Med%20Surg%20Exam%203%20review

Med%20Surg%20Exam%203%20reviewMed Surg Exam 3 review 1. You are calculating a patient’s daily output, what results in water loss from GI tract? (SATA) pg.36 vomiting or diarrhea (can cause hypokalemia and hyponatremia) 2. What does the intravascular fluid in the body do and what does it contain? Pg.32 fluid withing the blood vessels. Consists of plasma and fluid within blood cells. Contains large amounts of protein and electrolytes. 3. What hormones in the body promote the loss of water and sodium ions from the kidney tubules? (SATA) pg.32 Brain natriuretic peptide or B-type natriuretic peptide (BNP) Atrial natriuretic peptide (ANP) 4. What is the best way to assess the fluid status of the intravascular volume? Pg.32 monitoring the intravascular space and external signs and symptoms of too much or too little fluid. Taking a blood and chemistry panel and blood pressure is assessed in the vasculature. 5. What lab value would you find in a patient who has dehydration? Pg.35 Increased hematocrit, elevated temp, high urine specific gravity with low volume. Sodium imbalance/hypernatremia 6. What would you find when you assess a patient who has fluid overload? (SATA) Pg.35 Weight gain, bradycardia, elevated BP, edema, crackles in lungs, lethargy, neck veins when laying, decreased serum sodium, decreased hematocrit, low urine specific gravity with high volume. 7. Your patient is taking a diuretic and they have dehydration. What finding would make you call the doctor immediately? The client is hypotensive. Abnormal findings for potassium, decreased hearing or ringing in the ears. 8. If your patient is given a plasma expanding agent, what would they be deficient in? Pg.51 plasma is given primarily to replace coagulation factors but may also be used to increase blood volume (as in shock) and to provide protein. Plasma proteins 9. Look at the chart for pitting edema and know what each one means. Pg.40 1+ Mild pitting— 2mm. slight indentation with no perceptible swelling of the leg. 2+ Moderate pitting— 4mm. indentation subsides quickly, foot is perceived as mildly swollen. 3+ Deep pitting— 6mm. indentation remains for a short time and leg looks swollen. 4+ Very deep pitting— 8mm. indentation lasts for a long time and leg is very swollen. 10. Your patient is given an IV fluid without electrolytes. What solution would you give them? Pg.53 Dextrose in water 11. Your patient overuses antacids. What electrolyte disturbance are they at risk for? Pg.46 Hypermagnesemia 12. What acid base imbalance would you find in a patient's blood gas if they have short and shallow breathing? Pg.48 Respiratory Acidosis 13. What is an acute respiratory event that has deoxygenated blood returning to the left side of the heart? Pg.266-267 box 12.1 Downloaded by DANIEL NDAMBIRI () lOMoARcPSD| Hypoxemia oxygen deficit in the blood. (shunting) 14. Why is it important to diagnose and treat upper respiratory infections if the patient has streptococcus pyogenes? What can that infection lead to? Pg.268 Rheumatic heart disease and glomerulonephritis (sepsis) can result if strep throat is not properly identified and treated. Heart problems and kidney problems 15. Your patient is coughing and they’re beginning to get tired. What should you know about it, antitussive agent? Pg. 275 Ensure client is increasing their fluid intake. May be used to inhibit the cough reflex in the cough center in the brain. 16. . What mechanisms in the body stimulates breathing in a client with chronic lung disease such as emphysema? Pg.261 Body becomes accustomed to high CO2 levels, and the respiratory drive is triggered by the receptors for low arterial O2 instead of high levels of CO2. Hypoxemia 17. What should you recommend for a client with uncomplicated influenza? Nursing interventions. Pg.299 Increase fluid intake, encourage analgesics, saline gargles, suppressant cough med, mouth care q4, cater food/drink preference, antipyretic, and cooling measures for fever, humidify inhaled air, pillow while coughing, moisturize lips and nares, clear nostrils to prevent mouth breathing, get rest, monitor secondary infections. HAND HYGEINE 18. You're assessing a patient for respiratory failure. What would indicate the patient is in danger of respiratory failure. What levels would alert you that they’re in trouble? (Related to ABG’s). Pg. 267 box 12.1 Abnormality of gas exchange with either and excess of carbon dioxide or a deficit of oxygen, or both. Arterial oxygen below 50mmHg 19. you need to know nursing care interventions for a bronchoscopy. Pg.264 NPO, IV initiated, consent form, administer preop sedative, mouth care. Monitor VS q2- 4hrs. LOC, observe for bleeding, dyspnea, wheezing, discomfort, and swelling of face and neck. Position pt. on side until gag reflex has returned. 20. Your patient is having a thoracentesis. What should you as the nurse ensure during the procedure? (SATA) Pg.265 Monitor respirations and skin color during procedure. Assist patient to remain still. VS, consent form signed 21. What are the serious side effects of the medication Fluoroquinolone? Pg.301 safety alert Monitoring signs of Hypoglycemia. The mental health side effects include disturbances in attention, disorientation, agitation, nervousness, memory impairment, and delirium. 22. What is a priority nursing action for patient with epiglottitis? Pg.285 Ensuring there’s an artificial airway and oxygen at the bed side. Epiglottitis can cause an acute airway obstruction and should be monitored closely 23. What should you know about caring for older patient who has pneumonia? Pg. 302 Older adults require several weeks before usual activities can be resumed without experiencing fatigue. Confusion or altered mental status often is the most obvious sign of atypical pneumonia in older adults. May never quite regain the former level of wellness after a serious episode of pneumonia 24. Thick and purulent exudate in the pleural cavity, indicates what? Pg. 307 Downloaded by DANIEL NDAMBIRI (ndambiridaniel20@gmail