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N202 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

D5W

A

isotonic, used to KVO, supplies 170 calories/liter, excessive infusion can cuase hyponatremic encphalopathy and death from brain swelling

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2
Q

NS

A

isotonic, used to expand plasma volume, provide Na & Chloride, used for burns, GI fluid loss, metablic alkalosis, NO CALORIES
use caution with CHF pts

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3
Q

LR

A

isotonic, used for correction of metabolic acidosis, diarrhea, burns, fluid of choice for acute blood loss, NO CALORIES

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4
Q

D5 1/3 NS

A

isotonic, used to replace fluid and electrolytes, supplies 170 calories/liter

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5
Q

D10W

A

hypertonic, used when TPN is interrupted & until it is restarted, supplies 340 calories/liter

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6
Q

D5LR

A

hypertonic, used to replace gastric fluid loss, 170 cal/liter, dont use on liver disease pt

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7
Q

D5NS

A

hypertonic, used to replace fluid and electrolytes, supplies 170 cal/liter

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8
Q

D5 1/2 NS

A

hypertonic, used to replace fluid and electrolytes, 170 cal/liter, prepackaged availble with 20 mEq KCL

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9
Q

1/2 NS

A

Hypotonic, used to replace fluid & electroylets, no calories

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10
Q

pH

A

7.35-7.45

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11
Q

PaCO2

A

35-45

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12
Q

HCO3

A

22-26

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13
Q

PaO2

A

80-100

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14
Q

SaO2

A

96-100

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15
Q

myoglobin

A

men less than 92, women less than 76

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16
Q

TNI

A

less 0.4

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17
Q

BNP

A

less 100

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18
Q

Triglycerides

A

less 150

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19
Q

Cholesterol

A

less 200

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20
Q

HDL

A

more than 45

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21
Q

LDL

A

less than 130

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22
Q

PTT

A

21-35 sec

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23
Q

PT

A

10-14 sec

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24
Q

INR

A

1

valves or ortho pts 2-3

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25
Q

digoxin

A

0.8-2

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26
Q

Na

A

135-145

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27
Q

K

A

3.5-5.0

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28
Q

Cl

A

95-105

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29
Q

Mg

A

1.2-2.5

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30
Q

BUN

A

7-20

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31
Q

Creatinine

A

0.5-1.4

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32
Q

Hgb

A

13-16 or 12-15

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33
Q

Hct

A

41-50 or 36-44

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34
Q

RBC

A

4-5.5

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35
Q

Platelet

A

100-450 K

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36
Q

Ca

A

8.8-10.3

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37
Q

Glucose

A

60-110

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38
Q

HgA1C

A

less 6%

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39
Q

WBC

A

4500-10000

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40
Q

bronchidilators

A

decrease bronchospasm

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41
Q

beta adrenergic agonists

A

relax bronchial smooth muscle, decrease airway resistance

ex. albuterol, atrovent, symbicort, advair, xopenex

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42
Q

anti-cholinergic

A

inhibit cholinergic receptors on bronchial smooth muscle

ex. atrovent, spiriva

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43
Q

inhaled corticosteroids

A

anti-inflammatory, decrease mucus secretion

ex. pulmicort, flovent, advair, symbicort

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44
Q

leukotriene modifiers

A

decrease production of mucus/edema of airway wall

ex. singulair

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45
Q

ACE Inhibitor

A

prevent conversion of angiotensin I to II; decrease peripheral artery resistance
-pril

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46
Q

ARB’s

A

block vasoconstricting & aldosterone effects on angiotensin II by blocking itat AT1 receptors in vascular smooth muscles causing vasodilation
-sartan

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47
Q

Beta Blockers

A

block beta 1 in the myocardium & beta 2 in bronchial & vascular smooth muscle, decreases HR, CO & contractility
-olol

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48
Q

calcium channel blockers

A

inhibit flow of extracellular calcium across cardiac cell membranes & vascular tissue, relax arterial smooth muscle, decrease HR
-pine

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49
Q

insulin

A

helps with the passage of glucose, K, Mg across cell membranes, controls storage and metabolism of carbs, proteins & fats, promotes conversion of glucose to glycogen in the liver

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50
Q

somogyi effect

A

rebound hyperglycemia associated with chronic excessive insulin dosages, may need to increase intake or lower insulin does at night

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51
Q

down phenomenon

A

abnormal early morning increase in blood sugar, usually between 0200-0800, can be from insufficient insulin at night, incorrect med dose, or carbs at bedtime

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52
Q

lipodystrophy

A

depression at injection site due to break down of adipose tissue and not rotating injection sites

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53
Q

lipohypertrophy

A

accumulation of subQ tissue at injection site due to not rotating sites

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54
Q

rapid insulin

A

Humalog
onset 10-20 minutes
peak 1-3 hours
duration 3-5

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55
Q

short acting insulin

A

Humulin
onset 30-60 minutes
peak 1-5 hours
duration 6-10 hours

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56
Q

intermediate insulin

A

NPH
onset 1-2 hours
peak 6-14 hours
duration 16-24 hours

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57
Q

long acting insulin

A

Lantus
onset 1 hour
peak non
duration 24 hours

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58
Q

what insulin is IV only

A

regular

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59
Q

Heparin

A

blocks conversion of prothrombin to thrombin & fibrinogen to fibrin, prevents formation of new clots & extension of existing clots

  • check platelets, S/sx bleeding
  • SE: pruritus & buring at injection site
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60
Q

system of pt care delivery tht\at focuses on the achievment of outcomes within approp. time frames and resources

A

case mangagement

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61
Q

ensures the quality \, efficiency and cost effectiveness of services provided, manage 100% of all hospitialized pts

A

clinical case mangaement

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62
Q

stresses collar\boration between the individual pt, family, Mds, and other health care providers

A

community case management

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63
Q

what is the mission of community case management

A

encourage wellness and prevent illness

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64
Q

if a pt needs more than one home visit per week can they use community case management

A

no,

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65
Q

does community case management need a MD order

A

no but it is recommended

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66
Q

what are the key elements of patient centered medical home

A

facilitates communication and collaboration among providers, improves pt care outcomes, reduces health care expenditures

67
Q

requires killed care, acute illness or acute exacerbation of illness, requires intermittent or \frequent visits, homebound clients

A

home health

68
Q

is a Md order required for home halth

A

yes, along with authorization from the payer (insurance)

69
Q

te ICU is designed to observe the vital function of

A

ventilation, circulation, assimulation, elimination

70
Q

what is required in an ICU Rn

A

anticipate needs, eye for detail in observations of the process necessary to life, has the ability to deal with critical situations with speed, precision, and accuracy

71
Q

Critical care nursing

A

holistic and family approach, high burn out rate, most common cause is emotional overload

72
Q

pt conditions admitted to critial care units

A

severe trauma, mahor surgery with high risk surgical pts, MI, CVA, GI hemorrhage, dialysis, special procedures

73
Q

what is the last sense to leave a pt

A

auditory

74
Q

a reduction in the degree of sensory input

A

sensory deprivation

75
Q

Sx of sensory deprivation

A

loss of sense of time, delusions, illusions, hallucinations, restlessness, psychosis sx

76
Q

excessive sensory stimuli

A

sensory overload, caused by tension and anxiety increase when exposed to continuous periods of time without adequate rest

77
Q

pts who are prone to sensory deprivation or overload are

A

very young, old, post-op, unconcious

78
Q

altered emotional state occuring in a highly stressful enviornment

A

ICU syndrome/psychosis

79
Q

how can you prevent ICU syndrome/psychosis

A

clock, calender, tret pt as individual, allow to make decisions, touch, visting hours

80
Q

high priority

A

life threatening

81
Q

intermediate priority

A

do not directly threaten a persons life although may result in unhalthy physical or emotional consequesces

82
Q

low priority

A

problems that the person can handle themselves, require minimal assitance

83
Q

the process of assigning work from one organizational level to another or superior to subordinate

A

delegation of authority

84
Q

obligation, what must be done to complate a task

A

responsibilty

85
Q

power to make final decision and give command

A

power

86
Q

accepting ownership for the results or lack therof

A

accountability

87
Q

preparing scheme for doing

A

planning

88
Q

controlling use of time

A

time management

89
Q

each person remains accountable for the work delegated

A

principle of delegation

90
Q

nursing process

A

assessment, evaluation, nursing judgement

may not be delegated

91
Q

a tool which can be used to delegate effectively

A

job descriptions

92
Q

freedom to act within est. guidelines

A

authority

93
Q

steps to help in better delegation

A

think before you delegate, be specific when you delegate, monitor the results, give praise

94
Q

5 rights of delegation

A

task, circumstances, person, direction, supervision

95
Q

normal breath sounds are

A

soft and breezy

96
Q

discontinuous breath sounds

A

only heard either during inspiration or exhalation

97
Q

abnormal breath sounds are also called

A

advantisous

98
Q

crackes/rales

A

pneumopina or atelctesis, deflated or blocked airways, heard in the bases of lungs

99
Q

wheeze

A

high pitch musical, constriction of airways, COPD, asthma

100
Q

rhonnci

A

snoring, disappears after cough, cystic fibrosis, COPD

101
Q

strider

A

hear without stehascope, loud high pitch croup, epiglitis

102
Q

plural friction rub

A

creacking door, caused by pleural viseral rub, VERY PAINFUL

103
Q

absent

A

silent

104
Q

cutting back on activities

A

radical surgery

105
Q

S1

A

Lub, mitral and tricuspid closing, found 5th intercostal space midclavicular line

106
Q

S2

A

second intercoastal space, right sternal border, Dub, diastolye, simi lunar valve, hear with radial pulse

107
Q

S3

A

,abnormal heart sound, ventricular gallop, common in children, sounds like ken-tuck-ey, early diastolye, associated with valve disfunction

108
Q

S4

A

abnormal heart sounds atrial gallop, Ten-nes-see, hear before S1, late diastolye, seen in MI, angina, HTN, CAD, aortic dysfunction

109
Q

murmur

A

sound like whoosh, fell a thrill, hear a brue

110
Q

thrill and bruie

A

a turbulant blood flow found in both dialstole and systolic

111
Q

chart a murmur

A

grade it I/VI, II/VI, etc.

I/VI is barely audible, III/VI sounds same as S1/S2, Vi/VI dont need a stethscope to hear (loud with palpable thrill

112
Q

first level priority

A

airway problems, breathing, cardiac or circulation, VS concerns

113
Q

secondary level priority

A

LOC chane, untx medical problems, acute pain, abnormal lab values, risks of infection

114
Q

third level priority

A

lack of knowledge, activity, rest, family coping

115
Q

consists of clarification, simplification, organization, and rationalization of ideas

A

critical thinking

116
Q

venous insufficency

A

pooling of blood = valve problem, S/sx of edema, guarder sign, irregulaar ulcers with discharge, puritis, pain relieved by walking, dependent cyanosis, skin will feel warm to touch,

117
Q

arterial insufficnancy

A

absent or diminsihed pulses, cool to touch, sluggish cap refill, dependent rubor, elevation pallor, pins and needles, decrease sensation

118
Q

proactive approach, prevent adverse events

A

early nure intervention team

119
Q

reactive approach, rapid immediate care to unstable pt

A

tapid response team

120
Q

pain during ambulation

A

claudacation

121
Q

direct percussion

A

tapping directly on skin

122
Q

indirect percussion

A

tapping on hand that is directly on the skin

123
Q

blunt percussion

A

strike with ulnur surface of your hand, used to ID the size, loaction and density, helps to determin if the mass is air filled, solid or fluid filled

124
Q

tempany

A

high pitch, over abdomen (WNL)

125
Q

resonance

A

low pitch normal sound over hallow organs such as lung

126
Q

hyper resonance

A

loud booming sound heard over hyper inflated lung such as empazema

127
Q

dull

A

soft thud like, heard over all dense organs

128
Q

flattness

A

soft and high pitched, heard over bones, tumors

129
Q

normal size of pupils are

A

3-5-cm

130
Q

5 P’s of Nural assemssemtn

A

paralysiss, pulses, pain, pallor, parasteshia (numbness)

131
Q

crainal nerves

A

olfactory (smell) sensory
optic (sight) sensory
occular motor (movement of eyes, pupils) Motor
troclear (movement of eyes) motor
trigeminal (chewing, feeling on face) m & s
Abducens (movement of eyes) motor
Facial (smiling, taste) S&M
Accustic (hearing & equillibrium) S
Glossopharangeal (tasting, swallowing, gag reflex) S&M
Vagus (tasting, swallowing, gag reflex) S&M
Spinal accessory (neck, tripezious, sternoclaidomastoid muscles) M
Hypoglossal (stick your toungue out) M

132
Q

why are vascular access devices used

A

to have IV access for over 7 days

133
Q

Glascow coma scale

A 
standardized tool, quick and easy 
check eye opening, motor response, verbal response
15 fully intact
4-7 unconscious/coma
0-3 deep coma
134
Q

an indwelling IV catheter inserted centrally or peripherally and threaded into the superior vena cava and right atrium

A

central catheters

*can cause arrhythmias or valve damage

135
Q

decortication

A

injury is above brain stem, flexed, not good

136
Q

decerabration

A

extended, injury involves the brain stem

137
Q

placed directly into vessel, placed in a large vein such as jugular vein or neck or the femoral vein in the groin, temporary, sutured to skin at insertion side

A

non-tunneled central catheter

138
Q

surgically tunneled through tissue into vein, has a cuff that stimulates tissue growth, needed for long period of time, MD must remove

A

tunneled central catheter

139
Q

permanent device that consists of 2 parts, a catheter attached to a small reservoir and a single or double lumen, surgically inserted and removed

A

implanted port

140
Q

for all assesments besides GI

A

inspect, palpate, percuss, auscultate

GI: inspect, auscultate, palpate then percuss

141
Q

speed shock with access device

A

pushing a med too fast, S/Sx severe HA, chest pain, arrhythmias, death

142
Q

can a parent/surrogate decision maker refuse a blood transfusion

A

no

143
Q

contains red blood cells, white blood cells, and platelets

A

whole blood

144
Q

PRBCs

A

whole blood, removed plasma, used to raise Hct & Hgb while minimizing volume increase

145
Q

plasma

A

contains albumin, fibrogen, globulins, and other clotting factors

146
Q

FFP

A

plasma frozen within hours of donation, must be thawed before use

147
Q

platelets

A

small cellular components of blood that help the clotting process by sticking to the lining of blood vessels

148
Q

cyroprecipitated, AHF

A

removed from plasma by freexing and then slowly thawing the plasma, rich in clotting facots

149
Q

leukopenia

A

total WBC less than 4,000

150
Q

with the Rh system what can Rh- not recieve

A

+ blood

151
Q

with the Rh system what can Rh + recieve

A

any blood

152
Q

with group O blood who can you donate to, who can you recieve blood from

A

can donate to anyone

recive only from O

153
Q

with group A who can you donate to, who can you recieve blood from

A

can donate to A, AB

recive from O, A

154
Q

with group B who can you donate to, who can you recieve blood from

A

can doante to B, AB

recieve from B, O

155
Q

with group AB who can you donate to, who can you recieve blood from

A

can donate to AB

recieve from A, B, O, AB

156
Q

one unit of RBC will increase your Hgb how much

A

1 g/dl

157
Q

blood product to unit time

A

hang within 30 minutes from arrival to floor, complete transfusion within 4 hours from lab (or it can f\grow bacteria)

158
Q

what is used to prime the blood tubing before the blood arrives

A

ONLY NS

new tubing is to be used with every transfusion

159
Q

Blood transfusion procedure

A

VS prior, start at 50 ml/hr for 1st 15 minutes, then increase up to 125 ml/hr, monitor BVS Q 15 minutes

160
Q

acute hemolytic reaction

A

low back pain, chills, pain at IV site, hypotension

161
Q

febrile non hemolytic reaction

A

chills, increase of temp over 2 degrees, seen with mult transfusions of 5 or more

162
Q

circulatrory overload reaction

A

cough chest and back pain, dyspnea, cyanosis, crackles

163
Q

htn

A

150/90

N202 (8 decks)

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