NRS3015 Exam 3 Guide With Complete Solution

NRS3015 Exam 3 Guide Wit h Comp lete Solut ion What is hypercalcemia associated with? - ANSWER -Hyperparathyroidism -Suspected metastasis to the bone of cancer (bone destruction) Foods high in calcium - ANSWER dairy products, canned salmon, sardines, fresh oysters, and dark leafy green vegtables Foods low in potassium - ANSWER cranberries, grapes, canned peaches, lettuce, cabbage, green peppers, sweet onions, green peas, green beans. Refined grains have less than whole grains. Brewed tea and coffee, ginger ale, and root beer. Applesauce, angel food cake, butter, margarine, hard candy, sugar, and honey. Foods high in magnesium - ANSWER dark green vegtables, nuts, whole grains, seafood, peanut butter, cocoa Foods high in potassium - ANSWER avocados, broccoli, dairy products, dried fruit, cantaloupe, bananas, juices, melon, lean meats, milk, whole grains, and citrus fruits. Salt substitutes are high in potassium and can facilitate increased oral potassium intake. Calcium binds to _________. and a few extra facts - ANSWER Albumin Low albumin, you may also have a decreased calcium. The ionized calcium level should give the true calcium level when the client appears to have hypocalcemia with hypoalbuminemia. Low calcium and low albumin, may not want to treat that calcium level right away and instead grab an ionized calcium level Important cardiovascular finding in hypommagnesemia? - ANSWER ECG changes (presence of PVCs, flat/inverted T waves, ST depression, prolonged PR, widened QRS) Pulmonary edema nursing actions - ANSWER Position in high fowlers, administer oxygen (positive airway pressure BiPAP) if that doesn't work, may need to intubate patient for airway protection. Can use morphine to decrease respiratory rate and distress and use diuretic to help pull off this extra volume. Hypovolemia and nursing actions - ANSWER hypovolemic shock, occurs with significant loss of body fluid. Decreased mean arterial pressure, decrease perfusion to the tissue leading to shock leading to tissue and cell death. NA: administer oxygen, stay with client, monitor vital signs every 15min, colloids and crystalloids (NS & LR), vasoconstrictors utilized after fluid resuscitated Hematocrit reference range - ANSWER 42% to 52% for males and 37% to 47% for females. Salmeterol - ANSWER long-acting beta 2 agonist. Primarily are used for asthma attack prevention, not at the onset of an attack. Famotidine - ANSWER ulcer preventing agent Guaifenesin - ANSWER oral mucolytic agent. Top 2 tests to detect PE - ANSWER The multidetector-row computed tomography angiography (MDCTA) is the criterion standard for detecting PE. Pulmonary angiography is the gold standard test when MDCTA is unavailable to detect a PE, Isoniazid - ANSWER (TB) Isoniazid, commonly referred to as INH, is bactericidal and inhibits growth of mycobacteria by preventing synthesis of mycolic acid in the cell wall. NURSING ACTIONS ● This medication should be taken on an empty stomach. ● Monitor for hepatotoxicity (jaundice, anorexia, malaise, fatigue, and nausea) and neurotoxicity (such as tingling of the hands and feet). ● Vitamin B6 (pyridoxine) is often prescribed concurrently to prevent neurotoxicity from isoniazid. ● Liver function testing should be completed prior to and monthly after starting INH. CLIENT EDUCATION ● Do not drink alcohol while taking isoniazid, because it can increase the risk for hepatotoxicity. ● Report any manifestations of hepatotoxicity. Rifampin - ANSWER (TB) Rifampin, commonly referred to as RIF, is bacteriostatic and bactericidal antibiotic that inhibits DNA-dependent RNA polymerase activity in susceptible cells. NURSING ACTIONS ● Observe for hepatotoxicity. ● Liver function testing should be completed prior to and at least monthly after starting RIF.