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NURS 2209 Final
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Exam of 83 pages for the course TAMU Business 101 Semester Final Exam at TAMU Business 101 Semester Final Exam (NURS 2209 Final)
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NURS 2209 Final*T10* level of the umbilicus should provide adequate anesthesia for what procedures?
(3) - ANS-1. Hip sx
2. Vaginal/uterine sx
3. Bladder/prostate sx
*T12* level should provide adequate anesthesia for what procedure? - ANS-Lower
extremity sx w/o tourniquet
*T4* level of the nipple should provide adequate anesthesia for what procedures? -
ANS-Intra-abdominal sx
*T6* level of the xiphoid process should provide adequate anesthesia for what
procedure? - ANS-Lower intra-abdominal sx
% weight gain and degree of fluid excess - ANS-2% of weight gain = mild fluid excess
3% of weight gain = moderate fluid excess
8% of weight gain = severe fluid excess
2% weight gain indicates what - ANS-mild fluid excess
3 forms of biologically active calcium in body - ANS-45% bound to albumin
40% ionized
15% bound to other substances
3% normal saline - ANS-hypertonic
3% weight gain indicates what - ANS-moderate fluid excess
8% weight gain indicates what - ANS-severe fluid excess
A client in an OR holding area, who is to receive general anesthesia, reports having a
dry mouth because food & fluids have been withheld for 8 hours. Which action by a
nurse is most appropriate?
A. Teach client that primary reason food & fluids have been withheld is to prevent
vomiting & potential complications.
,B. Clarify that food & fluids should have been withheld only for 4 hours & offer a small
sip of water.
C. Explain that a full stomach puts pressure on the diaphragm & prevents full lung
expansion during surgery.
D. Tell client that general anesthetic will soon make client sleepy & unaware of mouth
dryness. - ANS-A. Teach client that primary reason food & fluids have been withheld is
to prevent vomiting & potential complications.
A client with diab keotacidosis, who is receiving IV fluids and insulin complains of
tingling and numbenss of the fingers and toes and SOB. The cardiac moniro shows the
appearance of a U Wave. The nurse concludes these symtpoms incidacte:. -
ANS-hypokalemia
A pt who has had a regional anaesthetic (e.g., spinal or epidural) should be assessed
for what? (3) - ANS-1. Residual sensory blockade
2. Motor blockade
3. Test for sensation & movement
Abdo spasms and severe diarrhea associated with which lyte imbalance? -
ANS-potassium
action of ADH - ANS-causes kidneys to reabsorb water and concentrate urine
active transport - ANS-process in which molecules move against concentration gradient
requires energy
actual hypokalemia causes - ANS-aldosterone secretion, cirrhosis, DI,
hyperaldosteronism, nephrosis, lasix, thiazide diuretics, digoix, GI loss, altered intake,
diaphoretic
Addison's disease - ANS-adrenal insufficiency leading to inability to produce
aldosterone
ADH - ANS-antidiuretic hormone
,ADH released from where - ANS-posterior pituitary
ADH stimulated by what - ANS-fluid volume deficit
aldosterone - ANS-conserves sodium in the body by causing kidneys to retain sodium
(indirect effect on water in the body)
aldosterone secreted from where? - ANS-adrenal gland
alkalosis related to hypokalemia - ANS-potassium pushed into the cell and hydrogen out
of the cell
anaphylactic shock - ANS-Severe allergic reaction
anions - ANS-negatively charged
another name for oncotic pressure - ANS-pulling osmotic pressure
As a LA spreads, what is observed? - ANS-Smaller concentration of LA at sites distal to
inj
ascites - ANS-accumulation of fluid in the peritoneal cavity
assessment of hypertonic dehydration - ANS-thirst, urine output, dry skin, flat neck
veins, hypotension, decreased cardiac output, tachypnea, changes in mental status,
acute weight loss
assessment of hypotonic fluid excess - ANS-peripheral edema, high central venous
pressure, venous enlargement, pulmonary edema, acute and rapid weight gain (>2%),
urine output
assessments when hypertonic solution is being administered - ANS-neuro, cardiac,
respiratory, urine output
asterixis - ANS-aka Liver Flap, a flapping tremor of the hands. When the client extends
the arms & hands in front of the body, the hands rapidly flex & extend.
at what age does the thirst mechanism get depressed? - ANS-60 years old
, atrial natriuretic peptide (ANP_ - ANS-released when atria are stretched by high blood
volume causing vasodilation in blood vessels and tells body to get rid of extra fluid and
sodium
balance of calcium controlled by? - ANS-parathyroid hormone, calcitonin
Before anesthetic induction, the circulating nurse may help establish what types of
monitoring? (6) - ANS-1. Temperature, pulse & resps
2. Blood pressure
3. Electrocardiogram
4. Oxygen saturation
5. Arterial, central venous pressure, & pulmonary artery lines
6. Input & output (urine, blood loss)
Best places to measure skin turgor - ANS-forearm and abdomen
Biggest contributers to third spacing - ANS-- incr fluid volume
- increased capillary hydrostatic pressure
- decreased sodium level, or hyponatremia
- albumin losses disrupting colloidal osmotic pressure
- incr cap permeability
- lymphatic system obstruction
Brain natriuretic peptide - ANS-cardiac hormone found in the ventricles the is released
with increased blood volume and pressure when ventricles are stretched
Burn Dirutetic Stage - ANS-48-78 hours after injury
Capillary membrane integrity returns
Edema fluid shifts back into vasculature - blood volume increases
Increase in renal blood flow: result in diuresis (unless renal damage)
Hemodilution - low Hct, decreased potassium as it moves back into the cell or is
excreted in urine with the diuresis
Fluid overload can occur due to increased intravascular volume
Metabolic acidosis
Burn Hypovolemic Stage - ANS-Rapid fluid shifts: from the vascular compartments into
the interstitial spaces
Capillary permeability with burns increases with vasodilates
Fluid loss deep in wounds
Initially sodium and water
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