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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
Nitroglycerin
Use: Vasodilation dilates coronary arteries to increase blood flow to ischemic areas during unstable angina Monitor: BP/HR before/after admin
26
Propranolol (Inderal) / metoprolol (Lopressor)
Beta blocker Use: Directly decreases myocardial contractility which decreases oxygen demand from muscle, decreases HR Monitor: bradycardia, HypoTN, wheezing NOT FOR ASTHMA
27
Cardizem
Calcium Channel blocker -Decrease strength of contraction and controls HR -decrease O2 demand Monitor: use with dig (dig tox), edema, flushing, HR, dizziness
28
Enalapril (Vasotec)
.
29
Valsartan (Diovan)
.
30
Questran
mixes and binds with cholesterol to excrete more cholesterol
31
Steps for administering nitro
1. Sit or lie down 2. 3x5 rul- take 1 q5min x3 3. Call EMS if not relieved after 1st dose
32
Things that affect (decrease) Preload
- Lasix - High-Fowler w/feet down - Fluid restriction
33
Things that affect contractility
DIG BB CCB
34
Things that affect Afterload
ACE ARB Nitrates (Nitro) CCB
35
Meds that decrease HR
BB | DIG
36
What is atypical angina
SOB, dizziness, fatigue weakness | -Usually in elderly women & diabetic hard to dx b/c no chest pain
37
Systolic Failure
Pump doesn't work/contraction inadequate Caused by dilation of LV S3, EF <40%
38
Diastolic Failure
Disorder of relaxation and filling Caused by hypertrophy S4, EF is normal (55-60)
39
Left Sided HF
``` Dyspnea on exertion orthopena crackles PND Blood tinged sputum S3, S4 ```
40
Right Sided HF
``` Peripheral edema Weight gain JVD hepatomegaly ascites anoreaxia ```
41
EARLY signs of pulmonary edema
Apprehension | Restlessness
42
Best lab to check CHF
BNP
43
Serevent (Salmeterol)
Long-acting B2-agonist | -safety issues when not taking w/CCsteroid
44
Atrovent (ipratropium)
short-acting anticholinergic, bronchodilator
45
Solu-Medrol (methylprednisone)
IV Anti-inflammatory, corticosteroid
46
Flovent
Inhaled Anti-inflammatory corticosteroid
47
Singulair
leukoriene antagonist | allergy, cold, cough remedies, bronchodilator
48
What is the cardiac condition associated with COPD
Cor Pulmonale | s/s same as Rt-sided HF
49
Combivent
Combo Atrovent + Albuterol short acting rescue inhaler
50
What lab is used for DM?
Microalbumin
51
What drug is given to decrease serum K+
Kayexalate & Loop diuretic
52
What does Phoslo do?
Decrease Phosporus to tx hypocalcemia
53
Dialysis Diet
Increase biological protein | Limit other protein, K+, phosphorus, Na+
54
Classic parkinson's symptoms
T=Tremor R=rigidity A=Akinesia/bradykinesia P=postural instibility
55
Sign os silent aspiration
Runny nose gurgling speech cough
56
Sinemet
``` 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
What class of drug stimulates dopamine receptors?
``` Dopamine agonist Dont recommend for elder Teach: orthostatic hypotension hallucination/drowsiness ```
58
MS is characterized by
exacerbations and remissions relapsing-remitting =return to baseline primary-progressive= steady decline
59
MS symptom management
Avoid aggravating factors: - Temperature extremes - Respiratory infection - Emotion - Physical exertion - Postpartum
60
MS meds - Cholinergic
Urecholine = urinary retention | monitor for hypotension
61
MS meds- Anticholinergic
Ditropan =tx spastic bladder, freq, urgency
62
MS meds Immunomodulators
Beta interferon- Avonex | Binds with T cells to prevent them from sending signals to attack myelin
63
MS meds - immunomodulators
Copaxone = myeline decoy
64
MS meds - immunomodulator
Cytoxan - Kills T cells to prevent attack
65
MS meds corticosteroids
to reduce inflammation
66
CVA Early detection
``` F = facial droop A = arm drift S = slurred speech T= time, call 911/hospital ```
67
Right Sided CVA S/S
Reckless Right, motoR - Spatial deficits - Poor judgment - Unaware of deficits - LEFT motor/sensory problems
68
Left sided CVA S/S
- Aphasia - Cautious - Intellectual impairment - Depression, frustration - RIGHT motor/sensory problems
69
Stroke prevention
Control manage HTN, Cholesterol | Anticoagulation
70
Embolic Stroke
RAPID | plaques or tiss trave and become lodged, origin usually endocardial tissue
71
Wernickes aphasia
Receptive aphasia | Give VISUAL instead of verbal cues
72
Broca's aphasia
Expressive aphasia
73
CVA Management
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
What is the penumbra
Area outside the area of cell death
75
Four ways to protect the penumbra
Keep BP up TpA O2 Control BS, temp, constipation
76
Dysphagia Diet
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
TB screeing
- Ask if positive - Not test if positive reactor - Use MANTOUX not tine
78
Mantoux/ PPD
``` 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
QFT gold test
New CDC recommendation One blood draw Less false positive no return visit
80
TB sputum smear
Does not differentiate TB from other mycobacterium
81
TB Precautions
PAPR N-95 Negative pressure room GLOVES, MASK, no gown
82
HIV, Stage 1
2-4wks after exposure ANTIBODY TESTS ARE NEGATIVE RETEST WITHIN 6 MONTHS
83
Long term non PROGRESSOR
HIV positive > 10yrs | Reasons: Genetics & Lifestyle
84
Long term SURVIVOR
AID > 8yrs | Reasons: Anti-viral meds & supportive therapies
85
Screens for HIV 1
ELISA, 2 wks- 6mo after infection
86
Used to confirm ELISA
Western Blot Assay
87
Tests for HIV-1 & HIV-2
Rapid tests
88
Viral load
HIV/RNA cell count | >55,000/mm3 indicates high risk of progression to AIDS in 3yrs
89
This monitors immune fuction
CD4+ counts | 500 Few s/s are present
90
MAC (Mycobacterium avium complex)
BACTERIAL - High fever - Night sweats - weight loss
91
PCP (pneumocystis carinii)
PROTOZOAN/ ATYPICAL FUNGUS "PCJ" Lung infection TX with LONG TERM BACTRIM
92
CMV (cytomeaglovirus)
VIRAL *LEADING CAUSE OF BLINDNESS IN AIDS tx antiviral
93
Kaposi's Sarcoma
NEOPLASM Most common Cx seen in HIV Brown-purple lesions skin & mucous membranes
94
AIDS dementia complex (ADC)
VIRUS damages brain/nerves Cognitive changes, motor impairment Nursing DX: RISK FOR INJURY
95
Wasting Syndrome
TX ORAL SUPPLEMENTS

Adult II (3 decks)

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