Med Surg Final Quiz

Fluid Volume Deficit and Excess

• Common causes of fluid volume deficit include dehydration, hemorrhage, and excessive diuresis.
• Clinical manifestations of fluid volume deficit are hypotension, tachycardia, and dry mucous membranes.
• Management of fluid volume deficit may involve fluid replacement, such as IV fluids.
• Potential clinical manifestations of fluid volume excess can include edema, hypertension, and shortness of breath.
• Electrolyte imbalance often associated with fluid volume excess is hyponatremia.
• Causes of fluid volume excess include excessive fluid intake and renal failure.
• Severe/sudden water excess can lead to cerebral edema and severe hyponatremia, risking seizures and coma.

Normal Electrolyte Ranges

• Potassium normal range is typically 3.5-5.0 mEq/L.
• Normal calcium levels are usually 8.5-10.5 mg/dL.
• Sodium's normal range is around 135-145 mEq/L.

Central Lines Management

• Patients should be positioned in a supine or Trendelenburg position with central lines to facilitate therapeutic effects and venous return.
• Site cleaning for a central line involves using chlorhexidine or alcohol-based solutions.
• Potential complications of central venous lines include infection and thrombosis.
• Maintaining patency of a central line requires regular flushing with saline or heparin.
• Important nursing intervention includes monitoring for signs of infection or complications.

Transfusion Reactions

• A hemolytic reaction occurs when the immune system attacks transfused red blood cells.
• Febrile reaction is characterized by fever and chills in response to blood transfusions.
• Mild allergic reactions may present as hives or itching, while severe reactions can result in anaphylaxis.

Platelet and Bleeding Precautions

• Normal platelet range is 150,000-450,000 per microliter of blood.
• Bleeding precautions for thrombocytopenia include avoiding invasive procedures and careful monitoring for signs of bleeding.
• Intervention for hemophilia may include administering factor replacement therapy.
• Client teaching for hemophilia emphasizes avoiding injuries and recognizing bleeding episodes.

Anemia Types

• Symptoms of iron deficiency anemia can include fatigue, weakness, and pallor.
• It is not typical for anemia to cause increased energy levels.
• The priority intervention for sickle cell anemia involves pain management during a crisis.
• Symptoms of sickle cell anemia include severe pain, swelling, and signs of organ ischemia.
• Treatment for sickle cell anemia does not typically include unnecessary transfusions.
• NSAIDs and opioids may be avoided during a sickle cell crisis due to potential complications.

Blood Transfusion and Reactions

• Erythropoietin stimulates bone marrow to produce red blood cells (RBCs).
• If the patient has a history of allergic reactions to blood transfusions, premedication with antihistamines may be required.

Respiratory Conditions

• Thoracentesis uses a needle to remove fluid from the pleural space.
• Patients are instructed to hold their breath or remain still during the procedure.
• Output of more than 200-300 mL during thoracentesis may lead to hypotension.
• Nursing intervention for COPD patients includes providing oxygen therapy and educating on breathing techniques.
• The drive to breathe for COPD patients is primarily hypoxia rather than increased carbon dioxide.

Asthma and TB Management

• In an acute asthma attack, bronchodilators are administered, with albuterol being a common drug.
• Monitoring during albuterol administration includes assessing respiratory rate and oxygen saturation.
• Treatment for TB typically involves a regimen of antibiotics.
• Individuals with active TB should not be involved in childcare or with immunocompromised patients.

Cardiovascular Health

• Keep the chest tube unit below the level of the patient's chest.
• Do not clamp the chest tube if suction is disconnected; notify the physician.
• Continuous bubbling in a water seal chamber may indicate a leak in the system.
• Support for a pulmonary embolism (PE) includes administering oxygen and anticoagulant therapy.
• To prevent Ventilator-Associated Pneumonia (VAP), do not use sedation unless necessary.

Heart Failure and Hypertension Management

• Primary intervention for uncontrolled atrial fibrillation (a-fib) involves rate control or rhythm conversion.
• Transesophageal echocardiography (TEE) assesses cardiac function and rule out clots prior to cardioversion.
• Symptoms of right-sided heart failure include peripheral edema and jugular vein distention.
• Symptoms of left-sided heart failure include dyspnea and pulmonary congestion.
• Non-pharmacological methods, such as lifestyle changes, should be discussed to control hypertension.
• Monitoring INR for patients on warfarin should ideally be between 2.0 and 3.0.

Additional Health Considerations

• Deep vein thrombosis (DVT) prevention includes ambulation and compression socks.
• Symptoms of pericarditis could include sharp chest pain and a friction rub on auscultation.
• Changes in ECG for pericarditis might show ST-segment elevation.
• Non-modifiable risk factors for carotid artery disease include age and family history.
• Atherosclerosis is often silent until blockage reaches 70% or more.

Angina and GERD Insights

• Unstable angina is an emergency requiring immediate medical attention.
• Stable angina is typically relieved by rest or nitrates.
• Prinzmetal angina is caused by coronary spasm rather than plaque buildup.
• Symptoms of gastroesophageal reflux disease (GERD) include heartburn and regurgitation.
• A complication of GERD can be esophagitis or Barrett's esophagus.

Diabetes and UTI Risks

• Symptoms of hypoglycemia may include sweating, tremors, and confusion.
• Treatment for hypoglycemia includes administering glucose or carbohydrate-rich foods.
• Prolonged hyperglycemia can lead to complications such as neuropathy but does not directly cause weight gain.
• Symptoms generally associated with a urinary tract infection (UTI) include dysuria and frequency.
• Risk factors for UTI include female gender, urinary catheterization, and diabetes.
• Normal finding with phenazopyridine (Pyridium) may include orange urine.

Osteoporosis and Related Conditions

• A urinary catheter can promote higher UTI risk, especially if indwelling.
• Non-risk factors for osteoporosis include active exercise and healthy dietary habits.
• Diagnosis of osteoporosis is commonly done through a dual-energy X-ray absorptiometry (DEXA) scan.
• Teaching regarding osteoporosis includes recommending weight-bearing exercises.

Osteomyelitis and Paget's Disease

• Risk factors for osteomyelitis include diabetes and chronic steroid use.
• Manifestations of osteomyelitis may consist of localized pain and fever.
• The medication of choice for osteomyelitis often includes antibiotics.
• A test for osteomyelitis may not include a standard blood test; imaging may be required.
• Paget's disease symptoms may not always present as pain; some cases are asymptomatic.
• Treatments for Paget's disease typically include bisphosphonates but may not include complete immobilization.

Cataracts and Eye Health

• Postoperative teaching for patients having cataract surgery does not typically include avoiding all activities.
• Risk factors for cataracts include aging, UV exposure, and diabetes.
• As cataracts advance, they may cause blurred vision and sensitivity to light.
• Symptoms not associated with cataracts may include halos around lights.
• Glaucoma diagnoses may not involve routine vision checks; specialized tests are necessary.
• Symptoms of glaucoma include peripheral vision loss and elevated intraocular pressure.

Macular Degeneration Characteristics

• The most common type of macular degeneration is dry macular degeneration.
• An early sign of dry macular degeneration can include difficulty seeing in low light.
• Wet macular degeneration is an emergency requiring immediate treatment.
• Gradual vision changes are characteristic of dry macular degeneration, while rapid changes occur in the wet type.

Eye Injuries and Conditions

• Symptoms not indicative of corneal abrasion might be foreign body sensation or pain when blinking.