Exam (elaborations)
AGACNP Exam Review
- Course
- Institution
Exam of 81 pages for the course AGACNP at AGACNP (AGACNP Exam Review)
[Show more]
Content preview
AGACNPEXAM REVIEW
Scope of Practice - answer- Based on legal allowances in each state, individual state
nurse practice acts providing guidelines for nursing practice
Key elements of the NP role include - answer- integration of care across the acute
illness continuum with collaboration and coordination of care; research based clinical
practices, clinical leadership, family assessment, and discharge planning
Standards of Advanced Practice are delineated by... - answer- American Nurses
Association which measure quality of practice, service, or education
State Practice Acts - answer- Authorize Boards of Nursing in each state to establish
statutory authority for licensure of RNs
State Practice Acts - authority includes: - answer- use of title, authorization for scope of
practice including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - answer- certification
Prescriptive authority - answer- Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - answer- registration
numbers, state practice acts dictate level of prescriptive authority allowed
Credentials encompass... - answer- required education, licensure and certification to
practice as an NP
,Credentials establish... - answer- minimal levels of acceptable performance
Credentialing is necessary to: - answer- ensure that safe healthcare is provided by
qualified individuals; comply with federal and state laws r/t APN
Credentials also... - answer- acknowledges the scope of practice of NP, mandates
accountability, enforces professional standards for practice
Licensure - answer- establishes that a person is qualified to perform in a particular
professional role
Licensure is granted as defined by rules and regulations set forth by - answer- a
governmental regulatory body (ie. state board of nursing)
Certification - answer- Person has met certain standards that signify mastery of
specialized knowledge
Certification is granted by nongovernmental agencies such as - answer- ANCC, AANP
Admitting privileges to hospitals (non physican) were granted - answer- 1983 by JC
Credentialing and privileging - answer- process which an NP is granted permission to
practice in an inpt setting
Credentialing with hospital privileges is granted by a - answer- Hospital Credentialing
Committee
Pt Medical Abandoment - answer- When caregiver-pt relationship is terminated w/o
making reasonable arrangements w an appropriate person so that care can be
continued
Determination of pt abandonment depends on factors such as: - answer- Whether NP
accepted pt assignment, whether NP provided reasonable notice before termination,
whether reasonable arrangements could have been made
Following do not constitute pt abandonment - answer- NP refuses to accept
responsibility for pt assignment when NP has given reasonable notice to proper
authority that NP lacks competence to carry out assignment; NP refuses assignment of
a double shift or addtl hrs beyond posted work schedule when proper notification has
been given..latter phrase can be controversial
Risk Mgmt - answer- Systematic effort to reduce risk begins w formal written risk mgmt
plan that includes: organizations goals, delineation of program's scope, components,
methods; delegating responsibility for implementation and enforcement; demonstrating
,commitment by the board; confidentiality and immunity from retaliation for those who
report sensitive info
Complications of parenteral nutrition - answer- Pneumothorax, hemothorax, arterial
laceration, air emboli, catheter thrombosis, catheter sepsis, hyperglycemia, HHNK
What is the most common electrolyte abnormality - answer- Hyponatremia
Urine sodium normal value - answer- 10-20
Sodium Osmolality normal value - answer- 2xs Na
275-285
Urine sodium >20 suggestive of what? - answer- Suggests renal salt wasting (problem
with kidneys)
Urine sodium <10 suggestive of what? - answer- Suggests renal retention of sodium to
compensate for extrarenal fluid loss (problem other than kidneys)
Isotonic hyponatremia what is it's other name? Lab value and causes and treatment -
answer- Pseudohyponatremia; serium osmo 284-295: lab artifact
Occurs with hyperlipidemia or hyperproteinemia, body water is normal and pts are
asymptomatic
Treatment: Cut down fat (no fluid restriction)
Hypotonic Hyponatremia normal lab value and definition - answer- Osmo <280. State of
body water excess diluting all body fluids: clinical signs arise from water excess.
Hypovolemic w/urine Na+ <10 causes? - answer- Dehydration, diarrhea, vomiting
Hypovolemic w/urine Na+ >20 is caused by? - answer- Low volume and kidneys cannot
conserve Na
Diuretics, ACE inhibitors, and mineralocorticoid deficiency
Hypervolemic, hypotonic hyponatremia treatment? What causes it? - answer- (restrict
water)
Edematous states, CHF, Liver disease, advanced renal failure
Hypertonic Hyponatremia lab value? What causes it? - answer- (Serum osmo >290)
Hyperglycemia: Usually HHNK
Osmo is high and Na is low
Management of hyponatremia - answer- Treat cause
if hypovolemic: give NS
if urine sodium > 20 treat cause
, if hypervolemic: restrict water
If symptomatic : give NS with IV loop diuretic
If CNS symptoms: give 3% with loop diuretic
Hypernatremia what causes it what are the indications - answer- Due to excess water
loss. Always indicates hyperosmolality (deficit of water) excessive sodium intake is rare
Treatment of Hypernatremia - answer- Free water if euvolemic
Hypernatremia with hypovolemia treatment - answer- Give NS followed by 1/2 NS
Hypernatremia with euvolemia Treatment - answer- Treat with free water
Hypernatremia with hypervolemia treatment - answer- Treat with free water (D5NS) and
loop diuretics....may need dialysis
Hypokalemia causes - answer- Causes: chronic use of diuretics, GI loss, excess renal
loss, and alkalosis
S/S of hypokalemia - answer- Muscle weakness, fatigue and muscle cramps
Constipation or ileum due to smooth muscle involvements
If severe (<2.5) may see flaccid paralysis, tetany, hyporeflexia, and rhabdomyolosis
Lab/Diagnostics of hypokalemia - answer- Decreased amplitude of ECG, broad T
waves, prominent U waves, PVCs, Vtach or Vfib
Management of hypokalemia - answer- Oral replacement if >2.5 and no ECG
abnormalities
IV replacement at 10mEq per hour if can't take PO
If <2.5 or s/s are present. Can give 40mEq/L/Hr IV, check every 3 hours and do
continuous ECG monitoring
Mg++ deficiency frequently impairs K correction
Hyperkalemia causes and what happens cellularly - answer- Causes: Excessive intake,
renal failure, drugs, hypoaldosteronism, cell death.Shifts of intracellular K+ to the
extracellular space occurs with acidosis. K+ increase 0.7 with each 0.1 drop in pH
Hyperkalemia S/S - answer- weakness, flaccid paralysis
Abdominal distention
diarrhea
Tall peaked waves on ECG
Management of Hyperkalemia - answer- Kayexalate
if >6.5 or cardiac toxicity or muscle paralysis is present, consider: Insulin 10U with one
amp D50 (pushes K into cell)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Greaterheights. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.09. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79650 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now