everything you need to know idk Flashcards
addisonian crisis s/s
N/V, abdominal pain, confusion, extreme weakness, hypoglycemia, dehydration, hypotension
result of probably not properly managing stress
what should neutropenic patients not receive?
fresh fruit
flowers
vaccines
treatment for spider bite/bleeding
RICE rest ice compression elevate extremity
treatment for sickle cell crises
HHOP heat hydration oxygen pain medications
how to position pt w asthma
orthopenic position where pt is sitting up and bent forward with arms supported on a table of chair arms
tripod
how to position pt post bronchoscopy
flat on bed with head hyperextended
how to position pt w cerebral aneurysm
high fowlers
how to position pt w hemorrhagic stroke
HOB elevated 30 degrees to reduce ICP and facilitate venous drainage
how to position pt w ischemic stroke
HOB flat
how to position pt w cardiac cath
keep site extended
how to position pt w epistaxis
lean forward
how to position pt w above the knee amputation
elevate for first 24h on pillow, position on prone daily for hip extension
how to position pt w below the knee amputation
foot of bed elevated for first 24 hours, position prone daily for hip extension
how to position pt w tube feedings with decreased LOC
position
patient on right side to promote emptying of the stomach with HOB elevated to prevent aspiration.
how to position pt w air/PE
turn pt to left side and lower HOB
how to position pt w postural drainage
lung segment to be drained should be in the uppermost position to allow gravity to work
how to position pt post lumbar puncture
pt should lie flat in supine to prevent H/A and leaking of CSF
how to position pt w CBI
catheter should be taped to thigh so legs should be kept straight
how to position pt after myringotomy
position on the side of affected ear after surgery (allows drainage of secretion)
how to position pt post catarats surgery
pt will sleep on unaffected side with a night shield for 1-4 weeks
how to position pt w detached retina
area of detachment should be in the dependent position
how to position pt post thyroidectomy
low or semi-fowler’s, support head, neck and shoulders
how to position pt w thoracentesis
sitting on the side of the bed and leaning over the table (During procedure); affected side up (after procedure)
how to position pt w spina bifida
position infant on prone so that sac does not rupture
how to position pt w buck’s traction
elevate foot of bed for counter-traction
how to position pt post total hip replacement
don’t sleep on operated side, don’t flex hip more than 45-60 degrees and don’t elevate HOB more than 45 degrees, maintain hip abduction by separating thighs with pillows
how to position pt w prolapsed umbilical cord
knee-chest position or trendelenburg
how to position pt w cleft-lip
position on back or in infant seat to prevent trauma to the suture line; while feeding, hold in upright position
how to position pt w cleft-palate
prone
how to position pt w hemorrhoidectomy
assist to lateral position
how to position pt w hiatal hernia
upright position
how to prevent dumping syndrome
eat in a reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low fiber diet, and small frequent meals)
enema administration position
position pt in left-side lying (sims) position with knees flexed
how to position pt post supratentorial surgery (incision behind the hairline)
elevate HOB 30-45 degrees
how to position pt post infratentorial surgery (incision at nape of neck)
position patient flat and lateral on either side
how to position pt w increased ICP
high fowlers
how to position pt post laminectomy
back as straight as possible, log roll to move and sand bag on sides
how to position pt with spinal cord injury
immobilize on spine board, with head in neutral position; immobilize head with padded C-collar, maintain traction and alignment of head manually; log roll patient and do not allow patient to twist or bend
how to position pt - liver biopsy
right side lying with pillow or small towel under puncture site for at least 3h
how to position pt for paracentesis
flat on bed or sitting
how to position pt - intestinal tubes
place pt on right side to faciliate passage into duodenum
how to position pt w NG tubes
elevate HOB 30 degrees to prevent aspiration, maintain elevation for congtinuous feeding or 1h after intermittent feedings
how to position pt for pelvic exam
lithotomy position
how to position pt for rectal exam
knee to chest position, sim’s or dorsal recumbent
how to position pt during internal radiation
pt should be on bed rest while implant is in place
how to position pt w autonomic dysreflexia
place pt in sitting position (Elevate HOB) first before any other implementation
how to position pt w shock
bed rest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified trendelenburg)
how to position pt w head injury
elevate HOB 30 degrees to decrease ICP
how to position pt for peritoneal dialysis when outflow is inadequate
turn pt side to side before checking for kinks in tubing
how to position pt for myelogram (3 types)
Water-based dye: semi-Fowler’s for at least 8h. Oil-based dye: flat on bed for at least 6-8h to prevent leakage of CSF.
Air dye: Trendelenburg.
s/s of lead poisoning
Anemia. Basophilic stripping. Colicky pain. Diarrhea. Encephalopathy. Foot drop. Gum (lead line).
s/s neuroleptic malignant syndrome
Fever. Encephalopathy. Vitals unstable. Elevated enzymes (CPK). Rigidity of muscles.
**idiosyncratic reaction to antipsychotic drugs
how to use incentive spirometry
- Sit upright.
- Exhale.
- Insert mouthpiece.
- Inhale for 3 seconds.
- Hold for 10 seconds.
anticholinergic side effects
anorexia blurry vision constipation/confusion dry mouth sedation/stasis of urine
steps to use a metered dose inhaler
- Shake the inhaler well before use (3/4x).
- Remove the cap.
- Breathe out, away from the inhaler.
- Bring the inhaler to your mouth, place it between your teeth and close your mouth around it.
- Start to breathe slowly. Press the top of the inhaler once and keep breathing in slowly until you have taken a full breath (3-5s).
- Remove the inhaler from your mouth and hold your breath for about 10s, then breathe out.
treatment for diabetic ketoacidosis
KING UFC K+. Insulin. Nasogastric tube: if comatose. Glucose: once serum levels drop. Urea: monitoring. Fluids: crystalloids. Creatinine: monitor and catheterize.
effect of c3 and above injury
unable to care for self, life-sustaining ventilator is essential
effect of injury at c6 injury
may use a lightweight wheelchair; feed self with devices; write and care for self; transfer from chair to bed
effect of injury at c7
can dress legs; minimal assistance is needed; independence in wheelchair; can drive car with hand controls
effect of injury at T1-T4
Some independence from wheelchair; long-leg braces for standing exercises
effect of injury at L3-L4
may use crutches or canes for ambulation
left cerebrovascular accident
- Paralyzed right side hemiplegia.
- Impaired speech and language.
- Slow performance.
- Visual field deficits.
- Aware of deficits: depression, anxiety.
- Impaired comprehension.
right cerebrovascular accident
- Paralyzed left side hemiplegia.
- Spacial-perceptual deficits.
- Tends to minimize problems.
- Short attention span.
- Visual field deficits.
- Impaired judgement.
- Impulsive.
- Impaired time concept.
s/s of left side CHF
FORCED Fatigue. Orthopnea. Rales/Restlesness. Cyanosis/Confusion. Extreme weakness. Dyspnea
s/s of right side CHF
BACONED Bloating. Anorexia. Cyanosis/Cool legs. Oliguria. Nausea. Edema. Distended neck veins.
TX for CHF
(UNLOAD FAST) Upright position. Nitrates. Lasix (Furosemide). Oxygen. ACE inhibitors. Digoxin. Fluids (decrease). Afterload (decrease).
high alert medications
- Insulin.
- Opiates and narcotics.
- Injectable potassium chloride (or phosphate) concentrate. - IV coagulants (heparin).
- Sodium chloride solutions >0.9%.
narrow therapeutic range drugs
- gentamycin.
- vancomycin.
- Warfarin.
- Lithium.
- Digoxin.
- Theophylline.
- Methotrexate.
- Phenytoin.
- Insulin.
- Ciclosporin.
TB drugs
(RIPE): Rifampicin Isoniazid Pyrazinamide Ethambutol
rifampicin
causes red-orange tears and urine
ethambutol
causes problems with vision, liver problems
isoniazid
can cause peripheral neuritis; take vitamin B6 to counter
MAOIs + tyramine-rich foods
- Tyramine-rich foods may cause severe hypertension in patients who take MAOI’s.
- Tyramine-rich foods include: aged cheese, chicken liver, avocados, bananas, meat tenderizer, salami, bologna, Chianti wine, and beer.
pyridium
- Urinary tract analgesic and spasmolytic
- Not an anti-infective
- Turns urine bright orange.
nitro patch administration timeframe
up to 3x with intervals of 5 mins