Respiratory
Endocrine
Cardiac
Renal
Urine my heart
100
What is the Allen test and what is the purpose?
Which is better? A Positive or Negative Allen test?
The Allen test is a test used to check for patency of the ulnar artery blood flow prior to performing a arterial blood gas. The Ulnar artery supplies the radial artery.
Negative. Positive= poor ulnar circulation.
100
A client is newly diagnosed with Addison’s disease. The nurse understands that this condition includes a decrease of which of the following hormones? Select all that apply.
A. Testosterone
B. Glucocorticoids
C. Androgen
D. Insulin
E. Mineralcorticoids
Answer: B and E
100
What is the electrical pathways through the heart?
SA node- intranodal pathways- AV node- Bundle of HIS/AV bundle- right and left bundle branches- purkinji fibers.
100
Select below the CORRECT sequence in how the renin-angiotensin-aldosterone system works:
1. Angiotensin I -> Angiotensin II -> ACE -> Renin -> Angiotensinogen
2. Renin-> Angiotensinogen -> Angiotensin I -> ACE -> Angiotensin II
3. Renin -> Angiotensin I -> Angiotensinogen -> ACE -> Angiotensin II
4. Angiotensinogen -> Renin -> ACE -> Angiotensin I -> Angiotensin II
Answer: 2
100
The client with urolithiasis has a history of chronic urinary tract infections. The nurse concludes that this client most likely has which of the following types of urinary stones?
a. Calcium oxalate
b. Uric acid
c. Struvite
d. Cystine
Answer: C
Calcium oxalate stones are due to excessive calcium, Uric acid stones are due to high levels of uric acid and purine foods. Cystine stones are rare.
200
The nurse is caring for a client after a bronchoscopy and biopsy. Which finding, if noted in the client, should be reported immediately to the health care provider?
1. Dry cough
2. Hematuria
3. Bronchospasm
4. Blood-streaked sputum
3. Bronchospasm
Rationale:
if a biopsy was performed during a bronchoscopy, blood-streaked sputum is expected for several hours. Frank blood indicates hemorrhage. A dry cough may be expected.
-The client should be assessed for signs/symptoms of complications, which would include cyanosis, dyspnea, stridor, bronchospasm, hemoptysis, hypotension, tachycardia, and dysrhythmias.
-Hematuria is unrelated to this procedure.
200
The nurse is monitoring a client diagnosed with hyperpituitarism who was treated with transsphenoidal hypophyysectomy and is recovering in the ICU. Which findings should alert the nurse to the presence of a possible postoperative complication? SELECT ALL THAT APPLY!
1. Anxiety
2. Leukocytosis
3. Chvostek's sign
4. Urinary output of 800 mL/hour
5. Clear drainage on nasal dripper pad
Answer: 2,4 and 5
200
What are the electrolytes involved in the phases of the cardiac conduction system?
What is the absolute refractory period?
Answer: Na, K, Ca
Absolute refractory period= completely impossible for another action potential to be activated. Channels are closed (no depolarization/contraction until the refractory period is over.)
200
List/Name the functions of the Kidneys.
A WET BED
acid base balance
water balance
electrolyte balance
toxin removal
blood pressure control
erythropoietin
vitamin D metabolism
200
What is the calculation for minimal urine output for patient centered care?
0.5 ml/kg/hr.
Anything below is considered oliguria per Beth's lecture.
300
What nine items would you ask about during the respiratory history?
Don't worry if you don't get them all! It's to help you think:)
1. Cough - production of phlegm or sputum, color, quantity, quality (dry, hacking, loose congested)
2. Shortness of breath, wheezing
3. Chest pain with breathing
4. Changes in weight
5. Past history of respiratory infections - bronchitis, pneumonia, emphysema, asthma
6. Family history of allergies, asthma or TB
7. Smoking history
8. Environmental exposure
9. Self care behavior - last TB test, CXR, flue shot, pneumovax
300
The nurse is preforming an assessment on a client with pheochromocytoma. Which assessment finding would indicate a potential complication associated with this disorder?
A. A urinary output of 50mL/hour
B. A coagulation time of 5 min.
C. A heart rate that is 90 bpm and irregular
D. A BUN of 20 mg/dL
Answer: C. A heart rate that is 90 bpm and irregular; common complication is circulatory collapse.
B is incorrect because clotting is more common, not bleeding. A is still within normal urine output. D. Is within normal range..barley.
300
When blood supply in decreases in the coronary arteries, which layer of the heart has a subsequent decrease in blood flow?
Answer: Endocardium
Ratoinale: coronary arteries are superfical and blood flows from the outer layers to the inner layers.
300
Select all the patients below that are at risk for acute intra-renal injury?
A. A 45 year old male with a renal calculus.
B. A 65 year old male with benign prostatic hyperplasia.
C. A 25 year old female receiving chemotherapy.
D. A 36 year old female with renal artery stenosis.
E. A 6 year old male with acute glomerulonephritis.
F. An 87 year old male who is taking an aminoglycoside medication for an infection.
Answer: C, E and F
C, E, and F. These patients are at risk for an intra-renal injury, which is where there is damage to the nephrons of kidney. The patients in options A and B are at risk for POST-RENAL injury because there is an obstruction that can cause back flow of urine into the kidney, which can lead to decreased function of the kidney. The patient in option D is at risk for PRE-RENAL injury because there is an issue with perfusion to the kidney
300
List Nursing interventions for post urolithiasis and nephrolithiasis treatment.
- Administer pain medication as ordered-hydromorphone (Dilaudid) or morphine sulfate (morphine)
-Administer antiemetics as ordered
- Administer alpha blockers as ordered
- strain urine
- Increase fluids(UO of >2L/day is recommended)
400
The nurse is caring for a client who just returned from an open lung biopsy and has a prescription for morphine by client controlled analgesia (PCA). Which of these actions to detect early opioid induced respiratory depression does the nurse recommend?
A. Continuous pulse oximetry
B. Serial arterial blood gas measurements
C. Continuous capnography
D. Apnea monitoring
Answer: Continuous capnography
Rationale:Capnography continuously monitors the PaCO2 in the airway during inhalation and exhalation and provides a written tracing. Best for EARLY identification of respiratory depression.
400
Describe the treatment of Hypopituitarism VS Hyperpituitarism.
Hypopituitarism: hormone replacement(of necessary hormones lacked), increase intake of Vitamin D and calcium(osteoperosis), PT to maximize mobility, Vital signs(watch for hypotension and tachycardia), safety precautions, watch for signs and symptoms of infection, increased stress(may need to increase dose of ACTH), Take hormone replacements in the morning(mimics normal release)
Hyperpituitarism: Dopamine agonists(inhibit the release of anterior pituitary hormones), Medications to inhibit the release of growth hormone(most commonly affected hormone), medications to decrease size of tumor. Surgery:transsphenoidal hypophysectomy and/or Stereotactic radiosurgery(high doses of radiation to specific part of brain to erradicate tumor with minimal effects on surrounding tissues)
400
The P wave represents what?
The QRS wave represents what?
The T wave represents what?
The U wave represents what?P= Atrial depolarization
QRS= Ventricular depolarization
T= Ventricular repolarization
U wave= repolarization of purkinji fibers
400
How long does each phase last?
Initiation:
Oliguric:
Diuresis:
Recovery:
Initiation: begins upon initial precipitating factor and can last for few hours to several days.
Oliguric stage:1-2 weeks(books says up to 14 days). Diuresis: 1-3 weeks
Recovery: Several months to a year
400
A client is receiving a radiation implant for the treatment of bladder cancer. Which of the following interventions is appropriate?
a. Flush all urine down the toilet
b. Restrict the client’s fluid intake
c. Place the client in a semi-private room
d. Monitor the client for signs and symptoms of cystitis
Answer: D
Cystitis is the most common complication after treatment of bladder cancer.
500
Solve this problem! AND provide normal ranges for the following
Problem: Lab values: pH 7.42, paCo2 32, HCO3 18
Ranges: PH, Pac02, Pao2, HC03
Answer: Respiratory Alkalosis (if you want to get fancy, fully compensated)
500
Describe treaments and nursing interventions of Cushings VS addisons.
Cushings:
- administer meds that interfere with cortisol production
- turn frequently to protect thin skin
- Head of bed elevated 45 degrees to decrease work of breathing(excess fluid volume)
- Vitals I&O, daily weight.
- monitor serum potassium and glucose
Addisons:
- administration of IV fluids containing sodium and glucose.
- IV admin of Cortisone.
-Safety precautions
- Vital signs, I&O
Labs: serum sodium, glucose, potassium, BUN/creatinine and cortisol level monitoring
500
Whats the difference between baroreceptors and chemo-receptors?
What triggers them? Location?
Baroreceptors: located in the aortic and carotid arch, respond to pressure changes. Increase pressure= Parasympathetic nervous system response by dilating blood vessels and reducing heart rate. Decreases in pressure cause a reaction by the sympathetic nervous system to constrict blood vessels and increase heart rate.
Chemo-receptors: (only triggered in acidotic states).Located on the aortic and carotid bodies. They respond to changes on C02 and 02 concentrations.
Response: respiratory rate increase, vasoconstriction to push more blood to lungs to increase oxygen.
500
A 65 year old male patient has a glomerular filtration rate of 55 mL/min. The patient has a history of uncontrolled hypertension and coronary artery disease. You're assessing the new medication orders received for this patient. Which medication ordered by the physician will help treat the patient's hypertension along with providing a protective mechanism to the kidneys?
A. Lisinopril
B. Metoprolol
C. Amlodipine
D. Verapamil
Answer: A. Lisinopril
There are two types of drugs that can be used to treat hypertension and protect the kidneys in patients with CKD. These drugs include angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs). The only drug listed here that is correct is Lisinopril. This drug is known as an ACE inhibitor. Metoprolol is a BETA BLOCKER. Amlodipine and Verapamil are calcium channel blockers
500
Define the following
Urge incontinence:
Stress incontinence:
Mixed incontinence:
Overflow incontinence:
Functional incontinence:
