Top Tips for Mastering the OIIQ-RN March 2025 Exam Medical Section
Introducing the OIIQ March 2025 Exam Cheat Sheet!
I am excited to share with you my specially created Cheat Sheet designed to help you prepare for the upcoming March 2025 OIIQ exam. This resource is tailored based on the exam themes, focusing on the most common topics and questions you may encounter.
Important Notes about the Cheat Sheet:
Practice Tool Only: Please remember that this cheat sheet is not a collection of official exam questions. Instead, it serves as a practice guide to help you familiarize yourself with potential answers and topics relevant to the exam theme.
Format: The content is not structured as multiple-choice questions and is not designed to assess your critical thinking skills.
Purpose: The primary goal of the cheat sheet is to enhance your understanding of the material and prepare you for the types of questions you may face in the exam.
Use this cheat sheet as a valuable study aid to boost your confidence and readiness for the OIIQ exam!
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Top Tips for Mastering the OIIQ-RN March 2025 Exam Medical Section

What does cultural safety in nursing practice mean? | Providing care that is free from discrimination, acknowledges cultural differences, and empowers patients to express their values and beliefs. |
Why is cultural safety important in patient care? | It fosters trust, improves communication, and ensures equitable health outcomes for individuals from diverse cultural backgrounds. |
What is the first step in providing culturally safe care? | Self-reflection to recognize personal biases and assumptions about different cultures. |
How can a nurse demonstrate cultural sensitivity during patient interactions? | By asking open-ended questions about the patient’s cultural preferences, beliefs, and practices. |
What is the nurse’s priority when caring for a patient who speaks limited English? | Use a professional medical interpreter rather than relying on family members for translation. |
How can the nurse communicate effectively with a patient from a different culture? | Use simple language, avoid medical jargon, and verify understanding using teach-back techniques. |
What should the nurse do if a patient declines a prescribed treatment due to cultural beliefs? | Respect the patient’s decision, explore alternative options, and collaborate with the patient to find acceptable solutions. |
How should the nurse respond to a patient who uses traditional healing practices in addition to prescribed medical treatment? | Encourage open discussion about traditional practices and ensure they do not interfere with the prescribed treatment. |
What should the nurse consider when assessing pain in a patient from a different culture? | Some cultures may underreport or overexpress pain; therefore, pain assessment tools should be used alongside observation of nonverbal cues. |
How can the nurse provide culturally safe pain management? | Discuss the patient’s preferred methods of pain relief, including traditional remedies, and incorporate them into the plan of care when appropriate. |
What is the nurse’s priority when providing end-of-life care to a patient from a different culture? | Assess the patient and family’s beliefs about death, afterlife, and rituals, and incorporate them into the care plan. |
What should the nurse do if a family requests to perform specific cultural rituals at the bedside of a dying patient? | Facilitate the family’s request within the limits of hospital policy and respect their traditions. |
How can the nurse ensure a patient’s dietary needs are culturally appropriate? | Assess the patient’s dietary preferences and restrictions and collaborate with the dietary team to provide suitable meals. |
What is the nurse’s best action when caring for a Muslim patient during Ramadan? | Plan care around fasting hours and offer meals before dawn and after sunset. |
What is an example of stereotyping in cultural care? | Assuming all individuals from a specific cultural background share the same beliefs or behaviors. |
How can the nurse avoid cultural stereotyping? | By treating each patient as an individual and asking about their unique cultural preferences. |
What is the nurse’s role in advocating for cultural safety? | Ensure the patient’s cultural values are respected in the care plan and educate colleagues about cultural diversity. |
How can the nurse support a patient who feels discriminated against due to their cultural background? | Report the incident to the appropriate authority and provide emotional support to the patient. |
What is the nurse’s priority when educating a patient from a different culture? | Assess the patient’s health literacy, preferred learning style, and cultural beliefs about illness and treatment. |
How can the nurse address a patient’s cultural belief that illness is a punishment? | Respect the belief while providing supportive education about the illness and available treatments. |
How can the nurse contribute to a culturally competent healthcare team? | Share knowledge about cultural practices and encourage discussions about cultural safety in team meetings. |
What is the nurse’s best action if a colleague makes a culturally insensitive comment? | Address the comment respectfully, educate the colleague, and promote an inclusive work environment. |
What is the primary action of anticoagulants like warfarin and heparin? | To prevent the formation or extension of blood clots by inhibiting clotting factors. |
How does enoxaparin (Lovenox) differ from heparin? | Enoxaparin is a low molecular weight heparin with a longer half-life and more predictable effects. Advantages: Lower risk of bleeding and not necessary to monitor the PT&INR. |
What are common indications for anticoagulant therapy? | Prevention and treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), atrial fibrillation, and prevention of stroke in high-risk patients. |
Which condition would contraindicate the use of anticoagulants? | Active bleeding, recent surgery, or hemorrhagic stroke. |
Which lab test is used to monitor warfarin therapy? | International Normalized Ratio (INR); therapeutic range is typically 2-3 for most conditions. |
What is the normal activated partial thromboplastin time (aPTT) range for a patient on heparin therapy? | 1.5-2.5 times the normal range (approximately 60-80 seconds). |
How often should INR levels be monitored for a patient on warfarin? | Initially daily or every few days, then weekly or monthly once stable. |
What is the correct injection technique for enoxaparin? | Subcutaneous injection in the abdomen (LOVE handles), avoiding the 2-inch area around the umbilicus. Do not expel the air bubble in the syringe before administration. |
What should the nurse do before administering heparin IV? | Double-check the dosage with another nurse and ensure the correct concentration is used. |
What is the most common side effect of anticoagulant therapy? | Bleeding (e.g., bruising, nosebleeds, blood in urine or stool). |
What is the nurse’s priority if a patient on anticoagulants has signs of bleeding? | Stop the medication, apply pressure if needed, monitor vital signs, and notify the healthcare provider. |
What is the antidote for warfarin overdose? | Vitamin K. |
What is the antidote for heparin overdose? | Protamine sulfate. |
What is used to reverse the effects of direct oral anticoagulants (DOACs) like dabigatran? | Idarucizumab (Praxbind) for dabigatran and andexanet alfa for some Factor Xa inhibitors. |
What should the nurse teach a patient on warfarin regarding diet? | Maintain a consistent/regular intake of vitamin K-rich foods (e.g., green leafy vegetables) to avoid fluctuations in INR. |
What should the nurse include in discharge teaching for a patient on anticoagulants? | Report signs of bleeding, use a soft toothbrush, avoid contact sports, and inform healthcare providers before invasive procedures. |
Which medications can increase the risk of bleeding in a patient on anticoagulants? | Aspirin, NSAIDs, and other antiplatelet drugs. |
How do antibiotics affect warfarin therapy? | Antibiotics can increase the effect of warfarin by altering gut bacteria that produce vitamin K. |
What should the nurse do when transitioning a patient from heparin to warfarin? | Overlap heparin and warfarin therapy for 3-5 days until INR is in the therapeutic range. |
Why must warfarin therapy be initiated several days before discontinuing heparin? | Warfarin takes several days (3-5 days) to reach therapeutic levels. |
What are examples of Direct Oral Anticoagulants (DOACs)? | Dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis). |
What is an advantage of DOACs over warfarin? | They do not require regular INR monitoring and have fewer dietary restrictions. |
What is the nurse’s priority before initiating anticoagulant therapy? | Assess baseline coagulation studies (e.g., PT/INR, aPTT) and review the patient’s history of bleeding or clotting disorders. |
What is the nurse’s action if a patient on warfarin has an INR of 4.5 and no signs of bleeding? | Hold the next dose, notify the physician, and anticipate an order to reduce the dose or administer vitamin K. |
Why is warfarin contraindicated during pregnancy? | It can cause fetal abnormalities; heparin or low molecular weight heparin is safer. |
What should the nurse monitor in an elderly patient on anticoagulants? | Increased risk of bleeding due to altered drug metabolism and potential polypharmacy. |
Which patient is at the greatest risk for falls? | An elderly patient with a history of falls, impaired mobility, or who is on medications such as sedatives or diuretics/antihypertensives. |
What intrinsic factors contribute to fall risk? | Age-related changes (e.g., decreased vision, muscle weakness), chronic conditions (e.g., Parkinson’s disease, arthritis), and cognitive impairment (e.g., dementia, delirium). |
What are extrinsic fall risk factors? | Environmental hazards such as poor lighting, slippery floors, and cluttered walkways. |
What is post-fall syndrome? | Post-fall syndrome is a psychological and physical condition that can occur after an individual, especially an older adult, experiences a fall. It involves a combination of fear, anxiety, and physical deconditioning that may significantly impact their quality of life and functional independence. |
What tool is commonly used to assess fall risk in hospitalized patients? | Tools like the Morse Fall Scale or Hendrich II Fall Risk Model. |
What is the nurse’s priority action for a patient identified as high risk for falls? | Implement fall precautions, such as placing the call light within reach, using non-slip footwear, and ensuring frequent monitoring etc... |
What is the most effective way to reduce fall risk in a hospital setting? | Conducting regular fall risk assessments and implementing individualized safety measures. |
What should the nurse include in a fall prevention plan for a patient with impaired mobility? | Use of assistive devices (e.g., walkers, canes), ensuring the bed is in the lowest position, and assisting with ambulation as needed. |
Which environmental modification can help reduce falls at home? | Removing loose rugs, installing grab bars in the bathroom, and ensuring adequate lighting. |
What is the nurse’s priority action when a patient falls? | Assess the patient for injuries (head-to-toe, fractures, pain, bleeding, v/s), maintain spinal alignment, and call for assistance if necessary. |
What documentation is required after a patient fall? | Document the incident in the patient’s chart, including the time, circumstances, assessment findings, interventions, and notification of the healthcare provider. Complete an incident report per facility policy. |
Which medications are most associated with increased fall risk? | Sedatives, hypnotics, antihypertensives, diuretics, and medications causing dizziness or orthostatic hypotension. |
What should the nurse monitor in a patient on antihypertensives to reduce fall risk? | Blood pressure changes, particularly orthostatic hypotension, and educate the patient to rise slowly from a sitting or lying position. |
Why are older adults at higher risk for falls? | Due to factors like decreased strength, impaired balance, visual changes, and polypharmacy. |
What interventions should be implemented for a pediatric patient at risk for falls? | Keeping crib rails up, supervising play, and removing choking or tripping hazards from the environment. |
What is a priority intervention for a patient with dementia who is at risk for falls? | Provide frequent reminders to call for assistance, ensure a safe and familiar environment, and consider bed alarms or video monitoring. |
How should the nurse manage a confused patient who frequently tries to get out of bed? | Place the patient in a room near the nurse’s station, use bed and chair alarms, and consider a sitter if necessary. |
What is the nurse’s priority when transferring a patient from bed to chair? | Use a gait belt, ensure the brakes on the bed and chair are locked, and assess the patient’s strength and balance before transferring. |
What should the nurse do if a high-risk patient refuses to call for assistance when ambulating? | Educate the patient on the importance of safety and involve family or other support systems to reinforce the need for assistance. |
What is the proper technique for using a cane? | Hold the cane on the stronger side of the body and advance it simultaneously with the weaker leg. |
How should the nurse instruct a patient to use a walker? | Move the walker forward first, then step into it, ensuring all four legs of the walker are on the ground. |
What interventions should the nurse implement for fall prevention in a long-term care facility? | Ensure proper footwear, provide scheduled toileting, and keep frequently used items within easy reach. |
How can the nurse reduce nighttime falls in long-term care residents? | Use nightlights, ensure clear pathways to the bathroom, and provide regular rounding. |
What should the nurse teach a patient with a history of falls about home safety? | Avoid loose rugs, install grab bars in the bathroom, and use adequate lighting in all rooms. |
How can the nurse educate family members to assist an elderly patient at risk for falls? | Encourage supervision during ambulation, provide proper footwear, and reduce environmental hazards. |
What is the nurse’s responsibility if a patient falls under their care? | Ensure the patient’s safety, provide immediate care, document the incident thoroughly, and complete an incident report. |
How can the nurse reduce liability for patient falls? | Adhere to fall prevention protocols, document assessments and interventions accurately, and educate patients and families on fall risks. |
What are the common causes of traumatic brain injury? | Falls, motor vehicle accidents, sports injuries, and assaults. |
What is the difference between a concussion and a contusion? | A concussion is a mild TBI with temporary symptoms, while a contusion involves bruising of the brain tissue and is more severe. |
What is a hallmark symptom of a concussion? | Brief loss of consciousness, confusion, headache, and dizziness. |
What are signs of a basilar skull fracture? | Raccoon eyes (periorbital ecchymosis), Battle’s sign (mastoid ecchymosis), and cerebrospinal fluid (CSF) leakage from the nose or ears. |
What is a classic sign of increased ICP? | Cushing’s triad (bradycardia, irregular respirations, widened pulse pressure"HYPERtension, BRADYcardia, BRADYpnea). |
What is the priority intervention if a patient exhibits signs of increased ICP? | Elevate the head of the bed to 30 degrees, maintain a quiet environment, and notify the physician. |
What is the range of the Glasgow Coma Scale? | 3 (deep coma) to 15 (fully alert). |
What does a GCS score of 8 or below indicate? | Severe brain injury and potential need for intubation. |
What is the nurse’s priority when caring for a patient with a suspected TBI? | Stabilize the cervical spine, maintain airway patency, and monitor for signs of increased ICP. |
What interventions can help reduce ICP? | Keep the head midline, avoid activities that increase intrathoracic pressure (e.g., coughing, straining), and minimize stimulation. |
What is a priority assessment in a patient with a head injury? | Monitor for changes in level of consciousness, pupil size/reactivity, and vital signs. |
What is a late sign of herniation in TBI? | Fixed and dilated pupils. |
What test can confirm that fluid leaking from the nose or ears is CSF? | Test for glucose or look for a "halo" sign on a sterile gauze pad. |
What should the nurse do if a CSF leak is suspected? | Elevate the head of the bed, avoid nasal suctioning, collect the leakage with a 4x4 gauze then check for halo sign, and notify the physician. |
Which medication is commonly used to reduce cerebral edema in TBI? | Mannitol (osmotic diuretic). |
What medications should be avoided in TBI patients? | Opioids and sedatives (unless necessary), as they can mask neurological assessments. |
What are common long-term complications of TBI? | Cognitive impairments, emotional changes, and physical disabilities. |
What is a sign of increased ICP in an infant? | Bulging fontanelles, high-pitched cry, and irritability. |
What should the nurse teach a patient recovering from a mild TBI (concussion)? | Rest, avoid strenuous activities, monitor for worsening symptoms, and return to the ER if signs of increased ICP occur. |
What should families watch for after discharge in a patient with TBI? | Changes in behavior, confusion, persistent vomiting, or severe headaches. |
Who provides consent for treatment if a patient with TBI is unconscious? | The spouse (if married), next of kin or legal guardian. |
What is the underlying cause of Type 1 diabetes? | Autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. |
What characterizes Type 2 diabetes? | Insulin resistance and relative insulin deficiency. |
Which symptoms are associated with hyperglycemia? | Polydipsia, polyuria, polyphagia, fatigue, blurred vision. |
What are the early signs of hypoglycemia? |
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How does metformin work to manage Type 2 diabetes? | Reduces hepatic glucose production and increases insulin sensitivity. |
What is a common side effect of sulfonylureas (e.g., glipizide)? | Hypoglycemia. |
What are hallmark signs of DKA? | Hyperglycemia, ketonuria, metabolic acidosis, Kussmaul respirations, and fruity breath. |
What is the priority treatment for DKA? | IV fluids, insulin therapy (Regular), and electrolyte replacement. |
How is HHS/HHNS different from DKA? | HHS has no significant ketoacidosis, but blood glucose is extremely high, and dehydration is severe. |
What is the priority nursing intervention for HHS/HHNS? | Aggressive rehydration and monitoring electrolytes. |
What are the microvascular complications of diabetes? | Retinopathy, nephropathy, and neuropathy. |
What is a macrovascular complication of diabetes? | Cardiovascular disease, such as coronary artery disease or stroke. |
What should be included in diabetic foot care teaching? | Inspect feet daily, avoid walking barefoot, use moisturizing lotion (not between toes), and wear properly fitting shoes. |
What is a sign of diabetic neuropathy in the feet? | Numbness, tingling, or burning sensations. |
What is the purpose of carbohydrate counting in diabetes management? | To regulate blood sugar levels by matching insulin to carbohydrate intake. |
Which type of diet is recommended for a diabetic patient? | Balanced diet with controlled carbohydrate intake, low saturated fats, and high fiber. |
What should a diabetic patient do if they are sick? | Continue taking insulin or oral medications, monitor blood glucose more frequently, stay hydrated, and consume carbohydrates if not eating normally. |
What should a diabetic patient do before exercising? | Check blood glucose, eat a small snack if levels are 5.6 mmol/L (<100 mg/dL), and carry a source of glucose. |
How does exercise affect blood sugar levels? | It lowers blood sugar by increasing insulin sensitivity and glucose uptake by muscles. |
What is the “Rule of 15” for hypoglycemia? | Consume 15 grams of fast-acting carbohydrates, wait 15 minutes, and recheck blood sugar. Repeat if necessary. |
What should the nurse do if a patient with hypoglycemia is unconscious? | Administer glucagon IM or IV dextrose (e.g., D50W). |
What are risk factors for gestational diabetes? | Obesity, history of gestational diabetes, advanced maternal age, and family history of diabetes. |
What is the primary treatment for gestational diabetes? | Diet and exercise; insulin if blood sugar is not controlled. |
What should a diabetic patient know about alcohol consumption? | Consume in moderation, eat food while drinking, and monitor blood sugar, as alcohol can cause hypoglycemia. |
How can stress affect blood sugar? | It can increase blood glucose due to the release of stress hormones (e.g., cortisol). |
What is the difference between primary and secondary hypertension? | Primary (essential) hypertension has no identifiable cause, while secondary hypertension results from an underlying condition (e.g., kidney disease). |
How does hypertension affect the cardiovascular system? | It increases the workload of the heart and causes damage to blood vessel walls, leading to complications such as atherosclerosis. |
Which factors are modifiable risk factors for hypertension? | Obesity, smoking, excessive alcohol intake, high-sodium diet, and physical inactivity. |
What are non-modifiable risk factors for hypertension? | Age, family history, race (e.g., African Americans are at higher risk), and gender (men at higher risk until age 65). |
Why is hypertension called the “silent killer”? | Most people with hypertension are asymptomatic until complications arise. |
What are symptoms of hypertensive crisis? | Severe headache, blurred vision, chest pain, confusion, and nausea/vomiting. |
What is the nurse’s priority in a patient with a hypertensive emergency? | Administer antihypertensive medications (e.g., IV labetalol) and monitor blood pressure closely. |
What lifestyle modifications should a nurse recommend for managing hypertension? | Reduce sodium intake, follow the DASH diet, maintain a healthy weight, and exercise regularly. |
What is a common side effect of ACE inhibitors (e.g., lisinopril)? | Persistent dry cough, hyperkalemia, and angioedema. |
What should the nurse teach a patient taking beta-blockers (e.g., metoprolol)? | Do not stop the medication abruptly (can cause rebound hypertension); monitor for bradycardia and fatigue. |
What is the recommended daily sodium intake for a patient with hypertension? | Less than 2,300 mg/day; ideally 1,500 mg/day. |
How does the DASH diet help lower blood pressure? | It emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy while reducing sodium and saturated fat. |
What are complications of uncontrolled hypertension? | Stroke, myocardial infarction, heart failure, kidney damage, and retinal damage. |
What is the most common cause of death in patients with hypertension? | Cardiovascular events (e.g., heart attack, stroke). |
What is the difference between hypertensive urgency and emergency? | Emergency involves end-organ damage, while urgency does not. |
What is the priority nursing intervention for a hypertensive emergency? | Gradual reduction of blood pressure with IV antihypertensives (e.g., nitroprusside) to prevent ischemia. |
What should a patient avoid before measuring their blood pressure? | Caffeine, smoking, or exercise for at least 30 minutes. |
How should the patient position their arm when taking a blood pressure reading? | At heart level, supported, and relaxed. |
What is the most severe complication of pregnancy-induced hypertension? | Eclampsia (seizures associated with PIH). |
What medication is commonly used to prevent seizures in preeclampsia? | Magnesium sulfate. |
What is a common reason for poor adherence to antihypertensive therapy? | Lack of symptoms, medication side effects, or financial barriers. |
What lifestyle factor has the greatest impact on reducing blood pressure? | Weight loss. |
What is a priority consideration for older adults with hypertension? | Start medications at lower doses to prevent orthostatic hypotension and falls. |
What causes a pressure ulcer? | Prolonged pressure, friction, shear, and/or moisture impair blood flow, leading to tissue ischemia and necrosis. |
Which areas of the body are most at risk for pressure ulcer development? | Bony prominences like the sacrum, heels, elbows, and hips. |
Which patients are at highest risk for developing pressure ulcers? | Patients with immobility, incontinence, malnutrition, decreased sensation, and poor circulation. |
What tool is commonly used to assess pressure ulcer risk? | Braden Scale. |
What characterizes a Stage 1 pressure ulcer? | Intact skin with non-blanchable erythema. |
What is the defining feature of a Stage 3 pressure ulcer? | Full-thickness skin loss with visible adipose tissue but no exposed muscle, bone, or tendon. |
What is an unstageable pressure ulcer? | A wound covered by eschar or slough, preventing visualization of the depth. |
What is the best intervention to prevent pressure ulcers in an immobile patient? | Reposition the patient every 2 hours. |
How can a nurse prevent shear injuries? | Use a draw sheet or mechanical lift when repositioning the patient. |
How is a Stage 1 pressure ulcer treated? | Relieve pressure, protect skin with barrier creams, and keep the area clean and dry. |
What type of dressing is appropriate for a Stage 2 pressure ulcer? | Moist dressings like hydrocolloids. |
What is the primary goal when treating a Stage 4 pressure ulcer? | Promote healing, prevent infection, and manage pain. |
Which nutrients are essential for wound healing? | Protein, Vitamin C, zinc, and fluids. |
What is an appropriate dietary recommendation for a patient with a pressure ulcer? | High-protein, calorie-dense meals with adequate hydration. |
What should be included in pressure ulcer documentation? | Size (length, width, depth), color, presence of drainage, odor, and surrounding tissue condition. |
How often should a pressure ulcer be reassessed? | At least once per shift or according to facility policy. |
What is the most serious complication of an untreated pressure ulcer? | Osteomyelitis or sepsis. |
What signs suggest infection in a pressure ulcer? | Increased redness, warmth, swelling, purulent drainage, and fever. |
What should be included in patient education for pressure ulcer prevention? | Keep skin clean and dry, reposition frequently, use supportive surfaces, and eat a healthy diet. |
How should caregivers clean a pressure ulcer at home? | Use gentle saline or prescribed wound cleansers, and avoid harsh chemicals like hydrogen peroxide. |
What type of mattress is recommended for a high-risk patient? | Pressure-reducing or low-air-loss mattresses. |
What is the purpose of a heel protector? | To offload pressure from the heels and prevent skin breakdown. |
What are the characteristics of a superficial (first-degree) burn? | Redness, mild swelling, pain, and intact skin; affects only the epidermis. |
What distinguishes a full-thickness (third-degree) burn? | Destruction of all skin layers, including subcutaneous tissue, with dry, leathery, or charred skin and possible lack of pain due to nerve damage. |
What is the Rule of Nines used for? | Estimating the total body surface area (TBSA) affected by burns in adults. |
What is the primary concern in the first 24 hours post-burn? | Hypovolemic shock due to massive fluid loss. |
What is the priority in a patient with burns to the face, neck, or chest? | Assess and secure the airway due to risk of inhalation injury and edema. |
What are signs of inhalation injury? | Singed nasal hairs, soot in the mouth or sputum, hoarseness, stridor, and difficulty breathing. |
What type of pain relief is preferred for severe burns? | IV opioids (e.g., morphine or fentanyl) for rapid and effective pain relief. |
Why are oral or IM pain medications not recommended initially? | Reduced absorption and circulation issues in burn patients. |
What is the purpose of debridement in burn care? | To remove dead tissue, reduce infection risk, and promote healing. |
What type of dressing is commonly used for partial-thickness burns? | Non-adherent, moist dressings (e.g., hydrocolloid or silver sulfadiazine). |
How should burns be cleaned? | Gently with saline or antiseptic solutions, avoiding harsh scrubbing. |
What are early signs of infection in a burn wound? | Increased redness, swelling, purulent drainage, odor, and fever. |
What nursing interventions reduce the risk of infection in burn patients? | Sterile technique during dressing changes, proper wound care, and prophylactic antibiotics as prescribed. |
Why do burn patients require a high-calorie, high-protein diet? | To support wound healing, tissue repair, and increased metabolic demands. |
What micronutrients are essential for burn recovery? | Vitamins C, A, zinc, and copper. |
What is the most common cause of death in burn patients? | Infection, particularly sepsis. |
What is the priority intervention for a patient with signs of compartment syndrome? | Notify the physician immediately and prepare for a possible escharotomy. |
What are common emotional responses to burn injuries? | Anxiety, depression, and body image issues. |
What nursing interventions support psychosocial health in burn patients? | Provide emotional support, involve the patient in care decisions, and refer to counseling if needed. |
What is the primary cause of left-sided heart failure? | Hypertension, coronary artery disease, or myocardial infarction. |
What happens in right-sided heart failure? | The right ventricle fails to pump effectively, leading to systemic venous congestion (e.g., peripheral edema, ascites). |
What is a common symptom of left-sided heart failure? | Dyspnea, orthopnea, pulmonary congestion (e.g., crackles, cough). |
What clinical findings indicate right-sided heart failure? | Jugular vein distension (JVD), peripheral edema, hepatomegaly, and weight gain. |
What is the priority nursing action for a patient with acute pulmonary edema? | Position the patient in high Fowler's to reduce pulmonary congestion (with legs down or flat on bed) and improve oxygenation. |
What interventions reduce fluid retention in CHF patients? | Restrict sodium intake, monitor daily weights, and administer diuretics as prescribed. |
What diagnostic test confirms heart failure? | Echocardiogram to assess ejection fraction (EF). |
What lab value is most specific to heart failure? | Elevated B-type natriuretic peptide (BNP) levels. |
What is the primary action of ACE inhibitors in CHF? | Reduce afterload by preventing vasoconstriction, thus improving cardiac output. |
Why are diuretics prescribed for CHF? | To reduce fluid overload and decrease pulmonary and peripheral edema. |
What is a key nursing consideration when administering digoxin? | Check the apical pulse for one full minute; hold the dose if the pulse is <60 bpm. |
What electrolyte imbalance increases the risk of digoxin toxicity? | Hypokalemia. |
What should a CHF patient monitor daily at home? | Weight changes; an increase of 2-3 pounds in a day or 5 pounds in a week should be reported. |
What dietary modifications are important for CHF patients? | Low-sodium diet and fluid restriction as prescribed. |
What activity advice should be given to CHF patients? | Balance rest and activity, and avoid overexertion. |
What are the signs of pulmonary edema in CHF? | Severe dyspnea, pink frothy sputum, crackles, and cyanosis. |
What is the priority intervention for a patient with pulmonary edema? | Administer oxygen, position the patient upright, and give prescribed diuretics and vasodilators. |
What is cardiogenic shock, and how does it relate to CHF? | Cardiogenic shock occurs when the heart cannot pump enough blood to meet the body's needs, often a severe complication of CHF. |
Why is it important for CHF patients to avoid NSAIDs? | NSAIDs can cause fluid retention and worsen heart failure. |
What causes rheumatoid arthritis? | An autoimmune response leads to chronic inflammation of the synovial membrane, resulting in joint damage and systemic effects. |
What is pannus in rheumatoid arthritis? | Pannus is an abnormal layer of fibrovascular or granulation tissue that forms in the joints, leading to cartilage and bone destruction. |
What are the early symptoms of rheumatoid arthritis? | Symmetrical joint pain, morning stiffness lasting more than 30 minutes, swelling, and fatigue. |
Which joints are typically affected first in RA? | Small joints of the hands (e.g., metacarpophalangeal and proximal interphalangeal joints) and feet. |
What are systemic manifestations of RA? | Fever, malaise, weight loss, rheumatoid nodules, and anemia. |
What lab tests are used to diagnose rheumatoid arthritis? | Rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). |
What imaging studies confirm joint damage in RA? | X-rays, ultrasound, or MRI showing joint erosion, deformity, or inflammation. |
What is the first-line medication for rheumatoid arthritis? | Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate. |
What are nursing considerations for methotrexate? | Monitor for bone marrow suppression, hepatotoxicity, and signs of infection; ensure the patient avoids alcohol and takes folic acid to reduce side effects. |
What are biologic agents used for RA, and what is a major concern? | Biologic agents like etanercept or adalimumab target specific inflammatory pathways. A major concern is increased susceptibility to infections, especially tuberculosis. |
What role do corticosteroids play in RA management? | They are used for short-term inflammation control but should be tapered off to prevent long-term complications. |
What is a priority nursing intervention for a patient with RA experiencing joint stiffness? | Encourage range-of-motion exercises and warm applications to improve flexibility and reduce stiffness. |
What type of assistive devices can help RA patients with daily activities? | Devices like jar openers, button hooks, and elevated toilet seats reduce joint strain and improve independence. |
How should activities be planned for a patient with RA? | Encourage frequent rest periods and plan activities during times when the patient feels less fatigued (e.g., after rest or treatments). |
What lifestyle changes can help reduce RA symptoms? | Maintain a healthy weight, engage in low-impact exercises (e.g., swimming, yoga), and avoid smoking. |
Why is adherence to medication critical in RA? | To prevent disease progression, joint deformity, and systemic complications. |
What dietary recommendations are beneficial for RA patients? | Encourage an anti-inflammatory diet rich in omega-3 fatty acids, fruits, and vegetables, and avoid processed foods. |
What are common joint deformities seen in RA? | Swan neck deformity, boutonnière deformity, and ulnar deviation. |
What is Felty's syndrome? | A rare complication of RA characterized by splenomegaly, neutropenia, and increased infection risk. |
How does rheumatoid arthritis affect extra-articular systems? | It can cause interstitial lung disease, pericarditis, vasculitis, and eye disorders like scleritis. |
What is the priority when a patient with RA develops fever and malaise? | Assess for signs of infection, especially if the patient is on immunosuppressive therapy. |
What role does physical therapy play in RA management? | It helps improve joint mobility, strengthen muscles, and reduce the risk of contractures. |
What should be included in discharge teaching for a patient with RA? | The importance of adhering to medications, engaging in daily joint exercises, using assistive devices, and recognizing early signs of complications. |
What is a common emotional response in patients with chronic RA? | Depression and anxiety related to chronic pain and loss of independence. |
How can nurses support the psychosocial needs of RA patients? | Provide emotional support, refer to counseling or support groups, and involve the patient in setting realistic goals for disease management. |
What is the primary pathophysiological process in liver cirrhosis? | Chronic liver damage leads to fibrosis and scarring, which disrupts normal liver function and blood flow. |
What are common causes of cirrhosis? | Chronic alcohol use, hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and biliary diseases. |
What are the early symptoms of liver cirrhosis? | Fatigue, anorexia, nausea, weight loss, and dull right upper quadrant pain. |
What are late signs of liver cirrhosis? | Jaundice, ascites, spider angiomas, peripheral edema, and pruritus. |
What causes jaundice in liver cirrhosis? | Impaired bilirubin metabolism due to decreased liver function. |
What is the most life-threatening complication of cirrhosis? | Esophageal variceal bleeding due to portal hypertension. |
What are signs of hepatic encephalopathy? | Confusion, altered mental status, asterixis (flapping tremor), and lethargy. |
What is the mechanism behind ascites in cirrhosis? | Decreased albumin production, portal hypertension, and sodium/water retention. |
What lab abnormality suggests coagulopathy in cirrhosis? | Elevated prothrombin time (PT) or international normalized ratio (INR). |
What lab results indicate worsening cirrhosis? | Elevated liver enzymes (ALT, AST), increased bilirubin, decreased albumin, and prolonged PT/INR. |
What imaging studies confirm cirrhosis? | Ultrasound, CT scan, or MRI showing liver nodules and fibrosis. |
What is the purpose of a liver biopsy in cirrhosis? | To confirm the extent of liver damage and scarring. |
What medication is used to treat hepatic encephalopathy? | Lactulose to reduce ammonia levels. |
What diuretics are commonly prescribed for ascites? | Spironolactone and furosemide. |
What medications should be avoided in cirrhosis? | Hepatotoxic drugs (e.g., acetaminophen in high doses) and NSAIDs. |
What is the priority nursing intervention for a patient with ascites? | Measure abdominal girth daily, monitor for respiratory distress, and position the patient in semi-Fowler’s. |
How should nutrition be managed for a patient with cirrhosis? | Encourage a low-sodium, high-protein diet unless hepatic encephalopathy is present, in which case protein intake may need to be restricted. |
What should the nurse monitor in a patient receiving a paracentesis? | Blood pressure, signs of hypovolemia, and infection at the puncture site. |
What is the purpose of a TIPS (transjugular intrahepatic portosystemic shunt) procedure? | To reduce portal hypertension and decrease the risk of variceal bleeding. |
How is esophageal variceal bleeding managed? | Administering octreotide, placing an esophageal band, or performing a balloon tamponade. |
What lifestyle changes should a patient with cirrhosis adopt? | Avoid alcohol, adhere to a low-sodium diet, and maintain a healthy weight. |
What are signs of worsening hepatic encephalopathy that patients and caregivers should watch for? | Increased confusion, irritability, and asterixis. |
Why is avoiding alcohol critical for patients with cirrhosis? | Alcohol exacerbates liver damage and accelerates disease progression. |
How can nurses support the psychosocial needs of cirrhosis patients? | Provide emotional support, refer to counseling or support groups, and educate on realistic expectations for disease management. |
What is the hallmark feature of Hodgkin's lymphoma? | Presence of Reed-Sternberg cells. |
Where does Hodgkin's lymphoma usually originate? | In a single lymph node or chain of lymph nodes, typically in the neck, chest, or axilla. |
What is the difference between Hodgkin's lymphoma and non-Hodgkin's lymphoma? | Hodgkin's lymphoma is characterized by Reed-Sternberg cells, while non-Hodgkin's lymphoma does not have these cells and typically involves multiple lymph nodes. |
What are the risk factors for Hodgkin's lymphoma? | Epstein-Barr virus (EBV) infection, immunosuppression, family history, and being in the age groups of 15-35 or over 50. |
Which gender is more commonly affected by Hodgkin's lymphoma? | Males. |
What is the most common early symptom of Hodgkin's lymphoma? | Painless enlargement of lymph nodes, typically in the neck, axilla, or groin. |
What are "B symptoms" associated with Hodgkin's lymphoma? | Fever, night sweats, and unexplained weight loss (more than 10% of body weight). |
What other symptoms might a patient with Hodgkin's lymphoma experience? | Fatigue, pruritus, alcohol-induced lymph node pain, and splenomegaly. |
What is the gold standard for diagnosing Hodgkin's lymphoma? | Lymph node biopsy showing Reed-Sternberg cells. |
Which imaging studies are commonly used to stage Hodgkin's lymphoma? | PET scan, CT scan, and chest X-ray. |
What lab findings are common in Hodgkin's lymphoma? | Elevated ESR, leukocytosis, anemia, and lymphocytopenia. |
What does Stage I Hodgkin's lymphoma indicate? | Involvement of a single lymph node or one extralymphatic site. |
What does Stage IV Hodgkin's lymphoma mean? | Disseminated disease with involvement of multiple extralymphatic organs (e.g., liver, bone marrow). |
How does the presence of "B symptoms" affect the prognosis? | Indicates a more aggressive disease and worse prognosis. |
What is the primary treatment for Hodgkin's lymphoma? | Combination chemotherapy (e.g., ABVD regimen: Adriamycin, Bleomycin, Vinblastine, Dacarbazine). |
What are common side effects of chemotherapy for Hodgkin's lymphoma? | Nausea, vomiting, alopecia, fatigue, myelosuppression, and risk of infection. |
What is the role of radiation therapy in Hodgkin's lymphoma? | Used for localized disease or in combination with chemotherapy. |
What is the priority nursing intervention for a patient undergoing chemotherapy for Hodgkin's lymphoma? | Monitor for signs of infection and implement neutropenic precautions if necessary. |
What dietary recommendations are helpful for a patient with Hodgkin's lymphoma? | High-protein, high-calorie diet to combat weight loss and fatigue. |
What measures can help manage pruritus in Hodgkin's lymphoma? | Use of antihistamines, keeping the skin moisturized, and avoiding hot showers. |
What are potential long-term complications of chemotherapy and radiation in Hodgkin's lymphoma? | Secondary cancers (e.g., leukemia, lung cancer), infertility, hypothyroidism, and cardiovascular disease. |
What complication should the nurse monitor for after a splenectomy in a Hodgkin's lymphoma patient? | Increased risk of infections (overwhelming post-splenectomy infection syndrome). |
What should a patient undergoing chemotherapy for Hodgkin's lymphoma avoid? | Crowded places, sick contacts, and raw/uncooked foods to reduce infection risk. |
A patient undergoing chemotherapy for Hodgkin's lymphoma. What signs and symptoms should patients report immediately? | Fever, chills, signs of bleeding, or severe fatigue. |
What is the primary cause of COPD? | Long-term smoking or exposure to irritants (e.g., air pollution, occupational dust). |
What pathophysiological change occurs in emphysema? | Destruction of alveoli, loss of lung elasticity, and air trapping. |
What pathophysiological change occurs in chronic bronchitis? | Increased mucus production and inflammation leading to airway obstruction. |
What is the hallmark symptom of COPD? | Progressive dyspnea on exertion. |
What are common signs of chronic bronchitis? | Productive cough, wheezing, cyanosis ("blue bloater"), and peripheral edema. |
What are common signs of emphysema? | Barrel chest, pursed-lip breathing, use of accessory muscles, and minimal sputum ("pink puffer"). |
What are early signs of COPD exacerbation? | Increased sputum production, worsening dyspnea, and increased cough frequency. |
What is the most common life-threatening complication of COPD? | Respiratory failure. |
What is cor pulmonale, and how does it relate to COPD? | Right-sided heart failure due to chronic lung disease. |
What are signs of worsening respiratory failure in COPD? | Altered mental status, paradoxical breathing, and worsening hypoxia. |
What is the gold standard test to diagnose COPD? | Pulmonary function tests (PFTs) showing decreased FEV1/FVC ratio (<70%). |
What does a chest X-ray show in a patient with emphysema? | Hyperinflated lungs and flattened diaphragm. |
Why should oxygen therapy be used cautiously in COPD patients? | High oxygen levels can suppress the hypoxic drive, leading to respiratory depression. |
What is the recommended oxygen saturation goal for a COPD patient? | 88-92%. |
Which oxygen delivery device is preferred for COPD patients? | Venturi mask (delivers precise oxygen concentration). |
What class of medications is first-line for COPD management? | Bronchodilators (beta-agonists and anticholinergics). |
Which bronchodilator is commonly used for long-term COPD management? | Tiotropium (Spiriva), an anticholinergic. |
What are common side effects of beta-agonists (e.g., albuterol)? | Tachycardia, tremors, palpitations, and nervousness. |
What corticosteroid is commonly prescribed for COPD exacerbations? | Prednisone or inhaled corticosteroids like fluticasone. |
What education should be provided when prescribing corticosteroids? | Rinse the mouth after use to prevent oral candidiasis (thrush). |
What breathing technique can help a COPD patient improve oxygenation? | Pursed-lip breathing. |
What position helps improve breathing in COPD? | High Fowler’s or tripod position. |
Why is hydration important for COPD patients? | Helps thin mucus for easier expectoration. |
What is the most important lifestyle change to slow COPD progression? | Smoking cessation. |
Why should COPD patients receive the flu and pneumonia vaccines? | To prevent respiratory infections that can worsen COPD. |
What is the recommended diet for COPD patients? | High-calorie, high-protein diet with small frequent meals to prevent weight loss and fatigue. |
What should a COPD patient avoid in their home environment? | Air pollutants, strong perfumes, and allergens that can trigger symptoms. |
What are signs of a COPD exacerbation? | Increased dyspnea, increased sputum production, and worsening cough. |
What is the priority intervention during a COPD exacerbation? | Provide bronchodilators and supplemental oxygen while monitoring for respiratory distress. |
Which medication is often used to treat bacterial infections in COPD exacerbations? | Antibiotics such as azithromycin or levofloxacin. |
What behavioral signs suggest alcohol abuse? | Lying about drinking, missing work or school, and drinking in risky situations (e.g., driving). |
Which questionnaire is commonly used to assess alcohol use disorder? | CAGE questionnaire (Cut down, Annoyed, Guilty, Eye-opener). |
When do alcohol withdrawal symptoms typically begin? | 6-12 hours after the last drink. |
What are early symptoms of alcohol withdrawal? | Anxiety, tremors, sweating, nausea, tachycardia, and hypertension. |
What is a life-threatening complication of alcohol withdrawal? | Delirium tremens (DTs). |
What are symptoms of delirium tremens (DTs)? | Severe confusion, hallucinations, fever, agitation, and seizures. |
Which electrolyte imbalance is common in alcohol withdrawal? | Hypomagnesemia and hypokalemia. |
What is the first-line medication for alcohol withdrawal? | Benzodiazepines (e.g., lorazepam, diazepam, chlordiazepoxide). |
Why are benzodiazepines used in alcohol withdrawal? | They prevent seizures and manage agitation. |
Which medication is used to maintain alcohol abstinence by causing unpleasant effects when alcohol is consumed? | Disulfiram (Antabuse). |
Which medication reduces alcohol cravings? | Naltrexone or acamprosate. |
What vitamin is crucial to administer in alcohol withdrawal? | Thiamine (Vitamin B1) to prevent Wernicke’s encephalopathy. |
What is Wernicke-Korsakoff syndrome? | A neurocognitive disorder caused by thiamine deficiency, leading to confusion, ataxia, and memory loss. |
What is alcoholic cirrhosis? | Irreversible liver scarring caused by chronic alcohol use. |
What is hepatic encephalopathy, and how is it treated? | Liver dysfunction leading to confusion due to ammonia buildup; treated with lactulose. |
What is the priority intervention in a patient experiencing alcohol withdrawal? | Administer benzodiazepines and monitor for seizures. |
What diet is recommended for a recovering alcoholic? | High-protein, high-vitamin diet with adequate hydration. |
What precautions should be in place for a patient at risk for withdrawal seizures? | Seizure precautions (e.g., padded side rails, suction at bedside). |
What is the most effective long-term support for sobriety? | Alcoholics Anonymous (AA) or other 12-step programs. |
Why should a patient taking disulfiram (Antabuse) avoid alcohol-containing products? | Even small amounts (e.g., mouthwash) can cause severe nausea, vomiting, and headache. |
Why is a strong support system important in alcohol recovery? | Reduces relapse risk and provides accountability. |
What are common causes of atrial fibrillation? | Hypertension, coronary artery disease (CAD), heart failure, hyperthyroidism, and valvular disease. |
What is the most common symptom of atrial fibrillation? | Palpitations. |
What other symptoms might a patient with AFib experience? | Fatigue, dizziness, shortness of breath, and chest discomfort. |
What are the key ECG characteristics of atrial fibrillation? | Irregularly irregular rhythm, no distinct P waves, and fibrillatory waves. |
What is the most dangerous complication of atrial fibrillation? | Stroke (due to blood clots forming in the atria). |
Why does AFib increase the risk of stroke? | Blood stasis in the atria promotes clot formation, which can embolize to the brain. |
What condition can result from prolonged untreated atrial fibrillation? | Heart failure due to reduced cardiac output. |
What are the two primary goals in managing AFib? | Rate control and stroke prevention. |
Which medications are used for rate control in AFib? | Beta-blockers (e.g., metoprolol), calcium channel blockers (e.g., diltiazem), and digoxin. |
Which medications are used for rhythm control in AFib? | Antiarrhythmics such as amiodarone and flecainide. |
What medication is given to prevent stroke in AFib patients? | Anticoagulants like warfarin, rivaroxaban, or apixaban. |
What lab test should be monitored in patients on warfarin? | INR (International Normalized Ratio), with a therapeutic range of 2.0-3.0. |
What is the antidote for warfarin overdose? | Vitamin K. |
What is the first-line treatment for new-onset atrial fibrillation with hemodynamic instability? | Electrical cardioversion. |
When is electrical cardioversion used in atrial fibrillation? | When the patient is unstable (e.g., hypotension, chest pain, altered mental status). |
What is the purpose of catheter ablation in AFib? | To destroy abnormal electrical pathways causing atrial fibrillation. |
What should a nurse assess in a patient with new-onset AFib? | Vital signs, oxygenation, and signs of stroke. |
What lifestyle changes should AFib patients follow? | Limit alcohol, quit smoking, maintain a heart-healthy diet, and manage hypertension. |
What foods should be limited while taking warfarin? | Foods high in vitamin K (e.g., leafy greens like spinach and kale). (Maintain regular intake do not eat too much) |
What should a patient with AFib do if they experience symptoms of stroke? | Seek emergency medical help immediately (FAST acronym: Face drooping, Arm weakness, Speech difficulty, Time to call 911). |
What is the most common causative organism of urinary tract infections? | Escherichia coli (E. coli). |
What are common risk factors for UTIs? | Female anatomy, pregnancy, diabetes, catheter use, dehydration, urinary stasis, and poor hygiene. |
Why are women more prone to UTIs than men? | Shorter urethra and proximity of the urethra to the anus. |
What is the most common route of infection in UTIs? | Ascending route (bacteria travel from the urethra to the bladder and kidneys). |
What is the difference between cystitis and pyelonephritis? |
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What are common signs of pyelonephritis? | Fever, chills, flank pain, nausea, vomiting, and costovertebral angle tenderness. |
What are the most common symptoms of a lower UTI (cystitis)? | Dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and cloudy urine. |
What are signs of UTI in older adults? | Confusion, agitation, delirium, or falls (often without typical urinary symptoms). |
What does cloudy, foul-smelling urine indicate? | Possible UTI or infection. |
What symptom differentiates pyelonephritis from cystitis? | Flank pain and fever (seen in pyelonephritis). |
What is the most common diagnostic test for UTI? | Urinalysis (UA) with culture and sensitivity (C&S). |
What findings in a urinalysis indicate a UTI? | Presence of leukocytes, nitrites, WBCs, and bacteria. |
What is the significance of a positive nitrite test in urine? | Bacteria (especially E. coli) convert nitrates to nitrites, indicating infection. |
What is the first-line antibiotic for uncomplicated UTIs? | Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim), nitrofurantoin (Macrobid), or fosfomycin. |
Which antibiotic should be avoided in pregnant women with UTIs? | Fluoroquinolones (e.g., ciprofloxacin) and tetracyclines. |
What medication is used to relieve dysuria in UTIs? | Phenazopyridine (Pyridium) (causes orange urine discoloration). |
Why should phenazopyridine (Pyridium) only be used short-term? | Can cause kidney toxicity if used for too long. |
Why should a urine culture be obtained before starting antibiotics | To identify the causative organism and ensure proper antibiotic selection. |
What is a serious complication of untreated pyelonephritis? | Urosepsis (systemic infection leading to septic shock). |
Which patient is at the highest risk for developing urosepsis? | Elderly, immunocompromised, and diabetic patients. |
What is the purpose of a PICC line? | Long-term IV access for medications, total parenteral nutrition (TPN), chemotherapy, antibiotics, or fluids. |
Where is a PICC line inserted, and where does the tip terminate? | Inserted into the basilic, brachial, or cephalic vein; tip should terminate in the superior vena cava. |
Which patients are candidates for a PICC line? | Patients requiring long-term IV therapy, chemotherapy, or difficult peripheral access. |
What is the priority assessment before using a newly inserted PICC line? | Confirm placement via chest X-ray before using the line. |
What should the nurse do if the patient experiences discomfort or swelling during PICC insertion? | Stop the procedure and assess for venous irritation or thrombosis. |
What position should the patient be in during PICC insertion? | Supine with arm extended to promote vessel dilation. |
How often should a PICC line dressing be changed? | Every 7 days if using a transparent dressing, or sooner if soiled or loose (or depending on unit policy). |
What type of aseptic technique is used when changing a PICC line dressing? | Sterile technique with a mask, gloves, and chlorhexidine for cleaning. |
How often should a PICC line be flushed to maintain patency? | Before and after medication administration and every 12 hours when not in use. |
What size syringe should be used for flushing a PICC line? | 10 mL or larger to avoid excessive pressure that could rupture the catheter. |
What solution is used for flushing a PICC line? | Normal saline or heparin (per facility protocol). |
What are signs of a PICC line infection? | Redness, swelling, warmth, purulent drainage, fever, chills. |
What is the priority nursing action if a PICC line infection is suspected? | Notify the physician, obtain blood cultures, and anticipate removal of the PICC. |
What should the nurse do if the PICC line is not flushing properly? | Reposition the patient, attempt to flush with gentle pressure, and notify the physician. |
Which technique should be used when flushing to prevent occlusion? | The "push-pause" method to create turbulence and prevent clot formation. |
What is the priority intervention if an air embolism is suspected? | Place the patient in Trendelenburg position on the left side and administer oxygen. |
What can the nurse do to prevent air embolism when removing a PICC line? | Have the patient perform the Valsalva maneuver (hold breath and bear down) during removal. |
What are signs of phlebitis in a patient with a PICC line? | Redness, warmth, and a palpable cord-like vein along the catheter track. |
What is the priority action if thrombosis is suspected? | Stop using the PICC, notify the physician, and assess for swelling or pain. |
Can blood be drawn from a PICC line? | Yes, but it depends on facility policy and proper flushing afterward is required. |
What is the correct sequence for administering IV medications through a PICC line? | Flush with saline → Administer medication → Flush with saline again. |
What should be done before administering incompatible IV medications through a PICC line? | Flush with normal saline between medications to prevent interactions. |
What is the correct technique for removing a PICC line? | Slowly and gently remove while having the patient exhale or perform the Valsalva maneuver. |
What should the nurse do if resistance is met while removing a PICC line? | Stop and notify the physician. |
How should the exit site be managed after PICC removal? | Apply pressure, cover with a sterile dressing, and monitor for bleeding or infection. |
What should patients avoid with a PICC line? | Heavy lifting, submerging in water, and excessive arm movement. |
How should patients care for their PICC line at home? | Keep dressing clean and dry, flush as instructed, and report signs of infection. |
What is the primary cause of acute pancreatitis? | Gallstones and chronic alcohol use. |
What happens in pancreatitis? | Autodigestion occurs when pancreatic enzymes (amylase, lipase) activate too early, leading to inflammation and tissue damage. |
What are common causes of chronic pancreatitis? | Long-term alcohol abuse, cystic fibrosis, autoimmune disease, and recurrent acute pancreatitis. |
What is the hallmark symptom of acute pancreatitis? | Severe epigastric pain radiating to the back, often worsened after eating fatty meals. |
What are other common symptoms of pancreatitis? | Nausea, vomiting, fever, abdominal distention, and steatorrhea (fatty stools). |
What two physical signs indicate severe pancreatitis? |
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Which two lab values are most specific for pancreatitis? | Elevated amylase and lipase. |
What imaging study is commonly used to diagnose pancreatitis? | CT scan of the abdomen. |
Which electrolyte imbalance is common in pancreatitis? | Hypocalcemia (may cause Trousseau’s or Chvostek’s sign). |
What is the most serious complication of acute pancreatitis? | Pancreatic necrosis leading to sepsis. |
What complication is indicated by a sudden decrease in pain and a rigid abdomen? | Pancreatic rupture or peritonitis. |
What is the priority nursing intervention for a patient with acute pancreatitis? | NPO status to rest the pancreas and prevent enzyme activation. |
What IV fluids are given in pancreatitis? | Lactated Ringer’s or normal saline for fluid resuscitation. |
What position can help relieve pancreatitis pain? | Side-lying with knees flexed or sitting forward in the fetal position. |
Which medication is used to reduce gastric acid secretion in pancreatitis? | Proton pump inhibitors (e.g., pantoprazole) or H2 blockers (e.g., ranitidine). |
What pancreatic enzyme supplement is used in chronic pancreatitis? | Pancrelipase (Creon, Pancrease) to aid digestion. |
How should pancreatic enzymes be taken? | With meals and snacks to aid digestion. |
What lifestyle modification is most important for patients with chronic pancreatitis? | Complete alcohol cessation. |
What foods should be avoided in pancreatitis? | Fried, greasy, spicy, or high-fat foods. |
Why is smoking cessation important for pancreatitis patients? | Smoking increases inflammation and worsens pancreatic damage. |
Why should patients with chronic pancreatitis eat small, frequent meals? | Helps prevent pancreatic enzyme overstimulation. |
When is surgery indicated for pancreatitis? | Severe necrotizing pancreatitis, abscesses, or gallstones causing obstruction. |
What surgical procedure is performed if gallstones cause pancreatitis? | Cholecystectomy (gallbladder removal). |
What is the primary goal of chemotherapy? | To destroy rapidly dividing cancer cells while minimizing damage to normal cells. |
Which type of cells are most affected by chemotherapy? | Rapidly dividing cells, including cancer cells, bone marrow, hair follicles, and the gastrointestinal lining. |
Why are chemotherapy drugs often given in cycles? | To allow normal cells to recover while maximizing cancer cell destruction. |
Which lab values should be closely monitored in patients receiving chemotherapy? | WBC (neutrophils), hemoglobin (Hgb), platelets. |
What is the priority concern in a patient with chemotherapy-induced neutropenia? | Risk of infection. |
What is the priority nursing intervention for thrombocytopenia in chemotherapy patients? | Monitor for bleeding, avoid IM injections, and use soft toothbrushes. |
Which medication is most commonly used to prevent chemotherapy-induced nausea and vomiting? | Ondansetron (Zofran), a serotonin receptor antagonist. |
What dietary modifications can help chemotherapy patients with nausea? | Small, frequent meals, avoiding strong odors, and cold/bland foods. |
What oral care should a chemotherapy patient with mucositis perform? | Use a soft toothbrush, rinse with saline, and avoid alcohol-based mouthwashes. |
What foods should be avoided in patients with mucositis? | Spicy, acidic, or rough-textured foods. |
Why does chemotherapy cause hair loss? | It affects rapidly dividing hair follicle cells. |
What should the nurse teach a patient experiencing hair loss from chemotherapy? | Use mild shampoos, avoid heat styling, and consider wearing a wig or scarf. |
What personal protective equipment (PPE) should be worn when administering chemotherapy? | Gown, gloves, mask, and eye protection. |
What is the priority nursing intervention if chemotherapy extravasation occurs? | Stop the infusion immediately and follow facility protocol (e.g., apply antidote if available). |
Which type of IV access is preferred for chemotherapy administration? | A central line (e.g., PICC line, implanted port) to reduce the risk of extravasation. |
What precautions should be implemented for a patient with neutropenia? | No fresh flowers, no raw foods, avoid crowds, and strict hand hygiene. |
What is the priority nursing action if a neutropenic patient develops a fever? | Notify the physician immediately (sign of possible sepsis). |
What is a neutropenic emergency? | Fever >100.4°F (38°C) with absolute neutrophil count (ANC) <500/mm³. |
What causes tumor lysis syndrome? | Rapid destruction of cancer cells releases potassium, phosphorus, and uric acid into the bloodstream. |
Which lab abnormalities are seen in tumor lysis syndrome? | Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia. |
What is the priority intervention for preventing tumor lysis syndrome? | Aggressive IV hydration and administration of allopurinol (to reduce uric acid levels). |
What is a major adverse effect of doxorubicin? | Cardiotoxicity (heart failure). |
What is the priority nursing assessment for a patient receiving doxorubicin? | Monitor for signs of heart failure (dyspnea, edema, fatigue). |
What are common side effects of cisplatin? | Kidney damage and hearing loss. |
What should the nurse monitor in a patient receiving cisplatin? | Renal function (creatinine, BUN) and hearing tests. |
What is a major concern with methotrexate therapy? | Bone marrow suppression, hepatotoxicity, and mucositis. |
Which supplement is given with methotrexate to reduce toxicity? | Leucovorin (folinic acid). |
What should be included in discharge teaching for chemotherapy patients? | Hand hygiene, avoiding sick contacts, drinking plenty of fluids, and managing nausea proactively. |
What type of diet is recommended for chemotherapy patients? | High-calorie, high-protein diet with small, frequent meals. |
What is a major psychosocial concern for chemotherapy patients? | Body image changes (hair loss, weight loss, skin changes). |
What is external beam radiation therapy? | A high-energy radiation beam directed from outside the body to the tumor site. |
What is a key nursing intervention for skin care in external radiation therapy? | Avoid lotions, perfumes, and sun exposure on the treated area. |
What is brachytherapy? | Radioactive material is implanted directly into or near the tumor. |
What is the primary safety concern for healthcare workers caring for patients receiving brachytherapy? | Radiation exposure. |
What precautions should be followed when caring for a patient with internal radiation implants? | Limit time in the room, maintain distance, and use lead shielding. |
What is a common skin reaction to external beam radiation? | Dry, red, peeling, or irritated skin (radiation dermatitis). |
What skin care instructions should be given to patients receiving radiation? | Use mild soap, avoid scrubbing, and wear loose-fitting clothing. |
What is a common symptom of radiation therapy? | Fatigue. |
What interventions can help manage fatigue? | Encourage rest periods, light exercise, and a well-balanced diet. |
What GI side effects occur with abdominal or pelvic radiation? | Nausea, vomiting, diarrhea, and loss of appetite. |
What dietary modifications help with radiation-induced diarrhea? | Low-fiber diet, increased fluid intake, and avoidance of dairy and fatty foods. |
What type of radiation therapy is most likely to cause bone marrow suppression? | Total body irradiation or radiation to large bones (pelvis, sternum). |
What lab values should be monitored for bone marrow suppression? | WBC, hemoglobin, and platelets. |
What are the three main principles of radiation safety? | Time, distance, and shielding. |
How should the nurse minimize radiation exposure when caring for a patient with internal radiation? | Spend less time in the room, maintain at least 6 feet distance, and wear a lead apron. |
What visitor restrictions should be in place for patients receiving brachytherapy? | No pregnant women or children under 18 should visit, and visits should be limited to 30 minutes per day. |
What should the nurse do if a radiation implant falls out? | Do not touch it with bare hands; use long-handled forceps and place it in a lead container. |
What should a patient avoid applying to the radiation treatment area? | No lotions, powders, or deodorants unless approved by the provider. |
How should a patient protect irradiated skin from sun exposure? | Wear protective clothing and use sunscreen (SPF 30 or higher). |
What should a patient do if experiencing radiation-related mucositis? | Use a soft toothbrush, rinse with saline, and avoid spicy or acidic foods. |
What is radiation pneumonitis? | Inflammation of the lungs due to chest radiation. |
What symptoms indicate radiation pneumonitis? | Dry cough, dyspnea, and low-grade fever. |
What are signs of spinal cord compression from radiation therapy? (if treating spinal tumors) | Back pain, weakness, numbness, and bowel/bladder dysfunction. |
What side effect is most common with head and neck radiation? | Mucositis and xerostomia (dry mouth). |
What is a priority intervention for pelvic radiation therapy? | Monitor for diarrhea and cystitis (bladder inflammation). |
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