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Nursing Process 2 > Exam 2 > Flashcards

Exam 2 Flashcards

Burns, GU, MH, GI, ABX

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1
Q

What are the four types of burns?

A

Thermal, Radiation, Electrical, Chemical

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2
Q

What are characteristics of a first degree burn?

A

Epidermis only, mild, NO BLISTERS, skin pink and dry.

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3
Q

What are characteristics of a second degree burn?

A

Deeper skin layers, red, painful, BLISTERS

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4
Q

What are characteristics of a third degree burn?

A

Very deep layers and bone, dead tissue, skin non-blanchable, skin graft is needed,

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5
Q

Describe the “Rule of Nines” when calculating body surface area for burns.

A

Head: Total - 9% (Front - 4 1/2, Back - 4 1/2)
Chest: Total - 18% (Front - 9, Back - 9)
Abdomen: Total 18% (Front - 9, Back - 9)
Groin: Total 1%
Arm (Single): Total - 9% (Front - 4 1/2, Back - 4 1/2)
Leg (Single): Total - 18% (Front- 9, Back- 9)

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6
Q

What are the stages of burn care?

A

Resuscitative/Emergent Phase
Acute Phase
Rehab Phase

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7
Q

What are the main concerns in the resuscitative/emergent phase of burn care?

A

Respiratory Distress
Hypovolemic Shock (Give Lots of Fluids!!)
Compartment Syndrome

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8
Q

What is the Parkland Formula for calculating fluid replacement in burn victims?

A

4mL x BSA(%) x Weight (kg)
Give half of the solution over the first 8 hours
Give the other half over the next 16 hours

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9
Q

What is an obvious sign of carbon monoxide poisoning?

A

Bright red lips.

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10
Q

In the acute phase of burn victims, what is the main concern?

A

High risk for infection! (along with pain management and wound care)

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11
Q

In the rehab phase of burn victims, what are main concerns?

A

Prevent scarring
Work with physical therapy
High protein diet
Coping with negative emotions (anger/sadness about body image etc)

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12
Q

What is an Escharotomy in a burn victim?

A

Surgical procedure; SUPERFICIAL incision made to relieve pressure from edema.

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13
Q

What is a Faschiotomy in a burn victim?

A

DEEP surgical incisions to relieve pressure from edema.

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14
Q

What should the nurse do before starting any patient on antibiotics?

A

Obtain culture and sensitivity test.

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15
Q

ABX: Penicillins (B-Lactams)

A

TREATS: Anthrax, Syphilis

  • Interfere with bacteria cell wall synthesis
  • Avoid in patients with mono
  • Do not give with cephalosporins if pt allergy is present
  • Can treat anthrax and syphilis
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16
Q

ABX: Cephalosporins

A

TREATS: MRSA, Penetrate CSF

  • Starts with Cef-
  • Can treat MRSA
  • Can cause nephrotoxicity
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17
Q

ABX: Macrolides

A

TREATS: Lots of things Macro = big = big spectrum (respiratory, skin, soft tissue, sexually transmitted, H. pylori and atypical mycobacterial infections)

  • azithromycin, erythromycin
  • can cause hepatic dysfunction
  • decreases PCN & Clindamycin effects
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18
Q

ABX: Oxazolidinones

A

TREATS: Bacterial Infections (including staphylococci, streptococci and pneumococci)

  • can cause eye issues (zolid -> lid -> eye)
  • can cause thrombocytopenia
  • can cause serotonin syndrome (temp, diarrhea, agitation, dilated pupils)
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19
Q

ABX: Lincosamides

A

TREATS: C-Diff, Acne, Infections

  • clindamycin; linomycin
  • can cause pancytopenia (all blood counts are LOW)
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20
Q

ABX: Glycopeptides

A

TREATS: C-Diff & Other Infections

  • Vancomycin, Telavacin, Oritavancin
  • Vancomycin can cause Red Man Syndrome if infused too quick (pt turns red, itchy, flushed) and nephrotoxicity
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21
Q

When should the nurse draw a vancomycin trough?

A

30 min before next dose of vancomycin

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22
Q

ABX: Tetracycline

A

TREATS: Chlamydia, Syphilis, Gonnorhea (Cycle = Cycle through men = STDs)

  • Tetracycline, Demeclocycline, doxycycline, minocycline, tigecycline (end in -cycline)
  • Can cause tooth discoloration
  • Avoid dairy/iron/antacids
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23
Q

ABX: Aminoglycosides

A

TREAT: SEVERE infections of the abdomen and urinary tract

  • Tobramycin, Gentamicin
  • Can cause ototoxicity and nephrotoxicity
  • Ends in -cin
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24
Q

ABX: Fluoroquinolones

A

TREATS: Variety of infections; respiratory and UTI, Skin

  • ends in Floxacin
  • tendon rupture
  • treat UTIs, Anthrax, PNA, skin infections
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25
Q

ABX: Sulfonamides

A

TREATS: Lots of Infections everywhere

  • starts with SULF
  • can cause crystalluria
  • increase fluids
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26
Q

ABX: Nitroimidazoles

A

Treats: H-Pylori and C-Diff

  • ends in ZOLE
  • treats H. Pylori and C-Diff
  • don’t take with alcohol (severe vomiting)
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27
Q

What are the THREE general adverse reactions to ABX?

A
  1. Allergy/hypersensitivity
  2. Superinfection (2ndary infection from being on ABX)
  3. Organ Toxicity
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28
Q

What are the two types of UTIs?

A

Upper UTI - Nephritis

Lower UTI - Bladder/Prostate/Urethra

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29
Q

Which type of UTI is uncomplicated?

A

Lower UTI, treated easier and responds better to tx

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30
Q

What is the most common cause of UTIs in hospitals?

A

Urinary Catheters

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31
Q

What is the most common type of UTI Infection?

A

Ascending Infection

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32
Q

In the gerontologic population, what are signs & symptoms of a suspected UTI?

A

Altered mental status, lethargy, agitation, confusion, new incontinence

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33
Q

What are common ABX for UTI treatment?

A
  • TriMETHOprim/SulfaMETHOxazole (Has “METHO” in it)
  • Fosfomycin
  • Nitrofurantoin
  • Cephalexin
  • Ceftriaxone

Remember: Metho-Fosfo-Nitro-Cephf = UTI TX!

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34
Q

What is Pyridium and what is a common side effect of it?

A

Anti-spasmatic, orange pee! Avoid citrus

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35
Q

In what time frame should a patient void after a catheter is removed?

A

6-8 Hours

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36
Q

What are the types of urinary incontinence?

A

Stress - happens with physical exertion (exercise, coughing, etc)
Urge - overactive bladder, strong urge to urinate, large amounts
Functional - due to medications or other health problems not related to bladder/urethra
Overflow - dribbling of urine caused by abnormal detrusor muscle contractions
Mixed - Mix of the above

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37
Q

What medicines can help with incontinence?

A
  • Anticholinergics
  • Antidepressants
  • Psuedoephedren Sulfate
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38
Q

Urinary tract stones are _______ based.

A

Calcium

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39
Q

What are clinical manifestations of urinary stones?

A
  • Pain (Flank = Kidney Stones)(Lower ABD = Ureter Stones) can be wave-like, spasms when stone is moving.
  • N/V/D
  • ABD Pain
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40
Q

What are nursing interventions for urinary stones?

A
  • pain management, control it
  • keep patient hydrated
  • have patient pee at least 2L daily
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41
Q

What is cystitis?

A

Inflammation of the bladder usually due to infection

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42
Q

Patients on ABX can get what type of UTI?

A

Fungal UTI (check their current med list)

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43
Q

In older women, what hormone replacement can help reduce the risk of UTIs?

A

Estrogen

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44
Q

What are the main symptoms of UTIs?

A

Frequency, Urgency, Dysuria (pain while urinating)

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45
Q

Erectile Dysfunction can be managed with what type of drugs?

A

PDE-5 Inhibitors (Phosphdiesterase Type 5 Inhibitors) such as:

  • Slidenafil (Viagra)(24Hr)
  • Vardenafil (Levitra)(24Hr)
  • Tadalafil (Cialis)(36 Hr)

Mneumonics:
Slide-in ;)
Vard = Hard
Tada! Erection

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46
Q

PDE-5 Inhibitors for erectile dysfunction are contraindicated with _________?

A

Nitrates (leads to dangerous hypotension)

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47
Q

What is Benign Prostatic Hyperplasia (BPH)?

A

Nonmalignant enlargement of the prostate.

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48
Q

What does BPH cause?

A
  • Increased residual urine

- Acute/chronic urinary retention

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49
Q

What are some BPH assessments?

A

Urinary problems such as: frequency, urgency, nocturia, reduce stream velocity, strain to start urinating, incomplete bladder emptying, hematuria, dribbling

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50
Q

What drugs can help treat BPH symptoms?

A
  1. 5-ARI (5 alpha reductase inhibitors)
    - end in -ride
  2. A-1SBA (Alpha-1 selective blocking agents)
    - end in -sin
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51
Q

What should people with BPH do for non-surgical interventions?

A
  • avoid alcohol/caffeine and diuretics
  • voide as soon as urge felt
  • avoid anticholinergics/antihistamines
  • release of prostatic fluid
52
Q

What is a common side effect for patients who have had a TURP, or transurethral resection of the prostate to treat BPH?

A

Retrograde ejaculation

53
Q

What is the second most common type of cancer that affects men above age 65 worldwide?

A

Prostate Cancer

54
Q

What is the best cure for prostate cancer?

A

Surgery!

55
Q

What medication can help block uptake of androgen by the prostate to help with prostate cancer?

A

Flutamide (Eulexin)

56
Q

In what population is testicular cancer more common in?

A

HIV population

57
Q

What age range does testicular cancer normally affect males?

A

Ages 20-35 years old

58
Q

What is the most common of all psychiatric illnesses?

A

Anxiety; affects women more than men. (2:1 ratio)

59
Q

What is anxiety? Is it good or bad?

A
  • Emotional response to stress, or external pressure.
  • Mild anxiety is normal and healthy, increases problem solving and learning potential
  • Moderate/Severe anxiety decrease thinking capacity, learning ability, and can cause physical symptoms
  • Panic is most severe form of anxiety, unable to think logically, or at all, loss of control, needs immediate intervention
60
Q

Patients must have at least ____# of symptoms to have panic disorder

A

at least 4 symptoms or more

61
Q

What interventions should a nurse provide for patients with anxiety/panic disorder?

A
  • coping techniques
  • medications such as SSRI’s and anxiolytics
  • decrease intake of stimulants
  • teach square breathing technique or pursed lip breathing technique when patient is at low anxiety levels
62
Q

Patients who have post-traumatic stress disorder have symptoms that are ___________?

A
  • present for 1 month or longer
  • interfere with daily life
  • occur at any age, at any time
  • may have self-harm ideations or behaviors
63
Q

What are some anxiety and panic disorder treatments, what are they used for, and why?

A
  • Cognitive therapy changes thought process
  • Behavior therapy teaches coping mechanisms and breathing techniques
  • Pharmacological Therapy: Anxiolytics (Benzos), Antidepressants (SNRIs, SSRIs, Tricyclic), Antihypertensives (situational anxiety)
64
Q

What is somatic symptom disorder?

A

Patient feels like something physically wrong with them, dramatic behavior and worry a lot.
- Pt spends money on diagnostic testings

65
Q

What is Illness Anxiety Disorder (Hypochondrasis)

A

Patients think they are ill with a severe disease, common in OCD people, doctor shopping may occur, fear persists despite no symptoms or reassurance they are not sick

66
Q

What is conversion disorder?

A
  • Loss or change in body function that cannot be medically explained. (Blindeness, Deafness, Paralysis, etc)
  • Labelle Indifference = Pt not concerned about severe symptoms
  • Resolves in 1-2 weeks or when anxiety is gone.
  • Results from anxiety converting to physical symptoms.
67
Q

What is Factitious Disorder? (Formerly Munchausen Syndrome)

A
  • Intentional faking of symptoms

- May harm themselves or others via proxy (Example: Mom makes child sick for attention and sympathy for herself)

68
Q

What happens in Dissociative Disorders?

A
  • Patient splits from reality and enters a fantasy-like land

- Not a conscious choice!

69
Q

What is dissociative amnesia?

A
  • Inability to recall personal information

- Brought on by severe stress

70
Q

What is dissociative amnesia with Dissociative Fugue?

A
  • Patient wanders, wakes up somewhere with no recollection of events
71
Q

What is Dissociative Identity Disorder (Multiple Personality Disorder)?

A
  • Patient has two or more personalities that exist within them
  • Personalities are unique and used as coping mechanisms
  • Results from severe trauma\
  • Patient can function normally if personalities aren’t destructive
  • Safety is highest priority, high risk of self-harm in these patients
72
Q

What is depersonalization-derealization disorder?

A
  • Depersonalization: Feelings of detachment from one’s own body, changes in self-awareness, unreal feeling in body
  • Derelization: objects in the environment are perceived as altered in size and shape, other people perceived as automatic or mechanical.
73
Q

What does the term ‘Anorexia’ mean?

A

Prolonged loss of appetite

74
Q

What is Anorexia Nervosa?

A
  • Fear of obesity and grossly distorted body image, refusal to eat
  • occurs mostly in females
75
Q

What is Bulemia Nervosa?

A
  • Binging and Purging of food
76
Q

What is a common eating disorder treatment?

A

Behavior Modification!

77
Q

Cachexia

A

Ill health, muscle and weight loss

78
Q

Steatorrhea

A

Oily, smelly stools that may float

79
Q

Amylase

A

Enzyme that converts starch and glycogen into simple sugars

80
Q

Lipase

A

Pancreatic enzyme that catalyzes breakdown of fats into fatty acids and glycerol

81
Q

Ammonia

A

Nitrogen and hydrogen, smelly colorless gas

82
Q

Hepotomegaly

A

Enlarged Liver

83
Q

Splenomegaly

A

Enlarged Spleen

84
Q

ALT Test

A

Blood test checks for liver damage (high levels = damage)

85
Q

AST Test (SGOT)

A

Blood test checks for liver damage (high levels = damage)

86
Q

Dyspepsia

A

Indigestion, pain, discomfort in upper abdomen

87
Q

BMI

A

Body Mass Index (Weight in KG divided by Hieghtin m^3)

88
Q

Albumin

A

Protein that keeps fluid from leaking out of blood vessels (Important for tissue growth, repair, nutrients)

89
Q

Cholesterol

A

Lipid molecule:

  • LDL = Bad cholesterol <189
  • HDL = good cholesterol < 150
90
Q

Edentulous

A

Tooth loss

91
Q

Refeeding Syndrome

A

Metabolic disturbance in starving patients due to the re-introduction of nutrients and electrolytes

92
Q

Overweight BMI

A

BMI of 25-29

93
Q

Obesity BMI

A

Above or equal to 30

94
Q

What does an anorectic drug do?

A

Reduces appetite

95
Q

Dumping Syndrome

A

Food moves too quickly from stomach into small bowel (usually happens after gastric bypass or stomach removal surgery)

96
Q

What are normal BUN and Creatinine levels?

A

BUN: 7-20
Creatinine: 0.6-1.3

97
Q

What are the functions of the GI System?

A

Digestion
Absorption
Elimination

98
Q

When a patient gets any type of GI testing done with contrast, what should the nurse monitor for?

A

Kidney Function

99
Q

Patients having an MRI need to complete an MRI checklist, which assures that they have no ___________ on or in them.

A

Metal

100
Q

Patients who are getting an upper or lower GI need to have a _____ diet the after midnight, the night before the test.

A

NPO

101
Q

What does an Upper GI test detect?

A

Tumors, ulcers, varicies, enteritis, malabsorption

102
Q

What does a Lower GI test detect?

A

Tumors, lesions, polyps

103
Q

What does a CT scan detect?

A

Appendicitis, Diverticulitis, Enteritis, Ulcerative Colitis, Diseases of the liver, kidney, spleen, pancreas and pelvic organs

104
Q

What does a PET scan detect?

A

Cancers! (Shows spots better than a CT scan)

105
Q

What does an EGD, or Esophagogastroduodenoscopy, detect?

A

Bleeding, Upper GI Cancers

106
Q

What does an ERCP, or endoscopic retrograde cholangiopancreatography, test do?

A

Treats problems with pancreatitis and bile ducts

107
Q

What does a colonoscopy detect, how is it performed, and what should the nurse monitor for?

A

Test used to detect cancers, remove polyps, treat bleeding, assess inflammatory bowel disease via scope inserted through rectum.

  • NPO
  • Monitor for cardiac changes/problems (Vagal Response)
108
Q

What is a PEG tube?

A

Surgically created stoma on patients stomach, used for feedings, medications, fluids

109
Q

What is parenteral nutrition?

A

Nutrients given via IV to help muscle mass, healing.

110
Q

What is bariatric surgery and what nursing care is associated with it?

A

Gastric Bypass (food skips stomach and duodenum and goes straight into jejunum) and Lap Band (decreases stomach size)

NSG Care:

  • Watch for dumping syndrome (pallor, tachy, N/V)
  • Avoid NSAIDS
  • Vitamin Replacements
111
Q

What are antihistamines/anticholinergic medications and what are some side effects?

A
  • They are antiemetics
  • Promethazine & Hydroxyzine (Antihistamines)
  • Scopolamine (anticholinergic)
  • Anticholinergic side effects include drowsiness, dry mouth, blurred vision, constipation, dry skin, hot, blinde, red pallor, Loopy
112
Q

What is a nursing consideration for the dopamine antagonist promethazine?

A

GIVE SLOWLY through IV!

113
Q

What causes dopamine antagonists to have increased CNS side effects?

A

Taken with alcohol or narcotics increases the CNS effects, avoid!

114
Q

What does the antiemetic/serotonin antagonist Ondansetron treat?

A

Emesis from Chemotherapy!

115
Q

What does the antiemetic/Cannabinoids such as Marinol treat?

A

N/V from cancer treatment, don’t use in psych disorder patients.

116
Q

What is Metoclopramide (Reglan) used for?

A

Post-Op Emesis, Chemo Emesis, GI Motility

-Headache/Sedation/Diarrhea side effects

117
Q

What are corticosteroids used for in GI?

A

Small dose for chemo emesis

118
Q

What are some osmotic laxatives and how do they work?

A
  • Max Citrate, Max Ox, Glycerin, Lactulose
  • Pull water into colon and increase water in feces
  • Can cause hypotension
119
Q

What are some stimulant laxatives and how do they work?

A
  • Bisacodyl, Senna, Castor Oil (Castro was a B.S. leader who stimulated trade bans)
  • irritates nerve endings in intestinal mucosa to increase peristalsis
120
Q

What are some bulk forming laxatives and how do they work?

A
  • Psyllium, Polycarbophil, Polyethylene glycol (Starts with P!)
  • Absorbs water into intestines to increase bulk
  • GIVE WITH WATER/JUICE, DRINK ASAP
121
Q

What are some emollient laxatives and how do they work?

A
  • Docusate, Mineral Oil
  • Docusate prevents constipation decreases straining by increasing water absorption. Stool softener
  • Mineral Oil lubricates!
122
Q

What are antacids and what do they do?

A
  • Sodium Bicarb, Calcium Carb, Mag Hydrozide, Aluminum Hydrox)
  • Neutralize hydrochloric acid in stomach
  • take 1-3 hours AFTER meals
123
Q

What are H2 blockers and what do they do?

A
  • cimeTIDINE, famoTIDINE, RaniTIDINE
  • reduces gastric secretions and concentration
  • take before meals
124
Q

What are PPIs and what do they do?

A
  • omePRAZOLE, esomePRAZOLE, pantoPRAZOLE, LansoPRAZOLE
  • PP = Prazole!
  • suppresses gastric secretions better than H2 blockers, has worse side effects though
  • take BEFORE meals
125
Q

What is Sulcrafate and what does it do?

A
  • Pepsin inhibitor
  • Covers and protects the ulcer, does not neutralize or decrease acid
  • give on empty stomach
126
Q

What is Misoprostol and what does it do?

A
  • supresses gastric seceretions, increases protective mucosa
  • CATEGORY X IN PREGNANCY
  • Give if patient is on long term NSAIDs

Nursing Process 2 (2 decks)

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