NUR 155 exam 2 Questions and
Complete Rationales Graded A+
Sodium normal range - Answer: 135-145 mEq/L
What is BMI? - Answer: Body Mass Index; a measure of body weight relative to height
BMI normal range - Answer: 18.5-24.9
how to prevent food borne illness - Answer: hygienic handling of food & dishes
cook food thoroughly
defrost foods in refrigerator
factors effecting normal elimination - Answer: psychosocial: privacy, positioning, sufficient time
fluid/intake: increase intake=increase output
medications: may cause retention, diuretics increase output
muscle tone: good strength increase emptying appropriately
pathologic conditions: renal failure, kidney stones
surgical: swelling post procedure
Altered urine production/elimination - Answer: polyuria, oliguria, anuria, nocturia, enuresis,
incontinence
polyuria (diuresis) - Answer: excessive production of urine
oliguria - Answer: Decreased urine output <500 mL / day
anuria - Answer: absence of urine production
,Frequency - Answer: voiding at frequent intervals >4 to 6 x/ day
nocturia - Answer: excessive urination at night >2x/night
urgency - Answer: feeling the need to urinate immediately, even if there isn't much urine
enuresis - Answer: involuntary urination in children starting around 4-5 / bed wetting
incontinence - Answer: inability to control bladder and/or bowels/ symptom not disease
nursing process of urinary elimination: - Answer: assess: collect data, obtain urines sample
diagnose: give NANDA Dx for specific urinary issue
plan: goal specific to diagnosis
implement: how will you help pt meet goal
evaluate: were the goals met? yes, discharge. No, change strategy.
assessment of urinary system - Answer: history: baseline, COCA
Physical: Genitourinary system, hydration status, examine urine
relate data to results of diagnostic tests
Hypovolemia - Answer: Fluid volume deficit (FVD)
Hypovolemia S/S - Answer: confusion
dark/low urine output
dry mucous membranes(mouth, nose,eyes)
poor skin turgor
thirst
changes in awareness/mental state
ortho static hypotension
,Hypervolemia - Answer: Fluid volume excess (FVE)
Hypervolemia S/S - Answer: Edema
shortness of air
increased BP
heart problems
cramping
headache
stomach bloating
Dehydration S/S - Answer: vomiting
diarrhea
fever
diaphoresis
dizziness
dry skin
lack of fluids
Over-hydration S/S - Answer: clear urine
headaches
nausea
frequent urination
muscle weakness
spasm cramps
drowsiness
constant feeling of fatigue
, Clinical measurements used in patients with fluid & electrolyte imbalance - Answer: - daily weight (1 kg =
1 Liter of fluid)
take before breakfast & after 1st void, similar clothing, same scale
- vital signs
- intake & output
-dietary changes
Assessment Measurements: - Answer: 1. subjective
2.objective
3.diagnosis
4.planning
5.outcomes
6.interventions
7.rationale
8.evaluation
labs for fluid imbalances - Answer: CMP or serum electrolytes
CBC or complete blood count
Hematocrit
OS molarity
Urine Specific Gravity
Urine pH
ABGs or Arterial bloodgases ; Acid base balance
external condom catheter - Answer: - An alternative to indwelling catheter / male patients not able to
hold urine
- A soft, pliable sheath made of silicone that is applied externally to the penis
- Most are self adhesive
- The catheter is connected to drainage tubing + a collection bag + can be used with a leg bag
Complete Rationales Graded A+
Sodium normal range - Answer: 135-145 mEq/L
What is BMI? - Answer: Body Mass Index; a measure of body weight relative to height
BMI normal range - Answer: 18.5-24.9
how to prevent food borne illness - Answer: hygienic handling of food & dishes
cook food thoroughly
defrost foods in refrigerator
factors effecting normal elimination - Answer: psychosocial: privacy, positioning, sufficient time
fluid/intake: increase intake=increase output
medications: may cause retention, diuretics increase output
muscle tone: good strength increase emptying appropriately
pathologic conditions: renal failure, kidney stones
surgical: swelling post procedure
Altered urine production/elimination - Answer: polyuria, oliguria, anuria, nocturia, enuresis,
incontinence
polyuria (diuresis) - Answer: excessive production of urine
oliguria - Answer: Decreased urine output <500 mL / day
anuria - Answer: absence of urine production
,Frequency - Answer: voiding at frequent intervals >4 to 6 x/ day
nocturia - Answer: excessive urination at night >2x/night
urgency - Answer: feeling the need to urinate immediately, even if there isn't much urine
enuresis - Answer: involuntary urination in children starting around 4-5 / bed wetting
incontinence - Answer: inability to control bladder and/or bowels/ symptom not disease
nursing process of urinary elimination: - Answer: assess: collect data, obtain urines sample
diagnose: give NANDA Dx for specific urinary issue
plan: goal specific to diagnosis
implement: how will you help pt meet goal
evaluate: were the goals met? yes, discharge. No, change strategy.
assessment of urinary system - Answer: history: baseline, COCA
Physical: Genitourinary system, hydration status, examine urine
relate data to results of diagnostic tests
Hypovolemia - Answer: Fluid volume deficit (FVD)
Hypovolemia S/S - Answer: confusion
dark/low urine output
dry mucous membranes(mouth, nose,eyes)
poor skin turgor
thirst
changes in awareness/mental state
ortho static hypotension
,Hypervolemia - Answer: Fluid volume excess (FVE)
Hypervolemia S/S - Answer: Edema
shortness of air
increased BP
heart problems
cramping
headache
stomach bloating
Dehydration S/S - Answer: vomiting
diarrhea
fever
diaphoresis
dizziness
dry skin
lack of fluids
Over-hydration S/S - Answer: clear urine
headaches
nausea
frequent urination
muscle weakness
spasm cramps
drowsiness
constant feeling of fatigue
, Clinical measurements used in patients with fluid & electrolyte imbalance - Answer: - daily weight (1 kg =
1 Liter of fluid)
take before breakfast & after 1st void, similar clothing, same scale
- vital signs
- intake & output
-dietary changes
Assessment Measurements: - Answer: 1. subjective
2.objective
3.diagnosis
4.planning
5.outcomes
6.interventions
7.rationale
8.evaluation
labs for fluid imbalances - Answer: CMP or serum electrolytes
CBC or complete blood count
Hematocrit
OS molarity
Urine Specific Gravity
Urine pH
ABGs or Arterial bloodgases ; Acid base balance
external condom catheter - Answer: - An alternative to indwelling catheter / male patients not able to
hold urine
- A soft, pliable sheath made of silicone that is applied externally to the penis
- Most are self adhesive
- The catheter is connected to drainage tubing + a collection bag + can be used with a leg bag
