Hesi Milestone 2 Blueprint V2 (Latest 2023/ 2024) |Guide with Verified Answers|100% Correct
QUESTION
Thrombocytopenia labs -
Answer:
A. CBC
-Plat... [Show More] elet count (low) (less than 100,000) B. PT/PTT
-Coagulation tests (60-70 secs) HgB Women 12-15.5
Men 13.5 - 17.5
HCT Women 35-49
Men 39-50
Ï Excessive bruising, bleeding, and petechiae are seen with platelets below 20,000.Ï Spontaneous and potentially fatal CNS or GI hemorrhage are seen when the platelet count is less than 5000.
Ï Treat with steroids and platelets (when life-threatening).
Ï Platelet count less than 15,000 platelets per microliter lower than normal; if your platelet count falls below normal, you may have thrombocytopenia
Ï Risk for serious bleeding doesn't occur until the count becomes very low - less than
10,000 or 20,000 platelets
QUESTION
Asthma-leukotriene inhibitors -
Answer:
Leukotriene inhibitors are potent bron- choconstrictors that also dilate blood vessels and altar permeability.
Action: Leukotrienes exert their action by interfering with leukotriene synthesis or by blocking receptors.
Alternative treatment to inhaled corticosteroids for mild persistent asthma or added to inhaled corticosteroids for severe asthma.
Singular (Montelukast). Accolate (Zarfirlukast). Zyflo (Zileuton).
QUESTION
Asthma Inhaler-
Answer:
Metered dose inhalers (MDI):
Short-acting beta-2-adrenergic agonists (SABAs) (e.g., albuterol, levalbuterol, pirbuterol) are the medications of choice for relief of acute symptoms and prevention of exercise-induced asthma. They are used to relax smooth muscles. Anticholinergics (e.g., ipratropium): These may be used in patients who do not tolerate short-acting beta-2-adrenergic agonists.
Long-acting control- Corticosteroids are the most potent and effective anti-inflam- matory medications currently available.
QUESTION
Transfusion action -
Answer:
Stop the transfusion. Maintain the IV line with normal saline solution through new IV tubing, given at a slow rate.
Assess the patient carefully. Compare the vital signs with baseline, including oxygen saturation. Assess the patient's respiratory status carefully. Note the presence of adventitious breath sounds; the use of accessory muscles; extent of dyspnea;
and changes in mental status, including anxiety and confusion. Note any chills, diaphoresis, jugular vein distention, and reports of back pain or urticaria.
Notify the primary provider of the assessment findings, and implement any treat- ments prescribed. Continue to monitor the patient's vital signs and respiratory, cardiovascular, and renal status.
Notify the blood bank that a suspected transfusion reaction has occurred. Send
the blood container and tubing to the blood bank for repeat typing and culture. The patient's identity and blood component identifying tags and numbers are verified.
QUESTION
Sickle cell signs of crisis-
Answer:
Vasoocclusive crisis; the classic signs include the following: (FAHS)
1.F-Fever.
2.A-Arthralgia
3.H-Hand-foot syndrome (infants); painful edematous hands and feet.
4.S-Severe abdominal pain.
Sudden pain, chest pain, shortness of breath, nausea, vomiting, and unusual headaches.
QUESTION
Infant Congenital Heart Defect - assessment -
Answer:
A). Manifestations of CHD
1.Murmur (present or absent; thrill or rub)
2.Cyanosis, clubbing of digits (usually after age 2)
3.Poor feeding, poor weight gain, failure to thrive
4.Frequent regurgitation
5.Frequent respiratory infections
6.Activity intolerance, fatigue
B). The following are assessed:
1.Heart rate, rhythm, and heart sounds
2.Respiratory status/difficulty
3.Pulses (quality and symmetry)
4.Blood pressure (upper and lower).
-First sign: Feeding difficulties; tires easily. Lab and Diagnostic tests:
-Echocardiography (use of structure and motion of heart),
-Electrocardiogram (EKG)- indicating R ventricle hypertrophy
-Cardiac catheterization and angiography- reveal the extent of structural defects
-Increased HCT, HGB, and RBC indicate polycythemia
QUESTION
Respiratory Syncytial Virus (RSV) distress-
Answer:
Fast belly breathing, grunting,
wheezing, flaring nostrils, retraction, fever,
cyanosis, lethargy.
Nursing Assessment
A. History of upper respiratory symptoms
B. Irritable, distressed infant
C. Paroxysmal coughing
D. Poor eating
E. Nasal congestion
F. Nasal flaring
G. Prolonged expiratory phase of respiration
H. Wheezing, rales can be auscultated
I. Deteriorating condition that is often indicated by shallow, rapid respirations
Nursing Plans and Interventions
A. Isolate child (isolation of choice for RSV is contact isolation).
B. Assign nurses to clients with RSV who have no responsibility for other children to prevent virus transmission.
C. Monitor respiratory status; observe for hypoxia.
D. Clear airway of secretions using a bulb syringe for suctioning. E. Provide care in mist tent; administer oxygen as prescribed.
F. Maintain hydration (oral and IV fluids).
G. Evaluate response to respiratory therapy treatments.
H. Administer palivizumab to provide passive immunity against RSV in high-risk children (younger than 2 years of age with a history of prematurity, lung disease, or congenital heart disease [CHD]).
HESI Hint
Severe cases of RSV may have to be treated with ribavirin. Ribavirin is a Pregnancy
Category X medication; pregnant mothers of children receiving ribavirin inhalation therapy and nurses who may be pregnant should not be exposed to the ribavirin aerosol.
QUESTION
Pyloric stenosis symptoms -
Answer:
A. Usually occurs in first-born males.
B. Vomiting (free of bile) usually begins around the third to sixth week of life (rarely seen in children over three years old). Projectile vomiting occurs within minutes after eating.
C. Hungry, fretful infant.
D. Weight loss, failure to gain weight.
E. Dehydration with decreased sodium and potassium.
F. Metabolic alkalosis (decreased serum chloride, increased pH, and bicarbonate or
CO2 content).
G. Palpable olive-shaped mass in the upper-right quadrant of the abdomen. H. Visible peristaltic waves. [Show Less]
