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exam 3 Flashcards

1
Q

what three vaccines do people need to prevent meningitis?

A

Haemophilus influenza type b, PPSV, meningococcal

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2
Q

signs and symptoms of meningitis

A

-excruciating headache, stiff neck, photophobia,
-positive kernig (pain with extension of leg), and brudzinski (flexion of knees and neck)
-tachycardia, red macular rash,hyperctive deep tendon reflexes,

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3
Q

what would show up on lab tests?

A

-high cbs, and protein, and decreased glucose

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4
Q

precaution for meningits

A

-isolate the client; droplet
-maitain bed at 30 angle
-avoid coughing and sneezing cause it could increase ICP

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5
Q

COPD is a combo of what?

A

emphysema (damage to alveoli) and chronic bronchitis

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6
Q

what two vaccines should a person have if they have copd?

A

influenza, and pneumonia

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7
Q

signs and symptoms of copd

A

-productive cough (especially in morning), barrel chest, hyper resonance,dependent edema due to RHF,clubbing of fingers
-high hematocrit, 88-92% O2 sat

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8
Q

bronchodilators

A

SABA (albuterol),
anticholinergic meds (ipratropium)
methylxanthines (theophylline): watch out for toxicity, causing tachycardia, nausea,

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9
Q

antiinflammatories for copd

A

-corticosteroids: prednisone, causing fluid retention, poor wound healing
-leukotriene antagonists: montelukast,
-report if black stools

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10
Q

tuberculosis

A

-caused by mycobacterium (airborne)
-appears aas round nodule, slow onset

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11
Q

Risk factors of tuber

A

-immigrantion, health care workers, immunocompromised

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12
Q

signs and symptoms of tuberculosis

A

-purulent sputum, sometimes bloody, night sweats, weight loss, persistent cough, low grade fever

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13
Q

patient care tuberculosis

A

heat and humidified air, negative airflow room, eat foods in vitamin c and b

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14
Q

meds for tuberculosis

A

-isoniazid:watch for hepatoxicity, take with vitamin b 6,
-rifampin: urine might be orange, jaundice, discoloration of contacts,
-pyrazinamide:report yellowing of skin, and drink with water

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15
Q

what are some risk factors with pulmonary embolism?

A

-hypercoagulability, sickle cell, HF,surgery, cancer

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16
Q

signs and symptoms of PE

A

-tachycardia, hypotension, sweats, pain upon inspiration, distended neck veins, heart murmur,petechiae
-prolonged: metabolic acidosis

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17
Q

meds for PE

A

-heparin,warfarin
-rivaroxaban,apixaban
-altePLASE,retePLASE

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18
Q

client education for PE

A

-use electric shavers and short bristle toothbrush
-avoid aspirin
-check mouth for bleeding

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19
Q

Classes of HF
-class I
-Class II
-Class III
-Class IV

A

-has cardiac disease but no manifestations
-has manifestations with everyday adls
-manifestations happen with minimal exertion
-manifestaitons happens at rest

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20
Q

risk factors of left and right sided heart failure

A

-left:hypertension, MI, angina
-right: LHF,pulmonary problems

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21
Q

T or F
pink frothy sputum happens in right sided HF

A

FALSE

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22
Q

T or F
BNP level higher than 200 equals HF

A

-false it has to be higher than 400, less than 100 means no HF

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23
Q

what types of meds are used in HF?

A

-diuretics,afterload reducing agents, inotropic agents, beta blockers, vaso dilators, anticoags

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24
Q

diuretics

A

-loop: furosemide, bumetanide
-hydrochlorothiazide, spironolactone
-loop and hydro can cause hypokalemia

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25
after loading agents
ACE inhibitors: enalapril ( can cause dry cough) -ARB: losartan -calcium channel blockers:diltiazem -these help heart pump easier by easing up the resistance
26
inotropic agents
-digoxin, dopamine -increase contractility -hold if apical pulse is less than 60, no taking with antacids
27
vasodilators
-nitroglycerin: reduce pre and after load -used to treat angina
28
acute pulmonary edema and pulmonary edema
-signs:tachycardia, altered LOC,pink frothy sputum, reduced urine output, high pulmonary vascular pressure -treated with diuretics,MORPHINE, vasodilators
29
which anemias are due to last oc dietary intake?
-iron, folic, and vitamin b12
30
Aplastic anemia
-exposure to radiation -causes fewer RBCs
31
T or F GI bleeding is the most common cause of anemia in older patients
true
32
expected findings in anemia
-fatigue, numbing in extremities, sensitivity to cold, spoon shaped nails, SOB
33
- size of red blood cells is what?
mean corpuscular volume
34
vitamin c helps absorb what better?
iron
35
vitamin B12 administration orally vs injection
-orally: is only when its due to inadequate dietary intake -injection: is when person doesnt have make intrinsic factor to absorb itl
36
folic acid is a ___ vitamin, -large doses of folic acid can mask what
-its water soluble - can mask vitamin b12 deficiency;
37
-excessive loss of what causes hypovolemia?
- GI loss, skin loss, renal system loss -aslo altered intake
38
findings of hypovolemia vs hypervolemia
-hypo: hypotension, tachycardia, hypothermia, tachypnea , dizziness, furrowed tongue, N/V, oliguria -hyper:tachycardia, hypertension, boundingg pulse, visual changes , ascites, liver enlargement , peripheral edema
39
lab tests hypo vs hypervolemia
-in hypo everything is increased while hyper everything is decreased
40
complications of hypovolemia
hypovolemic shock -mean arterial pressure drops, -admin O2,give colloids (whole blood, plasma), crystalloids (lactated ringers) -admin vasoconstrictors
41
risk factors for osteoarthritis
-aging, joint injury, obesity, diabetes and blood disorder -its progressive deterioration of articular cartilage
42
signs and symptoms
-crepitus,hypertrophy of joint, heberden nodes (distal), bouchard node (proximal), not symmetrical, limping gait
43
for patients with osteoarthritis, you need to check up on the psychosocial impact it has on their life
44
client education for OA
-heat for joint tenderness, cold for inflammation, lose weight, and make sure to rest
45
meds for OA
-acetaminophen, NSAIDs, opioids, muscle relaxants
46
HIV
-virus that attacks CD4 (T cells), platelets are also low -signs: fever night sweats, muscle aches, rash -can be dormant
47
when HIV finally makes it to being AIDS what is the CD4 count?
-less than 200; this is when there's opportunistic infections -end stage
48
what vaccines do HIV people need?
influenza, and pneumococcals
49
what are some risk factors for HIV?
-sex , blood transfusions, using dirty needle
50
nursing care for HIV
-monitor electrolytes, pain, vital signs (temp), skin integrity, neuro status
51
patient care for HIV
-good hygiene, no raw foods (vegetables, fruits), avoid crowded area, avoid cleaning pet litter, wash dishes in hot water
52
HIV meds
deals with preventing the DNA of the virus to integrate into the humans DNA
53
-chronic inflammation and destruction of healthy tissue -body makes antibodies that attack the healthy tissue
-lupus
54
what tests confirms a patient has HIV?
-a western blot and an ELISA
55
what is systemic lupus erhythematosus?
- this is when it starts to affect the connective tissues of multiple organ systems
56
signs and symptoms of lupus
-alopecia, weight loss, blurred vision, pleuritic pain, joint pain, raynauds phenomenon, butterfly rash
57
Nursing care for Lupus
-assess for systemic manifestations such as hypertension, edema, dimisniehd breath sounds, tachycardia, cyanosis, change in mental status
58
meds for lupus include -immunosuppressants , antimalarial and what
-corticosteroids and NSAIDs
59
client education for lupus
-avoid UV light, protect skin , use lotion, report edema, avoid crowds, mild soap , avoid drying agents to skin
60
difference between OA and RA
-RA is a chronic AI disease that causes inflammation of the synovial fluid in joints and can affect cartilage, bone, and blood vessels,s
61
RF and symptoms for RA
-environment, stress, older age, genetic, -morning stiffness, pleuritic pain, pain at rest, paresthesias, reddened sclera
62
lab tests for RA
-high ESR, high WBCs, + ANA
63
Nursing care and meds for RA
-monitor skin, encourage physical activity, monitor for low WBCs, -NSAIDS; watch for GI distress, take with food/milk, or use proton pump inhibitors -corticosteroids: can cause hyperglycemia, immunosuppression, cataracts and osteoporosis
64
hypercalcemia is seen in what type of cancer patients?
-those who have multiple myeloma and breast cancer
65
name some complications of cancer
-anorexia, lymphedema (causes decreased ROM),sleep disturbances, delirium, oral ulcers, constipation,neutropenia
66
superior vena cava syndrome
-tumor is compressing the SVC which causes bad blood flow, causing backup of fluid ie edema, specifically in face, also hoarse voice, shoulder pain, SOB, change in color of extremities -meds are steroids and chemo
67
what is the most common breast cancer?
ductal breast cancer; these can have estrogen receptors or progesterone precepts
68
what is the process of cancer cells?
-hyperplasia, dysplasia, and carcinoma in situ
69
RF for breast cancer
-age, genes, obesity , dense breast tissue, increased estrogen exposure (late menopause or early puberty)
70
Signs of breast cancer
-breast swelling, nipple discharge, nipple retraction, skin changes,
71
side effects of prostate cancer
-bladder leakage, fecal incontinence, increased frequency, weak stream, hot flashes , bladder spasm
72
treatments for erectile dysfunction
-medications,vacuum devices and penile implants
73
biphosphates are given to people whose prostate cancer has spread to bone
74
squamous cell carcinoma
-comes from keratinizing cells, sun exposure -high in patients who've done radiation -smooth, raised, pearly, firm, waxy, scaly, red brown
75
common manifestation in brain tumors
seizures, N/V,behavior changes, drowsiness, come , hearing loss, weakness numbness and difficulty swallowing
76
brain tumors
-stop anticoagulant/antiplatelets, CT/MRI scan, monitor for clear drainage , high priority mental status, elevated intracranial pressure, pain, risk of falls, diuretics and corticosteroids decrease intracranial pressure

Med Surg (6 decks)

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