NUR2243 Final Exam| Questions and Answers| Latest Update 100% Verified|
Grade A+ Content
Addison's s/sx - hyperpigmented skin
- weight loss
- fatigue
(everything LOW)
Addison's teaching - avoid stress
- take steroids for the rest of their life (making them immunocompromised); stopping can cause
deadly crisis
- small, frequent high protein, low carb meals
Diabetes insipidus (decreased ADH) s/sx DI = dry inside
- excessive UO and thirst, dehydration, weakness
Addisonian crisis - severe hypotension caused by stress or sudden withdrawal of steroids
- tx: steroid pen, IV steroids
DI tx vasopressin
Evaluation of successful tx of DI increased urine specific gravity, decreased urine output
Tube feedings can be cause which electrolyte, acid/base changes? Hypernatremia and
metabolic alkalosis
Pt in the ED needs an IV med, what is the first thing the nurse should do? start the IV
,Hypernatremia s/sx thirst, dry mouth, confusion, convulsions (cerebral and dehydration sx)
Oliguric renal disease complications - hyperkalemia
- hypermagnesemia
- hyperphosphatemia
- metabolic acidosis
When teaching a pt with oliguric renal disease, make sure to teach decrease intake of foods
high in potassium, magnesium, and phosphate to avoid imbalances
A pt with kidney disease is about to go for a CT scan, what med should be held? metformin,
risk for lactic acidosis; do not give for at least 48-hrs before test
Hypokalemia s/sx - cardiac dysrhythmias and arrest
- muscle weakness
- orthostatic hypotension (FALL PRECAUTIONS)
- shallow respirations
- mental status changes
Hyperkalemia s/sx - cardiac dysrhythmias; peaked T waves, elevated ST segment
- irritability
- tachypnea
- diarrhea
- increased muscle tone, clonus, hyperreflexia
Proteinuria indicates NEVER normal, indicates decreased renal function
, When making assignments for a travel nurse, the charge nurse understands float/travel
nurses must be treated like brand new nurse since they are new to the floor
Pt is experiencing EKG changes. The nurse should first assess pt before assessing machine;
do not call code unless both are assessed!
Pacemaker aftercare - check dressing, pulses, cap. refill
- do not lift arm for 6 weeks
- no tight clothing
- stay away from magnets (no MRI)
DIC treatment - platelet, FFP, or coagulation factors transfusion
- fixing cause
- priorities are circulation and oxygenation
Shock treatment - treat the underlying cause (restoration of volume, treatment of infection,
epi pen, etc.)
- oxygen
- meds (vasopressors + inotropes)
- fluids
Shock s/sx hypotension, tachypnea, tachycardia, narrowed MAP, decreased urinary output,
cold/clammy skin
Stress test considerations NPO 2-6 hours before, no beta blockers, no caffeine
Cardiac cath considerations - supine 6-8 hrs after test
- check groin, pedal pulses (if foot is cold, call HCP)
Grade A+ Content
Addison's s/sx - hyperpigmented skin
- weight loss
- fatigue
(everything LOW)
Addison's teaching - avoid stress
- take steroids for the rest of their life (making them immunocompromised); stopping can cause
deadly crisis
- small, frequent high protein, low carb meals
Diabetes insipidus (decreased ADH) s/sx DI = dry inside
- excessive UO and thirst, dehydration, weakness
Addisonian crisis - severe hypotension caused by stress or sudden withdrawal of steroids
- tx: steroid pen, IV steroids
DI tx vasopressin
Evaluation of successful tx of DI increased urine specific gravity, decreased urine output
Tube feedings can be cause which electrolyte, acid/base changes? Hypernatremia and
metabolic alkalosis
Pt in the ED needs an IV med, what is the first thing the nurse should do? start the IV
,Hypernatremia s/sx thirst, dry mouth, confusion, convulsions (cerebral and dehydration sx)
Oliguric renal disease complications - hyperkalemia
- hypermagnesemia
- hyperphosphatemia
- metabolic acidosis
When teaching a pt with oliguric renal disease, make sure to teach decrease intake of foods
high in potassium, magnesium, and phosphate to avoid imbalances
A pt with kidney disease is about to go for a CT scan, what med should be held? metformin,
risk for lactic acidosis; do not give for at least 48-hrs before test
Hypokalemia s/sx - cardiac dysrhythmias and arrest
- muscle weakness
- orthostatic hypotension (FALL PRECAUTIONS)
- shallow respirations
- mental status changes
Hyperkalemia s/sx - cardiac dysrhythmias; peaked T waves, elevated ST segment
- irritability
- tachypnea
- diarrhea
- increased muscle tone, clonus, hyperreflexia
Proteinuria indicates NEVER normal, indicates decreased renal function
, When making assignments for a travel nurse, the charge nurse understands float/travel
nurses must be treated like brand new nurse since they are new to the floor
Pt is experiencing EKG changes. The nurse should first assess pt before assessing machine;
do not call code unless both are assessed!
Pacemaker aftercare - check dressing, pulses, cap. refill
- do not lift arm for 6 weeks
- no tight clothing
- stay away from magnets (no MRI)
DIC treatment - platelet, FFP, or coagulation factors transfusion
- fixing cause
- priorities are circulation and oxygenation
Shock treatment - treat the underlying cause (restoration of volume, treatment of infection,
epi pen, etc.)
- oxygen
- meds (vasopressors + inotropes)
- fluids
Shock s/sx hypotension, tachypnea, tachycardia, narrowed MAP, decreased urinary output,
cold/clammy skin
Stress test considerations NPO 2-6 hours before, no beta blockers, no caffeine
Cardiac cath considerations - supine 6-8 hrs after test
- check groin, pedal pulses (if foot is cold, call HCP)