NUR 403 - ACUTE CARE QUESTIONS AND ANSWERS
BASED ON FINAL EXAM WITH 100% CORRECT
ANSWERS
What is an IV medication bolus? What are some advantages?
answers: - Giving a med very fast and low volume
- Adv: good for emergency, shift potassium, pain management, nausea when
vomiting, diuretic when someone is fluid overloaded
- Advanced Competency
- Administering an IV bolus medication incorrectly or too fast can have serious
patient outcomes.
What are some nursing considerations before you push a medication? (5)
answers: - Patient monitoring requirements - some must be on cardiac monitoring
or ventilated
- Medication/infusion compatibility
- Selection of IV line (Central or Peripheral)
- Assessment of site
- Medication Rights
Describe blood pressure monitoring for IV push meds
answers: Drugs requiring the use of non-invasive blood pressure monitoring with
vital signs being monitored more frequently than q1h or those drugs requiring
continuous arterial line blood pressure monitoring
Describe cardiac monitoring for IV push meds
answers: The patient must be connected to a cardiac monitor (excluding telemetry)
and the Regulated Health Care Professional administering the drug must be
,continuously monitoring the patient and have acquired the skill of ECG
interpretation
Describe Respiratory support for IV push meds
answers: There must be an oral airway, manual ventilator (ambubag), airway
suctioning and oxygen equipment readily available
Describe ventilator support for IV push meds
answers: The patient must have an endotracheal tube or tracheostomy tube in situ,
and must be mechanically ventilated.
What is homeostasis?
answers: A state of inner balance and stability
- Normal values must be achieved (volume, concentration, composition of body
fluids (electrolytes)
- When sick, homeostasis is hard to achieve, we might have tighter normal ranges
in critical patients to prevent them using a lot of energy to maintain
Where is the fluid held in the body?
answers: - Intracellular - (40%) Fluid inside each of the body's cells
- Extracellular
o Intravascular - (5%) Fluid within the blood vessels
o Interstitial - (15%) Fluid in tissue space outside of cells
What is osmotic pressure?
answers: - Osmotic Pressure - "Water Pulling"
o Amount of particles in a solution.
,o Particles do pulling
Particles in blood vessel pull water from the interstitial into the vessel
What is hydrostatic pressure?
answers: - Hydrostatic Pressure - "Water Pushing"
o Pushing H20 from high to low concentrations
Water wants to flow from blood vessels to interstitial because it wants to equalize
the pressure
What pressures is a blood pressure measuring?
answers: Osmotic versus hydrostatic
What is the stimulus? Where does it go? What is the message? Antidiuretic
hormone
answers: - 1. What is the stimulus?
o Increase in osmotic pressure (ie. blood getting "thicker")
- 2. Where does it go?
o As serum osmolality (thickness) increases -> ADH released and is carried to the
nephrons in the kidney
- 3. What is the message its taking?
o It tells the kidneys to keep water
- Urine and blood osmolality will always be opposite
What is the stimulus? Where does it go? What is the message? Aldosterone
, answers: - 1. What is the stimulus?
o A decrease in Na+ or an Increase in K+
- 2. Where does it go?
o Released and goes to the distal tubules (kidneys)
- 3. What is the message its taking?
o Please conserve Na+ -> therefore water stays -> potassium goes
What clinical presentation would suggest a fluid volume deficit?
answers: Dry mucus membrane, lower urine output, dark urine, skin turgor, heart
rate can go up, hypotension, weight loss, thirst, increase in body temperature
What clinical presentation would suggest a fluid volume overload?
answers: Swelling or edema, lung crackles, SOB, tachypneic, vein distention,
weight gain, Diaphoretic, weeping from skin
What are electrolytes?
answers: - Electrolytes - elements or compounds that when dissolve into water,
dissociate into ions.
- Electrolytes are located in all compartments
What are the functions of potassium in the body? Name 4. How do you treat high
vs low potassium?
answers: - Functions
o Transmission of nerve impulses
o Intracellular osmolality
o Enzymatic reactions
o Acid-base balance
BASED ON FINAL EXAM WITH 100% CORRECT
ANSWERS
What is an IV medication bolus? What are some advantages?
answers: - Giving a med very fast and low volume
- Adv: good for emergency, shift potassium, pain management, nausea when
vomiting, diuretic when someone is fluid overloaded
- Advanced Competency
- Administering an IV bolus medication incorrectly or too fast can have serious
patient outcomes.
What are some nursing considerations before you push a medication? (5)
answers: - Patient monitoring requirements - some must be on cardiac monitoring
or ventilated
- Medication/infusion compatibility
- Selection of IV line (Central or Peripheral)
- Assessment of site
- Medication Rights
Describe blood pressure monitoring for IV push meds
answers: Drugs requiring the use of non-invasive blood pressure monitoring with
vital signs being monitored more frequently than q1h or those drugs requiring
continuous arterial line blood pressure monitoring
Describe cardiac monitoring for IV push meds
answers: The patient must be connected to a cardiac monitor (excluding telemetry)
and the Regulated Health Care Professional administering the drug must be
,continuously monitoring the patient and have acquired the skill of ECG
interpretation
Describe Respiratory support for IV push meds
answers: There must be an oral airway, manual ventilator (ambubag), airway
suctioning and oxygen equipment readily available
Describe ventilator support for IV push meds
answers: The patient must have an endotracheal tube or tracheostomy tube in situ,
and must be mechanically ventilated.
What is homeostasis?
answers: A state of inner balance and stability
- Normal values must be achieved (volume, concentration, composition of body
fluids (electrolytes)
- When sick, homeostasis is hard to achieve, we might have tighter normal ranges
in critical patients to prevent them using a lot of energy to maintain
Where is the fluid held in the body?
answers: - Intracellular - (40%) Fluid inside each of the body's cells
- Extracellular
o Intravascular - (5%) Fluid within the blood vessels
o Interstitial - (15%) Fluid in tissue space outside of cells
What is osmotic pressure?
answers: - Osmotic Pressure - "Water Pulling"
o Amount of particles in a solution.
,o Particles do pulling
Particles in blood vessel pull water from the interstitial into the vessel
What is hydrostatic pressure?
answers: - Hydrostatic Pressure - "Water Pushing"
o Pushing H20 from high to low concentrations
Water wants to flow from blood vessels to interstitial because it wants to equalize
the pressure
What pressures is a blood pressure measuring?
answers: Osmotic versus hydrostatic
What is the stimulus? Where does it go? What is the message? Antidiuretic
hormone
answers: - 1. What is the stimulus?
o Increase in osmotic pressure (ie. blood getting "thicker")
- 2. Where does it go?
o As serum osmolality (thickness) increases -> ADH released and is carried to the
nephrons in the kidney
- 3. What is the message its taking?
o It tells the kidneys to keep water
- Urine and blood osmolality will always be opposite
What is the stimulus? Where does it go? What is the message? Aldosterone
, answers: - 1. What is the stimulus?
o A decrease in Na+ or an Increase in K+
- 2. Where does it go?
o Released and goes to the distal tubules (kidneys)
- 3. What is the message its taking?
o Please conserve Na+ -> therefore water stays -> potassium goes
What clinical presentation would suggest a fluid volume deficit?
answers: Dry mucus membrane, lower urine output, dark urine, skin turgor, heart
rate can go up, hypotension, weight loss, thirst, increase in body temperature
What clinical presentation would suggest a fluid volume overload?
answers: Swelling or edema, lung crackles, SOB, tachypneic, vein distention,
weight gain, Diaphoretic, weeping from skin
What are electrolytes?
answers: - Electrolytes - elements or compounds that when dissolve into water,
dissociate into ions.
- Electrolytes are located in all compartments
What are the functions of potassium in the body? Name 4. How do you treat high
vs low potassium?
answers: - Functions
o Transmission of nerve impulses
o Intracellular osmolality
o Enzymatic reactions
o Acid-base balance
