Mid-Point Flashcards
(29 cards)
what organ[s] is considered an endocrine and exocrine gland?
pancreas
liver
gonads
what gland is responsible for secreting a hormone that retains Na and water?
adrenal glands release aldosterone which is responsible for this mechanism
match the gland w/ the enzyme secreted by the gland: _ stomach _ pancreas _ liver _ small intestine -- _intrinsic factor _ trypsinogen _ bile _ lactase
the stomach secretes intrinsic factor
the pancreas secretes trypsinogen [converted into trypsin where it then aids in breaking down proteins into amino acids]
the liver secretes bile
the small intestine releases lactase
blood flowing from the superior vena cava enters what area?
right atrium
what term defines the amount of blood flow coming from the left ventricle per beat?
stroke volume
what wave form indicates ventricular depolarization?
QRS complex
what cranial nerve has a sensory component that consists of taste discrimination in the anterior 2/3 of the tongue?
facial
match the hormone with its correct response in the body: _ ADH _ thyroxine _ cortisol _ glucagon -- _ promotes reabsorption of water _ increases blood sugar _ decreases Ca _ retains Na and H2O and excretes K
ADH promotes the reaborption of water
thyroxine increases the heart rate
cortisol AND glucagon increases blood sugar
maslow’s hierarchy of needs
1 air, water, food
2 safety and security needs
3 love and belonging; friendship; love; social relationships
4 self-confidence, achievement, self-worth
5 self-actualization
x-ray films revel that a client has closed fractures of the right femur and tibia. multiple soft-tissue contusions also are present. an imp. short-term intervention would be to:
1. prepare the client for application of skeletal traction
2 reassure the client that these injuries are not that serious
3 prepare the client for operative reduction of the injured extremity
4 assess the circulatory, motor, and sensory status
4
a nurse is planning care for a client with an internal radiation implant. which of the following is an appropriate component for the nurse to include in the plan of care? select all that apply.
1 wearing gloves when emptying the client’s bedpan
2 keeping all linens in the room until the implant is removed
3 wearing a lead apron when providing direct care to the client
4 placing the client in a semiprivate room at the end of the hallway
1, 2, 3
a dangerous fire has occurred in the hospital, and the clients in the unit must be evacuated. the nurse must make the decision about how to evacuate the clients. which client should be evacuated last?
1 client w/ a severe head injury, no deep tendon reflexes, and receiving continuous IV’s and resp. support
2 client for whom total bed-rest has been prescribed b/c of R-sided paralysis caused by a cerebral accident 2 weeks ago; she is unable to walk and has a feeding tube
3 client with a long leg plaster cast on his R leg and an internal fixation device on his R arm who is mobile in a wheelchair
1
laboratory tests to screen for infection [normal values]
WBC count 5000-10000 mm ESR - up to 15 mm/h for men - up to 20 mm/h for women iron 60-90 g/100 mL sterile blood and urine possible normal flora of wounds, sputum, and throat
the nurse is caring for a client diagnosed w/ meningitis and implements which transmission based precautions for this client?
1 private room or cohort client
2 personal resp. protection device
3 private room w/ negative airflow pressure
4 mark worn by staff when the client needs to leave the room
1
a client is diagnosed w/ a nososcomial infection caused by MRSA and contact precautions are initiated. the nurse prepares to provide colostomy care to the client and obtains which of the following protective items to perform this procedure?
1 gloves, gown
2 gloves, goggles
3 gloves, gown, shoe protectors
4 gloves, gowns, goggles, and a face shield
4
the nurse knows discharge teaching in relation to warfarin sodium [coumadin] therapy has been understood when the client states, “I will…”
1 … take Tylenol for my occasional H/A
2 … spend most of the day working at my desk
3 … make an appointment to have a CBC drawn
4 … ask the doctor for antibiotics before going to the dentist
1
1 avoid ASA [interferes with platelets], tylenol should be used instead
2 prone to pooling and thrombus
3 PTT should be dne periodically, not CBC
4 not necessary, only for cardiac problems
the nurse is preparing to teach a client how to use crutches. before initiating the lesson, the nurse performs an assessment on the client. the priority nursing assessment should include which of the following?
1 the client’s fear r/t the crutches
2 the client’s understanding of the need or increased mobility
3 the client’s muscle strength and previous activity level
4 the client’s feelings about the restricted mobility
2
a nurse has prepared an IM inj. for a preoperative client. suddenly another client becomes entangled in an IV tubing and yells for help. the nurse rushes to assist. the surgery orderly is waiting for the preoperative client, so the nurse asks a 2nd nurse to give the inj. to the preoperative client. which of the following is the best response by the 2nd nurse?
1 helps the 2nd client so the nurse can give the preoperative client the inj
2 give the client the preoperative med.
3 prepare a new syringe for the preoperative client
1
coronary artery disease [CAD]
type of blood vessel disorder included under atherosclerosis [soft deposits of fat that harden w/ age]
risk factors: u.m. [age, gender, fam. hx, genetics], m. [elevated serum lipids, HTN, smoking, obesity, D.M., stress, homocysteine]
risks: collateral circulation [arterial branching providing blood and nutrients to the heart jeopardized by ischemia
s/s: angina pectoris [lack of O2 supply (reversible)], acute coronary syndrome [prolonged lack of O2 > unstable angina], sudden cardiac death
tx: diet therapy [reduce fats (esp. unsaturated) and cholesterol], smoking cessation, exercise
angina pectoris
causes: CAD
a transient chest pain caused by myocardial ischemia lasting for only 3-5 m; usually subsides when the precipitating factor [physical exertion, temp. extremes, smoking, stress] is relieved
- left ventricle most susceptible to ischemia
types: stable [occurs intermittently over long period w/ same pattern of sx.s], unstable [unpredictable, increasing frequency, easily provoked], prinzmetal [can occur at rest, usually in response to spasm of a major coronary artery
s/s: angina [radiating], severe indigestion, anxiety; SOB, cool/ clammy skin, weakness
dx: serum cardiac enzyme levels [CPK, LDH], troponin, myoglobin, angiogram
NI: ECG, VS, O2, nitro.
congestive heart failure [CHF]
adverse changes in contractility of the heart muscle, preload, afterload, and/ or heart rate can ultimately cause the heart to fail
types:
- left-sided- results from LV dysfunction > blood backs up through LA and into pulmonary veins > increased pulmonary pressure > fluid extravasation from pulmonary cap. bed > pulmonary congestion, edema
- right-sided- backward flow > venous congestion in systemic circulation
- - causes: l-sided HF [1o], cor pulmonale, right ventricular infarction
tx: O2, rest, elevated HOB, daily weights, I&O, salt-restricted diet, fluid restriction
cardiac compensatory responses
ventricular dilation- lengthening of muscle fibers that increases volume in heart chambers
ventricular hypertrophy- an increase in muscle mass and cardiac wall thickness in response to overwork and strain
increases SNS stimulation- produces venous, arteriolar constriction, tachycardia, and increased myocardial contractility
stimulation of renin-angiotensin system- baroreceptors stimulated if blood flow is decreased > release of potent vasoconstrictor > release of norep > stimulates adrenal medulla to secrete aldosterone > Na and H2O absorption > volume expands and increases preload
natriuretic peptide production- increase in volume > ANP stimulation, increased pressure > BNP stimulation; both hormones > vasodilation > decreased after/preload > increased diuresis and inhibits development of cardiac hypertrophy
cardiac decompensation
remodeling- hypertrophy of myocardial cells and sustained activation of neurohormonal [SNA] compensatory systems
- heart wall thickens > myocytes die at an abnormally accelerated rate > increased ventricular mass > changes in ventricular shape and impaired contractility
- SNA: remodeling icnreases wall stress > further neurohormonal stimulation > cycle
s/s of left ventricular heart failure
results from increased L ventricular and L atrial pressures
- dyspnea, SOB, orthopnea, paroxysmal nocturnal dyspnea [PND], cough, cheyne-stoes resp.’s, nocturia
- S3 and S4, increased HR, decreased O2 sat., point of maximum impulse [PMI] displaced inferiorly and posteriorly, LV heaves
- pulmonary edema- crackles, pallor, tachypnea, hypoxia, frothy sputum
