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Concepts Flashcards

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1
Q

Complete

A

complete break

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2
Q

incomplete

A

partial break

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3
Q

Closed (simple, nondisplaced)

A

bone is in alignment

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4
Q

Closed (simple, displaced)

A

bone is not in alignment, more painful.

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5
Q

Open (Compound)

A

bone is sticking out, complete break

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6
Q

Avulsion

A

overstretching or tearing of tendons or ligaments, separates from the bone

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7
Q

Comminuted

A

bone shattered into fragments

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8
Q

Compression

A

bone collapses on itself, also from osteoporosis

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9
Q

Depressed

A

skull, but also face, broken and pushed inward

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10
Q

Greenstick

A

incomplete, but one side is bent, common in children.

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11
Q

Oblique

A

45 degree angle across the bone

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12
Q

Spiral

A

fracture that wraps around the bone

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13
Q

Impacted

A

bone is wedged into each other.

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14
Q

Compartment Syndrome

A 
Pain (esp at rest)
Pressure
Paresthesia
Pallor
Paralysis
Pulselessness
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15
Q

Person with a cast has pressure and pain at the site, what should the nurse do?

A

Prepare the patient for the fasciotomy

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16
Q

Skin Traction

A

Skin traction: no holes in body, just boot a boot and ace wrap, and hang a weight, and pull the bone straight. For displaced fractures.
If its on the floor, move the patient up.

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17
Q

Skeletal Traction

A

pins in the bone

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18
Q

If a traction is removed, what can the nurse expect?

A

Muscle spasms

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19
Q

Pathophysiology of Strains

A

1st degree strain: minimal inflammation, shouldn’t affect ROM, symptoms can last several days
2nd strain: actual tearing of muscles and tendons, ecchymosis, swelling/inflammation for several hours or days, can last up to a week or several weeks
3rd: internal bleeding tearing of muscles or tendons, may need surgical repair

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20
Q

Pathophysiology of Sprains

A

1st: stretching, shouldn’t be tearing, edema, pain, should still be able to move joint, its intact, able to ambulate
2nd: tearing of ligament fibers, increased swelling, bruising, pain, might have weight bearing issues
3rd: patient unable to ambulate, joint is unstable

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21
Q

Management of Sprains and Strains

A

Management: Diagnosis based on history and physical examination, Confirmed by radiography, ultrasound, or MRI

Treatment of 1st and 2nd degree strains/sprains: RICE

3rd degree strains: may require surgical repair of the torn tendon or muscle

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22
Q

RICE

A

Rest, 72 hours, Ice no longer than 30 minutes 3-5 times per day for 24-72 hours, decrease inflammation (vasoconstrict, decrease bleeding and fluid accumulation in injured area), must wrap the ice in something, compression (ace wrap, compression dressing, wrap tightly but not to the point of altering neurovascular function (cutting circulation off)). Ensure that circulation, movement, sensation is intact. Assess pulses. Elevate affected area, NSAIDS.

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23
Q

Traumatic Amputations

A

Accident
Immediately control bleeding and replace blood lost from injury
Tourniquet can remain in place for up to 6 hours before the tissue becomes necrotic

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24
Q

Elective amputations

A

for some reason that limb has become necrotic, such as diabetes, cancer, PVD
Occur with chronic disorders

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25
Q

Amputation Complications

A

Hemorrhage
Infection: older patients with peripherovascular disease
Contractures: residual limb
Phantom limb pain: numbess, tingling, sharp pain
Neuromas: clumps of nerve axons in the distal area of the residual limb that have regenerated

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26
Q

Infection

A

is the invasion and multiplication of microorganisms in body tissues, which may be unapparent or the result of local cellular injury caused by competitive metabolism, toxins, intracellular replication, or antigen-antibody response.

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27
Q

Examples of Parasites

A

Parasitic: worms, malaria

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28
Q

Examples of Fungi

A

Fungal: yeast, candidiasis, tenia pedis

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29
Q

Examples of bacteria

A

Bacterial: E. Coli, MRSA, strep, C. Diff

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30
Q

Examples of viruses

A

Viral: flu, HIV, hepatitis,

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31
Q

Localized Infection Symptoms

A

red, swollen, red, edema, pain

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32
Q

Disseminated Infection

A

starts in one area and spreads, STI

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33
Q

Systemic Infection Symptoms

A

fever, fatigue, malaise

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34
Q

Hospital Acquired Infection examples

A

MRSA, C. Diff

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35
Q

Community acquired infection examples

A

MRSA

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36
Q

Primary

A

first infection

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37
Q

Secondary

A

infection that takes advantage of a situation

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38
Q

Endemic

A

common in a certain culture, geographic location, chickenpox in school age kids, usually predictable rate

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39
Q

epidemic

A

rapid spread, usually lasts less than two weeks (short time). Swine flu

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40
Q

pandemic

A

world wide spread of a new disease. Flu, HIV

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41
Q

Anatomy and Physiology of the Immune System

A

Lymphoid organs: spleen, thymus, tonsils,
Lymphoid cells: T cells, B cells, activated with immune response
Immune response: activates T and B cells

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42
Q

Chain of Infection

A

Pathogen: bacteria, viruses, fungi, protozoa
Host: a person, unvaccinated, immunocompromised, disease process (diabetes, maybe they’re sick)
Reservoir: people, equipment, where the pathogen stays, water
Portal of exit: vomit, body fluids, coughing, secretions, excretions, skin, droplets
Mode of transmission: contact, airborne, droplet, through ingestion
Portal of entry: cut, mouth, eyes, mucous membranes, orifices, GI tract, respiratory tract

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43
Q

Immune responses to bacterial invasion:

B lymphocytes

A

activated, resulting in the production of antibodies.

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44
Q

Immune responses to bacterial invasion: T lymphocytes

A

T lymphocytes are activated, resulting in phagocytosis.

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45
Q

Immune responses to bacterial invasion:

Complement System

A

enhance overall response.

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46
Q

Bacteria release…?

A

Endotoxins or exotoxins which damage the cells of the host and initiate an inflammatory response.

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47
Q

Once the body’s compensatory mechanisms (e.g., vascular, renal, nervous, respiratory) are overcome, the following process occurs.

A

Septic shock, multisystem failure, death

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48
Q

Lab tests

A

Complete blood count (with WBC differential): WBC’s should go down as infection is resolved
Culture and sensitivity: it will work if certain antibiotic is given
C-reactive protein (CRP)
Erythrocyte sedimentation rate (ESR)
Serological tests to detect specific antibodies or viruses

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49
Q

Radiographic tests for infection X-rays

A 
X-rays 
MRI
CAT
PET
indium scans (osteomyelitis)
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50
Q

Common Infection Screenings

A

Sexually transmitted infection in high-risk groups

Tuberculosis screening in high-risk groups

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51
Q

Interventions for Infection

A 
Antimicrobial therapy 
Rest and comfort care measures
Nutritional support
Fluids
Disinfection of physical environment
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52
Q

Antibiotic Agents

A 
Penicillin
Cephalosporins
First, second, third, and fourth generation
Fluoroquinolones
Tetracyclines
Macrolides
Aminoglycosides
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53
Q

Other Antimicrobial Agents

A

Antiviral
Antifungal
Antiprotozoal

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54
Q

Chemotherapy

A

Use of chemicals against invading organisms

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55
Q

Antibiotic

A

Strictly speaking—a chemical that is produced by one microbe and has the ability to harm other microbes

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56
Q

Antimicrobial

A

Any agent that has the ability to kill or suppress microorganisms

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57
Q

Antibiotic Combinations

A

To Treat severe infections of unknown etiology
Mixed infections
Decreased toxicity
Additive effect

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58
Q

Antibiotic Combination Disadvantages

A

Cost
increased risk of adverse effects
increased risk of superinfection

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59
Q

Prophylactic Use

A 
To prevent infection in: 
Surgery
Bacterial endocarditis
Neutropenia
Frequent UTI’s
STD exposure
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60
Q

Essential Implications of antibiotic therapy

A

It is ESSENTIAL to obtain cultures from appropriate sites BEFORE beginning antibiotic therapy

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61
Q

Signs of Superinfection

A

fever, perineal itching, cough, lethargy, or any unusual discharge

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62
Q

Common Adverse effects of antibiotics

A

nausea, vomiting, and diarrhea

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63
Q

Best way to absorb antibiotics

A

with 6-8 oz of water

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64
Q

Sensory Perception

A

refers to the ability to receive sensory input and, through various physiological processes in the body, translate the stimulus or data into meaningful information.

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65
Q

Sensation

A

Physical feeling

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66
Q

Perception

A

become aware of the sensation

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67
Q

Presbycusis

A

sensory hearing loss that is common in elderly

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68
Q

Ototoxity

A

toxic to the hear, Lasix, antibiotics, some are reversible, some are not.

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69
Q

Visual Examination

A 
Inspection of the external eye
Visual acuity
Eye movement
Ophthalmic examination
Pupillary response
Visual fields test, noncontact tonometry
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70
Q

Hearing Examination

A

Evaluation of hearing
Inspection of the external ear
Inspection of the internal ear
Pure tone air conduction hearing test, otoacoustic emissions (OAEs), auditory brainstem response (ABR)

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71
Q

Taste and smell examination

A 
Inspect tongue and oral cavity
Inspect nose
Check for patency of nasal airway
Test tasting ability
Test smell
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72
Q

Tactile assessment

(touch)

A

Romberg test for balance
Tests of hot and cold, sharp and dull, localization of sensation
Monofilament testing

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73
Q

Myringotomy

A

Tubes in ears

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74
Q

Silver Nitrate is used

A

to prevent infection in newborns’ eyes

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75
Q

Acid-Base balance definition

A

is the process of regulating the pH, bicarbonate concentration, and partial pressure of carbon dioxide of body fluids

76
Q

pH

A

7.35 (acid)-7.45 (base)

77
Q

PaCO2

A

45 (acid)-35 (base)

78
Q

HCO3

A

22 (acid)-26 (base)

79
Q

Base:

A

alkaline

80
Q

Acid production

A

Generation of acid through cellular metabolism

81
Q

Acid buffering

A

Process to control changes in pH by neutralizing acids with buffers

82
Q

Acid excretion

A

Removal of acid from the body

83
Q

Buffers

A

prevent swings of acids or bases

84
Q

Lungs remove

A

carbon dioxide, an acid

85
Q

kidneys secrete

A

HCO3, a base

86
Q

what compensates for metabolic acidosis/alkalosis?

A

Lungs (happens quickly)

87
Q

What compensates for respiratory acidosis/alkalosis

A

kidneys (slow, may take days to compensate)

88
Q

Respiratory acidosis

A

CO2 retention, makes blood acidic

89
Q

Respiratory alkalosis

A

excessive CO2 is lost, makes blood basic

90
Q

Metabolic acidosis

A

HCO3 (base) loss or H+ (acid) retention, makes blood acidic

91
Q

Metabolic alkalosis

A

HCO3 (base) excess or H+ loss (acid), makes blood basic

92
Q

Respiratory Acidosis
Low pH
High PaCO2

A

less than 12 breaths per minute, not expelling CO2, blood is acidic, lower pH. Build up of CO2 due to bradypnea, low pH, high PCO2, HCO3 will go up (to try an compensate, but may not be if its not fully compensated),

93
Q

Respiratory Acidosis Causes

A

Things that slow down breath, or cause it hard to breathe:
drugs (opioids), neuromuscular disorders (myasthenia gravis, GB) pulmonary edema (lungs do not work), pneumonia, injury to respiratory center of the brain, embolism (fat or blood clot), asthma (constricted bronchioles), COPD, emphysema.
May cause hyperkalemia

94
Q

Respiratory Acidosis S/Sx

A

altered LOC, drowsy, confused, neuro changes, fall asleep, headache, respiratory rate below 12, low BP.

95
Q

Respiratory Acidosis Tx

A

bronchodilators, cough and deep breathe, no more narcs, Narcan, intubate pneumonia: give antibiotics, monitor for respiratory distress, give oxygen, Semi-Fowler’s, hydration to thin secretions, restlessness (decrease this), may need suction, monitor electrolytes

96
Q

Respiratory Alkalosis
High pH
Low PaCO2

A

excessive loss of CO2, due to tachypnea (greater than 22 breaths per minute), kidneys will compensate, but they are slow. pH goes up, HCO3 goes up, PCO2 will go down,

97
Q

Respiratory Alkalosis causes

A

pain, fever, anxiety, hyperventilation, during intubation, mechanical ventilation, aspirin toxicity, neuro injuries, asthma, and embolism

98
Q

Respiratory Alkalosis S/Sx

A

fast respiratory rate, greater than 22, neuro changes, tired, fast heart rate, low Calcium, can cause muscle excitability (cramps), hypokalemia, fast heart rate

99
Q

Respiratory Alkalosis Tx

A

breath into a bag, something to slow breathing, give something for pain or anxiety. Emotional support, monitor for respiratory distress, teach to slow breathing, monitor K and Ca, may administer Ca to decrease tetany. Give antibiotics/meds if needed

100
Q

Metabolic Acidosis
Low pH
Low HCO3

A

kidneys, too much acid, pH is low, bicarb is low, PaCO2 can be low of high depending on if its compensating or not, lungs hyperventilate (Kussmaul’s respirations), cardiac changes

101
Q

Metabolic Acidosis Causes

A

aspirin toxicity, carbs that are not metabolized (lactic acid buildup or pyruvic acid), insufficient kidney function, diarrhea (rich in bicarb), Diabetic KetoAcisosis (excessive keytones), ostomy drainage, fistula. Diamox (diuretic), high fat diet, renal failure,

102
Q

Metabolic Acidosis S/Sx

A

weak, confused, rapid respirations, Kussmaul’s, cardiac changes

103
Q

Metabolic Acidosis Tx

A

dialysis, I & O, S/Sx of respiratory distress, monitor LOC, replace and monitor electrolytes, may give bicarb. Safety and seizure precautions

104
Q

Metabolic Alkalosis
High pH
High HCO3

A

loss of hydrogen acid, elevated bicarb, hypoventilation,

105
Q

Metabolic Alkalosis Causes

A

aldosterone production, angiotensin renin release holds sodium, loses Hydrogen, get elevated bicarb. Loop diuretics, hydrochlorothiazide. (HCTZ), K wasting, high bicarb foods, baking soda, antacids, milk, high citrate (given with dialysis, also with blood infusions, loss of fluids (vomiting, NG suction), increased bicarb infusion

106
Q

Metabolic Alkalosis S/Sx

A

slowed breathing to keep CO2, hypokalemia

107
Q

Metabolic Alkalosis Tx

A

stop diuretics, stop suction, treat, antiemetics, monitor for respiratory distress, monitor ABG’s, potassium, and calcium, give meds to increase excretion of bicarb. May have to replace K, safety precautions,

108
Q

Consequences of Impaired Cellular and Organ Function

A

Altered cell function, especially in the brain when CO2 crosses the blood–brain barrier
Change in intracellular enzyme activity resulting in cell dysfunction
Acidosis: decreases the level of consciousness (LOC)
Alkalosis: decreases the LOC and has other neurological manifestations; may cause dysrhythmias (hypokalemia)

109
Q

Prevention of Acid Base Imbalances

A 
Healthy eating habits
Safe weight loss 
Smoking prevention or cessation
Poison control measures
Safe food handling
110
Q

Collaborative Interventions for Acid/Base Imbalances

A

Problems caused by an underlying respiratory condition require respiratory support
Problems caused by an underlying metabolic

111
Q

Fluid and Electrolyte Balance

A

is the process of regulating the extracellular fluid volume, body fluid osmolality, and plasma concentrations of electrolytes.

112
Q

Osmolality

A

degree of concentration of a fluid

113
Q

Extracellular Fluid

A

carries water, nutrients, and oxygen to the cell, and removes waste products. .
Interstitial (within cells)
Vascular: within the blood

114
Q

Third Spacing

A

ECF, when fluid accumulates in areas such as the abdomen to create ascites, pericardial space, or blisters

115
Q

Intracellular

A

fluid within the cell

116
Q

What organ regulates fluid?

A

Kidneys

117
Q

A system that also regulates fluid

A

Endocrine (Addison’s disease, Cushing’s disease, diabetes insidious)

118
Q

Insensible Loss

A

occurs through skin, lungs, stool this type isn’t really controllable

119
Q

Output greater than intake and absorption

A

hypernatremia and electrolyte deficits and ECV deficit

120
Q

Output less than intake and absorption

A

Hyponatremia and electrolyte excess and ECV excess

121
Q

Hypovolemic shock

A

when a person is deficient in ECF (which provides tissue perfusion and cell oxygenation)

122
Q

Hyponatremia

A

water moves into cells

123
Q

Hypernatremia

A

water moves out of cells

124
Q

electrolytes involved in muscle function

A

Ca, Mg, K,

125
Q

Heart muscle contraction

A

K

126
Q

Symptoms of a fluid and electrolyte imbalance

A

Unexplained nausea, fatigue, dizziness, shortness of breath, muscle cramping, edema, sudden changes in weight

127
Q

Na (Sodium)

A

135-145

128
Q

Ca (Calcium)

A

8.6-10.2

129
Q

Mg (Magnesium)

A

1.3-2.3

130
Q

Sodium Patient teaching

A

avoid foods that are processed

131
Q

Potassium rich foods

A

fresh fruits, vegetables, bananas, potatoes

132
Q

most accurate measurement of fluid balance

A

weight

133
Q

If patient has edema

A

limit fluid intake

134
Q

Drugs to correct fluid and electrolyte imbalances

A

Drugs used to correct disorders of fluid volume and osmolality
Drugs used to correct disturbances of hydrogen ion concentration
Drugs used to correct electrolyte imbalances

135
Q

Agents that affect the volume and ion consent of body fluids

A

Disorders of fluid volume and osmolality
Acid-base disturbances
Electrolyte imbalances

136
Q

What organ maintains fluid volume and osmolality?

A

Kidneys

137
Q

Isotonic Contraction

A

Definition
Volume contraction in which sodium and water are lost in isotonic proportions
Decrease in total volume, but no change in osmolality
Causes
Vomiting, diarrhea, kidney disease, and misuse of diuretics
Treatment
Fluids that are isotonic to plasma
0.9% NS
Replenish slowly to prevent pulmonary edema

138
Q

Hypertonic Contraction

A

Definition
Loss of water exceeds loss of sodium
Reduced extracellular fluid volume and increase in osmolality
Causes
Excessive sweating, osmotic diuresis, concentrated food given to infants
Secondary to extensive burns or CNS disorders that interfere with thirst
Treatment
Hypotonic fluids (0.45% sodium chloride) or fluids that contain no solutes at all (D5W)
Initial therapy: Drink water

139
Q

Hypotonic Contraction

A

Definition

Loss of sodium exceeds loss of water (

140
Q

Adverse effects of diuretics

A

hypovolemia, acid-base imbalances, electrolyte imbalances

141
Q

Loop

A

Furosemide (Lasix): Most frequently prescribed loop diuretic
Mechanism of action
Acts on ascending loop of Henle to block reabsorption
Pharmacokinetics
Rapid onset (PO 60 minutes; IV 5 minutes)
Therapeutic uses
Pulmonary edema (fluid in lungs, backing up (HF), IV)
Edematous states (depends on where it’s at)
Hypertension (PO)
Kidneys working (can give Lasix and makes kidneys work again)

142
Q

Furosemide [Lasix] adverse effects

A 
Adverse effects
Hyponatremia, hypochloremia, and dehydration
Hypotension
Loss of volume
Relaxation of venous smooth muscle
Hypokalemia
Ototoxicity
Hyperglycemia
Hyperuricemia
Use in pregnancy (do not)
Impact on lipids, calcium, and magnesium ?
lowers HDL raises LDL
143
Q

Furosemide [Lasix] Drug Interactions

A

Digoxin
Ototoxic drugs: add another med, increased risk
Potassium-sparing diuretics:
Lithium: a salt, accumulate sin blood when Na is pulled
Antihypertensive agents: added effect
Nonsteroidal anti-inflammatory drugs: COX inhibitors block the COX which maintains the kidneys, and giving a NSAID, it will block this, so kidneys will not work as well when you give Lasix.

144
Q

Other High-Ceiling (Loop) Diuretics

A 
Ethacrynic acid [Edecrin]
Bumetanide [Bumex]
Torsemide [Demadex]
All can cause: 
Ototoxicity, hypovolemia, hypotension, hypokalemia, hyperuricemia, hyperglycemia, and disruption of lipid metabolism
145
Q

Thiazides and Related Diuretics

A

Also known as benzothiadiazides
Effects similar to those of loop diuretics
Increase renal excretion of sodium, chloride, potassium, and water
Elevate levels of uric acid and glucose
Maximum diuresis is considerably lower than with loop diuretics
Not effective when urine flow is scant (unlike with loop diuretics)

146
Q

Hydrochlorothiazide [HydroDIURIL]

A 
Hydrochlorothiazide [HydroDIURIL]
Most widely used
Action: Early segment distal convoluted tubule
Peaks in 4 to 6 hours
Therapeutic uses 
Essential hypertension
Edema
Diabetes insipidus
147
Q

Hydrochlorothiazide [HydroDIURIL] Adverse Effects

A 
Hyponatremia, hypochloremia, and dehydration
Hypokalemia
Use in pregnancy and lactation
Hyperglycemia
Hyperuricemia
Impact on lipids, calcium, and magnesium
148
Q

Hydrochlorothiazide [HydroDIURIL] Drug Interactions

A

Drug interactions
Digoxin
Augments effects of hypertensive medications (beta blockers)
Can reduce renal excretion of lithium (leading to accumulation)
NSAIDs may blunt diuretic effect
Can be combined with ototoxic agents without increased risk of hearing loss

149
Q

Potassium-Sparing Diuretics

A 
Useful responses
Modest increase in urine production
Substantial decrease in potassium excretion
Rarely used alone for therapy
Aldosterone antagonist
Spironolactone
Nonaldosterone antagonists
Triamterene 
Amiloride
150
Q

Spironolactone [Aldactone] Mechanism of action

A

Blocks aldosterone in the distal nephron
Retention of potassium
Increased excretion of sodium

151
Q

Spironolactone [Aldactone] Therapeutic Uses

A 
Hypertension
Edematous states
Heart failure (decreases mortality in severe failure)
Primary hyperaldosteronism
Premenstrual syndrome
Polycystic ovary syndrome
Acne in young women
152
Q

Spironolactone [Aldactone] Adverse Effects

A

Hyperkalemia
Benign and malignant tumors
Endocrine effects

153
Q

Spironolactone [Aldactone] Drug Interactions

A

Thiazide and loop diuretics

Agents that raise potassium levels

154
Q

Triamterene [Dyrenium] Mechanism of Action

A

Disrupts sodium-potassium exchange in the distal nephron
Direct inhibitor of the exchange mechanism
Decreases sodium reuptake
Inhibits ion transport

155
Q

Triamterene [Dyrenium] Therapeutic uses

A

Hypertension

Edema

156
Q

Triamterene [Dyrenium] Adverse Effects

A 
Hyperkalemia	 
Leg cramps
Nausea 
Vomiting 
Dizziness
Blood dyscrasias (rare)
157
Q

Amiloride [Midamor] Mechanism of Action

A

Blocks sodium-potassium exchange in the distal nephron

158
Q

Amiloride [Midamor] Therapeutic use

A

Counteract potassium loss caused by more powerful diuretics

159
Q

Amiloride [Midamor] Averse effects

A

Hyperkalemia

160
Q

Amiloride [Midamor] Drug interactions

A

ACE inhibitors, other drugs with hyperkalemia (spironolactone)

161
Q

Osmotic Diuretics: Mannitol [Omitrol]

A

Promotes diuresis by creating osmotic force within lumen of the nephron
Pharmacokinetics
Drug must be given parenterally

162
Q

Mannitol [Omitrol] Therapeutic uses

A

Prophylaxis of renal failure
Reduction of intracranial pressure
Reduction of intraocular pressure

163
Q

Mannitol [Osmitrol] Adverse Effects

A 
Edema
Headache
Nausea
Vomiting
Fluid and electrolyte imbalance
164
Q

How much urine must a person output per hour?

A

at least 30 mL

165
Q

Perfusion

A

refers to the flow of blood through arteries and capillaries, delivering nutrients and oxygen to cells.

166
Q

Infarction

A

death of tissue with inability to regenerate

167
Q

Central Perfusion

A 
Force of blood movement generated by cardiac output 
Requires adequate cardiac function, blood pressure, and blood volume
Cardiac output (CO) = Stroke volume × heart rate
168
Q

Tissue or Local Perfusion

A

Volume of blood that flows to target tissue

Requires patent vessels, adequate hydrostatic pressure, and capillary permeability

169
Q

Impairment of central perfusion occurs when

A

cardiac output is inadequate

170
Q

Reduced cardiac output results in

A

a reduction of oxygenated blood reaching the body tissues (systemic effect).
If severe, associated with shock
If untreated, leads to ischemia, cell injury, and cell death

171
Q

Impaired tissue perfusion

A

is associated with loss of vessel patency or permeability, or inadequate central perfusion
Results in impaired blood flow to the affected body tissue (localized effect)
Leads to ischemia and, ultimately, cell death if uncorrected

172
Q

Risk factors for impaired perfusion

A

Middle-aged and older adults
Men
African Americans

173
Q

Infants with inadequate central perfusion

A

Poor feeding
Poor weight gain
Failure to thrive
Dusky color

174
Q

Toddlers and Children with inadequate perfusion

A 
Squatting and fatigue
Developmental delay (failure to hit milestones)
175
Q

Creatine kinase

A

can be brain related, myocardial related. Tells you that there is breakdown in muscle so that CKMB (related to muscle) will be elevated in an MI. It also is elevated if someone’s had an orthopedic surgery or muscular injury.

176
Q

Lactic dehydrogenase

A

elevated when there is damage to the myocardium.

177
Q

Natriuretic peptides

A

BNP, used to detect heart failure.

178
Q

Troponin

A

elevated with an MI, can predict MI probability. Usually get Q6 hours.

179
Q

Homocysteine

A

predictor of CAD, stroke, venous thrombus, and used for people at risk (familial or complaints)

180
Q

CRP

A

acute inflammation

181
Q

Serum lipids

A

hyperlipidemia (at risk for vessel disease)

182
Q

Platelet

A

150K-450K

183
Q

Prothrombin time (PT)

A

bleeding time (coumadin or warfarin)

184
Q

Partial thromboplastin time (PTT)

A

bleeding time, heparin

185
Q

INR

A

goes with PT, usually what doctor will use to dose the coumadin off of

186
Q

aPTT and PTT

A

Heparin

187
Q

Primary Prevention of Perfusion Issues

A

Smoking and nicotine cessation
Diet
Exercise
Weight control

Nursing (2 decks)

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