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NSG 3600 Exam 3 Review Guide (Latest
Update 202 6 / 202 7 ) Questions & Answers
{Grade A} 100% Correct
Isotonic Dehydration - correct answer Sodium and Water leave at the same rate. Most Common type of dehydration - correct answer Isotonic dehydration Isotonic Dehydration greatest risk - correct answer Hypovolemic Shock Hypotonic Dehydration - correct answer Losing more sodium than water In which type of dehydration are physical symptom more severe? - correct answer Hypotonic Dehydration Treatment for Hypotonic and Isotonic Dehydration - correct answer Administer 1/2 D NK Dehydration s/s - correct answer Skin turgor
Dry mucous membranes Lower urine output and concentrated Sunken eyes & fontanles Weakness Hypotension Tachycardia Increased respiratory rate Hypertrophic Pyloric Stenosis - correct answer - hypertrophy of the pyloric sphincter causing tightening of the opening from the stomach to the small intestine
- enlarged muscles that don't open
- stomach pushes so hard to fit food through sphincter but ends up projectile vomiting Hypertrophic Pyloric Stenosis Population - correct answer Caucasian First Born Males Hypertrophic Pyloric Stenosis s/s - correct answer "Insatiable Feedings" Projectile Vomiting
How soon can a child with pyloromyotomy eat post-op? - correct answer Must wait six hours Pyloromyotomy food reintroduction AS TOLERATED The baby will not move to the next level until they can tolerate TWO of these feedings. - correct answer Pedialyte 15ml q. 2 hours 1/2 strength formula 15ml, two feedings 30ml formula 2 feeds 45 ml two feeds 60 ml two feeds Pyloromyotomy vomiting for 24 hours post-op - correct answer Expected Pyloromyotomy vomiting for 48 hours post-op - correct answer Notify PCP What do you do it a baby who underwent a pyloromyotomy vomits? - correct answer Nothing, clean up baby, let them recover for a moment, keep feeding
Hemodialysis - correct answer A technique in which an artificial kidney machine removes waste products from the blood What does dialysis do? - correct answer Prevents the accumulation of of unwanted fluids and toxins (essentially, acts as a kidney) Hemodialysis: how often do they go? - correct answer 3x per week. Sessions are 3- 4 hrs. long. Hemodialysis expected GFR? - correct answer Always greater than 15 Hemodialysis site priority - correct answer Keep site clean and do not allow to bruise Hemodialysis s/s - correct answer hypotension, muscle cramps, and anemia Enuresis - correct answer involuntary discharge of urine
Rectal Atresia treatment - correct answer Surgery ASAP Rectal Atresia diagnosis - correct answer X-ray, MRI, Ultrasound, IV pyelogram Rectal Atresia Pre-Operative Care - correct answer Get Consent, NPO, IV Rectal Atresia post-operative care - correct answer PO feedings can begin as soon as bowel sounds are heard Can not leave Hospital until they have bowel movement Rectal Atresia Surgery - correct answer Bowel Resection and Colostomy, then closure of colostomy and bowel repair "anastomosis" Gastroesophageal reflux disease (GERD) - correct answer Excessive relaxation of the lower esophageal spinchter, which allows the reflux to occur Gastroesophageal reflux disease (GERD) s/s - correct answer "it burns/stings" Halitosis
Chronic Cough Wheezing Refusal to Feed Regurgitation Gastroesophageal reflux disease (GERD) diagnosis - correct answer Barium Swallow 24 hours intraespohgeal ph monitor Endoscopy with biopsy to tell which type Gastroesophageal reflux disease (GERD) Medication - correct answer Proton Pump Inhibitors (PPI) 30 minutes prior to meals or daily in the morning on an empty stomach "-prazole" Gastroesophageal reflux disease (GERD) Care - correct answer thicken formula with cereal for infants Plain diet for children Remain upright after meals Provide Smaller, More frequent meals
In-and-out catheterization Suprapubic Aspiration (Least Preferred due to pain) Bag (Least preferred due to contamination odds) UTI Sample Collect Nursing Priority - correct answer Must send urine sample to lab ASAP. Within 10 minutes of collection. UTI Teachings - correct answer Hand hygiene, Wiping technique, Cotton underwear, Avoid Tight clothing, avoid baths, empty bladder regularly, avoid constipation. Teach s/s of infection Vesicoureteral reflux - correct answer Backflow of urine from the urinary bladder to the ureters and sometimes the kidneys Vesicoureteral reflux s/s - correct answer Looks like a UTI, but with a fever. Nausea and Vomiting Vesicoureteral reflux can... - correct answer Cause utis and Kidney Infections
Kidney infection results in distention of the kidneys, damaging kidneys. Vesicoureteral reflux diagnosis - correct answer voiding cystourethrogram (VCUG) + renal imaging X-ray while urinating, no metal Vesicoureteral reflux treatment - correct answer May need long term antibiotics or surgery Vesicoureteral reflux post-operative or post treatment care - correct answer Urine culture every 2- 3 Vesicoureteral reflux primary - correct answer Born with it Vesicoureteral reflux Secondary - correct answer Obstruction from abnormal tissue fold within the urethra
Acute glmerulonephritis s/s - correct answer Hypervolemia (HTN, dyspnea, crackles, edema) TEA COLOR URINE Edema in periorbital region (face and eyes) Acute glmerulonephritis assessment priority - correct answer ASK ABOUT RECENT STREP Acute glmerulonephritis Urinalysis Results - correct answer Increased blood and protein in urine Acute glmerulonephritis expected lab values - correct answer Elevated BUN and Creatinine Pediatric BUN - correct answer 5 - 18 Pediatric Creatinine - correct answer 0.3-0.
Pediatric Potassium - correct answer 3.4-4. Acute glmerulonephritis treatment - correct answer Antibiotics Acute glmerulonephritis may.. - correct answer Require peritoneal or hemodialysis Hemolytic Uremic Syndrome is the... - correct answer Most common cause of Acute Renal Failure in children Hemolytic Uremic Syndrome - correct answer effects kidney function and causes thrombocytopenia (decrease platelet) and hemolytic anemia Hemolytic Uremic Syndrome is most commonly caused by - correct answer E. Coli Hemolytic Uremic Syndrome prevention - correct answer Hygiene and Food Care Cook meat, especially hamburger, well-done, Steak is a low risk food even it's consumed rare, Avoid cross-contamination ,
Hypospadias and Epispadias - correct answer congenital defect where the urinary meatus is below/above its normal location Hypospadias and Epispadias teachings - correct answer Delay circumcision for surgical repair No baths post-op "WET COMPRESSION BEFORE REMOVAL" Hypospadias and Epispadias surgery - correct answer Monitor for s/s infection, urine quality Increased ICP can lead too... - correct answer secondary (preventable) brain injury ICP mmhg - correct answer 0 - 10mmhg = Normal 20mmhg= Dangerous
Increased ICP s/s - correct answer bulging fontanel, headache, vomiting, change in LOC, SUNSET EYES, & HIGH PITCHED CRY, blurred vision, etc. What labs would be altered with Hemolytic Uremic Syndrome? - correct answer Elevation in BUN Elevation in Creatine Elevation in Potassium Levels Decreased Platelet Count Hemolytic Uremic Syndrome Nursing Care - correct answer Assessment:
- VS, neuro checks, lab values (including electrolytes and CBC)
- Evidence of kidney impairment (oliguria, elevated serum potassium and creatinine)
- Signs of bleeding from thrombocytopenia (petechiae and ecchymosis)
- Increased ICP
- I & O's for Heart Failure Monitoring
- Daily Weights for Fluid retention
Acute Kidney Injury (AKI) Expected Labs - correct answer Increase in BUN, Creatinine, Phosphorus Decrease in Calcium (Normal: 8.8-10.8) Acute Kidney Injury (AKI) treatment - correct answer Identify risk factors (prevention) Treat hypoperfusion promptly Nephrology consult Nutrition Antibiotics Dialysis (Sometimes) Acute Kidney Injury (AKI) NURSING Priority - correct answer Increase perfusion to kidneys. ADMINISTER IV FLUIDS Acute Kidney Injury (AKI) you should Assess? - correct answer FLANK TENDERNESS/PAIN
Peritoneal Dialysis - correct answer dialysis in which the lining of the peritoneal cavity acts as the filter to remove waste from the blood Peritoneal Dialysis solution is - correct answer instilled into the abdomen through abdominal catheter Peritoneal Dialysis complications - correct answer peritonitis, leakage, bleeding, pain, electrolyte imbalance Peritoneal Dialysis Solution is cloudy - correct answer Notify PCP. Peritoneal Dialysis. Patient complains of extreme pain when dialysis begins. What do you do? - correct answer You can slow the rate. The patient MUST finish. Rotavirus - correct answer Most common cause of acute diarrhea Acute Diarrhea effects - correct answer Excessive Fluid and electrolyte loss in the stool
