NSG 555 Quiz 1 module 1
EXAM LATEST QUESTIONS
AND VERIFIED ANSWERS
in
polypharmacy - correct answer pathophysiology: use of >5 medications or any not medically
indicated, includes rX and OTC. Drug distribution/clearance affected by dec. lean body mass and
kidney/liver blood flow, inc in body fat. alters pharmacokinetics.
consequences--adverse drug rx-->GI, delirium, dizziness, depression, derm effects
management--BEERS list, improved rx in elderly tool, screening tool to alert doctors to the right
treatment, screening tool of older persons and potentially inappropriate prescriptions
cognitive impairment - correct answer most common is AD
short term memory loss is primary symptom +disorientation; exec. functioning problems, ADLs,
neuro (aphasia, apraxia, agnosia), sleep cycles reversed, psychomotor changes, irritability or
apathy in early stages
delirium: transient waxing/waning of LOC. acute onset. more common in hospitalized patients,
may actually be unmasking an undiagnosed dementia
dehydration - correct answer Na imbalance is most common
, pathophys:decreased thirst response, decreased renal plasma flow, vasopressin release
stimulated by low fluid volume diminished
clinical presentation: nonspecific: confusion, lethargy, weight loss, functional decline, FTT
PE: CV assessment--orthostatic drop in BP and rise in pulse indicates volume depletion, temp
elevatied if inflammatory or infectious process. dry mucous memranes (not tile late
dehydration)
labs: review electrolytes, BUN/Cr ratio, osmolality, h and h (elevated), glucose, Na (> 148)
BUN/Cr ratio that indicates dehydration - correct answer 25:1 or more
differential dx dehydration and management - correct answer fever, iatrogenic meds, GI fluid
losses
assess fluid deficit (preillness weight-current weight=deficit) then increase oral fluids
can replace with subq button (hypodermoclysis)
IV replacement is fastest but expensive and more complications (fluid overload, HF, cerebral
edema, IV issues)
dehydration prevention - correct answer 6-8 8oz glasses of fluid per day
full glass of fluid with meds
drink more when hot or fever
keep intake record X2 days
get dentition taken care of
EXAM LATEST QUESTIONS
AND VERIFIED ANSWERS
in
polypharmacy - correct answer pathophysiology: use of >5 medications or any not medically
indicated, includes rX and OTC. Drug distribution/clearance affected by dec. lean body mass and
kidney/liver blood flow, inc in body fat. alters pharmacokinetics.
consequences--adverse drug rx-->GI, delirium, dizziness, depression, derm effects
management--BEERS list, improved rx in elderly tool, screening tool to alert doctors to the right
treatment, screening tool of older persons and potentially inappropriate prescriptions
cognitive impairment - correct answer most common is AD
short term memory loss is primary symptom +disorientation; exec. functioning problems, ADLs,
neuro (aphasia, apraxia, agnosia), sleep cycles reversed, psychomotor changes, irritability or
apathy in early stages
delirium: transient waxing/waning of LOC. acute onset. more common in hospitalized patients,
may actually be unmasking an undiagnosed dementia
dehydration - correct answer Na imbalance is most common
, pathophys:decreased thirst response, decreased renal plasma flow, vasopressin release
stimulated by low fluid volume diminished
clinical presentation: nonspecific: confusion, lethargy, weight loss, functional decline, FTT
PE: CV assessment--orthostatic drop in BP and rise in pulse indicates volume depletion, temp
elevatied if inflammatory or infectious process. dry mucous memranes (not tile late
dehydration)
labs: review electrolytes, BUN/Cr ratio, osmolality, h and h (elevated), glucose, Na (> 148)
BUN/Cr ratio that indicates dehydration - correct answer 25:1 or more
differential dx dehydration and management - correct answer fever, iatrogenic meds, GI fluid
losses
assess fluid deficit (preillness weight-current weight=deficit) then increase oral fluids
can replace with subq button (hypodermoclysis)
IV replacement is fastest but expensive and more complications (fluid overload, HF, cerebral
edema, IV issues)
dehydration prevention - correct answer 6-8 8oz glasses of fluid per day
full glass of fluid with meds
drink more when hot or fever
keep intake record X2 days
get dentition taken care of