Exam 2 material
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
