Med Surg Unit 2 Pretest

Front 1

The random movement of particles in all directions

Back 1

Diffusion

Front 2

The natural tendency is for a substance to move from an area of _____ concentration to an area of _____ concentration.

Back 2

Higher; lower

Front 3

One example is the movement of ______ from the alveoli to the pulmonary capillaries

Back 3

Oxygen

Front 4

The concentration of oxygen in the alveoli is ______ than in the capillaries; therefore oxygen diffuses unto the capillaries and is transported through the _______ to other parts of the body

Back 4

Greater; bloodstream

Front 5

_____ is when a carrier protein transports the molecule through membranes toward an area of lower concentration. This process does not require ______.

Back 5

Facilitated diffusion; energy

Front 6

An increase in body of water

Back 6

Fluid overload

Front 7

Two types of excess fluid volume

Back 7

Extracellular and intracellular

Front 8

Extracellular fluid excess

Back 8

Isotonic

Front 9

Intracellular fluid excess

Back 9

Hypotonic

Front 10

Excess fluid volume may result from ______ and ______ failure with retention of fluid, increased ADH production, overload with isotonic IV fluids, or administration of D5W after surgery or trauma

Back 10

Renal and cardiac

Front 11

The body attempts to compensate for excess fluid volume by __ the filtration and excretion of sodium and water by the kidneys and decreasing the production of ___

Back 11

Increasing; ADH

Front 12

The severity of the __ in excess fluid volume depends on how quickly the condition develops

Back 12

Symptoms

Front 13

Severe excess fluid volume can cause or aggravate __ and __

Back 13

Heart failure and pulmonary edema

Front 14

Occurs when the body retains too much hydrogen ions or loses too many bicarbonate ions with

Back 14

Metabolic acidosis

Front 15

With too much acid and too little base the ph of blood

Back 15

Falls

Front 16

When the ph falls it leads to __ because the lungs try to compensate by blowing off co2 and lowering paco2 levels which __ the ph.

Back 16

Hyperventilation; raises

Front 17

Starvation, dehydration, diarrhea, shock, renal failure & diabetic ketoacidosis cause what?

Back 17

Metabolic acidosis

Front 18

Changing levels of consciousness, headache, vomiting, diarrhea, anorexia, muscle weakness and cardiac dysrhythmias are signs & symptoms of what?

Back 18

Metabolic acidosis

Front 19

Assessment of the patient in metabolic acidosis should focus on?

Back 19

Vital signs, mental status, and neurological status

Front 20

Substances from an area of lower concentration to an area of equal or greater concentration

Back 20

Active transport

Front 21

The transfer of water and solutes through a membrane from an area of high pressure to an area of low pressure

Back 21

Filtration

Front 22

Movement across a membrane from a less concentration to a more concentration solution

Back 22

Osmosis

Front 23

When electrolytes are broken down in water they become

Back 23

Ions

Front 24

Positively charged ions

Back 24

Cation

Front 25

Negatively charged ions

Back 25

Anion

Front 26

Sodium, potassium, calcium and magnesium are all

Back 26

Cations

Front 27

Chloride, bicarbonate, and phosphate are all

Back 27

Anions

Front 28

The concentration of a solution by number of dissolved particles per kg of water

Back 28

Osmolality

Front 29

Controls water movement and distribution by regulating the concentration of fluid in each body fluid compartment

Back 29

Osmolality

Front 30

Check the patients urine output before administering

Back 30

Potassium

Front 31

Urine output should be no less than

Back 31

30 ml/hr

Front 32

__ is always diluted before administration and is never given IV push.

Back 32

Potassium

Front 33

Rapid infusion of potassium can cause

Back 33

Cardiac arrest

Front 34

Patients with decreased renal function, people in metabolic acidosis and people taking potassium supplements are at risk for this

Back 34

Hyperkalemia

Front 35

What drug promotes excretion of excess potassium through the intestinal tract?

Back 35

Kayexalate

Front 36

Earliest sign of fluid deficit in older adults

Back 36

Constipation

Front 37

An __ hematocrit is seen with deficient fluid volume and dehydration because blood is more concentrated

Back 37

Increased

Front 38

__ is consistent with excess fluid volume because of dilution

Back 38

Low hematocrit

Front 39

Normal range for hematocrit

Back 39

Men- 40-54%

Women- 38-47%

Front 40

Older adults often have a reduced sense of __ and therefor may be in a state of chronic __.

Back 40

thirst; dehydration

Front 41

Fluid requirements for ages 55 to 65

Back 41

30 ml/kg

Front 42

Fluid requirements for ages 65 and older

Back 42

25 ml/kg

Front 43

Pulse, respirations, temperature and blood pressure can indicate changes in?

Back 43

Fluid and electrolyte imbalance

Front 44

Urine characteristics also give clues to?

Back 44

Fluid balance

Front 45

Darker, concentrated urine indicates the kidneys are?

Back 45

Retaining water

Front 46

Dry, flushed skin indicates

Back 46

Dehydration

Front 47

Pale, cool, clammy skin indicates

Back 47

severe fluid volume deficit that occurs with shock

Front 48

soft eyeballs and sunken eyes indicate

Back 48

severely deficient fluid volume

Front 49

puffy eyelids and fuller cheeks suggest

Back 49

excess fluid volume

Front 50

measured by pinching the skin over the sternum, clavicle, or the forehead

Back 50

skin turgor

Front 51

In patients that are __, skin flattens more slowly after the pinch is released

Back 51

dehydrated

Front 52

reflects water and sodium retention, which can result from excessive reabsorption or inadequate secretion of sodium

Back 52

edema

Front 53

depression remains in the tissue after pressure is applied with a finger tip

Back 53

pitting

Front 54

sodium excess causes the tongue to appear?

Back 54

red and swollen

Front 55

less water than normal in the body

Back 55

fluid volume deficit

Front 56

the body attempts to compensate for fluid volume deficit by?

Back 56

decreasing urine output

Front 57

when in fluid volume deficit the heart rate?

Back 57

increases

Front 58

when in fluid volume deficit the blood pressure?

Back 58

decreases

Front 59

timing of heat application?

Back 59

no more than 30 minutes at a time

Front 60

pain experienced by fresh surgical patients -- physician may order around the clock meds for first 24-48 hours

Back 60

predictable pain

Front 61

timing for cold application in order to prevent tissue injury or frostbite

Back 61

15 minutes at a time

Front 62

cold is contraindicated for patients with peripheral vascular disease or heart disease because it may cause?

Back 62

further vasoconstriction of blood vessels and decrease circulation

Front 63

requires a physician's order and is handled by the physical therapy department

Back 63

TENS unit

Front 64

this therapy involves external electrical stimulation on the skin and underlying tissues through electrodes attached to a small unit that the patient can carry around;

delivers low-voltage electrical currents to block pain signals

Back 64

TENS unit

Front 65

blocks effects at receptor sites;

designed to produce analgesia and block certain side effects

Back 65

opioid agonist-antagonist

Front 66

pain experienced in a location different from its source

Back 66

referred pain

Front 67

side effects of opioids

Back 67

constipation; sedation; respiratory depression

Front 68

JACHO says all patients must be assessed for this upon admission, on a regular basis and after intervention

Back 68

pain assessment

Front 69

__ is whatever the person experiencing it says it is and exists whenever they say it does

Back 69

pain

Front 70

To administer Morphine IM you may need to use what size needle?

Back 70

1.5 inch

Front 71

Factors that cause gate to open

Back 71

tissue damage; a monotonous environment; and fear of pain

Front 72

stimulation of large diameter fibers can close the gate and interfere with impulse transmission between spinal cord and the brain causing?

Back 72

diminished pain perception

Front 73

afferent and efferent pathways of the central nervous system carry the messages for?

Back 73

interpretation

Front 74

nerves that carry messages TO the brain for interpretation

Back 74

afferent pathways

Front 75

nerves that carry messages AWAY from the brain via the spinal cord

Back 75

efferent pathways

Front 76

natural opioid like substances that block transmission of painful impulses to the brain

Back 76

endorphins; serotonin; norepinephrine

Front 77

pneumonic for identifying warning signs associated with cancer

Back 77

C-change in bowl or bladder habits

A-a sore that does not heal

U-unusual bleeding or discharge

T-thickening or lump in a breast or elsewhere

I-indigestion or difficulty swallowing

O-obvious change in wart or mole

N-nagging cough or hoarseness

Front 78

cells that are relatively harmless, primarily because they do not spread to other parts of the body

Back 78

benign cells

Front 79

cells that change in appearance from normal cells or tissue of origin

Back 79

malignant cells

Front 80

a cardiotoxic drug used to treat cancer, antitumor antibiotic, antineoplastic drugs, classified as biotherapy

Back 80

adriamycin

Front 81

toxic effect on heart can lead to?

Back 81

heart failure

Front 82

common cancer sites for women

Back 82

breast; lung; colon; rectum; uterine corpus; thyroid

Front 83

common cancer sites for men

Back 83

prostate; lung; bronchus; colon; rectum; and urinary bladder

Front 84

standard dose of Roxanol

Back 84

10 or 15 mg

Front 85

for cancer pain

Back 85

Roxanol

Front 86

detects cancer cells in cervical smear, specimens of body fluids, secretions, or tissues are obtained and examined microscopically to detect the presence of malignant cells

Back 86

pap smear

Front 87

these patients should remember that although they are going to die eventually, they are living now and can still have some pleasure

Back 87

terminally ill

Front 88

sedation scale

Back 88

S-sleeping but easily aroused

1-awake and alert

2-slightly drowsy

3-frequently drowsy; drifts to sleep (Alert RN)

4-no response (emergency)

Front 89

Stages of Cancer

Stage 1

Back 89

malignant cells are confined to the tissue of the origin; no invasion of other tissues takes place

Front 90

Stages of Cancer

Stage 2

Back 90

limited spread of the cancer occurs in the local area, usually to nearby lymph nodes

Front 91

Stages of Cancer

Stage 3

Back 91

the tumor is larger or has spread from the site or origin to nearby tissues (or both); regional lymph nodes are likely to be involved

Front 92

Stages of Cancer

Stage 4

Back 92

cancer has metastasized to distant parts of the body; also described as advanced stage

Front 93

TNM Staging System for Cancer

Back 93

T- tumor 2, 3, 4

N- regional lymph nodes

M- distant membranes

Front 94

once a therapeutic limit is reached, increases in dose may produce side effects but no further beneficial effects

Back 94

ceiling effect

Front 95

the most dangerous adverse effect of antineoplastic drugs used in chemotherapy

Back 95

bone marrow suppression