1. Nurse Jojo is providing care for a 63 years old male who was diagnosed with Addison’s disease. What type of treatment should she expect the patient to have?
Rationale: Hormone replacement therapy and fluids for shock are treatments for Addison’s disease. Addison’s disease affects the adrenal glands, causing them to not produce enough cortisol and aldosterone. An example of a hormone replacement therapy for Addison’s disease is Hydrocortisone, which replaces the missing cortisol.
The first step is understanding how Addison’s disease affects the adrenal glands. The second step is understanding why hormone replacement therapy is necessary for Addison’s disease. If there are not enough cortisol and aldosterone being produced, which are hormones produced by the adrenal glands, then the treatment would be hormone replacement therapy.
If the patient experiences Addison’s crisis, fluids for shock would be required. Also, a patient with Addison’s disease would experience dehydration and fluids may be needed. A patient diagnosed with Addison’s diease would have increased thirst and would urinate frequently. Knowing the signs and symptoms would help one understand that fluids need to be ADDED for someone with Addison’s disease.
Dialysis treatments are for those with renal failure. Insulin is used to treat hyperglycemia. Glucose is used to treat hypoglycemia. Insulin and glucose would not be given together at the same time. Blood transfusion and oxygen are used to treat anemia, which causes someone to have shortness of breath and a lack of healthy red blood cells.
2. Which of the following inflammatory bowel disorder causes inflammation in the colon and rectum?
Rationale: Ulcerative colitis starts at the rectum and ascends towards the colon causing an inflammation. Systemic complications can occur, which contributes to the increasing mortality rate with ulcerative colitis.
Rectal bleeding, blood in diarrhea, weight loss, and abdominal cramping are signs and symptoms seen in ulcerative colitis. This chronic inflammatory bowel disorder can affect the patient for years or for an entire lifetime. If someone is experiencing rectal bleeding, bloody diarrhea, then one can associate these symptoms with abdominal cramping. Someone who is experiencing diarrhea may be experiencing weight loss due to the loss of fluids.
To diagnose ulcerative colitis, a colonoscopy or sigmoidoscopy may be ordered by the physician. Anti-inflammatories and antibiotics are used to treat ulcerative colitis.
Diverticulitis, gastroesophageal reflux disease (GERD), and gastric ulcer does not cause inflammation in the colon and rectum. Diverticulitis is an inflammation that occurs from food and bacteria getting trapped in the diverticula. GERD occurs when stomach contents ascends back up into the esophagus. This experience, known as acid reflux, occuring more than twice a week can indicate GERD. Gastric ulcer is not an inflammatory bowel disorder. Erosions in the gastric mucosa indicates gastric ulcer.
3. Nurse Jojo is assessing the 65 years old patient who is receiving meperidine (Demerol) via patient-controlled analgesia (PCA) to relieve pain post total knee replacement. Which of the following assessment finding should be reported to the physician?
Rationale: Respiratory rate of 10 breaths/min is an assessment finding that should be reported to the physician if the patient is taking meperidine (Demerol). The normal breath rate should be between 12-20 breaths/min. A respiratory rate off 22 breaths/min is a little higher than the normal breath rate, but would not be considered an assessment finding that needs to be reported to the physician.
Meperidine (Demerol) is a controlled substance that is used to treat moderate to severe pain. This pain relieving medication has a high risk for respiratory distress and can cause death when the dose is too high.
Someone reporting a pain score of 8/10 would be expected for someone who recently went through a total knee replacement, which is why meperidine (Demerol) is being administered in the first place. A normal pulse rate is 60-100 bpm. Tachycardia would be expected for someone who is experiencing pain.
4. Myopia, astigmatism, and hyperopia are examples of what type of eye disorders?
Rationale: Myopia, astigmatism, and hyperopia are examples of refractive errors, which occurs when the eye is not able to see clearly due to the shape of the eye not being able to bend light correctly. Blurry vision and headaches are common complaints associated with refractive errors.
Myopia is nearsightedness. Objects that are nearby are clear. Objects far away are blurry. Concave lens correct this type of refractive error.
Astigmatism causes blurry vision at both near and far distances. The light rays is refracted unequally due to this uneven surface of the cornea. If the cornea is not completely round, blurry vision is affected at all distances.
Hyperopia is farsightedness. Objects far away are clear. Objects that are nearby are blurry. Convex lens correct this type of refractive error.
Cataracts and glaucoma are examples of intraocular disorders, which are eye disorders that occur inside the eyeball.
Macular degeneration and hypertensive retinopathy are examples of retinal disorders, which are eye disorders that affect the innermost eye layer.
Contusions, lacerations, and foreign bodies are examples of traumatic injury, which occur from external factors causing injury to the eye(s). Only an ophthalmologist should remove objects that are protruding from the eye to prevent greater damage to the eye(s).
A way to remember the correct treatment for myopia is MY CAVE.
Myopia - concave lens.
Normal intraocular pressure is 10-21 mm Hg.