Final study guide for Nursing 135
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| show | 4th
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| show | Limited airflow to the lungs
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| COPD is an umbrella term for what diseases? | show 🗑
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| show | Alpha 1 Antitrypsin (A1A)
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| What does A1A do? | show 🗑
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| show | Constant irritation, burn, that causes inflammation to the bronchi & bronchioles in the lungs
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| show | Presence of cough & sputum for at least 3 consecutive months, every year for two years
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| show | Through constant exposure to an irritant
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| What happens to the alveoli with Emphysema? | show 🗑
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| What's the difference between Chronic Bronchitis & Emphysema? | show 🗑
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| show | The lungs lose elasticity and remain hyper-exteneded; over time, the ribs remain outward
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| show | CHAPP; Chest x-ray, History, ABG's, Pulmonary Function Test (PFT), & Pulse Oximetry
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| What is the management of COPD? | show 🗑
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| show | Relaxes smooth muscles in bronchioles and opens airways
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| show | The pt will develop Cushing's
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| show | Abnormal airway condition characterized by reversible inflammation
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| What part of the lungs are affected with asthma? | show 🗑
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| With asthma, what is produced in the bronchioles? | show 🗑
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| What is mild asthma? | show 🗑
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| show | Always having some sort of symptoms with frequent asthma attacks
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| With inhaler/neb use for asthma, how soon should you see some improvement? | show 🗑
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| When having an asthma attack without any response to usual treatments, when should you seek medical attention? | show 🗑
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| show | Short acting bronchodilators such as Albuterol
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| How would asthma be treated in the ER? | show 🗑
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| how do you use an inhaler? | show 🗑
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| What is a peak flow meter? | show 🗑
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| show | An infectious disease commonly caused by Myobacterium Tuberculosis
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| show | Less than 5 microns
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| What is the center point of granulomas of TB called? | show 🗑
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| What is used in a TB (Mantoux) test? | show 🗑
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| show | 10mm induration
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| show | 5 mm induration
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| How long does it take to complete a sputum culture? | show 🗑
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| show | 6-12 months; if person is positive but not actively infected, they are given INH for a few months?
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| In the hospital, what type of room is a TB pt put in? | show 🗑
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| What do you wear on your race before entering an airborne precaution room? | show 🗑
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| What does a Pulmonary Function Test do and how is it performed? | show 🗑
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| What do ABG's measure and how is it performed? | show 🗑
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| When is a pulse oximetry not reliable? | show 🗑
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| show | If pt is allergic to dyes
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| What is important to remember with a pt before they undergo an MRI? | show 🗑
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| show | Lung Scan (Ventilation Perfusion Scan)
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| When is the best time to do a sputum study? | show 🗑
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| What are nursing considerations for a bronchoscopy? | show 🗑
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| What is atropine used for? | show 🗑
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| show | It blocks parasympathetic nerves allowing sympathetic nervous system to takeover; it's a cardiac drug
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| What is used in a bronchscopy for conscious sedation? | show 🗑
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| show | It's a spray used to numb the throat and suppress the gag reflex. It can least up to three hours.
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| After a bronchoscopy is done, how long must a pt remain NPO? | show 🗑
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| If a pt cannot sit up for a thoracentesis, how are they positioned? | show 🗑
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| show | An air occlusive dressing, not gauze because gauze allows for air flow
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| show | -Pneumothorax (collapsed lung; most common) -Hemothorax (blood enters space and collapses lung) -Punctured lung a.e.b. pin-tinged or red & bloody sputum
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| What illness has an organism leading to inflamed lungs, leading to exudates in the alveoli? | show 🗑
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| show | An immunocompromised person
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| show | Lobar pneumonia- a segment or entire lobe is affected by pt swallowing something that has entered the lung
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| show | Yellow, blood streaked, rusty colored
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| show | White, splotchy dots
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| show | Blood cultures are done to see it it's spread, looking for sepsis
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| What is in the same family as penicillin? | show 🗑
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| show | Oral contraceptives aren't as effective
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| show | -PO -IV
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| show | IM, because it would be too painful
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| show | GI bleeding by irritating the lining of the intestines; could also lead to liver toxicity
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| What does mycin potentiate? | show 🗑
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| Name a long acting beta 2 agonist? | show 🗑
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| What is the definition of peripheral vascular disease? | show 🗑
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| show | The hardening & thickening of the walls of the arteries
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| show | A type of arteriosclerosis that involves the buildup of fat & fibrin on the walls of the artery
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| With atherosclerosis, what does plaque formation affect? | show 🗑
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| show | Where arteries biforcate
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| show | Fatty streaks and fibrous lesions
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| show | Fatty lesions
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| 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 angioplasty and not meds? | show 🗑
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| show | Kicks them off
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| show | The toes because they are the most distal
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| What are the s/s of intermittent claudication? | show 🗑
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| show | -Numbness, tingling & weakness on the side of the body oposite of the artery block, possible mini and full-blown strokes(TIA, CVA respectively), dizziness, and confusion
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| show | Angina & MI
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| show | It detects quality of peripheral blood flow to measure the pressure the blood flow in the legs and is used in conjunction with angiography
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| If a pt is found to have high cholesterol, what are they put on? | show 🗑
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| What is an endarterectomy? | show 🗑
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| show | Because it causes vasoconstriction
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| show | Inflammation of the walls of the vein & the presence of a clot in the flamed area
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| show | Inflammation of a vein without a thrombus
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| What is a phlebothrombosis? | show 🗑
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| What is venous stasis? | show 🗑
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| show | A clot due to clumping of platelets
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| show | It could obstruct a vessel completely or break off, become an embolus and travel
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| Why does a DVT becomes red & swollen? | show 🗑
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| What thrombus tends to be small, can dissolve on its own and doesn't tend to break off? | show 🗑
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| What is a venogram? | show 🗑
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| show | They are on infusion 5-7 days to keep clot from getting larger& to prevent new ones from forming
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| How is Coumadin given? | show 🗑
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| Name 3 thrombolytics. | show 🗑
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| If a pt doesn't qualify for thrombolytics, what do they have to undergo then? | show 🗑
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| show | basically anything that could rupture, has had trauma, or is recently healing: aneurysms, alcoholism, recent or impending surgery, severe renal or hepatic disease, infections, recent delivery of a baby
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| What does alcohol do with Coumadin? | show 🗑
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| show | Chronic venous insufficiency
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| show | 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 cells
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| What are s/s of arterial insufficiency? | show 🗑
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| show | Intermittent claudication
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| show | Aching & heavy feeling leg, brownish discoloration, swelling, extremity tends to feel warm, elevating leg tends to help with pain, avoid crossing legs & dangling, avoid constrictive clothing.
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| show | Venous
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| show | Surgical, Nonselective, Meds, Hyperbaric Oxygenation
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| show | Arterial
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| What is rheumatic endocarditis? | show 🗑
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| show | The valves in the heart- nodules form around or in the valves; can affect the way the valves open or close and lead to heart failure
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| What are s/s of rheumatic endocarditis? | show 🗑
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| How is rheumatic endocarditis diagnosed? | show 🗑
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| show | Bedrest, antibiotics for the strep, corticoid steroids for the inflammation, aspirin for the pain
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| What is infective endocarditis? | show 🗑
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| Who are at greater risk for endocarditis? | show 🗑
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| show | Platelets, fibrin and blood cells all cluster together to form tiny clots
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| What are Osler Nodes? | show 🗑
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| What are Janeway lesions? | show 🗑
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| How is infective endocarditis diagnosed? | show 🗑
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| What is the definition of congestive heart failure? | show 🗑
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| What type of CHF is more common? | show 🗑
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| What are causes of CHF? | show 🗑
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| What is the lab value for BUN? | show 🗑
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| show | 0.7-1.4
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| What is the lab value for BNP? | show 🗑
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| What does it mean when the BNP increases? | show 🗑
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| What measures the ejection fraction of the heart to see how much blood is pumping though the ventricles? | show 🗑
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| What is looked at to see if atherosclerosis will lead to CHF? | show 🗑
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| show | ACE Inhibitors, Beta Blockers (olol), Diuretics, Cardiac Glycosides, Calcium Channel Blockers
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| What do ACE Inhibitors do? | show 🗑
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| What do Cardiac Glycosides do? | show 🗑
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| show | 0.5-2ng/ml
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| What potentiates Digoxin? | show 🗑
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| Before you administer Digoxin what must you do with the apical heart rate? | show 🗑
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| When can you hold Digoxin? | show 🗑
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| How many grams of Na should a cardiac pt be given? | show 🗑
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| show | Yes! The normal amount for a person is 2-3 liters, a CHF pt needs to stay on the low end of that level.
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| What sort of weight gain should be reported with a CHF pt? | show 🗑
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| show | It can drop the potassium level
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| show | Hyperkalemia
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| What is angina pectoris? | show 🗑
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| show | Artherosclerosis, restricting blood flow; once stress appears, so does angina pectoris
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| show | -Physical exertion -Exposure to cold -Eating a heavy meal -Emotional stress/reaction
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| What are the two types of angina? | show 🗑
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| What is stable angina? | show 🗑
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| show | Very unpredictable that has pain lasting longer than usual and pain can occur while at rest
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| What kind of EKG is used to measure the electrical activity of the heart? | show 🗑
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| show | It's done to diagnose the risk factor of CAD
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| show | Cardiac catheterization where the blockage is visualized and identified
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| show | To decrease oxygen demand on the heart and increase supply of O2 to the heart
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| show | Nitrates in pill or spray form
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| show | -Assess them -Do VS -Listen to lungs & heart -Then administer med
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| How many doses of nitro do you give? | show 🗑
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| What is the BP standard that you should assess for before giving each dose of nitro? | show 🗑
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| What is a common side-effect of nitro? | show 🗑
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| What is the difference between Beta 1 & Beta 2 blockers? | show 🗑
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| What do Beta Blockers do? | show 🗑
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| show | COPD or asthma pt shouldn't take Inderal for example because it will worsen their respiratory problems
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| What is a big reason men are non-compliant on beta blockers? | show 🗑
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| show | The pt's BP to make sure they aren't hypotensive since it decreases BP
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| show | They block calcium from entering cells in cardiac and smooth muscles helping the coronary vascular smooth muscles to relax, dilating these arteries; it also slows down conduction between SA and AV node, slowing down the HR some
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| What are the calcium channel drugs? | show 🗑
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| What do anticoagulants do? | show 🗑
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| What do antiplatelets do? | show 🗑
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| show | Platelet count
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| show | 20-45 minutes
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| What is the CKMB-isenzyme, when does it peak and return back to normal? | show 🗑
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| show | 0.01-0.5 Elevates within 3-4hours of injury and it can stay elevated as long as 1-3 weeks
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| show | 162-325mg
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| show | -Relieves anxiety -Takes care of pain -Dilates vessels -Relieves workload of the heart
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| Angioplasties can be performed on those that can't use what? | show 🗑
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| show | Stents
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| show | Provides support to an artery but can get clogged again
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| How much drainage is expected within the first 24hrs after a neck dissection? | show 🗑
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| How much drainage should raise a flag if under 24hrs after a neck dissection? | show 🗑
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| What does albumin do in the body? | show 🗑
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| show | 5-35 units
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| What is the lab value for AST? | show 🗑
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| show | 100-200 units
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| What does a high level of bilirubin indicate? | show 🗑
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| In association with the liver, what does a high level of ammonia indicate? | show 🗑
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| What are the pancreatic enzymes? | show 🗑
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| What is acute pancreatitis? | show 🗑
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| show | Not a total obstruction, damage is done slowly over time; pain is noticed after alcohol or eating a heavy meal, can get worse when pt lays down
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| show | Left shoulder pain
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| Can alcoholism lead to pancreatitis? | show 🗑
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| show | Dark green, brown color
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| show | Jaundice
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| What two signs are looked for with pancreatitis? | show 🗑
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| show | Hypocalcemia with the following symptoms: Tetany Muscle spasms Parasthesia Steatorrhea
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| show | Greater than 12,000
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| What is the normal lab value of Amylase? | show 🗑
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| show | 40-140
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| show | Demerol
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| What used to be contraindicated to treat pancreatitis but is okay now? | show 🗑
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| What drugs are used to treat pancreatitis? | show 🗑
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| show | Pancreaticojejunostomy- anastamose the pancreatic duct to the jejunum; it allow it to drain form the pancreas to the jejunum
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| show | Trousseau's sign and Chvostek's sign
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| show | It breaks down (emulsifies) fat
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| What causes cirrhosis of the liver? | show 🗑
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| show | -Asymptomatic at first -Fatigue -Anorexia -Swelling -Weight loss -Nosebleeds -Bleeding gums
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| show | -Jaundice because bile isn't metabolized adequately -Petechiae -Easy bruising
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| show | 0-0.9 (start seeing jaundice at 2.5)
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| show | PT time
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| After a liver biopsy is done, how should the pt lie? | show 🗑
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| What is portal hypertension? | show 🗑
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| show | 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 retain sodium and water compounding ascites.
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| What are esophageal varices? | show 🗑
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| show | 1/3
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| show | 30%-50%
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| What is variceal ligation? | show 🗑
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| show | A management for esophageal varices in which the varices are injected with a solution that will shrink them; risks of bleeding are minimal after procedure is done
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| show | No longer than 48 hrs and it will be done while pt is in ICU
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| Is pressure important with an ST-Blakemore tube? | show 🗑
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| show | A liver transplant
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| show | A very late complication of cirrhosis that occurs with PROFOUND liver failure
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| What is the definition of hepatic encephalopathy? | show 🗑
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| show | *CSS Coma state Seizures Slow and sluggish movements
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| show | 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 lowers ammonia in the blood thereby reducing the mental changes
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| show | Increase
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| show | Decrease, protein elevates ammonia
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| What is the thyroid, where is it and what does it do? | show 🗑
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| show | They control cellular metabolism and tell the body how fast to convert things into energy
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| show | Iodine and it's found in: -Table salt -Seafood -Some dairy products
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| What does the pituitary gland release? | show 🗑
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| When does the pituitary gland release TSH? | show 🗑
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| What is the main purpose of Calcitonin? | show 🗑
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| What is another name for hyperthyroidism? | show 🗑
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| show | It's having too much thyroid hormone making metabolism very fast; body is in overdrive
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| show | A goiter and it could become toxic
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| show | Women ages 20-40
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| show | A bruit
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| show | T4
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| What is the cortisol levels during a 24hr cycle? | show 🗑
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| show | 0.9-1.7mg/dl Hyperthyroidism will be greater than 1.7
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| show | 0.4-6.15miliunits/ml Hyperthyroidism will make it low
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| What is the treatment for hyperthyroidism? | show 🗑
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| show | -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 thyroid hormone
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| show | Type of WBC that is drastically decreased s a result of taking PTU; client is at risk for infection
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| show | It's given before thyroid surgery 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
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| show | Pts will be given radioactive therapy known as I-131 which is administered by a radiologist to destroy the overactive thyroid cell
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| show | 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 body
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| show | About a week and they should stay away from pregnant women & children
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|
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| What is a subtotal thyroidectomy? | show 🗑
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| What is recommended that should be kept by the bedside after a subtotal thyroidectomy? | show 🗑
|
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| show | Hypocalcemia
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|
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| What is the main purpose of the parathyroid hormone and where is it located? | show 🗑
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| What should be kept on a hospital floor in case a pt shows s/s of hypocalcemia? | show 🗑
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| show | Semi-fowler's position with neck support ( a couple of pillows) to decrease tension at the sutures
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| show | The laryngeal nerve can become damaged so note the tone of their voice; hoarseness is to be expected but it shouldn't continue to get more hoarse, if so, contact MD
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| What triggers a thyroid storm? | show 🗑
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| show | Same as with hyperthyroidism but more exaggerated and much worse: Temp >103 -Diaphoresis -Restlessness -Tachycardia >130 -BP >200 -Agitated -Begin to show signs of cardiac dysrhythmias
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|
||||
| show | Myxedema
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|
||||
| show | Lack of thyroid hormone; metabolism slows down
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|
||||
| show | Women and the elderly population
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|
||||
| What are some causes of hypothyroidism? | show 🗑
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| How is hypothyroidism diagnosed? | show 🗑
|
||||
| What med is given as management for hypothyroidism? | show 🗑
|
||||
| Since pts with hypothyroidism are tired and slow, what do they need? | show 🗑
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| show | It is a MEDICAL EMERGENCY; same s/s of a thyroid storm but worse
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|
||||
| show | -Emotional stress -Trauma -Infection
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|
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| What are s/s of a myxedema coma? | show 🗑
|
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| What are the three hormones released by the adrenal gland? | show 🗑
|
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| What is the outer and inner part of the adrenal gland called respectively? | show 🗑
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| In regards to the adrenal gland, who is the pituitary gland to it and what does the pituitary gland release affecting it? | show 🗑
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| show | Stimulates the adrenal cortex to release the salt, sugar & sex hormones
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|
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| What is the main hormone of the glucocorticoid and what do they do? | show 🗑
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| What is a mineral corticoid and what does it do? | show 🗑
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| What does the androgen hormone do? | show 🗑
|
||||
| What is Cushing's syndrome? | show 🗑
|
||||
| show | Taking too many corticosteroid meds that may affect the adrenal cortex and if it becomes enlarged, it can lead to an excess of the salt, sugar & sex hormones being released
🗑
|
||||
| What does cortisol affect? | show 🗑
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||||
| What happens if you have too much excess of protein, carbs & fat in the body? | show 🗑
|
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| show | It keeps it from entering the bones and then bones become more prone to fractures
🗑
|
||||
| show | -It can mask infection -Decrease immune response -Decrease inflammatory response
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|
||||
| How is Cushing's diagnosed? | show 🗑
|
||||
| show | It suppresses the pituitary gland from releasing ACTH so levels would be low; if it's high, then it's Cushing's
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|
||||
| show | Both potassium & glucose would be high
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|
||||
| How do you treat Cushing's? | show 🗑
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||||
| Med wise, how would you treat Cushing's? | show 🗑
|
||||
| show | Transsphenoidal Hypophysectomy- a surgery to remove a tumor off of the pituitary gland
🗑
|
||||
| With the interventions involved for treating Cushing's, what crisis should you monitor for? | show 🗑
|
||||
| What is the definition of Addison's Disease? | show 🗑
|
||||
| show | Anything that causes adrenal cortex to atrophy; if the adrenal glands are removed, you end up with Addison's or if the pituitary is not producing enough ACTH
🗑
|
||||
| show | Through serum cortisol levels, serum glucose will be low
🗑
|
||||
| show | Potassium will be high, sodium will be low
🗑
|
||||
| show | A corticosteroid known as Prednisone- it's action is to erase inflammation and replaces; the hormones that the body is not creating
🗑
|
||||
| show | Same s/s of Addison't only worse; hypotension, rapid weak pulse, rapid respiratory rate, pallor, extreme weakness
🗑
|
||||
| How is an Adisonian Crisis treated? | show 🗑
|
||||
| What is cataracts? | show 🗑
|
||||
| show | Removal of the cloudy lens with an emulsification and put in an IO (intraocular lends) implant
🗑
|
||||
| What is the name of the surgical procedure for cataracts? | show 🗑
|
||||
| What drop are used in pre-op for Phaco? | show 🗑
|
||||
| show | Antibiotics or steroid drops to decrease chance of infection
🗑
|
||||
| show | Because the elderly are living longer
🗑
|
||||
| What is the leading cause of blindness in the U.S.? | show 🗑
|
||||
| What is glaucoma? | show 🗑
|
||||
| show | 10-21mm/Hg
🗑
|
||||
| How wide is the trabecular meshwork? | show 🗑
|
||||
| How do you treat open angle glaucoma? | show 🗑
|
||||
| show | Basically, it's closed angle because of a blockage so surgery is going into the eye to remove the blockage: -Laser Trabeculoplasty -Trabeculectomy -Iridotomy
🗑
|
||||
| What is macular degeneration? | show 🗑
|
||||
| show | Ppl over the age of 40
🗑
|
||||
| show | 85%-90%
🗑
|
||||
| show | Abnormal blood vessels under the retina cause leak & swelling and hardening of the retina and vision changes quickly
🗑
|
||||
| show | Amsler grid
🗑
|
||||
| What are the two ways wet macular degeneration are treated? | show 🗑
|
||||
| show | The sun
🗑
|
||||
| What is retinal detachment and the s/s? | show 🗑
|
||||
| What are the risk factors for retinal detachment? | show 🗑
|
||||
| What surgery can be done for retinal detachment? | show 🗑
|
||||
| What is the definition of low vision? | show 🗑
|
||||
| What is the definition of legal blindness? | show 🗑
|
||||
| What is the definition of blindness? | show 🗑
|
||||
| show | An ophthalmologist is a medical dr
🗑
|
||||
| show | Contact and Non-Contact
🗑
|
||||
| show | No more than 2 cups of fluid 4 hrs before the test
🗑
|
||||
| show | Don't drink any alcohol 12 hrs before the test
🗑
|
||||
| When should you cease smoking marijuana before a glaucoma test? | show 🗑
|
||||
| What are the three classifications of SLE (systemic lupus erythematosus)? | show 🗑
|
||||
| What is Lupus? | show 🗑
|
||||
| show | Seen 9 times more in women than men; usually diagnosed in teens or early adulthood
🗑
|
||||
| What are some common s/s of Lupus? | show 🗑
|
||||
| show | A pericardial friction rub
🗑
|
||||
| What would you see confirmed on a blood test for Lupus? | show 🗑
|
||||
| show | WBC would be low (<5000)
🗑
|
||||
| show | -NSAIDs (along with aspirin for the antiplatelet affect) -Corticosteroids -Antimalarial (ex. Plaquenil) -Immunosupressive (ex. Cytoxan but can cause pulmonary fibrosis)
🗑
|
||||
| What diet would a pt with Lupus be on? | show 🗑
|
||||
| What is gout and how is it characterized? | show 🗑
|
||||
| show | A by product of breaking down purines
🗑
|
||||
| show | Deposits of uric acid crystals in the peripheral areas of the body such as the big toes, the hands or the ears; kidney stones can result as well
🗑
|
||||
| show | Hard and irregular in shape
🗑
|
||||
| show | Results from excessive dieting or intake of foods high in purines
🗑
|
||||
| show | Results from cancers, anemias, psoriasis, drug-induced renal failure
🗑
|
||||
| Who is more at risk for gout, men or women? | show 🗑
|
||||
| What is the most common site for gout? | show 🗑
|
||||
| What is the normal level of uric acid? | show 🗑
|
||||
| show | 250-750mg
🗑
|
||||
| show | Aspirating and looking for uric acid crystals during artherocentesis
🗑
|
||||
| show | -Acute arthritis is the most common early symptom -Occurs at night -Big toe inflammation -Subsides after 3-10 days
🗑
|
||||
| What are some late s/s of gout? | show 🗑
|
||||
| What are the meds used to control gout? | show 🗑
|
||||
| Why should you avoid alcohol with gout? | show 🗑
|
||||
| How long does the PO form of Colchicine take and the IV form of Colchicine take? | show 🗑
|
||||
| How does Colchicine work? | show 🗑
|
||||
| How does Allopurinol (Zyloprim) work? | show 🗑
|
||||
| show | It's an infection in the bone
🗑
|
||||
| What are three ways of getting osteomyelitis? | show 🗑
|
||||
| show | You will see signs of flu-like symptoms: chills, high fever, rapid pulse, malaise....
🗑
|
||||
| show | You will see local, physical s/s: pain, warmth, swelling...
🗑
|
||||
| What will happen if osteomyelitis isn't treated quickly? | show 🗑
|
||||
| How can you prevent osteomyelitis? | show 🗑
|
||||
| show | First 24hrs- 200-500cc The next 48hrs- 25-30cc
🗑
|
||||
| What is CPM? | show 🗑
|
||||
| show | It's more sensitive than ESR and with osteomyelitis, you should see elevated WBC and ESR
🗑
|
||||
| Why would you use an MRI for osteomyelitis? | show 🗑
|
||||
| Why is an abscess a complication of osteomyelitis? | show 🗑
|
||||
| show | Through the blood, could result in a continuously draining sinus opening for life
🗑
|
||||
| show | They are given around the clock for 3-4 months and then switched from IV to PO
🗑
|
||||
| show | Fractures of the hips & wrists
🗑
|
||||
| show | Compression fracture of the spine and other parts of the body; affects 50% of women over 80 years of age
🗑
|
||||
| Why does osteoporosis affect so many elderly? | show 🗑
|
||||
| When do we reach peak bone mass? | show 🗑
|
||||
| Why do women develop osteoporosis ore frequently than men? | show 🗑
|
||||
| What is a great preventative strategy for osteoporosis? | show 🗑
|
||||
| show | White women, hyperparathyroidism, 3 months steroid use, low body weight, excessive alcohol intake, too little calcium in diet
🗑
|
||||
| What are some osteoporosis s/s that occur late in stage? | show 🗑
|
||||
| show | -DEXA scan -Spine CT -Spine or hip x-ray (but not enough to confirm but can see fracture or collapse)
🗑
|
||||
| What are osteoporosis meds? | show 🗑
|
||||
| How should you take bisphosphonates? | show 🗑
|
||||
| show | Osteonecrosis of the jaw
🗑
|
||||
| What does Calcitonin do in regards to osteoporosis? | show 🗑
|
||||
| What are a few things about calcium you should teach your pt? | show 🗑
|
||||
| show | Because they increase the risk of breast & endometrial cancer
🗑
|
||||
| show | -Thromboembolism -Stroke -PE -MI
🗑
|
||||
| show | It contains huma parathyroid hormones and is approved for treatment of osteoporosis for women at hight risk
🗑
|
||||
| What is Raloxifene (Evista)? | show 🗑
|
||||
| If women are on estrogen, taking calcium, what exams should they get? | show 🗑
|
||||
| How much calcium should you get a day? | show 🗑
|
||||
| show | 400-600IU
🗑
|
||||
| What are some early complications of fractures? | show 🗑
|
||||
| show | -Compensated is increased HR & RR and normal BP -Decompensated is increased HR & RR and decreased BP
🗑
|
||||
| What has a very rapid onset after injury and is an early complication of fractures? | show 🗑
|
||||
| show | -Immobilize the fracture immediately -Minimal manipulation of fracture -Maintain F&E balance
🗑
|
||||
| show | The elevation of tissue pressure within a closed fascial compartment; 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
🗑
|
||||
| What early complication of a fracture requires immediate intervention or it can lead to muscle necrosis in a few hours? | show 🗑
|
||||
| show | Surgery
🗑
|
||||
| show | At heart level, elevation is contraindicated
🗑
|
||||
| What is checked for with a neurovascular check? | show 🗑
|
||||
| With NV checks, what do cyanotic nail beds (fingers and toes) suggest? | show 🗑
|
||||
| With NV checks, what do pallor or blue, dusky look of the fingers themselves suggest? | show 🗑
|
||||
| show | Healing doesn't occur at a normal rate for the fracture
🗑
|
||||
| show | Malunion
🗑
|
||||
| show | Nonunion
🗑
|
||||
| show | Avascular Necrosis (AVN)
🗑
|
||||
| How is AVN treated? | show 🗑
|
||||
| show | Up to 72 hrs
🗑
|
||||
| show | Hourly while awake
🗑
|
||||
| show | Isometric exercises such as knee pushes or making a fist
🗑
|
||||
| show | Skin and skeletal
🗑
|
||||
| When is skin traction used? | show 🗑
|
||||
| When is skeletal traction used? | show 🗑
|
||||
| How often must you remove the foam when in traction? | show 🗑
|
||||
| What are the potential complications of Buck's traction? | show 🗑
|
||||
| How should the body be aligned when in traction? | show 🗑
|
||||
| What is recommended to clean pins used in traction? | show 🗑
|
||||
| show | Quadriceps-setting & gluteal setting
🗑
|
||||
| show | 200-500ml the first 24 hrs < 30ml at 48 hrs
🗑
|
||||
| To avoid hip dislocation, what should you keep between your legs? | show 🗑
|
||||
| What type of chair should be used to avoid hip dislocation? | show 🗑
|
||||
| How long should you keep up precautions to avoid a hip dislocation? | show 🗑
|
||||
| After a THA, how far do you want to flex? | show 🗑
|
||||
| How high should you elevate the HOB after a THA? | show 🗑
|
||||
| What accounts for most of the amputations of lower extremities? | show 🗑
|
||||
| show | Because of either traumatic injury or a malignant tumor
🗑
|
||||
| The amputations that occur due to PVD occur with pt that suffer from what? | show 🗑
|
||||
| show | -TENS (transelectrical nerve stimulation) -Beta Blockers -Tricyclic Antidepressants
🗑
|
||||
| What 3 things must you avoid with a lower extremity amputation? | show 🗑
|
||||
| show | By raising the FOB
🗑
|
||||
| What can an amputee pt do to stretch flexor muscles and prevent flexion contractions? | show 🗑
|
||||
| show | No more than 30 mins
🗑
|
||||
| How can an amputee pt prevent abduction deformity? | show 🗑
|
||||
| show | They are rapid acting insulin and have a peak of 1 hr
🗑
|
||||
| show | It's short acting and it's peak is 2-3hrs
🗑
|
||||
| show | -NPH (Neutral Protamine Hagedorn) -Humlin N, Iletin II Lente, Iletin II NPH, Novolin L [Lente], Novolin N[NPH]) And the peak is 4-12 hrs
🗑
|
||||
| What is a long acting insulin and what is it's peak? | show 🗑
|
||||
| What is Glargine (Lantus)? | show 🗑
|
||||
| show | Type 1
🗑
|
||||
| Which type of diabetes is usually diagnosed under the age of 30? | show 🗑
|
||||
| show | Type 2
🗑
|
||||
| DKA would occur with a pt with which type of diabetes? | show 🗑
|
||||
| show | Type 2
🗑
|
||||
| Which type of diabetes is usually controlled with diet and exercise? | show 🗑
|
||||
| For a hypoglycemic pt, when you have to give rapid acting insulin, what should you have nearby? | show 🗑
|
||||
| How is a dose of glucogon administered? | show 🗑
|
||||
| show | <50-60mg/dl
🗑
|
||||
| What are some examples of 15gram fast acting carb snacks? | show 🗑
|
||||
| show | After 15 mins and if it's still <70, then retreat
🗑
|
||||
| show | -IM or subq glucagon 1mg -25-50ml 50% dextrose solution IV
🗑
|
||||
| show | 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 blood sugar damages blood cells
🗑
|
||||
| show | Potassium; K level may stay the same or go up slightly with kDKA but drops quickly once DKA treatment starts
🗑
|
||||
| show | By HIE -Hydration -Insulin -Electrolyte replacement
🗑
|
||||
| How should you hydrate a pt with DKA? | show 🗑
|
||||
| When treating DKA, what type of insulin is given and in what form? | show 🗑
|
||||
| show | Ketones
🗑
|
||||
| What is the onset of hypoglycemic complications from fastest to slowest? | show 🗑
|
||||
| show | DIME -Diet -Insulin -Meds -Exercise
🗑
|
||||
| show | 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 blood clot could travel to the lungs and become a PE
🗑
|
||||
| show | They can be voiding as little as 30cc/hr but we would like to see 50cc/hr
🗑
|
||||
| show | A solution with an osmolality higher than that of serum
🗑
|
||||
| show | A hypotonic solution
🗑
|
||||
| show | A solution with the same osmolality as serum and other body fluids
🗑
|
||||
| What is the normal range for serum osmolality? | show 🗑
|
||||
| What are some isotonic solutions? | show 🗑
|
||||
| What is a hypotonic solution? | show 🗑
|
||||
| show | 3% NaCl (hypertonic saline) 5% NaCl (hypertonic solution)
🗑
|
||||
| What is fluid volume deficit (FVD)? | show 🗑
|
||||
| show | The loss of water alone with the increased serum sodium level (hyperosmolar deficit)
🗑
|
||||
| show | The equal loss of water and electrolytes; caused by GI wounds, v/d, third spacing (burns ascites, bowel obstruction)
🗑
|
||||
| What lab values should you see with FVD? | show 🗑
|
||||
| What is fluid volume excess (FVE) due to? | show 🗑
|
||||
| show | 4-10mm/Hg; however with FVE, it's increased
🗑
|
||||
| show | -Restriction of fluids and sodium -ADministration of diuretics
🗑
|
||||
| show | 3000mg
🗑
|
||||
| show | 2000mg
🗑
|
||||
| show | PMS -Processed -Milk; dairy products -Salt
🗑
|
||||
| show | Decreased
🗑
|
||||
| What renal treatment can also be a treatment for FVE? | show 🗑
|
||||
| What level is considered hypokalemia? | show 🗑
|
||||
| show | -GI losses -Meds -Hyperaldosteronism
🗑
|
||||
| How can hyperaldosteronism be a cause of hypokalemia? | show 🗑
|
||||
| show | Potassium
🗑
|
||||
| show | Stop it and this is known as a cardiac standstill; Flat T wave on the ECG
🗑
|
||||
| show | Potassium
🗑
|
||||
| What is the major player in the ICF compartment? | show 🗑
|
||||
| show | 3.5-5.0
🗑
|
||||
| show | >5.0
🗑
|
||||
| show | -Impaired renal function -Hypoaldosteronism -Tissue trauma -Acidosis
🗑
|
||||
| What are the biggest regulator of potassium? | show 🗑
|
||||
| show | Make it stop beating, this is known as ventricular fibrillation
🗑
|
||||
| What forces potassium back into the ICF compartment? | show 🗑
|
||||
| What type of diuretics should not be used with pts who have hyperkalemia and renal dysfunction? | show 🗑
|
||||
| show | 7.35-7.45
🗑
|
||||
| With an acid-base imbalance, what is the pCO2 level? | show 🗑
|
||||
| With an acid-base imbalance, what is the HCO3 level | show 🗑
|
||||
| show | CO2- carbonic acid
🗑
|
||||
| With acid-base imbalances, what do the kidneys help with? | show 🗑
|
||||
| With acid-base imbalances, what does plasma pH indicate? | show 🗑
|
||||
| show | -Buffer -Kidneys -Lungs
🗑
|
||||
| Out of pH, CO2 & HCO3, which one is is the more critical one to look at? | show 🗑
|
||||
| show | 20:1; 1 part carbonic acid to 20 parts sodium bicarbonate
🗑
|
||||
| show | First look at the pH Second, look at the pCO2 (respiratory) Third, look at the HCO3 (metabolic)
🗑
|
||||
| show | Compensation is done by the body & correction is done by medical intervention
🗑
|
||||
| What pneumonic is good for remembering F&E imbalances? | show 🗑
|
||||
| How long does it take for kidneys to compensate for respiratory problems? | show 🗑
|
||||
| How long does it take for lungs to compensate for metabolic problems? | show 🗑
|
||||
| What are the six rights of med administration? | show 🗑
|
||||
| show | -date and time order is written -drug name -drug dosage -route of administration -frequency and duration of administration -special instructions
🗑
|
||||
| show | 3 times
🗑
|
||||
| What sort of drug labels order shoiuld be checked agisnt the original order? | show 🗑
|
||||
| What is the longest needle? | show 🗑
|
||||
| What are the gauges and lengths of an ID needle? | show 🗑
|
||||
| show | Gauges -23, 25, 26 Lengths 3/8, 1/2, 58
🗑
|
||||
| show | Gauges -19, 20, 21, 22 Lengths -1, 1 1/2, 2
🗑
|
||||
| show | Angioedema
🗑
|
||||
| show | Protamine Sulfate
🗑
|
||||
| show | Vitamin K
🗑
|
||||
| show | Heparin
🗑
|
||||
| What two diseases are diuretics widely used for? | show 🗑
|
||||
| What kind of diuretic is Aldactone? | show 🗑
|
||||
| What kind of diuretics are Lasix & Demadex? | show 🗑
|
||||
| What suffixes do ACE Inhibitors have? | show 🗑
|
||||
| show | Yellow or green halos-blurred vision
🗑
|
||||
| show | Zocor & Lipitor
🗑
|
||||
| show | Antihyperlipidemics
🗑
|
||||
| show | The liver
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
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