Labs
You receive a patient that has been experiencing severe nausea and vomiting for the past two days. What two electrolytes would you anticipate being out of normal range?
Sodium (hypernatremia), Potassium (Hypokalemia)
There is an order for furosemide 40mg PO. The med cart has 20mg tablets. How many tablet would the nurse administer?
Two 20 mg tablets
What medications require an order before the nurse can administer?
All of them!!!!!!!!!!!
What are the four nursing metaparadigms?
Person, Environment, Health, and Nursing
what organ is known to regenerate itself with its cells that have stem-cell properties?
The liver
What lab test would be ordered if the patient is suspected to have a myocardial infarction?
Troponin
There is an order for ceftriaxone 1g IV every 24 hours to be infused over 30 minutes. Available is ceftriaxone 1000mg in 100ml of NS. The IV pump delivers mL/h. What rate should the nurse program the pump to deliver the medication?
200mL/h (100mL infused in 30mins)
The nurse is about to administer prescribed digoxin (Lanoxin) 0.25 mg PO daily. Prior to administering the med, what are the most important action(s) for the nurse to take? (more than one answer acceptable)
Check the patients potassium level and therapeutic range for digoxin.
Check apical pulse.
Digoxin is used to treat heart failure and arrhythmias. The range is 0.8-2 ng/ml, and K 3.5-5 mmol.
The Theory of Human Caring emphasizes caring as the essence of nursing. Who established this theory?
Jean Watson
at what time does the anterior fontanelle "close"?
**Double Points** If you can identify when the posterior fontanelle closes?
anterior: between 12 and 24 months
posterior: between 4-8 weeks
What is the purpose of a doctor ordering a d-dimer test?
D-dimer: a protein in the blood that indicates the body is trying to break up a blood clot
There is an order to administer ampicillin 50mg/kg/day q6h. The patient weighs 22kg. How much does the nurse administer per dose?
275mg per dose
1. 50mg(22kg) = 1100mg/day
2. 1100mg/4 doses = 275mg per dose
A patient is newly prescribed phenelzine for their depression. While the nurse is providing discharge teaching, the client states, "I always drink a glass of orange or grapefruit juice with my breakfast."
What is the most appropriate response? BONUS +100 points if you can name the drug class of phenelzine
A) "That's fine, as long as you take your medication with food."
B) "You need to avoid grapefruit as it increases the risk for serious side effects with your medication. Orange juice is acceptable to continue drinking."
C) "Drinking grapefruit juice will be beneficial for you because it reduces stomach upset caused by this medication, but orange juice MUST be avoided."
D) You need to increase vitamin C intake to avoid any deficiencies caused by taking this drug."
What core ethical principles does nursing have? (hint: 6)
Beneficence, Non-Maleficence, Autonomy, Justice Veracity and Fidelity
A patient arrives to the ER and an X-ray is performed on their leg. The doctor interpret that the bone has broken diagonally, but has not been displaced. What kind of fracture does the patient likely have?
Oblique (non-displaced) fracture
This test measures a specific protein in the blood that is released when the heart is under increased stress. The value is used to diagnose heart failure.
BNP (Brain/B-Type-Natriuretic Peptide)
You receive orders to begin an IV infusion of 800mL of NS over 6 hours. You obtain macrodrip tubing that has a drop factor of 15gtt/mL. What is the drip rate? (gtt/min)
6hrs = 360min
800mL(15gtt/mL)/360mins = 33.33 gtt/min or 33
equation: volume(ml) x drop factor divided by time(mins)
This insulin has no peak and lasts 24 hours.
A terminally ill patient with ALS communicates using an eye tracking device, and is indicating that they no longer want to receive enteral feedings, or any life-prolonging treatments. The patient's advanced directive supports the decision to not have life-prolonging treatments. However, the spouse of the patient insists "they would change their mind if they could speak", and is demanding to continue invasive care. What is the most ethically appropriate action for the nurse to take?
A) Follow the spouse's wishes and continue treatment
B) Consult the HCP and ethics committee about honouring the advanced directive
C) Encourage the spouse to speak with a chaplain or counselor
D) continue all treatments until the client improves and can confirm their wishes
The nurse is assessing a patient that has sustained damage to their phrenic nerve. Which finding would the nurse expect?
A) Dysphagia
B) Paralysis or dysfunction of diaphragm
C) Loss of sensation in arms
D) Inability to rotate their head
When a patient is receiving IV heparin therapy, this lab value must be monitored closely to assess the effectiveness, and this medication is the antidote for heparin overdose.
aPTT (activated partial thromboplastin time); protamine sulfate
The HCP orders dopamine to be infused at 5mcg/kg/h for a patient weighing 154lbs. The IV bag contains 400mg dopamine in 250ml D5W. How many ml/h should the nurse set the pump at?
13.1mg/h
1. 154lbs/2.2kg = 70kg
2. 5mcg(70kg)/min = 350mcg/min
3. 350mcg(60mins) = 21,000 mcg/h
4. 21,000 mcg = 21mg/h
5. 400mg/250ml = 1.6mg/ml
21mg/h divided by 1.6mg/ml = 13.125ml/h
Name 3 drugs that are commonly used during a code blue?
Adenosine, Sodium Bicarb, Epinephrine, Atropine, Amiodarone, Vasopressin, Lidocaine, Norepinephrine
A patient that is legally a minor has a hx of leukemia and is refusing further chemotherapy. It is determined that the patient is competent and understand the consequences of refusing treatment. The parents of the patient are insisting that treatment continues. What is the best course of action?
A) Notify HCP of parents decision and prepare chemotherapy as ordered
B) Respect clients decision and document the refusal of chemotherapy
C) Request an ethics consults to support decision making for the care team and family
D) Encourage the parents to take legal action that would enforce chemotherapy treatment
This part of the brain controls the vital functions like HR, breathing and BP.
Medulla Oblongata