Medical Nursing Review for Exam

A comprehensive set of 200 flashcards for studying essential medical nursing concepts and interventions.

What is characterized by PaCO2 greater than 45 mmHg and HCO3- being normal or slightly increased?

Respiratory Acidosis.

What does a PaCO2 less than 35 mmHg indicate?

Respiratory Alkalosis.

What is a common cause of Metabolic Acidosis?

Diabetic Ketoacidosis (DKA), diarrhea, renal failure.

What disorder is indicated by HCO3- levels below 22 mEq/L?

Metabolic Acidosis.

Clinical signs of Respiratory Acidosis include:

Confusion, lethargy, headache, hypoventilation, decreased respiratory rate.

Typical management for Respiratory Alkalosis?

Slow breathing, re-breathe into a paper bag if needed.

Signs of Metabolic Alkalosis?

Muscle twitching, tetany, tremors, signs of hypokalemia.

Main diagnostic for assessing acid-base disturbances?

ABG analysis: pH, PaCO2, HCO3.

What is the FiO2 range for a Simple Face Mask?

35-50%.

What oxygen administration method provides precise O2 delivery for COPD patients?

Venturi Mask.

What flow rate does a Non-Rebreather Mask typically require?

10-15 L/min.

What are Kussmaul respirations associated with?

Metabolic Acidosis.

Key assessment for patients receiving mechanical ventilation?

Monitor vital signs, ABGs, lung sounds.

What are common ventilator alarms and their causes?

High pressure: biting tube, secretions, kink; Low pressure: disconnection, leak.

What is the usual tidal volume (Vt) setting on a ventilator?

6-8 mL/kg.

How to identify if a pH change is compensated?

If pH is normal but PaCO2 or HCO3 is abnormal—fully compensated.

What do elevated BNP levels indicate?

Heart failure.

Clinical signs of a pulmonary embolism?

Sudden onset dyspnea, chest pain, tachypnea, hypoxia.

What finding is characteristic of Pressure Ulcers?

Localized injury to skin or underlying tissue.

What is the primary nursing action for confirming placement of an ET tube?

Chest rise and auscultation.

What medication is commonly used in DKA management?

Insulin.

When should you administer IV sodium bicarbonate?

In cases of severe metabolic acidosis.

During a respiratory assessment, what indicates pneumonia?

Crackles, rhonchi on auscultation.

What does CURB-65 stand for in pneumonia assessment?

Confusion, Urea > 20, Respiratory Rate > 30, BP < 90 systolic or < 60 diastolic, Age > 65.

Symptoms of heart failure include:

Dyspnea, fatigue, orthopnea, paroxysmal nocturnal dyspnea.

What is indicated by the presence of a Kussmaul respirations pattern?

Hyperventilation due to metabolic acidosis.

What is the primary aim in mechanical ventilation management?

Ensure adequate oxygenation and ventilation.

Management for Acute Respiratory Failure may include?

Supplemental O2, noninvasive ventilation (BiPAP/CPAP), or intubation.

Signs of fluid overload in patients with heart failure?

Crackles, edema, jugular venous distention.

What to educate families about caring for patients with tracheostomies?

Suctioning techniques, emergency reinsertion, and stoma care.

What is the goal for treating Acute Respiratory Distress Syndrome (ARDS)?

Improve oxygenation and treat underlying cause.

Key indicators of tracheal deviation in tension pneumothorax?

Shifting of the trachea away from midline.

What are early signs of increased intracranial pressure (ICP)?

Decreased level of consciousness, headache, vomiting.

When might you consider using ACLS protocols?

In cases of suspected cardiac arrest.

What does the Cushing's Triad indicate?

Imminent brain herniation, characterized by hypertension, bradycardia, and irregular respirations.

What are signs of kidney failure in patients with shock?

Decreased urine output (UOP), elevated BUN and creatinine.

Clinical manifestations of septic shock include?

Warm skin, tachycardia, and hypotension due to vasodilation.

What defines a cardiogenic shock?

Inadequate perfusion due to heart failure, often with elevated CVP.

What is necessary for managing neurogenic shock?

Administration of vasopressors.

Use of IVIG in Guillain-Barré Syndrome?

Blocks autoimmune antibodies and reduces symptoms.

Why is early intervention important in brain tumors?

To prevent complications such as increased ICP and brain damage.

What conditions might indicate a need for a craniotomy?

Brain tumor, hematoma, or hemorrhage.

How to manage autonomic dysreflexia in spinal cord injury patients?

Loosen clothing, check/eliminate noxious stimuli, and elevate the head of the bed.

What signifies the acute phase of Stroke management?

Immediate neuro checks, oxygenation, and prevention of complications.

What does a high D-dimer level suggest in potential thromboembolic disorders?

Possible presence of a clot (thrombosis).

What is the purpose of a lumbar puncture?

To analyze cerebrospinal fluid for signs of infection, bleed, or demyelinating diseases.

What should be noted in instructing patients on anticoagulant therapy?

Educate about dietary restrictions and regular monitoring requirements.

What does the term ‘neurogenic shock’ represent?

Loss of sympathetic tone leading to vasodilation and bradycardia after spinal injury.

In patients with heart failure, what should be limited to avoid fluid retention?

Sodium intake.

What does administration of fluids target in hypovolemic shock?

Restore blood volume and improve tissue perfusion.

What happens during permissive hypercapnia in mechanical ventilation?

Maintaining higher levels of CO2 to protect lung function.

What is a key nursing intervention for patients with COPD?

Encourage hydration and pulmonary hygiene.

What type of oxygen therapy is indicated for patients with acute respiratory distress?

High-flow nasal cannula or positive-pressure ventilation.

How to assess for hypoxemic respiratory failure?

Monitor PaO2 levels; < 60 mmHg indicates severe hypoxemia.

What do crackles on auscultation indicate in a respiratory assessment?

Potential fluid accumulation in the lungs (e.g., pneumonia, heart failure).

What routine should patients undergoing tracheostomy care receive?

Daily stoma care, suctioning, and monitoring for infection.

What clinical symptoms are characteristic of heart failure exacerbation?

Increased shortness of breath, rapid weight gain, and edema.

What type of drugs are used for prophylaxis against thromboembolism in high-risk patients?

Anticoagulants like heparin or low molecular weight heparins.

What diagnostic imaging should be prioritized for suspected pulmonary embolism?

CT pulmonary angiography.

What is a simple method to detect fluid overload in heart failure patients?

Daily weight monitoring.

What does telemetry monitoring allow in acute care settings?

Continuous observation of cardiac rhythms for abnormalities.

How is the status of a brain tumor typically confirmed?

Biopsy during surgery or imaging studies to visualize the tumor.

What signifies improvement in Guillain-Barré Syndrome?

Progressive return of motor function and reflexes.

How does one distinguish between hypoxic and hypercapnic respiratory failure?

Hypoxemic failure is linked with low oxygen levels (PaO2), while hypercapnic failure is characterized by high carbon dioxide levels (PaCO2).

What is essential in promoting effective communication with stroke patients who have residual deficits?

Speech therapy and communication aids.

What's the importance of maintaining normothermia in neuro patients?

Fever can increase mortality and worsen the neurological outlook.

What are indirect signs of intracranial pressure rise?

Nausea, vomiting, and altered level of consciousness.

What interventions are crucial post-thoracotomy?

Monitor for bleeding, respiratory complications, and pain management.

What is the medical management approach for hyperkalemia in acute renal failure?

Insulin and glucose, calcium gluconate, and sodium bicarbonate.

What distinguishes septic shock from other types of shock?

Elevated temperature and warm, flushed skin due to vasodilation.

When should fluid resuscitation be prioritized in shock management?

Immediately upon identification of hypovolemic or septic shock.

What is the initial treatment for patients in respiratory distress?

Maintain airway patency and provide supplemental oxygen.

What role does patient education play in post-discharge follow-up care?

Ensures adherence to medication regimens and awareness of symptom management.

What safety measurements should be implemented for patients with spinal cord injuries?

Use of lumbar support, encouragement of mobility, and fall prevention strategies.

What is the expected outcome of successful interventions in septic shock?

Restoration of hemodyamic stability and improved organ function.

How is the prognosis of cardiac arrest determined?

By the speed of resuscitation efforts and the time to restore circulation.

Why is it important to monitor electrolytes in patients with heart failure?

To detect imbalances that may exacerbate cardiac arrhythmias.

What should be noted in the history of patients with atrial fibrillation?

Presence of underlying heart disease or systemic conditions.

What should be given priority in patients with status epilepticus?

Establishing and maintaining a patent airway.

What characterizes post-operative care in cardiac surgery?

Monitoring cardiac rhythm, fluid status, and managing pain effectively.

What patient education is critical after mechanical ventilation?

Understanding the reasons for ventilation and maneuvers for self-management.

What is critical to confirm before administering tPA in suspected stroke patients?

Rule out hemorrhagic stroke via CT scan.

What assessment finding is concerning for patients receiving anticoagulant therapy?

Signs of bleeding, such as hematuria or unexplained bruising.

What complication should be anticipated following cardiomyopathy management?

Heart failure due to decreased cardiac output.

What laboratory monitoring aligns with post-ventilator weaning protocols?

Carbon dioxide levels, arterial blood gases, and oxygen saturation.

What lifestyle modifications can reduce the risk of stroke?

Blood pressure control, smoking cessation, and a healthy diet.

What is the anticipated outcome for patients with managed asthma?

Controlled symptoms without exacerbations.

What must be done if a patient's blood pressure is elevated during hypertensive emergencies?

Initiate IV antihypertensive therapy and monitor closely.

What does an abnormal GCS suggest?

Possible neurological impairment requiring immediate intervention.

What cues should be recognized in family education for patients with chronic respiratory diseases?

Understanding of medication usage, abstention from smoking, and recognizing exacerbation signs.

What is the leading cause of traumatic brain injury?

Falls or vehicular accidents.

What is typically elevated in response to myocardial injury?

Troponin levels.

Why are A1C levels significant in diabetes management?

Indicates long-term glycemic control.

What distinguishes type 1 and type 2 diabetes?

Type 1 is autoimmune destruction of beta cells; type 2 has insulin resistance.

What is a primary nursing intervention post-operative craniotomy?

Monitor neurological status and vital signs.

What intervention can alleviate back pressure in heart failure patients?

Elevating legs to reduce venous return.

What is a common presenting symptom of intracranial hemorrhage?

Severe headache or altered level of consciousness.

What is the purpose of administering vasopressors in shock management?

To elevate blood pressure and improve perfusion.

What immediate nursing action should be taken if a chest tube becomes dislodged?

Cover the area with sterile gauze to prevent pneumothorax.

What are the defining characteristics of mild asthma exacerbations?

Symptoms that can be controlled with rescue inhalers.