366 Exam 2

Question 1

What is phlebitis?

Answer 1

Irritation and infection
Sx: erythema, streak formation, pain, edema,
Tx: warm compress to vasodilator

Question 2

What is infiltration?

Answer 2

Fluid getting into surrounding tissue
Sx: skin blanched, cool to touch, edema, pain, bruised, area can feel hard
Tx: dc iv, warm compress to vasodilator

Question 3

What is extravasation?

Answer 3

Reaction to drug that is only compatiblewith bv, comes into contact with tissue
Sx: burning, decaying/necrotic tissue, pain,
TX: dc infusion, attempt to aspirate drug, cold compress, see if antidote call pharm for antidote, notify provider

Question 4

Hypotonic iv solution?

Answer 4

Lower osmolality, cells swell, water movement into cells. Und in patients with hypernatremia

Question 5

Isotonic iv fluid?

Answer 5

Same osmotality. Increases ECF doesn’t move into cells

Question 6

Hypertonic iv fluid?

Answer 6

Higher osmolality, cells shrink, water moves out of cells. Used to treat hyponatremis and trauma patients

Question 7

Cardiac A&p

Answer 7

5L / min,
Pericardial sac → 2 layers + 10-20 ml fluid
3 cardiac layers → epi-, myo-, endo-
4 chambers divided by septum
2 av values, 2 semilunar values, unidirectional blood flow
Coronary arteries → RCA, LCA/ left main

Question 8

What causes a MI?

Answer 8

Thrombus blocking blood flow causes irreversible myocardial cell death

Question 9

What is stemi mi?

Answer 9

ST elevation, occlusive thrombus
TX: Mona, PCI - balloon, thrombolytic therapy, cabg, anti platelet, anticoag

Question 10

What is nstemi mi?

Answer 10

Nonocclusive, t wave depression or inversion
TX: Mona, stress testing, anticoag, PCI stent, cabg

Question 11

Parts of EKG, what is p wave?

Answer 11

Impulses move through atria

Question 12

Parts of EKG, what is Pr interval?

Answer 12

Amount of time it takes for impulse to travel from atria to ventricles

Question 13

Part of EKG, what is QRS complex?

Answer 13

Impulse moves through ventricles

Question 14

Parts of EKG, what is t wave?

Answer 14

Ventricles depolarize

Question 15

Parts of EKG, what is time between end of T wave and start of P wave?

Answer 15

Heart at rest

Question 16

What are diagnostic test for heart failure?

Answer 16

CXR: cardiomegaly
ECG: rhythm, wide Qrs?
Echo: value function, ef, wall Motion
Cath: pulmonary pressures, filling pressures, coronary arteries, ef%
Labs: Na / cl ↓, bun / cr/ LFT ↑, rbc ↓, 02/ CO2 ↓, BNP > 100

Question 17

Define hypertension

Answer 17

Normal: SBP < 120, DBP < 80
Elevated: SBP 120 - 129 , DBP <80
Stage 1 hypertension: SBP 130-139, DBP 80-89
Stage 2 hypertension: SBP > 140, DBP > 90
Hypertensive crisis: SBP > 180, DBP > 120

Question 18

What are the 3 phases of peri- operative care?

Answer 18

Pre-op, intra-op, post-op

Question 19

What are nursing responsibilities during pre-op?

Answer 19

Intake an information, history, meds, labs I psychosocial, consent

Question 20

What is nursing considerations for intra-op?

Answer 20

Safety maintenance, monitoring, communication with family, anticipating and critical thinking, scds, positioning , site prep

Question 21

What is nursing considerations for post -op?

Answer 21

Frequent assessments, airways, cardio stability, pain and anxiety relief, surgical site, gi function, urine output, ambulate ASAP
Complications! Shock, hemorrhage,DVT, PE,cerebral vascular accident, urinary retention, pneumonia & acteractasis, intestinal obstruction

Question 22

What are national patient safety goals?

Answer 22

Identify patients correctly, prevent surgical mistakes, improve communication, safe med administration, alarm safety, reduce risk of health care associated infections, identify patient safety risks, improve health care equity

Question 23

How to calculate iv infusion rate?

Answer 23

Volume to be given / hours to infuse = ml/hr
Or
Volume to be given X 60min / # of mins to be infused = ml/hr

Question 24

How to calculate drops per minute?

Answer 24

Amount of fluid to be given x drop factor/ time in min= gtt/ min,
Or
1: amount of fluid to be given / hours to be administered = ml/hr
2: ml per hour X drop factor / 60 min = gtt/min

Question 25

What are AlC levels for diabetes?

Answer 25

> 6.5% = diabetes
5.7 - 6.4 %= prediabetes
Below 5.7% = normal

Question 26

What are blood glucose levels In relation to diabetes?

Answer 26

Fasting = 126 (diabetes), 100 - 125 (prediabetes), 99 or below (normal)

Glucose tolerance test= 200 or above (diabetes), 140 - 199 ( prediabetes ), 140 or below (normal)

Question 27

What would be a sign of diabetes in a urine test?

Answer 27

Ketones or glucose

Question 28

What is type 1 diabetes?

Answer 28

Autoimmune disorder against insulin
Beta cells in pancreas stop producing insulin or do not produce enough to survive
Sx: polydipsia, polyuria, polyphagia
Requires exogenous insulin

Question 29

What is type 2 diabetes?

Answer 29

Non-insulin dependent
Risk factors: overweight/obese, advanced age, family history,
Pancreas continues to produce insulin, but not enough or body does not use it properly
Insulin resistance, inappropriate hepatic glucose production, altered production of hormones and cytokines by adipose tissue
Sx: none, recurrent infection,fatigue, polydipsis, polyuris, polyphasis

Question 30

What is insulin lispro?

Answer 30

Class: short duration, rapid acting
Onset: 5-10 min
Peak: 30 - 90 min

Question 31

What is regular insulin?

Answer 31

Class: short duration, shout acting
Onset: 30 min - 1 hour
Peak: 2-5 hours

Question 32

What is NPH insulin?

Answer 32

Class: intermediate acting
Onset: 1 - 2 hours
Peak: 4-12 hours

Question 33

What is insulins glargine?

Answer 33

Class: long acting
Onset: 1-2 hours
Peck: none

Question 34

What are signs of hypoglycemia?

Answer 34

!COOL AND CLAMMY GIVE THEM CANDY!
Pallor, dizziness, headache, shaky, nervous, irritable, hungry, sweaty, blurred vision, confusion, slurred speech, tachycardia, numbness in fingers/ toes/ mouth, severe! Seizure & coma → death

Question 35

What are signs of hyperglycemia?

Answer 35

!HOT AND DRY SUGAR IS HIGH!
↑ thirst, dry mouth, ↑ urination, weakness, fired, blurred vision, glycosuria, nausea, vomiting, abdominal pain, sob, loss of consciousness. Severe! DKA/HHS

Question 36

What are signs of DKA?

Answer 36

Blood glucose > 240
Arterial ph < 7.3
Serum bicarbonate < 15
Presence of ketones in urine or blood

Management: iv access for fluids and electrolytes, short acting insulin, O2, K and bicarb for severe acidosis,monitor consciousness, 02, urine, vs

S/s: fast breathing, flushed face, frequent urination, dry skin/ mouth, fruity breath, headache, muscle stillness, lethargy/confusion, n/v, abdominal pain

Question 37

What is HHS?

Answer 37

More common in type 2 diabetes
UTIs, pneumonia, sepsis, acute illness, newly diagnosed,
Common cormorbidity of infection & dehydration
Cx: stroke, heart attack, meds, fluid loss,

Labs: ph > 7.3
Plasma glucose > 600
Ketones in urine= none or trace

TX: treat ↑ glucose with insulin, aggressive iv fluid for correction of fluid loss, administer electrolytes

Question 38

What are chronic complications of diabetes?

Answer 38

Retinopathy→ yearly eye exam
Nephropathy→ annual urinalysis
Neuropathy → daily checks and annual comprehensive exam
Cvd» annual visits

Question 39

What is Cho and connection factors, give an example.

Answer 39

Correction factor - 1:40 >150. The patients blood glucose is 200, now much insulin will you administer?

200 - 150 = 50
50 / 40 = 1.25 → 1.5

Question 40

What are pediatric cardiac disorders that ↓ pulmonary blood flow?

Answer 40

ASD/VSD → blood mixes and dumps into pulmonary circuit
PDA → aortic and pulmonic flow together
Av - canal →

S/s:
Color → pink
Respiration → perfort, tachypnea
Feel → edema on right side, putty, ↑ liver size