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92 Cards in this Set

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The mid stream specimen is collected for culture & sensitivity b/c:
1. urine has more bacteria
2. initital stream flushes urethral orifice & meatus of any resident bacteria
3. gives client more time to be prepared to collect sample
4. the initial stream flushes the cleansing agent away from the meatus
2-the initital stream flushes urethral orifice & meatus of any resident bacteria
How much urnie is needed for a culture & sensitivity specimen?
30-60 ml
When obtaining a timed urine collection the nursediscards the _______urine specimen.
first
A sterile urine specimen from an indwelling catheter is obtained from:
The sterile self-sealing specimen port on the catheter
Which of the following is not necessary to observe and document when obtaining urine form an indwelling catheter?
1. characteristic of urine
2. patency of the urinary drainage system
3. patient discomfort
4. total output
total output
Glucose present in the urine may be indicative of:
diabetes
A _________ ________ specimen is used for testing urine for glucose.
double voided
Which foods can alter the results of a stool for occult blood?
tomatoes & red meat
When obtaining a nasal or throat collection, it is preferred to have the client:
sitting upright or at a 45-degree angle
When obtaining a throat culture, the nurse should swab the:
Tonsillar area
The ampule at the end of the culture tube should be:
crushed
When obtaining a urethral discharge culture, the genital area for both m/f clients should be observed for:
redness, swelling, and discharge
How long is it necessary to wait after a meal before collecting a sputum specimen?
1-2 hours
When obtaining a wound culture sample the nurse should collect the sample from:
new drainage (exudate)
Aerobic organisms commonly grow in:
superficial wounds exposed to the air
Skin puncture sites for obtaining a glucose level are:
sides of the fingers, toes, heels
Diagnostic data helps to evaluate the success or failure of both...
nursing and medical interventions
What are reasons for urine specimen collection?
-gives us data that can tell us about our client's health
-means to assess for abnormalities

-method to evaluate treatment
Fluids in the cell are called ___________ & fluids outside the cell are____________.
Intracellular

Extracellular
Extracellular fluids are found __________ the cells, accounts for __/__ of total body fluid, & is subdivided into intra_______ & inter_______.
outside

1/3

intravascular & interstitial
Extracellular fluids are _____ the cells, account for __/__ of total body _____, & is comprised of __________ & ___________ fluid.
outside

1/3

fluid

intravascular & interstitial fluid
Intravascular fluid, also known as _________, is formed within the _______ system. The body contains _____ liters of intravascular fluid.
plasma

vascular

3 liters
Extracellular fluid that is in between cells is called __________ fluid that bathes cells & includes ________.
interstitial fluid

lymph
Intracellular fluids are found _______ the cells of the body & accounts for aprx. __/__ of the total body fluids.
within

2/3
Fluid loss we cannot see such as that from sweat or vapors from exhalation is called ________ fluid loss. Examples of sensible fluid loss are?
Insensible

would occur with 45 breaths per minute & presents "Risk" for fluid vol deficit)


Sensible fluid loss is seen it from the Kidneys (urine), & intestinal tract, skin, vomit
Examples of Insensible fluid loss ?

Examples of sensible fluid loss ?
Insensible fluid loss
Insensible fluid loss would occur with 45 breaths per minute & presents "Risk" for fluid vol deficit)

Sensible
We can see it in Kidneys, intestinal tract, skin, vomit
A patient with a fever presents what type of fluid loss?

A fever increases sweat, heart rate, and respirations.
Insensible fluid loss

A fever increases sweat, heart rate, and respirations.
A high respiration rate would present "Risk" for fluid vol deficit)
Name some abnormal fluid losses in a patient:

__________
__________
__________
__________
Fever
Severe burns
Hemorrhage
Emesis
Fistulas
Secretions
Wound exudate
Diaphoresis
Heart Problems
When assessing I & O's the general Rule is:

"The patients input should ____________ their output"

in addition to:

"The less ____ the less ____"
approximate

The less VOLUME the less PRESSURE
A normal intake & output of fluids in an adult is:
____-____cc.
200-300cc
______ have the highest proportion of water accounting for 70 - 80% of total body weight & the proportion of body water _______ with age.
Infants

decreases
In infants, most of the body fluid is contained in _______. Infants are prone to __________ & their kidneys are ________.
Extracellular fluid
(which is intravascular & interstitial fluid)

dehydration

immature
With people 60 years old+ the proportion of body water _______ approximately ___%. Fat tissue has ____ water than lean tissue.
decreases

50%

less
Because body fluids decrease with age, special considerations with the elderly are: (name some issues here:)
Kidneys (Fxn slows)
Heart (doesnt pump as fast)
Thirst Mechanism (low)
Bladder control (decreases)
Decrease in Aldosterone
Decrease in gastric juices
Decrease in Calcium absorption
Our daily fluid intake should equal __/__ of our body weight in ounces.
1/2
When you think "Aldosterone" think _________.
Na+
A decrease in aldosterone changes _______ level.
sodium
Sodium (Na+)
Potassium (K+)
Calcium (Ca++)
Magnesium (Mg++)
Chloride (Cl-)
Phosphate (HPO4--)

These are all Electrolytes that acquire an _________ _________
electrical charge
Na+, Ca++, & Cl- are intracellular or extracellular fluids?


K+, Mg++, & PO4-- are intracellular or extracellular?
extracellular

intracellular
Which of the following electrolytes are extracellular?

Na+
K+
Ca++
Mg++
Cl-
PO4--
Extracellular:
eXtra NCC!

Na+
Ca++
Cl-
Serum Electrolytes, Serum Osmolarity, Urine Osmolarity, Urine Specific gravity, & Arterial blood gasses are all names of ____ used in laboratory measurements.
tests
When kidney function is down K+ goes ____?
up
Normal lab values for extracellular electolytes:

Na+ ____

Ca++____

Cl- ____
Na+ 135-145

Cl- 96-106

Ca++ 8.5-10
Normal lab values for intracellular electolytes:

K+ ____

Mg ____

PO2 ____
K+ 3.5-5.0

Mg 1.5-2.5

PO2 2.7-4.5
Insulin, Parathyroid Hormone (PTH), Calcitonin, Urine, feces, sweat, & Aldosterone are _______ that regulate ______ ______.
Hormones

body fluids
During periods of moderate activity at moderate temps the avg adult drinks about _____mL per day but needs ____mL per day.
1500

2500
The heart is affected when ______ is high.
K+
When urine excretion decreases ___ & ___ go up.

Are they in extracellular fluid or intracellular?
Mg & K+

intracellular
Too much ___ in blood causes the cells to ________.
Na+

swell
Everyone who goes into the hospital has a potential _________ _________.
electrolyte imbalance
If a patient is on Digoxin the RN will be concerned with the _____ level.
K+
When you drink a gallon of water your urine becomes ______ & specific gravity goes ____ therefore ___ will be low.
dilute

down

Na+
What electrolyte, when high, relaxes the smooth muscles?

Is it in extracellular fluid or intracellular?
Mg

intracellular
What electrolyte causes vasodilation when values are high?

Is it in extracellular fluid or intracellular?
Mg

intracellular
Concentrated urine is high in ______.

Is it in extracellular fluid or intracellular?
Na+

extracellular
If a patient looses 1lb they lost ____ mL's of fluid. Therefore if a patient gains 2lb's they gain ___ in fluid.
500 mL's

1000mL's
If a patient has fluid volume excess their pulse will be?

a) full & bounding

b) weak & threading
full & bounding
You see furrows in a patients tongue & suspect fluid volume _________.
deficit
What electrolyte causes a neurological/sedative effect?
Mg
Normal Values of Na+ are __-___ & assists with generation & transmission of _____ _____ & an important part of the ___-___ pump.
135-145 mEq/L

nerve impulses

Na-K+
When ___ is out of balance, think neurological/brain problems.
Na+
Excess Na+ is secreted by kidneys & when you excrete Na you save ___.
K+
Where water goes ... so doth ___!
Na+
With the Renin-angiotension System ECF is ____ . Renin is produced by the ______. Angiotensin I is converted to ____________ & Aldosterone is secreted. Therefore, Na+ & water are ________ & the Vascular vol goes ___.
decreased

kidneys

Angiotensin II

retained

up
More water than Na+ causes _________.
Hyponatremia
Vomiting, sweating & only drinking water, D5W, & burns can cause a fluid imbalance called _____________.
Hyponatremia
If a patient urine output increases, has a decreased Specific gravity, experiences Nausea, abdominal cramps, headache, dry mucous membranes the RN will suspect _____________.
Hyponatremia
Treatment for hyponatremia is to replace ____. This should be replaced very, very slowly because it hits the _____ cells, cells swell & the swelling increases pressure in the ______.
Na+

brain

brain
When you think Na+.....
think ________.
neuro
If your patient presents changes in LOC check their _____ balance.
Na+
Sugar _______ thirst.
decreases
For every 1 glass of a sports drink you should have ___ glasses of water!
2
Sports drinks cause ________.
dehydration
With heat exhaustion urine output ________, & Specific gravity ______, in addition to nausea, abdominal cramps, headache, & dry mucous membranes which are S&S of high ____ vol & low ___ a condition called ____________.
increases

decreases

water

Na+

Hyponatremia
Hyperventilation, heat stroke, decrease in fluid intake; use of corticosteroids are all causes of Dehydration also known as __________. The Rn will restrict ___, give fluids _____, & check daily _____ in addition to I & O's.
Hypernatremia

Na+

slowly

weight
Signs & Symptoms of Hypernatremia is S A L T !

S = skin flushed
A = agitation
(tremors, weakness,
restless, change in LOC)
L = low grade fever
T = thirst (dry mouth,
swollen tongue)
Treatment is:
Treatment:

Restrict Na, give fluids slowly, daily weights, I & O's
Low fluid volume = ____ blood pressure which is a sign of __________, a condition called ___________.
low

dehydration

Hypernatremia
High fluid volume = ____ blood pressure which is a sign of _____________.
high

Hyponatremia
When K+ is out of balance think ________ & think _________.

K+ is extracellular or intracellular?
think muscles

heart (smooth muscle)

intracellular
Proper function of skeletal & cardiac muscle, & transmission of nerve impulses are under the influence of ____.
K+
An RN ask a patient who is low in K+ if they are on _______.
Diuretics (Lasix)
A RN should perform a _______ check before giving Na+.
neuro
K+ is secreted only by the ________ but levels of K+ are decreased with NG tube _______.
kidneys

suctioning
(Irrigation w/tap water would increase the loss of K+)
The ONLY way to get rid of excess K+ is through the ________.
kidneys
When kidney function stops ___ goes up/
K+
With corticosteroids Na+ goes ___ & K+ goes ___.
up

down
Hypokalemia is low ___ levels.
K+
S = skeletal muscle weakness
U = U wave changes (EKG chngs)
C = Constipation
T = Toxicity of digitalis
I = irregular & weak pulse
O = Orthostatic hypotension
N = numbness
Are signs of ______________.
Hypokalemia
The physician orders Lasix so the RN expects to give the patient ___.
K+
Treatment for hypokalemia is to administer ___ on a pump & never never by an IV push at ___mEq/L in ______cc IV fluid.
K+

20mEq/L

1000cc
Kidney troubles, Aldosterone secretion, & excessive intake (blood transfusions) are causes of ________________.
Hyperkalemia
Potassium is hard on ________, should be taken after _________, & should not be _________.
veins

eating

crushed