Final Exam Flashcards
What are the normal levels of Sodium?
135-145
What are the normal levels of Potassium?
3.5-5.0
What are the normal levels of Magnesium?
1.8-3.0
What are the normal levels of Calcium?
8.5-10.5
What are the normal levels of Phosphorus?
2.5-4.5
What are the types of bone fractures?
open, transverse, greenstick, comminutes, sigmental, closed, spiral, linear, impacted
The nurse understands that knowledge of appropriate laboratory values is important. The nurse asks a group of nursing students to state the appropriate ranges for potassium, magnesium, calcium, sodium, phosphorus, pH, CO2, and HCO3.
Potassium: 3.5 - 5.0
Magnesium: 1.8 - 3.0
Calcium: 8.5 - 10.5
Sodium: 135 - 145
Phosphorus: 2.5 4.5
pH: 7.35 - 7.45
CO2: 35 - 45
HCO3: 22 - 26
What is Vaginitis?
Inflammation and itching of the vagina
What are the s/s of trichomoniasis (trichomonas vaginalis)?
Itching/irritation
burning after peeing
clear,white, yellowish, or greenish discharge
What does the renin-angiotensin-aldosterone mechanism responsible for?
it’s a kidney mechanism that is responsible for the short term and long-term management of blood pressure
How does blood flow through the heart?
Blood flows through the heart in the following pathway:
Superior/ inferior vena cava
right atrium
Tricuspid valve
right ventricle
pulmonary semilunar valve
pulmonary artery
lungs for oxygenation
pulmonary vein
left atrium
mitral valve (aka bicuspid valve)
left ventricle
aortic valve
aorta
systemic circulation
A client in the hospital who has been on bed rest for the last 4 days rises from a lying position to standing. Upon standing the client experiences a syncopal episode (passes out) and falls to the floor. The nurse understands that what has most likely happened to this client?
The client has orthostatic hypotension. To assist in confirmation of this the client should have their blood pressure checked in the lying, sitting, and standing positions. The client should be advised to not get out of the bed or chair without assistance.
What is orthostatic hypotension (BP)?
Abnormal drop in blood pressure when standing
What are the s/s of hypocalcemia?
numbness, muscle cramps, tetany, bone pain, positive Chvostek & Trousseau
How do you test for hypocalcemia?
Positive Chvostek and Trousseau signs
The nurse understands that hypocalcemia can have serious adverse effects. When caring for a client with suspected hypocalcemia the nurse understands that these two non-invasive tests can assist in identifying a client with hypocalcemia.
Positive Chvostek and Trousseau signs are indicative of hypocalcemia.
How does herpes simplex type 2 spread (HSV 2)?
the virus is passed during intimate sexual contact prior to and following the outbreak of ulcers
A client reports to the client symptoms of painful blisters in the genital area. Some of these blisters have developed into ulcerations. The client reports that this happens periodically and she has had 3 occurrences of these blisters over the last 4 months. Does the nurse understand what the most likely diagnosis is?
The most likely diagnosis is HSV 2 (herpes simplex virus type 2, genital herpes). This virus will result in painful outbreaks of these blisters followed by periods of the patient appearing asymptomatic. The client can transmit this infection at all times not only during symptomatic outbreaks.
What is urinary incontinence?
can’t control bladder; involuntary loss of urine
A client is being diagnosed with urinary incontinence which is the involuntary loss of urine. The nurse understands that the different types of urinary incontinence include:
Stress incontinence: involuntary loss of urine from increased intra-abdominal pressure such as when coughing, sneezing, laughing, or lifting objects.
Urge incontinence: involuntary loss of urine associated with a strong desire to void (urgency).
Overflow incontinence: involuntary loss of urine that occurs when the patient is unable to completely empty the bladder which leads to an overflow of urine, that then leaks out unexpectedly.
Mixed incontinence: this is a combination of stress and urges incontinence.
What are the causes of hypovolemic shock?
15% blood loss, severe burns, severe dehydration
A client presents to the emergency department after an MVA in which the femoral artery has been severed. The nurse understands that this client is most at risk for this type of shock:
Hypovolemic shock due to a diminished blood volume resulting in inadequate filling of the vascular compartment. This type of shock occurs after 15 to 20% blood loss.
Who is at the highest risk for developing chronic kidney disease?
those with preexisting renal insufficiency, diabetes, and elderly persons
The nurse understands that client education is very important to client care. In discussing chronic renal failure with a client what would the nurse include as potential causes?
Potential causes include hypertension, diabetes, polycystic kidney disease, obstructions of the urinary tract, glomerulonephritis, cancer, autoimmune disorders, disease of the heart/lungs, and chronic usage of pain medications.
The following ABG problem indicates:
pH 7.21 PaCO2 50 HCO3 24
respiratory acidosis
When does tension pneumothorax occur?
occurs when the intrapleural pressure exceeds atmospheric pressure
The nurse understands that in a pneumothorax the patient will exhibit these symptoms because the entire lung has collapsed due to air in the pleural space.
Chest pain
Increased respirations
Shortness of breath (dyspnea)
Asymmetry of the chest
Tension pneumothorax - deviation of the trachea
The treatment of a tension pneumothorax involves the insertion of a large bore needle or chest tube what action should the nurse immediately take if the patient pulls out a chest tube and a sucking chest wound is noted?
The nurse should immediately apply an occlusive dressing such as Vaseline gauze.
The nurse understands that there are three types of pneumothoraxes. The nurse can describe these three types as:
Spontaneous Pneumothorax - occurs when an air-filled blister on the lung surface ruptures
Traumatic Pneumothorax - caused by penetrating or nonpenetrating injuries
Tension Pneumothorax - occurs when the intrapleural pressure exceeds atmospheric pressure
Tension pneumothorax causes the lung to
collapse
What is HPV (human papillomavirus infection)?
genital warts on genitals or anus; asymptomatic
What is the most serious potential consequence of HPV infections?
cancer
A female client has recently been diagnosed with HPV. The client states that she is lucky because this is not the type of HPV that causes genital warts so she has nothing to worry about. How should the nurse respond to this statement?
Although, the HPV type you have contracted may not cause genital warts at this time the most serious complication of HPV is cancer. Cancer can result in areas that are infected with the HPV cells such as the cervix, oropharynx, anus, penis, vagina, and vulva. Cancerous cells on the cervix can be removed. You will need to maintain regular screening visits to check for precancerous and cancerous cells.
What does HPV increase in a female patient?
cervical cancer
What is hip dysplasia?
a hip socket that doesn’t fully cover the ball portion of the upper thighbone. This allows the hip joint to become partially or completely dislocated. Doctors check for it when you are born
The nurse is caring for a client with polycystic kidney disease. The nurse understands that this is:
Polycystic kidney disease (PKD) is an inherited disorder in which clusters of cysts develop primarily within the kidneys, causing the kidneys to enlarge and lose function over time. Keep in mind these cysts are noncancerous. They are similar to other cysts in the body. The cysts are round sacs containing fluid.
What are the s/s of primary genital herpes in a male client?
tingling sensation in the genital area, small red bumps that turn into blisters, swelling in the groin, muscle aches, fever, headaches
Acid-base balance
when you compensate, a pH moves toward the normal range
What is the difference between benign paroxysmal positional vertigo and Meniere disease?
Benign paroxysmal positional vertigo (BPPV) is triggered by certain changes in head position, such as tipping the head up, down, or side to side. It results in a spinning sensation and dizziness. It’s rarely serious unless it increases the risk of falling. The episodes are typically brief (less than one minute) and resolve spontaneously. Meniere’s disease is a disease of unknown causes that affects the membranous labyrinth of the ear. Symptoms include fluctuating episodes of tinnitus, feelings of ear fullness, and violent rotary vertigo that often renders the person unable to sit or walk.
Compare expressive vs receptive aphasia as a complication of a stroke.
Expressive aphasia (stroke) - the patient knows what they want to say, but they have trouble saying or writing what they mean. The message will come out garbled or will not make any sense.
Receptive aphasia - the patient hears the voice or sees the print, but then they cannot make sense of the words.
What is influenza?
virus
Describe the medication treatment options for influenza.
Tylenol, ibuprofen, decongestants, etc. Antibiotics would not be utilized for viral infections.
Respiratory condition in which a barking cough is a cardinal feature
croup
Croup is an upper airway infection that is caused by viral infections. The nurse understands that croup will produce what symptoms in a child?
Barking cough
Stridor
Cold symptoms
The nurse understands that croup is treated by
Cool humidified air
Antipyretics for fever
Possibly steroid medication if symptoms warrant the need
Pitting edema (fluid volume excess)
elevated bp, shallow respirations, headache, edema, osmolality
What is one of Graves disease symptoms?
exophthalmos ( bulging eyes)
A patient is suspected of having a diagnosis of Graves Disease. What symptoms would the nurse anticipate in this patient?
The nurse should anticipate exophthalmos, headaches, nervousness, emotional instability, weight loss, thyroid goiter, sweating, tachycardia, nausea, diarrhea, oligomenorrhea, muscle weakness, and tremors. Graves disease is an autoimmune disorder. Treatment can include beta-blockers, radioactive iodine therapy, anti-thyroid medications, and/or surgical removal of the thyroid gland.
A patient presents with symptoms of anxiety, restlessness, difficulty sleeping, exophthalmos, tachycardia, weight loss, silky hair, and heat intolerance. The nurse suspects that the patient’s symptoms indicate a diagnosis of:
Hyperthyroidism which will be diagnosed by laboratory testing of T3, T4, and TSH. Laboratory testing of autoimmune causes of hyperthyroidism may include testing thyroid-stimulating immunoglobulins (TSI) and/or TSH receptor antibodies (TRAb). Graves disease is an autoimmune disorder resulting in hyperthyroidism.
What is muscle atrophy?
loss of muscle leading to its shrinking and weakening
In caring for a client with hypokalemia, what is the nurse’s highest priority?
provide adequate oral fluid intake
position to increase circulation
administer supplemental sodium
monitor for cardiac dysrhythmia
what is pericardial effusion
accumulation of fluid in the pericardial cavity; leads to cardiac tamponade
What is cardiac tamponade?
compression of the heart by an accumulation of fluid in the pericardial sac
What symptoms would the nurse anticipate in a client with a suspected cardiac tamponade?
Anxiety, chest pain, difficulty breathing, increased heart rate, JVD, low SBP (systolic blood pressure), and muffled heart sounds.
What treatment is preformed for a cardiac tamponade and what would occur if treatment is delayed or not completed?
Pericardiocentesis is performed for treatment and if not completed the patient will progress to circulatory shock and impending death
What is the most serious complication of a pericardial effusion?
Cardiac Tamponade from the increased pressure the fluid accumulating in the pericardial sac is placing on the heart
The nurse understands that a client experiencing a cardiac tamponade is at risk for this type of shock?
Obstructive shock which results in elevated right heart pressure because of impaired right ventricular function. Signs of right-sided heart failure will occur. This would include symptoms such as elevated CVP and jugular venous distention
What do you use for an allergic reaction?
epinephrine
what should a nurse caring for a child with airway obstruction avoid?
tongue depresser
A child is experiencing an acute exacerbation of asthma. What is a quick-acting medication?
Albuterol
What is DIC (disseminated intravascular coagulation)?
a paradox in that it involves both uncontrolled bleeding and uncontrolled clotting.
In a client with DIC what symptoms will the patient experience simultaneously?
DIC will result in the client experiencing both bleeding and clotting simultaneously
The nurse understands that hemorrhaging in DIC is the result of?
In DIC a client will have excessive clotting to the point that all clotting factors are used in the body. Since there will then be no clotting factors left the patient will begin to hemorrhage.
What symptoms would the nurse anticipate in a client dx with DIC?
The nurse should anticipate that the client will have petechiae, purpura, excessive bleeding from any wound, excessive bleeding from IV or catheter insertion, and excessive widespread clotting.
Explain what is happening in DIC to cause both bleeding and clotting in a patient.
There is so much clotting occurring that all clotting factors are being used and therefore uncontrolled bleeding occurs
What is c. diff (clostridioides difficile)?
a germ that causes diarrhea and colitis (an inflammation of the colon)
The nurse is assigned to care for a client with c-diff during her shift. Prior to entering the clients room the nurse understands that all clients with c-diff have these two things in common?
These patients all have copious amounts of foul smelling, watery diarrhea and a history of broad spectrum antibiotic usage.
The nurse understands that c-diff is highly contagious and is easily transferred from patient to patient. The nurse understands that hand hygiene can prevent infections from spreading. How should the nurse perform hand hygiene after caring for a patient with c-diff?
The nurse should only wash her hands with soap and water. The nurse should never use alcohol based hand sanitizer since this will not kill the c-diff spores.
The appendix is located in this quadrant of the abdomen
Righ lower quadrant
List potential complications of appendicitis?
Perforation (rupture), peritonitis, sepsis, localized periappendiceal abscess formation
What is the treatment for appendicitis?
treatment for appendicitis is surgery
The nurse is caring for a patient with appendicitis. The patient reports that the right lower quadrant pain has suddenly been relieved. What should the nurse suspect has happened?
The nurse should expect the appendix has ruptured.
List common symptoms associated with appendicitis
Abrupt onset with pain originally at the epigastric or periumbilical that then localizes to the lower right quadrant. Nausea, vomiting, RLQ tenderness, rebound tenderness, elevated WBC count, and fever.
Describe pancreatitis.
Pancreatitis is an inflammation of the pancreas. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. In acute pancreatitis the inflammation is brought on by premature activation of pancreatic enzymes and is reversible.
List potential causes of pancreatitis.
Potential causes of pancreatitis include gallstones, ETOH, hyperlipidemia, infections, cystic fibrosis, diabetes, medications, abdominal trauma or surgery.
The nurse is caring for a client with acute pancreatitis and knows that lab testing can be utilized as a part of the diagnosis of pancreatitis. What lab results would indicate acute pancreatitis?
Elevated serum amylase and lipase three or more times the upper limit of normal,
The nurse anticipates what treatment plan to be ordered by the physician in acute pancreatitis?
Acute pancreatitis treatment includes IV fluids, nasogastric tube insertion, and NPO (nothing by mouth). The patient will also require pain relief and electrolyte replacement.
The nurse understands that pancreatitis symptoms would include (name at least 2) and pancreatitis would be indicated by these lab tests being three times the upper limit of normal?
Amylase and lipase. Symptoms would include epigastric pain, bloating, fat in the stool, indigestion, nausea, vomiting, loss of appetite, weight loss, fever, tachycardia, hypotension, abdominal tenderness, respiratory distress, increase thirst, poor urine output, and ascites.
What treatment can a person having an ischemic stroke receive within a three hour window that can significantly improve their symptoms and outcome?
TPA (Tissue plasminogen activator) may be given to someone having an ischemic stroke because it is a clot buster. This medication should never be given to someone having a hemorrhagic stroke.
List potential symptoms of diabetes:
Polyuria - increased urination Polydipsia - increased thirst Polyphagia - increased hunger Dry mouth Fatigue Vision changes Difficulty healing Yeast infections Numbness in extremities End organ damage
Undescended testicles place a client at risk of
infertility, malignancy, testicular torsion, and psychological effects
A male infant has been diagnosed with cryptorchidism. The nurse understands that this means the client:
This means the client has an undescended testicle. The testicle may be in the abdominal cavity, inguinal canal, or high scrotal area. The testes should have descended into the scrotum during the 7th to 9th month of gestation. If the testicle does not move into the scrotum by 3 months of age surgical treatment will be completed after the patient reaches 6 months.
What are the symptoms of testicular torsion include?
sudden, severe pain and swelling in the testicle
An infant is 6 months old and cryptorchidism has persisted since birth. The parents have presented the child for a presurgical screening appointment. The parents ask the nurse why they cannot just leave the cosmetic problem of the testicle not being in the scrotum as it is rather than having surgery at this young age? What is the best response by the nurse?
The best response of the nurse is to educate the parents that this is not just a cosmetic issue. If the testicle is left in the incorrect location this can cause a sequelae of events with potential complications that include infertility, malignancy, psychological effects, and an approx 10 fold increase risk of testicular torsion.
A patient presents with sudden onset of severe pain rated 10/10 and testicular edema. The patient reports that he was running across the field in a football game and was inadvertently hit in the genital area. The nurse understands that the patient may have a diagnosis of _____________ which is a medical emergency and requires prompt treatment.
The client may have testicular torsion which is a twisting of the testicle. When the testicle rotates it will twist the spermatic cord and compress the vessels supplying blood. Surgical treatment is necessary or the testicle may not be salvageable. This could result in infertility.
What is gonococcal urethritis (GU)?
infection of the urethra
A client has symptoms of belching, nausea, burning pain in the chest, dry cough, and heartburn. The physician has dx with client with GERD. What medication treatment should should the nurse anticipate in this patient?
The nurse should anticipate antacids and proton pump inhibitors (PPI’s).
What treatment is indicated for GERD (heartburn) and why?
primary treatment is a proton pump inhibiter (decreases stomach acid)
The nurse is caring for an infant with severe projectile vomiting, weight loss, constipation, fatigue, excessive hunger, and a lump in abdomen. The physician tells the patient’s parents that the child has pyloric stenosis and failure to thrive. The parents begin to cry after the physician leaves and asks what they did wrong and why their infant is not gaining weight? The nurse says …
The nurse says that pyloric stenosis is a condition in which the opening between the stomach and small intestine (duodenum) thickens. This thickening will prevent food from entering the small intestine where most of the nutrients are absorbed. This means that no matter how much you feed your child the child will vomit the food up because it cannot move through the intestines. This is not your fault. You did nothing wrong, the cause of this disorder is unknown. Your child will need surgical correction of the problem
Describe pyloric stenosis
narrow opening between stomach and duodenum causing food to get stuck. results in projectile vomit
Death can result from mononucleosis (mono) as a complication of what occurring
a rupture of an enlarged spleen
A client has been diagnosed with mononucleosis and asks the nurse what caused this infection. The nurse understands that mononucleosis is the result of?
Mononucleosis is the result of the Epstein–Barr virus. This is passed from person to person most commonly through bodily fluids, especially saliva.
The nurse is educating a family on their child’s dx of mononucleosis. The child plays football (high impact sport) and the parents would like to know if their child will be able to play in the game scheduled for this weekend. The nurse will educate the family that high-impact sports in patients with mono pose what risk?
Mononucleosis causes enlargement of the spleen which places a client at high risk for rupture of the spleen from the impact that can occur in sports such as football.
What are the symptoms of mono?
fatigue, fever, sore throat, enlarged spleen; treatment includes rest, medication, ice packs, warm salt water; contact sports should be avoided
