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ATI Comprehensive Predictor Part 3

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This flashcard set highlights common comorbidities associated with bipolar disorder. It includes conditions like substance use disorder, anxiety disorders, eating disorders, and ADHD, which can complicate diagnosis and treatment.

What comorbidities may be observed with a patient who is bipolar?

Substance use disorder (experiences more rapid cycling), anxiety disorders, eating disorders, ADHD.

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Key Terms

Term
Definition

What comorbidities may be observed with a patient who is bipolar?

Substance use disorder (experiences more rapid cycling), anxiety disorders, eating disorders, ADHD.

What therapy will be useful for patients with bipolar?

Electroconvulsive therapy for the patient who is suicidal or rapid cycling who HAS taken Lithium and has proven ineffective. Used to subdue manic b...

What kind of medications are indicated for abstinence maintenance of alcohol?

Disulfiram (Antabuse), Naltrexone (Vivitrol), Acamprosate (Campral)

Teaching points for naltrexone (Vivitrol)?

Take with meals to supress GI distress. Monthly IM injections should be suggested for patients who have difficulty to adhering to the medication re...

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:
a) restrict fluid intake to 1 qt (1,000 ml)/day.
b) drink liquids only between meals.
c) don't drink liquids 2 hours before meals.
d) drink liquids only with meals.

B

A patient who has undergone colostomy surgery is experiencing constipation. Which of the following interventions should a nurse consider for such a patient?
a) Instruct the patient to keep a record of food intake
b) Instruct the patient to avoid prune or apple juice
c) Suggest fluid intake of at least 2 L per day
d) Assist the patient regarding the correct diet or to minimize food intake

C

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TermDefinition

What comorbidities may be observed with a patient who is bipolar?

Substance use disorder (experiences more rapid cycling), anxiety disorders, eating disorders, ADHD.

What therapy will be useful for patients with bipolar?

Electroconvulsive therapy for the patient who is suicidal or rapid cycling who HAS taken Lithium and has proven ineffective. Used to subdue manic behavior.

What kind of medications are indicated for abstinence maintenance of alcohol?

Disulfiram (Antabuse), Naltrexone (Vivitrol), Acamprosate (Campral)

Teaching points for naltrexone (Vivitrol)?

Take with meals to supress GI distress. Monthly IM injections should be suggested for patients who have difficulty to adhering to the medication regimen.

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:
a) restrict fluid intake to 1 qt (1,000 ml)/day.
b) drink liquids only between meals.
c) don't drink liquids 2 hours before meals.
d) drink liquids only with meals.

B

A patient who has undergone colostomy surgery is experiencing constipation. Which of the following interventions should a nurse consider for such a patient?
a) Instruct the patient to keep a record of food intake
b) Instruct the patient to avoid prune or apple juice
c) Suggest fluid intake of at least 2 L per day
d) Assist the patient regarding the correct diet or to minimize food intake

C

A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location?
a) Left lower quadrant
b) Left upper quadrant
c) Right upper quadrant
d) Right lower quadrant

D

Which outcome indicates effective client teaching to prevent constipation?
a) The client reports engaging in a regular exercise regimen.
b) The client limits water intake to three glasses per day.
c) The client verbalizes consumption of low-fiber foods.
d) The client maintains a sedentary lifestyle.

A

Patients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which of the following is a sign of potential hypovolemia?
a) Hypotension
b) Bradycardia
c) Warm moist skin
d) Polyuria

A

The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which of the following characteristics would the nurse be most likely to find?
a) Green color and texture
b) Black and tarry appearance
c) Clay-like quality
d) Bright red blood in stool

B

After teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders, the instructor determines that the teaching was successful when the students identify which of the following structures as possibly being affected?
a) Large intestine
b) Ileum
c) Stomach
d) Liver

C

A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission?
a) Skim milk
b) Nothing by mouth
c) Regular diet
d) Clear liquids

B

Bladder retraining for the treatment of urge incontinence:

• Use timed voidings to increase intervals between voidings/decrease voiding frequency.
• Perform pelvic floor (Kegel) exercises.
• Perform relaxation techniques.
• Offer undergarments while the client is retraining.
• Teach the client not to ignore the urge to void.
• Provide positive reinforcement as client maintains continence.
• Eliminate or decrease caffeine drinks.
• Take diuretics in the morning.

what are normal creatinine levels?
what are normal BUN levels?

0.8-1.4 mg/dL
8-25 mg/dL

What are total serum protein values (normals)

6-8 g/dL

Describe pre-albumin

this is the best tool for evaluating nutrition. it has a half-life of 2 days which is much shorter than albumin so it is much more accurate. (albumin's half-life is 2-3 weeks)

what is normal pre-albumin values?
what are normal serum levels of magnesium ?
what is a normal potassium serum level?

17-40 mg/dL
1.5-2.5 mEq/L (less than 1.5 is considered hypomagnesemia)
3.5-5.0 mEq/L (less than 3.5 is considered hypokalemia)

what are good sources of folic acid?

Excellent sources of folate include romaine lettuce, spinach, asparagus, turnip greens, mustard greens, calf's liver, parsley, collard greens, broccoli, cauliflower, beets, chicken liver and lentils.

Sources of potassium

beans, spinach, potatoes, dried apricots, acorn squash, yogurt, salmon, avocados, mushrooms and bananas

what is important about the diet of someone taking ACE inhibitors?

can result in high potassium levels. Limit potassium intake (beans, spinach, potatoes, dried apricots, acorn squash, yogurt, salmon, avocados, mushrooms and bananas)

Taking Coumadin. Which foods should the client limit?

Foods containing Vitamin K. Dark leafy greens (spinach), brussel sprouts, broccoli, asparagus, cabbage, pickels, prunes

what is a normal hematocrit level in a female?
What are normal Hgb values (female)?
what are normal values for WBCs?

37-48% (male is 42-52%)
12-16 g/dL (male 13-17)
4500-11,000 / uL

what foods should you avoid if you have diverticulitis?

avoid hard-to-digest foods such as nuts, corn, popcorn, and seeds, for fear that these foods would get stuck in the diverticula and lead to inflammation. (Eat foods high in fiber)

When taking MAOI's, limit your consumption of

thyramine--it can cause elevated BP. This is found in "aged" products such as aged cheeses (swiss), cured meats (pepperoni/salomi), sauerkraut, soy sauce...Examples of MAOI's are: Isocarboxazid (Marplan), Phenelzine (Nardil), Selogilive, Emsam, Eldepryl, Zelapar...

At what age does bone loss begin with osteoporotis
what are normal Calcium levels?

at age 35 (women)
8.6-10 mg/dL

A positive Chvosteks sign is found in a patient. The nurse would anticipate IV administration of

calcium gluconate (because hypocalcemia causes Chvostek's sign)

What are the S/S of lithium toxicity?
(depakote for bipolar disorder)

fine hand tremors, mild GI upset, slurred speech and muscle weakness

a nurse is obtaining a medication history from a client who is to start a new prescription for warfarin ( Coumadin) . which of the following over the counter medication should the nurse instruct the client to avoid

Aspirin

a nurse responsible for a client receiving a antihypertensive medication is to

teach the client to change position slowly to avoid dizziness or fainting

a client should receive a dose of flumazenil (romazicon) to treat symptoms of

benzodiazepine overdose

a nurse is reinforcing teaching to a client who is prescribed diazepam tor anxiety of the following statement indicated the client understand the teaching

I will tell my doctor before I stop taking the medication

a nurse is reinforcing teaching to a client who is starting amitriptyline (Elavil) for treatment of depression which of the following should the nurse include

1. change position slowly to minimize dizziness
2. chewing sugarless gum to prevent dry mouth

a client who is start taking lithium carbonate month ago tell the nurse she has just begun taking multiply daily doses of ibuprofen ( motrin) for tension headache. should the client avoid ibuprofen. why or why not ?

what , if any is the appropriate action for the nurse to take NSAIDS such as ibuprofen increase the renal reabsorption of lithium carbonate , possibly leading to lithium carbonate toxicity . therefor this client would avoid NSAIDS . the nurse should notify the provider of client headache and ibuprofen us

a client has prescription for valproic ( Depakote) which of the following laboratory value should the nurse anticipate monitor for the client taking this medication

thrombocytes, amylase count and liver function test

alcohol withdrawal
heroin withdrawal
nicotine withdrawal
alcohol abstinence
opioid over dose

chlordiazeproxide( Librium)
methadone( dolophine)
bupropion ( wellbutrin)
disulfiram ( antabuse)
naloxone (narcan)

a client who has parkinson's disease is prescribed levodopa/carbidopa (sinemet) and pramipexole ( Mirapex) for which of the following should the nurse monitor this client

orthostatic hypotension

a nurse is preparing to care for a client in the surgical unit who will be receiving lorazapam (ativan IV) . for what adverse effect should the nurse monitor this client

the nurse should monitor the client respiratory depression

a client has a new prescription for spironilactone ( aldactone ) which of the following laboratory value should the nurse recognized as a reason to withhold the morning dose of the medication and notify the provider

serum potassium 5.2

a nurse is caring for a client who prescribed daily dose of both digoxin ( llanoxin ) and furosemide ( Lasix) . the client potassium level 3.2 mEq/L for which of the following medication interaction is the client at risk

Toxic level of digoxin

a nurse is reinforcing a teaching on a client who has a prescription for verapamil ( calan) which of the following statement by the client indicated need further teaching

i should decrease the amount of calcium in my diet while taking the medication

A nurse is caring for an older adult client who ahs a new prescription for digoxin and takes multiple other medications. Concurrent use of which of the following medications places the client at risk for digoxin toxicity?

* Verapamil (Calan)

Adverse effect of Verapamil

Avoid grapefruit juice

Interaction of diuretics and ACE inhibitors

excessive reduction in blood pressure and symptomatic hypotension or hyperkalemia

What can prevent MI, stroke, or death in high-risk patients

Ramipril

What to monitor for when taking enoxaparin (lovenox)

Hyperkalemia

Cases of headache, hemorrhagic anemia, eosinophilia, alopecia, hepatocellular and cholestatic liver injury reported

What are the therapeutic effects of protamine

Antidote to severe heparin overdose + Reversal of heparin administered during procedures

How to prevent adverse effects of oxycodone

can cause respiratory depression.

What is the nursing intervention and/or client education ? Monitor vital signs.
› Stop opioids for respiratory rate less than 12/min, and notify the provider.
› Have naloxone and resuscitation equipment available.
› Avoid use of opioids with CNS depressant medications (barbiturates,
benzodiazepines, consumption of alcohol).

opioid agonists can cause Constipation
What is the nursing intervention and/or client education ?

Advise the client to increase fluid/fiber intake and physical activity.
› Administer a stimulant laxative such as bisacodyl (Dulcolax) to counteract
decreased bowel motility, or a stool softener such as docusate sodium (Colace)
to prevent constipation.

Adverse effects of ferrous sulfate

constipation;
upset stomach;
black or dark-colored stools; or.
temporary staining of the teeth.

Baclofen (Lioresal) therapeutic outcome:

Decrease the frequency and severity of muscle spasms (MS).

What is the difference between respiratory acidosis and respiratory alkalosis?

Acidosis refers to an excess of acid in the blood that causes the pH to fall below 7.35, and alkalosis refers to an excess of base in the blood that causes the pH to rise above 7.45.

Bowel elimination how to get a specimen collection

Collect stool specimens for serial fecal occult blood (guaiac) testing 3 times from 3 different defecations. Stool samples should come from fresh stools that are not contaminated with water or urine.

Identifying manifestations of transient ischemic attacks

symptoms r/t afffected area. Rapid onset of weakness, numbness, aphasia, visual field cuts. 1-2 clusters before stroke.

Musculoskeletal congenital disorders

Monitor skin for breakdown areas and prevent pressure sores.

The nurse caring for a child in Buck's skin traction will keep the:

Child pulled up in bed

Where should the cath bag be placed when urinary catheterization

Make sure the catheter bag/system is at a level below the client's bladder to avoid reflux.

What are the signs and symptoms of fluid volume deficit

loss of total body Na. Causes include vomiting, excessive sweating, diarrhea, burns, diuretic use, and kidney failure. Clinical features include diminished skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension.

What is the nursing action for dehiscence

Cover with a sterile towel moistened with sterile saline; Have patient flex knees slightly and put in Fowler's .