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Adult II > Adult II Final Review Questions > Flashcards

Adult II Final Review Questions Flashcards

1
Q

Pancytopenia

A

When WBC, PLT, RBC are all low

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2
Q

Desquamation

A

Skin damage/irritation r/t external radiation tx.
WET - Blistered sunburn
DRY - Red, sunburn

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3
Q

Induction Chemo

A
  • Acute forms start immediately
  • Very ill patient - bone marrow depression
  • Multiple drugs used
    • Decrease drug resistance
    • Minimize toxicity
    • Interrupts cell growth at diff. points in cycle.
    • Toxicity depends on chemo combo
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4
Q

Consolidation Chemo

A
  • Started AFTER remission is achieved
  • Additional course of chemo given
  • Goal: eliminate any remaining cx cells
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5
Q

Maintenance Chemo

A

2-3 low weekly dose therapy

Goal: stay in remission

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6
Q

ANC Formula

A

ANC = WBC x (Segs + Bands)

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7
Q

When would you expect to see SVCS?

A

OBSTRUCTION of venous drainage in upper thorax by tumor

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8
Q

When would you expect to see Tumor Lysis Syndrome

A

Seen within 24-48hr of chemo

-Cells die rapidly & intracellular particles (PO4,uric acid, K+) dump into blood system

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9
Q

When would you expect to see SIADH

A

From lung cancer cells that release ADH

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10
Q

S/S SVCS

A
  1. Facial Edema
  2. JVD
  3. HA
  4. Dyspnea
  5. Visual disturbances
  6. Chest Pain
  7. Dysphagia
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11
Q

BUN

A

Tests renal function

Varies with meals

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12
Q

Creatinine

A

[0.5-1.5]

  • Muscle breakdown, affected by muscle mass
  • Indicator of renal function, used to determine effectiveness of dialysis
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13
Q

Creatinine Clearance

A
  • Estimates GFR

- Ratio of serum/urine

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14
Q

GFR

A

.

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15
Q

Proteinurea Screening

A

Standard urine dipstick testing to identify early stages of KD

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16
Q

Best estimate of renal function

A

Creatinine

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17
Q

Which renal function is used to evaluate the effectiveness of dialysis

A

Creatinine

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18
Q

Types of peritoneal dialysis

A
  1. Intermittent
  2. Continuous Ambulatory PD
  3. Continuous Cyclic PD
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19
Q

Intermittent PD

A

several times a day with complete exchanges

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20
Q

Continuous Ambulatory PD

A
  • Four times a day at home q6hr
  • May keep tubing intact or disconnect
  • Dialysate remains in abd until next exchange
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21
Q

Continuous Cyclic PD

A

“Think Machine”

1-2L remains in the abd during day

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22
Q

Renal Diet for Renal Disease

A 
Limit dietary protein 
watch citrus, tomatoes
Limit K+
Restrict phosphate to <100mg/day
Avoid-milk, cheese, egg yolks, meat, fish, nuts
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23
Q

Common medications used for ESRD

A

Kayexalate & Loop diuretic = Hyperkalemia
Phoslo & calciferol (vit D) = Hypocalcemia
CCB, BB, K+ depleting diuretic= HTN

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24
Q

simvastatin (Zocor)

A

Use: Cholesterol lowering medication
Monitor: LFTs
NO grapefruit products!

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25
Q

Nitroglycerin

A

Use: Vasodilation dilates coronary arteries to increase blood flow to ischemic areas during unstable angina
Monitor: BP/HR before/after admin

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26
Q

Propranolol (Inderal) / metoprolol (Lopressor)

A

Beta blocker
Use: Directly decreases myocardial contractility which decreases oxygen demand from muscle, decreases HR
Monitor: bradycardia, HypoTN, wheezing
NOT FOR ASTHMA

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27
Q

Cardizem

A

Calcium Channel blocker
-Decrease strength of contraction and controls HR
-decrease O2 demand
Monitor: use with dig (dig tox), edema, flushing, HR, dizziness

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28
Q

Enalapril (Vasotec)

A

.

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29
Q

Valsartan (Diovan)

A

.

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30
Q

Questran

A

mixes and binds with cholesterol to excrete more cholesterol

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31
Q

Steps for administering nitro

A
  1. Sit or lie down
  2. 3x5 rul- take 1 q5min x3
  3. Call EMS if not relieved after 1st dose
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32
Q

Things that affect (decrease) Preload

A
  • Lasix
  • High-Fowler w/feet down
  • Fluid restriction
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33
Q

Things that affect contractility

A

DIG
BB
CCB

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34
Q

Things that affect Afterload

A

ACE
ARB
Nitrates (Nitro)
CCB

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35
Q

Meds that decrease HR

A

BB

DIG

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36
Q

What is atypical angina

A

SOB, dizziness, fatigue weakness

-Usually in elderly women & diabetic hard to dx b/c no chest pain

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37
Q

Systolic Failure

A

Pump doesn’t work/contraction inadequate
Caused by dilation of LV
S3, EF <40%

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38
Q

Diastolic Failure

A

Disorder of relaxation and filling
Caused by hypertrophy
S4, EF is normal (55-60)

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39
Q

Left Sided HF

A 
Dyspnea on exertion
orthopena
crackles 
PND
Blood tinged sputum
S3, S4
40
Q

Right Sided HF

A 
Peripheral edema
Weight gain
JVD
hepatomegaly
ascites
anoreaxia
41
Q

EARLY signs of pulmonary edema

A

Apprehension

Restlessness

42
Q

Best lab to check CHF

43
Q

Serevent (Salmeterol)

A

Long-acting B2-agonist

-safety issues when not taking w/CCsteroid

44
Q

Atrovent (ipratropium)

A

short-acting anticholinergic, bronchodilator

45
Q

Solu-Medrol (methylprednisone)

A

IV Anti-inflammatory, corticosteroid

46
Q

Flovent

A

Inhaled Anti-inflammatory corticosteroid

47
Q

Singulair

A

leukoriene antagonist

allergy, cold, cough remedies, bronchodilator

48
Q

What is the cardiac condition associated with COPD

A

Cor Pulmonale

s/s same as Rt-sided HF

49
Q

Combivent

A

Combo Atrovent + Albuterol short acting rescue inhaler

50
Q

What lab is used for DM?

A

Microalbumin

51
Q

What drug is given to decrease serum K+

A

Kayexalate & Loop diuretic

52
Q

What does Phoslo do?

A

Decrease Phosporus to tx hypocalcemia

53
Q

Dialysis Diet

A

Increase biological protein

Limit other protein, K+, phosphorus, Na+

54
Q

Classic parkinson’s symptoms

A

T=Tremor
R=rigidity
A=Akinesia/bradykinesia
P=postural instibility

55
Q

Sign os silent aspiration

A

Runny nose
gurgling speech
cough

56
Q

Sinemet

A 
Replaces dopamine
GOOD for elders
TAKE ONE EMPTY STOMACH
-combo give with carbidopa
SE:
on/off effect
orthostatic hypotension
Dry mouth
Avoid alcohol
dark urine/sweat= NORMAL
57
Q

What class of drug stimulates dopamine receptors?

A 
Dopamine agonist
Dont recommend for elder
Teach:
orthostatic hypotension
hallucination/drowsiness
58
Q

MS is characterized by

A

exacerbations and remissions
relapsing-remitting =return to baseline
primary-progressive= steady decline

59
Q

MS symptom management

A

Avoid aggravating factors:

  • Temperature extremes
  • Respiratory infection
  • Emotion
  • Physical exertion
  • Postpartum
60
Q

MS meds - Cholinergic

A

Urecholine = urinary retention

monitor for hypotension

61
Q

MS meds- Anticholinergic

A

Ditropan =tx spastic bladder, freq, urgency

62
Q

MS meds Immunomodulators

A

Beta interferon- Avonex

Binds with T cells to prevent them from sending signals to attack myelin

63
Q

MS meds - immunomodulators

A

Copaxone = myeline decoy

64
Q

MS meds - immunomodulator

A

Cytoxan - Kills T cells to prevent attack

65
Q

MS meds corticosteroids

A

to reduce inflammation

66
Q

CVA Early detection

A 
F = facial droop
A = arm drift
S = slurred speech
T= time, call 911/hospital
67
Q

Right Sided CVA S/S

A

Reckless Right, motoR

  • Spatial deficits
  • Poor judgment
  • Unaware of deficits
  • LEFT motor/sensory problems
68
Q

Left sided CVA S/S

A
  • Aphasia
  • Cautious
  • Intellectual impairment
  • Depression, frustration
  • RIGHT motor/sensory problems
69
Q

Stroke prevention

A

Control manage HTN, Cholesterol

Anticoagulation

70
Q

Embolic Stroke

A

RAPID

plaques or tiss trave and become lodged, origin usually endocardial tissue

71
Q

Wernickes aphasia

A

Receptive aphasia

Give VISUAL instead of verbal cues

72
Q

Broca’s aphasia

A

Expressive aphasia

73
Q

CVA Management

A

Anti-HTN (not routine only if BP >185/110)
HTN med resumed after 24hr
*IV Fluids to maintain BP above 150 (perfusion)
*Correct BS
*TX FEVER W/ Acetaminophen
*Tx Constipation

74
Q

What is the penumbra

A

Area outside the area of cell death

75
Q

Four ways to protect the penumbra

A

Keep BP up
TpA
O2
Control BS, temp, constipation

76
Q

Dysphagia Diet

A

Stage I = Severe, pureed
Stage II = baby food meats, scrambled eggs
Stage III =Ground meat w/ gravy, tuna
Stage IV =Swallow most food well, soft diet, soft foods

77
Q

TB screeing

A
  • Ask if positive
  • Not test if positive reactor
  • Use MANTOUX not tine
78
Q

Mantoux/ PPD

A 
Given intradermal
Read 48-72hrs
Must have induration to be positive
MEASURE INDURATION NOT REDNESS
<0-4mm = Not significant
5mm= only significant for close contact/immunosuppressed/HIV
10mm=increased risk healthcare worker, prison, foreign born, homeless
15mm=everyone else
79
Q

QFT gold test

A

New CDC recommendation
One blood draw
Less false positive no return visit

80
Q

TB sputum smear

A

Does not differentiate TB from other mycobacterium

81
Q

TB Precautions

A

PAPR
N-95
Negative pressure room
GLOVES, MASK, no gown

82
Q

HIV, Stage 1

A

2-4wks after exposure
ANTIBODY TESTS ARE NEGATIVE
RETEST WITHIN 6 MONTHS

83
Q

Long term non PROGRESSOR

A

HIV positive > 10yrs

Reasons: Genetics & Lifestyle

84
Q

Long term SURVIVOR

A

AID > 8yrs

Reasons: Anti-viral meds & supportive therapies

85
Q

Screens for HIV 1

A

ELISA, 2 wks- 6mo after infection

86
Q

Used to confirm ELISA

A

Western Blot Assay

87
Q

Tests for HIV-1 & HIV-2

A

Rapid tests

88
Q

Viral load

A

HIV/RNA cell count

>55,000/mm3 indicates high risk of progression to AIDS in 3yrs

89
Q

This monitors immune fuction

A

CD4+ counts

500 Few s/s are present

90
Q

MAC (Mycobacterium avium complex)

A

BACTERIAL

  • High fever
  • Night sweats
  • weight loss
91
Q

PCP (pneumocystis carinii)

A

PROTOZOAN/ ATYPICAL FUNGUS
“PCJ”
Lung infection
TX with LONG TERM BACTRIM

92
Q

CMV (cytomeaglovirus)

A

VIRAL
*LEADING CAUSE OF BLINDNESS IN AIDS
tx antiviral

93
Q

Kaposi’s Sarcoma

A

NEOPLASM
Most common Cx seen in HIV
Brown-purple lesions skin & mucous membranes

94
Q

AIDS dementia complex (ADC)

A

VIRUS damages brain/nerves
Cognitive changes, motor impairment
Nursing DX: RISK FOR INJURY

95
Q

Wasting Syndrome

A

TX ORAL SUPPLEMENTS

Adult II (3 decks)

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