Fluids
When substances move from high to low concentration until concentration on both sides of the membrane is equal this is called what?
What is diffusion or passive transport?
A patient who is taking diuretics has been experiencing vomiting and diarrhea and also reports heart palpitations. What electrolyte imbalance should the nurse be concerned with?
What is hypokalemia? (Low potassium)
A patient exhibiting slow and shallow respirations for a long period of time may exhibit which acid-base balance?
What is respiratory acidosis?
When issuing a Muslim patient their tray, the nurse knows he/she must send the tray back when the tray contains what?
What is Pork?
Prior to administering a tube feeding, the nurse must do what?
What is the nurse must check and verify the patient is receiving food that matches the physician’s order?
When the concentration of intracellular fluid and extracellular fluid is equal, this is called what kind of solution?
What is an isotonic solution?
A patient with pancreatic cancer with metastasis and bone resorption may exhibit which electrolyte imbalance?
What is hypercalcemia?
A patient who has kidney disease may have which electrolyte imbalance? What is the mechanism of action that causes this imbalance?
What is Metabolic Acidosis and what is there is decreased excretion of acids and decreased production of bicarbonate?
Where does carbohydrate digestion begin?
What is in the mouth where salivary glands excrete saliva?
There are a wide variety of patients who need feeding assistance. Give two examples of patient populations that may need assistance and what nursing interventions can be completed to aid the patient.
What is
Patients with paralysis of the arms- Promote independence but assist with feedings as appropriate
Patients with visual impairment - Position the foods in a clock face manner to explain what items are where
Patients with intravenous lines in their hands - Help move the IV pole closer, time medications as able so patient is not connected to an IV during meals
Severely impaired or weak patients - May need to use alternate utensils or be fed
Confused patients - Feeding may be delegated to a nursing assistant or family member
What requires cellular energy and can move molecules into cells regardless of their electrical charge?
What is active transport?
A 27 year old female arrives to the ER very confused, lethargic, and begins having a seizure in triage. The nurse is concerned that the patient may have which electrolyte imbalance?
What is hyponatremia?
A patient is hyperventilating upon the nurses' entry to the room. The nurse recognizes which acid-base imbalance can occur if hyperventilation continues? And what is a priority intervention for a hyperventilating patient?
What is Respiratory Alkalosis and what is determine the underlying cause for hyperventilation?
The nurse explains to a patient that since they follow a vegan diet, they are at risk of having a deficient diet. When the patient asks about which kind of deficiencies they may have, the nurse states: (give at least two)
What is Vitamin B6, vitamin B12, iron, zinc, riboflavin, and vitamin D?
A nurse is working in outpatient surgery and is making preoperative phone calls. Preoperative patients must be NPO or nothing by mouth for how much before their procedure?
What is preoperative patients are usually NPO 6 to 8 hours before the procedure ?
What is the term for "over-hydration" and what signs and symptoms may you see a patient exhibit? (minimum 3 symptoms)
What is FVO - Signs and Symptoms: Signs of over-hydration are weight gain, crackles in the lungs, slow bounding pulse, elevated blood pressure, and possibly edema. When fluid volume overload occurs, hypervolemia (excessive blood volume) may also occur. Hypervolemia causes an elevation of blood pressure?
A patient exhibits a positive Chvostek sign and Trousseau sign. The nurse knows that an imbalance in which TWO electrolytes can result in these two positive signs? Explain how to test for these two signs as well.
What is Magnesium and Calcium?
What is Chvostek sign is assessed by tapping the facial nerve about an inch in front of the earlobe. A unilateral twitching of the face is a positive response. To test for Trousseau sign, place a blood pressure cuff on the arm and inflate it above the patient’s systolic pressure for 3 minutes. A spasm of the hand indicates a positive Trousseau sign.
A patient who recently was diagnosed with metabolic alkalosis due to prolonged NG tube suctioning asks the nurse what else can cause Metabolic Alkalosis? The nurse provides at least two examples to the patient which are ______?
What is Vomiting; hypokalemia; medications: diuretics, antacids or bicarbonate, mineralocorticoids?
Cultural considerations are important to consider in the nurses daily practice. Provide examples of three cultural considerations the nurse can incorporate?
What is Asian American - high sodium and high fat content, Jewish - No meat and milk on the same plate, What is high sugar/salt content for African American patients, What is Mexican American high in fat/lard in preparation of fried foods?
Following a procedure and the return of _______, the patient can begin a clear liquid, and then a full liquid diet. What must return before a diet can begin and how does the nurse verify it? Give an example of a clear liquid and full liquid food.
What is bowel sounds, auscultation,
Full liquids
Milk and milk beverages
Yogurt, eggnog, pudding
Custard, ice cream, sherbet, popsicles
Puréed meats and vegetables in cream soups
Strained fruit and vegetable juices
Sweetened plain gelatin
Cooked refined cereals
Strained or blended gruel
All other beverages
Cream, margarine, butter
Clear liquids
Grape, apple, cranberry juices
Strained fruit juices
Vegetable broth
Carbonated water
Clear fruit-flavored drinks
Gelatin and ices
Clear candies
Popsicles
Tea, coffee
Clear broth
What is the term for "dehydration" or too little fluid intake and what signs and symptoms may you see a patient exhibit? (minimum 3 symptoms)
What is FVD? -
Thirst
Weakness
Dizziness
Postural hypotension
Decreased urine production
Concentrated urine
Dry, cracked lips
Dry, scaly skin
Dry mucous membranes
Thick saliva
Poor tissue turgor
Flat neck veins
Increased pulse rate
Weak, thready pulse
Elevated temperature
List all 5 of the electrolytes and explain two of their functions and how you could recognize a potential imbalance within your clinical practice.
What is Calcium, Phosphate, Sodium, Potassium, Magnesium?
See table 26.4 for part 2 answers
List the four acid-base imbalances and at least one associated fact with each of them.
What is Acid–Base Imbalances
Imbalance Causes Signs and Symptoms Arterial Blood Gas Valuesa
Respiratory acidosis Slow, shallow respirations/hypoventilation; respiratory congestion or obstruction; can be due to COPD, severe pneumonia, or excessive sedation; respiratory muscle weakness Hypoventilation, dyspnea, anxiety, confusion pH less than 7.35
PaCO2 greater than 45mm Hg
Metabolic acidosis Shock, diabetic ketoacidosis, lactic acidosis, kidney failure, diarrhea, starvation Kussmaul respirations, headache, confusion, malaise pH less than 7.35; HCO3− less than 23 mEq/L
Respiratory alkalosis Hyperventilation caused by anxiety or pain; mechanical ventilation Hyperventilation, confusion, light-headedness pH greater than 7.45; PaCO2 less than 35mm Hg
Metabolic alkalosis Vomiting; prolonged gastric suction; hypokalemia; medications: diuretics, antacids or bicarbonate, mineralocorticoids Hypoventilation, confusion, numbness/tingling, decreased LOC pH greater than 7.45; HCO3− greater than 30 mEq/L
Nutritional needs vary greatly across the lifespan. When providing a class for toddlers and preschool children, the nurse explains that there are a variety of tools/recommendations for this age group. List 5 of them.
What is
Try colorful foods (e.g., peas, carrots)
Provide a pleasant environment at mealtimes
Provide plates and utensils in a size that can be easily handled by a small child
Use dishes that are colorful and/or contain pictures of favorite characters
Avoid forcing a child to eat
Provide small servings
Offer foods that are easy to chew
Avoid combination foods
Toddlers prefer single-item foods that do not touch each other on the plate
A patient who is bulimic is receiving tube feedings via NG. This patient must be monitored for which kind of behavior? The patient also asks why they must have feedings via NG instead of in a central line. The nurse explains that TPN is used for which kinds of patients?
What is inducing self to vomit and
Used for patients on long-term therapy for:
Burns, intestinal obstruction, inflammatory bowel disease, AIDS, cancer (chemotherapy)