Summary
Summary NURSE 407 Final Exam Study Guide
- Course
- Nurse407
- Institution
- Sacramento City College
Detailed final exam study guide,all for YOU!!
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Final Exam Study Guide1. Chemistry 7 Labs
a. Increased hemoglobin, BUN, Creatinine, and Hematocrit can indicate dehydration.
b. Chemistry profiles reveal decreased blood sodium chloride and potassium.
i. Blood Urea Nitrogen (BUN) 8-32: kidney function, high levels of BUN can also be due to
dehydration urinary tract obstruction.
ii. Carbon Dioxide 22-28: Lungs and kidneys, can indicate metabolic alkalosis if too high.
iii. Creatinine 0.6-1.2: Kidney, Hypotension, Hypertension, myasthenia, over-hydration, muscular
dystrophy. Elevated labs can indicate kidney disease.
iv. Glucose 70-100: Can indicate diabetes if labs are high. Pancreatic function
v. Serum Chloride 96-106: kidney disease, heart failure, liver disease
vi. Serum Potassium 3.5-5.0: Heart Rhythm, Kidney Disease, can lead to hyperkalemia
vii. Serum Sodium 135-145: Dehydration, diarrhea, Endocrine disorders, trauma, bleeding,
hypernatremia
2. Acidosis Vs. Alkalosis
a. Acidosis s/s: Hyperventilation, impaired heart function, low blood pressure, coma
i. Treatment:
1. Metabolic: Diabetic Treatment
2. Respiratory: Breathing Treatment
b. Alkalosis s/s: Dizziness, lightheadedness, numbness of hands and feet, confusion, nausea and vomiting
muscle twitching or spasms, low levels of oxygen in blood, seizures, losing consciousness.
i. Treatment:
1. Metabolic: Fluids for fluid loss
2. Respiratory: treating underlying causes of hyperventilation, infection, pain or anxiety
3. Diabetes
a. Type I: Autoimmune dysfunction, insulin dependence
b. Type II: Insulin Resistance
4. Diabetic Keto Acidosis (DKA)
a. Uncontrolled hyperglycemia metabolic acidosis and an accumulation of of ketones in the blood and
urine.
b. Manifestations:
i. olyuria
ii. Polydipsia (excess thirst)
iii. Polyphagia
iv. Weight loss
v. GI effects (nausea, vomiting, abdominal pain)
vi. vision, headache, weakness
vii. Orthostatic hypotension
viii. Fruity odor of breath
ix. Kussmaul Respirations
x. Metabolic acidosis
xi. Mental status changes
5. Diabetic Screening Risk Factors
a. BMI >25
b. 45 years or older
c. Report of sedentary lifestyle
d. Hx of vascular disease, PCOS, Gestational diabetes, or giving birth to a 9lb baby.
e. African, Hispanic, Asian, American Indian, Pacific Islander
f. BP >140/90
g. HgA1C >5.7
h. HDL <35 or Triglycerides are >250.
i. Effects on older adults
, i. May not be able to drive.
ii. Altered metabolism
iii. Vision problems
iv. Hearing problems
v. Tissue Deterioration
6. Hypoglycemia Vs HyperGlycemia
a. Hypoglycemia s/s:
i. Sweating
ii. Weakness
iii. Dizziness
iv. Confusion
v. Headache
vi. Tachycardia
vii. Slurred Speech
b. Hyperglycemia
i. Increased Thirst
ii. Dry mouth
iii. Blurred vision
iv. Weight loss
v. Thrush
vi. UTI
vii. Skin Infection
7. Preventions
a. Diet
i. Carbs 45% Daily
ii. Protein 15-20% Daily
iii. Fats 20-35% Daily
b. Physical Exercise 3x per week
c. Diabetic Testing every 6 months
d. Foot Care – Inspect feet daily, no open toed shoes, pat dry, wear cotton socks, avoid prolonged sitting or
crossing legs
8. Insulins
a. Type I Regimen
i. Rapid, short, intermediate, long acting
ii. Given 2 or more times a day depending on glucose levels
b. Type 2 Regimen
i. Based on control of glucose levels
ii. Sometimes on fixed meds
iii. Diet and exercise is recommended.
c. Rapid acting Insulin
i. Given before meals
ii. Rapid onset 10-30mins
iii. Intermediate or long
d. Short acting (regular)
i. 30-60mins
ii. U-500 not IV insulin resistance
iii. U-100 IV for mostly all patients
e. Intermediate (NPH)
i. Between meals
ii. Contains protamine (Protein)
iii. 90 degrees only
iv. Mix only with short acting
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