EXAM #2 NUR 242 – MEDICAL-SURGICAL NURSING
GALEN COLLEGE OF NURSING RECOMMENDED
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
GRADED A+ LATEST
S/S of dehydration - ANSWER👀
•Vital signs: hyperthermia, ST, thread pulse, hypotension, decrease CVP
•Neuromusculoskeletal: Dizziness, syncope, confusion, weakness, fatigue
•GI: thirst, dry furrowed tongue, N/V, anorexia, weight loss
•Renal: Oliguria
•Other signs: Diminish capillary refill, cool clammy skin, diaphoresis, sunken
eyeballs, flat neck vein
Dehydration assessment - ANSWER👀
•Assess for condition leading to dehydration: diarrhea, poor intake, vigorous
exercise, vomiting, polyuria, fluid losses (burns, trauma) clients with drains/NG
tube, burns/fluid shifts, overuse of diuretic
Dehydration labs - ANSWER👀
•Serum electrolytes (hypernatremia)
•Increased serum osmolality normal 275- 295 mOsm/kg; elevated > 295 found in
dehydration; > 320 is critical finding
•CBC elevated H/H
•Elevated urine specific gravity > 1.030
,•Increased BUN
Dehydration interventions/goal - ANSWER👀
•Goal of interventions: replace fluid and electrolytes to achieve homeostasis
•Closely monitor status and rehydration, avoid overcorrection
•Monitor I/O and weight
•Identify and manage cause- diarrhea, vomiting, blood loss, poor intake
•Oral rehydration is priority if tolerating PO fluids
Dehydration priority interventions - ANSWER👀
•IV fluid resuscitation/replacement, general guidelines
•Hypertonic dehydration- hypotonic fluids- D5W once dextrose is metabolized;
0.45% NaCL (1/2 normal saline)
•Isotonic dehydration: isotonic fluids (normal saline, lactated ringers)
•Hypotonic dehydration: hypertonic fluids (3% or 5% saline solution)
•Blood products in increased blood loss/trauma
•Medications to treat cause: antidiarrheal, anti emetic, AB, antipyretics
•Ingestion of food to replace electrolytes
Complications of dehydration - ANSWER👀
•Hypovolemia
•Hypovolemia shock
•Seizures/coma
•Multiorgan system failure
, Dehydration medications - ANSWER👀
Diphenoxylate with atropine
Loperamide
Promethazine HCL
Acetaminophen
Causes of hypercalcemia - ANSWER👀
•increased intake of calcium, antacids, thiazide, glucocorticoids, kidney disease,
immobilization, calcium and vitamin D overdose, acidosis, milk alkali syndrome,
bone metastasis, hyperparathyroidism
Causes of hypocalcemia - ANSWER👀
low calcium intake, lactose intolerance, Malabsorption syndrome (crohn's
disease) End stage kidney disease, diarrhea, wound drainage (especially GI)
Calcium - ANSWER👀 9-10.5
S/S of hypocalcemia - ANSWER👀
•Vital signs: SB, low hypotension, weak pulses
•Assess for tetany, Chvostek sign, trousseau sign, laryngeal stridor, dysphagia,
fatigue, anxiety, depression, hyperreflexia, muscle spasm numbness, tingling of
extremities and around mouth
S/S of hypercalcemia - ANSWER👀 •Vital sign, ST, HTN, bounding pulses
GALEN COLLEGE OF NURSING RECOMMENDED
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
GRADED A+ LATEST
S/S of dehydration - ANSWER👀
•Vital signs: hyperthermia, ST, thread pulse, hypotension, decrease CVP
•Neuromusculoskeletal: Dizziness, syncope, confusion, weakness, fatigue
•GI: thirst, dry furrowed tongue, N/V, anorexia, weight loss
•Renal: Oliguria
•Other signs: Diminish capillary refill, cool clammy skin, diaphoresis, sunken
eyeballs, flat neck vein
Dehydration assessment - ANSWER👀
•Assess for condition leading to dehydration: diarrhea, poor intake, vigorous
exercise, vomiting, polyuria, fluid losses (burns, trauma) clients with drains/NG
tube, burns/fluid shifts, overuse of diuretic
Dehydration labs - ANSWER👀
•Serum electrolytes (hypernatremia)
•Increased serum osmolality normal 275- 295 mOsm/kg; elevated > 295 found in
dehydration; > 320 is critical finding
•CBC elevated H/H
•Elevated urine specific gravity > 1.030
,•Increased BUN
Dehydration interventions/goal - ANSWER👀
•Goal of interventions: replace fluid and electrolytes to achieve homeostasis
•Closely monitor status and rehydration, avoid overcorrection
•Monitor I/O and weight
•Identify and manage cause- diarrhea, vomiting, blood loss, poor intake
•Oral rehydration is priority if tolerating PO fluids
Dehydration priority interventions - ANSWER👀
•IV fluid resuscitation/replacement, general guidelines
•Hypertonic dehydration- hypotonic fluids- D5W once dextrose is metabolized;
0.45% NaCL (1/2 normal saline)
•Isotonic dehydration: isotonic fluids (normal saline, lactated ringers)
•Hypotonic dehydration: hypertonic fluids (3% or 5% saline solution)
•Blood products in increased blood loss/trauma
•Medications to treat cause: antidiarrheal, anti emetic, AB, antipyretics
•Ingestion of food to replace electrolytes
Complications of dehydration - ANSWER👀
•Hypovolemia
•Hypovolemia shock
•Seizures/coma
•Multiorgan system failure
, Dehydration medications - ANSWER👀
Diphenoxylate with atropine
Loperamide
Promethazine HCL
Acetaminophen
Causes of hypercalcemia - ANSWER👀
•increased intake of calcium, antacids, thiazide, glucocorticoids, kidney disease,
immobilization, calcium and vitamin D overdose, acidosis, milk alkali syndrome,
bone metastasis, hyperparathyroidism
Causes of hypocalcemia - ANSWER👀
low calcium intake, lactose intolerance, Malabsorption syndrome (crohn's
disease) End stage kidney disease, diarrhea, wound drainage (especially GI)
Calcium - ANSWER👀 9-10.5
S/S of hypocalcemia - ANSWER👀
•Vital signs: SB, low hypotension, weak pulses
•Assess for tetany, Chvostek sign, trousseau sign, laryngeal stridor, dysphagia,
fatigue, anxiety, depression, hyperreflexia, muscle spasm numbness, tingling of
extremities and around mouth
S/S of hypercalcemia - ANSWER👀 •Vital sign, ST, HTN, bounding pulses
