NUR 3225 Exam 1 Ques ons and answers Newest
RATED A+ 2025/2026 UPDATED NEW!!
Alarm Reac on
Alarm Reac on
o Flight or fight response
o Physiologic changes
o ↑secre on of cor costeroids (adrenal cortex)
o ↑SNS ac vity
o ↑norepinephrine (adrenal medulla)
o Low resistance to stressor
Stage of Resistance
Stage of Resistance
o Adap ng
o ↑Resistance to stressor (resources
o are mobilized)
o Physiologic changes
o Cor costeroids back to normal
o SNS normalizes
o Norepinephrine normalizes
o Flight/fight disappears
o High resistance to stressor
Stage of Resistance
Stage of Exhaus on
o Final stage
o Adapta on unsuccessful
o All energy expended
o Mild alarm s/s may be seen
o Illness/death
o May be reversed by external sources (medica ons)
Given a pa ent undergoing stress, the student will be able to develop an individualized nursing
plan of care to include tradi onal, complementary, alterna ve, and mind-body interven ons to
assist in the reduc on of stress.
,Relaxa on Strategies
• Relaxa on Breathing: can be performed while si3ng, standing, or lying down.
o Useful during a stressful or anxious situa on to reduce stress.
o Take 10 breaths each session and use the 4x4 method.
• Medita on: is a state of being with increased concentra on and awareness.
o Helps to reorient the brain from a stressful fight or flight mode to one of acceptance.
o Prac ce in a quiet place free from distrac ons
• Imagery: The use of one's mind to generate images that have a calming effect on the body.
COMPLEMENTARY/ ALTERNATIVE THERAPY
• ST. JOHNS WORT - DEPRESSION
• YOGA - GENERAL WELL BEING
• KAVA - ANXIETY
• Music: help achieve relaxa on and bring about healthy changes in emo onal or physical
states.
• Massage: Another important relaxa on strategy that involves the systemic manipula on of
the soE ssue of the body to reduce tension and enhance health and healing.
Given a person undergoing stress, the student will be able to iden fy and describe coping
methods and paFerns and determine whether or not each is effec ve or destruc ve.
Coping is a person's cogni ve and behavioral efforts to manage stressors that seem to exceed
available resources.
o Posi ve coping includes ac vi es such as exercise and spending me with friends and family.
o Nega ve coping may include substance abuse and denial.
o Emo on-focused coping involves managing the emo ons that an individual feels when a
stressful even occurs (Example: Discussing feelings with a friend or taking a hot bath)
o Primary purpose is to help decrease nega ve emo ons and create a feeling of well-being.
o Problem-focused coping involves aFempts to resolve the problems causing the stress.
(Example: Se3ng priori es or collec ng informa on and seeking advice)
o If a problem can be changed or controlled, this is the most helpful way
The student will be able to develop and implement an individual teaching plan for the pa ent
with stress.
Nursing Management
1. Assessment:
Pa ent
Family
,How/why do we consider the nurse well placed to recognize and intervene with pa ents and
families experiencing ↑ stress?
Sodium (Na+)
135 - 145 mEq/L
Potassium (K+)
3.5 - 5.0 mEq/L
Calcium
8.5 - 10.5 mg/dL
Magnesium
1.6 - 2.2 mEq/L
Phosphate
3 - 4 mg/dL
Hypo/Hyperosmolar Imbalances
• Fluid volume deficit: Too much sodium, not enough water. Sodium above 145, shiny skin,
hypotonic solu on 0.45 NS with IV diure cs to get rid of sodium may have circula on problem
• Fluid volume excess: weight gain, crackles in the lungs (fluid in alveolar space) give pa ent
diure cs (Lasix) to lose fluid, decrease sodium and potassium, put pt on fluid restric on
• Ra o of Na+ to water
• Problem within cell itself (ICF)
• Hypo-osmolar imbalance
o Water intoxica on
o Low serum Na+
• Hyper-osmolar imbalance
o Elevated serum Na+
Hypoosmolar Imbalance
• E ology
o Psychogenic polydipsia
o Over administra on of hypotonic fluids
o Increased ADH
• Pathophysiology
, o H2O moves from extracellular space to cell
o Cell swells
o Cell may rupture
• Clinical picture
o Mental status changes
Brain cells swell
Increased ICP
o
Serum osmolality < 285 mOsm/L
• Treatment
o Water restric on
o Diure cs
Hyperosmolar Imbalance
• E ology
o Water lost out of propor on to electrolytes
o Solutes taken in without sufficient water
• Pathophysiology
o Water lost
Hyperven la on
Excess secre ons (GI, diarrhea, trach, etc.)
Fever (insensible)
Kidneys unable to concentrate urine
• Pathophysiology
o Solute excess
Tube feedings
• Clinical picture
o CNS changes
Brain cells crenate
o Serum osmolality > 300 mOsm/L
• Treatment
o Replace water lost
o IV fluids: hypotonic solu ons: NS 0.45%
RATED A+ 2025/2026 UPDATED NEW!!
Alarm Reac on
Alarm Reac on
o Flight or fight response
o Physiologic changes
o ↑secre on of cor costeroids (adrenal cortex)
o ↑SNS ac vity
o ↑norepinephrine (adrenal medulla)
o Low resistance to stressor
Stage of Resistance
Stage of Resistance
o Adap ng
o ↑Resistance to stressor (resources
o are mobilized)
o Physiologic changes
o Cor costeroids back to normal
o SNS normalizes
o Norepinephrine normalizes
o Flight/fight disappears
o High resistance to stressor
Stage of Resistance
Stage of Exhaus on
o Final stage
o Adapta on unsuccessful
o All energy expended
o Mild alarm s/s may be seen
o Illness/death
o May be reversed by external sources (medica ons)
Given a pa ent undergoing stress, the student will be able to develop an individualized nursing
plan of care to include tradi onal, complementary, alterna ve, and mind-body interven ons to
assist in the reduc on of stress.
,Relaxa on Strategies
• Relaxa on Breathing: can be performed while si3ng, standing, or lying down.
o Useful during a stressful or anxious situa on to reduce stress.
o Take 10 breaths each session and use the 4x4 method.
• Medita on: is a state of being with increased concentra on and awareness.
o Helps to reorient the brain from a stressful fight or flight mode to one of acceptance.
o Prac ce in a quiet place free from distrac ons
• Imagery: The use of one's mind to generate images that have a calming effect on the body.
COMPLEMENTARY/ ALTERNATIVE THERAPY
• ST. JOHNS WORT - DEPRESSION
• YOGA - GENERAL WELL BEING
• KAVA - ANXIETY
• Music: help achieve relaxa on and bring about healthy changes in emo onal or physical
states.
• Massage: Another important relaxa on strategy that involves the systemic manipula on of
the soE ssue of the body to reduce tension and enhance health and healing.
Given a person undergoing stress, the student will be able to iden fy and describe coping
methods and paFerns and determine whether or not each is effec ve or destruc ve.
Coping is a person's cogni ve and behavioral efforts to manage stressors that seem to exceed
available resources.
o Posi ve coping includes ac vi es such as exercise and spending me with friends and family.
o Nega ve coping may include substance abuse and denial.
o Emo on-focused coping involves managing the emo ons that an individual feels when a
stressful even occurs (Example: Discussing feelings with a friend or taking a hot bath)
o Primary purpose is to help decrease nega ve emo ons and create a feeling of well-being.
o Problem-focused coping involves aFempts to resolve the problems causing the stress.
(Example: Se3ng priori es or collec ng informa on and seeking advice)
o If a problem can be changed or controlled, this is the most helpful way
The student will be able to develop and implement an individual teaching plan for the pa ent
with stress.
Nursing Management
1. Assessment:
Pa ent
Family
,How/why do we consider the nurse well placed to recognize and intervene with pa ents and
families experiencing ↑ stress?
Sodium (Na+)
135 - 145 mEq/L
Potassium (K+)
3.5 - 5.0 mEq/L
Calcium
8.5 - 10.5 mg/dL
Magnesium
1.6 - 2.2 mEq/L
Phosphate
3 - 4 mg/dL
Hypo/Hyperosmolar Imbalances
• Fluid volume deficit: Too much sodium, not enough water. Sodium above 145, shiny skin,
hypotonic solu on 0.45 NS with IV diure cs to get rid of sodium may have circula on problem
• Fluid volume excess: weight gain, crackles in the lungs (fluid in alveolar space) give pa ent
diure cs (Lasix) to lose fluid, decrease sodium and potassium, put pt on fluid restric on
• Ra o of Na+ to water
• Problem within cell itself (ICF)
• Hypo-osmolar imbalance
o Water intoxica on
o Low serum Na+
• Hyper-osmolar imbalance
o Elevated serum Na+
Hypoosmolar Imbalance
• E ology
o Psychogenic polydipsia
o Over administra on of hypotonic fluids
o Increased ADH
• Pathophysiology
, o H2O moves from extracellular space to cell
o Cell swells
o Cell may rupture
• Clinical picture
o Mental status changes
Brain cells swell
Increased ICP
o
Serum osmolality < 285 mOsm/L
• Treatment
o Water restric on
o Diure cs
Hyperosmolar Imbalance
• E ology
o Water lost out of propor on to electrolytes
o Solutes taken in without sufficient water
• Pathophysiology
o Water lost
Hyperven la on
Excess secre ons (GI, diarrhea, trach, etc.)
Fever (insensible)
Kidneys unable to concentrate urine
• Pathophysiology
o Solute excess
Tube feedings
• Clinical picture
o CNS changes
Brain cells crenate
o Serum osmolality > 300 mOsm/L
• Treatment
o Replace water lost
o IV fluids: hypotonic solu ons: NS 0.45%
