Nursing Care and Medication Management Quiz
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Questions and Answers

What is the first sign of low oxygen levels in a patient?

  • Hypoxemia
  • Cyanosis
  • Restlessness and agitation (correct)
  • Tachycardia

    • Which medication is considered a rescue treatment for asthma?

  • Nebulizer treatment
  • Antibiotics
  • Corticosteroids
  • Albuterol (correct)

    • What nursing intervention is appropriate for a patient experiencing pneumonia symptoms?

  • Provide a low-oxygen environment
  • Encourage fluids and ambulation (correct)
  • Recommend a high-carb diet
  • Limit patient mobility

    • Which assessment method would NOT typically be used for diagnosing pneumonia?

    <p>Electrocardiogram (ECG)</p> Signup and view all the answers

    What is a common side effect of corticosteroid use in patients?

    <p>Thrush</p> Signup and view all the answers

    Which of the following signs is NOT associated with asthma?

    <p>Rash</p> Signup and view all the answers

    In the management of asthma, when is it crucial to never leave the patient alone?

    <p>When having an asthma attack</p> Signup and view all the answers

    What is a recommendation for monitoring a patient on steroids?

    <p>Check for elevated blood glucose levels</p> Signup and view all the answers

    What is the primary use for a hypotonic solution like half NS (0.45%)?

    <p>Cerebral edema</p> Signup and view all the answers

    Which of the following is a characteristic sign of hyperkalemia?

    <p>Muscle weakness</p> Signup and view all the answers

    What effect does IV insulin have on potassium levels?

    <p>It lowers potassium levels.</p> Signup and view all the answers

    Which electrolyte has a normal range of 3.5 - 5?

    <p>Potassium</p> Signup and view all the answers

    Which symptom is associated with hypovolemia?

    <p>Low blood pressure</p> Signup and view all the answers

    What treatment is indicated for severe hyperkalemia?

    <p>Kayexalate and glucose with insulin</p> Signup and view all the answers

    Which food would you instruct a patient to avoid to manage hyperkalemia?

    <p>Bananas</p> Signup and view all the answers

    Which of the following is NOT a cause of hypokalemia?

    <p>Renal failure</p> Signup and view all the answers

    Which symptom is commonly associated with a left side stroke?

    <p>Aphasia or dysphasia</p> Signup and view all the answers

    What type of medication is TPA?

    <p>Thrombolytic</p> Signup and view all the answers

    Which of the following conditions requires antibiotics?

    <p>Acute otitis media</p> Signup and view all the answers

    In the case of a myocardial infarction (MI), what does ST elevation indicate?

    <p>Occlusive thrombus</p> Signup and view all the answers

    Which nursing intervention is appropriate to manage a patient experiencing a myocardial infarction?

    <p>Provide aspirin and call 911</p> Signup and view all the answers

    What distinguishes unstable angina from chronic stable angina?

    <p>Predictability of symptoms</p> Signup and view all the answers

    What is a common symptom associated with right-sided heart failure?

    <p>Peripheral edema</p> Signup and view all the answers

    What condition is typically differentiated by the causative organisms in a cerebrospinal fluid analysis?

    <p>Meningitis</p> Signup and view all the answers

    What is a primary postoperative goal for patients undergoing eye surgery?

    <p>Remain free of infection and other complications</p> Signup and view all the answers

    Which nursing management strategy is crucial for educating patients post-surgery?

    <p>Educate about disease processes and treatment options</p> Signup and view all the answers

    What clinical manifestation may indicate a deterioration in a patient's vision post-surgery?

    <p>Increased glare sensitivity</p> Signup and view all the answers

    Which diagnostic study is useful in assessing the condition of a patient's eyes?

    <p>Ophthalmoscopy</p> Signup and view all the answers

    What is a recommended non-surgical intervention for patients experiencing visual difficulties?

    <p>Regular changes to their eyewear prescription</p> Signup and view all the answers

    What is the primary characteristic of Type 1 diabetes?

    <p>Autoimmune response affecting insulin production</p> Signup and view all the answers

    Which treatment is NOT typically used in managing Diabetic Ketoacidosis (DKA)?

    <p>Antibiotics</p> Signup and view all the answers

    What is the typical peak time for short-acting insulin?

    <p>2-5 hours</p> Signup and view all the answers

    What condition is characterized by a fasting blood glucose of 126 or above?

    <p>Diabetes mellitus</p> Signup and view all the answers

    Which of the following is a cause for hypertension?

    <p>Sleep apnea</p> Signup and view all the answers

    What does the acronym F.A.S.T stand for in assessing stroke symptoms?

    <p>Face, Arms, Speech, Time</p> Signup and view all the answers

    What is the typical blood glucose level that indicates Hyperglycemic Hyperosmolar State (HHS)?

    <p>600 mg/dL</p> Signup and view all the answers

    Which class of medication aids in lowering blood glucose by stimulating the pancreas to produce more insulin?

    <p>Sulfonylureas</p> Signup and view all the answers

    What is considered a hypertensive crisis based on blood pressure readings?

    <p>180/120 mmHg</p> Signup and view all the answers

    What common side effect is associated with the Dawn phenomenon in diabetes?

    <p>Abnormal morning increase in blood glucose</p> Signup and view all the answers

    What is the main concern regarding acute endocarditis?

    <p>It appears abruptly and can deteriorate rapidly.</p> Signup and view all the answers

    Which population is at the highest risk of contracting meningitis?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of TPN (Total Parenteral Nutrition)?

    <p>To meet nutritional needs when the GI tract cannot be used.</p> Signup and view all the answers

    Which condition is commonly associated with untreated strep throat?

    <p>Rheumatic fever</p> Signup and view all the answers

    When monitoring a patient receiving tube feeding, what should be considered if the residual volume is greater than 500 mL?

    <p>Call the healthcare provider.</p> Signup and view all the answers

    What is a critical nursing diagnosis for patients with cataracts?

    <p>Self-Care Deficits</p> Signup and view all the answers

    What intervention should be avoided after pacemaker insertion?

    <p>Direct blows to the chest.</p> Signup and view all the answers

    Which imaging study is most reliable to check placement of a feeding tube?

    <p>Chest X-ray</p> Signup and view all the answers

    What should a patient with a pacemaker keep in mind regarding travel?

    <p>Carry a pacemaker ID card.</p> Signup and view all the answers

    Which laboratory value indicates malnutrition in a patient?

    <p>Low albumin levels</p> Signup and view all the answers

    In the context of failure to thrive, what physical problem can contribute to rapid deceleration in growth?

    <p>Cardiac defects</p> Signup and view all the answers

    What is a common etiology contributing to the development of cataracts?

    <p>Long-term corticosteroid use</p> Signup and view all the answers

    When assessing a patient with endocarditis, which symptom may indicate complications?

    <p>Rapid heart rate</p> Signup and view all the answers

    What should be done if a patient complains of cramping while receiving antibiotics through a central line?

    <p>Slow down the infusion.</p> Signup and view all the answers

    Study Notes

    Fluid and Electrolytes

    • Types of Solutions:
      • Hypotonic: Half normal saline (0.45%).
      • Isotonic: Normal saline and lactated Ringer's.
      • Hypertonic: 3% saline.
    • Uses:
      • Hypotonic: Cerebral edema, hyponatremia, hypovolemia.
      • Isotonic: Surgery, burns, blood loss.
      • Hypertonic: DKA, hypernatremia, sick cell.
    • Hypovolemia:
      • High blood pressure.
      • Rapid weight gain.
      • Edema.
      • Increased urine output.
      • Bounding pulse.
      • Shortness of breath (SOB).
      • Crackles (abnormal lung sounds).
      • Dedicated level of consciousness (LOC).
    • Hypervolemia:
      • Low blood pressure.
      • Dry mouth.
      • Rapid weight loss.
      • Low urine output.
      • Confusion.
      • Lethargy.
    • Normal Electrolyte Levels:
      • Potassium: 3.5 - 5.
      • Calcium: 9 - 11.
      • Sodium: 135 - 145.

    Potassium

    • Potassium Pumps the Heart: Immediately think cardiac monitor for potassium imbalances.

    • IV Insulin: Lowers potassium, SQ insulin does not.

    • Potassium Burns: A vesicant (causes blistering).

    • Foods High in Potassium: Avocados, fish, bananas, orange juice, raisins, dried fruits, meat, milk, fruits, vegetables, salt substitutes.

    • Hyperkalemia (High Potassium):

      • Signs/Symptoms: Changes in ECG (wide QRS, prolonged PR, absent P waves), muscle weakness/cramping, leg pain, areflexia, slow pulse, low blood pressure, diarrhea, abdominal cramping, nausea, oliguria.
      • Causes: Kidney failure, salt/potassium supplements, old blood transfusions, cell destruction, acidosis, hypoxia, exercise, catabolic state, potassium-sparing diuretics.
      • Treatment: Cardiac monitor, Kayexalate (oral or enema), calcium gluconate, glucose & insulin IV, restrict potassium-rich foods (meats, dairy, bananas, OJ, avocados, broccoli, potatoes, spinach), stop IV potassium, use diuretics (Lasix) if kidneys are functioning, dialysis may be needed.

    • Hypokalemia (Low Potassium):

      • Causes: Excessive vomiting, suctioning, dehydration, diarrhea, medications (diuretics, laxatives, insulin), alkalosis, rapid cell building (B12 or erythropoietin), aldosterone.
      • Signs/Symptoms: Weakness, nausea, vomiting, dysrhythmias (ST depression, changes in T waves, increased U waves), constipation, low blood pressure, increased pulse, increased digoxin toxicity, muscle weakness/paralysis, muscle cramps, rhabdomyolysis, hyperglycemia, diuresis.
      • Treatment: Encourage foods high in potassium (fruit juice, citrus fruits, dried fruits, bananas, nuts, vegetables). Monitor for digitalis toxicity. Stop diuretics (HCTZ, Lasix, cortisone). Ensure adequate urine output (600 mL/day or higher).

    Sodium

    • Hyponatremia: LOW sodium (less than 135 mEq/L) neuro/LOC concerns.

      • Symptoms: confusion, headaches, seizures (can progress to coma), abdominal cramps, nausea and vomiting.

    • Hypernatremia: HIGH sodium. Symptoms include lethargy, headache, confusion, apprehension, seizures, and coma.

    ABG's

    • Normal pH: 7.35-7.45.

    • Normal CO2: 35-45.

    • Normal HCO3: 22-26.

    • Respiratory Alkalosis: High ph, low CO2. Causes include hyperventilation. Metabolic: caused by vomiting, NG suction, diuretics, hypokalemia.

    • Respiratory Acidosis: Low pH, high CO2. Causes include COPD, pneumonia.

    • Metabolic Alkalosis: High pH, high HCO3. Causes include vomiting, NG suction, diuretics, hypokalemia.

    • Metabolic Acidosis: Low pH, low HCO3. Causes include DKA, diarrhea, renal failure, and starvation

    Anemia

    • Sickle Cell:
      • Signs/Symptoms: Low oxygen, pain, shortness of breath (SOB), jaundice, vision issues, organ failure, acute chest syndrome.
      • Interventions: Hydration, oxygen, pain management (hydroxyurea).
    • B12 Deficiency:
      • Signs/Symptoms: GI tract issues (sore, red, beefy tongue, anorexia, nausea, vomiting), abdominal pain, weakness, paresthesia (feet and hands), ataxia, reduced sensation, muscle weakness, impaired thought process.

    Blood Transfusion

    • Verification: Verify order, patient identity, blood type, and consent with two licensed personnel at bedside.
    • Infusion: Start slowly, monitor patient closely for first 15 minutes, vital signs per protocol; complete transfusion within 4 hours.
    • Reactions: STOP transfusion; maintain IV with normal saline; assess patient; notify Blood Bank and healthcare provider; send blood and tubing to lab; obtain labs and urine specimens; document.

    Pneumonia

    • Signs/Symptoms: Fever, tachypnea (rapid breathing)/dyspnea (shortness of breath), tachycardia, productive cough, chest pain, shaking chills, hypoxemia (low oxygen), Altered LOC, restless, agitation.
    • Interventions: Chest x-ray, sputum Gram stain, blood cultures, ABGs, antibiotics, nebulizer treatments, encourage fluids and ambulation, high fowler's position.

    Asthma

    • Signs/Symptoms: Albuterol, Corticosteroids, nasal polyps, asthma sensitive to NSAIDS, wheezing, dyspnea, prolonged expiration, chest tightness, speaking 1-2 words, tachycardia, anxiety, silent chest.
    • Interventions: Never leave pt in distress when having an attack. Albuterol and Corticosteroids to manage. Encourage fluids.

    Diabetes

    • Type 1 Diabetes: Autoimmune disease, cannot make insulin.
    • Type 2 Diabetes: Inadequate insulin secretion and resistance to cellular level.
      • Symptoms: Hyperglycemia (high blood glucose), possibly fruit-smelling breath, kussmal breathing, lethargic, and abdominal pain.
    • Treatment: Hydration (normal saline), regular/short-acting insulin, Potassium (10 meq/hr).
    • Normal Ranges: A1C ≥ 6.5, fasting blood glucose ≥ 126.
    • Types of Insulin: Rapid-acting (Lispro, Aspart, Glulisine, Apidra), short-acting (Regular, Humulin N, Novolin N), intermediate-acting (Humulin R, Novolin R), and long-acting (Glargine, Detemir, Degludec).

    Hypertension.

    • Causes: Cirrhosis, oral birth control, corticosteroids, SNS stimulants, endocrine disorders, neurological disorders, renal disease, sleep apnea.
    • Medications: ARBs, sartans, ACE inhibitors, beta-blockers, calcium channel blockers.
    • Management: DASH diet, low sodium, limit alcohol, exercise (30 minutes x 5 days a week), manage weight (BMI 18-25), stop smoking.
    • Labs to Monitor: HDL (+50), LDL (<100), triglycerides (<150), total cholesterol (<200).

    Stroke

    • Ischemic: Blood clot within the brain (cannot be seen in a CT scan). Mini stroke (TIA) puts you at higher risk for ischemic stroke. Watch for sudden numbness, confusion, trouble seeing, trouble walking, severe headaches. Act FAST (Face, Arms, Speech, Time!).
    • Hemorrhagic: Major bleed, patient often states "worst headache of my life." Ataxia, loss of muscle coordination, Hemianopsia (blindness in half the field of vision).
    • Interventions (Ischemic): CT scan, TPA if applicable (within 3-4.5 hours of onset).
      • Interventions (Hemorrhagic): Antiplatelets, anticoagulants.

    Myocardial Infarction (MI)

    • Types: ST-elevation MI (STEMI) - complete blockage, and Non-ST-elevation MI (NSTEMI) - partial or incomplete blockage.
    • Symptoms: ST elevation in ECG leads facing the infarction (90 min for STEMI); NSTEMI 12-72 hrs.

    Acute Otitis Media

    • Treatment: Antibiotics are required.

    Heart Failure

    • Left Side: Think lungs.
    • Right Side: Think rest of the body.
    • ECG Rhythm: An EKG shows the heart's electrical activity in a rhythmic waveform pattern.

    Meningitis

    • Causes: Bacterial (bacterial infection) or Viral (HIV, Herpes).
    • Bacterial: Streptococcus
    • Population at risk: +65, Prisons, People in dorms, Young.
    • Viral: HIV, Herpes

    Endocarditis

    • Definition: Disease of the endocardium and heart valves. Can be subacute (months) or acute (progressive illness).
    • Cause: Blood flow allows organisms to enter and infest previously damaged valves.

    Failure to Thrive

    • Causes: Underlying physical problems (medical issues, chromosomal abnormalities, lung/heart defects). Malnutrition.

    Pacemaker

    • Follow-up appointments.
    • Avoid direct blows.
    • No high-output generator (unless approved).
    • Microwaves OK.
    • Avoid antitheft devices.
    • Travel not restricted.
    • Monitor pulse, Pacemaker ID card, Medic alert ID card.

    Enteral Nutrition

    • Definition: Feeding a person with a functional gastrointestinal tract. Administering balanced liquefied food or formula through a stomach/intestinal tube.
    • Functioning GI Tract: Tube feeding is indicated if patient is unable or unsafe to take enough oral nutrition.

    Parenteral Nutrition

    • Definition: Nutrients are delivered directly into the bloodstream when the patient's GI tract is not functional for ingestion, digestion, and absorption.
    • Purpose: Meet needs when the GI tract is not functional. Customized to patient’s needs.

    Tonsillectomy

    • Post-op instructions: No red liquids, No suction.

    Vision

    • Classifications: Based on visual acuity in the better eye with correction:
      • 20/30-20/60: Mild loss/near normal vision.
      • 20/70-20/160: Moderate visual impairment.
      • 20/200 or worse: Severe visual impairment (legal blindness).
      • 20/500-20/1000 : Profound visual impairment
      • Less than 20/1000 : Near-total visual impairment
      • No light perception: Total visual impairment

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    Description

    This quiz covers essential topics related to nursing interventions, medication management, and assessment techniques in the context of respiratory conditions, electrolyte imbalances, and the use of corticosteroids. Test your knowledge on the signs and treatments associated with low oxygen levels, asthma, pneumonia, and hyperkalemia. Ideal for nursing students and professionals looking to reinforce their understanding of critical care concepts.

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