HESI Mid Curricular – A+ Questions and 100% Graded Answers

HESI Mid Curricular – A+ Questions and 100% Graded Answers Nursing process - CORRECT ANSWER-assess diagnose outcome/planning implement evaluate techniques of physical assessment - CORRECT ANSWER-inspection palpation percussion auscultation start physical assessment with - CORRECT ANSWER-general survey assess for -appearance -behavior -height/weight/BMI -nutritional status -waist circumference which can indicate obesity when assessing the integumentary system you are looking for - CORRECT ANSWER-erythema - indicating fever/inflammation cyanosis - indicating O2 loss jaundice - ^ billiruben pallor - low on blood ecchymosis petechiae lesions integumentary assessment - CORRECT ANSWER-palpate for temperature, moisture, turgor, edema and inspect adventitious breath sounds - CORRECT ANSWER-wheeze - high pitch indicating airway obstruction crackles - bubbling on in/ex stridor - harsh high pitch sound on inhale ronchi - sonourus , coarse low pitch friction rub extra heart sounds - CORRECT ANSWER-s3-normal in children s4- normal in older adults order to listen to heart sounds - CORRECT ANSWER-APETM aortic, pulmonic, erbs point, tricuspid, mitral assessing the abdomen what order - CORRECT ANSWER-inspect auscultate percussion palpate bowel sounds should occur - CORRECT ANSWER-every 5-35 seconds gurgling if no sounds for 5 minutes = silent ileus bruits - CORRECT ANSWER-abnormal bowel sound auscultated during abdominal assessment sounds like a swishing noise and indicates obstruction neurovascular assessment - CORRECT ANSWER-6 P's 1. pain 2. pallor 3. peripheral pulses 4. paresthesia 5. paralysis 6. pressure cranial nerve 5 - CORRECT ANSWER-trigeminal -motor/sensation CHEWING cranial nerve 7 - CORRECT ANSWER-facial SMILE cranial nerve 9 - CORRECT ANSWER-glossopharyngeal SWALLOWING cranial nerve 12 - CORRECT ANSWER-tongue STICK YOUR TONGUE OUT AT ME when to assess VS - CORRECT ANSWER-on admission based on policy with CHANGE in condition loss of consciousness before/after invasive procedure before/after med admin heat production measures the body takes - CORRECT ANSWER-shivering piloerection vasoconstriction increased metabolism heat losing measures the body takes - CORRECT ANSWER-sweating vasodilation increased respirations jellinek curve - CORRECT ANSWER-phase 1 - pre alcoholic - using to relieve every day stress phase 2 - early alcoholic - blackouts/needs it, secretive about it gulps 1st drink phase 3 - crucial phase - lost control and gets defensive phase 4 - chronic phase - greatest risk for seizures in alcohol withdrawal is - CORRECT ANSWER-within 7-48 hours of last drink CIWA-AR - CORRECT ANSWER-monitors pt response to tx; determines need for medication, prevents seizures. use ciwa-ar every 2 hours then 4 hours alcoholism medications that promote sobriety - CORRECT ANSWER-- Disulfiram (antabuse) - causes severe neg. reaction to alcohol can lead to death even if only around paint fumes. -Naltrexone (ReVia) - reduces cravings by blocking the effects of alcohol PRN or monthly inj. -acamprosate (campral) - reduces want/craving can't be used for pt with renal failure (2 tab 3x/day) 3 groups of laxatives and their functions - CORRECT ANSWER-1. chemical laxatives (stimulate/irritate lining of GI 2. bulk laxatives (causes feces to ^ in bulk by ^ water content) 3. lubricant (move more smoothly) medications that cause diarrhea - CORRECT ANSWER-antibiotics magnesium medications that cause constipation - CORRECT ANSWER-opioids antacids iron sulfate anticholinergics GI bleed stool will be - CORRECT ANSWER-black if bleed is high in GI tract red/pink if bleed is closer to rectum chemical stimulant laxatives - CORRECT ANSWER-caster oil cascara senna bisacodyl -used to evacuate bowel for diagnostic procedures bulk laxatives - CORRECT ANSWER-magnesium citrate lactulose psyllium magnesium sulfate magnesium hydroxide polyethylene glycol -reduce strain by increasing fluid lubricant laxatives - CORRECT ANSWER-mineral oil docusate (colase) glycerin -prevent straining by coating poop to ease passage and prevent water from being absorbed sequence of bowel studies - CORRECT ANSWER-least invasive 1st invasive procedures last