NSG 233 P & D Integumentary System;
NSG 233 Med Surg III EXAM QUESTIONS
AND ANSWERS
Fluid Management of hypovolemic Shock? - CORRECT ANSWER-Whenever a pt is
hemorrhaging—whether externally or internally—a loss of circulating blood results in a fluid
volume deficit & decreased cardiac output. Therefore, fluid replacement is imperative to
maintain circulation.
Typically, two large-gauge IV catheters are inserted, preferably in an uninjured extremity, to
provide a means for fluid & blood replacement.
Fluid Management of hypovolemic Shock? - CORRECT ANSWER-· Replacement fluids may
include isotonic electrolyte solutions (e.g., lactated Ringer's, normal saline), colloids, & blood
component therapy.
Packed RBC are infused when there is massive blood loss, which may also necessitate
transfusion of other blood components, including platelets & clotting factors.
Violence in the ED - CORRECT ANSWER-Precautions to take in order to avoid injury include:
· For prisoners, the hand or ankle restraint (handcuff) is never released, & a guard is always
present in the room.
· Nonrestraint techniques should be tried when possible—e.g., talking w/ the pt, minimizing
environmental stimulation.
,·
Pts from prison & those who are under guard need to be handcuffed to the bed &
appropriately assessed to ensure the safety of hospital staff & other pts.
Family Focused Interventions - CORRECT ANSWER-Allow family to be present!
The family is kept informed about where the pt is, how he or she is doing, & the care that is
being given.
Encouraging family members to stay w/ the pt, when possible, also helps allay their anxieties.
Reversal agents of anticoagulants? - CORRECT ANSWER-Protamine sulfate is an antidote for
standard heparin and LMWHs.
· A single dose should not exceed 50 mg
· The drug is given by slow IV infusion over at least 10 min
Heat Exhaustion Treatment - CORRECT ANSWER-Most importantly, immediate ingestion and
eventually IV replacement of large quantities of water, and placement in a cool environment
is helpful as well.
Heat Exhaustion prevention - CORRECT ANSWER-Preventing Heat-Induced Illnesses
· Maintain adequate fluid intake, wear loose clothing, and reduce activity in hot weather.
· Monitor fluid losses and weight loss during workout activities or exercise and replace fluids
and electrolytes.
Plan outdoor activities to avoid the hottest part of the day (between 10 AM and 2 PM
, Assessment & diagnostics for heat exhaustion. - CORRECT ANSWER-· When assessing the pt,
the nurse notes the following symptoms: profound (CNS) dysfunction (manifested by
confusion, delirium, bizarre behavior, coma, seizures); elevated body temperi (40.6°C [105°F]
or higher); hot, dry skin; & usually anhidrosis (absence of sweating), tachypnea, hypotension,
& tachycardia.
IV infusion therapy of NS or LR solution is initiated as directed to replace fluid losses &
maintain adequate circulation
Think of (circulation, airway, & breathing).
Frostbite - CORRECT ANSWER-Actual freezing of tissue fluid resulting in damage to the skin
and underlying tissue
Frostbite management consist of? - CORRECT ANSWER-The goal of management is to restore
normal body temperi. Constrictive clothing & jewelry that could impair circulation are
removed. Wet clothing is removed as rapidly as possible. If the lower extremities are
involved, the pt should not be allowed to ambulate.
Suture care - CORRECT ANSWER-- Close tissue to reduce scar formation, minimize trauma &
tension, & control bleeding
- Sutures, staples, steri-strips
Hypothermia Interventions - CORRECT ANSWER-Goal is to stop further heat loss. Passive
warming done first (remove patient from cold environment, remove wet/cold clothing, turn
up heat, warm blankets).
Active rewarming (hot packs on armpits and groin, warm IV fluids)
NSG 233 Med Surg III EXAM QUESTIONS
AND ANSWERS
Fluid Management of hypovolemic Shock? - CORRECT ANSWER-Whenever a pt is
hemorrhaging—whether externally or internally—a loss of circulating blood results in a fluid
volume deficit & decreased cardiac output. Therefore, fluid replacement is imperative to
maintain circulation.
Typically, two large-gauge IV catheters are inserted, preferably in an uninjured extremity, to
provide a means for fluid & blood replacement.
Fluid Management of hypovolemic Shock? - CORRECT ANSWER-· Replacement fluids may
include isotonic electrolyte solutions (e.g., lactated Ringer's, normal saline), colloids, & blood
component therapy.
Packed RBC are infused when there is massive blood loss, which may also necessitate
transfusion of other blood components, including platelets & clotting factors.
Violence in the ED - CORRECT ANSWER-Precautions to take in order to avoid injury include:
· For prisoners, the hand or ankle restraint (handcuff) is never released, & a guard is always
present in the room.
· Nonrestraint techniques should be tried when possible—e.g., talking w/ the pt, minimizing
environmental stimulation.
,·
Pts from prison & those who are under guard need to be handcuffed to the bed &
appropriately assessed to ensure the safety of hospital staff & other pts.
Family Focused Interventions - CORRECT ANSWER-Allow family to be present!
The family is kept informed about where the pt is, how he or she is doing, & the care that is
being given.
Encouraging family members to stay w/ the pt, when possible, also helps allay their anxieties.
Reversal agents of anticoagulants? - CORRECT ANSWER-Protamine sulfate is an antidote for
standard heparin and LMWHs.
· A single dose should not exceed 50 mg
· The drug is given by slow IV infusion over at least 10 min
Heat Exhaustion Treatment - CORRECT ANSWER-Most importantly, immediate ingestion and
eventually IV replacement of large quantities of water, and placement in a cool environment
is helpful as well.
Heat Exhaustion prevention - CORRECT ANSWER-Preventing Heat-Induced Illnesses
· Maintain adequate fluid intake, wear loose clothing, and reduce activity in hot weather.
· Monitor fluid losses and weight loss during workout activities or exercise and replace fluids
and electrolytes.
Plan outdoor activities to avoid the hottest part of the day (between 10 AM and 2 PM
, Assessment & diagnostics for heat exhaustion. - CORRECT ANSWER-· When assessing the pt,
the nurse notes the following symptoms: profound (CNS) dysfunction (manifested by
confusion, delirium, bizarre behavior, coma, seizures); elevated body temperi (40.6°C [105°F]
or higher); hot, dry skin; & usually anhidrosis (absence of sweating), tachypnea, hypotension,
& tachycardia.
IV infusion therapy of NS or LR solution is initiated as directed to replace fluid losses &
maintain adequate circulation
Think of (circulation, airway, & breathing).
Frostbite - CORRECT ANSWER-Actual freezing of tissue fluid resulting in damage to the skin
and underlying tissue
Frostbite management consist of? - CORRECT ANSWER-The goal of management is to restore
normal body temperi. Constrictive clothing & jewelry that could impair circulation are
removed. Wet clothing is removed as rapidly as possible. If the lower extremities are
involved, the pt should not be allowed to ambulate.
Suture care - CORRECT ANSWER-- Close tissue to reduce scar formation, minimize trauma &
tension, & control bleeding
- Sutures, staples, steri-strips
Hypothermia Interventions - CORRECT ANSWER-Goal is to stop further heat loss. Passive
warming done first (remove patient from cold environment, remove wet/cold clothing, turn
up heat, warm blankets).
Active rewarming (hot packs on armpits and groin, warm IV fluids)
