pediatric nursing and development questions

Click on the comments section to take a pediatric development quiz.

The answers are also in the comments section.

good luck!

Nursing 7 resources

Trina has posted lots of good stuff on this blog for Nursing 7, including the link to an explanation of the RAAS on Wikipedia. It was so helpful to me, I thought I should repost it, closer to the top... Check it out at this link... Renin-Angiotensin-Aldosterone System. (Thanks, Trina!)

Note: the author's starting point on the diagram is a decrease in renal perfusion, but -- in his/her notes -- points out there are other ways RAAS can be activated -- "...by a low NaCl concentration in the macula densa or by sympathetic activation."

Be sure to scroll down for all the Nursing 7-related information. There are lots of other good posts by Trina and others, like Bonnie's links to information on hemodynamic basics or links to videos to refresh your clinical skills, next to the Starbucks IV bag below. Drink it up, y'all!

Nursing 7 is the perfect time to reacquaint yoursef with (or introduce) the information available on Bonnie Boss' "original" student blog she created for fellow SJDC nursing students. In addition to her excellent test bank, bringing us tons of NCLEX practice, she includes many links to supplementary information on a variety of relevant topics under "practice tests and quizzes" and "helpful links." Get to know what's out there. Bonnie's already done a lot of the legwork for us.

(Muchas gracias, Bonnie!)

FYI, Bonnie's now a full-time RN working in ICU at Lodi Memorial.

more shock

1. Which is the most important goal of nursing care for a pt who is in shock?
a. Manage fluid overload
b. Manage increased CO
c. Manage inadequate tissue perfusion
d. Manage vasoconstrxn of vascular beds
2. Which nursing assessment finding indicates hypovolemic shock in a pt who has had a 15% blood loss?
a. Pulse <> 30mL/hr
b. Systolic bP > 110
c. Diastolic > 90
d. RR of 20 braeths/min
4. which is a risk factor for hypovolemic shock?
a. Hemorrhage
b. Antigen antibody rxn
c. Gram neg bacteria
d. vasodilation
5. what is a priority assessment for the pt in shock who is receiving an IV infusion of PRBC and NS?
a. Fluid balance
b. Anaphylactic rxn
c. Pain
d. ALOC
6. the pt who does not respond adequately to fluid replacement has an order for an IV infusion of dopamine hydrochloride at 5u/kg/min. the desired fx of the drug is
a. increased renal and mesenteric BF
b. increased CO
c. vasoconstrx
d. reduced preload and afterload
7. A male pt who has been taking coumadin has been admitted c severe acute rectal bleeding and the following lab results: INR 8, Hmg 11, hematocrit 33%. Which MD orders would the nurse expect to implement initially? Select all that apply.
a. IV D5 ½ NS
b. Schedule pt for sigmoidoscoy in the AM
c. Give 1 unit FF plasma
d. Admin vitamin K 2.5 mg PO
e. Begin polyethylene glycol-electrolyte solution in preparation for signoidoscopy
f. Admin fleet’s enema
8. the nurse in perop holding area keeps a pt c gastric bleeding in a dimly lit environment c one family member present. What is the primary rationale for these nursing interventions?
a. Stabilize fluid and lyte balance
b. Minimize O2 consumption
c. Increase pt and family comfort
d. Prevent infxn
9. when assessing a pt for early septic shock, the nurse observes for which of the following?
a. Cool clammy skin
b. Warm flushed skin
c. Decreased systolic bp
d. hemorrhage
10. a pt c toxic shock has been receiving ceftriaxone sodium, in add’n to culture and sensitivity studies. What other lab finding does the nurse monitor?
a. Serum creat
b. Spinal fluid analysis
c. ABG
d. Serum osmolality
11. what intervention is most important in preventing septic shock?
a. Admin IV fluid replacement therapy as orderd
b. Obtaining VS q 4 hrs for all pts
c. Monitoring RBC counts for elevation
d. Maintaining asepsis of indwelling urinary catheters
12. which is a indication of a complication of septic shock?
a. Anaphylaxis
b. ARDS
c. COPD
d. Mitral valve prolapse

Congenital Heart Defects

Thanks, Crista for the link to Mayo Clinic's slideshow on common congenital heart defects.

There are also some handy little animations of blood flow through various defects on our textbook's CD for chapter 48.

Peds was fun but we are definately ready to get 7 over with. How is it so far??

Shock it to me!!

1. DIC often results in complications initially associated c which of the following organs?

a. brain

b. kidney

c. lung

d. stomach

2. Which conditions is not caused by DIC?

a. organ tissue damage

b. depletion of circulating clotting factors

c. thrombus formation in the large vessels

d. activation of the clotting dissolving process

3. A 19yo pt admitted c heat stroke begins to show signs of DIC. Which lab finding is most consistent c DIC?

a. low platelet count

b. elevated fibrinogen levels

c. low levels of fibring degradation product

d. reduced PT time

4. Vasopressors may be indicated in which type of shock?
a. neurogenic
b. hypovolemic
c. respiratory
d. metabolic

5. For every unit of blood lost in trauma, how much crystalloid must be infused?
a. twice as much
b. equal amount
c. half as much
d. three times the amount

6. Which drug is a parasympathetic antagonist?
a. lidocaine
b. atropine
c. digoxin
d. dopamine

7. A heat exhaustion patient is suffering from what type of shock?
a. cardiogenic
b. neurogenic
c. hypovolemic
d. metabolic