176 Exam 1 with 100% correct answers 2024

- answers- Dementia: two goals - answers-Safety and 2. Self-care abilities (ADLs) Stroke patient: first action to take if waking up confused or agitated: - answers-perform a neuro check A younger patient 20-30, type 2 diabetes, blood sugar just under 300. This is hyperglycemia. What is symptom patient will suffer from? - answers-Polydipsia Day nurse said patient was fine, night time nurse reports pt has severe headache, has 9 out of 10 headache what do you check 1 st - answers-Check blood pressure Select all that apply: patient recently diagnosed with type 1 diabetes. Sending him home from hospital. What will you educate him on? - answers-Check glucose levels and understand that glucose level skyrockets when under stress. Educate on signs and symptoms of hyper and hypoglycemia. Must monitor more than once a day. Exercise: lowers glucose level, so check glucose level and EAT beforehand. Signs and symptoms Meningitis or encephalitis: before you can treat, what must you know? - answers-Determine the organism specific cause to provide proper treatment Pt. recently diagnosed with type 2 diabetes. You are teaching pt. the correct info to prevent complications. What will you educate on - answers-medications, exercise & maintain a healthy weight, examine feet every day (from poor wound healing), yearly eye exams Interventions for a dementia patient. Which interventions would you expect to see - answers-reduce distractions at meal time, large calendar and clock in room, monitor weight changes Type 1 diabetic had surgery a few days ago. Nurse should anticipate - answers-monitoring: glucose level, wound healing, signs for infection Pt. is having hallucinations, and diagnosed with delirium. What causes need for further teaching - answers-Delirium is not reversible. (Dementia is not reversible, but delirium is) Dementia patient: how many types of pain assessment? - answers-2. PQRST and the Faces. (Juan Baker?) MS drug - answers-Capaxone (Glatiramer Acetate) What does Lovenox do: anticoagulant. Must report what to higher up? - answers-Excessive bruising and bleeding gums Someone falls while seizing and you are standing next to them, what do you do: - answers-turn onto left side, and record details of seizure activity. When giving lantis (long acting), if we give at 2100 hours, when can we expect to see the insulin working? - answers-1 hour Pt. diagnosed with dysphagia, what will you do to their food: - answers-thicken liquids because they have difficulty swallowing and can aspirate. No use of a straw. Type 1 diabetic, signs and symptoms of hypoglycemic reactions: - answers-irritability, hungry (hunger is a sign of hypo and hyper) Need for further teaching: how do we draw regular insulin and NPH - answers-nph How do you teach diabetic about footcare (will be need for further teaching, look for wrong answers - answers-use hot water Diabetic type 2 patient who is taking prednisone, what do we need to make sure happens: - answers-Prednisone raises blood glucose so adjust the sliding scale of insulin Type 1 diabetic prescribed novalog and lantis. What 3 things should they do when they get sick - answers-check blood sugar more often, visible daily check of feet, administer novalog 15 minutes before meals. What are the medications used for seizures - answers-Dilantin, Tegretol, Valium, Depakote When someone is having a seizure and they are stiffening up, what is that called: - answers-tonic and clonic (entire body) Absence seizure: - answers-aka focal seizure. Partial seizure: Myoclonic: arms or legs only. Pt. has history of diabetes has higher risk of complications for what - answers-HDL, triglycerides, blood glucose. Someone has a stroke, what are modifiable risk factors - answers-smoking, sedentary lifestyle, decrease stress What test do they run for diabetic patients? - answers-A1C Patient has ICP, what question would nurse ask to assess ICP change - answers-are you having blurred vision? Pt. given novalog before breakfast. How long until nurse can see if a hypoglycemic action will occur? - answers-1 hour What does glucagon do? - answers-Raises blood sugar. Give to someone who has low blood sugar Dementia patient who is agitated and confused: - answers-Remove them from the situation 3 things we need to do for someone who has seizures: - answers-suction and oxygen just in case, padded rails, bed low to the ground Right sided paralysis: - answers-same as ^ but pads also on floor Someone has concerns about becoming a diabetic, what will you educate them on: - answers-diet and exercise Post prandial glucose: type 2 diabetes, and what types of diagnostic tests the nurse would anticipate being ordered - answers-A1C, fasting glucose and a post prandial glucose Small child with diabetes - answers-: likely to have type 1 What would nurse expect to observe in a child with diabetes - answers-polyphagia (increased appetite) polyuria (excessive pee) and weight loss Mannitol - answers-osmotic diuretic used for ICP. Pulls fluid off the brain. Know its working when we see increased output Type 2 diabetic needs further assessment when - answers-polyuria should Diabetic patients walk around without shoes? - answers-no Bacterial meningitis - answers-antibiotics cure it, VERY contagious. Important to vaccinate children. Type 1 diabetic: - answers-reduce junk food and increase exercise habits, be in meal routine, carbs before exercise What precautions would you expect with bacterial meningitis: - answers-droplet Ischemic stroke - answers-history of hypertension and high cholesterol. High heart rate and BP and respirations, oxygen will be low Patient with history of diabetes, what are new concerns or new symptoms - answers-loss of hair on lower legs Pt with type 2 and A1C is high, over 10, what would physician do for plan of care - answers-dietary consult In regards to insulin, what can't LPNs do: - answers-can't initiate IV insulin Can lantis and humulog be mixed together - answers-NO (need for further teaching) Myoclonic seizure - answers-jerking of extremities Dementia patient: how do we reorient them - answers-1. Set routine 2. Be truthful about answers, do not lie 3. Help them to do simple tasks. Early mid and late Alzheimer's - answers-Late-stage issue: dependent with ADL Caring for a type 1 diabetic, if blood sugar is continually low in the morning: - answers-ask what is your typical evening snack before bedtime Caring for 10 year old who has not been diagnosed with diabetes, but grandfather has. He comes in with blood sugar of nearly 400 and complaints of polyuria. What orders would you expect related to these findings - answers-GAD (juvenile diabetic test). Also, administer insulin (sliding scale) Patient fell 10 feet, vitals are okay, what would immediate action be for patient - answers-CT of his brain. I will give my insulin as soon as its removed from the refrigerator: - answers-WRONG. Cannot give insulin when it is cold. Symptoms of cluster match for DKA - answers-patient will be very thirsty, ABG will be low pH (acidosis, below 7.35), respirations fast. Giving lantis and novalog, how do give since you cannot mix it - answers-separate syringes. Receptive aphasia - answers-does not understand directions. Patient type 2 diabetic taking glucaphage, metformin, makes him nauseous and has diarrhea, how do you respond to patient so you can help him: - answers-ask doctor for different oral glycemic. Patient is hyperglycemic: - answers-s/s you can see are polyuria, polydipsia, hot and dry skin Contrast for CT, what is important for patient to do one to two days following CT - answers-drink plenty of water to flush system. Cold and Clammy - answers-give them some candy Hot and dry sugars are high - answers-let the insulin fly. Caring for a type 2 diabetic, heart racing and sweaty, what do you do first - answers-check blood sugar what precaution Meningitis is - answers-droplet precaution. Patient is afraid of getting dementia, what response from nurse is appropriate - answers-there is no guarantee you will develop. Pt. has severe headaches, what could be potential problem - answers-ICP Type 2 diagnostic test: - answers-fasting blood sugar, A1C, lipid panel. Glasgow coma what are 3 categories of assessment: - answers-1. Eye opening 2. Verbal 3. Motor skills ICP intervention to decrease pressure: - answers-1. Osmotic diuretic 2. 30-45-degree angle on the bed 3. Suction by the bed Early signs of ICP - answers-: headache, confusion, double vision Tegritol seizure medication, what should you be most concerned when using it - answers-dropped platelets.** Normal is 150,000-250,000. DKA treatments - answers-lower blood sugar with insulin, more fluids. Deltasone - answers-generic prednisone. SONE=steroids.