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Nursing Acute Care > Exam #2 > Flashcards

Exam #2 Flashcards

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1
Q

what percentage of the body is water?

A

60%

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2
Q

what is the purpose of water in the body?

A

transportation of nutrients and waste

insulator/shock absorber

regulates and maintains body temp

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3
Q

what is considered intake?

A

oral fluids

iv fluids

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4
Q

what is considered output?

A

urine
water stool
emesis

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5
Q

what is emesis?

A

vomit

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6
Q

how can you measure emesis?

A

emesis bag

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7
Q

how can you measure watery stool?

A

cylinder marks or hat

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8
Q

what do kidneys do?

A

removes waste from blood and urine
regulates fluid and electrolyte balance
regenerate, reabsorb, excrete bicarb

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9
Q

what is the primary regulator of fluid intake?

A

thirst

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10
Q

what does an antidiuretic hormone do?

A

regulates water excretion from the kidney
tells your kidneys to hold on to fluid

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11
Q

what does ADH do to you cells?

A

increases cell permeability allowing more water to go into the cells

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12
Q

do you excrete ICF or ECF?

A

ecf

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13
Q

what does renin angiotensin aldosterone do?

A

xx

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14
Q

what does Na do for the body?

A

regulates ECF…maintains blood volume…transmits nerve impulses

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15
Q

what is the main function of Na for the body?

A

Neuro…transmits nerve impulses and muscle contractions

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16
Q

what are some sources of Na?

A

table salt..cheese..canned foods..processed foods

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17
Q

what does hypernatremia mean?

A

too much sodium in the blood

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18
Q

what does hyponatremia mean?

A

too little sodium in the blood

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19
Q

what does K do for the body?

A

maintains ICF…transmits nerve and electrical impulses…regulates cardiac contraction

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20
Q

what is the main function of K for the body?

A

Cardiac…regulates cardiac contraction

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21
Q

what are sources of K?

A

bananas…spinach..tomatoes…meat..milk…oranges

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22
Q

what does hyperkalemia mean?

A

too much potassium in the blood

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23
Q

what does hypokalemia mean?

A

too little potassium in the blood

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24
Q

what does Ca do for the body?

A

forms bones and teeth….transmitts nerve impulses…reuglates muscle contraction and relaxation..maintains cardiac pace

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25
Q

what is the main function of Ca for the body?

A

Muscle….muscle contraction and relaxation

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26
Q

what are some sources of Ca?

A

milk…milk products..green leafy veggies….canned salmon

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27
Q

what does bicarb do for the body?

A

regulates acid base balance

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28
Q

what are some sources of bicarb?

A

not found in food….only produced in metabolic process…can be given as a medication

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29
Q

what are some symptoms of hypo/hyper natremia?

A

seizures…coma..confusion…headache.. decreased LOC

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30
Q

what are some symptoms of hypo/hyper kalemia?

A

extra heartbeats…rhythm changes

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31
Q

what are some symptoms of hypo/hyper calcemia?

A

tetany

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32
Q

what does tetany mean?

A

muscle spasms

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33
Q

what is Chvostek sign?

A

when you touch the cranial nerve the patient winks

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34
Q

what is the trousseau sign?

A

muscle contraction

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35
Q

what is the minimum output per hour?

A

30ml

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36
Q

what is fluid volume deficit?

A

when the body loses too much water and electrolytes from ecf

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37
Q

what is another term for fluid volume deficit?

A

dehydration

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38
Q

what are the symptoms of dehydration?

A

headache…tirdness..dry mouth..pale..weight loss…weak thready pulse

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39
Q

what happens to vital signs in a patient with fluid volume deficit/dehydration?

A

drop in BP…increased HR

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40
Q

what is the pulse like for a patient with fluid volume deficit/dehydration?

A

weak thready…+1

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41
Q

does the patient experience hemoconcentration in fluid volume deficit or fluid volume excess?

A

FVD

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42
Q

what is hemoconcentration?

A

when nutrients in the blood that would normally be distributed become overly concentrated

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43
Q

how can hemoconcentration affect lab value?

A

increases

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44
Q

what positioning is recommended for patients in fluid volume deficit?

A

flat or in Trendelinburg

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45
Q

why would you put your patient flat or in Trendelinburg when they are in fluid volume deficit?

A

it puts the fluid that is available to vital organs like the brain and heart

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46
Q

what electrolyte should be increased in patients with fluid volume deficit?

A

Na

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47
Q

what is the patient experiencing if their output is greater than their input?

A

fluid volume deficit

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48
Q

what the patient experience if input if greater than output?

A

fluid overload

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49
Q

when are some examples of when you would see fluid volume deficit in a patient?

A

extreme sweating…lack of water intake

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50
Q

what is fluid volume excess?

A

when the body retains both water and Na in similar proportions in ECF

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51
Q

what will the patient have if they are in fluid volume excess?

A

edema

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52
Q

what are some symptoms of fluid volume excess?

A

weight gain…shinny stretchy skin…distended jugular…sob..ascites…spleen/liver damage…crackles in lungs

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53
Q

what vital sign changes will you see in someone with fluid volume excess?

A

High BP…High HR

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54
Q

what will the pulse be like for a patient with fluid volume excess?

A

bounding pulse…+3

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55
Q

what positioning is recommended for patients in fluid volume excess?

A

high fowlers

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56
Q

what would you limit in patients with fluid volume excess?

A

Na

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57
Q

what lung sounds would be present in someone with fluid volume excess?

A

crackels

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58
Q

what type of acid base balance takes the longest to fix?

A

metabolic

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59
Q

what type of acid-base balance is the quickest to fix?

A

respiratory

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60
Q

what is the role of the lungs in acid base balance?

A

to release CO2

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61
Q

what is the role of the kidneys in acid base balance?

A

excretion or conservation of bicarb

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62
Q

what is the time frame for respiratory acidosis/alkalosis to be fixed?

A

within minutes

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63
Q

what is the time frame for metabolic acidosis/alkalosis to be fixed?

A

hours to days

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64
Q

what is the chemical formula for bicarb?

A

HCO3

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65
Q

what are the values for respiratory alkalosis?

A

pH above 7.45…PaCO2 below 35…Normal HCO3

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66
Q

when would someone be in respiratory alkalosis?

A

hyperventilation…anxiety…fear…PE…mechanical ventilation

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67
Q

what is recommended for patients with respiratory alkalosis?

A

to breathe into a paper bag or slow down breathing

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68
Q

what are the values for respiratory acidosis?

A

pH below 7.35…PaCO2 above 45….Normal HCO3

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69
Q

when would someone be in respiratory acidosis?

A

hypoventilation

70
Q

what patients most commonly get respiratory acidosis?

A

COPD, Asthma, drug OD, patients who have recently had anesthesia

71
Q

what do you do for someone with respiratory acidosis?

A

give bronchodilators

72
Q

what are the values for metabolic alkalosis?

A

pH above 7.45….Normal PACO2…HCO3 above 26

73
Q

what can cause metabolic alkalosis?

A

antacids…NG tube suctioning

74
Q

what do you do for someone with metabolic alkalosis?

A

stop taking antacids….put suctioning on intermittent

75
Q

what are the values for someone with metabolic acidosis?

A

pH below 7.35…Normal PACO2…HCO3 below 22

76
Q

what can cause metabolic acidosis?

A

dehydration…severe diarrhea..renal failure…liver failure…DKA…hypermetabolism

77
Q

what do you do for a patient with metabolic acidosis?

A

give bicarb

78
Q

what is included in the upper respiratory system?

A

mouth…nose..pharynx..larynx..trachea

79
Q

what is the lower respiratory system?

A

bronchioles…alveoli…bronchi…capillaries…pleural membrane

80
Q

what are some examples of an upper respiratory infection?

A

common cold…flu…strep…sinus infection

81
Q

what are some examples of a lower respiratory infection?

A

bronchitis…pneumonia…TB

82
Q

what infection has a higher probability of leading to death?

A

lower respiratory infection

83
Q

what is the function of the respiratory system?

A

oxygen transport…respiration…ventilation

84
Q

what is oxygen transport?

A

bringing air into the lungs and transporting the air into the bloodstream

85
Q

what is respiration?

A

the process of gas exchange in the capillaries

86
Q

what is ventilation?

A

process of moving air in and out of the lungs

87
Q

what is gas exchange?

A

intake of oxygen and release of carbon dioxide

88
Q

where does gas exchange occur?

A

alveoli

89
Q

what factors can alter respiratory function?

A

age…infection…genetics..environment…lifestlye…health…meds..stress

90
Q

what history information would you gather for the respiratory system?

A

family history…medical history…medications

91
Q

what are you looking for in a respiratory assessment?

A

respiration rate and rhythm
breath sounds
chest shape and size
use of accessory muscles
coughing
pulse…rate..rhythm…palpitations
BP
Skin color
overall appearance

92
Q

what are the adventitious breath sounds?

A

crackles…wheezes..rhonchi…stridor…pleural friction rub

93
Q

what do crackles indicate?

A

fluid in the lungs

94
Q

what do wheezes indicate?

A

constriction in the airway

95
Q

what are some signs of respiratory disease?

A

dyspnea….SOB…cough…sputum…chest pain..wheezing..hemoptysis

96
Q

what is hemoptysis?

A

coughing up blood

97
Q

what is hypoxemia?

A

low levels of oxygen in the blood

98
Q

what are the symptoms of hypoxemia?

A

headaches…SOB…coughing…tachycardia..wheezing…confusion…cyanosis

99
Q

what is hypoxia?

A

decreased oxygen in the tissue

100
Q

what are the symptoms of hypoxia?

A

restless..anxious…tachycardia…tachypnea..bradycardia..dyspnea…..

Tachy and Brady???

101
Q

what is eupnea?

A

normal breathing

102
Q

what is tachypnea

A

fast RR

103
Q

what is bradypnea?

A

slow RR

104
Q

what is apnea?

A

a stop in breathing

105
Q

what is Kussmaul breathing patterns?

A

deep and shallow breathing

106
Q

what acid-base condition commonly has Kussmaul breathing patterns?

A

metabolic acidosis…done to blow off excess acid

107
Q

what is cheyens strokes?

A

deep - shallow breathing with periods apnea

108
Q

when are Cheyenne’s strokes commonly seen?

A

before death and with HF patients

109
Q

what are biots breathing patterns?

A

shallow breaths with periods of apnea

110
Q

what is dyspnea?

A

trouble breathing

111
Q

what is orthopnea?

A

trouble breathing while lying down

112
Q

what interventions can aid in oxygenation?

A

positioning…suction…trach…vent…breathing techniques…elevated HOB…liquifying secretions with humidification and oral fluids

113
Q

what is pneumonia?

A

Inflammation of the lung parenchyma and is generally results from an infection

Infection that inflames air alveolar sacs in one or both lungs, which may fill with fluid

114
Q

is pneumonia primary or secondary or both?

A

both

114
Q

what are the risk factors for pneumonia?

A

older adults…vent use…aspiration….meds…immunocompromised…chronic lung disease…trach..EG…NG..prolonged immobility…smoking..underlying medical condition

115
Q

what are the classifications of pneumonia?

A

community acquired… hospital-acquired… ventilator….healthcare-associated

116
Q

what are the assessments for pneumonia?

A

cough…sputum…sudden onset chills or fever….pleuritis…tachypnea…fatigue…impaired nutritional status…decreased lung sounds…tachycardia…respiratory distress..hemoptysis… decreased spo2…elevated WBC

117
Q

what labs are looked at for pneumonia?

A

CBC…WBC…Blood Culture…Sputum cultures

118
Q

what diagnostic tool is used for pneumonia?

A

chest x-ray

119
Q

what interventions are there for pneumonia?

A

TCDB….spirometer…oral suction…monitor pulse…promote comfort/rest…antibiotics…

120
Q

what is a pulse oximeter?

A

noninvasive method for monitoring oxygen sat of hemoglobin…. Individual values should be 94% and above…probe can be placed on nail bed or ear lobe…cold extremities can give low readings…nail polish can also affect the accuracy of reading

121
Q

what are some mucus colors that could be present for pneumonia?

A

yellow…. blood-streaked…rusty

122
Q

what can cause pneumonia?

A

PCP and MAc

123
Q

what orders may a Dr ask for a pneumonia patient?

A

Sputum culture..chest x-ray…ABG

124
Q

what is pulmonary TB?

A

an airborne infection that is highly contagious….affects the lungs

125
Q

what are the risk factors for getting TB?

A

contact with someone who has TB… immunocompromised….crowded living conditions…foreign immigrants…older homeless people…lower socioeconomic groups…drug addicts… healthcare workers

126
Q

what are some symptoms of a patient with TB?

A

low-grade fever…chills…productive cough…night sweats..fatigue…weight loss…hemoptysis…anorexia…SOB…abnormal breathing sounds

127
Q

how long can TB symptoms last?

A

weeks to months

128
Q

how is TB diagnosed?

A

skin tests…blood tests…sputum culture…chest x ray

129
Q

what should nurses do for TB patients?

A

promote airway clearance….. activity…nutrition… adherence to treatment…prevent transmission

130
Q

generally how long does it take for TB patients to not be contagious?

A

3 weeks

131
Q

how long does the treatment of TB last?

A

6 months to 2 years

132
Q

how many sputum samples are collected before the diagnosis of someone with TB?

A

3

133
Q

what are some symptoms of respiratory acidosis?

A

hypoventilation…rapid shallow resp…decrease in BP…dyspnea…headache…hyperkalemia…drowsiness…dizziness..decreased LOC…muscle weakness…hyperreflexia

134
Q

what are some symptoms of respiratory alkalosis?

A

hyperventilation…tachycardia…drop of BP…hypokalemia…numbness…tingling…cramping…seizures..anxiety

135
Q

what respiratory acid-base patient would complain of not being able to catch their breath?

A

respiratory acidosis

136
Q

what are the symptoms of metabolic alkalosis?

A

confusion… dizziness….dysrhythmias…hypokalemia…tremors…cramps…

137
Q

what are the symptoms of metabolic acidosis?

A

headache…confusion…low BP….hyperkalemia….twitching….flushed skin…kussmaul resp

138
Q

what are the symptoms of hypoxia?

A

RAT….Restless…..Anxious…Tachycardia…Tachypnea

BED…Bradycardia…..Extreme anxiousness…Dysnpnea

139
Q

what are the symptoms of hypoxemia?

A

confusion…headache….coughing…wheezing…cyanosis…SOB…Tachycardia…

140
Q

what symptoms are shared between TB and Pneumonia?

A

cough….malaise/tiredness…temp…pleuritic pain…hemoptysis

141
Q

what are the symptoms of TB?

A

Weight loss…anorexia….night sweats…hemoptysis…

142
Q

what are the symptoms of pneumonia?

A

tachycardia…tachypnea…dyspnea…resp distress…chills…

143
Q

what are the symptoms of BPH?

A

post dribble…nocturia….weak stream….straining…hesitancy

144
Q

what is BPH?

A

enlargement of prostate

145
Q

what are risk factors for BPH?

A

male….minorities…over the age of 40…family history…obesity…lifestyle…high cholesterol

146
Q

what lab tests are for BPH?

A

psa…prosta specific antigent

147
Q

what diagnostic tests for BPH?

A

x ray…MRI…CT

148
Q

how much fluid should BPH patients drink?

A

2-3L

149
Q

should BPH patients chug or sip water?

A

sip

150
Q

what surgery is used for BPH?

A

TURP

151
Q

what are the complications of BPH?

A

kidney failure and prostaectomy

152
Q

what is cystitis?

A

inflammation of the bladder

153
Q

what is poly nephritis?

A

inflammation of the kidney

154
Q

what are risk factors for cystitis and polynephritis?

A

female…sexual activity…urinary catheters….medications…metabolic disease

155
Q

what are the symptoms of cystitis and polynephritis?

A

burning…hematuria…urgency….malaise…flank pain..pelvic pain

156
Q

what are the labs for cystitis and polynephritis?

A

Urine culture….ESR….WBC….BUN…Creatinine

157
Q

how much fluid should cystitis and polynephritis?

A

2L-3L

158
Q

what type cleaning technique should cystitis and polynephritis patients use?

A

sitz bath

159
Q

what are the complications of cystitis and polynephritis?

A

sepsis…..cystitis leading to poly nephritis…kidney failure

160
Q

what should be limited in cystitis and polynephritis?

A

caffeine…tight clothes…OJ…acidic drinks

161
Q

what is the TURP procedure?

A

part or full removal of the prostate

162
Q

when should patiets get the TURP procedure?

A

meds dont work….prostate too large…preference..combo with meds

163
Q

what color should urine be during irrigation?

A

reddish pink to pinkish yellow`

164
Q

what are some complications for TURP?

A

hemorrhage…blood clot…sexualy dysfunction…electrolyte imbalance from irrigation

165
Q

what should be done pre TURP?

A

baseline labs….urine C and S…H and P…..discharge education

166
Q

what should be done post TURP?

A

3 way foley cath….hydration…ambulation….med education…complications

167
Q

what nursing interventions should be considered for TURP?

A

monitor for bleeding….irrgation of foley for ideal color…monitor for clots….monitor for fluid overload…hyponatremia

168
Q
A
169
Q
A

Nursing Acute Care (4 decks)

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