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electrolyte imbalances: clinical manifestations of hypokalemia chapter 44 ~ 1. risk factors: decreased total body potassium from GI loss, kidney loss or skin loss, insufficient potassium or intracellular shift. 2. weak, irregular pulse, hypotension, respiratory distress. 3. may see PVCs, br...

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  • 7 augustus 2024
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Adult Medical Surgical ATI
Proctored Questions And
Answers

***electrolyte imbalances: findings associated with hypocalcemia chapter 44


✓~ -Tetany most common.

-parasthesia of the fingers and lips (early manifestations)


-muscle twitch


-seizure due to the irritability of the CNS


-frequent, painful muscle spasms at the rest in the foot and calf


-hyperactive DTRs


-positive chvostek's sign


-possitive trousseau's sign


-history of thyroid surgery or irradiation of the upper chest or neck.




***head injury: making room assignments for a group of clients chapter 14

,✓~ A. Close monitoring of the client's vital signs and neurological status will

allow early reporting of changes in the GCS score, an increase in the blood

pressure, and an alteration in respiratory pattern and effort.

B. Care should include professionals from other disciplines as indicated. This

may include physical, occupational, recreational, and/or speech therapists due to

neurological deficits that may occur secondary to the area of the brain

damaged.


C. Social services should be contacted to provide links to social service agencies

and schools.




infection control: admitting a client who has pertussis chapter 11 FUND


✓~




tuberculosis: client interventions to mange infections chapter 23


✓~ exposed family should be tested for TB. Educate on following the full

medication regimen of 6-12 months, even up to 2 years for multi-drug

resistant TB. Instruct follow up care for 1 full year. Sputum samples are

needed q2-4 weeks. Clients are no longer infectoius afer three negative

sputum cultures. Cover nose and mouth while sneezing. With active TB wear

a mask in public places or in a crowd.

,cardiovascular and hematologic disorders: dietary teaching with a client with

heart failure chapter 12 NUTRITION


✓~




***pituitary disorders: interventions for a client who has diabetes insipidus

chapter 77


✓~ obtain baseline weight, vitals, serum electrolytes and osmolarity, and urine

specific gravity. monitor hourly vital signs, urine specific gravity and weight.

Discontinue the test and re hydrate the client for loss of more than 2 kg in

body weight. Monitor for severe dehydration such as hypotension,

tachycardia, and dizziness. Advise client to report dizziness, headache, and

nausea. Promote regular diet, IV therapy for hydration I&Os matched to

prevent dehydration. electrolyte replacement. Promote safety. Add bulk foods

and fruit juices to diet. Possible laxatives. Provide mouth an skin care. Soft

toothbrush and mild mouthwash to avoid trauma to oral mucosa. Encourage

to drink fluids in respnse to thirst. Assess skin turgor. May give desmopressin

which is a synthetic ADH which results in increased water absorption from

kidneys and decreased urine output.




***emergency nursing principles and management: adverse effects following

epinephrine administration chapter 2

, ✓~ can lead to hypertensive crisis. May lead to angina. Monitor for

Dysrhythmias, change in heart rate, and chest pain. Monitor for

hyperglycemia in clients with diabetes mellitus.




pulmonary embolism: planning care for a client who is receiving enoxaparin

chatper 24


✓~ A. Assess for contraindications (active bleeding, peptic ulcer disease, history

of stroke, recent trauma).

B. Monitor bleeding times. Prothrombin time (PT) & international normalized

ration (INR), partial thromboplastin time, & complete blood count.


C. Monitor for side effects of anticoagulants (anemia, thrombocytopenia,

hemorrhage).




***rheumatoid arthritis: reviewing lab values chapter 88


✓~ A. Erythrocyte sedimentation rate (ESR) and high-sensitivity

B. C-reactive protein may be increased slightly related to secondary synovitis.


C. Osteoarthritis without synovitis is not an inflammatory disorder.

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