Exam 2 Flashcards
Severe abdominal pain
mid-gastric
Acute onset – 24-48 hours after eating or alcohol intake
Abdominal and back tenderness
Abdominal distention
Nausea and vomiting***
Rigid board-like abdomen – pt in danger of hemorrhaging and peritonitis
Low grade fever
Jaundice
Hypo-tension
Acute pancreatitis symptoms
▪ Serum amylase level high
▪ Serum lipase level high
▪ Liver enzyme levels high
▪ Triglyceride levels
▪ Glucose level
▪ Bilirubin level
▪ Serum calcium level low
Acute pancreatitis labs
tingling of fingers and toes, severe nausea and vomiting, confusion, respiratory depression Trying to
compensate), tachycardia, symptoms of hypokalemia
Metabolic Alk symptoms
Manifestations: headache, confusion, drowsiness, increased respiratory rate and
depth, hyperkalemia, nausea and vomiting, decreased blood pressure, decreased
cardiac output, dysrhythmias, shock; if decrease is slow, patient may be
asymptomatic until bicarbonate is 15 mEq/L or less
metabolic acidosis symptoms
Encourage ambulation
Active and passive leg exercise
Pumping exercise in bed or standing next to bed
Do not sit or lie for prolonged periods
Do not cross legs
Do not wear constrictive clothing
Anti-embolytic stockings
SCDs
Do not dangle legs – have feet on the floor
Larger IV catheters (central lines) should not be left in place for prolonged periods
ASSESS! – any s/s of clots?
ASSESS! – oxygenation – O2, IS, C&DB, expectoration, semi-fowler
Monitor thrombolytic therapy – VS, PTT, INR – BLEEDING PRECAUTIONS
Manage pain – opioid analgesics, semi-fowler position
Relieve anxiety
Monitor for complications – right ventricular failure, cardiogenic shock
Provide post-op nursing care – monitor pulmonary pressures, VS, UO, ambulate, leg
exercises
PE prevention
Dyspnea
Tachycardia
Bloody sputum
Cough
Chest pain (pleuritic)
Anxiety
Fever
Diaphoresis
Syncope
PE symptoms
oxygen therapy
Anticoagulation therapy
Thrombolytic therapy
PE treatment
Used in pt with acute PE, hemodynamically unstable, do not have any risk factors for
bleeding
▪Clot busters! – Activase, Streptase
▪Pt must meet criteria!
▪Labs done prior to starting tx – PTT, INR, Hematocrit, Platelets
▪Anticoagulant: Heparin IV if pat doesn’t meet criteria for clot busters
Thrombolytic therapy
Suspected PE – tx up to 10 days
▪After embolic event - long-term tx – 10 days to 3 months
▪With PE, but hemodynamically stable – LMW Heparin (Lovanox), unfractioned
Heparin (sq), or new oral agent such as Dabigatran (Pradaxa), Rivaroxaban (Xarelto)
▪If pt does not qualify for new oral agents – Coumadin – needs regular blood draws for
INR – bleeding precautions – antidote is Vit K
Anticoagulation therapy
Nasal O2 immediately to relieve hypoxemia, respiratory distress, central cyanosis
oxygen therapy
Trauma
▪Surgery (orthopedic, abdominal, pelvic,..)
▪Pregnancy
▪Heart Failure
▪Hypercoagulable states
Prolonged immobility
PE causes
RIFLE
Risk Injury Failure Loss End-stage kidney disease
fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice.
hepatitis symptoms
Neuromuscular blocking agents
any med ending in -IUM
limit for renal patients (hard on kidneys)
Contrast studies
