The nurse is caring for an older adult with hypernatremia. Which of these interventions
does the nurse perform first?
a) Monitor the serum osmolarity
b) Encourage fluid intake
c) Administer a diuretic
d) Restrict the client's intake of sodium
Give this one a try later!
, b) Encourage fluid intake
*When caring for an older adult with hypernatremia, the nurse first
encourages the client to take more fluid. Encouraging fluids in the older
adult is important to prevent dehydration with resulting concentrated
sodium levels.
Hypernatremia and fluid loss typically occur in tandem in the older adult.
Restricting sodium does not replace fluids needed by many elderly clients.
A diuretic will worsen the fluid volume deficit the client is experiencing.
Monitoring the osmolarity will detect an abnormality, but not resolve the
problem.
How does the nurse calculate dehydration fluid losses and need for that
replacement?
Give this one a try later!
1% or more of body mass of lost fluid
ex: 200 lbs - 1%= 198 lb so 2 lbs were lost & 2.2lbs= 1 L= 1,000 ml needs to be
replaced over 24 hrs or 42 mls/hr
What is a cristical moment vs worst case scenario for pt with schizophrenia?
Give this one a try later!
, Critical moment:
-suicidal
-non interactive w society
-unable to perform ADL's
Worst case scenario:
-increased symptoms & untreated schizophrenia
-delayed treatment makes disease process worse
The nurse caring for a client with heart failure is concerned that digoxin toxicity has
developed. For which signs and symptoms of digoxin toxicity does the nurse notify
the provider? (select all that apply)
a) Blurred vision
b) Tachycardia
c) Fatigue
d) Serum digoxin level of 1.5 ng/ml (1.92 nmol/L)
e) Anorexia
Give this one a try later!
a) Blurred vision
c) Fatigue
e) Anorexia
*The signs and symptoms of digoxin toxicity that the nurse notifies the
provider include: blurred vision, fatigue, and anorexia. Changes in mental
status, especially in older adults, may also occur.Sinus bradycardia and not
tachycardia is a sign of digoxin toxicity. A serum digoxin level between 0.8
and 2.0 (1.02 and 2.56 nmol/L) is considered normal and is not a symptom.
Match the New York Heart Association (NYHA) Stage with its best definition / patient
symptoms. Class 1; Class 2; Class 3; Class 4
____ Mostly comfortable and symptom-free, but ADLs makes the patient tired and/ or
, short of breath
____ Able to perform ADLs and normal activity with no CHF symptoms such as
shortness of breath.
____ The patient has trouble with any activity. Symptoms may be present even when
resting and get worse with any activity.
____ Ok when resting, but even minimal activity causes symptoms such as heart rhythm
changes.
Give this one a try later!
__2__ Mostly comfortable and symptom-free, but ADLs makes the patient
tired and/ or short of breath
__1__ Able to perform ADLs and normal activity with no CHF symptoms such
as shortness of breath.
__4__ The patient has trouble with any activity. Symptoms may be present
even when resting and get worse with any activity.
__3__ Ok when resting, but even minimal activity causes symptoms such as
heart rhythm changes.
*Take a look at the wording: get used to explaining each category in your
own words!
Which of the following is most correct for diastolic heart failure?
a) heart failure with reduced ejection fraction (HFrEF)
b) heart failure with preserved ejection fraction (HFpEF)
c) correct answer not shown
Give this one a try later!
b) heart failure with preserved ejection fraction (HFpEF)
Which intervention best assists the client with acute pulmonary edema in reducing
anxiety and dyspnea?
a) Monitor pulse oximetry and cardiac rate and rhythm.
does the nurse perform first?
a) Monitor the serum osmolarity
b) Encourage fluid intake
c) Administer a diuretic
d) Restrict the client's intake of sodium
Give this one a try later!
, b) Encourage fluid intake
*When caring for an older adult with hypernatremia, the nurse first
encourages the client to take more fluid. Encouraging fluids in the older
adult is important to prevent dehydration with resulting concentrated
sodium levels.
Hypernatremia and fluid loss typically occur in tandem in the older adult.
Restricting sodium does not replace fluids needed by many elderly clients.
A diuretic will worsen the fluid volume deficit the client is experiencing.
Monitoring the osmolarity will detect an abnormality, but not resolve the
problem.
How does the nurse calculate dehydration fluid losses and need for that
replacement?
Give this one a try later!
1% or more of body mass of lost fluid
ex: 200 lbs - 1%= 198 lb so 2 lbs were lost & 2.2lbs= 1 L= 1,000 ml needs to be
replaced over 24 hrs or 42 mls/hr
What is a cristical moment vs worst case scenario for pt with schizophrenia?
Give this one a try later!
, Critical moment:
-suicidal
-non interactive w society
-unable to perform ADL's
Worst case scenario:
-increased symptoms & untreated schizophrenia
-delayed treatment makes disease process worse
The nurse caring for a client with heart failure is concerned that digoxin toxicity has
developed. For which signs and symptoms of digoxin toxicity does the nurse notify
the provider? (select all that apply)
a) Blurred vision
b) Tachycardia
c) Fatigue
d) Serum digoxin level of 1.5 ng/ml (1.92 nmol/L)
e) Anorexia
Give this one a try later!
a) Blurred vision
c) Fatigue
e) Anorexia
*The signs and symptoms of digoxin toxicity that the nurse notifies the
provider include: blurred vision, fatigue, and anorexia. Changes in mental
status, especially in older adults, may also occur.Sinus bradycardia and not
tachycardia is a sign of digoxin toxicity. A serum digoxin level between 0.8
and 2.0 (1.02 and 2.56 nmol/L) is considered normal and is not a symptom.
Match the New York Heart Association (NYHA) Stage with its best definition / patient
symptoms. Class 1; Class 2; Class 3; Class 4
____ Mostly comfortable and symptom-free, but ADLs makes the patient tired and/ or
, short of breath
____ Able to perform ADLs and normal activity with no CHF symptoms such as
shortness of breath.
____ The patient has trouble with any activity. Symptoms may be present even when
resting and get worse with any activity.
____ Ok when resting, but even minimal activity causes symptoms such as heart rhythm
changes.
Give this one a try later!
__2__ Mostly comfortable and symptom-free, but ADLs makes the patient
tired and/ or short of breath
__1__ Able to perform ADLs and normal activity with no CHF symptoms such
as shortness of breath.
__4__ The patient has trouble with any activity. Symptoms may be present
even when resting and get worse with any activity.
__3__ Ok when resting, but even minimal activity causes symptoms such as
heart rhythm changes.
*Take a look at the wording: get used to explaining each category in your
own words!
Which of the following is most correct for diastolic heart failure?
a) heart failure with reduced ejection fraction (HFrEF)
b) heart failure with preserved ejection fraction (HFpEF)
c) correct answer not shown
Give this one a try later!
b) heart failure with preserved ejection fraction (HFpEF)
Which intervention best assists the client with acute pulmonary edema in reducing
anxiety and dyspnea?
a) Monitor pulse oximetry and cardiac rate and rhythm.
