Quiz II study

Question 1

Causes of hyponatremia

Answer 1

Medications: amiodarone, angiotensin II receptor blockers, angiotensin* converting enzyme inhibitors, desmopresin

Heart, kidney, and liver problems

SIADH

Chronic, severe vomiting or diarrhea causing dehydration.

Too much fluid intake

hormonal changes

Question 2

BUN

Answer 2

7 to 20 mg/dL

Question 3

CO2

Answer 3

23 to 29 mmol/L

Question 4

Creatinine

Answer 4

0.6 to 1.2 mg/dL

Question 5

Glucose

Answer 5

64 to 100 mg/dL

Question 6

Chloride

Answer 6

95 to 105 mEq/L

Question 7

Potassium

Answer 7

3.5 to 5 mEq/L

Question 8

Sodium

Answer 8

135 to 145 mEq/L

Question 9

Calcium

Answer 9

9 to 11 mg/dL

Question 10

S/S Hypokalemia

Answer 10

Impaired repolarization - flattened T wave, depressed ST segment, and presence of a U wave.

P waves peak and the QRS complex is prolonged

Ventricular dysrhythmias

Basic: constipation, heart palpitations, fatigue, muscle weakness, and tingling and numbness

Question 11

S/S Hyperkalemia

Answer 11

Tall, peaked T waves

depolarization decreases: loss of P waves, a prolonged PR interval, ST segment depression, and widening QRS complex.

Basic: fatigue, confusion, tetany, muscle cramps, paresthesias, and weakness.

Question 12

Etiology of Hypokalemia

Answer 12

Excessive loss of potassium

GI loss: vomiting, diarrhea, or laxative use

Renal loss: diuresis or low magnesium levels (stimulates renin and aldosterone release, resulting in potassium excretion)

Question 13

Diet - Foods with Potassium

Answer 13

Lentils
potatoes
bananas
avocados
spinach/broccoli
dried fruit (raisins, apricots)

Question 14

Metabolic acidosis impact

Answer 14

Renal: kidneys can’t properly filer acids from bloodstream

Raspatory

Question 15

Metabolic Acidosis

Answer 15

Normal
Ph: 7.35-7.45
PaCO2 - 35-45
HCO3 - 22-26

Ph:7.28
PaCO2: 36
HCO3: 19

Question 16

Lasix indications

Answer 16

Edema associated with CHF

Cirrhosis of the liver

Renal disease and nephrotic syndrome

Question 17

Lasix side effects

Answer 17

dehydration

electrolyte imbalance

metabolic alkalosis

Question 18

MOA of Lasix

Answer 18

Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule.

Increases renal excretion of water, sodium, chloride, mag, potassium and calcium.

Question 19

Pathology of Pulmonary Embolism

Answer 19

Occurs when a blood clot gets stuck in an artery in the lung, blocking blood flow to part of the lung.

Question 20

Etiology of Pulmonary Embolism

Answer 20

Blocked artery in the lungs

Question 21

S/S Pulmonary Embolism

Answer 21

dyspnea
hypoxemia
tachypnea
cough
chest pain
hemoptysis
crackles/wheezing
tachycardia
syncope

Question 22

Interventions for PE

Answer 22

Supplemental O2, intubation if needed
Monitor labs: hgb, aPTT, INR
Balance activity and rest

Question 23

PE treatment

Answer 23

Fibrinolytic agent
Heparin
Warfarin
analgesia

Question 24

Nurse action during intubation

Answer 24

Establish O2 support, prepare for a tracheostomy

Question 25

DOPE

Answer 25

displacement or obstruction of the ET, pneumothorax, and ventilator or equipment failure

Question 26

Nurse responsibility if intubated patients sats drop

Answer 26

Disconnect the ventilator and administer high flow 100% oxygen (FiO2) using a bag-valve-mask Assess using MASH approach Movement of chest during ventilation Arterial saturation (SaO2) Skin color Hemodynamic stability

Question 27

What can a UAP do with vented patients

Answer 27

Obtain vitals Measure I/O perform bedside glucose testing

Question 28

Zantac and critically ill patients

Answer 28

Used to prevent stress ulcers

Question 29

Treatment for large PE

Answer 29

heparin bolus - followed by continued intravenous infusion thrombolytics TPA

Question 30

Refractory Hypoxemia

Answer 30

A severe breathing problem that can happen due to mechanical ventilation and acute respiratory failure. Often occurring in the context of acute respiratory distress syndrome (ARDS)

Question 31

Actions to take with PE patients who are anxious

Answer 31

Therapeutic communication and pain medication

Question 32

VAP prevention

Answer 32

VAP bundle: HOB elevation between 30-45 degrees daily sedation vacation (readiness to wean assessment peptic ulcer disease prophylaxis DVT prophylaxis Oral care with chlorhexidine q8hrs Hand hygiene

Question 33

Promoting comfort in ventilated patients

Answer 33

Suction as needed assess pain and sedation needs sedation vacation