Final Exam Comprehensive Review

Questions and Answers

Which electrolyte is associated with EKG changes and leg cramping?

Potassium (correct)

Magnesium

Calcium

Sodium

What should not be used for patients at risk for cerebral edema?

Normal saline

Hypotonic fluids (correct)

Hypertonic fluids

Isotonic fluids

Which clinical manifestation is primarily associated with sodium imbalances?

Muscle spasms

Paresthesia

Cardiac arrest

Altered mental status (correct)

What fluid type is primarily used to address cellular swelling?

Hypertonic solutions Signup and view all the answers

Which of the following is NOT a source of fluid loss that is often overlooked?

Urination Signup and view all the answers

What aspects are NOT essential for potassium treatment knowledge according to the overview?

Specific treatments Signup and view all the answers

In the context of fluid types, which pair represents hypotonic and hypertonic fluids respectively?

D5W and 3% saline Signup and view all the answers

Which of the following statements about fluid gains is true?

Oral intake is a significant source of fluid gains. Signup and view all the answers

What is the primary concern when treating sodium imbalances?

Preventing neurological disturbances Signup and view all the answers

Which of the following is NOT considered a source of output related to fluid volume?

Oral intake Signup and view all the answers

What is a common clinical manifestation of fluid volume deficit?

Dry mucous membranes Signup and view all the answers

Which group is at higher risk for fluid volume deficit due to decreased coping mechanisms?

Elderly Signup and view all the answers

What is typically the first treatment step for addressing fluid volume deficit?

Offer preferred beverage Signup and view all the answers

Which of the following can lead to fluid volume excess?

Excessive IV administration of fluids Signup and view all the answers

What symptom is associated with fluid volume excess?

Edema Signup and view all the answers

What is the primary treatment for a patient experiencing fluid volume excess?

Diuretics Signup and view all the answers

Excessive salt intake can result in what physiological condition?

Fluid overload Signup and view all the answers

What is a potential cause of fluid volume deficit during physical activities?

Sweating in hot weather Signup and view all the answers

Which of the following symptoms is NOT indicative of fluid volume deficit?

Jugular vein distention Signup and view all the answers

What are the clinical manifestations associated with hyperglycemia in diabetes?

Polyuria, polydipsia, and polyphagia Signup and view all the answers

What is the primary complication associated with thoracentesis?

Pneumothorax Signup and view all the answers

What should patients be educated on to prevent long-term complications related to diabetes?

Preventing foot ulcers Signup and view all the answers

What are the key clinical manifestations of DKA (Diabetic Ketoacidosis) that need to be recognized?

Kussmaul respirations and fruity breath Signup and view all the answers

Why might a patient be advised against taking Metformin while hospitalized?

It may lead to lactic acidosis if renal function is compromised Signup and view all the answers

What position is recommended for a patient undergoing thoracentesis?

Sitting leaning forward over a table Signup and view all the answers

What happens to the glomerular filtration rate (GFR) as a person ages?

It decreases gradually. Signup and view all the answers

Which of the following is NOT a common clinical manifestation of renal calculi?

High fever. Signup and view all the answers

Which symptom is commonly associated with urinary tract infections (UTIs) in geriatric patients?

Frequent urination. Signup and view all the answers

What is a recommended preventive measure to reduce the risk of UTIs?

Wearing cotton underwear. Signup and view all the answers

Which of the following might indicate altered mental status due to a UTI in older adults?

Confusion or delirium. Signup and view all the answers

Which of the following is a common symptom of kidney stones?

Radiating pain to the groin. Signup and view all the answers

How does aging affect the kidneys' ability to concentrate urine?

It reduces the ability to concentrate. Signup and view all the answers

Which of the following symptoms is typically associated with UTIs?

Burning sensation while urinating. Signup and view all the answers

What is a known complication related to fluid and electrolyte imbalances in older adults?

Dehydration. Signup and view all the answers

What does the presence of blood in the urine typically indicate?

Renal calculi or kidney stones. Signup and view all the answers

What is the biggest complication associated with urinary retention?

Urinary tract infection Signup and view all the answers

Which nursing strategy is most effective for alleviating urinary retention?

Providing privacy Signup and view all the answers

Which activity is most likely to cause stress urinary incontinence?

Coughing or sneezing Signup and view all the answers

What is a common non-pharmacological method to stimulate urination?

Running warm water Signup and view all the answers

How does urge urinary incontinence manifest?

Frequent urination with inability to hold it Signup and view all the answers

What is a significant nursing consideration when managing urinary incontinence?

Maintaining patient confidentiality Signup and view all the answers

Which of the following best describes stress urinary incontinence?

Leaking urine during physical exertion Signup and view all the answers

Which position may help a male patient with urinary retention to urinate more easily?

Standing at the bedside Signup and view all the answers

Why is urinary retention a concern in prolonged situations?

It can lead to bladder distension Signup and view all the answers

What technique can be used to help relieve urinary retention besides privacy and positioning?

Tapping the pubic bone Signup and view all the answers

Study Notes

Final Exam Overview

Final exam content will cover chapters from exams one, two, and three.
Important topics include electrolytes, IV fluids, fluid volume issues, acid-base imbalances, renal calculi, urinary conditions, diabetes management, and thoracentesis.

Electrolytes

Key electrolytes: sodium and potassium.
Focus on clinical manifestations:
- Potassium: EKG changes, leg cramps, weakness, paresthesia.
- Sodium: Neurological issues, altered mental status, risk for seizures.
Treatment specifics for potassium should be known; sodium treatment specific details are not required.

IV Fluids

Types of IV fluids:
- Hypotonic: Avoid in patients with cerebral edema to prevent cellular swelling.
- Isotonic and Hypertonic: Know appropriate uses for different patient conditions.

Fluid Balance

Review sources of fluid loss: sweating, respiration, vomiting, diarrhea.
Fluid volume deficit manifestations include:
- Skin tenting, dry mucous membranes, hypotension, tachycardia.
Initial treatment for fluid volume deficit: encourage oral fluid intake of the patient's preferred beverage, followed by IV fluids if needed.

Fluid Volume Excess

Clinical manifestations include edema, crackles in lungs, jugular vein distension (JVD), and high blood pressure.
Causes: excessive fluid intake, excessive IV administration, excessive salt intake.
Treatment: diuretics.

Acid-Base Imbalances

Focus on interpreting arterial blood gases (ABGs).
No specific questions regarding clinical manifestations or treatments for acid-base imbalances.

Renal Calculi (Kidney Stones)

Clinical manifestations: CV angle tenderness, dull aching pain radiating to groin, hematuria (blood in urine).

Urinary Tract Infections (UTIs)

Key clinical signs include: delirium, burning sensation, foul smell, urgency, hesitancy, dysuria.
Prevention measures: drink water, avoid irritants, wear cotton underwear, and do not hold urine.

Urinary Retention

Major complication: urinary tract infections (UTI) due to prolonged retention.
Nursing strategies include ensuring patient privacy, providing upright positioning when possible, and techniques like running warm water or tapping the pubic bone to stimulate urination.

Urinary Incontinence

Stress incontinence: Leakage during activities that increase abdominal pressure (coughing, laughing).
Urge incontinence: Sudden, intense urge to urinate, often leading to involuntary loss of urine.

Diabetes Management

Recognize the three P's: polyuria, polydipsia, polyphagia.
Metformin: educate on use and why it's avoided during certain hospital procedures.
Important complications to know: hypoglycemia, diabetic ketoacidosis (DKA).
Insulin: understand sliding scale and timing of different insulin types.
Preventive measures for diabetic foot ulcers are critical.

Thoracentesis

Positioning: patient sitting upright in a tripod position, leaning over a pillow.
Common complication: pneumothorax from needle insertion during procedure.

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This quiz provides a comprehensive review of the final exam topics discussed in lectures. It covers key points from previous exams and outlines what will be included in the upcoming final. Prepare effectively by revisiting the essential materials presented throughout the course.