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CNSC exam with correct answers
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CNSC exam with correct answers
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CNSC exam with correct answersNGT |size |- |ANSWERS✔✔ |8 |- |16 |french
36 |inches
Nasoenteric |tube |size |- |ANSWERS✔✔ |8 |- |12 |french
Duodenal: |43 |inches
Jejunal: |60 |inches
Gastrostomy |tube |size |- |ANSWERS✔✔ |12 |- |28 |french
G-J |tube |size |- |ANSWERS✔✔ |6 |- |12 |french
Most |common |complication |s/p |enterostomy |tube |placement |- |ANSWERS✔✔ |peristomal |
infection
Buried |bumper |syndrome |- |ANSWERS✔✔ |results |from |growth |of |gastric |mucosa |over |the |
internal |bumper
risk |factors: |excessive |tension |between |internal/external |bumpers, |poor |wound |healing, |
significant |weight |gain
Decreasing |risk |of |aspiration |PNA |- |ANSWERS✔✔ |recent |data |suggests |jejunal |feeding |may |
be |associated |with |decreased |risk |of |asp |PNA
Diarrhea |- |ANSWERS✔✔ |>500mL |stool/24hr |(weigh |stool |= |1gm/1mL) |or |>3 |stools |for |at |
least |2 |consecutive |days
,Drug-induced |diarrhea |- |ANSWERS✔✔ |magnesium, |sorbital, |PPI, |prokinetics, |ABX
Hang |time |for |reconstituted |formula |- |ANSWERS✔✔ |4hr
Hang |time |for |prepared |formulas |- |ANSWERS✔✔ |depends |on |manufacturer; |generally |4-
12hr
Dehydration |- |ANSWERS✔✔ |dry |mouth, |dry |tongue, |thirst, |light-headedness, |HA, |fatigue, |
loss |of |appetite, |flushed |skin |, |dark |urine, |orthostatic |hypotension, |elevated |HR, |poor |skin |
turgor, |sunken |eyes, |muscle |cramps, |delirium, |elevated |BUN |(BUN:Cr |ratio |>20:1)(note: |
protein |intake, |renal |function, |muscle |mass |can |affect |this |ratio), |elevated |plasma |osmolality
Normal |urine |output |- |ANSWERS✔✔ |Minimum |output |~700mL/d
Typical |range |0.5 |- |2 |mL/kg/hr
Hepatic |steatosis |- |ANSWERS✔✔ |Hepatic |steatosis |generally |occurs |in |adults |and |presents |
with |mild |elevations |in |aminotransferases, |serum |alkaline |phosphatase, |and |bilirubin |
concentrations. |This |particular |type |of |hepatobiliary |disorder |is |most |often |a |complication |of |
overfeeding.
Cholestasis |- |ANSWERS✔✔ |Cholestasis, |occurring |primarily |in |children, |is |characterized |by |
impaired |biliary |secretion. |Elevated |conjugated |bilirubin |levels |are |the |most |common |
laboratory |manifestation |in |this |population. |
Elevations |of |alkaline |phosphatase, |gamma |glutamyltransferase |and |conjugated |(direct) |
bilirubin |most |likely |represent |cholestasis |or |biliary |obstruction. |Elevated |serum |conjugated |
bilirubin, |typically |defined |as |>2 |mg/dL, |is |considered |a |prime |indicator |of |cholestasis
Gallbladder |sludge |- |ANSWERS✔✔ |Gallbladder |sludging |or |stones |is |thought |to |result |from |
the |lack |of |enteral |stimulation |in |the |GI |tract |and |occurs |with |long-term |PN |use.
,Preferred |site |of |CVC |placement |in |adults |- |ANSWERS✔✔ |subclavian
Mural |thrombus |- |ANSWERS✔✔ |develops |when |fibrin |builds |up |inside |the |vein |which |may |
cause |the |vascular |access |device |to |adhere |to |the |vessel |wall
Fibrin |sheath |- |ANSWERS✔✔ |The |aggregation |of |fibrin |resulting |from |the |presence |of |a |
venous |access |device |in |the |vein |often |develops |as |a |fibrin |layer |(fibrin |sheath) |that |forms |
around |the |outside |of |the |catheter
Fibrin |tail |- |ANSWERS✔✔ |In |some |cases, |the |fibrin |sheath |can |grow |over |the |tip |of |the |
catheter, |or |may |accumulate |exclusively |at |the |distal |tip |of |the |catheter |creating |a |"fibrin |
tail."Cannot |aspirate
Intraluminal |thrombus |- |ANSWERS✔✔ |An |intraluminal |thrombus |occurs |as |fibrin |or |blood |
products |build |up |inside |the |catheter |lumen, |creating |a |partial |or |total |occlusion. |Cannot |
infuse |or |aspirate
Effective |solvent |for |dissolving |calcium |phosphate |- |ANSWERS✔✔ |The |use |of |0.1N |
hydrochloric |acid |has |been |reported |effective |in |clearing |catheters |with |crystalline |occlusions
|because |its |acidic |pH |is |favorable |for |calcium |and |phosphate |solubility. |Clinicians |should |be |
aware, |however, |that |direct |infusion |of |hydrochloric |acid |into |the |venous |system |can |be |
associated |with |fever, |phlebitis, |and |sepsis.
Effective |solvent |for |dissolving |lipid |residue |- |ANSWERS✔✔ |70 |percent |ethanol |is |the |most |
effective |solvent |to |dissolve |lipid |residue
Decreasing |the |risk |of |metabolic |bone |disease |- |ANSWERS✔✔ |The |most |important |
contributor |to |metabolic |bone |disease |is |a |negative |calcium |balance. |Hypocalcemia |occurs |as |
a |result |of |decreased |calcium |intake |and/or |increased |calcium |urinary |excretion. |Factors |that |
cause |hypercalciuria |include: |excessive |calcium |and |inadequate |phosphorus |
supplementation, |excessive |protein |in |PN |solutions, |cyclic |PN |infusions, |and |chronic |
metabolic |acidosis.
, Causes |of |metabolic |alkalosis |with |PN |- |ANSWERS✔✔ |An |elevated |serum |bicarbonate |level |
is |one |of |the |markers |of |metabolic |alkalosis. |Metabolic |alkalosis |may |be |caused |by |nasogastric
|suctioning, |volume |depletion |and |diuretic |use. |In |a |PN |patient, |excess |use |of |acetate, |which |is
|metabolized |to |bicarbonate, |may |precipitate |a |metabolic |alkalosis.
Causes |of |metabolic |acidosis |with |PN |- |ANSWERS✔✔ |Excess |chloride, |diarrhea |and |acute |
renal |failure |(ARF) |are |common |causes |of |metabolic |acidosis.
Normal |pH |- |ANSWERS✔✔ |7.35 |- |7.45`
Normal |PaCO2 |- |ANSWERS✔✔ |35 |- |45mmHg
Normal |serum |bicarbonate |- |ANSWERS✔✔ |23 |- |30mEq/L
Goshung |PICC |- |ANSWERS✔✔ |A |Groshong |PICC |has |a |pressure |sensitive |three-way |valve |at
|the |IV |tip |of |the |catheter |that |prevents |reflux |of |blood |into |the |catheter |which |should |
decrease |the |risk |of |occlusion. |Since |blood |cannot |reflux |into |the |catheter, |the |Groshong |
catheter |need |only |be |flushed |with |saline. |Flushing |with |heparin |is |not |necessary |to |maintain
|patency. |Although |additional |features |of |Groshong |catheters |include |soft |medical |grade |
tubing, |presence |of |antimicrobial |cuff |and |large |lumen |size, |none |of |these |contribute |to |a |
decreased |incidence |of |catheter |occlusion. |Groshong |catheters |are |not |coated |with |heparin.
Treatment |for |CVAD |occlusion |- |ANSWERS✔✔ |Alteplase |is |the |only |FDA-approved |
thrombolytic |agent |for |CVAD |occlusions.
Management |of |catheter |exit |site |infection |- |ANSWERS✔✔ |Management |of |catheter |exit |site |
infection |includes |culture |of |any |drainage |from |the |catheter |exit |site |in |addition |to |blood |
cultures.Topical |antimicrobial |agent |can |be |used |if |there |is |no |purulence |from |the |catheter |
exit |site |and |no |clinical |signs |of |sepsis. |Systemic |antimicrobial |treatment |is |used |in |the |
presence |of |purulent |drainage |from |the |catheter |exit |site |or |if |topical |treatment |is |
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