NUR 1648 NURSING 3 EXAM 3 STUDY GUIDE
(ACS, Stroke, Renal, Endocrine, Liver, Pancreas)-emphasis on first 3 listed!
ABCs
Priority of Care
Treat underlying cause!!
The older adult
CAD: Age is #1 risk factor for women.
Diabetes Insipidus: Decreased sense of thirst in elderly
Stroke: falls #1 cause, poorly tolerated stress, more susceptible to infection,
medical complications like HTN, cardiac problems.
Fluid and electrolyte balances (hyper/hypovolemia)
Hypervolemia:
o Increased, bounding pulses
o HTN
o Distended neck/hand veins
o Weight gain
o Increased, shallow respirations
o SOB
o Crackles
o Pitting edema
o Cool pale skin
o HA, weakness
Hypovolemia:
o Weak, thready pulses
o Hypotension (ESP. Orthostatic)
o Dizziness/Lightheadedness
o Flat neck/hand veins
o Increased RR
o Poor skin turgor (tenting)
o Dry, scaly skin
o Decreased Urine output
o Changes in LOC
, NUR 1648 NURSING 3 EXAM 3 STUDY GUIDE
Labs (know normal values and what they represent)
BUN: 7-25 RENAL
Creatine: 0.5-1.2 RENAL
NA+: 135-145
K+: 3.5-5
Calcium: 9-10.5
GFR: 90+ RENAL
ICP: 10-15
Albumin: 3.5-5.5 Fluid balance, indication of nutrition
What is the role of aspirin in MI and Stroke?
Antiplatelet to prevent clots NOT USED FOR PAIN
o Inhibits plate aggregation and vasoconstriction, decreasing chance of
thrombosis.
o Take 325mg of baby aspirin (81 mg each) and call 911!
MI-STEMI vs. NONSTEMI (s/s, tx, ECG changes)
STEMI: ST elevation is 2 adjacent leads
o Indicates MI / necrosis
Usually caused by rupture of atherosclerotic plaque leading to
aggregation and thrombus formation @ rupture site
Abrupt 100% occlusion to coronary artery
o Treatment: immediate revascularization of blocked artery, MONAH
NSTEMI: ST and T-wave changes
o Indicates myocardial ischemia, cell death or necrosis
o Troponin normal initially, increases 3-12 hrs after
o Caused by vasospasm, spontaneous dissection, sluggish blood flow
o Treatment: MONAH
CAD/stroke-health promotion and maintenance
CAD:
o AED use
o Control modifiable risks (smoking, HTN, high fat diet)
o Health teaching plans
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