MILESTONE EXAM 2 (HESI) MEDSURG 2/OB/PEDS Questions And Answers

MILESTONE EXAM 2 (HESI) MEDSURG
2/OB/PEDS Questions And Answers


24rhourrjaundice:r-rCORRECTrrANSWER-
productionrandreliminationrofrbilirubin,rriskrfactorsrincluder:polycythemia,rshortenedrerythr
ocyterlife,rimmaturerhepaticruptakerandrconjugationrprocesses.rManagement:rnurser8-
12rtimesrarday,rphototherapy.

Acuterpancreatitisrassessment:r-rCORRECTrrANSWER-
fulfillmentrofr⅔,rhistoryrofrupperrabdominalrpain,rbiochemicalrchangesrwithrserumramylaser
orrlipaserlevelrgreaterrthanrthreertimesrthernormalrlimit,rorrtypicalrfindingronrct.rElevatedrser
umramylaserandrlipaserlevels

Acuterrenalrfailurerpriorities:r-rCORRECTrrANSWER-
monitorrfluidrandrelectrolyterimbalancersuchrasrhyperkalemia,rpromotingrpulmonaryrfuncti
onr(turningrpatientrdeeprbreathing),rmetabolicrrater(treatrfeverrpromptly),rpreventrinfectionr(
asepticrtechnique),rskinrcare,

Acuterrespiratoryrdistressrfindings:r-rCORRECTrrANSWER-
rapidronsetrofrsevererdyspnea,rarterialrhypoxiarthatrdoesn'trrespondrtorsupplementalroxyge
n

Addison'srcrisisrhypoglycemia:r-rCORRECTrrANSWER-
sweatingrandrheadache.r5%rdextroserandrnormalrsaliner(0.9%)rTherlossrofrglucocorticoidsr
resultsrinrhypoglycemiarwithrcomplaintsrofrmusclerweakness,rlethargy,randrGIrsymptomsri
ncludingranorexia,rweightrloss,rnausearandrvomiting.MustrtakermedicationsrdailY

Alcrhepatitisrteaching:r-rCORRECTrrANSWER-sodiumrrestriction,ravoidrrawrshellfish,

Ardsrabgr-rCORRECTrrANSWER-
:monitorrclientrforrsignsrofro2rtoxicityrandrhypoxia.rPHrhighrmeansralkalosis,rlowrmeansraci
dosis,

Cancerrintractablerpainr-rCORRECTrrANSWER-
:rpioidrtherapyr(morphine,rfentanyl,rcodeine,roxycodone,rhydromorphone).rIVrandroral.rMo
strcommonrplanrofrcarerisrpalliativersedation

, Chemorsidereffects:r-rCORRECTrrANSWER-
nausearandrvomiting,rmyelosuppressionr(decreasedrwbc),relevatedrserumrcreatinerandrse
rumrelectrolytes,rcardiacrproblems,rinfertility,rperipheralrneuropathy,rmoodrchanges,rhairrl
oss,rulcers,

Cirrhosisrascites:r-rCORRECTrrANSWER-
spironolactonerisrusedrinrcirrhosis,rthertherapeuticrresponserwouldrberreducedrascites,rA.r
paracentesisrandrperitoneovenousrshuntsr(LeVeenrandrDenverrshunts)rmayrberindicated.r
(hesirbook)

CKDrmetabolicracidosisr-rCORRECTrrANSWER-
:rkidneysrarerunablertorexcreterincreasedrloadsrofracid,rdecreasedracidrsecretionrresultsrfro
mrtherkidneysrnotrbeingrablertorexcreterammonia,randrtorreabsorbedrsodiumrbicarb.

Compartmentrsyndrome:r-rCORRECTrrANSWER-
compromisesrbloodrflow,rtherercanrberpotentialrforrirreversiblerdamage.rYourmustrkeeprha
ndrelevatedrtormaintainrarterialrperfusion

Cushing'srsyndrome:r-rCORRECTrrANSWER-
surgicalrremovalrofrthertumor,rpostropradrenalrcrisisrisrtreatedrwithrhydrocortisone.rMonitorr
bloodrglucoserClientsrwithrCushingrsyndromeroftenrdeveloprdiabetesrmellitus.

Cysticrfibrosisrcomplicationsr-rCORRECTrrANSWER-
:rLungrinsufficiencyr(mostrcriticalrproblem).rALWAYSrMONITORrRESP.rhemoptysis,rpneu
mothorax,rbacterialrcolonization,rcorrpulmonale,rvolvulus,rintussusception,rintestinalrobstr
uction,rrectalrprolapse,rgastroesophagealrrefluxrdisease,rdiabetes,rportalrhypertension,rliv
errfailure,rgallstones,randrdecreasedrfertility.rAvoidrlungrinfections,rwashrhands,

Diabetesrinsipidus:r-rCORRECTrrANSWER-
patientrmayrfeelrveryrthirstyrduertorlackrofrADHrhormone,rdornotrattemptrtorlimitrwaterrintake
rbecauseritrcanrcausersevererdehydrationrandrhypernatremia,rtherdrugrofrchoicerforrDIrisrde

smopressin,ruserwithrcautionrwithrpeoplerwhorhaverCAD.

DialysisrHTNredema:r-rCORRECTrrANSWER-
dialysisrcanrberusedrforrhypertensionrandredemarthatrdoesn'trrespondrtorotherrtreatments.r
Swelling,rSOB,rweightrgain,rHTN,rmonitorrnarandrK.

Endrofrlifercarerplan:r-rCORRECTrrANSWER-
palliativercarerisrendrofrlifermakingrthemrcomfortable

Engorgement:r-rCORRECTrrANSWER-
postnatalrphysiologicrpainfulrconditionrinrwhichrdistentionrandrswellingrofrtherbreastrtissuer
occursrasrarresultrofranrincreaserinrbloodrandrlymphrsupplyrasrarprecursorrtorlactation.rUsu
allyrpeaksrwithinr4-
5rdaysrpostpartum.rApplyrheatrorrcoldrcompress,rbreastrmassage,rmilkrexpression,rultraso
und,rbreastrpumping,randrantiinflammatoryragents