Med/Surg Exam 1

1

What are the implications of IV therapy?

1

What type of IV solution is Hypotonic?

0.45% Normal Saline

10% Dextrose in Water

1 unit of whole blood

0.9% Normal Saline

1

What is the definition and an example of Hypertonic solution?

Pulls fluid from cells and interstitial tissues into vascular space. Ex: 3% Saline

Shifts body fluids out of blood vessels and into cells and interstitial space. Ex: 3% Saline

Maintains normal cell size. Ex: 0.9% Normal saline

1

What are 0.9% NS, D5W, and Lactated Ringers

Hypotonic Solutions

Hypertonic Solutions

Isotonic Solutions

Fluids

1

How many mL are in Whole Blood?

100

500

475

250

1

Have most of the plasma removed and only contains 285-300ml.

1

What blood products are WBC, Improves ability to fight infection, and must be transfused in 48hrs of collection?

Granulocytes

Cryoprecipitate

Albumin

1

Albumin:

Pulls 3rd spaced fluid by decreasing colloidal osmotic pressure.

Must be hung at least 4ft higher than the heart.

Is a Plasma protein, must be hung at least 3ft higher than the heart, infused within 30-60 minutes.

1

Is a mixture of clotting agents, treats blood clotting disorders, and diluted with NS with an infusion time of 4-6hrs.

1

Is separated from blood cells within 8hrs after collection and is frozen.

1

What tubing is used to transfuse blood and blood products?

Y Tubing

Piggyback

Primary Tubing

1

What Type of Cath is placed 3-6in above or below the armpit?

Midline

PICC Line

CVC

1

____ Is used to provide TPN, monitor central venous pressure, admin irritating medications, and used only when peripheral veins have collapsed.

PICC

Midline

CVC

IV

1

When is IV tubing replaced

q24h

Its a one time use only

q72-96h

q72hrs

1

DIAGNOISE S/S: Elevated BP, SOB, Bounding Pulse, anxiety

Infiltration

Circulatory overload

Pulmonary embolism

1

S/S: Redness, warmth and discomfort along vein.

Infiltration

Phlebitis

Thrombus formation

1

S/S: Sudden chest pain, SOB, anxiety, rapid heart rate, DROP in BP.

Circulatory overload

Pulmonary embolism

Air embolism

1

the infusion, elevated head, provide O2 and call provider when the patient is experiencing

1

IV and elevate arm when patient shows S/S of

1

Place patient on L side in Trendelenburg position, CALL FOR HELP, provide O2, and stay with patient when patient has S/S of

1

When administering you must ask for allergy and wean client before D/C to avoid a in

1

What labs need to be monitored while a patient is receiving TPN?

1

S/S: Hypotension, tachycardia, back pain, flushing, and DIB.

Circulatory Overload

Septic reaction

Incompatibility reaction

1

What do you do when a febrile reaction to a blood transfusion occurs?

Slow IV and infuse normal saline in piggyback

Stop infusion and infuse normal saline.

Stop infusion and give the client an icepack.

1

Reduce rate of infusion, elevate head, call provider, and admin diuretic for this reaction?

Septic reaction

Moderate Chilling

Circulatory overload

1

What must be sent to the lab after an incompatibility reaction occur?

1

Are the methods of transmission

1

do NOT elevate WBC

1

Mucous membranes, GI/GU Tract, Respiratory Tract, Broken Skin, and Blood are

1

Select the patient with SEPSIS

Patient with HR of 98bpm and WBC 13,000 cells/mm3

Patient with RR 27rpm and temp of 95.5F

Patient with PaCO2 28mmHg and HR 80bpm

Patient with temp of 100.3F and HR of 98bpm

1

A patient with severe sepsis has a lactic acid than 2 and must receive and within 1 hour of discovery.

1

TB, Measles, Chickenpox require what precautions

Contact

Airborne

Droplet

1

Meningitis and Pneumonia require what precaution?

Contact

Droplet

Airborne

1

After a culture is taken, when will the initial results be ready?

2 days

48-72 hours

7 days

5 days

1

Pain should be less than on pain scale.

1

is usually poorly localized and manifests as nausea, vomiting, and hypotension.

1

Is usually treated with

1

This phase of is the impulse transmission during which the brain experiences pain at a conscious level.

Transduction

Transmission

Perception

Modulation

1

are the theories of pain

1

Tier 1 of pain includes

Opioid for moderate or severe pain +/- non opioid and adjuvant

Opioid for mild pain +/- non opioid and adjuvant

non opioid +/- adjuvant

1

Always patches before putting them in

1

Monitor for and when administering an opioid

1

Analgesic Adjuvants:

Must be titrated down before stopping and increase fall risk

all the above

are Anticonvulsants

are Carbamazepine, Gabapentin, and Pregabalin

1

may increase risk for serotonin syndrome when taking

1

Prednisone:

must be titrated when stopping.

Decreases Potassium and increases glucose.

Causes sleep apnea.

Causes weightloss

1

Can a nurse push the button on a PCA for the patient

1

A client must wait before palliative sedation begins after consenting to process.

1

This procedure destroys the medial branch sensory nerve that protrudes between the spinal joints.

Cordotomy

Rhizotomy

1

When should the nurse reassess a patient's pain level after administering pain medications?

10 minutes

15 minutes

30 minutes

1 hour

1

When does a reaction to blood transfusion occur?

10 minutes

1 hour

5-15 minutes

After transfusion is complete.

1

Decreased metabolism, fluid overload, delayed wound healing and formation of blood clots are complications found in people.

1

Patients may experience F&E imbalance, delayed wound healing, and infections after surgery.

1

May cause altered respiratory functions, nutritional status, and impaired liver function complications.

1

dysfunction may cause delayed drug metabolism leading to drug toxicity, disrupted clotting mechanisms which causes

1

dysfunction may cause F&E imbalance, fluid overload, delayed excretion causing drug toxicity, and dysrhythmias.

1

is responsible for educating the patient about the procedure including the risks and benefits.

1

How long should a patient be NPO before a procedure?

2-4 hours

8-10hrs or after midnight

it does not matter

after 3am

1

Diazepam, Atropine, and Zofran are

1

A "Time Out" must identify the right

1

Propofol:

is a spinal anesthetic

decrease oral secretions

provides "twilight" sedation

1

What are the S/S of malignant hyperthermia

Jaw muscle rigidity, bradycardia, hypertension

Potassium elevation, diaphoresis, tachycardia

dry skin, PaCO2 elevation, Potassium elevation

1

A patient recovering from anesthesia is able to move 2 extremities, breathe freely, has a BP =/- 50mmHg, is aroused with verbal stimuli and is 94% on room air. What is the Aldrete score?

4

3

5

6

1

This intention heals within 8-10 days.

Tertiary

Secondary

Primary

1

Secondary intention is:

Widely sutured

sutured together

not sutured together

1

S/S of infection

pink and warm to touch

red and hot to touch

1

Hx of chemo, tobacco use, and insufficient vitamin c and protein are risk factor for

1

Distended abdomen, pain, vomiting and absent bowel sounds are:

normal after abdominal surgery

S/S of appendicitis

S/S of paralytic ileus

1

Med/Surg Exam 1

What type of IV solution is Hypotonic?

What is the definition and an example of Hypertonic solution?

What are 0.9% NS, D5W, and Lactated Ringers

How many mL are in Whole Blood?

What blood products are WBC, Improves ability to fight infection, and must be transfused in 48hrs of collection?

Albumin:

What tubing is used to transfuse blood and blood products?

What Type of Cath is placed 3-6in above or below the armpit?

____ Is used to provide TPN, monitor central venous pressure, admin irritating medications, and used only when peripheral veins have collapsed.

When is IV tubing replaced

DIAGNOISE S/S: Elevated BP, SOB, Bounding Pulse, anxiety

S/S: Redness, warmth and discomfort along vein.

S/S: Sudden chest pain, SOB, anxiety, rapid heart rate, DROP in BP.

What labs need to be monitored while a patient is receiving TPN?

S/S: Hypotension, tachycardia, back pain, flushing, and DIB.

What do you do when a febrile reaction to a blood transfusion occurs?

Reduce rate of infusion, elevate head, call provider, and admin diuretic for this reaction?

Select the patient with SEPSIS

TB, Measles, Chickenpox require what precautions

Meningitis and Pneumonia require what precaution?

After a culture is taken, when will the initial results be ready?

This phase of is the impulse transmission during which the brain experiences pain at a conscious level.

Tier 1 of pain includes

Analgesic Adjuvants:

Prednisone:

This procedure destroys the medial branch sensory nerve that protrudes between the spinal joints.

When should the nurse reassess a patient's pain level after administering pain medications?

When does a reaction to blood transfusion occur?

How long should a patient be NPO before a procedure?

Propofol:

What are the S/S of malignant hyperthermia

A patient recovering from anesthesia is able to move 2 extremities, breathe freely, has a BP =/- 50mmHg, is aroused with verbal stimuli and is 94% on room air. What is the Aldrete score?

This intention heals within 8-10 days.

Secondary intention is:

S/S of infection

Distended abdomen, pain, vomiting and absent bowel sounds are:

When can a patient go home after ambulatory surgery?

What type of IV solution is Hypotonic?

What is the definition and an example of Hypertonic solution?

What are 0.9% NS, D5W, and Lactated Ringers

How many mL are in Whole Blood?

What blood products are WBC, Improves ability to fight infection, and must be transfused in 48hrs of collection?

Albumin:

What tubing is used to transfuse blood and blood products?

What Type of Cath is placed 3-6in above or below the armpit?

____ Is used to provide TPN, monitor central venous pressure, admin irritating medications, and used only when peripheral veins have collapsed.

When is IV tubing replaced

DIAGNOISE S/S: Elevated BP, SOB, Bounding Pulse, anxiety

S/S: Redness, warmth and discomfort along vein.

S/S: Sudden chest pain, SOB, anxiety, rapid heart rate, DROP in BP.

What labs need to be monitored while a patient is receiving TPN?

S/S: Hypotension, tachycardia, back pain, flushing, and DIB.

What do you do when a febrile reaction to a blood transfusion occurs?

Reduce rate of infusion, elevate head, call provider, and admin diuretic for this reaction?

Select the patient with SEPSIS

TB, Measles, Chickenpox require what precautions

Meningitis and Pneumonia require what precaution?

After a culture is taken, when will the initial results be ready?

This phase of is the impulse transmission during which the brain experiences pain at a conscious level.

Tier 1 of pain includes

Analgesic Adjuvants:

Prednisone:

This procedure destroys the medial branch sensory nerve that protrudes between the spinal joints.

When should the nurse reassess a patient's pain level after administering pain medications?

When does a reaction to blood transfusion occur?

How long should a patient be NPO before a procedure?

Propofol:

What are the S/S of malignant hyperthermia

A patient recovering from anesthesia is able to move 2 extremities, breathe freely, has a BP =/- 50mmHg, is aroused with verbal stimuli and is 94% on room air. What is the Aldrete score?

This intention heals within 8-10 days.

Secondary intention is:

S/S of infection

Distended abdomen, pain, vomiting and absent bowel sounds are:

When can a patient go home after ambulatory surgery?