NSG 430 Exam 1
What guides our care? - CORRECT ANSWER -Code of Ethics - relieve suffering Principle of Beneficence - care is provided to benefit Standard of Care - define nursing acts that are required for safe and competent care
Assessments - last hours of life - CORRECT ANSWER -limit to comfort measures, concerns about pain and respiratory should be addressed, emotional/comfort support
Postmortem Care - CORRECT ANSWER -close pt's eyes, replace dentures, wash/position body - allow family privacy
Classic triad of DKA - CORRECT ANSWER -hyperglycemia (>250) ketones acidosis
Other manifestations of DKA include - CORRECT ANSWER -profound dehydration tachycardia fruity breath (early signs) - weakness/lethargy
DKA treatment includes - CORRECT ANSWER -IV fluids regular insulin - 0.1 U/kg/hr electrolytes (potassium esp.) - PRN
HHS occurs when - CORRECT ANSWER -Blood glucose >600
HHS vs DKA - CORRECT ANSWER -no ketones (has enough insulin to prevent this) severe hyperglycemia (>600) occurs gradually
Other HHS manifestations - CORRECT ANSWER -increased serum osmolality (concentrated) normal blood pH fever/warm dry skin
Palliative Care - CORRECT ANSWER -Care or treatment focusing on reducing the severity of symptoms; curative treatment can be involved
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Hospice Care - CORRECT ANSWER -treatment of the terminally ill with the goal of helping them to die comfortably, without pain; curative care is forgone
Physical manifestations of EOL - respiratory - CORRECT ANSWER -Cheyne-Stokes respirations, death rattle, terminal secretions, loss of gag reflex (risk for aspiration)
Physical manifestations of EOL - integumentary - CORRECT ANSWER -Mottling, cyanosis in nail beds, cold/clammy skin, and "waxlike" skin very near death
Decisional capacity - CORRECT ANSWER -ability to consent to or refuse care
Tissue/Organ donation - CORRECT ANSWER -Some used within hours, notify physician immediately
Treatment for HHS - CORRECT ANSWER -Same as DKA however fluids help as much as insulin therapy because of the correction of the osmolarity issue
Addison's disease - CORRECT ANSWER -insufficient corticosteroids (need to ADD)
Manifestations of Addison's disease - CORRECT ANSWER -hyper-pigmented skin hypoglycemia muscle weakness orthostatic hypotension salt craving hyperkalemia
Interprofessional care for Addison's - CORRECT ANSWER -hormone therapy (hydrocortisone) watch for s/s of Cushings increase dietary salt intake protect from extremes (light, noise, temp)
Important patient teaching for Addison's - CORRECT ANSWER -meds taken with food need to increase corticosteroids during times of stress how to administer IM hydrocortisone report s/s of deficiency or excess corticosteroids to HCP Medical ID bracelet
Addisonian's crisis - CORRECT ANSWER -a life-threatening emergency caused by insufficient adrenocortical hormones or a sudden sharp decrease in these hormone
Manifestations of addisionian's crisis - CORRECT ANSWER -Dehydration Change in mental status Hypotension Tachycardia, and shock
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