NUR 310 Final EXAM - study prep PDF

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NUR 310 FINAL EXAM—5 to 7 Questions KEY POINTS:  

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Post-Op Complications (Surgery content) Common Complications with all SXs:  DVT, Malignant Hyperthermia, Dehiscence, Hypoventilation  Hemorrhage, Evisceration, Emergent Delirium, Aspiration, Respiratory Depression  Worried about them lying in bed and having Pneumonia Pre-Op Communication (Surgery content) What do you talk to your Pts about before going into SX?  Previous Health History/PE  HX/Medications  Discharge teaching/Expectations Post-Op. Day of Surgery Care (Surgery content) What things are you required to talk to Pts about & check on Day of SX?  Witnessed—Signed—Consent  Make sure Pt has a full understanding of Procedure Care of Polycythemia Vera—Everything is up, everything is thick—How do you take care of these people—What are they going to be complaining about? How do you help them?  Hydration, Itching, Don’t take Hot Bath—Makes it worse & itch more Care of GI Bleed—  If someone’s having an active GI Bleed, what do I do as a nurse for that?  What am I worried about? If their an active bleed—I’m losing volume, BP  Different Anemias  How many different types of Anemia are there? 4  Need to know different types—What makes one different from the other  How to treat it Care of Lupus ‘SLE’  S/SXs seen in Pts with Lupus—Butterfly Rash  What are some treatments that we can do for these Pt’s? Care of Rheumatoid Arthritis  How do we care for those Pts? Care of Hypersensitivity  4 Different Types that your gonna see—How are they different? If someone comes in with a reaction—How are we going to treat them?  Know those 4 Different Types & their options Care of Gout  Clinical Manifestations  Treatment Options Post-Op Lithotripsy  What are some things we’re gonna monitor Post-Op? I&Os Care of UTI/Pyelonephritis  Know the different types of UTIs—Pyelonephritis being a Kidney Infection. Know what we’re gonna do to treat those Pts—What kind of S/SXs their gonna present with— Medications that we’re gonna give them Urine Specimen Collection  How do we successfully collect urine specimens? Care of BPH

 Know how to care for them—What are we going to see? S/SXs What are some treatment options? Remember conservative treatments 1st CHAPTER 48—DIABETES MELLITUS  Chronic DM complications  Macrovascular Complications: Angiopathy—Diabetic Retinopathy, Nephropathy, Vascular Disease, Heart Disease, Atherosclerosis of the Heart of the Brain—Risk for Stroke Heart Attack, Blindness, Kidney Failure, Kidney Disease, ERD—End Stage Renal Disease, Peripheral Nephropathy—Delay these by controlling GLU—Want HA1C — Educate about Diet & Exercise & getting GLU under control/

 What are the 3 Acute Complications of Diabetes? o HHS—Hyperosmolar Hyperglycemic Syndrome o DKA—Diabetic Ketoacidosis o Hypoglycemia 

Types (4) and other Types of DM—What are the 4 Types of Diabetes?  Type 1—Type 2—Gestational—Prediabetes  Type 1: An Autoimmune Disorder—The body develops antibodies against insulin &/or the pancreatic β-cells that produce insulin. Eventually results in NOT enough insulin for a person to survive o Absence of Endogenous Insulin (Self-Made Insulin produced by the Pancreas)

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 Type 2: “Most Prevalent” Inadequate insulin secretion—& resistance Don’t produce enough insulin, insulin resistance o The pancreas usually produces some Endogenous (Self-Made) insulin. However, the body either does not produce enough insulin or does not use it effectively, or both. **The presence of Endogenous Insulin is a Major distinction between Type 1- & Type 2-Diabetes  Contributing Risk Factors: o Overweight—Or Obese o Age—Being Older o Family HX o More Prevalent in: African Americans, Asian Americans, Hispanics, Native Hawaiians & Native Americans than Whites  Prediabetes: Are at Increased risk for Development of Type 2- Diabetes. o Is Defined as: Impaired Glucose Tolerance (IGT) Impaired Fasting Glucose (IFG), or Both. o It is an intermediate stage between Normal GLU Homeostasis & Diabetes, in which the GLU are elevated but not high enough to meet the diagnostic criteria for diabetes.  Gestational Diabetes: Develops during Pregnancy—At Risk for developing Type 2Diabetes later in life.  Other Specific Types of Diabetes—Occurs due to another Medical Condition or Treatment of a Medical Condition that cause abnormal GLU: o Cushing Syndrome, Hyperthyroidism, Recurrent Pancreatitis, Cystic Fibrosis, Hemochromatosis & Parenteral Nutrition—Pt in hospital (Stress)  Medications that can Induce Diabetes: —Corticosteroids (Prednisone) —Thiazides —Phenytoin (Dilantin) —Atypical Antipsychotics (e.g., clozapine [Clozaril]) o These can resolve when the underlying condition is treated or the medication discontinued. Exercise and DM—What does exercise do for the diabetic?  The ADA recommends: at least 30 minutes, 5 days/week of a moderate-intensity aerobic physical activity. Type 2- Diabetes—perform resistance training 3X’s/week  Exercise decreases insulin resistance & can have a direct effect on lowering GLU levels. Contributes to weight loss—which further decreases insulin resistance  Can decrease need for diabetes medications to reach target GLU  Exercise is best done after meals when GLU are rising.  Before exercise—if GLU are ≤100 mg/dL eat 15g carbohydrate snack, wait 15 to 30 min, recheck GLU if ≤100 mg/dL—Delay exercise. In a Type 1- if GLU ≥250 mg/dL Ketones are Present—Delay Vigorous activity until ketones are gone (Drink Fluids) Insulin Needs and Requirements Goal Diabetic Nutrition: COMPONENT Total Carbohydrate

RECOMMENDATIONS ●Include carbohydrate from fruits, vegetables, grains, legumes, & low-fat milk ●Monitor by carbohydrate counting, exchange lists, or use of appropriate proportions. ●Sucrose-containing food can be substituted for other carbohydrates im meal plan ●Fiber intake at 25-30 g/day

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Alcohol

●Nonnutritive sweeteners are safe when consumed W/I FDA daily intake levels. ●Individualize goals ●High-protein diets are not recommended for weight loss ● Individualize goals ●Minimize trans fat ●Dietary cholesterol...