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HURST REVIEW NCLEX RN READINESS EXAM: LATEST A+ QUESTIONS AND ANSWERS EDITION. How can HF lead to Hypervolemia? If the heart is weak - Cardiac output goes down - Kidney perfusion decreases - Urinary output decreases - so the volume stays in the vascular

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HURST REVIEW NCLEX RN READINESS EXAM: LATEST A+ QUESTIONS AND ANSWERS EDITION. How can HF lead to Hypervolemia? If the heart is weak - Cardiac output goes down - Kidney perfusion decreases - Urinary output decreases - so the volume stays in the vascular space Aldosterone Think Sodium & Water "salt-retaining hormone" Aldosterone promotes the retention of sodium by the kidneys. Sodium retention promotes water retention Watter retention promotes a higher blood volume and pressure What diseases are caused by TOO MUCH Aldosterone? Cushing's Hyperaldosteronism (Conn's disease) What diseases are caused by TOO LITTLE Aldosterone? Addison's disease ADH Think ? H2O Anti - Diuretic Hormone (ADH) Makes you RETAIN WATER Too Much ADH problems - Retain water - Fluid Volume Excess = SIADH Syndrome of Inappropriate Antidiuretic Hormone (SIADH) saying...? Too Many Letters = (retaining) Too Much Water SIADH urine characteristics Urine output is decreased Urine sodium is increased Urine concentration is increased Urine specific gravity is increased SIADH serum (blood) characteristics Serum sodium is Diluted (because of the increase of water in the body) Hematocrit is low Signs and symptoms of Fluid Volume Excess (FVE) Distended neck veins/peripheral veins (veins are full) Peripheral edema/third spacing (vessels can't hold any more, so they start to leak) Central Venous Pressure (CVP) numbers go up Lung sounds: wet, crackles (heard in lower lungs first) -SOB Polyuria (kidneys are trying to get fluid off to help diuresis) Pulse increases (can be full/bounding) BP increases (more volume more pressure) Weight increases (any acute gain or loss isn't fat, it's fluid) CVP (central venous pressure) A direct measurement of the blood pressure in the right atrium and vena cava. CVP reflects the amount of blood returning to the heart and the ability of the heart to pump blood from the right heart into the pulmonary system.

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HURST REVIEW NCLEX RN READINESS EXAM: LATEST A+
QUESTIONS AND ANSWERS EDITION.

When selecting an NCLEX answer or determining the order of priority what
should you remember or use and what is the exception?
Use the ABC rule: Airway breathing, and circulation. The exception to the rule is with
actual CPR, use C-A-B for CPR. Also remember safety first and acute before chronic. If
the pt. is not in distress, then you assess. If the pt. is in distress, then you should do
something. If the pt. has diaphoresis you should always do something.
How should you address questions related to Maslow's Hierarchy of Needs?
Address physiological needs first, followed by safety and security needs, love and
belonging needs, self-esteem needs and finally self-actualization needs. *When a
physiological need is not addressed in the question, look for the option that addresses
safety.
If a question is related to the nursing process, read the question to determine the
step of the nursing process. What are the steps in the nursing process and what
kind of question might be related to that step?
Assessment question address the gathering and verification of data.


Analysis questions require the nurse to: interpret data, collect additional information,
identify and communicate nursing diagnoses and determine the health team's ability to
meet the pts needs.


Planning questions ask about determining, prioritizing, and modifying outcomes of care.


Implementation questions reflect the management and organization of care and the
assignment and delegation of tasks. Be prepared for questions on client teaching.


Evaluation questions focus on comparing the actual outcomes of care with the expected
outcomes and on communicating and documenting findings.
What are the normal ranges for H&H? What are the nursing implications?

,Hemoglobin - Male 14-18 Female 12-16 Newborn 14-24


High altitude living increases value, slight decrease during pregnancy. Drug therapy can
alter values.


Hematocrit - Male 42-52 Female 37-47 Newborn 44-64


Prolonged stasis from vasoconstriction secondary to the tourniquet can alter values.
Abnormalities in RBC size may alter Hct values
What are the normal ranges for WBC?
What can increase values?
What can decrease values?
How long does the postpartum period of pregnancy affect normal ranges? What
range is normal during the postpartum period?
Both genders 5000-10000 Newborn 9000-30000


Anesthetics, stress, exercise, and convulsions can increased values.


Drug therapy can decrease values.


24-28 hr. postpartum: a count as high as 25000 is normal
What are the normal ranges for RBC?
What can increase levels
What happens to levels during pregnancy?
Males: 4.7-6.1 million
Female: 4.2-5.4 million
Exercise and high altitudes can cause an increase levels
pregnancy usually lower values
drug therapy can alter values
Never draw a specimen from an arm with an infusing IV.

, What are the normal ranges for PLATELETS?
What may increase values?
What may decrease values?
What drugs decrease values?
Both Genders: 150000-400000


Living at high altitudes, exercising strenuously or taking oral contraceptives may
increase values


decreased values may be caused by hemorrhage, DIC, reduced production of platelets,
infections, use of prosthetic heart valves, and drugs.


Drugs that decrease platelets: acetaminophen, aspirin, chemotherapy, H2 blockers,
INH, Levaquin, streptomycin, sulfonamides, thiazide diuretics.
What are the normal ranges for K+? What should you keep in mind when getting a
specimen?
3.5-5 is normal range for potassium
Exercise of the forearm with tourniquet in place may cause an increased level.
Hemolysis of specimen can result in a falsely elevated value
What are the normal ranges for Na+? What should you consider when collecting a
specimen?
136-145 is a normal sodium range
Do Not collect from an arm with an infusing IV solution
What are the normal ranges for Ca+?
What type of drug can increase calcium levels?
What are two tests with positive results that are associated with hypocalcemia?
How do you preform the two tests?
9-10.5 for adults. slightly lower in the elder
Use of thiazide diuretics can cause increased levels of calcium


Positive Chvostek and Trousseau tests are associated with hypocalcemia.

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