Exam 1: NSG233/ NSG 233 (New 2023/ 2024
Update) Med Surg 3 Exam| Guide with
Questions and Verified Answers| 100% Correct- Herzing
QUESTION
Triage
... [Show More] patients in the ED
Answer:
Use ESI (emergency severity index) tool
Responsibilities of triage nurse:
Assess, reassess, initiate treatment, manage and communicate, edu tients, transport them
QUESTION
Meds for managing sexual assault
Answer:
Prophylaxis for gonorrhea
Ceftriaxone + 1% lidocaine
Prophylaxis for syphilis and chlamydia: Single dose metronidazole
Single dose azithromycin
7-day oral regimen doxycycline
Anti-pregnancy:
Levonorgestrel and ethinyl estradiol
Give within 12-24 hours, no more than 72 hours post-intercourse
Antiemetic for side effects
QUESTION
Tension pneumothorax care
Answer:
Immediate needle decompression
Followed by chest tube insertion
S/S: chest pain, dyspnea, tachycardia, anxiety, air hunger, increased use of acces- sory muscles,
decreased/absent breath sounds on affected side, deviated trachea to unaffected side
QUESTION
Subcutaneous emphysema care
Answer:
Leaked air pockets under skin, feels like
"rice crispies"
Part of spontaneous pneumothorax
Not usually serious Report to provider Monitor airway
Absorbs once pneumothorax is treated
QUESTION
Intra-abdominal injury care
Answer:
Risk for hemorrhage - monitor for shock
Liver - right shoulder pain
Spleen - left shoulder pain
If stable --> CT
If unstable --> FAST exam (focused assessment with sonography for trauma) Management:
ABCs, C-spine precautions, NPO, antibiotics/tetanus, monitoring, surgery PRN
QUESTION
Pneumothorax assessment
Answer:
Tracheal alignment - midline (simple pneumoth- orax)
Chest expansion - decreased
Breath sounds - diminished/absent
Chest percussion - normal/hyper-resonant
QUESTION
Pneumothorax care
Answer:
Goal: to evacuate air/blood from pleural space
A small chest tube (28 Fr) is inserted near second intercostal space
If hemothorax, large tube (32 Fr or greater) is inserted in fourth or fifth intercostal space
Suction is applied
Pleural cavity is decompressed (drainage of air/blood)
QUESTION
Patient-controlled analgesia (PCA)
Answer:
Has programmable settings
Delivers morphine at a preset bolus
Can program a lockout period (control frequency)
HCP gives loading dose to attain therapeutic blood levels quickly (with continuous
IV infusion)
Assess pain scores after initiation, after any change in pump setting, and periodically
QUESTION
Assessment for appropriateness of PCA
Answer:
Pre-procedure cognitive assess- ment
If opioid-tolerant* or opioid-naive* Pain assessment
Sedation assessment (precedes resp depression) Respiratory assessment
*Tolerant - 60 mg for a week or longer
*Naive - less than tolerant criteria
QUESTION
Crush injuries
Answer:
At risk for rhabdomyolysis (crush syndrome) and compartment syndrome
Observe for: Hypovolemic shock Spinal cord injury
Erythema and skin blistering [Show Less]