NU 185
EXAM 3 3
STUDY GUIDE
Medical-Surgical Nursing II
Galen College of Nursing
This Document Description:
❖ This study guide for NU 185 at Galen College of Nursing
focuses on Exam 3 content from the Medical-Surgical
Nursing II course.
❖ It includes essential topics.
❖ The material is clearly organized to help students understand complex
systems and prepare effectively for exam questions.
, Cardiogenic Shock= poor perfusion
• Doesn’t matter what kind of shock, tissue can die
• Most important for perfusion is brain, heart and kidney
• Systolic pressure less than 90 is a concern
• We want to see 30mL/hr urine output
• Early sign is always a change in mental status
• Earliest signs of issues w/perfusion in the Brain
◦Change in mental status due to cellular hypoxemia
◦decrease in level of conscious
◦behavioral changes
◦By product if poor perfusion, carbon dioxide stays behind and now you have issues w/
acid base balance
◦Blood PH 7.35-7.45
• When your heart is not getting enough O2 your HR increases, because it wants to send that
blood around faster to pick up O2.
◦What is the treatment of hemorrhagic shock?
◦Need to get blood volume back in the body.
• What if your PT is hypovolemic shock?
◦Increase fluids
• How do you fix cardiogenic shock? And what is the one drug that increases the contractility of
the heart muscle?
◦Digoxin
• If the cause of a PT’s shock is autonomic dysreflexia, you have to identify the threat to remove
the problem.
Kidney
• helps maintain PH (huge buffering system) BUN/CREATININE (1.3 KIDNEY INJURY) rae
Earliest indicator that your kidneys is not perfused is urinary output
• <30 ml of urine per hour, if less than that, is it dehydration or pump is failing. If pump is failing
you have to act fast, because water is not going to go to the places that its needed.
If its R Side failure s/sx of fluid overload you see peripheral edema
How do you assess for fluid overload? Pitting Edema, JVD
If its L side failure s/sx pulmonary
•How do you assess for L side failure? Auscultation of lungs, Crackles = fluid
•What is the treatment for fluid overload? Furosemide sometimes given with PO K+ supplement
Furosemide (Lasix)
• 1st drug of choice for Heart Failure
• Loop Diuretic
• Potassium wasting diuretic; This mean that your patient is at risk for hypokalemia
Cardiac Diet
•Na sodium 2g/day
•Fluid intake 2L/day
•no Meats from animals that walk the land “FISH ONLY’ 9
•lots of veggies and fruits
What is the difference between furosemide and thiazides ? It’s K+ wasting = hypokalemia. K+ is
a major electrolyte responsible for contractility of the heart.
EXAM 3 3
STUDY GUIDE
Medical-Surgical Nursing II
Galen College of Nursing
This Document Description:
❖ This study guide for NU 185 at Galen College of Nursing
focuses on Exam 3 content from the Medical-Surgical
Nursing II course.
❖ It includes essential topics.
❖ The material is clearly organized to help students understand complex
systems and prepare effectively for exam questions.
, Cardiogenic Shock= poor perfusion
• Doesn’t matter what kind of shock, tissue can die
• Most important for perfusion is brain, heart and kidney
• Systolic pressure less than 90 is a concern
• We want to see 30mL/hr urine output
• Early sign is always a change in mental status
• Earliest signs of issues w/perfusion in the Brain
◦Change in mental status due to cellular hypoxemia
◦decrease in level of conscious
◦behavioral changes
◦By product if poor perfusion, carbon dioxide stays behind and now you have issues w/
acid base balance
◦Blood PH 7.35-7.45
• When your heart is not getting enough O2 your HR increases, because it wants to send that
blood around faster to pick up O2.
◦What is the treatment of hemorrhagic shock?
◦Need to get blood volume back in the body.
• What if your PT is hypovolemic shock?
◦Increase fluids
• How do you fix cardiogenic shock? And what is the one drug that increases the contractility of
the heart muscle?
◦Digoxin
• If the cause of a PT’s shock is autonomic dysreflexia, you have to identify the threat to remove
the problem.
Kidney
• helps maintain PH (huge buffering system) BUN/CREATININE (1.3 KIDNEY INJURY) rae
Earliest indicator that your kidneys is not perfused is urinary output
• <30 ml of urine per hour, if less than that, is it dehydration or pump is failing. If pump is failing
you have to act fast, because water is not going to go to the places that its needed.
If its R Side failure s/sx of fluid overload you see peripheral edema
How do you assess for fluid overload? Pitting Edema, JVD
If its L side failure s/sx pulmonary
•How do you assess for L side failure? Auscultation of lungs, Crackles = fluid
•What is the treatment for fluid overload? Furosemide sometimes given with PO K+ supplement
Furosemide (Lasix)
• 1st drug of choice for Heart Failure
• Loop Diuretic
• Potassium wasting diuretic; This mean that your patient is at risk for hypokalemia
Cardiac Diet
•Na sodium 2g/day
•Fluid intake 2L/day
•no Meats from animals that walk the land “FISH ONLY’ 9
•lots of veggies and fruits
What is the difference between furosemide and thiazides ? It’s K+ wasting = hypokalemia. K+ is
a major electrolyte responsible for contractility of the heart.
