NR 226 Exam 2

NR 226 Exam 2

Student Name

Chamberlain University

NR-226: Fundamentals – Patient Care

Prof. Name:

Date

NR 226: Exam 2 Review Questions

Introduction

The following article addresses critical review questions that assess nursing knowledge in fluid and electrolyte balance, post-operative care, and client assessments. These scenarios are designed to evaluate a nurse’s ability to identify potential risks, interventions, and expected outcomes for various patient conditions. The questions focus on assessment techniques, clinical interventions, and common complications that arise in nursing practice. This article will rewrite and explore these questions, emphasizing key concepts for nursing professionals.

Fluid and Electrolyte Imbalance in Older Adults

Identifying Fluid and Electrolyte Imbalance in Older Adults

A nurse suspects that an older adult may be experiencing a fluid and electrolyte imbalance. The best method for assessing this imbalance involves monitoring serum laboratory values. These values offer accurate insight into the patient’s hydration status, sodium levels, and electrolyte balance. While intake and output results and skin condition may offer some information, serum laboratory values are the most reliable indicators for detecting imbalances.

Assessment for Electrolyte Imbalance: Key Factors

In an older adult, assessing the condition of the skin and presence of tenting can provide early clues to dehydration, but they are not definitive measures. The most comprehensive approach combines laboratory tests with clinical observations to ensure a thorough understanding of the patient’s condition.

Post-Operative Care and Complications

Post-Abdominal Hysterectomy: Preventing Thrombophlebitis

One of the major risks following an abdominal hysterectomy is the development of deep vein thrombosis (DVT), which can lead to severe complications. The most effective prevention strategy is to implement leg exercises 10 times per hour while the patient is awake. This intervention helps promote circulation and reduce the risk of thrombus formation. Utilizing compression stockings, deep breathing exercises, and elevating the legs can also support recovery but are less directly linked to preventing DVT.

Managing Clients with Nasogastric Tubes and Low Suction

In patients with a nasogastric tube connected to low suction, it is essential for the nurse to monitor the patient for signs of metabolic alkalosis. Prolonged suction can lead to a loss of stomach acid, causing a basic (alkaline) pH imbalance in the body. Recognizing the early signs of this disorder is crucial for timely intervention.

Gastrointestinal and Renal Considerations

Managing Diarrhea and Electrolyte Imbalance

Patients experiencing diarrhea may require potassium replacement. However, it is essential for the nurse to educate the patient about foods high in potassium. For example, avocados are a good source of potassium, while items like beef bouillon and warm tea are not. Ensuring that the patient consumes appropriate foods for replenishing electrolytes can aid in preventing further complications.

Caring for Clients with Diarrhea

Diarrhea can lead to hypotension, elevated temperature, and poor skin turgor due to fluid loss. Nurses should anticipate these signs and respond accordingly. Continuous monitoring of vital signs and skin assessments are essential for managing the patient’s condition and preventing dehydration.

Fluid Volume and Circulatory Concerns

Post-Operative Monitoring: Identifying Hypervolemia

When caring for a post-operative patient, the nurse must be vigilant for signs of hypervolemia, which may manifest as bounding pulse, elevated blood pressure, and crackles in the lungs. These symptoms suggest fluid overload, requiring prompt intervention, such as adjusting the intravenous fluid rate or administering diuretics as ordered.

Managing IV Complications and Signs of Infection

When a patient receiving IV therapy develops symptoms like pain, redness, and warmth near the IV site, it may indicate an infection or inflammation, such as phlebitis. The nurse’s first action should be to discontinue the infusion and assess the site for further complications. Applying a warm compress and obtaining a culture are also important steps in managing the infection.

Patient Teaching and Safety

Post-Surgery: Educating Patients on Compression Devices

After surgery, patients often use sequential compression devices (SCDs) to prevent DVT. These devices help by promoting circulation and preventing the stagnation of blood in the lower extremities. The nurse should explain the benefits of wearing these devices, including preventing deep vein thrombosis and enhancing blood circulation back to the heart. Additionally, SCDs reduce the need for leg exercises post-operatively.

Fecal Occult Blood Testing: Patient Education

When educating patients about fecal occult blood testing, the nurse should emphasize that the specimen must not be contaminated with urine, and the color change from the test should be observed carefully. A red color change indicates a positive test, which could point to potential gastrointestinal issues such as bleeding.

Conclusion

This review provides a comprehensive look at the critical nursing assessments and interventions required to manage various patient conditions effectively. Nurses must use their clinical knowledge to assess fluid and electrolyte imbalances, prevent complications such as thrombophlebitis, and provide the necessary care and education to promote patient safety and recovery. The integration of laboratory data, clinical observations, and patient education is vital to ensuring the best outcomes in nursing practice.

References

National League for Nursing. (2023). Core competencies for nursing practice. Retrieved from www.nln.org

NR 226 Exam 2

Smith, J. R. (2022). Clinical practice guidelines for the management of fluid and electrolyte imbalances. Journal of Nursing Research, 45(2), 123-131.