Review

Question 1

TSH- thyroid stimulating hormone is responsible for what?

Answer 1

Thyroid stimulating hormone (TSH) stimulates the thyroid gland, which helps regulate the body’s metabolism

Question 2

Which gland releases ACTH- adrenocorticotrophic hormone?

Answer 2

Adrenocorticotrophic hormone (ACTH) controls the hormones released by the adrenal gland that support blood pressure, metabolism, and the body’s response to stress

Question 3

FSH and LH stimulate what, in males and in females?

Answer 3

Gonadotropins (Follicle stimulating hormone or FSH and Luteinizing hormone or LH) stimulate production of sperm in a man’s testicles or eggs in a woman’s ovaries and regulate a woman’s menstrual cycle

Question 4

What do growth hormones promote in the body?

Answer 4

Growth hormone promotes growth of the long bones in the arms and legs, thickens the skull and bones of the spine, and causes the tissue over the bones to thicken

Question 5

what does prolactin stimulate?

Answer 5

Prolactin stimulates milk production in women after childbirth

Question 6

This hormone secreted by the anterior pituitary, stimulates the movement of fat from the body to the bloodstream

Answer 6

lipotropin

Question 7

what are the hormones secreted by the posterior pituitary?

Answer 7

oxytocin and antidiuretic hormone (vasopressin)

Question 8

this hormone increases reabsorption of water by the kidneys and allows a person to stay hydrated

Answer 8

ADH= vasopressin

Question 9

What does the parathyroid gland produce and regulate?

Answer 9

parathyroid hormone, which helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning

Question 10

What is an increased BNP level associated with and why?

Answer 10

heart failure- BNP is a neurohormone that’s released from the ventricles when the ventricles experience increased pressure and stretch

Question 11

How should a child be positioned in the first 24 hours after the placement of a ventriculoperitoneal shunt?

Answer 11

supine with the head of the bed flat to prevent too rapid a decrease in cerebrospinal fluid pressure

Question 12

Why is an exchange transfusion necessary in an infant with erythroblastosis fetalis?

Answer 12

to reduce the blood concentration of bilirubin and correct the anemia. The Rh-pos blood is replaced by Rh-neg blood

Question 13

List the risk factors for colon cancer.

Answer 13

hx of inflammatory bowel disease, age>40, hx of familial polyposis, colorectal polyps, and high fat or low fiber diet

Question 14

What do you include in the plan of care of a women in labor that tested positive for gonorrhea?

Answer 14

Administer erythromycin (E-mycin) eye drops to the infant after birth
monitor fetal heart tones more frequently

Question 15

Identify symptoms of acute epididymitis

Answer 15

acute tenderness and pronounced swelling of the scrotum, gradual onset of unilateral scrotal pain, urethral discharge, and fever
occasionally, but not routinely, associated with urinary tract infection

Question 16

What does sever diarrhea lead to?

Answer 16

metabolic acidosis due to large bicarbonate losses

Question 17

At what point does brain damage occur after the loss of cardiopulmonary function?

Answer 17

after 4-6 min. permanent brain damage is almost certain. it is important to begin CPR promptly after a cardiopulmonary arrest

Question 18

What is the purpose of an abduction bar with a patient in a spica cast?

Answer 18

it is incorporated into the cast to increase the cast’s strength and maintain the legs in alignment

Question 19

What should the nurse assess for after a bilateral adrenalectomy?

Answer 19

Persistent cortisol excess undermines the collagen matrix of the skin, impairing wound healing. It also carries an increased risk of infection and of bleeding.

Question 20

thrombocytopenia

Answer 20

= low blood platelet count

• Platelets (thrombocytes) are colorless blood cells that play an important role in blood clotting. Platelets stop blood loss by clumping and forming plugs in blood vessel holes.
• • often occurs as a result of a separate disorder, such as leukemia or an immune system problem, or as a medication side effect

Question 21

Why should a nurse assess a client with thrombocytopenia who has also developed a hemorrhage, for tachycardia?

Answer 21

because the heart beats faster to compensate for decreased circulating volume and decreased numbers of oxygen-carrying RBCs. The degree of cardiopulmonary distress and anemia will be related to the amount of hemorrhage that occurred and the period of time over which it occurred. Bradycardia is a late symptom of hemorrhage; it occurs after the client is no longer able to compromise and is debilitating further into shock.

Question 22

If a hemorrhaging pt with thrombocytopenia develops bradycardia, what could potentially be the outcome?

Answer 22

If bradycardia is left untreated, the client will die from cardiovascular collapse. Decreased PaCO2 is a late symptom of hemorrhage, after transport of oxygen to the tissue has been affected.

Question 23

SIADH

Answer 23

characterized by excess antidiuretic hormone (ADH, vasopressin) secretion, despite low plasma osmolality. Excess ADH causes water retention. As blood volume expands, plasma becomes diluted resulting in dilutional hyponatremia. Aldosterone is suppressed, resulting in increased renal sodium excretion. Water moves from the hypotonic plasma and the interstitial spaces into the cells.

Question 24

What is the earliest sign of HF in an infant?

Answer 24

tachycardia/ sleeping rate>160 bpm

Question 25

When planning a 15-month-old toddler's daily diet with the parents, what amount of milk should the nurse include?

Answer 25

Toddlers around the age of 15 months need 2 to 3 cups (500 to 750 mL) of milk per day to supply necessary nutrients such as calcium. A daily intake of more than 3 cups (750 mL) of milk may interfere with the ingestion of other necessary nutrients

Question 26

at what age is screening for scoliosis appropriate?

Answer 26

screening for scoliosis should begin at age 8 and be performed yearly thereafter

Question 27

At what age should a toddler be able to speak 3 words?

Answer 27

By age 18 months, 90% of children can say three words. Typically a child 23 months of age can build a tower of four cubes. The ability to use a spoon or fork with little spilling is accomplished by the age of 20 months. Throwing a ball overhand typically is achieved by age 3

Question 28

Normal ABGs

Answer 28

pH: 7.35-7.45 PaCO2: 35-45 mmHG PaO2: 80-100 mmHG HCO3: 22-26

Question 29

normal creatinine

Answer 29

0.6-1.3 mg/dL

Question 30

s/s of respiratory alkalosis

Answer 30

``` seizures deep, rapid breathing hyperventilation tachycardia decr. or normal BP hypokalemia numbness & tingling in extremities lethargy, confusion, light headedness, n/v ```

Question 31

causes of respiratory alalosis

Answer 31

hyperventilation (anxiety, fear, PE) | mechanical ventilation

Question 32

s/s of metabolc alkalosis

Answer 32

``` restlessness followed by lethargy dysrhythmias (tachy) compensatory hypoventilation confusion (decr. LOC, dizzy, irritable) n/v/d tremors, muscle cramps, tingling of fingers & toes hypokalemia ```

Question 33

causes of metabolic alkalosis

Answer 33

severe vomiting, excessive GI suctioning, diarrhea, excessive NaHCO3

Question 34

Causes of hypernatremia (MODEL)

Answer 34

``` meds, meals (too much sodium intake) osmotic diuretics diabetes insipidus excessive H2O loss low H2O intake ```

Question 35

CBC lab values

Answer 35

``` RBC: 4.5-5 F, 4.5-6.3 M Hgb: 12-15f, 14-16.5 m Hct: 35-52% Plt: 150-400,000 WBC: 5,000-10,000 ```

Question 36

Ulcerative colitis

Answer 36

location: colon mainly disease development: uniform progression spread from rectum through the colon s/s: bloody diarrhea, abdominal pain, weight loss, ulceration and bleeding liver diseases, anemia, fever, arthritis and skin changes

Question 37

crohn's disease

Answer 37

location: entire GI tract, although most common site is between small and large intestine disease development: eleven spread, inflamed intestinal segments between healthy intestinal areas s/s: abdominal pain, weight loss, diarrhea, perforation in the colon, toxic megacolon fistulas, abscesses, anemia, fever, arthritis and skin changes

Question 38

The nurse is caring for a primigravida in active labor when the client's membranes rupture spontaneously. The nurse should assess the client for:

Answer 38

Whenever the membranes rupture, it is important for the nurse to assess for a prolapsed cord.

Question 39

Describe the transition phase of labor

Answer 39

the last part of active labor- Irritability, nausea, vomiting, and often the urge to push are all signs that the client is beginning the transition phase of labor that occurs when the client is 8 to 10 cm dilated Contractions are usually very strong, coming every two and a half to three minutes or so and lasting a minute or more, and you may start shaking and shivering

Question 40

Explain TORCH

Answer 40

refers to Toxoplasmosis, Other Rubella virus, Cytomegalovirus, and Herpes simplex virus — agents that may infect the fetus or neonate, causing numerous ill effects

Question 41

define x-linked recessive inheritance

Answer 41

a mode of inheritance in which a mutation in a gene on the X chromosome causes the phenotype to be expressed in males and in females who are homozygous for the gene mutation

Question 42

causes of fluid volume excess

Answer 42

CHF, renal failure, cirrhosis, overhydration,

Question 43

symptoms and lab findings with fluid volume excess

Answer 43

symptoms: peripheral edema, periorbital edema, elevated BP, dyspnea, altered LOC labs: decr BUN, Hgb, Hct, serum osmolality, urine specific gravity

Question 44

causes of fluid volume deficit

Answer 44

inadequate fluid intake, hemorrhage, v/d, massive edema

Question 45

symptoms and lab findings in a pt with fluid volume deficit

Answer 45

sym: weight loss, oliguria, postural hypotension labs: incr. BUN, Hgb, Hct, urine specific gravity

Question 46

common presentation and treatment of a patient with hypokalemia

Answer 46

rapid, thready pulse, flat T waves, fatigue, anorexia, muscle cramps IV K+ supplements, encourage foods high in K+ (bananas, oranges, spinach)

Question 47

common presentation and treatment of a patient with hyperkalemia

Answer 47

tall, tented T waves, bradycardia, muscle weakness | give 10-20% glucose with regular insulin, Kayexalate, renal dialysis may be needed