Dialysis/Kidney Probs
A nurse is assessing the AV fistula of a client who is receiving hemodialysis. Which of the following findings indicates that the fistula is functioning properly?
A. absence of bruit over the site
B. presence of a palpable thrill over the site
C. cool skin temp at the site
D. redness and ecchymosis at the site
B. a presence of a palpable thrill and an auditory bruit indicates proper functioning. Also, an absence of warmth, bruising, bleeding, and drainage are also good indicators.
What is the correct positioning for a patient undergoing a thoracentesis?
A. Sitting upright leaning forward over a table
B. Side-lying affected side down
C. Prone
D. High Fowlers with knees to chest
A. Sitting upright leaning forward over a table
This helps the fluid drain easier, while leaning forward separates the ribs for easier insertion of the needle
A young women with type 1 DM is brought to the ED with N/V, excessive thirst, deep, rapid respirations, and fatigue. What other assessment finding would the nurse expect?
A. Hypoglycemia
B. Ketones present in urine
C. pH 7.45
D. BUN and Creatinine low
B. the presence of ketones is expected in DKA
Which of the following is true about implanted cardiac defibrillators? Select all that apply.
a. ICD deliver a shock when it assesses lethal dysrhythmias
b. The patient will have upper extremity ROM limitations for 2 weeks after implantation.
c. The patient will no longer be able to travel by air
d. The ICD paces the heart to ensure a rate of 60 bpm
a. ICD deliver a shock when it assesses lethal dysrhythmias
b. The patient will have upper extremity ROM limitations for 2 weeks after implantation.
What is the nurse's priority intervention for this client during the resuscitation of phase of injury?
a. Pain management
b. Maintain the airway
c. Nutritional Support
d. Physical Therapy
b. Maintain the airway
The nurse is providing education to about preventing CKD to a group of clients. Which of the following should the nurse include in the teaching? Select all that apply.
A. Limit NSAIDS
B. Daily weights
C. Control hypertension and blood glucose levels
D. Eat foods high in potassium and sodium
A, B, C are correct
Food high in potassium and sodium can make potential kidney problems worse.
A client has the following ABG results: pH 7.31; CO2 50; HCO3 25. Which of the following interpretations are correct?
A. Metabolic acidosis, uncompensated
B. Respiratory acidosis, uncompensated
C. Respiratory alkalosis, partially compensated
D. Metabolic alkalosis, fully compensated
B. Respiratory acidosis, uncompensated
A nurse is caring for a pt with in DKA who has an order for IV Regular insulin. What lab should the nurse monitor closely?
A. sodium
B. calcium
c. magnesium
d. potassium
D. Potassium
Because insulin will be given as part of the treatment, potassium must be monitored because insulin moves potassium into the cells and the pt will be at risk for hypokalemia
Which of the following is a symptom of hypovolemic shock?
a. flushed skin
b. polyuria
c. hypertension
d. tachycardia
d. tachycardia
A patient with inflammatory bowel disease should avoid _____ in their diet and seek emergency care for indications of __________ .
caffeine, alcohol, and lactulose.
bowel obstruction or perforation
A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis?
A. distended abdomen
B. fever and nausea
C. bradycardia
D. hyperactive bowel sounds
B. fever indicates infection
The abdomen could be rigid and board-like with peritonitis. Tachycardia would be expected with infection. Bowels would be hypoactive.
The nurse is providing care to a pt who has recently diagnosed with ARDS. Vitals are: BP 80/40; O2 75%; 26 RR; HR 120 bpm. What order from the provider would the nurse expect to see?
A. 0.9% NS bolus
B. Obtain ABG
C. Place a foley
D. Mechanical ventilation
D. Mechanical ventilation
Which of the following are treatments for DKA? Select all that apply.
A. Glucocorticosteriods
B. Metformin
C. Regular insulin
D. Normal Saline
E. Potassium replacement
C, D, E, are correct
Which of the following is a side effect of Nitroglycerin?
a. Bradycardia
b. Headache
c. Hypertension
d. Decreased respirations
b. Headache
Due to vasodilation. Tachycardia and Hypotension are also side effects.
Which stage of pressure injuries is characterized by partial thickness skin loss involving the dermis?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
b. Stage 2 involves partial thickness loss involving the dermis.
A nurse is teaching a client about self-administered peritoneal dialysis. Which of the following statements is correct?
A. You may warm the fluid but do not microwave the dialysate fluid prior to administration.
B. You don't have to worry about infection as long as you use sterile technique
C. The outflow fluid is going to be foul smelling and dark
D. You will put in more fluid than you will get out
A. You may warm the fluid but do not microwave the dialysate fluid prior to administration.
A 19 year old pt presents with persistent vomiting and electrolyte imbalances. What is the imbalance base of these ABG results?
pH: 7.5
PaCO2 36
PO2 92
HCO3 29
Metabolic Alkalosis
metabolic alkalosis presents with pH > 7.45 and HCO3 > 26. Vomiting can lead to this condition.
A nurse is caring for a patient in DKA. Which of the following physical assessment findings would the nurse expect?
A. RR of 10 breaths/min
B. Fruity breath
C. Decreased urine output
D. Hypotension
B is correct
RR would be elevated. Urine output would be increased. Hypotension could be present but not a primary symptom.
What is a complication of CABG characterized by hypotension, JVD, muffled heart sounds, and a narrowed pulse pressure?
Cardiac Tamponade- a build-up of blood/fluid in the pericardial sac which puts pressure on the heart and prevents it from pumping effectively.
Mannitol is a drug that is given to treat ______ edema.
Cerebral
Which of the following labs will be elevated in clients with CKD? Select all that apply
A. Creatinine
B. BUN
C. Potassium
D. Calcium
E. pH level
A, B, C are correct.
Usually clients with CKD have low pH levels (acidosis) and hypocalcemia
A nurse is drawing an ABG sample from the radial artery. What is the priority assessment before obtaining the ABG?
A. Blood pressure
B. Pulse ox
C. Apical pulse for one minute
D. Allen's test
D. Allen's test
This ensures good collateral circulation of the ulnar artery prior to puncturing the radial artery
The nurse is caring for a pt in DKA on an insulin gtt. The blood glucose level is now 200. What fluid choice should the nurse expect to give?
D5W
To prevent hypoglycemia, the nurse would hang fluids with Dextrose.
What are the H's and T's?
Possible causes of lethal arrythmias.
H- hypoxia, hypovolemia, hypothermia, hydrongen ions9 (acidosis), Hypo/hyperkalemia
T- Tablets, Tamponade, Tension pneumothorax, Thrombosis
What do we teach that FAST stands for when educating about how to spot a stroke?
Face drooping
Arm weakness
Speech difficulty
Time to call 911