UTA NURS 3561 Med-Surg Exam 1
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| Anti-HTN periop concerns | show 🗑
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| show | potentiate effect of opioids and barbiturates
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| Insulin or oral hypoglycemic agents periop concerns | show 🗑
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| Aspirin, clopidogrel (Plavix), and NSAIDs periop concerns | show 🗑
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| show | excessive postoperative bleeding
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| show | May cause inflammation of the liver if used with certain medications
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| Feverfew periop concerns | show 🗑
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| Garlic periop concerns | show 🗑
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| Ginger periop concerns | show 🗑
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| show | May increase bleeding, especially in patients taking anticoagulants
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| show | May increase bleeding, especially in patients taking anticoagulants; may cause increased heart rate or elevated blood pressure (BP)
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| Goldenseal periop concerns | show 🗑
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| show | May prolong the effects of certain anesthetics or antiseizure medications; may cause liver injury
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| Licorice periop concerns | show 🗑
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| show | May have additive effects with other hormone therapies
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| show | May prolong the effects of anesthetic agents
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| show | May prolong the effects of certain anesthetics or antiseizure medications; may cause liver injury
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| show | May increase bleeding, especially in patients taking anticoagulants; may affect thyroid gland function; in high doses may cause increased BP in patients who already have high BP (Lewis 112010, p. 338)
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| show | witnessing patient's signature; verifying patient understands information on consent, implications of consent, and that consent is voluntary and can be withdrawn anytime.
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| show | Renal dysfunction, Diabetes, Impaired immune system, and Nutritional deficiences (especially protein, vitamins A, C, & B complex)
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| Risk factors for respiratory complications | show 🗑
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| show | All patients: deep breathing, coughing, and early ambulation; Individualized teaching: incentive spirometers, PCA pumps, pain rating & management, surgery specific information
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| Hyperglycemia manifestations | show 🗑
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| show | cold/clammy skin, numbness of fingers/toes/mouth, rapid heartbeat, emotional changes, headache, nervousness/tremors, faintness/dizziness, unsteady gait/slurred speech, hunger, changes in vision, seizures/coma
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| show | diabetes meds, monitor blood glucose and urine ketones, drink fluids hourly
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| show | immediately ingest 15-20 g of simple carbs, repeat every 15 min, contact provider if no relief, discuss med dosage with provider
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| show | an acute metabolic complication of diabetes occurring when fats are metabolized in the absence of insulin resulting in formation of acid by-products, such as ketones (Lewis 112010, p. G-3)
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| show | dehydration (poor skin turgor, dry moucous membranes, tachycardia, orthostatic hypotension), lethargy/weakness, abdominal pain, anorexia, vomiting, Kussmaul respirations, fruity breath.
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| Kussmaul respirations | show 🗑
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| show | life-threatening syndrome that can occur in the patient with diabetes who is able to produce enough insulin to prevent diabetic ketoacidosis but not enough to prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion
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| Rapid-acting insulins | show 🗑
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| show | regular (Humulin R, Novolin R, ReliOn R)
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| show | NPH (Humulin N, Novolin N, ReliOn N)
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| Long-acting insulins | show 🗑
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| show | Onset: 15 min, Peak: 60-90 min, Duration: 3-4 hr
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| show | Onset: 1/2-1 hr, Peak: 2-3 hr, Duration: 3-6 hr
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| Intermediate-acting insulin Onset, Peak, & Duration | show 🗑
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| Long-acting insulin Onset, Peak, & Duration | show 🗑
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| Primary hypertension | show 🗑
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| show | elevated blood pressure associated with any of several primary diseases, such as renal, pulmonary, endocrine, and vascular diseases (Lewis 112010, p. G-8)
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| show | Diuretics, Adrenergic Inhibitors, Direct Vasodilators, Ganlionic Blockers, Angiotensin inhibitors, Renin Inhibitors, Calcium Channel Blockers
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| Diuretic considerations | show 🗑
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| show | Monitor for orthostatic hypotension & advise that sudden d/c may cause withdrawal syndrome (Lewis et al., 2010, p. 748)
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| Direct Vasodilator considerations | show 🗑
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| show | Admin by IV infusion & monitor for visual disturbances (Lewis et al., 2010, p. 748)
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| Angiotensin Inhibitors considerations | show 🗑
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| show | May cause angioedema & don’t use when pregnant (Lewis et al., 2010, p. 748)
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| Calcium Channel Blockers considerations | show 🗑
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| Diabetes Type 1 | show 🗑
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| Diabetes Type 2 | show 🗑
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| show | gestational
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| show | diabetes secondary to another condition
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| Sulfonylureas Problems | show 🗑
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| Meglitinides Problems | show 🗑
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| show | Diarrhea, lactic acidosis
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| α-Glucosidase Inhibitors Problems | show 🗑
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| Thiazolidinediones Problems | show 🗑
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| Dipeptidyl Peptidase-4 (DPP-4) Inhibitors Problems | show 🗑
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| show | 2 A1C ≥6.5%; 2 fasting blood glucose levels ≥126 mg/dL; 2 glucose tolerance tests >200 mg/dL; or a random glucose ≥200 mg/dL
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| Diabetic Retinopathy | show 🗑
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| show | a microvascular complication associated with damage to the small blood vessels that supply the glomeruli of the kidney. (Lewis 112010, p. 1249)
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| show | nerve damage that occurs because of the metabolic derangements associated with diabetes mellitus (Lewis 112010, p. 1249)
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| show | a dark, coarse, thickened skin predominantly seen in flexures and on the neck (Lewis 112010, p. 1251)
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| Diabetic dermatopathy | show 🗑
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| show | associated with type 1 diabetes, usually appears as red-yellow lesions, with atrophic skin that becomes shiny and transparent revealing tiny blood vessels under the surface (Lewis 112010, p. 1251)
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| show | associated mainly with type 1 diabetes, is probably autoimmune in nature and forms partial rings of papules, often on the dorsal surface of hands and feet (Lewis 112010, p. 1251)
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| Macrovascular complications | show 🗑
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| Microvascular complications | show 🗑
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| show | Male: 13.2-17.3; Female: 11.7-16.0; possible etiology if decreased: hemorrhage
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| Hematocrit normal | show 🗑
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| show | 4.0-11.0 × 103/μL; possible etiology if increased: infection
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| Cholesterol normal | show 🗑
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| Creatinine normal | show 🗑
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| Glucose (fasting) normal | show 🗑
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| show | 4-24 μU/mL; possible etiology if elevated: untreated mild type 2 diabetes; possible etiology if decreased: inadequately treated type 1 diabetes
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| show | 275-295 mOsm/kg; possible etiology if elevated: DM
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| Phosphorus normal | show 🗑
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| show | <150 mg/dL; possible etiology if elevated: DM
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| show | 4.0%-6.0%; possible etiology if elevated: poorly controlled DM
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| show | negative; possible etiology if elevated: DM
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| show | <100 mg/day; possible etiology if elevated: DM
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| Urine Glucose normal | show 🗑
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| Urine Ketone bodies normal | show 🗑
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| show | 1.003-1.030
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| show | 3.5-5.0 mEq/L; possible etiology if elevated: DKA, diuretics
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| Sodium normal | show 🗑
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| b-Type natriuretic peptide (BNP) normal | show 🗑
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| Pulmonary edema manifestations | show 🗑
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| Dopamine (Intropin) Drug Alert | show 🗑
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| show | Syncope (sudden loss of consciousness) occasionally occurs 30 to 90 minutes following initial dose, a too-rapid increase in dose, or addition of another antihypertensive agent to therapy. (Lewis 112010, p. 752)
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| show | Instruct patient not to discontinue drug abruptly as this may precipitate angina and/or heart failure. (Lewis 112010, p. 757)
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| Clonidine (Catapres) Drug Alert | show 🗑
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| show | Do not use in patients with kidney disease, liver disease, or heart failure, or in people who drink excessive amounts of alcohol. (Lewis 112010, p. 1230)
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| show | Increased risk of MI & stroke; not for use in pts with HF
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| show | Class: Biguanide; Action: ↓ Rate of hepatic glucose production; augments glucose uptake by tissues, especially muscles; Side Effects: Diarrhea, lactic acidosis
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| show | Acute pancreatitis and kidney problems have been associated with its use. (Lewis 112010, p. 1230)
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| Pramlintide (Symlin) Drug Alert | show 🗑
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| Nitropursside (Nipride) Drug Alert | show 🗑
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| Captopril (Capoten) Drug Alert | show 🗑
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| show | Monitor potassium; may reduce effects of digoxin; avoid foods high in potassium; Gynecomastia is a common side effect of long-term use
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| Carvedilol (Coreg) Drug Alert | show 🗑
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