Adult Health 2 Exam 1 Latest Update Questions and Correct Answers Guaranteed 100% Score Rate
Acromegaly - Correct Answer: too much growth hormone
assessment: large face, hands, and feet, speech problems, thick skin, neuropathy, muscle weakness, visual changes, headaches, hyperglycemia
Diagnostic: IGF 1(insulin like growth factor), most reliable, OGTT, MRI, CT
Nursing care: post op care from a hypoposectomy (airway, bleeding, elevate HOB,
neuro checks, oral care), post radiation care, medication administration (octreotide), avoid brushing teeth for 10 days
Acute kidney failure - Correct Answer: Can develop over hours or days
Three phases: oliguric (reduction of urine output<400 mL/day, occurs 1-7 days of injury), diuretic (high volume of urine output 3-5L or more a day), recovery (everything goes back to normal)
S/S: hypovolemia, metabolic acidosis, hypernatremia, hyperkalemia, leukocytosis, waste product accumulation, edema, weight gain, change in mental status
DX: history/physical exam, creatinine and BUN levels, electrolytes, urinalysis,
ultrasound, renal scan, CT
Diet low in protein, moderate fats, sodium and potassium, high carbs
Addison's Disease - Correct Answer: not enough ACTH
Assessment: weakness, weight loss, N/V, *bronze colored* skin in creases, orthostatic *hypotension, hyponatremia, hyperkalemia, hypoglycemia, anemia, increased BUN and creatinine*
Dx: cortisol, ACTH, CT, MRI
complications: addisonian crisis
Nursing care: hormone therapy, VS, daily weights, monitor glucose, NA, K, quiet
environment, fluids, I&O, LOC
Adrenalectomy - Correct Answer: Post-op: risk for hemorrhage, fluid and electrolyte imbalance, monitor I&O, stabilize BP, risk for infection, check wound drainage
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Home care: wear medic alert bracelet, avoid extreme temps, emotional disturbances, adjust corticosteroids according to their stress level
Basal bolus insulin - Correct Answer: Most closely mimics endogenous insulin
production Rapid or short acting insulin before meals Intermediate or long acting background insulin once or twice a day Less intense regimens can also be used Goal to achieve or a near normal glucose level of 70-130 before meals
Cancer of thyroid gland - Correct Answer: tumor of the thyroid gland
usually benign more common in women
Causes: metaplasia, radiation, iodine deficiency, goitrogens
Assessment: painless, hard palpable nodule or nodules in an enlarged thyroid gland, hemoptysis, and airway obstruction
Dx: ultrasound, CT, MRI, PET, FNA (fine needle aspiration)
Management: conservative, meds, thyroidectomy
Cane and crutch walking - Correct Answer: Cane should be on unaffected side and
move with affected side to provide extra support
Crutches:
- point- partial weight bearing on both legs move right crutch with left leg and left crutch
with right leg
- point- no weight bearing on one foot. Move unaffected leg and then move both
crutches then affected leg
- point- move right crutch then move left leg then move left crutch then move right leg
Going up stairs with crutches: step up with unaffected leg then bring crutches to same stair then move affected leg to same stair
Going down stairs with crutches: move crutches down a step then bring unaffected leg down to same step then being affected leg to same step
Chronic kidney disease - Correct Answer: progressive, irreversible loss of kidney function, decreased GFR <60mL/min longer than 3 months, results in uremia, dialysis necessary
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S/S: HTN, pulmonary edema, neurologic impairment (fatigue, headache, sleep
disturbances), decreasing urinary function (hematuria, proteinuria, cloudy urine, oliguric 100-400mL/day, anuric <100mL/day), jaundice, pruritis, dry scaly skin, GI upsets, metallic taste in mouth, ammonia breath, waste product accumulation, CKF affects every system
DX: history and physical, ultrasound, renal scan, CT, renal biopsy, BUN, creatinine and creatinine clearance levels, electrolytes, lipid profile, protein to creatinine ration, urinalysis, hct/hgb levels
TX: correct extracellular fluid volume overload or deficit, calcium supplement, phosphate binders, antihypertensive drugs, ANE/ARBS, treat hyperlipidemia, renal replacement therapy
Clean catch teaching - Correct Answer: Use sterile container, touch only outside
women: clean meatus using three sponges wiping front to back
men: retract foreskin if present and clean glCorrect Answer: with three sponges
after cleaning pt should begin voiding into toilet then continue voiding into container
Complications of dialysis - Correct Answer: Exit site infection (staph aureus, s.epidermidis, s/s redness at site, tenderness, drainage), peritonitis (contamination/progression of an exit site or tunnel infection, s/s cloudy peritoneal effluent, WBC >100, abd pain, D/V, abd distention, hyperactive bowel sounds, fever), hernias, lower back problems, bleeding, atelectasis, pneumonia, bronchitis, protein loss, catheter obstruction from clots/kinks, insufficient outflow, hypotension, hypovolemia, hyperglycemia, abdominal pain, muscle cramps, hepatitis, sepsis, disequilibrium syndrome, cardiovascular disease, exsanguination
Complications of uncontrolled DM - Correct Answer: macrovascular (large vessels): stroke, PVD, CAD, MI (if A1c is >6.5% increase pt chance for these complications)
microvascular: diabetic retinopathy, cataracts, glaucoma
nephropathy: CRF, HTN, edema
peripheral neuropathy: paresthesia, pain, loss of sensation and motor control
foot ulcers, poor healing
Cushing's Syndrome - Correct Answer: too much corticosteriod (glucocorticosteroid)
Assessment: obesity, moon face, striae, hirsutism, HTN, hyperglycemia, delayed wound healing
Dx: corisol levels, 24-hour urine, CT, and MRI
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