Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Surg Exam 1 > Exam 1 SG > Flashcards

Exam 1 SG Flashcards

1
Q

Fluid Volume Deficit Causes

A

-Fluid loss (diarrhea, vomiting, polyuria, hemorrhage)
-Inadequate intake (unconscious, not thirsty)
-Fluid shift (burns)

HYPOVOLEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fluid Volume Deficit Labs

A

Electrolytes are lost (elderly at risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fluid Volume Deficit S/S-

A

-Confusion, restlessness/drowsy
-Thirst, dry mucous membranes*, decreased skin turgor & capillary refill
-Postural hypotension, increased HR, RR, low BP, low concentrated urine
-Weakness and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fluid Volume Deficit Treatment

A

-Correct underlying causes and replace water and electrolytes (orally, blood products, balanced (isotonic) IV solutions
-Seizure precautions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fluid Volume Excess Causes

A

-Excess fluid intake
-Renal failure
-Heart failure
-Burns (interstitial to plasma fluid shift)

-HYPERVOLEMIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fluid Volume Excess Labs

A

-Electrolytes aren’t necessarily unbalanced
-Monitor daily weights and I&O’s
1kg = 1L of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fluid Volume Excess S/S

A

-Weight Gain
-HA, confusion
-Peripheral edema, JVD, increased CVP
-S3 heart sounds, bounding pulse, increased BP
-Polyuria
-Dyspnea, crackles, pulmonary edema
-Muscle spasms, seizures, coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fluid Volume Excess Treatment

A

-Diuretics
-Na+ restriction
-Para/thoracentesis
-Monitor I&O’s
-Seizure Precautions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypertonic IV

A

-Too much can dehydrate cells, causing them to shrivel
-pulls fluid from cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hypotonic IV

A

-Too much can burst cells, cerebral edema
-Fluid moves into cells, plumps up the cells
- Risk for cells to explode!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Isotonic IV

A

-Too much can cause fluid overload
-Hydrates the cells, expands vascular volume
-ISO = same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hypernatremia Lab Value

A

> 145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hyponatremia Lab Value

A

<136

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hyperkalemia Lab Value

A

> 5.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hypokalemia Lab Value

A

<3.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypercalcemia Lab Value

A

> 10.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hypocalcemia Lab Value

A

<9.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypermagnesemia Lab Value

A

> 2.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hypomagnesemia Lab Value

A

<3.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hyperphosphatemia Lab Value

A

> 4.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hypophosphatemia Lab Value

A

<3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hypernatremia causes

A

“MODEL”
M-medications, meals (too much sodium intake)
O-osmotic diuretics
D-diabetes insipidus
E-excessive water loss
L-low water intake

> 145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hypernatremia S/S

A

“FRIED & SALTED”
F-fever (low grade)
R-restlessness and agitation
I-increased fluid retention
E-edema: peripheral & pitting
D-dry mouth

S-skin flushed
A-altered LOC, confusion
L-low urinary output
T-thirst
E-elevated BP
D-decreased energy, weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hypernatremia Treatment

A

Decreased ECF
-PO or IV isotonic fluid replacement

Normal/increased ICF
-Hypotonic IV (plumps up cells)
-Diuretics for Na+
-Na+ restriction
-Seizure precautions
-Fluid restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hyponatremia Causes

A

“MOBS Fail”
M-medications (diuretics)
O-oral gastric tube suctioning
B-burns
S-SIADH
F-failure: heart, kidney, liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hyponatremia S/S

A

“LOW SODIUM”
L-LOC altered (confusion*)
O-orthostatic hypotension
W-weak muscles

S-seizures*
O-osmolality low (serum)
D-diarrhea
I-increased ICP (difficulty concentrating*)
U-urine osmolality high
M-more bowel sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hyponatremia Treatment

A

Fluid and Na+ loss
-Administer isotonic IV solutions
-Encourage oral fluid intake
-Stop diuretics

Dilutional hyponatremia
-Fluid restriction
-Diuretics
-Demeclocycline

Correct sodium level slowly (to prevent brain damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Hyperkalemia Causes

A

“SIMM”
S- shift from ICF to ECF (acidosis)
I-impaired renal excretion (MOST COMMON)
M-massive intake of K+ (salt substitutes)
M-medications: digoxin, beta blockers, ACE inhibitors, potassium sparing diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Hyperkalemia S/S

A

“MURDER”
M-muscle cramps
U-urine abnormalities
R-respiratory distress
D-decreased cardiac contractility
E-EKG changes (Peaked T waves and QRS waves, widened P wave)
R-reflexes (depressed/absent DTRs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hyperkalemia Treatment

A

-Stop oral or parenteral K+ intake
-Increase excretion
-Force into ICF with dextrose, insulin, bicarb, or albuterol (temporary)
Stabilize cardiac membranes using IV calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Hypokalemia Causes

A

“GRIM”
G- GI losses (diarrhea & vomiting)
R-renal losses (magnesium deficiency, diuretics)
I-inadequate K+ intake
M- metabolic alkalosis or insulin administration (shifts K+ into ICF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hypokalemia S/S

A

“7 L’s”
L-lethargic (N/V)
L-low shallow respirations (failure)
L-Lethal cardiac dysrhythmias (prominent U wave, ST depression, shallow T)
L-Leg cramps
L-Limp muscles
L-Low BP
L-Low GI motility

Hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hypokalemia Treatment

A

1) Oral K+ first
2) Then IV
more K+ in diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Hypercalcemia Causes

A

“CHIVE”
C-cancer
H-hyperparathyroidism
I-immobilization
V-vitamin D overdose
E-elevated vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hypercalcemia S/S

A

“BACK ME”
B-bone pain
A-arrhythmias, HTN
C-cardiac arrest
K-kidney stones
M-muscle weakness
E-excessive urination (dehydration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Hypercalcemia Treatment

A

Mild
-Stop meds
-low calcium diet
-exercise
-hydration

Severe
-Isotonic IV
-Calcitonin (inhibits Ca movement)
-Biphosphates (inhibit osteoclast activity, prevents Ca release)
-Dialysis (if life threatening)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Hypocalcemia Causes

A

“MAID”
M-multiple blood transfusions (6-10 per day)
A-alkalosis
I-increased calcium loss
D-decreased production of PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Hypocalcemia S/S

A

“CATS go Numb”
C-convulsions
A-arrhythmias
T-tetany
S-spasms and stridor
NUMB-numbness in the fingers and around mouth

*Trousseau’s (BP cuff, hand spasms)
*Chvostek’s (eye/lip twitch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Hypocalcemia Treatment

A

-Treat underlying cause
-increase dietary calcium intake
-Vit D supplements
-IV calcium gluconate
-Change loop to thiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Hypermagnesemia Cause

A

-Increased intake of Maalox/milk of mag with renal insufficiency/failure
-Excess IV Mg administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Hypermagnesemia S/S

A

-Hypotension, facial flushing
-Lethargy
-N/V
-Impaired DTR’s
-Muscle paralysis
-Resp and cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Hypermagnesemia Treatment

A

-Avoid Mg food/drugs
-Fluid administration to promote excretion
-Calcium gluconate IV to counteract the effects of the elevated Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Hypomagnesemia Causes

A

-Chronic alcoholism
-Prolonged fasting/starvation
-Fluid loss from GI tract
-Prolonged parenteral nutrition w/o supplementation
-Diuretics, PPI’s
-Hyperglycemic osmotic diuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Hypomagnesemia S/S

A

Resembles hypocalcemia
-Muscle cramps, tremors, hyperactive DTRs, Chvostek’s and Trousseau’s sign
-Confusion, vertigo and seizures
-Dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Hypomagnesemia Treatment

A

-Treat underlying cause
-Increase oral Mg intake
-Administer Mg IV if needed (monitor for hypotension and arrhythmias)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Hyperphosphatemia Causes

A

-Acute kidney injury
-Chronic kidney disease
-Excessive intake
-Excessive vitamin D
-Hypoparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Hyperphosphatemia S/S

A

-Tetany, muscle cramps, paresthesia
-Hypotension, dysrhythmias
-Seizures
-Calcium deposition -> organ dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Hyperphosphatemia Treatment

A

-Treat underlying cause
-Restrict dietary intake of phosphate
-Calcium carbonate to bind
-Volume expansion & forced diuresis with loop diuretics
-Dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Hypophosphatemia Causes

A

-Malnourishment/malabsorption
-Alcohol withdrawal
-Diarrhea
-Phosphate binding antacids
-Inadequate replacement from parenteral feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Hypophosphatemia S/S

A

-CNS depression
-Muscle weakness (including resp.) and pain
-Resp. and heart failure
-Rickets
-Osteomalacia (soft bones)
-Rhabdomyolysis (skeletal muscle breaks down rapidly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Hypophosphatemia Treatment

A

-Increase oral intake (dairy)
-Supplements (can irritate GI tract)
-IV supplements (slow) (potassium phosphate, sodium phosphate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

pH Values

A

7.35-7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Carbon Dioxide (PaCO2) Values

A

35-45

54
Q

Bicarb (HCO3) values

A

22-26

55
Q

Partial Pressure of Arterial O2 (PaO2) Values

A

80-100

56
Q

Saturation of Arterial O2 (SaO2) Values

A

95%-100%

57
Q

Respiratory Acidosis Cause

A

-HYPOVENTILATION
-Respiratory depression from lungs
-Airway obstructions (COPD, pneumonia, PE)
-Ventilator hypoventilation
-Excess HCO3 (bicarb)

58
Q

Respiratory Acidosis Labs

A

pH: <7.35
CO2: <45

59
Q

Respiratory Acidosis Treatment

A

Stimulate them

60
Q

Respiratory Alkalosis Cause

A

-HYPERVENTILATION
-Anxiety, stress
-Pain
-High ventilator settings

61
Q

Respiratory Alkalosis Labs

A

pH: >7.45
CO2: <35

62
Q

Respiratory Alkalosis Treatment

A

Calm them down

63
Q

Metabolic Acidosis Causes

A

-Diarrhea
-Acid gain from hypoxia
-Renal Failure
-Drugs or toxins
-Bicarb loss from bile drainage
-Pancreatic fistulas

64
Q

Metabolic Acidosis Labs

A

pH: <7.35
HCO3 (bicarb): <22

65
Q

Metabolic Acidosis Treatment

A

-Encourage breathing
-Give bicarb

66
Q

Metabolic Alkalosis Causes

A

Acid Loss
-Vomiting
-NG suctioning
-Diuretics
-Steroids
-Cushing’s
-Hyperaldosteronism
-Hepatic disease
-Hypokalemia
-Hypochloremia

Bicarbonate Gain
-Dosing with bicarb
-Excess infusion of lactated ringers’ solution

67
Q

Metabolic Alkalosis Labs

A

pH: <7.45
HCO3 (bicarb): <26

68
Q

Metabolic Alkalosis Treatment

A

Slow breathing

69
Q

Daily amount of insulin secreted by an adult?

A

40-50 units

70
Q

Type 1 Diabetes Mellitus Patho

A

-Autoimmune disease resulting in progressive destruction of pancreatic B cells
-80-90% of B cells are destroyed before S/S manifest
-Accounts for 5-10% of all diabetes cases
-Generally, affect those under 40 years

71
Q

Type 1 Diabetes Mellitus Causes

A

-Genetic predisposition (human leukocyte antigen)
-Exposure to a virus or idiopathic

72
Q

Type 1 Diabetes Mellitus Diagnostics

A

-A1C: >6.5
-Fasting glucose >126
-Random glucose >199
-2-hour OGTT >200

73
Q

Type 1 Diabetes Mellitus S/S

A

-Polyuria, polydipsia, polyphagia
-Fatigue
-Weight loss
-No insulin produced

74
Q

Type 1 Diabetes Mellitus Treatment-

A

-Will require insulin, should exercise

75
Q

Type 2 Diabetes Mellitus Patho

A

-Most prevalent type 90-95%
-Pancreas continues to produce some insulin but not enough insulin is produced and the body does not use insulin effectively

76
Q

Type 2 Diabetes Mellitus Cause

A

-Obese/overweight
-Old age
-Family history

77
Q

Type 2 Diabetes Mellitus Diagnostics

A

-A1C >6.5
-Fasting glucose >126
-Random glucose >200
-2-hour OGTT >200

78
Q

Type 2 Diabetes Mellitus S/S

A

-Recurrent infection (increase insulin needed)
-Fatigue
-Polyuria, polydipsia, polyphagia
-Prolonged wound healing, visual changes

79
Q

Type 2 Diabetes Mellitus Treatment

A

-Emphasis on goals for glucose, lipids and BP
-Calorie reduction and weight loss to improve insulin sensitivity
-Needs exercise

80
Q

Short Acting Insulin Examples

A

Regular Insulin
-Humulin R
-Novolin R

81
Q

Short Acting Insulin Onset

A

30-60 minutes
Inject 30-45 minutes before meals

82
Q

Short Acting Insulin Peak and Duration

A

Peak: 2-5 hours
Duration: 5-8 hours

83
Q

Short Acting Insulin Uses/Administration Considerations

A

-Several hours after meal, may have hypoglycemia
-Insulin still present and glucose is falling post meal
-Abdomen is preferred site for all insulin-most rapid and consistent absorption
-The only insulin that can be given IV when immediate onset of action is desired

84
Q

Rapid Acting Insulin Examples

A

Lispro (Humalog)
aspart (NovoLog)
Glulisine (Apidra)

85
Q

Rapid Acting Insulin Onset

A

10-30 minutes
Inject 0-15 minutes before meals

86
Q

Rapid Acting Insulin Peak/Duration

A

Peak: 30 minutes- 3 hours
Duration: 3-5 hours

87
Q

Rapid Acting Insulin Uses/Administration Considerations

A

-Peak and duration more consistent with digestion and metabolism pattern postprandial.
-Better for meal coverage, but because of short duration of action a basal background insulin must be used in conjunction with it.

88
Q

Intermediate Insulin Examples

A

NPH (cloudy)
Humulin N or Novolin N

89
Q

Intermediate Insulin Onset

A

1.5-4 hours

90
Q

Intermediate Insulin Peak and Duration

A

Peak: 4-12 hours
Duration: 12-18 hours

91
Q

Intermediate Insulin Uses/Administration Considerations

A

-2 injections provide coverage for 24 hours
-Give at breakfast and dinner
-Hypoglycemia attacks most likely with peak of action, if food is not eaten at that time
-Mixed with zinc and protamine to prolong the action, therefore must be mixed (shaken) before administration

92
Q

Long-Acting Insulin Examples

A

-Glargine (Lantus)
-Detemir (Levemir)
-Degludec (Thesiba)

93
Q

Long-Acting Insulin Onset

A

0.8-4 hours
Administer at bedtime or in the morning (follow the regimen patients uses at home); important to give at the same time each day

94
Q

Long-Acting Insulin Peak and Duration

A

Peak: no pronounced peak
Duration: 16-24 hours

95
Q

Long-Acting Insulin Uses/Administration Considerations

A

-Mimics the basal cell level of insulin produced by the body in 24-hour period, low risk for hypoglycemia.
-DO NOT MIX WITH OTHER INSULINS
-Useful for people with nighttime rises in blood sugar
-Hold metformin for type 2 DM contrast procedures.

96
Q

Hyperglycemia Glucose

A

> 126 mg/dl

97
Q

Hyperglycemia Causes

A

Poorly controlled diabetes

98
Q

Hyperglycemia Long Term

A

Can lead to neuropathy, kidney disease, vision loss, stoke, amputation.

99
Q

Hypoglycemia Glucose

A

<70 mg/dl

100
Q

Hypoglycemia Causes

A

-Too much insulin
-Exercise
-poor timing (r/t administration of insulin)

101
Q

Hypoglycemia S/S

A

-Anxious, irritable, sweaty, cool clammy skin, hungry
-Confused, blurred/double vision

102
Q

Hypoglycemia Treatment

A

-15g of carbs like fruit juice if below 70, recheck in 15 minutes, repeat if needed.
-IV D50 or IM glucagon if unresponsive/unconscious
-A set meal pattern with bedtime snacks is necessary to prevent this

103
Q

Diabetic Ketoacidosis (DKA) Cause

A

-Profound lack of insulin
-Characterized by hyperglycemia, ketosis, acidosis, and dehydration (needs fluids)
-Occurs more with type 1 DM

104
Q

Diabetic Ketoacidosis (DKA) Labs

A

Glucose >250
Blood pH <7.30, bicarb <16
High ketones in urine

105
Q

Diabetic Ketoacidosis (DKA) S/S

A

-Hyperglycemia
-Ketosis (fruity breath), ketonuria
-Deep rapid breathing (Kussmaul)
-Metabolic acidosis, dehydration
-Hyperkalemia, tachycardia

106
Q

Diabetic Ketoacidosis (DKA) Treatment

A

-Stat isotonic IV, then insulin
-Electrolyte replacement
-Only regular insulin can be used
-Potassium may need to be replaced when insulin is given
-If glucose is below 250 give dextrose in IV

107
Q

Hyperglycemia Hyperosmolar Syndrome (HHS) Glucose

A

> 600

108
Q

Hyperglycemia Hyperosmolar Syndrome (HHS) Causes

A

-Infections (UTI’s pneumonia, sepsis)
-New type 2 diabetes
-Impaired thirst/lack of fluids

109
Q

Hyperglycemia Hyperosmolar Syndrome (HHS) S/S

A

->600
-Dry parched mouth, extreme thirst, polyuria
-Warm but not sweaty, fever
-Sleepiness, confusion, vision loss, hallucinations

110
Q

Hyperglycemia Hyperosmolar Syndrome (HHS) Treatment

A

-Boat load of fluids
-IV NaCl and insulin
-More fluids and less insulin is needed compared to DKA
-Add dextrose to IV when glucose <250
-Monitor pt closely, especially K+ levels

111
Q

Diabetic Retinopathy

A

-Diabetes is the most common cause of new cases of blindness
-Cataracts and glaucoma
-Control diabetes, surgery

112
Q

Diabetic Nephropathy

A

-Kidney dysfunction
-Labs-elevated BUN and creatinine
-ACE inhibitors and angiotensin receptor 2 blockers with tight glucose control. Dialysis in late stages

113
Q

Diabetic Foot Ulcer

A

-Staged ulcer resulting from poor lifestyle choices r/t diabetes. Common with sensory neuropathy and peripheral artery disease, smoking increases risk.
-Ulcer, risk for infection
-Wound care and debridement, pt must have meticulous foot care.
-Check water temperature with thermometer, not feet.

114
Q

Diabetic Neuropathy

A

-Distal symmetric loss of sensation with uncontrolled diabetes (hands and feet), deformities may be present.
-Numbness, burning, tingling, shooting pain and cramps of extremities. Impaired balance, foot deformities, hot and cold sensitivity. Worse at night.
-Delayed gastric emptying CV problems, sexual dysfunction, neurogenic bladder
-Tight glucose control. Drugs- topical creams, tricyclic antidepressants, SSIs and NE reuptake inhibitors, antiseizures.

115
Q
A
116
Q
A
117
Q
A
118
Q
A
119
Q
A
120
Q
A
121
Q
A
122
Q
A
123
Q
A
124
Q
A
125
Q
A
126
Q
A
127
Q
A
128
Q
A
129
Q
A
130
Q
A
131
Q
A
132
Q
A

Med Surg Exam 1 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions