Exam 2 material

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The nurse is reviewing the laboratory studies for a group of patients. Which patient is most likely to experience a decrease in serum osmolality

A patient with kidney failure

A patient had a carotid endarterectomy yesterday and when the nurse arrived in the room to perform an assessment, the patient states, "All of a sudden, I am having trouble moving my right side." What concern should the nurse have about this complaint?

A thrombus formation at the site of the endarterectomy

The nurse is caring for a patient in the neurologic ICU who sustained head trauma in a physical altercation. which optimal range does the nurse identify for this patient

0-10 mm Hg

The health care provider has prescribed a hypotonic IV solution for a patient. which IV solution should the nurse administer

0.45% sodium chloride

patient has AKI with a negative nitrogen balance, how much weight does the nurse expect the patient to lose

0.5kg/day

Creatinine

0.6-1.2 mg/dL* (commonly used: 0.5 - 1.5 mg/dL) end product of muscle metabolism a better indicator of renal function than blood urea nitrogen

The nurse assess that a patient is exhibiting symptoms associated with a Transient Ischemic Attack (TIA). After which period of time will the nurse monitor for these symptoms to subside

1 hour

The nurse is caring for a patient who was involved in a motor vehicle injury and sustained a head injury. When assessing deep tendon reflexes (DTR), the nurse observes diminished or hypoactive reflexes. How will the nurse document this finding?

1+

A patient is in the acute phase of an ischemic stroke. How long does the nurse determine that this phase may last

1-3days

at the end of five peritoneal exchanges , a patient's fluid loss was 500 ml how much is this loss equal to

1.0 lbs

Urine Specific Gravity

1.005-1.030 measures kidney's ability to excrete or conserve water

The average daily urinary output in an adult is

1.5 L

fluid management as a method of behavioral therapy for incontinence requires a daily liquid intake of

1.5ml

blood urea nitrogen (BUN)

10-20 mg/dL made up of urea; end product of protein metabolism by liver

the nurse notes that a patient who is retaining fluid had a 1kg weight gain documentation will indicate that this is equivalent to about how many mL

1000ml

the nurse will assess the patient for signs of lethargy, increasing intracranial pressure, and seizures when the serum sodium reaches which level?

115 mEq/L

A patient has a moisture-retentive dressing for the treatment of a sacral decubitus ulcer. How long should the nurse leave the dressing in place before replacing it?

12-24 hrs

normal range of sodium

135-145 mEq/L

The normal adult produces about ___ ml of cerebrospinal fluid daily from the ventricles

150

a patient who is semiconscious presents with restlessness and weakness. The nurse assess a dry, swollen tongue and a body temperature of 99.3F. the urine specific gravity is 1.020. Which is the most likely serum sodium value for this patient

155 mEq/L

patient with ESKD is scheduled to have an arteriovenous fistula created. the nurse explain that the patient will have a temporary dialysis catheter because the fistula has to "mature" nurse will explain that the patient will have to wait how long before using the fistula

2-3 months

The epidermis is almost completely replaced every

2-3 weeks

A patient is admitted with severe vomiting for 24 hrs as well as weakness and "feeling exhausted" the nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete

2.0 mEq/L

A patient's serum sodium concentration is within the normal range. Which will the nurse estimate the serum osmolality to be?

275 to 300 m0sm/kg

plasma osmolality

275-295 mOsm/kg

A nurse assess the patient's LOC using the Glasgow coma scale which score indicates severe impairment of neurologic function

3

a woman is taught to catheterize herself by inserting the catheter

3 inches into the urethra

the urine osmolality level that indicates an early sign of kidney disease is

300 m0sm/kg

Thrombolytic therapy with recombinant plasminogen activator (rt-PA) for ischemic stroke has significantly decreased post stroke symptoms. However, the treatment challenge is that the therapy has to be given within

4-5hrs

urine pH

4.5-8

normal adult bladder capacity is

400-500ml of urine

nurse changing dressing of chronic wound there is no sign of infection or heavily drainage how long will the nurse leave the wound covered?

48-72 hrs

A patient is admitted with a diagnosis of kidney injury. The patient reports "stomach distress" and describes ingesting several antacid tablets over the past 2 days. Blood pressure is 110/70 mm Hg, face is flushed, and the patient is experiencing generalized weakness. which is most likely magnesium level associated with symptoms

5 mEq/L

About ___ % of the of the ___L of total blood volume is

50,6,plasma

The emergency department nurse is caring for a patient weighing 110 lb who is having a stroke. when administering recombinant rt-PA, which minimum dose will the patient receive

50mg

As a cause of death in the United States, stroke currently ranks

5th

The upper and lower blood pH levels that are incompatible with life are ______ and ______.

6.8 for lower range 7.8 for upper range

about___ % of total body fluid is in the intracellular space

60

The nurse is caring for an adult patient with a body temp within normal range. which is the approximate insensible water loss per day in this patient

600ml/day

The normal blood pH is

7.35-7.45

The normal serum pH is

7.35-7.45

A patient is admitted to the hospital with an ICP reading of 20 mm Hg and a mean arterial pressure of 90 mm Hg. which is the calculated cerebral perfusion pressure?

70 mm hg

Cardiac effects if hyperkalemia are usually present when the serum potassium level reaches

8 mEq/L

in a patient with excess fluid volume, hyponatremia is treated by restricting fluids to how many mL in 24 hr

800

the most common type of renal carcinoma arises from the renal epithelium and accounts for more than ____% of all kidney tumors

85

A normal oxygen saturation value for arterial blood is

95%

the nurse is caring for a patient with dementia in the long-term facility when the patient has a change in cognitive function. which condition does the nurse identify is likely occurring with the patient

A UTI

patient comes to the clinic and asks the nurse why the skin of the forehead, palms, and soles has a yellow-orange tint. there is no yellowing of the sclera or mucous membrane. which question would be most approriate to ask the patient to identify a potential cause of the skin discoloration

"Have you been eating a large amount of carotene-rich foods?"

a patient is scheduled for a test with contrast to determine kidney function. which statement made by the patient should the nurse inform the health care provider about prior to testing

"I am allergic to shrimp"

A patient arrives to have an MRI done in the outpatient department. Which information provided by the patient warrants further assessment to prevent complication related to the MRI

"I am trying to quit smoking and have a patch on"

The nurse observes an African American patient with a large hypertrophied area of scar tissue on the left ear lobe. which does the nurse document this finding as?

Keloid

The epidermis is composed of three types of cells

Keratinocytes, Merkel cells, and Langerhans Cells

What are the potential complications of steven-Johnson's syndrome (SJS) and toxic epidermal necrolysis (TEN)?

Keratoconjunctivitis, sepsis , multiple organ dysfunction syndrome

renin-angiotensin-aldosterone mechanism

Kidney release renin if hypo, renin acts on angiotensinogen from the liver convert to angiotensin I, lungs which have angiotensin converting enzyme (ACE) convert to , angiotensin II, to adrenals which releases aldosterone to absorb sodium from the heart , arteries vasoconstricts, increased BP, kidney : sodium and water retention, which increased BP

lotions with added oil for increased softening of the skin

Liniments

A patient who has had a stroke begins having complications regarding spasticity in the lower extremity. Which prescribed medication will the nurse administer as prescribed to help alleviate this issue

Lioresal

A patient has a lesion affecting the pons, resulting in paralysis and the inability to speak, but has vertical eye movements and lid elevation. This patient is suffering from

Locked in syndrome

The nurse is called to attend to a patient having a tonic-clonic seizure in the waiting area. Which nursing interventions are provided for this patient?

Loosening constrictive clothing positioning the patient on their side with head flexed forward providing for privacy

Unaware of the borders of objects

Loss of peripheral vision

positive Chvostek sign

Magnesium deficit

the nurse is caring for a patient with an altered level of consciousness (LOC) which is the first priority of treatment for this patient

Maintenance of a patient airway

The nurse is caring for a patient with increased ICP. As pressure rises what osmotic diuretic does the nurse prepare to administer as prescribed?

Mannitol

the substance responsible for coloration of the skin

Melanin

formula for approximate value of serum osmolality

NA x2 = glucose/18+BUN/3

Anti-infective, urinary tract

Nitrofurantoin

A patient is brought to the emergency department with symptoms that indicate a possible stroke. Which initial diagnostic test for a stroke, usually performed in the emergency department, will the nurse prepare the patient for

Noncontract computed tomography

Excitatory response, mostly affecting mood

Norepinephrine

A patient 3 days postoperative from a craniotomy informs the nurse, "I feel something trickling down the back of my throat and I taste something salty." What priority intervention does the nurse initiate?

Notify the health care provider of a possible cerebrospinal fluid leak

When educating a patient about the use of anticonvulsant medication, what will the nurse inform the patient is a result of long term use of the medication in women?

Osteoporosis

Which is the optimal way to determine the level of a patient's alertness

Patient's ability to open eyes spontaneously or in response to a vocal or noxious stimulus (pressure or pain)

a patient is being treated for chronic venous stasis ulcers of the lower extremities. Which medication prescribed by the health care by decreasing the viscosity of blood and assist with the healing of the ulcers

Pentoxifylline

a prescription scabicide

Permethrin

Pinpoint red spots that appear on the skin as a result of blood leakage into the skin

Petechiae

a patient with a urinary tract infection (UTI) is having burning and pain when urinating. which urinary analgesic does the nurse administer as prescribed for relief of these symptoms

Phenazopyridine

urinary analgesic agent

Phenazopyridine (Pyridium)

After having a stroke, a patient has cognitive deficits. which cognitive deficits does nurse identify patient has as a result of stroke

Poor abstract reasoning decreased attention span Short-and long-term memory loss

The nurse is assessing a patient with a primary skin lesion called a macule. which does the nurse identify is a clinical example of this lesion

Port-wine stains

four major objectives of therapy for patients with dermatologic problems

Prevent additional damage prevent secondary infection revise inflammatory process relieve symptoms

The nurse is assessing the fingernails of a patient at the clinic. the nurse observes pitting on the surface of the nail. Which disorder is this finding indicative of?

Psoriasis

the nurse assess a patient with silvery-white, thick scales on the scalp, elbows, and hand of a patient that bleed when picked off. which skin disorder correlates with this assessment finding?

Psoriasis

A patient is diagnosed with psoriasis after developing scales on the scalp, elbows, and behind the knees. the patient asks the nurse, "where did I catch this from?" which is the best response

Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin

Osmotic pressure definition

Pulling force due to presence of solutes in solution; exerted by protein in plasma

Unable to comprehend the spoken word

Receptive aphasia

The nurse is assessing a patient for psoriatic lesions after treatment with a nonsteroidal cream. Which characteristics is typical of a plaque psoriatic lesion?

Red, raised path covered with silver scales

five potential collaborative problems for a patient with an altered LOC

Respiratory distress, pneumonia, aspiration, pressure injury, deep vein thrombosis

The nurse is performing a neurologic assessment and requests that the patient stand with eyes open and then closed for 20 seconds to assess balance. which type of test is the nurse performing

Romberg test

an enzymatic debriding agent

Santyl

patient reports severe itching that intensifies at night. the nurse assess the skin using a magnifying glass and penlight to look for the "itch mite" Which skin condition does the nurse assess?

Scabies

The nurse is caring for a patient with dark skin who is having gastrointestinal bleeding. how will the nurse determine from skin color change that shock may be present?

The skin is ashen gray and dull

A patient having an acute stroke with no other significant medical disorders has a blood glucose level of 420 ml/dl which significance does the hyperglycemia have for this patient

This is significant for poor neurologic outcomes

Most common fungal infection of skin or scalp

Tinea

A patient comes to the emergency department with severe pain in the face that was stimulated by brushing teeth. the nurse identifies which cranial nurse

V Trigeminal

A patient had a small pituitary adenoma removed by the transsphenoidal approach and has developed diabetes insipidus. What pharmacologic therapy will the nurse be administering to this patient to control symptoms?

Vasopressin

The nurse assess a patient and observes a herpes simplex/zoster skin lesion. how will the nurse document this lesion?

Vesicle

patient has stage 3 chronic kidney failure which will the nurse expect the patient's glomerular filtration rate

a GFR of 30 to 59 mL/min/1.73m2

The nurse is assisting with a lumbar puncture and observes that when the health care provider obtains cerebrospinal fluid (CSF), it is clear and colorless. What is the significance of this finding

a normal finding; the fluid will be sent for testing to determine other factors

two complications of renal surgery that are believed to be caused by reflex paralysis of intestinal peristalsis and manipulation of the colon or duodenum during surgery are

abdominal distension and paralytic ileus

The parasympathetic division of the autonomic nervous system yields impulses that are mediated by the secretion of _______ the dominant neurotransmitter in parasympathetic nervous system functions

acetylcholine

The nurse notes that a patient's urine osmolality is 980 mOsm/kg. Which will the nurse assess as a possible cause of this finding

acidosis

The most common skin condition in adolescents and young adults between the ages of 12 and 35 years is

acne

the two forms of nephrosclerosis are

acute hypertensive and benign

The subcutaneous tissue, which is primarily composed of

adipose tissue

A patient has had a large ischemic stroke and is hospitalized in the neurologic intensive care unit. Which interventions will be provided for this patient to decrease intracranial pressure?

administer mannitol as prescribed Maintain the partial pressure of arterial carbon dioxide (PaCO2) within a range of 30-35 mm Hg Administer supplemental oxygen if the oxygen saturation is below 80%

nurse is reviewing the potassium level of a patient with kidney disease. results of test are 6.5 mEq/L and the nurse observes peaked T waves on the ECG. which priority action will the nurse perform as prescribed to reduce the potassium level q

administration of sodium polystyrene sulfonate

a 24-hr urine collection is scheduled to begin at 8am when should the nurse initiate the procedure

after discarding the 8am specimen

what are the six categories of risk factors for UTIs

age, suppressed immune system, gender, pregnancy, medications, cognitive disturbances

contribute to hypomagnesemia

alcohol abuse, diarrhea, gentamicin administration, untreated ketoacidosis

the regulation of the amount of sodium excreted depends on the hormone

aldosterone

what does the regulation of sodium volume excreted depend on

aldosterone, hormone synthesized and released from adrenal cortex

contribute to hypokalemia

alkalosis, vomiting, gastric suction, anorexia nervosa, hyperaldosteronism, furosemide administration, steroid administration, penicillin administration

Osmotic pressure

amount of hydrostatic pressure needed to stop flow of water by osmosis, determined by concentration of solutes

corticosteroids are widely used in treating dermatologic conditions to provide

anti- inflammatory, antipruritic, and vasoconstrictive effects

the patient has been diagnosed with urge incontinence. which classification of the medication does the nurse educate the patient about the help alleviate the symptoms

anticholinergic agents

Water is reabsorbed, rather than excreted, under the control of the

antidiuretic hormone (ADH)

the nurse assess a patient upon admission to the hospital. which significant nursing assessment data is relevant to renal function

any voiding disorders the patient's occupation the presence of hypertension or diabetes

the nurse is instructing a patient on how to apply a corticosteroid cream to lesions on the arm. Which intervention will the nurse instruct the patient to do to increase the absorption of the medication

apply an occlusive dressing over the site after application

the nurse is caring for a patient with diagnosis of hyponatremia. which nursing intervention is appropriate to include in the plan

assess for symptoms of nausea and malaise monitor neurologic status restrict tap water status

A patient had a renal angiography and is being brought back to the hospital room. What nursing interventions should the nurse carry out after the procedure to detect complications? Select all that apply.

assess peripheral pulses compare color and temperature between involved and uninvolved extremities examine the puncture site for swelling and hematoma formation

how can the nurse assist the patient with all of the testing required to detect possible renal tumor

assist to prepare physically and psychologically monitor carefully for s/s of dehydration and exhaustion

Staggering, unsteady gait

ataxia

a patient has a cardioembolic stroke. What is the most common cardiac arrhythmia that is observed on the monitor

atrial fibrillation

Pemphigus vulgaris is an

autoimmune disease in which the immunoglobulin G (IgG) antibody is directed against a specific cell surface antigen in epidermal cells

Process that uses the body's own digestive enzymes to break down necrotic tissue

autolytic debridement

compare and contrast: autosomal dominant and autosomal recessive polycystic kidney disease

autosomal dominant : most common inherited form. symptoms develop ages 30 and 40; 90% cases are autosomal dominant Autosomal recessive: rare inherited form, s/s begin in early months of life or in utero

The most common buffer system in the body is the

bicarbonate-carbonic acid buffer system

the most common site of a lower UTI is the

bladder

List five risk factors related to the development of melanoma

blue eyed, history of sunburns, family history of melanoma and pancreas cancer , Caucasian skin color

how production of melanin is controlled

by hormone secreting from hypothalamus of the brain called melanocytes stimulating hormone

a patient reports tingling in the fingers as well as feeling depressed. the nurse assess positive trousseau and Chvostek signs. which decreased lab results does the nurse observes

calcium

a patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. Which deficit does the nurse evaluate the patient for

calcium deficit

carpopedal spasm and tetany

calcium deficit

muscle hypotonicity and flank pain

calcium excess

which clinical manifestation may be present to indicate that a patient with chronic glomerulonephritis is likely developing heart failure

cardiomegaly, gallop rhythm, distended neck veins, and other s/s of heart failure, crackles in the lungs

The leading cause of seizures in the older adult is

cardiovascular disease

The main surgical procedure for managing transient ischemic attacks (TIAs) is

carotid endarterectomy

50% of all hospital-acquired infections are UTIs, and in the majority of cases these are

catheter-associated UTI

bactericidal antibiotic

cephalexin

The brain center responsible for balancing and coordination is the

cerebellum

V Trigeminal

chewing, face and mouth touch and pain (facial sensation)

major anions

chloride, bicarbonate, phosphate, sulfate, proteinate ions

what are eight risk factors for bladder cancer

cigarette smoking exposure to environmental carcinogens recurrent or chronic bacterial infections of urinary tract

a patient has been diagnosed with urinary tract infection (UTI) and is prescribed an antibiotic. which first-line fluroquinolone antibacterial agent for UTIs does the nurse administer as prescribed that is highly effective for treatment

ciprofloxacin

fluoroquinolone antibiotic

ciprofloxacin

nurse is educating a patient who is required to restrict potassium intake. Which foods will the nurse suggest the patient eliminate that are rich in potassium

citrus fruits

the nurse educating a patient who will be performing self-catheterization at home. which information provided by the nurse will help reduce the incidence of infection

clean the catheter with antibacterial soap, thoroughly rinse, and dry before reinsertion

a patient comes to the clinic suspecting a possible UTI. Which symptoms of a UTI does the nurse identify from the assessment data gathered

cloudy urine

Trimethoprim/Sulfamethoxazole

co-trimoxazole

A patient is scheduled for an electroencephalogram (EEG) in the morning. which food on the patient's tray should the nurse remove prior to the test

coffee

How are calcium levels regulated?

combined actions of parathyroid hormone (PTH) and vitamin D

function of the receptor endings of nerves in the skin

constantly monitor the conditions of immediate environment sense temperature, pain, light, touch, pressure

VII Facial

controls most facial expressions secretion of tears & saliva taste

XI Spinal Accessory

controls trapezius & sternocleidomastoid controls swallowing movements

two blood levels that are significantly increased in acute kidney injury (AKI) are

creatinine and BUN

A patient being seen in the clinic for possible kidney disease. which major sensitive indicator of kidney does the nurse prepare the patient for

creatinine clearance level

the test that most accurately reflects glomerular filtration and renal excretory function is the

creatinine clearance test

what are the various causes of transient for urinary incontinence

delirium, UTI, atrophic vaginitis urethritis, prostatitis, medications

any abnormal skin condition

dermatosis

____ and _____ cause approximately 70% of the cases of chronic kidney disease

diabetes and hypertension

Describe how thrombolytic agents treat ischemic stroke

dissolves blood clot that is blocking blood flow to brain

Affects behavior, attention, and fine movement

dopamine

Parkinson's disease is caused by an imbalance in the neurotransmitter known as

dopamine

difficulty in swallowing

dysphagia

the major manifestation of nephrotic syndrome is

edema

excitatory; inhibits pain transmission

enkephalin

There are three layers of the skin

epidermis, dermis, subcutaneous tissue

Redness of the skin caused by congestion of the capillaries

erythema

when the nurse performs a neurologic examination, what will be included

evaluation of mental status cranial nerve function cerebellar function reflexes and motor and sensory function Glasgow coma scale

patient is advised to apply a suspension type lotion to a dermatosis site. the nurse will advise the patient to apply the lotion how often to be most effective

every 3 hours

unable to form words that are understandable

expressive aphasia

VI Abducens

eye movement; turns eye laterally

A patient has a severe neurologic impairment from a head trauma. which does the nurse recognize is the type of posturing that occurs with the most severe neurologic impairment

flaccid

oliguria and weight loss

fluid volume deficit

crackles and dyspnea

fluid volume excess

Assist with daily active or passive range of motion

footdrop, paralyzed extremity

A person's personality and judgement are controlled by the area of the brain known as the

frontal lobe

voluntary muscle control is governed by a vertical band of "motor cortex" located in the

frontal lobe

Muscle and nerve inhibitory transmissions

gamma-aminobutyric acid

the three natural defenses to bacterial invasion of the urinary tract are

glycosaminoglycan (GAG) (Protein), urinary immunoglobin A, and normal flora of vagina and urethral area which interfere with the adherence of Escherichia coli

VIII Vestibulocochlear

hearing and equilibrium

which laboratory findings does the nurse determine are consistent with hypovolemia in a female patient

hematocrit level of >47% urine specific gravity of 1.027 urine osmolality of >450 m0sm/kg

most common motor dysfunction of a stroke

hemiplegia

Which factors commonly contribute to UTIs in older adult patients

high incidence of multiple chronic conditions frequent use of antimicrobial agents presence of infected pressure injury immunocompromised

a patient undergoing a CT scan with contrast has a baseline creatinine level of 3 mg/dl which is the most effective intervention to reduce the risk of developing radiocontrast induced nephropathy (CIN)

hydrating with saline intravenously before the test

a patient with mild fluid volume excess is prescribed a diuretic that blocks sodium reabsorption in the distal tubule. which diuretic does the nurse anticipate administering to this patient

hydrochlorothiazide

contribute to hypophosphatemia

hyperparathyroidism, major thermal burns, alcohol withdrawl

contribute to hypercalcemia

hyperparathyroidism, malignant tumors, immobilization because of multiple fractures, thiazide diuretics

likely due to the use of glucose containing dialysate, is common in patients on long term PD

hypertriglyceridemia

the nurse is caring for a patient with end stage kidney disease in the hospital and smells a fetid odor from the patient's breath. which major manifestation of uremia will be present

hypocalcemia with bone changes

The sleep-wake cycle regulator and the site of the hunger center is known as the

hypothalamus

nurse is caring for a patient after kidney surgery. which major danger will the nurse closely monitor for

hypovolemic shock caused by hemorrhage

cause of respiratory alkalosis

hypoxemia, gram-negative bacterial infection

when will a patient need to receive renal replacement therapy

if total number of functioning nephron is less than 20%

place the patient in a lateral position

impaired cough reflex

elevate the head of the bed to 30 degrees

impaired cough reflex and paralyzed diaphragm

institute a bowel training program

incontinence

the nurse is educating a patient with urolithiasis about preventative measures to avoid another occurrence. Which intervention does the nurse educate the patient to perform

increase fluid intake so that the patient can excrete 2500 to 4000 ml every day , which will help prevent additional stone formation

when a person is dehydrated, the urine osmolality is

increased

The nurse is caring for a patient postop after intracranial surgery for the treatment of subdural hematoma. The nurse observes an increase in the patient's blood pressure from the baseline and a decrease in the heart rate from 86 to 54 , and crackles in the bases of the lungs. Which situation does the nurse suspect is occurring

increased ICP

what factors influence mortality rate in patients with AKI

increased age, comorbid conditions, preexisting kidney and vascular disease and respiratory failure

what assessment findings are significant for the patient who has nephrotic syndrome

increased protein (albumin) in urine, decrease albumin in blood, diffuse edema, high serum cholesterol, low density lipoproteins

the major complication of neurogenic bladder is

infection

the four phases of AKI are

initiation, oliguria, diuresis, and recovery

explain the general principles/guidelines that the nurse will adhere to in order to prevent infection in a patient with an indwelling urinary catheter

instruct to drink a measured amount of fluid specific times to void; bladder scan

Comprises fluid surrounding cell

interstitial space

Comprises about 60% of body fluid

intracellular space

Space where plasma is contained

intravascular space

The extracellular space is divided into three compartments

intravascular, interstitial, and transcultural

two categories of stroke

ischemic and hemorrhagic

an insoluble, fibrous protein that forms the outer layer of skin

keratin

the nurse is caring for a patient with severe pain related to ureteral colic. which medication will the nurse administer as prescribed that will inhibit the synthesis of prostaglandin E, reducing swelling and facilitating passage of the stone

ketorolac

dull, constant ache

kidney

contribute to hypermagnesemia

kidney failure

the major cause of death for patients with neurologic impairment of the bladder is

kidney failure

contribute to hyperphosphatemia

kidney failure and neoplastic disease chemotherapy

cause of metabolic acidosis

lactic acidosis, ketoacidosis, diarrhea

nurse is caring for a patient in the oliguric phase of AKI. Which does the nurse determine the daily urine output

less than 400 mL

The nurse is caring for a patient with a traumatic brain injury (TBI) which does the nurse identify at the earliest sign of serious impairment of brain circulation related to increasing ICP

lethargy and stupor

where are amino acids and glucose usually filtered

level of glomerulus and reabsorbed so that neither is excreted in urine

A patient has contact dermatitis on the hand, and the nurse observes an area that is thickened and rough between the thumb and forefinger how will the nurse document this finding

lichenification

a patient is having an MAG3 renogram and is informed that radioactive material will be injected to determine kidney function. which will the nurse instruct the patient to do during the procedure

lie still on the table for approximately 35 minutes

a patient who has been treated with uric acid for stones is being discharged from the hospital which type of diet does the nurse discuss with the patient

low-purine diet

contribute to hypocalcemia

massive administration of citrated blood, pancreatitis , kidney failure, aminoglycoside administration

The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. which condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for

metabolic acidosis

Primary complication of hyperphosphatemia which occurs when the calcium-magnesium product exceeds 70 mg/dl

metastatic calcification of soft tissue, joints, and arteries

a patient has had surgery to create an ileal conduit for urinary diversion. which is a priority intervention by the nurse in the postoperative phase of care

monitor urine output hourly and report output greater than 30 mL/h

A nurse is assessing a patient's urinary output as an indicator of diabetes insipidus related to a traumatic brain injury. the nurse identifies that an hourly output of which volume over 2 hours may be a positive indicator

more than 200 ml/hr

filtration

movement of water, solutes occur from area of high hydrostatic pressure to area of low hydrostatic pressure (e.g kidneys filtrate urine)

Sodium establishes the electrochemical state necessary for ________ and the ____________.

muscle contraction and transmission of nerve impulses

what clinical manifestations occur when there is destruction or dysfunction in the basal ganglia

muscle rigidity, disturbances of posture and difficulty initiating or changing movement

The functional unit of each kidney is the

nephron

the type of kidney disease characterized by increased glomerular permeability and manifested by massive proteinuria

nephrotic syndrome

the nurse applying fam dressing to an exudate sacral decubitus ulcer. after application of the foam dressing, what is important for the nurse to do?

nonadherent, nurse must apply secondary dressing to keeping in place

A patient has been involved in a traumatic accident and is hemorrhaging from multiple sites. the nurse expects that the compensatory mechanisms associated with hypovolemia would cause which clinical manifestations

oliguria, tachycardia, bradycardia

a patient with abnormal sodium losses is receiving a regular diet. How will the nurse supplement the patient's diet to provide 1600 mg of sodium daily

one beef cube and 8 oz of tomato juice

why the administration of a 3% to 5% sodium chloride solution requires intense monitoring

only small volumes are needed to elevate serum sodium from dangerously low levels

Sodium, the most abundant electrolyte in extracellular fluid, is primarily responsible for maintaining fluid _____, which ______________________________.

osmolality, affect movement of water between fluid compartment

the major clinical manifestation of renal stones is

pain

Difficulty with proprioception

paresthesia

There are three types of wound dressings

passive, interactive, active

A patient is visiting the health care provider to determine what type of allergy is causing to rash. Which type of testing will be appropriate in order to determine the cause of this finding

patch test

What is meant by an altered level of consciousness (LOC)

patient is not orientated, does not follow commands, needs persistent stimuli to achieve a state of alertness

the nurse providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of urinary tract infections (UTIs) in the female population. Which interventions will the nurse discuss in the program

perform hand hygiene prior to patient care assist the patients with frequent toileting provide careful perineal care

the most common and serious complication of continuous ambulatory peritoneal dialysis (CAPD) is

peritonitis

The "master gland" is also known as the

pituitary gland

Three major potential complications in a patient with a depressed level of consciousness are:

pneumonia, aspiration, and respiratory failure

The major positively charged ion in intracellular fluid is

potassium

soft, flabby muscles and weakness

potassium deficit

irritability and intestinal colic

potassium excess

Which common risk factors are responsible for urinary incontinence

pregnancy, menopause, GI surgery, pelvic muscle weakness, immobility, diabetes

vague discomfort

prostatic

chronic weight loss and fatigability

protein deficit

How do cytokines work

proteins with mitogenic activity that release increased amount of growth factors into wound stimulates cell growth and granulation of skin

The nurse is assessing a patient with risk factors related to human immune deficiency virus (HIV) which assessment finding does the nurse identify as a manifestation of the disease

purplish cutaneous lesions

hydrostatic pressure

pushing force on water due to the presence of more fluid in one region than another; exerted on walls of blood vessels

Bacterial skin infections

pyodermas

major physical processes involved in loss of heat from the body to the environment

radiation, conduction, and convection

potential complications of a hemorrhagic stroke include

rebleeding/ hematoma expansion cerebral vasospasm seizure acute hydrocephalus

nurse is reviewing a patient's lab results. which findings does the nurse assess that are consistent with acute glomerulonephritis

red blood cells in the urine proteinuria, white cell casts in the urine

Describe the role and functions of the autonomic nervous system

regulates activities of internal organs maintenance and restoration of internal homeostasis largely responsible of ANS

nephron is located in the

renal cortex

baroreceptors

responsible for monitoring circulating volume, small nerve receptors that detect changes in pressure within blood veseels

scabies is an infestation of the skin by the itch mite

sarcoptic scabies

an infestation caused by itch mite

scabies

Jaundice can be first observed by examining the

sclera and mucous membrane

cause of respiratory acidosis

sedative overdose, severe pneumonia, acute pulmonary edema

osmoreceptors

sense changes in sodium concentration

inhibits pain pathways and can control sleep

serotonin

The nurse is reviewing the laboratory studies for a patient suspected of acute kidney injury. Which test would be the best indicator of the patient's renal function

serum creatinine

A patient is exhibiting classic signs of a hemorrhagic stroke. which report from the patient would be an indicator of this type of stroke

severe headache

which will the nurse assess for to determine if a patient using corticosteroids for a dermatologic condition is having local side effects

skin atrophy, striae, telangiectasia

Name the most common type of ischemic stroke

small, penetrating artery thrombic stroke affect one or more vessels, most common type of ischemic stroke

I Olfactory

smell

The major positively charged ion in extracellular fluid is

sodium

fingerprinting on the sternum

sodium deficit

rough,dry tongue and thirst

sodium excess

major cations

sodium, potassium, calcium, magnesium, hydrogen ions

active transport

sodium-potassium pump

diffusion

solutes move from area of higher concentration to one of lower concentration

osmosis

solvent particles across a semipermeable membrane from the area of low solute concentration to area of high solute concentration

bullous impetigo, deep-seated infection characterized by large, fluid-filled blisters, is caused by the bacteria

staphylococcus aureus

a patient informs the nurse that every time she sneezes or coughs, she urinate in her pants. which type of incontinence does the nurse identify the patient is experiencing

stress incontinence

the type of incontinence that results from a sudden increase in intra-abdominal pressure is

stress incontinence

X Vagus

swallowing, gastric motility, and secretion

two types of skin glands

sweat and sebaceous

The main secretory function of the skin is performed by the

sweat glands

helps regulate body temperature

sweat glands

the nurse is educating a female patient with a urinary tract infection (UTI) regarding the pharmacologic regimen for treatment. which education is important for the nurse to provide to the patient

take the antibiotic for 3 days as prescribed

red marks on the skin caused by distention of the superficial blood vessels

telangiectasia

subcutaneous tissue, which is primarily composed of adipose tissue has a major role in

temperature regulation

The lobe of the cerebral cortex that is responsible for the understanding of language and music is the

temporal lobe

The most characteristics manifestation of hypocalcemia and hypomagnesemia is

tetany

which clinical indication of hypophosphatemia does the nurse assess in patient

tetany

A patient has a suprapubic catheter inserted postoperatively. What would be the advantages of the suprapubic catheter versus a urethral catheter? Select all that apply.

the patient can void sooner than with a urethral catheter the suprapubic catheter allows for more mobility the suprapubic catheter permits measurement of residual urine without urethral instrumentation

patient placed on hemodialysis for the first time. the patient reports a headache with nausea and begins to vomit, and the nurse observes a decreased level of consciousness. which does the nurse identify has occurred with the patient

the patient is experiencing a cerebral fluid shift

the nurse is educating a patient about preparation for an IV urography. which will the nurse include in the preparation instructions

the patient may have liquids before the test

Where is antidiuretic hormone (ADH), also known as vasopressin, synthesized/ secreted?

the posterior portion of the pituitary gland in response to changes in osmolality of the blood

sodium is regulated by

thirst, antidiuretic hormone, renin-angiotensin aldosterone system

XII Hypoglossal

tongue movement

There are three types of therapy indicated for the treatment of psoriasis

topical, phototherapy, and systemic

contribute to hyperkalemia

tourniquet too tight when collecting blood sample, leukocytosis, kidney failure , adrenal steroid deficiency

a potentially fatal skin disorder

toxic epidermal necrolysis (TEN)

the smallest compartment of the extracellular fluid space

transcellular space

the major waste product of protein metabolism is ___, with approximately _____g produced and excreted daily

urea, 20-30

severe, sharp, stabbing , colicky

ureteral

three areas of ureters that have a propensity for obstruction by renal calculi

ureteropelvic junction, ureteral segment, ureterovesical junction

Pain variable, most severe during & immediately after voiding

urethral

II Optic

vision

a localized or widespread condition characterized by destruction of the melanocytes in circumscribed areas of the skin, resulting in white patches

vitiligo

contribute to hyponatremia

vomiting, diarrhea, diuretics, adrenal insufficiency, syndrome of inappropriate antidiuretic hormone, excessive parenteral administration of dextrose and water solution

cause of metabolic alkalosis

vomiting, hypokalemia

contribute to hypernatremia

watery diarrhea, inability to quench thirst, burns over a large surface area, heat stroke, status post therapeutic abortion, diabetes insipidus with water restriction

The most accurate indicator of fluid loss or gain in an acutely ill patient is

weight

a patient taking an alpha-adrenergic medication for the treatment of hypertension is having a problem with incontinence. which education does the nurse provide to the patient

when the medication is discontinued or changed, the incontinence will resolve

the nurse is assigned to care for a patient in the oliguric phase of kidney failure when does the nurse document that oliguria is present

when the urine output is less than 30 ml/hr

the nurse is administering calcium acetate to patient with ESKD when is the best time for nurse to administer

with food

when assessing the skin of an older adult, which major age-related changes are seen in the skin?

wrinkling, uneven pigmentation, various proliferative lesions, dryness, cellular changes-aging include thinking at junction of dermis and epidermis

Overly dry skin

xerosis

the nurse is reviewing the laboratory values for a patient and observes an increase in blood osmolality. which significance of this increase

ADH stimulation

Primarily excitatory, can produce vagal stimulation of heart

Acetylcholine

The nurse is caring for a patient with extensive bullous lesions on the trunk and back prior to initiating skin care, which is a priority for the nurse

Administer analgesic pain medication

A patient is diagnosed with seborrheic dermatitis on the face and is prescribed a corticosteroid preparation for use. Which will the nurse educate the patient about regarding use of the steroid on the face

Avoid using the medication around the eyelids because it may cause cataracts and glaucoma

if a patient with an altered LOC requires suctioning, which intervention is a priority for the nurse to provide

Before and after : adequately ventilated to prevent hypoxia

dull continuous pain, intense when voiding

Bladder

The primary concentration of phosphorous (85%) is located in the____, with about 15% located in

Bone , soft tissue

a nurse caring for patient with head trauma will be monitoring patient for Cushing triad. which are the identified symptoms associated with Cushing triad that the nurse docs

Bradycardia, bradypnea, hypertension

Stroke which is also called a _____ ______ to emphasize the urgency of its occurrence

Brain attack

The primary, lethal complication of ICP is

Brain herination resulting in death

A patient who has suffered a stroke is unable to maintain respiration and is intubated and placed on mechanical ventilator support. which portion of the brain is most likely responsible for the inability to breathe

Brain stem

Three primary complications of increased ICP are

Brain stem herination, diabetes insipidus , and syndrome of inappropriate antidiuretic hormone (SIA DH)

Hemorrhagic strokes are caused by bleeding into

Brain tissue ventricles subarachnoid space

Skin needs to be exposed to sunlight to manufacture vitamin ________

D

Double vision

Diplopia

A patient is being tested for a gag reflex. When the nurse places the tongue blade to the back of the throat, there is no response elicited. which dysfunction does the nurse identify the patient is experiencing

Dysfunction of the vagus nerve

A patient having a stroke is having difficulty forming words. How will the nurse document this finding

Dysphagia

symptoms associated with air embolism, a complication of intravenous therapy

Dyspnea, cyanosis, weak pulse, hypotension, unresponsiveness, pain

three organisms most frequently found in UTIs are

E.coli, pseudomonas, and enterococcus

The nurse will assess all possible causes of pruritus for a patient reporting generalized pruritus which does the nurse understand can be other causes for this condition

End-stage kidney disease

Comprises the intravascular, interstitial, and transcellular fluid

Extracellular fluid

III Oculomotor

Eye movement, pupil constriction

An antiviral agent used to treat herpes zoster

Famvir

principal signs of lower motor neuron disease

Flaccid paralysis and atrophy of affected muscles

a topical corticosteroid with medium to high potency

Fluocinonide

maintain dorsiflexion to affected area

Footdrop

A patient had a lumbar puncture 3 days ago in the outpatient clinic and calls the nurse reporting a throbbing headache. Which education will the nurse provide to the patient regarding relief of the discomfort?

Force fluids (unless contraindicated) get plenty of bed rest take some over-the-counter analgesics

function of the blood-brain barrier

Form continuous tight junctions, creating barrier to macromolecules and many compounds

a patient who had a stroke is experiencing memory loss and impaired learning capacity. In which lobe does the nurse determine that brain damage has most likely occurred?

Frontal

A patient sustained a head injury during a fall and has changes in personality and affect. which part of the brain does the nurse identify has been affected in this injury

Frontal lobe

What foods can the nurse recommend for the patient with hypokalemia?

Fruits such as bananas and apricots

a semisolid emulsion that becomes liquid when applied to the skin or scalp

Gel

important principle of psoriasis treatment

Gentle removal of the scales

A patient is having a lumbar puncture and the health care provider has removed 20 ml of cerebrospinal fluid (CSF) which nursing action is a priority after the procedure

Have the patient lie flat for 6 hrs

The nurse is assisting with the collection of a Tzanck smear. which is the suspected diagnosis of the patient?

Herpes Zoster

The risk of coronary heart disease and stroke has decreased in women on the Dietary Approaches to Stop Hypertension (DASH) diet. what does this dietary regimen consist of?

High in fruit, vegetables, moderate low-fat dairy products, and low in animal protein

The nurse is educating a patient with a seizure disorder. which nutritional approach for seizure management would be beneficial for this patient?

High in protein and low in carbohydrate

describe why moisture-retentive dressings are efficient at removing exudate

High moisture vapor transmission rate some have reservoirs to hold excessive exudate

the condition of having excessive hair growth

Hirsutism

Difficulty judging distances

Homonymous hemianopsia

Increase in the melanin of the skin, resulting in an increase in pigmentation

Hyperpigmentation

Most common cause of intracerebral hemorrhage is

Hypertension

common causes of stroke

Hypertension and Diabetes

decrease in the melanin of the skin, resulting in a loss of pigmentation

Hypopigmentation

The nurse should know that clubbing of the nails is usually an indicator of

Hypoxia

leading cause of death in people with blistering disease

Infection

A patient has expressive speaking aphasia after having a stroke. which portion of the brain does the nurse identify has been affected

Inferior posterior frontal areas

IV Trochlear

Innervates superior oblique turns eye downward & laterally.

third space fluid shift

Intravascular fluid volume deficit

a patient is being evaluated for nodular cystic acne. Which systemic pharmacologic agent may be prescribed for the treatment of this disorder

Isotretinoin

A patient has a serum bilirubin concentration of 3mg/100ml what to observe?

Jaundice

The nurse is applying a cold towel to a patient's neck to reduce body heat. How will the nurse determine that the heat is reduced?

Conduction

penicillin antibiotic

Ampicillin (Omnipen)

patient with chronic kidney failure experiences decreased levels of erythropoietin which serious complication related to those levels will the nurse assess for when caring

Anemia

most common cause of cerebrovascular disease

Arteriosclerosis

The nurse is assessing the pupils of a patient who has had a head injury. which parasympathetic effect does the nurse identify the patient is experiencing

Constricted pupils

the preganglionic fibers of the sympathetic neurons are located in the segments of the spinal cord identified as

C8-L3

The nurse is performing an assessment of cranial nerve function and asks the patient to cover one nostril at a time to see if the patient can smell coffee, alcohol, and mint. The patient is unable to smell any of the odors. which cranial nerve does the nurse identify is not functioning as it should

CN I Olfactory

The nurse obtains a Snellen eye chart when assessing cranial nerve function. Which cranial nerve is the nurse testing when using the chart?

CN II Optic

The nurse assess a dark-skinned patient who has cherry-red nail beds, lips, and oral mucosa. Which disorder does the nurse identify correlates with this assessment finding?

Carbon monoxide poisoning

localized skin infection involving hair follicles

Carbuncles

A patient has developed a boil on the face, and the nurse observes the patient squeezing the boil. Which complication will the nurse discuss with the patient after encouraging them not to manipulate the boil

Cellulitis

the nurse is caring for a patient with hypernatremia. Which complication of hypernatremia should the nurse continuously monitor

Cerebral edema

Nursing postoperative management includes detecting and reducing ________, relieving ________, preventing __________, and monitoring ________ and _______.

Cerebral edema, pain, seizures, increased ICP, neurologic status

What function the hair of the skin serves

Provides thermal insulation in mammals, enhanced during cold or fright by piloerection, caused by contraction of tiny erector muscles attach to the hair follicle

The nurse is assessing a patient with toxic epidermal necrolysis (TEN) which assessment data will indicate that the patient may be progressing to keratoconjunctivitis

Pruritus of eyes burning of eyes dryness of eyes

The nurse is caring for a patient having a hemorrhagic stroke. In what position un the bed will the nurse maintain this patient

Semi-fowler

an neurotransmitter that helps control mood and sleep

Serotonin

A major potential complication of epilepsy is

Status epilepticus

The primary cerebrovascular disorder in the United States is

Stroke

IX Glossopharyngeal

Swallowing, saliva, taste

The major receiving and communication center for afferent sensory nerves is the

Thalamus

A patient having an ischemic stroke is admitted to the acute care facility. When will the nurse plan the rehabilitation for this patient

The day the patient has the stroke


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