NUR 265 EXAM 4 2023 /183
Questions And Answers (A+)
Quiz :Lupus: Hallmark sign - √Answer :butterfly rash on face
Quiz :Lupus: Indication of flare - √Answer :Fever and fatigue
*also assess BUN function
*c reactive protein remains normal
Quiz :Lupus: Interventions - √Answer :-Falls precautions
-treat pain with tylenol and NSAIDS (monitor kidney function)
-AVOID SUNLIGHT
-REPORT FLARE IMMEDIATELY
-clean skin with mild soap and pat dry and apply lotion
Quiz :Lupus: medical management - √Answer :-hydroxychloroquine(anti-malarial) decreases
absorption of UV light
Quiz :Scleroderma - √Answer :inflammatory, autoimmune connective tissue disease
Quiz :Scleroderma: Hallmark Sign - √Answer :Hard, leather-like edematous skin
Late: esophageal dismotility
Quiz :Scleroderma: Assess - √Answer :Swallow safety--esophageal dysmotility
(ASPIRATION)
O2
circulation
skin
Quiz :Scleroderma: Interventions - √Answer :aspiration precautions (keep HOB at 60 degrees
during meals and after)
skin protection measures
small frequent meals--avoid caffeine and alcohol
-avoid spices, caffeine and pepper
Quiz :fibromyalgia: S/sx - √Answer :extreme fatigure
GI symptoms
dysuria
blurred vision
forgetfulness
Quiz :fibromyalgia: Assess - √Answer :pain level
extreme fatigue
GI symptoms
,Quiz :Fibromyalgia: Interventions - √Answer :NSAIDS
Nuerontin (gabapentin)
Lyrica (pregabalin)
SNRI and tricyclic antidepressants (amitriptyline)
promote sleep and low impact exercise (stretching, walking, swimming, rowing, water
exercise)
Quiz :Lyme Disease: Hallmark sign - √Answer :stage 1: "bulls eye rash" and flu-like
symptoms
Stage 2: facial paralysis, carditis, meningitis
Quiz :Lyme Disease: Assess - √Answer :Skin
history of tick bites
Quiz :Lyme Disease: Interventions - √Answer :prevention!
Insect repellant with DEET
early stage--doxycycline antibiotics ORAL
late stage--Iv antibiotics (ceftriaxone)
avoid tall grass
wear light colored clothing
have pets wear tick collars
Quiz :Allergic Reaction Priority - √Answer :STOP THE INFUSION/ELIMINATE the
trigger, then STOP the immune response
Give Epi
maintain airway
Quiz :Latex allergy: risks - √Answer :-frequent use of latex condoms
-healthcare workers
-allergy to avocados, bananas, and some nuts
Quiz :Anaphylactic shock - √Answer :AIRWAY--give epi IV or IM STAT and intubate if
needed
BREATHING--apply O2; mechanically ventilate
CIRCULATION--monitor for distributive shock; give fluids
Quiz :Epinephrine Auto-injector teaching - √Answer :always carry 2 devices
inject by "stabbing" into top of thigh with pants on (AVOID pockets)
call 911 immediately--patient still needs to be monitored
keep epi in cool dark place.
Quiz :Immunocompromised Patient - √Answer :-Do not drink anything that has been sitting
out
-take temp at least once per day
-clean toothbrush once weekly in diswasher or bleach solution
-do not eat raw foods; salad, cottage cheese
-do not scoop litter boxes
-no plants or soil exposure
, -antibacterial soap
-AVOID reptiles
Quiz :HIV: Assess - √Answer :CD4 count
ELISA test once per year for at risk patients
Quiz :HIV: Interventions - √Answer :PREVENTION:
-condoms
-PreP (truvada) must take 4 consecutive days in a row before protected; cant miss more than
one dose in a row
-needle safety
-post exposure prophylaxis-start cART within 24-36 hours of exposure
Quiz :HIV: Nutrition - √Answer :high calorie
high protein
low fat
small frequent meals
thrush--treat with anitfungal
Quiz :HIV tx: HAART/cART - √Answer :DOES NOT CURE
Does not prevent secondary/opportunistic infections
MUST TAKE 90% of the time --otherwise resistance will occur
Quiz :HIV: complications --- AIDS - √Answer :CD4 count less than 200mmhg
most likely to experience opportunistic infections
--I.e Pneumocystic jiroveci pneumonia (ASSESS AIRWAY!!)
consult pallative care/hospice
Quiz :candida albicans - √Answer :-Hallmark sign-- white patches in the mouth
-"food doesnt taste right"
-If patient wants a coke they can have it! They just have to rinse mouth out with water
(fungus loves sugar)
Quiz :tuberculosis - √Answer :hallmark sign-- night sweats, high fever, cough
-airborne isolation
-do not trust TB skin test in client with HIV
Quiz :Fungal pneumonia - √Answer :ABC's
monitor ABG--if hypoxemia present
antifungal drugs IV
Quiz :External Radiation - √Answer :-teach client to leave markings in place
-use sunscreen
-wash skin with mild soap and use lotion frequently
Quiz :Breast Cancer: Risks - √Answer :-BRCA 1&2 genes (preventative mastectomy)
-women age 65-80
-elevated estrogen levels
-alcohol consumption
-history of child after 30 years of age
Questions And Answers (A+)
Quiz :Lupus: Hallmark sign - √Answer :butterfly rash on face
Quiz :Lupus: Indication of flare - √Answer :Fever and fatigue
*also assess BUN function
*c reactive protein remains normal
Quiz :Lupus: Interventions - √Answer :-Falls precautions
-treat pain with tylenol and NSAIDS (monitor kidney function)
-AVOID SUNLIGHT
-REPORT FLARE IMMEDIATELY
-clean skin with mild soap and pat dry and apply lotion
Quiz :Lupus: medical management - √Answer :-hydroxychloroquine(anti-malarial) decreases
absorption of UV light
Quiz :Scleroderma - √Answer :inflammatory, autoimmune connective tissue disease
Quiz :Scleroderma: Hallmark Sign - √Answer :Hard, leather-like edematous skin
Late: esophageal dismotility
Quiz :Scleroderma: Assess - √Answer :Swallow safety--esophageal dysmotility
(ASPIRATION)
O2
circulation
skin
Quiz :Scleroderma: Interventions - √Answer :aspiration precautions (keep HOB at 60 degrees
during meals and after)
skin protection measures
small frequent meals--avoid caffeine and alcohol
-avoid spices, caffeine and pepper
Quiz :fibromyalgia: S/sx - √Answer :extreme fatigure
GI symptoms
dysuria
blurred vision
forgetfulness
Quiz :fibromyalgia: Assess - √Answer :pain level
extreme fatigue
GI symptoms
,Quiz :Fibromyalgia: Interventions - √Answer :NSAIDS
Nuerontin (gabapentin)
Lyrica (pregabalin)
SNRI and tricyclic antidepressants (amitriptyline)
promote sleep and low impact exercise (stretching, walking, swimming, rowing, water
exercise)
Quiz :Lyme Disease: Hallmark sign - √Answer :stage 1: "bulls eye rash" and flu-like
symptoms
Stage 2: facial paralysis, carditis, meningitis
Quiz :Lyme Disease: Assess - √Answer :Skin
history of tick bites
Quiz :Lyme Disease: Interventions - √Answer :prevention!
Insect repellant with DEET
early stage--doxycycline antibiotics ORAL
late stage--Iv antibiotics (ceftriaxone)
avoid tall grass
wear light colored clothing
have pets wear tick collars
Quiz :Allergic Reaction Priority - √Answer :STOP THE INFUSION/ELIMINATE the
trigger, then STOP the immune response
Give Epi
maintain airway
Quiz :Latex allergy: risks - √Answer :-frequent use of latex condoms
-healthcare workers
-allergy to avocados, bananas, and some nuts
Quiz :Anaphylactic shock - √Answer :AIRWAY--give epi IV or IM STAT and intubate if
needed
BREATHING--apply O2; mechanically ventilate
CIRCULATION--monitor for distributive shock; give fluids
Quiz :Epinephrine Auto-injector teaching - √Answer :always carry 2 devices
inject by "stabbing" into top of thigh with pants on (AVOID pockets)
call 911 immediately--patient still needs to be monitored
keep epi in cool dark place.
Quiz :Immunocompromised Patient - √Answer :-Do not drink anything that has been sitting
out
-take temp at least once per day
-clean toothbrush once weekly in diswasher or bleach solution
-do not eat raw foods; salad, cottage cheese
-do not scoop litter boxes
-no plants or soil exposure
, -antibacterial soap
-AVOID reptiles
Quiz :HIV: Assess - √Answer :CD4 count
ELISA test once per year for at risk patients
Quiz :HIV: Interventions - √Answer :PREVENTION:
-condoms
-PreP (truvada) must take 4 consecutive days in a row before protected; cant miss more than
one dose in a row
-needle safety
-post exposure prophylaxis-start cART within 24-36 hours of exposure
Quiz :HIV: Nutrition - √Answer :high calorie
high protein
low fat
small frequent meals
thrush--treat with anitfungal
Quiz :HIV tx: HAART/cART - √Answer :DOES NOT CURE
Does not prevent secondary/opportunistic infections
MUST TAKE 90% of the time --otherwise resistance will occur
Quiz :HIV: complications --- AIDS - √Answer :CD4 count less than 200mmhg
most likely to experience opportunistic infections
--I.e Pneumocystic jiroveci pneumonia (ASSESS AIRWAY!!)
consult pallative care/hospice
Quiz :candida albicans - √Answer :-Hallmark sign-- white patches in the mouth
-"food doesnt taste right"
-If patient wants a coke they can have it! They just have to rinse mouth out with water
(fungus loves sugar)
Quiz :tuberculosis - √Answer :hallmark sign-- night sweats, high fever, cough
-airborne isolation
-do not trust TB skin test in client with HIV
Quiz :Fungal pneumonia - √Answer :ABC's
monitor ABG--if hypoxemia present
antifungal drugs IV
Quiz :External Radiation - √Answer :-teach client to leave markings in place
-use sunscreen
-wash skin with mild soap and use lotion frequently
Quiz :Breast Cancer: Risks - √Answer :-BRCA 1&2 genes (preventative mastectomy)
-women age 65-80
-elevated estrogen levels
-alcohol consumption
-history of child after 30 years of age
