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Competency > Competency retake > Flashcards

Competency retake Flashcards

1
Q

Glucose: normal value & effects of balance

A

Normal value: 70-110

High glucose: 3 p’s (polydipsia, polyuria, polyphagia)
Low glucose: confusion, irritability, diaphoresis

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2
Q

Na+ : normal value & effects of balance

A

Normal value: 135-145

High or Low sodium = confusion (change in neuro status) - affected by fluid balance

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3
Q

K+ :normal value & effects of balance

A

Normal value: 3.5-5

High or low dysrhythmia
High: diarrhea, cramping - acidotic states
Low: constipation, leg cramps - alkalotic states

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4
Q

Ca+ : normal value & effects of balance

A

Normal value: 8.5-10.5

High: constipation, slowed reflexes, kidney stones
Low: tetany, increased reflexes, Chvosteks & Trousseau sign, diarrhea

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5
Q

BUN: normal value & effects of balance

A

Normal value: 10-20

affected fluid balance and diet (protein intake - if eat a lot of protein then high if little protein intake then low.) Kidney function but not specific

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6
Q

Creatinine: normal value & effects of balance

A

Normal value: 0.5-1.5

Specific to kidney function

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7
Q

WBC: normal value & effects of balance

A

Normal value: 5,000-10,000

Low= sepsis
High = infection
Very high= leukemia

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8
Q

Platelets: normal value & effects of balance

A

Normal value: 150k-400k

High: clotting
Low: bleeding

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9
Q

Hgb: normal value & effects of balance

A

Normal value: 10-15

Low: anemia (sob, lethargic, pallor)

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10
Q

Hct: normal value & effects of balance

A

Normal value: 35% > up 48%

Low: anemia (sob, lethargic, pallor)
High: clotting

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11
Q

Bilirubin: normal value & effects of balance

A

<1

High: jaundice, abdominal pain, clay stools, brown urine,

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12
Q

State 2 differences between an ileostomy and colostomy

A

Consistency:
Ileostomy= watery, continuous output.
Colostomy= more formed- not continuous

Location:
ileocecal (right lower quadrant - ileostomy)
colostomy ascending, transverse

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13
Q

How often should an ostomy pouch/wafer be changed?

Bag emptied?

A

7-10 days or prn if there is a leak.

2/3 full

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14
Q

A client calls the clinic stating they have not had any output from their ileostomy for 2hrs. What is the best response by the nurse?

A

knee chest, ambulate, change the wafer, warm shower,

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15
Q

State 3 reasons a nurse would clamp a chest tube?

A
  • leaks (intermittently)
  • Changing the drainage container
  • Getting ready to remove it.
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16
Q

MRI Pre and Post

A

Pre- Make sure there is no metal in the client e.g. welders may have fragments in their eyes and not know it, older pace-makers, rods, etc. Also, are they claustrophobic?

Post- It depends if it’s just a MRI (don’t need to do anything);

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17
Q

CT with contrast: Pre and Post

A

Pre- check for allergies for shellfish or iodine. Hold Glucophage the day of the procedure and 48 hours after

Post- Hold Glucophage 48hrs after the procedure. Increase hydration to excrete dye

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18
Q

Arterial Blood Gas Pre and Post

A

Pre- Allen’s test, check bleeding profile (PT/INR, PTT, Liver function)

Post- Hold pressure for 5 minutes or even longer if on meds that cause bleeding.

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19
Q

Endoscopy Pre and Post

A

Pre- NPO 4-6 hours before to prevent aspiration

Post- Gag reflex before anything PO

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20
Q

Cardiac Catherization

A

Pre- NPO 4-6 hours prior, check allergies shellfish

Post- HOB less 30 degrees; maintain pressure, check site q15 minutes and distant pulses, bp/hr for internal bleeding. Hydration to remove dye from body

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21
Q

Thoracentesis

A

Pre- remain still, assess their lungs, vital signs prior, consent, bleeding time, meds that may increase risk of bleeding

Post- CXR immediately after, assessment of lungs, vital signs immediately

22
Q

State 3 factors that increase a client’s risk for falls

A

Age, medication, previous fall, uses equipment to ambulate (cane, walker), lines

23
Q

How are crutches measured?

A

2-3 fingerbreadths below axillary, 20 degree angle wrist pressure on wrists not axillary

24
Q

A client is being discharged home after hip surgery, what “hip precaution” teaching will you provide?

A

do not cross legs, do not bend over 90 degrees, chair height (upside down stop light), raised toilet seat. chairs with arms

25
Q

What do nurses need to know about traction e.g. bucks or cervical?

A
  • continuous never release

- never change weights

26
Q

State 2 nursing considerations when communicating with a client who is hearing impaired

A

quiet environment, face them, lighting, hearing aids in if they have them, set aside enough time to speak with client

27
Q

A nurse is discharging home a client with a visual deficit. State 3 home safety interventions:

A

no extension cords, good lighting, no scatter rugs

28
Q

What can be delegated to an LPN?

A

Anything but EAT (Evaluate, Assess, and Teach)

stable patients, chronic conditions

29
Q

State 3 nursing ethical principles:

A

autonomy, veracity (telling truth), fidelity (doing what you say you will do, keep your word), beneficence (doing good); nonmaleficence (not doing harm)

30
Q

A client is at risk for aspiration (difficulty swallowing) what should the nurse instruct the CNA to do when feeding the client?

A

90 degrees, chin tuck, no straws, speech and swallow

31
Q

Which type of cerebrovascular bleed requires immediate surgery (lucid then deteriorates quickly)?

A

Epidural bleed

32
Q

State 2 interventions you would do if clear drainage was observed draining from the nares of a client with a basilar skull fracture?

A

halo test; mustache dressing. High risk for CNS infection = nuchal rigidity

33
Q

What are the cardinal signs of Parkinson’s Disease? (TRAPI)

A

Tremors, rigidity, akinesia (bradykinesia slow movement), Postural instability

34
Q

How is autonomic dysreflexia treated? Who is at risk?

A

T6 spinal injury or above, high bp caused by a stimulus below the injury usually bladder distention or constipation or tight clothing.

Sit them up, look for the problem. If SBP >170 give BP medication.

35
Q

State 2 things a nurse needs to know about traction (Gardner wells or Bucks)

A

continuous traction

Do not change weights

36
Q

Where is the phlebostatic axis located?

A

right atrium (4th ICS, mid axillary)

37
Q

What are signs and symptoms of pericarditis?

A

friction rub, pain relieved if leaning forward, and NSAIDS

38
Q

Which type of valve replacement requires life-long anticoagulants?

A

mechanical

biological do not, but need to get a new biological every 8-10 years whereas mechanical is for life

39
Q

How does a venous ulcer differ from an arterial ulcer?

A

Arterial= there is not enough blood, blood is warm and it carries all the nutrients; decreased blood flow to lower extremities will not have edema, will be cool; scarce hair and thick toenails

Venous= blood pools in the feet due to incompetent valves make it difficult for the blood to return to the right side of the heart so edema, warm feet, good pulses, toenails are fine and hair is not patchy. Wounds are shallow with irregular borders

40
Q

What medication(s) would you use to lower systemic vascular resistance?

A

vasodilators, antihypertensives

41
Q

Interpret the following ABG: pH 7.20, pC02 32, Hc03 18, Pa02 70

A

Metabolic Acidosis, partial compensation, hypoxemia

42
Q

What would cause a low pressure alarm on a ventilator?

A

disconnected, pneumothorax, leak, tracheostomy cuff is down.

43
Q

What is the cardinal sign of ARDs?

A

refractory hypoxemia needs mechanical ventilation and high PEEP

44
Q

What labs would the nurse expect for a client admitted with adrenal crisis?

A

Adrenal crisis= hyperkalemia, hyponatremic, hypotension, hypoglycemic

45
Q

What are the complications (emergency) of hypothyroid and hyperthyroid?

A

Hypothyroid emergency/complication: myxedema coma - give synthroid (thyroid hormone)
Hyperthyroid emergency/complication: thyroid storm - treat symptoms High BP, High temperature

46
Q

Using the rule of nines and Parkland formula calculate fluid resuscitation for first 8 hours:
Burns to the face, entire right arm, entire chest and abdomen, entire right leg and groin. Client weighs 68kg

Total to be infused in the first 8hrs: _____________________

A

face: 4.5, 9, 18, 18, 1= 50.5 x 4mL x 68= 13,736/2 = 6868 first 8hrs (has to be infused within 8hrs of the when the burn occurred e.g. if burned at 1000, then it must be infused by 1800) then the rest over the next 16 hours
6868/8= 858.5

47
Q

Compare and contrast

Glomerulonephritis and Nephrotic Syndrome - how are they similar and how are they different?

A

strep infection undetected/not treated - damaged kidneys, more permeable losing large cells albumin and red blood cells. Low albumin look like pillsbury dough boy (edema) frothy coca cola urine (frothy album and coca cola is red blood cells) ; red blood cells anemic. - treat glomerulonephritis antibiotic, go slow with replacing albumin.

If glomerulonephritis is not treated properly then they will develop nephrotic syndrome - irreversible chronic renal failure - go ahead and replace albumin.

48
Q

What are 3 types (causes) of acute renal failure?

A

pre-renal (volume)
intrarenal (drugs aminoglycoside)
post-renal (enlarged prostate or stone)

49
Q

Frequency and Complications that might occur:

Hemodialysis

A

Frequency: 3 days a week for few hours

Complications that might occur: hypotension

50
Q

Frequency and Complications that might occur:

Peritoneal Dialysis

A

Frequency: several exchanges a day

Complications that might occur: fluid overload

Competency (1 decks)

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