Questions and Answers
What is the primary clinical manifestation of hyponatremia?
Which treatment is appropriate for severe hypokalemia?
What is a common clinical manifestation associated with hyperkalemia?
Which electrolyte imbalance typically presents with a risk for seizures?
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Which fluid type is contraindicated for patients with cerebral edema?
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What is the normal sodium level range in the human body?
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What is a significant risk factor for developing hyperkalemia in older adults?
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Which condition primarily leads to a fluid volume deficit?
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Which condition is characterized by loss of water alone and increased serum sodium levels, specifically affecting the elderly population?
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What is the preferred route for administering treatment in cases of fluid loss, if the patient is stable?
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In cases of metabolic acidosis, which electrolyte imbalance may occur due to potassium shifts?
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Which clinical manifestation is NOT typically associated with fluid volume excess?
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What condition is primarily indicated by a painless lump or mass in the testis and is most common in men aged 15 to 40?
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Which condition is characterized by the narrowing of the foreskin resulting from poor hygiene in uncircumcised patients?
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What is a common contraindication for the use of PDE5 medications, such as sildenafil?
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In continuous bladder irrigation with I&O monitoring, what indicates a potential complication such as obstruction or bladder rupture?
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Which of the following electrolyte imbalances is likely to cause metabolic alkalosis?
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What laboratory findings are indicative of glomerulonephritis post-streptococcal infection?
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What is the primary cause of prerenal acute renal failure?
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Which clinical manifestation is typically associated with renal calculi?
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Which of the following is a common cause of urinary tract infections (UTIs)?
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What first intervention should a nurse take for a patient experiencing urinary retention?
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Which statement correctly identifies a phase of acute renal failure?
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What mechanism is most directly linked to increased susceptibility to kidney injury in older adults?
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What abnormal urine finding is directly indicative of glomerular damage?
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What is a significant nursing intervention for managing a patient with urinary incontinence?
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How does urinary retention potentially lead to renal calculi formation?
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What precaution helps prevent urinary tract infections related to hygiene?
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What mechanism primarily leads to the destruction of insulin-producing beta cells in Type 1 Diabetes?
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Which of the following symptoms is most commonly associated with severe hypoglycemia?
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Which category of insulin has no peak and lasts for 24-72 hours?
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In patients with Type 2 Diabetes, which symptom is least likely to manifest at diagnosis compared to Type 1 Diabetes?
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What is the primary use of metformin in diabetic patients?
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Which of the following would be considered a macrovascular complication of diabetes?
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What is a primary nursing action when treating DKA (Diabetic Ketoacidosis)?
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Which intervention is most appropriate for managing epistaxis (nosebleeds)?
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Which clinical manifestation is commonly associated with upper respiratory tract infections (URIs)?
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In the context of bronchoscopy, what is the most critical nursing intervention after the procedure?
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What is the primary purpose of a stress test in cardiac assessment?
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Which clinical manifestation is NOT typically associated with tuberculosis?
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In the management of sinus bradycardia, when is atropine indicated?
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What does a STEMI indicate in an ECG reading?
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Which of the following is a common risk factor for coronary artery disease that is modifiable?
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What is the initial treatment for myocardial infarction?
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What is the recommended intervention when assessing a patient with obstructive sleep apnea who is experiencing daytime sleepiness?
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Study Notes
Chapter 10: Fluid and Electrolytes
- Sodium levels normal range: 135-145 mEq/L. Hyponatremia presents with neurological changes, seizures risk, headaches, hypotension, nausea, and dry mucosa.
- Hypernatremia occurs with fluid volume deficits or excesses, manifesting as thirst, irritability, elevated temperature, and edema.
- Potassium normal range: 3.5-5 mEq/L. Hypokalemia causes muscle cramping, ECG changes, and weakness, treated with potassium supplementation and monitoring.
- Hyperkalemia, more common in older adults, can lead to cardiac arrest, presenting with dysrhythmias, muscle weakness, and anxiety.
- Fluid volume deficit (FVD) results from excessive fluid loss, often caused by diarrhea, sweating, or poor access to fluids. Symptoms include dry skin, tachycardia, and confusion.
- Treatment for FVD includes oral rehydration and IV fluids; isotonic solutions preferred for acute losses.
- Fluid volume excess can lead to edema, distended neck veins, and respiratory distress. Common causes include heart failure and kidney injury.
- Monitor for electrolyte imbalances through ABG values; metabolic acidosis has low pH and bicarbonate, while alkalosis has elevated pH and bicarbonate.
- Older adults are particularly at risk for both fluid excess and deficit due to age-related physiological changes.
Chapter 53: Male Reproductive Disorders
- Phimosis is the narrowing of the foreskin, often associated with poor hygiene or infection, presenting as pale skin and purulent drainage.
- Treatment includes cleaning, steroid cream, or circumcision if severe.
- PDE5 inhibitors like Sildenafil are contraindicated in patients taking nitrates. They should be taken before intercourse and can cause headaches and flushing.
- Monthly testicular exams are crucial for early detection of testicular cancer, which typically presents as a painless lump in men aged 15-40.
- Continuous bladder irrigation requires accurate intake/output monitoring to prevent bladder rupture. Severe pain indicates potential obstruction.
Chapter 48: Kidney Disorders
- Glomerulonephritis primarily affects ages 21-40, often following strep infection. It leads to inflammation, reduced GFR, and proteinuria.
- Clinical manifestations include hypertension, edema, and renal failure signs. Management focuses on monitoring fluid balance and electrolyte status.
- Acute renal failure can be pre-renal (caused by shock), intra-renal (due to inflammation or toxins), or post-renal (due to urinary obstructions).
Chapter 47: Urinary Function
- Abnormal urine findings include hematuria, dysuria, and proteinuria indicating various infections or conditions affecting kidney function.
- Aging affects urinary function, reducing GFR, and increasing susceptibility to kidney injury.
- Urinary retention may lead to chronic infections or renal calculi; first nursing intervention is education on normal voiding patterns.
Chapter 49: Urinary Disorders
- Renal calculi present as severe, radiating pain and hematuria. Management requires pain control and hydration.
- UTIs are primarily caused by E. coli. Clinical signs include dysuria and increased urinary frequency.
- Preventive strategies include proper hygiene, hydration, and urinating post-intercourse.
Chapter 46: Diabetes
- Type 1 diabetes results from autoimmune destruction of insulin-producing cells, leading to severe hyperglycemia.
- Type 2 diabetes involves insulin resistance, is often associated with obesity, and primarily affects adults over 30.
- Common symptoms across both types include polyuria, polydipsia, and fatigue. Type 1 may present with sudden weight loss.
- Metformin is contraindicated in renal impairment and should be taken before meals. Side effects include lactic acidosis.
- Hypoglycemia is critical and can result in symptoms like sweating, confusion, or seizures. Treatment includes administration of quick-acting carbohydrates.
Chapter 18: Upper Respiratory Tract Disorders
- Upper respiratory infections (URIs) require symptomatic treatment, focusing on hydration and symptom management.
- Laryngeal cancer symptoms include persistent hoarseness and throat pain.
- For epistaxis, sit upright, lean forward, and apply pressure to prevent aspiration.
Chapter 17: Respiratory Function
- Thoracentesis involves inserting a needle into the thoracic cavity; complications include pneumothorax.
- Post-bronchoscopy care includes monitoring airway patency and hemodynamics.
Chapter 19: Chest and Lower Respiratory Tract Disorders
- Tuberculosis manifests with night sweats and cough. PPE includes N95 masks and negative pressure rooms.
- Atelectasis prevention includes deep breathing exercises and mobilization.
- Pneumothorax signs include tracheal deviation and abnormal breath sounds.
Chapter 20: Chronic Pulmonary Disease
- Obstructive sleep apnea leads to intermittent airway obstruction during sleep; CPAP therapy is the primary treatment.
- COPD presents as chronic bronchitis or emphysema; management includes monitoring and lifestyle modifications, particularly smoking cessation.
- Tracheostomy care calls for clear communication methods if the patient has difficulty speaking.### Adventitious Sounds and Respiratory Concerns
- Adventitious sounds include gurgling, crackles, and hoarse sounds indicating respiratory distress.
- Increased respiratory rate is often observed in conditions like asthma, which presents with wheezing, tachypnea, and dyspnea.
- Albuterol serves as a treatment, functioning as an inhaled bronchodilator targeting beta-2 adrenergic receptors.
Cardiac Output and Stress Testing
- Cardiac output equals the total blood ejected from one ventricle per minute, calculated as stroke volume plus heart rate.
- Stress tests assess heart conditions by simulating myocardial demand, diagnosing shortness of breath, chest pain, and monitoring ECG changes.
- Ensure patient stability, vital sign monitoring, and intervene if symptomatic during tests, such as stopping activities for chest pain or dyspnea.
Cardiac Conduction System and ECG Analysis
- The heart's conduction pathway includes the SA node, AV node, Bundle of His, bundle branches, and Purkinje fibers.
- ECG interpretation identifies cardiac rate and rhythm:
- P wave signifies atrial depolarization.
- QRS complex indicates ventricular depolarization.
- T wave represents ventricular repolarization.
Sinus Bradycardia and Tachycardia
- Sinus Bradycardia: heart rate <60 bpm, normal P wave, management based on symptoms—may require atropine or pacing if symptomatic.
- Sinus Tachycardia: heart rate >100 bpm, management follows symptom presentation; potential interventions include synchronized cardioversion or administration of adenosine.
Myocardial Infarction (MI) Overview
- MI, known as a heart attack, presents with angina, substernal chest pain, and can result from acute coronary syndrome.
- Differentiate between STEMI (evidence of ECG changes) and NSTEMI (elevated biomarkers without definite ECG changes).
- Key diagnostic tools include 12-lead EKG, cardiac biomarkers, and catheterization.
Treatment and Nursing Considerations for MI
- Initial treatment includes oxygen, nitroglycerin, morphine, and aspirin; nitroglycerin is contraindicated with Viagra.
- Nursing interventions involve monitoring and IV placement, along with discharge education on lifestyle modifications to mitigate future risks.
Angina Types
- Stable angina: pain relieved by rest; typically activity-induced.
- Unstable angina: pain persists even at rest and is not activity-triggered.
- Variant angina: symptoms can vary significantly in onset and duration.
Heart Failure: Clinical Manifestations and Patient Education
- Heart failure presents with distinct left and right-sided symptoms:
- Left: dyspnea and orthopnea due to pulmonary congestion.
- Right: edema, distended neck veins, and ascites.
- Risk factors include myocardial infarction, aging, valve issues, and cardiomyopathy.
- Educate patients on low sodium diets and the importance of daily weight monitoring.
Pulmonary Edema Management
- Clinical manifestations include pink frothy sputum and crackles; patients may feel air-hungry, akin to drowning.
- Nursing interventions: position patient upright, elevate the head of the bed, and administer diuretics to reduce fluid overload.
Abdominal Aortic Aneurysm (AAA)
- Often asymptomatic, AAA is primarily caused by atherosclerosis and can lead to severe complications if untreated.
- Monitor for symptoms like severe lower abdominal pain or pulsation; timely referral to a provider is crucial.
Hypertension: Overview and Complications
- Hypertension is defined as BP ≥130/80 mmHg; it can be primary (no identifiable cause) or secondary (with identifiable causes).
- Risk factors include age, race, obesity, and lifestyle choices.
- Educate patients on the importance of regular BP checks and dietary modifications, such as low sodium and the DASH diet.
Hypertensive Crisis Management
- HTN crisis is when BP exceeds 180/120 mmHg, with two subdivisions: emergency (with organ damage) and urgency (without immediate danger).
- Emergency management involves IV vasodilators; urgency may be managed with oral agents if there's no acute organ damage.
- Causes of crisis include abrupt cessation of medications or poorly controlled hypertension.
Clinical Calculations and Assessments
- Familiarize with dosage calculations and medical abbreviations commonly encountered in nursing practice.
- Understanding military time for accurate medication administration and scheduling.
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Description
Test your knowledge on electrolyte imbalances and their clinical manifestations. This quiz covers topics such as hyponatremia, hypokalemia, and hyperkalemia, including their treatments and risks. Assess your understanding of these important medical concepts!
