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MED-SURGE > FINAL REVIEW > Flashcards

FINAL REVIEW Flashcards

1
Q

malignancy with?

A

hypercalcemia

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2
Q

tetany. wrist spams

A

hypocalcemia

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3
Q

hypocalcemia
&
hypomagnesemia have?

A

trousseau’s sign

chovestks sign

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4
Q

as calcium increases….what decreases

A

phosphate

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5
Q

total daily intake

A

2500

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6
Q

400 ml is loss by which

A

skin & lungs

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7
Q

treat hypernatremia with?

A

D5W

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8
Q

Na

A

135-145

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9
Q

Ca

A

8-10

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10
Q

Cl

A

85-115

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11
Q

HCO3-

A

22-26

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12
Q

K

A

3.5-5.5

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13
Q

PO4+

A

2.5-4.5

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14
Q

Mg+

A

1.3-2.0

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15
Q

fans of electrolytes

A
  1. promote neuromuscular excitability
  2. maintain fluid volume
  3. distributes water between fluid compartments
  4. regulates acid base balance
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16
Q

ex of diffusion

A

exchange of CO2 & O2

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17
Q

ex of filtration

A

(hydrostatic pressure)

arterial capillary bed to interstitial fluid

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18
Q

hypotonic solution

A

0.45%

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19
Q

isotonic solution

A

0.9%

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20
Q

hypertonic solution

A

3.0%

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21
Q

force of BP pushing out of blood stream

A

hydrostatic pressure

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22
Q

how not to give K+

A

IM

IV push

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23
Q

hypovolemia is treated with which type of fluid?

A

isotonic fluid

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24
Q

dehydration is treated with which type of fluid?

A

hypotonic solution

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25
Q

pt at greatest risk of hypovolemic shock

A

hemorrhage (multiple trauma)

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26
Q

sx of hypovolemia–

A

oliguria

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27
Q

2.2 lbs =

A

1 L of fluid added

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28
Q

alcoholism

A

hypomagnesemia

hypophosphatemia

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29
Q

salt substitutes is not okay for pts taking?

A

potassium sparing diuretics

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30
Q

Hyponatremia

A

floppy

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31
Q

if Na falls below 115

A

increased ICP

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32
Q

what to do if pt is hypernatremia

A

offer fluids

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33
Q

heart wave on hypokalemia

A

prominent U wave & flat T wave

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34
Q

heart wave of hyperkalemia

A

peak T wave

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35
Q

hypocalcemia: floppy or twitchy?

A

twitchy

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36
Q

hypocalcemia sign

A

trousseau’s sign

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37
Q

hypercalcemia: floppy or twitchy

A

floppy

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38
Q

hypotonic solution treats

A

hypernatremia & severely dehydrated patient

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39
Q

hypokalemia sx:

A

muscle weakness

fatigue

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40
Q

not a sx of hypovolemia

A

HTN

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41
Q

treating hyponatremia with solution. what to assess

A

breath sounds

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42
Q

most accurate way to determine fluid & electrolyte imbalances

A

daily weights

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43
Q

metabolic alkalosis compensation sxs….

A

increased urine output

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44
Q

hypokalemia, what do you monitor?

A

assess cardiac function

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45
Q

tingling around the mouth

A

hypocalcemia

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46
Q

infiltration manifestations

A

cool to touch

swollen

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47
Q

what should you do 1st in phlebitis

A

stop infusion

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48
Q

COPD develops into

A

respiratory acidosis

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49
Q

antacids and bicarb can cause

A

metabolic alkalosis

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50
Q

hypocalcemia

A

trousseau’s sign

carpedal spasms

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51
Q

what causes tingling and numbness?

A

hypokalemia

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52
Q

what will you see with metabolic acidosis

A

deep, rapid respirations

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53
Q

perform venipuncture quickly and release tourniquet quickly for who?

A

elderly

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54
Q

a patient in respiratory alkalosis, and is telling you they hurt, what should you do?

A

admin PRN pain medication

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55
Q

pH

A

7.35-7.45

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56
Q

PaCO2

A

35-45

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57
Q

HCO3-

A

22-26

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58
Q

what can oral antacids cause?

A

metabolic alkalosis

59
Q

with someone who is hypokalemia, what would you watch?

A

breathing (affects muscle contraction)

60
Q

role of kidneys on metabolic acidosis

A

the kidneys excrete hydrogen ions and conserve bicarbonate ions

61
Q

a patient has just returned from surgery, what is nurses first priority?

A

maintain a patient airway

62
Q

a patient has been admitted with hyponatremia. what would the nurse frequently assess?

A

breath sounds

63
Q

caused by alveolar hypoventilation– acute or chronic

A

respiratory acidosis

64
Q

ex of chronic respiratory acidosis

A

COPD

65
Q

ex of acute respiratory acidosis

A

overdose

66
Q

manifestations of respiratory acidosis

A

low pH
high PaCO2
HCO3 normal if acute
HCO3 high if chronic

67
Q

treatment of respiratory acidosis

A

improve alveolar ventilation

68
Q

caused by alveolar hyperventilation–acute or chrnoic

A

respiratory alkalosis

69
Q

manifestations of respiratory alkalosis

A

high pH
low PaCO2
HCO3 normal if acute
HCO3 high if chronic

70
Q

treatment of respiratory alkalosis

A

treat cause of hyperventilation

71
Q

caused by gaining acid or by loss of ability to excrete acid or by loss of base

A

metabolic acidosis

72
Q

cause of metabolic acidosis

A 
diabetes
diarrhea
lower intestinal fistula
ureterostomies
diuretic use
early renal insufficiency
excessive administration of chloride
administration of parenteral nutrition without bicarb
73
Q

levels for metabolic acidosis

A

low Ph

low HCO3

74
Q

manifestations for metabolic acidosis

A 
headache
confusion
drowsiness
increased RR and depth
N/V
decreased BP
cold clammy skin
dysrhythmias
shock
75
Q

treatment of metabolic acidosis

A

sodium bicarb

76
Q

caused by potassium ion depletion or by excess sodium bicarbonate intake

A

metabolic alkalosis

77
Q

which patient has metabolic alkalosis

A

antacid overdose

NG tube patients

78
Q

levels for metabolic alkalosis

A

high pH

high HCO3

79
Q

manifestations for metabolic alkalosis

A

tingling of fingers and toes, dizziness, hypertonic muscles, respiratory depression, atrial tachycardia

80
Q

treatment of metabolic alkalosis

A

replace potassium carefully

81
Q

what to do for phlebitis

A

stop infusion

cold compress

82
Q

what to do for infiltration

A

stop infusion

warm compress

83
Q

hypertonic cells

A

shrink

84
Q

isotonic cells

A

normal

85
Q

hypotonic cells

A

swollen/fat

86
Q

use of hypertonic fluids

A

prevent fluid from 3rd spacing

87
Q

isotonic fluids are used to?

A

expand ECF volume

88
Q

hypotonic solutions are used to?

A

replace cellular fluids or to provide free water for excretion of body wastes

89
Q

uncontrolled type 1 diabetes mellitus

A

metabolic acidosis

90
Q

respiratory acidosis levels that you will see….

A

pH 7.50

PaCO2 50

91
Q

heroin OD

A

respiratory acidosis

92
Q

a patient has just returned from surgery, what is the nurses first priority?

A

maintain patient airway

93
Q

a patient just had abdominal surgery and is refusing to wear anti embolism stockings. what is the patient at risk for?

A

PE

94
Q

the PACU nurse is caring for a patient that is still unconscious. the patient is bluish and dusty. The patient is not breathing. What is the nurses initial reaction?

A

check for laryngeal obstruction then tilt head back and push jaw forward

95
Q

Patient identification prior to the ER: select all that apply

A

name of physician performing procedure

have a patient stage first and last name

compare patient ID with chart

96
Q

A patient admitted for surgery wants to know why he’s not allowed to eat for 8hrs prior to his surgery. The nurses best response is:

A

Pts. should be NPO for 8 hours to decrease the risk for aspiration

97
Q

a 38 year old pt that is in recovery from surgery is apprehensive, restless, and thirsty. the pt asks if he can have a drink of water. Upon assessment you notice the pt’s skin is cool, moist, and pale. What should you be concerned for?

A

hemorrhage and shock

98
Q

what is a PACU nurses first responsibility?

A

resp. status

99
Q

what is a unit nurses first responsibility?

A

vital signs

100
Q

if a patient says she doesn’t know what the surgery entails, what should the nurse do?

A

don’t have patient sign consent and inform the doctor.

101
Q

the OR personnel responsible for maintaining safety of the client and the surgical environment.

A

Circulating nurse:

102
Q

a patient is in the PACU with BP of 117/60, P of 72, and with warm dry skin; his pre-op BP was 121/72 what should the nurse do?

A

administer O2 therapy

103
Q

Problems with obese clients:

A

impaired tissue perfusion

104
Q

The scrub nurse is responsible for

A

preparing the sterile instruments for the surgical procedure.

105
Q

the PACU nurse is caring for an older adult who presents with clinical manifestations of delirium. Which short-term outcome would be most important for this client? The client:

A

maintains adequate oxygenation status

106
Q

Pt. has normal BP and increased respirations

A

tell them to breathe in deeply

107
Q

The nurse understands that the purpose of the “time-out” is to:

A

maintain the safety of the client

108
Q

a client has a hysterectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to:

A

auscultate bowel sounds

109
Q

as a circulating nurse, what task are you solely responsible for?

A

keeping records

110
Q

the nurse recognizes which of the following as clinical manifestations of shock?

A

rapid, weak, thready pulse

111
Q

Your patient is in the recovery room following chest surgery. The patient complains of severe nausea. What would you do next?

A

turn the patient completely to one side

112
Q

You are discharging your patient home from day surgery after a general anesthetic, what instruction would you give the patient prior to the patient leaving the hospital?

A

the patient is not to drive a vehicle

113
Q

Your patient is a 78-year-old male who has had outpatient surgery. You are getting him for his first walk postoperatively. To decrease the potential for orthostatic hypotension, what should you plan to have the patient do?

A

stand upright for 2-3 minutes prior to ambulating

114
Q

occurs when the postoperative patient fails to move, cough, and breathe deeply. with good nursing care, this is an avoidable complication

A

atelectasis

115
Q

a WBC count of 14,000 indicates:

A

infection

116
Q

You admit a patient to the postanaesthesia care unit with a blood pressure of 130/90 and a pulse of 68 beats per minute. After 30 minutes, the patient BP is 120/65, and pulse is 100. You document the patients skin as cold, moist, and pale. what is the patient showing signs of?

A

hypovolemic shock

117
Q

You are the nurse caring for a patient after abdominal surgery in the post anesthesia care unit. The patient’s BP is increased and the patient is restless. The patient’s oxygen saturation is 97%. You know that the change in your patient is most likely caused by?

A

the patients in pain

118
Q

a 38 year old patient has just been admitted to the PACU following abdominal surgery. As the patient begins to awaken, he is restless and asking for “a drink of water.” The nurse checks his skin and it is cold, moist, and pale. What is the nurse concerned the patient may be at risk for?

A

hemorrhage and shock

119
Q

The nursing instructor is discussing postoperative care with the junior nursing students. A student nurse asks, “Why does the patient go to the PACU prior to the medical-surgical unit?” What is the nursing instructor’s best response?

A

“The PACU allows the patients to recover from the effects of anesthesia, and the patient says in PACU until he or she is oriented, HAS STABLE VITAL SIGNS, and is without complications.”

120
Q

You are the intraoperative nurse transferring a patient from the OR to the PACU after replacement of the right see. The patient is a 73 year old female. You know that special attention must be paid to what?

A

keeping the patient warm—HYPOTHERMIA

121
Q

What are the determining factors for a patient to be discharged from the PACU?

A

stable BP

adequate oxygen saturation

adequate respiratory function.

122
Q

the nursing student is preparing an elderly patient for surgery. the patient is scheduled for a general anesthetic. which side effect should the nurse monitor the patient for?

A

hypothermia

123
Q

You are the circulating nurse caring for a 78 year old patient who is scheduled for a total hip replacement. which of the factors should you consider during the preparation of the patient in the operating room

A

pressure points should be assessed and well padded

124
Q

earliest sign of malignant hyperthermia?

A

tachycardia

125
Q

a patient is admitted to the emergency department complaining of severe abdominal pain. the patient is vomiting, “coffee-ground” like vomitus. The patient is diagnosed with a bowel obstruction and is informed that he needs surgery. when can the patient anticipate the surgery will be scheduled?

A

without delay because the bowel obstruction is emergent

126
Q

TCDB & incentive spirometry every 2 hours used to?

A

promote optimal lung expansion

127
Q

sign of hypovolemic shock=

A

rapid, weak, thready pulse

128
Q

who is more @ risk for hypovolemia?

A

x48 year old with multiple trauma

129
Q

patient needs more teaching about infection when states?

A

red streaks are normal and will disappear

130
Q

local anesthesia performed when??

A

had food & fluid

131
Q

how to check for bladder distention?

A

palpate

132
Q

You are the nurse working in the preoperative holding area. Your patient has just received a preanesthetic medication. What should you instruct the patient to do?

A

use the call light to summon the nurse for assistance

133
Q

You are obtaining the patient’s signature on the surgical consent form. What are the criteria for a valid informed consent?

A

consent must be freely given

consent must be obtained by a physician

signature must be witnessed by a professional staff member

134
Q

nurse takes care of several pts who received anesthesia. which pt is at highest concern?

A

pt. w/ emphysema

135
Q

Age related integumentary changes

A

thinning of skin

uneven pigmentation
dry skin

136
Q

pt. at greatest risk for pressure ulcers

A

thoracic vertebrae

137
Q

where do you check for jaundice?

A

hard pallets

138
Q

damage to lg. vessels which result in lack of blood flow to the extremity thus resulting in lack of nutrients

A

Stasis Dermatitis

139
Q

ingrown hair

sweating, shaving, or heat

A

folliculitis

140
Q

“BOIL”

induration but localized

A

Furuncles

141
Q

caused by varicella-zoster virus

A

Herpes Zoster (shingles)

142
Q

painful vesicular rash along a dermatome

A

Herpes Zoster (shingles)

143
Q

tx Herpes Zoster (shingles) with ?

A

antiviral

cover with wet dressing

wash hands

144
Q

found on the lower anterior legs, forearms, thighs & over bony prominences
primary lesions

A

Diabetic Dermopathy (shin spots)

MED-SURGE (5 decks)

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