NURS 488 Final Exam With
Complete Solution
What are the vital signs and 2 manifestations seen in hypervolemia? -
ANSWER - Vital signs = ↑BP, ↑P, ↑RR
- SOB, edema
What are the vital signs and 2 manifestations seen in hypovolemia? -
ANSWER - Vital signs = ↓BP, ↑P
- ↓ urine output (poor kidney perfusion), cool extremities
What should you monitor Blood Products for? - ANSWER monitor for blood
reactions
What do you run RBC infusions with? - ANSWER RBCs carry O2 - only run
with normal saline
What does plasma do? - ANSWER Plasma (FFP) carries clotting factors (no
platelets)
What does albumin do? - ANSWER Albumin holds fluids in vessels (COP)
How fast do you administer potassium? - ANSWER Administer 10 mmol/hour
(faster in critical care units with a cardiac monitor)
What are the risks associated with hypercalcemia and hypocalcemia? -
ANSWER - Hypercalcemia ↑ risk for kidney stones
- Hypocalcemia ↑ risk for muscle spasms, Chvostek's and Trousseau's sign
What is the treatment for hypernatremia? - ANSWER Hypernatremia
,treatment ↑ fluids and/or ↓ Na intake
What is the treatment for hyponatremia? - ANSWER Hyponatremia treatment
↓ fluids and/or ↑ Na intake
What is the max daily dose for Tylenol in a healthy adult? (what can
overdosing cause) - ANSWER Tylenol maximum dose 4 grams (healthy adult)
- overdosing can lead to liver necrosis and failure
What are some adverse reactions of Opiate Analgesics? - ANSWER -
Respiratory depression (Naloxone/ Narcan used as an opiate antagonist)
- Constipation/nausea/histamine release (itching)
What is analgesic addiction? - ANSWER Impaired control over the drug use
What is analgesic tolerance? - ANSWER Decrease in the drugs effectiveness
over time
What is analgesic dependency? - ANSWER Withdrawal symptoms can be
produced when the drug is abruptly stopped
Pain is best controlled by: - ANSWER Giving analgesics scheduled around the
clock
With what type of analgesics is break through pain managed? - ANSWER
Long-acting analgesics with short-acting (for chronic pain or pain such as
with Cancer)
What is an analgesic adjuvant? (examples) - ANSWER - used for better pain
control
- something on top of the pain analgesic
- ex: NSAIDs, acetaminophen, and muscle relaxants
, Titration of analgesics is a way of controlling pain by what means? - ANSWER
Adjusting the dosage of analgesics following an evaluation
Morphine sulphate may cause these adverse effects... - ANSWER itching,
nausea, constipation
Local anesthetic is mixed with epinephrine for this purpose: - ANSWER
Vasoconstriction to keep it at the local site and prevent bleeding
A patient who needs larger doses of opiate analgesic to give the same effect
is known as: - ANSWER Opiate tolerance
A patient is discharged with 1 week's supply of an oral opiate. What teaching
is required? - ANSWER How to prevent constipation
A patient overdoses on acetaminophen (Tylenol) and is given acetylcysteine
(mucomyst) to prevent... - ANSWER liver necrosis
What is NOT an NSAID? - ANSWER Tylenol (acetaminophen)
Properties of NSAIDs include... - ANSWER antipyretic, analgesic, and
anti-inflammatory properties
A patient is on Duragesic (fentanyl) patch. They are drowsy with a respiratory
rate of 9/ minute. What do you do first? - ANSWER Remove the patch
What is included in the care of people receiving vaccines? (4) - ANSWER
Warm compress, acetaminophen, distraction and comfort
At what ages does a child receive the DTaP-IPV- Hib vaccine? - ANSWER 2,4
and 6 months
At what age does a child receive a live vaccine at? - ANSWER 1 year old
What should you monitor with infections? - ANSWER - Monitor temperature
and WBCs
Complete Solution
What are the vital signs and 2 manifestations seen in hypervolemia? -
ANSWER - Vital signs = ↑BP, ↑P, ↑RR
- SOB, edema
What are the vital signs and 2 manifestations seen in hypovolemia? -
ANSWER - Vital signs = ↓BP, ↑P
- ↓ urine output (poor kidney perfusion), cool extremities
What should you monitor Blood Products for? - ANSWER monitor for blood
reactions
What do you run RBC infusions with? - ANSWER RBCs carry O2 - only run
with normal saline
What does plasma do? - ANSWER Plasma (FFP) carries clotting factors (no
platelets)
What does albumin do? - ANSWER Albumin holds fluids in vessels (COP)
How fast do you administer potassium? - ANSWER Administer 10 mmol/hour
(faster in critical care units with a cardiac monitor)
What are the risks associated with hypercalcemia and hypocalcemia? -
ANSWER - Hypercalcemia ↑ risk for kidney stones
- Hypocalcemia ↑ risk for muscle spasms, Chvostek's and Trousseau's sign
What is the treatment for hypernatremia? - ANSWER Hypernatremia
,treatment ↑ fluids and/or ↓ Na intake
What is the treatment for hyponatremia? - ANSWER Hyponatremia treatment
↓ fluids and/or ↑ Na intake
What is the max daily dose for Tylenol in a healthy adult? (what can
overdosing cause) - ANSWER Tylenol maximum dose 4 grams (healthy adult)
- overdosing can lead to liver necrosis and failure
What are some adverse reactions of Opiate Analgesics? - ANSWER -
Respiratory depression (Naloxone/ Narcan used as an opiate antagonist)
- Constipation/nausea/histamine release (itching)
What is analgesic addiction? - ANSWER Impaired control over the drug use
What is analgesic tolerance? - ANSWER Decrease in the drugs effectiveness
over time
What is analgesic dependency? - ANSWER Withdrawal symptoms can be
produced when the drug is abruptly stopped
Pain is best controlled by: - ANSWER Giving analgesics scheduled around the
clock
With what type of analgesics is break through pain managed? - ANSWER
Long-acting analgesics with short-acting (for chronic pain or pain such as
with Cancer)
What is an analgesic adjuvant? (examples) - ANSWER - used for better pain
control
- something on top of the pain analgesic
- ex: NSAIDs, acetaminophen, and muscle relaxants
, Titration of analgesics is a way of controlling pain by what means? - ANSWER
Adjusting the dosage of analgesics following an evaluation
Morphine sulphate may cause these adverse effects... - ANSWER itching,
nausea, constipation
Local anesthetic is mixed with epinephrine for this purpose: - ANSWER
Vasoconstriction to keep it at the local site and prevent bleeding
A patient who needs larger doses of opiate analgesic to give the same effect
is known as: - ANSWER Opiate tolerance
A patient is discharged with 1 week's supply of an oral opiate. What teaching
is required? - ANSWER How to prevent constipation
A patient overdoses on acetaminophen (Tylenol) and is given acetylcysteine
(mucomyst) to prevent... - ANSWER liver necrosis
What is NOT an NSAID? - ANSWER Tylenol (acetaminophen)
Properties of NSAIDs include... - ANSWER antipyretic, analgesic, and
anti-inflammatory properties
A patient is on Duragesic (fentanyl) patch. They are drowsy with a respiratory
rate of 9/ minute. What do you do first? - ANSWER Remove the patch
What is included in the care of people receiving vaccines? (4) - ANSWER
Warm compress, acetaminophen, distraction and comfort
At what ages does a child receive the DTaP-IPV- Hib vaccine? - ANSWER 2,4
and 6 months
At what age does a child receive a live vaccine at? - ANSWER 1 year old
What should you monitor with infections? - ANSWER - Monitor temperature
and WBCs
