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NR324 (Adult Health I) Final Review 2024/2025. $12.49   Add to cart

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NR324 (Adult Health I) Final Review 2024/2025.

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NR324 (Adult Health I) Final Review 2024/2025. 112 Questions and Answers.

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  • April 10, 2024
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  • 2023/2024
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NR324 (Adult Health I) Final Review 2024/2025.
What are some conditions/procedures that put patient @ high risk for fluid volume deficit?

-diabetes insipidus
-osmotic diuresis
-hemorrhage
-GI losses: vomiting, NG suction
-diuretics
-inadequate fluid intake
-third-space fluid shifts: burns, pancreatitis

What are some of the things nurse monitors when administering fluids/electrolytes?

-Daily weights
-x-ray
-I/O
-labs:
--BUN
--NA
--K
--HCT
--Osmolality
-monitor vitals
-monitor tissue perfusion
-assess skin turgor/mobility

How do we know we're on the right track with fluid balance?

-when I/O's are WNL
-when BP and HR stabilize

What are the vitals fluid volume deficit

-BP decreases
-HR increases
-RR increased (shallow)

Vitals fluid volume excess

-BP increases
-HR decreases
-RR decreases

Respiratory alkalosis

1. Causes: hyperventilation, pain, anxiety, fever
2. Effects: Restlessness, muscle twitching, paresthesia, coma

,3. Compensation: kidneys conserve H+ ions, kidneys eliminate bicarb
4. Results: pH > 7.45, HCO3 < 22 (compensation)

Respiratory acidosis

1. Causes: hypoventilation, overdose, sedation, chronic COPD
2. Effects: confusion, high urine pH, lethargy, coma, death
3. Compensation: kidneys secrete acid, increased bicarbonate
4. Lab results: pH < 7.35, HCO3 > 26 (compensation)

Metabolic acidosis

1. Causes: renal failure, diarrhea, DKA, shock

2. Effect: confusion, high urine pH, lethargy, coma, death

3. Compensation: Lungs increase RR, kidneys retain HCO3- and eliminate H+ ions

4. Lab results: pH < 7.35, PCO2 < 35 (compensation)

Metabolic alkalosis

1. Causes: excessive vomiting, excessive GI suction/drainage, excessive antacids, hypokalemia

2. Effects: restlessness, muscle twitching, paresthesia, coma

3. Compensation:
-lungs decrease RR
-kidneys conserve H+ & eliminate HCO3-

4. Lab results:
-pH > 7.45, PCO2 > 45 (compensation)

Normal ABG'S

a. pH: 7.35-7.45
b. PaCO2: 35-45
c. HCO3: 22-26
PaO2: 92-100%

Hypoxia s/s

mild:
-restlessness, tachycardia, dysrhythmias,
dyspnea
HTN
moderate:
-confusion
-lethargy

, -dysrhythmias

severe
-cyanosis
-coma
-resp/cardiac arrest

How do you reduce resp. complications after surgery?

-monitor vitals, esp pulse O2, capnography, resp assessment
-position patient in lateral "recovery" position to keep airway open/reduce aspiration risk if vomiting
occurs

Meds prescribed to patient after MI to prevent clot

-nitrates
-angiotensin-converting enzyme (ACE) inhibitors,
-beta blockers,
-calcium channel blockers

Why do you assess apical/radial pulses?

-to evaluate their heart health
-if radial pulse < apical pulse, this signals pulse deficit.
patient has atrial fib, decreased left ventricular output, or congestive heart failure

What do you tell a patient who has a pacemaker inserted newly?

-follow up with provider to check function
-report signs of infection @ incision site
-keep incision dry for 4 days after insertion
-avoid lifting arm on that side until approved
-don't go in MRI
-don't drive/have sex until cleared
-tell security it will set off metal detector
-always carry ICD identification card

Common blood tests to determine depth of tissue injury in MI

-creatine-kinase (CK)
--CK-MB band is specific to heart muscle cells & helps quantify myocardial damage.
--CK-MM (muscle)
--Ck-BB (brain)

and troponin.

How do we determine the location of the cardiac muscle injury?

-10-lead EKG

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