Remediation Comprehensive Final

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Bucks County Community College *

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105

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Health Science

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Apr 3, 2024

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docx

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Remediation Comprehensive Final Med Surg Learning Activity:  Acute Kidney Injury and Chronic Kidney Disease 1. Define the following terms: Azotemia- high level nitrogen containing compounds in the blood such as urea and creatinine, oliguria- (Low urine output) urine output is 100 to 400ml/24 hr, anuria- No urine output, and nephrotoxin- toxin agents that destroys the kidney cells and tissues (cytotoxin). 2. What are some potentially nephrotoxic substances? Control protein intake, restrict sodium, potassium, phosphorous and magnesium, restrict fluids. 3. What are dietary recommendations for clients in renal failure? Daily protein- 0.8-1.0g/kg, meat 4-6oz/day, dairy intake half cup, caloric intake 35 kcal/kg Fundamentals Learning Activity:  Enteral Feeding 1. A nurse is caring for a client who has suspected dumping syndrome. Describe dumping syndrome and interventions to avoid. Dumping syndrome occurs due to rapid emptying of gastric contents from stomach to small intestines. Rapid rate of enteral tube feeding infusion is a potential cause. Eating smaller meals or slowing infusion rate of feedings can be helpful. 2. A nurse is caring for a client who is receiving enteral feedings. How much residual is too much? What actions should the nurse take if too much residual is noted? Gastric residual exceeds 100ml hold the feeding. If residual is more than volume of previous feeding or providers identified volume, hold feeding and follow institution policy or provider orders. Med Surg Learning Activity:  Shock 1. What are the classic signs of shock? Hypotension (arterial pressure <60), weak thread pulse, hypoxia, tachycardia. 2. A nurse is caring for a client who is experiencing anaphylactic shock. What medications should the nurse anticipate administering? Antihistamines, epinephrine, corticosteroids: hydrocortisone, methylprednisolone Pharmacology Learning Activity:  Blood Products 1. What are the indications for giving a client whole blood? Replacement therapy for acute blood loss secondary to traumatic injuries or surgical procedures. Volume expansion in clients with extensive burn injury, dehydration, or shock. 2. A nurse is administering blood to a client with heart failure. Which of the following signs and symptoms should the nurse observe for regarding fluid overload? Cough, SOB, crackles, hypertension, tachycardia, distended neck veins.
Pharmacology Learning Activity:  Endocrine Pharmacology 1. A nurse is providing teaching to a client who has hypothyroidism and is starting levothyroxine. What should the nurse include in the teaching? Monitor prothrombin time and international normalized ration when on warfarin, levothyroxine can increase anticoagulant effects, do not discontinue this meds even if you feel better this is a lifelong replacement therapy. 2. A nurse in an acute care unit is caring for a client who has Addison’s disease. What medication should the nurse expect to administer? What are appropriate nursing actions for this client? Hydrocortisone is administered to patient with Addison disease. Monitor weight, blood pressure, and electrolyte (sodium, potassium), instruct client to notify the provider of symptoms of increased adrenal insufficiencies (fever, muscle and joint pain, fatigue and weakness), take it with calcium and vitamin D due to increased risk of osteoporosis, avoid contact with people who have a cold or communicable disease, monitor sign of infection. Maternal Newborn Learning Activity:  Contraceptives 1. A nurse is caring for a client in a health department for contraception. The client asks for an intrauterine device (IUD). Which of the following would make an IUD a poor choice for this client? A. The client is 35 years of age. B. The client has mild hypertension. C. The client has never been pregnant. D. The client has a history of thromboembolic disease. 2. A nurse is caring for a client who reports wanting use a “fertility awareness method” of birth control. Which of the following would help the client determine when she is ovulating? (Select all that apply.) A. Client’s breasts will be sensitive to cool air. B. Client will experience slight elevation of body temperature. C. Client may experience breakthrough bleeding. D. Client’s cervical mucus is thin and watery. E. Client may feel mild abdominal cramping. 3. The diaphragm is a safe form of barrier contraception. A diaphragm would most likely be contraindicated in which of the following? A. A client who has a history of miscarriages B. A client who is older than 40 years of age C. A client who has irregular periods D. A client who has a history of frequent urinary tract infections
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