HESI Milestone #2 Study Guide with Questions, Answers and Rationale (Updated Exam)

HESI Milestone #2 -Chemo Side Effects Answers:-o Nausea/vomiting (24-48 hr, can be delayed up to 1 week) Meningitis first step Answers:-o Antibiotics - penicillin (ampicillin) AND cephalosporin o Corticosteroids Multiple sclerosis and urinary retention Answers:-o Sensation of void heeded immediately (bed pan/urinal @ bedside) o Voiding schedule (start 1/5-2hr then extend) o Drink specific amt every 2 hour; urinate 30 min after w/ timer o Self-catherization Acute renal failure priority Answers:-o Maintain fluids o Avoid fluid excess o Renal replacement therapy o Reduce metabolic rate o Promote pulmonary function Acute Respiratory distress priority findings Answers:-o Hypoxia o Intercostal retractions o Crackles o BNP levels (alveoli collapse because small airways are narrowed due to interstitial fluid and bronchial obstruction) End of life plan of care Answers:-o Signs and symptoms of impending death are recognized and communicated in developmentally appropriate language for children and patients with cognitive disabilities with respect to family preference. Care appropriate to this phase of illness is proved to the patient and the family Cushing Syndrome Answers:-o Can result from corticosteroids ***Attempt to reduce/taper medication while still treating underlying disease o Alternate day therapy decrease symptoms and allows adrenal glands to recover Valve replacement teaching Answers:-o Anticoagulant therapy (frequent follow-up/lab tests) § Pt on warfarin has specific normal ratios o Prevent infection o ANTIBIOTIC PROPHYALXIS FOR DETAL PROCEDURES!!! Cancer intractable pain plan of care Answers:-o Pain, other symptoms and side effects are managed based on the best available evidence, with attention to disease-specific pain and