Fluid and Electrolytes

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

What is fluid volume excess? What is another term for fluid volume excess? How can congestive heart failure cause hypervolemia (or fluid volume excess)? How can renal failure cause fluid volume excess? How can IV fluids with sodium induce hypervolemia? Alka-Seltzer contains a lot of which electrolyte? How can Alka-Seltzer cause hypervolemia? Fleets enemas contain a lot of which electrolyte? How can a fleet enema cause hypervolemia? What is the normal action of aldosterone? How can aldosterone cause hypervolemia? What is the name of the disease a client can have that will induce hypervolemia due to too much aldosterone?

13. 14. 15. 16. 17. 18.

What hormone works the opposite of aldosterone? How does ANP correct FVE? What is the normal action of ADH, and what does ADH stand for? How can ADH cause hypervolemia? Where is ADH stored? What will the effects be on the body if a client is producing too much ADH? What is the name of this disease? What will the effects be on the body if the client does not have enough ADH? What

19.

is the name of this disease?

20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

What happens to the veins of the client who is hypervolemic? Why does the hypervolemic client develop edema? Define CVP. Where is CVP measured? What is normal CVP? If a client is hypervolemic, what will happen to the CVP? If a client is hypovolemic, what will happen to the CVP? If a client is hypervolemic, what are the lung sounds like and why? Why does the client who is hypervolemic develop polyuria? What happens to the blood pressure and pulse with hypervolemia? Explain why. What happens to the weight in hypervolemia? Why? What type of diet is prescribed for hypervolemic client? Explain why.

31.

If a hypervolemic client is placed on a high-sodium diet, what would happen?

32. 33. 34.

Why would you do a daily weight on the hypervolemic client? Explain why diuretics are given to the hypervolemic client. Lasix is a common diuretic. What is the major electrolyte imbalance that you are worried about with this drug? What is the major electrolyte imbalance to watch for with thiazide diuretics? Aldactone is a potassium-sparing diuretic. What is the major electrolyte imbalance you watch for with this drug? How does bed rest cause diuresis?

35. 36.

37.

38.

Why is it so important to give IV fluids very slowly to the elderly?

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39.

What is another name for fluid volume deficit?

40.

Define fluid volume deficit.

41.

How can GI losses affect your vascular space?

42. 43. 44. 45.

What is third spacing? How can ascites induce hypovolemia? How can burns induce hypovolemia? Why will the diabetic client develop polyuria?

46. 47. 48. 49.

The person with polyuria will eventually develop what life threatening complication? What three changes will you see in the urine output that will indicate the body is compensating? How does hypovolemia affect the weight? During hypovolemia, what happens to the blood pressure and pulse and why?

50. 51. 52.

During hypovolemia, what happens to the CVP? Explain why. During hypovolemia, what happens to the veins? Explain why. Why do the extremities of a client who is hypovolemic become cool?

53.

And what is going to happen to the urine specific gravity if a client is hypovolemic?

54. 55. 56.

What is the treatment for mild fluid volume deficit? What is the treatment for severe FVD? What safety precautions are needed for the FVD client and why?

IV Fluids
57.

How do isotonic solutions work?

58. 59. 60. 61. 62. 63. 64. 65.

Why is an isotonic solution contraindicated in a client with hypertension? What complications do we worry about when administrating isotonic solutions? How do hypotonic solutions work? Give examples. When would a hypotonic solution be used? Why would I worry about FVD in the client receiving a hypotonic solution? How do hypertonic solutions work? Give an example. When would a hypertonic solution be used? Why would I worry about FVE in the client receiving a hypertonic solution?

Magnesium and Calcium: Hypermagnesemia:

66. 67. 68. 69.

How do we get rid of excess magnesium from our body? Renal failure can cause hypermagnesemia. Explain why. Magnesium acts like a _______________________. If a client has hypermagnesemia, what will happen to their DTRs, muscle tone, respirations, and level of consciousness? Could the client with hypermagnesemia have a life-threatening arrhythmia?

70.

71.

Why does the client who has hypermagnesemia develop flushing and warmth?

72.

What effect will this flushing and warmth from hypermagnesemia have on the blood pressure?

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73.

Why would a client with hypermagnesemia require a ventilator?

74.

Why would a client with hypermagnesemia be dialyzed?

75.

Why is calcium gluconate given to someone who has hypermagnesemia?

Hypercalcemia:
76.

Hyperparathyroidism can induce hypercalcemia. Explain how.

77.

What is the normal action of parathormone?

78. 79.

How do thiazide diuretics cause hypercalcemia? How does immobilization (bed rest) cause hypercalcemia?

80. 81. 82. 83.

If a client has too much calcium in the blood, what kind of muscle tone will the client have? What will the clients DTRs be like? How will it affect the clients LOC, pulse, and respirations? Could the client have an arrhythmia? Could the client have a kidney stone? Why?

84.

Why is it so important to get the client walking or weight-bearing with hypercalcemia?

85. 86.

Why is it so important to increase fluids in hypercalcemia? Calcium has an inverse relationship with what other electrolyte?

87.

What do steroids do to your serum calcium level?

88.

How does vitamin D help calcium?

89.

What drug will return calcium to the bones? What disease is this drug used for?

Hypomagnesemia:
90. 91.

How can diarrhea induce hypomagnesemia? Why are alcoholics prone to hypomagnesemia?

92.

If you have a client with hypomagnesemia, what will the clients muscles be like?

93. 94.

Could the client have a seizure? Why do we worry about the clients airway?

95.

Why does the client with hypomagnesemia have a positive Chvosteks and Trousseaus, and what will happen to the DTRs? Could the client with hypomagnesemia have arrhythmias? Describe the level of consciousness of the client with hypomagnesemia. Would the client with hypomagnesemia have problems swallowing?

96. 97. 98.

99.

Why is it so important to check renal failure prior to giving IV magnesium?

100. Why

are seizure precautions necessary when caring for a client with hypomagnesemia?

101. Why

is it so important to discontinue the mag-sulfate infusion if a client begins to have flushing and sweating?

Hypocalcemia:
102. How

does hypoparathyroidism affect the serum calcium levels?

103. How

could a radical neck dissection/thyroidectomy affect the serum calcium level?

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104. List

symptoms of hypocalcemia and explain why the client has these symptoms. do we give the hypocalcemic client vitamin D?

105. Why

106. If

a client has hyperphosphatemia, what other electrolyte imbalance will be present? will phosphate binders increase calcium levels?

107. How

108. Why

do we give the hypocalcemic client calcium carbonate and calcium gluconate?

109. When

you are giving someone IV calcium, what is the most important thing you need to remember to do? Explain why.

Sodium: Hypernatremia:
110. If

you have a client who is very dehydrated, what will happen to their serum sodium level? Explain why.

111. If

you have a client who is dehydrated, what will happen to their H&H? Explain why.

112. Why

does the client who is hypernatremic have dry sticky mucous membranes and why are they thirsty? is one organ in the body that really does not like it when sodium is out of balance. What is it?

113. There

114. Why

is it so important when you are trying to lower someones serum sodium level that you dilute the client with IV fluid gradually?

115. If

you have a client who is becoming dehydrated, what will begin to happen to their sodium level? And what should you do before the client becomes hypernatremic? is it so important to ensure proper water replacement with tube feedings?

116. Why

Hyponatremia:
117. If

a client is hyponatremic, what is their blood like? Concentrated or dilute? Why?

118. How

can D5W make someones serum sodium go down?

119. How

can drinking too much water make your serum sodium go down?

120. When

you have a hyponatremic client, it is important that you restrict water. Explain why.

121. What

IV fluids are used to treat hyponatremia? What nursing alerts are necessary when administering these fluids?

Potassium: Hyperkalemia:
122. What

organs must be working properly to help maintain your normal potassium level in your blood? can renal failure cause hyperkalemia? can Aldactone cause hyperkalemia?

123. How 124. How

125. What

are the major symptoms of hyperkalemia?

126. When

a client with a potassium imbalance has an arrhythmia, they are very dangerous. Why? What type of arrhythmias will the client have?

127. When

you have a hyperkalemic client, why do we dialyze them?

128. Why

do we give the hyperkalemic client calcium gluconate?

129. Why

do we give the hyperkalemic client glucose and insulin?

130. How

does Kayexalate work?

131. When

you give Kayexalate, you can expect the serum potassium level to go down; therefore, what will happen to the serum sodium level? Explain

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Hypokalemia:
132. How

can vomiting induce hypokalemic?

133. What

are the S/S of hypokalemic?

134. Why

is it so important that you monitor the digoxin client closely for hypokalemia or other electrolyte imbalances?

135. How

does Aldactone help hypokalemia?

136. Why

is it so important to asses urine output before starting IV potassium?

137. What

are some foods high in potassium?

138. What

is the major side effects of oral potassium supplements?

Acid Base
139. What

are the major acid/base chemicals? Are they acids or bases? What organs control each chemical? does the pH tell you?

140. What

141. What 142. In 143. In 144. In 145. In

organ does not like it when the pH is messed up?

respiratory acidosis or alkalosis, what are the problem organs? respiratory acidosis or alkalosis, who is going to compensate? metabolic acidosis or alkalosis, what are the problem organs? metabolic acidosis or alkalosis, who is going to compensate? you think of the lungs, what chemical needs to pop into your mind?

146. When

147. When 148. Can

you think of the kidneys, what chemicals needs to pop into your mind?

CO2 be a chemical that makes you sick and be a chemical that makes you compensate? bicarb and hydrogen be chemicals that make you sick and be chemicals that make you compensate?

149. Can

150. What 151. What

is the only way you can have a buildup of CO2 in your blood? is the only way to lower CO2 in the blood?

Respiratory Acidosis:
152. In

respiratory acidosis, which organs are not working right? Who is going to compensate? How does the compensation work?

153. In

respiratory acidosis, what has happened to the CO2 level in your blood? What caused the increase? Give examples.

154. In

respiratory acidosis, how is the client breathing? And how does this affect the CO2 level in the blood?

155. What 156. Why

is going to happen to the bicarb level in respiratory acidosis?

does it do this?

157. When

someone gets very acidotic, what happens to their level of consciousness?

158. When

a client has a high CO2 level is their blood, what is going to happen to the oxygen level in their blood? are the early signs of hypoxia?

159. What

160. When

you have a client in respiratory acidosis, what is the primary thing that has to

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be fixed? Explain some ways this can be fixed.

Respiratory Alkalosis:
161. When

someone is in respiratory alkalosis, what organs are going to compensate? With what chemicals are they going to compensate? Explain the compensation.

162. When 163. How

someone is in respiratory alkalosis, how do they have to be breathing?

does their breathing cause alkalosis? has happened to the pH in respiratory alkalosis? is the bicarb level going to do in respiratory alkalosis? someone is hysterical, why can they go into respiratory alkalosis?

164. What 165. What

166. When 167. What 168. If

is the immediate treatment for respiratory alkalosis?

you have a client who is on the ventilator, and the respiratory rate is set too high, will the client go into respiratory acidosis or respiratory alkalosis? Explain why. will sedation affect respiratory alkalosis?

169. How

Metabolic Acidosis:
170. In

metabolic acidosis, what are the problem organs? What chemicals are altered? happens to the pH and why?

171. What

172. Which 173. If

organs are going to compensate? With what chemical will they compensate?

you have a client who is in acidosis, do you want that client to retain CO2 to compensate, or do you want this client to lose more CO2? is a what?

174. CO2 175. If

you have a client in metabolic acidosis, what is going to happen to their respiratory rate and why?

176. How

can a DKA client go into metabolic acidosis?

177. How

can an anorexic or bulimic client go into metabolic acidosis?

178. What 179. How

are ketones and how do they affect the blood?

can diarrhea induce metabolic acidosis?

180. In

any type of metabolic acidosis, what is going to happen to the serum potassium level? Therefore, what is the major electrolyte imbalance they will have, and what is the major side effect they will have? Metabolic Alkalosis:

181. In

metabolic alkalosis, which organ has the problem? Therefore, what chemicals are going to be altered?

182. In

metabolic alkalosis, which organs are going to compensate? What chemical are they going to compensate with? Explain compensation.

183. How

can vomiting or a NG tube suction induce metabolic alkalosis?

184. Explain

why antacids can cause metabolic alkalosis.

185. Why

do we have to worry about hypokalemia in the alkalotic client? What life threatening complication can occur?

186. Treatment

for metabolic alkalosis is directed toward what?

Burns
187. If

someone has been burned, fluid seeps out into the tissue, why?

188. When

the fluid seeps into the tissue, what happened to the blood pressure and the pulse? Explain why.

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189. Why

does the cardiac output decrease when the fluid seeps out into the tissue?

190. During

this phase (when the fluid is seeping into the tissue), is this client in a fluid volume deficit or fluid volume excess? a client is in a fluid volume deficit, why does their urine output decrease?

191. When

192. After

a major burn, when fluid is seeping out into the tissue, why is it important that ADH and aldosterone are secreted?

193. What

is the treatment for carbon monoxide poisoning? Explain why.

194. When

a client has any type of upper body burns, why do we have to worry about the airway?

195. What

are the s/s of airway injury in the burn client? the Rule of Nines. 2nd 8 hours,

196. Explain 197. Using

and

3rd

the Parkland formula, what percent volume of fluid is given the 1st 8 hours, 8 hours?

198. What

measurement is the best to way evaluate fluid volume status in the burn

client?

199. How

will an IV with albumin help fight shock? What are the risks with albumin administration?

200. Explain

the difference between the tetanus toxoid and the tetanus immune globulin.

201. What 202. What 203. Why

is the purpose of the escharotomy? electrolyte do we worry about with burns?

do clients with burns have to take Mylanta and Tagamet? is the purpose of measuring a gastric residual?

204. What 205. Why

are multiple antibiotics when treating burns?

206. When 207. How 208. Why

a client has an electrical injury, they are at a high risk for what arrhythmia?

long is the client at risk for life-threatening arrhythmias? can a client with an electrical burn have kidney failure?

Oncology
209. At

what age should yearly mammograms start? do testicular exams need to be done monthly?

210. Why

211. Explain

nursing assignments for radiation clients.

212. When

a client has a radiation implant, why do we put them on a low fiber diet?

213. Why

does this client have a foley catheter?

214. Why

do we want to keep the client with a radiation implant on bed rest?

215. When

a client has a radiation implant, there is a chance it will become dislodged. What would you do?

216. Explain

the nursing care for the markings that a client will have when they are receiving external radiation therapy.

217. List

basic side effects of chemotherapy.

218. What

is a vesicant?

219. What

do you do if a vesicant infiltrates?

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220. What

is the danger of a vesicant infiltrating?

221. List

6 general ways to prevent infection in the client receiving chemotherapy

222. What

is one of the major complications post-hysterectomy and why?

223. When

a client has had an abdominal hysterectomy, what is the position to avoid? And explain why.

224. Explain

the post op care for a client who has had a mastectomy.

225. Why

is it so important that the mastectomy client elevate her arm on the affected side?

226. Why

is it important that the client exercise the affected side after a mastectomy?

227. List

discharge teaching precautions for the mastectomy client.

228. When 229. What

a client has a bronchoscopy, they are NPO until what returns?

are some complications of a bronchoscopy that you need to watch for?

230. Explain

procedure to obtain a sputum specimen.

231. When

a client has had a pneumonectomy, what is the nursing care as far as positioning and why?

232. Why

does the client who has had a total laryngectomy need to have a tracheostomy?

233. Why

does the client who had a total laryngectomy have to be positioned in the

Fowlers position?

234. Why 235. Why

does the laryngectomy client need to have NG feedings? is it important that the laryngectomy client have frequent mouth care?

236. Explain

suctioning.

237. Why

is ulcerative colitis and Crohns disease considered to be risk factors for colon cancer? in your own words, an ileal conduit.

238. Explain,

239. What 240. Why

is the major symptom of bladder cancer?

is it important that hourly outputs be monitored after a client has had an ileal conduit?

241. Is

mucous in this urine normal? is it important that the ileal conduit client change their appliance in the morning?

242. Why

243. Explain

the pathophysiology behind an enlarged prostate (benign prostatic hypertrophy).

244. What

are the symptoms of BPH? Why do they get these symptoms?

245. What

is the major lab work assessed when prostate cancer is suspected?

246. Why

does the client not have an incision with a TURP? is the most common complication of a TURP?

247. What

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248. When

a client has had a TURP, why do they not have to worry about impotency and infertility?

249. Explain

how a three-way catheter works and why the prostatectomy client has to have it.

250. How

do Kegel exercises help prostatectomy clients?

251. Why

is it important that the prostatectomy client avoid sitting, driving, strenuous exercise, and lifting?

252. Why

does the prostatectomy client have to take Colace?

253. What

is one of the major signs diagnostically of stomach cancer?

254. When

a client has had a fresh GI surgery, such as gastrectomy, is it okay for the nurse to manipulate the NG tube?

255. What 256. What

are the two major complications of gastrectomy? are the S/S of GI tract obstruction?

Endocrine
257. List

the major symptoms of hyperthyroidism.

258. What 259. Why

is another name for hyperthyroidism?

does the client develop the symptoms of hyperthyroidism? happens to the workload of the heart in hyperthyroidism?

260. What

261. What

do you have to have in your diet to make thyroid hormones? how the antithyroid drugs work.

262. Explain

263. Give 264. Why

examples of the antithyroid drugs: do we give iodine compounds preoperatively?

265. Why 266. Why

do you have to give iodine compounds in milk or juice and use a straw?

does the hyperthyroid client have to be put on beta blockers? How does this help the client? does radioactive iodine work? is one of the major complications of radioactive iodine?

267. How

268. What

269. When

a client has had a thyroidectomy, why is it so important for them to support their neck?

270. How

do you want a thyroidectomy client to be positioned? Explain why.

271. Why

do we check for bleeding behind the neck with a thyroidectomy client?

272. Why

do we keep a trach set at the bedside with a thyroidectomy client?

273. How

do you assess for recurrent laryngeal nerve damage in the thyroidectomy client? do we have to assess for parathyroid removal in the thyroidectomy client?

274. Why

275. How

do you assess for parathyroid removal?

276. What

is another name for hypothyroidism? someone is hypothyroid, what has happened to their thyroid hormone levels?

277. When 278. What

are the S/S of hypothyroidism?

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279. What

is cretinism?

280. How

do you treat hypothyroidism?

281. When

a client has started on drug therapy for hypothyroidism, is it temporary or permanent?

282. When

somebody is hyperparathyroid, what is the major electrolyte imbalance they have? do you have to worry about the bones of a client with hyperparathyroidism?

283. Why

284. Why

does the hyperparathyroid client have kidney stones?

285. What 286. What

is the major electrolyte imbalance a hypoparathyroid client will have? type of symptoms will this client exhibit?

287. Why 288. Why

does the hypoparathyroid client need a quiet environment? does the hypoparathyroid client need a trach tray at the bedside?

289. Why

is it important that the hypoparathyroid client have a diet that is limited in phosphorus?

290. Explain

how Amphojel works for the hypoparathyroid client.

291. When

a client has Pheochromocytoma, what is the major problem they have?

292. What 293. What

happens to this clients blood pressure and pulse? is the major diagnostic test for Pheochromocytoma? Explain.

294. What

are the four major actions of glucocorticoids?

295. When

you hear the word mineralocorticoids, what is the major word you need to think of? does aldosterone work?

296. How

297. What

is another name for glucocorticoids, mineralocorticoids, or sex hormones?

298. Why

do steroids drive your blood sugar up?

299. If

a client is making too much aldosterone, what is going to happen to the vascular space? Explain why.

300. Explain

briefly the basic pathophysiology of Addisons disease.

301. What

is the major electrolyte imbalance a client with Addisons disease will have?

302. What

are the S/S of hyperkalemia?

303. Could

the Addisons disease client also have a life-threatening arrhythmia? Is so, why?

304. Does

the Addisons disease client have too many steroids in their blood or not enough steroids in their blood?

305. Why

does the Addisons disease client have trouble with shock?

306. Why

does the Addisons disease client need more sodium in their diet?

307. Why

is I&O such an important nursing intervention with the Addisons disease client?

308. Is

the Addisons disease client in a fluid volume deficit or a fluid volume excess?

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309. What

happens to the Addisons disease clients blood pressure?

310. When

a client has Cushings syndrome, explain briefly, in your own words, what The client will look like?

311. When

a client has Cushings syndrome, do they have too many steroids or not enough steroids?

312. Why

does the Cushings syndrome client experience the following?

a. b. c. d. e.
313. Is

Growth arrest Thin extremities and skin Increased risk for infection Hyperglycemia Psychosis to depression (changes in mood) the Cushings syndrome client in a fluid volume deficit or excess? does the Cushings syndrome client develop high blood pressure and heart failure?

314. Why

315. When

a client has Cushings syndrome, their serum potassium level goes down. Why?

316. Why

does the Cushings syndrome client need more calcium in their diet?

317. Does

the Cushings syndrome client need to be on a low-sodium diet or a highsodium diet? Explain.

318. Why

does the Cushings syndrome client have ketones and glucose in their urine?

319. Why

does the Cushings syndrome client not have protein in their urine? Is it normal to have protein in the urine?

320. In

the diabetic client, why does the glucose build up in their blood?

321. In

the diabetic client, why does the body start breaking down protein and fat?

322. Anytime 323. Ketones 324. What

you break down fat, you are going to get production of what? are what?

is the major acid base imbalance the diabetic client can develop and explain why.

325. Why

does the diabetic develop the following symptoms?

a. b. c. d.

Polyuria Weight loss Polydypsia Polyphagia how oral hypoglycemic agents work and give examples.

326. Explain

327. Why

will an oral hypoglycemic agent not work in a Type I diabetic?

328. Why

does a Type II diabetic have problems with wounds that will not heal or repeated vaginal infections?

329. What

is the common treatment for Type II diabetics?

330. In

the treatment of a diabetic, why do we have to limit the protein in the diet?

331. Why

are diabetics prone to coronary artery disease?

332. How

can a high-fiber diet benefit a diabetic client?

333. When

the diabetic client exercises, why do they have to worry about hypoglycemia and how can they prevent it?

334. Why

is it important that a diabetic client exercise when their blood sugar is at its highest? you start giving a client insulin, what is going to happen to their blood sugar?

335. When

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336. When

you give a client insulin, why should the client not have ketones and glucose in the urine?

337. How

does the insulin dosage need to be adjusted for the diabetic client who has glucose and ketones in the urine? is the only type of insulin that can be given IV?

338. What

339. When

insulin is at its peak, that means the insulin is working really hard; therefore, what is going to happen to the blood sugar at the peak time? can hypoglycemia be prevented?

340. How

341. Why

is rotating injection sites important for the client on insulin? is going to happen to anybodys blood sugar when they are sick or stressed?

342. What

343. When

a diabetic client is sick, their blood sugar is going to go up; therefore, what do they need to do with the dose of their insulin? major complication can occur in a Type I diabetic when the blood sugar is uncontrolled? are some general S/S of hypoglycemia, and what is the immediate nursing action?

344. What

345. What

346. After

giving a simple sugar to the hypoglycemic client, what would the nurse do next?

347. Why

is hypoglycemia considered to be more dangerous than hyperglycemia?

348. If

you walk into a diabetic clients room and find the client unconscious, do you as hypoglycemic or hyperglycemic? is it so important that a diabetic client eat regularly and take their insulin regularly?

treat the client

349. Why

350. Explain

the basic pathophysiology behind diabetic ketoacidosis.

351. When

a client has diabetic ketoacidosis, why is it important that we measure the blood sugar and the potassium hourly?

352. When

you give a client insulin, what do you expect it to do to the clients blood

sugar? Why?

353. When

you give a client insulin, what do you expect it to do to the clients serum potassium level? Explain why.

354. Why

is it so important that we monitor the diabetic ketoacidotic clients EKG so closely?

355. Why

are we measuring hourly output on the diabetic ketoacidosis client?

356. When

a client has oliguria and anuria, what do you really have to start worrying about and why?

357. Explain

diabetic foot care thoroughly.

Cardiac
358. Describe

preload and afterload.

359. What

is cardiac output?

360. If

your cardiac output is decreased, do you perfuse as well as you normally do? conditions can affect your cardiac output?

361. What

362. If

you are taking care of a client with decreased cardiac output, what is going to happen to their level of consciousness? they start complaining of chest pain?

363. Could 364. Why

does a clients (whose cardiac output is low) skin feel cool and clammy?

365. When

you are taking care of a client who has decreased cardiac output, why do they

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get short of breath and have wet lung sounds?

366. When

you are taking care of a client who has decreased cardiac output, why do their peripheral pulses diminish?

367. What

is going to happen to urine output when you have a client who has decreased cardiac output?

368. When

you have a client with decreased cardiac output, why does their blood pressure drop?

369. How

will bradycardia affect cardiac output?

370. How

can tachycardia (i.e., heart rare> 150) affect cardiac output?

371. When

someone has had an MI, how can this affect cardiac output and why?

372. If

my blood pressure is really high, how will this affect cardiac output and why?

373. Draw

a picture of my square heart and include the lungs and the aorta and trace the normal blood flow through the heart. is angina?

374. What

375. Explain

the pain a client has with angina.

376. Why

is nitroglycerine given?

377. When 378. How 379. Why

you give somebody nitroglycerine, more ________________ is going to get to the heart muscle? do you teach a client to take their nitroglycerine? should nitroglycerine burn?

380. What

is common and expected side effect of nitroglycerine?

381. When

you give somebody nitroglycerine, are they going to vasoconstrict or vasodilate? Therefore, what is going to happen to their blood pressure? do clients with angina need beta blockers? List several examples.

382. Why

383. What

is the purpose of aspirin for the angina client?

384. Why

do angina clients need calcium channel blockers? List several examples.

385. Why

is it so important that the angina client avoid isometric exercise, overeating, caffeine, or any drugs that increase the heart rate and avoid cold weather?

386. Why

is it so important that the angina client rest frequently?

387. Is

it okay for a client with angina to take their nitroglycerine prophylactically? they take their nitroglycerine, should the client sit down or stand up? Explain.

388. Before

389. Why

is it so important that you ask the client if they are allergic to iodine before they go for a heart catheterization?

390. Any

time you have a client who is injected with iodine-based dye, what is the common complaint the client will have?

391. In

post-cardiac catheterization, you have to watch the puncture site closely. What watching it for?

are we

392. When

a client has had a heart cath, you have a pertinent nursing assessment you need to do distal to the insertion site. Explain.

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393. With

a MI (myocardial infarction), why does the client have necrosis?

394. Will

rest or nitroglycerine relieve MI pain? how MI pain feels.

395. Explain

396. Why

does an MI client get cold, clammy, and their blood pressure drop?

397. Why 398. Why

does the MI clients white count go up? does their temperature go up? biomarker would be appropriate if the client has delayed treatment post MI?

399. Which 400. Is

a negative myoglobin a goof thing or a bad thing? a client has had a MI, what is the drug of choice? a client is having a MI, what arrhythmia is a very high risk? a client goes into V-fib, what is the priority nursing action?

401. When 402. When 403. When 404. What 405. What

antiarrhythmics or used when the V-Fib are resistant to defibrillation? drugs are used for chest pain when the MI client arrives to the ED?

406. How

do thrombolytics work? Give me three examples of common thrombolytics.

407. What

is the major complications of a thrombolytic?

408. Before

you give a thrombolytic, you are supposed to get a good history. What did I tell you to focus on (what type of disease or illness)?

409. After

someone has received a thrombolytic, why is it so important that we decrease puncture sites?

410. What

is angioplasty and what is the major complication of angioplasty?

411. What 412. What

is your natural pacemaker? do artificial pacemakers do?

413. Can

the electrical part of your heart be working and the pumping mechanism not?

414. Explain

the difference between a demand and a fixed-rate pacemaker.

415. You

really need to get worried about a pacemaker malfunctioning when the rate of the pacemaker does what?

416. Why

is it so important that we immobilize the arm on the affected side after pacemaker insertion?

417. Why

does the pacemaker client need to check their pulse every day?

418. Why

does the pacemaker client have to avoid microwaves and MRIs?

419. If

you increase preload, what do you do to the workload of the heart? some ways preload can be increased. some ways preload can be decreased.

420. List 421. List

422. Explain

afterload in your own words.

423. If 424. If

you increase afterload, what do you do to the cardiac output? cardiac output is decreasing, that means the blood is not moving forward. If blood is not moving forward, then it has got to go backwards, so therefore where is it going to wind up? are the major symptoms of left-sided heart failure and explain why.

425. What

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426. Why

does a client with left-sided failure have restlessness and tachycardia?

427. Why

does a client with left-sided failure have nocturnal dyspnea?

428. Why

does the client with left-sided failure basically have pulmonary symptoms?

429. What

are the major symptoms of right-sided failure?

430. When

a client is in right-sided failure, is the blood backing up into the arterial system or the venous system? does a Swan Ganz catheter measure inside the heart?

431. What

432. What

does this catheter measurement tell you?

433. What

is an A-line?

434. What

is an Allens test?

435. Why

is it so important that the distal circulation be checked when a client has an Aline? Explain your checks that you are going to do (nursing assessment).

436. If

an A-line is accidentally pulled out, what is the first thing that needs to be done?

437. When

a client has an A-line, pressure has to be kept in the infusion bag. Why? What would happen if you didnt keep the pressure on the infusion bag?

438. Why

does the client in heart failure develop cardiomagaly?

439. Explain

how digitalis works.

440. When

you slow down someones heart rate, you give the ventricles more time to do what? your heart squeezes down with more force and strength and on more blood, what is going to happen to cardiac output? What is going to happen to kidney perfusion?

441. When

442. Any

time you increase kidney perfusion, what is probably going to happen to urine output?

443. When 444. When

you start giving a client Digoxin, should their cardiac output go up or down?

you increase a clients cardiac output, what is actually happening inside the heart?

445. When

you increase a clients cardiac output, should they appear better oxygenated or less oxygenated? you start giving somebody Dig, we expect their cardiac output to increase; therefore, what should happen to their: Level of consciousness? Lung sounds? Urine output? Skin? Peripheral pulses? Blood pressure? does a congestive heart failure client need Lasix?

446. When

a. b. c. d. e. f.

447. Why

448. When

a client goes on a low-sodium diet and bed rest, what might happen to them?

449. Why 450. If

do we give diuretics in the morning?

a HF client notices their weight increasing, what could that put them at risk for?

451. What

is pulmonary edema?

452. How

does a client develop pulmonary edema?

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453. What

are the major S/S of pulmonary edema?

454. When

does pulmonary edema usually occur and why?

455. Why 456. Why

is the client in pulmonary edema restless and anxious?

is it so important that we hurry up and decrease the circulating volume in the pulmonary edema client?

457. When

a client is in pulmonary edema, why do we give them Digoxin?

458. When

a client is in pulmonary edema, why do we give them morphine?

459. How

much morphine do we give them?

460. When

a client is in pulmonary edema, why is it important that you sit them up with their legs down? is intermittent claudication?

461. What

462. Explain

how intermittent claudication develops.

463. When

a client has an arterial problem, that means the oxygen/blood are having a hard time getting to the tissue, so therefore different S/S develop. Explain the S/S.

464. Could

a client with an arterial problem develop ischemia and necrosis in the affected extremity? Explain.

465. How

will angioplasty help an arterial problem?

466. Whether

you are studying Buergers disease or Raynauds disease, what is the key word that I told you to remember? Buergers disease and Raynauds disease, there is significant vasoconstriction, What type of things bring on the vasoconstriction in Buergers and Raynauds disease?

467. In

468. Explain

the nursing care for someone with Buergers disease and Raynauds disease.

469. What 470. Why

is the most important thing to teach your client about Buergers disease or Raynauds disease- to avoid the __________________? do Buergers disease clients have to do such excellent foot care?

471. When

a client has a venous disorder, are they having trouble with oxygenation of the affected extremity? you elevate venous disorders or lower venous disorders (such as an affected extremity)? the pathophysiology behind a venous disorder.

472. Do

473. Explain

474. Why

does a client with a venous disorder need Heparin?

475. How

do TED hose help venous disorders?

476. When

taking care of a client with a venous disorder, do you use warm moist heat or cold wet packs? DVT prevention is the key. We _____________ and _______________ the client.

477. With

Psychiatric Nursing
478. Why

is the client with depression irritable?

479. Why

do we want to prevent isolation when a person is depressed?

480. Why

as depression lifts does the suicide risk go up?

481. How

do you respond to a clients delusion of grandeur?

482. Why

does the manic client like to dress seductively?

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483. What

is the reason a manic client likes to manipulate?

484. Why

do you not want to argue with or try to reason with the manic client?

485. What

is an example of inappropriate affect in the schizophrenia client?

486. How

does the nurse respond to the schizophrenia clients neologism?

487. What

is the most important thing to remember with a suicidal client?

488. If

you use restraints for a suicidal client what must you do?

489. What

is most important in the treatment of paranoia?

490. Why

does the highly anxious client need step-by-step instructions?

491. Why

do we include time in the schedule for rituals with an obsessive compulsive client?

disorder

492. Why

does the alcoholic have trouble with losing their magnesium and potassium?

493. Why

would you observe the bulimic client for one hour after they have eaten a

meal?

494. Explain

the reason follow up is the key to successful treatment of a phobia?

495. How

can the client with panic attacks learn to stop the anxiety?

496. Why

do you warn a hallucinating client before you touch them?

497. Why

do you give atropine pre procedure for electro-convulsive therapy?

Renal
498. What

is the major cause of glomerulonephritis?

499. When

a client has glomerulonephritis, are they in a fluid volume deficit or a fluid volume excess?

500. When

a client has glomerulonephritis. Why do they develop malaise and headache?

501. When

a client has glomerulonephritis, why does their urine output go down?

502. When

a client has glomerulonephritis, why does their BUN and creatinine go up?

503. When

a client has glomerulonephritis, why do they get protein in the urine?

504. Explain

CVA tenderness.

505. In

glomerulonephritis, why does the blood pressure go up?

506. And

what will happen to the urine specific gravity?

507. With

any type of kidney disease, it is not uncommon for the BUN to be elevated; therefore, why do we limit the protein in the diet?

508. If

you gave a client with any type of renal disease protein in their diet, what will happen to the BUN?

509. Why

does the glomerulonephritis client need rest?

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510. When

determining fluid replacement for a renal disease client (glomerulonephritis), you always give them what they lost in a 24- hour period plus 500cc. What is the purpose of adding 500ccs?

511. Once

diuresis begins in glomerulonephritis, will the client be at risk for a fluid volume deficit or fluid volume excess? a client has nephrotic syndrome, what is the major element that is leaking out into their urine?

512. When

513. What 514. If

will protein or albumin hold onto in the vascular space?

a client does not have protein or albumin in their vascular space (blood), what is going to happen to all the fluid that is supposed to stay in their vascular system?

515. How

does this affect the vascular space?

516. Therefore,

will the nephrotic syndrome client (in the acute stages) be in a fluid volume deficit or fluid volume excess?

517. When

a client has nephrotic syndrome, they develop total body edema, What is the proper term for total body edema? a client has nephrotic syndrome, it is not uncommon for them to be placed on prednisone. Why?

518. When

519. Does

the nephrotic syndrome client need a high-sodium diet or a low-sodium diet? Explain why.

520. Does

the nephrotic syndrome client need a high-protein diet or a low-protein diet? Explain why.

521. How

can bradycardia cause renal failure?

522. How

can hypovolemia cause renal failure?

523. How

can shock cause renal failure?

524. How

can decreased cardiac output cause renal failure?

525. How

can glomerulonephritis, nephrotic syndrome, or diabetes cause renal failure?

526. How

can a kidney stone cause renal failure?

527. How

can ureteral swelling cause renal failure?

528.

How can a tumor or an enlarged prostate cause renal failure?

529. When

a client is in renal failure, why does their BUN and creatinine go up?

530. What

happens to the specific gravity in renal failure?

531. Why

can renal failure client become anemic?

532. Why

does the renal failure clients blood pressure go up?

533. Why

is the renal failure client at risk for congestive heart failure?

534. Why

does the renal failure client develop anorexia, nausea, and vomiting?

535. Why

does the renal failure client develop an itching frost?

536. Why

does the renal failure client have to worry about osteoporosis?

537.

There are two phases of renal failure. The first phase is an oliguric phase, If a client is oliguric, what has happened to the urine output?

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538. Why

does the oliguric client go into a fluid volume excess?

539. Why

does the oliguric client develop hyperkalemia?

540. The

second phase of renal failure is called the diuretic phase. When a client is diuresing, what has happened to their urine output? will a client who is diuresing go into a fluid volume deficit?

541. Why 542. If

a client goes into a fluid volume deficit, what will happen to their blood pressure? will happen to their heart rate? Explain why.

543. What

544. When

a client is diuresing, their serum potassium level goes down (hypokalemia). Explain why.

545. If

a client is allergic to Heparin, they cannot be hemodialyzed. Why?

546. Is

hemodialysis done every day? the client who is being hemodialyzed have to watch what they eat and drink in between treatment? Why?

547. Does

548. Explain

the basic nursing care for a circulatory access (A-V shunt, fistula, or graft).

549. Why

cant a client who has an alternate circulatory access device have blood pressures or venipunctures in that extremity?

550. Explain

in your own words what peritoneal dialysis is.

551. When

a client is having peritoneal dialysis, where is the fluid going into?

552. What

would you do if you instilled 1,000 ccs of fluid into the peritoneal dialysis client and only 700 ccs came back?

553. What 554. What

should the drainage of peritoneal dialysis look like? would be S/S of infection with peritoneal dialysis?

555. When

a client has CAPD for their renal failure, why do they have to increase protein and fiber in their diet?

556. When

a client has CAPD, why do they have a constant sweet taste and why do they have anorexia?

557. What 558. What 559. Why

are the major signs of kidney stones? is the number one thing you need to remember with kidney stones?

is the serum creatinine not affected by what we eat?

560. What 561. Is

type of specimen do you have to have to test a creatinine level on a client?

the BUN affected by what we eat?

Gastrointestinal
562. What

are the two major functions of the pancreas?

563. What

is the major cause of pancreatitis?

564. How

can gallbladder disease cause pancreatitis?

565. List

all of the symptoms of pancreatitis. (Explain WHY these occur) Abdominal distention and ascites Abdominal mass

a. b.

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c. d. e. f. g. h.

Rigid board-like abdomen Bruising Fever Jaundice Hypotension Serum lipase and amylase (up or down)? do we give the pancreatitis client steroids?

566. Why

567. Why

do we give the pancreatitis client anti-cholinergic drugs?

568. Why 569. Is

do we give the pancreatitis client Tagamet and antacids?

it possible that a pancreatitis client might have to have insulin? Explain why.

570. What

is a peritoneal lavage and how does the pancreatitis client benefit from this?

571. What

are the dietary changes needed for the pancreatitis client?

572. What

is cirrhosis?

573. When

a client has cirrhosis, what happens to the blood pressure in their liver and what is the proper term for this?

574. Explain

the S/S of cirrhosis and explain why the client develops each symptom.

575. Why

does the cirrhosis client sometimes develop hepatic encephalopathy and coma?

576. Your

client is going to have a liver biopsy. What clotting studies should be explain why.

checked? Please

577. Why

is it so important that vital signs be checked pre-liver biopsy?

578. How

is a client positioned during a liver biopsy?

579. How

is a client positioned post-liver biopsy? Explain why.

580. Why

does the client have to exhale and hold while the primary healthcare provider into the liver?

is puncturing

581. Why

are worried about I & O and daily weights with the cirrhosis client?

582. Why

is rest so important with a cirrhosis client?

583. Why

are we worried about prevention of bleeding in the cirrhosis client?

584. Why

do we measure the abdominal girth in the cirrhosis client and what will it tell us?

585. What

is a paracentesis? a client is having a paracentesis, what position do you put them in?

586. When

587. Why

is it so important that the paracentesis client void pre-procedure?

588. Why

is it so important to monitor the vital signs pre- and post-paracentesis?

589. During

a paracentesis, the client could be thrown into a fluid volume deficit or fluid excess? is the first place a cirrhosis client might develop jaundice?

volume

590. Where 591. When

jaundice gets to the skin, what is one of the major nursing diagnoses?

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592. Why

do you have to avoid narcotics in any liver client?

593. When 594. Why

a client has a liver disease, what should be done with protein in the diet?

does the liver client need a low-sodium diet? chemical builds up in the blood that makes a client go into a hepatic coma?

595. What 596. How

did that chemical develop?

597. What

are symptoms of a hepatic coma? Explain why the client develops these symptoms.

598. What

is the major drug used in hepatic coma? Explain why.

599. If

a client is in hepatic failure and eats protein, what is going to happen to the ammonia level in their blood? Explain why.

600. What

are bleeding esophageal varices?

601. Why

does a client develop bleeding esophageal varices?

602. Why

is the oxygen important with a client who has bleeding esophageal varices?

603. Explain

how Octreotide (Sandostatin) works.

604. What

is one of the complications of giving Octreotide (Sandostatin)?

605. Why

does the client with bleeding esophageal varices need a Sengstaken Blakemore tube?

606. What

is the nursing care associated with a Sengstaken Blakemore tube?

607. Explain

symptoms of peptic ulcers.

608. What

is the pre-procedure care of a gastroscopy? Explain to your client what to are going to have a gastroscopy.

expect if they

609. When

a client has a gastroscopy, they have to be NPO until their gag reflex returns. Why?

610. What 611. Why

would be a major sign of perforation post-gastroscopy?

do we give the peptic ulcer client antacids? What type of antacids would be the best- liquid or tablet?

612. Why

do we give the client with peptic ulcer disease H-2 receptor antagonist? List some examples.

613. Why

do we give the peptic ulcer client Carafate?

614. Why

is it important that the peptic ulcer client decrease stress?

615. Why

is it important that the peptic ulcer client stop smoking?

616. Explain

what you would teach a peptic ulcer client about diet.

617. What 618. What 619. What

is the difference in a peptic ulcer and a duodenal ulcer? is a hiatal hernia? are the major symptoms of a hiatal hernia?

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620. What

are the major nursing interventions for a client who has a hiatal hernia?

621. What

is dumping syndrome?

622. After

what surgery does a client get dumping syndrome?

623. What

are the symptoms of dumping syndrome?

624. What

are the major nursing interventions for a client who has dumping syndrome?

625. What

is the difference in ulcerative colitis and Crohns disease?

626. What

are the symptoms of ulcerative colitis and Crohns disease?3

627. What 628. You

is another name for Crohns disease? going to

are taking care of a client who is going to have an upper GI. Explain what is happen to the client.

629. Your

client is going to have a barium enema. What is the pre-procedure care?

630. How

would you describe a barium enema to a client?

631. Why

is it so important that the client have a bowel movement after a barium

enema?

632. When

a client has ulcerative colitis or Crohns disease, do they need a high-fiber or low-fiber diet? Why?

633. Why

does the client with ulcerative colitis or Crohns need to avoid cold foods and smoking?

634. What

is one of the major antibiotics given for ulcerative colitis and Crohns disease? How does this drug help?

635. Why

does the client with ulcerative colitis or Crohns disease need steroids?

636. What

is the surgical treatment for ulcerative colitis?

637. What

is the surgical treatment for Crohns disease?

638. When 639. Why 640. Why

a client has an ileostomy, what will the drainage be like?

should an ileostomy client need to avoid rough foods or high-fiber foods? does the ileostomy client need Gatorade?

641. Why

is the ileostomy client at risk for kidney stones?

642. When

a client has an ileostomy, what electrolyte are they losing a lot of? the nursing care for a colostomy.

643. Explain

644. Why

does a client develop appendicitis?

645. Explain

the major symptoms of appendicitis?

646. Why

do we avoid giving enema to a client who has appendicitis?

647. When

a client has had any abdominal surgery, what is the position of choice and why?

648. What

is another name for Hyperalimentation?

649. Why

does a client who is receiving Hyperalimentation need a central line?

650. Why

do we discontinue Hyperalimentation gradually?

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651. Why

is it so important that we monitor daily weight in the hyperal client?

652. The

hyperal client may have to start taking insulin. Why?

653. When

a client is on hyperal we check their urine every day. What are some things you should be checking it for?

654. Why

is it so important that we not mix hyperal ahead of time?

655. Why

does Hyperalimentation need to be in a pump?

656. Why

is it so important that home TPN clients emphasize hand washing?

657. How

should you position your client?

658. Where

does the central line go?

659. If

air gets into your central line, what is going to happen? What position should you place the client in?

660. After

the central line has been inserted, we always get a chest x-ray. What two checking for in this chest x-ray?

things are we

Neuro
661. When

performing an assessment on the neuro client, what is most important?

662. What

is the pulse pressure?

663. What

happens to the pulse pressure with increased intracranial pressure?

664. If

a neuro client complains of a headache, what would this mean?

665. Explain

the dolls eye reflex.

666. Explain

the ice water calorics test.

667. Explain

the Babinski and what is the difference for a child less than one year of age and anyone greater than one year of age.

668. When 669. Can

a client is having a CT of the head, is it okay for them to talk?

a CT scan be done with contrast medium (dye)? type of client cannot tolerate an MRI scan?

670. What

671. Explain

everything that you would teach a client about an MRI.

672. What

is cerebral angiography?

673. When

a client is having cerebral angiography, what artery do they go through?

674. What

other procedure did we use the femoral artery for?

675. Why

is it so important that a client who is about to have cerebral angiography be well hydrated?

676. Why

is it so important that we assess the peripheral pulses before cerebral angiography?

677. When

a client is having a cerebral angiography, it is not uncommon for them to complain of a warmth in the face. Explain why.

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678. Is

it so important that you ask this client who is about to have cerebral angiography if they are allergic to something. What is it? the post-procedure care for the cerebral angiography client and explain

679. Explain

why.

680. Why

is it so important that we watch for an embolus after cerebral angiography? Explain what you would watch for specifically in your client.

681. What 682. What

is an EEG? is the pre-procedure care for a client who is going to have an EEG?

683. If

a client were about to have an EEG, what would you tell them about the procedure?

684. When 685. What

a client is having a lumbar puncture, do we get into cerebrospinal fluid?

are some reasons for doing a lumbar puncture?

686. How

do you position a client for a lumbar puncture?

687. Why

do you put them in this position?

688. What 689. What

should cerebrospinal fluid look like? is the post-procedure care of a lumbar puncture? Explain why.

690. What 691. How

is the most common complication of a lumbar puncture?

is this complication treated?

692. What 693. What 694. What

is a big complication of a lumbar puncture? is one of the most important things you need to remember with a scalp injury? is an open head injury?

695. What 696. With

is a closed head injury?

which fracture is the client most at risk for infection? S/S of a basal skull fracture.

697. Explain

698. When

a client has a basal skull fracture, where is the fracture?

699. What

is Battles sign?

700. What

are raccoon eyes?

701. What

is cerebrospinal rhinorrhea?

702. Explain

the S/S of a concussion.

703. If

a client has been diagnosed with a concussion, what things should you teach before they go home?

704. Is 705. If

it okay for a concussion client to go home alone? a client has an epidural hematoma, explain the sequence of events that will occur and why the client has these changes.

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706. What

is the treatment for an epidural hematoma?

707. When

a trauma client comes into the emergency room, why do we have to assume a C-spine injury is present?

708. Why

is it so important to keep the body in perfect alignment after trauma?

709. How

do you tell CSF from other drainage?

710. When

you have a head injury client, why is it so important that we keep the environment quiet?

711. When

you have a head injury client, why do we have to pad the side rails?

712. With

a neuro client, why do we want to avoid narcotics?

713. What

happens to intracranial pressure (ICP) when the client sits up and lies down?

714. What

is posturing?

715. Explain

the two different types of posturing.

716. When 717. Why

a client is posturing, what happens to their caloric needs?

are osmotic diuretics used in the treatment of intracranial pressure? Explain exactly how they work.

718. When

a client is on an osmotic diuretic, they better have two organs that are working perfectly. What are they?

719. Why

are clients with increased intracranial pressure given steroids?

720. How

can hyperventilation decrease intracranial pressure?

721. What

would happen to the intracranial pressure if the temperature were to exceed 100.4F? taking care of a head injury client with increased intracranial pressure, why is it so important that you space your nursing interventions?

722. When

723. What

is the purpose of a barbiturate induced coma?

724. Why

is it so important to restrict the fluids in a head injury client?

725. What

should you restrict the fluids to? (How many ccs per day?)

726. If

a client were to become bradycardic, what would happen to the cerebral perfusion? Explain why.

727. If

a client were to develop an increased blood pressure, what will happen to cardiac output? Explain how this would affect cerebral perfusion.

728. What 729. Why

is a major risk when a client has an ICP monitoring device?

is it so important that we keep the connections tight on an ICP monitoring device and also why is it so important to keep the dressings dry?

Respiratory
730. What

is the purpose of a thoracentesis?

731. When 732. What

a client is having a thoracentesis, where is the fluid being removed from?

is the pleural space?

733. When 734. Any

the pleural space fills with fluid, what happens to the lungs?

time you are pulling fluid from a clients body (thoracentesis, paracentesis, foley catheter), you are putting the client at risk for going into a fluid volume deficit or fluid volume excess. Why?

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735. There

is a possibility with a thoracentesis that a pneumothorax could occur. Why?

736. What

has happened when a client needs a chest tube?

737.

Chest systems have a water seal. First of all, what is the purpose of the water seal and what would happen if there was not water seal?

738. When

a client has chest tubes, hopefully the lungs will do what?

739. What

critical numbers would you report related to oxygenation and drainage in a drainage system? is the CDU kept below the level of the chest?

closed chest

740. Why

741. What

do you do when: a. Tubing disconnects from chest tube b. CDU falls over and water leaks out c. When is bubbling normal? d. When is bubbling a problem?

742. What 743. What 744. What 745. What

would happen if the water seal in the chest system is broken? life threatening complication can occur if you clamp a test tube? is a hemothorax? is pneumothorax?

746. When

blood or air or fluid accumulates in the pleural space, what is going to happen to the lung? should you do if a client presents with a penetrating object to the chest?

747. What

748. What

is a tension pneumothorax?

749. With

a mediastinal shift, what will happen to the trachea?

750. When

a client has an open pneumothorax, you are supposed to put a piece of petroleum gauze over the area. How many sides are taped down? Why do we leave one side open?

751. When

a client has a fractured sternum or ribs, why are the respirations so shallow? What acid base imbalance will this put them at risk for?

752. With

a fractured sternum or ribs, why do we give non-narcotic analgesics?

753. What 754. What

is flail chest? is paradoxical chest wall movement?

755. Why

does the client with flail chest develop paradoxical chest wall movement?

756. With

a fractured sternum or ribs, why is the client put on a ventilator with PEEP?

757. What

is PEEP?

758. What

is CPAP?

759. What

is the major difference between the two (PEEP and CPAP)?

760. How

can dehydration promote an embolus?

761. How

can venous stasis promote a pulmonary embolus?

762. When 763. When 764. When

a client has a pulmonary embolus, why does their pulse go up? a client has a pulmonary embolus, describe their chest pain. a client has a pulmonary embolus, the blood pressure is going to go up into

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their lungs. What effect will that have on the right side of the heart?

765. With

a pulmonary embolus, the client will have fever and their WBC count will go up. Why? does the PO2 go down with a pulmonary embolus? type of line will be put into the client to monitor the right side of the heart?

766. Why

767. What 768. How

will Heparin help the client who has developed a pulmonary embolus?

Orthopedics
769. Why

is it so important that fractures be immobilized as soon as possible?

770. What 771. What

type of emboli do you worry about with a fracture? would you do if a client came in with an open fracture? a neurovascular check.

772. Explain

773. There

are two parts to a neurovascular check.

a. b.

What is the neuro component? What is the vascular component? S/S of a fat embolus?

774. Give

775. What

is compartment syndrome?

776. If

you suspect a compartment syndrome, what should you do first?

777. In

your Student Book pages explained several different things under Cast Care. Such as ice packs should go on the sides. Go through those components under Cast Care and explain why we do all of those things. Ice packs on sides No indentations Use palms for the first 24 hours. Keep uncovered and dry.

a. b. c. d.

e. f. g. h.

Do not rest cast on hard surface or sharp edge. Mark breakthrough bleeding circle area, date, and time site. Cover cast close to the groin with plastic. Neurovascular checks with the 5 Ps

i. Elevate
778. When

a client with an orthopedic injury complains of pain, what is the first thing you should do?

779. What

are some of the purpose of traction?

780. Weight

on traction should hang freely. Explain why.

781. What

is skin traction. Give examples.

782. What

type of assessment is very important when a client has skin traction? Explain why.

783. What

is skeletal traction? Explain. Give examples.

784. Explain

how to do pin care.

785. When

a client has a total hip replacement, there are some important things to remember about positioning. Explain why you want neutral rotation. Limit flexion. Want extension. Abduction

a. b. c. d.

786. Discuss

the general nursing care for someone with the continuous passive motion machine.

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787. What

are some good exercises for the total hip replacement client?

788. Why

is it so important that the total hip replacement client avoid flexion?

789. Give

examples of things a total hip replacement client should avoid specifically related to flexion.

790. Why

is it important that we keep a tourniquet at the bedside with amputation?

791. Why

is elevation so important with an amputation (for the first 24 hours)?

792. What

can we do in the amputation client to prevent hip and knee contractures?

793. What

is phantom pain?

794. Describe

the nursing care with someone with phantom pain

Maternity
795. List

presumptive, probable, and positive signs of pregnancy.

796. When

teaching a pregnant client about exercise what heart rate do you tell her not to above when exercising? And why?

get

797. The

client should be taught to be alert for what danger signs during pregnancy?

798. What

signs of true labor would the nurse teach the client?

799. Why 800. The

is an IV fluid bolus of 1000 ml NS or LR given prior to an epidural?

nurse caring for a laboring client receiving Pitocin would discontinue the Pitocin if what occurred?

801. When 802. What

you assess tachycardia in a postpartum client, what should you think? boggy? And

why?

should the nurse do when palpating the postpartum clients fundus that is

803. The

nurse teaching a group of pregnant clients about breast feeding would include important points?

what

804. What

assessments are scored with the Apgar and when is it done?

Complications of Maternity
805. What 806. What 807. List

is the first sign of an ectopic pregnancy? are the two priorities in the treatment of Abruptio placenta?

treatments for the client with Hyperemesis Gravidarum.

808. By

definition, preeclampsia involves what assessment data? do the face and hands of the preeclamptic client swell?

809. Why

810. What

are priority assessments for the client receiving magnesium sulfate?

811. The

nurse caring for a client in preterm labor would observe for which side effects o f Brethine?

812. Why 813. Why

is Betamethasone given to the mom in preterm labor?

is it important to check FHTs when membranes rupture, either artificially or spontaneously? are pregnant clients routinely assessed for GBS risk factors?

814. When

Pediatrics
815. When

a. b. c.

assessing a pediatric client, what is the order of obtaining vital signs? Respirations-always count for 1 full minute Heart rate- always count for 1 full minute Blood pressure

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d.

Temperature

816. The

child with mild coup can be treated at home with steam (hot showers), cool mist humidifiers, and car rides with windows down. How does cool-temperature therapy help the child with mild croup?

817. Why 818. Why 819. Why

is the child, post tonsillectomy, positioned on their side, or head of bed would we want the child with Otitis Media to lie on the affected side? is it so important to recognize signs and symptoms of RSV quickly?

elevated, or prone?

820. Why 821. Why

is the child with Cystic Fibrosis at risk for hyponatremia? rested, when

do we need to feed the pediatric client with heart failure when they are well they wake up and are showing signs of hunger, and before they start crying? should an infant with a cleft lip and palate be burped frequently? why babies with esophageal Atresia do not have meconium?

822. Why

823. Explain

824. Treatment

for the client with mononucleosis consist of rest, analgesics, and fluids. not want this client to participate in contract sports?

Why would we

Management and Delegation

825. Why 826. Why 827. Why 828. Why

do you need to know med-surge core content first when delegating routine and nursing assistive personnel (NAPs)? can NAPs only perform routine, simple, repetitive common activities on stable uncomplicated situations? types of assignment transfers both responsibility and accountability?

tasks to LPNs clients in

is the RN responsible for knowing the staffs strengths and weaknesses in delegation? should the RN do when a weakness is identified in a staff member?

regards to

829. What 830. Why 831. Why

can the LPN not do any form of evaluation? should the RN assess the newly admitted client first?