Nursing Quiz on Dumping Syndrome and ABGs

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Questions and Answers

Which of the following is a characteristic of dumping syndrome?

Decreased heart rate and blood pressure

Increased blood flow to extremities

Slow gastric emptying rate

Rapid emptying of gastric contents into the duodenum (correct)

A patient experiencing dumping syndrome is likely to exhibit which combination of symptoms?

Bradycardia, hypertension, and dry skin

Tachycardia, pallor, and acute abdominal distress (correct)

Lethargy, bounding pulse, and decreased bowel sounds

Bradypnea, flushed skin, and increased urination

Which of the following dietary modifications is recommended for a patient with dumping syndrome?

Decrease in protein content

Increase in fluid intake with meals

Increase in protein content (correct)

Increase in carbohydrate content

Which intervention would be LEAST appropriate for managing dumping syndrome?

Consuming large amounts of fluids with each meal (A) Signup and view all the answers

In addition to 'drunk' and 'shock' symptoms, what other significant condition is present in a patient experiencing dumping syndrome?

Acute abdominal distress (B) Signup and view all the answers

A patient's arterial blood gas results show a pH of 7.30. According to the provided reference values, how would this be characterized?

Acidic (D) Signup and view all the answers

When assessing a patient's arterial blood gas, which value should you analyze first to determine acid-base imbalances?

pH (A) Signup and view all the answers

What is the normal range for partial pressure of carbon dioxide (CO2) in arterial blood gas analysis, according to the reference values provided?

35 to 45 (D) Signup and view all the answers

A patient experiencing hyperkalemia would MOST likely exhibit which of the following?

Tented T waves and bradycardia (A) Signup and view all the answers

According to the provided ranges, a patient with a bicarbonate (HCO3) level of 30 would be considered:

Higher than normal (A) Signup and view all the answers

If a patient presents with a pH of 7.50, what would be the initial interpretation of their acid-base status?

Alkalotic (B) Signup and view all the answers

Which of the following clinical manifestations is MOST consistent with hypokalemia?

Tachycardia and polyuria (B) Signup and view all the answers

What is the normal range for pH, as provided in the text?

7.35 to 7.45 (A) Signup and view all the answers

A patient with hypercalcemia would MOST likely present with which of the following symptoms?

Lethargy and constipation (A) Signup and view all the answers

A patient has a CO2 of 25. According to the content, the patient's CO2 level is:

Lower than normal (D) Signup and view all the answers

What set of symptoms suggests hypocalcemia?

Agitation and hyperreflexia (D) Signup and view all the answers

Which electrolyte imbalance is MOST strongly associated with muscle tetany?

Hypocalcemia (C) Signup and view all the answers

Which arterial blood gas value should be examined last when evaluating a patient for acid-base disturbances?

This is not specified (A) Signup and view all the answers

A patient is exhibiting diarrhea, which electrolyte imbalance is most likely the cause?

Hyperkalemia (A) Signup and view all the answers

A patient's arterial blood gas shows a pH of 7.40, a CO2 of 40, and an HCO3 of 24. How would these values be described?

Within normal limits (D) Signup and view all the answers

If a patient is experiencing neurological symptoms along with skeletal involvement, which electrolyte is the MOST likely to be imbalanced?

Calcium (B) Signup and view all the answers

If a patient has a pH of 7.30 and a CO2 of 30. What two concepts could be initially considered?

Acidosis and respiratory alkalosis (A) Signup and view all the answers

Which of the following best describes the relationship between magnesemia and its associated symptoms?

Symptoms decrease with increased levels (hypermagnesemia) (D) Signup and view all the answers

What is a major risk associated with low calcium levels?

Tetany leading to airway spasm (B) Signup and view all the answers

Which symptom is NOT associated with hypothyroidism?

Increased metabolism (B) Signup and view all the answers

What should be clarified regarding a patient's Synthroid medication before surgery?

NPO order for Synthroid (C) Signup and view all the answers

What is a significant concern in myxedema coma?

Decreased mental status (C) Signup and view all the answers

Which of the following is a characteristic sign of Addison's disease?

Hyperpigmentation of the skin (B) Signup and view all the answers

What could happen if a patient with Addison's disease cannot adapt to stress?

Risk of shock or adrenal crisis (D) Signup and view all the answers

What should patients with severe hypothyroidism avoid prior to surgery?

Sedation (D) Signup and view all the answers

What is the purpose of the stress response in an individual?

To maintain normal blood pressure and glucose levels (A) Signup and view all the answers

What is the primary treatment for Addisonian crisis?

Steroids (D) Signup and view all the answers

What signaling symptom might indicate a patient with Cushing's syndrome?

Truncal obesity (B) Signup and view all the answers

In patients receiving glucocorticoid therapy, what is important to monitor for due to the similarity in symptoms to diabetes?

Accu-Checks (A) Signup and view all the answers

Which of the following is NOT a common side effect of steroids?

Weight gain from muscle mass (C) Signup and view all the answers

What is an essential characteristic of toys suitable for infants at least 9 months old?

They provide verbal interaction. (C) Signup and view all the answers

What occurs after a bilateral adrenalectomy?

Addison disease (D) Signup and view all the answers

Which type of play is predominantly exhibited by toddlers aged 1 to 3 years?

Parallel play (A) Signup and view all the answers

What is a significant complication to consider for a patient on steroid therapy who also has diabetes?

Worsening hyperglycemia (D) Signup and view all the answers

Which of the following activities is most appropriate for preschoolers to enhance their fine motor skills?

Using scissors to cut paper (C) Signup and view all the answers

Which of the following is a common sign in a patient with Cushing's syndrome?

Buffalo hump (B) Signup and view all the answers

When selecting toys for children, which of the following is NOT a consideration?

Is it on sale? (B) Signup and view all the answers

What is one characteristic of school-aged children (7 to 11 years) in terms of play?

They show creativity in their play. (A) Signup and view all the answers

At what age do individuals begin to exhibit characteristics of peer group association?

12 to 18 years (B) Signup and view all the answers

Which is a primary focus of play for preschool-aged children?

Imaginative cooperative activities (C) Signup and view all the answers

What permanent restriction applies to patients who have undergone a laminectomy?

They should avoid horseback riding indefinitely. (B) Signup and view all the answers

What skill should toddlers focus on developing that involves engaging in physical activities?

Gross motor skills through running (C) Signup and view all the answers

Study Notes

Acid-Base Balance

Normal values for pH, CO2, and HCO3 (bicarbonate) are: pH 7.35-7.45, CO2 35-45, HCO3 22-26.
Acidotic imbalance if pH <7.35.
Alkalotic imbalance if pH >7.45.
Determine if the imbalance is metabolic or respiratory by checking if HCO3 moves in the same or opposite direction as pH.
If pH and HCO3 move in the same direction, it's metabolic; otherwise, it's respiratory.

Drug Toxicities

Lithium is used for bipolar disorder (manic episodes) with a therapeutic level of 0.6-1.2 and a toxic level of >2.0. A gray area exists between 1.3 and 2.
Lanoxin (Digoxin) is used to treat atrial fibrillation (A-Fib) and congestive heart failure (CHF) with a therapeutic level of 1-2 and a toxic level of >2.
Aminophylline is a bronchodilator with a therapeutic level of 10-20 and a toxic level >20.
Dilantin (phenytoin) is a seizure medication with a therapeutic level of 10-20 and a toxic level of >20.
Bilirubin is a breakdown product of red blood cells. Normal adult levels are 0.2-1.2. Neonatal bilirubin levels can be much higher. Levels above 20 are considered toxic.

Maternity and Neonatology

Naegele's rule is used to estimate the due date (EDD). (Add 7 days to the LMP, subtract 3 months.)
Normal weight gain during pregnancy is 25-31 lbs.
A 12-week prenatal visit, the next visit will be at 16 weeks.
Fetal heart rate is 120-160 bpm. Quickening usually occurs between 16-20 weeks.
The 3 stages of labor are Latent, Active, and Transition.
The 4th stage of labor is recovery (2 hours after delivery of placenta).
"LION" can help remember interventions for low fetal heart rate. (Left side, IVs, Oxygen, Notify HCP.)
Monitor the fetus and manage any complications at delivery and postpartum.

Emergency/Crisis Care

A pt with a suspected overdose, the first question to answer is "Is it an upper or a downer?"
DKA (Diabetic Ketoacidosis) complications is related to hyperglycemia, dehydration, ketones in the blood, and acidosis. Assess for tachycardia, Kussmaul breathing, dry mouth, and hot, dry skin. Treatment includes insulin IV, fluid volume replacement (200 mL/hr).
HHNK (Hyperosmolar Hyperglycemic Nonketotic Syndrome) complications are a type 2 diabetes complication. Assess for dry, flushed skin, decreased turgor, increased HR, and dehydration. Treatment includes fluid volume replacement.

Prioritization, Delegation

Prioritization of patients is based on the severity and immediacy of the condition.
The modifying phrase in assessment questions usually carries the priority information.
UAP duties (activities of daily living tasks) may be delegated to patients. However, assessment, administering medications (IV, oral), or making a care plan should NOT be delegated.

Psychosocial Aspects

Denial is a common psychological defense mechanism.
Dependency arises when the person depends on others for decisions or actions, while codependency is when someone derives self-esteem from meeting another person's needs.
Effective communication in psychiatric care includes techniques such as empathy, concreteness, avoidance of direct advice, and acknowledgment of feelings.

Infectious Disease/Transmission-Based Precautions

Standard precautions (universal precautions), contact precautions, droplet precautions, and airborne precautions are applied based on the pathogen.
PPE (personal protective equipment) for contact or droplet precautions includes gown, gloves, and mask. Airborne precaution also includes a respirator mask or N95 mask.

Fetal Monitoring

Low fetal heart rate, should do "LION" (Left side, IVs, Oxygen, Notify HCP, Stop Pitocin)
High fetal heart rate should document and manage but is often not as high a priority
Low baseline variability is concerning (do LION)
High baseline variability is good.

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Description

Test your knowledge on dumping syndrome, its symptoms, dietary recommendations, and management strategies. Additionally, explore key concepts in arterial blood gas analysis, including pH levels and hyperkalemia implications. This quiz is perfect for nursing students looking to solidify their understanding of these critical health topics.