NUR 2356 / NUR2356 Multidimensional Care I (MDC 1) Final Exam Review (Latest 2026/2027 Update) | Rasmussen University | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A

NUR 2356 / NUR2356 Multidimensional Care I (MDC 1) Final Exam Review (Latest 2026/2027 Update) | Rasmussen University | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A Q: What does a liver panel show you? -ALT, AST, and ammonia levels Q: What is the cause of Ascites? -Fluid accumulation in the peritoneum Q: What does a nurse assess/intervene for in a patient with ascites? -Daily weights -Measure abdominal girth -Low salt diet -Diuretics Q: What is a key sign of Hepatic Encephalopathy? -Asterixis (hand-flapping tremors) Q: What are other s/s of Hepatic Encephalopathy? -Mood & sleep changes -Agitation -Confusion -Peripheral edema Q: What is the treatment for Hepatic Encephalopathy? -Lactulose: decreases ammonia by excretion in stool (goal: 2-3 stools/day) -Provide a safe environment -Monitor neuro status & ammonia levels Q: What is Chloecystitis? -Inflammation of the gallbladder. RUQ pain may radiate to the right shoulder. Q: What are the s/s of a blocked bile duct? -Jaundice -Orange, foamy urine -Clay-colored stool Q: What are the s/s of Pancreatitis? -LUQ abdominal pain -Rigid abdomen -Flank bruising -Mental confusion, agitation -N/V, jaundice Q: What are the risk factors of Pancreatitis? -Alcohol -Smoking -Age 40-60 -Gallstones Q: What is Peritonitis? Inflammation of the peritoneum. Medical emergency! Q: What are the s/s of Peritonitis? High temp, rigid board-like abdomen, high HR, N/V, anorexia, and abdominal pain Q: Where is Diverticulitis pain located? LLQ (left lower quadrant) Q: Post thyroidectomy/Parathyroidectomy: -Monitor calcium - risk of hypocalcemia -Watch for Trousseau's and Chvostek's signs Q: What are the s/s of Hypothyroidism? Tired, fatigue, weight gain, and cold intolerance. More common in older women. Q: What is the diet for Hyperthyroidism? High-calorie, high-protein, small frequent meals Q: What are the s/s of Thyroid Storm? High temp, tachycardia, palpitations, restlessness, anxiety, SOB Q: What is the treatment for Hyperthyroidism? -Methimazole -Cool environment -Monitor for thyroid storm -Surgical removal or radioactive iodine therapy What are the s/s of Addison's Disease? Bronze skin, weight loss, N/V, weakness, lethargy What is the treatment for Addison's Disease? Lifelong corticosteroid + mineralcorticoid replacement Teaching for Addison's Disease: -Never stop corticosteroids abruptly -During stress/illness: increase sodium Adrenal Insufficiency crisis: -Can occur if steroids are stopped abruptly -Ensure the patient always has enough medication Adrenal insufficiency diet: High sodium during illness and hot weather What is Type 1 Diabetes? -Autoimmune destruction of beta cells -Fasting blood glucose 126 mg/dL -Ketones in urine/blood - insulin dose incorrect -Must take insulin even during illness What are the sick day rules for Type 1 Diabetes? -Continue insulin -Check BG more frequently -Stay hydrated Why is exercise and diet management important in diabetes? Lowers blood glucose levels and reduces CV risk factors What are the s/s of Hypoglycemia? -Sweating -Irritability -Shakiness -Disphoresis -Confusion -Drowsiness What is the management for Hypoglycemia? Give 15g of carbohydrates and recheck glucose in 15 minutes What are the s/s of Hyperglycemia? Polyuria, polydipsia, polyphagia What is the priority treatment for Type 2 Diabetes? Weight loss What is the cause of DKA? Taking too little insulin What are the s/s of DKA? Fruity breath, Kussmaul respirations, excessive urination, dehydration, thirst, abdominal pain, confusion, metabolic acidosis, ketones, hyperkalemia *DKA is seen in Type 1 What is the treatment for DKA? IV regular insulin and isotonic fluids What are the characteristics of HHS? No ketones, blood glucose greater than 600, severe dehydration *HHS is seen in Type 2 What is the treatment for HHS? Fluids - insulin Macrovascular complications in diabetes: MI risk Lispro/Humalog: Monitor for hypoglycemia 1 hour after administration What should we teach patients about Peripheral Neuroapathy (foot care)? Inspect feet daily, wash with warm water, dry between toes, wear well-fitting shoes, do NOT soak feet Crohn's disease: Cobblestone appearance What is the treatment for Crohn's disease? Low-fiber diet during flares, B12 injections, corticosteroids, monitor for bowel obstruction What is the treatment for Ulcerative Colitis? Low-fiber diet during flares, corticosteroids, during exacerbation - NPO (possible surgery) What is the priority for Small Bowel Obstruction? Maintain fluid and electrolyte replacement What is the treatment for SBO? NG tube to decompress What are the s/s of Appendicitis? RLQ pain, N/V, McBurney's point Duodenal ulcer: Pain relieved by food What is dumping syndrome? This is when the stomach empties quickly (15 minutes) after eating, and the client experiences uncomfortable to severe side effects. Usually secondary to gastric bypass, gastrectomy, or gall bladder disease. What are the s/s of dumping syndrome? Weakness, dizziness, diaphoresis, epigastric fullness, tachycardia, palpitations, urgency to defecate Gastritis Etiology & Pathophysiology: Smoking decreases the secretion of bicarb of the pancreas into the duodenum, increasing the acidity of the duodenum What are the causes of gastritis? Smoking, alcohol, NSAIDS, stress What to avoid in gastritis? Smoking, alcohol, promote rest, caffeine, decrease stress, modify diet (avoid triggering foods) How is H. pylori diagnosed? Urea breath test What are the complications of gastritis? Perforation - peritonitis What are the s/s of Diabetes Insipidus? Excretes large amounts of dilute urine, low specific gravity, high serum osmolality, and high sodium (hypernatremia) What are interventions for Diabetes Insipidus? I & O, daily weights, oral fluids, desmopressin Teaching for SIADH: Fluid restriction, daily weights, high-sodium foods (hyponatremia) Normal lab value for sodium: 135-145 mEq/L Normal lab value for potassium: 3.5-5.0 mEq/L What are the s/s of hypomagnesmia? Hyperrflexia, deep tendon reflexes, and painful muscle contractions. Common cause - alcoholism Teaching for hypercalcemia: Encourage up to 4,000mL/day fluids What are the causes of hyperkalemia? Potassium-containining salt substitutes *can occur with acidosis Restrict what with hyponatremia? Fluids What is the teaching for hypernatremia? Read labels for sodium content Respiratory alkalosis causes: Hyperventilation Respiratory acidosis causes: Hypoventilation (COPD, pneumonia) Metabolic alkalosis causes: NG suctioning, vomiting Metabolic acidosis causes: DKA, severe diarrhea How do the kidneys help maintain pH? Kidneys reabsorb and regenerate bicarb How is cancer diagnosed? Biopsy What is metastasis in cancer? Metastasis is the spread of cancer cells from the original tumor to other parts of the body. What is a sign of liver metastasis? Unexplained weight loss What are nursing interventions for neutropenic precautions? -Private room -Restrict visitors -No flowers, fresh fruits/veggies -Monitor temperature -Inspect possible entry sites for infection What are the oncologic emergencies? SVC syndrome, Tumor Lysis Syndrome, Sepsis, SIADH, Spinal Cord Compression What are the s/s of Superior Vena Cava Syndrome? Facial swelling, JVD, hoarseness, dyspnea, chest pain, skin tightness What are the interventions for Superior Vena Cava Syndrome? -Elevate HOB -Administer O2 -Monitor airway What are the s/s of Spinal Cord Compression? Back pain, weakness, sensory loss, incontinence What are the interventions for Spinal Cord Compression? Administer corticosteroids, prepare for radiation/surgery, monitor neuro status What are s/s of Tumor Lysis Syndrome? Increased potassium, increased phosphate, decreased calcium, high uric acid - dysrhythmias & renal failure What are the interventions for Tumor Lysis Syndrome? Aggressive hydration, allopurinol, ECG monitoring, diuretics, and monitor labs What are the s/s of SIADH? Water retention - hyponatremia, confusion, low urine output What are the nursing interventions for SIADH? Fluid restriction, monitor sodium, give hypertonic saline if severe Radiation Therapy Safety: Visitors limit exposure time for clients with radiation implants Infiltration vs. Extravasation: Infiltration - swelling, pale, cool skin Extravasation - chemotherapy infiltrate - blistering, necrosis Primary prevention examples: HPV vaccine Secondary prevention examples: Screenings (colonoscopies, mammograms) What is hospice care? 6 months or less to live. Priority in actively dying patient - pain