Exam 1

Question 1

term:
response to trauma. surgery, severe illness, or body cavity

Answer 1

physiologic stress

Question 2

flight or flight response

Answer 2

sympathetic response

Question 3

during a sympathetic response what happens to blood vessel?

Answer 3

vasoconstriction

Question 4

when in flight or flight what happens to pupils?

Answer 4

Dialation

Question 5

rest and digest

Answer 5

Parasympathetic

Question 6

what happens to blood vessels during a parasympathetic response?

Answer 6

Vasodilation

Question 7

fluid moves to what area of the body?

Answer 7

interstitial tissue

Question 8

fluid shifts result in

Answer 8

peripheral edema and fluid accumulation around the surgical or trauma site

Question 9

where does Na flow?

Answer 9

Na follows water

Question 10

during surgery is sodium high or low?

Answer 10

High because in surgery you are always given fluids and sodium will always follow

Question 11

What is the normal sodium range?

*know for acid base imbalance

Answer 11

135 - 145

Question 12

What is the normal range for potassium

Answer 12

3.5 - 5.0

Question 13

potassium will most likely only go up during what

Answer 13

renal problem or kidney failure

Question 14

what happens to potassium?

Answer 14

It gets excreted

Question 15

during surgery what occurs for Na and K?

Answer 15

Na goes up

K goes down

Question 16

why is the passing of K important?
excretion of potassium

Answer 16

if K is not in the normal range, you cannot shock a person back during arrhythmias.

K helps with electricity

Question 17

what does the EKG tracing show for low K

Answer 17

Shows a “U”

Question 18

Post surgery where are some areas we can expect to see fluid build up?

Answer 18

at the site of the surgery (Appendectomy, for example)

feet, ankles, shins, hands, face, and maybe even above the eyes

Question 19

Why is fluid accumulation / edema around the eyes bad?

Answer 19

it can cause damage to the cornea and the eyeball itself

Question 20

what happens when a vein gets hit and / or a large bone?

Answer 20

Lots of blood loss very rapidly

• Femur, blood marrow, hips, pelvis, and tibia for example

Question 21

when you loose blood what is also going to happen?

Answer 21

Hypotension, hypovolemia, and thirst

Question 22

“Low blood volume”

Answer 22

Hypovolemia

Question 23

taking bp while sitting down, standing up, and laying down

Answer 23

orthostatic hypotension

Question 24

what does ACTH affect?

Answer 24

Our cortisol levels

Question 25

sodium and water retention and potassium excretion what does this mean for the nurse?

Answer 25

less urine produced increased blood volume increased blood pressure inability to reabsorb sodium and excrete potassium due to compromised renal regulation

Question 26

if a patient has increased water retention, what happens with blood pressure?

Answer 26

BP goes up slightly

Question 27

At what point (systolic value) do you stop perfusing your kidneys and you are in danger

Answer 27

Kidneys stop perfusing at 70 systolic

Question 27

if a patient is struggling to urinate after surgery and look at the surgical notes: You read that during the procedure the patients blood pressure fell to 70 systolic, why is this important?

Answer 27

because at 70 systolic - you stop perfusing your kidneys. So it would be "normal" to have a delayed urination

Question 27

what gland releases an AntiDiuretic hormone?

Answer 27

pituitary gland

Question 28

prior to surgery a patient had a blood pressure of 120/80 after surgery the monitor reads 130/84 why did it increase?

Answer 28

The fluid shift

Question 29

cortisol affects

Answer 29

glucose

Question 30

What is a possible glucose level after an open heart surgery (very invasive and stressful procedure) think about cortisol..

Answer 30

It's not uncommon to see over 700

Question 30

what is a normal glucose level?

Answer 30

7.5

Question 30

vasopressin causes

Answer 30

kidneys to conserve water and is a vascular pressor

Question 31

what population is more susceptible to high cortisol levels?

Answer 31

older clients and female

Question 32

involves an increased level of endogenous hepatic glucose production while insulin-stimulated peripheral glucose uptake is reduced

Answer 32

stress hyperglycemia (acute response)

Question 33

is diabetes chronic or an acute condition?

Answer 33

Chronic

Question 34

too much stress can cause a gastric ulcer. how?

Answer 34

damage to the stomach mucosal barrier

Question 35

what causes stomach ulcers, what increases and decreases?

Answer 35

bile salts increases and blood flow decrease

Question 36

what to do to prevent stomach ulcers

Answer 36

raise the head of the bed (better oxygenation and also prevents from gastrics coming up) and give IV Push ProTonics

Question 37

NG tube patients must never lay in what position

Answer 37

Laying flat - aspiration is highly if flat

Question 38

What is an IV Push of Protonics

Answer 38

it's a proton pump inhibitor to help from developing a stomach ulcer

Question 39

What are some symptoms of a stress ulcer?

Answer 39

- dull stomach paining - heartburn -bloating and feeling full -nausea