeding and hemorrhage) What are the expected aPTT ranges for a child with Hemophilia A? 45 seconds A client with an above-the-knee amputation should... Lie prone every 4 hours.