NUR 426 EXAM 2 VOIT ASU SPRING
QUESTIONS AND ANSWERS
You should know the significance of the following (why would it be high vs low), but
do not need to memorize know normal ranges - ANSWER-Phosphorus→ (high)
foods like proteins, dairy, nuts, inc renal absorption; (low) vitamin D deficiency
(calcitriol) → kidney dysfunction (CKD), long term use of phosphate binders
Calcium→ (high) inc calcium intake, too much vitamin D; (low) CKD, vitamin D
deficiency
Magnesium (in relationship to AKI/CKD)→ (high) CKD; (low) poor absorption, r/t
hypokalemia
CMP (complete metabolic panel)- what electrolytes are included in a CMP? (answer:
calcium, sodium, potassium, bicarbonate, chloride)
Alanine transaminase (ALT) and Aspartate aminotransferase (AST) (liver
enzymes)→ (high) hepatitis, chronic alcohol use; (low) CKD
WBC→ (high) infection; (low) immunocompromised
BUN→ (high) kidney dysfunction, dehydration, corticosteroids, catabolism from
infection, fever, severe injury, GI bleed; (low) liver damage, very low protein diet
Hemoglobin→ (high) inc need of O2 carrying capacity→ COPD, HF; (low)
hemorrhage
Hematocrit→ (high) dehydration; (low) hemorrhage
Platelets→ (high) platelet disorder; (low) hemorrhage
Creatinine→ (high) kidney dysfunction; (low) liver disease
Sodium→ (high) dehydration ; (low) fluid overload
Potassium→ (high) CKD/AKI, furosemide ; (low) potassium sparing diuretics, r/t
hypomagnesemia
Lactate→ (high) infection, kidney and liver disease; (low) N/A
Blood Glucose→ (high) uncontrolled diabetes; (low) hypoglycemia
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Potassium Chloride - ANSWER-Indications→ potassium replacement
Side effects→ dysrhythmias
Considerations→ not IVP, monitor K+ levels
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Diazepam - ANSWER-Indications→ seizures, anxiety
Side effects→ CNS depression, drowsiness
Considerations→ monitor BP and RR, flumazenil reversal agent
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Furosemide - ANSWER-Indications→ antihypertensive, edema, HF
,Side effects→ voiding, hypokalemia
Considerations→ potassium supplements, monitor BP
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Insulin - ANSWER-Indications→ hyperglycemia
Side effects→ hypoglycemia, hypokalemia
Considerations→ monitor potassium
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Erythropoietein - ANSWER-Indications→ CKD
Side effects→ HTN, thrombosis at fistulas
Considerations→ monitor BP
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Renvela (Sevelamer) - ANSWER-Indications→ phos binder for CKD
Side effects→ hypophosphatemia (long-term)
Considerations→ monitor bicarb and chloride levels
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Baclofen - ANSWER-Indications→ muscle spasms
Side effects→ muscle relaxation, toxicity, drowsiness, sedation, diaphoresis
Considerations→PO, for larger does (severe spasm) needs a pumps (intrathecal
catheter)
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Botulinum toxin A - ANSWER-Indications→ muscle spasms, spastic CP
Side effects→ temporary weakness
Considerations→ inc need for botox over time, lasts 3-6 mo, peaks at 2 weeks
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Dextrose - ANSWER-Indications→ hypoglycemia, adjunct for DKA tx
Side effects→ raise blood glucose levels
Considerations→ monitor blood glucose
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Acetaminophen - ANSWER-Indications→ mild pain, fever
, Side effects→ drowsiness
Considerations→ liver damage
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Tacrolimus - ANSWER-Indications→ prevention of organ transplant rejection
Side effects→ immunosuppression
Considerations→ monitor BP (HTN), renal/hepatic function
Additional medications for CP - ANSWER--pain meds- opioids or NSAIDs
-Botox IM (typically quads) inc need for botox over time
-Baclofen (PO not best option)- centrally acting skeletal muscle relaxant→ best for
severe spastic
-benzos- seizure prophylactic but also reduce spasms
-stool softeners
-gabapentin, Parkinson drugs
Contrast the pathophysiology spina bifida occulta and spina bifida cystica -
ANSWER--folic acid deficiency during pregnancy
-spina bifida→midline defect due to failure of the spine to close
-myelodysplasia (any malformation of the spinal cord and canal)
-usually occurs in lumbosacral area
-occulta→ may dimple or cannot be seen (sacral dimple)
-likely to have no outward s/s
-cystica→ can be seen outside the body
-meningocele→ meninges and spinal fluid
-myelomeningocele→ meninges, spinal fluid, and nerves
-causes→ drugs, genetics, malnutrition, other syndromes
Assessment fo spina bifida cystica - ANSWER--Assessment
-risk of infection (cystica)- skin care, dressings Q2- sterile saline and do not pull
dressing off if sticky, add more saline
-hypersensitivity to latex- no latex pacifier
-neurological deficit is most important factor in determining functional ability
Disease function of cerebral palsy (CP) - ANSWER--CP→ change in developing
brain, permanent, non-progressive, not curable
-considered static encephalopathy (static in nature)
-brain anomaly does not change nor get worse, but symptoms changes with
development over time
-ex. Muscle spasticity can get better, worse, or remain the same
-Causes
-premature <28 wks
-VLBW, LBW
Idiopathic
Pre-birth→ infection (chorio), toxic exposure, brain abnormalities
Birth→ traumatic birth, long labor-brain damage (O2 deficits), stroke, bradycardia
After birth→ kernicterus (jaundice after birth), shaken baby syndrome, bacterial
meningitis, multiple births, hypoxia, seizures
QUESTIONS AND ANSWERS
You should know the significance of the following (why would it be high vs low), but
do not need to memorize know normal ranges - ANSWER-Phosphorus→ (high)
foods like proteins, dairy, nuts, inc renal absorption; (low) vitamin D deficiency
(calcitriol) → kidney dysfunction (CKD), long term use of phosphate binders
Calcium→ (high) inc calcium intake, too much vitamin D; (low) CKD, vitamin D
deficiency
Magnesium (in relationship to AKI/CKD)→ (high) CKD; (low) poor absorption, r/t
hypokalemia
CMP (complete metabolic panel)- what electrolytes are included in a CMP? (answer:
calcium, sodium, potassium, bicarbonate, chloride)
Alanine transaminase (ALT) and Aspartate aminotransferase (AST) (liver
enzymes)→ (high) hepatitis, chronic alcohol use; (low) CKD
WBC→ (high) infection; (low) immunocompromised
BUN→ (high) kidney dysfunction, dehydration, corticosteroids, catabolism from
infection, fever, severe injury, GI bleed; (low) liver damage, very low protein diet
Hemoglobin→ (high) inc need of O2 carrying capacity→ COPD, HF; (low)
hemorrhage
Hematocrit→ (high) dehydration; (low) hemorrhage
Platelets→ (high) platelet disorder; (low) hemorrhage
Creatinine→ (high) kidney dysfunction; (low) liver disease
Sodium→ (high) dehydration ; (low) fluid overload
Potassium→ (high) CKD/AKI, furosemide ; (low) potassium sparing diuretics, r/t
hypomagnesemia
Lactate→ (high) infection, kidney and liver disease; (low) N/A
Blood Glucose→ (high) uncontrolled diabetes; (low) hypoglycemia
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Potassium Chloride - ANSWER-Indications→ potassium replacement
Side effects→ dysrhythmias
Considerations→ not IVP, monitor K+ levels
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Diazepam - ANSWER-Indications→ seizures, anxiety
Side effects→ CNS depression, drowsiness
Considerations→ monitor BP and RR, flumazenil reversal agent
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Furosemide - ANSWER-Indications→ antihypertensive, edema, HF
,Side effects→ voiding, hypokalemia
Considerations→ potassium supplements, monitor BP
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Insulin - ANSWER-Indications→ hyperglycemia
Side effects→ hypoglycemia, hypokalemia
Considerations→ monitor potassium
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Erythropoietein - ANSWER-Indications→ CKD
Side effects→ HTN, thrombosis at fistulas
Considerations→ monitor BP
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Renvela (Sevelamer) - ANSWER-Indications→ phos binder for CKD
Side effects→ hypophosphatemia (long-term)
Considerations→ monitor bicarb and chloride levels
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Baclofen - ANSWER-Indications→ muscle spasms
Side effects→ muscle relaxation, toxicity, drowsiness, sedation, diaphoresis
Considerations→PO, for larger does (severe spasm) needs a pumps (intrathecal
catheter)
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Botulinum toxin A - ANSWER-Indications→ muscle spasms, spastic CP
Side effects→ temporary weakness
Considerations→ inc need for botox over time, lasts 3-6 mo, peaks at 2 weeks
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Dextrose - ANSWER-Indications→ hypoglycemia, adjunct for DKA tx
Side effects→ raise blood glucose levels
Considerations→ monitor blood glucose
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Acetaminophen - ANSWER-Indications→ mild pain, fever
, Side effects→ drowsiness
Considerations→ liver damage
The following medications could be tested on this exam. You should know the
medication's indications, side effects, and nursing considerations when administering
these:
Tacrolimus - ANSWER-Indications→ prevention of organ transplant rejection
Side effects→ immunosuppression
Considerations→ monitor BP (HTN), renal/hepatic function
Additional medications for CP - ANSWER--pain meds- opioids or NSAIDs
-Botox IM (typically quads) inc need for botox over time
-Baclofen (PO not best option)- centrally acting skeletal muscle relaxant→ best for
severe spastic
-benzos- seizure prophylactic but also reduce spasms
-stool softeners
-gabapentin, Parkinson drugs
Contrast the pathophysiology spina bifida occulta and spina bifida cystica -
ANSWER--folic acid deficiency during pregnancy
-spina bifida→midline defect due to failure of the spine to close
-myelodysplasia (any malformation of the spinal cord and canal)
-usually occurs in lumbosacral area
-occulta→ may dimple or cannot be seen (sacral dimple)
-likely to have no outward s/s
-cystica→ can be seen outside the body
-meningocele→ meninges and spinal fluid
-myelomeningocele→ meninges, spinal fluid, and nerves
-causes→ drugs, genetics, malnutrition, other syndromes
Assessment fo spina bifida cystica - ANSWER--Assessment
-risk of infection (cystica)- skin care, dressings Q2- sterile saline and do not pull
dressing off if sticky, add more saline
-hypersensitivity to latex- no latex pacifier
-neurological deficit is most important factor in determining functional ability
Disease function of cerebral palsy (CP) - ANSWER--CP→ change in developing
brain, permanent, non-progressive, not curable
-considered static encephalopathy (static in nature)
-brain anomaly does not change nor get worse, but symptoms changes with
development over time
-ex. Muscle spasticity can get better, worse, or remain the same
-Causes
-premature <28 wks
-VLBW, LBW
Idiopathic
Pre-birth→ infection (chorio), toxic exposure, brain abnormalities
Birth→ traumatic birth, long labor-brain damage (O2 deficits), stroke, bradycardia
After birth→ kernicterus (jaundice after birth), shaken baby syndrome, bacterial
meningitis, multiple births, hypoxia, seizures
