Review Revised Med Surg Final
1. If the patient has hypokalemia 3.0 = muscle cramping, weakness and dysrthymia
2. If a patient has hypocalcemia:
3. A condition that would cause hyperkalemia = chronic kidney disease
o Because you are retaining potassium. There is a problem with retention,
reabsorption of electrolytes
o If potassium is high, sodium is low
o Give patient to excrete potassium = kayexalate (sodium polystyrene)
4. Patients with liver cirrhosis:
o Clinical manifestations = jaundice, abdominal pain, ascites, icteric sclera, elevated
ALT and ASD, dark colored urine due to the protein in the urine ( have hard time
filtering)
o Ascites – because they have liquid in their peritoneal
5. What would be something you would monitor if the patient has ascites:
o Measure the abdominal girth
o Difficulty breathing, high fowlers position
o Will perform paracentesis:
▪ What do we need to prepare?
• Bottles, consent, have patient go to restroom prior to procedure
6. If patient comes with live cirrhosis, what else will you monitor?
o What else can be elevated = ammonia levels
▪ s/s: confusion
▪ Lactulose = given to patient to remove ammonia
7. What would be another clinical manifestation for a patient who has asthma exacerbation
and hypoxemia?
o Wheezing, agitation, anxious, restless
8. CHEST PAIN: if patient is presented with chest pain and diaphoresis, what is the first
thing you want to asses?
o EKG – what to know if they are having a STEMI or ST elevation
9. What is the standard of care if the patient does have STEMI?
o EKG = 10 min
o TPA = 30 min
o Angioplasty/ Heart Cath = 90 min
o TPA is to solve the clots, to open up
10. What are other clinical manifestations of patients who have an MI?
o Epigastric pain, diaphoresis, left shoulder pain
11. If a patient has a heart cath after the STEMI, they undergo a procedure and come back to
the unit, what are we looking for?
o Grey’s Turner Sign = retroperitoneal bleeding
12. How do we differentiate between a stable angina and an MI?
o Angina gets better with rest and nitroglycerin
o If there is no relief from rest and nitro = MI
13. How do we know a patient is having an MI?
, o ST elevations
o Could be a STEMI, a STEMI is always an MI however an MI is not always a
STEMI
14. Assessing a patient with hypothyroidism, what can we expect?
o Bradycardia (slow hear rate), cold intolerance, gaining weight, hypotension
o High TSH, Low T3/T4
15. If the patient has hyperthyroidism, or cancerous thyroid and have a thyroidectomy, what
do they need?
o Suctioning and oxygen – if they have excess bleeding
16. If the patient is having asthma exacerbation attack, what is the highest priority?
o Give albuterol
17. If the patient is taking aspirin and the patient can take aspirin for different things,
arthritis, stroke, prevention of a stroke, why would we give patient baby aspirin for a
stroke?
o Helps with fever, inflammation, pain and is also a blood thinner
18. If a patient is prescribed aspirin for whatever reason, what would be a potential adverse
effect?
o Tinnitus – ringing of the ears
19. Patient with end stage renal is manifesting shortness of breath and swelling, maybe
crackles of the lungs, what would we suspect?
o Hyperkalemia
o Fluid overload - hypervolemia
20. When would the patient experience hypovolemia, pt with end stage renal, post op?
21. If a patient is coming into the ER with severe acute pain, what would be some of the
clinical manifestations?
o Tachycardia, increased heart rate, blood pressure
22. If a patient has hypoglycemia, but the patient is alert and able to move?
o Give 15 grams of simple carbohydrates
23. If patient presents with diabetes insipidus, what would be some of the manifestations, pt
has had a lot of fluid excretion?
o What can trigger high sodium? Seizures and hypernatremia
24. If a patient with diabetes insipidus is prescribed vasopressin?
o Vasopressin = regulates ADH
o Precaution with cardiac patients that are on nitroglycerin because vasopressin will
also reduce blood pressure
25. Thyroidectomy, what do we have at the beside?
o Trachea, suction and oxygen
26. Patient with chronic kidney disease, what would we see?
o Hyperkalemia
o Electrolyte imbalance
o High Potassium
1. If the patient has hypokalemia 3.0 = muscle cramping, weakness and dysrthymia
2. If a patient has hypocalcemia:
3. A condition that would cause hyperkalemia = chronic kidney disease
o Because you are retaining potassium. There is a problem with retention,
reabsorption of electrolytes
o If potassium is high, sodium is low
o Give patient to excrete potassium = kayexalate (sodium polystyrene)
4. Patients with liver cirrhosis:
o Clinical manifestations = jaundice, abdominal pain, ascites, icteric sclera, elevated
ALT and ASD, dark colored urine due to the protein in the urine ( have hard time
filtering)
o Ascites – because they have liquid in their peritoneal
5. What would be something you would monitor if the patient has ascites:
o Measure the abdominal girth
o Difficulty breathing, high fowlers position
o Will perform paracentesis:
▪ What do we need to prepare?
• Bottles, consent, have patient go to restroom prior to procedure
6. If patient comes with live cirrhosis, what else will you monitor?
o What else can be elevated = ammonia levels
▪ s/s: confusion
▪ Lactulose = given to patient to remove ammonia
7. What would be another clinical manifestation for a patient who has asthma exacerbation
and hypoxemia?
o Wheezing, agitation, anxious, restless
8. CHEST PAIN: if patient is presented with chest pain and diaphoresis, what is the first
thing you want to asses?
o EKG – what to know if they are having a STEMI or ST elevation
9. What is the standard of care if the patient does have STEMI?
o EKG = 10 min
o TPA = 30 min
o Angioplasty/ Heart Cath = 90 min
o TPA is to solve the clots, to open up
10. What are other clinical manifestations of patients who have an MI?
o Epigastric pain, diaphoresis, left shoulder pain
11. If a patient has a heart cath after the STEMI, they undergo a procedure and come back to
the unit, what are we looking for?
o Grey’s Turner Sign = retroperitoneal bleeding
12. How do we differentiate between a stable angina and an MI?
o Angina gets better with rest and nitroglycerin
o If there is no relief from rest and nitro = MI
13. How do we know a patient is having an MI?
, o ST elevations
o Could be a STEMI, a STEMI is always an MI however an MI is not always a
STEMI
14. Assessing a patient with hypothyroidism, what can we expect?
o Bradycardia (slow hear rate), cold intolerance, gaining weight, hypotension
o High TSH, Low T3/T4
15. If the patient has hyperthyroidism, or cancerous thyroid and have a thyroidectomy, what
do they need?
o Suctioning and oxygen – if they have excess bleeding
16. If the patient is having asthma exacerbation attack, what is the highest priority?
o Give albuterol
17. If the patient is taking aspirin and the patient can take aspirin for different things,
arthritis, stroke, prevention of a stroke, why would we give patient baby aspirin for a
stroke?
o Helps with fever, inflammation, pain and is also a blood thinner
18. If a patient is prescribed aspirin for whatever reason, what would be a potential adverse
effect?
o Tinnitus – ringing of the ears
19. Patient with end stage renal is manifesting shortness of breath and swelling, maybe
crackles of the lungs, what would we suspect?
o Hyperkalemia
o Fluid overload - hypervolemia
20. When would the patient experience hypovolemia, pt with end stage renal, post op?
21. If a patient is coming into the ER with severe acute pain, what would be some of the
clinical manifestations?
o Tachycardia, increased heart rate, blood pressure
22. If a patient has hypoglycemia, but the patient is alert and able to move?
o Give 15 grams of simple carbohydrates
23. If patient presents with diabetes insipidus, what would be some of the manifestations, pt
has had a lot of fluid excretion?
o What can trigger high sodium? Seizures and hypernatremia
24. If a patient with diabetes insipidus is prescribed vasopressin?
o Vasopressin = regulates ADH
o Precaution with cardiac patients that are on nitroglycerin because vasopressin will
also reduce blood pressure
25. Thyroidectomy, what do we have at the beside?
o Trachea, suction and oxygen
26. Patient with chronic kidney disease, what would we see?
o Hyperkalemia
o Electrolyte imbalance
o High Potassium
