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NUR355 MEDSURG EXAM 2|2025-
2026|126Qs&As|ALREADY GRADED A+
Name three risk factors of osteoarthritis (OA) Age, previous injury to a joint, and genetics (Female gender and metabolic disorders such as diabetes) A new pt complains to the nurse about her arthritis, she states it is in both her hands equally and she is concerned she is experiencing an external curving of her fingers now. The nurse recognizes the pt has this type of arthritis. rheumatoid arthritis A pt is taking daily Ibuprofen for OA. The nurse teaches the pt to monitor for these GI symptoms regarding chronic Ibuprofen use. black/tarry stools This antidepressant drug is at times used to treat the pain of fibromyalgia. duloxetine (Cymbalta)
Three criteria for diagnoses of SLE Butterfly (malar) rash, positive antinuclear antibody test, and alopecia A pt has edema, redness (erythema) and warmth to an area. The nurse would describe this best as this Inflammation A pt is experiencing a flare of her SLE after a vacation to sunny Florida. The nurse explains the potential causes to the pt could be these three things? Change in diet, increased stress due to travel, and increased sun exposure during vacation A pt with SLE is taking this medication which prompts the provider to make sure the pt is getting regular eye exams. hydroxychloroquine A nurse suspects a pt's SLE is worsening and attacking the kidneys when he sees an elevation in this lab creatinine
A pt with HIV starts to run a fever, these are the nurse's priority actions after assessing fever. initiate isolation precautions and contact the provider A pt develops nausea and vomiting, confusion, urinary incontinence, loss of appetite, fever. The nurse suspects this disease process. urosepsis (will take sepsis) A pt receiving an antibiotic is experiencing shortness of breath with auditory wheezing, stridor, numb lips and facial swelling. The nurse recognizes the pt is experiencing this. anaphylaxis The nurse knows to perform this priority intervention when a pt is experiencing a transfusion reaction. stop the transfusion This lab value will be elevated with a type I hypersensitivity reaction. eosinophils
A pt states she walked through poison ivy and now has an itching rash. The nurse recognizes the pt is going through this type of reaction. type 4 hypersensitivity reaction Name two drugs used to treat hypersensitivity type I reactions. (Drug or drug class is acceptable) epinephrine and antihistamines (ex. Benadryl) will also accept steroids (ex. Solumedrol) Besides medications for anaphylaxis, what two interventions will the nurse provide? administer oxygen and place pt in high Fowler's position A pt asks what areas of the body where gout could develop. The nurse knows to respond with this answer foot/ankle, hands, knee JOINTS A pt asks what causes gout, the nurse knows to respond with this answer.
Types of immunity active immunity (natural and artificial immunity), passive immunity and innate what is active natural immunity? being exposed to the pathogen through infection with the actual disease what is active Artificial? vaccines what is Innate/Passive immunity? breast feeding assessing allergies verify allergy status, reaction from allergy, place allergy band, and confirm allergy is in medical record
Type 1 hypersensitivity reaction Allergy. Anaphylaxis (airway closes), or seasonal allergies (allergy to a pathogen) If patient is struggling breathing what position do we place them in high fowlers, DONT LEAVE!!! Patient teaching for anaphylaxis epi pen Type 2 hypersensitivity Cytotoxic. The opposing rh factor in blood or a Blood transfusion cytotoxic reaction. S&S of cytotoxic reaction
Type 4 hypersensitivity delayed responses Examples of type 4 reactions poison ivy, TB skin test Type 5 hypersensitivity stimulated antibodies Examples of type 5 reactions hyperthyroidism->graves disease Risk factors of hiv/aids unprotected intercourse and IV drug use
Patho of HIV/AIDS when rapid rise in HIV viral load and CD4+ falls below 200 cells/mm3 it turns into AIDS Meds/Tx of HIV/AIDS protective isolation= reverse. Antiretroviral therapy (ART) Nursing education for HIV safe sex Nursing Interventions for HIV universal precautions and protective
Neutrophil elevation indicates what type of infection? acute infection What do high eosinophils tell us? allergies Creatinine is excreted from kidneys Normal range of creatinine is 0.6-1. What is the role of creatinine
helps with muscles How do NSAIDS impact your creatinine levels can raise the level If you have a patient on long term NSAID use you should monitor creatinine What does serum uric acid levels tell us if pt has gout What is the normal serum uric acid level 1.5-6.
When looking at sepsis also draw lactate level Lactate levels tell us what about sepsis? how far we are ABC airway, breathing, circulation. These COME FIRST what is the difference between acute and chronic pain? acute pain is temporary and occurs from injury, chronic last more than 6 months and resistant to pain relief
what is the pain goal? pain will never be zero, but can be tolerable to perform day to day activities What is pain assessment? PQRST What doe PQRST stand for? provoking quality region severity timing Fibromyalgia diagnostics It is a diagnosis of exclusion—no one test can test for it, must rule out other disease processes prior to a diagnosis of fibromyalgia.
OA risk factors
- over 65
- woman
- bone deformities-some people are born with malformed joints or defective cartilage, which can increase the risk of OA
- obesity and in activity
- certain occupations. if your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop OA
- other diseases, having diabetes, underactive thyroid, gout or pagets disease of bone can increase your risk of developing OA rheumatoid arthritis Relieving pain and discomfort Medications:
- steroids (prednisone)—SE of prednisone include increased blood sugars, hunger, irritability, upset stomach (take w/ food) Medications on a schedule can help with chronic pain—true for any chronic pain process** Pathology of gout
Urate crystals are deposited in joints, bone, and soft tissues clinical manifestation of gout Limited range of motion Inflammation (signs of inflammation, including redness, warmth, & edema) Lingering discomfort, labs may show an increase in uric acid serum levels (>6. MG/DL), best diagnostic is joint aspiration to assess for uric acid crystals directly Intense joint pain risk factors of gout Males 40-60 yrs old Females 55-70 yes old 2% of US obesity Hypertension Eating large amounts of meat and seafood Thiazide diuretics Large quantities of alcohol
