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Nurs. 302 > Exam 3 > Flashcards

Exam 3 Flashcards

0
Q

What is the major cause of tooth loss in adults older than 35 years?

A

Gum disease

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1
Q

What is the decay of teeth with the formation of cavities called?

A

Caries

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2
Q

What is gingivitis?

A

Gingivitis is an inflammation of the gingiva, tissue surrounding the teeth

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3
Q

What is periodontitis?

A

Periodontitis is a marked inflammation of the gums that also involves degeneration of the dental periosteum and bone

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4
Q

What is stomatitis?

A

Stomatitis , an inflammation of the oral mucosa, has numerous causes, such as bacteria, viruses, mechanical, trauma, irritants, nutritional deficiencies, and systemic infection. Symptoms include heat, pain, increased flow of saliva, and halitosis.

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5
Q

What is glossitis?

A

Glossitis, an inflammation of the tongue,can be caused by deficiencies of vitamin B12, folic acid, and iron

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6
Q

What is cheilosis?

A

Cheilosis, an ulceration of the lips, is most often caused by vitamin B deficiencies (esp. Riboflavin)

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7
Q

What are the symptoms of periodontitis ?

A

Symptoms include: bleeding gums, swollen, red, painful gum tissue,receding gum lines,, pus that appears when gums are pressed and loose teeth

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8
Q

What is pediculosis?

A

It means to be infested with lice

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9
Q

What are the 3 common types of lice?

A

Pediculus humanus capitis: hair/scalp

Pediculus humanus corporis: body

Phthirus pubis: pubic

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10
Q

Where should you store dentures?

A

Store denture in cold water, leaving dentures to dry can cause warping

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11
Q

True or false
In a patient that wears contacts, the cornea requires more than the normal supply of oxygen because it’s metabolic rate increases

A

True

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12
Q

What could happens if you don’t pull the foreskin back up after cleansing?

A

It could cause constriction of the penis,which may result in edema and tissue injury

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13
Q

The nurse observes a marked inflammation of the gums, and recession and bleeding of the gums and documents this using what term?

A

Periodontitis

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14
Q

Mr. James has an eye infection with a moderate amount of discharge. Which action would be most appropriate for the nurse to use when cleaning his eyes?

A

Positioning him on the same side as the eye to be cleaned, this helps to discourage contamination of the other eye

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15
Q

Why is adequate oral hygiene an essential part of nursing care?

A

Adequate oral hygiene is essential for promoting the patients sense of well being and
Preventing deterioration of the oral cavity. Diligent oral hygiene care can also improve oral health and limit the growth of pathogens in the oropharyngeal secretions, decreasing the incidence of aspiration pneumonia

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16
Q

What is the first indication that a pressure ulcer may be developing?

A

Blanching (pale and white) when pressure is applied to the area

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17
Q

What is reactive hyperemia

A

It’s a blanchable reddening of the skin that occurs when pressure is removed

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18
Q

True or false

Reactive hyperemia is not a pressure ulcer

A

True, it is not a pressure ulcer

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19
Q

Describe stage I pressure ulcer

A

A stage I pressure ulcer is a defined area of intact skin with non-blanchable redness of a localized area usually over a bony prominence. The area may be painful, firm, warmer or cooler compared to other tissue

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20
Q

Describe a stage II pressure ulcer

A

A stage II pressure ulcer involves partial thickness loss of dermis

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21
Q

Describe a stage III pressure ulcer

A

A stage III ulcer presents with full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscle is not exposed. Slough that may be present does not obscure the depth of tissue loss. May include undermining and tunneling

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22
Q

Describe a stage IV pressure ulcer

A

Stage IV ulcers involve full thickness tissue loss with exposed bone, tendon, or muscle. Slough or Escher May be present on some part of the wound and often includes undermining and tunneling

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23
Q

Describe a suspected deep tissue ulcer

A

A suspected deep tissue injury presents as purple or maroon localized area of discolored intact skin or blood filled blister due to damage of underlying soft tissue

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24
Q

When would pressure ulcers be classified as unstageable?

A

Pressure also are classified as unstageable when the base of the ulcer is covered by slough ( yellow, tan, green, brown) and or Eschar ( tan, brown, black)

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25
Q

What is Eschar ?

A

It’s a thick, leathery scab or dry crust that is necrotic tissue and must be removed before the stage can be determined accurately

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26
Q

What is sodium (Na+) normal range?

A

135-145 mEq/L

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27
Q

What is potassium (K+) normal range?

A

3.5-5.0 mEq/L

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28
Q

What is calcium (Ca+) normal range?

A

4.5-5.5 mg/dL

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29
Q

What is bicarbonate (HCO-3) normal range?

A

In the artery: 22-26

In the vein:25-29

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30
Q

What’s chlorides (Cl-) normal ranges?

A

95-107 mEq/L

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31
Q

What’s magnesium (Mg2+) normal range?

A

1.5-2.5 mEq/L

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32
Q

What’s phosphates normal ranges?

A

2.5-4.5 mg/dL

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33
Q

Describe sodiums role

A
  • most abundant cation

- major factor in maintenance of water balance

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34
Q

Describe potassium role

A
  • major cation in intracellular compartment

- normal cardiac conduction

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35
Q

Describe calciums role

A
  • stored in bone, plasma, and body cells

- necessary for bone formation, blood clotting, muscle contraction

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36
Q

What is sodiums main function?

A

Controls and regulates volume of body fluids

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37
Q

What is potassiums main function?

A

Chief regulator of cellular enzyme activity and water content

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38
Q

What is calciums main function?

A

Calcium is important in nerve impulse, blood clotting, muscle contraction, B12 absorption

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39
Q

What is magnesium so main function?

A

Metabolism of carbohydrates and proteins, vital actions involving enzymes

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40
Q

What is chlorides main function?

A

Maintain osmotic pressure in blood, produces hydrochloric acid

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41
Q

What is bicarbonate main function?

A

It’s the body’s primary buffer system

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42
Q

What is phosphates main function?

A

Involved in important chemical reactions in body, cell division, and hereditary traits

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43
Q

What is osmosis?

A

When water passes from area of lesser solute concentration to greater concentration until equilibrium is established

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44
Q

What is diffusion?

A

The tendency of solutes to move freely throughout a solvent

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45
Q

What is active transport?

A

Active transport requires energy for movement of substances throughout cell membrane from lesser solute concentration to hire sorry concentration (needs ATP)

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46
Q

What is filtration?

A

The passage of fluid through permeable membrane from area of higher to lower pressure
I.e. Colloid osmotic pressure
And hydrostatic pressure

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47
Q

What is the average adult intake for fluid?

A

2200-2700 ml day

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48
Q

What is hypovolemia?

A

Excessive fluid loss

-vomiting, hemorrhage

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49
Q

What is ADHs role in the regulation of body fluids?

A
  • pituitary gland
  • released during times of stress, pain, circulating blood volume
  • causes the body to save water
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50
Q

What is angiotensin I & II role in the regulation of body fluids?

A

-vasoconstriction and kidney perfusion

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51
Q

What is aldosterone’s role in regulating body fluids?

A

Volume regulator

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52
Q

True or false

ANP acts as a diuretic

A

True

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53
Q

How much of a person’s weight is water?

A

50-60%

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54
Q

True or false

Because ECF is more easily lost from the body then ICF, infants are more prone to fluid volume deficit

A

True

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55
Q

Where is the thirst control Center located

A

Within the hypothalamus, the thirst control Center is stimulated by intracellular dehydration and decreased blood volume

56
Q

What are the major cations in the body?

A

Sodium, potassium, calcium, hydrogen, and magnesium

57
Q

What are the major anions in the body?

A

Chloride, bicarbonate, and phosphate

58
Q

What are solvents?

A

Solvents are liquids that hold of substance in solution

Water is the primary solvent in the body

59
Q

What are solutes?

A

Solutes are substances that are dissolved in a solution.

The primary solutes in the body or electrolytes and nonelectrolyte

60
Q

What is the major method of transporting body fluids?

A

Osmosis

61
Q

What is capillary filtration?

A

Capillary filtration results from the force of blood pushing against the walls of the capillaries. The pushing force is referred to as hydrostatic pressure. When the hydrostat static pressure inside the Caplerry exceeds the surrounding interstitial space, fluids are forced out of the capillary wall into the interstitial space.

62
Q

What is an acid?

A

An acid is a substance containing H+ that can be liberated or released

The strong acid dissociates completely in solution and releases all of it H ions, where as a weak acid releases only a small number

63
Q

What is the base?

A

A base is a substance that can accept or trap H+ ions

64
Q

What is acidosis?

A

Acidosis is a condition characterized by an excess of H ions or lost based ions in the ECF in which pH falls below 7.35

65
Q

What is alkalosis?

A

Alkalosis occurs when there is a lack of H ions or a gain of base ions in the pH exceed 7.45

66
Q

The narrow range of normal pH is achieved by what three major homeostatic regulators?

A
  1. Chemical buffer systems
  2. Respiratory mechanism
  3. Renal mechanism
67
Q

What is the buffer?

A

A buffer is a substance that prevents body fluids from becoming overly acidic or alkaline.

Buffers work in one of two ways. A buffer can function like a base and bind up free hydrogen ions or a buffer can function like an acid and release hydrogen ions when too few are present.

68
Q

What are the three buffer systems of the body?

A
  1. The carbonic acid sodium bicarbonate buffer system
  2. The phosphate buffer system
  3. The protein buffer system
69
Q

Hypervolemia vs. Hypovolemia

A

Hypervolemia is excessive retention of water and sodium in ECF

Hypovolemia is excessive fluid loss

70
Q

What is Edema?

A

Edema is an accumulation of fluid in the interstitial space. It can be observed around eyes, fingers, ankles, and sacral space

71
Q

What is hyponatremia?

A

Hyponatremia refers to as sodium deficit in ECF caused by a loss of sodium Or gain of water. (Less than 135 mEq/L NA)

Symptoms: confusion, hypotension, edema, muscle cramps, weakness, and dry skin

72
Q

What is hypernatremia?

A

Hypernatremia refers to a surplus of sodium in ECF caused by excess water loss or an overall excess of sodium. (More than 145 mEq/L NA)

Symptoms: neurological impairment, restlessness, weakness, disorientation, delusion, and hallucinations

73
Q

What is hypokalemia?

A

Hypokalemia refers to a potassium deficit and ECF and is a common electrolyte abnormality ( less than 3.5 mEq/L)

Symptoms: muscle weakness, leg cramps, fatigue, paresthesias, and dysrhythmia

74
Q

What is hyperkalemia?

A

Hyperkalemia refers to an excess of potassium in ECF ( more than 5 mEq/L)

Symptoms: skeletal muscle weakness, paralysis, cardiac arrest

75
Q

What is hypocalcemia?

A

Hypocalcemia refers to a calcium deficit in ECF (serum ca <4.5)

Symptoms: numbness and tingling fingers mouth or feet, muscle cramps, seizures

76
Q

What is hypercalcemia?

A

Hypercalcemia refers to an excess of calcium in ECF ( serum ca >10.1, ionized ca >5.1)

Symptoms: nausea, vomiting, constipation, bone pain, excessive urination, thirst, confusion, lethargy, slurred speech

77
Q

What is hypomagnesemia?

A

Hypomagnesemia refers to a magnesium deficit in the ECF ( serum mg <1.5 mEq)

Symptoms: muscle weakness, tremors, seizures, heart block, changes in mental status, respiratory paralysis

78
Q

What is hypermagnesemia?

A

Hypermagnesemia refers to a magnesium accessing the ECF ( serum mg >2.5 mEq)

Symptoms: nausea, vomiting, weakness, Flushing, lethargy, respiratory depression, coma, cardiac arrest

79
Q

What is hypophosphatemia?

A

Hypophosphatemia refers to a below normal concentration of phosphorus in the ECS ( serum <2.5 or 2.8)

Symptoms: irritability, fatigue, confusion, seizures, coma

80
Q

What is hyperphosphatemia?

A

Hyperphosphatemia refers to an above normal concentration of phosphorus in the ECF ( serum >4.5 or 2.6)

Symptoms: tetany, anorexia, nausea, muscle weakness, tachycardia

81
Q

What is hypochloremia?

A

Hypochloremia refers to a below normal level of chloride in the ECF ( serum <96)

Symptoms: Hyperexcitability of muscles, tetany, weakness, muscle cramp

82
Q

What is hyperchloremia?

A

Hyperchloremia refers to the above normal level of chloride in the ECF ( serum >106)

Symptoms: tachpnea, weakness, lethargy, hypertension, decreased cardiac output, dysrhythmias, coma

83
Q

What is respiratory acidosis?

A

Respiratory acidosis is a primary excess of carbonic acid in the ECF. The body increases respiratory rate to expel more CO2…. CO2 level in the blood is reduced

84
Q

What is respiratory alkalosis?

A

Respiratory alkalosis is a primary deficit of carbonic acid in the ECF. It is the result of alveolar hyperventilation, breathing that it’s faster and deeper, and the consequent increasing the elimination of CO2

85
Q

What is metabolic acidosis?

A

Metabolic acidosis (low pH) is a proportionate deficit of bicarbonate in ECF. The lines attempt to increase the carbon dioxide excretion by increasing the rate and depth of respirations. However, respiratory compensation is generally not adequate, and the kidneys attempt to compensate by retaining HCO3 and by excreting more hydrogen

86
Q

What is metabolic alkalosis?

A

Metabolic alkalosis( high pH) is associated with an excess of HCO3, a decrease in H+ ions, or both in the ECF. The body attempts to compensate by retaining carbon dioxide. The respirations become slow and shallow, and periods of no breathing may occur. The kidneys attempt to excrete excess H2O and NA ions with the excess bicarbonate and retain H ions

87
Q

What is the pH of urine?

A

4.6-8.2 with the normal around 6

88
Q

What can lower than normal urinary pH indicate?

A

Metabolic acidosis, diabetic ketosis, and diarrhea

89
Q

What can higher than normal urinary pH indicate?

A

Respiratory alkalosis, potassium depletion, and chronic renal failure

90
Q

What are the normal values for calcium and phosphorous?

A

Serum calcium: 9.0-11.0

Phosphorous: 3.0-4.5

91
Q

Describe the calcium/phosphate relationship

A

Calcium >11.0 = phosphate 4.5

92
Q

What causes a fluid volume deficit?

A

Fever, excessive perspiration, burns, hemorrhage, diarrhea, vomiting, use of diuretics

93
Q

What causes a fluid volume excess?

A

CHF, renal failure, cirrhosis of deliver

94
Q

Hyperosmolar/dehydration

A

Diabetes insipidus, diabetic ketoacidosis, hypertonic parental fluids or to feeding formula

95
Q

Hypoosmolar/water excess

A

Syndrome of inappropriate anti diuretic hormone and excess water intake

96
Q

Describe acidic pH

A

The more H+ ions….the more acidic….lower the pH

97
Q

Describe alkaline pH

A

The less H + ions….more alkaline….higher pH

98
Q

What is the pH of arterial blood?

A

7.35-7.45

99
Q

Describe an arterial blood gas analysis

A

pH: 7.35-7.45

PaCO2: 35-45 mmhg

HCO3-: 22-26 mEq/L

100
Q

Respiratory acidosis vs. respiratory alkalosis

A

Respiratory acidosis is the primary excess of carbonic acid in ECF

Respiratory alkalosis is the primary deficit of carbonic acid in ECF

101
Q

Metabolic acidosis versus metabolic alkalosis

A

Metabolic acidosis is proportionate deficit of bicarbonate ECF

Metabolic alkalosis is primary excess of bicarbonate ECF

102
Q

What causes respiratory acidosis?

A

Hyperventilation, hypoxemia, hyperkalemia, hypercalcemia

103
Q

What causes respiratory alkalosis?

A

Hyperventilation, asthma, overdose of aspirin

104
Q

What is your BP like in respiratory acidosis and alkalosis?

A

Respiratory acidosis: low BP (vasodilation)

Respiratory alkalosis: low or normal BP

105
Q

What can cause metabolic acidosis?

A

Severe diarrhea, renal disease

106
Q

What Can cause metabolic alkalosis?

A

Vomiting, gastric suction

107
Q

In respiratory acidosis

A

PH : low
CO2 : high
HCO3: low

108
Q

In respiratory alkalosis

A

PH: high
CO2: low
HCO3: high

109
Q

In metabolic acidosis

A

PH: low
CO2: low
HCO3: low

110
Q

In metabolic alkalosis

A

PH: high
CO2: high
HCO3: high

111
Q

What is isotonic?

A

Same concentration of particles of plasma

112
Q

What Is hypertonic?

A

Greater concentration of particles in plasma

113
Q

What is hypotonic?

A

Lesser concentration of particles in plasma

114
Q

Examples of isotonic solutions

A

D5W

0.9% normal saline

115
Q

Examples of hypotonic solutions

A
  1. 45 NS

0. 33 NS

116
Q

Examples of hypertonic solution

A

D10W dextrose 10% in water
D5 in 0.9% NS ( NS is normal saline)
D5 in 0.45% NS
D5 in lactated ringers

117
Q

What is phlebitis?

A

Inflammation of vein

118
Q

What are signs you are giving fluids to quickly?

A

SOB
Crackles
Tachycardia

119
Q

True or false

70% of water is intracellular

A

True

120
Q

What foods have a lot of potassium in them?

A

Oranges, banana, sweet potato

121
Q

Compensated versus uncompensated

A

If pH is abnormal it’s uncompensated

If pH is normal it’s been compensated

122
Q

Lasix and digoxin together

A

Lasic increases urine production and does not spare potassium loss
Without a potassium supplement the patient becomes hypokalemic
Increases bricks for digoxin toxicity
Both hypokalemia and hyperkalemia can cause cardiac dysrhythmia

123
Q

Plasma the liquid constituent of blood, is correctly identified as which of the following?

A

Intravascular fluid or plasma is extracellular fluid and composes 5% of total body fluid

124
Q

Potassium functions as which of the following?

A

The major cation of intracellular fluid

125
Q

The movement of the solvent water from an area of lesser solute concentration to an area of greater solute concentration until equilibrium is establishes known as what?

A

Osmosis

126
Q

Which of the following with the nurse use of the most reliable indicator of a patient’s fluid balance status?

A

Daily weight

127
Q

Which acid base in balance with the nurse suspect after assessing the following arterial blood gas values

pH: 7.30
PaCO2: 36 mm hg
HCO3:: 14 mEq

A

Metabolic acidosis

Hello pH indicates acidosis. This coupled with the low bicarbonate, indicates metabolic acidosis

128
Q

Which of the following with the nurse need to keep in mind when preparing to assist the physician with insertion of a non- tunneled percutaneous central venous catheter?

A

A chest radiograph is required to confirm placement for any central venous access device

129
Q

The nurse overtly assesses the acid-base balance of a patient because she is aware that the patient will be unable to effectively control his carbonic acid supply. This is most likely patient with bad damage to which of the following?

A

Lungs, The lungs are the primary controller of the bodies carbonic acid supply and thus if damage can affect acid-base balance

130
Q

True or false

The kidneys are the primary controller of the bodies bicarbonate supply

A

True

131
Q

The nurse instructed patient to Kokusai grieving more slowly as the most effective intervention for which acid-base imbalance?

A

Respiratory alkalosis

Breathing more slowly causes accumulation of carbon dioxide to reverse carbonic acid deficit or respiratory alkalosis

Breathing more slowly would further increase a patient’s respiratory acidosis, due to the increased carbon dioxide

132
Q

Which of the following is the most common etillogic factor related to nursing diagnosis of excess fluid volume?

A

Excessive IV infusion is the most common factors associated with excess fluid volume

133
Q

Which assessment finding would lead to the nurse to suspect that a patient’s IV infiltrated?

A

If the site is pale, cool, swollen, and painful

134
Q

When developing a teaching plan for a patient Iris for hyperkalemia which foods with the nurse instructed patient to avoid?

A

Bananas and apricot, Hyperkalemia is an elevated serum potassium level bananas and apricots or foods high in potassium and should be avoided in the situation

135
Q

Which site would be most appropriate for initiating IV therapy for patient who has sustained multiple injuries after novelty accident and has a cast on his right arm?

A

The left forearm is the best site selection because of the condition of the patients right arm

136
Q

When implementing the plan of care for a patient receiving IV therapy, which intervention would be most appropriate?

A

Monitoring the flow rate at least every hour

137
Q

While administering a blood transfusion, when with the nurse assessed the patient for a blood transfusion reaction?

A

They should closely observed patient for the first 15 minutes and then check the patient thereafter every 15 minutes while they are receiving a blood transfusion

138
Q

Hypo/hyper- tonic and isotonic

A

Hypertonic: RBC shrunk

Isotonic: RBC normal

Hypotonic: RBC swelled

Nurs. 302 (6 decks)

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