Podcast
Questions and Answers
Which of the following is a characteristic of dumping syndrome?
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?
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?
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?
Which intervention would be LEAST appropriate for managing dumping syndrome?
In addition to 'drunk' and 'shock' symptoms, what other significant condition is present in a patient experiencing dumping syndrome?
In addition to 'drunk' and 'shock' symptoms, what other significant condition is present in a patient experiencing dumping syndrome?
A patient's arterial blood gas results show a pH of 7.30. According to the provided reference values, how would this be characterized?
A patient's arterial blood gas results show a pH of 7.30. According to the provided reference values, how would this be characterized?
When assessing a patient's arterial blood gas, which value should you analyze first to determine acid-base imbalances?
When assessing a patient's arterial blood gas, which value should you analyze first to determine acid-base imbalances?
What is the normal range for partial pressure of carbon dioxide (CO2) in arterial blood gas analysis, according to the reference values provided?
What is the normal range for partial pressure of carbon dioxide (CO2) in arterial blood gas analysis, according to the reference values provided?
A patient experiencing hyperkalemia would MOST likely exhibit which of the following?
A patient experiencing hyperkalemia would MOST likely exhibit which of the following?
According to the provided ranges, a patient with a bicarbonate (HCO3) level of 30 would be considered:
According to the provided ranges, a patient with a bicarbonate (HCO3) level of 30 would be considered:
If a patient presents with a pH of 7.50, what would be the initial interpretation of their acid-base status?
If a patient presents with a pH of 7.50, what would be the initial interpretation of their acid-base status?
Which of the following clinical manifestations is MOST consistent with hypokalemia?
Which of the following clinical manifestations is MOST consistent with hypokalemia?
What is the normal range for pH, as provided in the text?
What is the normal range for pH, as provided in the text?
A patient with hypercalcemia would MOST likely present with which of the following symptoms?
A patient with hypercalcemia would MOST likely present with which of the following symptoms?
A patient has a CO2 of 25. According to the content, the patient's CO2 level is:
A patient has a CO2 of 25. According to the content, the patient's CO2 level is:
What set of symptoms suggests hypocalcemia?
What set of symptoms suggests hypocalcemia?
Which electrolyte imbalance is MOST strongly associated with muscle tetany?
Which electrolyte imbalance is MOST strongly associated with muscle tetany?
Which arterial blood gas value should be examined last when evaluating a patient for acid-base disturbances?
Which arterial blood gas value should be examined last when evaluating a patient for acid-base disturbances?
A patient is exhibiting diarrhea, which electrolyte imbalance is most likely the cause?
A patient is exhibiting diarrhea, which electrolyte imbalance is most likely the cause?
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?
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?
If a patient is experiencing neurological symptoms along with skeletal involvement, which electrolyte is the MOST likely to be imbalanced?
If a patient is experiencing neurological symptoms along with skeletal involvement, which electrolyte is the MOST likely to be imbalanced?
If a patient has a pH of 7.30 and a CO2 of 30. What two concepts could be initially considered?
If a patient has a pH of 7.30 and a CO2 of 30. What two concepts could be initially considered?
Which of the following best describes the relationship between magnesemia and its associated symptoms?
Which of the following best describes the relationship between magnesemia and its associated symptoms?
What is a major risk associated with low calcium levels?
What is a major risk associated with low calcium levels?
Which symptom is NOT associated with hypothyroidism?
Which symptom is NOT associated with hypothyroidism?
What should be clarified regarding a patient's Synthroid medication before surgery?
What should be clarified regarding a patient's Synthroid medication before surgery?
What is a significant concern in myxedema coma?
What is a significant concern in myxedema coma?
Which of the following is a characteristic sign of Addison's disease?
Which of the following is a characteristic sign of Addison's disease?
What could happen if a patient with Addison's disease cannot adapt to stress?
What could happen if a patient with Addison's disease cannot adapt to stress?
What should patients with severe hypothyroidism avoid prior to surgery?
What should patients with severe hypothyroidism avoid prior to surgery?
What is the purpose of the stress response in an individual?
What is the purpose of the stress response in an individual?
What is the primary treatment for Addisonian crisis?
What is the primary treatment for Addisonian crisis?
What signaling symptom might indicate a patient with Cushing's syndrome?
What signaling symptom might indicate a patient with Cushing's syndrome?
In patients receiving glucocorticoid therapy, what is important to monitor for due to the similarity in symptoms to diabetes?
In patients receiving glucocorticoid therapy, what is important to monitor for due to the similarity in symptoms to diabetes?
Which of the following is NOT a common side effect of steroids?
Which of the following is NOT a common side effect of steroids?
What is an essential characteristic of toys suitable for infants at least 9 months old?
What is an essential characteristic of toys suitable for infants at least 9 months old?
What occurs after a bilateral adrenalectomy?
What occurs after a bilateral adrenalectomy?
Which type of play is predominantly exhibited by toddlers aged 1 to 3 years?
Which type of play is predominantly exhibited by toddlers aged 1 to 3 years?
What is a significant complication to consider for a patient on steroid therapy who also has diabetes?
What is a significant complication to consider for a patient on steroid therapy who also has diabetes?
Which of the following activities is most appropriate for preschoolers to enhance their fine motor skills?
Which of the following activities is most appropriate for preschoolers to enhance their fine motor skills?
Which of the following is a common sign in a patient with Cushing's syndrome?
Which of the following is a common sign in a patient with Cushing's syndrome?
When selecting toys for children, which of the following is NOT a consideration?
When selecting toys for children, which of the following is NOT a consideration?
What is one characteristic of school-aged children (7 to 11 years) in terms of play?
What is one characteristic of school-aged children (7 to 11 years) in terms of play?
At what age do individuals begin to exhibit characteristics of peer group association?
At what age do individuals begin to exhibit characteristics of peer group association?
Which is a primary focus of play for preschool-aged children?
Which is a primary focus of play for preschool-aged children?
What permanent restriction applies to patients who have undergone a laminectomy?
What permanent restriction applies to patients who have undergone a laminectomy?
What skill should toddlers focus on developing that involves engaging in physical activities?
What skill should toddlers focus on developing that involves engaging in physical activities?
Flashcards
pH
pH
A measure of the acidity or alkalinity of a solution. A pH of 7.35 to 7.45 is considered normal.
CO2
CO2
A waste product produced by the body, it's partially regulated by respiratory system. A CO2 level of 35 to 45 is considered normal.
HCO3 (Bicarbonate)
HCO3 (Bicarbonate)
A substance in the blood that helps regulate acid-base balance. A HCO3 level of 22 to 26 is considered normal.
Acidosis
Acidosis
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Alkalosis
Alkalosis
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Compensation
Compensation
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Respiratory Acid-Base Imbalances
Respiratory Acid-Base Imbalances
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Metabolic Acid-Base Imbalances
Metabolic Acid-Base Imbalances
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ROME
ROME
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Acid-Base Disorder Analysis
Acid-Base Disorder Analysis
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Dumping Syndrome
Dumping Syndrome
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Hyperglycemia
Hyperglycemia
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Rapid Gastric Emptying
Rapid Gastric Emptying
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Protein's Effect on Gastric Emptying
Protein's Effect on Gastric Emptying
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Positioning for Dumping Syndrome
Positioning for Dumping Syndrome
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Hypernatremia
Hypernatremia
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Hypokalemia
Hypokalemia
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Hyperkalemia
Hyperkalemia
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Hypocalcemia
Hypocalcemia
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Hypercalcemia
Hypercalcemia
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Hypomagnesemia
Hypomagnesemia
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Hypermagnesemia
Hypermagnesemia
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Tetany
Tetany
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Myxedema coma
Myxedema coma
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Myxedema
Myxedema
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Levothyroxine (Synthroid)
Levothyroxine (Synthroid)
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Addison disease
Addison disease
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Hyperpigmentation in Addison disease
Hyperpigmentation in Addison disease
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Purpose of stress response
Purpose of stress response
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Inability to adapt to stress in Addison disease
Inability to adapt to stress in Addison disease
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Addisonian Crisis
Addisonian Crisis
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Cushing's Syndrome
Cushing's Syndrome
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Steroid Side Effects
Steroid Side Effects
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Glucocorticoids (e.g., Prednisone, Methylprednisone)
Glucocorticoids (e.g., Prednisone, Methylprednisone)
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Solu-Medrol (Methylprednisone)
Solu-Medrol (Methylprednisone)
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Bilateral Adrenalectomy
Bilateral Adrenalectomy
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Cushinoid-like Appearance
Cushinoid-like Appearance
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Purposeful Play
Purposeful Play
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Gross Motor Skills
Gross Motor Skills
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Push/Pull Toys
Push/Pull Toys
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Parallel Play
Parallel Play
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Fine Motor Skills
Fine Motor Skills
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Cooperative Play
Cooperative Play
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Creativity
Creativity
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Competitive Play
Competitive Play
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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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