How do you walk up stairs with crutches? - ANS Use railing if there is one; lead with good leg,
using crutches for support of bad leg
What are signs of compartment syndrome? - ANS MEDICAL EMERGENCY! tingling,
numbness, worsening pain, edema, pain on passive movement, unequal pulses
What should you do for suspected compartment syndrome? - ANS Call doctor immediately,
loosen dressings, and prepare to assist with fasciotomy
What interventions do you do for suspected enterocolitis? - ANS Assess and measure
abdominal girth, monitor/manage fluid, electrolyte, and blood replacement, monitor for
sepsis/peritonitis/shock, and give antibiotics
What are some signs and symptoms of Hirschsprung's disease? - ANS Newborn: failure to pass
meconium in 24-48 hours, vomiting bile, refusing to eat, abdominal distention; infant: FTT,
vomiting, constipation; child: undernourished, anemic appearance, abdominal distention, visible
peristalsis, palpable fecal mass, constipation
What should you advise your patient of who has peripheral vascular disease? - ANS Sleep with
legs in a dependent position (hanging off the bed) to reduce swelling and discomfort of legs;
avoid crossing legs, avoid restrictive clothing, and elevate legs but not above heart level;
exercise and eat low fat diet
What is intermittent claudication? - ANS Burning, cramping, and pain in the legs during
exercise; present in peripheral vascular disease
What are some expected findings of Peripheral Vascular Disease? - ANS bruit over
femoral/aortic arteries, decreased capillary refill, diminished pulses, loss of hair on
ankle/calf/foot, dry/scaly/mottled skin, thick toe nails, RUBOR!, cold/cyanotic extremity, and
ulcers/gangrene of toes
What is a cardiac stress test? - ANS Measures the patient's heart ability to respond to external
stress in a controlled clinical environment; patient will exercise for 10-15 minutes; doctor will use
an EKG, BP, HR and O2 level; shows pumping ability; used in PVD
What are expected findings of pulmonary edema? - ANS Crackles in lungs, edema, cough with
pink/frothy sputum, cyanosis, confusion/stupor, tachycardia, tachypnea/dyspnea/orthopnea,
anxiety, inability to sleep, hypoxemia, decreased urine output
What would you advise a patient with pulmonary edema? - ANS Fluid restriction and low sodium
diet, high fowler's position, daily weights at same time of day, effective breathing techniques,
report SOB, swelling and angina; stay compliant with meds even if patient starts to feel better!
, Nursing interventions for pulmonary edema? - ANS High fowlers, vitals q15 min, hourly urine
output, monitor ABGs and electrolytes, monitor I & O, hemodynamic status
Why might someone have pulmonary edema? - ANS Most common cause is cardiogenic!
Patient will have increased pulmonary vascular pressure; patient may also be in opiate OD,
inhaled irritants, too rapid of IV fluids, head injury
What are some expected findings of cataracts? - ANS Blurry vision! decreased visual acuity,
diplopia (double vision), ABSENT RED REFLEX; visual opacity; cloudy pupils
What would you educate a patient with cataracts? - ANS Annual eye exams after 40!; Wear
sunglasses anytime outside, avoid activities that increase IOP (bending, sneezing, coughing,
straining, sex, restrictive clothing, head hyperflexion); report pain with n/v, limit activities
(cooking, driving, sports)
What laboratory test would you order to confirm diagnosis of HF? - ANS hBNP (level will be
elevated if patient has HF); heart is working harder, so more BNP in the blood
What is cystic fibrosis? - ANS mucus glands that secrete an increase in thick mucous, leading to
an obstruction of organs; the nurse will see and increase in SODIUM + CHLORIDE IN THE
SWEAT
What is the goal of case management? - ANS Avoid fragmentation of care and control cost
What is Rifampin and what should one warn the patient about? - ANS Rifampin is used to treat
TB; educate client to expect orange urine
What is Isoniazid and what should one warn the patient about? - ANS Isoniazid is used to treat
TB; educate client to avoid all alcohol and that the liver will need to be monitored due to
hepatotoxicity; monitor for tingling hands
What are expected findings of TB? - ANS persistent cough (longer than 3 weeks), purulent
sputum (or blood-streaked), fatigue/lethargy, weight loss, night sweats, low-grade fever in the
afternoon, older adults: confusion/altered mentation and unusual behavior
Why should people be tested for TB? - ANS People may have it and not know it; It may be
latent for years and become active when older or when immunocompromised; IT IS
AIRBORNE!!
What are the diagnostic procedures for TB? - ANS -Mantoux test or "PPD" (read 48 to 72 hr)
10mm is +; 5mm is + for immunocompromised
-chest x-ray
-acid-fast bacilli smear can culture
using crutches for support of bad leg
What are signs of compartment syndrome? - ANS MEDICAL EMERGENCY! tingling,
numbness, worsening pain, edema, pain on passive movement, unequal pulses
What should you do for suspected compartment syndrome? - ANS Call doctor immediately,
loosen dressings, and prepare to assist with fasciotomy
What interventions do you do for suspected enterocolitis? - ANS Assess and measure
abdominal girth, monitor/manage fluid, electrolyte, and blood replacement, monitor for
sepsis/peritonitis/shock, and give antibiotics
What are some signs and symptoms of Hirschsprung's disease? - ANS Newborn: failure to pass
meconium in 24-48 hours, vomiting bile, refusing to eat, abdominal distention; infant: FTT,
vomiting, constipation; child: undernourished, anemic appearance, abdominal distention, visible
peristalsis, palpable fecal mass, constipation
What should you advise your patient of who has peripheral vascular disease? - ANS Sleep with
legs in a dependent position (hanging off the bed) to reduce swelling and discomfort of legs;
avoid crossing legs, avoid restrictive clothing, and elevate legs but not above heart level;
exercise and eat low fat diet
What is intermittent claudication? - ANS Burning, cramping, and pain in the legs during
exercise; present in peripheral vascular disease
What are some expected findings of Peripheral Vascular Disease? - ANS bruit over
femoral/aortic arteries, decreased capillary refill, diminished pulses, loss of hair on
ankle/calf/foot, dry/scaly/mottled skin, thick toe nails, RUBOR!, cold/cyanotic extremity, and
ulcers/gangrene of toes
What is a cardiac stress test? - ANS Measures the patient's heart ability to respond to external
stress in a controlled clinical environment; patient will exercise for 10-15 minutes; doctor will use
an EKG, BP, HR and O2 level; shows pumping ability; used in PVD
What are expected findings of pulmonary edema? - ANS Crackles in lungs, edema, cough with
pink/frothy sputum, cyanosis, confusion/stupor, tachycardia, tachypnea/dyspnea/orthopnea,
anxiety, inability to sleep, hypoxemia, decreased urine output
What would you advise a patient with pulmonary edema? - ANS Fluid restriction and low sodium
diet, high fowler's position, daily weights at same time of day, effective breathing techniques,
report SOB, swelling and angina; stay compliant with meds even if patient starts to feel better!
, Nursing interventions for pulmonary edema? - ANS High fowlers, vitals q15 min, hourly urine
output, monitor ABGs and electrolytes, monitor I & O, hemodynamic status
Why might someone have pulmonary edema? - ANS Most common cause is cardiogenic!
Patient will have increased pulmonary vascular pressure; patient may also be in opiate OD,
inhaled irritants, too rapid of IV fluids, head injury
What are some expected findings of cataracts? - ANS Blurry vision! decreased visual acuity,
diplopia (double vision), ABSENT RED REFLEX; visual opacity; cloudy pupils
What would you educate a patient with cataracts? - ANS Annual eye exams after 40!; Wear
sunglasses anytime outside, avoid activities that increase IOP (bending, sneezing, coughing,
straining, sex, restrictive clothing, head hyperflexion); report pain with n/v, limit activities
(cooking, driving, sports)
What laboratory test would you order to confirm diagnosis of HF? - ANS hBNP (level will be
elevated if patient has HF); heart is working harder, so more BNP in the blood
What is cystic fibrosis? - ANS mucus glands that secrete an increase in thick mucous, leading to
an obstruction of organs; the nurse will see and increase in SODIUM + CHLORIDE IN THE
SWEAT
What is the goal of case management? - ANS Avoid fragmentation of care and control cost
What is Rifampin and what should one warn the patient about? - ANS Rifampin is used to treat
TB; educate client to expect orange urine
What is Isoniazid and what should one warn the patient about? - ANS Isoniazid is used to treat
TB; educate client to avoid all alcohol and that the liver will need to be monitored due to
hepatotoxicity; monitor for tingling hands
What are expected findings of TB? - ANS persistent cough (longer than 3 weeks), purulent
sputum (or blood-streaked), fatigue/lethargy, weight loss, night sweats, low-grade fever in the
afternoon, older adults: confusion/altered mentation and unusual behavior
Why should people be tested for TB? - ANS People may have it and not know it; It may be
latent for years and become active when older or when immunocompromised; IT IS
AIRBORNE!!
What are the diagnostic procedures for TB? - ANS -Mantoux test or "PPD" (read 48 to 72 hr)
10mm is +; 5mm is + for immunocompromised
-chest x-ray
-acid-fast bacilli smear can culture
