NURS250: Med-Surg I - Exam 2 Questions With Complete
Solutions
3 key homeostasis processes Correct Answer Filtration
Movement of WATER AND SOLUTES through a cell or blood
vessel membrane because of BP
Diffusion
Movement of PARTICLES (SOLUTE) from an area of higher
particle concentration to an area of lower particle concentration
Osmosis
Movement of WATER ONLY from an area of lower particle
concentration to an area of higher particle concentration
Kidneys maintain responsibility to maintain balance of both
fluid and electrolytes by making and excreting urine.
Dark urine is more concentrated and has less fluid
Dilute urine has lots of fluid
Acid base imbalances- lab values; causes of Correct Answer
•Acids - a substance that RELEASES hydrogen (formed as end
products of metabolism)
•Base - a substance that BINDS hydrogen
•Extracellular fluid = 7.4
•Blood = 7.35-7.45
•< 6.8 or > 8.0 - CRITICAL - death can occur
•Acidosis (acidemia) below: 7.35
,•Alkalosis (alkalemia) above: 7.45
Asthma: medications (long term vs short term)/client education
Side effects Correct Answer Airways in the lungs
•Bronchospasm
•Swell (Inflammation)
•Produce mucus
•Airway becomes hypersensitive
-> Triggers: Pollen, dust, dander, cats, exercise
•Ranges from dyspnea to status asthmaticus (severe asthma
attack that doesn't respond to treatment)
•Prognosis: No cure, but manageable with treatment and
avoidance of triggers
Signs and Symptoms
•Wheeze
-> Audible Wheeze
-> No wheezing at all (no air exchange)
•Dyspnea
-> Accessory muscle use
•Chest Tightness
•Expiration time prolonged / breathing cycle requires more
effort
•Cough
•Vital Signs
-> HR up, RR up, LOC down
•Oral Mucosa - dusky
•Nail Beds - dusky
,Arterial Blood Gases (ABGs)
•PaO2
•PaCO2
**Respiratory alkalosis turns to acidosis
Blood Tests
•WBC with differential ... looking for elevated eosinophils
->Eosinophils can become active in response to a trigger ->
causes inflammation -> worsens symptoms
•Immunoglobulin E (IgE)
Pulmonary Function Tests
•Forced Vital Capacity (FVC)
•Forced Expiratory Volume in first second (FEC1)
•Peak Expiratory Flow (PEF)
Green: >80% personal best (no treatment change)
Yellow: 50-80%(rescue inhaler/repeat PFM)
Red: <50%(rescue inhaler/ER visit)
Education / Treatment Goals:
•Avoid the substances that trigger symptoms
•Control airway inflammation
•Take control drugs daily even if you are not symptomatic
Bronchodilators
•Beta2 agonists: Relax smooth muscle and open bronchioles
•Short Acting Beta Agonists - Reliever/Rescue
-> Albuterol (**TACHY), Proventil, Ventolin
•Long Acting Beta Agonists - Control
-> Salmeterol, Serevent
, Cholinergic Antagonists: used more if people can't tolerate beta
agonists
•Atrovent, Spiriva
Anti-inflammatory Agents: decrease inflammatory responses in
airways
-> Corticosteroids - Control (Flovent, Pulmicort, Oral
Prednisone)
-> Leukotriene Modifiers - Control (Singulair, Xolair)
Auscultation of lung sounds-descriptions of adventitious sounds
Correct Answer Crackles: fluid in the lungs
Wheeze: bronchoconstriction/mucus
Rhonchi: deep scratchy snore from cancer/pneumonia
Pleural Friction Rub
Stridor: upper airway wheeze = airway is closing
Body fluid composition Correct Answer Intracellular - inside
the cells
2/3 of all body fluid
Assists in cellular metabolism
Extracellular - outside of the cells
1/3 of body fluid
Contains water, electrolytes, and nutrients
-> Intravascular - within the blood stream
-> Interstitial - between the cells of the body
-> Transcellular - within epithelial lined spaces (3rd spacing)
Solutions
3 key homeostasis processes Correct Answer Filtration
Movement of WATER AND SOLUTES through a cell or blood
vessel membrane because of BP
Diffusion
Movement of PARTICLES (SOLUTE) from an area of higher
particle concentration to an area of lower particle concentration
Osmosis
Movement of WATER ONLY from an area of lower particle
concentration to an area of higher particle concentration
Kidneys maintain responsibility to maintain balance of both
fluid and electrolytes by making and excreting urine.
Dark urine is more concentrated and has less fluid
Dilute urine has lots of fluid
Acid base imbalances- lab values; causes of Correct Answer
•Acids - a substance that RELEASES hydrogen (formed as end
products of metabolism)
•Base - a substance that BINDS hydrogen
•Extracellular fluid = 7.4
•Blood = 7.35-7.45
•< 6.8 or > 8.0 - CRITICAL - death can occur
•Acidosis (acidemia) below: 7.35
,•Alkalosis (alkalemia) above: 7.45
Asthma: medications (long term vs short term)/client education
Side effects Correct Answer Airways in the lungs
•Bronchospasm
•Swell (Inflammation)
•Produce mucus
•Airway becomes hypersensitive
-> Triggers: Pollen, dust, dander, cats, exercise
•Ranges from dyspnea to status asthmaticus (severe asthma
attack that doesn't respond to treatment)
•Prognosis: No cure, but manageable with treatment and
avoidance of triggers
Signs and Symptoms
•Wheeze
-> Audible Wheeze
-> No wheezing at all (no air exchange)
•Dyspnea
-> Accessory muscle use
•Chest Tightness
•Expiration time prolonged / breathing cycle requires more
effort
•Cough
•Vital Signs
-> HR up, RR up, LOC down
•Oral Mucosa - dusky
•Nail Beds - dusky
,Arterial Blood Gases (ABGs)
•PaO2
•PaCO2
**Respiratory alkalosis turns to acidosis
Blood Tests
•WBC with differential ... looking for elevated eosinophils
->Eosinophils can become active in response to a trigger ->
causes inflammation -> worsens symptoms
•Immunoglobulin E (IgE)
Pulmonary Function Tests
•Forced Vital Capacity (FVC)
•Forced Expiratory Volume in first second (FEC1)
•Peak Expiratory Flow (PEF)
Green: >80% personal best (no treatment change)
Yellow: 50-80%(rescue inhaler/repeat PFM)
Red: <50%(rescue inhaler/ER visit)
Education / Treatment Goals:
•Avoid the substances that trigger symptoms
•Control airway inflammation
•Take control drugs daily even if you are not symptomatic
Bronchodilators
•Beta2 agonists: Relax smooth muscle and open bronchioles
•Short Acting Beta Agonists - Reliever/Rescue
-> Albuterol (**TACHY), Proventil, Ventolin
•Long Acting Beta Agonists - Control
-> Salmeterol, Serevent
, Cholinergic Antagonists: used more if people can't tolerate beta
agonists
•Atrovent, Spiriva
Anti-inflammatory Agents: decrease inflammatory responses in
airways
-> Corticosteroids - Control (Flovent, Pulmicort, Oral
Prednisone)
-> Leukotriene Modifiers - Control (Singulair, Xolair)
Auscultation of lung sounds-descriptions of adventitious sounds
Correct Answer Crackles: fluid in the lungs
Wheeze: bronchoconstriction/mucus
Rhonchi: deep scratchy snore from cancer/pneumonia
Pleural Friction Rub
Stridor: upper airway wheeze = airway is closing
Body fluid composition Correct Answer Intracellular - inside
the cells
2/3 of all body fluid
Assists in cellular metabolism
Extracellular - outside of the cells
1/3 of body fluid
Contains water, electrolytes, and nutrients
-> Intravascular - within the blood stream
-> Interstitial - between the cells of the body
-> Transcellular - within epithelial lined spaces (3rd spacing)
