Tag: Nursing

Under which section of the nutrition assessment would the patient be questioned about the use of herbal supplements?
a.Diet History
b.Social History
c.Medical and Medication History

The lower chambers of the heart are called the:
bicuspids
pericardia
ventricles
atria
Which of the following isn’t a vital sign?
respiration rate
blood pressure
muscle response
heart rate

The nurse anticipates which assessment finding in a patient 18 hours after kidney transplantation surgery?
Hypokalemia
Hyponatremia
Large urine output
Leukocytosis with cloudy urine

What would most likley be the position youwould transport a patient experiencing respiratory breathing issues?
A. Supine.
B. Fowlers.
C. Semi-fowlers.
D. Left lateral recumbant.

The model of health focuses on the diagnosis and treatment of physical diseases and symptoms. Select one:
medical
long term care
Stewart
public health
Brittmore

The nurse is caring for a client experiencing rencelcolic asseciated with nephrocithiasis. Which of thebllowing nursing measures should receive priority in the care of the client

What are the important criteria for selecting a patient for heart/lung transplantation? Include – indications, contraindications, and relative contraindications in the response.
Overview
Selection for heart or lung transplantation balances urgency of disease, likelihood of benefit, and transplant-related risks. Candidates undergo multidisciplinary evaluation (cardiology/pulmonology, transplant surgery, infectious disease, oncology, psychiatry/psychology, social work, rehabilitation and dietetics) to confirm indications and screen for contraindications or modifiable risk factors.
Indications
Heart transplant — common indications
Advanced, refractory heart failure despite optimal medical, device and revascularization therapy (NYHA class III–IV, recurrent hospitalizations for heart failure).
Progressive severe left ventricular dysfunction or cardiomyopathy with poor prognosis despite maximal therapy.
Recurrent ventricular arrhythmias not controlled by therapy and associated with significant hemodynamic compromise.
Patients requiring continuous inotropic support, mechanical circulatory support (MCS) as bridge to transplant, or with poor functional capacity (objective testing such as low peak VO2 often used).
Lung transplant — common indications
End-stage parenchymal lung disease with poor prognosis despite maximal therapy: examples include advanced idiopathic pulmonary fibrosis (IPF), cystic fibrosis (CF) with rapid decline, chronic obstructive pulmonary disease (COPD) with severe airflow obstruction and hypercapnia or recurrent exacerbations, and bronchiolitis obliterans syndrome after lung transplant (for retransplant).
Severe pulmonary arterial hypertension (group 1) with right heart failure or progressive symptoms despite medical therapy.
Progressive functional limitation (e.g., worsening exercise capacity, frequent hospitalizations, oxygen dependence) and poor expected survival without transplant.
Absolute contraindications
Current practices vary by center, but commonly accepted absolute contraindications include:
Active, uncontrolled infection (systemic sepsis or uncontrolled localized infection).
Active malignancy with significant recurrence risk (recent or untreated cancer). Many centers require a disease‑free interval (commonly 2–5 years depending on tumor type) before listing; certain low‑risk nonmelanoma skin cancers may be exceptions.
Severe, irreversible dysfunction of another major organ system (liver, kidney, brain) that is not correctable or not planned to be transplanted simultaneously.
Ongoing substance abuse (alcohol, illicit drugs) or active tobacco use without documented cessation and program participation.
Severe, uncontrolled psychiatric illness or inability to adhere to complex post‑transplant regimens.
Severe malnutrition or cachexia not amenable to optimization.
Uncontrolled HIV or other viral infections with high risk of progression (note: stable, treated HIV may be acceptable in selected centers).
Relative contraindications
Relative contraindications may be modifiable or evaluated case-by-case; many are managed pre‑listing or may influence candidacy rather than exclude it outright:
Advanced age: older age is not an absolute barrier at many centers but increases risk; thresholds vary (age >65–70 often considered higher risk).
Obesity (BMI thresholds vary; BMI >35 commonly increases perioperative risk and many centers consider it a relative contraindication until weight is reduced).
Significant frailty or poor rehabilitation potential.
Poor social support, unreliable caregivers, or demonstrated nonadherence to medical care.
Severe peripheral vascular disease or other comorbidities that markedly increase perioperative mortality.
High immunologic sensitization (high PRA, donor-specific antibodies) increases complexity—may be manageable but affects waitlist strategy.
Fixed, severe pulmonary hypertension in a heart transplant candidate that is not reversible with vasodilator testing—may favor combined heart‑lung transplant rather than isolated heart transplant.
Chronic infections with difficult organisms: e.g., certain Burkholderia cepacia complex species in CF may be centerspecific contraindications or require special consideration.
Recent malignancy with lower but nonzero recurrence risk—may require individualized assessment and disease‑free interval.
Key elements of pretransplant evaluation
Comprehensive cardiopulmonary testing: echocardiography, CT chest, pulmonary function tests, cardiopulmonary exercise testing (peak VO2), right‑heart catheterization when indicated.
Infectious disease screening: TB, hepatitis B and C, HIV, CMV, EBV and other regionally relevant pathogens; dental exam and eradication of dental foci.
Oncologic screening per age and risk (colon, breast, prostate, cervical, skin exams) and history‑directed cancer workup.
Nutritional, hepatic and renal function assessment; endocrine optimization (e.g., diabetes control).
Psychosocial assessment including adherence history, substance use screening, and evaluation of social supports and access to post‑transplant care.
Immunologic assessment: HLA typing and assessment of sensitization (PRA/DSA) to plan desensitization or listing strategy.
Rehabilitation and frailty assessment with plans to optimize physical conditioning pre‑transplant.
Special considerations
Combined heart‑lung transplantation is considered when both organs are irreversibly diseased (e.g., severe pulmonary vascular disease with irreversible damage to both heart and lungs).
Bridge strategies (mechanical circulatory support for heart, ECMO for lung) may be used to stabilize candidates while awaiting transplant; candidacy still requires assessment for eventual recovery and transplant benefit.
Center‑specific policies and local organ allocation rules strongly influence timing and eligibility; multidisciplinary case review is essential for borderline cases.
Summary
Appropriate selection requires confirming that the patient has end‑stage heart or lung disease likely to benefit from transplant, while excluding conditions that predict unacceptably high perioperative mortality, graft failure, or poor long‑term outcomes. Many contraindications are center‑dependent or modifiable; optimization and multidisciplinary evaluation are critical to convert relative risks into acceptable candidacy when possible.

The increased use of advance directives, such as do-not-resuscitate orders, has made discussions about end-of-life care much easier for patients and professionals alike.TrueFalse

Which adverse effects should be expected following an overdose of acetaminophen?
Chest pain and palpitations
Diarrhea and jaundice
Heartburn and hematemesis
Tinnitus and hearing loss

The doctor orders 0.1 mg/KG atropine IV for you bradycardic patient who weighs 130 pounds the atropine in your ambulance raise 1 mg/ML how many milliliters will you administer