Tag: Nursing

Explain the pathophysiology of each of the following clinicalmanifestations in this patient.a. spider angiomasb. gynecomastiac. splenomegalyd. edemae. jaundice and icteric sclera
Spider angiomas
Result from cutaneous arteriolar dilation and formation of telangiectasias driven by increased circulating estrogens (reduced hepatic metabolism of estrogens) and local vasodilators (e.g., nitric oxide, VEGF). Portosystemic shunting in chronic liver disease also contributes by allowing vasoactive substances to bypass hepatic clearance.
Gynecomastia
Occurs because impaired hepatic metabolism raises circulating estrogens and alters the estrogen:androgen ratio (and sometimes decreases testosterone production or increases SHBG), leading to proliferation of glandular breast tissue in men.
Splenomegaly
Portal hypertension causes increased pressure in the splenic vein and congestive enlargement of the spleen (congestive splenomegaly). This leads to sequestration of blood cells and reticuloendothelial hyperplasia, often producing hypersplenism and cytopenias.
Edema
Multifactorial: hypoalbuminemia from reduced hepatic synthesis lowers plasma oncotic pressure; portal hypertension increases hydrostatic pressure in splanchnic and systemic capillaries; and activation of renal sodium/water retention mechanisms (RAAS, sympathetic tone, ADH) promotes fluid accumulation in interstitial spaces.
Jaundice and icteric sclera
Reflect elevated plasma bilirubin due to impaired hepatic uptake, conjugation, or excretion (hepatocellular injury and/or cholestasis). Accumulated bilirubin deposits in elastin-rich tissues (sclera) producing icterus; the pattern of conjugated vs unconjugated bilirubin helps indicate the underlying defect.

In patients taking warfarin, dietary intake of which vitamin should be monitored closely, as it can affect the drugs effectiveness?
a) Vitamin C
b) Vitamin A
c) Vitamin D
d) Vitamin K

ICD-10-CM Guidelines for Coding and Reporting should be used when coding from ICD-10-CM.
a. companion document
b. CAC software application
c. encoder

Health threats in military operations include the following; Select all that apply
A. Climatic or environmental extremes
B. Endemic disease
C. Paranoia
D. Obesity
E. Sleep deprivation

A patient over 65 has Medicare and sees a physician for a yearly physical. Which part of Medicare would cover this service?
Group of answer choices
Part B
Part D
Medicare Advantage
Part A

1. What are common potentially serious complications for patients undergoing joint replacement surgery? Circle all that apply.
Hemorrhage
Infection
Pain
Thrombo embolism

hich potential issue would be the most likely scenario the nurse should be prepared for at the delivery for this patient?
Shoulder dystocia
Resuscitation
Hemorrhage
Stat cesarean delivery

One key factor in creating habits includes the following: It has to occur on a regular schedule, the same day(s), at the same time, for the same duration.✓ Select an optionTrueFalse
Select an option
True
False

Mr. Neviaser requires which initial nursing approach due to his paranoia?
A warm and close approach
Firm limits
Respect for boundaries and limits
Maintenance of a great deal of distance

Question 48 (2 points)
The Patient Self-Determination Act (PSDA) is to ensure that a patient’s rights of free choice in health care decisions are communicated and protected.TrueFalse
Select an answer
True
False