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complex concepts level 2 > complex final > Flashcards

complex final Flashcards

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1
Q

Pneumonia clinical manifestations

A

-Productive cough, pleuritic pain
-crackles and wheezes
-fever
-SOB
-O2 sat. less than 90%

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2
Q

Pneumonia nursing interventions

A

-collect sputum culture
-auscultate lung sounds
-monitor ABG’s
-suction as needed
-breathing treatments
-oxygen as needed

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3
Q

Pneumonia education

A

-Use incentive spirometer 10x Q1-2hrs
-Drink 2-3L fluid per day
-cough and deep breathe

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4
Q

Tuberculosis clinical manifestations

A

-cough lasting longer than 3 weeks
-purulent or bloody sputum
-weight loss
-night sweats
-lethargy

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5
Q

Airborne precautions

A

-N95 mask
-Gown
-Gloves
-Negative pressure room
-if client has to leave they need to wear a surgical mask

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6
Q

TB meds

A

RIPE orange
-Rifampin- orange secretions
-Isoniazid
-Pyrazinamide
-Ethambutol

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7
Q

What therapy for TB patients?

A

-heated and humidified oxygen therapy

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8
Q

What if pH less than 7.35 and HCO3 less than 22?

A

Metabolic Acidosis

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9
Q

What if pH less than 7.35 and PaCO2 greater than 45?

A

Respiratory Acidosis

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10
Q

What if pH greater than 7.45 and HCO3 greater than 26?

A

Metabolic Alkalosis

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11
Q

What if pH greater than 7.45 and PaCO2 less than 35?

A

Respiratory Alkalosis

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12
Q

Asthma clinical manifestations

A

-Dyspnea
-chest tightness, barrel chest
-anxiety or stress
-coughing, wheezing, mucus production

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13
Q

Asthma nursing interventions

A

-silent chest (no sounds)- very bad
-Raise HOB (high fowlers)
-administer Oxygen as prescribed
-monitor cardiac rate and rhythm during an acute attack
-monitor RR and rhythm
-incorporate rest into ADLs
-administer meds as prescribed

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14
Q

COPD clinical manifestations

A

-dyspnea
-productive cough
-crackles and wheezes
-rapid and shallow respirations
-use of accessory muscles, barrel chest
-enlarged neck muscles
-clubbing of fingers and toes
-pallor and cyanosis

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15
Q

COPD nursing care

A

-high fowlers
-encourage coughing to remove secretions
-2 to 4 L/min nasal cannula of oxygen
-monitor weight
-exercise walking for 20 min 3x a week
-drink 2-3L fluid a day

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16
Q

COPD meds

A

-Chronic Medications Save Lives
C- corticosteroids
M- methylxanthines and Mucolytics
S- short acting bronchodilators
L- long acting bronchodilators

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17
Q

Corticosteroids

A

-Fluticasone and Prednisone
-decrease airway inflammation
-can cause increased risk for infection, hyperglycemia, easy bruising
-rinse mouth after inhalational use
-don’t discontinue med suddenly

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18
Q

what medication is a Methylxanthine?

A

Theophylline

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19
Q

Mucolytic agents

A

-thin secretions
-acetylcysteine and dornase alfa are nebulizer treatments
-Guaifenesin is an oral agent

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20
Q

Short acting bronchodilators

A

-provide rapid relief
-albuterol
-can cause tachycardia and tremors

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21
Q

Long acting bronchodilators

A

-Ipratropium (anticholinergic)
-suck on hard candy
-palpations can occur

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22
Q

Complications of COPD

A

-respiratory infections
-Right sided HF (cor pulmonale)

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23
Q

HIV clinical manifestations

A

-Similar to flu
-night sweats, headache, sore throat, weakness, fatigue, chills, rash

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24
Q

HIV diagnostics

A

-enzyme linked immunosorbent assay test (ELISA)
- if positive, will be confirmed with a positive Western Blot test
-then if both positive= HIV
-Then viral load test done next
-also drug resistance and liver testing, Brain or lung MRI or CT scan

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25
HIV nursing care
-Assess risk factors (sexual practices, IV drug use) -monitor I&O's, weight loss, nutritional intake, electrolytes
26
HIV education
-avoid crowds, cleaning litter boxes, RAW food -conduct frequent CD4+ and Viral load counts -no live vaccines -clean needles with bleach
27
SLE findings
-Alopecia -Fatigue/malaise/weakness -blurred vision -pleuritic pain -anorexia/weight loss -depression -joint pain, swelling, tenderness
28
SLE physical assessment findings
-erythematous "butterfly" rash -reynaud's -anemia -lymphadenopathy -fever
29
ulcerative colitis expected findings
-left lower quadrant pain -rectal bleeding -diarrhea: up to 15-20 liquid stools per day
30
Crohn's disease expected findings
-Right lower quadrant pain -anorexia and weight loss -diarrhea: 5 loose stools per day
31
UC/Crohn's nutrition
-High protein and calorie -Low fiber -vitamins and b12 injections
32
C and C findings
-sharp pain in right upper quadrant (often radiates to right shoulder) -rebound tenderness (blumberg's sign) -Dyspepsia and eructation -jaundice
33
C and C education
-low fat diet -no gas forming foods (beans, cabbage, cauliflower, broccoli) -regular exercise
34
C and C meds
-analgesics -bile acid
35
Genital herpes manifestations
-Pain -small red bumps -blisters -ulcers -scabs
36
Genital herpes meds
-antivirals like acyclovir
37
Chlamydia manifestations
-females are often asymptomatic -painful urination -lower abdominal pain -vaginal discharge -penile discharge -painful sexual intercourse
38
Chlamydia meds
-azithromycin and doxycyclin -2x a day for 7 days -no sex for 7 days, recheck in 3 months
39
Chlamydia complications
-other STI's -pelvic inflammatory disease -infertility -infection in newborns
40
Gonorrhea manifestations
-dysuria -painful urination -discharge from penis -pain or swelling in testicles -targets male urethra and female cervix -infertility -infections can spread to joints -infants can have blindness -vaginal bleeding
41
gonorrhea meds
antibiotics
42
BPH manifestations
-voiding difficulties -incontinence -intra-abdominal pressure increased -infections -Hematuria
43
BPH diagnostics
-Digital rectal exam (DRE) -lab work (urinalysis, prostate-specific antigen test) -cytoscopy -transrectal ultrasound
44
hypertensive crisis
-headache -chest pain -SOB -dizziness -blurry vision
45
hypertension meds
-Thiazide diuretics -Ace inhibitors (Pril's) -ARB's (sartans) -calcium channel blockers (dipine's) -Beta blockers (olol's)
46
hypertension education
-limit sodium, alcohol, caffeine -smoking cessation -exercise -measure and keep records of BP at home
47
right sided HF symptoms
SWELLING S- swelling of leg, hands, liver W- weight gain E- edemal pitting L- large neck vein L- lethargic I- irregular heart rhythm N- nocturia G- girth of abdominal size
48
Left sided HF symptoms
DROWNING D- dyspnea R- rales (crackles) O- orthopnea W- weakness N- nocturnal proximal dyspnea I- increased HR N- nagging cough G- gaining weight (2-3lbs/day, 5lbs/week)
49
HF diagnostics
-BNP -Echocardiogram -Chest x-ray -ultrasound
50
HF nutrition
-limit fluid to 2L/day -limit sodium to 2-3g/day -increase protein
51
HF teaching
-raise HOB -Aerobic exercises -daily weight -compliance with meds
52
PAD risk factors
-hypertension -diabetes -smoking -obesity -hyperlipidemia -females -age over 65 -elevated C-reactive protein -hyperhomocysteinemia
53
PAD teaching
-stop and rest if pain while walking -avoid restrictive clothing and crossing of legs -maintain warm environment and wear socks -dangle legs to alleviate pain
54
DVT manifestations
-leg pain -redness and inflammation and edema -unilateral swelling
55
DVT diagnostic
D Dimer
56
DVT teaching
-don't massage legs -compression socks
57
DVT meds
Anticoagulants
58
A fib
can't tell where P wave is (all look different, can't tell which one is the P wave)
59
A flutter
too many P waves
60
hyperthyroidism manifestations
-tachycardia -restlessness, irritability, nervousness -decreased attention span -heat intolerance -weight loss, diarrhea -menstrual problems -sweaty -goiter
61
hypothyroidism manifestations
-bradycardia -fatigue, lethargy -intolerance to cold -weight gain, constipation -depression -dry, flaky skin -swelling in face/tongue/hands/feet (myxedema) -menstrual problems
62
Diabetes manifestations
SUGARR S- slow wound healing U- blUrry vision G- glycosuria A- acetone breath R- rash on skin R- repeated yeast infection (women)
63
hypoglycemia manifestations
"I'm cold and clammy give me some candy" -sweaty, clammy, confused, light headed -give fruit juice, hard candies, graham crackers -if unconscious give IV D50
64
Hyperglycemia manifestations
3 P's Polyuria Polydypsia (very thirsty) Polyphagia (very hungry)
65
peripheral neuropathy for diabetics
check feet daily with mirror
66
osteoporosis health promo
-consume calcium, and vitamin D -spend time outdoors -weight bearing exercises
67
foods with calcium
-milk -green leafy vegetables -orange juice -cereals -read and white beans -figs
68
foods with vitamin D
-most fish -egg yolks -cereal and fortified milk
69
osteoporosis care
-environment safety (clear walkways) -limit caffeine, alcohol, carbonated beverages
70
Cataracts/ Glaucoma/ Macular Degeneration management of care
- Don't do things that increase intraocular pressure: - Bending over - Sneezing - Straining
71
Macular degeneration nutriton
High in antioxidants, vitamin E and B12
72
Cataract meds
Anticholinergics (atropine 1% ophthalmic solution)
73
Glaucoma meds
- Pilocarpine ophthalmic solution - Beta blockers: Timolol (1st line)
74
Peripheral Neuropathy clinical manifestations
- Dependent of affected nerve - Aching, shooting, burning pain - Feelings of cold feet
75
Peripheral Neuropathy teaching
- Foot care - Smoking cessation - Avoid toxic chemicals - Massage to improve circulation - Stimulate nerve and reduce pain - Avoidance of repetitive motion or prolonged pressure - Guided imagery - Relaxation techniques
76
MS clinical manifestations
- Fatigue - Memory loss - Decreased visual acuity - Ataxia - Nystagmus - Bowel dysfunction - Uhtoffs sign (temporary worsening of vision)
77
MS diagnostics
- Cerebrospinal fluid will have elevated protein level and increased WBC - MRI: plaques of the brain and spine
78
MS management of care
- watch for back stiffness - Monitor speech patterns and swallowing - Increase fluids to decreased risk of UTI - Communication board - Eye patches for diplopia - Energy conservation
79
MS meds
- Muscle relaxors - Dantrolene - Baclofen - Diazepam · Jaundice · Muscle weakness · Don't stop abruptly - Immunomodulators - Interferon beta · Treat or prevent relapses - Anticonvulsants - carbamazepine
80
parkinson's diagnostics
No definitive diagnostic procedures
81
Parknison's meds
Carbidopa Levidopa -no protein
82
Parkinson's Management of care
- Document weight weekly - Semisolid foods and thickened liquids - Keep a diet intake log - Encourage fluids and document intake - Small frequent meals - Maintain mobility as long as possible - Promote communication as long as possible
83
Osteoarthritis manifestations
-joint pain and stiffness -pain with activity that improves with rest -crepitus -excess joint fluid -finger joints enlarged -limp gait -back pain
84
Osteoarthritis management of care/ teaching
-NSAIDS prior to activity or as needed -proper body mechanics like using two hands and bending in the knees not back -assess if mobility aids needed -high energy activities in morning -heat for joint tenderness and stiffness -cold for inflammation
85
Back pain diagnostics
- X ray - CT - MRI - Electromyogram - Arthogram - Bone Scan
86
back pain meds
-NSAIDs -mild opioids (tramadol) -topical creams, sprays, and gels -Ziconotide (for severe chronic back pain)
87
Stroke clinical manifestations
- Facial weakness - Arm and leg weakness - Speech problems (aphasia) -writing problems (agraphia)
88
Stroke nursing interventions/ management of care
- Communication/ picture board - HOB at least 30 degrees - ROM - Unilateral neglect - Swallow test
89
GCS
Eyes: - Spontaneous (4) - To verbal (3) - To pain (2) - No response (1) Verbal: - Oriented (5) - Confused (4) - Inappropriate (3) - Incomprehensible (2) - No response (1) Motor: - Obeys (6) - Localizes (5) - Withdrawals (4) - Flexion (3) - Extension (2) - No response (1)
90
Tonic- clonic seizure
- Starts with stiffening of muscles and loss of consciousness (tonic) - 1-2 min of jerking of extremities (clonic) - breathing can stop during tonic and become irregular during clonic - Biting of cheek or tongue during clonic - Incontinence - Period of confusion following
91
Myoclonic seizure
- Brief jerking or stiffening of extremities, which can be symmetrical or asymmetrical - Last for seconds
92
Atonic or akinetic seizure
- Few seconds in which muscle town is lost - Followed by period of confusion - Results in falling
93
complex partial seizure
-associated automatisms (behaviors client is unaware of like lip smacking or picking at clothes) -loss of consciousness or blackout for several minutes
94
simple partial seizure
-consciousness is maintained -unusual sensations like changes in HR and abnormal flushing -unilateral abnormal extremity movements
95
Seizure nursing interventions
-seizure precautions -turn patient to side -loosen restrictive clothing -vagal nerve stimulation (partial seizures)
96
Seizure meds
Phenytoin -no oral contraceptives or warfarin
97
With aura (classic migraine)
- Awareness of findings for hours or days before: irritability, depression, food craving, gi effects - Aura develops over min to hrs and include neurological findings - 2ndstage: severe, incapacitating, throbbing headache lasting hrs - 3rd: (4-72 hrs) dull headache - Recovery: exercise worsens it
98
Without aura (common migraine)
- Pain is aggravated by physical activity - Unilateral, pulsating pain - One or more manifestations: photophobia, phonophobia, N/V - Persist for 4-72 hrs (usually in the morning)
99
Atypical migraine
- Status migraine: Headache lasting longer than 72 hrs - Migranious infraction: Neurological lasting more than 7 days - Unclassified: does not fit other criteria
100
Cluster headaches
- Brief episodes of intense, unilateral, nonthrobbing pain lasting 30 min to 2 hr that can radiate to forehead, temple or cheek - Occurs daily around same time - Followed by period of remission for 9-12 months -watery eyes with runny nose -facial sweating
101
Anemia clinical manifestations
- Pallor - Fatigue - Numbness or tingling of extremities - Nail bed deformities - Smooth, sore, bright red tongue (pernicious)
102
Anemia diagnostics
- MCV: Size of RBC - MCH: amount of hgb per RBC - MCHC: hgb amount relative to the size of the cell - Schilling test: measures B12 absorption with and without intrinsic factor
103
Anemia Meds
- Folic acid - Vitamin B12 - Ferrous sulfate - Epoetin alpha
104
Anemia nutriton
- Iron fortified cereals and breads - Fish - Poultry - Dried peas and beans - Green leafy vegetables
105
thrombocytopenia clinical manifestations
bleeding -of gums -nosebleeds
106
thrombocytopenia management of care
-safe environment -use electric razor, soft toothbrush, avoid blowing nose vigorously, make sure dentures fit
107
Leukemia diagnostics
- CBC: high, low or normal WBC, decreased HCT&HGB - Bone marrow biopsy - Coagulation time: increased
108
Leukemia management of care
- Monitor for infection - Hand hygiene - Screen visitors carefully - Private room - No fresh or raw fruits or vegetables - No fresh flowers or plants
109
Leukemia meds
- Filgrastim - Chemo - Bone marrow transplant

complex concepts level 2 (1 decks)

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