Mix 2 Flashcards by Jade Ring

Which is appropriate for preop MRI

A. Shave grion & insert catheter
B. Remove metal containing objects from patient
C. NPO 6 hrs before test
D. Teach inhale techniques for administration of radioscope

B: Remove metal containing objects from patient

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Mag levels are usually between ____ - _____

What will be the effects if Higher or Lower

1.8 - 2.6

Lower = Increase everything
Higher = Decrease everything

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NCSBN, ID 5 processes in the test plan that are fundamental to the practice of nursing

Caring
Communication & Documentation
Nursing Process ADOPIE
(Assess, Diagnosis, Outcomes, Planning, Implantation, Evaluation)
Culture & Spirituality
Teaching & Learning

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Client with cast complains of pain when arm is passively moved. Which should be the first nursing action?

A. Elevate arm
B. Document findings.
C. Additional analgesic pain relief
D. Assess arm for paresthesia & paralysis

Which disease process is the scenario associated with?

What would be the procedure to correct this problem?

Compartment syndrome

fasciotomy relieves pressure

Surgeon makes incisions in the
Fascia (the tissue surrounding the muscles) to release the pressure and allow blood flow to return to normal

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Client hospitalized for angina pectoris begins to experience chest pain.

Nurse gives Nitroglycerin, sublingual, but the pain is unrelieved.

What is the next nursing action?

A. Reposition client
B. Call clients family
C. Contact HCP
D. Administer another Nitroglycerin tab

D. Administer another Nitroglycerin tab

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How do / can you administrator Nitroglycerin tabs in the hospital as a nurse to relieve chest pain.

Administer (# of pills) ( minutes part)

Up to

3 pills, 5 minutes apart

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Which action is taken before a CT scan.

A. NPO minium of 3 hrs before test
B. Only 2 cigarettes morning of the test
C. Clear liquid breakfast
D. Take all routine medication on morning of the test

The rest are alike because they all say “morning of test”

You can eliminate Like results

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Difference between:

Veracity & Fidelity

Veracity = obligation to tell the truth

Fidelity = duty to do what one promised

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What is a tort in the law

Civil wrong, other than breach in contract, in which allows an injured person to seek damages

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FEMA

What is highest disaster level

Lowest

Highest = level 1

Lowest = level 3

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Triage color management

Red
Yellow
Green

“Black”

Red: Need immediate help or death
Yellow need help within 30 min - 2 hr
Green can wait atleast 2 hrs

“Black” Dead or close to death
Medical attention cannot help them

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Which is the most appropriate assignment for AP

A. Client requiring a colostomy
B. Client receiving continuous tube feedings
C. Client who requires urine specimen collection
D. Client with difficulties swallowing

C. Client who requires urine specimen collection

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Best way for a nurse to handle an AP who is resistant to new policy changes.

A. Ignore the resistance
B. Exert coercion on the AP
C. Positive rewards system
D. Confront AP to encourage verbalization of feelings regarding the change.

D. Confront AP to encourage verbalization of feelings regarding the change.

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While giving a bed bath an AP informs you that another patient has requested pain meds.

How do you best handle this?

A. Finish bedbath and administrator medication afterwards
B. Ask AP to find out last time pain meds were issued
C. Ask AP to tell client that they will receive their pain meds as soon as bedabth is complete
D. Cover client, raise side rails, inform patient that to you leave breafly to give meds.

Pain management is the priority proper

D. Cover client, raise side rails, inform patient that to you leave breafly to give meds.

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Which is the priority for the nurse to assess first

A. Complaining of muscle aches, headaches, history of seizures
B. Client with twisted ankle
C. Minor laceration from a cooking accident
D. Chest pain after eating pizza with a spicy sauce

Chest pain after eating pizza with a spicy sauce

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This system is used to express the combining activity of an electrolyte

mEq

1 mEq cation will always react with 1mEq of an anion

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Generalized Edema, aka anasarca, is an excessive accumulation of fluid in the ______ space.

Causes: cardiac, renal, or liver failure

Interstitial

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Most likely causes of

Hypertonic overhydration

Hypotonic overhydration

Hypertonic overhydration: Excessive Na consumption

Hypotonic overhydration: Water intoxication

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Causes of

Hypertonic Dehydration

Hypotonic Dehydration

Hypertonic Dehydration: Excessive sweat, hyperventilation, ketoacidosis, prolonged fevers, Diarrhea, early-stage kidney disease, diabetes Insipidus

Hypotonic Dehydration: Chronic Illness, excessive hypotonic fluid replacement, kidney disease, chronic malnutrition

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AKI, Chronic kidney disease, heart failure puts client at risk for…

(Fluid volume: Excess or Deficiency)

Excess

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Increases secretions of Aldosterone, Cushings Syndrome, will have this affect _____ on the electrolyte _____

LOWER POTASSIUM <3.5

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Which methods my K be given to a patient

IV (never Push) & Oral

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Bananas, oranges, cantaloupes, honeydew, apricots, grapefruit (some dried fruits, such as prunes, raisins, and dates)
Cooked spinach.
Cooked broccoli.
Potatoes.
Sweet potatoes.
Mushrooms.
Peas.
Cucumbers.

Are foods high in this electrolyte

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What does sodium polystyrene sulfonate do?

Cation-exchange resin

Promotes the gut to absorb Na and excretion of K

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IV calcium or Insulin with glucose Maybe given to a patient with Hyperkalemia to solve the problem T or F

True

Diuretics can cause Hypo/Hypernatremia

Hyponatremia Where water goes Na flows

Caution If client is taking Lithium monitor it's level if patient is (hyponatremic / Hypernatremic)

Hyponatremic Hyponatremia can cause diminished Lithium excretion, resulting in toxicity

Corticosteroids Cushing syndrome Kidney disease Hyperaldosteronism (Hyponatremia/Hypernatremia)

Hypernatremia

Aluminum hydroxide (increases / reduces) Phosphorus levels, causing (higher / lower) calcium levels

Reduces phosphate Increases calcium

Seizure precautions for Hypo/Hypercalcemia

Hypocalcemia

Why would you move a client with a calcium imbalance carefully?

They are at a risk for fractures

_____ is the antidote for magnesium OD

Calcium Gluconate

Fluid is found in 3 compartments Intercellular ___% Interstitial ____% Intravascular ____%

Intercellular 70% Interstitial 22% Intravascular 6%

Increased serum osmolality Increased hematocrit Increased BUN (Blood urea nitrogen) Increased serum sodium Increased Urine specific gravity (Dehydration / Fluid Overload) Decreased serum Decreased hematocrit Decreased BUN (Blood urea nitrogen) Decreased serum sodium Decreased Urine specific gravity (Dehydration/ Fluid Volume Overload)

Increased serum osmolality Increased hematocrit Increased BUN (Blood urea nitrogen) Increased serum sodium Increased Urine specific gravity Dehydration Decreased serum Decreased hematocrit Decreased BUN (Blood urea nitrogen) Decreased serum sodium Decreased Urine specific gravity Fluid Volume Overload

Infusion rate of K

5 - 10 mEq/hr Never >20

Client with Addisons disease, hyperuricemia, or tissue damage is at risk for... Hypokalemia/ Hyperkalemia

Hyperkalemia

Client taking corticosteroids, Hyperaldosteronism, or Cushings syndrome is at risk for... Hyponatremia/ Hypernatremia

Hypernatremia Cushings also creates hypokalemia/ Hypernatremia

Normal serum phosphate levels are ______ What factors contribute to Hypophosphatemia /Hyperphosphatemia

3 - 4.5 mg/dL Hypophosphatemia = Malnutrition/ Aluminum hydroxide or Magnesium-based antiacids Hyperphosphatemia: Renal insufficiency, hypoparathoidism, tumor lysis syndrome ( metabolic emergency that can occur when cancer treatment kills large amounts of tumor cells, causing them to break apart and release their contents into the bloodstream.)

Difference between Insensible Loss & Sensible Loss (Hydration Related)

Insensible= Skin & Lungs (Can't notice) Sensible = Urine, wound drainage, GI tract loss

Cushings syndrome = hypo /Hyperkalemia Addisons syndrome = hypo/ Hyperkalemia

Cushings syndrome = hypokalemia Addisons syndrome = Hyperkalemia The Oppsite is true for the Na values

During Acidosis the body moves H ions into the cell (to lower the pH) To make room for the H in the cell the cell kicks K out. This creates Hypokalemia/ Hyperkalemia During Alkalosis the cells pump H into the bloood stream and this forces K back into the cells. Creating: Hypokalemia / Hyperkalemia

Hyperkalemia Hypokalemia

Adminsiter ____ for tetany

Calcium Gluconate

______ is a medication used to manage hypocalcemia, cardiac arrest, and cardiotoxicity due to hyperkalemia or hypermagnesemia

Calcium gluconate

A diet low in ____ will lessen the Acidosis in DKA

Protein

ABG When _____ occurs the pH is within normal limits But, the Co² & HCo³ will be out of normal limits

Full compensation

ABG Type of disorder that occurs when both Metabolic & Respiratory are either Acidosis/ Alkalosis

Mixed disorder

Allen's test Apply pressure to ulnar and radial arteries simultaneously Ask client to open & close fist Release pressure from _____ while compressing the ____ artery Assess color: Normal = color returns Abnormal = Stay pallor When is this preformed? What action is taken immediately afterwards?

Release pressure from Ulnar while compressing the Radial artery When is this preformed? Before ABG blood draw What action is taken immediately afterwards? Apply pressure for 5 - 10 minutes

What values equal death in ABG

6.8 Acidosis 7.8 Alkalosis

Posistion of client for rectal temperature

Sims

Nasal or oral surgery Jaws wired shut NG tube in place Risk for seizures All have temperature taken how

Rectal

Apical pulse (Left side 5th intercostal space) is assessed for 1 full minute in patients with heart conditions before the administration of ___ or ____

Digoxin or Beta Blockers

Difference between systolic & disystolic pressure is callled

Pulse pressure Helps to predict cardiovascular complications (Heart attack / stroke) Normal 40 - 60

What is idiopathic pain?

Pain in which the source of pain cannot be identified

What is the TENS/PENS device used for

To deliver low electrical current to the skin in an attempt to block pain

NSAIDS (Aspirin/ Ibuprofen) Contradictions Acetaminophen (Tylenol) Contradictions

NSAIDS (Aspirin/ Ibuprofen) Contradictions Bleeding Risk, Oral antidiabetic meds, CCB (Dipine) Acetaminophen (Tylenol) Contradictions Acetaminophen: Liver & renal problems

Acetylcyseine Function

Antidote to Acetaminophen

1. How does physical trauma without bleeding affect potassium levels? 2. How do burns affect K levels

1. Hyperkalemia. The cells break open releasing K into the blood stream 2. If the burn causes oozing / Fluid loss Hypokalemia. The K will leave the body along with the fluid

Elevated WBC & platelets will cause this condition of K Hypokalemia/ Hyperkalemia

Hyperkalemia

See deck on Coagulation

Ed's class 1355 or something

Affects of leafy green foods on Warfarin

Makes it less effective Shortens the Pt time

____ is the main component of erythroctes and serves as the vehicle for transportation of oxygen & carbon dioxide

Hemoglobin

____ represent RBC % in blood and is an important measurement in the presence of anemia or polycythaemia

Hematocrit

COPD, High altitudes, polycythaemia Decreased /Elevated Hemoglobin

Elevated hemoglobin

Dehydration, high altitudes, polycythaemia Decreased/ Elevated hematocrit

Elevated

Anemia, hemorrhage Affected hemoglobin levels how? (Part of the RBC that transports oxygen) Anemia, hemorrhage, bone marrow failure, leukemia, overhydration Affect hematocrit how? (the ratio of the volume of red blood cells to the total volume of blood)

Both lower level

Do clients take morning insulin/ oral antidiabetic medication before receiving a fast blood sugar test How long do they fast before test What are normal & abnormal values for this test

No 8 - 12 hrs 70 - 99 normal 100 - 125 pre-diabetic 125 + diabetes

Affects on BS Addisons disease / Cushings Hyperthyroidism/ Hypothyroidism

Addisons disease: Lower Addison crisis life-threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potassium. Cushings: Higher High level Cortisol makes Insulin Ineffective & produces more glucagon Hyperthyroidism: Higher Insulin resistance Hypothyroidism: Lower decrease in metabolism, which can lead to excess insulin in the body and low blood sugar episodes.

Is fasting required before measuring A1c

Avoid (2) before measuring Serum Creatinine

Exercise 8 hrs Red Meat 24 hrs

Below normal Values <0.8 in Serum Creatinine are seen in these types of diseases

Diseases with Decreases Muscle Mass Muscular Dystrophy Myasthenia gravis

BUN LEVEL Burns, dehydration, GI bleeding, Fever/ Stress, renal disease, UTI Decreased / ELEVATED Fluid Overload, malnutrition, severe liver damage, syndrome of inappropriate antidiuretic hormone Decreases / Elevated

Burns, dehydration, GI bleeding, Fever/ Stress, renal disease, UTI ELEVATED Fluid Overload, malnutrition, severe liver damage, syndrome of inappropriate antidiuretic hormone Decreased

Stages of hypertension Normal = less than 120/80 Elevated = Systolic ___ / Diastolic ___ Stage 1 = Systolic ___ / Diastolic ____ Stage 2 = Systolic ___/ Diastolic ____ Hypertensive Crisis = Systolic ___ / Diastolic ___

Elevated = Systolic 120 - 129/ Diastolic <80 Stage 1 = Systolic 130 - 139/ Diastolic 80 - 89 Stage 2 = Systolic 140 Min. / Diastolic 90 Min Hypertensive Crisis = Systolic >180 / Diastolic >120

WBC range 5,000 - 10,000 Normal What does above and below mean

Below immune suppression (AIDS) - Neutropenic precautions Above Fighting infection

Normal platelets range 150,000 - 400,000 What does above and below signify

<150,000 bleeding risk >400,000 blood clot risk

Caring for a client on a opiod PCA pump. Client appears to be sleeping Vital signs: HR: 52, BP: 101/ 58, RR: 11, SpO² 93% @ 3 L oxygen via nasal Cannula What action should take place next A. Document findings B. Attempt to arouse client C. Contact HCP D. Check med history on pump

B. Attemp to arouse If successful, the vitals may normalize. When sleeping vitals decrease

Amenorrhea...

Absence of period

Longterm protien status can be determined by evaluating this protein...

Serum albumin

Limit Na intake to ...

<2300 mg

This type of diet is used for clients with dsyphagia, surgery of head or neck, dental problems

Mechanical soft

This diet maybe used as a transition diet after full clear liquid. Includes Ice cream Breakfast drinks Fruit / veg juices Foods that are liquid at body temperature

Full liquid diet

This diet is used as Initial feeding after Complete Bowel Rest Feeding after Malnourishment Bowel prep / Post op

Clear liquid diet

T or F All foods are allowed on a Soft Diet Liquid, chopped, or pureed foods are tolerated best

True

Which client would get a High Fiber Diet (how many grams) Low Fiber Diet

High Fiber Diet: Constipation, IBS (Alternating Diarrhea & Constipation), Asymptomatic diverticulitis 20 - 35 Low Fiber Diet IBS, partially obstructed intestines, gastroenteritis, Diarrhea

Who is the DASH Diet used for What does it consist of...

Atherosclerosis, DM, Hyperlipidemia, hypertension, MI, Nephrotic syndrome/ renal failure Normal healthy foods

Fat restricted diet is used in which clients...

Malabsorption disorder, pancreatitis, gallbladder disease, GERD

High calorie/ High protein diet Used for...

Severe stress, burns, wounds,Cancer, AIDS, COPD, Respitory failure,

Type of diet for DM, Hypo/Hyperglycemia, obesity

Carbohydrate-consistent diet

Type of client on a protein restricted diet

Renal disease/ end stage liver disease

Low-purinenl diet is indicated for.. Types of patients Types of food to avoid

"Purine is a precursor for Uric Acid, which forms stones & crystals " Gout: Inflammatory arthritis Caused by a buildup of uric acid in the bloodstream, Forms needle-like crystals which Hurt Kidney Stones Elevated Uric Acid levels Anchovie & similar small fish Organ meats, gravies, wild game

High Iron Diet Which type of patients... Special consideration

Anemia Concurrent intake of Vitamin C will enhance absorption

Pregnancy nutrition considerations (4)

Increase: Calcium (fetal bones) Iron (Increase Blood Volume), Folic Acid (DNA synthesis & RBC production) 60g protein

Breastfeeding considerations Nutrition

Increase: Protein, calcium, Vitamins A,B,C Addition 500 calories daily Avoid alcohol, caffeine, drugs

Bouillon, carbonated beverages, gelatin, hard candy, lemonade, ice pops, regular & decaf coffee Are this type of food

Clear liquid diet

Meats & Dairy products are high in these vitamins

Parathyroid hormone regulates calcium, magnesium, and phosphorus levels in the blood. When PTH production is low, calcium levels in the blood ( drop / raise ), and phosphorus levels (drop / rise)

Low PTH = Low calcium Low calcium = High phosphorus