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HONDROS NUR 185 Exam 1 2025/2026 Adult
Health Nursing for the Practical Nurse II
Questions with Key Detailed Answers A+
Graded
What are the nursing interventions for Tracheostomy? Provide oxygen following trach suctioning. In what order do you suction a tracheostomy?
- Wash hands, wear a face shield, use sterile technique.
- Use lubricant.
- Oxygenate patient before suctioning.
- Apply suction intermittently while rotating catheter back & forth as it is withdrawn.
- Suction should be no more than 10-15 seconds.
- Rinse the catheter by suctioning normal saline through it
- Oxygenate patient again after suctioning.
How do you care for a tracheostomy?
- Use Standard Precautions
- Suction the tracheostomy before removing the old dressings.
- Don sterile gloves to remove and clean the inner cannula. (Note that the nurse does not remove the outer cannula.) 4 Use a sterile solution of normal saline or other solution per agency procedure to clean the inner cannula.
- Reinsert inner cannula in outer cannula.
- Change tracheostomy ties & dressings What are the nursing interventions for a ventilator?
- Provide the patient with a communication board.
- Provide suctioning PRN to prevent airway obstruction.
- Provide alternative means of nutrition via TPN or G-tube feeds per orders to meet patients' nutritional needs.
- Provide IV antibiotics to prevent ventilator associated pneumonia (VAP).
- Check patient's ventilator settings against orders. Timed-Cycled Ventilators Terminate or Control Inspriation after a present time---Volume of air regulated by length of inspiration and flow rate of air---Pure time cycled rarely used in adults, mostly in Newborns or Infants
CPAP (continuous positive airway pressure) Requires a mask during sleep. Maintains airway during & prevent apnea during sleep. Ventilator A Machine that delivers predetermine parentage of oxygen to assist for breathing. Chest Tube Drain inserted into chest cavity to re-expand the lung or for draining. Non-Rebreather Mask Delivers 100% oxygen to the patient. Set oxygen between 10-15 liters. What is the purpose of a chest tube? Used to drain air or fluid from the pleural spaces of the lungs.
What are the nursing interventions for a chest tube?
- Auscultate lung sounds.
- Keep drainage system upright on the floor.
- Mark drainage level on the chamber after each shift & chart output. What are the side effects for Theophylline Decreased perfusion Hypotension Dizziness What is Mucomyst (acetylcysteine) used for? Prevention of hepatotoxicity due to acetaminophen overdose. Prednisone Is a Steroid to help decrease inflammation. ( used to treat COPD & respiratory conditions)
- Thinning Hair
- Dry Skin What are interventions for a patient with hypothyroidism?
- Patient will need to follow a low calorie, high protein diet and participate in exercise due to lowered metabolism.
- Administer Synthroid (levothyroxine) on an empty stomach. What is the treatment for hypothyroidism? Synthroid (levothyroxine) Increases the production of thyroid hormone What are signs and symptoms of hyperthyroidism?
- Exophthalmos (bulging of the eyes)
- Weight Loss
- Hypertension
- Tachycardia
- Heat Intolerance (Excessive Sweating)
- Edema of the Neck
- Fine Tremors
- Insomnia
- Pretibial Myexedema What are the interventions for hyperthyroidism?
- Increase caloric intake due to increased metabolism.
- Administer radioactive iodine
- Surgical treatment for hyperthyroidism is thyroidectomy What are the signs and symptoms of Thyroid Storm ALL Signs & Symptoms of hyperthyroidism are present & magnified PLUS
- Cardiac Arrythmias
- Restlessness
- Extreme Hypertension
- Delirium
and palpitations. Cushing's disease In Cushing’s disease the pituitary gland is secreting too much ACTH which leads to an increase in cortisol production What are the causes of Cushing's disease?
- Endogenous (Internal): pituitary tumor or adrenal tumor
- Exogenous (External): prolonged administration of high dose corticosteroids What are the signs and symptoms of Cushing's disease?
- Buffalo Hump
- Hyperglycemia
- HypoKalmia
What is the treatment for Cushing's disease? surgical removal of tumor (Adrenalectomy) What are the nursing interventions for Cushing's disease?
- Monitor VS for signs & symptoms of shock
- Monitor intake & output
- Patient Education: Glucocorticoid replacement therapy will be required post-op What are the signs and symptoms of Addison's disease? Unexplained weight loss What is the patient education for Addison's?
- Wear a medical alert bracelet
- Take medications as directed
What is the treatment of a Addison's crisis?
- Hydrocortisone Administer intramuscularly
- IV Fluids
- Electrolyte Replacement Propranolol (Inderal) Beta-blocker. used to treat tremors, angina and hypertension. ( can cause a decrease in BP take before giving) Hydrocortisone A steroid used to treat Addison's disease. What can a LPN administer to an adult patient?
Normal saline A LPN cannot administer
- IV antibiotics or IVF to a peds patient
- heparin drip to an adult or pediatric patient What nursing intervention would you do if your patient's ventilator alarm keeps beeping and won't go off? Disconnect the vent tubing and give breaths with an ambu bag. What nursing interventions would you implement for a ventilator dependent patient?
- Make sure they're wearing their SCD's
- Limit suctioning to 30 seconds
- Don't put NS down NG tube- this can crystalize and cause a clog What is monitored with a patient who just had a thyroidectomy?
- S/S of hypocalcemia (Chvotek's/Trousseau and Laryngospasm)
- Assess for hemorrhage, resp distress, thyroid storm
- Monitor labs and incision site
- Hypotension- hypertension
- Thick coarse skin- thinning skin
- Hair loss
- Weight gain
- Deposits of adipose tissue in the trunk
- Moonface
- Buffalo hump
- Darkening of skin
- Stretch marks What is the treatment for Cushing's disease?
- Reducing steroid use
- Surgery
- Radiation
- Medication How do you test for Cushing's? Urinary free cortisol (UFC) determination What causes Cushing's? The overproduction of Cortisol
What is Addison's disease? The adrenal glands produce insufficient amounts of the hormone cortisol and sometimes aldosterone What causes Addison's? Occurs when there is damage to the adrenal glands causing adrenal insufficiency and low cortisol production. Usually caused by autoimmune disease How do you test for Addisons?
- Blood test. This test can measure blood levels of sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH). ...
- ACTH stimulation test. ACTH tells the adrenal glands to make cortisol. ...
- Insulin-induced hypoglycemia test. ...
- Imaging tests What do you monitor after administering Duoneb (Nebulizer Tx)?
- Assess lung sounds before and after tx
incision site for s/s infection and hemorrhage, breathing and airway How do you prevent VAP HOB 30-45 degrees, peptic ulcer meds, oral care Q2h, mouthwash chlorhexidine daily, sedation, scd's, antibiotics what labs do you monitor for hyperthyroidism TSH, T3, T Gold standard for hyperthyroidism radioactive iodine Meds used for hyperthyroidism PTU, tapazole pt with nausea, vomiting, diarrhea past 2 days, hr 100, bp 80/40 what would you anticipate to do IV fluids, NG tube, give meds to relieve symptoms
Pt teaching that is standard for preop what the surgery is going to entail, what to expect after surgery, SCD, using IS, splinting, ambulating, possible change in diet interventions for pt on ventilator educate pt and family, prevent infection, maintain airway, vitals Q2-4h which pt would you see first a. pt with COPD just finished a breathing treatment, r 20, they state they can't breath b. pt post op complaining of pain in leg c. pt. needing education on medication to take at home b. pt post op complaining of pain in leg which of the following will concern you the most in a pt doing a stress test:bp 140/70 hr 130, O2 sat 96% chest pain, sweating chest pain #1 priority for ventilator patients communication board
