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complex concepts level 2 > complex final > Flashcards

complex final Flashcards

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
Q

HIV nursing care

A

-Assess risk factors (sexual practices, IV drug use)
-monitor I&O’s, weight loss, nutritional intake, electrolytes

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26
Q

HIV education

A

-avoid crowds, cleaning litter boxes, RAW food
-conduct frequent CD4+ and Viral load counts
-no live vaccines
-clean needles with bleach

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27
Q

SLE findings

A

-Alopecia
-Fatigue/malaise/weakness
-blurred vision
-pleuritic pain
-anorexia/weight loss
-depression
-joint pain, swelling, tenderness

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28
Q

SLE physical assessment findings

A

-erythematous “butterfly” rash
-reynaud’s
-anemia
-lymphadenopathy
-fever

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29
Q

ulcerative colitis expected findings

A

-left lower quadrant pain
-rectal bleeding
-diarrhea: up to 15-20 liquid stools per day

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30
Q

Crohn’s disease expected findings

A

-Right lower quadrant pain
-anorexia and weight loss
-diarrhea: 5 loose stools per day

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31
Q

UC/Crohn’s nutrition

A

-High protein and calorie
-Low fiber
-vitamins and b12 injections

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32
Q

C and C findings

A

-sharp pain in right upper quadrant (often radiates to right shoulder)
-rebound tenderness (blumberg’s sign)
-Dyspepsia and eructation
-jaundice

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33
Q

C and C education

A

-low fat diet
-no gas forming foods (beans, cabbage, cauliflower, broccoli)
-regular exercise

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34
Q

C and C meds

A

-analgesics
-bile acid

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35
Q

Genital herpes manifestations

A

-Pain
-small red bumps
-blisters
-ulcers
-scabs

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36
Q

Genital herpes meds

A

-antivirals like acyclovir

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37
Q

Chlamydia manifestations

A

-females are often asymptomatic
-painful urination
-lower abdominal pain
-vaginal discharge
-penile discharge
-painful sexual intercourse

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38
Q

Chlamydia meds

A

-azithromycin and doxycyclin
-2x a day for 7 days
-no sex for 7 days, recheck in 3 months

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39
Q

Chlamydia complications

A

-other STI’s
-pelvic inflammatory disease
-infertility
-infection in newborns

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40
Q

Gonorrhea manifestations

A

-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

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41
Q

gonorrhea meds

A

antibiotics

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42
Q

BPH manifestations

A

-voiding difficulties
-incontinence
-intra-abdominal pressure increased
-infections
-Hematuria

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43
Q

BPH diagnostics

A

-Digital rectal exam (DRE)
-lab work (urinalysis, prostate-specific antigen test)
-cytoscopy
-transrectal ultrasound

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44
Q

hypertensive crisis

A

-headache
-chest pain
-SOB
-dizziness
-blurry vision

45
Q

hypertension meds

A

-Thiazide diuretics
-Ace inhibitors (Pril’s)
-ARB’s (sartans)
-calcium channel blockers (dipine’s)
-Beta blockers (olol’s)

46
Q

hypertension education

A

-limit sodium, alcohol, caffeine
-smoking cessation
-exercise
-measure and keep records of BP at home

47
Q

right sided HF symptoms

A

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
Q

Left sided HF symptoms

A

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
Q

HF diagnostics

A

-BNP
-Echocardiogram
-Chest x-ray
-ultrasound

50
Q

HF nutrition

A

-limit fluid to 2L/day
-limit sodium to 2-3g/day
-increase protein

51
Q

HF teaching

A

-raise HOB
-Aerobic exercises
-daily weight
-compliance with meds

52
Q

PAD risk factors

A

-hypertension
-diabetes
-smoking
-obesity
-hyperlipidemia
-females
-age over 65
-elevated C-reactive protein
-hyperhomocysteinemia

53
Q

PAD teaching

A

-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
Q

DVT manifestations

A

-leg pain
-redness and inflammation and edema
-unilateral swelling

55
Q

DVT diagnostic

A

D Dimer

56
Q

DVT teaching

A

-don’t massage legs
-compression socks

57
Q

DVT meds

A

Anticoagulants

58
Q

A fib

A

can’t tell where P wave is
(all look different, can’t tell which one is the P wave)

59
Q

A flutter

A

too many P waves

60
Q

hyperthyroidism manifestations

A

-tachycardia
-restlessness, irritability, nervousness
-decreased attention span
-heat intolerance
-weight loss, diarrhea
-menstrual problems
-sweaty
-goiter

61
Q

hypothyroidism manifestations

A

-bradycardia
-fatigue, lethargy
-intolerance to cold
-weight gain, constipation
-depression
-dry, flaky skin
-swelling in face/tongue/hands/feet (myxedema)
-menstrual problems

62
Q

Diabetes manifestations

A

SUGARR
S- slow wound healing
U- blUrry vision
G- glycosuria
A- acetone breath
R- rash on skin
R- repeated yeast infection (women)

63
Q

hypoglycemia manifestations

A

“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
Q

Hyperglycemia manifestations

A

3 P’s
Polyuria
Polydypsia (very thirsty)
Polyphagia (very hungry)

65
Q

peripheral neuropathy for diabetics

A

check feet daily with mirror

66
Q

osteoporosis health promo

A

-consume calcium, and vitamin D
-spend time outdoors
-weight bearing exercises

67
Q

foods with calcium

A

-milk
-green leafy vegetables
-orange juice
-cereals
-read and white beans
-figs

68
Q

foods with vitamin D

A

-most fish
-egg yolks
-cereal and fortified milk

69
Q

osteoporosis care

A

-environment safety (clear walkways)
-limit caffeine, alcohol, carbonated beverages

70
Q

Cataracts/ Glaucoma/ Macular Degeneration management of care

A
  • Don’t do things that increase intraocular pressure:
  • Bending over
  • Sneezing
  • Straining
71
Q

Macular degeneration nutriton

A

High in antioxidants, vitamin E and B12

72
Q

Cataract meds

A

Anticholinergics (atropine 1% ophthalmic solution)

73
Q

Glaucoma meds

A
  • Pilocarpine ophthalmic solution
  • Beta blockers: Timolol (1st line)
74
Q

Peripheral Neuropathy clinical manifestations

A
  • Dependent of affected nerve
  • Aching, shooting, burning pain
  • Feelings of cold feet
75
Q

Peripheral Neuropathy teaching

A
  • 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
Q

MS clinical manifestations

A
  • Fatigue
  • Memory loss
  • Decreased visual acuity
  • Ataxia
  • Nystagmus
  • Bowel dysfunction
  • Uhtoffs sign (temporary worsening of vision)
77
Q

MS diagnostics

A
  • Cerebrospinal fluid will have elevated protein level and increased WBC
  • MRI: plaques of the brain and spine
78
Q

MS management of care

A
  • 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
Q

MS meds

A
  • Muscle relaxors
  • Dantrolene
  • Baclofen
  • Diazepam
    · Jaundice
    · Muscle weakness
    · Don’t stop abruptly
  • Immunomodulators
  • Interferon beta
    · Treat or prevent relapses
  • Anticonvulsants
  • carbamazepine
80
Q

parkinson’s diagnostics

A

No definitive diagnostic procedures

81
Q

Parknison’s meds

A

Carbidopa Levidopa
-no protein

82
Q

Parkinson’s Management of care

A
  • 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
Q

Osteoarthritis manifestations

A

-joint pain and stiffness
-pain with activity that improves with rest
-crepitus
-excess joint fluid
-finger joints enlarged
-limp gait
-back pain

84
Q

Osteoarthritis management of care/ teaching

A

-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
Q

Back pain diagnostics

A
  • X ray
  • CT
  • MRI
  • Electromyogram
  • Arthogram
  • Bone Scan
86
Q

back pain meds

A

-NSAIDs
-mild opioids (tramadol)
-topical creams, sprays, and gels
-Ziconotide (for severe chronic back pain)

87
Q

Stroke clinical manifestations

A
  • Facial weakness
  • Arm and leg weakness
  • Speech problems (aphasia)
    -writing problems (agraphia)
88
Q

Stroke nursing interventions/ management of care

A
  • Communication/ picture board
  • HOB at least 30 degrees
  • ROM
  • Unilateral neglect
  • Swallow test
89
Q

GCS

A

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
Q

Tonic- clonic seizure

A
  • 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
Q

Myoclonic seizure

A
  • Brief jerking or stiffening of extremities, which can be symmetrical or asymmetrical
  • Last for seconds
92
Q

Atonic or akinetic seizure

A
  • Few seconds in which muscle town is lost
  • Followed by period of confusion
  • Results in falling
93
Q

complex partial seizure

A

-associated automatisms (behaviors client is unaware of like lip smacking or picking at clothes)
-loss of consciousness or blackout for several minutes

94
Q

simple partial seizure

A

-consciousness is maintained
-unusual sensations like changes in HR and abnormal flushing
-unilateral abnormal extremity movements

95
Q

Seizure nursing interventions

A

-seizure precautions
-turn patient to side
-loosen restrictive clothing
-vagal nerve stimulation (partial seizures)

96
Q

Seizure meds

A

Phenytoin
-no oral contraceptives or warfarin

97
Q

With aura (classic migraine)

A
  • 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
Q

Without aura (common migraine)

A
  • 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
Q

Atypical migraine

A
  • Status migraine: Headache lasting longer than 72 hrs
  • Migranious infraction: Neurological lasting more than 7 days
  • Unclassified: does not fit other criteria
100
Q

Cluster headaches

A
  • 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
Q

Anemia clinical manifestations

A
  • Pallor
  • Fatigue
  • Numbness or tingling of extremities
  • Nail bed deformities
  • Smooth, sore, bright red tongue (pernicious)
102
Q

Anemia diagnostics

A
  • 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
Q

Anemia Meds

A
  • Folic acid
  • Vitamin B12
  • Ferrous sulfate
  • Epoetin alpha
104
Q

Anemia nutriton

A
  • Iron fortified cereals and breads
  • Fish
  • Poultry
  • Dried peas and beans
  • Green leafy vegetables
105
Q

thrombocytopenia clinical manifestations

A

bleeding
-of gums
-nosebleeds

106
Q

thrombocytopenia management of care

A

-safe environment
-use electric razor, soft toothbrush, avoid blowing nose vigorously, make sure dentures fit

107
Q

Leukemia diagnostics

A
  • CBC: high, low or normal WBC, decreased HCT&HGB
  • Bone marrow biopsy
  • Coagulation time: increased
108
Q

Leukemia management of care

A
  • Monitor for infection
  • Hand hygiene
  • Screen visitors carefully
  • Private room
  • No fresh or raw fruits or vegetables
  • No fresh flowers or plants
109
Q

Leukemia meds

A
  • Filgrastim
  • Chemo
  • Bone marrow transplant

complex concepts level 2 (1 decks)

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