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nursing funds > Week 6--- ati hw & ch 38 > Flashcards

Week 6--- ati hw & ch 38 Flashcards

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1
Q

normal pH range

A

7.35 to 7.45

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2
Q

CO2 range

A

35 to 45 mmhg

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3
Q

HCO3- range

A

bicarbonate
21 to 28 mEq/L

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4
Q

PO2 range

A

80 to 100hg

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5
Q

Respiratory acidosis

A

ph less than <7.35
*Co2 >45
HCO3 normal

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6
Q

Respiratory Alkalosis
(AHHHHH-kalosis)

A

*hyperventilation causing excess CO2 release

pH: >7.45
*CO2: <35
HCO3: normal

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7
Q

Metabolic Alkalosis

A

pH: >7.45
CO2: normal
*HCO3 : > 28

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8
Q

Metabolic Acidosis

A

pH: <7.35
CO2 : normal
*HCO3: <21

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9
Q

R.O.M.E.

A

*** relationship w PH
R. —respiratory
O. —opposite (pH w/ CO2)
M. —metabolic
E. —equal (pH w/ HCO3)

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10
Q

pH will determine if

A

acidosis <7.35
or
alkalosis >7.45

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11
Q

hyperventilation
vs
hypoventilation

A

hypo = more CO2 is retained & body is more acidic

hyper = CO2 is excreted and body is more basic

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12
Q

how long to infuse blood

A

over a 4 hour time period

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13
Q

When applying IV to a client with a high risk for bleeding…

A

apply blood pressure cuff set to 30 mmHg

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14
Q

universal blood donor

A

O- blood

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15
Q

universal recipient

A

AB+

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16
Q

Blood type A- can donate to

A

A-, A+, AB-, AB+

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17
Q

Blood type A+ can donate to

A

A+, AB+

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18
Q

Blood type B- can donate to

A

B-, B+, AB-. AB+

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19
Q

Blood type B+ can donate to

A

B+, AB+

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20
Q

Blood type AB- can donate to

A

AB-, AB+

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21
Q

Blood type AB+ can donate to

A

AB+

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22
Q

Blood type O- can donate to

A

universal donor

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23
Q

Blood type O+ can donate to

A

O+ A+, B+, AB+

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24
Q

Blood type A- can receive from

A

A- or O-

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25
Q

Blood type A+ can receive from

A

A+, A-, O+, or O-

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26
Q

Blood type B- can receive from

A

B-, or O-

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27
Q

Blood type B+ can receive from

A

B+, B-, O+, O-

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28
Q

Blood type AB- can receive from

A

A-, B-, AB- or O-

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29
Q

Blood type AB+ can receive from

A

Everyone

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30
Q

Blood type O- can receive from

A

O-

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31
Q

Blood type O+ can receive from

A

O+, O-

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32
Q

during a blood transfusion the nurse should

A

check on the client every 15 minutes
2 nurse check
tubing w/ a filter

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33
Q

Iv solution for blood transfusion & dehydration

A

0.9% NaCl (sodium chloride)

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34
Q

WBC count normal range

A

5,000 to 10,000

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35
Q

normal platelet count

A

150,000 to 400,000

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36
Q

potassium range

A

3.5 to 5 mEq/L
*intracellular

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37
Q

sodium range

A

136 to 145 mEq/L
*extracellular

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38
Q

calcium range

A

9 to 10.5 mg/dL
absorption dependent on Vitamin D

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39
Q

Magnesium range

A

1.3 to 2.1 mEq/L

*Mg has a long 1/2 life–takes 24 hrs to decrease levels

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40
Q

definition of dehydration

A

excess water loss without a loss of sodium

*increased urine specific gravity (>1.030)
*hypernatremia

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41
Q

hypovolemia is

A

decrease in blood volume due to body fluid or blood loss

symptoms:
-tachycardia & tachypnea
-hypotension
-thirst
-decreased skin tugor & urine output

42
Q

serum osmolality

A

increased = dehydration
285 to 295 mOsm/kg

43
Q

potassium is responsible for

A

transmission of electrical impulses & conduction of nerve cells in the heart

3.5 to 5

44
Q

hypokalemia

A

<3.5 mEq/L
symptoms:
- muscle weakness
-hypotension
-fatigue
-constipation
- cardiac arrhythmias

45
Q

hypokalemia is caused by;

A

amphotericin B
diabetic ketoacidosis
diuretics
excessive sweating
metabolic alkalosis
theophylline

46
Q

for hypokalemia admin potassium at

A

10 to 20 mEq/hr

47
Q

hyperkalemia

A

> 5 mEq/L
symptoms:
-n/v
-deep tendon reflexes
- dysrhythmias

48
Q

patients with hyperkalemia are at an increased risk for

A

hypoglycemia

49
Q

hyperkalemia could be caused by:

A

acidosis
ACE Inhibitors
burns
dehydration
diabetes mellitus
NSAID
potassium diuretics
sepsis

50
Q

trreatment for hyperkalemia may include

A

calcium gluconate
calcium chloride
insulin
hemodialysis
resin medication

51
Q

hyponatremia

A

<136 mEq/L
**older adults = higher risk
symptoms:
-confusion
-headache
-irritability
-lethargy
-seizure/coma

52
Q

hyponatremia can be caused by

A

burns
excess water/alcohol
*Thiazide Diuretics
vomiting
diarrhea

53
Q

treatment for hyponatremia may include

A

3% sodium chloride
BMP or CMP
urinalysis
limiting fluid intake
Iv administration

54
Q

hypernatremia

A

> 145 mEq/L
w/ plasma osmolality >295 mOsm/kg

symptoms:
-confusion
-lethargy
- irritability

55
Q

hypernatremia is caused by

A

burns
excess sweating
diabetes
vomiting

56
Q

treatment for hypernatremia

A

0.45% NaCl
decrease sodium levels SLOWLY to prevent edema

57
Q

ionized calcium levels

A

calcium binds to protein, so ionized calcium levels are a separate order to analyze 50% of total calcium

levels should be between 4.5 to 5.6

58
Q

hypocalcemia

A

< 9 mg/dL (ionized < 4.5)
symptoms:
-chest pain
-wheezing
-dysphagia
-dryness
-numbness in fingers & toes

59
Q

hypocalcemia can be caused by;

A

glucocorticoids (-one)
H2 Blockers (-dine)
hypoparathyroidism
low Vitamin D
low albumin levels
loop diuretics (-ide)
proton pump inhibitors (-azole)
menopause (low estrogen)

60
Q

Chvostek Sign

A

indicates low Calcium or Magnesium

(+) = twitching of facial muscles when tapped 2 cm in front of tragus of ear

61
Q

Trousseau Sign

A

indicates low Calcium or Magnesium

(+) = flexion of wrist, thumb, & finger joints w/ hyperextension of fingers when blood pressure cuff is 20mmHg above client’s systolic for 3-5 min

62
Q

treatment for hypocalcemia

A

Vitamin D supplements
Calcium injections

63
Q

hypercalcemia

A

> 10.5 mg/dL (ionized >5.6)
symptoms:
–elevated PTH
–N/V
-constipation
-anorexia
-kidney stones
-polyuria
-thirst

64
Q

hypercalcemia symptoms mnemonic

A

abdominal MOANS, painful BONES, kidney STONES, GROANS, & neurologic OVERTONES

65
Q

hypercalcemia is caused by

A

*thiazide diuretics
*prolonged bed rest
Vitamin D toxicity
cancer
hyperparathyroidism

66
Q

treatment for hypercalcemia includes

A

IV saline bolus w/ loop diuretic
hemodialysis

67
Q

hypomagnesemia

A

< 1.3 mEq/L
symptoms:
-muscle cramps
-numbness
-weakness
-N/V

68
Q

hypomagnesemia is caused by:

A

*hypocalcemia
*hypokalemia
loop diuretics
thiazide diuretics
proton pump inhibitos
antibiotics
burns

69
Q

treatment for hypomagnesemia

A
  • slow admin of IV magnesium w/ 2 nurse verification
    -monitoring urine

-adverse effects: flushing, sweating, & respiratory depression

70
Q

hypermagnesemia

A

> 2.1 mEq/L

ABSENT PATELLAR REFLEX
*24hrs to decrease levels bc of long Mg half life

symptoms:
-loss of deep tendon reflex
-nausea & dizziness
-confusion
-bradycardia
-hypotension
-weakness
-bladder paralysis

71
Q

hypermagnesemia is caused by:

A

*opiods
*hypothyroidism
antacids
acidotic state
analgesics
laxatives
kidney disease
trauma

72
Q

treatment for hypermagnesemia

A

calcium carbonate
calcium gluconate
IV diuretics
ECG
serum blood test

73
Q

urine specific gravity range

A

1.005 - 1.030
*elevated = dehydration

74
Q

hypovolemia is caused by:

A

*Third spacing (fluids sequestered in body cavities)
-severe burns
-excessive sweat
-diuretics

75
Q

treatment for hypovolemia includes

A

0.9% normal saline
IV Ringers lactate

76
Q

hypervolemia

A

excess body fluid

symptoms:
-jugular vein distention
-bounding pulse
-hypertension

77
Q

hypervolemia is caused by

A

-hypertension meds (vasodilators, calcium channel blockers, glitazones)
-pregnancy
-cirrhosis
-liver failure

78
Q

nursing interventions for hypervolemia

A

-daily weight
-limit fluid intake
-diuretics

79
Q

nursing interventions for rehydration

A

-record intake & output HOURLY
*child = 5ml every 5 to 10 min

80
Q

hypotonic solution

A

0.45% NaCl
fewer solutes outside than inside cell
*hypernatremia
*diabetic ketoacidosis

81
Q

isotonic solution

A

0.9% NaCl
Lactated Ringers
5% dextrose

82
Q

hypertonic solution

A

more solutes outside than inside cell
3% NaCl
5 & 10% dextrose

83
Q

tidal volume

A

amount of air inspired and expired with each breath

84
Q

vital capacity

A

maximum volume of air that is expelled after maximal inspirationt

85
Q

total lung capacity

A

volume of air remaining in the lung after maximal inspiration

86
Q

tactile fremitus

A

vibration felt in the chest wall during palpation or auscultation found when speaking

87
Q

right vs left heart failure

A

right = edema
left = lungs

88
Q

nasal cannula

A

prongs in nares
1 to 6 Liters per minute
24% - 44% oxygen

89
Q

regurgitation

A

leaking heart valves that do not close
sounds like a murmur

90
Q

simple face mask

A

5 to 8L per minute
40% to 60% oxygen
retains CO2

91
Q

partial rebreather mask

A

10 to 15 L per minute
60% to 90% oxygen
**reservoir bag

92
Q

Nonrebreather mask

A

10 to 15 L per minute
80% to 95% oxygen

not for clients w COPD

93
Q

Venturi Mask

A

barrel at base of mask
4 to 10 L per minute
24% to 50%

94
Q

A nurse in a provider’s pffice is caring for a client who states that, for the past week, “I have felt tired during the day & cannot sleep at night.” Which of the following responses should the nurse ask when collecting data about the client’s difficulty sleeping? (sap)

1.”Have your working hours changed recently?”

  1. “Do you feel confused in the late afternoon?”
  2. “Do you drink coffee, tea, or other caffeinated drinks? If so, how many cups per day?”
  3. “Has anyone ever told you that you seem to stop breathing for a few seconds while you are asleep?”
  4. “Tell me about any personal stress you are experiencing.”
A

1.”Have your working hours changed recently?”

  1. “Do you drink coffee, tea, or other caffeinated drinks? If so, how many cups per day?”
  2. “Has anyone ever told you that you seem to stop breathing for a few seconds while you are asleep?”
  3. “Tell me about any personal stress you are experiencing.”
95
Q

A nurse is talking with a client about ways to help sleep & rest. Which of the following recommendations should the nurse give to the client to promote sleep & rest? (sap)

  1. Practice muscle relaxation techniques

2.Exercise each morning

  1. Take an afternoon nap
  2. Alter the sleep environment for comfort
  3. Limit fluid intake at least 2 hours before bedtime
A
  1. Practice muscle relaxation techniques

2.Exercise each morning

  1. Alter the sleep environment for comfort
  2. Limit fluid intake at least 2 hours before bedtime
96
Q

A nurse is caring for a client who has been following the facility’s routine & bathing in the morning. However, at home, the client always takes a warm bath just before bedtime. Now the client is having difficulty sleeping at night. Which of the following actions should the nurse take first?

  1. Rub the client’s back for 15 min before bedtime
  2. Offer the client warm milk and crackers at 2100
  3. Allow the client to take a bath in the evening
  4. Ask the provider for a sleeping medication
A
  1. Allow the client to take a bath in the evening
97
Q

A nurse is preparing a presentation at a local community center about sleep hygiene. When explaining REM sleep, which of the following characteristics should the nurse include? (sap)

  1. REM sleep provides cognitive restoration
  2. REM sleep lasts about 90 min
  3. It is difficult to awaken a person in REM sleep
  4. Sleepwalking occurs during REM sleep
  5. Vivid dreams are common during REM sleep
A
  1. REM sleep provides cognitive restoration
  2. It is difficult to awaken a person in REM sleep
  3. Vivid dreams are common during REM sleep
98
Q

A nurse is instructing a client who has narcolepsy about measures that might help with self-management. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

  1. “I’ll add plenty of carbohydrates to my meals.”
  2. “I’ll Take a short nap whenever I feel a little sleepy.”
  3. “I’ll make sure I stay warm when I am at my desk at work.”

4.”It’s okay to drink alcohol as long as I limit it to one drink per day.”

A
  1. “I’ll Take a short nap whenever I feel a little sleepy.”
99
Q

sleep apnea is

A

more than 5 breathing cessations lasting longer than 10 seconds per hour during sleep resulting in decreased O2 saturation levels

100
Q

REM Sleep

A

20 min long – 90 min after falling asleep & 90 min recurrences

cognitive restoration
difficult to awaken
vivid dreaming

101
Q

NREM sleep

A

stage 1 = very light sleep - few min

stage 2 = deeper sleep 10 to 20 min

stage 3 = slow wave or delta sleep
psychological rest and restoration
reduced sympathetic activity

nursing funds (15 decks)

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