Final Exam Flashcards

Question

What are symptoms of BPH?

Answer 1

- issues initiating a stream - decreased force of urine stream check what else

Answer 2

PSA: prostate specific antigen test - typically recommended at age 50 unless person has a history/genetic component

Answer 3

TSE (testicular self-examination) monthly

Answer 4

clot obstruction -- need to irrigate

Answer 5

don't want to catheterize them - if you have to, sometimes a suprapubic catheter

Answer 6

- heart problems - medications contraindicated: vasodilators, nitroglycerin

Answer 7

Slow down the infusion rate because they are probably not absorbing it

Answer 8

if on long-term meds - what for? history of weight gain and loss infected wound and nutritional needs

Answer 9

- turn off the feeding - should be stopped 30-60 minutes before to prevent aspiration

Answer 10

Drinking liquids with food - increases dumping syndrome - need to drink fluids **in between** but not with them - should have low-fat foods and low fiber

Answer 11

- crackles in lung sounds - pulmonary edema - cerebral edema

Answer 12

**get vital signs** because they could go into shock with losing blood - stable or stable - are they coding - check airway

Answer 13

- they are EXPECTED to not have bowel sounds - a complication could be leakage into abdominal cavity: peritonitis, infection -- REEDA, WBCs elevated, increased temperature - abdominal distention

Answer 14

- **avoid foods that cause pain after consumption** - no acidic foods - no tomatoes - no oranges - no coffee needs can be individual

Answer 15

- blood in the suctioning - rigidity (board-like abdomen) can become septic, hypovolemic shock: check vital signs

Answer 16

- antibiotics - fluid or bowel rest Don't want to take imodium because we want to rid the body of bacteria

Answer 17

Upper GI: endoscopy if want to look at lower GI - colonoscopy, barium enema

Answer 18

- consume high fiber and fluids - encourage ambulation - some OTC meds can cause constipation - some bulk-forming laxatives are good source of fiber: miralax, metamucil

Answer 19

high fiber, low in fat and red meat

Answer 20

enema, then manual removal if enema doesn't work

Answer 21

assisted personnel, patient, us Assisted personnel cannot change the appliance

Answer 22

NPO and fluids if ACUTE - bowel rest Before going home: high fiber, high fluid

Answer 23

Monitor for stool in blood: heme occult Malnutrition

Answer 24

pain, rigidity, abdominal distention, absent bowel sounds

Answer 25

NPO with IV fluids --> bowel rest

Answer 26

cirrhosis, Tylenol, alcohol, statins

Answer 27

stop drinking alcohol; avoid it

Answer 28

Give it for hepatic encephalopathy - gets rid of the ammonia

Answer 29

Assessing mental status and seeing an improvement

Answer 30

Pressure-relief mattress because they are at increased risk of skin breakdown due to it being thinner and leaking

Answer 31

Altered mental status, jaundice Want to notify provider with a change in mental status - as a new finding

Answer 32

Tan or gray stools due to the lack of bile

Answer 33

RICE - Rest - Ice: 24-48 hours 20-30 mins at a time - Compression: elastic bandage; apply distal to proximal - Elevate: above the heart

Answer 34

Top of crutches should be 1-2 in below armpit, weight should be on hands not armpit. handgrips should be even with top of hips. Navigating Stairs - Up Stairs: Lead with your uninjured leg, moving it to the next step first, then move your crutches and injured leg to the same step. Remember the phrase: “Up with the good.” - Down Stairs: Place the crutches on the lower step, move your injured leg down next, and then follow with your uninjured leg. Remember: “Down with the bad.”

Answer 35

Widen a person’s base of support, should not be for bearing weight hold cane on stronger side cane about 4 inches to side of foot and extend to wrist crease elbow slightly bent; flexed 15 degrees teach patients to stand erect and not lean on it patient stand w/ weight evenly distributed cane on stronger side and advance one small stride ahead supporting weight on stronger leg and cane, patient advances the weaker foot forward to parallel to the cane supporting weight on weaker leg and cane, patient brings stronger leg forward to finish the step

Answer 36

stand between the back legs of the walker with arms relaxed at the side top of walker should align w/ the crease on inside of patient wrist grip top of the walker at the handles with elbows slightly bent lift walker and position about one step ahead; keep back upright place one leg inside the walker (ensure doesn’t roll away if wheels) push straight down on grips of walker and step forward with remaining eg repeat process

Answer 37

Foot drop, or drop foot, is a condition where the foot cannot be lifted or dorsiflexed at the ankle, often causing the foot to drag when walking. Nursing interventions for foot drop focus on preventing falls, maintaining mobility, and addressing pain. - can use assistive devices - physical therapy - splints - active and passive exercises

Answer 38

Would want to assess the abdomen - could go into the bladder or urethra

Answer 39

Is perceived pain in missing part of the limb - often worries patient - usually subsides with time - can become chronic Shooting, burning, or crushing pain and feelings of coldness, heaviness, and cramping No single therapy: - virtual reality treatment - mirror therapy - theory: visual information, replaces sensory feedback in brain Still need to treat the pain

Answer 40

Renal monitoring: BUN/Cr

Answer 41

Makes it worse: sugar and caffeine --> want to take these out (inflammation)

Answer 42

exercise, warm shower in mornings because moist heat helps with stiffness

Answer 43

Nadir - lowest point in all labs

Answer 44

- neutropenia - anemia - thrombocytopenia increased risk of infection, bleeding

Answer 45

TNM: tumor, node, metastasis - used to determine the anatomic extent of cancer involvement - not used with all cancer types (ex: not leukemia b/c not solid tumors) 3 parameters: - Tumor: size and invasiveness - Node: presence or absence of regional spread to lymph nodes - Metastasis: to distant organ sites?

Answer 46

A condition in which bone marrow activity is DECREASED resulting in **fewer RBCs, WBCs, and platelets** - can lead to infection, hemorrhage, and overwhelming fatigue One of the most common effects of chemotherapy; bone marrow function is affected throughout the whole body for chemo - radiation is only for a specific area Nursing care: monitor the CBC especially neutrophils, platelets, and RBC counts

Answer 47

CV, renal, eye issues

Answer 48

Lifestyle, diet, exercise

Answer 49

sexual history, partner history

Answer 50

treating partner of someone positive for an STD; treating prophylactically so they don't need to come in to get tested

Answer 51

Women can be asymptomatic, which leads to bigger issues - want to treat them

Answer 52

- avoid intercourse during an outbreak - can spread even w/out symptoms - can reduce number of outbreaks, but no cure - comfort and lesion help: sitz bath

Answer 53

diet, exercise, spreading out meals, carb-control

Answer 54

cold and clammy, need a candy - tachycardia - diaphoresis - tremors/shakiness - slurred speech - pallor - trouble concentrating add in others

Answer 55

- 3 P's - nausea/vomiting - blurred vision - confusion - dry mucous membranes - dehydration - poor skin turgor "hot and dry"

Answer 56

Chvostek's sign (twitching of cheek)

Answer 57

decrease in parathyroid hormone

Answer 58

Less than 9 increased muscle excitability, tetany, paresthesia, circumoral numbness

Answer 59

Less than 9 oral or IV calcium supplements

Answer 60

greater than 11 hyperparathyroidism, cancers

Answer 61

greater than 11 fatigue, lethargy, weakness, seizures, cardiac dysrhythmias

Answer 62

greater than 11 restricting diet, loop diuretics, hydration w/ isotonic solution

Answer 63

- distended jugular veins - increased RR - crackles - dyspnea - high blood pressure will give diuretic in between units to prevent TACO

Answer 64

Stop it Change tubing too

Answer 65

A1C add in others

Answer 66

Aspart, Lispro, Inhaled, Glulisine Onset: 15-30 mintues Peak: 30-90 minutes Duration: 3-5 hours

Answer 67

Humulin R, Novolin R Onset: 30-60 minutes Peak: 2-5 hours Duration: 5-8 hours

Answer 68

NPH; Humulin N Novalin N Onset: 1-2 hours Peak: 4-12 hours Duration: 12-18 hours

Answer 69

Glargine (Lantus), Detemir (Levemir) Onset: 2 hours Peak: none Duration: 24 hours

Answer 70

Titer: anti-HBs to indicate positive response - surface antibodies

Answer 71

void bladder

Answer 72

removing fluid from the abdomen

Answer 73

- alcohol consumption - gallbladder issues in women

Answer 74

amylase and lipase

Answer 75

no gluten - need to know foods that contain gluten

Answer 76

smaller, frequent meals

Answer 77

Can go to the kidneys, then to the systems, experiencing flank pain and higher fever

Answer 78

Receptive vs Expressive (Wernicke's vs Broca)

Answer 79

B.E.F.A.S.T B= balance E= eyes F= face A= arms S= speech T= time

Answer 80

Symptoms: - weak pulses - low BP - increased HR - tenting - dry pale mucosa - sudden weight loss - dark urine - confusion - increased lab values: BUN, H&H, Glucose, electrolytes Treatment: correct cause: antiemetics for N/V, antipyretics, oral fluid or IVF Goals: replace f&e, prevent further fluid loss, prevent injury Nursing interventions: daily weight, IO, labs, cardio/resp care, skin care, patient safety

Answer 81

Symptoms: - bounding pulse - difficulty breathing - bradycardia - neck vein distention - edema - weight gain - decreased h&H and serum protein Causes: kidney failure, HF, excessive fluid replacement Treatment: diuretics, fluid restriction, restriction of sodium, remove fluid Goals: patient safety, restore fluid balance, supportive care, prevent overload Nursing: daily weight, IO, labs, skin/cardio/resp care, safety

Answer 82

Acute infection of the lung parenchyma - normal defenses incompetent Causes range from aspiration, tracheal intubation, air pollution, smoking, viral URI, aging, chronic disease

Answer 83

- Viral: may be mild or life threatening; cannot be treated with antibiotics - Bacterial: may need hospitalization; sputum culture - mycoplasma (atypical) - aspiration - necrotizing: rare form of bacterial - Opportunistic: immunosuppressed patients

Answer 84

Medical emergency, partial or complete Symptoms: choking, stridor, use of accessory muscles, wheezing, cyanosis, change in LOC Immediate assessment and treatment Interventions: - heimlich, ET intubation, suction, chest CR, laryngoscopy, bronchoscopy

Answer 85

Blockage of one or more pulmonary arteries by thrombus, fat, air embolism or tissue - clot in venous system into pulmonary circulation, then lodges into small vessel and obstructs alveolar perfusion - lower lobes most often

Answer 86

- immobility/reduced motility - surgery w/in 3 months - hx of VTE - cancer - obesity - smoking - prolonged air travel - HF - pregnancy - clotting disorders

Answer 87

Depends on size and type - dyspnea; mild to moderate hypoxemia - tachy, cough, chest pain - hemoptysis - crackles, wheezing - tachypnea - fever - syncope - pulmonic heart sound Massive PE will most likely change mental status, hypotension, impending doom/death Complications: pulmonary infarction and pulmonary HTN

Answer 88

Dx: D dimer, CT scan w/ contrast, V/Q scan Tx: adequate tissue perfusion & resp function - oxygenation - pulmonary hygiene to prevent atelectasis - fluids & vasopressors for shock - anticoags and fibrinolytic agents - surgery for massive PE Nursing: - prevent by IPCs, early ambulation, anticoags - bed rest in semi fowlers - assessment, O2, meds, fluids - monitor coag labs and complications

Answer 89

Preventable, treatable, often progressive disease characterized by persistent airflow limitations Risk factors: cigs, recurrent resp. infections, asthma

Answer 90

- dyspnea - chest heaviness - chest breather; use of accessory and intercostal muscles - wheezing, chest tightness - fatigue - weight loss - anorexia - prolonged expiration - barrel chest

Answer 91

Nursing: reduce exacerbations, maintain patent airway, effective coughing, effective respiratory values, CO2/O2 levels return to pt's baseline Acute/Interprofessional care: - oxygen therapy (want >90% at rest) - drug therapy (bronchodilators, anticholinergics, oral corticosteroids) - resp care: pursed lip breathing, diaphragmatic breathing (not accessory) - nutrition therapy: well balanced, high in protein

Answer 92

Deals with the bronchioles - productive thick mucus - rhonchi - wheezing - ABG: hypercapnia, hypoxemia - inspiratory dysfunction - increased RBC production (b/c chronic and trying to get air) Tx: - fluids, expectorant airway clearance - steroids Important to note: - respiratory acidosis - high risk for infections - expiratory dysfunction - tripod position

Answer 93

Pink, squishy lung tissue - no cough (complications w/ infections develop) - no adventitious breath sounds Alveoli: pink squishy: overinflated - decreased elasticity - CO2 gets trapped Pursed lipped breathing to get CO2 out - hypercapnia - 88-92% O2 levels the sweet spot so they keep breathing Important to note: - respiratory acidosis - high risk for infections - expiratory dysfunction - tripod position

Answer 94

Period of time, about 7-10 after starting chemo, where the patient will have the lowest blood cell counts - exact onset depends on drug regimen

Answer 95

Hgb: 12-16 in females, 14-18 in males - measures oxygen carrying capacity of RBC Hct: 37-46% F; 42-52% M - %age of RBC compared to total blood volume Decrease in H&H, RBC seen with anemia, hemorrhage, hemodilution Increase in H&H, RBC seen w/ polycythemia or hemoconcentration

Answer 96

150,000-400,000/microL - counts less than 100K indicate thrombocytopenia - thrombocytosis: too many platelets, occurs w/ inflammation/cancer

Answer 97

A person w/ cardiac or renal insufficiency is at risk for developing circulatory overload - especially true if large quantity of blood is infused in a short period, particularly in an older patient

Answer 98

Is a type of arthritis caused by the deposit of uric acid crystals into 1 or more joints Causes: when either kidneys cannot excrete uric acid; too much is made; metabolic syndrome contributes

Answer 99

dusky, cyanotic, extremely tender and swollen

Answer 100

Dx: H&P, synovial fluid aspiration finding urate crystals Tx: - acute attack: treating pain & inflammation - future attacks prevented by drug therapy, weight loss, adequate hydration, limited alcohol and red/organ meats

Answer 101

Systolic: 120-139 Diastolic: 80-89 Vital signs monitored regularly to see if HTN remains consistent and necessary lifestyle modifications should be applied

Answer 102

Tx is aimed at removing or treatment cause Lifestyle modifications: - weight reduction - DASH diet - decrease sodium, moderate alcohol - physical activity - avoid tobacco products - manage risk factors Drug therapy to decrease blood volume and reduce vascular resistance: - adrenergic blockers (AB and BB) - ACE inhibitors (-prils) - ARBs (-sartans) - CCBs (-pine) - direct vasodilators - diuretics

Answer 103

Can be prescribed to modify risk factors and reduce the onset/progression of disease, but need lifestyle changes - activity and dietary changes - smoking cessation - medications to regulate modifiable risk factors -- BP meds -- lipid lowering drug therapy -- drugs that restrict production of lipoproteins or increase removal of lipoproteins

Answer 104

Is a clinical manifestation of CAD - refers to chest pain that occurs intermittently over long period w/ same pattern of onset, duration, and intensity Is transient (reversible) chest pain that occurs when heart muscle becomes ischemic during exertion or increased cardiac activity - subsides when precipitating factor is resolved and/or when NTG is provided - no permanent injury to cardiac cells occurs

Answer 105

Occurs when ischemia is prolonged (more than 30 minutes) and no immediately reversible "intermittent" - ACS (acute coronary syndrome): develops and include spectrum of UA - NSTEMI - STEMI: ST-segment-elevation MI (worse damage to ST interval - total occlusion) High risk for developing an MI and must be treated aggressively

Answer 106

High risk for developing an MI so must be treated aggressively - MI occurs as a result of sustained ischemia, causing irreversible cell death of myocardium - contractile function of heart stops in areas of necrosis - degree of altered function depends on area of heart involved and size

Answer 107

Primary assessment focuses on cardiac, respiratory, and neurological status If patient is stable, obtain symptoms, onset, duration, nature and changes: - history of any similar symptoms - current medications - hx of risk factors & other illnesses - FHx of stroke, aneurysm, or CV disease

Answer 108

Wernicke's aphasia unable to comprehend speech; lack of comprehension - sentences spoken don’t make sense damage to Wernicke's area

Answer 109

- LOC, NIH stroke scale, cognition, motor abilities - cranial nerve function - proprioception - cerebellar function - deep tendon reflexes

Answer 110

impairment to all modalities of receptive and expressive language - very singular comprehension and expression

Answer 111

unable to communicate back comprehensively Damage to Broca's area - Broca's aphasia

Answer 112

Thrombolytic drugs contraindicated for hemorrhagic stroke b/c can increase bleeding - Drugs and tx: oral anticoagulants for pt w/ AFib or antiplatelets/ASA for someone at risk of stroke Acute care: - control f&e balance - after pt has stabilized and to prevent further clot formation, patient w/ strokes caused by thrombi and emboli may be treated w/ anticoagulants and platelet inhibitors (ASA, ticlopidine, clopidogrel, dipyridamole) - use statins (lower cholesterol) effective after ischemic stroke Rehab: - after pt stabilized for 12-24 hours, care goals shift from preserving life to lessening disability and reaching optimal function - OT (ADLs and home assess) & PT (larger muscle movements) Planning & Goals: - maintain stable/improved LOC - attain max physical function & self-care abilities/skills - maintain stable body function, adequate nutrition, & effected personal coping - maximize communication abilities - avoid complication of stroke Implementation: - health promotion: stroke prevention, reduce modifiable risk factors - BP screening and anti-HTN therapy - anticoagulation therapy for AFib - teach early symptoms of stroke & TIA

Answer 113

Preventative therapy management of modifiable risk factors Meds for at-risk patients Acute care: - control f&e balance - after pt has stabilized and to prevent further clot formation, patient w/ strokes caused by thrombi and emboli may be treated w/ anticoagulants and platelet inhibitors (ASA, ticlopidine, clopidogrel, dipyridamole) - use statins (lower cholesterol) effective after ischemic stroke

Answer 114

Goal is to help with blood flow back to heart - Keep Hydrated - Movement every 2 hrs prevent sitting do not cross legs - Elevate legs to DEC pain - Compression stockings, IPC devices Drug Therapy - Anticoags to prevent VTE

Answer 115

Reduce CVD risk factors - BP control(reduce sodium and DASH diet) - smoking Cessation - A1C <7.0% for diabetics - Tx of hyperlipidemia-diet and statins Exercise and Nutritional therapy Drug Therapy - ACE inhibitors- ramipril DEC CV morbidity/mortality, INC peripheral blood flow, INC ABI, INC. walking distance - Cilostazol(Pletal) and Pentoxifylline(Trental) are prescribed to tx intermittent claudication to inhibit platelet aggregation and vasodilate//improve flexibility of RBCs, WBCs Important to teach about routine foot checks and not to use heating pads.

Answer 116

Clinical Manifestation: LUTS (hesitancy, intermittency, post void dribbling, incomplete emptying, dysuria, cloudy or hematuria in urine) UUTS (flank pain, chills, fever, fatigue, anorexia) - Elderly will become confused first for sx of UTI, dementia will exacerbate with UTI Causes: most common outpatient infection caused by pathogen E Coli, fungal and parasitic By location: upper or lower can be complicated or uncomplicated - Urethritis- urethra common UTI - Cystitis- bladder - Pyelonephritis- renal parenchyma and collecting system; pain all the way up to flank, costovertebral tenderness - Urosepsis- systemic, infection in bloodstream Drugs/Tx - Fluid intake 3,000mL - phenazopyridine and antibiotics for 3 days - Reoccurant UTI may need longer antibiotic tx - Relieve symptoms, no upper urinary tract involvement, no recurrence

Answer 117

nitrates and WBCs?

Answer 118

10:1-20:1: if ratio below or higher, may have issues w/ kidneys or not well hydrated Normal BUN: 7-20 mg/dL Normal Cr: 0.7-1.2mg/dL Creatinine is better indicator that something is going on w/ kidneys - look at BUN for BPH

Answer 119

Normal: around 125 mL/min = 180 L/day - with a higher number, better - CKD uses this to stage it

Answer 120

Requires rapid blood flow & access to a large blood vessel - obtaining vascular access is the most difficult problem - AVFs created most often in forearm w/ anastomosis between an artery (radial or ulnar) and a vein (cephalic) - native fistulas have best overall patency rates & least number of complications - surgically placed has fistulas that vibrate upon palpitation: feel thrill r/t turbulent blood flow -- should hear bruit

Answer 121

- hypotension (change in VS) - muscle cramps - loss of blood - concerns for fluid volume loss - hyperkalemia needs dialysis quickly - hepatitis

Answer 122

- fluid restrictions - limb alert on limb w/ fistula

Answer 123

Causes: autoimmune disorder, genetic - body develops antibodies against insulin or pancreatic B cells not producing insulin - complete destruction of pancreatic B cells Disease onset: islet cell autoantibodies present for many months to years before symptoms - when pancreas no longer makes enough insulin is when symptoms appear

Answer 124

- rapid onset of ketoacidosis - sudden weight loss (extra metabolic function) - polydipsia - polyuria - polyphagia

Answer 125

requires exogenous insulin

Answer 126

Most prevalent type of diabetes: 90-95% - pancreas usually makes some endogenous insulin but not enough is produce OR the body uses if ineffectively Defective secretion of insulin leads to increased insulin secretion - beta cells get exhausted - glucagon secretion increases - alters glucose and fat metabolism - muscles have defective insulin receptors - insulin resistance - decreased uptake of glucose by the cells: hyperglycemia Gradual onset - person may go years w/ undetected hyperglycemia

Answer 127

in T2DM there is endogenous insulin present, but T1DM is absent

Answer 128

- nonspecific symptoms - fatigue - recurrent infection - prolonged wound healing - visual problems gradually appear as disease progresses

Answer 129

- can be genetic link - metabolic syndrome - avg age of 50 - sedentary lifestyle - poor diet - lack of exercise - smoking

Answer 130

Glucose level <70 - too much insulin in proportion to glucose present in blood - ANS activated epinephrine release, neuroendocrine hormones released

Answer 131

Causes: - too much insulin - exercise - illness - not eating & peaks of meds on empty stomach Tx: - glucagon - D50 IV - consume 15g of carb

Answer 132

- fasting glucose 100-125 - OGTT: 140-199 - A1C i believe is 5.7-6.4%

Answer 133

- A1C > 6.5% - impaired OGTT > 200 - fasting glucose > 126 - random glucose > 200 (2 readings)

Answer 134

Must be reported to public health; 2nd most common Caused by gram negative Spread by direct physical contact during sexual activity

Answer 135

● Site of infection for men is urethra sx include: dysuria, purulent discharge ● For women often asymptomatic or might have vaginal discharge, frequency of urination or bleeding after sex ● Can infect the throat and rectum r/t anal or oral sex ● If untreated infertility may occur in men r/t epididymitis -- for women it is PID, ectopic pregnancy, bartholin's abscess

Answer 136

● Dual therapy w single IM dose of ceftriaxone and PO azithromycin ● Expedited partner therapy

Answer 137

Primary herpes simplex virus (HSV) infections (i.e., genital herpes) ● Tend to be associated with local inflammation and pain ● May be accompanied by systemic manifestations of fever, headache, malaise, myalgia, and regional lymphadenopathy. ● The symptoms of recurrent genital herpes episodes are less severe, and the lesions usually heal within 8 to 12 days

Answer 138

STIs are transmitted mostly through sexual contact - important to know if sexual partner has had a STD and also inform partners if you contract one

Answer 139

For pts who are not candidates for hormone therapy or want alternatives, there are some non hormonal drug tx options - antidepressants: SSRI, SNRI - gabapentin - antihypertensives

Answer 140

Surgically implanted to deliver radiation to pubic area for females with cervical cancer

Answer 141

Serious public health problem in which consent was not freely given - Serious public health problem - A forensic examination is not mandatory: need informed consent - SANE often called in as it is complex nursing care - Assessment includes: -- tx of acute injuries -- evaluation for STIs -- pregnancy screening and prevention -- psychological assessment and support -- forensic exam

Answer 142

Gardasil vaccine protects against many forms of HPV - 16 and 18 are high risk types

Answer 143

Hysteroscopy allows for visualization of the uterine lining - used primarily for diagnosis and assessment of abnormal uterine bleeding

Answer 144

first sign of endometrial cancer

Answer 145

- This procedure is removal of some of the prostate gland - Assess the urine(hematuria, clots in urine) - CBI(continuous bladder irrigation)3 way foley: 2 3 L bag roller clamp at bottom to titrate to **fruit punch color**, look at all tubing, communicate who is emptying bag and when bc fills up quickly - Input 2L in but had output 2850mL... 850 true/net urine - Bladder spasms may occur - If clot in tube flush w pump motion

Answer 146

Lower urinary tract symptoms (LUTS) ● Difficulty starting a urine stream ● DEC/weaker flow of urine ● Urinary frequency Irritative symptoms: inflammation or infections ● Nocturia, urinary freq, urgency, dysuria, bladder pain, incontinence Obstructive symptoms: prostate enlargement causes DEC diameter of urethra ● DEC in caliber and force of urinary stream, difficulty initiating stream, intermittency, dribbling at end of urination

Answer 147

Causes: Noncancerous enlargement of the prostate gland Risk factors: - aging - obesity (INC waist circumference) - lack of activity - high intake red meat - alcohol use, smoking - DM - erectile dysfunction - FHx

Answer 148

BUN because urine can't get out

Answer 149

- ED drugs (tadalifil: Cialis) effectively dilates urethra for easier passing of urine - have PSA screening for prostate cancer

Answer 150

Urinary incontinence common - overflow incontinence(can only release small amount have to push against) d/t urinary retention

Answer 151

- PSA for men 55-69 every 2 years for prostate cancer - testicular cancer screening in HS aged males

Answer 152

Involuntary leakage of urine - more prevalent in older adults and women - men: mostly from BPH or prostate cancer, overflow incontinence from urinary retention Patho: - bladder pressure > urethral closure pressure - interference with bladder or sphincter control

Answer 153

D: delirium, dehydration, depression R: restricted mobility, rectal impaction I: infection, inflammation, impaction P: polyuria, polypharmacy

Answer 154

- lifestyle modification - scheduled voiding regimes - pelvic floor muscle rehab - anti-incontinence devices

Answer 155

Used for treatment of ED: causes smooth muscle relaxation and increased blood flow promoting erection - can't use with nitrates

Answer 156

- fever - chills - back/perineal pain - dysuria - frequency - urgency - cloudy urine Note: - mimic UTI; acute cystitis is uncommon in men - urinary catheter is contraindicated - DRE prostate is very swollen, tender, and boggy

Answer 157

- anti-inflammatory agents - warm sitz bath - alpha adrenergic blockers (keep vessels open and relaxed) - antibiotics for up to 4 weeks pain resolves as infection resolves

Answer 158

can't give as much sugar or nutrients

Answer 159

Involves central line - high glucose content: only good for 24 hours - check every order - 1x/day lipids - always on a pump

Answer 160

- vegans eat only plants, nothing from animals - vegetarian can eat dairy - lacto-ovo vegetarians: watch for iron deficient anemia - heart failure patients on 2g Na+ diet

Answer 161

- food insecurity - heat or eat phenomenon - physical illness - GI disease

Answer 162

- weakness - fatigue - poor muscle tone - anemia - increased susceptibility to infection - changes in weight - dry skin - rashes - hair loss - thin and brittle nails; may have lines or cracked

Answer 163

when someone goes from starvation to a fed state - must feed them gradually Manifestations: - hypophosphatemia - hyperglycemia - fluid retention - hypokalemia - hypomagnesemia

Answer 164

Can be: - overnutrition: ingestion of more food than required - undernutrition: nutrition reserves depleted - starvation related: not absorbing food or eating disorder - chronic disease related (cancer) - acute disease or injury-related (trauma, surgery, burns)

Answer 165

N/V, exercise, trauma, diuretics, NG suctioning can decrease major minerals - calcium, chloride, magnesium, phosphorus, potassium, sodium, sulfur Look further into studies after vitamins: - decreased serum albumin - increased C-reactive protein - fluctuating electrolytes - decreased CBC - increased liver enzymes - decreased vitamin levels

Answer 166

Tube feedings - administration of nutritionally-balanced liquified food or formula through tube, catheter, or stoma directly into GI tract (stomach, duodenum, jejunum) - PEG and gastrotomy tube is most common MUST have functioning GI tract - diverticulitis or other issues: won't help Cheaper than TPN Check for residual - if patient not absorbing: stop it and restart at lower rate

Answer 167

- anorexia - orofacial features - head/neck cancer - extensive burns - chemo/radiation

Answer 168

- GI obstruction - prolonged ileus - fistulas

Answer 169

- daily weights - bowel sounds - I&O - initial glucose checks - label w/ date and start time - change tubing every 24 hours

Answer 170

- can get clogged easily - harder to check for residual - prone to occlusion - can be dislodge - can become kinked

Answer 171

- turn it off it repositioning - flush before and after for meds through a tube - have HOB sitting up - assess for respiration

Answer 172

Common manifestation in GI disorders

Answer 173

- most PEG tube feeding can occur within 4hrs of insertion - ensure bowel sounds are head - safer than surgical placement - flush feeding tubing w/ 30mL every 4hrs - administered on feeding pump w/ occlusion alarm - check placement every 8 hours

Answer 174

- aseptic procedure can be done at bedside - confirm placement with x-ray - have patient sitting upright for feeding and 1hr after feeding - used for short-term neutral nutrition - risk for metabolic alkalosis - don't send people home w/ it because can rip it out and go into lungs

Answer 175

- consider food preferences, cultural traditions, food availability - can help patients come up with individualized plan for their condition - education surrounding food and medication labels - education on where to buy certain food-related products

Answer 176

Involves surgery on the stomach and/or intestines to help a person with extreme obesity to lose weight - can be classified as restrictive, malabsorptive, or combo surgery - currently the only treatment that has a successful and lasting impact for sustained weight loss for those with extreme obesity Criteria: BMI >40 or >35 with a comorbidity When have surgery, they are likely to have other comorbidities & places them at risk for complications: - DM - altered cardiorespiratory function - abnormal metabolic function - hemostasis - atherosclerosis

Answer 177

- feeding is often liquid at first -- full normal diet around 4-6 weeks after surgery - wound infection is most common complication - early ambulation is important Late complications: - anemia - vitamin deficiencies - diarrhea - psychosocial problems

Answer 178

- surgery on stomach to create a pouch (restrictive) - small gastric pouch is then connected to jejunum - remaining stomach and first segments of SI are bypassed (malabsorptive)

Answer 179

- better weight loss results w/ restrictive procedures - lower incidence of malnutrition and diarrhea - rapid improvement of comorbidities

Answer 180

- leak at site of anastomosis can occur - anemia - folic acid deficiency - calcium deficiency - dumping syndrome

Answer 181

Always assume it is contagious; enteric considerations - clean with bleach, private room, soap and water - isolation of family members Antidiarrheals not always given - wait for culture C. Diff: vancomycin

Answer 182

PUD must have dietary modifications as erosion of the GI mucosa from the digestive action of HCl and pepsin - avoid spicy foods - avoid citrus - eat high in fiber - eat diet rich in veggies, fruit, and whole grains

Answer 183

Primarily from ingestion of undercooked meats; has been found in lettuce, fruits, nuts Symptoms: diarrhea and abdominal cramping Treatment: - hydration - blood transfusions and dialysis may occur if hemolytic uremic syndrome results

Answer 184

Dx: Endoscopy, Colonoscopy, ERCP(contrast used), EGD(esophagus, gastro, duodenum), Sigmoidoscopy, CT scan, Ultrasound Blood Tests: Amylase(pancreas), gastrin(stomach, duodenum and pancreas), lipase(pancreas) Stool tests: Fecal analysis, fecal DNA testing, fecal occult blood test, stool culture

Answer 185

- laxatives - enemas - increased fiber - increased fluids - increased activity

Answer 186

- low fiber diet - decreased physical activity - medications like opioid - ignoring urge to defecate - disease that slows GI tract elderly have the most issues with constipation because of decreased movement and meds

Answer 187

Is the result of constant constipation - stool is stuck inside the rectum Enemas and manual disimpaction are treatment options - also stool softeners and dietary changes

Answer 188

Cause is unknown; main factor contributing to the development is lack of fiber - characterized by saccular dilations or outpouchings of mucosa Symptoms: - can be none - abdominal pain - bloating - flatus - changes in bowel habits

Answer 189

Is an inflammation of the diverticula resulting in complications: - perforation - abscess - fistula formation - bleeding Common in older adult - need teaching about high-fiber diet mainly from fruits and veggies - decreased intake of fat and red meat to prevent exacerbation

Answer 190

- abdominal pain in LLQ - bloating - flatulence - changes in bowel habits Can have fever and increased WBC

Answer 191

- providing wound care - monitor for complications - promote nutrition - assessing stoma - providing an appropriate pouching Need to teach patient or caregiver how to appropriately change pouch, provide skin care, control odor, and identify symptoms of complications

Answer 192

Occurs in either small or large intestine, can be partial or complete, simple or strangulated - partial obstruction usually resolved w/ conservative treatment - complete obstruction need surgery - simple has blood supply - strangulated does not have blood supply and emergency surgery needed Types: - mechanical: physical - non-mechanical: reduced or absent peristalsis due to altered neuromuscular parasympathetic innervation

Answer 193

Is an autoimmune disease characterized by damage to the small intestinal mucosa from the ingestion of wheat, barley, and rye in genetically susceptible persons Three factors necessary for development (gluten intolerance): - genetic predisposition - gluten ingestion - immune-mediate response

Answer 194

- foul-smelling diarrhea - steatorrhea - flatulence - abdominal distention - symptoms of malnutrition

Answer 195

Early diagnosis and treatment of celiac disease can prevent complications, such as cancer, osteoporosis, and chronic inflammation - gluten-free diet is only effective treatment - most patients need to maintain gluten-free diet for rest of lives

Answer 196

- H. pylori infection - use of drugs: NSAIDs, digoxin, alendronate - certain dietary issues - autoimmune factors

Answer 197

- have patient void or insert catheter - obtain vitals, weight, palpate abdomen - measure girth - high fowler sitting position w/ feet on floor - give sedatives/analgesia if ordered

Answer 198

- biliary tract disease (common in women) - alcoholism - hypertriglyceridemia

Answer 199

- abdominal pain in LUQ - N/V - low grade fever - hypotension - tachycardia - jaundice

Answer 200

serum amylase and lipase Nursing: - manage acute pain - fluid & electrolyte imbalances - impaired nutritional intake

Answer 201

Consists of ulcerative colitis and Crohn's disease - Overactive, inappropriate or sustained immune response to substances that are usually tolerated - Unpredicted intervals may have a few over a lifetime - Tx: bowel rest, control inflammation and infection, nutrition, DEC stress//focus on hemodynamic stability, fluid and electrolyte balance in acute exacerbations - Complications: colorectal cancer(fecal occult test) - Goal: resting bowel, PN, anti-inflammatory - Diet for chronic IBD low residue diet which means like bland foods

Answer 202

Mucosal layers (innermost) - is a disease of the colon and rectum - starts in rectum and spreads to the colon - pseudopolyps form which are tongue-like projections in the bowel - classified as IBD Can be cured with total colectomy

Answer 203

- bloody diarrhea - abdominal pain - mild, moderate, and severe based on amount of stools per day - fever - rapid weight loss - anemia - tachycardia - dehydration - protein loss in stool - electrolyte loss -> can't absorb through inflamed tissue

Answer 204

cobblestone appearance; affects all layers - diarrhea - cramping - abdominal pain - weight loss from malabsorption - some rectal bleeding Classified as IBD

Answer 205

If perforation occurs, the immediate focus is to stop spillage of contents into peritoneal cavity and restore blood volume Bowel sounds likely to be absent, patient may be hypovolemic, in shock, N/V - emergency surgery most likely needed - want to prevent infection - start antibiotics - restore hemodynamics

Answer 206

- want it red, pink, moist - want hole to be not too small to avoid constriction - want hole to not be too big because of skin breakdown - empty when 3rd full; burping bag

Answer 207

- hepatitis - long-term drug or alcohol use - chronic hepatocyte destruction - inflammation

Answer 208

Liver damage from consuming high amounts of alcohol - liver biopsy is gold standard for diagnosis

Answer 209

Lactose intolerance is most common cause of malabsorption syndrome Can be due to lactase enzyme deficiency or lactose malabsorption - lactase enzyme deficit occurs when not present to break down lactose into glucose or galactose - malabsorption occurs due to bacterial overgrowth promoting lactose fermentation in small bowel

Answer 210

- bloating - flatus - cramping - abdominal pain - diarrhea usually occurs 30 mins after ingesting

Answer 211

Checking skin lesions associated with cirrhosis

Answer 212

Most common is viral hepatitis; most will recover if it is acute - Hep B: can get from needle stick - Hep A/E: from contaminated food or drinking water - Hep C: can lead to chronic cirrhosis or liver failure - Hep D: need HBV to survive

Answer 213

Incidence decreased with vaccination - given at birth at 24hrs, 6mos, 1 years - likely need to repeat At-risk persons: - men who have sex with men - household contact of chronically infected - pt on hemodialysis - healthcare workers and public safety - prisoners, veterans, homeless - drug users - blood product recipients

Answer 214

Liver's metabolic processes are compromised, toxins go to the brain - too much ammonia in blood r/t lack of metabolism of ammonia into urea - ammonia is a waste product of protein - ammonia travels from bloodstream to the brain and causes a change in LOC

Answer 215

- lactulose to excrete ammonia in feces - limit protein intake - rifaximin given to kill bacteria in gut that typically breaks down protein

Answer 216

Most often associated with stones or sludge Symptoms: - inflammation confined to mucus lining or entire wall - may be distended w/ bile or pus - scarring and fibrosis after attack - pain is steady and excruciating - tachycardia - diaphoresis - RUQ tenderness - occurs after high fat meal or when patient lies down

Answer 217

- dark amber urine - clay colored stools - intolerance to fatty foods

Answer 218

- control possible infection - anticholinergics - can remove gallbladder if needed - low fat diet

Answer 219

- biliary cirrhosis - abscesses - pancreatitis

Answer 220

Is an acute inflammation of the pancreas Causes: - gallstones in women - alcohol use in men - drug reactions - pancreatic cancer - hypertriglyceridemia

Answer 221

- abdominal pain -- radiates to back - pain is sudden - eating worsens pain

Answer 222

- increased amylase, lipase, urinary amylase, blood glucose, triglycerides - decreased calcium

Answer 223

pseudocysts and abscesses

Answer 224

- expect patient to be NPO to suppress pancreatic secretions - reduce enzymes (PPIs) - pain management

Answer 225

Periumbilical ecchymosis - can be indicative of hemorrhage intraperitoneally or retroperitoneally - associated with acute pancreatitis along w/ other diseases

Answer 226

ONline: Nursing care for a patient with a fixator (external fixation device) focuses on preventing complications like infection and maintaining the integrity of the device and the patient's well-being. Key aspects include pin site care, assessing neurovascular status, and patient educatiom - regular cleaning - infection prevention - monitor - dressings

Answer 227

- delayed union - nonunion - malunion - angulation - pseudoarthrosis - refracture - myositis ossificans

Answer 228

Direct: - bone infection - bone nonunion or malunion - avascular necrosis Indirect: - compartment syndrome - VTE - fat embolism - rhabdomyolysis - hypovolemic shock

Answer 229

Swelling and increased pressure within a limited space 6 P's: - pain - pressure - paresthesia - pallor - paralysis - pulselessness Need to relieve pressure; fasciotomy

Answer 230

- do not elevate extremity above the heart - do not apply cold compresses or ice

Answer 231

Disruption or break in continuity of structure of bone - majority from trauma - can be secondary to cancer or osteoporosis

Answer 232

Multistage healing process (union) 1. Fracture hematoma 2. Granulation tissue 3. Callus formation 4. Ossification 5. Consolidation 6. Remodeling

Answer 233

- displacement and site of injury - blood supply - other local tissue injury - immobilization - internal fixation devices - infection - poor nutrition - age - smoking

Answer 234

Pulling force applied to injured or diseased body part or extremity Purpose: - prevent or reduce pain and muscle spams - immobilize joint or part of body - reduce fracture or dislocation - treat a pathologic joint condition Two most common types: - skin traction: short term (48-72hrs) - skeletal traction: long-term pull to maintain alignment; pin or wire inserted into bone (aligns injured bones, joints, treat joint contractures or DDH)

Answer 235

Chronic systemic autoimmune disease - inflammation of connective tissue in synovial joints marked by periods of remission and exacerbation

Answer 236

- fatigue - weight loss - stiffness - limited ROM - heat - swelling - tenderness

Answer 237

- can be made by blood tests - xray not specific

Answer 238

Slowly progressive, noninflammatory disease of synovial joints - results from cartilage damage leading to cracking, softening, and erosion of articular cartilage

Answer 239

- increased age - genetics - obesity - lack of exercise - occupations with frequent kneeling

Answer 240

mild discomfort to disability with joint pain

Answer 241

- managing pain and inflammation - preventing disability - maintaining improving joint function

Answer 242

Femoral and tibial osteotomy Osteotomy is surgical removal of a wedge or slice of bone to restore alignment, shift weight bearing and relieve pain

Answer 243

Surgical fusion of a joint - severely damaged or infected articular surfaces that prevent joint replacement Relieves pain - stable but immobile joint Common areas for fusion: - wrist, ankle, cervical spine, lumbar spine, metatarsophalangeal (MTP) joint of great toe

Answer 244

A chronic disorder characterized by a widespread, non-articular musculoskeletal pain and fatigue with multiple tender points - believed to be abnormal central processing of nociceptive pain input

Answer 245

- nonrestorative sleep - morning stiffness - IBS - anxiety

Answer 246

- rest - meds - relaxation strategies - massage high level of patient motivation is needed

Answer 247

Diffuse, idiopathic, inflammatory myopathy of striated muscle that causes bilateral weakness

Answer 248

- weight loss - increased fatigue - gradual weakness of muscles that leads to difficulty performing activities

Answer 249

high dose corticosteroids - immunosuppressants may be given

Answer 250

injury to ligaments around a joint - can be classified as first, second, or third degree according to the amount of damage

Answer 251

usually self-limiting with full function returning in 3-6 weeks

Answer 252

may require surgical repair of muscles, tendons, surrounding fascia

Answer 253

excessive stretching of muscle and fascia; may involve tendon

Answer 254

complete displacement or separation of the articular surfaces of the joint - is an orthopedic emergency

Answer 255

partial or incomplete displacement of the joint surface; symptoms less severe

Answer 256

Caused by compression of the median nerve; increased incidence w/ DM, PVD, RA, women Manifestations: - impaired sensation, pain, numbness, or weakness Tinel's sign or Phalen's sign

Answer 257

Blood is slightly alkaline at pH 7.35 to 7.45  Less than 7.35 is acidosis  Greater than 7.45 is alkalosis

Answer 258

CO2 + H2O ----> H2CO3 ---> H++ HCO3− - Respiratory center in medulla controls breathing - Increased respirations lead to increased CO2 elimination and decreased CO2 in blood (Hyper) - Decreased respirations lead to CO2 retention (Hypo)

Answer 259

-Conserves bicarbonate and excretes some acid - Three mechanisms for acid excretion  Secrete free hydrogen  Combine H+ with ammonia (NH3)  Excrete weak acids

Answer 260

Acid-base status Underlying cause of imbalance Body's ability to regulate pH Overall oxygenation status | ARTERIAL BLOOD WILL PULSATE

Answer 261

7.35 to 7.45

Answer 262

pH less than 7.35

Answer 263

pH greater than 7.45

Answer 264

* Buffer system * Respiratory system * Renal system

Answer 265

Controls breathing to regulate CO2 levels.

Answer 266

CO2 retention occurs, leading to respiratory acidosis.

Answer 267

* Secrete free hydrogen * Combine H+ with ammonia (NH3) * Excrete weak acids

Answer 268

Potassium is shifted into extracellular fluid.

Answer 269

Look at pH.

Answer 270

Respiratory Opposite, Metabolic Equal

Answer 271

* Carbonic Acid in Excess caused by.. * Hypoventilation * Respiratory failure

Answer 272

* Carbonic Acid Decific caused by... * * Hypoxemia from acute pulmonary disorders * Hyperventilation

Answer 273

-Can buffer with bicarbonate shift; -renal compensation if chronic. -Rarely occurs when chronic

Answer 274

Metabolic acidosis

Answer 275

Deep and rapid breathing associated with metabolic acidosis. | compensatory mechanism

Answer 276

Base Bicarb excess caused by... * * Prolonged vomiting or gastric suction * Gain of HCO3–

Answer 277

* Renal excretion of HCO3– * Decreased respiratory rate to increase plasma CO2 (limited)

Answer 278

* Maintenance * When oral intake is not adequate * Replacement * When losses have occured

Answer 279

Fluids that have Lower osmolality compared to plasma (Dilutes the ECF)

Answer 280

Maintenance and Replacement ## Footnote Maintenance is used when oral intake is not adequate, while Replacement is for when losses have occurred.

Answer 281

Lower osmolality compared to plasma ## Footnote Hypotonic fluids dilute ECF and cause water to move from ECF to ICF by osmosis.

Answer 282

Isotonic; used when both fluid and sodium are lost | 0.9% ## Footnote NS is the only solution that can be used with blood transfusion

Answer 283

Sodium, potassium, chloride, calcium, and lactate ## Footnote It is isotonic and expands ECF, useful for treating burns and GI losses.

Answer 284

Common maintenance fluid; replaces fluid loss -Is hypertonic | Monitor ABC's and Lung sounds ## Footnote KCl may be added for maintenance or replacement.

Answer 285

Hypertonic; provides 340 kcal/L ## Footnote D10W provides free water but no electrolytes and is the limit of dextrose concentration that may be infused peripherally.

Answer 286

Excess carbonic acid or base bicarbonate deficit caused by -Ketoacidosis -Lactic acid accumulation (shock) -Severe diarrhea -Kidney disease

Answer 287

pH: 7.35-7.45 Partial pressure of oxygen (PaO2): 75-100 mmHg Partial pressure of carbon dioxide (PaCO2): 35-45 mmHg Bicarbonate (HCO3-): 22-26 mEq/L

Answer 288

pH low, metabolic low - metabolic acidosis

Answer 289

pH high, CO2 low - respiratory alkalosis

Answer 290

Mild fluid and electrolyte deficits -Water -Glucose -K+ -Na+

Answer 291

Used to replace water losses, helps prevent ketosis (also good for diarrhea patients)

Answer 292

For patients with liver dysfunction, hyperkalemia, and severe hypovolemia

Answer 293

-BP -Lung sounds (crackles..lungs will start to retain fluid) -Serum sodium levels

Answer 294

Noticing, Interpreting, Responding, and Reflecting; essentially, recognizing relevant cues, understanding their meaning, taking appropriate action based on that interpretation, and then evaluating the patient's response to the action taken.

Answer 295

R patient R medication R dose R route R time R reason R assessment R response R document R to education R to refuse

Answer 296

Meds that have the highest risk of causing patient harm. 1. Insulin 2. chemotherapy drugs 3. opioids 4. potassium 5. parenteral nutrition 6. anticoagulants 7. look alike and sound alike drugs

Answer 297

**Right task:** The task that is delegated should be appropriate for the patient and the delegatee's scope of practice **Right circumstance:** The patient's condition, available resources, and other relevant factors should be considered **Right person:** The delegatee should be competent to handle the task **Right direction and communication:** Clear expectations should be communicated, and feedback should be encouraged **Right supervision:** The delegatee should have the necessary supervision

Answer 298

- access to education - economic stability - neighborhood and built environment - access to quality healthcare - social and community context

Answer 299

- socioeconomic factors - stereotyping - biases

Answer 300

Can decrease incidence through education

Answer 301

- awareness - sensitivity - adaptation of care *integrate culturally-based therapies along with Western medicine* *ask about beliefs, support systems* old card just as extra info: - services to meet unique diverse needs of patients with consideration to culture - recognize that culture matters in certain clinical encounters - recognize limits of knowledge of a patient's situation - avoid generalizing assumptions - be aware of provider and patient biases - ensure mutual understanding through patient centered communication - respectfully asking open ended questions about patient's circumstances and values when appropriate - understand health related behaviors resulting from cultural beliefs - recognize values stemming from individual experience and cultural background

Answer 302

daily weights

Answer 303

- thirst mechanism decreases with age - teach client to assess signs of dehydration -- dry mucosa -- thick oral secretions

Answer 304

Give small amount of IV hypertonic saline solution (3% NaCl) (10% dextrose in 0.9% sodium chloride) Important to note: - can cause water retention - monitor for signs of fluid volume excess *take daily weight, assess for peripheral edema, assess for crackles in lungs* old cards: Greater concentration of particles than plasma. causing water to move out of the cells and to be drawn into the intravascular compartment, causing the cell to shrink. Definition: solutions that are more concentrated or have a higher osmolality than body fluids - concentrate ECF and cause movement of water from cells into ECF by osmosis - **monitor for fluid overload, but used to treat hypovolemia and replace fluid and electrolyte** don’t want to dehydrate cells - they can shrivel Example: 5% dextrose in 0.9% normal saline Example: 5% dextrose in LR ## Footnote They are used to treat severe hyponatremia and cerebral edema.

Answer 305

0.45% sodium chloride Diarrhea or vomiting. Heart failure. online: Hypotonic solutions are given to treat cellular dehydration, hypernatremia, and to provide fluid for the kidneys to excrete waste. They are also used for patients with diarrhea, vomiting, or heart failure. old card information: Lesser concentration of particles than plasma - should be administered slowly to prevent cellular edema – causes cells to swell - used for dehydration - definition: solutions that are more dilute or have a lower osmolality than body tissues Example: 0.45% NSS

Answer 306

Examples of isotonic IV fluids: 0.9% normal saline (NaCl) and Lactated Ringer's solution (LR). Uses of isotonic IV fluids : - Fluid volume deficit (hypovolemia) - Vomiting - Diarrhea - Shock - Metabolic acidosis - Resuscitation - Blood and blood product administration

Answer 307

136-145 mEq/L its primary function is to help maintain proper fluid balance in the body, supporting nerve and muscle function by regulating the movement of fluids across cell membranes

Answer 308

3.5-5.0 mEq/L nerve and muscle function, particularly in the heart, by helping to carry electrical signals to cells throughout the body.

Answer 309

* Cofactor in enzyme for metabolism of carbohydrates * Required for DNA and protein synthesis * Blood glucose control * BP regulation * Needed for ATP production **1.3- 2.1 milligrams per deciliter (mg/dL)**

Answer 310

6 to 20 milligrams per deciliter (mg/dL) its function is to measure the amount of urea nitrogen in your blood

Answer 311

0.6-1.2 mg/dL for men 0.5 - 1.1 mg/dL for women

Answer 312

* Thirst * Changes in mental status (drowsiness, restlessness, confusion, lethargy, seizures, coma) * Symptoms of fluid volume deficit

Answer 313

decreased fluid intake, salt loading, hypovolemia

Answer 314

Replace fluid orally or IV with isotonic or hypotonic fluids.

Answer 315

* Mild: headache, irritability, difficulty concentrating * More severe: confusion, vomiting, seizures, coma

Answer 316

diarrhea, vomiting, excessive sweating, hypervolemia

Answer 317

*seizure precautions* For severe hyponatremia: Give a small amount of IV hypertonic saline solution (3% NaCl). For mild: limit fluid intake

Answer 318

* Dysrhythmias * Fatigue, confusion * Tetany, muscle cramps * Weak or paralyzed skeletal muscles * Abdominal cramping or diarrhea

Answer 319

decreased renal perfusion, massive intake, drugs, severe infections, massive cell destruction, potassium-sparing diuretics, acidosis

Answer 320

* Stop oral and parenteral potassium intake * Increase potassium excretion (diuretics, dialysis) * Force potassium from ECF to ICF by IV insulin with dextrose * Stabilize cardiac cell membrane by administering calcium gluconate IV

Answer 321

* Cardiac most serious * Skeletal muscle weakness (legs) * Weakness of respiratory muscles * Decreased GI motility * Hyperglycemia

Answer 322

diuretics (thiazide or loop), poor intake, GI/kidney disease, alkalosis

Answer 323

treated with oral or intravenous potassium supplements. Treatments depend on the severity of the condition Always dilute IV KCl, NEVER give KCl via IV push or as a bolus, and should not exceed 10 mEq/hr.

Answer 324

Always dilute IV KCl, NEVER give KCl via IV push or as a bolus, and should not exceed 10 mEq/hr. Only use a pump.

Answer 325

* Hypotension * Facial flushing * Lethargy * Nausea and vomiting * Impaired deep tendon reflexes * Muscle paralysis * Respiratory and cardiac arrest

Answer 326

increased intake w/ renal insufficiency, excessive IV/medication

Answer 327

Prevention first—restrict magnesium intake in high-risk patients. When a patient has symptoms: * IV CaCl or calcium gluconate * Fluids and IV furosemide to promote urinary excretion * Dialysis

Answer 328

* Resembles hypocalcemia * Muscle cramps, tremors * Hyperactive deep tendon reflexes * Chvostek’s and Trousseau’s signs * Confusion, vertigo, seizures * Dysrhythmias

Answer 329

prolonged fasting/starvation, chronic alcoholism, fluid loss from GI tract

Answer 330

* Treat underlying cause * Oral supplements * Increase dietary intake * Parenteral IV or IM magnesium when severe

Answer 331

HGB Men: 13.5-17.5 Women: 12.0-15.5 HCT Male: 41-50% Women: 36-44%

Answer 332

5,000-10,000

Answer 333

8.5-10.2 mg/dL | have also seen 9-11 and 9-10.5

Answer 334

* Poor skin turgor * Dry mucosa * Headache * Nausea * Abdominal cramping * Edema * Crackles * JVD * Altered mental status * Lethargy * Seizures * General weakness

Answer 335

- Hgb/Hct may be slightly decreased - WBC usually unchanged

Answer 336

- *hypercalcemia may lead to complications such as dysrhythmias or seizures* *calcium is the most important lab to monitor with multiple myeloma because it can cause cardiac rhythm issues and seizures if high* Hypercalcemia in the blood could be an indicator of multiple myeloma Excess calcium in the blood can cause bone pain and kidney problems. goals are to control pain and fractures because of hypocalcemia

Answer 337

when the ANC (absolute neutrophil count) is less than 1000 cells/uL

Answer 338

Hodgkin's staging: - A or B classification -- presence of systemic symptoms when disease is found -- A is absence; B is present - Roman numeral (I to IV) -- location and extent of disease -- stage III is above and below diaphragm; stage I is single lymph NHL categorized by: - level of differentiation - cell of origin - rate of cellular proliferation - immunophenotype (cell surface markers) - clinical features

Answer 339

- *call 911 if pain is the same or worse after 5 minutes* - *can be used to prevent chest pain before strenuous activities* - *sit down before taking SL NTG because it can lower BP and make the patient dizzy* - *may be on short and long-acting nitrates: do not take off nitro patch before SL NTG*

Answer 340

K: *monitor for hypokalemia with diuretics and digoxin* BNP: higher levels = higher risk of failure Na: should be limited intake idfk Creatinine: elevated levels common in HF I think all she cares about is potassium level. below 3 for heart failure

Answer 341

Primary HTN: elevated BP of unknown cause - altered endothelial function - increased SNS activity - increased sodium intake - overproduction of sodium-retaining hormones - overweight - diabetes - tobacco - excess alcohol Secondary HTN: elevated BP with a specific cause; sudden development; underlying cause - cirrhosis - aortic problems - drug-related - endocrine, neurologic, renal problems - pregnancy-induced - sleep apnea - *if someone comes in with a sudden increase in BP with no history of HTN, they will need to be admitted and treated*

Answer 342

hypokalemia furosemide, bumetanide, and torsemide - cause loss of potassium

Answer 343

a sudden increase in BP in a patient with no history of HTN - will need treatment - usually inpatient; admitted and treated secondary HTN: elevated BP with a specific cause; sudden development - clinical findings relate to underlying cause - treatment aimed at removing or treating underlying cause

Answer 344

Causes: - General manifestations of anemia develop slowly due to tissue hypoxia GI problems: - Neuromuscular problems *Basically a vit b12 deficiency ----------------- Causes megaloblastic anemia Folic acid is needed for DNA synthesis RBC formation and maturation

Answer 345

abnormally low number of platelets in the blood Normal Homeostasis - Involved vascular endothelium, platelets, and coagulation factors. Pts often asymptomatic - Will cause internal bleeding- can be insidious or acute

Answer 346

SBP > 180mmHg and/or DBP >120 mmHg

Answer 347

Check for orthostatic hypertension acute kidney injury/renal failure (if BP is acute with no hx of BP check kidney function) Potential MI/ monitor cardiac function Neurological checks with patient is admitted for hypertensive emergency

Answer 348

Infrequent, incomplete, or difficult passage of stool - most common GI complaint - is a symptom not a disease - treatment directed toward relieving cause

Answer 349

- fewer than 3 spontaneous BMs/week - passage of hard/lumpy stool with >25% of defecations - straining >25% of defecations - incomplete evacuation or obstruction >25% of time - manual maneuvers to remove stool >25% of time

Answer 350

Primary: idiopathic Secondary: r/t medical conditions, medications, structural abnormalities, lifestyle: - primary disorder of GI motility - disease processes (DM, MS, spinal cord injury, obstruction, etc) - certain medication s(like opioids) - post surgery - diet; poor fluid intake

Answer 351

- high carb/low fiber diet want high fiber diet and fluids

Final Exam Flashcards

(382 cards)