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NUR 2571 NUR2571 Professional Nursing II PN 2 Exam 2 week 7 study guide.
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1NUR 2571 / NUR2571: Professional Nursing II / PN 2 Exam 2week 7 study guide
Know what the secondary stage of the inflammatory response is.
Stage I: (vascular) change in the blood vessels (phase I constriction/phase II hyperemia and
edema
**Stage II: (cellular exudate) neurtophilia, pus**
Stage III: (tissue repair and replacement) WBCs trigger new blood vessels and growth
(angiogenesis) and scar tissue formation.
What drugs are used to treat OA?
Acetaminophen (Tylenol), Lidocaine 5% patches, other analgesics and NSAIDs (short-term use)
What is the post-operative care of a patient after a total hip replacement?
-For pt who has had a posterior sx approach, use an abduction pillow or splint to prevent
adduction after surgery if the pt is very restless or has an altered mental state. For pt with an
anterior sx approach, no adbuction pillow is needed.
-Keep pt’s heels off the bed to prevent pressure injuries.
-Don’t rely on fever as a sign of infection; older pt often have infection w/out fever. Be alert to
decreasing mental status and /or elevated WBCs as indicated.
-Assisting pt out of bed, move pt slowly to prevent orthostatic hypotension.
-Encourage pt to deep breathe and cough and to use incentive spirometer every 2 hours.
-As soon as permitted, get pt to recliner chair to prevent complications of immobility.
-Anticipate the pt’s need for pain medication
-Expect a temporary change in mental state immediately after surgery as a result of the anesthetic
and unfamiliar sensory stimuli. Reorient the pt frequently.
Know signs and symptoms of rheumatoid arthritis (RA).
-EARLY S/S: joint inflammation with low grade fever, fatigue, weakness, anorexia, and
paresthesias
-Late S/S: joint deformities and moderate to severe pain and morning stiffness. Osteoporosis,
severe fatigue, anemia, wt loss, subcutaneous nodules, peripheral neuropathy, vasculitis,
pericaditis, fibrotic lung disease, sjogren;s syndrome, kidney disease and felty’s syndrome.
Know what Sjogren’s syndrome is and how to diagnose it
In pt with advanced RA, the triad of dry eyes, dry mouth, and dry vagina (hahaha not me!!)
caused by obstruction of secretory ducts and glands by inflammatory cells and immune
complexes.
Know signs and symptoms of lupus and how to treat it, also know complications that can occur
due to lupus
-S/S: Joint pain especially in the joints of wrist, hand, fingers and knees. Joints may become
inflamed and warm to the touch, but unlike RA, it does not cause permanent damage the joint.
Raynaud’s phenomenon and rash (butterfly rash on face).
-Treatment: Rest, cover up when in sunlight, no smoking, exercise, improve stress management,
Topical cortisone drugs, Tylenol or NSAIDs, plaquenil, chronic steroids, immunosuppressive
agent, and Bulimumab (1st drug approved in 60 yrs for SLE)
-Complications: Immune cells attack the body’s own healthy tissues, leading to inflammation
and tissue damage. Lupus can be limited to the skin, but can also cause internal problems such as
joint pain, heart, kidney, and vital organs: kidney failure, pericarditis, DVT, pneumonia, PE, adb
pain, CNS lupus (not common), pulmonary HTN, ulcers, esophagitis and GERD.
Know what actions can be taken to avoid infection after joint replacement surgery
, 2
-Keep pt’s heels off the bed to prevent pressure injuries.
-Don’t rely on fever as a sign of infection; older pt often have infection w/out fever. Be alert to
decreasing mental status and /or elevated WBCs as indicated.
-Encourage pt to deep breathe and cough and to use incentive spirometer every 2 hours.
- Use aseptic technique for wound care
- wash hands thoroughly when caring for pt
-Culture draining fluid, if change
- Report excessive inflammation or drainage to surgeon
***Know pre-op teaching to give before hip replacement surgery
- make sure pt’s level of understanding
-pt need to have any necessary dental procedures done at least 2 weeks before sx to avoid any
infection that could migrate to the surgical area
-make sure pt to tell any future health care provider that they had any total joint arthroplasty
-make sure pre-op labs are done
-Tell pt that drugs that increase the risk of clotting and bleeding such as NSAIDs and vitamin C
be discontinued 5-10 dys before sx, depending on surgeon’s instructions.
-instruct pt to take a shower with special antiseptic soap 1-3 nights before and the morning of the
sx
Know the normal lab values for WBC, RBC, Hemoglobin, and hematocrit
WBCs: 4.5-10.5
RBC: male 4.6-6.0/ female 4.2-5.2
HGB: male 13.5-17.5/ female 12.-16
HCT: male 42-52/ female 37-47
Know what Celebrex is and any contraindications
Antirheumatics, no steroidal, anti-inflammatory agent
Reliefs of S/S of OA, RA, ankylosing sodalities, and juevenile RA. Management of acute pain
including primary dysmenorrheal.Inhibit’s the enzyme COX-2.
Contraindications: hypersensitivity; cross-sensitivity may exist with other NSAIDs, including
ASA. Hx of allergic-type reactions to sulfonamides; hx of asthma, urticaria, or allergic-type
reaction to ASA or NSAIDs.
Know the stages of HIV and the values of the CD4+cell count for each like stage 0,1,2,etc.
Stage 0: pt who develops a 1st + HIV test result w/in 6 months after a -HIV test result. Changing
the pt’s status to stage 1,2, or 3 doesn’t occur until 6 months have elapsed since the stage 0
designation, even whe the CD4+ T-cell counts decrease. No AIDS defining condition is present.
Stage 1: Pt with a CD4+ T-cell count of greater than 500 cells/mm3 or percentage of 29% or
greater. No AIDS-defining illness.
Stage 2: pt with CD4+ T-cell count between 200-499 cells/mm3, a percentage of 14-28%. No
AIDS-defining illness
Stage 3: Pt with a CD4+ T-cell count less than 200 cells/mm3 or percentage of less than 14%.
An adult who has higher CD4+ T-cell counts or percentages but eho also has an AIDS-defining
illness meets the STAGE 3 CDC case definition.
Stage Unknown: any pt confirmed HIV infection but no information regarding CD4+ t-cell
counts, or percentage and AIDS-defining illness is available.
Know what an epi pen is and why it is used. What other information should you tell the patient?
The epipen is a spring-loaded injector that delievers 0.3mg of epinephrine per 2-ml dose directly
into the subcut tissue. An epipen is used for anaphylaxis reaction. Ananphylaxis has a rapid onset
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