Blue Book 2 Flashcards
Patients on levodopa should avoid, which vitamin
B6 pyridoxine (beef liver, salmon, tuna, organ meats)
Levodopa might make patient’s urine
Very dark
Pernicious anemia pts lack which vitamin
What factor do they lack
What doesn’t mature due to this lack of this factor?
B12
Intrinsic factor
RBC, they become anemic
Classic and unique signs of pernicious anemia
Beefy red tongue
Numbness and tingling of the hands
Sores in the mouth
Chest pain
Sensory motor stage age
Birth - 2
Concrete operational thinking age
7-11
Preoperational, thinking age (preschool)
3-5
Placenta previa pain?
When does the bleeding start?
Three complications
Hospitalization?
Painless placenta previa
Third trimester
Shock, maternal death, fetal death
Yes, always if bleeding
Which impaired gas exchange is most common in pneumonia
Respiratory alkalosis. Because the hyperventilation blows off more CO2 in the consolidation traps in the blood.
Polycythemia vera is an increase in ___, ____ and ____
A blood disease with an increase in erythrocytes, leukocytes and platelets
Pts with polycythemia vera have which kind of complexion
What will their diet look like?
What are three signs of polycythemia vera?
What oral problem will these patients have?
What organ will be enlarged?
Ruddy red, almost a purple
Low iron
Headache, weakness, and itching
Bleeding mucous membranes
Due to increased destruction of red blood cells seen in polycythemia vera what acid blood level will be increased
Uric acid levels will be high.
Remember, uric acid levels are always high when cells are being destroyed as in hemolysis, chemotherapy or radiation therapy
Pregnancy increases or decreases the bodies insulin requirements, why?
Can oral hypoglycemic be used during pregnancy?
During pregnancy, what complication is most dangerous for the fetus of a diabetic, why
Increases, hormones of pregnancy work against insulin
No, they are teratogenic
Ketosis, in utero ; hypoglycemia after delivery. Brain cells die without glucose, resulting in brain damage.
Preeclampsia makes the neuromuscular system more or less irritable
What vision problem will these patients have
What types of precautions will be in effect?
More
Blurred vision
Seizure precautions; suction machine in the room, 02 in room, padded side rails up x four, must stay on unit, ambulation with supervision only, no more than one pillow
When is pre-eclampsia called eclampsia
Once convulsions have occurred
Premature rupture of membranes is a ___ break in the amniotic sac ___ the ___ of contractions
What is the danger with PROM?
Spontaneous, before, onset
Infection
Amniotic fluid is acidic or alkaline
Alkaline
Pulmonary edema is a common complication of which disorder
Pulmonary edema, usually results from ____ failure
Four signs of pulmonary edema
Cardiovascular
Left ventricle
Dyspnea on exertion
Paroxysmal nocturnal dyspnea
Orthopnea
Coughing
In pulmonary edema is the heart rate tachycardic or bradycardic
What drug is used in pulmonary edema to reduce fluid in the lungs
What drug is used to increase ventilation in pulmonary edema
Since pulmonary edema, is caused by left ventricular failure, what drug is given
Why would morphine be given
Tachycardic
Diuretic
Aminophylline (bronchodilator)
Digitalis
To decrease apprehension and decrease preload, resting the heart
Pulmonary embolus is an obstruction of the pulmonary ___ bed by a dislodged ___ or a foreign substance (air, fat, tumor)
Where do the emboli that cause pulmonary embolus usually come from?
What treatment modality can lead to pulmonary embolus
What drug class can lead to pulmonary embolus
Capillary, thrombus
The legs
Bed rest
Oral contraceptives
What heart problems can lead to pulmonary embolus
What genetic problems can lead to pulmonary embolus
First sign of pulmonary embolus; will the heart rate increase or decrease
Two major treatments of pulmonary embolus.
Atrial fibrillation (R atrial fibrillation, L atrial fibrillation, causes cerebral embolus)
Sickle cell anemia
Dyspnea; increase
02 and anticoagulants
I’m coming in is therapeutic, the INR should be between ___ & ___
2.0 and 3.0
What is Lovenox?
A low-dose heparin used for anticoagulation and postop thrombophlebitis prevention, not for use in pulmonary embolus
What is pyelonephritis?
What organism causes this?
What are the symptoms that polynephritis and cystitis have in common
And bacterial infection of the kidneys
E. coli
Frequency, urgency, burning, cloudy foul, smelling urine
Five s/s with polynephritis not seen with cystitis
What is the big danger with polynephritis?
How is polynephritis prevented 
Fever, flank pain, increase white blood count, malaise, chills, HTN
Permanent scarring and kidney damage
By preventing or treating all cystitis’s (UTIs)
What test is done to confirm a diagnosis of pyloric stenosis
Why does the pyloric valve becomes to notes in pyloric stenosis?
What position should a child with pyloristenosis be after feeding?
What type of vomiting do you see in patients with pyloric stenosis? Is it bile stained?
Upper G.I. series (barium swallow)
It hypertrophies
Right side with HOB up
Projectile, not bile stained
Typical Child with pyloric stenosis
Symptoms of pyloric stenosis, most commonly appear at age ___ to ___
First born full-term white boy
4 to 6 weeks
Purpose of a wound drain
Remove secretions from the area so healing occurs
What is another name for second intention?
Granulation
Scoliosis most commonly effects
How many hours a day should a patient wear a Milwaukee brace?
Teenage girls
23 hours
What are the number one and number two causes of sickle cell crisis
The most common type of crisis that occurs is a ___-____ crisis
In this crisis, the vessels become included with _____ _____
Why do the crescent shape RBCs cause occlusion of the vessels
Hypoxia and dehydration
Vaso-occlusive
Abnormal red blood cells
They come together and create a sludge
Top three priorities in care of a patient with sickle cell crisis
Why can’t a sickle cell patient not take aspirin
Sickle cell anemia symptoms do not appear before the age of ___ months, due to the presence of ___ ____
Sickle cell anemia, most commonly seen in what race
Oxygenation, hydration, and pain control
Can cause acidosis, which makes the crisis and sickly worse
Six, fetal hemoglobin
Black
What is spinal shock?
When does this occur? And how long will it last?
Common occurrence in spinal cord injury in which the spinal cord swells above, and below the level of injury
Immediately or within two hours of injury; five days to three months
What is spinal cord injury is at level of ___ or ___ patient will be a quadriplegic
C1 or C8
When the spinal cord injury is between ____ and ___ there is permanent respiratory paralysis
C1 and C4
Spinal cord injury in the thoracic/lumbar region’s result in
If airway obstruction occurs at the accident site and he suspects spinal cord injury what maneuver is used to open the airway
Paraplegia
Modified jaw thrust
Why should a patient with an order to be up move slowly with a spinal cord injury?
Because of severe orthostatic hypotension
Patient with neurogenic bladder needs to be straight catheterized every how many hours
Patience with spinal cord injury will have flaccid or spastic muscles
Three drugs used to treat spasms
Six
Spastic
Baclofen, Valium, dantrium* (* also treats malignant hyperthermia)
What is autonomic dysreflexia or hyperreflexia
What are the s/s
What would you do first what would you do second for these patients?
A common complication of quadriplegics in response to a full bladder or bowel
Sweating headache, nausea and vomiting, gooseflesh and severe hypertension
Raise HOB, second, check the bladder and bowel
What position should the client be during a spinal tap?
Activity restriction necessary after a lumbar puncture
Purpose of spinal taps
Lateral recumbent on the right side
Lie flat for 6 to 12 hours
To measure or relieve pressure and obtain a CSF sample
How much section should be used for a child?
How much suction should be used for an adult?
80 to 100
120 to 150
Late syphilis attacks which three body organs?
What organism causes syphilis?
What is the most common signs of Neurosyphilis?
Liver, heart and brain
Treponema palladium
Ataxia (gait problems)
What is the most common cause of mastoiditis?
4 s/s of mastoiditis
Common side effect of mastoidectomy; major concern
Chronic Otis media
Drainage from ear, high fever, headache and ear pain tenderness over mastoid process
Dizziness/vertigo ; safety
Virulence means
Ability of an organism to produce disease
Emulsion is a mixture of ___ and ___
Oil and water
A drug given by the parenteral route, acts outside the G.I. tract, true or false
For most common parenteral route of administration
T
SQ, IM, IV, ID (intradermal)
Maximum cc administered per IM into the deltoid of an adult
Which type of medication’s are given by Z track; how long is a needle kept inside during Z track injection?
1cc
Irritating or staining; 10 seconds
Two sites for intradermal injections; primarily used for what
Inner forearm and upper back; skin testing
Rectal suppository is inserted ____ in an adult, and ____ in a child
4; 2
Does Tagamet need to be given with meals? Does Zantac need to be given with meals?
Yes, for Tagamet; No for Zantac
