Exam (elaborations)
MEDICAL SURGICAL TESTBANK QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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Davis Advantage for Medical-Surgical Nursing: Maki
Institution
Davis Advantage For Medical-Surgical Nursing: Maki
MEDICAL SURGICAL TESTBANK QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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MEDICAL SURGICAL TESTBANK
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
ExamT1T-TANSWERTfluidTandTelectrolyres
acidTbase
thermoregulation
ChapterT17:TFluid,TElectrolyte,TandTAcid-BaseTImbalancesT-TANSWERT---
1.TTheTnurseTobtainsTallTofTtheTfollowingTassessmentTdataTaboutTaTpatientTwithTdeficientTfluidTvolumeTcaus
edTbyTaTmassiveTburnTinjury.TWhichTofTtheTfollowingTassessmentTdataTwillTbeTofTgreatestTconcern?
a.
TheTbloodTpressureTisT90/40TmmTHg.
b.
UrineToutputTisT30TmlToverTtheTlastThour.
c.
OralTfluidTintakeTisT100TmlTforTtheTlastT8Thours.
d.
ThereTisTprolongedTskinTtentingToverTtheTsternum.T-TANSWERTTheTbloodTpressureTisT90/40TmmTHg.
,Rationale:TTheTbloodTpressureTindicatesTthatTtheTpatientTmayTbeTdevelopingThypovolemicTshockTasTaTresul
tTofTfluidTloss.TThisTwillTrequireTimmediateTinterventionTtoTpreventTtheTcomplicationsTassociatedTwithTsyste
micThypoperfusion.TTheTpoorToralTintake,TdecreasedTurineToutput,TandTskinTtentingTallTindicateTtheTneedTf
orTincreasingTtheTpatientsTfluidTintakeTbutTnotTasTurgentlyTasTtheThypotension.
2.TATrecentlyTadmittedTpatientThasTaTsmallTcellTcarcinomaTofTtheTlung,TwhichTisTcausingTtheTsyndromeTofTin
appropriateTantidiureticThormoneT(SIADH).TTheTnurseTwillTmonitorTcarefullyTfor
a.
increasedTtotalTurinaryToutput.
b.
elevationTofTserumThematocrit.
c.
decreasedTserumTsodiumTlevel.
d.
rapidTandTunexpectedTweightTloss.T-TANSWERTdecreasedTserumTsodiumTlevel.
Rationale:TSIADHTcausesTwaterTretentionTandTaTdecreaseTinTserumTsodiumTlevel.TWeightTloss,TincreasedTur
ineToutput,TandTelevatedTserumThematocritTmayTbeTassociatedTwithTexcessiveTlossTofTwater,TbutTnotTwithT
SIADHTandTwaterTretention.
3.TWhenTtheTnurseTisTevaluatingTtheTfluidTbalanceTforTaTpatientTadmittedTforThypovolemiaTassociatedTwithT
multipleTdrainingTwounds,TtheTmostTaccurateTassessmentTtoTincludeTis
,a.
skinTturgor.
b.
dailyTweight.
c.
presenceTofTedema.
d.
hourlyTurineToutput.T-TANSWERTdailyTweight.
Rationale:TDailyTweightTisTtheTmostTeasilyTobtainedTandTaccurateTmeansTofTassessingTvolumeTstatus.TSkinTt
urgorTvariesTconsiderablyTwithTage.TConsiderableTexcessTfluidTvolumeTmayTbeTpresentTbeforeTfluidTmovesTi
ntoTtheTinterstitialTspaceTandTcausesTedema.THourlyTurineToutputsTdoTnotTtakeTaccountTofTfluidTintakeTorTo
fTfluidTlossTthroughTinsensibleTloss,Tsweating,TorTlossTfromTtheTgastrointestinalTtractTorTwounds.
4.TWhenTcaringTforTanTalertTandTorientedTelderlyTpatientTwithTaThistoryTofTdehydration,TtheThomeThealthTn
urseTwillTteachTtheTpatientTtoTincreaseTfluidTintake
a.
inTtheTlateTeveningThours.
b.
, ifTtheToralTmucosaTfeelsTdry.
c.
whenTtheTpatientTfeelsTthirsty.
d.
asTsoonTasTchangesTinTlevelTofTconsciousnessT(LOC)Toccur.T-TANSWERTifTtheToralTmucosaTfeelsTdry.
Rationale:TAnTalert,TelderlyTpatientTwillTbeTableTtoTself-
assessTforTsignsTofToralTdrynessTsuchTasTthickToralTsecretionsTorTdry-
appearingTmucosa.TTheTthirstTmechanismTdecreasesTwithTageTandTisTnotTanTaccurateTindicatorTofTvolumeT
depletion.TManyTolderTpatientsTpreferTtoTrestrictTfluidsTslightlyTinTtheTeveningTtoTimproveTsleepTquality.TTh
eTpatientTwillTnotTbeTlikelyTtoTnoticeTandTactTappropriatelyTwhenTchangesTinTLOCToccur.
5.TATpatientTisTtakingTaTpotassium-
wastingTdiureticTforTtreatmentTofThypertension.TTheTnurseTwillTteachTtheTpatientTtoTreportTsymptomsTofTa
dverseTeffectsTsuchTas
a.
personalityTchanges.
b.
frequentTlooseTstools.
c.
facialTmuscleTspasms.