exam 1 Flashcards
USED TO DECREASE INTRAVASCULAR VOLUME IN HEART FAILURE?
diuretics
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
with ___ you want to treat the disease like valve replacement or controling HTN
HF
with ___ you want to treat the disease like cardiac ablation and pacemker insertion
HF
you will do teaching and med ands diet/exercise to prevent ___
HF
weigh daily, cardiac rehab, and food logs are care for ____
HF
do nutritional and drug therapy for ___
HF
DASH diet, 2.5g Na a day, and restrict fluid if you have ___
HF
weight yourself daily and R 3 lb over 1-2 days and 3-5 lb over a week for ___
HF
you want to decrease symptoms and improve cardiac function with _
HF
reverse ventricular remodeling and improve QOL with __
HF
increase exercise tolerance and decrease edema with ___
HF
decrease morbitity and mortality with __
HF
give BB(-olol) and ACEI and K supp for ___
HF
give vasodilators and digoxin/digitalis for ___
HF
put a pt in high fowlers and give O2 for ___
HF
DO CONTINUOUS ECG MONITORING AND USE DIURESIS TO DECREASE IVF FOR ___
HF
hypoventilation and low chest expansion cause ____ acidosis
resp
pneumonia and PE cause ___ acidosis
resp
OD and pulm edema cause ___ acidosis
resp
chest trauma and NM disease cause ____ acidosis
resp
COPD and airway obstruction cause ____acidosis
resp
DKA and salicylate OD cause ___ acidosis
met
shock and diarrhea(loose bicarb) cause ___ acidosis
met
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?
BC
• 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
3
for a complicated UTI, give drugs for 7-14 days and give prophylactic for recurrant UTIs. t or f
t
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
OA
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.
OA
with ____, cartilage becomes soft and less elastic, less resistant to wear with heavy use
OA
stiff joints that resolve in 30 min with ___
OA
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
OA
with ___, you see osteoporosis and ANA pos
RA
with __, there is pos anti-CCP and elevated ESR/CRP and RF pos
RA
you cannot prevent ___, it is a chronic systemic autoimmune disease and genetic
RA
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
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 __
RA
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
on
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 ___
NS
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 __
2
with stage_, adipose and deeper tissue not available
2
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
2
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
4
in stage __. tendon and ligament is seen
4
in stage __, cartilage and bone is seen
4
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
2
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 __
HH
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
HF
4-8L/min is a __ CO
normal
low QOL and short life is ass with __
HF
ventricular dysfunction and low exercise tolerance are ass with __
HF
__ 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
