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Question: How does COPD rank leading causes of death in U.S.?Answer: Question: What is the definition of COPDAnswer: Limited airflow to the Question: COPD is an umbrella term for what ?Answer: Emphysema & Bronchitis Question: What abnormality deficiency could cause COPD?Answer: Alpha 1 (A1A) Question: What does A1A do?Answer: Protects the lungs; without this, natural body-made would attack the lungs Question: What Chronic Bronchitis?Answer: Constant , burn, that causes inflammation to the bronchi & bronchioles in the lungs Question: How is Chronic defined?Answer: Presence of cough & sputum for at 3 consecutive months, every year for two years Question: How does develop?Answer: constant exposure to an irritant Question: What to the alveoli with Emphysema?Answer: They lose elasticity and are unable to close out and push out CO2 exhalations Question: What's the difference Chronic Bronchitis & Emphysema?Answer: CB deals with bronchi & bronchioles; Emphysema with the alveoli Question: How do pts with Emphysema become -chested?Answer: The lungs lose elasticity and remain hyper-exteneded; over time, the ribs outward Question: How is COPD ?Answer: ; Chest x-ray, History, ABG's, Pulmonary Function Test (PFT), & Pulse Oximetry Question: What is the of COPD?Answer: -High Fowler's as long as pt can tolerate it -TCDB -Use IS -Teach diaphragmatic breathing -Teach pursed lip breathing -May need to breath in tripod position -Upon inspiration, hold for once second and then release to facilitate gas exchange Question: What do do?Answer: Relaxes smooth muscles in and opens airways Question: How do you know if the dosage of corticosteroids is right when treating COPD?Answer: The pt will Cushing's Question: What is ?Answer: airway condition characterized by reversible inflammation Question: What part of the lungs are affected with ?Answer: Bronchioles are affected by the of airways & become hyper responsive to the the point of spasming Question: With asthma, what is produced in the ?Answer: with edema present Question: What is mild ?Answer: S/S occur less than a week Question: What is moderate/sever ?Answer: Always having some sort of with frequent asthma attacks Question: With inhaler/neb use for , how soon should you see some improvement?Answer: 15 after administration Question: When having an asthma attack any response to usual treatments, when should you seek medical attention?Answer: 30 minutes Question: What meds are used for asthma attacks?Answer: Short bronchodilators such as Albuterol Question: How would asthma be in the ER?Answer: With IV Question: how do you use an ?Answer: 1. Shake it 2. of deep breaths, then insert it 3. Breath in as inhaler is depressed 4. Hold breath for 10 seconds 5. Wait 1 minutes before each puff; usually 2 puffs ordered Question: What is a peak flow ?Answer: Pt blows as hard as they can 3 and highest number is recorded Question: What is (TB)?Answer: An disease commonly caused by Myobacterium Tuberculosis Question: What size must a be to be considered airborne?Answer: Less than 5 Question: What is the center point of of TB called?Answer: Ghon Question: What is used in a TB (Mantoux) test?Answer: Purified solution of 0.1cc Question: What is a positive TB skin test result for the public?Answer: 10mm Question: What is a TB skin test result for the immunocomproised?Answer: 5 mm Question: How long does it take to a sputum culture?Answer: 2-4 Question: How long does it take to treat an infection of TB?Answer: 6-12 months; if person is positive but not actively infected, they are INH for a few months? Question: In the , what type of room is a TB pt put in?Answer: A negative room Question: What do you wear on your race entering an airborne precaution room?Answer: A N95 respirator mask that you have to be fitted Question: What does a Pulmonary Function Test do and how is it ?Answer: -Assess lung function -Pt breathes into tube a series of exhalations/inhalations & machine measures amount of oxygen/carbon dioxide going in & out -Pts shouldn't smoke 4-6 hrs before test -Some pts should abstain from using inhalers 24 hrs before Question: What do ABG's and how is it performed?Answer: -Measures pH and CO2 in arteries -Painful -Radial artery used, insert at 90 degree angle & aspirate blood Question: When is a pulse oximetry not ?Answer: When the pt has high monoxide levels Question: What you always check for with a CT Scan?Answer: If pt is to dyes Question: What is important to remember with a pt before they an MRI?Answer: If they have in their bodies or patches on their bodies Question: What is the KEY test for finding a emboli?Answer: Lung Scan (Ventilation Scan) Question: When is the best time to do a study?Answer: In the Question: What are considerations for a bronchoscopy?Answer: -Pt must sign an informed consent -Must be NPO 8-12 -RN is responsible on educating pt on test and expectations -Dentures must be removed Question: What is used for?Answer: Bronchoscopy- used to dry up secretions in the Question: What does block?Answer: It blocks parasympathetic nerves allowing sympathetic nervous system to takeover; it's a drug Question: What is used in a for conscious sedation?Answer: Versed Question: What is xylocaine ?Answer: It's a spray used to numb the throat and the gag reflex. It can least up to three hours. Question: After a bronchoscopy is done, how long must a pt NPO?Answer: Until the gag reflex back which could take 2-3 hrs Question: If a pt cannot sit up for a , how are they positioned?Answer: Lying down on the unaffected side with the HOB elevated 30-50 Question: Post-op for a thoracentesis, what tp of is applied?Answer: An air occlusive dressing, not gauze because gauze allows for air Question: What are complications of ?Answer: -Pneumothorax (collapsed lung; most common) -Hemothorax (blood enters space and lung) -Punctured lung a.e.b. pin-tinged or red & bloody sputum Question: What illness has an organism leading to lungs, leading to exudates in the alveoli?Answer: Pneumonia Question: Who is at risk for the worst s/s of ?Answer: An immunocompromised Question: What is another name for aspiration ?Answer: Lobar pneumonia- a segment or entire lobe is by pt swallowing something that has entered the lung Question: What color is sputum from a with pneumonia?Answer: Yellow, blood streaked, colored Question: What does pneumonia look like on a x-ray?Answer: White, splotchy Question: If a pneumonia pt continues to spike a high temp of 104-105, what is doneAnswer: Blood cultures are done to see it it's spread, looking for Question: What is in the same as penicillin?Answer: CEF's; ceftriaxone, cefdinir; if to cillin's, could be allergic to CEF's Question: What should you always educate a pt about when they are on penicillin?Answer: Oral aren't as effective Question: How are 's given?Answer: -PO -IV Question: How are 's NOT given?Answer: IM, because it would be too Question: Since mycin's are , what can this lead to?Answer: GI bleeding by irritating the lining of the intestines; could also lead to toxicity Question: What does potentiate?Answer: (anticoagulant) Question: Name a long acting beta 2 ?Answer: Terbutaline Question: What is the of peripheral vascular disease?Answer: A disease of blood vessels outside of the heart & Question: What is ?Answer: The hardening & thickening of the of the arteries Question: What is ?Answer: A type of arteriosclerosis that the buildup of fat & fibrin on the walls of the artery Question: With atherosclerosis, what does formation affect?Answer: The intima (innermost of the artery) of the large and medium arteries mostly Question: does plaque tend to accumulate in the arteries?Answer: Where arteries Question: What are 2 types of lesions involved with ?Answer: Fatty streaks and fibrous Question: What type of lesion tends to be yellow & smooth, protrude slightly into the lumen of the artery, buildup but not , composed of lipid & elongated smooth muscle cells, found in ppl of ANY age, don't have s/s but considered a 'good' lesion to have?Answer: lesions Question: What type of lesion is white to whitish yellow, composed of lipids, collagen, plasma components, are considered to be the 'bad' plaque, builds upon itself, obstruction is irreversible and only made better by and not meds?Answer: streaks Question: What does monoxide to do oxygen carried by hemoglobin?Answer: them off Question: When gangrene occurs by severe , where is it most commonly seen?Answer: The toes they are the most distal Question: What are the s/s of claudication?Answer: -Aching & cramping of the legs during ambulation because muscles aren't enough blood flow -Pain will usually stop 1-2 minutes after ambulation has ceased -Seems to be worse at night -Lowering the legs tends to make this better Question: If a artery becomes blocked, what would you feel?Answer: -Numbness, tingling & weakness on the side of the body of the artery block, possible mini and full-blown strokes(TIA, CVA respectively), dizziness, and confusion Question: A blockage in the coronary artery result in?Answer: & MI Question: What is a UTS and what is used with it at times?Answer: It detects quality of peripheral blood flow to the pressure the blood flow in the legs and is used in conjunction with angiography Question: If a pt is to have high cholesterol, what are they put on?Answer: 'Statin' Question: What is an ?Answer: Used to 'clean out' artery and done mostly on the carotid artery. Considered a high risk procedure because can break off and become an embolus Question: Why should you not use ice on a leg intermittent claudication?Answer: Because it vasoconstriction Question: What is a (aka venous thrombosis)?Answer: Inflammation of the walls of the vein & the presence of a clot in the flamed Question: What is a ?Answer: Inflammation of a vein a thrombus Question: What is a ?Answer: A clot in the vein inflammation Question: What is venous ?Answer: It happens when blood collects & stagnates in the lower leg due to venous insufficiency Question: What is a ?Answer: A clot due to of platelets Question: What could happen when a get very large?Answer: It obstruct a vessel completely or break off, become an embolus and travel Question: Why does a DVT red & swollen?Answer: Because veins are to return blood to the heart & due to a DVT, blood just accumulates and can't get back to the heart Question: What thrombus to be small, can dissolve on its own and doesn't tend to break off?Answer: A thrombus in a superficial Question: What is a ?Answer: Dye is injected into the vein, pics are taken to look at the perfusion of the legs and Question: How long is a pt on anticoagulant ?Answer: They are on infusion 5-7 days to keep clot from larger& to prevent new ones from forming Question: How is given?Answer: It's given PO; pt may have to stay on med for 3+ months diagnosis of DVT Question: Name 3 .Answer: TPO, , Streptokinase Question: If a pt 't qualify for thrombolytics, what do they have to undergo then?Answer: Thrombolectomy Question: What are the of anticoagulant therapy?Answer: basically anything that could rupture, has had trauma, or is recently : aneurysms, alcoholism, recent or impending surgery, severe renal or hepatic disease, infections, recent delivery of a baby Question: What does do with Coumadin?Answer: It interferes with the way it Question: What are leg ulcers due to?Answer: venous insufficiency Question: How does a leg occur?Answer: Blood stagnates and can't be returned to heart and increases pressure in the area it's affecting. This can lead to compression of the arteries in the area; tissues don't get O2 and metabolic wastes aren't removed, eventually Question: What are s/s of insufficiency?Answer: Impaired flow, intermittent claudication, toes mainly affected, extremity tends to be cold,pale &numb, pain is better when leg dangles, ulcers tend to be large, irregular and superficial Question: What is the hallmark symptom of insufficiency?Answer: Intermittent Question: What are s/s of venous ?Answer: Aching & heavy feeling leg, brownish discoloration, , extremity tends to feel warm, elevating leg tends to help with pain, avoid crossing legs & dangling, avoid constrictive clothing. Question: are higher up, venous or arterial ulcers?Answer: Venous Question: What are four of debridement?Answer: Surgical, Nonselective, Meds, Oxygenation Question: What does gangrene usually result from?Answer: Arterial Question: What is rheumatic ?Answer: The endocardium (inside layer of the heart) is infected; rheuatic fever usually follows a strep throat infection and can lead to endocarditis Question: What does rheumatic endocarditis affect?Answer: The valves in the heart- nodules form around or in the valves; can affect the way the valves open or close and lead to failure Question: What are s/s of endocarditis?Answer: Sore throat & pus pockets on the throat; usually a high fever from the strep, s/s of problems (murmurs), RA symptoms may develop, chorea may develop (rapid jerky movements of the face and extremities in severe cases). Question: How is rheumatic endocarditis ?Answer: Throat culture (strep & rapid strep), echocardiogram, and a pt with no of murmurs who now has a murmur Question: What is the treatment for rheumatic ?Answer: Bedrest, antibiotics for the strep, corticoid steroids for the , aspirin for the pain Question: What is endocarditis?Answer: The inside layer of the heart becomes but it's NOT CAUSED BY STREP. Question: Who are at risk for endocarditis?Answer: Ppl with valve Question: What as a result of the infection to the endocardium?Answer: Platelets, fibrin and blood cells all cluster together to form tiny Question: What are Nodes?Answer: Very painful nodes that form on the pads of fingers and toes with infective endocarditis Question: What are lesions?Answer: They look like discolorations in the palms, fingers & ; a s/s of infective endocarditis Question: How is infective endocarditis ?Answer: Through a blood and echocardiogram Question: What is the of congestive heart failure?Answer: Heart is failing and not adequately pumping; the amount of blood coming out is decreased and tissues aren't getting adequately enough Question: What type of CHF is more ?Answer: Systolic Question: What are of CHF?Answer: CAD, MI, HTN, Valve Diseases, Question: What is the lab for BUN?Answer: 10-20 Question: What is the lab value for ?Answer: 0.7-1.4 Question: What is the lab for BNP?Answer: 1-200 Question: What does it mean when the BNP ?Answer: The higher the level is, the worse CHF Question: What measures the ejection of the heart to see how much blood is pumping though the ventricles?Answer: An echocardiogram, also used to CHF Question: What is at to see if atherosclerosis will lead to CHF?Answer: test & cardiac catheterization Question: What 5 meds are used to CHF?Answer: ACE Inhibitors, Beta Blockers (olol), Diuretics, Cardiac Glycosides, Calcium Channel Question: What do ACE do?Answer: They inhibit the conversion of A1 to A2 and reduct eh amount of aldosterone in the Question: What do Cardiac do?Answer: They help a failing be more strong with what it has left tow work with by slowing it down and strengthening the force of it's contractions Question: What is the window for Digoxin?Answer: 0.5-2ng/ml Question: What Digoxin?Answer: Low Question: Before you administer Digoxin what must you do with the heart rate?Answer: Assess it for one Question: When can you hold ?Answer: When there is a fib and the HR is less than 60 bpm Question: How many grams of Na should a pt be given?Answer: 2-3 Question: Are fluid restrictions in regards to a pt with CHF?Answer: Yes! The normal amount for a person is 2-3 liters, a CHF pt needs to stay on the low end of that . Question: What sort of gain should be reported with a CHF pt?Answer: More than 2-3lbs in a day or 5lbs in a Question: How can Lasix affect ?Answer: It can drop the level Question: ACE inhibitors can lead to hyperkalemia or ?Answer: Question: What is pectoris?Answer: Pain/pressure in the chest caused by inadequate blood flow through the coronary ; with decreased blood flow, there is a lack of oxygen and this leads to ischemia Question: What is the main of angina pectoris?Answer: , restricting blood flow; once stress appears, so does angina pectoris Question: What are some s/s of the chest pain of angina ?Answer: -Physical -Exposure to cold -Eating a heavy meal -Emotional stress/reaction Question: What are the two of angina?Answer: Stable and Question: What is angina?Answer: Predictable pain that goes Question: What is unstable ?Answer: Very unpredictable that has pain longer than usual and pain can occur while at rest Question: What kind of EKG is used to measure the electrical activity of the ?Answer: 12 lead Question: What does a panel have to do with CAD?Answer: It's done to diagnose the risk of CAD Question: If a pt has a stress test, what is done next?Answer: Cardiac where the blockage is visualized and identified Question: What is the main for angina pectoris?Answer: To decrease oxygen demand on the and increase supply of O2 to the heart Question: What is the line of meds given for angina pectoris?Answer: Nitrates in pill or form Question: When a pt is in pain from angina pectoris, what are taken?Answer: -Assess them -Do VS -Listen to & heart -Then administer med Question: How many of nitro do you give?Answer: 3 is the Question: What is the BP standard that you assess for before giving each dose of nitro?Answer: BP must be 90+ Question: What is a side-effect of nitro?Answer: Headache Question: What is the difference between Beta 1 & Beta 2 ?Answer: Beta 1 blockers affect the heart while Beta 2 blockers the lungs- both relax smooth muscles Question: What do Beta do?Answer: They HR, force of contraction and rate of AV conduction Question: Because some beta blockers are not selective, who should not take these?Answer: COPD or asthma pt shouldn't take Inderal for example it will worsen their respiratory problems Question: What is a big reason men are non-compliant on beta ?Answer: Because it circulation enough for them to be impotent Question: Before giving beta blockers, what must you first?Answer: The pt's BP to make sure they aren't since it decreases BP Question: What do channel blockers do?Answer: They block calcium from entering cells in cardiac and smooth muscles helping the coronary vascular muscles to relax, dilating these arteries; it also slows down conduction between SA and AV node, slowing down the HR some Question: What are the channel drugs?Answer: *Very Nice -Verapanul -Nifedine -Diltiazem Question: What do do?Answer: Prevent clot formation of Question: What do do?Answer: platelet aggregation Question: With Lovenox, what's looked at more, PT time or count?Answer: Platelet Question: When an area of the doesn't get enough blood flow, how long can it take to die?Answer: 20-45 Question: What is the CKMB-isenzyme, when does it peak and back to normal?Answer: It's specific to the heart that with injury to the the heart. It peaks 24hrs after injury and returns to normal in about 2-3 days Question: What is Troponin I's normal lab value and when does it peak and to normal?Answer: 0.01-0.5 Elevates within 3-4hours of injury and it can stay as long as 1-3 weeks Question: What is the of aspirin given for an acute MI?Answer: 162-325mg Question: What does doe?Answer: -Relieves anxiety -Takes care of pain -Dilates vessels -Relieves workload of the Question: Angioplasties can be on those that can't use what?Answer: Question: What can be used with angioplasty?Answer: Stents Question: What does a do?Answer: Provides to an artery but can get clogged again Question: How much drainage is within the first 24hrs after a neck dissection?Answer: 80-120ml Question: How much drainage should raise a flag if under 24hrs after a neck ?Answer: Question: What does do in the body?Answer: It's produced in the liver and maintains the colloidal osmotic pressure that keeps fluids where they should be; if pt has low level, you could expect some swelling in the Question: What is the lab for ALT?Answer: 5-35 Question: What is the lab for AST?Answer: 10-40 Question: What is the lab for LDH?Answer: 100-200 Question: What does a high of bilirubin indicate?Answer: A possible Question: In association with the , what does a high level of ammonia indicate?Answer: Hepatic Question: What are the enzymes?Answer: Amylase- breaks down carbs Trypsin- breaks down protein Lipase- down fat Question: What is pancreatitis?Answer: A medical emergency; a blockage that occurs very fast and s/s manifest Question: What is chronic pancreatitis & when is pain ?Answer: Not a total obstruction, damage is done slowly over time; pain is noticed alcohol or eating a heavy meal, can get worse when pt lays down Question: What is the referred pain for ?Answer: Left pain Question: Can alcoholism lead to ?Answer: Yes Question: What will vomit be with pancreatitis?Answer: Dark green, brown Question: If begins to elevate, what will be seen physically?Answer: Question: What two signs are for with pancreatitis?Answer: Cullen sign- bluish discoloration to the umbilicus Turner's sign- bluish to the flank area Question: Will pt with show hyper- or hypocalcemia?Answer: Hypocalcemia with the symptoms: Tetany Muscle spasms Parasthesia Steatorrhea Question: What would a WBC count be with ?Answer: than 12,000 Question: What is the lab value of Amylase?Answer: 60-120 Question: What is the lab value of Lipase?Answer: 40-140 Question: What used to be the drug of for treating pancreatitis?Answer: Demerol Question: What used to be contraindicated to pancreatitis but is okay now?Answer: Question: What drugs are used to pancreatitis?Answer: Demerol Morphine H2 Antacid Enzyme replacement such as Viocase Question: What surgical method is used to pancreatitis other than gallstone removal?Answer: - anastamose the pancreatic duct to the jejunum; it allow it to drain form the pancreas to the jejunum Question: When managing pancreatitis, what s/s should you that indicates hypocalcemia?Answer: Trousseau's sign and 's sign Question: What does bile do?Answer: It breaks down (emulsifies) Question: What cirrhosis of the liver?Answer: *HAA Hepatitis Alcoholism Alcohol Question: What are early s/s of ?Answer: -Asymptomatic at first -Fatigue -Anorexia -Swelling -Weight loss -Nosebleeds -Bleeding Question: What are late s/s of ?Answer: -Jaundice bile isn't metabolized adequately -Petechiae -Easy bruising Question: What is the normal lab of bilirubin?Answer: 0-0.9 (start jaundice at 2.5) Question: Along with PTT and platelet count, what else is looked at a liver biopsy is done?Answer: PT Question: After a liver biopsy is done, how the pt lie?Answer: Place the pt on the right side with a under the intercostal margin and pt lays i that position for a few hours Question: What is hypertension?Answer: It's the main complication of cirrhosis; it can develop from all the scar tissue that impedes the blood flow through the liver; if blood can't flow through, it will back up and into the esophagus and Question: What is ?Answer: Can result from hypotension and from liver's inability to make albumin; liver metabolizes aldosterone and if it can't , then it tends to stay in the body and make you sodium and water compounding ascites. Question: What are esophageal ?Answer: Stems from hypertension, increases the tension in the veins in the esophagus and they dilate, bulge and bleed Question: How many pts with cirrhosis, have varices?Answer: 1/3 Question: How many pts with esophageal varices may not make it an episode?Answer: 30%-50% Question: What is ligation?Answer: A management therapy for esophageal varices where, using an endoscope, bands are put on the varices to strangle them which keeps the;m from bleeding or growing further Question: What is injection therapy?Answer: A management for esophageal varices in which the varices are injected with a solution that will them; risks of bleeding are minimal after procedure is done Question: How long can an ST-Blakemore tube stay in?Answer: No longer than 48 hrs and it will be done pt is in ICU Question: Is important with an ST-Blakemore tube?Answer: Yes, too much can cause esophageal necrosis Question: What is the ultimate cure for ?Answer: A transplant Question: What is encephalopathy?Answer: A very late complication of that occurs with PROFOUND liver failure Question: What is the definition of encephalopathy?Answer: Liver metabolizes substances and if not working properly, these metabolites an build up in the body, enough so that it can lead to a life hepatic coma Question: What are s/s of hepatic encephalopathy?Answer: *CSS Coma Seizures Slow and sluggish movements Question: What is ?Answer: A sugar that is broken down into acid by bacteria in the colon that draws water into the colon & softens stools; ammonia also moves from the blood into the colon & in pts with cirrhosis, it ammonia in the blood thereby reducing the mental changes Question: With regular cirrhosis, do you increase or protein?Answer: Increase Question: With hepatic , do you increase or decrease protein?Answer: , protein elevates ammonia Question: What is the thyroid, is it and what does it do?Answer: The thyroid is a very vascular, butterfly shaped gland located in the front of the that releases 3 hormones: Thyroxine (T4), Triiodothyronine (T3) and Calcitonin Question: What do T3 & T4 do?Answer: They cellular metabolism and tell the body how fast to convert things into energy Question: What must the body have to make thyroid ?Answer: Iodine and it's found in: -Table salt -Seafood -Some products Question: What does the pituitary release?Answer: TSH (Thyroid Hormone) Question: When does the gland release TSH?Answer: When it senses a change in the thyroid, it releases TSH which the thyroid to make and release more thyroid hormone Question: What is the main of Calcitonin?Answer: To control or lower blood calcium levels by sending calcium into the bone; too high a level makes calcitonin to kit it into the bones to lower it or simply get it out of the stream Question: What is another name for ?Answer: 's Disease Question: What is ?Answer: It's too much thyroid hormone making metabolism very fast; body is in overdrive Question: What is it called when the enlarges?Answer: A goiter and it become toxic Question: Among whom is seen more frequently?Answer: ages 20-40 Question: When diagnosing hyperthyroidism, what can you hear on a goiter if it's ?Answer: A Question: To diagnose , which thyroid hormone is looked at specifically?Answer: T4 Question: What is the cortisol levels during a 24hr ?Answer: 0800- 5-23 micrograms/dl 1600- 3-13 /dl Question: What is the level for T4?Answer: 0.9-1.7mg/dl Hyperthyroidism will be than 1.7 Question: What is the level for TSH?Answer: 0.4-6.15miliunits/ml Hyperthyroidism will make it Question: What is the for hyperthyroidism?Answer: *RAT -Radioactive iodine -Antithyroid drugs -Thyroid Question: What are the meds?Answer: -Propylthiouracil (PTU)-blocks synthesis of conversion of T3 to T4; s/e of agranulocytosis -Methimazole (Tapazole)- blocks synthesis of thyroid hormone; more toxic than PTU -Potassium iodide (Lugol's solution)- suppresses release of hormone Question: What is ?Answer: Type of WBC that is drastically s a result of taking PTU; client is at risk for infection Question: What is 's solution?Answer: It's given before thyroid to decrease blood loss/hemorrhage; it's bitter and should be administered with water or OJ and should be sipped with a straw because it will stain teeth Question: What is the next step if meds don't work?Answer: Pts will be given radioactive known as I-131 which is administered by a radiologist to destroy the overactive thyroid cell Question: Is the pt who radioactive on any contact protocol?Answer: Yes, isolation contact; have to keep room shut due to the radioactive pt; must flush toilet twice, men have to void sitting down, have them drink plenty of fluids to flush radioactive med out of Question: How long will the pt be when undergoing I-131 therapy?Answer: About a week and they stay away from pregnant women & children Question: What is a subtotal ?Answer: Pt will be given PTU and Lugol's solution and 5/6 of the gland can be or the entire thing; an incision will be made in the neck so assessment must be prompt because trachea can collapse resulting in respiratory distress Question: What is that should be kept by the bedside after a subtotal thyroidectomy?Answer: A tracheotomy tray for the first Question: What is a huge risk with a subtotal thyroidectomy?Answer: Question: What is the main purpose of the hormone and where is it located?Answer: To calcium and is located behind the thyroid gland Question: What should be kept on a hospital floor in case a pt shows s/s of ?Answer: gluconate Question: What position should the bed be in a subtotal thyroidectomy?Answer: Semi-fowler's position with neck support ( a couple of pillows) to tension at the sutures Question: What is a of the surgery?Answer: The laryngeal nerve can become damaged so note the tone of their voice; hoarseness is to be but it shouldn't continue to get more hoarse, if so, contact MD Question: What a thyroid storm?Answer: -Emotional -Trauma -Infection Question: What are the s/s of a storm?Answer: Same as with hyperthyroidism but more exaggerated and much worse: Temp >103 -Diaphoresis -Restlessness -Tachycardia >130 -BP >200 -Agitated -Begin to show of cardiac dysrhythmias Question: What is name for hypothyroidism?Answer: Myxedema Question: What is ?Answer: Lack of hormone; metabolism slows down Question: whom is hypothyroidism more prevalent?Answer: and the elderly population Question: What are some of hypothyroidism?Answer: -Something wrong with the or pituitary gland -Radioactive killed too many cells -Thyroidectomy -Tumor in pituitary gland Question: How is diagnosed?Answer: By a decrease in T4 and increase in TSH; also at lab work Question: What med is as management for hypothyroidism?Answer: (Levothroid) Question: Since pts with hypothyroidism are and slow, what do they need?Answer: They need and you may have to repeat instructions more than once for them Question: What is a coma?Answer: It is a EMERGENCY; same s/s of a thyroid storm but worse Question: What a myxedema coma?Answer: -Emotional -Trauma -Infection Question: What are s/s of a coma?Answer: -Almost unconscious person -Respirations very low -Low BP -Low HR -Extremely Question: What are the hormones released by the adrenal gland?Answer: 3 S's -Salt (mineral ) -Sugar (glucocorticoid) -Sex (androgen) Question: What is the and inner part of the adrenal gland called respectively?Answer: Adrenal & medulla Question: In regards to the adrenal gland, who is the pituitary gland to it and what does the pituitary gland release it?Answer: Pituitary gland is the boss; It releases ACTH (adrenocorticotropic ) Question: What does ACTH (adrenocorticotropic ) do?Answer: the adrenal cortex to release the salt, sugar & sex hormones Question: What is the main hormone of the and what do they do?Answer: Cortisol; glucocorticoids affect metabolic glucose in the body and directly affects the blood glucose level; they try to keep you happy & emotionally stable; they help you deal with Question: What is a corticoid and what does it do?Answer: Aldosterone; it electrolyte metabolism and is very important in controlling sodium Question: What does the hormone do?Answer: It masculine features. If a female has too much, she can grow facial hair Question: What is 's syndrome?Answer: Having too much of the salt, sugar, & sex Question: What is the of Cushing's syndrome?Answer: Taking too many corticosteroid meds that may the adrenal cortex and if it becomes enlarged, it can lead to an excess of the salt, sugar & sex hormones being released Question: What does cortisol ?Answer: It affects the way that protein, carbs & fat are Question: What happens if you have too much excess of protein, & fat in the body?Answer: It can lead to fatty deposits such as a 'Moon Face' with fat deposits in the fact but other areas as well like the back of the neck & Question: How does 's affect calcium?Answer: It keeps it from entering the bones and then bones become more to fractures Question: What if you take too much glucocorticoids?Answer: -It can mask -Decrease immune response -Decrease inflammatory response Question: How is Cushing's ?Answer: By checking serum cortisol levels (their levels will be elevated and stay elevated instead of dropping in the ) and by an ACTH Suppression Test Question: What is an ACTH (adrenocorticotropic ) Suppression Test?Answer: It suppresses the gland from releasing ACTH so levels would be low; if it's high, then it's Cushing's Question: With Cushing's, how potassium and glucose be?Answer: Both potassium & glucose would be Question: How do you Cushing's?Answer: Take away drugs such as steroids, but them off, never abruptly Question: Med wise, how would you Cushing's?Answer: By them glucocorticoid inhibitors such as: -Mitotane (Lysodren) -Ketoconazole (Nizoral) -Metyrapon (Metopirone) Question: What surgery is for treating Cushing's?Answer: Transsphenoidal Hypophysectomy- a surgery to remove a tumor off of the gland Question: With the involved for treating Cushing's, what crisis should you monitor for?Answer: Adisonian- occurs if the treatment is so that it throws client into the opposite extreme (Addison's) Question: What is the of Addison's Disease?Answer: An insufficiency of the salt, , & sex hormones (adrenal cortex does not release the hormones in adequate amounts) Question: What Addison's Disease?Answer: Anything that causes adrenal cortex to atrophy; if the adrenal glands are removed, you end up with Addison's or if the is not producing enough ACTH Question: How is 's diagnosed?Answer: Through serum cortisol levels, serum glucose will be Question: What is the relationship between potassium and ?Answer: Potassium will be high, will be low Question: What is the of choice for Addison's?Answer: A corticosteroid as Prednisone- it's action is to erase inflammation and replaces; the hormones that the body is not creating Question: What is an Adisonian ?Answer: Same s/s of 't only worse; hypotension, rapid weak pulse, rapid respiratory rate, pallor, extreme weakness Question: How is an Adisonian Crisis ?Answer: With Solu-Cortef IV, a steroid Question: What is ?Answer: An opacity or cloudiness of the lens; a cause of blindness in the world Question: What is the treatment for cataracts?Answer: Removal of the cloudy lens with an and put in an IO (intraocular lends) implant Question: What is the name of the procedure for cataracts?Answer: Phacoemulsificaton (Phaco)- a common Question: What drop are used in pre-op for ?Answer: Mydriatics because they the pupils; miotics constrict the pupils Question: Post-op for , what is usually prescribed medicinally?Answer: Antibiotics or steroid to decrease chance of infection Question: Why is the #1 surgery in most hospitals?Answer: Because the are living longer Question: What is the cause of blindness in the U.S.?Answer: Question: What is ?Answer: Increased IOP (intraocular ) causes optic nerve damage; vitreous/aqueous humor in the eye can't drain and float through the eye so pressure in the eye increases Question: What is the pressure in the eye?Answer: 10-21mm/Hg Question: How wide is the meshwork?Answer: 1/50th of an inch Question: How do you open angle glaucoma?Answer: With miotics (constricts, ex. Pilocarpine); works by causing pupil to constrict increases the amount of aqueous and more fluid can drain through meshwork Question: How do you treat closed glaucoma?Answer: , it's closed angle because of a blockage so surgery is going into the eye to remove the blockage: -Laser Trabeculoplasty -Trabeculectomy -Iridotomy Question: What is degeneration?Answer: Affects central vision, center part of and is characterized by Drusen (yellow spots) beneath the retina Question: Who is at risk for ?Answer: Ppl over the age of Question: What is the percentage of the has dry macular degeneration?Answer: 85%-90% Question: What is the wet of macular degeneration?Answer: Abnormal blood vessels under the retina cause leak & swelling and hardening of the and vision changes quickly Question: What is the and most reliable way to detect changes with macular degeneration?Answer: grid Question: What are the two ways wet degeneration are treated?Answer: -Photodynamic Therapy (PDT)- abnormal vessels are zapped by laser -Angiogenesis research- drug at stunting abnormal vessel growth Question: What should a pt avoid for five days PDT (photodynamic therapy)?Answer: The Question: What is retinal and the s/s?Answer: The retinal layers separate; s/s are: -Floaters or spots -Lines or flashes of -Like a curtain was pulled over the eyes Question: What are the risk for retinal detachment?Answer: -Diabetes -Severe -Trauma Question: What surgery can be done for detachment?Answer: Scleral buckle- buckle of silicone goes around the eyeball to hold the together; MD may inject an air bubble called a gas tamponade to assist it but pt has to be in prone position for 2-4 weeks Question: What is the definition of low ?Answer: Best corrected acuity of 20/70- 20/200 Question: What is the of legal blindness?Answer: Visual acuity of 20/200 or less in the eye with the best correction possible OR widest visual field is 20 degrees or less Question: What is the definition of ?Answer: Best corrected visual acuity of 2400 to no perception Question: What's the difference between an ophthalmologist and an ?Answer: An ophthalmologist is a dr Question: What two of tonometry are there to check for glaucoma?Answer: and Non-Contact Question: What is the fluid for a glaucoma test?Answer: No more than 2 cups of 4 hrs before the test Question: When should you drinking alcohol before a glaucoma test?Answer: Don't drink any alcohol 12 hrs the test Question: When you cease smoking marijuana before a glaucoma test?Answer: Don't smoke any marijuana 24 hrs the test Question: What are the three classifications of SLE (systemic lupus )?Answer: -Drug-induced- associated with the use of Apresoline (BP med), INH (TB med) and -Discoid lupus- involves the skin only -Systemic lupus- involves one or more systems such as cardiovascular, central nervous, renal, lungs, etc Question: What is ?Answer: A chronic, inflammatory connective tissue disease of unknown origins that affects almost all body systems; a immune response with exaggerated production of autoantibodies that has remissions & exacerbations Question: Among whom is more prevalent?Answer: Seen 9 times more in women than men; usually diagnosed in or early adulthood Question: What are some s/s of Lupus?Answer: Butterfly rash, painful or swollen joints, unexplained fever, unusual loss of hair, pale and fingers, extreme fatigue, ulcers in the mouth, (reynaud's phenomena, vasculitis- not common but occurs) Question: What can you hear in the chest to be diagnosed with ?Answer: A pericardial friction Question: What would you see confirmed on a test for Lupus?Answer: Decreased C4 or C4 compliment Increased anti-DNA Increased ANA titer Question: With , would the WBC be high or low?Answer: WBC be low (<5000) Question: What meds are used with ?Answer: -NSAIDs (along with aspirin for the antiplatelet affect) -Corticosteroids -Antimalarial (ex. Plaquenil) -Immunosupressive (ex. but can cause pulmonary fibrosis) Question: What diet a pt with Lupus be on?Answer: Low fat, low , high fiber keeping portion control in mind Question: What is gout and how is it ?Answer: It's a condition that results from uric acid depositing in tissues in the body and characterized by recurring attacks of joint and hyperuricemia (>7mg/dl) Question: What is uric acid?Answer: A by of breaking down purines Question: What are ?Answer: Deposits of uric acid crystals in the peripheral areas of the body such as the big toes, the hands or the ears; kidney can result as well Question: How would tophi feel upon ?Answer: Hard and in shape Question: What is gout?Answer: Results from excessive dieting or of foods high in purines Question: What is gout?Answer: Results from cancers, anemias, psoriasis, drug-induced failure Question: Who is more at risk for gout, men or ?Answer: Men, seen in 9 times more men than women and diagnosed between puberty and a peak age of 75; women usually see it menopause Question: What is the most site for gout?Answer: The joint at the base of the big toe 90% of the Question: What is the normal of uric acid?Answer: 3-7 Question: What is the normal of uric acid we excrete in 24 hours?Answer: 250-750mg Question: What is the most test for gout?Answer: and looking for uric acid crystals during artherocentesis Question: What are some s/s of gout?Answer: -Acute arthritis is the most common early symptom -Occurs at -Big toe inflammation -Subsides after 3-10 days Question: What are some late s/s of gout?Answer: -Tophi -Attacks last longer -More joint -Renal stones Question: What are the meds used to gout?Answer: -Analgesics -NSAIDs -Colchicine- one of the drugs for gout in 1936 (KEY drug) -Probenecid (Benemid)- used for chronic attacks -Allopurinol (Zyloprim)- used for chronic attacks -Corticosteroids Question: Why should you avoid with gout?Answer: Because it can lead to which would lead to a slowing down of the excretion of uric acid, building up uric acid leading to gout attacks Question: How long does the PO form of take and the IV form of Colchicine take?Answer: PO takes 12-48 hrs IV 4-12 hrs Question: How does work?Answer: It suppresses inflammation in gout attacks Question: How does (Zyloprim) work?Answer: It blocks uric acid Question: What is the of osteomyelitis?Answer: It's an infection in the Question: What are three ways of osteomyelitis?Answer: 1. Soft tissue infected, it can move to the bone 2. Direct communication of bone from surgery fractions 3. Question: If osteomyelitis is borne, how is it manifested?Answer: You will see signs of flu-like : chills, high fever, rapid pulse, malaise.... Question: If osteomyelitis is NOT borne, how is it manifested?Answer: You will see , physical s/s: pain, warmth, swelling... Question: What will happen if isn't treated quickly?Answer: An abscess will form and infect the pt for life Question: How can you osteomyelitis?Answer: -Do do surgery with a pt that has an infection -Give antibiotics prior to dental work/surgeries -Early removal of catheter and drains Question: How much drainage you expect from a correction of an osteomyelitis wound?Answer: 24hrs- 200-500cc The next 48hrs- 25-30cc Question: What is CPM?Answer: Continuous Passive Motion- it helps increase circulation & prevents adhesions from Question: What is C-reactive (CRP)?Answer: It's more sensitive than ESR and with , you should see elevated WBC and ESR Question: Why you use an MRI for osteomyelitis?Answer: it shows osteomyelitis earlier and more intense elevations Question: Why is an abscess a complication of ?Answer: Because it steals the blood supply and contains sequestrum (dead bone tissue) Question: How could osteomyelitis spread the body?Answer: Through the blood, could result in a continuously draining opening for life Question: How are given for osteomyelitis?Answer: They are given around the clock for 3-4 months and then switched from IV to Question: What does make you susceptible to?Answer: Fractures of the hips & Question: What is ?Answer: Compression of the spine and other parts of the body; affects 50% of women over 80 years of age Question: Why does osteoporosis affect so many ?Answer: they may excrete too much calcium through the kidneys Question: When do we peak bone mass?Answer: Between the ages of 35-40; as we get , calcitonin is decreased and calcitonin inhibits bone reabsorption & promotes bone formation Question: Why do develop osteoporosis ore frequently than men?Answer: Because women have a lower peak bone Question: What is a great preventative for osteoporosis?Answer: Exercise is a great strategy Question: What are a few risk factors for ?Answer: White , hyperparathyroidism, 3 months steroid use, low body weight, excessive alcohol intake, too little calcium in diet Question: What are some osteoporosis s/s that occur late in ?Answer: Pain or tenderness, fractures, loss of height, low back pain, neck pain, stooped (Kyphosis) Question: How is examined?Answer: -DEXA scan -Spine CT -Spine or hip x-ray (but not to confirm but can see fracture or collapse) Question: What are meds?Answer: -Bisphosphonates -Calcitonin -Parathyroid -Raloxifene Question: How you take bisphosphonates?Answer: If taken PO, you should take it on an stomach and drink a full glass of water with it and be upright 30-60 minutes afterward Question: What is a rare s/e of ?Answer: Osteonecrosis of the Question: What does do in regards to osteoporosis?Answer: It slows the rate of bone & relieves bone pain; can come as an injection or spray and is less effective than bisphosphonates; unlabeled use for it is for phantom limb pain Question: What are a few about calcium you should teach your pt?Answer: -Chronic use of laxatives decreases absorption of calcium -They be taken with or after meals & to increase absorption -Absorption is highest in doses less than 500mll -Protein & Vitamin D are needed to enhance calcium absorption Question: Why are calcium supplements and HRT (Estrogen) rarely used as for osteoporosis?Answer: they increase the risk of breast & endometrial cancer Question: What are some life s/s of HRT?Answer: -Thromboembolism -Stroke -PE -MI Question: What is the Hormone (Forteo)?Answer: It contains huma hormones and is approved for treatment of osteoporosis for women at hight risk Question: What is (Evista)?Answer: It is used for prevention & treatment in osteoporosis & breast prophylaxis; reduces spinal fractures by 50% Question: If are on estrogen, taking calcium, what exams should they get?Answer: -Regular -Mammograms qyr -Pelvic -Pap Question: How much should you get a day?Answer: Question: How much D should you get a day?Answer: 400-600IU Question: What are some early complications of ?Answer: *SDFC -Shock -DVT -Fat Embolism -Compartment Question: When you're in hypovolemic shock from hemorrhage, how can you tell the difference compensated and decompensated?Answer: -Compensated is increased HR & RR and normal BP -Decompensated is HR & RR and decreased BP Question: What has a very rapid after injury and is an early complication of fractures?Answer: Fat embolism; it's onset is 24-72 hrs injury but can occur up to a week after injury; pt will shows signs of respiratory distress and if it's systemic then petechiae will show Question: How do you reduce the risks of a fat ?Answer: -Immobilize the fracture immediately -Minimal manipulation of fracture -Maintain F&E Question: What is compartment ?Answer: The elevation of tissue pressure within a closed fascial ; it can compromise circulation & function and can be seen in that part of the body that can lead to irreversible nerve injury and muscle necrosis Question: What complication of a fracture requires immediate intervention or it can lead to muscle necrosis in a few hours?Answer: syndrome Question: With compartment syndrome, if s/s aren't relieved in a few minutes, what be done next?Answer: Question: With syndrome, where should the limb sit? Answer: At heart , elevation is contraindicated Question: What is checked for with a check?Answer: The 5 P's: -Pallor -Pain -Parasthesia (early sign) -Paralysis (late sign) -Pulselessness (very late sign) Question: With NV checks, what do cyanotic nail beds (fingers and toes) ?Answer: congestion Question: With NV , what do pallor or blue, dusky look of the fingers themselves suggest?Answer: Diminished perfusion Question: What occurs with a union?Answer: Healing doesn't occur at a normal rate for the Question: What from failure of the ends of a fractured bone to unite in normal alignment?Answer: Question: What results from failure of the ends of a fractured bone to ?Answer: Nonunion Question: What occurs fracture with disruption of blood supply?Answer: Necrosis (AVN) Question: How is AVN ?Answer: With bone , replacement with prosthetic bone or fusions Question: How long does it take a cast to dry?Answer: Up to 72 Question: How should you encourage toe and finger exercises for body parts in a cast?Answer: Hourly while Question: While wearing a cast, what can help to disuse syndrome?Answer: Isometric exercises such as knee or making a fist Question: What are the two types of used?Answer: Skin and Question: When is skin used?Answer: To control muscle spasms and immobilize an area after surgery; accomplished by using a weight to pull on traction tape or on a foam boot to the skin Question: When is traction used?Answer: To treat fractures of the: -Femur -Tibia -Cervical Applied directly to the bone with a metal pin or wire Question: How often must you the foam when in traction?Answer: Question: What are the complications of Buck's traction?Answer: -Skin breakdown -Circulatory & nerve Question: How should the body be when in traction?Answer: Down the center of the Question: What is recommended to clean pins used in ?Answer: Chlorhexidine but sterile water and saline are (betadine may damage healthy tissue) Question: What are some isometric exercises of the immobilized ?Answer: Quadriceps-setting & setting Question: With a THA (total hip ), what is normal drainage?Answer: 200-500ml the first 24 hrs < 30ml at 48 Question: To avoid hip , what should you keep between your legs?Answer: A pillow to abduction Question: What type of chair should be used to hip dislocation?Answer: A high chair, same with toilet, you want the hips to be higher than the knees Question: How long should you keep up to avoid a hip dislocation?Answer: 4-6 Question: a THA, how far do you want to flex?Answer: No more than 90 Question: How high should you the HOB after a THA?Answer: No more than 60 Question: What accounts for most of the amputations of extremities?Answer: Question: Why do of upper extremities usually occur?Answer: Because of traumatic injury or a malignant tumor Question: The amputations that occur due to PVD occur with pt that from what?Answer: Diabetes; 50%-75% of all are performed on pt with diabetes Question: How is phantom limb pain ?Answer: -TENS (transelectrical nerve stimulation) -Beta -Tricyclic Antidepressants Question: What 3 things must you avoid with a lower amputation?Answer: Avoid: -Abduction -External -Flexion Question: If lower extremity is to be after an amputation, how is it done?Answer: By raising the Question: What can an amputee pt do to stretch flexor muscles and prevent flexion ?Answer: Turn from side to side & assume prone positions several throughout the day Question: How long an amputee pt sit at a time?Answer: No more than 30 Question: How can an pt prevent abduction deformity?Answer: By keeping legs Question: What type and peak do Lispro (Humalog) & (Novolog) have?Answer: They are rapid acting insulin and have a peak of 1 Question: What type of insulin is Regular (Humalog R, R, Iletin II Regular) and what is it's peak?Answer: It's acting and it's peak is 2-3hrs Question: What are intermediate acting insulins and what are the ?Answer: -NPH (Neutral Protamine Hagedorn) -Humlin N, Iletin II , Iletin II NPH, Novolin L [Lente], Novolin N[NPH]) And the peak is 4-12 hrs Question: What is a long insulin and what is it's peak?Answer: ("UL") and it's peak is 12-16hrs Question: What is (Lantus)?Answer: A very long acting insulin that is continuous, it doesn't have a Question: Which type of diabetes is due to no being produced?Answer: Type Question: Which type of diabetes is diagnosed under the age of 30?Answer: Type Question: Which type of diabetes is made up of 90%-95% of all ?Answer: Type Question: DKA would occur with a pt with which type of ?Answer: Type Question: HHNK would occur with a pt with type of diabetes?Answer: Type Question: Which type of diabetes is usually with diet and exercise?Answer: Type Question: For a hypoglycemic pt, when you have to give rapid acting insulin, what should you have ?Answer: Food Question: How is a dose of glucogon ?Answer: Administered either IM or Subq Takes 20-30 mins to work and doesn't last long, once the pt is able to eat, you give them some protein Question: What is an low bgl?Answer: <50-60mg/dl Question: What are some of 15gram fast acting carb snacks?Answer: -2 tspn molasses -2-3 tspns honey -3-4 tablets -4-6 ozs of juice or regular soda -6-10 hard candies Question: After giving some fast acting carb , when should you retest the bgl?Answer: After 15 mins and if it's still <70, then Question: If a pt is unconscious and/or can't , how do you treat hypoglycemia?Answer: -IM or subq glucagon 1mg -25-50ml 50% dextrose solution Question: What is the with DKA?Answer: Blood sugar is so high, it spills into the kidneys and begins to build up ketones i the blood stream leading into metabolic acidosis so then you need to administer sodium bicarb for metabolic acidosis; the high sugar damages blood cells Question: What is the major electrolyte to about with DKA?Answer: Potassium; K level may stay the same or go up slightly with kDKA but quickly once DKA treatment starts Question: How is DKA ?Answer: By HIE -Hydration -Insulin -Electrolyte Question: How you hydrate a pt with DKA?Answer: Hydrate with solution NS 0.9%, then will be switched to hypotonic solution, NS 0.45% when a pts blood sugar drops to 250-300 Question: When treating DKA, what type of insulin is and in what form?Answer: Regular and in IV Question: What does DKA have in the and urine that HHNS doesn't?Answer: Ketones Question: What is the onset of hypoglycemic complications from to slowest?Answer: -Hypoglycemia -DKA -HHNS Question: What is the best way to diabetes?Answer: DIME -Diet -Insulin -Meds -Exercise Question: What test can you perform on a pt post-op to for thrombophlebitis?Answer: Homan's test- Pain would be exhibited in the calf upon dorsiflexion of the foot. This is a + sign and mean ls thrmombophlebitis may have developd; if so, look at legs for redness and/or edema. This clot could travel to the lungs and become a PE Question: What is the minimum amount of urine we want to see in a post-op pt?Answer: They can be as little as 30cc/hr but we would like to see 50cc/hr Question: What is hypertonic ?Answer: A solution with an osmolality higher than that of Question: Which solution has an lower than that of serum?Answer: A hypotonic Question: What is an solution?Answer: A solution with the same as serum and other body fluids Question: What is the range for serum osmolality?Answer: 280-300mOsm/kg Question: What are some solutions?Answer: -0.9 NaCl (Normal saline) -Lactated Ringer's solution (Hartmanns' ) -5% dextrose in water (D5W)- does convert to hypotonic solution over time Question: What is a hypotonic ?Answer: 0.45 NaCl (Half strength ) Question: What is a solution?Answer: 3% NaCl (hypertonic saline) 5% NaCl (hypertonic ) Question: What is volume deficit (FVD)?Answer: The loss of extracellular fluid the intake ratio of water Question: What does refer to?Answer: The loss of water with the increased serum sodium level (hyperosmolar deficit) Question: What is an iso-osmolar ?Answer: The equal loss of and electrolytes; caused by GI wounds, v/d, third spacing (burns ascites, bowel obstruction) Question: What lab should you see with FVD?Answer: Elevated BUN in relation to serum Increased hematocrit increased hemoglobin Possible serum electrolyte changes Question: What is volume excess (FVE) due to?Answer: It's due to a fluid overload or homeostatic mechanisms Question: What is the level of central venous pressure (CVP) when measured by a watermenometer?Answer: 4-10mm/Hg; however with FVE, it's Question: What is the management of FVE?Answer: -Restriction of and sodium -ADministration of diuretics Question: What is the intake of Na/day?Answer: Question: What is the hospitals low diet?Answer: Question: What are the PMS that can be cut down for sodium's sake?Answer: PMS -Processed -Milk; products -Salt Question: In FVE, what is BUN, hemoglobin and hematocrit? or decreased?Answer: Decreased Question: What renal treatment can also be a for FVE?Answer: Question: What level is considered ?Answer: <3-5mEq/l Question: What are some causes of ?Answer: -GI -Meds -Hyperaldosteronism Question: How can hyperaldosteronism be a of hypokalemia?Answer: Too much aldosterone which r/t Na & H2o and too much of that makes potassium decrease Question: What low level of an electrolyte can cause paralytic ?Answer: Question: What can a low level of potassium eventually do to the ?Answer: Stop it and this is known as a cardiac standstill; Flat T wave on the Question: What should be dealt with , potassium or sodium?Answer: Question: What is the major player in the ICF ?Answer: Question: What is the normal level of ?Answer: 3.5-5.0 Question: What level is considered ?Answer: >5.0 Question: What are some of hyperkalemia?Answer: -Impaired function -Hypoaldosteronism -Tissue trauma -Acidosis Question: What are the biggest of potassium?Answer: Question: What can a high level of potassium eventually do to the ?Answer: Make it stop beating, this is known as ventricular Question: What forces potassium back into the ICF ?Answer: -Restricting in diet -Dialysis -Combination of insulin and glucose Question: What type of diuretics should not be used with pts who have and renal dysfunction?Answer: Potassium-sparing diuretics because they may elevation of potassium Question: With an acid-base , what is the pH level base?Answer: 7.35-7.45 Question: With an acid-base imbalance, what is the pCO2 ?Answer: 35-45 Question: With an acid-base , what is the HCO3 levelAnswer: 22-26 Question: With acid=base , what do the lungs help with?Answer: CO2- acid Question: With acid-base , what do the kidneys help with?Answer: level Question: With acid-base imbalances, what does pH indicate?Answer: H+ (hydrogen ion) Question: What three mechanisms come into play when with F&E imbalances?Answer: -Buffer -Kidneys -Lungs Question: Out of pH, CO2 & HCO3, one is is the more critical one to look at?Answer: Question: What is the pH ration?Answer: 20:1; 1 part carbonic acid to 20 sodium bicarbonate Question: How should you systematically the cause of an ABG disorder?Answer: look at the pH Second, look at the pCO2 (respiratory) Third, look at the HCO3 (metabolic) Question: With F&E imbalances, what is done by and what is correction done by?Answer: Compensation is done by the body & is done by medical intervention Question: What pneumonic is good for F&E imbalances?Answer: ROME -Respiratory -Opposite -Metabolic -Even Question: How long does it take for to compensate for respiratory problems?Answer: 3 days Question: How long does it take for lungs to compensate for metabolic ?Answer: Immediately Question: What are the six rights of med ?Answer: Right dose Right med pt Right route Right time Right documentation Question: What are the components of a drug ?Answer: -date and time order is written -drug name -drug -route of administration -frequency and duration of administration -special instructions Question: How many do you read a drug label?Answer: 3 times Question: What sort of drug order shoiuld be checked agisnt the original order?Answer: -First dose -One time -PRN Question: What is the longest ?Answer: IM Question: What are the and lengths of an ID needle?Answer: -25, 26 Lengths -3/8 -1/2 -5/8 Question: What are the and lengths of an SC needle?Answer: Gauges -23, 25, 26 3/8, 1/2, 58 Question: What are the gauges and of an IM needle?Answer: Gauges -19, 20, 21, 22 Lengths -1, 1 1/2, Question: What is an reaction to ACE inhibitors?Answer: Question: What is the to Heparin & Lovenox?Answer: Sulfate Question: What is the antidote for ?Answer: Vitamin Question: What do you not take with ?Answer: Heparin Question: What two are diuretics widely used for?Answer: HTN & failure (also used for fluid volume overload) Question: What kind of is Aldactone?Answer: K Question: What kind of are Lasix & Demadex?Answer: Question: What suffixes do ACE have?Answer: -pril Question: What's a big sign of toxicity?Answer: Yellow or green halos-blurred Question: What are the two most antihyperlipidemics?Answer: Zocor & Question: With what group of meds should you avoid drinking more than one of grapefruit juice a day?Answer: Question: Antihyperlipidemics can be very to what?Answer: The |
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