Adult Exam 2 Flashcards
what medication SHOULDN’T you give someone with hepatitis
acetaminophen
what puts people at higher risk for hepatitis
drug users
gay men
sex partners
tattoos needles
blood transfusions
places/populations with higher hepatitis risk
prisons and homeless
warning signs of TB
COUGHING UP/SPUTUM BLOOD
night sweats
Classic symptoms of COPD
chronic productive cough
wheezing
barrel chest
clubbing
what can COPD progress into?
right-sided heart failure
Nursing Priority for COPD
monitor SPO2 levels (don’t want them too high)
COPD diet
high-calorie diet/ nutritional supplement
high protein
small frequent meals
treating patients with COPD with “hard work of breathing”
sit them up, pursed-lip breathing, oxygen, rescue inhaler
DON’T NEED OXYGEN
what should a COPD patient do if their O2 is low at home while they have home oxygen on
call provider (priority)
don’t change O2 levels on your own
how many liters of O2 are necessary to humidify O2?
4 L = humidify
why do we humidify O2?
to protect nasal cavities (icky redness)
what lubricants do we use vs not use
use: water-based
don’t: petroleum
classic symptoms of pneumonia
wheezing/crackles accompanied by FEVER
not just one or another
SOB
vitals for pneumonia
HR: increase
Neuro: confusion
education for pneumonia
take meds all the way through (not just until you feel better) or bacteria/fungus might become resistant
how to prevent pneumonia
spirometer
cough and deep breathing exercises
encourage mobility after procedure (at high risk post-op)
how do we know that a patient’s O2 therapy is effective?
ABG levels (PAO2 level)
what is not normal for CHRONIC emphysema?
crackles
crackles= acute/something new is wrong
bradycardia
HR of 60 or lower
tachycardia
100 or higher
normal sinus rhythm
60-100
elevated BP =
systolic 120-129
OR
diastolic less than 80
stage 1 HTN
systolic 130-139
OR
diastolic 80-89
stage 2 HTN
systolic 140-149
OR
diastolic 90-100
How many readings to determine if someone is HTN
3 times
what diet should someone with HTN have?
low sodium
low sodium diet
not salting meats
nothing canned
no soups
HTN person taking ACE-1 concern/teaching
what to do if concern happens?
“ACE cough” switch to ARB
ONE OR THE OTHER TO TREAT HTN
steps to treat HTN
diet/exercise before medicating
HTN meds:
ACE or ARB
diuretics
beta-blockers
what to know before starting a diuretic
check potassium level
beta-blocker concern
check HR
HTN crisis levels:
systolic over 180
diastolic over 120
symptoms of HTN crisis
not always symptomatic
SOB, heart palpations, BLOODY NOSE
nurse intervention during HTN crisis
keep patient safe (they stay in bed)
regularly check BP (every 15 min)
call provider to escalate care
orthostatic hypotension
standing up or laying down causing drop in BP
left-sided vs right-sided heart failure differences
left = lungs
right = body
left-sided heart failure priorities
ABCs then oxygen
test to evaluate heart failure
echo- shows ejection fraction
what ejection fraction percentage is considered heart failure?
less than 55%
left-sided heart symptoms
dyspnea
crackles
oliguria
decreased O2 levels
right-sided heart failure symptoms
jugular vein distension (JVD)
anorexia/nausea
increase peripheral venous pressure
ascites (fluid in abdomen)
AICD
Implantable cardioverter-defibrillator
shocks heart when not working
(built-in defibrillator/on-the-go!)
what to teach with AICD
can’t do MRI
airport security is a special process
medical alert bracelet
know CPR
what to do after AICD fires (as patient)
call the provider immediately
in general: what is PVD?
Peripheral vascular disease
narrowing of peripheral blood vessels
PVD signs/symptoms
intermittent claudication (pain while active)
paresthesia (pins and needles)
who is at risk for PVD
older adults
SMOKING
diabetes
high cholesterol
how to screen/test for PVD
ABI test (ankle brachial index test)
compares wrist pulse to ankle pulse
venous PVD sign
swelling dark pigment
arterial PVD sign
cool and white (pallor)
pain during leg elevation
which one is more critical arterial or vein?
Arterial
meds to treat VTE
blood thinners (either heparin or Lovenox injection)
what is a VTE
blood clot in vein
how is a VTE diagnosed?
ultrasound
what not to do to someone’s leg when they have a blood clot?
do NOT massage
Raynaud’s phenomenon
color change
cold/numb skin
vasospasms in hand
- caused by cold
what not to do during Raynaud’s
don’t just warm hands up
medicate!
