midterm med surge Flashcards
(96 cards)
1
Q
Maslow stages
A
self actualization esteem love/belonging safety physiological
2
Q
IV fluids
A
isotonic
hypertonic
hypotonic
3
Q
Evidence based practice
A
Evaluation of quality Applicability of existing research Patient preferences Costs Clinical expertise Clinical setting
4
Q
levels of research
A
One
Two
Three
Four
5
Q
cultural sensitivity
A
knowledge, awareness, and acceptance of other cultures
6
Q
which IV fluid has the same osmolarity as blood
A
9% percent saline
7
Q
a pt has new crackles. What does this indicate?
A
indicates fluid volume overload
8
Q
potassium levels
A
3.5 to 5 mEq/L
9
Q
sodium
A
135 to 145 mEq/L
10
Q
calcium
A
8.4 to 10.2
11
Q
magnesium
A
1.6 to 2.6 mEq/L
12
Q
s/s of hypocalcemia are after a thyroidectomy
A
tachycardia, fever, or sudden change in mental status
13
Q
why is calcium gluconate used?
A
for magnesium sulfate toxicity
14
Q
chevostic sign
A
indicative of hypocalcemia
the face twitches when tapped
15
Q
truseau sign
A
spasms of the hand and wrist
16
Q
if the IV pump is beeping and it says blockage
A
kinks
roller clamps, obstructuction and oclusion
17
Q
parenteral nutrition
A
intravenous administration of nutrition
18
Q
hypodermoclysis, who is it used for?
A
infusing fluid into sub-Q into dehydrated pt.’s
19
Q
what is the difference between a macro drip and a micro drip
A
the tubing
20
Q
what are the interventions for a evisceration
A
notify the provider
cover it
21
Q
pt has abdominal surgery and is screaming for help
A
put them back in bed
call for help
call doctor, normal saline
22
Q
SA node rate
A
60 to 100
23
Q
AV node rate
A
40 to 60 beats per minute
24
Q
ventricular rate
A
20 to 40
25
complications of hypertension are..?
```
Atherosclerosis
Coronary artery disease
Myocardial infarction
Heart failure
Stroke
Kidney/eye damage
```
26
Interventions for aortic regurgitation
Digitalis
Diuretics
Vasodilators
Valve replacement
27
what is the antidote for heparin?
protamine sulfate
28
how do you care for a patient with peripheral vascular disease (PVD)
elevate their legs
29
side effects of statins
weakness, tiredness, and muscle pain
30
why are loose teeth the greatest risk for a nurse?
pt can aspirate them blocking the airway which results in the pt choking
31
high pitch tinkling is associated with what?
bowel obstruction
32
how do you check placement of NG tube prior to use. Check by
aspirate contents and checking the Ph.
| must be acidic
33
What is gavage?
irrigation in a NG tube
| temporary intervention
34
non vented NG tube.
| What suction should it be on?
low-intermittent suction
35
What is the cause of C-diff?
antibiotics
36
a pt would benefit from parenteral nutrition if the pt has?
Esophageal cancer
NPO because of esophageal varices or
Severe burns on the face and chest
37
Which anemia is vitamin b12 required?
pernicious anemia
38
patients that need vitamin b12 are ?
pt's undergoing/undergone gastrectomy
39
GERD leads to changes to the epithelial cells of the esophagus which leads to barrettes which is?
pre-cancerous
40
What is the major cause of peptic ulcers?
H.pylori
41
what foods must be eliminated from the diet of a patient that has celiac disease?
wheat
42
If someone has a diverticulosis diagnosis. What do not cause infection?
nuts, seeds, and hulls
43
the main goal for a acetaminophen overdose is to maintain what?
functional ability of the liver
44
What does a decreased amount of bile in the T-Tube indicate?
a sign of impending rejection of a newly transplanted liver
45
level 1 evidence
Strongest evidence
Systematic reviews of randomized controlled trials
True experimental studies: Factors that could falsely change results controlled as possible
46
level 2 evidence based practice
At least one well-designed randomized controlled trial
47
level 3 evidence based practice
Evidence obtained from quasi-experimental research studies
Factors that could falsely change the results are not controlled
Less predictive of effectiveness
48
level 4 evidenced based practice
Evidence obtained from quasi-experimental research studies
Factors that could falsely change the results are not controlled
Less predictive of effectiveness
49
level 1 resources
Joanna Briggs Institute’s Evidence-Based Resources and Cochrane Reviews
50
```
Which I V fluid is hypertonic?
5% dextrose in 0.9% sodium chloride
Normal saline
0.33% sodium chloride
Lactated Ringer’s solution
```
Correct Answer: 1
51
there is precipitate in piggy back IV line. What do you do? What is happening?
the meds may not be compatible
| stop it and alert someone
52
who is at the highest risk for death related to cardiovascular disease?
the elderly
53
thrombophlebitis therapeutic measures
Warfarin (coumadin)
Monitor appropriate lab values
Bedrest (elevate extremity above heart level)
54
What are the therapeutic measures for a DVT?
compression socks
blood thinners
ambulation every two hours
55
what are the 6 P's of PVD
```
pain
paresthesia( decreased sensation)
pallor
pulselessness
paralysis
poikilothermia (assumes temperature of the environment)
```
56
what are the s/s peripheral vascular disease?
numbness, tingling, or weakness
57
what are some complications of a DVT?
Chronic venous insufficiency
Varicose veins
Recurrent D V T
58
data collection for thrombophlebitis
contrast venography
MRI
CT scan
59
pericarditis s/s
chest pain, cough, edema, low-grade fever, and pericardial friction rub
60
pericarditis therapeutic measures
treat underlying causes
| Anti-inflammatory medication, corticosteroids, pericardiocentesis, and percardiectomy
61
What are the complications of aortic stenosis?
Heart failure
Arrhythmias
Emboli
62
who is at risk for DVT?
hospitalized patients who are immobile after surgery
63
what is dilated cardiomyopathy ?
Size of the heart chambers increase
The wall of the heart become thin
Cardiac output is reduced
64
what is angina?
chest pain due to not enough blood or oxygen
65
causes of ineffective endocarditis
Most commonly bacteria but possibly fungi or other organisms.
Entry of organism into bloodstream
66
interventions and rationales for a nursing diagnosis of decreased cardiac output related to post op cardiac surgery
Closely monitor fluid intake, including IV lines. Maintain fluid restriction if ordered.
Place on a cardiac monitor; monitor for dysrhythmias, especially atrial fibrillation.
67
what are the safety measures for coumadin use?
monitor INR and monitor for bleeding (teach patient to report bleeding)
68
a non pharmacological intervention
call the HCP
69
the nurse needs to administer a hypertensive med. The pt's blood pressure is 70/38. What do you do?
call the physician
| do not hold unless she instructs it.
70
what medication will be prescribed for stage 1 hypertension?
Thiazide-like diuretic
ACE inhibitors
Calcium channel blockers
71
hypertensive emergency
systolic bp higher than 180 mm Hg or diastolic BP higher than 120 occurs
72
follow up time frames for different blood pressures
```
For those with normal B P
• 3 to 5 years
For those over the age of 39 or with
increased risk
• Annually
```
73
under inspection
what is brown discoloration and
purple skin?
may be seen in the presence of venous flow problems.
74
what test do you perform if potassium level is out of range
EKG
75
interventions for pulse deficit
Contact The HCP
76
criteria for a heart donor
```
no hypertension
diabetes
absent of malignant diseases
no active infections
no significant cardiac disease
```
77
dissecting aortic aneurysm
created when blood separates the layers of the artery wall forming a cavity between them.
78
foods high in potassium
banana's, potatoes, citrus fruit, cooked spinach
79
pink frothy sputum is an indicator of
pulmonary edema
| Contact Healthcare Provider
80
bnp high level indicates
heart failure
81
symptoms of digoxin toxicity
abdominal pain, anorexia, nausea, vomiting, visual changes, and bradycardia
82
increase in potassium can cause
ventricular fibrillation
83
common cause of a PVC is
caffeine
84
V-FIB =
D-Fib
85
pt has a pacemaker placed what should you do?
take radial pulse for 1 minute
86
main treatment of buergers disease
smoking cessation
87
sudden back or flank pain are classic symptoms of a...?
abdominal aortic aneurism
| needs to be reported immediately because it can rupture
88
a pt has had a vascular surgery. When a neuro vascular check is done the extremity is cool to the touch and dusty in color. What should you do?
notify the physician
89
Buerger's disease
occlusive disease of the median and small arteries and veins.
90
peripheral arterial disease (PAD)
a chronic disorder in which partial or total arterial occlusion deprives the lower extremities of oxygen and nutrients
91
Raynaud's
the vasospasm of the arterioles and arteries of the upper and lower extremities.
92
females who smoke and take birth control are at a higher risk for a...?
MI
93
5% dextrose in 0.9% sodium chloride
is isotonic
94
Normal saline
hypotonic
95
0.33% sodium chloride
hypotonic
96
Lactated Ringer’s solution
isotonic
