NUR 205 Exam 3 Review: Injections, Medications, Diabetes, Exams of Nursing

A comprehensive q&a review for nur 205 exam 3, covering key concepts in medication administration, including injection sites and the six rights, and diabetes management, encompassing blood sugar levels, types of diabetes, and related complications. it also includes questions on fluid and electrolyte balance, crucial for nursing practice. The questions and answers are detailed and cover a wide range of topics, making it a valuable study resource for nursing students.

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NUR 205 Exam 3
Where are the IM injection sites? - CORRECT ANSWER-Deltoid
Gluteus Maximus (not recommended)
Vastus lateralis ***
Recurs femoris
Subcutaneous injections - CORRECT ANSWER-Injection of a small amount of a
medication under the skin into fatty or connective tissue
45-90 degree angle
1 ml fluid maximum
Transdermal injection - CORRECT ANSWER-diffuse through the epidermis at a known
rate into the dermis
5-15 degree angle
Bevel up
Pull skin back
Make a "wheel"
6 rights of drug administration - CORRECT ANSWER-Right patient, right drug, right
dose, right route, right time, right documentation
3 medication checks - CORRECT ANSWER-Check MAR/order
Check when you pull the medication
Check at the patient bedside
How to know if your patient can swallow pills whole? - CORRECT ANSWER--ask if they
can
-check gag reflex
-when given report ask if they can take pills whole
Intramuscular (IM) - CORRECT ANSWER-injection into a muscle
No more than 3 ml
At a 90 degree angle
Endocrine system - CORRECT ANSWER-Glands secrete hormones that regulate
processes such as growth, reproduction, and nutrient use (metabolism) by body cells.
Insulin Hormone - CORRECT ANSWER-Necessary for carb regulation and glucose
control
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NUR 205 Exam 3

Where are the IM injection sites? - CORRECT ANSWER-Deltoid Gluteus Maximus (not recommended) Vastus lateralis *** Recurs femoris Subcutaneous injections - CORRECT ANSWER-Injection of a small amount of a medication under the skin into fatty or connective tissue 45 - 90 degree angle 1 ml fluid maximum Transdermal injection - CORRECT ANSWER-diffuse through the epidermis at a known rate into the dermis 5 - 15 degree angle Bevel up Pull skin back Make a "wheel" 6 rights of drug administration - CORRECT ANSWER-Right patient, right drug, right dose, right route, right time, right documentation 3 medication checks - CORRECT ANSWER-Check MAR/order Check when you pull the medication Check at the patient bedside How to know if your patient can swallow pills whole? - CORRECT ANSWER--ask if they can

  • check gag reflex
  • when given report ask if they can take pills whole Intramuscular (IM) - CORRECT ANSWER-injection into a muscle No more than 3 ml At a 90 degree angle Endocrine system - CORRECT ANSWER-Glands secrete hormones that regulate processes such as growth, reproduction, and nutrient use (metabolism) by body cells. Insulin Hormone - CORRECT ANSWER-Necessary for carb regulation and glucose control

Hormones - CORRECT ANSWER-Chemical messengers, mostly those manufactured by the endocrine glands, that are produce metabolic change Normal BS - CORRECT ANSWER- 70 - 120 Fasting BS - CORRECT ANSWER- 70 - 100 Pre-diabetic BS - CORRECT ANSWER-over 140 Mild Hypoglycemia Symptoms - CORRECT ANSWER-Hunger Nervousness Palpitations Sweating Tachycardia Tremor Moderate Hypoglycemia Symptoms - CORRECT ANSWER-Confusion Double Vision Drowsiness Emotional Changes Headache Impaired Coordination Inability to concentrate Irrational or combative behavior Lightheadedness Numbness of the lips and tongue Slurred speech Severe Hypoglycemia Symptoms - CORRECT ANSWER-Difficulty arousing Disoriented behavior Loss of consciousness Seizures Hyperglycemic Symptoms - CORRECT ANSWER-Polydipsia (increased thirst) Polyphasia (Increase hunger) Polyuria (increased urination) Warm, flushed skin Blurred vision Poor wound healing Diabetic Keto acidosis (DKA) - CORRECT ANSWER-Higher than 300 glucose Ketones in urine Kussmal breathing Acetone (fruity) breath Tachycardia

  • DKA's very common
  • Must eat regularly 5-6 times/day
  • Cannot take oral glycemic meds Type 2 Diabetes - CORRECT ANSWER--Pancreas is worn out by too much carb/sugar intake that it becomes INSULIN RESISTANT
  • Happens later in life
  • Slow onset of diagnosis
  • Increased obesity, sedentary lifestyle, poor nutrition Chronic Complications of Diabetes - CORRECT ANSWER--Stroke
  • Heart attack
  • Peripheral artery disease
  • Diabetic retinopathy
  • Cataracts
  • Glaucoma
  • Neuropathy
  • Skin conditions
  • Poor wound healing Statins - CORRECT ANSWER-drugs used to lower cholesterol in the bloodstream
  • reduce the risk of MI and stroke Oral hypoglycemic agents - CORRECT ANSWER-These medications promote insulin release from the ilet cells in the pancreas. Examples of oral hypoglycemics - CORRECT ANSWER--Metformin
  • Glypiside Do not give oral hypoglycemics to who? - CORRECT ANSWER-Type 1 diabetics Metabolic Syndrome - CORRECT ANSWER-A cluster of conditions like high BS, high BP, excessive wasting, body fat, abnormally high lipids acting together that increase the risk of heart disease, stroke, and diabetes. Type 1 DM Glycogen - CORRECT ANSWER-Found in the pancreas; stores glucose (stored sugar for energy source) Euglycemia - CORRECT ANSWER-The term used to describe normal BS levels 70 -- 120 A1C test - CORRECT ANSWER-Diabetic diagnosis test checking sugar on red blood cells to get an average glucose level over several months (90 days) A1C Normal range - CORRECT ANSWER-Optimal level is lower than 7

DM type 2 education - CORRECT ANSWER-HYDRATION Increase exercise Proper Vit D intake Low carb Increased Fiber intake Check BS before meals DM type 1 CANNOT/have - CORRECT ANSWER-Oral glycemic Diuretics Fasting When blood sugar level is low, you first need to try - CORRECT ANSWER-Try fast acting carbs *orange/apple juices, crackers & pB, honey Fluid in each of the body compartments contains? - CORRECT ANSWER-Electrolytes To have normal body function ____________ - CORRECT ANSWER-the bodies cells must have fluids and electroytles in the right compartment intracellular fluid - CORRECT ANSWER-Fluid inside cells; majority of fluids are inside cell extracellular fluid - CORRECT ANSWER-body fluids located outside of cells Third-spacing - CORRECT ANSWER-the accumulation and sequestration of trapped extracellular fluid in an actual or potential body space as a result of disease or injury Edema - CORRECT ANSWER-Abnormal accumulation of fluid in interstitial spaces of tissues. Occurs as a result of conditions such as cardiac, renal or liver disease Body Fluids - CORRECT ANSWER-Transport nutrients to the cell and then carry waste products from the cells isotonic Solution - CORRECT ANSWER-A solution whose solute concentration is EQUAL to the solute concentration inside a cell Hypotonic solution - CORRECT ANSWER-Solute concentration is less than that inside the cell; cell gains water (SWELLS) Hypertonic Solution - CORRECT ANSWER-Solute concentration is greater than that inside the cell; cell loses water (SHRINKS)

Treatment for FVD - CORRECT ANSWER--IV fluids

  • IV bolus
  • Oral fluids
  • I&O/ daily weights
  • Blood or biproducts
  • Freq assessments
  • vital signs Causes of FVD - CORRECT ANSWER--not drinking enough fluids
  • GI losses (diarrhea and vomiting)
  • GI suctioning (NG tube)
  • insensible fluid loss
  • food poisoning
  • burns
  • NPO status pt's Fluid Volume Excess (FVE) - CORRECT ANSWER-Abnormal retention of fluids and electrolytes. Too much water in not enough out. Hypervolemia Fluid Overload Symptoms of FVE - CORRECT ANSWER--**high HR; bounding pulse
  • **high BP
  • Increased wt
  • edema
  • JVD
  • **SOB/Crackles
  • pink frothy sputum
  • change in LOC
  • diluted/ sediment urine
  • low SPO2/ fast resp Causes of FVE - CORRECT ANSWER--Renal disease/failure
  • Liver disease/failure
  • CHF
  • Pulmonary edema
  • excess fluid intake (oral/intravenous)
  • increased ADH or SIADH
  • too much Na+
  • high cortico steroid levels caused by stress or pain
  • stopped diuretics Treatments for FVE - CORRECT ANSWER--Fluid restriction
  • Sodium restriction
  • strict I&O
  • diuretics
  • daily weights
  • O2 may be needed
  • elevate HOB
  • slow IV infusion or stop
  • treat underlying cause Normal Calcium - CORRECT ANSWER-8.5- 10 Metabolic Acidosis - CORRECT ANSWER-Low pH (lower than 7.35) Low HCO3 (lower than 22) Causes: diarrhea, alcohol, DKA, excessive laxatives, kussmal breathing Metablolic Acidosis Treatments/Interventions - CORRECT ANSWER-Monitor K+ values Seizure precautions Strict I&O monitoring Monitor LOC Sodium bicarb Rehydrate patient Metabolic Alkalosis - CORRECT ANSWER-High pH (7.45 or higher) High HCO3 (26 or higher) Causes: vomiting, gastric suctioning, dehydrations, overuse of antacids Results in hypokalemia Metabolic Alkalosis Treatment/Interventions - CORRECT ANSWER-Monitor signs for resp distress Monitor K+ and Ca+ levels K+ replacement Medications to flush out the excessive bicarb Iv/Oral fluids Administer antiemetic medications Nutrition replacement Seizure precautions Respiratory Acidosis - CORRECT ANSWER-Low pH (7.35or lower) High Pc02 (45 or higher) Causes: COPD, hypoventilation, asthma, pneumonia, pulmonary edema, sedation Respiratory Acidosis Treatment/Interventions - CORRECT ANSWER-Administer 02 as prescribed sit HOB or orthopenic position Encourage fluids to thin secretions

Causes: Burns, acute kidney failure, excessive use of K+ supps and intake of K+ foods, intestinal obstruction, cell damage Hyperkalemia S/S - CORRECT ANSWER-muscle weakness hypotension diarrhea hyperactive bowel sounds flat P waves Prolonged PR interval Depressed ST Hyperkalemia Treatment/Interventions - CORRECT ANSWER-Place pt on cardiac monitor monitor I&O monitor vital signs enforce K+ restricting diet Give kayexlate Dialysis may be required Hypocalcemia - CORRECT ANSWER-Lower than 8 Causes: Inadequate intake of calcium & vit D Diarrhea Excessive GI loss Diuretics Caffeine Laxatives Crohns Disease Hypocalcemia S/S - CORRECT ANSWER-HIgh HR Tetany Positive Chovostek's or Trousseaus sign Diarrhea Twitching Hyperactive bowel sounds *Laryngeal spasm Hypocalcemia Treatment/Interventions - CORRECT ANSWER-Monitor GI and cardiac status Administer Ca+ supplements or IV solutions Administer Phosphate and vitamin D Seizure precautions Increase Ca+ foods Rapid-Acting Insulins - CORRECT ANSWER-Lispro (Humalog)

Aspart (Novolog) Glulisine (Apidra) Hypercalcemia - CORRECT ANSWER-Higher than 10 Causes: Excessive intake of calcium supplements or vit D Kidney disease Adrenal insufficiency Hyperparathyroidism Use of lithium Hypercalcemia S/S - CORRECT ANSWER-High HR High BP Muscle weakness N/V Constipation ABD distension Lethargy Even coma Hypercalcemia Treatment/Interventions - CORRECT ANSWER-Monitor cardiac on tele Restrict Ca+ intake and oral meds Diuretics that will help excrete the excess calcium Dialysis Calcium Gluconate is the antidote for what? - CORRECT ANSWER-Magnesium overdose Calcium and phosphate - CORRECT ANSWER-have reciprocal relationships. decrease Ca->increase P04 (twitch, sz, chevastke, troussou) increase Ca->decrease P04 (muscle weakness, apathy) Rapid Acting: Onset? Peak? Duration? - CORRECT ANSWER-Onset: 15 minutes Peak: 60 minutes Duration: 3-4 hours Short-Acting Insulins - CORRECT ANSWER-Regular (Humulin R, Novolin R) Short-Acting Onset?