232 midterm Flashcards
(175 cards)
1
Q
List the 4 diagnostics for inflm
A
WBC count, differential, CRP, rheumatoid factor
2
Q
List the 7 diagnostics for infection
A
WBC count, differential, CRP, procalcitonin, C&S, gram stain
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
4
Q
What is a differential?
A
breakdown of WBCs
5
Q
Elevated neutrophils means what type of infection
A
bacterial or pyogenic
6
Q
Eosinophil elevation indicates what infection
A
allergic and parasitic
7
Q
Elevated basophils are what infections
A
parasitic and some allergic
8
Q
Lymphocytes elevated means __ infection
A
viral
9
Q
Monocyte elevation is for ___ infections
A
chronic
10
Q
What does the rheumatoid factor determine
A
diagnose rheumatoid arthritis
11
Q
what population of people can have a false positive for rheumatoid factor?
A
elderly
12
Q
CRP and procalcitonin are ___ indicators
A
nonspecific
13
Q
What does procalcitonin test for
A
detect or rule out bacterial sepsis
14
Q
low levels indicates __ risk of bacterial sepsis
A
low
15
Q
What is a culture test?
A
microorganisms grow in a growth medium
16
Q
what is a Sensitivity test
A
determines the sensitivity of bacteria to an antibiotic and evaluates for resistance
17
Q
Define hyponatremia
A
low sodium
18
Q
Mnfts of hyponatremia
A
weakness, confusion, ataxia, stupor and coma
19
Q
Causes of hyponatremia
A
diarrhea, vomiting, diuretics, NG tube
20
Q
Define hypernatremia
A
high sodium
21
Q
Mnfts of hypernatremia
A
thirst, agitation, mania, convulsions, dry mucous membranes
22
Q
Causes for hypernatremia
A
inc. Na intake, excessive free body H2O loss, Cushing syndrome
23
Q
What is hypokalemia
A
low potassium
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
25
causes of hypokalemia
GI losses, diarrhea, vomiting, burns
26
Define hyperkalemia
high potassium
27
mnfts of hyperkalemia
irritability, N/V, diarrhea, intestinal colic
28
causes of hyperkalemia
excessive dietary intake, ARF/CRF, infection
29
Ex of localized infection
infected wound
30
mnfts of localized infections
pus, swelling, redness, warmth
31
Ex of systemic infection
sepsis
32
mnfts of systemic infection
BP decreases, fever, nausea, HR inc
33
Name 5 ex of common infections
UTI, pneumonia, hep B&C, ESBL, C-diff, MRSA, VRE, ARO, HIV
34
What temp is considered a fever
38.5 degrees
35
Name 3 drugs that treat inflm
anti-inflammatories, NSAIDs- ibuprofen and ASA
36
3 drugs that are Antipyretics
acetaminophen, ASA, ibuprofen
37
What are three antipyretics
Acetaminophen, ASA and ibuprophen
38
Why is acetaminophen the most common antipyretic
can be given across the lifespan and comes in many forms
39
Ibuprofen decreases ___ and is an ___
inflm, antipyretic
40
SE of acetaminophen
affects the liver irreversibly
41
SE of ibuprofen
GI bleeds, ulcers, renal impairment
42
ASA is not good for fever treatment because...
causes platelet aggregation
43
SE of ASA
GI. bleeding and Rhys syndrome
44
3 categories of infections
chronic, acute and colonization
45
3 examples of chronic inflm
chrones, asthma, arthritis
46
Define colonization
can't get rid of bacteria but antibiotics will minimize the amount of bacteria
47
Name 10 mnfts of infection
inflammation, neutrophils, fever, fatigue, dec BP, burning/inc frequency, delirium, diaphoretic, sputum, crackles, pain with inspiration
48
Name risk factors of arthritis
age, female, smoking, family history, environment, obesity
49
Mnfts of arthritis
pain, swollen joints, limits movement, stiffness, fatigue, weakness
50
Name some non pharmacological Tx for arthritis
heat, water aerobics, braces, mobility, sleep
51
Pharmacological Tx of arthritis
manage symptoms, reduce inflm, steroids
52
Risk factors of UTI
catheters, female, poor hygiene, not peeing enough, not completely emptying their bladder when voiding, enlarged prostates, diabetes d/t high glucose in urine
53
S&S of UTI
pain and burning, frequency, urgency, nocturia, suprapubic or pelvic pain, hematuria
54
What percent of people don't show symptoms of UTI why?
50%, colonization
55
Pharmacological interventions for UTI
antibiotics and drug to decrease spasms in the bladder
56
Non pharmacological interventions for UTI
inc. fluids, frequent urination, avoid irritants, good hygiene, remove/replace Foley catheter, patient knowledge
57
Risk factors of C-diff
antibiotics, surgery in abdomen, disease of colon, weakened immune system, chemotherapy drugs
58
Signs and symptoms of C-diff
watery diarrhea, severe abdominal pain, loss of appetite, fever, blood or pus in stool, weight loss
59
What tests can be done for C-diff
culture and sensitivity, electrolytes, WBC count and neutrophils
60
Pharmacological interventions for C diff
vancomycin, fecal transplants, probiotics and antimedics
61
non pharmacological interventions for c diff
fluids, isolation precautions, maintain nutrition, promote patient knowledge,
62
What is a primary wound
closed w stitches or staples
63
What is a secondary wound
pressure wounds and burns left open to heal on their own
64
What is a tertiary wound
leave open and then close later surgically
65
What are the 4 stages of wound healing
hemostasis, inflammation, proliferation, remodelling
66
How long does each stage of wound healing last?
hemo (1-4 days), inflm (up to 4 days), proliferation (4-21 days), remodelling (up to 2 years)
67
Ex of issues affects hemostasis
anticoagulants, low platelet count
68
Ex of issues w inflm
immunodeficiency, continuous irritation, infection
69
Issue w proliferation
not enough nutrition
70
How fast do acute wounds heal
less than 21 days
71
Define a chronic wound
reoccurs frequently, disrupted at one or more stages in wound healing
72
what age is at increased risk of chronic wounds? Why?
Elderly d/t dec mobility, nutrition, diabetes and cardiovascular
73
Define pressure ulcer
ulcer in a localized area of infarcted soft tissue that occur when pressure is applied to skin over time
74
10 risk factors for pressure ulcers
friction, prolonged pressure, loss of protective reflex, immobility, malnutrition, incontinence, dry skin, casts, critically ill
75
Explain care plan for pressure ulcers
assess total skin condition and erythema for blanching, inspect each pressure site and dry skin
Assess mobility, circulatory status, neuromuscular status, nutrition
76
Stage 1 pressure ulcer
redness, skin still intact, affects top layer
77
Stage 2 pressure ulcer
going into dermis layer, can have blistering and shearing, inc risk of infection
78
Stage 3 pressure ulcer
through the dermis layer, damage to SC tissue, drainage, measure length and width
79
Stage 4 pressure ulcer
all the way down to bone, muscles or tendons, will have drainage
80
What is an unstageable pressure ulcer covered by
slough or eschar
81
What causes lower limb ulcers
diabetes, or arterial/venous insufficiency
82
What diagnostic and treatments for ulcers
doppler ultrasound, compression dressings
83
Describe a venous ulcer
dull heavy aching, edema, superficial irregular shape, highly exudative, pulse present
84
Name 4 major goals for venous ulcer prevention
nutrition, restored skin integrity, improved physical mobility, absence of complications
85
Modifiable risk factors for arterial ulcers
nicotine, diet, HTN, diabetes, obesity, stress, sedentary lifestyle
86
Non modifiable risk factors for arterial ulcers
age, gender, genetics
87
Characteristics of arterial ulcers
typically deep and circular, small, minimal drainage, no bleeding and weak pulse
88
Where are arterial ulcers located
on or between toes, heel, shin
89
Name 5 arterial ulcer interventions
eliminate restrictive clothing, apply warmth, elevate HOB, exercise as tolerated, proper support surfaces
90
Why are diabetics likely to have foot ulcers
high blood sugars, hyperglemia, motor and sensory neuropathy, PVD
91
Assessment of ulcers
Pain, quality of pulses, check edema, limitations in mobility, moisture, nutritional status, Hx of diabetes, vascular disease,
92
Example of nursing Dx for ulcer
impaired skin integrity r/t vascular insufficiency
93
Plan for Tx ulcer
improve/restore skin integrity
94
Name 5 interventions for ulcers
protect skin, remove obstacles from Pt path, frequent repositioning, pain meds, nutrition, change dressings
95
Name two main things to evaluate if interventions worked for ulcers
restored skin integrity and adequate nutrition
96
Wound healing past the dermis is known as
scar formation
97
Name examples of secondary intention wounds
Pressure, venous, arterial, diabetic,
98
Define nociceptors where are they located and where are they not?
free nerve endings in the skin, cornea, joints, not found in organs and internal structures
99
What is a mediator for pain
prostaglandin
100
Explain gate control theory
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
name factors influencing pain
past experience, culture, gender, anxiety
102
How do nurses assess pain
NOPQRSTUV
103
Non pharmacological Tx of pain
massage, thermal therapies, distraction, relaxation, hypnosis
104
Describe geriatric considerations for pain sensation
loss of myelination causes decreased perception of pain
105
What 5 considerations are there for geriatric patients receiving analgesics
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
What is the number 1 reason for medical help
pain
107
Name the 3 types of pain
acute, procedural, chronic
108
How to assess Pt with disabilities for pain
- non verbal cues including, tense, grimace, sweating, BP, HR inc., interpreters and visual pain scale
109
non pharmacological Tx for pain
heat, meditation, relaxation, deep breathing,
110
What is an adjuvant
drug used to dec. amount of other drugs being used
111
How are nonopioid analgesics used for pain
adjunctive Tx
112
What therapeutic drug classification is gabapentin, how is it used for pain
anticonvulsants helps with nerve pain (good for diabetics)
113
Example of antidepressant used for pain. what type of pain
amitriptyline for chronic pain
114
How do corticosteroids help with pain
stop inflm response
115
How do NSAIDs help w pain
inflm response
116
SE of NSAIDs
GI bleed will worsen and anaphylactic shock
117
What age group can't have ASA and why
infants b/c of Reyes syndrome
118
How does ASA help w pain
enhances prostaglandin synthesis
119
SE of ASA
nausea, tinitus, GI bleeding
120
Pre/Post checks for giving ASA
allergies, platelets, pain assessment,
121
if platelets are ___ don't give ASA
low
122
therapeutic classification of ibuprofen
NSAIDs, antipyretic
123
What are available doses of ibuprofen
200-400mg
124
Indications for ibuprofen
inflm disorders, mild to moderate pain, fever
125
indications for acetaminophen
inhibits synthesis of prostaglandin
126
SE of acetaminophen
anaphylactic shock, toxic liver, jaundice
127
What tests can be done to test liver when giving acetaminophen
liver function tests
128
Acetaminophen Is used to treat ___ pain
mild
129
Therapeutic classification of morphine
opioid analgesics
130
What routes of admin is morphine prescribed
tablets, capsules, suppositories, extended release
131
Mechanism of action of morphine
binds to opiate receptors in the CNS. Alters perception and response to painful stimuli.
132
Indication of morphine
moderate to severe chronic pain
133
SE of morphine
respiratory depression, constipation, hypostatic hypotension
134
Pre/post assessments for morphine
allergies, pain assess, RR, BP
135
onset and duration of morphine
rapid onset 60 min lasts up to 7h
136
therapeutic classification of hydromorphone
opioid analgesis
137
Routes of admin hydromorphone
tablets, capsules, parenteral, IR and SR
138
MA of hydromorphone
binds to opiate receptors in CNS alters perception and response to painful stimuli while producing generalized CNS depression
139
indications of hydromorphone
moderate to severe pain
140
SE of hydromorphone
toxic epidermal necrosis, hepatotoxicity
141
Pharmacologic classification of fentanyl
opioid analgesic
142
routes for fentanyl
parenteral and transdermal
143
MA of fentanyl
bind to opiate receptors in CNS. Alter perception of and response to painful stimuli while CNS depression
144
indications for parenteral fentanyl
pre/post anesthesia
145
indications for transdermal fentanyl
moderate to severe chronic pain requiring 24/7 opioid
146
Ex of someone needing transdermal fentanyl
cancer Pt
147
SE of fentanyl
respiratory depression and constipation
148
Pre/post checks fentanyl
allergies, pain assess, RR, BP, hepatic and renal impairment
149
Duration of fentanyl patch and can the patches be cut
72H and NO`
150
pharmacologic classification of naloxone
opioid antagonist
151
Indications of naloxone
reversal of CNS depression and respiratory depression b/c of suspected overdose
152
MA of nalaxone
blocks the effects of opioids
153
SE of naloxone
ventricular arrhythmias, nausea vomiting
154
pre/post assessments naloxone
RR, BP, level of consciousness,
155
therapeutic classification of vancomycin
anti-infectives
156
Indications of vancomycin
Tx of life-threatening infections. Tx pneumonia, meningitis,
157
MA of vancomycin
binds to bacterial cell wall
158
Route of admin vancomycin
IV
159
SE of vancomycin
nephrotoxicity, phlebitis
160
Pre/post assess for vancomycin
monitor IV site, assess infection, BP, urine output
161
Pharmacologic classification for cefazolin
first-generation cephalosporins
162
Indications for cafazolin
Tx of bacterial infections including pneumonia, UTI, genital, billiard tract, bone and joint
163
Action of cefazolin
bind to bacterial cell wall membrane for cell death
164
Route of admin cefazolin
IV
165
SE of cefazolin
diarrhea, nausea, vomiting, rash, pain, phlebitis
166
Pre/pos assess of cefazolin
Assess for infection, anaphylaxis, monitor bowel Fx, skin rash
167
WBC signifies activation of ___ response and possible ____
inflammatory, infection
168
Low elevated levels of PCT means
low risk of bacterial sepsis
169
Name 10 common infections nurses will encounter
pneumonia, C-diff, sepsis, MRSA, VRE, ARO, HIV, HepB,UTI, ESBL
170
Antiviral agent ex
acyclovir
171
Two antibacterial drugs
cefazolin, vancomycin
172
common side effects of antibiotics
nausea, vomiting, diarrhea, nephrotoxicity, hepatic toxicity
173
Pediatric considerations for antibiotics
doses are based on weight
174
Geriatric consideration for antibiotic
lower dosages
175
Pregnancy consideration for antibiotics
potential harm to fetus or mother
