Elsevier practice questions: Sleeping, Fluid & Electrolyte, Elimination

A client with pain during urination and a profuse, yellowish-green penile discharge may have gonorrhea caused by

Neisseria gonorrhea

Hypocalcemia, not hypercalcemia, is present when:

kidney failure occurs

Organisms such as Escherichia coli may cause pelvic inflammatory disease. Signs include

lower abdomen and pelvic pain

Classic signs of peritonitis:

-abdominal rebound tenderness -diminished or absent bowel sounds -a rigid, boardlike abdomen -the heart will be tachycardia

A client is admitted to the hospital in the oliguric phase of acute kidney injury. The client's urine output for the past 12 hours was 200 mL. The nurse notes a prescription for 900 mL of oral fluids over the next 24 hours. Which interpretation of the amount of prescribed fluid would the nurse make? -It equals the expected urinary output for the next 24 hours - It will prevent the development of pneumonia and a high fever - It will compensate for both insensible and expect4ed output over the next 24 hours - It will reduce hyperkalemia which can lead to life-threatening cardiac dysrhythmias

- It will compensate for both insensible and expect4ed output over the next 24 hours ( Insensible losses are 500 mL to 1000 mL in 24 hours, with an average of about 600 mL; the measured output is about 400 mL in 24 hours based on the available history (about 200 mL in 12 hours). Based on the history, the expected urinary output should be about 400 mL in the next 24 hours, far less than 900 mL. More than 900 mL daily is necessary to help prevent pneumonia and its associated fever. Hyperkalemia in acute kidney injury is caused by inadequate glomerular filtration and is not related to fluid intake.)

Hesitancy Incontinence Nocturia etiology

-Partial urethral obstruction -benign prostatic hyperplasia -Neurogenic bladder - bladder infection - injury to external sphincter -Kidney disease with impaired concentrating ability -bladder obstruction, heart failure, diabetes mellitus, finding after renal transplant, excessive evening and nighttime fluid intake

The nurse is caring for a client during the emergent phase of a severe burn injury. Which parenteral intervention prescribed by the health care provider would the nurse question? - Colloids - Potassium -Hypertonic saline -lactated Ringers Solution

-Potassium Potassium replacement generally is not indicated in the initial management of burns because hyperkalemia results from the liberation of potassium ions from the injured cells.

Sleep deprivation symptoms Psychological

-confused and disoriented -increased sensitivity to pain -irritable, withdrawn, apathetic -agitated -hyperactive -decreased motivation -excessive sleepiness

Sleep deprivation symptoms physiological

-ptosis, blurred vision -fine motor clumsiness -decreased reflexes -decreased judgement and reasoning -Decreased auditory and visual altertness -Cardiac arrythmias

A client with cirrhosis and ascites will require what kind of diet?

moderate to low fat and low sodium intake also caffeine can cause distention to these type of patients

what is pneumaturia?

passage of urine containing gas

What action does vasopressin promote?

Reabsorption of water

Normal range of urine calcium

100-400 mg/24 hours (2.50-7.50 ,,p;/kg/24 hr)

administration of enemas in children: Ml and insertion distance Infant

120-240 ml 2.5 cm (1 inch)

1 liter of fluid loss weighs

2.2 lbs

Anuria description

24 hr urine output of less than 100 ml

administration of enemas in children: Ml and insertion distance 2-4 years

240-360 ml 5cm

administration of enemas in children: Ml and insertion distance 4-10 years old

360-480 7.5 cm (3 inches)

pruritic skin dx often interferes with

sleep

What does aldosterone promote

sodium reabsorption

A client weighing 132 pounds (60 kilograms) with burns over 35% of the body arrives at the hospital an hour after being rescued from a fire. Which amount of lactated Ringer solution would the nurse anticipate being infused in the next 8 hours?

4200 mL (In the first 8 hours, 4200 mL should be infused. According to the Parkland (Baxter) formula, one-half of the total daily amount of fluid should be administered in the first 8 hours. Because the client weighs 60 kg (132 pounds ÷ 2.2 kg = 60 kg), the calculation is 60 kg × 4 mL/kg × 35% burns = 8400 mL per day; half of this amount should be infused within the first 8 hours. 2100 mL, 6300 mL, and 8400 mL are incorrect calculations.)

administration of enemas in children: Ml and insertion distance 11 years old

480 - 720 ml 10 cm (4 inches)

Treponema pallidum, which causes _______ , is manifested by _____ and ____.

syphilis; chancres, rashes

What is bladder exstrophy

the bladder is on the outside of the body

What is melena?

A black, tarry stool indicating a GI bleed

What is the calyx of the kidney?

A structure that collects the urine at the end of each pyramid

Possible etiology of anuria

Acute kidney injury, end-stage renal dx, bilateral urethral obstruction

What is happening in SIADH?

Too much ADH hormone causing the body to retain too much water

natriuretic hormones promote

tubular secretion of sodium

adrenal insufficiency is associated with an excess of what electrolyte?

Calcium, so adrenal insufficiency would cause hypercalcemia

A client experiences melena, and gastric cancer is discovered. A partial gastrectomy is performed, a jejunostomy tube is surgically implanted, and a nasogastric (NG) tube for suctioning is placed. What would the nurse expect regarding NG drainage during the first 24 hours after surgery? Minimal to know drainage contains some blood and clots contains large amounts of frank blood similar to coffee grounds in coca

Contains some blood and clots (Drainage containing some blood and clots is an expected response during the first 24 hours after a gastric resection because oozing blood and blood coagulation. There will be a moderate amount of drainage, not minimal or no drainage. Green and viscid are normal characteristics of gastric contents, which are unexpected after gastric surgery. Drainage containing large amounts of frank blood indicates hemorrhage, which is unexpected. Material that appears similar to coffee grounds results from blood that has been digested by the gastric acid; gastric bleeding with a nasogastric tube in place will be red because gastric acids will not have time to act on the blood.)

etiology of pneumaturia

Fistula connections between bowel and bladder, gas-forming urinary tract infections

Hypertonic saline and LR solution are given to replace:

Fluid and electrolytes

Common symptoms of a UTI:

Frequency, hesitancy or difficulty urinating, low back pain, incontinence, pyuria (cloudy urine) suprapubic tenderness or fullness Fever, chills, N/V, flank pain, malaise

The laboratory reports of a client with adrenal adenoma show high urine aldosterone levels and a low specific gravity of urine. The serum potassium is 2.8 mEq/L (2.8 mmol/L). Which other findings will be present on assessment? Select all that apply. One, some, or all responses may be correct. -Hypernatremia -Hypertension -Hypoglycemia -Hypercalcemia -Metabolic Alkalosis

Hypernatremia Hypertension Metabolic Alkalosis (Rationale: Adrenal adenoma may cause primary hyperaldosteronism, which may result in high aldosterone in the urine, low specific gravity of the urine, and hypokalemia (indicated by a serum potassium level less than 3.5 mEq/L [mmol/L]). Increased aldosterone levels may result in sodium retention, which leads to hypernatremia. Sodium retention increases blood volume, which raises blood pressure and causes hypertension. High aldosterone levels may excrete hydrogen ions, leading to metabolic alkalosis. Hypoglycemia is caused by a deficiency of adrenocorticotropic hormone. Hypercalcemia is associated with adrenal insufficiency.)

A deficiency of adrenocorticotropic hormone may cause what insufficiency?

Hypoglycemia

Which clinical findings would the nurse expect when assessing a client with chronic kidney failure? Select all that apply. One, some, or all responses may be correct. -Polyuria -Lethargy -Hypotension -Muscle twitching -respiratory avidosis

Lethargy and muscle twitching (Rationale: Lethargy results from anemia, buildup of urea, and vitamin deficiencies. Muscle twitching results from excess nitrogenous wastes. Extensive nephron damage causes oliguria, not polyuria. Hypotension does not occur; the blood pressure is within the expected range or elevated as a result of increased total body fluid. Metabolic, not respiratory, acidosis occurs because of the kidneys' inability to excrete hydrogen and regulate sodium and bicarbonate levels.)

a bacterium that produces bacterial vaginosis, which is manifested by upper genital tract infections.

Mycoplasma Hominis

A client is prone to hyponatremia. Which factors would the nurse identify that can precipitate hyponatremia? Select all that apply. One, some, or all responses may be correct. -Wound drainage -Diuretic therapy - GI suction - Parenteral infusion of 0.9% sodium chloride - Inappropriate ADH secretion

Wound drainage, diuretic therapy, GI suction, Inappropriate ADH secretion (Wound drainage can result in hyponatremia from loss of sodium ions. Most diuretics interfere with sodium reabsorption in the nephrons and have the side effect of hyponatremia. Gastrointestinal fluids are rich in sodium ions, which are lost by GI suction. With the syndrome of inappropriate antidiuretic hormone (SIADH), high levels of the antidiuretic hormone (ADH) are produced, causing the body to retain water instead of excreting it normally in the urine. Parenteral infusion of 0.9% sodium chloride, an isotonic solution, should be compatible with body fluids; if given in excess, it may lead to hypernatremia)

The tip of each kidney pyramid is called

a papilla

Colloids are given to draw fluids from:

edematous tissue back into the bloodstream

Which clinical findings correspond with the secretion of antidiuretic hormone (ADH)? Select all that apply. One, some, or all responses may be correct. a. Edema b. Polyuria c. Bradycardia d. Muscle cramps e. hyponatremia

d & e (Rationale: Muscle cramps occur when sodium level is less than 125 mEq/L and are caused by osmotic fluid shift. ADH causes water retention, which dilutes serum electrolytes such as sodium, with a resultant hyponatremia. Edema is not usually seen in syndrome of inappropriate ADH (SIADH) because water retention is not extracellular. A decreased urine output occurs with SIADH because ADH causes reabsorption of fluid in the kidney glomeruli. The increased fluid volume associated with SIADH results in tachycardia, tachypnea, and crackles.)

what is peritonitis?

inflammation of the peritoneum, typically caused by bacterial infection either via the blood or after rupture of an abdominal organ.

What can radiation do to the bowel mucosa

damage and cause bleeding

an antidiarrheal medication prescribed to clients with AIDS to manage frequent diarrhea experienced by a client with AIDS.

diphenoxylate hydrochloride