Exam 3: NUR280/ NUR 2 80 (Latest 2023/ 2024) Comprehensive Exam Review (Transition to RN Practice ) | Complete Guide with Verified Answ ers| 100% Correct - Galen QUESTION contraindications for thrombolytic alteplase ? Answer: - active bleeding - hx of hemorrhage stroke - icp or trauma - intracranial and intraspinal sx in last 2 mo - thoratic, pelvic, abd sx in last 10 days - hepatic or renal dx - uncontrolled htn - recent cpr done - allergies QUESTION alteplase (tpa) monitor ? Answer: - bleeding (occult blood) - dysrhythmias - allergic reactions - vitals - neuro QUESTION what levels should you monitor with alteplase ? Answer: - aptt, pt , hct, plt and fibrinogen level QUESTION what precaution should the client be on alteplase? Answer: Bleeding precaution - avoid injections, apply pressure 20 -30min - hadle pt with care bleeding precautions - electric razor - if bleeding stop med! QUESTION what is the antidote for thrombolitics ? Answer: Aminocaproic acid Fresh frozen plasma QUESTION pt sob and elevated d - dimer is? Answer: Pe QUESTION d-dimer test Answer: D-dimer is a protein that is excreted by clots of blood. The amount of d -dimer circulating in the body can be measured. If the d -dimer is positive it does not necessarily mean there is a pe . It only means the pt must be ruled out for a pe: they must receive a ct scan. QUESTION pe s/s Answer: Sudden onset dyspnea, tachycardia, tachypnea, cough, crackles, hemoptysis, chest pain QUESTION pe treatment Answer: - rrt notified and pcp stat - hob elevated - 02 -iv, ekg, abg -thrombolytic agents/ heparin -surgery -ivc filter QUESTION prevention of pe Answer: • passive, active rom; ambulate soon after surgery • change position every 2 hours • anti-embolism stockings (scd's ) • avoid tight garters, girdles, constricting clothing • no pillows under knees • comprehensive peripheral circulatory assessment • elevate affected limb 20 degrees above heart • no massaging or compressing leg muscles • do not cross legs • prophylactic low dose anticoagulant and antiplatelet drugs QUESTION body mechanics techniques Answer: -don't move heavy objects -slide or push rather than lift -directly face object to be lifted - keep object close to body -keep object at waist level -don't balance on toes - firm & broad bos - bend at knees & hips, not waist, straight back, breathe while lifting, lift by straigthening legs, don't rotate trunk but pivot entire body, lower body to level of work Pt dangle legs - lower the bed - w/c on strong side QUESTION latex allergies - risk factors Answer: Health care workers who wear latex gloves People w/ allergic tendencies People w/ food allergies (kiwi, banana, chestnuts, avocado, pineapples, papaya, potatoes) Latex industry workers People w/ asthma, spina bifida, or history of multiple surgical procedures or exposures to latex QUESTION pt with a pulse of 50 and has already a pacemaker and taking metropolol bid (lowers pulse) what would you do ? Answer: External pace the patient QUESTION what is external pace the patient ?
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