Exam 1

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normal range for serum sodium

135-145 mEq/L

Medications for Cystic Fibrosis

pancreatic enzymes, antibiotics, gene therapy bronchodilators, anti-inflammatories

How often should you change blood tubing?

every 4-6 hours

An infant is admitted to the pediatric unit with bronchiolitis caused by RSV. Which intervention would the nurse provide for the infant?

- instilling saline nose drops - maintaining droplet precautions - nasal suctioning to remove mucus

How much NS should you flush with before giving medication?

10 mL

normal potassium levels in infants

3.5-5.0 mEq/L

microdrip factor

60 gtt/mL

Which medications would the nurse anticipate teaching the parent about for a preschooler newly diagnosed with cystic fibrosis?

Antibiotics Pancreatic enzymes Fat-soluble vitamins

Which symptom would the nurse monitor for when caring for a client who has hyponatremia?

Change in level of consciousness

When a client with COPD reports a 5 lb weight gain in 1 week, the nurse will assess for other signs and symptoms of which complication?

Cor pulmonale = right ventricular failure

Which goal is the priority for a client with asthma who has a prescription for an inhaled bronchodilator?

Demonstrates use of a metered-dose inhaler

Which action would the nurse include in the plan for care for a 6-month-old infant with RSV who is in respiratory distress?

Maintain droplet and contact precautions RSV is highly contagious. The infant should be isolated or placed with other infants with RSV. Droplet and contact precautions are instituted to limit the spread of pathogens to others.

Which nursing assessment would be performed by a nurse before administering IV infusion of potassium chloride?

Urinary output Last serum potassium level Patency of the IV access

What should be hanging when giving blood transfusion

Y tubing with filter with NS

Aldosterone

a mineralocorticoid secreted by the adrenal cortex that maintains sodium and water balance

hematopoisesis

blood cell formation

Which intervention would the nurse provide a 3-month-old infant hospitalized with RSV?

clustering care to conserve energy

Hypotonic solutions contain....

contain less than 0.85 g of sodium chloride in each 100 mL

RSV management

droplet/contact precautions prevention : palivizumab can be given in each month of RSV season protects for 30 days reserved for high risk children

Which assessment finding indicates to the nurse that a client with COPD who is receiving oxygen is retaining carbon dioxide?

drowsiness irregular pulse mental confusion

phlebitis

inflammation of vein --> redness along site of vein if med is a vesicant, put through central line instead of peripheral IV

chronic bronchitis (blue bloater)

inflammed bronchial tubes with excessive mucus production Recurrent cough & sputum production digital clubbing cardiac enlargement use of accessory muscles pulmonary hypertension = may have edema causign swelling in appearance

Hypertonic solutions contain ...

more than 0.85 g of solute in each 100 mL

what does an increase in carbon dioxide level lead to?

respiratory acidosis

Which electrolyte deficiency triggers the secretion of renin?

sodium

Tracheostomy (how to care for)

suctions only when needed 10-15 seconds at a time

Emphysema (Pink puffer)

hyperinflated air sacs from damage to lung tissues that reduces ability to recoil Barrel chest pursed lip breathing thin in apperance anxious

Medications for COPD

same as asthma may use systemic drugs (steroids) Mucolytics and expectorants may play more of a role = due to all of the secretion

When preparing a child with asthma for discharge, which instructions wold the nurse emphasize to the family?

- limit allergens in the home - continue the medications even if the child is asymptomatic

Which IV solution would a nurse anticipate administering when caring for a client with a history of severe diarrhea for the past 3 days who is admitted for dehydration?

0.9% sodium chloride

In which order would the nurse take these prescribed actions when caring for a client with COPD who is admitted with fever, increased dyspnea, and oxygen saturation of 86%?

1. Start oxygen non-rebreather mask 2. Obtain blood sputum cultures 3. Infuse ceftriaxone 1g intravenously 4. Administer acetaminophen for fever

3 functions of blood

1. Transportation 2. Regulation 3. Protection

Macrodrip factor

10,15,20 gtts/mL

Medications Asthma

Bronchodilators Short-acting B-Adrenergic agonists (SABAs) example: albuterol - most effective for relieving acute bronchospasm with acute attack take before exercise to prevent attack

Which clinical finding would the nurse anticipate when admitting a client with an extracellular fluid volume excess?

Distended jugular veins

A 12-year-old child with cystic fibrosis is prescribed four pancrelipase capsules 5 times a day. The nurse explains to the child they would take the medication with meals and snacks to accomplish which goal?

Facilitate the excretion of fats

Which insect or arthropod is a common trigger for children with asthma?

Household cockroach

Which treatment would the nurse anticipate for an infant admitted with bronchiolitis caused by respiratory syncytial virus (RSV)?

Humidified cool air and adequate hydration

The parents and 2 siblings of a 6-week-old infant are grieving the infant's death as a result of SIDS. Which short-term goal would the nurse have for this family?

Including the infant's sibling in the events and grieving in the wake of the infant's death The siblings need to be involved with the grieving process and to work through their own feelings

Antiinflammatories: Corticosterioids

Inhaled Corticosteroids (ICS) = can cause thrush action = used to treat COPD and asthma --> antinflammatory effect on airways, most effective long term drug. Maintenance medicine take after bronchodilator (wait 5 min). not a rescue inhaler prevent yeast: use spacer and rinse mouth after each use

What is pulmonary function testing used for?

It is used to diagnose progression of disease in clients with COPD.

The nurse is teaching pursed-lip breathing to a client with COPD. The client asks about the benefit of the exercises. Which explanation would the nurse give?

Keeps the airway open longer to decrease the work that goes into breathing

Which clinical finding would the nurse recognize as an early sign of cystic fibrosis in a neonate?

Meconium ileus = intestines may be obstructed by thick tenacious, pasty meconium

Which initial change in acid-base balance will the nurse expect when a client is in the progressive stage of shock?

Metabolic acidosis

Which finding would be of most concern when the nurse assesses a client with emphysema?

Oral cyanosis

The nurse advises a client receiving furosemide about potassium intake. Which fruits would the nurse encourage the client to eat?

Orange, Banana, Dried fruit

Which serum hormone level elevates in response to a client's total serum calcium concentration of 7.9 mg/dL?

Parathyroid hormone (PTH)

An older client is admitted to the hospital for rehydration therapy after 3 days of diarrhea. In addition to sodium, which electrolyte would the nurse be most concerned about?

Potassium

Which diagnostic test would be most useful in evaluating the effectiveness of treatment for asthma? a. Chest x-ray b. Pulmonary function test c. serum eosinophil counts d. immunoglobulin E levels

b. pulmonary function tests The most useful test when evaluating the effectiveness of asthma treatment is pulmonary function testing, which measures airflow.

Long Acting Adrenergic Agonist Drugs

end in -terol slow onset, control meds, long lasting can be combined with inhaled corticosteroid side effects: tachycardia palpations tremors NEVER USE FOR ACUTE ATTACK

Anticholinergics

end in -tropium second in line during acute attack (used more in COPD) side effects: - dry mouth and throat hoarseness blurred vision hypotension

Which finding in a client with asthma exacerbation requires the most rapid action by the nurse? a. report of chest tightness b. heart rate of 112 beats per minute c. expiratory wheezes in both lungs d. markedly decreased breath sounds

d. Markedly decreased breath sounds markedly decreased breath sounds may indicate very limited airflow and life-threatening asthma exacerbation

how often should you change IV site?

every 48-72 hours

how often should you change IV tubing?

every 72 hours

status asthmaticus

sever, life-threatening, acute episode of airway obstruction - does not respond to common therapy * prepare for emergency intubation `

what is given to treat hyperkalemia?

sodium polystyrene sulfonate (decreases potassium levels)

chest tubes

tube inserted to pleural space of the lung to drain air, fluid, or blood


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