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FINAL COACHING -CPEG,RN,CMT

1. Formalize decision making process between employer & employee - collective bargaining
2. Greatest concern about patient electronic records privacy
3. 3. Type of pain that is resistant to intervention intractable pain
Treatment of choice: SURGERY/ Nerve resection
4. Obliteration of pain below the level of sphinothalamic tract - cordotomy
5. Perform to alleviate pain of the head & neck due to cancer / neuralgia rhizotomy
6. Method of pain management that permits clients to treat the pain patient control analgesia
7. TRUE about patient control analgesia - negative addiction but positive tolerance
8. Advantages of patient control analgesia increase independence & decrease sedation
9. Ethical implication of PCA self determination / AUTONOMY
10. Common route of PCA ORAL (put a star! With a big big star!!) rationale: self medication is a
form of PCA. Huwag IV ang isasagot mo josh ha, kasi pag sinabing PCA, tendency IV agad
iisipin natin
11. Any medication / procedure that produces an effect because of an implicit or explicit intent
PLACEBO
WHO ANALGESIC LADDER FOR PAIN
Mild non-opiod / (+/-) adjuvant
o Antidepressants --- phantom pain
o Anticonvulsant
Drug of choice for mild-moderate
Acetaminophen
NSAIDS -- mefenamic, ibuprofen, naproxen
Moderate weak opioid, (+/-) non opioid, (+/-) adjuvant
Severe - strong opioid, (+/-) non opioid, (+/-) adjuvant
12. Purpose of WHO analgesic ladder provides the health professionals with GENERAL PAIN
MANAGEMENT CHOICES based on the level of pain
13. Factors that determines the appropriateness & acceptability of pain management cultural
background
14. Wong baker face scale is used to : -- identify the intensity & severity of pain
15. Indication of wong baker faces scale
Children
Elderly & impaired cognition & communication
Patients who do not speak English
Patient unable to communicate discomfort verbally
16. Type of pain felt on a body part that is MISSING phatom limb pain
17. Pain felt around the affected part radiating pain e.g. angina pain
18. Pain felt away from the affected part referred pain
19. Brain hemisphere used in guided imagery Right brain hemisphere
20. Patient taking Zidovudine (AZT), Lab test to watch out WBC
21. s/s indicative of AIDS dementia complex - unsteady gait / incoordination
22. INFECTIOUS MONONUCLEOSIS (kissing disease), patient understands if she states?? -- I should
avoid PLAYING SOCCER
23. Route of transmission of HIV, no risk of exposure donation of a pint of whole blood
24. (+) diagnosis of HIV - (+) ELISA & western blot
25. Blood screening result for patient with AIDS decrease cd4 & T cell

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CD4 normal levels : 800 1200 cell / mm


<200 full blown aids
Nurse taking the BP of a patient with AIDS wash hands thoroughly
Common opportunistic infection in AIDS pneumocystis carinii pneumonia (PCP)
Nsg. Diagnosis for patient with PCP impaired gas exchange
common malignancy r/t AIDS KAPOSIS SARCOMA
confirmatory test for Kaposi - cutaneous pinch biopsy / skin biopsy
patient with aids is receiving palliative treatment
palliative care = no care
to decrease s/s
to relieve the clients discomfort
hospice care provide palliative care
palliation
promote death with dignity
ELISA determines presence of - HIV ANTIBODY
Patient requires hospice care 75 y/o with terminal metabolic cancer
Activity bests for clients with vaso occlusive crisis e.g. reynauds, buerguers DRAWING /
PAINTING
rationale: conserves oxygen
Positive effect of PTU (for hyperthyroidism) sleep pattern
Food for hypoparathyroidism spinach
Priority to assess for patient with pheochromocytoma (adrenal gland) hypertension
Initial sign of SIADH mental confusion
Insulin U-100 means - insulin contains 100 units/ml
Diagnostic test that doesnt require an informed consent EEG
Nursing intervention for EEG - shampoo the hair
Client is scheduled for EEG, food to avoid - cup of coffee (stimulant)
Side effect of epidural anesthesia - hypertension
Priority service in an urban poor community immunization
Personal protective equipment (PPE) that is considered 1st line of defense GLOVES
RA 7170 (organ donation act of 1991), which is NOT TRUE?? a minor cant donate any organ
Principle that supports the clients rights to self determination (AUTONOMY) consent
Client who doesnt have any risk for undergoing MRI 19 y/o with pierced ear
Emergency equipment at bedside
Patient with myasthenia gravis / multiple sclerosis / buillain barre syndrome TRACHEOSTOMY SET
Amputation tourniquet
Chest tube clamp
Sengstaken Blakemore tube scissors
Solutions to control odor of urine bag, pseudomonas infections, jellyfish sting vinegar
Management for tick bite use twizzers & PULL the tick slowly and gently
Management for snake bite
Assess the bite / fang mark
Do not cut, suck, apply tourniquet, wash instead
Essential component of therapeutic relationship empathy
To verify placement & correct position of TPN chest xray
TPN is inserted - subclavian vein
Tubings & filters are changed every?? 24 hours

57. TPN temporarily unavailable, what to give? D10W


58. Priority to monitor to patient with TPN hyperglycemia
Notes about TPN
BLOOD PRODUCTS ARE NOT INFUSED VIA TPN
Line can be used for medication administration e.g. insulin
Flush TPN line with NSS 20 ml
59. vegan diet - for 7th day Adventist / full vegetarian
60. disadvantage of vegan diet - b12 deficiency
61. halal diet for muslims; no pork, no gelatin and no alcohol
62. kosher diet for jewish; milk & meat should not be eaten together; should be eaten 6-12 hours
apart
63. stages of nursing practice patricia benner
64. no experience, limited, inflexible, governed by context free rules & regulation NOVICE
65. marginally acceptable performance with meaningful aspects of a real situation - advanced
beginner
66. 2-3 years of experience with organizational & planning ability competent
67. 3-5 years of experience uses maxims as guides & focuses on long term goals proficient
68. Performance is fluid, flexible & highly proficient & doesnt require rules, regulations & maxims to
provide appropriate actions EXPERT
69. Problems to be prevented in positioning
Fowlers position posterior flexion of lumbar curvature; hyperextension of neck;
hyperextension of knee; pressure on heels
Dorsal recumbent posterior flexion of lumbar curvature; external rotation of legs;
pressure on heels; hyperextension of knees
Prone flexion/ hyperextension of neck; hyperextension of lumbar curvature;
footdrop
Lateral position lateral flexion of neck; internal rotation & adduction of femur and
shoulder
Sims / semi prone lateral flexion of neck; foot drop; internal rotation of shoulder and
arm; internal rotation & adduction of femur
70. Statement TRUE about fear and anxiety anxiety is non-specific & fear is specific
71. Persons apprehension of physical contact constitutes ASSAULT
72. Cardioversion - synchronous / shock in R wave
73. Defibrillation asynchronous / shock anytime
74. BUERGUERS DISEASE thromboangitis obliterans
Cigarette smoking
Vasoconstriction = effect of c. smoking
Stop smoking = prevention
Common in males
75. REYNAUDS PHENOMENON
Stress and cold
Vasoconstriction
Common in females (young)
76. Hepa A transmission oral-fecal route
77. Hepa B transmission body blood secretions e.g. hemodialysis
78. Hepa c transmission blood transfusion
79. Hepa C is also known as post transfusion hepatitis

80. Initial sign of aspirin toxicity tinnitus


81. Antidote none
82. Aspirin toxicity management activated charcoal thru gastric lavage / dialysis for svere ASA
toxicity
83. Priority in antibiotic therapy allergic reaction
84. Cyclophosphamide (Cytoxan) & cysplatin (platinol) causes hemorrhagic cystitis
85. Vincristine (0ncovine) management increase fiber in diet
86. Iron supplementation best time to take empty stomach
87. How is best taken orange juice
88. Route for iron dextran z track IM ; no massage
89. Proper procedure of z track - simultaneously withdraw the needle & release the muscle
90. To give z track injection the nurse measures the correct medication dose and draws small
amount of air in the syringe to function as air lock technique
91. Function of air lock technique adding air prevents drug from flowing back into the needle
tract
92. Patient taking theophylline has 4.8 mcg/ml, the nurse should?? - increase the dose ; normal
level of theophylline is 10 19
93. s/s of theophylline toxicity nausea, diarrhea & GI disturbances
94. position of patient with impaired gas exchange high fowlers
95. patient with asthma has respiratory alkalosis, the RN should - instruct to breathe in a paper bag
96. patient given with ephedrine SO4 SQ, how soon the effect takes place? rapidly
97. s/s of lidocaine toxicity confusion & restlessness
98. patient with supplemental oxygen, the effectiveness is identified in ABG partial pressure of
artrial oxygen
99. patient with cystic fibrosis undergoing CPT, the RN should give CPT when? 2hours after meal
100.
priority nursing diagnosis for chest trauma impaired gas exchange