Brainscape's Knowledge GenomeTM

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


See full index

nursing > final exam med surg 2 > Flashcards

final exam med surg 2 Flashcards

1
Q

Hourly urine output

A

30 mL/hr

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

Sodium

A

135-145

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

Potassium

A

3.5-5

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

Magnesium

A

1.6-2.6

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

Types of isotonic IV solutions

A

Lactated ringers, normal saline

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

Types of hypotonic solutions

A

1/2 NS

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

Hypertonic solutions

A

3-5% NS, D5 and D10 NS

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

What does hypertonic IV solutions cause in the cells?

A

water leaves the cells to try to balance out solutes in the blood (they shrivel)

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

What does hypotonic IV solutions cause in the cells?

A

Water enters the cell to try to balance the solutes (swells)

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

What is the sodium-potassium pump?

A

Located on the cell membrane; moves sodium into the cell from ECF and potassium from cell to ECF

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

Types of sensible (countable) fluid outputs

A

Urine, feces, vomit

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

What is ADH?

A

antidiuretic hormone; helps body retain fluid-if the body is dehydrated, more ADH will be produced; if the body is in fluid overload, less ADH will be produced

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

Renin-angiotensin system and what it does

A

Kidneys release renin-liver releases angiotensin. angiotensin and renin= angiotensin 1- to the lungs, which creates angiotensin 2-causes the blood vessels to constrict. Nephrons retain sodium and water and the blood volume is increased.

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

What is aldosterone?

A

Released by adrenal glands; holds sodium and water-excrete potassium

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

What is spironolactone?

A

Aldosterone antagonist; saves potassium and rids sodium and water

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

Where is potassium excreted and commonly lost?

A

excreted by kidneys (kidney disease can cause build up) and commonly lost through GI d/t vomiting or diarrhea

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

Foods that raise potassium

A

bananas, spinach, potatoes

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

Calcium

A

8.5-10.5

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

Where is calcium regulated?

A

By the parathyroid (PTH) and thyroid( calcitonin)

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

Which vitamin helps with the absorption of calcium?

A

Vitamin D

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

What does PTH do in terms of calcium?

A

Released when calcium is low; pulls from bone into blood.

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

How does the thyroid regulate calcium?

A

When calcium levels in the blood are to high, calcitonin is released and the calcium is pushed into the bones

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

Chloride

A

95-105

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

Phosphorus

A

2.5-4.5

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

What is the inverse of calcium?

A

Phosphorus (if one is high, the other is low)

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

Bicarbonate

A

22-26

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

Where does bicarb come from and what does it do?

A

Made by kidneys; assists in acid-base balance; alkalotic

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

CO2

A

35-45

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

Hypovolemia

A

Dehydration; low bp, high HR, flat veins, tented skin turgor, concentrated urine with high specific gravitiy

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

Specific gravity

A

1.005-1.020

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

Hypervolemia

A

Can be caused by excessive salt intake or cardiac, kidney, liver disease; elevated BP, bounding pulse, distended neck veins, weight gain, edema

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

Severe hypervolemia

A

Crackles in lungs, dyspnea, ascites

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

Severe hypovolemia (hypovolemic shock)

A

rapid, weak pulse and orthostatic hypotension

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

Hyponatremia

A

Can be caused by diuretics, adrenal insufficiency (decreased secretion of aldosterone), kidney disease, SIADH. Weakness, lethargy, nausea and vomiting, muscle cramps, seizures

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

Hypernatremia

A

Caused by excessive sodium intake, excessive water loss, decreased sodium excretion, and hyperaldosteronism (holds onto sodium, so if more is released-more is held). thirst, dry mouth, hallucinations, irritability, lethargy, seizures, altered mental status

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

Hypokalemia

A

Can be caused by potassium-wasting diuretics, GI loss, hyperaldosteronism (excretes more potassium), anorexia/bulimia, and alkalosis. Can cause dysrhythmias, flat T-weaves, muscle weakness and cramps, and increased sensitivity to digitalis (digoxin)

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

How is IV potassium given?

A

NEVER PUSH; on pump and diluted

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

Hypocalcemia

A

Can be caused by hypoparathyroidism (PTH draws calcium out of the bone into the blood when needed), malabsorption, vitamin D deficiency, increased calcium excretion (kidney disease, diarrhea), and hyperphosphatemia. Diarrhea, numbness/tingling, tetany, cardiac irritability, muscle cramps, convulsions, Chvostek and Trousseu’s

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

Hyperkalemia

A

Renal failure, potassium-sparing diuretics (spironalactone), hypoaldosteronism (aldosterone causes potassium to be excreted), major trauma/burns. Muscle twitching and late flaccid paralysis, dysrhythmias, elevated T-waves, diarrhea

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

If a pt’s potassium is low or high, what should be a priority for the nurse?

A

CARDIAC MONITOR

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

What can be given IV to help with cardiac excitability d/t hyperkalemia?

A

Calcium gluconate

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

Why is insulin and glucose sometimes given with hyperkalemia?

A

Insulin forces potassium back into cells and glucose to prevent hypoglycemia (REGULAR INSULIN ONLY)

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

Hypercalcemia

A

Malignant bone disease, hyperparathyroidism, hypothyroidism, prolonged immobilization. Constipations, bradycardia, kidney stones of calcium, muscle weakness, changes in mental status.

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

Hypomagnesemia

A

Malnutrition, starvation, alcoholics. Hyperactive reflexes, mood changes, disorientation, dysrhythmias.

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

Hypermagnesemia

A

excess antacids, renal failure. hypoactive reflexes, drowsy, lethargic, depressed respirations, hypotension, bradycardia

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

Hypophosphatemia

A

acidosis, refeeding after starvation, hyperparathyroidism, high calcium. May experience no symptoms or have joint stiffness, seizures, cardiomyopathy, paresthesia

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

TPN

A

Should always be started slowly to avoid drops in phosphate; always ask about allergies to eggs d/t fat emulsions

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

Hyperphosphatemia

A

hyperthyroidism/hypoparathyroidism (would cause calcium to be low so phosphate would go up), chemo, renal failure. Tetany and calcification of soft tissue if imbalance lasted long term.

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

Intraosseous nursing considerations

A

drill into bones for access; no longer than 24 hours, tibia is the most common location. Complication can be osteomyelitis which may lead to amputation

50
Q

Extravasation at IV site

A

infiltration with caustic fluids that causes tissue damage.

51
Q

CVAD

A

central venous access device; typically inserted into major vein-subclavian or jugular. Risk for sepsis or air embolism

52
Q

How do the lungs work to restore normal pH in acidosis?

A

Respiratory rate increases and depth decreases-get as much CO2 out as quickly as possible

53
Q

How do the lungs works to restore normal pH in alkalosis?

A

Respiratory rate decreases and depth increases-hold on to CO2

54
Q

How do the kidneys work to restore normal pH?

A

In acidosis, bicarb is retained. In alkalosis, bicarb is excreted.

55
Q

How is potassium affected with Acid-base abnormalities?

A

Acidosis-potassium is pushed out of cells by hydrogen ions; in alkalosis, potassium is pushed into cell

56
Q

Atelectasis is:

A

when the alveoli collapse; happens in respiratory acidosis. Can be prevented with turn, cough, deep breath and incentive spirometer

57
Q

What type of respirations are common in metabolic acidosis?

A

Kussmaul; rapid deep breathing. DKA

58
Q

Metabolic alkalosis is commonly caused by

A

excessive vomiting or gastric suctioning causing loss of acid

59
Q

Correct order for abdominal assessment

A

Inspection, auscultation, percussion, and palpation

60
Q

Fecal occult blood test-color and location of bleed

A

Black-upper GI(peptic), Bright red-lower GI (hemorrhoids or polyps).

61
Q

Pt education for fecal occult blood test

A

No red meats, aspirin, or NSAIDs for 72 hours prior-possibility of a false positive. Vitamin C ingestion the morning of can cause false negatives. No laxatives, enemas, or suppositories for 3 days before testing.

62
Q

Pt education for H. Pylori breath test

A

No antibiotics or bismuth for 1 month prior to test, no PPIs for 2 weeks prior, no antacids for 24 hours prior. H. Pylori is a bacteria that infects your stomach or duodenum and can cause a peptic ulcer if not treated.

63
Q

Pt education for after a barium swallow

A

Increase fluids to help evacuate the barium-if it is not excreted, it will harden like concrete. Return immediately if you don’t pass the barium or have bleeding.

64
Q

Prior to CT scan

A

Patient’s renal function should be checked (creatinine and BUN) and allergies to shellfish or iodine should be assessed

65
Q

Creatinine

A

0.8-1.2 for males

66
Q

BUN

A

8-20

67
Q

Post endoscopy, pt should be NPO until

A

gag reflex returns

68
Q

What position should the pt be placed in for colonoscopy?

A

Left side with legs drawn to chest

69
Q

Potential complications for a pt receiving enteral nutrition

A

Diarrhea, vomiting, stomach discomfort, tube displacement, clogging, infection at tube site, refeeding syndrome (drop in phosphate-can be life threatening), aspiration, high blood sugar

70
Q

What position should the bed be in when a pt is receiving enteral feeding?

A

At least 30 degrees

71
Q

What should the graft of a patient with neck resection with a radial forearm free flap look like?

A

Should be pink, if it is blue/mottle there may be venous congestion-immediately alert dr. Look for chyme leakage and immediately report if seen

72
Q

What position should a pt be in post neck dissection?

A

Fowler’s-promotes comfort and spontaneous breathing

73
Q

What to know about suction on a pt with a neck dissection

A

Avoid suctioning near suture line as it can destroy the graft

74
Q

What can be given IV to a pt with an esophageal obstruction from eating?

A

Glucagon-relaxes the esophagus and allows pt to swallow.

75
Q

What is given to treat peptic ulcers?

A

Antibiotics and a PPI; kills the bacteria and stops acid production to promote healing

76
Q

How does H. Pylori cause an infection?

A

Through contaminated food or water

77
Q

What is washboard abdomen a sign of?

A

Perforation/Bleeding (emergency)

78
Q

What is the duration of treatment for a patient with peptic ulcer disease?

A

4-8 weeks

79
Q

How long to listen for bowel sounds before charting absent?

A

5 minutes

80
Q

Meds that can be given for hyperkalemia

A

lokelma and kaexalate, regular IV insulin and glucose

81
Q

Universal donor

A

O-

82
Q

Universal recipient

A

AB

83
Q

TPN risk factors

A

SOB, egg allergy, and IV dextrose

84
Q

What to watch for with blood transfusion

A

Flank pain, SOB- immediately stop transfusion

85
Q

Priority nursing action when caring for a pt with an NG tube post-Whipple procedure

A

DO NOT MANIPULATE

86
Q

Steatorrhea

A

Fat in stool

87
Q

What is stool going to look like after barium swallow?

A

White, chalky

88
Q

S/S for a pt with appendecitis

A

belly button pain, fever and chills, nausea and vomiting, rebound tenderness, bloating, constipation or diarrhea

89
Q

Nursing priority for pt with GI bleed

A

Watch for S/S of shock-low bp, high and weak pulse, diaphoretic; watch for fluid-electrolyte imbalances

90
Q

Dietary measures for pts with Crohn’s

A

increase oral fluids; low residue, high protein, high calorie diet with supplemental vitamins and iron. Avoid foods that could exacerbate symptoms-stuff that can cause bloating and diarrhea

91
Q

Assessment for acute diverticulitis

A

typically dx by colonoscopy; abdominal CT with contrast to confirm diverticulitis; cramping in left lower quadrant, change in bowel habits, bloating, nausea, anorexia, abdominal distention

92
Q

Assessment for stoma 3 days postop

A

Stoma is beefy, red and moist; some serous drainage is normal.

93
Q

Medication that a pt with glaucoma should not take for N/V

A

Phenergan

94
Q

The goal of care in an IBS pt

A

That they will be able to make the lifestyle/diet changes necessary to get the flares under control

95
Q

Nutritional education for a pt with ascites

A

Low sodium to help avoid fluid retention

96
Q

S/S of hepatic encephalopathy

A

Increased serum ammonia, mental status changes, motor disturbances-pt looks confused and unkempt and has alterations in mood and sleep patterns- asterixis (liver flap), apraxia (not being able to remember how to do something), fetor hepaticus

97
Q

What is asterixis and what causes it?

A

Asterixis is the involuntary flapping of the hands when the pt holds their arm out and it is d/t hepatic encephalopathy

98
Q

Nursing priorities for pt with esophageal varices

A

treat for shock, administer oxygen, IV fluids and electrolytes, Vasopressin SOmatostatin Octreotide to decrease bleeding, Beta blockers (lols) to decrease portal pressure

99
Q

Nursing interventions for pts with ascites and portal hypertension

A

daily weights and abdominal girth, administer diuretics as prescribed, low sodium diet

100
Q

What is spironolactone and why would a pt be prescribed it?

A

Spironolactone is an aldosterone antagonist; it is a potassium sparing diuretic so a pt with low potassium but built up fluid would be prescribed this

101
Q

C-diff diarrhea can:

A

cause you to lose a lot of potassium leading to arrhythmias

102
Q

Cullen’s sign is

A

bruising around the umbilicus-pointing to hemorrhagic pancreatitis

103
Q

S/S of chronic pancreatitis

A

severe upper abdominal and back pain, vomiting, weight loss***, steatorrhea (fat in the stool), pale clay colored stool

104
Q

What to watch for after gallbladder surgery

A

Bleeding, peritonitis, sepsis; if the pt complains of any or if it s/s are noticed by nurse-report to dr immediately; rigidity of abdomen, bowel sounds, hypotension and tachycardia

105
Q

Nutrition for pts with gallbladder disease

A

avoid fatty foods, eat low residue diet

106
Q

What to watch for after Endoscopic retrograde cholangiopancreatography (ERCP)?

A

Signs of bleeding and perforation(rigid abdomen, signs of shock) and lozenges can be used for sore throat once gag reflex returns

107
Q

Rapid Acting Insulin

A

Lispro, aspart, glulisine; 15 min onset, 1 hour peak, <5 hour duration; DO NOT GIVE UNTIL PT IS EATING

108
Q

Short-acting/Regular Insulin

A

These will have names like Humulin-R; 30-60 minute onset, 2-3 hour peak, 4-6 hour duration; typically given 15 min before meal

109
Q

Intermediate/NPH insulin

A

these will have names like Humulin-N; 1-1.5 hour onset, 4-12 hour peak, up to 24 hour duration; food given around onset and peak

110
Q

Long-Acting Insulin

A

Glargine, Detemir; 3-6 hour onset, no peak, 24 hour duration; this will be the patient’s basal dose

111
Q

Addisonian Crisis

A

Shock, hypotension, rapid and weak pulse, pallor, extreme weakness; loss of fluid and cortisol drops dramatically

112
Q

Sick day rules for diabetes

A

Take insulin as prescribed, adding more if needed. Alert provider of hyperglycemia and dehydration

113
Q

1st thing to do for pts in DKA

A

Address fluid and electrolyte imbalances

114
Q

What disease typically causes cola-colored urine?

A

Glomerulonephritis

115
Q

Normal BUN

A

8-20

116
Q

Normal creatinine (males)

A

0.6-1.2

117
Q

BPH is treated by

A

-zosins or -osins; Tamsulosin, terazosin, doxazosin

118
Q

Which hormone regulates calcium?

A

Parathyroid hormone causes calcium to leave the bones and enter the blood; calcitonin causes serum calcium to enter the bones

119
Q

What insulin can be given IV?

A

Regular ONLY

120
Q

What is the most common symptom of Addison’s?

A

Muscle weakness

121
Q

What are the functions of the kidneys?

A

filtering blood, producing urine, acid-base balance, regulating fluids

nursing (15 decks)

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