Download Electrolyte Imbalances & GI Disorders: Q&A for Medical Students and more Exams Advanced Education in PDF only on Docsity!
CMSRN 2 Exam Questions And Accurate Answers
what type of hyponatremia is most common, is due to excessive fluid intake and leads toa decreased concentration of serum sodium? ANSWER dilutional hypotnatremia
symptoms of diltuional hyponatremia ANSWER edema, confusion, weight gain treatment of dilutional hyponatremia ANSWER fluid restriction what type of hyponatremia is due to the loss of fluid and sodium? ANSWER truehyponatremia
symptoms of true hyponatremia ANSWER dry tissue, weight loss, hypotension,tachycardia
treatment of true hyponatremia - ANSWER replace sodium AND water (NS or LR) causes of true hyponatremia - ANSWER burns, hemorrhage, adrenal insufficiency what kind of sodium imbalance results from inadequate intake of fluid or loss of waterwithout sodium loss? - ANSWER hypernatremia
causes of hypernatremia - ANSWER fever, IVF w/sodium, DI, high protein TF symptoms of hypernatremia - ANSWER dry tissues, weight gain, thirst, tachycardia,oliguria
treatment of hypernatremia - ANSWER decrease sodium, replace fluids
which electrolyte does sodium work with? - ANSWER chloride - works to maintainacid/base balance
which labs are most important to watch with potassium abnormalities? - ANSWER renal what does potassium have an inverse relationship with? - ANSWER PH, insulin, calcium causes of hyperkalemia - ANSWER cell wall destruction, increased intake, potassiumsparing diuretics, renal failure, acidosis
symptoms of hyperkalemia - ANSWER irritable muscles, cardiac arrhythmias,hyperactive bowels, bladder treatment of hyperkalemia - ANSWER limit intake, kaexylate, calcium gluconate, IVglucose and insulin, dialysis
what electrolyte imbalance should you avoid green leafy vegetables and citrus fruits? -ANSWER hyperkalemia
what electrolyte are avocado, dried fruits, and potato skins high in? - ANSWERpotassium
causes of hypokalemia - ANSWER vomiting, diarrhea, DKA, prolonged NG suction,burns, potassium wasting diuretics
symptoms of hypokalemia - ANSWER muscle flaccidity and weakness, constipation,alkalosis, shallow respirations, cardiac arrest POA for hypokalemia - ANSWER potassium supplements, monitor magnesium levelsnormal calcium level - ANSWER 9-10. where is calcium stored? - ANSWER bones
Normal level of sodium - ANSWER 135- Normal level of potassium - ANSWER 3.5-5.0 mEq/LSymptoms of hypermagnesemia - ANSWER poor renal excretion, muscular depression Symptoms of hypomagnesemia - ANSWER Hyperactive deep tissue reflexes, tremors,seizures, cardiac arrhythmia, confusion (resembles hypocalcemia) Treatment for hypermagnesemia - ANSWER calcium gluconate what is serum osmolality? - ANSWER how thick solution is what does it mean if serum osmolality is high? - ANSWER the patient is dry what type of solution is NS, LR? - ANSWER isotonic what does an isotonic solution do? - ANSWER expands blood volume increases blood pressure if dehydrated has same osmolarity as our cellscan cause electrolyte increase
what type of solution is D5LR, D5NS? - ANSWER hypertonic what does a hypertonic solution do? - ANSWER Pulls fluid into the intravascular spacefrom tissue, do NOT give if dehydrated
what type of solution is 1/2 NS, 1/4 NS? - ANSWER hypotonic what does a hypotonic solution do? - ANSWER contain less solute than our cells used for cellular hydration
has more water than electrolytes given after surgery due to dehydration What organ metabolizes most nutrients? - ANSWER liver gallbladder location - ANSWER RUQ appendix location - ANSWER RLQ stomach location - ANSWER LUQ what quadrant is indicative of IBD? - ANSWER LLQ when a diabetic has epigastric pain, what can this indicate? - ANSWER gastroparesis,MI
what does it mean if abdominal auscultation is dull? - ANSWER fluid or mass order for GI assessment? - ANSWER inspect, auscultate, peruss, palpate GERD causes/risk factors - ANSWER obesity, hiatal hernia, esophageal sphincterproblems, gastric empty delay
symptoms of GERD - ANSWER -Dyspepsia -Chest pain-Esophagitis -Hoarseness in the morning -Persistent heartburn
- Amoxicillin/Biaxin Changes in lifestyle and diet Complications of peptic ulcer - ANWER bleeding, perforation (w/perf, need abx, fluids,NGT and pain meds, surgical repair)
What Inflammatory bowel disease involves the WHOLE bowel system, has classiccobblestone bowel, involves all layers of bowel w/ NO rectal bleeding - ANWER crohns
which inflammatory bowel disease affects the LEFT colon, starts at the rectums andascends, has shallow ulcerations, and has either bloody diarrhea or formed stool with streaks? - ANSWER ulcerative colitis Diet for Inflammatory Bowel Disease - ANSWER High protein, high calorie (3,000+ aday), low fiber, low roughage/residue
causes for large bowel obstruction - ANSWER MOST COMMON is neoplasm,diverticulitis, strictures, abscesses
Causes of small bowel obstruction- ANSWER adhesions, hernias, polyps, ileus,lymphoma
Which of the following bowel obstruction presents with gradual onset, pain is low grade,absence of stool, distention, high bitches bowel sounds? -ANSWER large bowel obstruction Which of the following bowel obstruction presents with rapid onset, crampy colickypain, emesis, distention, high pitched bowel sounds? -ANSWER small bowel obstruction
which type of bowel obstruction is more likely to need surgical intervention? - ANSWER
large bowel obstruction sac like herniation of large bowel that can get food or fecal matter caught and result ininflammation/infection? - ANSWER diverticulitis
complications of diverticulitis - ANSWER perforation, peritonitis, bleeding Causes of cholecystitis - ANSWER gall stones, bile stasis what type of infection presents with RUQ pain, N/V, biliary colic, fever, and murphyssign? - ANSWER cholecystitis
Palpation under rib causes cessation of inspiration; sign + indication? - ANSWERmurphys sign, indicates cholecystitis
what type of diet should a pt with cholecystitis be on? - ANSWER low fat what infection presents with navel and RLQ pain (acute), rebound tenderness, fever,N/V, elevated WBC, loss of appetite, gas/bloating? - ANSWER appendicitis
What is the sign for pancreatitis that would appear as a grey color to the flank, andappears as an old bruise? - ANSWER grey turner sign
Diet for pancreatitis after NPO status - ANSWER High carb and protein, low fat. Which GI tract organ produces antibodies, prothrombin, fibrinogen, albumin,metabolizes glucose-stores/releasing, bile salt formation, detox of noxious agents - ANSWER liver Tylenol is toxic to what organ and can cause hemorrhage/damage? - ANSWER liver
diet for patients with liver failure? - ANSWER high calorie, low protein, low fat, lowsodium
medications for liver failure? - ANSWER lactulose and rifaximin diet for patients with bariatric surgery - ANSWER high protein and nutrients, smallfrequent fluids
which type of nutrition is indicated for a patient who has a functional GI tract,inadequate intake for 3-5 days, and has inability to increase Po intake? - ANSWER enteral nutrution contrainidications for enteral nutrition? - ANSWER complete intestinal obstruction, lackof access, intractable vomiting or diarrhea, ileus, massive GI bleed, fistula, GI ischemia
what type of nutrition is indicated for a patient who requires nutrition support for >10days, whose nutritional needs are increased and who have GI tract disorders? - ANWER parenteral nutrition contraindications for parenteral nutrition? - ANWER functioning GI tract, no venousaccess
what lung disease that usually presents with grayish/white/blood streakedmucus/purulent sputum? - ANWER tuberculosis
ABG: pH low - ANWER acidosis ABG normal pH - ANWER 7.35-7. ABG: pH high - ANWER alkalosis
ABG: PCO2 range - ANSWER 35- ABG: PCO2 low - ANSWER alkalosis ABG: PCO2 high - ANSWER acidosis ABG: HCO3 (bicarb) range - ANSWER 22- ABG: HCO3 low - ANSWER acidosis ABG: HCO3 high - ANSWER alkalosis ABG: PO2 range - ANSWER 80- ABG: PO2 low - ANSWER hypoxemia ABG: PO2 high - ANSWER on O ABG: SaO2 range - ANSWER 95- ABG: SaO2 low - ANSWER hypoxemia ABG in metabolic acidosis - ANSWER decreased pH, decreased bicarb (HCO3) ABG in metabolic alkalosis - ANSWER increased pH, increased bicarb (HCO3) ABG in respiratory acidosis - ANSWER decreased pH, increased PCO
ANSWER emphysema Which pulmonary disease would you expect to see, based on the following nursingassessment, local crackles, exp wheezes, tachypnea and hacking/rasping/productive cough with thick mucoid sputum. - ANSWER chronic bronchitis Which pulmonary disease would you expect to see, based on the following nursingassessment fine crackles, tachypnea/dyspnea, mildly hypoxic, little or no sputum. - ANSWER emphysema Diet for patient with COPD? - ANSWER high protein, high calorie Which of the following medications for asthma are for maintenance? ANSWERanti-inflammatory, long acting bronchodilators, Singulair
Which of the following medications for asthma are for rescue? ANSWER short actingbronchodilators, theophyllines
What is the most common bacterial pneumonia? ANSWER Steptococcus pneumoniae What is the rare kind of pneumonia that requires isolation? ANSWER Meningococcalpneumonia
Treatment for pneumothorax ANSWER Reestablish negative pressure : chest tube,needle aspiration, oxygen
Should there be continuous bubbling in the water seal chamber of a chest tube?ANSWER NO- there may be tidaling but shouldn't be continuous
What is the name of the risk factor identification method for pulmonary embolism thattakes into account blood stasis (circulatory status), endothelial damage, and hypercoagulation? ANSWER virchows triad
What is the respiratory condition characterized by pink frothy sputum, crackles,dyspnea, and a feeling of fear? ANSWER pulmonary edema
in what organ are platelets stored? - ANSWER spleen Which WBC is the first line of defense? - ANSWER neutrophils which WBC is the most effective bacterial killer? - ANSWER monocytes/macrophages Which type of lymphocyte attacks and destroys infected body cells? - ANSWER Tlymphocyte
which type of lymphocyte becomes an antibody when exposed to something seen as along term threat? - ANSWER B lymphocyte
which type of anemia is due to a lack of B12? -ANSWER pernicious pressure injury: purple or maroon discoloration of skin due to pressure/sheer -ANSWERDTI
pressure injury: skin intact, non blanchable redness over bony prominence -ANSWERstage 1: prevention, turns
pressure injury: partial thickness loss of dermis, shallow open ulcer -ANSWER stage 2:cover with hydrocolloid
Pressure Injury: full thickness tissue loss, with no exposure of bone, muscle or tendon -ANSWER Stage 3: May require debridement or surgical consultation
which statin drug may cause flushing and for this reason must be given at bedtime?ANSWER niacin
of the following cholesterol-lowering drugs may cause rhabdomyolysis? ANSWERstatins
what is the term for any condition in which adequate blood supply to the heart muscle isobstructed? ANSWER acute coronary syndrome
what % do you want to keep a client's O2 sats above after an MI? ANSWER 94% orhigher
which type of MI is from full occlusion (acute coronary syndrome)? - ANSWER STEMI which type of MI is from partial occlusion? - ANSWER NSTEMI treatment for MI? (MONA) - ANSWER morphine, oxygen, nitrates, aspirin which type of heart failure has pulmonary causes/symptoms - ANSWER left ventricularheart failure
which type of heart failure is characterized by edema? - ANSWER right ventricular heartfailure (diastolic)
which type of heart failure is manifested by the following S/S: orthopnea, dyspnea withexertion, crackles, s3/s4 sounds, systolic murmur - ANSWER left ventricular heart failure which type of heart failure is manifested by the following S/S: JVD, dependent edema,hepatomegaly, abd distention - ANSWER right ventriclar heart failure (diastolic)
-olol - ANSWER beta blocker: decrease workload of the heart -pril - ANSWER ACE inhibitor: decrease preload and afterload -sartan - ANSWER ARB: decrease preload and afterload -pine - ANSWER calcium channel blocker: negative inotropic effect that decreases forceof contraction
which type of vascular disease results in a lack of oxygen to tissues: loss of hair,extremities cool/pale - ANSWER PAD
which type of vascular disease results in inability to remove waste products: edema,wounds that won't heal - ANSWER PVD treatment for PAD? - ANSWER thrombolytics, stents, bypass treatment for PVD? - ANSWER antiplatelets, diuretics Antidote for Coumadin - ANSWER Vitamin K type of shock: decrease in cardiac OP, decreased tissue perfusion and elimination ofwaste (decreased UOP), results from MI/severe cardiomyopathy/cardiac injury - ANSWER cardiogenic type of shock: most common- from massive blood loss - ANSWER hypovolemic stage of hypovolemic shock that the cardiac output and BP are maintained - ANSWERcompensated
What patients should you watch for SIADH? - ANSWER stroke, trauma, tumor, infection treatment for SIADH? - ANSWER alleviate cause, fluid restriction/diuretics, daily weights what are two important nursing aspects to remember with a thyroid storm? - ANSWERdo not give ASA, do not treat increased temp
which endocrine organ stores and maintains calcium levels? - ANSWER parathyroid which endocrine organ produces epi and norepinephrine? - ANSWER adrenal medulla which endocrine organ is responsible for steroid hormones (aldosterone, cortisol,testosterone) - ANSWER adrenal cortex
what endocrine insufficiency is caused by under secretion of steroids from the adrenalcortex r/t tumor? - ANS primary (adrenal) addisons disease
what endocrine insufficiency is caused by under secretion of ACTH r/t tumor? - ANSsecondary (pituitary) addisons disease
how do you treat addisons disease? - ANS steroid replacement what endocrine insufficiencies are related to the adrenal glands? - ANS addisons andcushings
What endocrine insufficiency is caused by over secretion of steroids from the adrenalcortex r/t tumor? - ANSWER primary (adrenal) cushings
What endocrine insufficiency is caused by over secretion of ACTH? - ANSWERsecondary (pituitary) cushings
How do you treat cushings disease? - ANSWER surgery for tumor removal, steroid taper What category of insulin are lantus, levemir, and NPH? - ANSWER basal What category of insulin are regular, humalog, novalog? - ANSWER prandial/bolus How long do you withhold metformin after IV dye is given? - ANSWER 48 hrs Which of the following insulins has an onset of 10-20 minutes, peak of 1-3hrs and aduration of 3-5 hrs? - ANSWER novolog
Which of the following insulins has an onset of 30 minutes, peak of 2-5 hrs and a durationof 5-8 hours? - ANSWER regular
which insulin has an onset of 1-3 hrs a peak of 6-12 hrs and a duration of 16-24 hrs? -ANSWER intermediate (NPH)
which insulin has an onset of 1hr and a duration of 24-48hrs with no peak? - ANSWERlong acting (lantus)
causes of death from DKA? - ANSWER dysrhythmias from hyperkalemia or acidosis What kind of breathing is rapid and deep, a compensation of metabolic acidosis, sweetand fruity in odor? ANSWER kussmaul respirations
Treatment for DKA ANSWER IV insulin, IVF, treat high potassium with IVinsulin/kaexylate-(will likely need to replace again once drops)
