CCC2 PRN 1178 Exam 1
Signs/symptoms of cancer
Unexplained weight loss, fever, fatigue, pain, skin changes, Obstruction, Hemorrhage, Anemia, Fracture,
Infection, Cachexia.
Screenings for men and women and when should be done
Breast 20+, Cervix 21-65, Colorectal men & women 50+, Endometrial women at menopause, Lung if
smoker 55-74, Prostate 50+, Cancer related check up 20+.
Dehydration Signs & Symptoms and Interventions
cool dry skin, poor skin turgor, weak thready pulse. IV fluids or fluid orally.
Osmosis
Movement of pure solvent (liquid) across membrane, moves from area of less solute concentration to
area of greater concentration until the solutions in the compartments are of equal concentration. Takes
place via a semipermeable membrane.
Diffusion
Movement of molecules from an area of higher concentration to an area of lower concentration. Passive
transport is substances move back and forth across the membrane until evenly distributed throughout the
available space
Filtration
A process that separates materials based on the size of their particles.
Active Transport
Movement of ions or molecules across a cell membrane into a region of higher concentration, assisted by
enzymes and requiring energy.
Hypokalemia Signs and Symptoms
muscle weakness, fatigue, nausea and vomiting, intestinal distention decreased bowel sounds
decreased, deep tendon reflexes, ventricular dysrhythmias, paresthesias weak, irregular pulse, low
potassium flat t waves, high heart rate low blood pressure decreased GI motility.
Fluid Overload Signs and Symptoms
Shortness of breath, cough, elevated b/p, puffiness around the eyes, edema in dependent areas;
distended veins, moist breath sounds, crackle lungs, increased urine output.
Hypocalcemia Signs and Symptoms
Diarrhea, Numbness and tingling of extremities, Muscle cramps ,Tetany, Convulsions,Laryngeal spasms,
Cardiac irritability,Positive Trousseau's and Chvostek's signs,· Low calcium, low BP, abnormal HR,
hyperactivity, numbness. Shift of calcium in the bones.
Hypernatremia
Causes an osmotic shift of fluid from the cells to the interstitial spaces, which causes a cellular
dehydration and interruption of normal cell processes.
Electrolyte
sodium, potassium, chloride.
Fluid Balance Interventions
Maintaining equal input and output. Replace water loss with fluids containing sodium.
Hypercalcemia
Muscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, shallow
respirations, emergency, elevated b/p, thirst, polyuria, hypo-activity.
Interstitial fluid
Fluid in the spaces between cells. Extracellular.
Intracellular and extracellular
Fluid within the cell. Fluid outside of the cell. Extracellular is Intravascular, Interstitial and Transcellular.
Cancer
,A disease in which some body cells grow and divide uncontrollably, damaging the parts of the body
around them.· External radiation therapy/teachings: help with coping, skin care, wash area once daily with
mild soap, limit sun exposure, do not use lotion, salve or alcohol on the area, wear loose clothing over the
area, do not shave the area.
Dietary teaching to reduce risk for developing cancer:
Moderate your portion of red and processed meats, maintain healthy weight, fruits and veggies, stay
away from smoked foods.
Chemotherapy side effects and interventions
Nausea and vomiting, Loss of appetite, Hair loss, Mouth sores, Fatigue, Skin care, Encourage good
nutrition and hydration, monitor signs of infections.
Antimetics
Control nausea and vomiting by blocking nerve impulses to the vomiting center of the brain during chemo
treatments.
CANCER Interventions
C = Comfort
A = Altered body image
N = Nutrition
C = Chemotherapy
E = Evaluate response to medications
R = Respite for caretakers
Cancer interventions, dietary
Surgery, radiation, chemotherapy, Pharmacologic cognitive behavioral, psychotherapeutic interventions.
High protein, vitamin supplementation, low temperature food, favorite foods, small meals frequently
Cancer Education
Mouth care, increase fluid intake, small frequent meals, weight should be taken and compared, avoid
spicy foods, alcohol and tobacco.
Colon cancer risk factors, signs and symptoms.
Increased age-40+, Ethnicity-blacks, Colorectal polyps, History of breast cancer, genetics, Abdominal
pain, Blood in the stool, Changes in bowel habits, Weight loss, alternating diarrhea & constipation,
defecation urgency, increased flatus, decrease in stool caliber, feeling of incomplete evacuation age 40
and up, inflammatory bowel disease, high fat, high protein, low fiber diet, low level of exercise, Polyps in
rectum, Obesity and physical inactivity, Smoking, Alcohol, Large amounts of red meat, colitis.
Terminally ill, palliative care and interventions, pain
Pain management, addressing physical, psychological, social and spiritual needs.
Diarrhea treatment
Treatment includes restoration of adequate hydration/electrolyte balance, Reintroduce Diet,
Antimicrobials may be given when diarrhea is bacterial or parasitic in nature, Avoid dairy, Skin
assessment for break down.
Intravenous Complications
Infection, inflammation, hypervolemia.
LPN scope of practice
Located state board of nursing
Intravenous Medication Administration
Right Patient, Right Drug, Right Dose, Right Route, Right Time, Right Reason, Right Response, Right To
Refuse, Right Documentation, and Right To Education.
Signs of contamination of IV solution
Cloudy, Particles visible
Hyponatremia risk factors
Loss of sodium due to sweating, use of diuretics; gain of water due to hypotonic tube feedings, excessive
intake of water; caused by head injury, AIDS, malignant tumors. Excess water, inadequate sodium in
take, low sodium diet.
Adenosine triphosphate (ATP)
Principal chemical compounds that living things use to store and release energy.
Electrolyte normal/abnormal labs
Potassium: 3.5-5, Sodium: 135-145, Mag: 1.5-2.5
Calcium: 9-11, Phosphate: 2.5-4.5, Chloride: 95-105
,Clients at risk dehydration
Elderly and children.
Low sodium diet
This type of diet is good for those with heart disease or kidney disease. Protein foods, fish, unsalted nuts,
dried beans and pea.
Risk factors for cancer
Family history , Life style, obesity, age.
Cancer Risk Factors
Heredity, chemicals, radiation, diet, cigarette smoking, excessive alcohol use, genetics, stress.
intracellular fluid
Found in spaces surrounding cells.
Hypokalemia
Low potassium.Symptoms are Fatigue, muscle aches, cardiac arrhythmias.
Intracelluar Fluid ICF
Found within the cells of the body and makes up about 2/3 of the body fluid of adults.
Foods not high in sodium
Grilled chicken and carrots.
Mechanisms is the most important regulatory of fluid intake.
Thirst.
Risk factors of fluid, electrolyte, and acid base imbalances,
Elderly and very young. An 85 year old client who is cognitively impaired.
Salt concentration of 0.9% is most like the fluid
In the human body.
Hypocalcemia
Low blood calcium possibly due to inadequate vitamin D
Hyponatremia
low sodium in the blood
Electrolytes
Minerals or salts that are dissolved in body fluids. Help maintain the body's fluid balance
Diffusion
Substances freely move back and forth until they are evenly distributed
Order for 500 ml IV fluid infused over 4 hours. What is the flow rate in ml/hr?
125
Order for 250 ml IV fluid infused over 90 minutes. What is the flow rate ml/hr?
166.7
Types of IV fluids
isotonic, hypotonic, hypertonic
Active transport
Process that moves molecules into cells regardless of their electrical charge or concentration. Requires
the use of Adenosine triphosphate (ATP)
Hypertonic Solution
Dextrose 10% in water
Isotonic Solution
0.9% sodium chloride
Normal level potassium
3.5-5.0 mEq/L
Osmosis
Water moves from an area of less solute concentration to more solute concentration.
The Nurse Practice Act
Defines professional nursing and what it takes to be licensed, provides for discipline, of professional
nurses, sets minimum education standards for licensure. Defines the legal parameters of professional
and practical nursing.
Salt concentration of 0.9%
Most like the fluid in the human body.
, PRN 1178 Exam 2 Study Guide
What is Acid-Base balance?
The maintenance of hydrogen ion concentration in the blood and tissue fluids so that body can function
properly. Necessary for homeostasis.
Normal pH range? What is considered Acidic? What is considered alkalotic?
7.35-7.45
(Below 7.35 = Acidity)
(Above 7.45= Alkaline)
What body systems regulate acid-base balance?
Buffers, Kidneys, and Lungs
Respiratory Acidosis Common Causes?
Acute Airway Obstruction, COPD, Asthma, Pulmonary Edema, Opiate Overdose, Pneumonia, Atelectasis
How might a patient present with respiratory acidosis?
Hypoventilation/hypoxia, Rapid Shallow Respirations, Decreased BP with vasodilation, Dyspnea,
Headache, Hyperkalemia, Dysrhythmias, Drowsiness, Dizziness, Disorientation, Muscle Weakness,
Hyperreflexia,
Prevention Strategies Acid-Base Imbalances?
Healthy diet, exercise, limit alcohol consumption, Drink 6-8 cups of water per day, maintain healthy
weight, refrain from smoking, manage stree
Common Causes of Respiratory Alkalosis
Hyperventilation (anxiety, fear), Mechanical Ventilation, High Fever/Sepsis, Prolonged Sunctioning, Pain,
Alcohol Withdrawal.
Common Causes of Metabolic Acidosis
Diarrhea, Renal Failure, Diabetic Ketoacidosis, Hyperkalemia, Alcoholism
Compensating Mechanisms for Metabolic Acidosis
Kussmaul Respirations
Common Causes of Metabolic Alkalosis
Vomitting, Excessive Gastric Suctioning, Hypokalemia, Excess use of Antacids, Steroid Therapy, Potent
Diuretic Use
What are ABG's?
Arterial Blood Gases
pH 7.35-7.45 <7.34 acid >7.45 base
PaCO2 35-45mmHg >45 acid <35 base
HCO3 22-26mEq/L <22 acid >26 base
O2 sat
PaO2
pH normal range
7.35-7.45 Below 7.35 means
PaCO2 normal range. What do imbalances mean?
35-45 mm Hg. Below 35 means alkalotic, above 45 means acidiosis.
HCO3 normal range
22-26 mEq/L. Below 22 means acidosis, about 26 means alkalotic
RO ME
Respiratory Opposite Metabolic Equal
When pH and Respiratory are Opposite directions, this is a respiratory problem, when pH and Metabolic
are in the same direction its a metabolic issue.
pH 7.32
PaCO2 55
