Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing classes exams > Adult Health one - exam #4 > Flashcards

Adult Health one - exam #4 Flashcards

comprehensive portion/ Diabetes/ Fluid electrolyte balance& acid base balance/ Perioperative & thermoregulation

1
Q

Ph value for arterial blood gases

A

7.35-7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does a low pH indicate relating to the hydrogen ions?

A

the higher level of ions in blood or fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does the body regulate Acid-Base Balance

A

the first line of defence is the binding to hydrogen ions with excess acids also called the ACID-BASE BUFFER SYSTEMS

Respiratory system eliminates or retains CO2

Renal system (kidneys) very slow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acid

A

release hydrogen ions in body fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Base

A

binds with hydrogen ions in body solutions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what type of body system acts withing seconds/minutes to regulate acid-base balance

A

Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

normal range of PaCO2 for ABG

A

35-45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PaO2 arterial blood gas range

A

80-100 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HCO3 (bicarb)

A

21-28 MEQ/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SaO2 normal parameters ABG

A

95%-100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Base excess Normal parameters ABG

A

-2 to +2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what indicates Metabolic

A

Ph and bicarb HCO3 the same raised or low
ROME

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What indicates respiratory from arterial blood gases

A

PH is opposite from Co2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the normal parameters for osmolarity

A

270-300mOsm/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a high osmolality level

A

> 300 mOsm/L
could indicate salty and possible dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a low Osmolality concentration

A

<270 mOsm/L
indicates fluid overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Positively charged ions are cations examples of cations are

A

K+,NA+,Mg+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Negatively charged ions are anions examples include

A

Cl-, ioide-, HCO3-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what percentage of the body is composed of water

A

males 60%
females 55%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are examples of filtration in the body?

A

Kidneys and Capillary beds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are examples of isotonic iv fluids

A

Normal saline, 0.9% sodium chloride, lactated ringers solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what type of patients would you use isotonic solutions for

A

Hypotensive and Hpovolemic states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why are older adults at an increased risk of fluid overload with isotonic solutions?

A

due to not always having net movement across the membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are some examples of hypertonic iv fluids

A

4% sodium chloride

D5NS (5% dextrose in normal saline)

D5LRS ( 5% dextrose in lactated ringers solution)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does hypertonic solutions do to the cell

A

they pull fluid from the cell and is used in patients hyponatremia, elevated cranial pressure or cerebral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what do you watch for with hypertonic iv solutions

A

intravascular overload (edema, crackles in lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hypotonic Iv fluid solution examples

A

0.45% normal saline or 1/2 NS

D5 0.45% NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what type of patients would hypotonic solutions be used in patients

A

intracellular dehydration DKA, hypernatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the 3 processes associated with fluid homeostasis

A

Fluid intake & absorption/
Fluid distribution/
Fluid Output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is Dehydration

A

Fluid intake is less than what is needed

Fluid loss from ECF

Circulating Blood volume is decreased

Older adults- high risk for dehydration

net fluid negative balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is fluid overload

A

an excess of body fluid intake/inadequate excretion of fluids

fluid/intake or retention is less than the body’s needs

Hypervolemia-excessive fluid in the ECF

can affect the cardiac/pulmonary/renal system mostly older adults

net fluid positive balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the most critical electrolytes for homeostasis

A

Ca+, K+, MG+, and NA+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hyperkalemia

A

what is it? potassium level higher than 5
what does it look like? N/V, abdominal cramps
DYSRHYTHMIAS-talll t waves
what causes it? renal failure, acidosis, burns., starvation, med
how does the nurse treat it?
Kayexalate, furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hypokalemia

A

what is it? <3.5 K+

what does it look like? decreased bowel sounds, muscel cramps & weakness, shallow breathing

what causes it? diuretics, alkalosis

what does the nurse do for it? administer K+ replacement IV or PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Hypernatremia

A

What is it?
Na >145

What does it look like? excessive thirst, elevated temp, dry, sticky, membranes, restlessness

what causes it? Diarrhea, impaired thirst DKA

how does the nurse treat it? give hypotonic iv fluid solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hyponatremia

A

what is it? low sodium levels of <136

What does it look like? weakness, fatigue, N/V, anorexia, abdominal cramps
headache, confusion, lethargy, muscle twitching,, tremoes

what causes it? diurteic therapy, vomiting, diarrhea, excessive GI suctioning, CHF

what does the nurse do for it? administer Normal saline to restore balance and in extreme cases administer 3% sodium chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what happens if the sodium level is <115

A

leads to seizure coma and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Hypercalcemia

A

What is it? Ca >10.5

what does it look like? fatigue, muscle weakness, headache, confusion, lethargy

what causes it? bone cancer and excessive calcium supplements

how does the nurse treat it? Discontinue calcium supplements and a low calcium diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are the 2 signs of hypocalcemia upon physical assessment

A

Chvostek’s and trousseaus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Hypermagnesemia

A

what is it? >2.1

what does it look like? flaccid muscle tone

what causes it? renal disease and excessive magnesia medication

how does the nurse treat it? discontinue the medication containing magnesium and treat with calcium gluconate, dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Hypomagnesemia

A

what is it? <1.3

what does it look like? muscle cramps, tremors, positive chvostek signs

what is the cause? malabsorption in the gut poor diet

how does the nurse treat it? Magnesium replacement IV or PO

when magnesium is low check the potassium and calcium levels because they are best of friends they hang out together all the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Hyperchloremia

A

what is it? >106

what does it look like? fatigue or weakness, excessive thirst, dry mucous membranes

what causes it? diuretic therapy, vomiting &dehydration, too much IV saline
solution

how does the nurse treat it? Iv solutions, stopping IV fluids that contain NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Hypochloremia

A

what is it? <98

what does it look like? weakness, fatigue, difficulty breathing

what causes it? fluid loss, CHF, diarrhea, vomiting, metabolic alkalosis, laxatives

what does the nurse do for it? IV fluids, treat the underlying problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

normal glucose parameters

A

74-106 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Hypoglycemia

A

what is it? blood sugar less than 74 mg/dl

what does it look like? lethargy, shakiness, confusion, diaphoresis

what causes it? type 1 diabetes mellitus/ pancreas unable to secrete insulin

what does the nurse do to treat it? glucose foods, IVFs containing dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Hyperglycemia

A

what is it? >106 mg/dL

what does it look like? increased thirst, increased urination, feeling hungry, blurred vision,

what causes it? stress, illness, certain medications, diabetes, DKA

what does the nurse do to treat it? give insulin, treat underlying cause, in some cases it will resolve on its own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what are the different diagnostic tools to asses for diabetes

A

Glycosylated hemoglobin (A1C)

fasting blood glucose (FBG)

Oral glucose tolerance test

Prediabetic -BMI greater than 25 kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what are the A1C values regarding diagnosis of diabetes

A

normal range: 4%-5.7%

Prediabetes range: 5.7%-6.4%

Diabetes: >6.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what are the fasting blood glucose ranges regarding the diagnosis of diabetes

A

Normal range: 74-106

Prediabetes: 100-125

Diabetes: >126

49
Q

what would the range be for a diagnosis of diabetes regarding the oral glucose test

A

greater than or equal to 200 mg/dL

Prediabetic 140-199 mg/dL

50
Q

Diabetes Mellitus type 1

A

what is it?

what does it look like?

what causes it?

how do you treat it?

51
Q

Diabetes Mellitus Type II

A

what is it?

what does it look like?

what causes it?

How do you treat it?

52
Q

what is part of glucose imbalance

A

Polyuria, Polydipsia, Polyphagia

53
Q

What BMI indicated prediabetic

A

greater than 25 kg

54
Q

what are some acute complications of diabetes Mellitus

A

Hypoglycemia, Hyperglycemia

55
Q

What are the chronic complications of diabetes mellitus

A

Macrovascular conditions cardiovascular disease

56
Q

what are the microvascular complications

A

Eye/Vision Diseases - Diabetic Retinopathy / Diabetic Peripheral Neuropathy / Diabetic Autonomic Neuropathy / Diabetic Nephropathy / cognitive dysfucntion

57
Q

what is an oral drug therapy

A

Metformin
Adverse reactions: lactic acidosis
Contraindications: kidney disease, liver disease, or heart failure

58
Q

what is the sick day rules regarding diabetic patients

A

Notify Phyisician/ monitor blood glucose at least every 4 hours/ Continue to take insulin or other antidiabetic agents, unless instructed otherwise by physician/ Drink 8-12 oz of sugar free liquids every four hours while awake or drink clear fluids that contains sugar is blood sugar remains low/ continue to eat meals at a regular time/get plenty of rest

59
Q

when do you call the physician when sick for diabetic individuals

A

persistent nausea and vomiting/ moderate or high ketones/ temp above 101.5 or increasing fever/ treat diarrhea, nausea, vomiting

60
Q

what would be an important thing to assess with nursing process pertaining to diabetes

A

Outwards signs of complications associated with DM1 & DM2 / Medications/ Diet esp carb intake/ weight gain/loss/ exercise/ urine output

61
Q

what happens with a patient on Metformin mixed with contrast dye

A

pose a risk of kidney injury and exacerbate metformin-induced lactic acidosis

62
Q

adverse reaction of hypoglycemia

A

dizziness, weakness, difficulty walking or seeing clearly, confusion, unusual behavior, loss of coordination

63
Q

Rapid acting -lispro

A

onset: 15-30 minutes
duration: 3-6 hours
peak : 1/2 an hour to 2.5 hours

64
Q

Short acting- regular human insulin injection

A

Onset: 30-60 minutes
Duration: 6-10 hours
Peak: 1-5 hours

65
Q

Intermediate acting- isophane Insulin (NPH)

A

Onset: 60-120 minutes
Duration: 16-24 hours
Peak: 6-14 hours

66
Q

Long Acting - Lantus

A

Onset: 70 minutes
Duration: 18-25 hours
Peak: none

67
Q

Malignant Hyperthermia

A

what is it? genetic disorder that produces a life-threatening hypermetabolic state
What does it look like? hypercarbia (increased co2), tavhycardia, muscle rigidity, rhabdomyolysis, and hyperthermia

what causes it? patients exposure to certain anesthetic agents such as succinylcholine and anesthetic gases

what does the nurse do for it? administer Dantrolene recognize early signs of MH, be familiar with your institutions protocol, review the patient’s history

68
Q

what is the perioperative team consist of

A

perioperative nurse, respiratory therapist, surgeon, Anesthesia personnel

69
Q

what is the intraoperative team

A

Circulating RN, anesthesia provider, Surgeon, first assistant, surgical technologist, Perfusionist, environmental services

70
Q

who is part of the postoperative team

A

Recovery room RN, Respiratory Therapist, Surgeon, Anesthesia Provider

71
Q

what diagnostic test is usually ordered for preoperative on patients over the age of 50
and
who determines the diagnostic test be ordered

A

chest X-ray and EKG

Ordered by the surgeon and anesthesia provider

72
Q

what are the safety protocols for preoperative

A

HandOff Reports, Pre-procedure verification process, surgical time outs

73
Q

what level of classification is a patient that is healthy

A

ASA I

73
Q
A
74
Q

what is an example of a patient with a mild systemic disease

A
75
Q

what level of classification is a patient with a mild systemic disease

A

ASA II

76
Q

what level of classification is a patient with a severe systemic disease

A

ASA III

77
Q

What is an example of a patient with a severe systemic disease

A
78
Q

what is an example of a patient with a life-threatening severe illness and level of classification

A

ASA IV

79
Q

What is ASA V

A

Patient is not expected to survive more than 24 hours unless surgery occurs

80
Q

What is ASA VI

A

brain dead

81
Q

the patient is brain dead how would that be classified part of ASA physical status classification system

A

ASA VI

82
Q

what is a laryngeal mask airway

A

anesthesia provider chooses airway management device

Inserted into pharynx, forms seal around laryngeal inlet, creates positive-pressure ventilation

83
Q

What is an endotracheal tube

A

inserted through vocal cords into trachea

84
Q

what are the common medications in the operating room

A

Antiemetics, Nonopioid analgesics, Anxiolytics, Opioid analgesics, general anesthetics, antibacterial drugs

85
Q

what are the different type of surgical procedures

A

Reconsrtuctive, Diagnostic, Elective, Emergency, Palliative, Transplant

86
Q

what is an example of a reconstructive surgery

A
87
Q

what is an example of a diagnostic surgery

A
88
Q

what is an example of a elective surgery

A
89
Q

what is an example of a emergency surgery

A
90
Q

what is an example of a palliative surgery

A
91
Q

what is an example of a transplant surgery

A
92
Q

what is the surgical wound classification

A

Class I, Class II, Class III, Class IV

93
Q

What is Class I

A

Clean

94
Q

what is Class II

A

Clean contaminated

95
Q

what is Class III

A

Contaminated

96
Q

what is Class IV

A

Dirty, Infected

97
Q

what is the purpose of surgical wound classification

A

Predicts risk of surgical site infection, breaks in sterile technique increase level

98
Q

what is surgical postioning and why is it important

A

the position for providing exposure to the surgical site
-joints and nerves must be protected during movement and final positioning
-padding is used under pressure points to prevent nerve injuries and to protect the skin
-proper positioning and padding of the patient is extremely important to patient safety and ptimal surgical outcomes

TO PREVENT NERVE DAMAGE

99
Q

what are potential intraoperative complications

A

hypovolemia, Hypervolemia, Hyponatremia, Hypernatremia, Hypokalemia, Hyperkalemia, Increased Intracranial pressure, Hypothermia, Hyperthermia, Malignant Hyperthermia

100
Q

Implmentation tactics for heat exhaustion

A

-Stop physical activity, move to a cool place
-Cooling measures on neck, chest, abdomen, groin
-soak in cool water or fan while spraying water on skin
-Remove constricitve clothing
-Provide sports drink or oral rehydration therapy because plain water can worsen the sodium deficit
-DO NOT GIVE SALT TABLETS
-Call ambulance to transport to hospital if symptoms persist

101
Q

Nursing process Heat exhaustion

A

-Monitor vital signs
-rehydrate with IV 0.9% saline as prescribed
-draw blood for serum electrolyte levels

102
Q

non exertional Heat stroke

A

what is it? a medical emergency humid conditions from over a period of time from chronic exposure to humid conditions

What does it look like? body temperature 40 degrees Celsius or 104 degrees Fahrenheit, mental status change, Hypotension, tachycardia, tavhypnea, elevated cardiac troponin

what causes it? prolonged exposure to humid conditions

how do you treat it? Oxygen, at least one large bore need or cannula infusing NS as prescribed (cooled if possible), cooling blanket, lab tests, rectal probe to measure core temperature

103
Q

Exertional Heat stroke

A

what is it? sudden, onset, from strenuous activity in hot humid conditions

what does it look like? elevated body temperature of 104 degrees Fahrenheit or 40 degrees celsius , mental status changes, confusion, bizarre behaviot, seizures, coma, , Hypotension, tachycardia, tachypnea, elevated cardiac troponin

what causes it? physical activity in hot humid conditions

how does the nurse treat it?
analyzes electrolyte serum levels for assessment, administers oxygen while monitoring the airway, infuse NS as prescribed through a large bore needle or cannula and use a cooling blanket on the patient

104
Q

Heat exhaustion

A

what is it? results primarily from dehydration

what does it look like? flu-like symptoms (headache, weakness, nausea, vomiting, Body temperature may not be elevated) if left untreated can lead to heat stroke becoming a medical emergency

what causes it? heavy perspiration and inadequate fluid and electrolyte intake

how does the nurse treat it? cooling measures on neck, chest, abdomen, groin / monitor vital signs / rehydrate with IV 0.9% saline as prescribed/ draw blood for serum electrolyte analysis

105
Q

what do you teach your patient such as a homeless person to avoid cold-related injuries

A

to wear synthetic clothing, to strictly avoid cotton in cold weather, to layer clothing, to wear a hat, to avoid heat loss through the head, to refrain from restricting food or fluid intake

106
Q

what are the different classifications of hypothermia

A

Mild 90-95 degrees Fahrenheit to 32 to 35 degrees Celsius

Moderate: 82.4-90 degrees Fahrenheit or 28-32 degrees Celsius

Severe: Below 82.4 degrees Fahrenheit or < 28 degrees Celsius

107
Q

what conditions increase the risk of hypothermia

A

Cold-water immersion, Acute illness, Traumatic Injury, Shock states, immobilization, cold weather, older age, selected medications such as phenothiazines and barbiturates, Inappropriate alcohol and substance use, Malnutrition, Hypothyroidism, inadequate clothing or shelter

108
Q

how do you treat hypothermia in the community setting

A

shelter from the cold, remove wet clothing, engage in warming, drink warm-high carbohydrate liquid if hypothermia is uncomplicated

109
Q

how does a nurse in a clinical setting treat hypothermia

A

Protect from further heat loss, place in supine position, standard resuscitation efforts, external and core rewarming, warm iv fluids, heated oxygen or inspired gas, heated peritoneal, pleural, gastric, or bladder lavage

110
Q

Frostbite

A

what is it? superficial cold injury

what does it look like? blisters on body part or damage to tissue integrity

what causes it?
Inadequate insulation against cold weathers

how does the nurse treat it? Rapid rewarming, swirl part in water do not allow to touch side of the container to prevent tissue damage, analgesics IV opiates IV rehydration, Ibuprofen every 8 hours as prescribed, elevate part above heart level, assess for compartment syndrome, tetanus immunization, Loose nonadherent sterile dressings, avoid compression of injured tissues, topical and systemic antibiotics, arteriography may be needed, debridement of necrotic tissue or amputation may be needed

111
Q

what are the different classification of frostbite

A

Grade 1, Grade 2, Grade 3, Grade 4

112
Q

what is grade 1 frostbite

A

Hyperemia and edema

113
Q

what is grade 2 frostbite

A

Largre, clear-to-milky, fluid-filled blisters with partial-thickness skin necrosis

114
Q

what is grade 3 frostbite

A

Small blisters containing dark fluid; body part is cool, numb, blue or red and doesn’t blanch

115
Q

what is grade 4 frostbite

A

blister over the carpal or tarsal ( not just the digit); numb, cold, bloodless; necrosis extends to muscle and bone

116
Q

how do you treat an individual with frostbite of a community setting

A

another person frequently assess skin, seek shelter from wind and cold, use body heat to warm the affected area

117
Q

what is the Aldrete score

A

a score system used to assess a patient’s transition from phase 1 recovery to Phase2 recovery, from discontinuation of anesthesia to return of protective reflexes and motor functions

118
Q

what is phase 1 of Aldrete score

A

this occurs with the discontinuation of anesthesia

119
Q

what is phase 2 of Aldrete score

A

begins when the patient’s protective reflexes and motor functioning return, indicating that the patient is effectively recovering from anesthesia

120
Q
A

Nursing classes exams (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions