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Hurst Review NCLEX Exam
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Hurst Review NCLEX Exam Hurst Review NCLEX Exam Hurst Review NCLEX Exam
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Hurst Review NCLEX ExamFluid Volume Excess (hypervolemia) - CORRECT ANS Too much fluid in the vascular space caused by:
HF, RF, and High Na intake (meds, food, IVF with Na) and Hormones (aldosterone and ADH)
How does HF cause FVE (Fluid Volume Excess)? - CORRECT ANS bc the weak heart cant perfuse the
the kids therefore decreased Urine out put.
How does RF cause FVE? - CORRECT ANS the kidneys are not functioning therefore no urine out put
and fluid remains in vasc space
Aldosterone - CORRECT ANS created in adrenal glands on Kidneys, it is a steroid and
mineralocosteroid; retains water and sodium. therefore increases BP
AHD - CORRECT ANS anti diuretic therefore RETAINS water only. found in pituitary therefore any head
trauma, surgery, or increased ICP can lead to ADH issues.
Dx name for it is Vasopressin or "Pressins"
Too much ADH - CORRECT ANS SIADH, therefore reatains water in vasc space. Urine is concentrated
(increased serum spef) and blood is diluted (decreased Blood HCT).
Too little ADH - CORRECT ANS Diabetes insipidus; diuresis fluid leads to FVD (shock), Urine will be
dilute (urine spef will decrease) and blood will be conc. (HCT will be increased).
the three labs that concentration (increases) and dilution (decreases) - CORRECT ANS Na, Hct, Urine
spef
FVE SS - CORRECT ANS incresaed: BP, P, RR, CVP (2-6), DW, JVP
wet lungs, polyuria,
P is bounding and full
3rd spacing
FVE trx - CORRECT ANS low Na, fluid restriction
,I&O and DW
Diuretics
bed rest
FVD (hypovolemia) - CORRECT ANS not enough fluid in vasc space which can lead to shock and is
casued by fluid loss, 3rd space, Disease with polyuria.
FVD ss - CORRECT ANS wt decreases,
poor skin turg,
dry mm
decreased Urine
decrease BP & CVP,
Tachy and weak/thready,
cool clammy r/t vasocons
increase urine spef.
FVD trx - CORRECT ANS prevent loss,
replace fluid
safety precs (falls r/t loc),
Hypermagnesemis - CORRECT ANS acts like a sedative and think of muscles;
excreted by kidneys therefore:
RF and antacids can be the problem.
Hypermagnesemia ss - CORRECT ANS vasodil--> warm/flushing;
decreased DTRS, flaccid tone, decreased LOC/P/RR, and arrythmias (same as....hypo....)
Hypermagnesemia trx - CORRECT ANS ventilator, dialysis, Ca Gluc (antidote), safety precs (sedation)
Hypercalcemia - CORRECT ANS Sedative, think of the muscles;
,caused by hyperparatyroidism too much PTH therefore pulls from bones into blood; Thiazides
retains Ca, and immobility
Hypercalcemia SS - CORRECT ANS bones and stones
Decreased DTRs, flaccid,
decrease: P, RR< LOC
arrythmias
Hypercalcemis Trx - CORRECT ANS Mobility, increase fluids, inverse r/s with phos so admin
phosphates and calcitonin, steroids, safety precs,
Hypomagnesemia - CORRECT ANS Not enough sedative; caused by diarrhea and alcoholism bc it
suprresses ADH and it is a hypertonic solution and they dont eat.
Hypomagnesemia & Hypocalcemia ss - CORRECT ANS Convulsions. confusion (loc change)
Arrythmias
Tetany, DTRS increase,
Sstridor, swallow prob
(positive Stridor and chevotske)
Hypomagnesemia Trx - CORRECT ANS give Mg (IV, PO, Foods) , monitor Kidney fxn, seizure precs, stop
infusion with flushing/sweating
Hypocalcemia caused by: - CORRECT ANS caused by hypoparathyroidism, radiac neck, thyroidectomy
therefore decreased PTH=decreased Ca serum
Hypocalcemia trx - CORRECT ANS PO, IV Ca therefore give slow and on cardiac monitor, give Vit D,
phophate binders: ca acetate, sevelamer hydrochloride
HyperNa - CORRECT ANS think neuro changes, dehydration too much Na not enough water, r/t
hyperventialation, heat stroke and DI
, HypoNa - CORRECT ANS think neuro changes, too much water and not enough Na r/t excessive water
replacemoent for sweating, psychogenic polydipsia, D5W and SIADH
Hyper Na SS - CORRECT ANS dry mouth, thristy, swollen tongue, neuro changes
HypoNA ss - CORRECT ANS HA, seizure, coma
HyperNa trx - CORRECT ANS Na restriction, diulre fluids, DW, I&O, labs
hypoNa TRX - CORRECT ANS give NA, no water, hypertonic saline, give hypertonic saline if neuro
problems occure
HyperKa - CORRECT ANS it is excreted by kidney so it increases think kidney problems or medications
like spironalactone
HypoKa - CORRECT ANS excreted by kid therefore you can think of diuretics of problem or not
gettingenough in diet or NG suction of vomitting
SS HyperK - CORRECT ANS muscle twitch leads to weak to paraplysis; brady Tall T prolonged/wide
QRS, vfib
SS hypoK - CORRECT ANS cramps to weak to arrythmias ECG: u waves, PVCs, and Vtach
HyperKa trx - CORRECT ANS dialysis, ca gluc (arrythmia), gluc and insulin; sodium polystyrene
sulfaonate
sodium pollystyrene sulfonate - CORRECT ANS Kayexalate
HypoKa trx - CORRECT ANS give K IV (never push and only on a monitor with a pump and will burn) ,
PO (med may cause GI upset), or spironolactone
Respiratory Acidosis - CORRECT ANS gas exchange issue (obstructive), too much CO2 r/t
Hypoventilation. Think Lethargy.
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