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NUR 2090 EXAM 2 |133 QUESTIONS| WITH 100% PASSED ANSWERS!!
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NUR 2090 EXAM 2 |133 QUESTIONS| WITH 100% PASSED ANSWERS!!
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NUR 2090 EXAM 2 |133 QUESTIONS| WITH 100% PASSED ANSWERS!! what is an isotonic solution and give the 2 examples Answer- Isotonic solutions are used to increase the extracellular fluid volume due to blood loss, surgery, dehydration, fluid loss that has been depleted extracellularly. Same osmotic concentration as that found in a cell. They are used for vascular expansion, and electrolyte replacement.Examples to know: Normal saline and Lactated Ringer's
What is a hyptonic solution, what is it used for, and give an example. Answer- Hypotonic solutions move fluid into cells and interstitial space. They are used for cellular dehydration. Example to know: 0.45% NaCl
What is a hypertonic solution, what is it used for, and give an example. Answer- Hypertonic solutions draw fluid from the intracellular to the intravascular. Used for intravascular dehydration with interstitial and intracellular fluid overload and sepsis.
Example to know: 3% NaCl
what are the nursing considerations when it comes to giving ISTONIC solutions? Answer- Monitor closely for signs of fluid overload, especially if the patient has a history of renal or cardiovascular disease. Avoid use of lactated Ringer's in patients with liver disease or those in metabolic acidosis
what are the nursing considerations when it comes to giving HYPOTONIC solutions?
Answer- -Monitor regularly because the solutions can cause a sudden shift of fluid into the cells. This can lead to intravascular fluid depletion and cardiovascular collapse.
-Dont give to patients at risk for increased intracranial pressure- head trauma, neurosurgery, and cerebrovascular accident. Increases ICP can result from shift of fluid into brain cells. -Don't give to patients at risk for abnormal fluid shifts into the interstitial compartment
(third spacing), burn victims, trauma, liver failure, and severe protein malnutrition
what are the nursing considerations when it comes to giving HYPERTONIC solutions? Answer- -closely monitor the patient for fluid overload because these solutions expand the intravascular compartment -avoid use in patients with renal or cardiac impairment -avoid use in patients with intracellular dehydration such as diabetic ketoacidosis -rarely used clinically outside of the intensive care unit
Hypotonic solutions are used when the cell is ________ and fluids need to be put back ____________. This happens when patients develop ___________ or __________. Answer- Hypotonic solutions are used when the cell is DEHYDRATED
and fluids need to be put back INTRACELLULARLY. This happens when patientd develop DIABETIC KETOACIDOSIS or HYPEROSMOLAR HYPERGLYCEMIA.
It is preferred to give hypertonic solutions via ____________ due to..... Answer- It is preferred to give hypertonic solutions via a CENTRAL LINE due to the hypertonic solutions BEING VESICANT ON THE VEINS AND THE RISK OF INFILTRATION.
what are some visible signs of fluid overload? Answer- -dyspnea, shortness of breath, pulmonary edema (crackles), orthopnea; increased respiratory rate -anxiety; mental status changes; restlessness -high blood pressure; bounding pulse; increased pulse rate -jugular vein distention; peripheral edema -wieght gain -decreased urine output
Risk of fluid overload is increased for which patients? Answer- Risk of fluid overload in increased for patients who have a history of congestive heart failure or renal insufficiency. Always use an EID to regulate infusions and avoid sudden increases in
infusion rate
List all of the equipment for peripheral IV infusion (this will be a select all that apply question on the test)**** Answer- 1. Access device (IV catheter) 2. Container with IV solution 3. IV tubing 4. Electronic infusion deivce (EID) (if available) 5. Needleless connection 6. watch with second hand if calculation drop rate
INFILTRATION
Signs and Symptoms: Action:
Prevention: Answer- INFILTRATION Signs and Symptoms: swelling, coolness, and discomfort at sight; slowed infusion rate; absence of blood return Action: discontinue IV and restart in another location; apply warm soaks to decrease swelling
Prevention: select a site that is over long bones to act as a splint; avoid sites over joints; consider using manufactured stabilization devices
PHLEBITIS Signs and Symptoms: Action: Prevention: Answer- PHLEBITIS Signs and Symptoms: pain, warmth, and redness at site; vein may feel hard and cord like; slowed infusion rate Action: discontinue IV and restart in another location; apply warm soaks to decrease discomfort; do not irrigate Prevention: change IV sites every 72 h; use large veins and large gauge needles rather than catheters; dilute medications well and infuse slowly; use central line for very irritating solutions
INFECTIONS Signs and symptoms: Action: Prevention: Answer- INFECTIONS Signs and symptoms: -Local: redness, warmth, and purulent drainage at site -Systemic: fever, chillls, mailase, and elevated WBCs Action: Discontinue IV and restart in another location; culture catheter tip and draw blood cultures; treat with appropriate antibiotics Prevention: maintain strict asepsis when dealing with IV's; use good handwashing; change tubing and dressings every 96 hours according to agency protocol
FLUID OVERLOAD
Signs and symptoms:
Action:
Prevention: Answer- FLUID OVERLOAD
Signs and symptoms: elevated blood pressure; increased pulse and respirations; dyspnea; crackles, neck vein distention, weight gain Action: slow IV to keep open rate and notify provider; place patient in high or semi-
fowler position; administer O2 as needed Prevention: monitor rates carefully, especially for high risk patients; use EID; dont catch up when IV gets behind for high risk patients
AIR EMBOLISM (central venous catheters Signs and symptoms: Action:
Prevention: Answer- AIR EMBOLISM (central venous catheters Signs and symptoms: pain in the chest, shoulder, or back; dyspnea, hypotension, thready pulse, cyanosis, loss of consciousnes Action: place on the left side in Trendelenberg position, notify the provider, monitor vital signs closely
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