NUR 2090 Exam 2 Review – Flannery
Questions With Correct Answers
Isotonic |- |CORRECT |ANSWER✔✔-Normal |Saline; |Lactated |Ringer's
Vascular |Expansion, |electrolyte |replacement |is |indications
*Avoid |lactated |ringers |with |patients |who |have |liver |disease |or |metabolic |acidosis*
Hypotonic |- |CORRECT |ANSWER✔✔-0.45% |NaCl, |cellular |dehydration |is |an |indication; |dont |give
|to |patients |at |risk |for |increased |intracranial |pressure- |NEURO |OR |HEAD- |increased |ICP |can |
result |from |shift |of |fluid |in |brain |cells
*dont |give |to |patients |at |risk |for |abnormal |fluid |shifts |(interstitial |compartment) |- |third |
spacing-, |burn |victims, |liver |failure |and |severe |protein |malfunctions
Hypertonic |- |CORRECT |ANSWER✔✔-3% |NaCl |- |intravascular |dehydration |with |interstitial |and |
intracellular |fluid |overload |and |sepsis |are |indications- |avoid |use |in |patients |with |renal |or |
cardiac |impairment, |intracellular |dehydration |(diabetic |ketoacidosis), |and |rarely |used |clinically
|, |outside |ICU |(assists |with |edema)
What |are |isotonic |solutions |used |for? |- |CORRECT |ANSWER✔✔-to |increase |the |extracellular |
fluid |volume |due |to |blood |loss, |surgery, |dehydration, |fluid |loss |that |has |been |depleted |
extracellularly |- |same |osmotic |concentration
what |are |hypotonic |solutions |used |for? |- |CORRECT |ANSWER✔✔-osmolarity |below |250 |
mOsm/L, |when |the |cell |is |dehydrated |and |fluids |need |to |be |put |back |intracellularly. |Happens |
when |patients |develop |diabetic |ketoacidosis |(DKA) |or |hyperosmolar |hyperglycemia
*watch |out |for |depleting |the |circulatory |system |of |fluid |since |its |trying |to |push |extracellular |
fluid |into |the |cell |to |re-hydrate |it. |Never |give |hypotonic |solutions |to |patients |who |are |at |risk |
,for |increased |cranial |pressure |(can |cause |fluid |shift |to |brain |tissue), |extensive |burns, |trauma, |
etc- |you |can |deplete |their |fluid |volume
what |are |hypertonic |fluids |used |for |? |- |CORRECT |ANSWER✔✔-used |very |cautiously...most |
likely |ot |be |given |in |the |ICU |due |to |quickly |arising |side |effects |of |pulmonary |edema/fluid |
overload. |in |addition, |it |is |preferred |to |give |hypertonic |solutions |via |central |line |due |to |
hypertonic |solution |because |vesicant |on |the |veins |and |the |risk |of |infiltration
fluid |overload |visible |signs |- |CORRECT |ANSWER✔✔-dyspnea, |anxiety, |high |blood |pressure, |
bounding |pulse |(increased |pulse |rate), |jugular |vein |distension; |peripheral |edema, |weight |gain, |
decreased |urine |output |~risk |of |fluid |overload |is |increased |for |patients |with |history |of |
congestive |heart |failure |or |renal |insufficiency. |always |use |an |EID |to |regulate |infusions |and |
avoid |sudden |increase |of |rate
equipment |for |Peripheral |IV |Infusion |- |CORRECT |ANSWER✔✔-access |device |(IV |catheter), |
container |with |IV |solution, |IV |tubing, |EID |(electronic |infusion |device), |Needleless |connection
Complications |of |IV |therapy |- |CORRECT |ANSWER✔✔-Infiltration, |Phlebitis, |infections, |fluid |
overload, |air |embolism
signs |and |symptoms |of |infiltration |- |CORRECT |ANSWER✔✔-swelling, |coolness, |and |discomfort,
|slowed |infusion |rate |and |and |absence |of |blood |return
actions |and |preventions |of |infiltration |- |CORRECT |ANSWER✔✔-Action: |discontinue |IV |and |
restart |in |DIFFERENT |location; |apply |warm |soaks |to |reduce |SWELLING
Prevention: |select |a |site |of |insertion |that |is |over |long |bones |that |act |as |a |splint- |avoid |sites |
over |joints- |consider |manufactured |stabilization |devices
signs |and |symptoms |of |phlebitis |- |CORRECT |ANSWER✔✔-pain, |warmth, |redness |at |site; |vein |
may |feel |hard |and |cord |like |- |slowed |infusion |rate
, action |and |prevention |of |phlebitis |- |CORRECT |ANSWER✔✔-action: |Discontinue |and |restart |IV |
in |different |location- |apply |warm |soaks |to |decrease |DISCOMFORT; |dont |irrigate
prevention: |change |IV |sites |every |72 |hr, |use |large |veins |with |large |gauge |needles |rather |than |
catheter, |dilute |medications |and |infuse |slowly, |use |central |line |for |very |irritating |solutions
signs |and |symptoms |of |infection |- |CORRECT |ANSWER✔✔-Local: |redness, |warmth |and |purulent
|drainage |at |IV |site
Systemic: |fever, |chills, |malaise |and |elevated |WBC
action |and |prevention |of |infection |- |CORRECT |ANSWER✔✔-action: |discontinue |IV |and |restart |
in |another |location; |culture |catheter |tip |and |draw |blood |cultures- |treat |with |antibiotics
prevention: |maintain |strict |asepsis; |use |good |handwashing; |change |tubing |and |dressings |every
|96 |hrs
signs |and |symptoms |of |fluid |overload |- |CORRECT |ANSWER✔✔-elevated |BP, |increased |pulse |
and |respirations, |dyspnea, |crackles, |neck |vein |distention, |weight |gain
action |and |prevention |of |fluid |overload |- |CORRECT |ANSWER✔✔-action: |Slow |IV |to |'keep |open'
|rate |and |notify |provider, |place |patient |in |high |or |semi-fowlers |position, |administer |oxygen |as |
needed
prevention: |monitor |rates |especially |for |high-risk |patients |(elderly, |infants, |congestive |heart |
failure, |or |renal |disease) |use |EID, |dont |catch |up |when |IV |gets |behind |for |high |risk |patients
signs |and |symptoms |of |air |embolism |( |CVC- |central |venous |catheters) |- |CORRECT |
ANSWER✔✔-pain |in |chest, |shoulder |or |back, |dyspnea, |hypotension; |thready |pulse, |cyanosis, |
loss |of |consciousness
actions |and |preventions |of |Air |Embolism |- |CORRECT |ANSWER✔✔-Action: |Place |on |left |side |in |
trendelenburg |position, |notify |provider, |monitor |vital |signs |closely
Questions With Correct Answers
Isotonic |- |CORRECT |ANSWER✔✔-Normal |Saline; |Lactated |Ringer's
Vascular |Expansion, |electrolyte |replacement |is |indications
*Avoid |lactated |ringers |with |patients |who |have |liver |disease |or |metabolic |acidosis*
Hypotonic |- |CORRECT |ANSWER✔✔-0.45% |NaCl, |cellular |dehydration |is |an |indication; |dont |give
|to |patients |at |risk |for |increased |intracranial |pressure- |NEURO |OR |HEAD- |increased |ICP |can |
result |from |shift |of |fluid |in |brain |cells
*dont |give |to |patients |at |risk |for |abnormal |fluid |shifts |(interstitial |compartment) |- |third |
spacing-, |burn |victims, |liver |failure |and |severe |protein |malfunctions
Hypertonic |- |CORRECT |ANSWER✔✔-3% |NaCl |- |intravascular |dehydration |with |interstitial |and |
intracellular |fluid |overload |and |sepsis |are |indications- |avoid |use |in |patients |with |renal |or |
cardiac |impairment, |intracellular |dehydration |(diabetic |ketoacidosis), |and |rarely |used |clinically
|, |outside |ICU |(assists |with |edema)
What |are |isotonic |solutions |used |for? |- |CORRECT |ANSWER✔✔-to |increase |the |extracellular |
fluid |volume |due |to |blood |loss, |surgery, |dehydration, |fluid |loss |that |has |been |depleted |
extracellularly |- |same |osmotic |concentration
what |are |hypotonic |solutions |used |for? |- |CORRECT |ANSWER✔✔-osmolarity |below |250 |
mOsm/L, |when |the |cell |is |dehydrated |and |fluids |need |to |be |put |back |intracellularly. |Happens |
when |patients |develop |diabetic |ketoacidosis |(DKA) |or |hyperosmolar |hyperglycemia
*watch |out |for |depleting |the |circulatory |system |of |fluid |since |its |trying |to |push |extracellular |
fluid |into |the |cell |to |re-hydrate |it. |Never |give |hypotonic |solutions |to |patients |who |are |at |risk |
,for |increased |cranial |pressure |(can |cause |fluid |shift |to |brain |tissue), |extensive |burns, |trauma, |
etc- |you |can |deplete |their |fluid |volume
what |are |hypertonic |fluids |used |for |? |- |CORRECT |ANSWER✔✔-used |very |cautiously...most |
likely |ot |be |given |in |the |ICU |due |to |quickly |arising |side |effects |of |pulmonary |edema/fluid |
overload. |in |addition, |it |is |preferred |to |give |hypertonic |solutions |via |central |line |due |to |
hypertonic |solution |because |vesicant |on |the |veins |and |the |risk |of |infiltration
fluid |overload |visible |signs |- |CORRECT |ANSWER✔✔-dyspnea, |anxiety, |high |blood |pressure, |
bounding |pulse |(increased |pulse |rate), |jugular |vein |distension; |peripheral |edema, |weight |gain, |
decreased |urine |output |~risk |of |fluid |overload |is |increased |for |patients |with |history |of |
congestive |heart |failure |or |renal |insufficiency. |always |use |an |EID |to |regulate |infusions |and |
avoid |sudden |increase |of |rate
equipment |for |Peripheral |IV |Infusion |- |CORRECT |ANSWER✔✔-access |device |(IV |catheter), |
container |with |IV |solution, |IV |tubing, |EID |(electronic |infusion |device), |Needleless |connection
Complications |of |IV |therapy |- |CORRECT |ANSWER✔✔-Infiltration, |Phlebitis, |infections, |fluid |
overload, |air |embolism
signs |and |symptoms |of |infiltration |- |CORRECT |ANSWER✔✔-swelling, |coolness, |and |discomfort,
|slowed |infusion |rate |and |and |absence |of |blood |return
actions |and |preventions |of |infiltration |- |CORRECT |ANSWER✔✔-Action: |discontinue |IV |and |
restart |in |DIFFERENT |location; |apply |warm |soaks |to |reduce |SWELLING
Prevention: |select |a |site |of |insertion |that |is |over |long |bones |that |act |as |a |splint- |avoid |sites |
over |joints- |consider |manufactured |stabilization |devices
signs |and |symptoms |of |phlebitis |- |CORRECT |ANSWER✔✔-pain, |warmth, |redness |at |site; |vein |
may |feel |hard |and |cord |like |- |slowed |infusion |rate
, action |and |prevention |of |phlebitis |- |CORRECT |ANSWER✔✔-action: |Discontinue |and |restart |IV |
in |different |location- |apply |warm |soaks |to |decrease |DISCOMFORT; |dont |irrigate
prevention: |change |IV |sites |every |72 |hr, |use |large |veins |with |large |gauge |needles |rather |than |
catheter, |dilute |medications |and |infuse |slowly, |use |central |line |for |very |irritating |solutions
signs |and |symptoms |of |infection |- |CORRECT |ANSWER✔✔-Local: |redness, |warmth |and |purulent
|drainage |at |IV |site
Systemic: |fever, |chills, |malaise |and |elevated |WBC
action |and |prevention |of |infection |- |CORRECT |ANSWER✔✔-action: |discontinue |IV |and |restart |
in |another |location; |culture |catheter |tip |and |draw |blood |cultures- |treat |with |antibiotics
prevention: |maintain |strict |asepsis; |use |good |handwashing; |change |tubing |and |dressings |every
|96 |hrs
signs |and |symptoms |of |fluid |overload |- |CORRECT |ANSWER✔✔-elevated |BP, |increased |pulse |
and |respirations, |dyspnea, |crackles, |neck |vein |distention, |weight |gain
action |and |prevention |of |fluid |overload |- |CORRECT |ANSWER✔✔-action: |Slow |IV |to |'keep |open'
|rate |and |notify |provider, |place |patient |in |high |or |semi-fowlers |position, |administer |oxygen |as |
needed
prevention: |monitor |rates |especially |for |high-risk |patients |(elderly, |infants, |congestive |heart |
failure, |or |renal |disease) |use |EID, |dont |catch |up |when |IV |gets |behind |for |high |risk |patients
signs |and |symptoms |of |air |embolism |( |CVC- |central |venous |catheters) |- |CORRECT |
ANSWER✔✔-pain |in |chest, |shoulder |or |back, |dyspnea, |hypotension; |thready |pulse, |cyanosis, |
loss |of |consciousness
actions |and |preventions |of |Air |Embolism |- |CORRECT |ANSWER✔✔-Action: |Place |on |left |side |in |
trendelenburg |position, |notify |provider, |monitor |vital |signs |closely
