Med Surg Final Quiz

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Questions and Answers

Which of the following is a common cause of fluid volume deficit?

High sodium intake

Overhydration

Heart failure

Excessive sweating (correct)

What is a potential clinical manifestation of fluid volume deficit?

Tachycardia (correct)

Bounding pulse

Hypertension

Edema

Which intervention is appropriate for managing fluid volume deficit?

Encouraging bed rest

Encouraging diuretic use

Increasing sodium intake (correct)

Restricting fluid intake

What is a potential clinical manifestation of fluid volume excess?

Tachycardia Signup and view all the answers

Which electrolyte imbalance is often associated with fluid volume excess?

Hyponatremia Signup and view all the answers

What is a potential cause of fluid volume excess?

Heart failure Signup and view all the answers

What can occur with severe/sudden water excess of severe hyponatremia?

Seizures Signup and view all the answers

Potassium's normal range

3.5-5.0 Signup and view all the answers

Calcium's normal level

8.5-10 Signup and view all the answers

Sodium's normal range

135-145 Signup and view all the answers

What position should the patient be in with central lines?

Trendelenburg Signup and view all the answers

What do you clean the site of a central line with?

chlorhexidine Signup and view all the answers

what is a potential complication of central venous lines?

air embolism Signup and view all the answers

how do we maintain for central line patency?

flushing it (with NS or heparin) Signup and view all the answers

what is one important nursing care/intervention for central lines?

making sure it is well secured to the patient Signup and view all the answers

what is a hemolytic reaction?

incompatibility Signup and view all the answers

what is a febrile reaction?

reaction to WBC Signup and view all the answers

what is a mild allergic reaction?

rash Signup and view all the answers

what is a severe allergic reaction?

shock Signup and view all the answers

what is the normal platelet range?

150,000 - 450,000 Signup and view all the answers

what is a bleeding precaution for someone with thrombocytopenia?

using a soft-bristle toothbrush or gauze Signup and view all the answers

what is a hemophilia intervention/action?

checking for bruising, nosebleeds Signup and view all the answers

what is a client teaching for hemophilia?

importance of frequent CBC labs Signup and view all the answers

s/s of iron deficiency anemia

pallor Signup and view all the answers

what is NOT something that occurs with anemia?

warm extremities Signup and view all the answers

what is the priority intervention for sickle cell anemia?

oxygen Signup and view all the answers

s/s of sickle cell anemia

extreme pain Signup and view all the answers

which is NOT a treatment of sickle cell anemia?

limit fluid intake Signup and view all the answers

what should NOT be used for sickle cell anemia?

cold Signup and view all the answers

what stimulates bone marrow to produce RBCs?

erythropoietin Signup and view all the answers

what do we do if someone is allergic to blood transfusions in the past?

give Benadryl and start Signup and view all the answers

s/s of worsening oxygenation

changes in LOC Signup and view all the answers

what is used in a thoracentesis?

local anesthesia Signup and view all the answers

what is the patient instructed to do during a thoracentesis?

not move Signup and view all the answers

how much output can lead to hypotension during a thorancentesis?

> 500 mL Signup and view all the answers

what is a nursing intervention for someone with COPD?

pursed-lip breathing teaching Signup and view all the answers

what is the drive to breathe for COPD patients?

O2 Signup and view all the answers

s/s of asthma

wheezing, dyspnea, change in LOC Signup and view all the answers

what do we give in an acute asthma attack?

albuterol Signup and view all the answers

what do we monitor with albuterol?

tachycardia and tremors Signup and view all the answers

what is the treatment for TB?

long term medication Signup and view all the answers

who should NOT be involved in TB treatment?

house keeper Signup and view all the answers

where do we keep the chest tube unit?

below the insertion site Signup and view all the answers

what do you NOT do if the suction is disconnected from the chest tube?

shove it back together Signup and view all the answers

what does continuous bubbling mean?

air leak Signup and view all the answers

how do you support someone with a PE?

give oxygen and anticoagulants Signup and view all the answers

what should you NOT do to prevent VAP?

perform mouth care every 4 hours Signup and view all the answers

what is the primary intervention for uncontrolled a-fib?

CCB or beta blockers, amiodarone, or dig Signup and view all the answers

what is the purpose of a TEE?

detect a clot before cardioversion Signup and view all the answers

s/s of right-sided HF

JVD Signup and view all the answers

s/s of left sided heart failure

crackles Signup and view all the answers

what would we NOT do to control HTN?

gain weight Signup and view all the answers

what is NOT monitored for warfarin?

aPTT Signup and view all the answers

when taking warfarin, what should INR be at?

2-3 x higher Signup and view all the answers

DVT prevention includes what?

anticoagulation Signup and view all the answers

s/s of pericarditis

pleuritic chest pain Signup and view all the answers

pericarditis ECG change

ST elevation Signup and view all the answers

what is NOT a modifiable risk factor of carotid artery disease?

race Signup and view all the answers

what percentage blockage is atherosclerosis silent until?

40% Signup and view all the answers

what is NOT a type of angina?

constant Signup and view all the answers

which type of angina is an emergency?

unstable Signup and view all the answers

what type of angina is relieved by rest or medications?

stable Signup and view all the answers

what type of angina is caused by coronary spasm and not plaque buildup

varient Signup and view all the answers

which is NOT a s/s of coronary artery disease

restlessness Signup and view all the answers

what is NOT a s/s of GERD?

hypertension Signup and view all the answers

what is a complication of GERD?

barretts esophagus Signup and view all the answers

s/s of hypoglycemia

diaphoresis Signup and view all the answers

how do we treat hypoglycemia?

15-15 rule Signup and view all the answers

what is NOT a consequence of prolonged hyperglycemia?

liver damage Signup and view all the answers

which is NOT a manifestation of an UTI?

clear urine Signup and view all the answers

what is a risk factor of an UTI?

catheterization Signup and view all the answers

what is a normal finding with pyridium?

orange urine Signup and view all the answers

what kind of catheter promotes a higher risk for an UTI?

indwelling Signup and view all the answers

what is NOT a risk factor for osteoporosis?

premenopausal women Signup and view all the answers

what is the test used to diagnose osteoporosis?

DEXA Signup and view all the answers

which would we NOT teach the patient to do with osteoporosis

alcohol consumption Signup and view all the answers

what medication helps osteoporosis?

bisphosphinates Signup and view all the answers

what is NOT a risk factor for osteomyelitis?

children < 1 Signup and view all the answers

what is NOT a manifestation of osteomyelitis?

constipation Signup and view all the answers

what is the medication of choice for osteomyelitis?

IV antibiotics Signup and view all the answers

what is NOT a test for osteomyelitis?

CT Signup and view all the answers

what is NOT a manifestation of paget's disease?

small skull Signup and view all the answers

what is NOT a treatment for paget's disease?

pyridium Signup and view all the answers

what is used for someone who had a hip replacement?

raised toilet seat Signup and view all the answers

what should someone who has a hip replacement NOT do?

lie on affected side Signup and view all the answers

what is NOT a risk factor of cataracts?

being active Signup and view all the answers

what happens as cataracts advances?

pupil gets white/grey Signup and view all the answers

what is NOT a manifestation of cataracts?

rapid loss of vision Signup and view all the answers

what is NOT one of the postop teaching for patients having cataract surgery?

lifting objects more than 5 lb is okay Signup and view all the answers

which is NOT a risk factor of glaucoma?

hyperthyroidism Signup and view all the answers

what is a s/s of glaucoma?

gradual loss of peripheral vision Signup and view all the answers

what is the most common type of glaucoma?

open angle Signup and view all the answers

what type of glaucoma is an emergency?

acute angle Signup and view all the answers

which is NOT a teaching about glaucoma?

play contact sports Signup and view all the answers

what is the most common type of macular degeneration?

dry Signup and view all the answers

what is an early indication of dry macular degeneration?

drusen bodies Signup and view all the answers

which type of macular degeneration is an emergency?

wet Signup and view all the answers

which type of macular degeneration is gradual?

dry Signup and view all the answers

which type of macular degeneration is rapid?

wet Signup and view all the answers

what is NOT a s/s of corneal abrasion?

normal movement of the eye Signup and view all the answers

what is NOT a patient teaching for corneal abrasion?

no restrictions Signup and view all the answers

what is NOT a s/s of vertigo?

fatigue Signup and view all the answers

what should the nurse teach the patient about vertigo?

decrease salt, nicotine, alcohol Signup and view all the answers

what does meniere's triad consist of?

normal eye movements Signup and view all the answers

what medication does NOT help meniere's?

opioids Signup and view all the answers

what is another s/s of meniere's?

tinnitus Signup and view all the answers

what is NOT a way to keep symptoms manageable for meniere's?

limit exercise Signup and view all the answers

what is the cure for meniere's?

there is no cure Signup and view all the answers

what is NOT an intervention for vertigo?

X-Ray Signup and view all the answers

Study Notes

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.

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.

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Description

Test your knowledge on fluid volume deficit with this quiz. Explore common causes, clinical manifestations, and appropriate interventions for managing this condition.