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232 > 232 midterm > Flashcards

232 midterm Flashcards

1
Q

List the 4 diagnostics for inflm

A

WBC count, differential, CRP, rheumatoid factor

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2
Q

List the 7 diagnostics for infection

A

WBC count, differential, CRP, procalcitonin, C&S, gram stain

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3
Q

How does WBC count tell if there is inflm/inf

A

WBC are the body’s primary defence so inc. in WBC means inflm response

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4
Q

What is a differential?

A

breakdown of WBCs

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5
Q

Elevated neutrophils means what type of infection

A

bacterial or pyogenic

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6
Q

Eosinophil elevation indicates what infection

A

allergic and parasitic

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7
Q

Elevated basophils are what infections

A

parasitic and some allergic

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8
Q

Lymphocytes elevated means __ infection

A

viral

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9
Q

Monocyte elevation is for ___ infections

A

chronic

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10
Q

What does the rheumatoid factor determine

A

diagnose rheumatoid arthritis

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11
Q

what population of people can have a false positive for rheumatoid factor?

A

elderly

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12
Q

CRP and procalcitonin are ___ indicators

A

nonspecific

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13
Q

What does procalcitonin test for

A

detect or rule out bacterial sepsis

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14
Q

low levels indicates __ risk of bacterial sepsis

A

low

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15
Q

What is a culture test?

A

microorganisms grow in a growth medium

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16
Q

what is a Sensitivity test

A

determines the sensitivity of bacteria to an antibiotic and evaluates for resistance

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17
Q

Define hyponatremia

A

low sodium

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18
Q

Mnfts of hyponatremia

A

weakness, confusion, ataxia, stupor and coma

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19
Q

Causes of hyponatremia

A

diarrhea, vomiting, diuretics, NG tube

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20
Q

Define hypernatremia

A

high sodium

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21
Q

Mnfts of hypernatremia

A

thirst, agitation, mania, convulsions, dry mucous membranes

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22
Q

Causes for hypernatremia

A

inc. Na intake, excessive free body H2O loss, Cushing syndrome

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23
Q

What is hypokalemia

A

low potassium

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24
Q

mnfts of hypokalemia

A

dec. in contractility of smooth, skeletal and cardiac muscles, weakness, paralysis, hyporeflexia, ileus, cardiac dysrhythmias, thirst, flat T waves

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25
Q

causes of hypokalemia

A

GI losses, diarrhea, vomiting, burns

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26
Q

Define hyperkalemia

A

high potassium

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27
Q

mnfts of hyperkalemia

A

irritability, N/V, diarrhea, intestinal colic

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28
Q

causes of hyperkalemia

A

excessive dietary intake, ARF/CRF, infection

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29
Q

Ex of localized infection

A

infected wound

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30
Q

mnfts of localized infections

A

pus, swelling, redness, warmth

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31
Q

Ex of systemic infection

A

sepsis

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32
Q

mnfts of systemic infection

A

BP decreases, fever, nausea, HR inc

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33
Q

Name 5 ex of common infections

A

UTI, pneumonia, hep B&C, ESBL, C-diff, MRSA, VRE, ARO, HIV

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34
Q

What temp is considered a fever

A

38.5 degrees

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35
Q

Name 3 drugs that treat inflm

A

anti-inflammatories, NSAIDs- ibuprofen and ASA

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36
Q

3 drugs that are Antipyretics

A

acetaminophen, ASA, ibuprofen

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37
Q

What are three antipyretics

A

Acetaminophen, ASA and ibuprophen

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38
Q

Why is acetaminophen the most common antipyretic

A

can be given across the lifespan and comes in many forms

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39
Q

Ibuprofen decreases ___ and is an ___

A

inflm, antipyretic

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40
Q

SE of acetaminophen

A

affects the liver irreversibly

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41
Q

SE of ibuprofen

A

GI bleeds, ulcers, renal impairment

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42
Q

ASA is not good for fever treatment because…

A

causes platelet aggregation

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43
Q

SE of ASA

A

GI. bleeding and Rhys syndrome

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44
Q

3 categories of infections

A

chronic, acute and colonization

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45
Q

3 examples of chronic inflm

A

chrones, asthma, arthritis

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46
Q

Define colonization

A

can’t get rid of bacteria but antibiotics will minimize the amount of bacteria

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47
Q

Name 10 mnfts of infection

A

inflammation, neutrophils, fever, fatigue, dec BP, burning/inc frequency, delirium, diaphoretic, sputum, crackles, pain with inspiration

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48
Q

Name risk factors of arthritis

A

age, female, smoking, family history, environment, obesity

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49
Q

Mnfts of arthritis

A

pain, swollen joints, limits movement, stiffness, fatigue, weakness

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50
Q

Name some non pharmacological Tx for arthritis

A

heat, water aerobics, braces, mobility, sleep

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51
Q

Pharmacological Tx of arthritis

A

manage symptoms, reduce inflm, steroids

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52
Q

Risk factors of UTI

A

catheters, female, poor hygiene, not peeing enough, not completely emptying their bladder when voiding, enlarged prostates, diabetes d/t high glucose in urine

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53
Q

S&S of UTI

A

pain and burning, frequency, urgency, nocturia, suprapubic or pelvic pain, hematuria

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54
Q

What percent of people don’t show symptoms of UTI why?

A

50%, colonization

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55
Q

Pharmacological interventions for UTI

A

antibiotics and drug to decrease spasms in the bladder

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56
Q

Non pharmacological interventions for UTI

A

inc. fluids, frequent urination, avoid irritants, good hygiene, remove/replace Foley catheter, patient knowledge

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57
Q

Risk factors of C-diff

A

antibiotics, surgery in abdomen, disease of colon, weakened immune system, chemotherapy drugs

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58
Q

Signs and symptoms of C-diff

A

watery diarrhea, severe abdominal pain, loss of appetite, fever, blood or pus in stool, weight loss

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59
Q

What tests can be done for C-diff

A

culture and sensitivity, electrolytes, WBC count and neutrophils

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60
Q

Pharmacological interventions for C diff

A

vancomycin, fecal transplants, probiotics and antimedics

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61
Q

non pharmacological interventions for c diff

A

fluids, isolation precautions, maintain nutrition, promote patient knowledge,

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62
Q

What is a primary wound

A

closed w stitches or staples

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63
Q

What is a secondary wound

A

pressure wounds and burns left open to heal on their own

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64
Q

What is a tertiary wound

A

leave open and then close later surgically

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65
Q

What are the 4 stages of wound healing

A

hemostasis, inflammation, proliferation, remodelling

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66
Q

How long does each stage of wound healing last?

A

hemo (1-4 days), inflm (up to 4 days), proliferation (4-21 days), remodelling (up to 2 years)

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67
Q

Ex of issues affects hemostasis

A

anticoagulants, low platelet count

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68
Q

Ex of issues w inflm

A

immunodeficiency, continuous irritation, infection

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69
Q

Issue w proliferation

A

not enough nutrition

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70
Q

How fast do acute wounds heal

A

less than 21 days

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71
Q

Define a chronic wound

A

reoccurs frequently, disrupted at one or more stages in wound healing

72
Q

what age is at increased risk of chronic wounds? Why?

A

Elderly d/t dec mobility, nutrition, diabetes and cardiovascular

73
Q

Define pressure ulcer

A

ulcer in a localized area of infarcted soft tissue that occur when pressure is applied to skin over time

74
Q

10 risk factors for pressure ulcers

A

friction, prolonged pressure, loss of protective reflex, immobility, malnutrition, incontinence, dry skin, casts, critically ill

75
Q

Explain care plan for pressure ulcers

A

assess total skin condition and erythema for blanching, inspect each pressure site and dry skin
Assess mobility, circulatory status, neuromuscular status, nutrition

76
Q

Stage 1 pressure ulcer

A

redness, skin still intact, affects top layer

77
Q

Stage 2 pressure ulcer

A

going into dermis layer, can have blistering and shearing, inc risk of infection

78
Q

Stage 3 pressure ulcer

A

through the dermis layer, damage to SC tissue, drainage, measure length and width

79
Q

Stage 4 pressure ulcer

A

all the way down to bone, muscles or tendons, will have drainage

80
Q

What is an unstageable pressure ulcer covered by

A

slough or eschar

81
Q

What causes lower limb ulcers

A

diabetes, or arterial/venous insufficiency

82
Q

What diagnostic and treatments for ulcers

A

doppler ultrasound, compression dressings

83
Q

Describe a venous ulcer

A

dull heavy aching, edema, superficial irregular shape, highly exudative, pulse present

84
Q

Name 4 major goals for venous ulcer prevention

A

nutrition, restored skin integrity, improved physical mobility, absence of complications

85
Q

Modifiable risk factors for arterial ulcers

A

nicotine, diet, HTN, diabetes, obesity, stress, sedentary lifestyle

86
Q

Non modifiable risk factors for arterial ulcers

A

age, gender, genetics

87
Q

Characteristics of arterial ulcers

A

typically deep and circular, small, minimal drainage, no bleeding and weak pulse

88
Q

Where are arterial ulcers located

A

on or between toes, heel, shin

89
Q

Name 5 arterial ulcer interventions

A

eliminate restrictive clothing, apply warmth, elevate HOB, exercise as tolerated, proper support surfaces

90
Q

Why are diabetics likely to have foot ulcers

A

high blood sugars, hyperglemia, motor and sensory neuropathy, PVD

91
Q

Assessment of ulcers

A

Pain, quality of pulses, check edema, limitations in mobility, moisture, nutritional status, Hx of diabetes, vascular disease,

92
Q

Example of nursing Dx for ulcer

A

impaired skin integrity r/t vascular insufficiency

93
Q

Plan for Tx ulcer

A

improve/restore skin integrity

94
Q

Name 5 interventions for ulcers

A

protect skin, remove obstacles from Pt path, frequent repositioning, pain meds, nutrition, change dressings

95
Q

Name two main things to evaluate if interventions worked for ulcers

A

restored skin integrity and adequate nutrition

96
Q

Wound healing past the dermis is known as

A

scar formation

97
Q

Name examples of secondary intention wounds

A

Pressure, venous, arterial, diabetic,

98
Q

Define nociceptors where are they located and where are they not?

A

free nerve endings in the skin, cornea, joints, not found in organs and internal structures

99
Q

What is a mediator for pain

A

prostaglandin

100
Q

Explain gate control theory

A

stimulation from the skin causes nervous impulses from three different systems in the spinal cord. stimulation of the large diameter fibers closes the gate so there is no pain and small fibers opens the gate so pain is felt

101
Q

name factors influencing pain

A

past experience, culture, gender, anxiety

102
Q

How do nurses assess pain

A

NOPQRSTUV

103
Q

Non pharmacological Tx of pain

A

massage, thermal therapies, distraction, relaxation, hypnosis

104
Q

Describe geriatric considerations for pain sensation

A

loss of myelination causes decreased perception of pain

105
Q

What 5 considerations are there for geriatric patients receiving analgesics

A

need lower dose, metabolizes slower, inc risk of drug toxicity, inc risk of drug interactions, inc risk of depression of nervous and respiratory system

106
Q

What is the number 1 reason for medical help

A

pain

107
Q

Name the 3 types of pain

A

acute, procedural, chronic

108
Q

How to assess Pt with disabilities for pain

A
  • non verbal cues including, tense, grimace, sweating, BP, HR inc., interpreters and visual pain scale
109
Q

non pharmacological Tx for pain

A

heat, meditation, relaxation, deep breathing,

110
Q

What is an adjuvant

A

drug used to dec. amount of other drugs being used

111
Q

How are nonopioid analgesics used for pain

A

adjunctive Tx

112
Q

What therapeutic drug classification is gabapentin, how is it used for pain

A

anticonvulsants helps with nerve pain (good for diabetics)

113
Q

Example of antidepressant used for pain. what type of pain

A

amitriptyline for chronic pain

114
Q

How do corticosteroids help with pain

A

stop inflm response

115
Q

How do NSAIDs help w pain

A

inflm response

116
Q

SE of NSAIDs

A

GI bleed will worsen and anaphylactic shock

117
Q

What age group can’t have ASA and why

A

infants b/c of Reyes syndrome

118
Q

How does ASA help w pain

A

enhances prostaglandin synthesis

119
Q

SE of ASA

A

nausea, tinitus, GI bleeding

120
Q

Pre/Post checks for giving ASA

A

allergies, platelets, pain assessment,

121
Q

if platelets are ___ don’t give ASA

A

low

122
Q

therapeutic classification of ibuprofen

A

NSAIDs, antipyretic

123
Q

What are available doses of ibuprofen

A

200-400mg

124
Q

Indications for ibuprofen

A

inflm disorders, mild to moderate pain, fever

125
Q

indications for acetaminophen

A

inhibits synthesis of prostaglandin

126
Q

SE of acetaminophen

A

anaphylactic shock, toxic liver, jaundice

127
Q

What tests can be done to test liver when giving acetaminophen

A

liver function tests

128
Q

Acetaminophen Is used to treat ___ pain

A

mild

129
Q

Therapeutic classification of morphine

A

opioid analgesics

130
Q

What routes of admin is morphine prescribed

A

tablets, capsules, suppositories, extended release

131
Q

Mechanism of action of morphine

A

binds to opiate receptors in the CNS. Alters perception and response to painful stimuli.

132
Q

Indication of morphine

A

moderate to severe chronic pain

133
Q

SE of morphine

A

respiratory depression, constipation, hypostatic hypotension

134
Q

Pre/post assessments for morphine

A

allergies, pain assess, RR, BP

135
Q

onset and duration of morphine

A

rapid onset 60 min lasts up to 7h

136
Q

therapeutic classification of hydromorphone

A

opioid analgesis

137
Q

Routes of admin hydromorphone

A

tablets, capsules, parenteral, IR and SR

138
Q

MA of hydromorphone

A

binds to opiate receptors in CNS alters perception and response to painful stimuli while producing generalized CNS depression

139
Q

indications of hydromorphone

A

moderate to severe pain

140
Q

SE of hydromorphone

A

toxic epidermal necrosis, hepatotoxicity

141
Q

Pharmacologic classification of fentanyl

A

opioid analgesic

142
Q

routes for fentanyl

A

parenteral and transdermal

143
Q

MA of fentanyl

A

bind to opiate receptors in CNS. Alter perception of and response to painful stimuli while CNS depression

144
Q

indications for parenteral fentanyl

A

pre/post anesthesia

145
Q

indications for transdermal fentanyl

A

moderate to severe chronic pain requiring 24/7 opioid

146
Q

Ex of someone needing transdermal fentanyl

A

cancer Pt

147
Q

SE of fentanyl

A

respiratory depression and constipation

148
Q

Pre/post checks fentanyl

A

allergies, pain assess, RR, BP, hepatic and renal impairment

149
Q

Duration of fentanyl patch and can the patches be cut

A

72H and NO`

150
Q

pharmacologic classification of naloxone

A

opioid antagonist

151
Q

Indications of naloxone

A

reversal of CNS depression and respiratory depression b/c of suspected overdose

152
Q

MA of nalaxone

A

blocks the effects of opioids

153
Q

SE of naloxone

A

ventricular arrhythmias, nausea vomiting

154
Q

pre/post assessments naloxone

A

RR, BP, level of consciousness,

155
Q

therapeutic classification of vancomycin

A

anti-infectives

156
Q

Indications of vancomycin

A

Tx of life-threatening infections. Tx pneumonia, meningitis,

157
Q

MA of vancomycin

A

binds to bacterial cell wall

158
Q

Route of admin vancomycin

A

IV

159
Q

SE of vancomycin

A

nephrotoxicity, phlebitis

160
Q

Pre/post assess for vancomycin

A

monitor IV site, assess infection, BP, urine output

161
Q

Pharmacologic classification for cefazolin

A

first-generation cephalosporins

162
Q

Indications for cafazolin

A

Tx of bacterial infections including pneumonia, UTI, genital, billiard tract, bone and joint

163
Q

Action of cefazolin

A

bind to bacterial cell wall membrane for cell death

164
Q

Route of admin cefazolin

A

IV

165
Q

SE of cefazolin

A

diarrhea, nausea, vomiting, rash, pain, phlebitis

166
Q

Pre/pos assess of cefazolin

A

Assess for infection, anaphylaxis, monitor bowel Fx, skin rash

167
Q

WBC signifies activation of ___ response and possible ____

A

inflammatory, infection

168
Q

Low elevated levels of PCT means

A

low risk of bacterial sepsis

169
Q

Name 10 common infections nurses will encounter

A

pneumonia, C-diff, sepsis, MRSA, VRE, ARO, HIV, HepB,UTI, ESBL

170
Q

Antiviral agent ex

A

acyclovir

171
Q

Two antibacterial drugs

A

cefazolin, vancomycin

172
Q

common side effects of antibiotics

A

nausea, vomiting, diarrhea, nephrotoxicity, hepatic toxicity

173
Q

Pediatric considerations for antibiotics

A

doses are based on weight

174
Q

Geriatric consideration for antibiotic

A

lower dosages

175
Q

Pregnancy consideration for antibiotics

A

potential harm to fetus or mother

232 (2 decks)

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