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134 Cards in this Set

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Degree of glucose intolerance at the onset of pregnancy occurs in:

a) 5% of all pregnancies

b) 7% of all pregnancies

c) 10% of all pregnancies

d) 15% of all pregnancies
7% of all pregnancies
Risk factors for gestational Diabetes are all of the following EXCEPT:

a) Markedly obese

b) Prior history of GDM

c) Glycosuria

d) Stong family history of DM
All are risk factors
Many women w/GDM progress over time to:

a) DKA

b) Type I

c) Type II
Type I & Type II
Metabolic Changes in Pregnancy that in crease risk for DM are:

a) changes in carbohydrate, protein, & fat metabolism

b) Increase in estrogen from beta cells

c) Increase in progesterone secretions from beta cells
Metabolic Changes in Pregnancy that in crease risk for DM are:

a) changes in carbohydrate, protein, & fat metabolism

b) Increase in estrogen from beta cells

c) Increase in progesterone secretions from beta cells
In the 1st trimester:

a) need for insulin inreases

b) need for insulin decreases
the need for insulin is decreased in the 1st trimester
N & V causes dietary changes increasing the incidence of:

a) hypoglycemia

b) macrovascular complications

c) microvascular complications

d) edema
N & V causes dietary changes that increase the incidence of:

a) hypoglycemia
In the 2nd trimester:

a) need for insulin increases

b) need for insulin decreased
need for insulin increases
By the end of pregnancy, insulin needs in women w/gestational diabetes may:

a) increase

b) decrease

c) double

d) quadruple
double or quadruple
The increased energy needed for labor may require:

a) decreased insulin to increase glucose

b) increase insulin to decrease glucose

c) increase insulin to balance IV glucose

d) decrease insulin to increase glycogen reserves
increase insulin to balance IV glucose
Maternal Complications with diabetes are:

a) pregnancy induced hypertension (PIH)
b) preeclampsia
c) polyhydramnios (Excess of amniotic fluid)
d) Cesarean section
e) Increased risk for developing DM in subsequent pregnancies
f) Increased risk for developing Type 2 DM
ALL are Maternal Complications
Fetal complications in gestational diabetes, most often those involving:

a) cardiovascular

b) central nervousnes system

c) skeletal systems

d) respiratory distress

e) stillbirth
ALL are risk to the fetus in gestational diabetes
Fetal exposure to ___________ in the 3rd trimester is associated w/ respiratory distress syndrome & _________ stillbirth?

a) hypoglycemia & still birth

b) hyperglycemia & stillbirth
hyperglycemia & stillbirth
A child exposed to fetal hyperglycemia is at risk for developing: ______, ______, _____, & ______ in childhood.
obesity, impaired glucose tolerance, and diabetes
With gestational diabetes, the primary goals in maternal care is:

a) achieve & maintain normal maternal glucose levels

b) prompt identification & management of complications associated w/diabetes & pregnancy
Both are correct
For the RN caring for a mother with diabetes, assessment includes:

a) History

b) Three “P’s”

c) Abdominal assessment (uterine size)

d) fetal well being, size & activity

e) ultrasound to determine gestational age
All are Correct
Teaching women w/gestational diabetes about diet includes:

a) 10-20% from complex carbohydrates distributed throughout day in 3 main meals w/2 to 4 snacks.

b) a) 20-30% from complex carbohydrates distributed throughout day in 3 main meals w/2 to 4 snacks.

c) 50-60% from complex carbohydrates distributed throughout day in 3 main meals w/2 to 4 snacks.
50-60% from complex carbohydrates distributed throughout day in 3 main meals w/2 to 4 snacks.
Teaching women w/gestational diabetes about diet includes:

a) less than 1/2 of meal should be complex carbs

b) no more than 1/4 of meal should be complex carbs

c) approximtely 1/3 of meal should be complex carbs

d) approximately 2/3 of meals should be complex carbs
approximately 2/3 of meal should be complex carbs
(50 - 60%)
Teaching women w/gestational diabetes about diet includes:

a) 2/3 of meal should be protein (+ 60%)

b) 50-60% carbs, 12-20% proteins, 20-30% fat

c) 2/3 plate carbs, 1/3 plate proteins, 1/3 plate fats

d) approximately 2/3 plate proteins, 1/3 plate carbs, 1/3 plate fats
50-60% carbs, 12-20% proteins, 20-30% fat

RULE OF THUMB:

2/3 carbs, 1/3 proteins, 1/3 fats
Teaching women w/gestational diabetes about diet includes:

a) 50 - 60% of daily diet is complex carbs w/ 2-4 snacks a day & bedtime snack

b) 50 - 60% of daily diet is complex carbs w/ 1-3 snacks a day & bedtime snack
50 - 60% of daily diet is complex carbs w/ 2-4 snacks a day & bedtime snack
The RN instructs pregnant women with gestational diabetes to:

a) have bedtime snack to prevent episode of hyperglycemia

b) have bedtime snack to prevent episodes of hypglycemia
have bedtime snack to prevent episode of hyperglycemia
The RN advices pregnant women with gestational diabetes to:

a) check blood glucose 1-2 times daily

b) check blood glucose 2-4 times daily

c) check blood glucose 4-6 times daily
check blood glucose 4-6 times daily
The RN advices pregnant women with gestational diabetes to:

a) check glucose 2hrs after meals

b) check glucose 2hrs before meals

c) check glucose before bedtime

d) check glucose before breakfast
check glucose 2hrs before meals

check glucose before bedtime

check glucose before breakfast
Which insulin is not recommeded in pregnancy:

a) NPH

b) Lantus
Lantus
Performing 15-20 minutes of armchair exercises daily can help pregnant woman reduce ________ hyperglycemia w/out increasing the risk of?
inducing uterine contraction
After delivery, the RN should observe the diabetic mother for:

__________

__________

__________

__________
hypoglycemia

infection

hemorrhage

BP changes
Patients with gestational diabetes:

a) may require increased insulin in the 1st 24 hrs

b) may require no insulin for the first 24 hours

c) may require decreased insulin in the 1st 24 hrs
may require no insulin for the first 24 hours or decreased to 1/4 to 1/2 insulin in 1st 24 hrs
Composition of breast milk or is not altered by diabetes?
Composition of breast milk is NOT altered by diabetes
Three groups of children who should be considered for possible DM are?

a) children w/glycosuria, polyuria

b) weight loss/failure to thrive

c) manifestations of metabolic acidosis
all are correct
Diagnosis of Type I Diabetes in children & adolescents is based on:

a) Serum Glucose levels: Fasting >70mg/dL/Random > 120 mg/dL

b) Serum Glucose levels: Fasting >126mg/dL/Random > 200 mg/dL
Serum Glucose levels: Fasting >126mg/dL/Random > 200 mg/dL
Clinical Manifestations of Type I diabetes are:

a) Polyphagia, polyuria, polydipsia
b) Wt. Loss & enuresis
c) Irritability
d) Short Attention Span
e) Fatigue, Hypoglycemia
f) Dry skin, Poor wound healing
g) Headache, Blurred vision
h) Deep rapid respirations
i) DKA
All are correct
Fill in the blanks to complete NDX for patient’s with Diabetes Mellitus

a) Risk for ______ related to hyperglycemia

b) Risk for injury r/t to ________ of needed _______

c) Altered _________ less than or more than body requirements_
a) injury

b) deficit/glucose

c) nutrition
Fill in the blanks to complete NDX for patient’s with Diabetes Mellitus

a) Risk for injury related to ____________

b) Altered health maintenance related to _________ deficit of proper ________ intake or proper insulin dosage or proper balance of diet and insulin dosage
a) hyperglycemia

b) knowledge/dietary
Fill in the blanks when it comes to nursing care of patients w/diabetes:

a) education of patient & _________

b) Meal ________

c) _________ blood glucose

d) Insulin ____________
a) parents

b) planning

c) monitoring

d) administration
Fill in the blanks when it comes to nursing care of patients w/diabetes:

a) Family ____________

b) ___________ considerations

c) diet & _________
a) support

b) developmental

c) exercise
Antepartal assessment of fetal well-being includes:

a) Non- _______ test

b) __________ for fetal maturity
a) stress

b) Amniocentesis
Things to consider with diabetic pregnancy are:

(1)______of fetal well-being, (2)daily _______, (3)______ signs, (4) ______ height, (5) _______ support.

b)
1 - assessment

2 - weight

3 - vital

4 - fundal

5 - emotional
After delivery, the RN should:

1) Observe for ____________ , infection, hemorrhage, BP changes

2) Monitor _________

3) Monitor blood ________

4) Encourage ___________
1) hypoglycemia

2) healing

3) glucose

4) breastfeeding
What are the 3 "P's" ?
Polyphagia

Polyuria

Polydipsia
Three groups of children who should be considered for possible DM:

1) Children w/glycosuria & _____
2) Weight _____/failure to _____

3) Manifestations of ________ acidosis
1) polyuria

2) loss/thrive

3) metabolic
Women who don’t have contraindicating medical or ________ complications should be encouraged to participate in ________ programs approved for _________.
obstetrical

exercise

pregnancy
Performing 15-20 minutes of ________ exercises daily can _____ a pregnant woman reduce __________ without increasing the risk of inducing uterine _________.
armchair

help

hyperglycemia

contraction
With Type I Diabetes it is recommended that a woman eats 50 - 60% complex ______ distributed throughout the day in ___ main meals, have ___ to ___ snacks & one _____ night.
carbs

3

2 - 4

snack
In caring for a patient with Gestation Diabetes, the primary goal of the RN is:

Achieve & maintain normal maternal __________ levels & promptly identify & ________ complications associated w/ ________ & pregnancy
glucose

manage

diabetes
Hyperglycemia exposure in the _____ trimester is associated with ________ distress syndrome & stillbirth, as well as a risk of ________, impaired glucose tolerance, & diabetes in childhood
third

respiratory

obesity
Fetuses exposed to __________ in the first trimester are at increased risk for ________ abortion & congenital anomalies, most often those involving the ______, central ________ system, & ________ systems
hyperglycemia

spontaneous

cardiovascular

nervous

skeletal
With gestational diabetes the developing fetus ________ glucose and _____ _____ from mom’s circulation
removes

amino acids
Glucose and amino acids are readily transported across the _______. _______ is not.
placenta

Insulin
Maternal hyperglycemia leads to fetal beta cells _________ and fetal _________.
hyperplasia

hyperinsulimia
Increased _______ needed for labor may _______ the need for insulin to balance IV _______.
energy

increase

glucose
After birth there may be an abrupt _______ in insulin requirement after passage of the _________.
decrease

placenta
In the 1st trimester the need for ________ is decreased.
insulin
Metabolic Changes in Pregnancy
include changes in ____________ , protein, and fat metabolism
carbohydrate
Metabolic Changes in Pregnancy
include a _______ in estrogen and ___________ secretions from beta cells causing Hyperplasia and hyperinsulinimia
increase

progesterone
Many women with GDM progress over time to ________ or type II DM
type I
The goal of Insulin Therapy is to mimic the pattern of normal _________ ________
insulin secretions
The goal of Insulin Therapy is to mimic the pattern of normal insulin secretions, therefore, _______ _______ is essential
Accurate monitoring
There are 4 types of insulin which are based on:

1- ________

2- ________

3- ________

4- ________
ONSET
how soon the insulin starts working

PEAK TIME
when it works the hardest

DURATION
how long it will last in the body
Short-acting Insulin has an onset of _____min after injection & peaks in ______hrs
Short acting Insulin, regular,(Humulin R)

Onset: 30 minutes/Peak 2-3hrs
Short-acting Insulin has a duration of _____hrs
Short acting insulin, regular,(Humulin R) has a duration of 4-6 hrs
Humulin R is a:

a) short acting insulin

b) intermediate acting insulin

c) long-acting insulin
short acting insulin
Intermediate acting insulin has an onset of ____hrs & peaks in _____hrs
Onset: 2 hours

Peak: 6-8 hours
Intermediate Insulin has a duration of _______hrs
duration: 12-16 hours
NPH, Lente, Humulin L or N, are all what type of insulins?
intermediate
Long-acting Insulins have an onset of _____hrs & peak in _____hrs
 Onset: 2 hours
 Peak: 10-16 hours
Long-acting Insulins have a duration of ______hrs
 Duration: 20-24 hours
Ultralente, Humulin U is what type of Insulin?
Long acting
Combination Insulin therapy is regular insulin plus a ________ ________ insulin
Regular plus longer acting insulin
Combination Insulin therapy provides meal time and _____ _____ coverage
base line
Name 3 delivery methods of Insulin:

1-
2-
3-
 SC
 Insulin pens
 Insulin pumps
 Nasal spray
Hyperatophy or atrophy of SC tissue at injection site is called?
 Lipodystrophy
Problems that occur with administration of insulin include ________ or atrophy of SC tissue at injection site & ____ insulin absorption
which are commonly associated w/_____ or _____beef or pork insulin in addition to allergic reaction, Somogyi Effect & Dawn Syndrome
Lipodystrophy -
hyperatophy or atrophy of SC tissue at injection site

Erratic insulin absorption

Commonly associated with beef or pork insulin, rarely Humulin insulin
Two types of an Allergic reaction with insulin are local reaction & ______ ______ reaction
 Local reaction
 True insulin reaction
Symptoms of a local reaction are 1)______ 2)______ 3)_____ which are self limiting, resolving in ___-___ months
Local reactions are:

Erythema

Itching

Burning around injection site

(Self-limiting/Resolving in 1-3 months)
Symptoms of a True insulin reaction are Urticaria, possible ___________ shock & usually caused by _______ insulin
Symptoms of a True insulin reaction are Systemic responses such as Urticaria & Possible anaphylactic shock usually caused by Animal insulin
Periods of hypoglycemia followed by hyperglycemia (Glucose drops below normal during the night) is a result of too much ____. A condition known as _______ _______.
Somogyi Effect is wide differences in early morning(low) and fasting (high) glucose levels (periods of hypoglycemia followed by hyperglycemia) as a result of too much Insulin.
 Glucose drops below normal during the night
 Too much insulin
Dawn Phenomenon is hyp______glycemia in the early AM caused by the release of _______ hormone.
Dawn Phenomenon is Hyperglycemia early AM caused by the release of growth hormone
The release of growth hormone influences _________.
insulin
Oral Insulin Medications are:

_______lureas

___litinides

___guanide

______lidinediones

Alpha-_______idase inhibitors
Oral Insulin Medications are:

Sulfonylureas
Meglitinides
Biguanide
Thiazolidinediones
Alpha-glucosidase inhibitors
Sulfonylureas is a oral medication for diabetes that stimulates the ______ to ______ insulin
pancrease

stimulate
Monitor Sulfonylureas for ___________ for which S&S are dizziness, weakness, sweating, pale skin, & vision problems.
hypoglycemia
Diabinese, Tolinase, Gluctrol, Glybride are oral medications classified as _______ylureas.
 Sulfonylureas
Meglitinides (Prandin) ________ the pancrease to secrete _______. rapid and short-lived
 Prandin
 Watch for signs of hypoglycemia
stimulate

insulin
Meglitinides such as Prandin are _______ & short-lived oral diabetic medications & the RN should watch for signs of ____________ in the patient
 Prandin
 Watch for signs of hypoglycemia
rapid

hypoglycemia
Biguanides, an oral diabetic medication such as __________ Glucophage, helps the body use ________ better & _______ decreases the rate of hepatic ________ production
Glucophage

insulin

glucose
The RN instructs the patient to take Glucophage ____ ____ if this med causes diarrhea & to notify HCP of _____ pain, fast _____, or unusual _____.
with food

muscle

breathing

sleepiness
Thiazolidinediones, an oral diabetic medication such as Rezulin, helps the body use _________ better & decreases peripheral insulin __________ in _________ muscle without stimulating insulin secretion.
insulin

resistance

skeletal
Thiazolidinediones, an oral diabetic medication such as Rezulin, helps the body ____ _________ better.
use insulin
Thiazolidinediones, an oral diabetic medication such as Rezulin, helps the body use insulin better & the RN will instruct the patient to notify HCP if experiencing __&__, abdominal pain, _____ of appetite, fatigue, _____-_____ urine (liver problems), or swelling in ____ or ____, & SOB (heart failure.)
N & V

loss

dark-colored

feet or ankles
Alpha-glucosidase inhibitors, oral dibetic medications such as Precose & Glyset, help the body _____ the rise of blood glucose ______ eating by slowing or blocking the breakdown of certain sugars & starches.
slow

after
Alpha-glucosidase inhibitors, oral diabetic medications such as Precose & Glyset, help the body slow the rise of blood glucose after eating by slowing or blocking the breakdown of certain _____ & _____. The RN advises the patient this drug may cause _____ & _____.
sugars & starches

diarrhea and gas
Alpha-glucosidase inhibitors, oral anti diabetic medication such as Precose & Glyset, slows the breakdown of _________ & _______ in small intestines & may cause _______ & gas.
disaccharides & polysaccharides

diarrhea
Things to consider w/oral antidiabetic meds are some meds may directly interact w/ sulfonylurease by potentiating a ________ &/or ________ effect .
hypoglycemic &/or hyperglycemic effect
Oral antidiabetic meds may be contraindicated in patients with ______ ______.
renal failure
Oral antidiabetic meds may be not be effective & the patient may have to go on _______ during stressful events.
injections
Oral agents are a part of the triangle of care consisting of ______, ______, & _______.
medicine, diet and exercise
Diabetic Ketoacidosis, DKA, is a diabetic _____ that develops _______or over several days & more common in Type ___ diabetes than in Type ___ diabetes.
coma

quickly

More common in Type 1
Diabetic Ketoacidosis, DKA, a diabetic coma, develops quickly or over several days, more common in Type 1 & occurs as a result of _______ treatment of existing diabetes such as not taking ______ __ ______, a change in _____ & _____ when demand for insulin cannot be met.
inadequate

insulin as prescribed

diet or exercise
Causes of Diabetic Ketoacidosis is too ______ insulin with increase in ________ calorie intake, physical or emotional ______, & ____________ diabetes.
little

calorie

stress

Undiagnosed
With a insufficient _______ supply glucose cannot be used by the cells for energy & stays in the blood resulting in elevated _____ ______ so the body converts stored ____ & _____ for energy producing ketones. Excessive ketones alters __ leading to acidosis.
insulin

blood sugar

fats & proteins

pH
Clinical Manifestations of Diabetic Ketoacidosis is ___ mouth, thirst, _______ pain, N & V, confusion, lethargy, ___ skin, rapid weak _____, labored breathing, fever, polyuria, _____ breath, serum glucose greater >than _____, glucosuria & ketonuria
dry

abdominal

dry

pulse

fruity

300 mg/dL
Four treatment goals for Diabetic Ketoacidosis are

1._________
2._________
3._________
4._________
 Dehydration
 Electrolyte loss
 Acidosis
 Prevention
Initial Nursing Treatment for a patient w/Diabetic Ketoacidosis is to insure ______, supply _____, using a ___-______ mask or cannula, obtain an _____access w/a large bore _______ using NS at 1L/hour until _______ output is 60 mL/hr & set IV insulin for 0.1U/kg/hr.
Airway

02

Non-rebreather

IV

catheter

urinary
Initial Nursing Treatment for a patient w/Diabetic Ketoacidosis includes identifying vital history such as time of last _____ & time & amount of last _______ _________
food

insulin injection
Ongoing nursing management of Diabetic Ketoacidosis includes ongoing monitoring of the patients:

____ signs, LOC, ______ rhythm, ___ Saturation, _____ output, ________ sounds, ______ overload, crackles.
vital

Cardiac

02

urinary

breath

fluid
After initial interventions for patients with diabetic ketoacidosis the RN should monitor serum _______ & serum _______ & anticipate possible administration of ______ _______ for severe acidosis. (ph<7.0)
glucose

potassium

sodium bicarb
Hyperglycemia Hyperosmolar Nonketotic syndrome is similar to DKA & occurs primarily in ______ diabetics.
Type II
With Hyperglycemia Hyperosmolar Nonketotic syndrome _____ breakdown (Lipolysis) does not occur.
 Frequently seen in the elderly
 Usually traced to some precipitating event
fat
In Hyperglycemia Hyperosmolar Nonketotic syndrome, the breakdown of fat(Lipolysis) does not occur and is seen most frequently in the ________
 Usually traced to some precipitating event
elderly
In Hyperglycemia Hyperosmolar Nonketotic syndrome, the breakdown of fat(Lipolysis) does not occur, is seen most frequently in the elderly & is usually traced to a _________ _____.
precipitating event
Clinical Manifestations of Hyperglycemia Hyperosmolar Nonketotic syndrome are _______tension, Hypotension, profound ________dehydration, tachycardia, variable neurologic signs, a history of inadequate _______ intake, increasing ________ & poly___.
Hypotension

dehydration

fluid

depression

polyuria
HHNK constitutes a ____________ ____________.
medical emergency
Initial HHNK Nursing Management is to administer ______ acting insulin (regular), administer IV fluids of _____L in 1st __-__ hrs depending on degree of ____________ & 0.9% or 0.45% ________ chloride, _________ replacement, & assessment of ________ status
 I & O
rapid

6-20 Liters

24-48 hours

dehydration

Sodium

electrolyte

mental
In addition to Initial HHNK Nursing Management which includes administering rapid acting insulin, IV fluids of 6-20L in 1st 24-48 hrs depending on degree of dehydration & 0.9% or 0.45% sodium chloride, electrolyte replacement, & assesses the patients mental status, the RN also assesses I & O's, ____ ____ levels, blood & urine for _______, & EKG monitoring.
blood glucose

ketones
Management of DKA and HHNK are similar except HHNK needs a greater _________ replacement.
fluid
NCLEX
Hypovolemic shock is best characterized by which of the following:

a) rapaid vasodilation and subsequent pooling of blood within the peripheral vessels

b) occurs when pump failure causes inadequate tissue perfusion

c) reaction to bacterial toxins which cause leakage of plasma into the tissues

d) occurs when there is a loss of fluid resulting in inadequate tissue perfusion

e) an allergic reaction that causes a release of histamine and subsequent vasodilation
Hypovolemic shock occurs when there is a loss of fluid resulting in inadequate tissue perfusion
NCLEX
Identify initial hypovolemic shock:

a) He appears restless and lethargic. His skin is cool, moist, and cyanotic. His respirations are labored & you can hear fine crackles. His blood pressure is low, pulse rapid, and arrhythmia is detected.

b)She complains of fever, chills, weakness, N & V with diarrhea. She is alert and oriented, flushed, and warm to the touch. Her blood pressure is pretty normal but could be progressing towards hypotension, and her pulse is rapid. She is breathing fast and deep.

c) He presents as alert & oriented, he is a little pale, hands and feet are cool to the touch, and he is thirsty. His respirations are within normal, capillary refill is decreased, and his blood pressure has decreased slightly. His pulse may be a little increased from baseline but other than that he seems stable.

d) She is restless and lethargic. She appears swollen around the lips & eyes, her skin is warm to the touch and she is itching. She is wheezing, her blood pressure is low, and her pulse is irregular and increasing. She has vomited, is experiencing diarrhea, and complains of abdominal cramps.

e) She is restless and lethargic. She did feel warm to the touch at first but has become a little cooler. Her body temperature is decreased and her blood pressure is low. Her respirations vary and her pulse is slow and bounding.
c) He presents as alert & oriented, he is a little pale, hands and feet are cool to the touch, and he is thirsty. His respirations are within normal, capillary refill is decreased, and his blood pressure has decreased slightly. His pulse may be a little increased from baseline but other than that he seems stable.
NCLEX
Planning & implementation for patients experiencing shock are all of the following except:

a) keep client warm and place in supine position

b) monitor hemodynamic status and vital signs

c) allay patients anxiety

d) administer intravenous fluids as ordered

e) monitor oxygen saturation and provide oxygen therapy as indicated

f) elevation of lower extremities to ensure circulation to vital organs.

g) vasoconstricting drugs to increase blood pressure
All of these are correct nursing interventions!
Lewis p.1796
Relative hypovolemia is characterized by which two (2)of the following:

a) loss of whole blood such as from a hemmorhage from trauma, surgery, GI bleeding

b) masive vasodilation

c) loss of body fluids through vomiting, diarrhea, diuresis, diaphoresis, diabetes insipidus or mellitus, loss of plasma as seen with burns

d) pooling of blood or fluids as seen in acites, peritonitis, and bowel obstruction
b) masive vasodilation

d) pooling of blood or fluids as seen in acites, peritonitis, and bowel obstruction
Lewis p.1796
Absolute hypovolemia is characterized by which two (2)of the following:

a) loss of whole blood such as from a hemmorhage from trauma, surgery, GI bleeding

b) masive vasodilation

c) loss of body fluids through vomiting, diarrhea, diuresis, diaphoresis, diabetes insipidus or mellitus, loss of plasma as seen with burns

d) pooling of blood or fluids as seen in acites, peritonitis, and bowel obstruction
a) loss of whole blood such as from a hemmorhage from trauma, surgery, GI bleeding

c) loss of body fluids through vomiting, diarrhea, diuresis, diaphoresis, diabetes insipidus or mellitus, loss of plasma as seen with burns
NCLEX
Identify cardiogenic shock:

a) He appears restless and lethargic. His skin is cool, moist, and cyanotic. His respirations are labored & you can hear fine crackles. His blood pressure is low, pulse rapid, and arrhythmia is detected.

b)She complains of fever, chills, weakness, N & V with diarrhea. She is alert and oriented, flushed, and warm to the touch. Her blood pressure is pretty normal but could be progressing towards hypotension, and her pulse is rapid. She is breathing fast and deep.

c) He presents as alert & oriented, he is a little pale, hands and feet are cool to the touch, and he is thirsty. His respirations are within normal, capillary refill is decreased, and his blood pressure has decreased slightly. His pulse may be a little increased from baseline but other than that he seems stable.

d) She is restless and lethargic. She appears swollen around the lips & eyes, her skin is warm to the touch and she is itching. She is wheezing, her blood pressure is low, and her pulse is irregular and increasing. She has vomited, is experiencing diarrhea, and complains of abdominal cramps.

e) She is restless and lethargic. She did feel warm to the touch at first but has become a little cooler. Her body temperature is decreased and her blood pressure is low. Her respirations vary and her pulse is slow and bounding.
a) He appears restless and lethargic. His skin is cool, moist, and cyanotic. His respirations are labored & you can hear fine crackles. His blood pressure is low, pulse rapid, and arrhythmia is detected.

other ans:
b) early septic shock

c) initial hypovolemic shock

d) anaphylactic shock

e) neurogenic shock
A patient who is experiencing a sudden onset of chest pain, hypotension, swelling of the lips and tongue, wheezing, and stidor, with flushing, pruritis, uticaria, angiodema and feel a sense of impending doom is characteristic of:

a) hypovolemic shock

b) cardiogenic shock

c) septic shock

d) neurogenic shock

e) anaphylactic shock
anaphylactic shock
NCLEX
Identify early septic shock:

a) He appears restless and lethargic. His skin is cool, moist, and cyanotic. His respirations are labored & you can hear fine crackles. His blood pressure is low, pulse rapid, and arrhythmia is detected.

b)She complains of fever, chills, weakness, N & V with diarrhea. She is alert and oriented, flushed, and warm to the touch. Her blood pressure is pretty normal but could be progressing towards hypotension, and her pulse is rapid. She is breathing fast and deep.

c) He presents as alert & oriented, he is a little pale, hands and feet are cool to the touch, and he is thirsty. His respirations are within normal, capillary refill is decreased, and his blood pressure has decreased slightly. His pulse may be a little increased from baseline but other than that he seems stable.

d) She is restless and lethargic. She appears swollen around the lips & eyes, her skin is warm to the touch and she is itching. She is wheezing, her blood pressure is low, and her pulse is irregular and increasing. She has vomited, is experiencing diarrhea, and complains of abdominal cramps.

e) She is restless and lethargic. She did feel warm to the touch at first but has become a little cooler. Her body temperature is decreased and her blood pressure is low. Her respirations vary and her pulse is slow and bounding.
b)She complains of fever, chills, weakness, N & V with diarrhea. She is alert and oriented, flushed, and warm to the touch. Her blood pressure is pretty normal but could be progressing towards hypotension, and her pulse is rapid. She is breathing fast and deep.
NCLEX
Identify neurogenic shock:

a) He appears restless and lethargic. His skin is cool, moist, and cyanotic. His respirations are labored & you can hear fine crackles. His blood pressure is low, pulse rapid, and arrhythmia is detected.

b)She complains of fever, chills, weakness, N & V with diarrhea. She is alert and oriented, flushed, and warm to the touch. Her blood pressure is pretty normal but could be progressing towards hypotension, and her pulse is rapid. She is breathing fast and deep.

c) He presents as alert & oriented, he is a little pale, hands and feet are cool to the touch, and he is thirsty. His respirations are within normal, capillary refill is decreased, and his blood pressure has decreased slightly. His pulse may be a little increased from baseline but other than that he seems stable.

d) She is restless and lethargic. She appears swollen around the lips & eyes, her skin is warm to the touch and she is itching. She is wheezing, her blood pressure is low, and her pulse is irregular and increasing. She has vomited, is experiencing diarrhea, and complains of abdominal cramps.

e) She is restless and lethargic. She did feel warm to the touch at first but has become a little cooler. Her body temperature is decreased and her blood pressure is low. Her respirations vary and her pulse is slow and bounding.
e) She is restless and lethargic. She did feel warm to the touch at first but has become a little cooler. Her body temperature is decreased and her blood pressure is low. Her respirations vary and her pulse is slow and bounding.
NCLEX
Identify anaphylactic shock:

a) He appears restless and lethargic. His skin is cool, moist, and cyanotic. His respirations are labored & you can hear fine crackles. His blood pressure is low, pulse rapid, and arrhythmia is detected.

b)She complains of fever, chills, weakness, N & V with diarrhea. She is alert and oriented, flushed, and warm to the touch. Her blood pressure is pretty normal but could be progressing towards hypotension, and her pulse is rapid. She is breathing fast and deep.

c) He presents as alert & oriented, he is a little pale, hands and feet are cool to the touch, and he is thirsty. His respirations are within normal, capillary refill is decreased, and his blood pressure has decreased slightly. His pulse may be a little increased from baseline but other than that he seems stable.

d) She is restless and lethargic. She appears swollen around the lips & eyes, her skin is warm to the touch and she is itching. She is wheezing, her blood pressure is low, and her pulse is irregular and increasing. She has vomited, is experiencing diarrhea, and complains of abdominal cramps.

e) She is restless and lethargic. She did feel warm to the touch at first but has become a little cooler. Her body temperature is decreased and her blood pressure is low. Her respirations vary and her pulse is slow and bounding.
d) She is restless and lethargic. She appears swollen around the lips & eyes, her skin is warm to the touch and she is itching. She is wheezing, her blood pressure is low, and her pulse is irregular and increasing. She has vomited, is experiencing diarrhea, and complains of abdominal cramps
Anemia is a deficiency in the number of ___, the quantity of ___, &/or the volume of ___:

1. _____
2. _____
3. _____
1.erythrocytes (RBC's)

2.hemoglobin

3. packed RBC's (hematocrit)
Erythrocyte disorders can lead to tissue?
hypoxia

RBC's transport 02
The normal hemoglobin (Hgb)range for females is:

a) 8-16g/dl
b) 10-16g/dl
c) 12-16g/dl
d) 14-16g/dl
c) 12-16g/dl
The normal reduced volume of packed RBC's (Hct) for females:

a) 37-47%
b) 37-57%
c) 37-67%
a) 37-47%
The normal range for hemoglobin in males is:

a) 13.5 - 15.5g/dl
b) 13.5 - 16.5g/dl
c) 13.5 - 17.5g/dl
d) 13.5 - 18.5g/dl
c) 13.5 - 17.5g/dl
The normal range of packed RBC's (Hct) in males is:

a) 40-44%
b) 40-54%
c) 40-64%
b) 40-54%
Morphologic classification is based on descriptive, objective laboratory information about:

a) the number of erythrocytes
b) the quantity of hemoglobin
c) erythrocyte size & color
d) etiology
c) erythrocyte size & color
The most accurate means of classifying anemia is:

a) etip;ogy
b) morphology
b) morphology

morphology = cellular characteristics

etiology = underlying cause
A female patient with an Hct of 36.5 & Hgb of 11.2 is:

a) within normal range
b) anemic
b) anemic

Normal Hct/females = 37-47%
Normal Hgb/females = 12-16g/dl
A male patient with an Hct of 42 & Hgb of 16.5 is:

a) within normal range
b) anemic
a) within normal range

Norm Hct/males= 40-54%
Norm Hgb/males= 13.5-17.5g/dl