NSG 123 Exam 5 Review Questions With Correct Solutions, Already Passed!!

Fluid Volume Deficit Lab & Vitals - Answer-Increased BUN & Creatinine Increased Hematocrit & Hemoglobin Increased Urine Specific Gravity Decreased BP Increased Pulse Increased Temp Fluid Volume Excess Lab & Vitals - Answer-Decreased Hematocrit, Hemoglobin Decreased Urine Specific Gravity Increased BP Increased Respirations Bounding Pulse DMARD Methotrexate Monitor - Answer-Prior to and during therapy, monitoring the CBC, renal function, and liver function is essential. Liver function tests help guide methotrexate dosage. What disease is Methotrexate given for? - Answer-RA Diagnostic Test for RA - Answer-Antibodies to cyclic citrullinated peptide (anti-CCP) have a specificity of approximately 95% at detecting RA The ESR and CRP tend to be significantly elevated in the acute phases of RA and are therefore useful in monitoring active disease and disease progression. In SLU Where is the butterfly rash located? - Answer-Cheeks The most familiar skin manifestation (occurring in less than 50% of patients with SLE) is an acute cutaneous lesion consisting of a butterfly-shaped erythematous rash across the bridge of the nose and cheeksComplication and Teaching of Corticosteriods for Long Term - Answer-Osteoporosis, increase calcium and vitamin D Gout Dietary Restrictions - Answer-The nurse encourages the patient to restrict consumption of foods high in purines, especially organ meats, and to limit alcohol intake Fluid Movement in Hypotonic Solutions - Answer-WATER INTO CELLS. When the extracellular fluid has fewer solutes (osmolarity) than the fluid in the cells. Water will move from extracellular space into the cells. Fluid Movement in Hypertonic Solutions - Answer-WATER OUT OF CELLS When the extracellular fluid has more solutes (osmolarity) than within the cells, water flows out of the cells Fluid Movement in Isotonic Solutions - Answer-Both the extracellular and intracellular fluids have the same osmolarity, so there is no movement of water between them Hypotonic Solutions - Answer-0.45% Sodium Chloride 0.225% Saline 0.33% Saline Hypertonic Solutions - Answer-3% Saline & 5% Saline Isotonic Solutions - Answer-Normal Saline (0.9% Saline) Lactated Ringer 5% Dextrose in Water Phlebitis Definition - Answer-Phlebitis is characterized by a reddened, warm area around the insertion site or along the path of the vein, pain or tenderness at the site or along the vein, and swelling Prevention of Phlebitis - Answer-Phlebitis can be prevented by using aseptic technique during insertion, using the appropriate-size cannula or needle for the vein, considering the composition of fluids andmedications when selecting a site, observing the site hourly for any complications, anchoring the cannula or needle well, and changing the IV site according to agency policy and procedures. Patient Teaching for Fluid Volume Excess - Answer-Daily weight Report respiratory changes Limit sodium & fluid What makes the blood more acidic or alkaline? - Answer-The pH is the indicator What does compensation look like in metabolic acidosis? - Answer-Lungs compensate, Respiratory Rate (should be hyperventilating) What does compensation look like in metabolic alkalosis? - Answer-Lungs Compensate, Hypoventilation to increases 2 Major Buffer Systems - Answer-Kidneys & Lungs The body's major extracellular buffer system is the bicarbonate-carbonic acid buffer system, which is assessed when arterial blood gases are measured What is the kidney's role in regulating the pH? - Answer-The kidneys regulate the bicarbonate level in the ECF; they can regenerate bicarbonate ions as well as reabsorb them from the renal tubular cells. In respiratory acidosis and most cases of metabolic acidosis, the kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. In respiratory and metabolic alkalosis, the kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance Osteoporosis S/S - Answer-The bones become progressively porous, brittle, and fragile. They fracture easily under stresses that would not break normal bone. This occurs most commonly as compression fractures of the thoracic and lumbar spine, hip fractures, and Colles fractures of the wrist. These fractures may be the first clinical manifestation of osteoporosis Risk Factors for Osteoporosis - Answer-Alcohol intake of 3 or more drinks daily Current use of tobacco productsFamily history History of bone fracture during adulthood Inactive or sedentary lifestyle Inadequate calcium and vitamin D intake Low body mass index Malabsorption disorders (e.g., eating disorder, celiac disease, bariatric surgery) Men older than 60 years of age Women who are postmenopausal Prescribed corticosteroids (e.g., prednisone) for longer than 3 months Diagnostic Test for Osteoporosis - Answer-Osteoporosis is diagnosed by dual-energy x-ray absorptiometry (DEXA), which provides information about BMD at the spine and hip. S/S of Hypercalcemia - Answer-Hypercalcemia produces adverse effects in several body systems. GI effects include anorexia, nausea, vomiting, abdominal pain, and constipation. Central nervous system effects are apathy, poor memory, depression, drowsiness, and disorientation. Cardiac effects include dysrhythmias, and an electrocardiogram (ECG) shows a prolonged QT interval and an inverted T wave. Weakness and decreased tone in skeletal and smooth muscles, dysphagia, polyuria, and polydipsia may also occur. Alendronate (Fosamax) Teaching - Answer-It is always necessary to take the drug with a full glass of water, not juice or coffee, at least 30 minutes before breakfast and before taking other drugs. The person must remain upright (either with the head elevated 90 degrees if in bed, sitting upright in a chair, or standing) for at least 30 minutes after administration. Alendronate (Fosamax) Action and Disease - Answer-Inhibits calcium resorption from the bone. Treats hypercalcemia and osteoporosis Clinical Manifestation of RA - Answer-The initial clinical manifestations of RA include symmetric joint pain and morning joint stiffness lasting longer than 1 hourSymmetric joint pain, swelling, stiffness, warmth, erythema, and lack of function are classic symptoms. Skin Nodules & Anemia Palpation of the joints reveals spongy or boggy tissue. Often, fluid can be aspirated from the inflamed joint. Characteristically, the pattern of joint involvement begins in the small joints of the hands, wrists, and feet. Deformities of the hands (e.g., ulnar deviation and swan neck deformity) and feet are common in RA The onset of symptoms is usually acute. Symptoms are usually bilateral and symmetric What triggers stiffness and joint pain in RA? - Answer-Stiffness and Joint Pain worse in morning lasting longer than an hour Exercise for Osteoarthritis - Answer-Exercise, especially in the form of cardiovascular aerobic exercise and lower extremity strength training, has been found to prevent OA progression and decrease symptoms of OA Exercises such as walking should be begun in moderation and increased gradually.v Exercise for Osteoporosis - Answer-Weight-bearing exercise, walking, hiking Resistance and impact exercises are most beneficial in developing and maintaining bone mass The best exercises are weight-bearing exercises that force an individual to work against gravity. These exercises include walking, hiking, weight training, stair climbing, tennis, and dancing. Walking is preferred to high-impact aerobics or running, both of which may put too much stress on the bones and may cause stress fractures.