Fluids & Volume Status
Name two expected findings with fluid volume deficit.
Tachycardia, hypotension/orthostatic hypotension, dry mucous membranes, poor skin turgor, decreased UOP, concentrated urine.
What’s the priority first step for a K⁺ of 6.8?
Place on cardiac monitor (life-threatening dysrhythmias).
Pneumonia patient gets worse dyspnea + low SpO₂—priority action?
Administer oxygen (ABCs).
COPD: what breathing technique reduces air trapping?
Pursed-lip breathing.
GERD lifestyle: name two.
Elevate HOB, avoid spicy/acidic/caffeine/alcohol, small meals, avoid lying down after eating, weight loss if needed.
Which lab/assessment best suggests dehydration?
Increased urine specific gravity and/or rising Hct/BUN.
Name one med that stabilizes the cardiac membrane in severe hyperkalemia.
IV calcium gluconate.
PE: sudden dyspnea + SpO₂ 88%—priority?
Oxygen + rapid provider notification/rapid response per policy.
COPD on O2 becomes drowsy with decreased respiratory effort—priority?
Reduce O2 to ordered target + assess for CO₂ retention (check ABG if ordered).
Barrett’s esophagus—why are follow-ups important?
Risk for dysplasia/esophageal cancer → needs surveillance endoscopy.
Which finding is most concerning in fluid volume overload?
Crackles, dyspnea, worsening oxygenation (pulmonary edema risk).
Name one intervention that shifts potassium into cells.
IV insulin + dextrose (also albuterol, sodium bicarb in some cases).
Gold standard”/best confirmatory test commonly used for PE?
CT pulmonary angiography (CTPA).
Best test to confirm COPD airflow limitation?
Spirometry / FEV1 (↓).
PUD sign of upper GI bleed?
Melena (black, tarry stools).
Define third spacing and name one condition that causes it.
Fluid shifts into interstitial/“trapped” spaces (not usable by circulation). Causes: burns, sepsis, pancreatitis, liver failure/cirrhosis.
Sodium 128 (hyponatremia): what serious neuro symptom do you watch for?
Confusion, seizures.
Active TB: which isolation and which mask for staff?
Airborne isolation + N95/respirator.
Chronic bronchitis patho behind cough + infections + cyanosis?
Mucus hypersecretion + airway inflammation.
Billroth II patient dizzy/sweaty/palpitations after eating = ? and first teaching?
Dumping syndrome; small frequent meals, limit simple carbs, higher protein/fat, lie down after meals if instructed, fluids between meals.
Priority nursing action when suspecting acute pulmonary edema from overload?
High Fowler’s, apply O2, notify provider/prepare diuretics (ABCs).
Refeeding syndrome: which electrolyte drops and can cause respiratory failure?
Phosphate (hypophosphatemia).
TB teaching: what is the BIG adherence point?
Complete the full medication course (months), even if symptoms improve (prevents resistance).
Asthma teaching—what statement is WRONG?
I will use my rescue inhaler every day to prevent attacks. (Rescue = PRN; controller meds prevent).
Metabolic syndrome: name 3 common components
Central obesity (↑ waist), ↑ BP, ↑ fasting glucose, ↑ triglycerides, low HDL.