RNSG 1128 And 1424 Exam With
Complete Solutions
Acidosis - ANSWER an acid-base imbalance characterized by an increase in H+
concentration (decreased blood pH) (A low arterial pH due to reduced
bicarbonate concentration is called metabolic acidosis; a low arterial pH due to
increased PCO2 is called respiratory acidosis.)
Ascites - ANSWER a type of edema in which fluid accumulates in the peritoneal
cavity
Active transport - ANSWER physiologic pump that moves fluid from an area of
lower concentration to one of higher concentration; active transport requires
adenosine triphosphate for energy
Alkalosis - ANSWER an acid-base imbalance characterized by a reduction in H+
concentration (increased blood pH) (A high arterial pH with increased
bicarbonate concentration is called metabolic alkalosis; a high arterial pH due
to reduced PCO2 is called respiratory alkalosis.)
Diffusion - ANSWER the process by which solutes move from an area of higher
concentration to one of lower concentration; does not require expenditure of
energy
Homeostasis - ANSWER maintenance of a constant internal equilibrium in a
biologic system that involves positive and negative feedback mechanisms
Hydrostatic pressure - ANSWER the pressure created by the weight of fluid
against the wall that contains it. In the body, hydrostatic pressure in blood
vessels results from the weight of fluid itself and the force resulting from cardiac
contraction.
Hypertonic solution - ANSWER a solution with an osmolality higher than that of
serum
Hypotonic solution - ANSWER a solution with an osmolality lower than that of
serum
Isotonic solution - ANSWER A solution with the same osmolality as serum and
other body fluids
,Osmolality - ANSWER the number of milliosmoles (the standard unit of osmotic
pressure) per kilogram of solvent; expressed as milliosmoles per kilogram
(mOsm/kg) (The term osmolality is used more often than osmolarity to evaluate
serum and urine.)
Osmolarity - ANSWER the number of milliosmoles (the standard unit of osmotic
pressure) per liter of solution; expressed as milliosmoles per liter (mOsm/L);
describes the concentration of solutes or dissolved particles
Osmosis - ANSWER the process by which fluid moves across a semipermeable
membrane from an area of low solute concentration to an area of high solute
concentration; the process continues until the solute concentrations are equal
on both sides of the membrane
Tonicity - ANSWER fluid tension or the effect that osmotic pressure of a solution
with impermeable solutes exerts on cell size because of water movement across
the cell membrane
perfusion-clinical manifestation - ANSWER Intermittent claudication
Pain in the extremities at rest
Tropic changes: thickened nails, a sense of hair and taut, shiny skin.
Diminished or absent pulses in extremities (unilateral finding has greater
significance than bilateral finding)
Temperature changes in extremities
Color changes in extremities: rubor, cyanosis, pallor
Ulcerations in extremities
nursing interventions -PVD - ANSWER INEFFECTIVE PHERIPERAL TISSUE
PERFUSION R/T COMPROMISE CIRCULATION
-To increase ARTERIAL BLOOD SUPPLY TO EXTREMITIES
= Lower the extremities below the level of the heart
=encourage moderate amount of walking or graded extremity exercises if not
contraindication exist.
*to decrease VENOUS CONGESTION
= elevate extremities above heart level
=Discourage standing still or sitting for prolonged periods
=Encourage walking
*To promote vasodilation and prevention of vascular compression
=maintain warm temperature and avoid chilling
=Discourage use of tobacco products
=counsel in ways to avoid emotional upsets; stress management
=encourage avoidance of constrictive clothing and accesories
=Encourage avoidance of crossing the legs
=Administer vasodilator medications and adrenergic blocking agents as
prescribed, with appropriate nursing Considerations
, CHRONIC PAIN R/T IMPAIRED ABILITY OF PERIPHERAL VESSELS TO SUPPLY
TISSUE WITH O2.
*Relief of Pain
=Promote increased circulation through exercise
=Administer analgesic agents a prescribed
RISK FOR IMPAIRED SKIN INTEGRITY R/T COMPROMISED CIRCULATION
*Attainment/ Maintenance of tissue integrity
= instruct in ways to avoid trauma to extremities
=Encourage wearing protective shoes and padding for pressure areas; wear
new shoes for short period of time and then inspect feet for signs of injury
=encourage meticulous hygiene; bathing with neutral soaps, apply lotions and
carefully trimming nails
=Promote good nutrition, adequate intake of Vitamin A and C, protein and zInc;
control obesity
DEFICIENT KNOWLEDGE REGARDING SELF CARE ACTIVITIES
*Adherence to self- care program
=include family/significant others in education
=provide written instructions about foot care, leg care and exercise program
=Assist to obtain properly fitting clothing, shoes and stocking
=Refer to self-help groups as in
PVD- POST SURGICAL CARE - ANSWER **DISAPPEARANCE OF A PULSE THAT
WAS PRESENT WAY TO INDICATE THROMBOTIC OCCLUSION OF THE GRAFT--
NOTIFY SURGEON IMMEDIATELY--
maintain adequate circulation through the arterial repair
pulses
Doppler assessment
color and temperature
capillary refill
sensory and motor function of the affected extremity and compared with those
of the other extremity.
These values are recorded initially every 15 min, then progressively longer
intervals if the patient status remains stable
The ABI Is monitored at least every 8 hours for the first 24 hours then each day
until discharge.
PVD- Assessment - ANSWER coolness and pallor of the affected extremity
decreased capillary refill and difference in arm blood
pressures of more than 20 mmHg
-Noninvasive studies
Upper and forearm blood pressures
Dupplex ultrasonography to identify the anatomics of the blood flow
PVD- patient teaching - ANSWER Demonstrate ability to manage activities of
daily living independently.
Complete Solutions
Acidosis - ANSWER an acid-base imbalance characterized by an increase in H+
concentration (decreased blood pH) (A low arterial pH due to reduced
bicarbonate concentration is called metabolic acidosis; a low arterial pH due to
increased PCO2 is called respiratory acidosis.)
Ascites - ANSWER a type of edema in which fluid accumulates in the peritoneal
cavity
Active transport - ANSWER physiologic pump that moves fluid from an area of
lower concentration to one of higher concentration; active transport requires
adenosine triphosphate for energy
Alkalosis - ANSWER an acid-base imbalance characterized by a reduction in H+
concentration (increased blood pH) (A high arterial pH with increased
bicarbonate concentration is called metabolic alkalosis; a high arterial pH due
to reduced PCO2 is called respiratory alkalosis.)
Diffusion - ANSWER the process by which solutes move from an area of higher
concentration to one of lower concentration; does not require expenditure of
energy
Homeostasis - ANSWER maintenance of a constant internal equilibrium in a
biologic system that involves positive and negative feedback mechanisms
Hydrostatic pressure - ANSWER the pressure created by the weight of fluid
against the wall that contains it. In the body, hydrostatic pressure in blood
vessels results from the weight of fluid itself and the force resulting from cardiac
contraction.
Hypertonic solution - ANSWER a solution with an osmolality higher than that of
serum
Hypotonic solution - ANSWER a solution with an osmolality lower than that of
serum
Isotonic solution - ANSWER A solution with the same osmolality as serum and
other body fluids
,Osmolality - ANSWER the number of milliosmoles (the standard unit of osmotic
pressure) per kilogram of solvent; expressed as milliosmoles per kilogram
(mOsm/kg) (The term osmolality is used more often than osmolarity to evaluate
serum and urine.)
Osmolarity - ANSWER the number of milliosmoles (the standard unit of osmotic
pressure) per liter of solution; expressed as milliosmoles per liter (mOsm/L);
describes the concentration of solutes or dissolved particles
Osmosis - ANSWER the process by which fluid moves across a semipermeable
membrane from an area of low solute concentration to an area of high solute
concentration; the process continues until the solute concentrations are equal
on both sides of the membrane
Tonicity - ANSWER fluid tension or the effect that osmotic pressure of a solution
with impermeable solutes exerts on cell size because of water movement across
the cell membrane
perfusion-clinical manifestation - ANSWER Intermittent claudication
Pain in the extremities at rest
Tropic changes: thickened nails, a sense of hair and taut, shiny skin.
Diminished or absent pulses in extremities (unilateral finding has greater
significance than bilateral finding)
Temperature changes in extremities
Color changes in extremities: rubor, cyanosis, pallor
Ulcerations in extremities
nursing interventions -PVD - ANSWER INEFFECTIVE PHERIPERAL TISSUE
PERFUSION R/T COMPROMISE CIRCULATION
-To increase ARTERIAL BLOOD SUPPLY TO EXTREMITIES
= Lower the extremities below the level of the heart
=encourage moderate amount of walking or graded extremity exercises if not
contraindication exist.
*to decrease VENOUS CONGESTION
= elevate extremities above heart level
=Discourage standing still or sitting for prolonged periods
=Encourage walking
*To promote vasodilation and prevention of vascular compression
=maintain warm temperature and avoid chilling
=Discourage use of tobacco products
=counsel in ways to avoid emotional upsets; stress management
=encourage avoidance of constrictive clothing and accesories
=Encourage avoidance of crossing the legs
=Administer vasodilator medications and adrenergic blocking agents as
prescribed, with appropriate nursing Considerations
, CHRONIC PAIN R/T IMPAIRED ABILITY OF PERIPHERAL VESSELS TO SUPPLY
TISSUE WITH O2.
*Relief of Pain
=Promote increased circulation through exercise
=Administer analgesic agents a prescribed
RISK FOR IMPAIRED SKIN INTEGRITY R/T COMPROMISED CIRCULATION
*Attainment/ Maintenance of tissue integrity
= instruct in ways to avoid trauma to extremities
=Encourage wearing protective shoes and padding for pressure areas; wear
new shoes for short period of time and then inspect feet for signs of injury
=encourage meticulous hygiene; bathing with neutral soaps, apply lotions and
carefully trimming nails
=Promote good nutrition, adequate intake of Vitamin A and C, protein and zInc;
control obesity
DEFICIENT KNOWLEDGE REGARDING SELF CARE ACTIVITIES
*Adherence to self- care program
=include family/significant others in education
=provide written instructions about foot care, leg care and exercise program
=Assist to obtain properly fitting clothing, shoes and stocking
=Refer to self-help groups as in
PVD- POST SURGICAL CARE - ANSWER **DISAPPEARANCE OF A PULSE THAT
WAS PRESENT WAY TO INDICATE THROMBOTIC OCCLUSION OF THE GRAFT--
NOTIFY SURGEON IMMEDIATELY--
maintain adequate circulation through the arterial repair
pulses
Doppler assessment
color and temperature
capillary refill
sensory and motor function of the affected extremity and compared with those
of the other extremity.
These values are recorded initially every 15 min, then progressively longer
intervals if the patient status remains stable
The ABI Is monitored at least every 8 hours for the first 24 hours then each day
until discharge.
PVD- Assessment - ANSWER coolness and pallor of the affected extremity
decreased capillary refill and difference in arm blood
pressures of more than 20 mmHg
-Noninvasive studies
Upper and forearm blood pressures
Dupplex ultrasonography to identify the anatomics of the blood flow
PVD- patient teaching - ANSWER Demonstrate ability to manage activities of
daily living independently.
