ATI MedSurg Comprehensive Review Questions with correct Answers Diabetic Ketoacidosis Correct Answer - - assessment: dehydration, ketosis, metabolic acidosis, hyperglycemia - admin fast acting insulin that can be effective within 10 min, admin IV
- kussmaul resp
Beta blockers (Propanolol) Correct Answer - - monitor: sore throat, vision changes,
blurred vision, dry eyes, dry mouth, abd cramping, colitis, acute pancreatitis
- notify provider: night cough
Factors that affect wound healing Correct Answer - - dehydration (UO)
- infection
- BMI <18.5 or >25
- malnutrition (low protein, vita C)
- age
- decreased hgb, tissue perfusion
- wound stress
HIV/AIDS Correct Answer - - positive response to treatment monitored by viral load
- risk for infection: do not drink fluids left out for longer than 60 min, clean toothbrush in dishwasher weekly, avoid fresh produce, check temp daily
- dx test: ELISA confirmed by western blot/IFA, viral load
Fluid replacement Correct Answer - - monitor BUN Cerebrovascular accident Correct Answer - - right sided: visual, spatial, proprioception; poor impulse control/judgment; unilateral neglect
- left sided: language, math, analytical skills
Preventing UTIs Correct Answer - - wipe from front to back
- void after intercourse
- avoid baths - drink 2-3 L of fluid daily - cotton underwear
- urinate Q2-4h
Radiation therapy Correct Answer - - do not remove ink markings - wash area gently with warm water and mild soap
- avoid sun esposure for 1 year
- dispose body fluids in lead container
- limit visits to 30 min a day - staff should wear dosimeter badge to monitor exposure - keep all soiled linens in room until implant is removed
Kidney transplants Correct Answer - - hemodialysis sometimes needed following surgery because kidneys from deceased donors may not function immediately
- requires lifelong immunosuppressive therapy - complications: cardiovascular disease Hemodialysis Correct Answer - - expected: weight loss, decrease BP, increase temp - complications: hypocalcemia, bleeding, infection, hypovolemia, anemia
- disequilibrium syndrome: nausea, restlessness, dysrhythmias, seizures, headache
- notify: headache, nausea, dizziness during dialysis
- do not eat during dialysis
Inotropic medications Correct Answer - - dopamine, digoxin, dobutamine, milirinone
- increase contractility and improve CO - monitor HR (apical), hold if <60 min
Diabetes inspidus Correct Answer - - deficiency in ADH
- inability to concentrate urine, 1.001-1.005
- assessment: hypotension, weak peripheral pulses, polydipsia, polyuria (4-30L/day), nocturia, dehydration
- DILUTE urine chemistry, CONCENTRATED serum chemestry
- treatments: desmopressin, vasopressin (synthetic ADH) - complications: CNS damage, serizures
Heart failure Correct Answer - - monitor daily weight and i/o
- prevention/health promotion: exercise regularly, consume diet low in Na, fluid restrictions, smokin cessation
- left sided HF r/t hypertension, CAD, angina, MI, valvular disease... decreased systemic perfusion
- right sided HR r/t left sided HF, pulmonary problems, right ventricular MI
- kussmaul resp
Beta blockers (Propanolol) Correct Answer - - monitor: sore throat, vision changes,
blurred vision, dry eyes, dry mouth, abd cramping, colitis, acute pancreatitis
- notify provider: night cough
Factors that affect wound healing Correct Answer - - dehydration (UO)
- infection
- BMI <18.5 or >25
- malnutrition (low protein, vita C)
- age
- decreased hgb, tissue perfusion
- wound stress
HIV/AIDS Correct Answer - - positive response to treatment monitored by viral load
- risk for infection: do not drink fluids left out for longer than 60 min, clean toothbrush in dishwasher weekly, avoid fresh produce, check temp daily
- dx test: ELISA confirmed by western blot/IFA, viral load
Fluid replacement Correct Answer - - monitor BUN Cerebrovascular accident Correct Answer - - right sided: visual, spatial, proprioception; poor impulse control/judgment; unilateral neglect
- left sided: language, math, analytical skills
Preventing UTIs Correct Answer - - wipe from front to back
- void after intercourse
- avoid baths - drink 2-3 L of fluid daily - cotton underwear
- urinate Q2-4h
Radiation therapy Correct Answer - - do not remove ink markings - wash area gently with warm water and mild soap
- avoid sun esposure for 1 year
- dispose body fluids in lead container
- limit visits to 30 min a day - staff should wear dosimeter badge to monitor exposure - keep all soiled linens in room until implant is removed
Kidney transplants Correct Answer - - hemodialysis sometimes needed following surgery because kidneys from deceased donors may not function immediately
- requires lifelong immunosuppressive therapy - complications: cardiovascular disease Hemodialysis Correct Answer - - expected: weight loss, decrease BP, increase temp - complications: hypocalcemia, bleeding, infection, hypovolemia, anemia
- disequilibrium syndrome: nausea, restlessness, dysrhythmias, seizures, headache
- notify: headache, nausea, dizziness during dialysis
- do not eat during dialysis
Inotropic medications Correct Answer - - dopamine, digoxin, dobutamine, milirinone
- increase contractility and improve CO - monitor HR (apical), hold if <60 min
Diabetes inspidus Correct Answer - - deficiency in ADH
- inability to concentrate urine, 1.001-1.005
- assessment: hypotension, weak peripheral pulses, polydipsia, polyuria (4-30L/day), nocturia, dehydration
- DILUTE urine chemistry, CONCENTRATED serum chemestry
- treatments: desmopressin, vasopressin (synthetic ADH) - complications: CNS damage, serizures
Heart failure Correct Answer - - monitor daily weight and i/o
- prevention/health promotion: exercise regularly, consume diet low in Na, fluid restrictions, smokin cessation
- left sided HF r/t hypertension, CAD, angina, MI, valvular disease... decreased systemic perfusion
- right sided HR r/t left sided HF, pulmonary problems, right ventricular MI
