Med surg and pharm final study guide
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Multiple Myeloma | show 🗑
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| show | Bone pain (intense)espsecially, anemia, recurrent infections, weakness, fatigue
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| show | physiologic, safety and security, love and belonging, self esteem, self actualization.
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| Physiological needs("The Physical needs") are classified as... | show 🗑
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| Safety needs are classified as... | show 🗑
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| Love and Belonging needs are classified as..... | show 🗑
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| show | Feeling good about oneself and feeling that others hold one in high regard. Individuals with high self esteem feel confident about themselves and confident that they are appreciated by others; low self-esteem may feel helpless and inferior.
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| show | ability to solve problems, willingness to accept suggestions and criticism from others, broad interests, good communication skills, self confidence and good self esteem, maturity and desire for new experiences and knowledge.
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| show | use your own bone marrow stem cell transplant ; products coming from own body (skin grafts, blood)
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| 1st step in reaching pt adaptability is to determine? | show 🗑
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| show | Encourage daily self care from the pt, allow the pt to participate.
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| show | No sounds and decreased wheezing....
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| An improvement of asthmatic pt's condition | show 🗑
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| What does an increased PaCo in a COPD pt mean? The nurse recognizes what?? | show 🗑
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| CO2 and Bicarbanates are.. | show 🗑
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| show | elevate the pt HOB 10 degrees or semi-fowlers
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| show | Extremities= 9 each; Truck/back= 18 each; Groin= 1; Example: both legs chest burned 56%..
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| show | a cancer of the lymphatic system, which is part of the immune system. In Hodgkin's disease, cells in the lymphatic system grow abnormally & may spread beyond the lymphatic system. As the disease progresses it comprimises bodies ability to fight infection
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| show | Initial s/s a similar of the flu(fever, fatigue, night sweats), eventually, tumors develop. Lymph enlargement (hallmark finding), Reed steinburg cells and afte biopsy.
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| Non-Hodgkins | show 🗑
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| show | disorders that go against the body's own tissue; body breaks down it's own natural defense.
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| show | red/reddish purple skin lesion caused by low platelet count and clotting problems; blood leaks outside the blood vessel.
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| show | autoimmune disorder caused by lack of WBC's and decreased bone marrow production; Pt has an increased risk of infection.
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| Neutropenia s/s | show 🗑
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| show | Higher to lower- particles move randomly in all directions- only takes place in respiratory; the movement of gas exchange. Diffusioin is how the O2 is transported in the blood.
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| show | Transfer of water and solutes thru a membrane; high to low only in the kidneys..
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| show | Only in the presense of water- goes from high to low; low to high. water draws sodium into tissue cells only by osmosis-"edema" less concentration to more fluid balance.
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| Durable POA | show 🗑
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| Medical POA | show 🗑
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| show | carrier proteins used to transport substances across cell membranes; from low to equal/high
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| show | Pt cannot be aroused even by powerful stimuli
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| show | no energy, altered LOC; weak and tired
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| show | unnatural drowsiness
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| show | accummulation of nitrogenous compounds in the blood
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| show | Alarm reaction- flight/fight, response to stress.Resistance Stage- adapted to stressor.Exhaustion Stage- body drained of energy.
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| Pt with neutropenia (low WBC count) with an increased risk of infection, what rational is used. | show 🗑
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| Conscious sedation | show 🗑
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| show | Ambulate the pt or dangle pt; Get the pt up, turn, coughing and deep breathing.
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| show | Asprin
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| show | Offer a urinal/ bed pan, get pt up to BSC or bathroom- if not successful inform charge nurse.
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| show | Normal Specific Gravity of urine is 1.01- 1.025
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| How much urine should a patient be voiding per hour before potassium can be hung? | show 🗑
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| Greiving process "Kubbler Ross" | show 🗑
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| Sensory changes during the death process | show 🗑
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| show | Asthma, Emphysemia, Chronic Bronchitis
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| show | Full code- everything done to substain life.DNR- no actions takenChemical Code- no drug, no compression, no defib's.
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| show | NG tube
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| What are the s/s of anaphalaxis shock? | show 🗑
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| If a pt is stuperous and/or withdrawls from painful stimuli. Pt does not appear conscious, pt is considered? | show 🗑
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| Ulcerative mouth disease | show 🗑
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| show | always use aseptic technique
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| show | pt will need seizure precautions.
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| show | Hypertension, bradycardia, widening pulse pressure.
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| Before pt under goes a liver or spleen scan, the nurse must explain the procedure to the pt and... | show 🗑
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| show | Varicose Veins
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| Pneumothorax | show 🗑
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| show | never a normal state
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| Post residual voiding | show 🗑
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| Types of incontinence- | show 🗑
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| show | Low Ph, Normal CO2
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| show | High Ph, Normal CO2
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| Respiratory acidosis | show 🗑
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| show | High Ph, High CO2; common cause of hyperventilation.
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| show | Vitamin D is the Intrinsic factor in the gut
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| show | when they bind together, the bone wull hold onto the calcium.
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| Healthy bone marrow with chemotherapy; increased risk of? | show 🗑
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| show | 3 tumors, 2 lymph nodes, 3 metastisized to 3 organs..
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| show | Give the pain medication and call DR. and let him know pt is having break thru pain symptoms.
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| show | Most abundant inner cellular electrolyte; a decrease causes cardiac arrythmias; potassium maintains fluid osmolarity and volume in the cell.
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| show | 135-145 good; most abundant extracellular electrolyte. Water follows sodium; water draws sodium in to tissue onl by osmosis, primary electrolyte.
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| show | active transport carrier of sodium. assist in regulation osmotic pressure between compartments. Regulates acid base balances
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| show | 99% is in matrix of the bones. Promotes normal transmission of nerve impulses and normal muscle contraction.
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| show | Filtration problems- blood cannot be filtered out, blood in urine.Dx tests- BUN, creatine clearence, and serum creatine
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| Magnesium | show 🗑
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| show | the main regulators of fluid balance by using renin, aldosterone and antidiuretic hormones; BP falls, renin produced aldosterone, produced when renin is present by adrenal.
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| Electrolyte imbalances- | show 🗑
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| Urinary incontinence; Post urinary void | show 🗑
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| Urinary Incontinence; Bladder Training | show 🗑
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| show | Urge- involuntary loss of urine shortly after a strong urge to urinate; results are overactive bladder muscle.Overflow- involuntary loss of urine with overdistended bladder; small amounts of urine lost off and on, can cause kidney damage.
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| Urinary Incontinence: Types of incontinence CONTINUED!! | show 🗑
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| show | Bladder drained q4h..Greater than 500ml in less then 4h, less than 200ml, greater than the length of time between caths.
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| show | incontinence education,bladder training, check for skin breakdown and risk of infection.
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| show | Central structure includes cerebrum, brainstem, cerebellum 2 hemispheres- left dominant controls the right brain covered by cortex.
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| show | controls vital basic functions (resp, heart rate, LOC)
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| show | used information recalled from cerebrum muscles, joints, inner ear to coordinate balance.
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| show | initiation of movements, sensory input recognition, regulation of endocrine and autonomic functions.
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| show | stroke or brain attack.S/S- numbness, weakness of face, arms or legs of one side, sudden confusion, trouble speaking, walking, dizziness, severe headache
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| Transient Ischemic Attacks (TIA)- | show 🗑
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| Safety | show 🗑
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| show | Patho- HTN, cardiac disease, DM, HYPO TN, Migraine headache, increased risk of blood clotting 51-74yo, Family Hx, Sickle Cell, leukemia.Lifestyle- excessive alcohol consumption, cig smoking, obesity, high fat diets, drug abuse.
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| show | patho- any condition that decreases blood flow to the kidney's that impairs renal function* Acute or Chronic based on onset and reversibility*
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| show | PreRenal- decreased blood flow to glomeruli- BP has to be > 70IntraRenal- toxic agents, kidney infections occlusions of arteries, DM, trauma to kidneys.PostRenal-obstruction around the kidneys, calculi in ureters-urine backs up.
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| show | Onset, oliguria, diuresis, recovery
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| show | onset- 1-3 days, increased BUN, increased serum creatine, No decrease in urine output
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| Acute Renal Failure Stage 2, Oliguric | show 🗑
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| Acute Renal Failure Stage 3, Diuretic | show 🗑
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| Acute Renal Failure Stage 4, Recovery | show 🗑
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| show | Azotemia- 1st sign- increased nitrogen waste in blood. Kidney unable to concentrate wrine, potassium retained. Results in Hyperkalemia which cause the most life threatening of chronic renal failure. Cardiac problems can occur.
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| Blood Transfusions- Reactions | show 🗑
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| Blood tranfusion S/S- | show 🗑
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| Nursing Interventions for s/s during blood transfusion: | show 🗑
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| Endocrine | show 🗑
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| Pituitary Gland- two lobes, Anterior lobe and Posterior lobe- | show 🗑
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| show | Early in childhood/ puberity before growth plates close- stimulated by too much growth hormone(GH) Hyper pituitary!!
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| Acromegaly | show 🗑
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| show | excessive corticosteriods (cortisol) due to overproduction of adrenocortisol hormones from internal ot external causes- excess of ACTH from pituitary tumor. Adrenal hyper secretes..
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| Cushings Syndrome-S/S, DX, TX- | show 🗑
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| Nursing Dx with Cushings Syndrome | show 🗑
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| show | Cardiac Arrest- absense of heart beatRespiratory Arrest- Absense of respirationsCardio-pulmonary Arrest- Absense of Heart rate and Respirations.
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| Nursing Interentions for "ARRESTS" | show 🗑
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| Hypoxemia | show 🗑
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| show | S/S- dyspnea, productive cough, wheezing, tachycardia, tachypnea.N.I- Monitor resp rate, pattern, give O2, Support pt in fowlers, give ordered broncho-dilators,assess for adverse reactions.
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| Shock- results from acute circulatory failure; inadequate tissue perfusion impaired cellular metabolism. | show 🗑
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| show | Get medical help, give O2, ABC's, if bleeding- control with pressure, maintain target organs, keeppt still and calm, position flat, keep pt temp balanced, withhold fluids.
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| CHF- heart fails to pump effectively, bloodbacks up into vascular of lungs producing congestion | show 🗑
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| show | Catheter is passed thru a vein or artery and dye injected. assess for allergies. Tell pt what to expect, NPO before procedure, signed consent req'd!N.I- Check puncture site, maintain pressure if nec., mv/s, extrermity pulses of affected, bedrest
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| show | increase indictative of damage to myocaridal cells. Increased 4-6hrs after MI.
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| show | Protein involved with cardiac muscle contraction- Trop T & Trop I specific to cardiac muscle are released into the circulation after an acute myocardial infarction after onset of symptoms (3-6hrs) peak @ 24hrs.
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| Cardiac Enzymes- MyoGlobin | show 🗑
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| Angina- Chest pain, tx with nitroglycerin. Most common s/s of CAD-> demand for O2 exceeds the O2 being delivered- Heart is starving for O2 | show 🗑
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| show | Occlusion of artery, ischemia results. S/S- pain, heavy pressure pain, sweaty, lightheaded, N/V, Skin cold & clammy.DX- lab markers- Troponin released.Complications of MI- dysrhythmias, heart failure, shock, thromoembolism, ventricul aneurysm/ rupture
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| Respiratory Disorders- Suctioning tracheostomy techniques- to remove excess mucous secretions to improve gas exchange do the following: | show 🗑
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| Asthma and Emphysema are COPD- | show 🗑
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| show | S/S- dyspnea on exertion, or at rest. Pt thin and uses accessory muscles to breath, pt appears with barrel chest, depression/irritability common.DX- pulm function testTX- O2 therapy, Drug therapy( Broncho-dilaters, inhalors)
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| 7 Warning Signs of Cancer *CAUTION* | show 🗑
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| Breast exams | show 🗑
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| show | Monthly. Over 50 undergo annual rectal exam and PSA. Men are at high risk should start screening at 40.
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| Pap smears | show 🗑
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| Colonoscopy | show 🗑
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| show | Bone marrow suppression is the most adverse efect of chemo. Most dangerous. Protect pt from infection.N/V- most distressing, give antiemetics.Neutropenia- WBC decreases- protect pt.
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| Increased intracranial pressure- pressure exerted on the cranium (tumor) S/S: Abnormal posturing- abnormal flexion in upper extremities-lower extended, increased BP. Late signs- pulse, resp pattern, BP changes | show 🗑
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| Spinal Shock | show 🗑
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| Autonomic Dysreflexia- most serious. Danger of spinal cord injured pt- autonomic nervous system exaggerates its response to painful stimuli- @ T6 or increased level. | show 🗑
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| show | evaluate pt for orientation to person, place, and time. If pt respond o only physical stimuli-LOC is impaired.
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| show | unnatural drowsiness- sleepiness
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| show | Excessive Drowsiness
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| show | decreased response with decreased motor spontanity
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| show | assess pupils, assess neuromuscular response, assess vital signs
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| Hypo Volemic Shock | show 🗑
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| Cardiogenic Shock | show 🗑
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| Shock occurs due to cardio system failing to function adequately due to an... | show 🗑
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| show | Hallmark sign- Butterfly rash across bridge of nose and cheeks, skin sensitivity.Life threatening: Inflammation of kidney,heart and lungs results in organ failure.N.I-> Monitor pain, pt avoid prolonged sunlight exposure, use SPF 15
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| Positive Homan's Sign | show 🗑
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| show | S/S: extremity edema, warm tender pain, see veins through skinN.I-> Monitor V/S, TED hose prevents, Homan's Sign test, monitor for pain
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| Hemothorax- Blood in pleaural space with pneumothorax- caused by torn/lacerated blood vessels, lacerated lung tissue, lung malignancy, pulmonary embolus, anticoagulant therapy. | show 🗑
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| Pneumothorax- accumulation of air in plural cavity-collapse of lung..2 types: Tension- air enters with inspiration/ no escape; Open- chest wound allows air in/out freely. | show 🗑
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| show | Internal Hemorrhage-S/S: abdominal distention, pain, hematemesis or dyspnea.N.I-> direct continuous pressure elevate
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| show | CD4 count normal 600-980 cells/mm; Full blown AIDS= CD4 under 200; viral load describes how much virus is found in blood, use universal precautions.
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| Stages of HIV infection (Initial, Latent, 3rd, AIDS) | show 🗑
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| show | CD4 <200 end with death within 1 year usually due to infection- pneumonia leads the causes.Kaposis sarcomia- lesions due to cancer of the skin.
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| show | S/S: Polyuria, polydipsia, polyphagia, wt loss, fatigue, increased infection, rapid onset, early onset, before 15 yrs mostlyNormal BS 115-140Acceptable BS-140-160
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| show | S/S: wt gain, vision problems, slow onset, polyuria, polydipsia, polyphagia, fatigue, increased UTI,family hx, slowed healing wounds, numb feet, dizziness.N.I-> Pt education, lifestyle changes, BS monitoring, increased exercise, monitor I/O
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| Diabetes Insipidus (DI)- Pituitary disorder due to ADH production and kidneys dont respond or inadequate ADH secreted results in very large amounts of urine excreted- diluted urine tubules do not reabsorb excessive water diuresis occurs. | show 🗑
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| DKA- *life threatening emergency, no insulin*-Hx of febrile illness, GI upset. Blood viscosity thickens, body burns fat/muscle for glucose store. Puts off ketones as by product (acidosis), loss of lean muscle mass | show 🗑
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| HHNKS- Diabetic Coma, due to high glucose >600 | show 🗑
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| show | S/S: shaky, tachycardia, sweaty, anxious, dizziness, hunger,blurred vision, H/AN.I -> Give pt 10-15gm of quick carbs
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| Insulin Therapy_RAPID ACTING | show 🗑
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| show | Humalin R; Novalin ROnset: 30 min-1 hrPeak: 2-3hrsDuration: 3-6hrs
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| Insulin Therapy- Intermediate Acting (NPH)- give in morning ot bedtime, give snacks in the evening | show 🗑
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| Insulin Therapy- Long Acting. * Not given in the morning.*( Ultra Lente, Lantus) | show 🗑
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| Foot care in a Diabetic Pt: | show 🗑
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| Liver disease: examine abdomen,measure abdominal girth with tape measure, mark pt, remeasure as needed. | show 🗑
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| show | Bile produced, maintains blood glucose, metabolizes proteins and lipids, detoxes blood and aids in blood coagulation- helps develop antibodies for immunity, metabolizes hormones.
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| show | Pt in supine with right arm behind head.N.I -> Pt lies on right side after procedure.
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| Liver enzymes: | show 🗑
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| show | Pt fasts 4-6 hrs pre-scan, Assess the pt. Post procedure education: wash hands thoroughly when voiding for 24 hrs, fluid encouraged.
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| Hepatitis- inflammed liver | show 🗑
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| show | Pre-icteric Phase: Malaise, fever, H/A, Right abdominal pain, anorexia, N/V.Icteric phase: Jaundice, clay stools, dark urine, pruritis (bile salts under skin).Post-Icteric Phase: liver enlargement, fatigue, malaise.
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| Cirrhosis- degeneration/ destruction of liver impaired blood flow and lymph fluids. | show 🗑
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| Hepatic Encephalopathy- Liver cannot detox ammonia. | show 🗑
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| show | Pt teaching includes: do not use toilet paper, turn specimen in immediately. Pt should not eat red meat for 2-3 days prior to test. Pt should not take ASA, Vitamin C, Anticoagulants, or Steriods.
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| show | used to deliver feedings or keep the digestive tract empty or decompressed.
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| show | Tube thru nostril into stomach and sttached to suction. Common tube used is the LEVIN!!Post-Surgery: pt usually has a nasogastric tube for decompression.
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| Dumping Syndrome- occurs with rapid feedings of too concentrated of a formula: | show 🗑
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| show | Allows rapid dilution of the concentration, prevent blood clots, can be used long term. Monitor BS levels.Prevent Infection: DO NOT turn off machine ot give meds --> CAN BE FATAL..
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| Appendicitis-inflammation of appendix: DX test: WBC increase > 10,000 | show 🗑
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| show | Post-op: pain relief, V/S, breath sounds, assess for bleeding from dressing if theres an incision.
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| show | Pt cannot take deep breath when two fingers pass below hepatic margin.
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| 3 of the following factors cause clients to have fluid volume deficit EXCEPT... | show 🗑
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| show | I/O, Skin, Weight, Answer not high calorie
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| Isotonic Solution is same as.... | show 🗑
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| Regulation of fluid balance is done by.. | show 🗑
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| Two major hormones that affect Fluid balance are... | show 🗑
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| Pyridium: | show 🗑
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| TURP measurement, What is collected in bag? | show 🗑
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| Burn Pt- 1st 18 hrs fluid volume shifts and in 18-36 hrs, shifts back.... | show 🗑
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| For specific gravity, If 1.35, urine concentration is high. | show 🗑
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| For eczema in small children.. | show 🗑
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| show | red lesions with silvery scales
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| Your the 1st @ the scene, pt has fallen of of a telephone pole, what do you suspect 1st? | show 🗑
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| A burn victim has a foul smell and color, what do you suspect? | show 🗑
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| show | Mature Bone cells
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| show | abduction pillow between legs until the surgeon says remove it.
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| Pt will gout has pain in right big toe due to uric acid buildup after hip surgery, opiates are used for the pain. What is the side effect? | show 🗑
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| With an open reduction internal fixation, pt is at risk for.. | show 🗑
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| Pt with a new DX of asthma, pt education.... | show 🗑
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| show | Color and Temperature of the fingertips.
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| With asthma, pt will have... | show 🗑
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| show | ASA...antiplatelet prevents from agrregating.DIC stops clotting, Factor 8
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| show | Take all of them and DO NOT stop abruptly
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| show | Acute Leukemia
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| show | than it is leaking
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| With pleurisy or inflammation of the pleural space, the pt will experience? | show 🗑
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| Are open headed injuries or closed headed injuries more serious? | show 🗑
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| A pt with increased ICP, you will see? | show 🗑
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| show | Pernicous anemia
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| With hodgkin's disease, you will check for? | show 🗑
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| In home health, the way to manage pain control is... | show 🗑
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| show | loneliness and pain; *In dealing with the grief and terminally ill,be a compassionate nurse!!
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| With HIV, if your CD4 is below 200, your are considered what? | show 🗑
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| Antineoplastic is.. | show 🗑
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| show | Sympathomimetics. Epinephrine- controls hemorrhage. Used for glaucoma(decreases aqueous formation) and decreases mucous secretions..
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| Cholinergics.... | show 🗑
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| show | electrolytes
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| show | antineoplastics
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| Pt takes a thiazide diuretic which depletes? | show 🗑
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| What food would you encourage with hypokalemia? | show 🗑
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| What is a decrease in the production and excretion of urine? | show 🗑
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| Prothrombin, PTT and bleeding time are known as... | show 🗑
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| show | lower conjunctival sac
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| show | an anti-viral
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| show | anaerobic
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| To administer epinephrine parentally that nurse would obtain.... | show 🗑
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| A drug the removes and dissolves excessive growth of the epidermis is known as... | show 🗑
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| show | chemotherapy
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| A class of drugs that causes tachycardia, palpitations and tremors are... | show 🗑
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| Nasal decongestant act 1st by shrinkning mucous membranes. After 3rd day, rebound congestion can occur and cause... | show 🗑
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| show | orange, red urine and staining
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| show | Proteinuria
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| An Anti-psoriasis medication that cannot be used during pregnancy is... | show 🗑
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| show | L-dopa; Side effects include: migraine, hypertension, angina, cardiac arrythmias.
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| Patient teaching of beta blockers.. | show 🗑
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| Meds that reduce production of bacteria? | show 🗑
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| Purpose of bronchodilators is to.... | show 🗑
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| show | Rheumatoid Arthritis
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| What is the main drug used for Arthritis? | show 🗑
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| Side effects of Epoieten Alfa include? | show 🗑
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| show | colony stimulator regulates production of blood cells, stimulates the bone marrow to produce more red blood cells.
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| show | Must be kept in refrigerator until administration. Given at room temperature and DO NOT SHAKE.
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| show | 1.35 is more concentrated
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| When giving Heparin, DO NOT... | show 🗑
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| show | Tetracycline
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| show | Phlebitis
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| Thrombolytics (3 types of blood thinners): | show 🗑
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| What will happen to a pt that has increased heart rate, a decreased BP while on thrombolytics? | show 🗑
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| show | Protamine Sulfate
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| A pt taking ASA is experiencing tinnitis(ringing of the ears), what does this indicate? | show 🗑
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| show | In children recieving antibiotic Gentamycin--> A hearing test is given; When older adults are takin Gentamycin--> If UTI's or experiencing tinnitis, notify physician for possible deafness.
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|
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| What do you give for an overdose of a Cholinergic Drug? | show 🗑
|
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| show | Bruising and bleeding
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| When monitoring for bleeding, what tests will be done? | show 🗑
|
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| show | Allopurinal(Zyloprim)
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| show | Dopamine
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|
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| show | Asthma
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|
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| show | acute enlarged lymph nodes, decreased RBC, Thrombosytopenia, decreased WBC. Acute leukemia is controlled with Chemo.
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| show | Hepatotoxicity
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| show | Sdie effects include: nausea, vomiting, diarrhea, dizziness, blurred vision, hepatic toxicity.<--potentiated by dilantin... Alternative drug is Rifompin: Side effect is rash..
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|
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| show | decrease clots..Taken orally..Observe for CVA- they dont dissolve they interfere with coagulation as a prophylaxis. Perform INR test..
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|
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| show | Vitamin K
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| show | NSAIDS, alcohol, tricyclic antidepressants, acetaminophen, estrogen, corticosteriods
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|
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| Heparin is given how? | show 🗑
|
||||
| show | Blood in urine (hematuria), minor bleeding (petechiae, epistaxis, and bruising)
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|
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| show | Dilantin- anticonvulsantsPhenytoin- control seizuresSide effects: CNS, GI, Gingiual hyperplasia (overgrowth of gum disease), skin disorder
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|
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| show | Lasix
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|
||||
| show | sedation, headache, dizziness, hypotension, flushing, rash, pruritis
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|
||||
| Opiods are contraindicated with: | show 🗑
|
||||
| Normal Prothrombin is... | show 🗑
|
||||
| Normal INR is... | show 🗑
|
||||
| show | EPOGEN
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|
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| show | Hypertension, headache, arthralgia (joint pain)
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|
||||
| Thromboplastin, Prothrombin and Fibrogen are... | show 🗑
|
||||
| show | Bleeding
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|
||||
| If taking oral anticoagulant (Coumadin), what test will be given? | show 🗑
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||||
| show | Bleeding
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|
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| show | DVT, massive pulmonary emboli, acute MIA.
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|
||||
| What is the antidote for Thrombolytics? | show 🗑
|
||||
| show | Phlebotomy about 500-2000ml..
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|
||||
| When Hodgkins disease is suspected, what will you be looking for when the biopsy is performed on the lymph nodes? | show 🗑
|
||||
| Best time to administer oral Iron preparations? | show 🗑
|
||||
| Agents used to promote natural defenses and increase WBC? | show 🗑
|
||||
| Poitin Alpha (Procrit): | show 🗑
|
||||
| Cation- | show 🗑
|
||||
| Anion- | show 🗑
|
||||
| Adrenergics- | show 🗑
|
||||
| T-Cells- | show 🗑
|
||||
| B-Cells- | show 🗑
|
||||
| show | Leukopenia
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|
||||
| Normal urine specific gravity is... | show 🗑
|
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