Exam 1
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