Exam 2: NUR242/ NUR 242 (Latest 2023/ 2024) Medical-Surgical Nursing Exam Review| Questions and Verified Answers| 100% Correct- Galen
Exam 2: NUR242/ NUR 242 (Latest 2023/
2024) Medical-Surgical Nursing Exam
Review| Questions and Verified Answers|
100% Correct
Q: S/S of dehydration
Answer:
•Vital signs: hyperthermia, ST, thread pulse, hypotension, decrease CVP
•Neuromusculoskeletal: Dizziness, syncope, confusion, weakness, fatigue
•GI: thirst, dry furrowed tongue, N/V, anorexia, weight loss
•Renal: Oliguria
•Other signs: Diminish capillary refill, cool clammy skin, diaphoresis, sunken eyeballs, flat neck
vein
Q: Dehydration assessment
Answer:
•Assess for condition leading to dehydration: diarrhea, poor intake, vigorous exercise, vomiting,
polyuria, fluid losses (burns, trauma) clients with drains/NG tube, burns/fluid shifts, overuse of
diuretic
Q: Dehydration labs
Answer:
•Serum electrolytes (hypernatremia)
•Increased serum osmolality normal 275- 295 mOsm/kg; elevated > 295 found in dehydration; >
320 is critical finding
•CBC elevated H/H
•Elevated urine specific gravity > 1.030
•Increased BUN
Q: Dehydration interventions/goal
Answer:
•Goal of interventions: replace fluid and electrolytes to achieve homeostasis
•Closely monitor status and rehydration, avoid overcorrection
•Monitor I/O and weight
•Identify and manage cause- diarrhea, vomiting, blood loss, poor intake
•Oral rehydration is priority if tolerating PO fluids
Q: Dehydration priority interventions
Answer:
•IV fluid resuscitation/replacement, general guidelines
•Hypertonic dehydration- hypotonic fluids- D5W once dextrose is metabolized; 0.45% NaCL
(1/2 normal saline)
•Isotonic dehydration: isotonic fluids (normal saline, lactated ringers)
•Hypotonic dehydration: hypertonic fluids (3% or 5% saline solution)
•Blood products in increased blood loss/trauma
•Medications to treat cause: antidiarrheal, anti emetic, AB, antipyretics
•Ingestion of food to replace electrolytes
Q: Complications of dehydration
Answer:
•Hypovolemia
•Hypovolemia shock
•Seizures/coma
•Multiorgan system failure
Q: Dehydration medications
Answer:
Diphenoxylate with atropine
Loperamide
Promethazine HCL
Acetaminophen
Q: Causes of hypercalcemia
Answer:
•increased intake of calcium, antacids, thiazide, glucocorticoids, kidney disease, immobilization,
calcium and vitamin D overdose, acidosis, milk alkali syndrome, bone metastasis,
hyperparathyroidism
Q: Causes of hypocalcemia
Answer:
low calcium intake, lactose intolerance, Malabsorption syndrome (crohn’s disease) End stage
kidney disease, diarrhea, wound drainage (especially GI)
Q: Calcium
Answer:
9-10.5
Q: S/S of hypocalcemia
Answer:
•Vital signs: SB, low hypotension, weak pulses
•Assess for tetany, Chvostek sign, trousseau sign, laryngeal stridor, dysphagia, fatigue, anxiety,
depression, hyperreflexia, muscle spasm numbness, tingling of extremities and around mouth
Q: S/S of hypercalcemia
Answer:
•Vital sign, ST, HTN, bounding pulses
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