FCCN LEVEL 1 EXAM QUESTIONS AND ANSWERS
VERIFIED 100% CORRECT
blood - ANSWER -- not a risk free fluid replacement
- this is liquid transplant
third spacing - ANSWER -- fluid is not lost from the body but the fluid is not
available for use in the intracellular or extracellular compartments (fluid is in
between tissues/cells)
- this patient is intravascularly dry and still needs more fluid
-
can you give platelets through the ranger - ANSWER -- no it will aggreggate the
platelets
hyponatremia - ANSWER -- less than 135 -145
- weakness
- abdominal cramping/leg cramps
- dizzy
- change in LOC
- seizures
different ways to treat hyponatremia - ANSWER -- hypovolemic (give IV fluid)
- euvolemic (fluid restriction)
- hypervolemic (diuretic)
severe hyponatremia - ANSWER -- EMERGENCY
- below 115
- give hypertonic saline if patient is symptomatic
- in ICU setting
*infused slowly in small amounts....be prepared to handle seizures*
hypokalemia ECG changes - ANSWER -- prolonged QT
,- ST depression
*U WAVE is hallmark sign*
if you see a U wave then YOU need K+
hypokalemia - ANSWER -- 3.5 to 5
- muscle weakness
hyperkalemia ECG changes - ANSWER -- tall tented T waves is the earliest sign
- AV blocks
treating hyperkalemia - ANSWER -- Calcium chloric or gluconate to antagonize
cardiac abnormalities
- Bicarbonate for pt with acidosis
- IV insulin and 50% dextrose to shift K into cells
- kayexelate (fecal excretion of K)
- dialysis for ARF
hypocalcemia - ANSWER -8.5 - 10.2
- tetany
- muscle cramps
- trousseau's and chvosteks sign
- colicky abdominal pain
treating hypocalcemia - ANSWER -- IV calcium gluconate or calcium chloride
(CENTRAL LINE)
- consider seizure precautions
- replace Mg in addition to Ca because pt might not respond to Ca treatment
hypercalcemia - ANSWER -caused by
- cancers and hyperparathyroidism
- excessive Ca and Vit. D supplements
- muscle weakness
- depressed CNS (confusion)
- dysrhythmias (prolong QT, AV block)
, - abdominal pain
treating hypercalcemia - ANSWER -- administer IV NS to promote diuresis
- administer loop diuretics
- corticosteroids to decrease absorption from GI
- phosphates to decrease breakdown of bones by inhibiting release
- dialysis
hypomagnesemia - ANSWER -- tetany
- weakness
- confusion
- ECG changes (wide QRS, prolong PR/QT)
treating hypomagnesemia - ANSWER -- CPR
- magnesium
- shock
hypomagnesemia and digoxin - ANSWER -- low MG increases pharmacologic
action of digoxin
- look for N/V, bradycardia, AV block, yellow tinged vision
hypermagenesemia - ANSWER -- take too many antacids or laxatives
- respiratory depression
- muscle relaxation
hypophosphatemia - ANSWER -- cause by hyperparathyroidism, chronic diarrhea,
long term diuretic use, malnutrition and severe burns
- muscle weakness
- impaired cardiac function
- poor tissue oxygenation
- failure to wean from mechanical ventilation
- depressed CNS - confusion
treating low phosphorus - ANSWER -- increase intake of phos rich food
- IV
- assess for hypercalcemia
- consider Mg replacement simultaneously
VERIFIED 100% CORRECT
blood - ANSWER -- not a risk free fluid replacement
- this is liquid transplant
third spacing - ANSWER -- fluid is not lost from the body but the fluid is not
available for use in the intracellular or extracellular compartments (fluid is in
between tissues/cells)
- this patient is intravascularly dry and still needs more fluid
-
can you give platelets through the ranger - ANSWER -- no it will aggreggate the
platelets
hyponatremia - ANSWER -- less than 135 -145
- weakness
- abdominal cramping/leg cramps
- dizzy
- change in LOC
- seizures
different ways to treat hyponatremia - ANSWER -- hypovolemic (give IV fluid)
- euvolemic (fluid restriction)
- hypervolemic (diuretic)
severe hyponatremia - ANSWER -- EMERGENCY
- below 115
- give hypertonic saline if patient is symptomatic
- in ICU setting
*infused slowly in small amounts....be prepared to handle seizures*
hypokalemia ECG changes - ANSWER -- prolonged QT
,- ST depression
*U WAVE is hallmark sign*
if you see a U wave then YOU need K+
hypokalemia - ANSWER -- 3.5 to 5
- muscle weakness
hyperkalemia ECG changes - ANSWER -- tall tented T waves is the earliest sign
- AV blocks
treating hyperkalemia - ANSWER -- Calcium chloric or gluconate to antagonize
cardiac abnormalities
- Bicarbonate for pt with acidosis
- IV insulin and 50% dextrose to shift K into cells
- kayexelate (fecal excretion of K)
- dialysis for ARF
hypocalcemia - ANSWER -8.5 - 10.2
- tetany
- muscle cramps
- trousseau's and chvosteks sign
- colicky abdominal pain
treating hypocalcemia - ANSWER -- IV calcium gluconate or calcium chloride
(CENTRAL LINE)
- consider seizure precautions
- replace Mg in addition to Ca because pt might not respond to Ca treatment
hypercalcemia - ANSWER -caused by
- cancers and hyperparathyroidism
- excessive Ca and Vit. D supplements
- muscle weakness
- depressed CNS (confusion)
- dysrhythmias (prolong QT, AV block)
, - abdominal pain
treating hypercalcemia - ANSWER -- administer IV NS to promote diuresis
- administer loop diuretics
- corticosteroids to decrease absorption from GI
- phosphates to decrease breakdown of bones by inhibiting release
- dialysis
hypomagnesemia - ANSWER -- tetany
- weakness
- confusion
- ECG changes (wide QRS, prolong PR/QT)
treating hypomagnesemia - ANSWER -- CPR
- magnesium
- shock
hypomagnesemia and digoxin - ANSWER -- low MG increases pharmacologic
action of digoxin
- look for N/V, bradycardia, AV block, yellow tinged vision
hypermagenesemia - ANSWER -- take too many antacids or laxatives
- respiratory depression
- muscle relaxation
hypophosphatemia - ANSWER -- cause by hyperparathyroidism, chronic diarrhea,
long term diuretic use, malnutrition and severe burns
- muscle weakness
- impaired cardiac function
- poor tissue oxygenation
- failure to wean from mechanical ventilation
- depressed CNS - confusion
treating low phosphorus - ANSWER -- increase intake of phos rich food
- IV
- assess for hypercalcemia
- consider Mg replacement simultaneously
