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Fortis Nursing > Medsurg Exam 2 > Flashcards

Medsurg Exam 2 Flashcards

1
Q

What may someone experience in relation to fluid volume deficit?

A

High Hematocrit
High BUN
Decreased urine output <30ml/hr
High Sodium
Low Blood pressure
Elevated Heart Rate

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2
Q

What are symptoms of hypocalcemia?

A

-numbness, tingling, twitching, muscle weakness.
-Laryngeal Stridor
-positive chvosteks sign (contraction of facial muscles when taping on facial nerve)
- Trousseau’s sign (carpal spasm)

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3
Q

What may taking hydrochlorothiazide due to your lab values?

A

May increase loss of potassium, leading to hypokalemia 

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4
Q

What should be monitored of a patient on a thiazide?

A

blood pressures, potassium and renal levels

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5
Q

What may help monitor fluid loss with cardiac edema?

A

Daily Weights , should not loose more than 0.5kg/day

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6
Q

What are the signs of hypovalemia?

A

-confusion
-bounding pulses
-low sodium (hyponatremia)

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7
Q

What may a patient with gastroenteritis be at risk for?

A

Fluid volume deficit— due to increased bleeding, vomiting, polyuria, diarrhea

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8
Q

What are signs of hypermagnesemia?

A

-diminished deep tendon reflexes
-Urinary retention
-Nausea vomiting
-Bradycardia
-hypotension

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9
Q

What are signs of hypomagnesemia?

A

-Increased urine output
-hyperactive deep tendon reflexes
-Muscle cramps

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10
Q

What are the signs of dehydration?

A

Irregular pulse - Report to provider

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11
Q

What symptoms may someone who is having a blood transfusion reaction experience?

A

itching skin, hives

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12
Q

What may put a patient at risk for iron deficiency anemia?

A

inadequate diet, blood loss

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13
Q

What is the client who consumes a vegetarian diet at risk for?

A

iron deficiency anemia

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14
Q

Who is at risk for disseminated intravascular coagulation?

A

a patient who has sepsis

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15
Q

What interventions may be done in relation to pernicious anemia?

A

Vitamin B12 injections, oral iron supplements

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16
Q

What lab values indicate multiple myeloma?

A

hypernatermia (High calcium)

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17
Q

what should we monitor of a patient diagnosed with multiple myeloma?

A

Monitor i/os

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18
Q

What are signs of severe anemia?

A

tachycardia due to increase cardiac output

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19
Q

What are symptoms of hodgkin’s lymphoma?

A

Lymph node enlargement
fever
night sweats

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20
Q

What occurs when platelet count is below 150,000?

A

Thrombocytopenia

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21
Q

What should the nurse educate the patient about when taking ferrous sulfate?

A

take medication with orange juice

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22
Q

What education should the nurse teach when prescribed an oral iron liquid supplement?

A

Take one hour before eating, or two hours after
Rinse mouth
black tarry stool
eat leafy greens

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23
Q

What are risk factors for aplastic anemia?

A

Radiation/ Chemo
Toxins (pesticides, cigarette smoke)
Infectious diseases (hepatitis)
Autoimmune disorder
Pregnant

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24
Q

What should you educate your patient when on neutropenia precautions?

A

avoid gardening
eat throughly cooked food, no fruits/veggies
brush teeth 4 times a day, only floss once
drink prepackaged water

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25
Q

What precautions should be taken of a patient with pertussis? (whooping cough)

A

cover mouth
wash hands
droplet isolation (if in hospital)

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26
Q

What diagnostic test would be orders for suspicion of pneumonia?

A

Chest X-ray
CBC-look for increased WBCs
Sputum Culture

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27
Q

What are prevention measures for pneumonia in older adults?

A

Annual Flu/ Pneumococcal Vaccine
Stop smoking
hand washing
avoid ill people/crowds

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28
Q

What are early indications of hypoxia?

A

Anxiety, confusion, restlessness

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29
Q

What diagnostic test confirms diagnosis of TB?

A

3 sputum cultures

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30
Q

What is Von Willebrand disease?

A

Bleeding disorder, blood doesn’t clot properly

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31
Q

What is the treatment for Von Willebrand disease?

A

desmopressin (DDAVP) injections

32
Q

What should a client with pneumonia include in their diet?

A

foods high in protein
nuts, seeds, white fish, sardines

33
Q

What is the priority interventions for a client post bronchoscopy?

A

Keep NPO, wait for gag reflex
patient is at risk for aspiration, maintain open airway

34
Q

What education should be provided to your patient to prevent asthma attacks?

A

-avoid air pollutants (perfumes)

35
Q

What are the priority interventions for a client having an acute asthma attack?

A

nebulizer
bronchodilators

36
Q

What assessment findings are expected for clients with COPD?

A

decreased chest expansion
hyperresonance on percussion
diminished breath sounds

37
Q

What can you delegate to a UAP regarding oxygen therapy for a COPD client?

A

Assist the client to get out of the bed.
Only able to assist with positioning and activities of daily living

38
Q

What is effective discharge teaching of a client with home oxygen therapy?

A

instruct client to not smoke
avoid exposure to others with infections
adhere to activity limitation

39
Q

What is the best lab value indicator of respiratory insufficiency?

A

ABG

40
Q

What is the best diagnostic test to indicate respiratory insufficiency?

A

pulse ox
chest x-ray
ABGs
end tidal carbon dioxide monitoring

41
Q

What is the priority assessment for a client with a nasal feature and head trauma?

A

Safety, make sure patient doesn’t aspirate

42
Q

What should be done for a cystic fibrosis client?

A

chest physiotherapy every 4 hours, schedule airway clearances

43
Q

What would the assessment of a bleb be if someone is exposed to TB?

A

Palpable, hardened or swelling (no redness

44
Q

What may indicate from a bleb of someone who lives in a nursing facility or in end stage renal disease is TB positive?

A

Bleb is 10mm or larger

45
Q

What may indicate from a bleb of someone who is immunocompromised is TB positive?

A

bleb is 5mm or larger

46
Q

What are the adverse effects of isoniazid treatment for TB?

A

Isoniazid hepatic toxicity
vomiting
confusion
headaches
elevated ALT, AST

47
Q

What should you instruct your client to do when using isoniazid for TB?

A

Take on empty stomach
Avoid alcohol
Avoid acetaminophen

48
Q

What should you instruct to your client when using antitubercular medications for TB?

A

when taking medications such as isoniazid, rifampin, and pyrazinamide patient may get
nonviral hepatitis

49
Q

What is the normal range for urine specific gravity?

A

1.005 to 1.030

50
Q

If you noticed Trousseau’s sign on assessment, what should you obtain?

A

Calcium Levels- they will be low

51
Q

What kind of patient has the greatest risk for hypovalemia?

A

A draining wound

52
Q

What is priority when your patient is having a reaction to blood transfusion?

A

Stop the infusion

53
Q

What is your patient at risk for if they are having a panic attack?

A

Respiratory alkalosis

54
Q

If your patient has folic acid anemia, what should your next step be?

A

Place a dietary consult

55
Q

Your patient was diagnosed with severe anemia, what may they experience?

A

Tachycardia

56
Q

What will be present if your patient has hodgkins lymphoma?

A

presence of sternburg cells

57
Q

Your patient is newly prescribed heparin, what are they at risk for?

A

Heparin induced thrombocytopenia

58
Q

What should you ask your patient diagnosed with hemophilia?

A

Ask about joint pain
Color of stools
do you bruise easily

59
Q

Who is at risk for aspiration pneumonia?

A

Decreased level of consciousness
NG tubes
Difficulty swallowing

60
Q

Your patient qualifies for at home oxygen therapy, what education needs provided?

A

Avoid wool blankets
No smoking
only use length of tubing necessary to prevent falls

61
Q

How should your patient clean their oxygen delivery?

A

Wash prongs with soap and water once a week, change tubing if sick

62
Q

What is the normal sodium levels?

A

135-145

63
Q

What is normal magnesium levels?

A

1.5-2.5

64
Q

What is normal calcium levels?

A

9-11

65
Q

What is a normal BUN level?

A

7-20

66
Q

Normal hemoglobin level (female)

A

12-16

67
Q

normal hemoglobin level (male)

A

13-18

68
Q

normal hematocrit level (female)

A

36-48%

69
Q

normal hematocrit levels (male)

A

39-54%

70
Q

Normal PaCO2 level

A

35-45

71
Q

normal PaO2 level

A

80-100

72
Q

Normal HCO3 level

A

22-26

73
Q

normal creatinine level

A

0.6-1.2

74
Q

What does metabolic alkalosis levels look like?

A

PH greater than 7.45
HCO3 greater than 26

75
Q

What does metabolic acidosis look like?

A

PH less than 7.35
HCO3 less than 22

76
Q

What does respiratory alkalosis look like?

A

PH greater than 7.45
CO2 less than 35

77
Q

what does respiratory acidosis look like?

A

PH less than 7.35
CO2 greater than 45

Fortis Nursing (4 decks)

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