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ABSN > AH Exam III > Flashcards

AH Exam III Flashcards

1
Q

Which type of cells are destroyed with Type I DM?

A

Beta Cells (they secrete insulin)

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2
Q

Which type of DM is associated with a family hx?

A

Type II

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3
Q

Treatment for Type I vs. Type II Diabetes

A

Type I:
insulin
diet
exercise

Type II: 
insulin
diet
exercise 
ORAL HYPOglycemics
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4
Q

Which type of DM presents with Ketones

A

Type I

but Type II can present under stressful conditions (rare)

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5
Q

Which type of DM presents with a positive DR/DQ antigen?

A

Type I

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6
Q

Early symptoms of DM:

A

Polyuria
Polydipsia
Polyphagia

Weight LOSS

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7
Q

What are 2 severe manifestations of DM?

A

ketoacidosis

shock

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8
Q

What are 3 diagnostic criteria for DM?

A

Hemoglobin A1C > 6.5%
Fasting glucose > 126 on 2 readings
Postprandial glucose of 200

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9
Q

Stressors that can lead to DKA?

A

Decreased electrolytes (except K, which will increase, then decrease as dehydration worsens)

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10
Q

S&S of DKA?

A

fruity breath
Kussmaul breathing
ketones

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11
Q

Mortality rate of hyperglycemic hyperosmolar nonketotic coma? Which type of DM?

A

70% - Type II

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12
Q

5 Risk Factors for Metabolic Syndrome?

A
  1. large waist circumference
  2. high triglycerides
  3. Low HDL
  4. High glucose
  5. BP 130/85
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13
Q

Info for Short Acting “Regular” (Humulin R) Insulin

A

onset 30min
peak 2-4 hrs
duration 5-7 hrs

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14
Q

Info for NPH insulin:

A

onset 1.5 hrs
peak 4-12
duration 16-24

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15
Q

How do you pull up insulin?

A

clear then cloudy

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16
Q

Do you give Metformin before surgery?

A

NO - HOLD before surgery

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17
Q

Somogi Effect:

A

HYPERglycemia in the morning r/t HYPOglycemic while sleeping
DO eat before bed

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18
Q

Dawn Effect:

A

HYPERglycemia in the morning

Do NOT eat before bed

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19
Q

HYPOglycemia is defined at what BG level?

A

< 70

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20
Q

Mild, moderate and severe HYPOglycemia levels?

A

mild <70 (15g)
moderate <40 (15-30g)
severe <20 (no food - give 1mg glucagon)

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21
Q

15g snack

A 
6-10 hard candies 
6 oz regular soda (not diet)
4 ox fruit juice
3-4 glucose tabs
3 gram crackers
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22
Q

When should a diabetic NOT exercise?

A

< 80

>250

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23
Q

When should diabetics buy their shoes?

A

in the evening

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24
Q

Alcohol recommendations for diabetics:

A

men: 2 drinks/day

women 1 drink/day

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25
Q

Serum T3 levels:

A

70-205

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26
Q

Serum T4 levels:

A

4-12

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27
Q

Free T4 level:

A

0.8-2.8

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28
Q

TSH levels:

A

2-10

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29
Q

S&S of HYPERthyroidism

A

lookin hot

soft, fine hair

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30
Q

Hallmark sign of Graves:

A

exopthalmous

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31
Q

Treatment of HYPERthyroidism:

A

Tapazole - birth defects
PTU - no crowds
Radioactive Iodine - your secretions are very toxic

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32
Q

Risk factors for Goiter?

A

iodine deficiency
cabbage, turnips, soybean
lithium

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33
Q

S&S of HYPOthyroidism?

A 
low and slow 
myxedema coma (high mortality)
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34
Q

Myxedema Coma S&S:

A

HYPOtension
HYPOthermia
HYPOnatremia
HYPOglycemia

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35
Q

Priority nursing action after thyroidectomy:

A

elevate the head of the bed

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36
Q

If you have Type II diabetes, what thyroid issue are you at risk for?

A

HYPERthyroidism

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37
Q

Which electrolyte should be monitored after a thyroidectomy?

A

calcium

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38
Q

Decreased insulin is related to:

A

Decreased storage of glycogen
Increased production of glucose
Increased metabolism of glycogen, lipids and ketones

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39
Q

What position should a patient be in after an endoscopy?

A

side lying to prevent aspiration

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40
Q

What is fundoplication?

A

a treatment for severe GERD

  • on antacids 1 month
  • NO driving 1 week
  • NO heavy lifting
  • NO carbonated beverages
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41
Q

What is the Stretta procedure?

A

GERD procedure

- no NG tube for 1 month after procedure

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42
Q

Patho of gastritis:

A

H. pylori

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43
Q

Patho of peptic ulcer disease:

A

H. pylori

chronic NSAID use

44
Q

Which ulcer gives you pain at night?

A

duodenal (1-2am)

45
Q

Which ulcer gives you pain in the RLQ?

A

duodenal

46
Q

Which ulcer gives you pain in the upper epigastric region?

A

gastric

47
Q

Which ulcer gives you hematemesis?

A

gastric

48
Q

Which ulcer gives you melena?

A

duodenal

49
Q

Which ulcer gives you risk for gastritis?

A

gastric

50
Q

Which type of antacid can a renal px not have?

A

Mg based

51
Q

Who would experience dumping syndrome?

A

pt after a gastric resection

52
Q

S&S of EARLY dumping:

A

15-20 mins after eating

TACHYcardia 
pale
palpitations 
vertigo 
sweating
53
Q

S&S of LATE dumping:

A

2-3 hrs after eating

diarrhea
high pitched sound
cramping
distension

54
Q

How do we avoid dumping syndrome?

A 
avoid sugar/milk/salt
low carb 
small meals
avoid drinking with meals
lie down after meals
55
Q

S&S of diverticulitis

A

fever 101
LLQ pain
rectal bleeding
constipation

56
Q

Management of diverticulitis:

A

NPO for acute
fiber
antibiotics

surgery if nothing else works

57
Q

What are expected finding for Chrone’s?

A 
fatty poopy (5-6/day)
b/c it's patchy all over
58
Q

What are expected finings for UC?

A 
bloody poopy (10-20/day)
just at the butt
59
Q

Which urinary diversion do we use for bladder cancer?

A

Kock pouch - catheterize the stoma regularly

60
Q

What are some complications of TPN?

A

electrolyte/metabolic px

61
Q

Unexpected findings after bariatric surgery:

A

pulmonary emboli, anastomotic leaks, ascites

62
Q

Colicysectomy post op care:

A

manage gas pains - tell them to walk and give PO pain med

63
Q

What causes Hep A & E

A

food

64
Q

What causes Hep B & D

A

body fluids

65
Q

What causes Hep C?

A

needle stickies

66
Q

S&S of Hepatitis:

A

Preicteric: elevated bili, NO jaundice
Icteric: elevated bili, jaundice, brown urine, light stools
Posticteric: normal bili, less jaundice, increased energy

67
Q

How old can blood be when giving it to an older pt?

A

1 week

68
Q

S&S of hemolytic rxn? nursing action?

A

low back pain, headache

actions: SOP, CALL, FLUSH and IV antihistamine

69
Q

S&S of febrile (most comm) rxn? nursing actions?

A

fever

STOP, CALL, FLUSH and give acetaminophen

70
Q

When do we see a graft vs. disease?

A

2 weeks after transfusion

71
Q

What are the S&S of a mild allergic rxn to blood?

A

bronchospasm, urticaria, pruritus

72
Q

Smallest gauge to give blood?

A

20 - pink

73
Q

If blood is being given and a pt gets mm spasm, what do you give? crackles?

A

mm spasm - calcium

crackles - diuretics

74
Q

Acute glomerulonephritis:

A

ask about a recent strep infection

recovery may be 2 years

75
Q

Hallmark sign of nephrotic syndrome:

A

recent weight gain r/t edema

76
Q

Renal artery stenosis assessment and interventions:

A

sudden onset HTN after 50
abdominal bruits

Tx:
Stop smoking
mangage HTN

77
Q

Renal Calculi diet interventions:

A

Calcium stone:
avoid spinach, black tea, rhubarb, sodium, beets, pecans, peanuts, okra, chocolate

Phosphate Stone:
avoid animal protein, dairy, sodium

Struvite stone:
diary, organ meat, whole grains

Uric acid:
purine - organ meat, poultry, fish, red wine, sardine

78
Q

Risk factors for nephrosclerosis:

A

HTN and diabetes

79
Q

Bladder cancer incontinence management:

A

Kock pouch and conduits

80
Q

TURP procedure indication:

A

BPH

81
Q

TURP procedure pt teaching:

A

frequent Kock pouch catheterization

82
Q

TURP procedure continuous bladder irrigation (CBI) management:

A

if the bladder spasms while administering CBI, slow the flow

83
Q

Treatment for kidney stones?

A

Lithotripsy (shock wave)

pre - give anesthetic cream 45 min before procedure

post - check urine output, expect to see bruising

84
Q

What should you NOT do with prostatitis?

A

DO NOT CATHETERIZE

85
Q

What should you NOT do with prostatitis?

A

DO NOT CATHETERIZE

86
Q

Consideration for a patient receiving PSA (prostate specific antigen)

A

do not ejaculate for 24-48 hrs before you receive it b/c it can increase the levels

87
Q

Consideration for a patient receiving PSA (prostate specific antigen)

A

do not ejaculate for 24-48 hrs before you receive it b/c it can increase the levels

88
Q

Polycystic kidney S&S:

A

cloudy urine
hematuria
nocturia
HTN

89
Q

Polycystic kidney pt teaching:

A

avoid aspirin and do daily weights

90
Q

Polycystic kidney pt teaching:

A

avoid aspirin and do daily weights

91
Q

HgB levels for mild, moderate and severe anemia:

A

mild: 10-14
moderate: 6-10
severe: < 6

92
Q

Patho of aplastic anemia:

A

Epstein-Barr or other virus fucks up bone marrow and causes decreased production of RBCs

93
Q

Patho of aplastic anemia:

A

Epstein-Barr or other virus fucks up bone marrow and causes decreased production of RBCs

94
Q

Which foods are high in iron?

A 
dark leafys 
organ meat
fortified cereal
beans
raisins
95
Q

Iron supplement expected findings:

A

black tarry stools

96
Q

Cause of B12 “pernicious” anemia?

A

gastric surgery/malabsorption

lack of dairy

97
Q

Cause of B12 “pernicious” anemia?

A

gastric surgery/malabsorption

lack of dairy/B12

98
Q

Which foods are high in B12?

A

meat, fish, eggs, nuts, dairy, citrus fruit

99
Q

What precautions are put in place for thrombocytopenia?

A

bleeding precautions

100
Q

Hallmark S&S of Hodgkin’s?

A

Reed Sternberg cells

night sweats

101
Q

Which cells are present in Non-Hodgkin’s?

A

B or T cells

102
Q

S&S of sickle cell crisis?

A

acute chest syndrome

  • cough
  • SOB
  • X-ray with infiltrates
103
Q

S&S of sickle cell crisis?

A

acute chest syndrome

  • cough
  • SOB
  • X-ray with infiltrates
104
Q

When taking a 24 hour urine collection ________.

A

Get rid of the first specimen and start the count.

105
Q

When taking a 24 hour urine collection ________.

A

Get rid of the first specimen and start the count.

106
Q

What are the 2 main complications of chemo?

A

tumor lysis

superior vena cava syndrome

ABSN (18 decks)

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