exam 1 Flashcards by Jessica Warren

USED TO DECREASE INTRAVASCULAR VOLUME IN HEART FAILURE?

diuretics

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A PATIENT HAS 40 MG OF ORAL FUROSEMIDE PRESCRIBED TWICE A DAY. WHAT TIME WILL YOU INSTRUCT THE PATIENT TO TAKE THE MEDICATION?`

8 am and 2 pm-So they aren’t up at night having to pee, prevent nocturia

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with ___ you want to treat the disease like valve replacement or controling HTN

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with ___ you want to treat the disease like cardiac ablation and pacemker insertion

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you will do teaching and med ands diet/exercise to prevent ___

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weigh daily, cardiac rehab, and food logs are care for ____

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do nutritional and drug therapy for ___

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DASH diet, 2.5g Na a day, and restrict fluid if you have ___

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weight yourself daily and R 3 lb over 1-2 days and 3-5 lb over a week for ___

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you want to decrease symptoms and improve cardiac function with _

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reverse ventricular remodeling and improve QOL with __

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increase exercise tolerance and decrease edema with ___

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decrease morbitity and mortality with __

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give BB(-olol) and ACEI and K supp for ___

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give vasodilators and digoxin/digitalis for ___

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put a pt in high fowlers and give O2 for ___

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DO CONTINUOUS ECG MONITORING AND USE DIURESIS TO DECREASE IVF FOR ___

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hypoventilation and low chest expansion cause ____ acidosis

resp

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pneumonia and PE cause ___ acidosis

resp

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OD and pulm edema cause ___ acidosis

resp

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chest trauma and NM disease cause ____ acidosis

resp

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COPD and airway obstruction cause ____acidosis

resp

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DKA and salicylate OD cause ___ acidosis

met

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shock and diarrhea(loose bicarb) cause ___ acidosis

met

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renal failure and impaired liver(little bicarb made)cause___ acidosis

met

lactic acidosis and ketoacidosis cause ___ acidosis

met

ETOH and ASA (both acids)in excess cause __ acidosis

met

HEADACHE AND HYPERKALEMIA ARE S/S OF ___ acidosis

MET

disorientation and muscle twitching are s/s of ___acidosis

met

LOC changes and kussmals are ___ of met acidosis

s/s

CO2 retention is resp acidosis. t or f?

true

HCO3 loss or H+ rentention is met acidosis. t or f?

true

CO2 loss is resp alkalosis. t or f?

true

seizures and deep/rapid breathing are ___of resp alkalosis

s/s

hyperventilation and confusion are __ of resp. alkalosis

s/s

hypokalemia and light headed are __ of resp alkalosis

s/s

tingling extremities are __ of resp alkalosis

s/s

anxiety and altitude are causes of resp alkalosis. t or f?

true

pregnancy and fever are causes of resp alkalosis. t or f?

true

hypoxia, shock and PE are causes of resp alkalosis. t or f

tru

HOC3 excess or H+ loss is met alkalosis. t or f

true

low gastric juices and antacid overuse cause met alkalosis. t or f?

tru

K wasting diuretics cause met alkalosis. t or f

true

diarrhea and hypokalemia are __ of met alkalosis.

s/s

slow respirations and nausea are __ of met alkalosis

s/s

confusion that is linked to LOC thats low is a __ of met alkalosis

s/s

restless then lethargic is a __ of met alkalosis

s/s

hypoventilation and dysrhythmias are __ of met alkalosis

s/s

alkalosis is caused by loss of too much acid or retention of too much base. t or f

true

acidosis is caused by retention of too much acid or loss of too much base. t or f

true

resp probs are where CO2 are opp direction of pH. t or f

tru

met probs are where HCO3 is equal and the same direction as pH. t or f

tru

• A nurse is caring for a HF pt and R shortness of breath. what do you do?

Assist into high fowlers position first

• Nurse got lab values of K at 5.2. when calling provider, expect what action to do?

o Cardiac monitoring continuous

increases the digoxin toxicity . what K level? 3.4 or 4.8?

3.4

• Address bp of __/__ and pulse of 110 in a pt who just came out of surgery

80/56

with __ you see compression socks used and a high protein diet

VLU

with VLU, use moist environment dressings and elevation. t or f

true

with VLU, use hyperbaric support like angiogenesis and you see edema. t or f

true

with VLU, you see veins and valves fail to move due to ___ valves and calf muscle pump.

imcompetant

with VLU, you see venous hypertension, VTE, and variscosities t or f

true

with VLU, medial and painful ulcers & hemosiderin staining. t of f

true

with VLU, you see friable skin and think/hard/leather skin. t or f?

true

with digoxin, R BC or TC?

• A nurse is giving furosemide for edema, do…assess for tinnitus, eat a banana, elevate head before ambulating, mon K levels. t or f?

true

with VLU, you see weeping wounds and medial mallolus location. t or f?

tru

with VLU, you see dependent pain and yellow or ruddy granulation. t or f?

tru

with VLU, you see irregular shapes and lots of drainage. torf

true

• Teaching on hydrochlorothiazide is to take it with food due to the GI upset. t or f

true

• Pt has PAD, you expect pallor on elevation of limbs, and rubor when limbs are dependent. torf

true

• Pt has chronic ____ insufficiency, apply compression stockings in morning and bf out of bed

venous

with VLU, pain is worse when dependent and actue leads to chronic if ___ treated

NOT

with VLU, it is __ for wounds to reappear in the same location

common

with VLU, amputation is rare, there is less change of necrosis and bc the fluid doesn't get back to the heart. but the blood can get to the extremities. t or f?

true

edu a pt to empty the bladder and void every 3-4 hours with a uti. t or f

true

edu a pt with a UTI to pop regular and tell that 20% of liquid comes from food. t or f

true

with a UTI mon for urine color and clarity. t or f

true

with UTI, get a HH and a physical. and ask abt meds they take. t or f

true

with a UTI, ask abt foley in last 30 days and hygeine habits. t or f

true

do a urinalysis for e. coli(for diagnosis, you need a count of 100,000). t or f

true

do a UA C&S for microbes, RBC, WBC. t or f

true

UTI diagnoses are impaired urine elimination. t or f?

true

UTI diagnoses are acute pain and confusion. t or f

true

UTI diagnoses are altered sensory perception and bad management of self. t or f

true

for UTI give antibiotics like nitrofurantoin(turns urine brown and is a ____(weakens the bacteria)

bacteriostatic

for UTI give antibiotics like trimethoprim/sulfamethoxazole. t or f

true

for an uncomplicated UTI, give short term antibiotics for 1 to __ days

for a complicated UTI, give drugs for 7-14 days and give prophylactic for recurrant UTIs. t or f

when your pee burns, give phenzopyridine which turns your urine ___

orange

for a UTI and pain give acetylomenophine. t or f

true

avoid catheters when you can and incontinent episodes. t or f

true

slow progressive noninflammatory disease of joints and NOT normal to aging

put OA off by maintaining weight. t or f

true

OA common in ages 50-60 and can __ at 20-30

begin

OA results from ___ damage that makes a metabolic response

cartilage

with ____, cartilage becomes dull, yellow and granular.

with ____, cartilage becomes soft and less elastic, less resistant to wear with heavy use

stiff joints that resolve in 30 min with ___

overactive can cause joint effusion and ___ stiffness with OA

increase

early stages in OA, rest relieves pain but in late stages, pain is when you ___

rest

OA is __ symetrical and has H and B nodes with fingers still straght

not

prevent OA, thru diet, exercise and joint protection. t or f

true

with ___, joint space narrowing/sclerosis/subchondral cysts/osteophytes

with ___, you see osteoporosis and ANA pos

with __, there is pos anti-CCP and elevated ESR/CRP and RF pos

you cannot prevent ___, it is a chronic systemic autoimmune disease and genetic

CT in joints are inflammed in RA, and there are remission and ___ periods

exacerbation

RA effects more __ than men

women

infection or stress can cause RA and has a insidious onset. t or f

true

RA is symetrical and stiffness can last more than 60 min and has ___ destruction

bone

with RA, __ become tender, painful and warm

joints

with RA, joint pain __ with motion

increases

with __ there are flexion contractures and hand deformities

RA can cause diminished grasp ___

strength

with RA, you want to reduce inflammation and manage pain. t or f

true

with RA, you want to prevent/minimize joint deformity and maintain joint function. t or f

true

DMARDS like methotrexate can ___ the permanent effects of RA

lessen

can give NSAIDS and corticosteroids for __

for OA and RA, do rest and joint ___

protection

for OA and RA, rest in a ___ up

flare

for OA and RA, ____ flexion and promote extension

avoid

for OA and RA, ___ activities to put less stress on joints

modify

for OA and RA, use a ___ and immobilze in inflammation

splint

for OA and RA, ice is for___ inflammation and heat for stiffness

acute

balance nutrition and __ for OA and RA & avoid processed food and chemicals and red meat and diary and sugar.

exercise

for OA and RA, in a flare up walk and water aerobic and reduce ____ if you can

weight

for OA and RA, reduce stress and stop ___ and give meds

smoking

red and swelling =

inflammation

pain and warmth are

inflammation

vasodilation and function lost are

inflammation

maintain hygiene to prevent

inflammation

RestIceCompressionElevation for inflmmation. t or f

true

RICE helps to ___ swelling

minimize

RICE is the most beneficial for the which time period?

first 24-48 hours

for ____ check for edema, cap refill and pulse

inflammation

with ice, use 20 __ and 20 off

elevate how high?

above your heart level

give which drug for inflammation?

NSAIDS

with VLU, give anti____

coags

with DKA, you see ___ of insulin

deficient

with DKA, you see hyperglycemia and ketosis. t or f

true

with DKA, you see acidosis and dehydration. t or f

true

type 1 DM is ass with DKA and ass with ___/infection

illness

with DKA, the precipitating factors are ____ insulin dosage, neglect, and poor management

insufficient

with DKA, glucose isnt energy so fat is broken down. ketones then are involved. t or f

true

byproduct of fat metabolism

ketone

___ cause met acidosis

ketones

DKA ___ are kussmal respirations with fruity breath and reverses met acidosis

s/s

DKA ___ are ab pain, OH, and TC

s/s

DKA ___are lethargy and weakness and dehydration

s/s

DKA ___are to give O2

interventions

DKA ___ are to give 0.45 or 0.9% NaCl to restore urine output, raise BP and correct imbalance

interventions

DKA treatment needs 5% dextrose added when BG is 250 to prevent ___glycemia

hypo

DKA ___ K and NaHCO3 back in

needs

in insulin therapy, insulin drip follows a __

bolus

life threatening and less common than DKA

HHS

ass with type 2 DM and has neurologic symptoms

HHS

UTI, pneumonia, and sepsis cause

HHS

__ is ass with a history of low fluid intake, depression and polyuria

HHS

BG is GT400 and absent ketones is ass with ___

HHS

high mortality rate and needs greater fluid replacement than DKA

HHS

with ___ give IV fluids, insulin therpay and electrolytes like potassium

HHS

with HHS, ____ renal status and cardiopulmonary status

assess

with HHS, __ LOC and signs of K imbalance

assess

with HHS, ___ cardiac monitoring and VS

assess

treat ___ probs then chronic ones

acute

treat unstable then stable. t or f?

true

ABCS stand for

airway, breathing, circulation

if you have DKA, you will have ___ monitoring to ID dysrhythmias bc of hypokalemia

cardiac

____ prevention is skin hygiene and adequate nutrition and hydration for tissue integrity

primary

primary ___ is avoidance of sun exposure and activity restriction for tissue integrity

prevention

to prevent ___ ulcers, inspect skin daily and minimize pressure

pressure

to prevent pressure ___, reposition Q2 hours and do incontinence care

ulcers

to prevent pressure ____, bath with soap and warm water

ulcers

to prevent ____ ulcers, lotion and massage

ulcers

when cleaning pressure ulcers, use ___

to treat ulcers, give antibiotics and steroids. t or f

true

to treat ___ ulcers, use emollients and chemotherapy

pressure

use phototherapy for ___ ulcers

pressure

give proteins, vit A/C for pressure ____

ulcers

atrophy of skin and muscles & delayed skin are ass with ___

PAD

wound infection & non healing and gangrene are ass with

PAD

tissue necrosis and amputation are ass with __

PAD

do diet modification and stop smoking for ___ and VLU

PAD

hygiene and weight management for PAD and ___

VLU

do BP control and BG regulation for PAD and ___

VLU

do coagulation and cardio/pulm care for ___ and VLU

PAD

debride, do bypass, and angioplasty are ____ for PAD and VLU

intervention

mon labs and US are ____ for PAD and VLU

intervention

cultures and ABI are ___ PAD and VLU

interventions

involves progressive narrowing and degeneration of arteries of extremities

PAD

atherosclerosis is the leading cause of the cases of ___

PAD

you see paresthesia and thin, shiny, & taut skin with ____

PAD

loss of hair on lower legs and no pulses with ___

PAD

intermittent claudication and foot pallor with elevation with ___

PAD

reactive hyperemia of foot with dependent position and rest pain with ___

PAD

ulcers on toe, foot, and lateral malleolus are ass with ___

PAD

rounded, smooth punched out look and minimal discharge ass with ___

PAD

black eschar or pale pink granulation ass with __

PAD

___ of resp acidosis are headache and decreased LOC

s/s

___ of resp acidosis are hypoventilation and cardiac dysrhythmias

s/s

___ of resp acidosis are hypotension

s/s

for ___ conditions, do resp support

resp

for ____ conditions, do fluid and electrolyte support

metabolic

WITH ___ care, assess anxiety/fear and culture needs

periop

with __ care, assess treatment fears, learning needs, and readiness for surgery

post op

teach the middle amt of needs, not too much and not __ little

too

___ abt what to do bf surgery and what to expect after surgery

teach

a ___ will reinforce surgeon teaching

nurse

polish off, no metal and pee bf ___

surgery

dentures out, hearing aids and glasses, ID/allergy/blood cross and type the day of _____

surgery

____ is IV opiods and epidural caths for pericare

implementation

______is PCA and NSAIDs for pericare

implementation

_____ is regional anesthetic blockade for pericare

implemention

____ surgical complications are obstruction, hypoxemia, and hypoventilation

resp

_____ surgical complications are hypo/hypertension and dysrhythmias

cardiac

NPO status is to ___ choking

prevent

if a ___ problem, lay lateral if unconsious and supine/head elevated and reposition Q1-2 hours

resp

if a ___ prob, give O2, deep breathing, and coughing

resp

if a ___ prob, do ventilation with analgesics and ambulation

resp

if a ___ prob, you see SBP <90 and >160 & BC or >120

cardiac

if a ___ prob, watch for change in ___ rhythm

cardiac

if a __ prob like hypotension give O2 and inspect surgical incision

cardiac

if a __ prob like hypotension do a fluid bolus and drug intervention

cardiac

if a __ prob do I and O & run labs like electrolytes, Hb, Hct

cardiac

if a __ prob do early ambulation

cardiac

if a __ prob you will do slow position changes

cardiac

if a __thrombosis prob, do activity and nutrition and circulation aids

venous

if a __thrombosis prob, do anticoag and thrombolytic therapy(heparin is the most common)

venous

intact skin and nonblanchable erythma with no blisters

stage 1

with ___ skin, it lightens with pressure then goes back to red

blanchable

non____ skin doesnt lighten with touch

blanchable

partial thickness loss with exposed dermis is stage __

with stage_, adipose and deeper tissue not available

with stage 2, there is ___ tissue but NO slough/eschar present

granulation

with stage 2, this is due to: ___over pelvis or heal

shear

stage __ can go to the dermis and epidermis but is shallow and can appear red

stage 3 is __ thickness with fat visible and granulation present

full

stage 3 has undermining(wound can be larger and away from edges under skin)and tunneling(can __ healing)

delay

stage 4 is__ thickness and tissue loss

full

in stage _, you fascia and muscle

in stage __. tendon and ligament is seen

in stage __, cartilage and bone is seen

in stage 4, slough and eschar is __. u also see epibole, undermining and tunneling

visible

unstageable is __ full thickness skin and tissue loss

obscured

with a diabetic foot ulcer, you see them on toe joints and metatarsal __

head

with a diabetic foot ulcer, you see them on the foot plantar and under __

heel

with a diabetic foot ulcer, you see ___ foot sensation and warm/dry skin

decreased

with a diabetic foot ulcer, you see callus and skin__

cracks

with a diabetic foot ulcer, you see fissures and __ toe nail growth

abnormal

with a diabetic foot ulcer, you see plantar foot atrophy and ___ toe

hammer

with a diabetic foot ulcer, you see claw toe and ___ foot

charcot

with a diabetic foot ulcer, you see partial __ to full with bone involved and regular wound margins

thicknesss

with a diabetic foot ulcer, you see inflammed and infected and osteo___

myelitis

with a diabetic foot ulcer, the RF are visual ___ or retinopathy and PAD

impairment

with a diabetic foot ulcer, the RF are neuropathy and foot deformity and ___ ankle ROM

limited

with a diabetic foot ulcer, the RF are high ___ foot pressures and minor trauma think plantar or dorsal

plantar

with a diabetic foot ulcer, the RF are ___ trauma and ulcer/amputation

minor

with a diabetic foot ulcer, the causes are LEND/peripheral neuropathy and ___ with poor circulation

PVD

with a diabetic foot ulcer, the causes are mechanical stress/pressure and ___ glucose levels

poor

with cirrhosis, a nurse will teach to abstain from ETOH and ID hepatitis ___

early

with cirrhosis, ID biliary disease and teach on ___ nutrition

good

with cirrhosis,___ should look like high carb and low fat

nutrition

with cirrhosis ___ should be soft diet and small meals

nutrition

with cirrhosis ___ is 3000 cal a day

nutrition

with cirrhosis do low Na, rest and ___ hygeine

oral

with cirrhosis M for F and EI & ___ disorders

bleeding

with cirrhosis get I/O and __ weight

daily

with cirrhosis get ab girth and ___ extremities

measure

with cirrhosis give semi-high fowlers position and turn Q ___hours

with hepatic encephalopathy you assess LOC and sensory/motor ____

abnormalities

hepatic encephalopathy is ass with ___

cirrhosis

with cirrhosis rest and abstain from ___

ETOH

with cirrhosis have a good diet and ___ intake is met

evaluate

with cirrhosis ____ skin integrity and look for albumin levels

evaluate

with cirrhosis labs are ammonia and PT and ___

bilirubin

with cirrhosis relieve discomfort and have a __ Na diet(for ascites and edema)

low

with cirrhosis ask about ETOHism and hepatitis in past __

with cirrhosis assess jaundice and weight __

loss

with cirrhosis ___ ab distention and nausea

assess

with cirrhosis ____ altered mental status and RUG pain

assess

chronic progressive disease

cirrhosis

destruction of liver cells and has scar tissue due to liver trying to heal after inflammation

cirrhosis

this has a insideous course and more common in men

cirrhosis

biliary ___ has biliary inflammation and obstruction

cirrhosis

cardiac ___ comes from RSHF

cirrhosis

enlarged liver/spleen and lethargic are ___ signs of cirrhosis

early

fever and BM changed are __ signs of cirrhosis

early

N/V and ab pain are ___ and late signs of cirrhosis

early

anorexia and dyspepsia are early and ___ signs of cirrhosis

late

liver breath and hematemsis are ____ signs of cirrhosis

late

varices are ___ signs of cirrhosis

late

jaundice and spider___ are signs of cirrhosis

angioma

red palms and blotchy red dots are sign of __

cirrhosis

anemia and low PLTs(thrombocytopenia) are signs of ____

cirrhosis

leukopenia(low WBC) and coag disorders are ___ of cirrhosis

signs

hypo(albumin and K) and Na imbalances are signs of ___

cirrhosis

portal hypertension and fluid retention are __ of cirrhosis

signs

peripheral edema and ascites are ___ of cirrhosis

signs

amenorrhea and testicle atrophy are s/s of ___

cirrhosis

man boobs and impotence are ___ of cirrhosis

s/s

asterixis(hand flapping) is ass with

cirrhosis

fever and fatigue are systemic __

infection

apetite loss and gross feeling are ___ infection

systemic

incision and red are local ____

infection

pus, swollen and warm are __ infection

local

invasion of microbe into body

infection

E. coli and women cause __

UTI

weak stream and enuresis is due to __

UTI

nocturia and incontinent due to __

UTI

urgency and frequent pee

UTI s/s

hematuria and hesitancy due to __

UTI

intermittency and dribly pee due to ___

UTI

dysuria and pain on peeing due to

UTI

confusion and less likely to have a fever with a UTI if young or old?

old

use a ___ to decrease the IVF in HF

diuretic

with furosemide, give at 8am and 2pm to prevent ___

nocturia

impaired cardiac pumping/filling(not enough CO)is what disease

4-8L/min is a __ CO

normal

low QOL and short life is ass with __

ventricular dysfunction and low exercise tolerance are ass with __

__ sided HF is due to blood backing up

Left

LSHF has ___ probs

lung

you get RSHF from __ sided HF

left

JVD and portal HTN are __ of RSHF

s/s

hepato/splenomegaly and GI tract congestion are due to right___ HF

side

peripheral edema are due to right __ HF

side

fatigue and dyspnea are s/s of HF. t or f?

true

discoloration but intact skin from damage to underlying tissue.

suspected deep tissue injury, unknown depth

No determination of stage because eschar or slough obscures the wound. The actual depth of injury is unknown.

Unstageable/unclassified, full‑thickness skin or tissue loss, depth unknown

Wound margins are well approximated; examples include laceration and surgical incision. This process has the most rapid healing.

primary intention

Wound margins are not well approximated; larger wound area requires the formation of granulation tissue to fill in the gap. A longer period of time is needed to heal.

Secondary intention

Wound healing is delayed and occurs when the wound that was previously open is now closed. This process is usually associated with large infected and contaminated wounds.

Tertiary intention