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PCC2: Parker > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What type of blood vessel must TPN nutrient solutions be administered within?

A

a vein with rapid blood flow, such as the superior vena cava

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2
Q

Why is sterile technique especially important in TPN administration?

A

the high dextrose content creates a environment that can potentially harbor bacterial growth

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3
Q

How soon do TPN solutions have to be hung after mixing?

A

24 hours

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4
Q

What is a central line?

A

aka central venous catheter, a tube placed into a large vein near the center of the body

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5
Q

What is refeeding refeeding syndrome?

A

physiologic response to initiation of nutrient delivery after a period of malnourishment

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6
Q

What is the tonicity of nutrient solutions used in TPN?

A

hypertonic

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7
Q

How does a lipid solution look like?

A

milky

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8
Q

How does a TPN solution look like?

A

lemon-lime Gatorade

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9
Q

What is included in a TPN solution?

A

vitamins, minerals, electrolytes, and fluids

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10
Q

What is the primary component of a lipid solution?

A

fatty acids

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11
Q

What is a 0 on the phlebitis scale?

A

no symptoms

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12
Q

What grade of phlebitis contains erythema at the access site with or without pain?

A

1

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13
Q

What is a grade 2 phlebitis?

A

pain at the access site with erythema

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14
Q

A palpable venous cord, streak formation, and pain at the access site with erythema combined represent what level of phlebitis?

A

grade 3

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15
Q

What are the clinical criteria for grade 4 phlebitis?

A

purulent drainage, streak formation, pain at access site with pain, and palpable venous cord > 2.54 cm in length

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16
Q

What is extravasation?

A

when vesicant medication has leaked into the tissue around the cath site, killing the surrounding tissue

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17
Q

What is infiltration?

A

IV medication not going into vein, and leaking into surrounding tissue

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18
Q

What gauge needle is used for blood transfusion?

A

20 gauge

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19
Q

How long is a peripheral IV good for?

A

1 week

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20
Q

How long can a midline catheter be used?

A

up to 1 month

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21
Q

What type of IV device should be utilized if patient requires for greater than 1 month?

A

PICC (peripherally inserted central catheter) line

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22
Q

What are examples of isotonic solutions?

A

NS (0.9% Sodium Chloride/NACl) and LR (lactated ringers)

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23
Q

What type of fluid is 1/2 NS (0.45% NaCl)?

A

hypotonic

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24
Q

2 and 3 % NaCl are both examples of what type of fluid?

A

hypertonic

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25
Q

What are some common symptoms of FVD (fluid volume deficit)?

A

-decreased weight, poor skin turgor, dry mucous membranes, increased pulse and RR, decreased BP, urine output and capillary refill. Flat neck veins

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26
Q

What may be expected for a patient presenting with JVD, increased weight, SOB/crackles, edema, increased BP and decreased pulse?

A

FVO (fluid volume overload)/ FVE )excess)

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27
Q

What happens to hematocrit for FVD?

A

increase

28
Q

What describes fluid in a non-utilizable part of the body, such as fluid in ascites?

A

3rd spacing

29
Q

What interventions may be necessary for individuals experiencing fluid volume deficit?

A

giving isotonic fluids electrolytes orally or IV, IV replacement of blood, removal of third spaced fluids (chest tubes, paracentesis, peritoneal taps)

30
Q

What describes an IV complication presenting with cold, pale, puffy, but not painful area surrounding the site?

A

infiltration

31
Q

What are the symptoms of hyperglycemia?

A

polydipsia (thirsty), polyuria (frequent urination), polyphagia (hungry)

32
Q

What may occur to a patient if TPN is discontinued abruptly?

A

hypoglycemia

33
Q

What refers to a venous device that terminates in a great vessel?

A

central line

34
Q

How many mL are in one ounce?

A

30 mL

35
Q

What are some manifestations of speed shock?

A

facial flushing, irregular pulse, severe headache, hypotension, and may progress to LOC or cardiac arrest

36
Q

What action should the nurse take if speed shock is suspected?

A

clamp IV, notify provider, possibly administer O2, and monitor VS frequently

37
Q

What system is likely to be affected by hypercalcemia?

A

neuromuscular system (confusion, headache, decreased deep tendon reflex

38
Q

You are observing a clients b.p. and observe a carpal spasm(Trousseau’s Sign) , which electrolyte imbalance might you expect?

A

hypocalcemia

39
Q

What is Chvostek’s Sign, and which electrolyte imbalance is it associated with?

A

twitch of facial muscles when tapping on cheek related to hypocalcemia

40
Q

What is the priority nursing intervention for a client who has hyperkalemia?

A

get an EKG

41
Q

What is referred to as generalized edema?

A

anasarca

42
Q

What may happen to the heart if potassium is too low?

A

cardiac arrest (sudden loss of heart function)

43
Q

What is the rate for Iv push potassium?

A

bruh, you NEVER push potassium, given on pump never quicker than 10 mEq/hour

44
Q

What are the special considerations for D10 in water (this is a hypertonic solution)?

A

monitor blood sugar levels

45
Q

What are good dietary sources of magnesium?

A

nuts, seeds, cashews, pumpkin seeds, dark chocolate, and fatty fish

46
Q

What foods are high in calcium?

A

dairy, tofu, kale, and broccoli

47
Q

What electrolyte is plentiful in junk food, canned products, and fast food?

A

Na+ (sodium)

48
Q

Bananas, cantaloupe, plain yogurt, and potatoes are useful in providing which electrolyte?

A

K+ (potassium)

49
Q

If hypoglycemia occurs for a patient on TPN, what should the nurse administer while waiting for a new mix of formula from pharmacy?

A

D10

50
Q

What type of solution may be usedfor cerebral edema or hyponatremia?

A

hypertonic ( 2 and 3 % NaCl)

51
Q

What type of solution can be utilized in intracellular dehydration, DKA and water replacement?

A

hypotonic

52
Q

When are isotonic solutions often used?

A

hypovolemia, blood transfusions, fluid challenges, and burns

53
Q

When should 0.45 NaCl never be used?

A

cerebral edema/increased ICP

54
Q

With which type of solution should you monitor for hypovolemia (tachycardia)?

A

hypotonic

55
Q

This type of fluid has the potential for causing fluid volume excess. It is used in patients with cerebral edema and hyponatremia?

A

hypertonic ( 2 and 3 % NaCl)

56
Q

This isotonic fluid is given during blood transfusions, shock and in patients with fluid challenges.

A

normal saline (0.9% NaCl)

57
Q

What type of fluid is contraindicated in renal and liver patients and is used in patients with burns, dehydration, electrolyte challenges?

A

lactated ringers

58
Q

What is a potential risk for isotonic fluids?

A

fluid overload, especially in kidney and heart patients

59
Q

What type of isotonic fluid is given in DKA (metabolic acidosis) because the lactate component can increase blood pH by converting to bicarbonate?

A

lactated ringers

60
Q

What type of fluid may be given if there is a high concentration of solutes in the intravascular space, such as in hypernatremia?

A

hypotonic (0.45% NaCl)

61
Q

What should be monitored closely in patients receiving hypotonic solutions?

A

mental status changes (brain swelling), hypovolemia, low blood pressure (water is being pulled into cells, out of intravascular space)

62
Q

What are the symptoms of hypoglycemia?

A

dizziness, shakiness, weakness, tachycardia, sweating/clammy

63
Q

What may indicate a central line infection for an individual receiving TPN?

A

redness, drainage, increased WBC, fever

64
Q

What electrolyte imbalance may occur due to diuretics (furosemide), GI losses, Cushing syndrome, and metabolic alkalosis?

A

hypokalemia

65
Q

Dysrhythmias, muscle spasms/weakness, and constipation/ileus are effects of which electrolyte imbalance?

A

hypokalemia

66
Q

What is a priority assessment in a client who has dehydration?

A

mental status

PCC2: Parker (6 decks)

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