Final Flashcards by Krissa Thrift

What test it looked at for warfarin and what are the levels?

PTNINR

6-11.8 sec males
5-11.3 females

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Nervousness, neadache, weakness, irritability, huger, blurred vision are all S/S of what

Hypoglycemia

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polydipsia, polyphagia, polyuria, nausea, abdominal pain, flushed dry skin, fruity breath

Hyperglycemia

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Fasting blood glucose

draw 8 hr after fasting
126 or higher = diabeties
100-126 = prediabeties

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Random glucose

measures blood sugar at intervals after pt drinks a concentrated carbohydrate drink. Blood glucose 200 or higher after 2 hrs =diabeties. 140-199 at 2 hrs is prediabeties

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HGA1C

Normal: 5.7%
Prediabetic: 5.7-6.5%
Diabeties: 6.5% or higher

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food considerations for diabetics

Limit sweet desserts
Prefferably six meals per day, with three major meals and three snacks
Complex carbs with cellulose such as whole grains and legumes
Carbs makin gup 50% or less of the meal

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How is diabeties tx in pregnant women?

Tx with weight loss and exercise and drinking more water. If not controlled then insulin will be considered.

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Toxic Dig level and when to draw

0.5-2ng/mL serum dig levels drawn 6-8 hr after admin

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Digioxin toxicity for older adults

Abd pain, anorexia, vomiting, visual distrubances, bradycardia, and other arrythmias.

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Dig toxicity in infants

Cardiac arrhythmias

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Why are electrolytes important when taking

Digioxin?

Monitor electrlytes esp K, Mg, Ca, renal and hepatic function. DO not admin if pt is hypokalema, hypomagnesemia, hypercalcemia= graeter risk for toxicity.

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Hypocalcemia

muscle cramps, tetany, low BP, tingling and numbness in fingers/toes, bronchospasm, high DTR, prolonged qt intrevals.
Causes- inadequate vitamin D, pancreatitis, alkalosis, hypothyroidism, metabolic disorder.

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Hypercalcemia

constipation, anorexia, nasuea, vomiting, polydipsia, lethargy, low DTR, bone fracture w/o injury, confusion, slurred speech
Causes- prolonged bedrest, excessive vitamin D, Cancer, metabolic disorder, excessive serum levels.

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Trust vs mistrust

birth-18 months

learn to trust othrs

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Autonomy vs Shame/doubt

18 months- 3 yrs

learn self control and ability to express onself and cooperate

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Initiative vs Guilt

3-5 yrs

Initiate activities and influence environment

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Industry vs inferiority

5-12 yrs

Develop sense of social skills and self esteem

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Identity vs. role confusion

12-18 yrs

Seek sense of self an plan according to one’s abilities

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Intimacy vs Isolation

18-40 yrs

Develop intimate relationships and choose a career

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Generativity vs Stagnation

40-65 yrs

become a productive member of society and establish a family

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Integrity vs. Despair

65+ yrs

Accept worth, uniqueness and death

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Major considerations for Estrogen patch

fluid retention, thrombolic disorder, mental depression, or hepatic dysfunction

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Test for heparin

aPTT 30-40 sec

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Leukocytosis

increased WBC

Leukopenia

Decreased WBC

Normal WBC levels

4,500-11,00 | increase with infection

Esinophils | Increases why?

2.7% | increases in allergry response some leukemias

Basophils | Increases with why?

0.5% | increase in hyperthyroidism some bone marrow disorders ulcerative colitis

Lymphocytes | Increases why?

34% | increases with viral infection, chronic bacterial infection, some leukemias

Monocytes

4% | Increase in chronic inflammatory disorders, some leukemia

Pulse

60-100 bpm

Temp

97-99.6 F

Resp

12-20

100/60-120-80

S/S of iron toxicity (think children)

stomach pain, fever, nausea, vomiting, diarrhea

Foods to avoid when taking iron suppluments

milk, calcium, antacid, coffee, tea, eggs, whole grain breads

Correct angle for an IV

10-15 degree angle

How high up should the IV be from the IV site

4-8 in

physiological causes of Erectile dysfunction

stress, anxiety, depression, fatigue

Psychological issues that cause erectile dysfunction

kidney failure, pyreonic disease, low testosterone, diabeties, sleep apnea, heart disease, athreloctis, stroke, metabolic syndrome, spinal chord, metabolic syndrome, spinal chord injury, parkinson, MS, life style (alcohol, smoking, drugs

Medications that can cause Erectile dysfunction

HTN and CV meds

Heparin antidote

Protamine sulfate

Test for heparin

APTT

APTT range

60-80 sec

What to report when taking heparin

Unsual bleeding, bruising, black tarry stools, hematuria, falls w/ injury. Fever, chills, urticaria

How often should platelets be checked when taking heparin

2-3 days

Normal Hematocrit range

38. 6-48.6 men | 35. 5-44.9 women

``` My Pretty Kitty CAn CLimb Nicely ```

``` Mg: 1.6-2.2 Phos: 2.5-4.5 K: 3.5-5.3 Ca: 8.2-10.2 Cl: 97-107 Na: 135-145 ```

S/S Hypocalcemia

muscle cramps, tetany, low BP, tingling and numbness in fingers/toes, bronchospasm, high DTR, prolonged qt intrevals.

Positive trousseau’s and chvosteck’s sign =

Hypocalcemia

S/S Hypercalcemia

constipation, anorexia, nasuea, vomiting, polydipsia, lethargy, low DTR, bone fracture w/o injury, confusion, slurred speech

Causes of Hypercalcemia

prolonged bedrest, excessive vitamin D, Cancer, metabolic disorder, excessive serum levels.

Causes of Hypocalcemia

inadequate vitamin D, pancreatitis, alkalosis, hypothyroidism, metabolic disorder.

What to expect in pt's who are chronically hypocalcemic

commonly have poor digestive absorption (anorexia, or inflammatory bowel disease). Loss of bone and high blood pressure. Osteoperosis.

Calcium rich foods

``` almond (milk/nuts) calcium fortified foods canned salmon/sardines cheese cream soups (with milk) greens: collard/mustard/turnip kale milk soy (beans/milk) spinach tofu yogurt ```

phenytoin major considerations

Major considerations- suicidal ideation, cardiac arrest, DRESS, Steven-john syndrome, arganulocytes, acute hepatic failure, angioedema, hypotension, ataxia, bradycardia

Lying on the left side in semiprone position with right leg flexed up and drawn up toward the chest; left arm is positioned along the pt's back

Left sims

What is left sims used for?

Rectal examination and enemas

Lying on right side in semi prone position with left leg flexed; right arm is positioned along the pt's back

right sims

What is the purpose pf the right sims position?

To relieve pressure on bony prominences of coccyx and sacrum

Head of bed elevated 90 degrees | To eat and drink without risk of choking

High fowlers

What is the purpose of high fowlers

To assist patients who have difficulty breathing

Lying on back with knees flexed above the hips and legs supported in stirrups

lithotomy

WHat is the purpose of the lithotomy position?

For vaginal examinations, delivery of neonate, pelvic and gynecological surgery and procedures

Lying on the back with arms at sides, legs apart, knees bent, and feet flat on the bed

Dorsal recumbant

What is the purpose of dorsal recumbant

Physical examination of abd, genitalia, perinial care, examination during labor

Erythema of intact skin = what stage pressure injury

Partial thickness loss and exposed dermis = what stage pressure injury

full-thickness loss involving damage to the epidermis, dermis and subcutaneous tissue but not involving muscle or bone. Undermining tunneling may be seen in this stage. = what stage pressure injury

stage 3

full-thickness skin and tissue loss, only it involves deep tissue necrosis of muscle, fascia, tendon, joint capsule and sometimes bone. Maybe tunneling and undermining. = what stage pressure injury

Eschar is black, brown, or tan dead tissue that has a leathery appearance. Impossible to accurately stage due to the wound bed being obscured by eschar or excessive slough. = what stage pressure injury

unstageable

These are S/S of what? None or acute retroviral syndrome. CAn have an asymptomatic phase. Immune system impairment (fever, dyspnea, weightloss, fatigue, night sweats, persistent diarrhea, oral or vaginal candidiasis ulcers, dry skin, skin lesions, peripheral neuropahy, shingles, dementia CD4 T-Lymphocyte count below 200 or opportunistic infections and diseases occur

HIV/AIDS

Diagnostic test for HIV/AIDS

``` HIV antibody/antigen combination immunoassay nucleic acid test antibody differentiation immunoassay CBC/lymphocyte count CD4 T-Lymphocyte count Viral load testing Genotyping ```

Theraputic measures for HIV/AIDS

CCR5 Agonists Fusion inhibitors Integrase inhibitors Non-nucleoside reverse transcriptase inhibitors Nucleoside reverse transcriptase inhibitors Post attatchment inhibitors protease inhibitors

Complications associated with HIV/AIDS

AIDS wasting syndrome Opportunisti infections and cancer AIDS dementia complex

What are these S/S associated with? Conjunctivitis. Men: epididymitis, prostatitis Women: MPC, Urethritis

Chlamydia

Dx test for Chlamydia

NAAT culture, urine

Complications of Chlamydia

Fits-hugh-curtis sydnrome, increased susceptibility to HIV infection, PID, Infertility, transmission to baby at birth, co-infection with gonorrhea

What are these S/S associated with? Vesicles/ulcerations in mouth, genitals, flu-like symptoms, lymphadenopathy urethritis, cystitis, MPC

Herpes Simplex

Dx test for herpes simplex

Culture, western blot, ELISA

Complications of herpes simplex

Life long infection, dissminated infection, nervous system invasion, increased risk of cervical cancer, transmission to baby at birth

S/S of primary Syphilis

Chancre

S/S of secondary syphilis

flu-like symptoms, rashes, condylomatous growths

Tertiary Syphilis

gumma damage to the heart, circulatory system, nervous system; transmission to fetus during pregnancy

Dx testing for syphilis

VDRL test, ELISA, RPR test, FTA-ABS

criminal laws

Law that protect the public or society

Tort

A violation of a civil law, involves a wrong against an individual or his or her property

Civil law

The individual or personal rights guaranteed by federal law such as the constitution and the Bill of Rights.

Defendant

The individual or personal rights guaranteed by federal law such as the constitution and the Bill of Rights.

Maslows in order

``` Physiological Safety and security Love and belonging Self-esteem Cognitive Asethetic Self actualization Transcendence ```

Timing for taking iron supplement and take it with what?

Admin 1 hour before meal or 2 hrs after meal w/full glass of water or juice.

Vitamin K foods

``` asparagus beet greens broccoli brussel sprouts cabbage collard greens dandelion leaves garden cress green tea leaves kale mustard greens parsley spinach swiss chard turnip greens ```

Coumadin antidote

Vitamin K

With hold a beta-bocker if...

Pulse is less than 50

With hold Digioxin if...

less than 60 bpm in adults, less than 70 bpm in a child, or less than 90 bpm in an infant.

Muscle weakness, flaccid, ABD distention, decreased deep tendon reflexes, Orthostatic hypotension, Urinary retention, Cardiac dysrhythmias, if caused by digoxin toxicity, client may report seeing yellow halos around objects These are all S/S of what?

Hypokalemia

Slow pulse, hypotension, restlessness, irritability, weakness, paresthesia, dysrhythmias, increased motility, diarrhea, hyperactive bowel sounds, nausea, abdominal cramping. Metabolic acidosis w/kidney failure Muscle weakness, flaccid, Cardiac dysrhythmias • Can lead to cardiac arrest These are all S/S of what?

Hyperkalemia

hypothermia, tachycardia, thready pulse, hypotension, tachypnea, hypoxia, dizziness, syncope, confusion, dry mouth, thirst, weight loss, oliguria, cool clammy skin, flattened veins, poor skin turgor, seizures. These are all S/S of what?

Hypovolemia

ABG values

PH 7.35 -7.45 PACO2 35-45 HCO3 22-26

PH values

7.35-7.45

PACO2

35-45

HCO3

22-26

(Ph greater than 7.45) - Vomiting, NG TUBE Suctioning, Bulimia, Renal disease.

Metabolic alkalosis

(Ph under 7.35) – diarrhea, renal disease, small intestine, surgery, laxative abuse

Metabolic acidosis

(PH greater than 7.45) – Hyperventilation

respiratory alkalosis

(PH under 7.35)- COPD, sleep apnea, opioid toxicity, asthma, anesthesia

Respiratory acidosis

Nagel's rule

Subtract 3 months, add 1 year and 7 days.

Reassuring fetal heart tones

normal heart rate, good variability, acceleration 15 bpm for 15 sec is a good sign.

Dyspnea, Rales (crackled), Orthopnea, Weakness/fatigue, Nocturnal paroxysmal dyspnea, Increased HR, nagging cough (frothy, pink tinges sputum), Gaining. Weight (2-3. Lbs a day), hypotension, s3 gallop. S/S of what?

Left sided heart failure

Swelling of the legs and hands, Weight gain, Edema, Large neck veins (JVD), Lethargy/fatigue, Irregular heart rate, Nocturia, Girth (Ascites), Hepatomegaly, Splenomegaly, Anorexia. Are S/S of what?

Right sided heart failure

Final Flashcards

(111 cards)