NURS 120/NURS120 MIDTERM EXAM | LATEST UPDATE | QUESTIONS AND ANSWERS WITH RATIONALES | 100 OUT OF 100 | GRADED A - WCU.

NURS 120/NURS120 MIDTERM EXAM | LATEST UPDATE | QUESTIONS AND ANSWERS WITH RATIONALES | 100 OUT OF 100 | GRADED A - WCU. Question: What are anticholinergics used for? To dry secretions & to treat asthma Question: What is diabetes type 1? what will lab results show? insulin deficiency, lab tests will show high glucose but low circulating insulin in blood The common symptoms of diabetes (4)? polydipsia (excess thirst), polyuria (excess urination), polyphagia (excess hunger), weight loss, muscle wasting Question: Diabetes type 1 manifestations? the big "4" alongside altered mentation, Kussmaul's respiration (rapid deep breathing), increased frequency of infections, fatigue Question: Diabetes type 1 treatment? and teaching to watch out for? insulin dependency for life, monitor blood glucose, diet/activity changes DKA, microvascular and macrovascular Question: Types of insulin basal and bolus? basal is long acting so it mimics pancreas action by providing small amounts of coverage continuously bolus is short acting so it covers intake by "sliding scale" so it's very individual to the client Question: Where is insulin and glucagon hormones made/released from? pancreas Question: Where does insulin move glucose to? the cells to use or the liver for storage Question: What diet should you have for diabetes? balanced diet in carbs, proteins, and fats Question: What is diabetes type 2? what will lab results show? insulin resistance. There will be high levels of circulating insulin as well as high glucose levels Question: What are the risk factors for diabetes type 2? obesity, sedentary lifestyle, poor diet, age, ethnicity, possible genetics? Question: Diabetes type 2 treatment? and teaching to watch out for? lifestyle changes (weight loss, diet change, exercise), oral antidiabetics/hypoglycemics (make sure patient takes it with between meal and before bed snacks) Question: What are normal HbA1C results? What is this test for? 4-6 is normal 6.1-6.4 is pre diabetic 6.5 is diabetic This is the avg glucose levels over the past 3 months (as RBC lifespan is 3 months) Question: What are normal blood glucose levels? 70-110 mg/dL Question: The blood sugar nmemonic! HYPERGLYCEMIA hot and dry= sugar high HYPOGLYCEMIA cold and clammy= need some candy Question: Hyperglycemia s/s? polyphagia,polyuria,polydipsia, flushed dry skin, kussmaul's respiration can cause stupor or coma Question: Hypoglycemia s/s? T.I.R.E.D. Tachycardia. Irritability. Restless. Excessive Hunger. Diaphoresis can lead to seizures/coma (hypoglycemia is much more dangerous as it can occur in minutes) Question: Care for hypoglycemia? provide glucose (sugar!) give either OJ if alert and able to swallow lethargic w/o IV give IM glucagon (glucagon takes glucose out of the liver into the bloodstream for use) lethargic with IV give IV Dextrose 50% (dextrose is a sugar similar to glucose) always follow up with longer acting carb such as milk, sandwich, protein, or other complex carb Question: Antidiabetic drugs (nonsulfonylureas)? instructions for drugs? Metformin (Glucophage)- reduces glucose production/increases sensitivity for insulin take with food to decrease GI effects Question: Antidiabetic drugs (sulfonylureas)? glipizide (glucotrol)- stimulated insulin production and secretion Question: Antidiabetic drug (meglitinide)? teachings? take at beginning of meal and skip med if meal is skipped Question: Rapid acting insulin 0.5-1 hour peak Question: Short acting isnulin 2-3 hour peak Question: Intermediate acting insulin 4-12 hour peak Question: Long acting no real peak (duration lasts 24 hours) Question: GERD etiology, S/S, treatments, nursing considerations? inflammation and erosion of esophagus due to backflow of gastric acids S/S: heartburn (pyrosis), acid taste in mouth treatment: EGD to diagnose. Antacids, PPI, H2 receptor antagonist, antiulder meds, promotility agents NC: sit up 1-2 hours after any intake Question: Gastritis etiology, S/S, treatments, nursing considerations? inflammation of gastric lining. Can be caused due to excess acid, organisms, stress. Can lead to ulcers, perforation, GI bleeding S/S: epigastric/abdominal pain, nausea, vomiting, loss of appetite, diarrhea, GI bleeding treatment: symptom management (pain control, antiemetics, PPI or anti ulcer, antibiotics). EGD for diagnosis NC: check stool for occult blood, O&P, or culture. NPO status with severe symptoms Question: peptic ulcers etiology, S/S, treatments, nursing considerations? ulcers in GI tract due to acid/pepsin imbalance, stress, use of NSAIDs, aspirin, or other meds that damage mucosal lining. H pylori is most common cause organism S/S: burning pain in epigastric region. Usually during food intake as acids secrete during that time. nausea, vomiting, diarrhea treatment: EGD or biopsy to diagnose antibiotics for H pylori NC: check stool for occult blood or sudden increase in pain (can be from poss. perforation), NG tube for gastric distention and removal of contents Question: Irritable bowel syndrome etiology, S/S, treatments, nursing considerations? disorder with intermittent periods of diarrhea/constipation alongside abdominal pain. Caused by hypersensitivity of bowel wall, especially during times of stress S/S: abdominal pain often relieved by defication, flatulence, constipation, diarrhea. Stool may have mucous appear on them) treatment: symptom management, stress reduction NC: educate about high fiber diet and limit on gas producing food Question: ulcerative colitis etiology, S/S, treatments, nursing considerations? continuous inflammation and ulcers in mucosa and submucosa of colon. May lead to megacolon, fistulas, or perforations. HIGH RISK FOR DEVELOPING COLON CANCER S/S: frequent episodes of diarrhea with blood/pus. Abdominal cramps at onset of each stool. May lead to incontinence of stool and severe electrolyte disturbances treatment: colon resection. Anti-inflammatory, antidiarrheal, antibiotics, corticosteroids NC: prep for surgery teaching, aftercare stuff chron's disease etiology, S/S, treatments, nursing considerations? intermittent inflammation and ulceration anywhere on GI tract. May lead to bowel obstruction due to scar tissue, fistula, fissures, abscesses S/S: diarrhea, fatigue, abdominal cramping/pain, weight loss, electrolyte imbalance, fever. Malnutrition may develop due to inability of intestines to absorb nutrients treatment: EGD or colonoscopy to diagnose (tissue will be inflamed with a cobblestone appearance) anti-inflammatory, corticosteroids, vitamins NC: nutrition support (tube feeding may be needed) Question: Diverticulosis etiology, S/S, treatments, nursing considerations? pouch like herniations occur in colon S/S: symptoms only occur with perforation/inflammation. fever, abdominal pain, elevated WBC, diarrhea, constipation treatment: GI radiographic exams or colonoscopy to diagnose. acute: NPO and gastric decompression. Antibiotics if causative organism or prophylaxis (preventive measure) for peritonitis may require surgical intervention for obstruction or perforation by resection of affected colon NC: surgical prep Question: Diverticulitis etiology, S/S, treatments, nursing considerations? inflammation of diverticulum in colon. can lead to obstruction, perforation, peritonitis, and septicemia S/S: symptoms only occur with perforation/inflammation. fever, abdominal pain, elevated WBC, diarrhea, constipation treatment: GI radiographic exams or colonoscopy to diagnose. acute: NPO and gastric decompression. Antibiotics if causative organism or prophylaxis (preventive measure) for peritonitis may require surgical intervention for obstruction or perforation by resection of affected colon NC: surgical prep paralytic illeus etiology, S/S, treatments, nursing considerations? temporary paralysis of the bowels S/S: abdominal distention, nausea, vomiting, liquid stools, abdominal pain treatment: goal is to prevent this from occurring. Slow introduction of nutrition, meds to stimulate gastric motility, gastric decompression NC: encourage early ambulation and motility, diet should advance once bowels are active. Enemas may be required obstruction etiology, S/S, treatments, nursing considerations? can be due to retained stool, tumor, stricture, scar tissue, foreign body cholecystitis etiology, S/S, treatments, nursing considerations? inflammation of gall bladder. may be due to obstruction in biliary ducts, gallstones, or tumor S/S: indigestion, abdominal/epigastric pain esp. after intake of fatty foods, nausea, vomiting, steatorrhea, clay colored stool treatment: cholecystectomy surgery or lithotripsy to help break stones down to passable sizes NC: post op care, low fat diet and avoid spicy foods cholelithiasis etiology, S/S, treatments, nursing considerations? development of gallbladder stones S/S: indigestion, abdominal/epigastric pain esp. after intake of fatty foods, nausea, vomiting, steatorrhea, clay colored stool treatment: cholecystectomy surgery or lithotripsy to help break stones down to passable sizes NC: post op care, low fat diet and avoid spicy foods pancreatitis etiology, S/S, treatments, nursing considerations? inflammation of pancreas either from organism or repeated irritation (alcohol), or obstruction of the common bile duct which blocks release of pancreatic enzymes S/S: extreme pain, nausea, vomiting, elevated pancreatic enzymes treatment: NPO to allow the decrease in enzyme production. Antibiotics, monitor labs NC: NPO, oral care to keep cavity moist, pain management, IV fluid 6 P's of fracture assessments pain, pulse, pallor, paresthesia, paralysis, pressure fiberglass cast can be wet? T or F True what is salicylates used for? example: acetylsalicylic (aspirin) analgesic, antipyretic, anti-inflammatory, prevents clotting What to watch for with salicylates? tinnitus, headache, dizziness, excess perspirations reyes syndrome can occur with salicylates in children what is nonsalicylates used for? example: tylenol analgesic, antipyretic What to watch for with nonsalicylates? hepatotoxic! watch for liver function what is NSAIDS used for? example: ibuprofen (advil/motrin) NSAIDS block COX1 and 2 anagelsic, antipyretic NSAIDS consideration? take with food what is bisphosphonates used for and nursing considerations? for metabolic bone diseases which are caused by bone deterioration take will full glass of water or empty stomach and stay upright for 30 minutes arteries vs veins how to differentiate Arteries are Away from heart. They carry oxygenated blood from the heart to the body exception: pulmonary veins carry oxygenated blood back to the heart from the lungs different urinary tract infections Cystitis? Pyelitis? Nephritis? Pyelonephritis? in bladder in renal pelvis in kidney/nephrons in entire kidney Most common organism to cause UTI? E. coli what is urolithiasis? what are S/S? treatment? formation of urinary calculi (stones) excruciating flank/pelvic pain, nausea, vomiting, hematuria (blood in urine) encourage 3-4L of fluid what labs do you watch for urinary system issues? BUN (7-20), creatinine (0.6-1.2), electrolytes, CBC, PSA (prostate specific antigen) Normal results for an urinalysis? pH 4.6-8.0 sp. gravity 1.003-1.030 small amounts of leukocytes (abnormal results will have blood, ketones, protein, albumin, or glucose) What is hyperalbuminemia? dehydration What is hypoalbuminemia? loss in proteins (due to nephron disease, loss in urine, drainage from wounds, inflammatory process), decreased production (liver disease, malnutrition) What is 0.9% NaCl used for? Increase volume, dilute meds, keep veins open What is lactated ringers used for? fluid resuscitation What are diuretics used for? increase excretion of urine Contraindications for diuretics? pre-existing electrolyte imbalance (hypokalemia, hyponatremia), severe liver/kidney dysfunction, anuria What do loop diuretics do? Example? Furosemide (Lasix) inhibits reabsorption in the loop of Henle to increase excretion of Na+ and Cl-, water, and K+ What do thiazide diuretics do? inhibits reabsorption of Na+ and Cl- in ascending loop of Henle and distal tubules What do potassium sparing diuretics do? Depresses the reabsorption of Na+ in tubules OR antagonizes the action of aldosterone to block Na+ resabsorption What do osmotic diuretics do? increase osmotic pressure of filtrate in glomerulus What is an anti-infectives? example? used for UTI by interfering with bacterial multiplication in the urine example: nitrofurantoin (macrobid, macrodantin) what is an antispasmodics? example? cholinergic blocking agents that inhibit bladder contractions, thereby decreasing urge to void example: Oxybutynin (Ditropan) What is Phenazopyridine (Pyridium)? exerts analgesic effects to lining of urinary tract to relieve dysuria associated with UTI/overactive bladder can cause red/orange discoloration of urine/other bodily fluids What should you avoid with Nitrofurantoin (Macrobid) and Methenamine (Urex)? What should you watch out for with Macrobid? citrus monitor for S/S of acute pulmonary reaction Nursing implementations for Fosfomycin (manurol) (this is an antiinfective)? administer drug immediately after dissolving it in water What hormones in the kidney regulate fluid volume? ADH, aldosterone hormonal influences in kidney? renin-angiotension- aldosterone (aldosterone causes kidneys to reabsorb water/Na+) ADH= increases retention (reabsorption) of water in kidneys erythopoieten= released in response to anemia/hypoxemia