Download NUR 198 Exam 1 – Ryno QUESTIONS WITH VERIFIED SOLUTIONS | 2026 UPDATE and more Exams Nursing in PDF only on Docsity!
NUR 198 Exam 1 – Ryno QUESTIONS WITH
VERIFIED SOLUTIONS | 2026 UPDATE
An older adult comes in with new onset of confusion. What should you do first? Labs, to check for UTI or pneumonia. Electrolytes issue like Hyponatremia tolerance the diminishing effect with regular use of the same dose of a drug, requiring the user to take larger and larger doses before experiencing the drug's effect dependence A state in which there is a compulsive or chronic need, as for a drug first symptom of acidosis hyperventilation, increased RR action of 3% sodium hyperosmolar agent used in patients with severe hyponatremic encephalopathy, traumatic brain injury, and cerebral edema pain scales numeric rating scale: numbers visual analog scale: faces categorical scale: words, numbers, colors, locations on the body nonverbal cues of pain
Decreased activity, grimacing, frowning, crying, moaning, and irritability. Priority assessment in the PACU breathing, circulation, and respiratory adequacy ABCs: airway, breathing, circulation malignant hyperthermia a genetic severe reaction to certain drugs used for anesthesia malignant hyperthermia symptoms dangerously high body temperature, rigid muscles or spasms, a rapid heart rate tachycardia, tachypnea, high fever medications that can cause malignant hyperthermia anesthesia drugs: halothane sevoflurane desflurane succinylcholine malignant hyperthermia treatment dantrolene by limiting the activation of calcium receptor appropriate medications for low-moderate pain
depression risk of suicide is increased from losses, isolation, and illness delirium
- Acute
- Fluctuating state of confusion
- Onset: fast
- Duration: hours to less than 1 month
- Causes: multiple, such as surgery, infection (sepsis, stoke, UTI's), drugs
- Management: remove or treat the cause
- Nursing interventions: reorient the client to reality; provide a safe environment possible causes of delirium ○ Dehydration ○ Electrolyte imbalance/ emotional stress ○ Lung, liver, heart, kidney, brain disorders ○ Infection (sepsis, stroke, UTI's) ○ Rx Drugs ○ Immobility ○ Untreated pain, unfamiliar environment ○ Metabolic disorders if delirium is left untreated what are possible outcomes changes in level of consciousness, irreversible brain damage, and sometimes death
what assessments are performed on patients when they are in a state of acute confusion with alterations in attention and cognition? (delirium is suspected) CAM, confusion assessment method healthcare team's primary goals for delirium patients § Improve oxygen § Reorient the client to reality; provide a safe environment § Supporting cognitive function § Reducing anxiety and agitation § Improve communication dementia
- Chronic
- Loss of short-term memory, thinking (cognitive), and behavior, causing reduced ability to perform ADL's
- Progressive cognitive decline
- Onset: slow
- Duration: months to years
- Causes: unknown, possibly familial, chemical
- Management: treat signs and symptoms
- Nursing interventions: reorientation is not effective in late stages; use validation therapy (acknowledge client's feelings and do not argue); provide safe environment Non-Alzheimer's disorders
mild to moderate pain, fever albuterol indications Acute bronchospasm due to asthma or COPD ceftriaxone indications
- Suspected meningococcal septicemia
- Severe sepsis (consult only) bacterial infections Aging changes alters the drug pharmacokinetics and dynamics absorption, metabolism, distribution, excretion BEERS criteria A list of medications that are generally considered inappropriate when given to elderly people
- Increased sensitivity to medications such as sedatives, analgesics and anti-cholinergic drugs nursing implications for medications in the older adult ○ Need adjustment of dosage due to age; start low, go slow ○ Assess knowledge of medications and use ○ Review need for medication, coordination of prescriber ○ Factors that affect compliance ○ Keep medication regimen as simple as possible ○ Strategies to improve compliance recommendations for older adults to track medications with polypharmacy
medications list medication organizer set a routine or reminder tools keep medications in a visible location record side effects or concerns Role as a nurse with someone coming in with a plastic bag full of 100 pills? Safety goal/s when looking through meds to figure them out. Are there any that react negatively if taken together? Are any expired? Are there duplicates of the same med? Medication reconciliation form? Separate/label them? common acid/base imbalance with COPD patients
- elevated PaCO2 levels
- decreased pH
- kidneys attempt to compensate
- clinical manifestations: dyspnea, respiratory distress, confusion, respiratory failure major side effects of opioids respiratory depression, constipation, sedation, decreased LOC how to administer opioid medications through IV
low pH, low HCO respiratory acidosis low pH, high CO metabolic alkalosis high pH, high HCO respiratory alkalosis high pH, low CO acid/base imbalance that can cause vomiting and numbness and tingling in fingers and toes metabolic alkalosis
- excess of bicarbonate (HCO3-) in the blood, leading to an increase in blood pH
- Alkalosis can affect the levels of ionized calcium in the blood, leading to hypocalcemia (low levels of calcium) physiological changes in older adults Cardiovascular System: Reduced elasticity of blood vessels. Increased risk of hypertension. Decreased cardiac output. Slower heart rate at rest. Respiratory System:
Decreased lung elasticity and vital capacity. Reduced respiratory muscle strength. Increased susceptibility to respiratory infections. Musculoskeletal System: Loss of muscle mass (sarcopenia). Decreased bone density (osteoporosis). Joint stiffness and reduced flexibility. Nervous System: Slower nerve conduction. Decline in cognitive function, memory, and reaction time. Changes in sleep patterns. *Increased confusion with physical illness. Gastrointestinal System: Slower digestion and reduced absorption of nutrients. Decreased gastric acid secretion. Increased risk of constipation. Renal System: Decline in renal function and filtration rate.
Decreased estrogen production in females. Metabolic Changes: Slower metabolism. Altered body composition with increased fat and decreased lean muscle mass. Nutritional Changes: Fewer calories. Require more nutrient rich, healthy diet. Increase in protein. ageism
- a bias that discriminates, stigmatizes, and disadvantages older adults based solely on their chronologic age
- fear of aging
- negative images in society
- feelings of increased
- burden on family Sodium (Na) salty sodium regulate fluid balance, blood pressure, and nerve transmission salt lives in the BRAIN
potassium (K) keeping potassium maintaining proper heart and muscle function potassium lives in the HEART Calcium (Ca) calming calcium involved in muscle contraction and nerve transmission. It helps regulate heart rate and blood clotting. calcium lives in the MUSCLE Magnesium (Mg) might magnesium muscle and nerve function, blood glucose control, and bone health magnesium lives in the REFLEXES chloride (Cl) chloride in cells maintain fluid balance and is an essential component of stomach acid (HCl) phosphate (PO4) phosphate in the bones crucial for bone and teeth formation and is involved in energy metabolism
- Prevent , manage crises, complications
- Carry out regimens as prescribed
- Validate individual self-worth, family functioning
- Manage threats to identity
- Normalization of personal and family life
- Altered time, social isolation, loneliness
- Establish networks of support, resources that can enhance quality of life
- Return to satisfactory way of life after acute debilitating episode or reactivation of chronic condition
- Die with dignity and comfort § Die the way they want to (if they don't want to take meds) § Dying at home Nursing Process ○ Identify specific problems, trajectory phase ○ Establish, prioritize goals ○ Plan of action to achieve desired outcomes ○ Interventions focus: § Regimens to control symptoms, avoid complications § Psychosocial issues affect quality of life ○ Evaluate outcomes, reassess problems
(ADPIE)
Assess, Diagnose, Plan, Implement, Evaluate Nurses primary goals prevention of chronic disease: immunizations, vaccines, seatbelts, treatment management of care: screenings, blood sugar checks avoid complications: health promotion, health screenings, treatment hypotonic solution out of vessel into cells swell 0.45% NS,0.25 NS isotonic solution stays where I put in, stays the same 0.9 NS, D5W, Lr hypertonic solution enter vessel out of cells shrink 3% NS, D10, D5.9/0.45, D50, albumin colloid
§ Oral fluids § Ice chips are 1/2 the frozen measurement § IV fluids, flushes, medications, blood products § Enteral feedings § Catheter and/or tube irrigants § Yogurt § NOT oatmeal output § All liquids excreted from the body □ Urine □ Liquid stool □ Blood □ Emesis □ Tube drainage □ Wound drainage □ Fistula drainage □ Gastric suctioning measuring intake and output ○ 1 oz = 30 mL ○ 8 oz = 1 cup ○ 1 cup = 240 mL ○ Measuring using calibrated container
○ Measure at eye level ○ If you see a meniscus, measure at the bottom of the meniscus excessive fluids results in what fluid volume overload, electrolyte changes, and organ dysfunction insufficient fluids results in what dehydration, electrolyte changes, and organ dysfunction fluid volume disturbances hypovolemia and hypervolemia hypovolemia causes and treatment ○ Causes: § Abnormal fluid losses - Vomiting, diarrhea, sweating, GI suctioning § Decreased intake - Nausea, anorexia, lack of access to fluids § Third-space fluid shifts - Due to burns, ascites § Additional causes - Diabetes insipidus, adrenal insufficiency, hemorrhage ○ treatment: § oral route § IV fluids: isotonic, hypotonic, hypertonic § assess I&O, vitals, LOC, breath sounds hypervolemia causes and treatment ○ Causes: § Excess oral fluids or IV fluids
