Physiological Adaptation Flashcards
6 cards from real RN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Physiological Adaptation flashcards as text
A patient presents with absent breath sounds on the left, tracheal deviation to the right, and severe respiratory distress. The nurse should prepare for:
Answer: Emergency needle decompression for tension pneumothorax
Tracheal deviation away from the affected side with absent breath sounds and respiratory distress are hallmarks of tension pneumothorax, requiring immediate needle decompression.
Which finding in a burn patient indicates adequate fluid resuscitation during the first 24 hours?
Answer: Urine output of 0.5–1 mL/kg/hour
The Parkland formula targets urine output of 0.5–1 mL/kg/hour as the primary indicator of adequate tissue perfusion during burn resuscitation.
A patient on mechanical ventilation has a sudden decrease in oxygen saturation and increasing peak airway pressures. The nurse's first action should be:
Answer: Disconnect from the ventilator and manually ventilate with a bag-valve mask
DOPE mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure) guides troubleshooting; manual ventilation with a bag-valve mask confirms and bypasses equipment failure immediately.
A patient with Addison's disease is admitted with hypotension, hyponatremia, and hyperkalemia during a stressful illness. The nurse anticipates:
Answer: Administration of IV hydrocortisone
Addisonian crisis results from adrenocortical insufficiency; IV hydrocortisone rapidly replaces both glucocorticoid and mineralocorticoid activity needed during stress.
Which lab value is the most sensitive early indicator of acute pancreatitis?
Answer: Elevated serum lipase
Serum lipase remains elevated longer than amylase (up to 14 days vs. 2–3 days) and is more specific and sensitive for acute pancreatitis.
A patient with deep partial-thickness burns to 30% TBSA is at highest risk for which complication in the first 24–48 hours?
Answer: Hypovolemic shock
Massive fluid shifts from burned tissue into interstitial spaces cause hypovolemic shock as the primary life threat in the first 24–48 hours post-burn.