Nursing Exam 2 Study Guide
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Questions and Answers

What is the preferred laboratory test for assessing malnutrition due to its quick response to inadequate nutrition?

  • Albumin measurement
  • Prealbumin assessment (correct)
  • Complete blood count
  • Electrolyte panel

    • Older adults are at the least risk for decreased perfusion due to non-modifiable risk factors.

    False

    List two foods rich in potassium (K+).

    Bananas, Potatoes

    Decreased peripheral perfusion can result in _____ and may lead to tissue ulcers or cell death.

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

    Match the signs and symptoms to the type of decreased perfusion:

    <p>Dyspnea = Decreased central perfusion Hypotension = Decreased central perfusion Coolness = Decreased peripheral perfusion Decreased hair distribution = Decreased peripheral perfusion</p> Signup and view all the answers

    What is the primary function of insulin in the body?

    <p>Promotes glucose uptake into cells</p> Signup and view all the answers

    Hyperglycemia is characterized by low blood sugar levels.

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

    Name one potential complication of hyperglycemia.

    <p>Kidney damage</p> Signup and view all the answers

    One risk factor for diabetes includes ______.

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

    Match the medical condition with its respective intervention:

    <p>Diabetes = Monitor blood glucose regularly Fluid imbalance = Monitor intake and output (I&amp;O) Clotting risk = Ambulate frequently Stress management = Educate on recognizing early signs</p> Signup and view all the answers

    Which of the following is NOT a risk factor for fluid and electrolyte imbalances?

    <p>Regular exercise</p> Signup and view all the answers

    It is advisable to avoid crossing legs to decrease the risk of clotting.

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

    What should a patient do if they experience redness and warmth in their lower extremities?

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

    Anticoagulants are also known as ______.

    <p>blood thinners</p> Signup and view all the answers

    Which symptom is NOT associated with hypoglycemia?

    <p>Increased thirst</p> Signup and view all the answers

    What is Respiratory Acidosis characterized by?

    <p>pH &lt; 7.35 + PaCO2 &gt; 45 mmHg</p> Signup and view all the answers

    Infiltration occurs when an IV catheter is inserted correctly but the vein ruptures.

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

    What are two common symptoms of phlebitis?

    <p>Redness and swelling</p> Signup and view all the answers

    Metabolic Alkalosis is characterized by a pH greater than 7.35 and HCO3 greater than ______ mEq/L.

    <p>26</p> Signup and view all the answers

    What is the most significant risk associated with anticoagulants?

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

    Match the treatment options with the condition:

    <p>Stop infusion and discontinue IV = Phlebitis Aspirate the drug from the catheter = Infiltration with vesicant Apply warm, moist compress = Phlebitis Discontinue IV if there is no vesicant = Infiltration without vesicant</p> Signup and view all the answers

    NSAIDs decrease the risk of peptic ulcers and gastritis.

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

    List one side effect of NSAIDs related to the gastrointestinal system.

    <p>Gastric irritation</p> Signup and view all the answers

    Which of the following is NOT a risk factor for phlebitis?

    <p>Slow IV rates</p> Signup and view all the answers

    Excessive CO2 retention in the body leads to the formation of ______, which decreases blood pH.

    <p>carbonic acid</p> Signup and view all the answers

    What is the technical term used when a damaging drug enters the tissues from an IV?

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

    Match the following side effects with their corresponding medication type:

    <p>NSAIDs = Gastric irritation Anticoagulants = Bleeding Opioids = CNS depression Antiplatelets = Petechiae</p> Signup and view all the answers

    Which of the following is a sign of thrombocytopenia?

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

    Anemia can be caused by NSAIDs due to chronic blood loss from the gastrointestinal tract.

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

    What condition is marked by redness, pain, swelling, and warmth in the legs and indicates increased clotting?

    <p>Venous thrombosis</p> Signup and view all the answers

    A drop in platelet count associated with heparin is known as ______.

    <p>heparin induced thrombocytopenia (HIT)</p> Signup and view all the answers

    What is provided through patient-controlled analgesia (PCA) for post-operative pain control?

    <p>A steady, low-level basal dose</p> Signup and view all the answers

    What is the primary component of extracellular fluid?

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

    Transcellular fluid is part of the interstitial fluid compartment.

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

    List the two major divisions of extracellular fluid.

    <p>Intravascular fluid and Interstitial fluid.</p> Signup and view all the answers

    The fluid secreted by epithelial cells is referred to as ______.

    <p>transcellular fluid</p> Signup and view all the answers

    Which of the following is NOT a sign of acute hemolytic transfusion reaction?

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

    It is important to administer antihistamines in response to febrile non-hemolytic transfusion reactions.

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

    What should a nurse do first when a febrile non-hemolytic transfusion reaction is suspected?

    <p>Stop the transfusion.</p> Signup and view all the answers

    Signs of severe allergic reactions may include ______ and ______.

    <p>Hypotension, Bronchospasm</p> Signup and view all the answers

    Match the transfusion reactions to their signs and symptoms:

    <p>Febrile non-hemolytic reaction = Temperature increases by more than 2% Acute hemolytic reaction = Fever and chills Allergic reaction = Urticaria and pruritus Severe allergic reaction = Hypotension and bronchospasm</p> Signup and view all the answers

    Study Notes

    Exam 2 Study Guide

    • Fluid and Electrolytes (Potter & Perry Chapter 42): Includes normal values for electrolytes (sodium, potassium, chloride, total CO2, bicarbonate, calcium, magnesium, phosphate, anion gap) and arterial blood gases (pH, PaCO2, PaO2, O2 saturation, base excess).
    • Overview of Health Concepts for Medical-Surgical Nursing (Ignatavicius Chapter 3): Covers general health concepts.
    • Antihypertensive and Anemia Drugs (Lilley Chapters 22 and 54): Details antihypertensive medications and anemia drugs.

    Metabolic Acidosis

    • Signs and Symptoms (Physical): Kussmaul respirations, decreased level of consciousness, abnormal heartbeat (hypokalemia), abdominal pain (nausea & vomiting), and low blood pressure.
    • Signs and Symptoms (Lab): pH below 7.35, HCO3 below 21.
    • Important Considerations: Acidosis leads to a chain reaction, where dehydration worsens the problem and hypokalemia disrupts heart signals..

    Metabolic Alkalosis

    • Causes: Increase of bicarbonate (excessive administration of sodium bicarbonate, massive blood transfusion, mild/moderate ECV deficit), loss of metabolic acid (vomiting, NGT suction, hypokalemia, dehydration, excess aldosterone).
    • Signs and Symptoms (Physical): Lightheadedness, numbness/tingling (fingers, toes, circumoral), muscle cramps, decreased level of consciousness, and dysrhythmias.
    • Signs and Symptoms (Lab): pH above 7.45, HCO3 above 28 (compensated).

    Respiratory Acidosis

    • Causes: Not breathing out enough CO2.
    • Signs & Symptoms (Physical): Decreased level of consciousness (lethargy, confusion, coma), abdominal pain, dysrhythmias
    • Signs & Symptoms (Lab): pH below 7.35, PaCO2 above 45, HCO3 normal (compensated) above 28.

    Respiratory Alkalosis

    • Causes: Breathing out too much CO2 quickly.
    • Signs & Symptoms (Physical): Lightheadedness, numbness/tingling (fingers, toes, circumoral region), increased respirations, dysrhythmias
    • Signs & Symptoms (Lab): pH above 7.45, PaCO2 below 35, HCO3 normal (uncompensated) below 21.

    Blood Gases

    • Normal Values: pH (7.35-7.45), PaCO2 (35-45 mmHg), PaO2 (80-100 mmHg), HCO3 (21-28 mEq/L).

    Phlebitis and Infiltration

    • Phlebitis: Inflammation of a vein, often due to IV solutions, rapid infusion rates, medications, improper catheter placement. Symptoms include redness, swelling, warmth, and pain at the IV site.
    • Infiltration: Occurs when IV fluid leaks into the surrounding tissues. Symptoms include swelling, coolness, blanching of the area, and edema.

    Hyperkalemia

    • Causes: Increased potassium intake, insufficient insulin, shift of potassium from cells into the extracellular fluid, decreased potassium output.
    • Symptoms: Muscle weakness, life-threatening cardiac dysrhythmias, cardiac arrest, abdominal cramps, and diarrhea.

    Hypokalemia

    • Causes: Loss of potassium, diuretics, vomiting, diarrhea, use of potassium-sparing diuretics, or adrenal insufficiency
    • Symptoms: Muscle weakness, life-threatening cardiac dysrhythmias, cardiac arrest, abdominal cramps, and diarrhea

    Blood Transfusion Reactions

    • Febrile Nonhemolytic Reaction (FNHTR): Immune response to white blood cells, such as fever, chills, headache, and vomiting.
    • Acute Hemolytic Transfusion Reaction (AHTR): Incompatible blood transfusions; symptoms such as fever, chills, tachycardia, hypotension, abdominal pain, chest pain, back pain, flank pain, dyspnea, and shock.
    • Allergic Reaction (Allergic Transfusion Reaction): Signs like urticaria, pruritus, facial flushing, and mild wheezing.
    • Severe Allergic Reaction: Hypotension, tachycardia, urticaria, bronchospasm, anxiety, nausea, vomiting, diarrhea and abdominal pain.
    • Transfusion Related Acute Lung Injury (TRALI): Symptoms include fever, respiratory failure, hypoxemia, hypotension, and pulmonary edema.
    • Transfusion Associated Circulatory Overload (TACO): Symptoms include dyspnea, cyanosis, tachycardia, orthopnea, jugular vein distention, hypertension, and cough.

    Other important conditions:

    • Anemia: Low red blood cell count.
    • Chronic Kidney Disease: Kidney impairment; symptoms include fatigue, swelling, changes in urination, high blood pressure, nausea/vomiting.
    • Diabetes Mellitus: Elevated blood sugar; symptoms include fatigue, increased urination, and thirst.
    • Peripheral Vascular Disease (PVD): Impaired blood flow to the extremities, resulting in pain, coolness, and decreased pulses.

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    Exam 2 Study Guide PDF

    Description

    Prepare for your Nursing Exam 2 with this comprehensive study guide that covers essential topics like Fluid and Electrolytes, metabolic acidosis and alkalosis, and key medications such as antihypertensive and anemia drugs. Each concept is crucial for understanding medical-surgical nursing and effective patient care.

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