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Acute Care > Acute Quiz 1 > Flashcards

Acute Quiz 1 Flashcards

1
Q

Hypovolemia Definition

A

Loss of fluids (plasma, blood, water)

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2
Q

Hypovolemia Clinical Manifestations

A

dehydration, significant blood loss, fatigue, elevated HR (maintain CO)

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3
Q

Hypervolemia Definition

A

excessive fluid intake or fluid retention

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4
Q

hypervolemia clinical manifestation

A

fatigue, shortness of breath, usually related to abnormal retention of fluid due to heart failure

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5
Q

Basic Metabolic Panel (BMP)

A

Sodium (134-142 mEq/L), chloride (98-108 mEq/L), BUN (6-21mg/dL), Potassium (3.7-5.1mEq/L), CO2 (22-29 mol/L), Creatinine (0.8-1.4mg/dL), Glucose (70-100mg/dL)

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6
Q

Hypernatremia Definition

A

High Levels of Sodium (Na+), usually due to high salt intake and severe dehydration

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7
Q

hypernatremia clinical manifestation

A

irritability, hypotension, tachycardia, depressed urine output, >150 may need to hold therapy

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8
Q

hyponatremia definition

A

Low sodium levels, due to anything leading to hypovolemia/hypervolemia

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9
Q

hypoatremia clinical manifestation

A

headache, lethargy, confusion, seizures, coma, <125 may need to hold therapy

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10
Q

Sodium (Na+)

A

assists with fluid balance, muscle contraction, regulates neuromuscular activity

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11
Q

Hyperkalemia Definition

A

High potassium, caused by impaired excretion(renal failure), medication, excess intake

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12
Q

Hyperkalemia Clinical Manifestation

A

muscle weakness, paralysis, numbness/tingling, bradycardia, ventricular fibrillation, cardiac arrest, deter treatment >5.1

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13
Q

hypokalemia definition

A

low potassium, caused by excessive loss (diarrhea, vomiting) or inadequate intake

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14
Q

hypokalemia clinical manifestation

A

extremity weakness, numbness and tingling, leg cramps, cardiac arrhythmias and arrest, deter Rx <3.2

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15
Q

potassium (K+)

A

involved in neuromuscular functioning of skeletal and cardiac muscle, and in protein synthesis, can be replenished through IV (V small window)

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16
Q

hypercalcemia definition

A

high levels of calcium, due to excess intake or release from bones, inadequate excretion by kidneys

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17
Q

hypercalcemia clinical manifestations

A

cardiac arrhythmias ( bradyarehythmias ), asystole, lethargy, weakness. possible poor tolerance to Rx (defer for arrhythmias)

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18
Q

hypocalcemia definition

A

low calcium levels, caused by inadequate dietary intake, limited absorption in GI, excess loss

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19
Q

hypocalcemia clinical manifestations

A

anxiety, confusion, irritability, arrhythmias (ventricular tachycardia risk), fatigue, muscle cramps, therapy contraindication <CV 6.0

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20
Q

Calcium (Ca2+)

A

functions in bone formation, cell growth and division, blood clotting, muscle contraction, and neuromuscular functioning

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21
Q

hyperchloremia definition

A

low chloride, caused by high salt diet w/o water, IV solutions, kidney failure

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22
Q

hyperchloremia clinical manifestation

A

lethargy, weakness, tachypnea/dyspnea, tachycardia

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23
Q

hypochloremia definition

A

low chloride, caused by decrease intake or too much water, excessive loss (vomiting, diarrhea, diuretics)

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24
Q

hypochloremia clinical manifestation

A

agitation, irritability, cramping, twitching

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25
Q

chloride (Cl-)

A

normal (98-108mEq/L), major anion in extra cellular fluid. accompanies sodium to maintain osmotic pressure of blood. maintains electrical neutrality

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26
Q

CO2 (BMP) (22-29 mmol/L)

A

high- respiratory acidosis (lower pH, and lethargy)
low- respiratory alkalosis (elevated pH, dizziness/ confusion)

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27
Q

Creatinine (Cre)- Kidney Panel {norm:0.5-1.2mg/dL)

A

byproduct of muscle metabolism, if increased: (impaired GFR, muscle injury), pt’s mental status is altered

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28
Q

BUN (blood urea nitrogen) (kidney panel)norm: 6-30mg/dL

A

urea forms in liver, increased (renal impairment, high levels of protein breakdown), pt’s altered mental state

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29
Q

Hyperglycemia Definition

A

High Blood Sugar, occurs with diabetes, acute stress, and steroids

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30
Q

hyperglycemia clinical manifestations

A

deter Rx for BS of >300-500, critical level >450 (life threatening, risk of diabetic ketoacidosis)

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31
Q

hypoglycemia definition

A

low blood sugar, occurs in presence of too much insulin, inadequate food intake

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32
Q

hypoglycemia clinical manifestations

A

dizziness, shakiness, CV <50 hold treatment, symptoms can appear <60-70

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33
Q

blood glucose

A

normal (ages 2 and up)= 70-100mg/dL

34
Q

Liver Function Tests (LFT)

A

liver function can really impact mental status, no direct PT regulations

35
Q

Complete Blood Count (CBC)

A

WBC, Hgb, Hct, PLT

36
Q

WBC normal

A

4,000-11,000

37
Q

Hgb normal

A

13-18 gm/dl (male)
12-16 gm/dl (female)

38
Q

Hct normal

A

40.7-50.3% -male
36.1-44.3%- female

39
Q

PLT normal

A

150,000-350,000

40
Q

WBC <4000

A

increased risk for infection hand hygiene (leukopenia)

41
Q

WBC > 11,000

A

leukocytosis- dealing with some sort of infection, can be a result of increase stressed, symptoms can include fever, weakness, dizziness

42
Q

Low Plt

A

increased risk of bruising, bleeding, need to be mindful of fall risks/bumping into things

43
Q

High plt

A

increased risk from thrombosis (clot)

44
Q

plt <5k

A

strict bed rest

45
Q

plt 5k-20k

A

AROM, walking in room, light ADL

46
Q

plt 20k-50k

A

light resistance training, bike, walking as tolerated

47
Q

plt 50k-150k

A

mod resistance training, bike, walking as tolerated

48
Q

plt 150k-450k

A

activity as tolerated

49
Q

Low Hgb

A

symptoms of low oxygenation, decreased tolerance to exercise, fatigue, tachycardia

50
Q

low Hgb CV

A

CV<8 (therapy may contraindicate… likely transfusion)
CV<5 (can progress to heart failure or death)
CV>20 (clogging of capillaries, blood thickening)

51
Q

Hct CV

A

CV <15-20% (severely reduced tolerance to exercise, SOB) [mostly due to surgery]
CV> 60% (clogged capillaries)

52
Q

Coagulation Profile Tests

A

-Prothrombin time (PT)
-International Normalized Ratio (INR)
-Partial Thromboplastin Time (PTT)
-Activated Partial Thromboplastin Time (aPTT)
-D-diner

53
Q

International Normalized Ratio (INR): normal: 0.8-1.2

A

used for monitored Coumadin (Warfarin) dosage
-pt at higher riskier for bleeding >3.6
-absolute hood for activity >6.0

54
Q

Partial Thromboplastin Time (PTT): normal 30-45 seconds

A

Used to monitor affects of heparin

-therapeutic range (for effective anti coagulation) 2-2.5x normal [60-109s]

> 70s increased risk for spontaneous bleeding

55
Q

Cardiac Biomarkers

A

Troponin I/ Troponin T- TnI, TnT

used for diagnosing MI or other inflammatory trauma to heart, if these are increasing heart is still being damaged

norm TnI: <0.04ng/mL
norm TnT: <0.01ng/mL

56
Q

Vesicular Lung Sounds

A

most commonly heard lung sound, heard over most lung surfaces
:quiet, mostly heard on inhale, soft low pitched, rustling quality

57
Q

Bronchovesicular Lung Sounds

A

heard over 1st and 2nd intercostal spaces b/w scapulae, equal inhale and exhale, mixture of bronchial breath sounds near trachea and vesicular sounds of alveoli

58
Q

Bronchial Lung Sounds

A

heard adjacent to manubrium/main stem bronchi, longer expiratory vs inspiration sound, low pitched, hollow sound

59
Q

Respiratory Rate

A

Normal: 12-18 breaths per minute, tidal volume 500cc

60
Q

Physiological Effects of BedRest

A

-deconditioning: loss of physiologic and performance adaptations
-multi-system involvement

61
Q

Atrophy: bed rest

A

predominate response to rest , reduction in muscle bulk and density in bone size, can also see a loss of neuromuscular excitation

62
Q

muscle length: bed rest

A

Reduced ROM, loss of muscle fiber length, contracture formation/deformities

(affects blood flow, puts pt at risk for pressure injuries)

63
Q

cardiovascular adaptations : bed rest

A

reduction of aerobic power, reduced CO from reduced blood volume, increased HR, increased venous compliance (stretch), orthostatic intolerance (trouble getting blood to head)

64
Q

orthostatic intolerance : bed rest

A

postural hypotension

-plasma volume loss and excessive pooling of blood in lower extremities when upright

-decline in cerebral perfusion

65
Q

vital sign changes: bed rest

A

-increased HR (trying to maintain CO)
-exaggerated HR response w/ activity
*3 days of BR ^32%
*7 days of BR ^62%
*21 days of BR ^89%

66
Q

DVT : bed rest

A

people on airplanes are at risk

-Virchows Triad (venous stasis, hyper coagulability, vessel trauma)
-reduced muscle pump
-manifestations are pain and swelling

67
Q

risk of PE: bed rest

A

PE- peripheral clot that travels and lodges in lung
symptoms of PE: dyspnea, tachypnea, chest pain, cough

68
Q

pulmonary affects: bed rest

A

-reduced ventilators muscle strength and endurance
-decreased strength of contraction
-increased RR and work of breathing
-contributes to atelectasis (collapse of alveoli) mucus pooling and impaired cilia functioning * PNEUMONIA*

69
Q

gastrointestinal affects :bed rest

A

-reduced appetite, fluid intake
-increased risk for reflux
-constipation

70
Q

genitourinary affects: bed rest

A

-increased diuresis
(excretion of sodium’s and fluid in urine, reduced blood volume)
-difficulty voiding
-increased risk of UTI

71
Q

integumentary affects: bed rest

A

-pressure injuries (bony prominences)

72
Q

psychological affects: bed rest

A

-increased number of stressors isolation
-sleep deprivation
-impaired cognition
-dependency
-reduced tolerance to pain
-depression and anxiety
-delirium

73
Q

Delirium: bed rest

A

sense of vulnerability, high confusion
movement can clear delirium

74
Q

VS respiratory rate (normal)

A

12-18 breaths per minute equal rate and depth

75
Q

VS Pulse Rate norm

A

60-100 beats per minute

76
Q

VS blood pressure norm

A

120/80

77
Q

prehypertensive BP

A

120-129/ <80

78
Q

stage 1 hypertension BP

A

130-139 / 80-89

79
Q

stage 2 hypertension BP

A

> = 140 or >=90

80
Q

hypertensive crisis BP

A

> = 180 and or >120

Acute Care (1 decks)

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