Exam 1 Summary Set Flashcards
____ is the first-line treatment for OA
acetaminophen
young to middle-aged women are at risk for ____
rheumatoid arthritis (RA)
Sjogren syndrome is a manifestation of ____
RA
____ is the drug treatment for RA
methotrexate
methotrexate is contraindicated in ____
pregnant women
the 4 stages of cancer development
(1) initiation
(2) promotion
(3) progression
(4) metastasis
how similar the cancer cells look to the parent cell
grading
determines the exact location of the cancer and whether metastasis has occurred
staging
the 7 warning signs of cancer are CAUTION - what does it stand for?
C = changes in bowel and bladder habits
A = a sore threat
U = unusual bleeding or discharge
T = thickening / lump
I = indigestion / difficulty swallowing
O = obvious change in wart or mole
N = nagging cough
drugs designed to target specific molecules or pathways involved in cancer growth
targeted therapy
surgery and radiation are ____ types of therapy
localized
chemo, hormonal, and targeted therapy are ____ types of therapy
systemic
the priorities for neutropenic precautions are _____
(1) protect from infection
(2) educate family and friends on how to reduce risk of infection
describe some of the care for someone with neutropenia
(1) HH
(2) private room
(3) clean room at least 1x per day
(4) VS q4h
(5) daily WBC checks
the most common location for metastasis of colorectal cancer is ___
the liver
bleeding from the rectum
Hematochezia
what is the definitive diagnostic test for CRC?
colonoscopy
empty colostomy bag when it is ___ full
1/3 to 1/2
what should you NOT put in a colostomy bag and why?
aspirin b/c risk of ulcers
<____mL/hr urine output can lead to kidney damage
30
what is the main difference between dehydration and fluid volume deficit?
dehydration is loss of water ONLY; FVD is loss of water and salt
Na > 145 and increased osmolality are signs of what?
dehydration
which solution do you use to treat dehydration?
isotonic (.9%) Na+ solution and extra water
aldosterone function
increased water and Na reabsorption; increased K excretion
ADH function
water reabsorption
the best indicator of fluid overload is ___
weight gain
diphenoxylate hydrochloride is given to pts with gastroenteritis but should be withheld from ____
older adults b/c of drowsiness
metabolic acidosis and which electrolyte imbalance are linked?
hyperkalemia
Kussmaul respirations
Dysrhythmias
Decreased LOC
Decreased reflexes
What is this?
metabolic acidosis
what are the lab values for metabolic acidosis?
pH < 7.35
HCO3 < 23
massive blood transfusion is a risk factor for which acid-base imbalance?
metabolic alkalosis
positive Chvostek & positive Trousseau are seen in which conditions?
(1) Respiratory alkalosis
(2) hypocalcemia
(3) hypomagnesemia
during ____, you should re-breath expired air as a treatment option
respiratory alkalosis
which electrolyte imbalance can lead to cerebral edema?
hyponatremia
how does hyponatremia affect HR?
increases
what solution should you treat hyponatremia with?
hypertonic 3% normal saline
Cushing disease is a risk factor for which electrolyte imbalance?
hypernatremia
inverted T wave and depressed ST segment are signs of which imbalance?
hypokalemia
peaked T wave and widened QRS segment are signs of which imbalance?
hyperkalemia
Ca gluconate can be used to treat ____
hyperkalemia and hypermagnesemia
one thing to have on standby with hypocalcemia is ____
emergency trach equipment
laxative misuse can lead to ____
hypomagnesemia
magnesium normal range
1.3-2.1 mEq/L
diagnosis for DM
A1C > 6.5% or
FBG > 126 mg/dL; or
2-hr GTT > 200 mg/dL; or
s/s hyperglycemia + random BG > 200 mg/dL
name 3 three key drugs (besides insulin) used to treat DM
(1) metformin (biguanide)
(2) GLP-1 agonist (semaglutide, ozempic)
(3) sulfonylureas (glipizide)
sulfonylureas work by…
triggering the release of insulin from the liver
lab values of DKA
BG > 300 mg/dL
Ketones positive
pH < 7.35
HCO3 < 15
elevated BUN / creatinine
lab values of HHS
BG > 600 mg/dL
No ketones
pH > 7.4
HCO3 > 20
elevated BUN / creatinine
Osmolarity > 320 mOsm/L
most common GI problem with DM is ___ d/t ___
constipation; peripheral neuropathy
older adults with DM are at higher risk of developing ____
dementia
myxedema coma can result from
hypothyroidism
name at least 3 s/s of myxedema coma
(1) respiratory failure
(2) hypotension
(3) hypothermia
(4) bradycardia
(5) reduced mental status
nursing considerations for levothyroxine
(1) administer 1hr before meals and other meds
(2) monitor TSH levels
___ is used to treat hyperthyroidism (medication)
methimazole
nursing considerations for methimazole
(1) monitor for hypothyroidism and liver toxicity
(2) contraindicated in pregnancy
name the pharmacologic treatment options for alzheimer’s disease from least to most invasive
(1) donepezil
(2) memantine
(3) diazepam & haloperidol
___ and ___ are considered chemical restrains
diazepam and haloperidol
side effects of hydantoin are ____
headache and drowsiness
pharmacologic treatment for seizures is
(1) benzodiazepines
(2) hydantoin
nursing considerations with hydantoin
(1) don’t use with warfarin d/t bleed risk
(2) can lead to gingival hyperplasia so oral care is important
the two types of benzodiazepines given for seizures are usually what?
Lorazepam, clorazepate
____ is given IV to manage status epilepticus
Lorazepam
clorazepate function
prevent seizures
what should you monitor for with use of benzodiazepines?
(1) hypotension
(2) respiratory depression
BEFAST acronym stands for…?
B - balance
E - eye or vision changes
F - facial drooping
A - arm weakness
S - speech changes
T - time of onset
key considerations with the administration of IV alteplase
(1) dosed by pt weight
(2) must be given within 3-4.5 hrs of onset of symptoms
(3) test blood glucose for hypoglycemia
(4) may need to administer antihypertensive drug first
(5) stop anticoagulants for 24 hrs after d/t bleed risk
the main priority for stroke patients is
to restore perfusion to the brain
ABCS of stroke prevention are
A - aspirin as appropriate
B - blood pressure management
C - cholesterol management
S - smoking cessation
2 key s/s of hemorrhagic stroke are
headache and intracranial pressure
the two types of manifestations of delirium are
hypoactive and hyperactive
hypoactive s/s of delirium include
apathetic, lethargic, unaware, withdrawn
hyperactive s/s of delirium include
agitation, restlessness, aggression
difficulty writing
agraphia
inability to perform simple commands
apraxia
loss of balance or coordination
ataxia
inability to recognize familiar objects by sight, hearing, or touch
agnosia
inability to speak or understanding language
aphasia
crepitus is
coarse grating of the joints
post-op PAC means
pharmacology, ambulation, and compression
post-op PAC is used to
avoid clotting
low-grade fever, weight loss, and symmetric, bilateral joint inflammation is what?
rheumatoid arthritis
respiratory complications of RA
(1) pleurisy
(2) pneumonitis
(3) pulmonary HTN
cardiac complications of RA
(1) myocarditis
(2) pericarditis
eye complications of RA
(1) iritis
(2) scleritis
what are the safety precautions for use of methotrexate?
(1) take med 1x weekly
(2) can cause mouth ulcers (self-resolve)
(3) can cause mild liver irritation
(4) contraindicated in pregnant women
the three components inside the skull are
brain tissue, CSF, intravascular blood
the brain is dependent on which two systems (primarily)?
cardiac, respiratory
normal ICP is
7-15 mmHg
the first compensations in Intracranial Regulation will occurr in the ___
CSF
what can cause ICR impairment?
(1) impaired perfusion of oxygenated blood
(2) compromised neurotransmission
(3) glucose regulation
(4) pathology of the brain (i.e., tumors, inflammation)
Name the 3 major consequences of ICR impairment
(1) cerebral edema
(2) increased intracranial pressure
(3) neuronal injury or death
Population risk factors for ICR impairment include
(1) older adults
(2) adolescent and YA
(3) children
(4) accidents - falls, assault, MVA
T/F: There is no screening test for ICP.
True
to decrease ICP, HOB at ___ to ___
30 degrees; help with neck and head alignment
____ can decrease ICP by reducing metabolic demand of the brain
Propofol
which type of diuretic can be used to decrease ICP?
osmotic - Mannitol
two surgical interventions for ICP are
(1) craniotomy
(2) shunt procedure
which stroke is r/t atherosclerotic buildup, dysrhythmias, and prolonged HTN?
ischemic
which stroke is r/t prolong HTN, aneurysm, and drug abuse?
hemorrhagic
why do you monitor urine output for acetaminophen use?
check renal function
common s/s of both metabolic and respiratory acidosis
Dysrhythmias
Decreased LOC
Confusion
Lethargy
common s/s of both metabolic and respiratory alkalosis
N/T in fingers, feet, face
Lightheaded
basal insulin can be covered by which type(s) of insulin?
NPH intermediate
Long-acting
Ultra-long-actin
name the adverse effects of metformin
(1) GI symptoms
(2) hypoglycemia
(3) avoid with alcohol b/c liver metabolizes both
hold ____ 24 hours before contrast and surgery
metformin
adverse effects of GLP-1 agonists are
pancreatitis - abdominal pain and nausea
key pt education for taking sulfonylureas
take with meals to avoid hypoglycemia
which types of insulin should NEVER be combined with others in the same syringe?
long-acting
administer rapid-acting insulin ___ minutes before eating
10
give rapid-acting insulin at least ___ apart because of ___
4 hours; 3-hour peak
NPH intermediate insulin lasts
16-24 hours
glargine is
long-acting insulin
detemir is
long-acting insulin
degludec is
ultra-long acting insulin
____ should be given 30m before eating
regular insulin
____ should be given 10m before eating
rapid insulin
what is the therapeutic range for phenytoin?
10-20 mcg/mL
phenytoin <10 is a risk for
seizures
phenytoin >20 is a risk for
drug toxicity
stage 1 pressure injury is
non-blanchable, redness
stage 2 pressure injury is
blistering, partial thickness
stage 3 pressure injury is
full-thickness, subcutaneous fat / tissue, tunneling
stage 4 pressure injury is
bone, tissue, ligaments, muscle
