Adult Medical Surgical Nursing

Question 1

1 Kg (2.2lbs) of body weight is approximate to ? L of fluid

Answer 1

1 Liter

Question 2

Fluid volume deficit - most common is ? dehydration

Answer 2

isotonic

Question 3

Fluid volume deficit (FVD) manifestation

Answer 3

weight loss, increased heart rate and respirations, thready pulse, weakness, fatigue, orthostatic hypotension, Late signs: oliguria, decreased CVP, flattened neck veins

Question 4

FVD diagnostic procedures

Answer 4

serum electrolytes ( ) BUN ( 10-20) creatinine (0.5 - 1.2) Hct ( M-42%-52% F-37% - 47%) - urine specific gravity and osmolarity Medications = Electrolyte replacement and IV fluids

Question 5

Isotonic solutions

Answer 5

Normal saline 0.9%, Lactated ringers, 5% dextrose in water D5W

Question 6

Hypotonic solutions

Answer 6

0.45% NS, 2.5% dextrose in 0.45% saline

Question 7

Hypertonic solutions

Answer 7

10% dextrose in water, 50% dextrose in water, 5% dextrose in 0.9% saline, 5% dextrose in 0.45% saline, 5% dextrose in LR

Question 8

Fluid volume excess (FVE) manifestations

Answer 8

cough, dyspnea, crackles, increased BP, tachypnea and tachycardia, bounding pulse, weight gain, increased urine output, edema,

Question 9

Diagnostic procedures for FVE

Answer 9

Serum electorylytes, BUN(10-20) creatinine (0.5-1.2) Hct, urine specific gravity and osmolatiry, chest x-ray - use semi fowlers positions and repo every 2 hours

Question 10

Major intracellular electrolytes

Answer 10

potassium, phosphorus, magnesium

Question 11

major extracellular electrolytes

Answer 11

sodium, calcium, chloride, bicarbonate

Question 12

muscle weakness, cramping, fatigue, N&V, irritability, confusion, decrased bowels, paresthesia, dysrhythmias, flat and or inverted T waves (electro imbalance )

Answer 12

Potassium (hypokalemia)

Question 13

peaked T waves, ventricular dysrhythmias, muscle twitching and paresthesia, ascending muscle weakness, increased bowels (electro imbalance)

Answer 13

Potassium (hyperkalemia)

Question 14

weakness, lethargy, confusion, seizures, headaches, anorexia, N&V, muscle cramps, twitching, hypotension, tachycardia, weight gain edema (E.I)

Answer 14

Sodium ( hyponatremia)

Question 15

fever, swollen, dry tongue, sticky mucous membrane, hallucinations, lethargy, restlessness, irritability, seizures, tahycarida, hypertension, hyperreflexia twitching, pulmonary edeam (E.I)

Answer 15

Sodium (hypernatremia)

Question 16

tetany, cramps, paresthesias, dysrhythmais, trousseau’s sign, chvostek’s sign, seizures, hyperreflexia, impaired clotting time (E.I)

Answer 16

Calcium ( hypocalcemia)

Question 17

muscle weakness, hypercalciuria/kidney stones, dysrhythmias, lethargy/coma, hyporeflexia, pathologic fractures, flank pain, deep bone pain, polyuria, polydipsia, dehydrations, hypertension, N&V (E.I)

Answer 17

calcium ( hypercalcemia)

Question 18

paresthesias, dysrhthmias, Trousseau’s sign, chvostek’s sign, agitation, confusion, hyperreflexia, hypertension, insomnia, irritability, anorexia, N&V, dysphagia (E.I)

Answer 18

Magnesium (hypomagnesemia)

Question 19

hypotension, drowsiness, bradycardia, bradypnea, coma, cardiac arrest, hyporeflexia, N&V, facial flushing (E.I)

Answer 19

Magnesium (Hypermagnesemia)

Question 20

paresthesia, muscle weakness, bone pain and deformities, chest pain, confusion, seizures, nystagmus (E.I)

Answer 20

phosphorus (hypophosphatemia)

Question 21

tetany, cramps, paresthesias, dysrhythmias, Trousseau’s sign, chvostek’s sign, hyperreflexia, anorexia, N&V, sot tissue calcifications (E.I)

Answer 21

Phosphorus (hyperphosphatemia)

Question 22

Metabolic Acidosis

Answer 22

Decreased PH, Normal PCO2, Decreased HCO3

Question 23

Metabolic Alkalosis

Answer 23

Increased PH, Normal PCO2, Increased HCO3

Question 24

Respiratory Acidosis

Answer 24

Decreased PH, Increased PCO2, Normal HCO3

Question 25

Respiratory Alkalosis

Answer 25

Increased PH, Decreased PCO2, Normal HCO3

Question 26

ROME

Answer 26

Respiratory Opposite (PH & PCO3) - Metabolic Equal (PH & HCO3)

Question 27

pH level

Answer 27

7.35 - 7.45

Question 28

PCO2

Answer 28

35 - 45

Question 29

HCO3

Answer 29

21 - 28

Question 30

(acid base Imb) bradycardia, weak pulses, hypotension, tachypnea, flaccid paralysis, confusion, hypreflexia, lethargy, warm flushed dry skin, Kussmauls respirations.

Answer 30

Metabolic acidosis - decreased pH and HCO3

Question 31

(acid base Imb) dizziness, paresthesieas, hypertonic muscles, decreased respirations

Answer 31

metabolic alkalosis - increased pH and HCO3

Question 32

(acid base Imb) dizziness, palpitations, muscle twitching, convulsions

Answer 32

respiratory acidosis - decreased PH and Increased PCO2

Question 33

acid base Imb) tachypnea, anxiety, tetany, paresthesias, palpitations, chest pain

Answer 33

Respiratory alkalosis - increased PH and Decreased PCO2