Fluid and Electrolytes
Gerontologic Considerations for fluid and electrolyte balance
Structural changes in the kidney decrease ability to conserve water
Hormonal changes include a decrease in Renin and Aldosterone and an increase in ADH and ANP
Loss of subQ tissue leads to increase moisture loss
This member of the surgical team remains in sterile gown and gloves and monitors sterile procedure throughout the surgery
What is the scrub nurse
How will the nurse monitor a Jackson-Pratt (JP) drain?
The nurse will check the drain at least every 4 hours and empty the drain when it is one-half to two-thirds full, checking for output and drainage type (COCA).
A 22 year old patient has presented to her primary care provider for her scheduled pap smear. Abnormal results of this diagnostic test may imply this infection
What is human papillomavirus (HPV)
Where will the nurse draw blood from a well newborn for its routine screening?
The sides of the heel
What is included in a newborn screening? When should it be done?
What does a child with a harsh, barky cough suggest?
Croup
Hypovolemia vs Hypervolemia
Hypovolemia: ECF Volume Deficit; abnormal loss of body fluids, inadequate fluid intake, or plasma to interstitial fluid shift.
Hypervolemia: ECF Fluid Volume Excess; Excess intake of fluids, abnormal retention of fluids, or interstitial to plasma fluid shift.
What would be S/SX of each?
This is a sterile technique for donning surgical gloves without assistance, primarily used when not wearing a gown or for re-gloving.
What is Open Gloving
It involves touching only the inside of the cuff with bare hands and keeping the outside sterile.
What is penrose drains use gravity to drain fluid from the area around the wound.
Major risk factors for contracting an STI include
Alcohol or drug use, multiple sexual partners, youth and young adults (15-24), already having an STI
How will a nurse elicit the Babinski reflex in a full-term newborn?
The nurse will stroke the outer sole of the foot from the heel to the little toe.
A normal response will be where the big toe bends up and the other toes fan out.
Bullying should be closely monitored for in a child who has
Precocious Puberty
Nursing Management of Hyponatremia
Fluid Restriction
Loop Diuretics
Seizure management
Administration of small amounts IV hypertonic saline (3% NaCl)
Increased oral intake of sodium
Drugs that block vasopressin (look them up!)
The nurse may serve as a witness to the client's signature on this after the physician has explained the procedure, risks, benefits, & complications, before sedation is given and before surgery is performed.
What is an informed consent
What is a requirement a patient must meet before using an abdominal binder?
The patient must have adequate ventilatory capacity
Methods of contraception that also provide protection from STIs:
Barrier methods. This includes condoms (male and female) and dental dams
The nurse is assessing a newborn 3 minutes after birth. When counting the heart rate the nurse remembers the range of heart rate for a healthy alert neonate is this
What is 120 to 160 beats per minute
A child who has undergone radiation should be monitored for:
Burns and skin irritation
Physical Exams for Hypocalcemia include:
Trousseau's Sign (tapping on the facial nerve to trigger twitching)
Chvosteck's sign (inflating a blood pressure cuff to induce a hand spasm)
In this process, the patient's identification, surgical site marking, signed consent and procedure to be done are all verified
What is a time out for safety
The correct procedure for the wet-to dry dressing method
Place moist gauze into the wound and remove it when it is dry
A client is diagnosed as being in the primary stage of syphilis. The expected finding would include this:
Genital chancres
What are the other stages? How is syphilis treated?
A neonate's 1 minute assessment includes the following: HR= 125, RR= 44, Active movement with a good cry, and pink body with blue tinged hands and feet. The neonate's APGAR score calculates to this number
What is APGAR of 9
A child with Wilm's tumor should avoid which sport?
Football
IV Fluid types and what they do:
Hypotonic - more water than electrolytes; water moves from ECF to ICF by osmosis; usually a maintenance fluid (0.45% NaCl)
Isotonic - water and electrolytes are equal; water doesn't move, it only expands the ECF; ideal for replacing ECF volume deficit (0.9% NaCl, LR, D5W is technically isotonic but acts as a hypotonic when the dextrose is metabolized)
Hypertonic - more electrolytes than water; water moves from ICF to ECF (reducing swelling); used to treat severe hyponatremia and cerebral edema; requires monitoring of BP, lung sounds, and Na levels (3% NaCl)
A patient in surgery is noted to have symptoms of malignant hyperthermia: Muscle rigidity, a fast heart rate, and an elevated temperature from baseline.
The circulating nurse knows following interventions will occur:
What is administer IV dantrolene and cold IV saline
The vacuum of a hemovac is re-established after emptying by this method
What is compressing the drum and then capping the drainage port.
A nurse is teaching a health class to a group of clients likely to be at highest risk for gonorrhea. What statement would indicate a need for further teaching?
"I can have sex again after I start my antibiotics"
"I don't want to tell anyone because I'm embarrassed."
"My girlfriend should be fine because she has an IUD."
There are two methods to check for hip dislocation in an infant. Name them.
What is the Barlow maneuver and the Ortolani maneuver. The Barlow maneuver includes grasping the neonate's thighs and adducting them with gentle downward pressure. The Ortolani maneuver includes putting downward pressure on the hip and then inwardly rotating the neonate's thighs inwardly.
Which vitamin will help increase absorption of Iron?
Vitamin C