NSG 233 Med Surge 3 Final Exam Latest Update 2024-2025 200 Questions and 100% Verified Correct Answers Guaranteed A+ At First Attempt
A client is recieving CPR. After asystole is confirmed in two leads and sending for the trancutaneous pacemaker, which IV med should be administered? - CORRECT
ANSWER: Epinephrine
A male client is admitted to the cardiac intensive unit with chest pain that began twelve hours ago. The nurse recognizes increased ventricular ectopic. Based on this what action is important for the nurse to implement? - CORRECT ANSWER: Initiate the unit's antiarrythmic protocol if symptomatic
AAA- Post Op - CORRECT ANSWER: The patient who has had an endovascular repair
must lie supine for 6 hours; the head of the bed may be elevated up to 45 degrees after two hours. The patient needs to use a bedpan or urinal while on bed rest. Vital signs and Doppler assessment of peripheral pulses are performed initially every 15 minutes and then at progressively longer intervals if the patient's status remains stable. The access site (usually the femoral artery) is assessed when vital signs and pulses are monitored. The nurse assesses for bleeding, pulsation, swelling, pain, and hematoma formation. Skin changes of the lower extremity, lumbar area, or buttocks that might indicate signs of embolization, such as extremely tender, irregularly shaped, cyanotic areas, as well as any changes in vital signs, pulse quality, bleeding, swelling, pain, or hematoma, are immediately reported to the primary provider.The patient's temperature should be monitored every four hours, and any signs of postimplantation syndrome should be reported. Postimplantation syndrome typically begins within 24 hours of stent-graft placement and consists of a spontaneously occurring fever, leukocytosis, and occasionally, transient thrombocytopenia. This condition has been attributed to complex immunologic changes that occur because of manipulations with sheaths and catheters with the aortic lumen, although the exact etiology is unknown. The symptoms are thought to be related to the activation of cytokines. They can be managed with a mild analgesic (e.g., acetaminophen [Tylenol]) or an anti-inflammatory agent (e.g., ibuprofen [Motrin]) and usually subside within a week.Because of the increased risk of hemorrhage, the primary provider is also notified of persistent coughing, sneezing, vomiting, or systolic blood pressure greater than 180 mm Hg. Most patients can resume their pre-proce
AAA- Tests - CORRECT ANSWER: The most important diagnostic indication of an
abdominal aortic aneurysm is a pulsatile mass in the middle and upper abdomen. Most clinically significant aortic aneurysms are palpable during routine physical examination; however, the sensitivity depends upon the size of the aneurysm, abdominal girth of the patient (i.e., more difficult to find in the patient with obesity), and the skill of the examiner. A systolic bruit may be heard over the mass. Duplex ultrasonography or CTA 1 / 2
is used to determine the size, length, and location of the aneurysm. When the aneurysm is small, ultrasonography is conducted at 6-month intervals until the aneurysm reaches a size so that surgery to prevent rupture is of more benefit than the possible complications of a surgical procedure. Some aneurysms remain stable over many years of monitoring.
AIDS Dementia - CORRECT ANSWER: HIV encephalopathy was formerly referred to
as AIDS dementia complex (see Chart 36-10). It is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV infection. HIV has been found in the brain and cerebrospinal fluid (CSF) of patients with HIV encephalopathy. The brain cells infected by HIV are predominantly the CD4+ cells of monocyte-macrophage lineage. HIV infection is thought to trigger the release of toxins or lymphokines that result in cellular dysfunction, inflammation, or interference with neurotransmitter function rather than cellular damage.Chronic confusion
As the nurse is turning a client with a chest tube, the tube becomes dislodged from the
pleural space. What action should the nurse take first? - CORRECT ANSWER: Have
the client exhale forcefully and tape three sides of a sterile gauze over the insertion site
Asystole Drug Choice - CORRECT ANSWER: In such cases, the treatment is the same
as for asystole and pulseless electrical activity (PEA) if the patient is in cardiac arrest or for bradycardia if the patient is not in cardiac arrest. Interventions include identifying the underlying cause; administering IV epinephrine, atropine, and vasopressor medications; and initiating emergency transcutaneous pacing. In some cases, idioventricular rhythm may cause no symptoms of reduced cardiac output. Ventricular asystole is treated the same as PEA.
Automatic Dysreflexia S&S - CORRECT ANSWER: This syndrome is characterized by a severe, pounding headache with paroxysmal hypertension, profuse diaphoresis above the spinal level of the lesion (most often of the forehead), nausea, nasal congestion, and bradycardia. It occurs among patients with cord lesions above T6 (the sympathetic visceral outflow level) after spinal shock has subsided.
Autonomic Dysreflexia- Document - CORRECT ANSWER: Autonomic dysreflexia, also
known as autonomic hyperreflexia, is an acute life-threatening emergency that occurs as a result of exaggerated autonomic responses to stimuli that are harmless in people without SCI. It occurs only after spinal shock has resolved. This syndrome is characterized by a severe, pounding headache with paroxysmal hypertension, profuse diaphoresis above the spinal level of the lesion (most often of the forehead), nausea, nasal congestion, and bradycardia. It occurs among patients with cord lesions above T6 (the sympathetic visceral outflow level) after spinal shock has subsided. A number of stimuli may trigger this reflex: distended bladder (the most common cause); distention or contraction of the visceral organs, especially the bowel (from constipation, impaction); or stimulation of the skin (tactile, pain, thermal stimuli, pressure ulcer).
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