NUR 310 Final Exam Study Outline Fall 2024 PDF

**NUR 310 Final Exam Study Outline: Fall 2024** **75 questions total** **This Study Outline is intended to help you focus your studies. You are encouraged to review course resources including those listed at the bottom of the outine:** 1. **Pharmacology (1)** - Explain general principles of...

**NUR 310 Final Exam Study Outline: Fall 2024** **75 questions total** **This Study Outline is intended to help you focus your studies. You are encouraged to review course resources including those listed at the bottom of the outine:** 1. **Pharmacology (1)** - Explain general principles of - Pharmacokinetics- movement from the administration site to the circulatory system - Pharmacodynamics- biochemical changes that occur in the body as a result of taking a medication. - Agonists- medications that bind with a receptor and precipitate a greater-than-typical response - Antagonists- medication that bind with a receptor and either block a response or precipitate a less-than- typical response. An antagonists the compete with a agonist are "competitive antagonists". Antagonists the blocks an agonist access to receptor site are "noncompetitive antagonists" - Absorption- the movement of medication from the site of administration into the circulatory system - Distribution- the movement of a medication by the circulatory system to its intended site of action - metabolism -- is the change that occurs in a medication into a more or less potent form of the medication - Excretion- the removal of the medication or its metabolites through the kidney, gastrointestinal tract, skin or lungs - Onset- amount of time it takes for the medication to demonstrate a therapeutic response - Peak- time it takes the medication to demonstrate its full therapeutic effect - Duration- action is the length of time the medication therapeutic effects without additional doses 2. **Perfusion (1)- refers to the flow of blood through arteries and capillaries delivering nutrients and oxygen to cells.** - - - Central- reduced cardiac output results in a reduction of oxygenated blood reaching the body tissue (systemic effect). Can lead to shock if severe. If untreated, leads to ischemia, cell injury and cell death - Local- loss of vessel patency or permeability or inadequate central perfusion. Results in impaired blood flow to the affected body tissue (localized effect). Leads to ischemia and cell death - Patient will be pallor (pale skin), decreased blood flow. Pain/discomfort, hypertension, lack of exercise/diet, edema - Nursing interventions- vasodilators to promote blood flow, vascular intervention to open narrowed artery. Reduce modifiable risk factor (frequent BP screen, diet, exercise, etc.) - Peripheral arterial disease/Venous - Arterial - Affects arteries (blood carried AWAY from the heart) - Burning, cramping and pain in the legs during exercise (**[intermittent claudication will be relieved when they stop the activity]**). Numbness or burning pain in the feet when in bed. Pain is relieved by placing legs at rest in a [dependent] position (dangling). **Sharp pain (at night rest pain). Cool to touch**. Thin/dry/ scaly skin, hairless and thick toenails. Dangle legs= Rubor. Elevate legs=pale. Very poor/absent pulse. No edema. Lesions (end of toes, top of feet, [lateral ankle] region). Very little drainage/ punched out. pale/pink. - Venous - Affects veins (blood carried TOWARDS the heart) - VTE (blood clot formed because of venous stasis, endothelial injury or hypercoagulability), venous insufficiency (occurs secondary to incompetent valves in the deeper veins of the lower extremities) and varicose veins (enlarged, twisted and superficial veins that occur in any part of the body. But mainly in the lower leg) main disorders - Patient will want to **elevate leg** (decrease swelling and helps blood flow). Heavy, dull, throbbing and achy. Pain worst when standing or sitting (w/ legs dangling). **Warm to touch.** Thick, tough skin, brownish color. Present/ normal pulse. Edema. Lesion ([medical part/ ankle], swollen drainage, deep pink red. Irregular edges, shallow) - - - - - Correct positioning - Client education - - Correct positioning- avoid crossing the legs. Refrain from wearing restrictive garments. Elevate the legs to reduce swelling but not above the heart (can slow arterial blood flow to the feet) - Client education- Encourage exercise, promote vasodilation (warm environment, wear insulated socks), reduce stress, caffeine and nicotine. avoid vasocontraction (cold). Take antiplatelet medications (ASA, clopidogrel, pentoxifylline) - - - Clinical manifestations and priority nursing assessments- when the blood pressure is higher than 120/80. They can be in stage 1 (130-139/80-89) or stage 2 (140-greater/90-greater). There aren't really any symptoms in primary hypertension, but a person can experience headaches, facial flush, dizziness, fainting. - - Pharmacological - Beta adrenergic blocker (Beta Blocker): **metoprolol** (lopressor) - - - Medications - DASH diet, lifestyle modifications- Dietary approaches to stop hypertension. Balanced eating plan that helps create a heart- healthy eating style for life. 3. **Fluid and Electrolytes** - Causes and risk factors for impaired fluid and electrolyte imbalance- process of regulating the extracellular fluid volume, body fluid osmolality and plasma concentrations of electrolytes. - Clinical manifestations and priority nursing assessments - Fluid volume excess-(hypervolemia) excess intake of fluids. Abnormal retention of fluids. Labs show a **decrease** level because it is being washed out/ overshadowed by the extra number of fluids. **[10% dextrose/0.9% sodium chloride or 3% sodium chloride]** - fluid volume deficit- (hypovolemia) abnormal loss of body fluids, inadequate fluid intake or plasma to interstitial fluid shift (burns). Not the same as dehydration. Lab value **increase** due to the lack of fluids. Therefore, it looks like more nutrients. [5% dextrose or 0.45% sodium chloride] - Sodium - Hypernatremia- high sodium\>145. Dehydration, Needs cardiac monitoring, seizure precautions , vital signs, I/O, IV [D5W]. - Hyponatremia- low sodium 145\ - Causes and risk factors for all the types of diabetes - Clinical manifestations and priority nursing assessment - Hyperglycemia versus hypoglycemia clinical manifestations - Priority nursing interventions - Rule of 15 for hypoglycemia treatment - Treatment for hypoglycemic client that is unconscious - Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS) - Pharmacological - Biguanides**: metformin** (Glucophage) - pancreatics: **glucagon** (GlucaGen) - Insulin Rapid-acting: **lispro** (Humalog) - Onset, peak, duration of insulins (fast-acting (Lispro) , short-acting (Regular), NPH, and long-acting - Non-pharmacological - Client education - Blood Glucose monitoring, diet & lifestyle modifications - Insulins and metformin 7. **Hormonal Regulation** - **Hyper/Hypothyroid** - Causes and risk factors for hyper and hypo thyroid - Clinical manifestations and priority nursing assessment - hyper vs hypo thyroid clinical manifestations - Priority nursing interventions - Pharmacological - Thyroid Replacements: **levothyroxine** (Synthroid) - Antithyroid Drugs-**propylthiouracil** (PTU) - Non-pharmacological - Client education - Lifestyle modifications - Medications 8. **Infection** - Causes and risk factors for infection - Clinical manifestations and priority nursing assessment - Systemic versus local infection - Cellulitis - Priority nursing interventions - Prevention of infection - Standard precautions - Isolation precautions: Contact, airborne, droplet - Pharmacological - Penicillin: **amoxicillin or Penicillin** - Vancomycin-**vancomycin** - Non-pharmacological - Client education - Infection prevention - Medications 9. **Elimination** - **Constipation and Diarrhea** - - - - - Pharmacological - Diarrhea - Opioid: **diphenoxylate with atropine** (Lomotil) - - Stimulant laxative: **bisacodyl** (Dulcolax) - - - - 10. **Nutrition** - **Peptic Ulcer Disease** - - - - Pharmacological - Proton Pump Inhibitors (PPI): **omeprazole** (Prilosec) - Nausea: Serotonin agonists: **ondansetron** (Zofran) - Non-pharmacological - Client education - Lifestyle modifications for prevention and management - Medications 11. **Tissue Integrity** - **Pressure Ulcers** - - - - - - - - **Perioperative** - - - - - - - - 12. **Inflammation** - **Osteo and Rheumatoid arthritis** - Causes and risk factors for osteo and rheumatoid arthritis - Clinical manifestations and priority nursing assessments - - - Priority nursing interventions - Pharmacological - Glucocorticoids**: prednisone** (Deltasone) - Nonbiologic (Traditional) DMARD: **methotrexate** (Rheumatrexate, Trexall) - Non-pharmacological - - - 13. **Adrenal** - **Cushing and Addisons Disease** - - - - Pharmacological - Glucocorticoids: **hydrocortisone** - Non-pharmacological - Client education - Lifestyle modifications for prevention and management - Medications **Medications that you may be tested on:** **These medications have already been listed in the blueprint, but I included them in a list here for easy reference** 1. Beta adrenergic blocker (Beta Blocker): **metoprolol** (lopressor) 2. Glucocorticoids-Prototype Medication: **hydrocortisone** 3. Glucocorticoids**: prednisone** (Deltasone) 4. Nonbiologic (Traditional) DMARDS: antineoplastic: **methotrexate** (Rheumatrexate, Trexall) 5. Opioid: **diphenoxylate with atropine (Lomotil)** 6. Stimulant laxative: **bisacodyl** (Dulcolax) 7. Proton Pump Inhibitors (PPI): **omeprazole** (Prilosec) 8. Serotonin agonists: **ondansetron** (Zofran) 9. Thyroid Replacements: **levothyroxine** 10. Antithyroid Drugs: **propylthiouracil** 11. Penicillin: **amoxicillin or Penicillin** 12. Vancomycin: **vancomycin** 13. Beta2-adrenergic agonists: **albuterol** (Proventil HFA) 14. Biguanides**: metformin** (Glucophage) 15. pancreatics: **glucagon** (GlucaGen) 16. Insulins Rapid-acting: **lispro** (Humalog) 17. First generation NSAIDS: **Ibuprofen** (Motrin) 18. Opioid Analgesics: Opioid agonists: **morphine** 19. Opioid antagonists-**naloxone** (Narcan) **Study Resources:** 1. ATI Pharm Made Easy: Drug tables, flashcards 2. ATI Review Modules & Engage Fundamentals 3. Evolve.Elsevier.com: Textbooks and Resource Books for Lewis-Medical-Surgical Text and Giddens-Nursing Concepts book for content and practice questions 4. ATItesting.com for Practice Dynamic Quizzex/Quiz bank-create custom quizzes 5. **ATI-Create your own Quiz: Log in to your ATI Account:** Click Path to make you own custom quizzes: - Log in to your ATI Account - My ATI - Assessments tab - Quiz Bank - Dynamic Quizzes - Quizzes and assignments - New Custom Quiz (create your own quiz) - Browse Questions (Will filter for topic you want, such as Heart Failure, Cirrhosis, etc) - Look through the questions and mark to the right the questions that match the best with what we have been studying in class. When you have the questions you like, click on \"marked\" and then \"create quiz with these filters\" - Select \"Study\" - Scroll to bottom of page and select \" Start Quiz\" ATI- my ati- learn tab-review modules 2023 RN- find book you want (RN adult medical surgical nursing)- quiz-find chapter-application exercises