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fundamentals > sem 2 exam 2 > Flashcards

sem 2 exam 2 Flashcards

1
Q

IV where

Used for:
Long Term Therapy
All IV Therapies
Blood Draws
Bad peripheral veins
Large fluid volumes
Total parenteral nutrition (only IV nutritional supplement)
A

Central Lines

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2
Q

Potassium (Normal Value: )

A

3.5-5.0 mEq

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3
Q

Clinical Manifestations :

  • Anorexia, N/V
  • Weakness
  • Lethargy
  • Confusion, headache
  • Muscle cramps/twitching
  • Seizures
  • Coma
A

Hyponatremia

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4
Q

Type of Anesthesia where

Administration of drugs by inhalation, intravenous, rectal, or oral route

a patient loses all sensation, consciousness, and reflexes, including gag and blink reflexes.

involves major procedures with extensive tissue manipulation

A

General

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5
Q

Bowel Diversion

Injuries
Cancer
Perforated Diverticulitis
Fistulas

A

Colostomy

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6
Q

same concentraion as plasma

action: fluid stays in the vessels, no gain/ loss of fluids at the cellular level

A

isotonic

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7
Q

Classic Signs

Erythema, warmth, edema, drainage, and discomfort

A

IV site infection

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8
Q

Pooling of blood into subcutaneous tissues around the venipuncture site.

A

Hematoma

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9
Q

Type of Cleansing Enema that

Irritate mucosa
Distends the colon

A

Soap suds

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10
Q

Phase of General Anesthesia

—starts when patient emerges from anesthesia and is ready to leave operating room

A

Emergence

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11
Q

Nurses signature on informed consent indicates what 2 things

A
  1. Patient signed without coercion

2. Patient was alert & aware (competent)

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12
Q

Central Lines _____ side prefereed

A

Left

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13
Q

How well are the lungs excreting CO2?

A

PaCO2

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14
Q

Catheter “broke” off an tip entered the circulatory system

Rare but deadly.

Pain at site, decreased BP, weak rapid pulse, cyanosis

A

Severed Catheter

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15
Q

2 Metabolic Alkalosis causes

A

Increase of bicarbonate

Loss of metabolic acid

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16
Q

Restores function lost or reduced as result of congenital anomalies

A

Constructive

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17
Q

No BM in 3 days- act on/before day 2

A

Constipation-

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18
Q

How well are the kidneys excreting metabolic acids? High: the blood has too few metabolic acids. Low: too many metabolic acids.

A

HCO3

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19
Q

Type of Medicated Enema that

Not for stool, but to remove potassium rapidly!

A

Kayexalate

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20
Q

Post-Op Stoma Care requires

Low-______ diet first few weeks

A

fiber

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21
Q

potassium Less than 3.5 mEq

A

Hypokalemia

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22
Q

Clinical Presentation:
Seizures
Headache
Dysrhythmias

A

Metabolic Alkalosis

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23
Q

: constipation, too much water reabsorbed, dry stools

A

Delayed transit times

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24
Q

Pain at access site with erythema or edema

is a grade __ on the Phlebitis Scale

A

2

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25
Q

type of IV Solution that

Uses
Intracellular/cellular hydration

Fluid management for a patient who is both volume-depleted and hyperosmolar

A

Hypotonic

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26
Q

Loss of more water than sodium
Hypertonic imbalance
Water deficit

ECV Deficit + Hypernatremia
Gastroenteritis (Severe N&V)

clinical dehydration

A

Hypovolemia

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27
Q

No symptoms

is a grade __ on the Phlebitis Scale

A

0

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28
Q 
Clinical Manifestations:
- + Chvostek’s sign
- + Trousseau’s sign
Numbness/tingling
Muscle twitch
Cramping
Hyperactive reflexes
Tetany 
Seizures
A

Hypocalcemia

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29
Q

interventions

Restrict Na & H2o
Promote excretion
Strict I&O
Daily weight
Assessment (including vital sign, respiratory and skin)
Raise HOB
Skin care: protect edematous tissue
Monitor labs
Patient teaching
A

HYPERVOLEMIA

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30
Q

Type of Anesthesia where

involves loss of sensation at the desired site by inhibiting peripheral nerve conduction

commonly used in ambulatory surgery

can also be used in addition to general or regional anesthesia

patient experiences a loss in pain and touch sensation and motor and autonomic activities

A

Local anesthesia

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31
Q

Increase in the number of stools and the passage of liquid, uniformed feces

Often intestinal cramping

Usually a protective response

Large amounts of fluids and electrolytes lost places

person at risk for complications:
Fluid & Electrolyte Imbalances
Infants, young children, elderly at greatest risk
Skin excoriation and breakdown

A

Diarrhea

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32
Q

often a symptom of illness/infection

A

Diarrhea-

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33
Q

Pain at access site with erythema and edema, streak, palpable cord>1 inch in length & purulent drainage

is a grade __ on the Phlebitis Scale

A

4

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34
Q

Lab Values for ________

  • Increased serum osmolality
  • Increased specific gravity
A

Hypernatremia

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35
Q
  • Excess or trapped gas
    Can result from slowed motility
    Gas- can be painful, embarrassing
A

Flatulence

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36
Q 
Clinical Presentation:
Tachycardia
Pulmonary Edema
Tachypnea
Confusion
Coma
A

Metabolic Acidosis

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37
Q

Nuts, beans
Canned entrees
Frozen bread, meals
Smoked/cured/canned meat and poultry

are all rich in ______

A

Sodium

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38
Q

Bowel Diversion

Injuries: Gunshot, MVA
Familial Polyposis
Cancer

Inflammatory Diseases
Ulcerative colitis
Crohn’s Disease

A

Ileostomy

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39
Q

nursing interventions for patients who are receiving IV potassium:

Dilute potassium in an IV bag: NEVER give_____ (can result in cardiac arrest)

A

IV Push

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40
Q

Spicy foods- increase _______ time

A

transit

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41
Q

Fluid reservoir is surgically inserted in a subcutaneous pocket(usually upper chest) with catheter via the internal jugular or subclavian vein with the tip resting in the superior vena cava

All IV Therapies can be administered through the port

Have a low infection rate

Has cosmetic advantages

Must use non-coring needle to access

A

Implanted Ports

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42
Q

Calcium (Normal Value: )

A

9-10.5 mEq

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43
Q

Signs and Symptoms:

Change in Vital Signs, fever, chills, rash, hypotension, shock

A

Blood Transfusion Reactions

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44
Q

type of IV Solution that

Examples:
0.9%NS
Lactated Ringers (LR)
D5W (note: D5W is the low end of isotonic, this can also be considered hypotonic)

A

Isotonic

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45
Q

Clinical Manifestations

Increased pulse
Increased BP
Increased RR
JVD
SOB, crackles, cough, hypoxia (Pulmonary Edema)
Increased weight
Increased edema
Muscle weakness
Confusion, lethargy, change in LOC (seizures, coma)
A

HYPERVOLEMIA

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46
Q

Not enough oxygen rich blood circulating - the acid in the blood is not used and builds up

A

Metabolic Acidosis

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47
Q

Regulates amount of water in the body

Helps with electrical signals in the brain, nervous system and muscles

A

Sodium

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48
Q

—onions, cabbage, beans, cauliflower

A

Gas-producing foods

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49
Q

high pH

high HCO3

A

Metabolic Alkalosis

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50
Q

Antibiotic therapy is vigorously initiated if blood cultures verify a __________ condition.

A

septicemia

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51
Q

Type of Cleansing Enema that

Draws water into colon

A

Hypertonic (Fleet phosphate)

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52
Q

Not enough fiber in the diet

Lack of physical activity (especially in the elderly)

Some medications – opioids, pain medications

Milk , cheese (except in lactose intolerance, allergy)

Irritable bowel syndrome

Changes in life or routine such as pregnancy, aging, and travel

Abuse of laxatives

Ignoring the urge to have a bowel movement

Dehydration

Specific diseases or conditions, such as stroke (most common)

Problems with the colon and rectum

A

Causes of Constipation

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53
Q

Type of Cleansing Enema that

Distends the colon
Stimulates peristalsis
Softens feces

A

Hypotonic (tap water)

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54
Q

6 Hypocalcemia causes

A
  • Renal failure
  • Hypoparathyroidism
  • Malabsorption: ie chronic diarrhea, steatorrhea
  • Pancreatitis
  • Alkalosis
  • Thyroid surgery (parathyroids removed or damaged)
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55
Q

potassium Greater than 5 mEq

A

Hyperkalemia

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56
Q

causes:

vein has ruptured allowing vesicant to seep into surrounding tissues

A

Extravasation

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57
Q

Skeletal structure and function (bone and teeth health)

Transmitting signals through the body

A

Calcium

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58
Q

Surgically placed (not PICC)
Placement verified by x-ray (Superior Vena Cava)
Sterile dressings and technique
Flushing and Locking per facility policy
Complications include: Central Line Infection, pneumothorax, hemothorax, cardiac perforation,

A

Central Lines

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59
Q

size of catheter for

Most medical/surgical patients, daily use

A

20-24 gauge

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60
Q

—fruits and vegetables, bran, chocolate, alcohol, coffee

A

Foods with laxative effect

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61
Q

Not breathing adequately- not exhaling means that you are not getting rid of excess CO2

A

Respiratory Acidosis

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62
Q

HCO3 normal range

A

22-26

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63
Q

(not blowing off the CO2).

A

High: hypoventilation

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64
Q

5 Methods of Emptying the Colon of Feces

A 
Cathartics and Laxatives
Enemas
Rectal suppositories
Fecal Management tube system
Digital removal of stool
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65
Q

Potassium is the main intracellular ion for all cell types.

Responsible for action potential of the cells (potassium/sodium ion channel)

A

Potassium

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66
Q

involves physiological changes that help normalize the pH but do not correct the cause of the problem

A

compen­sation

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67
Q

2 Advance Directives

A

Living wills

Durable power of attorney

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68
Q

Blowing off too much CO2 - not enough CO2 in the blood (eventually the body will start to compensate)

A

Respiratory alkalosis

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69
Q

6 Hyperkalemia interventions

A

Interventions:

  • Eliminate parenteral potassium
  • Kayexalate
  • Monitor EKG
  • Administer calcium gluconate to protect the heart
  • IV loop diuretics
  • Renal dialysis
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70
Q

Clinical Manifestations:

  • F: fever/flushed dry skin
  • R: restless
  • I: Increased fluid retention
  • E: Edema
  • D: Decreased urine output
  • Seizures
  • Irritability/hallucinations
  • Thirst, sticky mucus membranes
A

Hypernatremia

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71
Q

type of IV Solution that

Uses:
Correct fluid volume deficit in the vascular system
Treatment of vascular dehydration
Fever
Labor
Running
A

Isotonic

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72
Q

Daily Average Fluid Intake

Oral ( - )
Foods ( - )
Metabolism ( )

A

1100 – 1400 mL

800-1100 mL

300 mL

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73
Q

Base Excess normal range

A

-2 to +2

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74
Q

nursing interventions for patients who are receiving IV potassium:

Check renal status: at least ___ml of urine output per day

A

600

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75
Q

A hematoma around an artery or vein is dangerous because pressure from the expanding hematoma obstructs_________

A

blood flow.

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76
Q

Relieves or reduces intensity of disease symptoms; does not produce cure

A

Palliative

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77
Q

Sodium (Normal Value: )

A

135-145 mEq

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78
Q

Lab Values

Decreased HGB & HCT
Decreased Na
Decreased Serum Osmolality
Decreased BUN

A

Fluid Volume Excess

HYPERVOLEMIA

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79
Q

5 Hyponatremia causes

A

causes:
- Diuretics
- GI fluid loss
- Hypotonic tube feedings
- Hypotonic IV fluids
- Diaphoresis

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80
Q

less concentrated than plasma

action:fluid shifts from plasma into the cells

A

hypotonic

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81
Q

Daily Average Fluid Output

Skin ( - )
Insensible- Lungs ( )
GI ( - )
Urine ( - )

A

Skin (500 – 600 mL)
Insensible- Lungs ( 400 mL)
GI (100-200 mL)
Urine (1200 – 1500 mL)

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82
Q

Classification of Surgical Procedure where

Diagnostic, ablative, palliative, reconstructive, transplantation, constructive

A

Purpose

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83
Q

FLUID SPACING

Abnormal

Trapped, cannot be easily exchanged with the ECF

ACITES
EDEMA (a/w burns, trauma, sepsis)

A

3rd

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84
Q

Type of Anesthesia where

Used on mucous membranes, open skin, wounds, burns

A

Topical anesthesia

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85
Q

Respiratory alkalosis cause

A

Deep and Fast Breathing!

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86
Q

Classification of Surgical Procedure where

Major
Minor

A

Risk

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87
Q

(blowing off too much CO2).

A

Low: hyperventilation

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88
Q 
Clinical presentation: 
Altered LOC
Tachycardia
Diaphoresis
Headache
A

Respiratory Acidosis

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89
Q

size of catheter for

Trauma, large volume at a rapid rate

A

14-16 gauge

90
Q

Peripheral Catheter are for what durration

A

short term

91
Q

4 Interventions for Hypernatremia

A
  • Restrict sodium intake in diet
  • Increased water intake
  • Dietary education: beware of hidden sodium in foods
  • Seizure precautions-
92
Q

Age/Developmental considerations

Personal Habits/Daily patterns-when, where, how often, position during defecation

Food and fluid intake

Physical Activity and muscle tone

Lifestyle, psychological variables

Pathologic conditions (disease, pain, pregnancy)

Medications

Diagnostic tests

Surgery and anesthesia

A

Variables Influencing Bowel Elimination

93
Q

2 Metabolic Acidosis causes

A

Increase of metabolic acids

Loss of bicarbonate

94
Q

type of IV Solution that

Caution (do not use in)
Cerebral/peripheral edema

A

Hypotonic

95
Q

FLUID SPACING

Abnormal

Accumulation in the interstitial spaces

EDEMA

A

2nd

96
Q

nursing interventions for patients who are receiving IV potassium:

Patient should receive no more than __mEq/hr

A

20

97
Q

Blood Transfusion Reactions

Treatment: give __________, prepare for emergency drugs; save tubing

A

Normal Saline

98
Q

5 thing for Promoting Regular Bowel Habits

A

Timing – after meals and exercise

Positioning—commode or toilet vs bedpan- if a bedpan in necessary- make sure you sit the HOB to a 90 degree angle to facility proper positioning of bowel elimination

Privacy

Nutrition— fluids, fiber, fruits and veggies

Exercise
Abdominal settings
Thigh strengthening

99
Q

Blood Transfusions 9 step Process

A

Verify physician order; Obtain Consent

Patient must have a type and cross-match blood sample performed

Large bore catheter: 18 gauge

Administer with 0.9% Normal Saline

Baseline vital signs, hold and notify if abnormal

Pre-medication may be ordered: Diphenhydramine, Acetaminophen

Begin transfusion slowly- watch for reactions

Observe closely for first 15 min- Stop immediately if any sign of reaction

Blood may not hang longer than 4 hours

100
Q

Type of Cleansing Enema that

Distends the colon
Stimulates peristalsis
Softens feces

A

Isotonic (Normal saline)

101
Q

Acidic (acidosis): too much acid

pH lower than ______

A

7.35

102
Q

PaCO2 normal range

A

34-45

103
Q

Collection of hardened feces/stool in the rectum

Often liquid stool is symptom.

Results from unrelieved constipation

Ask when the last normal formed bowel movement was

A

Impaction

104
Q

Too much bicarbonate - not enough acid

A

Metabolic Alkalosis

105
Q

low pH

low HCO3

A

Metabolic Acidosis

106
Q

Symptoms: swelling, change in color, sensation, or warmth or mass, that often takes on a bluish coloration.

A

Hematoma

107
Q 
Clinical Manifestations:
- Fatigue
- Anorexia, N/V
- Muscle weakness
- Decreased GI motility
Dysrhythmia
Parasthesia
Flat T waves on EKG
A

Hypokalemia

108
Q

: Balance between fluid intake and absorption, fluid distribution and fluid output

A

Fluid Homeostasis

109
Q

6 Hypercalcemia interventions

A
  • Decreased calcium intake (no antacids)
  • Increased fluid intake
  • Weight bearing exercises
  • Tx constipation
  • Renal dialysis if severe
  • Give calcitonin to decrease calcium level
110
Q

6 Hyperkalemia causes

A
  • Hemolyzed serum sample (in lab)
  • Oliguria
  • Acidosis
  • Renal failure
  • Addison disease
  • Multiple blood transfusions
111
Q

Rehydration is most important

Skin care-use protectant lotion for all incontinence, especially diarrhea! Protect the skin!

Anti-diarrheal meds usually after bacteria is ruled out

A

Treatment of Diarrhea

112
Q

type of IV Solution that

Caution:
Should be used with extreme caution
Used cautiously in patients with cardiac and renal failure

A

Hypertonic

113
Q

loose stools, diarrhea, less absorption of nutrients, less water reabsorbed

A

Rapid transit times:

114
Q

1/3 to 1/2 of food waste is excreted in stool within ___ hours (“normal” transit time)

A

24

115
Q

Pouches and Barrier where

—you take the whole thing off each time you want to throw away the bag

A

One-piece

116
Q

—cheese, lean meat, eggs, pasta

A

Constipating foods

117
Q

Pain at access site with erythema or edema plus streak formation and palpable cord

is a grade __ on the Phlebitis Scale

A

3

118
Q

type of IV Solution that

Examples:
3% NS
D5W/0.9%NS
D5W/LR

A

Hypertonic

119
Q

Surgical exploration that allows health care providers to confirm diagnosis; often involves removal of tissue for further diagnostic testing

A

Diagnostic

120
Q

—lasts from admission to recovery room to a follow-up evaluation in the clinical setting or home.

A

Postoperative

121
Q

size of catheter for

Surgical patient, rapid administration of fluids and blood products

A

18 gauge

122
Q

Infiltration Score where

blanching, cool to touch, edema 1-6 inch

A

2

123
Q

Vein is hard to touch and painful – positive ________

A

phlebitis

124
Q

IV where

Therapy will continue for 1 month or more

Therapy includes administration of a vesicant infusion or long-term antibiotic therapy

A

Peripherally inserted central catheter (PICC)

125
Q

Type of Anesthesia where

Anesthetic agent injected near a nerve or nerve pathway or around operative site. No sedation.

protect a patient’s limbs from injury until sensation returns.

results in loss of sensation in an area of the body by anesthetizing sensory pathways

A

Regional

126
Q

Blood Transfusion Reactions

caused by what two things

A

Blood incompatibility

Allergic sensitivity

127
Q

Classification of Surgical Procedure where

Elective, urgent or emergency

A

Urgency

128
Q

Causes: puncture of the back wall of the vein, leakage from venipuncture site, too rapid reapplication of tourniquet

A

Hematoma

129
Q

Peripherally inserted central catheter (PICC)

Must end up in the ________

A

superior vena cava

130
Q

causes

Intake
Decreased PO intake
Decreased Na intake
Inability to drink/express thirst

Output
Diarrhea, vomiting
Profuse sweating, drainage
Hemorrhage

Drugs
Diuretics, laxatives

Diseases
Renal disease
Third spacing: burns

A

Hypovolemia

131
Q

5 Hypernatremia causes

A
  • Increased salt intake
  • Hypertonic IV solutions
  • Decreased renal excretion
  • Corticosteroids
  • Water loss
132
Q

sodium Greater than 145 mEq

A

Hypernatremia

133
Q

—extends from admission to surgical department to transfer to recovery room

A

Intraoperative

134
Q

type of IV Solution that

Examples
0.2% NS
0.45% NS
D5W

A

Hypotonic

135
Q 
Potatoes 
Orange juice 
Avacados 
Strawberries 
Spinach 
Ish (FISH)
Ushroom (mushroom)
Melons (cantaloupe)
A

Potassium

136
Q

interventions

Replace fluids!!!
Assess, assess, assess!

Hypovolemic:
Isotonic solution (stays in the vessels to increase BP)

Clinical Dehydration:
Oral or IV replacement (Hypotonic solution because of hemoconcentration)

A

Hypovolemia

137
Q

Signs and Symptoms

Fever, chills, prostration, pain, headache, nausea, and vomiting

A

Septicemia

138
Q

Less than 135 mEq of sodium

A

Hyponatremia

139
Q

Infiltration Score where

blanching, cool to touch, edema >6 inches pitting, Moderate to severe pain, Circulatory impairment

A

4

140
Q

Blood Transfusion Reactions

Anaphylactic Reaction is promptly treated with
_______,_____________ & _______________

A

antihistamines, steroids, and epinephrine

141
Q

nursing interventions for patients who are receiving IV potassium:

Make sure there is no more than __mEq in a one liter bag of IV fluids

A

40

142
Q

3 Hypokalemia interventions

A

Interventions:
-Administer potassium supplement
PO can have a bad taste and be irritating to the GI tract
IV must be well diluted and NEVER given as a bolus

  • Assess renal status (UOP) prior to giving supplemental potassium
  • Encourage foods rich in potassium
143
Q

causes

INTAKE
Increased fluid intake
Rapid isotonic IV fluids
Increase consumption of salty foods

Output
Increased retention of H2O or H2O+ salt
Kidney Disease
Aldosterone

Drugs
Corticosteroids

Diseases
Kidney, heart and liver failure

A

Fluid Volume Excess

HYPERVOLEMIA

144
Q

Pouches and Barrier where

—you can leave the wafer on the skin, and change only the bag

A

Two piece

145
Q

A systemic infection occurs from pathogens introduced into the circulating bloodstream.

A

Septicemia

146
Q

Hard, dry stool; difficult to eliminate.

Low or inactive bowel sounds

Excessive straining, bloating, and the sensation of a full bowel.

Very common. Over 2 million MD visits/year!

Women; adults over 65; during pregnancy
Assess for paralytic ileus if patient has had surgery, anesthetic- especially bowel surgery!

A

Constipation

147
Q

dilated, engorged veins in lining of rectum

Internal or external, painful

needing treatment as to not interfere with normal bowel habits

A

Hemorrhoids

148
Q

4 Respiratory Acidosis causes

A
  • Insufficient ventilation
  • Impaired gas exchange
  • Impaired neuromuscular function
  • Dysfunction of brainstem respiratory control
149
Q

type of IV Solution that

Uses:
Treat intravascular dehydration with interstitial or cellular over-hydration
Third spacing

A

Hypertonic

150
Q

3 ways Blood Gas is measured?

A

Arterial
Venous
Capillary

151
Q

Type of Enema that

  • lubricates and softens stool
A

Oil Retention

152
Q

Excision or removal of diseased body part

A

ablative

153
Q

Erythema at access site with or without edema

is a grade __ on the Phlebitis Scale

A

1

154
Q

Accidental administration of a non-vesicant solution into subcutaneous tissues.

The severity of the swelling is measured an a standardized scale

A

Infiltration

155
Q

Restores function or appearance to traumatized or malfunctioning tissues

A

Reconstructive/restorative

156
Q

are pairs of chemicals that work together to maintain normal pH of body fluids. If there are too many free H+ ions, a buffer takes them up so they no longer are free. If there are too few, can release H+ ions to prevent an acid-base imbalance

A

Buffers

157
Q

Measure gas exchange and oxygenation. Low: poor oxygenation of the blood

A

PaO2

158
Q

Viruses and Bacteria from people or surfaces

Clostridium difficle – wash your hands! Can not be removed by hand sanitizers- must use soap and water

Medications: Antibiotics

Patients receiving enteral nutrition

Food Allergies and Intolerances

Communicable foodborne pathogens

A

Diarrhea Causes

159
Q

Phase of General Anesthesia

—from incision to near completion of procedure

A

Maintenance

160
Q

Type of Anesthesia where

Used for short-term procedures, diagnostic, and therapeutic procedures that do not require complete anesthesia but rather a depressed level of consciousness

A

Conscious sedation

161
Q

low pH

high PCO2

A

Respiratory acidosis

162
Q

For optimal cell function, the arterial pH of an adult is _______-_______

A

7.35-7.45

163
Q

Infiltration of a vesicant medication or solution that causes destruction by chemical injury and/or severe vasoconstriction.

A

Extravasation

164
Q

Type of Medicated Enema that

before colon surgery

A

Neomycin

165
Q 
Clinical Manifestations:
- Muscle weakness
- Bradycardia
Dysrhythmias
Flaccid paralysis
Intestinal colic
Tall T waves on EKG
M-muscles weakness 
U- urine output decreased 
R- respiratory failure 
D- decreased cardiac contractility  
E-  early muscle twitching 
R- rhythem changes
A

Hyperkalemia

166
Q

Lentils
Beef
Almonds
Milk, cheese, yogurt

are all rich in

A

Calcium

167
Q

size of catheter for

Small children, Older adults, small vein access

A

22-24 gauge

168
Q

clinical manifestations

Thready pulse
Decreased BP, Increased HR, Increased RR
Decreased Cap Refill, cool clammy skin, poor skin turgor
Hypoxia
Weak, dizzy
Decreased Weight
Increased thirst
Decreased urine output
Confusion, changes in LOC, lethargy (seizures, coma)
A

Hypovolemia

169
Q

Is a measurement of the body’s ability to buffer acid/base balance. Below -2: excessive metabolic acids. Above +2: excessive amounts of bicarbonate

A

Base Excess

170
Q

Type of Enema that

  • to relieve flatus (gas)
A

Return-flow/Carminative/Cathartics

171
Q

First sign of IV infection is ____

A

pain

172
Q

Lab Values:

  • Decreased serum osmolality
  • Decreased urine specific gravity
A

Hyponatremia

173
Q

Removal of organs and/or tissues from a person pronounced brain dead for transplantation into another person

A

Procurement for transplant

174
Q

Type of Enema that

To relieve constipation or impaction, to empty for surgery, to clear out for exams, to establish bowel function during training

A

Cleansing

175
Q

when Administering Parenteral Fluids, Monitor site every __ to __ hours or as per policy

A

1 to 2 hours

176
Q

Signs and symptoms

Statement of “not feeling right”

Chills, fever, low back pain, pruritus, Hives/Rash, hypotension, nausea and vomiting, decreased urine output, hematuria, chest pain, dyspnea, shock

A

Blood Transfusion Reactions

177
Q

—begins with decision to have surgery, lasts until patient is transferred to operating room

A

Pre-operative

178
Q

Alkaline (alkalosis): not enough acid

pH higher than _______

A

7.45

179
Q

State of relative constancy in the internal environment of the body; maintained naturally by physiological adaptive mechanisms

A

homeostasis

180
Q

6 causes of Hypercalcemia

A
  • Increased calcium intake
  • Decreased kidney excretion
  • Prolonged immobilization
  • Hyperparathyroidism
  • Decreased calcitonin
  • Bone disease
181
Q

calcium Greater than 10.5 mEq

A

Hypercalcemia

182
Q

Loss of water and electrolytes
OR
Isotonic Loss

Fluid Volume Deficit decrease in ECF

A

Hypovolemia

183
Q

calcium Less than 9 mEq

A

Hypocalcemia

184
Q

Inability to control passage of feces/gas from anus

Can be neurological in nature

A

Incontinence

185
Q

PaO2 normal range

A

80-100

186
Q

If the infused blood is not compatible with the patient’s blood type, an acute _____ reaction will occur.

A

hemolytic

187
Q

3 Hypocalcemia interventions

A
  • Increased calcium and Vitamin D
  • Seizure precautions
  • Quiet environment
188
Q

4 Hyponatremia interventions

A

Interventions:
- Restrict fluid intake (if that is the cause of the hyponatremia)

  • Replace sodium
  • Hypertonic IV fluids (infuse slowly)
  • Seizure precautions
189
Q

Reduces length of hospital stay and cuts costs

Reduces stress for the patient

May require additional teaching and home care services for certain patients

Older patients, chronically ill patients, patients with no support system

A

Ambulatory Surgery

190
Q

Infiltration Score where

blanching, cool to touch, edema > 6 inches, Mild to moderate; numbness

A

3

191
Q

6 cause of Hypokalemia

A
  • Diuretics
  • Diarrhea
  • Vomiting
  • Gastric suction
  • Steroid administration
  • Bulemia

D- drugs (steroids, diuretics, laxatives)
I- inadequate intake (nothing by mouth, anorexic)
T- too much (water, base, insulin)
C- Cushing syndrome
H- heavy fluid loss (suctioning)

192
Q

Clinical presentation:
Numbness
Muscle twitches
Seizures

A

Respiratory alkalosis

193
Q

Large Lumen Catheter surgically placed into a central vein (subclavian or internal jugular)

A

Central Lines

194
Q

Fluid Volume Excess

A

HYPERVOLEMIA

195
Q

high pH

low PCO2

A

Respiratory alkalosis

196
Q

Symptoms: swelling, redness, pain, blisters

A

Extravasation

197
Q

8 things on Informed Consent Information

A

Description of procedure and alternative therapies

Underlying disease process and its natural course

Name and qualifications of person performing procedure

Explanation of risks and how often they occur

Explanation that patient has the right to refuse treatment or withdraw consent

Voluntary Agreement

Legal document with ethical imperatives

Person performing surgery obtains consent (usually MD)

Nurse Witnesses

198
Q

Phase of General Anesthesia

—from administration of anesthesia to ready for incision

A

Induction

199
Q

FLUID SPACING

Normal

Between
ICF & ECF

A

1st

200
Q

more concentrated than plasma

action: fluid shifts from the cells into the plasma

A

hypertonic

201
Q 
Clinical Manifestations:
- Muscle weakness
- Constipation
- Anorexia, N/V
- Dysrhythmias
- Neurosis
Diminished reflexes
Renal calculi (flank pain)
A

Hypercalcemia

202
Q

Central Lines watch for what 6 things

A

Watch for: SOB, chest pain, cough, hypotension, tachycardia, anxiety after or during insertion

203
Q

This results from mechanical irritation (the needle moving in the vein), the low pH of some IV solutions, and highly concentrated additives.

A

Phlebitis

204
Q

Blood clotting

Muscle contraction

A

Calcium

205
Q

lab values

Increased Na
Increased HGB & HCT
Increased serum osmolality
Increased BUN
Increased urine specific gravity
A

Hypovolemia

206
Q

Infiltration Score where

blanching, cool to touch, edema < 1 inch

A

1

207
Q

Reduces length of hospital stay and cuts costs

Reduces stress for the patient

May require additional teaching and home care

services for certain patients

not good for Older patients, chronically ill patients, patients with no support system

A

Ambulatory Surgery

208
Q

reflects the electrical activity of the conduction system.

monitors the regularity and path of the electrical impulse through the conduction system; however, it does not reflect the muscular work of the heart.

A

An electrocardiogram (ECG

209
Q

measures red blood cell count; volume of red blood cells; and concentration of hemoglobin, which reflects patient’s capacity to carry O2.

A

Complete blood count

210
Q

to determine the type of IV fluids and electrolyte additives to administer before and during surgery.

A

serum electrolyte levels

211
Q

Includes a number of tests that are used for screening and are diagnostic for fluid and electrolyte disturbances, urinary tract infection, presence of blood and other metabolic problems

A

urinalysis

212
Q

Nurse’s Role in Presurgical Screening

Ensure_______are explained to the patient

Ensure ______ are recorded in patient records before surgery

Ensure that________ are reported

A

tests

results

abnormal results

213
Q

type of Medications such as warfarin (Coumadin) or aspirin alter normal clotting factors and thus increase risk of hemorrhaging. Discontinue at least 48 hours before surgery.

A

Anticoagulants

214
Q

type of Medications that enhance action of anesthetic agents. If taken within 2 weeks before surgery, aminoglycosides (gentamicin, neomycin, tobramycin) may cause mild respiratory depression from depressed neuromuscular transmission.

A

Antibiotics

215
Q

type of Medications (e.g., beta blockers) can reduce cardiac contractility and impair cardiac conduction during anesthesia.

A

Antidysrhythmics

216
Q

type of Medications Long-term use

alters metabolism of anesthetic agents.

A

Anticonvulsants

217
Q

type of Medications such as beta blockers and calcium channel blockers interact with anesthetic agents to cause bradycardia, hypotension, and impaired circulation. They inhibit synthesis and storage of norepinephrine in sympathetic nerve endings

A

Antihypertensives

218
Q

type of Medications cause adrenal atrophy, reducing the ability of the body to withstand stress. Before and during surgery, dosages are often increased temporarily.

A

Corticosteroids

219
Q

type of Medications potentiate electrolyte imbalances (particularly potassium) after surgery.

A

Diuretics

220
Q

type of Medications (e.g., ibuprofen) inhibit platelet aggregation and prolong bleeding time, increasing susceptibility to postoperative bleeding.

A

NSAIDs

221
Q

is an RN who does not scrub in and uses the nursing process in the management of patient care activities in the OR suite.

also manages patient positioning, antimicrobial skin preparation, medications, implants, placement and function of IPC devices, specimens, warming devices, and surgical counts of instruments and dressings

A

. The circulating nurse

222
Q

is either an RN or surgical technologist who is often certified (CST).

must have a thorough knowledge of each step of a surgical procedure and the ability to anticipate each and every instrument and supply needed by the surgeon

A

scrub nurse

fundamentals (6 decks)

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