NURS 3130- FINAL QUESTIONS WITH COMPLETE
SOLUTIONS
a. fib Correct Answers causes: cardiomyopathy, pericarditis,
pulmonary disease, vascular disease, CAD, HTN
tx: beta blockers, anticoagulants, digoxin, cardioversion,
ablation
a. flutter Correct Answers causes: MI, valvular disease,
thyrotoxicosis, COPD, CABG, digoxin toxicity
tx: beta blockers, anticoagulants, digoxin, cardioversion,
ablation
abdominal aortic aneurysm Correct Answers - teach smoking
CESSATION
- initially asymptomatic....
- RUPTURE: life threatening -->
sudden, tearing pain in chest, back, shoulders, abdomen;
diaphoresis; N/V; faintness; tachycardia; hypovolemic shock
from blood loss
absence seizure Correct Answers daydreaming, inattentive, only
lasts 5-10 seconds
acute blood loss anemia Correct Answers - fatigue, tachycardia,
chest pain, increased RR, dizziness when standing
interventions:
- blood transfusion when Hgb < 8!
,acute kidney injury (AKI) Correct Answers usually due to hypo
perfusion of kidneys
1. initiating- onset of sx, decreased UOP
2. oliguric- no urine produced; <30 mL/hr output, high BUN/Cr
3. diuretic- kidneys regain function, UOP increases, hydrate (PO
or IV)
4. recovery- back to normal lab values (BUN/Cr)
causes:
- pre-renal: hypovolemia, hypo perfusion
- intra-renal: NSAIDS, contrast, acute tubular necrosis,
hemolysis, glomerulonephritis
- post-renal: problems w/ ureters/bladder; BPH, kidney stones
*usually reversible
s/sx: JVD, edema, DOB, HTN, seizures, constipation, anemia,
chest pain "fluid overload"
tx: diuretics, high carb, LOW protein, LOW fat diet; dialysis, Na
& K restriction, O2 therapy, fluid restriction
complications: hyperkalemia (met. acidosis & temporary
dialysis) + fluid vol overload
addison's disease Correct Answers decreased secretion of
glucocorticoids & mineralocorticoids
complications: adrenal crisis, Na+ and fluid loss, hyperkalemia
(heart issues), hypoglycemia, bronze skin
,tx: IVF, corticosteroids, safety precautions (fall risk!)
ALS Correct Answers s/sx: rapid progression, affects voluntary
movement; cognition & sense remain in tact; muscle cramps,
weakness, slurred speech, difficulty swallowing, eventually
respiratory failure
no known cause
tx: no cure; BENZOTHIAZOLE is the only drug to slow
progression of disease; meds to treat symptoms
complications:
- aspiration/pneumonia = always elevate HOB when
eating/drinking
- immobility (DVT, PE, contractures)
- respiratory depression/failure
amputations Correct Answers GOAL = stop bleeding
- tourniquet applied (up to 6 hours)
- replace blood
- obtain cross match, insert large bore IV
complications:
- hemorrhage: hypovolemic shock
- infection: high in elderly w/ PVD
- contractures: residual limb b/c of bone, nerve & muscle loss
=> CALL MD
- phantom limb: numb, tingling, sharp, burning sensations
- neuromas: clumps of nerve axons in distal end of residual limb
=> CALL MD
, **NO PILLOW under remaining limb
**ice applied 15-20 min
appendicitis Correct Answers fever, N/V, rebound tenderness,
RLQ pain
*perforation: high pain w/ cough, pain better w/ right knee bent,
change in BP or pulse
dx: CT, mcburney's point
tx: PREPARE pt for operating room (NPO, consent, IV); knees
flexed, HOB elevated 30-45, NEVER APPLY HEAT
asthma Correct Answers s/sx: wheezing, not able to speak in
full sentences, high RR, high sputum, dyspnea, musical lung
sounds, high pulse, BP, accessory muscle use.
tx: #1 O2 THERAPY, #2 RESCUE MEDICATION
(bronchodilators); maintenance medication (anti
inflammatories), listen to LUNG sounds to make sure they are
improving!! encourage tripod positioning.
complications:
*status asthmatics
tx: O2, IV fluids, bronchodilators, steroids, possible ET tube
*respiratory failure
- LISTEN TO LUNG SOUNDS; are they improving or
stopping?!
SOLUTIONS
a. fib Correct Answers causes: cardiomyopathy, pericarditis,
pulmonary disease, vascular disease, CAD, HTN
tx: beta blockers, anticoagulants, digoxin, cardioversion,
ablation
a. flutter Correct Answers causes: MI, valvular disease,
thyrotoxicosis, COPD, CABG, digoxin toxicity
tx: beta blockers, anticoagulants, digoxin, cardioversion,
ablation
abdominal aortic aneurysm Correct Answers - teach smoking
CESSATION
- initially asymptomatic....
- RUPTURE: life threatening -->
sudden, tearing pain in chest, back, shoulders, abdomen;
diaphoresis; N/V; faintness; tachycardia; hypovolemic shock
from blood loss
absence seizure Correct Answers daydreaming, inattentive, only
lasts 5-10 seconds
acute blood loss anemia Correct Answers - fatigue, tachycardia,
chest pain, increased RR, dizziness when standing
interventions:
- blood transfusion when Hgb < 8!
,acute kidney injury (AKI) Correct Answers usually due to hypo
perfusion of kidneys
1. initiating- onset of sx, decreased UOP
2. oliguric- no urine produced; <30 mL/hr output, high BUN/Cr
3. diuretic- kidneys regain function, UOP increases, hydrate (PO
or IV)
4. recovery- back to normal lab values (BUN/Cr)
causes:
- pre-renal: hypovolemia, hypo perfusion
- intra-renal: NSAIDS, contrast, acute tubular necrosis,
hemolysis, glomerulonephritis
- post-renal: problems w/ ureters/bladder; BPH, kidney stones
*usually reversible
s/sx: JVD, edema, DOB, HTN, seizures, constipation, anemia,
chest pain "fluid overload"
tx: diuretics, high carb, LOW protein, LOW fat diet; dialysis, Na
& K restriction, O2 therapy, fluid restriction
complications: hyperkalemia (met. acidosis & temporary
dialysis) + fluid vol overload
addison's disease Correct Answers decreased secretion of
glucocorticoids & mineralocorticoids
complications: adrenal crisis, Na+ and fluid loss, hyperkalemia
(heart issues), hypoglycemia, bronze skin
,tx: IVF, corticosteroids, safety precautions (fall risk!)
ALS Correct Answers s/sx: rapid progression, affects voluntary
movement; cognition & sense remain in tact; muscle cramps,
weakness, slurred speech, difficulty swallowing, eventually
respiratory failure
no known cause
tx: no cure; BENZOTHIAZOLE is the only drug to slow
progression of disease; meds to treat symptoms
complications:
- aspiration/pneumonia = always elevate HOB when
eating/drinking
- immobility (DVT, PE, contractures)
- respiratory depression/failure
amputations Correct Answers GOAL = stop bleeding
- tourniquet applied (up to 6 hours)
- replace blood
- obtain cross match, insert large bore IV
complications:
- hemorrhage: hypovolemic shock
- infection: high in elderly w/ PVD
- contractures: residual limb b/c of bone, nerve & muscle loss
=> CALL MD
- phantom limb: numb, tingling, sharp, burning sensations
- neuromas: clumps of nerve axons in distal end of residual limb
=> CALL MD
, **NO PILLOW under remaining limb
**ice applied 15-20 min
appendicitis Correct Answers fever, N/V, rebound tenderness,
RLQ pain
*perforation: high pain w/ cough, pain better w/ right knee bent,
change in BP or pulse
dx: CT, mcburney's point
tx: PREPARE pt for operating room (NPO, consent, IV); knees
flexed, HOB elevated 30-45, NEVER APPLY HEAT
asthma Correct Answers s/sx: wheezing, not able to speak in
full sentences, high RR, high sputum, dyspnea, musical lung
sounds, high pulse, BP, accessory muscle use.
tx: #1 O2 THERAPY, #2 RESCUE MEDICATION
(bronchodilators); maintenance medication (anti
inflammatories), listen to LUNG sounds to make sure they are
improving!! encourage tripod positioning.
complications:
*status asthmatics
tx: O2, IV fluids, bronchodilators, steroids, possible ET tube
*respiratory failure
- LISTEN TO LUNG SOUNDS; are they improving or
stopping?!
