NURSING 1211C Study guide exam #3

1. Know the manifestations of hypocalcemia.  Tetany (intermittent muscular spasms, caused by malfunction of the parathyroid glands and a consequent deficiency of calcium). Chvostek sign (contraction of the facial muscles from a light tap over the facial nerve in front of the ear), Trousseau sign (a carpopedal spasm by inflating a blood pressure cuff, downward turn of the wrist). Seizures, mental changes such as depression, impaired memory, confusion, delirium and hallucinations, dyspnea, torsades de pointes which is a type ventricular tachycardia. Osteoporosis. Pp. 2. Know side effects of radiation therapy.  Toxicity localized in the area being irradiated (may be increased with chemotherapy). Altered skin integrity is common. Alopecia (hair loss) associated with whole brain radiation, radiation dermatitis, erythema and dry desquamation (flaking of skin), potential ulceration. Depending on the area being radiated… inflammation of oral tissues, decreased salivation and xerostomia (dryness of the mouth), loss of taste. Inflammation of the oral tissues, gastrointestinal mucosa, causing mucositis (inflammation of the lining of the mouth, throat, and gastrointestinal tract. Pg. 340 Text book 3. Know patient teaching for external radiation therapy for cancer.  Skin over targeted area marked “tattooed”, well-balanced diet, no red meat, alter taste, manage fatigue by activity with rest periods, monitor injury to skin, avoid spicy, salty, acidic foods, gently wash skin, do not remove marking, apply powders, ointments, do not expose skin to sun or heat source. 4. Know the normal values of pH and HCO3; which values denote acidosis and alkalosis.  PH 7.35-7.45 Anything below 7.35 is Acidosis Anything above 7.45 is Alkalosis  HCO3 7.45-7.35 Anything above 7.45 is Acidosis Anything below 7.35 is Acidosis (it is the opposite). 5. Know priority of nursing care following a thyroidectomy.  Educate on coughing and deep-breathing (incentive spirometer), stress importance of supporting the neck, explain the patient may be hoarse for a few days after surgery, the patient may have a drain in after surgery. Monitor for: vitals frequently, for hemorrhage, respiratory distress, hoarseness. *hypocalcemia (if the parathyroid is hit during surgery) this would cause Hypocalcemia… so now you will see weakness/tetany positive Trousseaus (hand bent at wrist) or Chvostek’s sign (contraction of the facial muscles), laryngeal stridor, dysphagia (hard time swallowing) Tingling around the mouth or in the extremities. 6. Know the clinical features of DKA and HHS.  Know the clinical features of DKA:  Type 1 Diabetes  too much acid  dehydration/loss of electrolytes  hyperglycemia  kussmaul respirations