Download NURS2101 Exam Questions & Answers: Patient Care, Cancer, Fluids and more Exams Nursing in PDF only on Docsity!
NURS2101 Exam Questions With
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How can empathy improve patient safety? - ANSWER Instills a sense of cooperation: coordination, integration, continuity of care, emotional support, physical comfort. Examples of patient-centred care? - ANSWER 1) Respect for patients preferences,
- Coordination and integration of care,
- Information, communication and education,
- Physical comfort,
- Emotional support,
- Involvement of friends and family,
- Continuity and transition,
- Access to care. Members of inter-professional Healthcare team - ANSWER 1) Dietician
- Physiotherapist,
- Pain CNC,
- Wound CNC,
- Clinical pharmacist,
- GP Aetiology of colorectal cancer - ANSWER 1) Genetic predisposition,
- Diet,
- Inflammatory bowel disease,
- Obesity,
- Smoking,
- Alcohol,
- Physical inactivity Bowel Cancer can be prevented by: - ANSWER Eating a healthy diet and exercising - could prevent 66% - 75% of bowel cancer cases. True or False: Bowel Cancer is one of the most curable types of cancer? - ANSWER True
- with early detection. Pathogenesis of Cancer Cells? - ANSWER 1) Cancer cells sequester nutrients for their own use at expense of neighbours,
- Capable of unrestrained growth,
- Encroach upon their neighbours and if possible migrate elsewhere,
- Insensitive to apoptosis. Cancer is a result of? - ANSWER Errors in cell growth, regulation and or differentiation. Pathogenesis of Colorectal cancer? - ANSWER 1) Age is one of the biggest factors in cancer,
- Involves the mutation of gene P53 Suppressor Protein,
- Most are adenocarcinomas and develop from adenomas (polyps). Signs of bowel cancer? - ANSWER 1) Blood in faeces,
- Diarrhoea or
- Constipation,
- Changes in bowel habit,
- Frequent gas pains, bloating or fullness, cramps, 6) Stools that are narrower than usual,
- A lump or mass in the tummy,
- Weight loss for no known reason,
- Persistent abdominal pain,
- Feeling tired,
- Vomiting.
- Tongue turgor poor,
- Postural or orthostatic hypotension,
- Venous pressure falls: flat neck veins,
- Increased haematocrit, urea and creatinine
- Tachycardia,
- Vasoconstriction: pale, cool skin,
- Decreased urine output - oliguria,
- Specific gravity of urine increases.
- Sensations of thirst, weakness, dizziness, muscle cramps.
- Capillary filling time elongated Signs and symptoms of Hypervolaemia? - ANSWER 1) Peripheral oedema,
- Full bounding pulse,
- Distended neck and peripheral veins,
- Increased venous and right atrial pressures,
- Dyspnoea,
- Orthopneoa when supine,
- Tachycardia,
- Hypertension,
- Moist crackles in lungs,
- Reduced oxygen saturations,
- Increased urine output,
- Ascites,
- Decreased levels of haematocrit, BUN, sodium and serum
- Altered mental state and anxiety,
- Pulmonary oedema.
- Weight gain How can Hypovolaemia be prevented? - ANSWER 1) Fluid management: Fluid balance
chart,
- Encourage fluid intake,
- Reduce intake of coffee, tea, alcohol,
- Assess vital signs,
- Daily weighing,
- IV therapy as ordered,
- Monitor laboratory values,
- Monitor for changes in level of consciousness, 9) Turn every two hours,
- Safety precautions for falls,
- Avoid exercise during extreme heat,
- Educate patient and family. How can Hypervolaemia be prevented? - ANSWER 1) Fluid management: Fluid balance chart,
- Fluid needs to be restricted, reduce IV to TKVO.
- Monitor weight,
- Sodium restricted diet,
- Oral hygiene - keep mucous membranes intact, relieve thirst: ice chips,
- Monitor lung crackles and wheezing,
- Monitor SATS and administer oxygen as required, 6-8 litres via hudson mask.
- Administer diuretics as prescribed,
- Turn every two hours,
- Educate patient and family,
- Sit in high fowlers position.
Why are older people at increased risk of fluid imbalance? - ANSWER 1) Changes in normal ageing process affect homeostasis,
- Total body water is 10% lower than younger adults,
- Sodium and water regulation is less efficient,
Water constitutes? % of body weight of 70kg male? - ANSWER 60%
Water constitutes? % for elderly woman - ANSWER 40% or less.
Water constitutes? % for babies or children - ANSWER 80-90%
Dehydration is a loss of fluid from where? - ANSWER Intracellular fluid
Up to? % of older people are malnourished? - ANSWER 60%
Principles of Wound Management? - ANSWER T issue, I nflammation, M oisture, E dge
What factors govern movement of fluids between body compartments? - ANSWER 1) Osmolality of fluids in each compartment,
- Sodium levels in the ECF,
- Colloids, especially albumin,
- Glucose,
- Balance between hydrostatic and colloidal osmotic pressure,
- Lymph system,
- Integrity of cell membranes.
What is hypovolaemia? - ANSWER Abnormally low volume of body fluid in the intravascular compartment.
What can cause hypovolaemia? - ANSWER 1) Blood loss,
- Vomiting,
- Diarrhea,
- Fever,
- Excess sweating,
- Burns,
- Diabetes insipidus,
- Diabetes Mellitus,
- Anaphylaxis or sepsis
How is hypovolaemia different to dehydration? - ANSWER Hypovolaemia is the reduction of effective circulating volume in the intravascular space, whereas dehydration is depletion of whole body fluid.
What is hypervolaemia? - ANSWER Hypervolaemia is abnormally high volumes of body fluid in the intravascular compartment.
Possible causes of hypervolaemia? - ANSWER 1) Sodium and fluid intake via IV fluids.
- Rapid blood transfusion,
- Sodium and water retention,
- Heart failure, liver failure, kidney failure
- Low protein intake,
- Fluid shift into the intravascular space after administration of hypertonic fluids or plasma proteins.
Causes for Cyrils fluid status day 1: - ANSWER 1) Loss of fluids and electrolytes with Pico Preps,
- Nil orally - NBM,
- Surgery: loss of blood and destruction of epithelial cells,
Hypokalaemia can cause arrhythmias, decreased bowel sounds, muscle weakness, irregular pulse, polyuria, cardiac arrest, cramps.
Percentage of risk acquiring a cannula infection in hospital? - ANSWER 6.2%
How might one acquire an infection? - ANSWER 1) Inadequate hand hygiene.
- Breakdown in asepsis.
- Re-palpation of site immediately before introducing vascular device.
- Contamination of injection ports, hubs and bungs by microorganisms.
- Use of contaminated tape to seal puncture sites.
- Self-infection: when microorganisms colonising one site are transferred to another.
- Cross infection: due to contact with other patients, visitors, healthcare professionals or contaminated environments.
Signs and symptoms of cannula site infection? - ANSWER 1) Pain,
- Erythema near site.
- Swelling,
- Induration - a hardened mass or formation.
- Pyrexia
- Palpable venous cord.
How can cannula site infections be prevented? - ANSWER 1) Decontaminate hands before collecting equipment, repeat after removal of gloves.
- Decontaminate proposed cannula site and leave to dry for 30 seconds.
- Use universal infection prevention precautions.
- Apply sterile, semipermeable dressing at site, must be clearly visible and transparent.
- Document insertion and main accurate records of ongoing care.
How does effective communication promote medication safety? - ANSWER It encourages collaboration and helps prevent errors.
What are the difference between acute and chronic pain? - ANSWER Acute pain has a sudden onset, is usually temporary and localised. It is pain that lasts for less than 3 months and has an identified cause. Most often the result from tissue injury from trauma, surgery or inflammation. Chronic pain is ongoing prolonged pain. Not always associated with identifiable cause but often arises from an acute situation such as post trauma, herpes zoster, acute back pain and postoroperative surgical pain.
What factors affect individual responses to pain? - ANSWER 1) Sociocultural influences.
- Psychological status.
- Past experiences with pain.
- Source and meaning.
- Age
How is pain best assessed? - ANSWER 1) Health history - Numeric pain intensity scale.
- Physiological response.
- Examination.
- Behavioural response.
- Response to treatment.
Advantages of PCA? - ANSWER 1) Patient has control and independence over analgesia.
- Reduces delays inherent in other methods.
- Works quicker than oral s/c or IM injections.
- Maintains plasma concentration of drug at therapeutic levels.
- Maximises relief from pain while minimising effects.
- Allows titration to patient needs.
c) Recall knowledge.
- Process information: a) Interpret. b) Discriminate. c) Relate. d) Infer. e) Match. f) Predict.
- Identify problem/issue.
- Establish goals.
- Take Action.
- Evaluate.
- Reflect on process and new learning.
Define PQRST - ANSWER P = Provokes Q = Quality R = Radiates S = Severity T = Time
Body Fluids consist of? - ANSWER 1) Water,
- Solutes: non-electrolyte and electrolytes.
Tonicity? - ANSWER The ability of an extracellular solution to make water move into or out of a cell by osmosis.
Normal tonicity is? - ANSWER 280-300sm/kg.
What constitutes the vast majority of normal tonicity? - ANSWER Sodium ions.
Osmotic gradient? - ANSWER The difference in concentration between two solutions on either side of a semi-permeable membrane and is used to tell the difference in percentages of the concentration of a specific particle dissolved in a solution.
Osmosis? - ANSWER The net movement of solvent molecules through a semi-permeable membrane into a region of higher solute concentration, in the direction that tends to equalize the solute concentrations on the two sides.
Examples of non-electrolytes? - ANSWER Glucose, lipids, creatinine and urea. They do not break down in water.
Examples of electrolytes? - ANSWER Inorganic salts, all acids and bases and some proteins. They do break down in water and determine the chemical and physical reactions of fluids.
What is Acute Kidney Injury? - ANSWER It is a sudden decline in kidney function occurring over hours to days resulting in a failure to maintain fluid, electrolyte and acid-base homeostasis. 5-7% of hospitalised people develop AKI. The most common cause is ischaemia and exposure to nephrotoxic agents.
What is Chronic Kidney Disease? - ANSWER It is a progressive loss of renal function. It is defined as the occurrence of kidney damage or decreased kidney function (decreased glomerular filtration rate, GFR) for a period of three or more months. CKD is responsible for substantial burden of illness and premature death. It is however a preventable and treatable condition.
What is the difference between AKI and CKD? - ANSWER AKI is usually caused by an event that leads to kidney malfunction, such as dehydration, blood loss from major surgery or injury, or the use of medicines.
- Pruritus
- Azotaemia
How does diabetes contribute to CKD? - ANSWER 1) It damages blood vessels throughout the body which:
- Impedes GFR.
- Ischaemic damage to cortex and medulla.
- It damages (thickens) glomerular basement membrane causing glomerulosclerosis.
- Proteinuria and hypoalbuminaemia.
- Oedema.
- Increased susceptibility to infection.
- Hyperlipidaemia - large amounts of lipoproteins exported from liver to compensate for loss of plasma protein
How does hypertension contribute to CKD? - ANSWER 1) Small blood vessels damaged over time (ischaemia damages nephrons).
- Decreased GFR - release of renin - causes increase in BP.
- Cycle of worsening hypertension.
How does obesity contribute to CKD? - ANSWER 1) Extra workload on kidneys to meet increased metabolic demands of increased body mass index.
- Haemodynamic burden on kidneys - hyperfiltration - glomerular injury.
- Proteinuria is a recognised complication of morbid obesity.
- Microalbuminuria exacerbates hypertension.
Common causes of acute deterioration in CKD? - ANSWER AKI most important complication. Causes of AKI multifactorial and include:
- Nephrotoxic drugs.
- Sepsis.
- Decreased renal perfusion.
- Surgery postoperative factors
- Radiocontrast media
What is azotaemia? - ANSWER Increased blood levels of nitrogenous waste products.
What is Uraemia? - ANSWER Urine in the blood, the syndrome or group of symptoms associated with end stage renal failure.
CKD risk factors? - ANSWER 1) Diabetes
- Hypertension
- Age over 60
- Smoking
- Obesity
- Family history
- Cardiovascular disease
- Aboriginal or Torres Strait Islander
What are NOT CKD risk factors? - ANSWER 1) NSAID use.
- COPD
- Alcohol consumption
- Sedentary lifestyle
Screening tests for CKD? - ANSWER 1) Blood pressure test.
- Blood test for serum creatinine (calculate GFR)
- Urine test for proteinuria or albuminuria.
Causes of fluid loss? - ANSWER Fluid loss can be from excessive sweating due to an increase in ambient temperatures , fever, vomiting , diarrhea, impaired oral intake and burns.
Isotonic dehydration? - ANSWER Isotonic occurs from illnesses that affect the gastrointestinal tract where salt and water are equally lost.
Hypertonic dehydration? - ANSWER Hypertonic can occur either when there is an insufficient intake of water or an excess of water loss, with no loss of salt.
Hypotonic dehydration? - ANSWER Hypotonic occurs when there is an increase in the loss of salt such as the replacement of lost fluids by water.
Why are infants and children at higher risk of dehydration? - ANSWER 1) Children have a higher surface area-to-mass ratio which means that more heat is absorbed but there is less tissue for it to be dispersed to.
- Children under five years have the ability to increase their heart rate but they are unable to increase their cardiac output when experiencing high temperatures, this inevitably leads to exhaustion and cardiac failure.
- Children have smaller sweat glands which are not as sensitive to heat compared to adults resulting in less sweat production, this limits a child's ability to cool themselves down.
- Infants are at a greater risk for dehydration as their body weight is approximately 75% water.
- Infants can not relocate them selves to a cooler area and they have an inability to express their thirst.
Mild signs of dehydration? - ANSWER 1) 3% of body weight dehydrated.
- Reduced urine output.
- Thirst.
- Dry mucous membranes.
Moderate signs of dehydration? - ANSWER 1) 5% of body weight dehydrated.
- Dry mucous membranes.
- Tachycardia.
- Abnormal respiratory pattern.
- Lethargy.
- Reduced skin turgor.
- Sunken eyes and fontanel.
Severe signs of dehydration? - ANSWER 1) 10% of body weight dehydrated.
- Dry mucous membranes.
- Tachycardia.
- Abnormal respiratory pattern.
- Lethargy.
- Reduced skin turgor.
- Sunken eyes and fontanel.
- Poor perfusion: mottled, cool limbs, slow capillary refill, altered consciousness.
- Shock: thready peripheral pulses with marked tachycardia,
Treatment of dehydration? - ANSWER 1) Oral rehydration therapy (ORT) is a non invasive and cost effective treatment which uses oral rehydration salts that are dissolved in water to treat children with mild to moderate dehydration.
- Nasogastric (NG) therapy is an option for rehydrating if oral therapy is unsuccessful.
- Should ORT and NG therapy fail in adequately rehydrating children then the administration of fluids via intravenous therapy is necessary such as a bolus dose of fluid containing dextrose. Intravenous fluids can be administered safely in amounts of 50ml/Kg (mild dehydration) to 100ml/kg (moderate dehydration) over 1-3 hours.
Nursing actions for dehydration? - ANSWER 1) Gather and document a valuable history of the illness and any precipitating factors.
