NUR 242 MED SURG EXAM:COMPLETE REAL EXAM WITH ALL CORRECT ANSWERS /SOLUTION A+.
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Course
NUR 242 MED SURG
Institution
NUR 242 MED SURG
NUR 242 MED SURG EXAM:COMPLETE REAL EXAM WITH
ALL CORRECT ANSWERS /SOLUTION A+.
Complications of central line access
Pneumothorax - CORRECT ANSWERS-Occurs following insertion of the central line
fatal if not treated
s/s: tachypnea, absent breath sounds on the affected side, decreased oxygen
s...
NUR 242 MED SURG EXAM:COMPLETE REAL EXAM WITH
ALL CORRECT ANSWERS /SOLUTION A+.
Complications of central line access
Pneumothorax - CORRECT ANSWERS-Occurs following insertion of the central line
fatal if not treated
s/s: tachypnea, absent breath sounds on the affected side, decreased oxygen
saturation, and restlessness
ALWAYS verify placement of a central line with a chest x-ray
TPN Total Parenteral Nutrition - CORRECT ANSWERS-Nutritional status is monitored
by checking protein levels, such as albumin and pre-albumin levels
TPN care and maintenance of - CORRECT ANSWERS-check each bag of TPN for
accuracy by comparing it with the physician's order (2 nurses to check to prevent errors)
if the TPN solution is unavailable, give 10% dextrose/water (or 20% D/W) until the TPN
solution can be obtained
if the TPN administration is not on time, do not increase the rate
Change IV tubing every 24 hours when new bag is hung
dressing change around the IV site should be changed every 48-72 hours
canoe used for individuals receiving chemotherapy
huber needle is used to access the port at a 90 degree angle
Complications of central Line Access
Central line associated blood stream infection (CLABI) - CORRECT ANSWERS-s/s:
localized erythema, tenderness, fever, drainage
can lead to a systemic infection and sepsis
d/c the central line and culture the tip
tx: ABT and antifungals
prevention: meticulous hand washing
Complications of Central Access Device
Air Embolism - CORRECT ANSWERS-Bolus of air enters circulation
potentially fatal
s/s: tachycardia, chest pain, dyspnea, and cyanosis
interventions: trapping the air into the R atrium, turn the client to the left side in
trendelenberg position
all lines should be primed prior to use and connections secure when not in use
Complications of central line access
Clotted access - CORRECT ANSWERS-The catheter becomes clogged from either the
solution being infused or from insufficient flushing
a thrombolytic can be ordered from the physician to dwell and dissolve the clot
needs to be treated promptly to prevent having to remove the central line
, prevention: routine flushing
Sickle cell Disease - CORRECT ANSWERS-RBC's are sickle shaped, rigid and clump
together. the clumps form assess of sickled RBC's that block blood flow, leads to tissue
hypoxia. Repeated episodes of ischemia lead to progressive organ damage
Pain is the most common problem
Sickle cell crisis - CORRECT ANSWERS-pain due to tissue injury caused by poor
oxygenation from obstructed blood flow. Pain is severe enough to require hospitalization
and large doses of opioid analgesic. concerns about substance abuse can lead to
inadequate pain treatment
Care of Patient in Sickle Call Crisis - CORRECT ANSWERS-Give prescribed pain
medication
hydrate with normal saline IV, encourage oral intake of fluids without caffeine
administer oxygen
remove restrictive clothing, no blood pressure with external cuff
check circulation in extremities every hour
Vitamin B12 Deficiency - CORRECT ANSWERS-Results from poor intake of foods
containing B12
Vitamin B 12 anemia (pernicious anemia) caused by deficiency of intrinsic factor
needed for intestinal absorption of B12. Seen in patients with bowel resections, chronic
diarrhea, diverticula, tape worms, or overgrowth of intestinal bacteria
s/s: glossitis (a smooth, beefy red tongue) fatigue, weight loss, and pallor or jaundice
Methicillin Resistant Staphylococcus Aureus (MRSA) - CORRECT ANSWERS-Avoid
close contact with others until infection clears
sleep in separate bed from others
wash all soiled clothing and linens with hot water and laundry detergent
do not share any personal items
Cellulitis - CORRECT ANSWERS-generalized infection with either staphylococcus or
streptococcus and involves deeper connection tissue
infection can spread by scratching or rubbing the skin
can result from a secondary bacterial infection of an open wound or unrelated to skin
trauma
localized area of inflammation that may enlarge rapidly if not treated
warm compresses to the area are recommended
treatment with IVABT
Hand Hygiene - CORRECT ANSWERS-wash hands with soap and water when hands
are visible soiled or contaminated
not visible soiled may use ABHR
before direct contact with patients wash or use ABHR
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