3/9

Question 1

Daily weights
Same time every day with same amount of clothing and same scale

Answer 1

How evaluate fluid status esp renal pt

Question 2

Depends on severity of tear - most able to back to norm activities in couple months; lifting requirements; not fully functional within until 1 year after

Answer 2

How long recover from rotator cuff injury

Question 3

Repetitive motions
Trauma
Getting older - risk factor

Answer 3

rotator cuff injury

Question 4

Special splints used
Change position frequently - not stay in same spot
Correct this - surgical procedure if can correct it
Able move own and change position - not concern
Concern: lot time in bed; turn; if trying to prevent pressure injuries - prevent this as well

Answer 4

Contractures

Question 5

Depends
Keep in mind what else is going wrong
See if too unstable
Move ASAP unless contraindicated

Answer 5

Ambulate after surgery

Question 6

Dehydration - high BUN with norm Cr - eventually lead to AKI - hypovolemia
No damage - min damage - time to replace fluid

Answer 6

AKI

Question 7

high BUN with norm Cr - signs dehydration
Muscle tissue damage - bruising
Staying in same spot for long time

Answer 7

Rhabdomyolysis

Question 8

Lactic acidosis - going towards rhabo - systemic and issue with kidneys

Answer 8

Intrarenal

Question 9

Lack intake fluids; fluid volume deficit
Hypotension
Lack fluid within vascular space

Answer 9

Prerenal

Question 10

Same rib broken in sev areas
Hallmark: paradoxical chest wall movement - go opp direction with rest of rib cage
Effects lung expansion - not able breathe
O2 on pts
Often intubate them with high end expiratory pressures - allow for full lung expansion until to surgery - so pin in place and let heal
Not oxygenating well esp flail chest - intubation first line
Lung collapses - whole area lung where not doing gas exchange - atelectasis and blocking off
Main N. diagnosis: impaired gas exhange

Answer 10

Flail chest

Question 11

Renal - depends on what stage renal failure; stage 4 - edge of dialysis
MS issues

Answer 11

Difference in nutrition between renal issues and MS issues

Question 12

Low protein limit damage to kidneys
Low Na - not want them having lots Na - fluid volume overload
No salt substitute - K high
Consult dietician as well

Answer 12

Renal - depends on what stage renal failure; stage 4 - edge of dialysis - Difference in nutrition between renal issues and MS issues

Question 13

High protein for bone healing
High carbs for bone healing
More calcium
Vit D appropriate

Answer 13

MS issues - Difference in nutrition between renal issues and MS issues

Question 14

No protein added - hurting kidneys because proteins excreted in urine - still pull more fluid and protein
Can use albumin - last ditch effort - pee it out
Very high state of supporting pt or slowing down progression
Supportive measure: antihyperlipidemic (Zocor), BP med (ACEI)
Kayxelatye - for kidney relate - higher K happens in renal failure

Answer 14

Nephrotic syndrome

Question 15

Emergent set meds: shift K intracellular: insulin and D50 - pulls K inside cell - not get rid K - need get rid K - inside cell cardio protective - not hurt heart which concerned about with high K
Kayxelatye - get rid K in stool

Answer 15

Deal with high K

Question 16

pneumothorax - treatment: chest tube

Answer 16

Tracheal deviation -

Question 17

pain - med: allopurinol (reduce uric acid levels - preventative maintance mediation) and ibuprofen - drink lot water

Answer 17

Gout -

Question 18

systemically dry - stool dry - need help bring water - increased fiber, stool softeners, laxatives later

Answer 18

Pts not filtering appropriately -

Question 19

Always have it once have it - exacerbations preventable with diet and meds - high pruine foods avoids
Can affect diabetic pts - lifestyle habits that exacerbate gout exacerbate DM

Answer 19

Gout

Question 20

Tissue swelling related
Cast sometimes
Often need surgical intervention
Rapid response good
Follow facility protocols

Answer 20

Acute compartment syndrome

Question 21

Once infection bone harder treat - often leads to amputation - high risk for sepsis
What kill pt first
Priority make sure getting to surgery or notified who needs to notified to preserve limb

Answer 21

Osteomyelitis

Question 22

All Ps
Cyanosis - worse - decreased blood flow

Answer 22

Compartment syndrome

Question 23

• rhabdomyolysis which can lead to renal failure - (also on telemetry - high K)

Answer 23

Same position for extended period time and trauma

Question 24

Do not touch them - call provider

Answer 24

Traction - Weights on floor

Question 25

Give them pain med

Answer 25

Phantom limb pain

Question 26

Take deep breaths
Monitor end tidal CO2
Expert consultation
Not mean not give opioids but will give potential epidurals (caines) and less resp depression

Answer 26

Control pain and high pain level but resp depression

Question 27

Chest tube

Answer 27

Pneumothorax

Question 28

PE

Answer 28

d/c after fracture with cast - comes back with extreme SOB

Question 29

High risk for big bone break

Answer 29

Paget’s disease

Question 30

No

Answer 30

If not break bone - at risk fat emboli

Question 31

No - not blood clot; it is fat
Medication that dilates the vessel
Often bed rest to not dislodge clot to dangerous area
Petichae above clot - distinct line - purple from nipple line up

Answer 31

TPA fat embolism

Question 32

Both can lead to each other
Compartment - acute loss of circ to limb or tissue - go in and get circ restored; muscle - fasciotomy; abdominal - open, burn - remove; surgical to relieve pressure
Crush - myoglobin released into bloodstream as result - do damage to further organs; acute renal failure
How prevent it - cannot; disaster - days - in condition; fluids to flush substances out; dialysis if cannot process anymore; combo; maybe use some bicarb to help if caught early

Answer 32

Compartment syndrome vs crush syndrome