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Acute > Final > Flashcards

Final Flashcards

1
Q

Orthostatic intolerance

A

Plasma volume loss and pooling in LE when upright -> exaggerated HR and decreased diastolic filling

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2
Q

Cardiac output

A

Stroke volume x HR

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3
Q

Stroke volume

A

Volume of blood ejected during each heartbeat

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4
Q

Cardiovascular effects of bed rest

A

Reduced cardiac output due to reduced volume, increased venous compliance, orthostatic intolerance, increased resting HR

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5
Q

DVT Virchows triad

A

Venous stasis (pooling), vessel trauma, hypercoagulability

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6
Q

Pulmonary Embolism

A

Peripheral clot that dislodges and goes to lungs. Symptoms are dyspnea, chest pain, coughing

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7
Q

Pulmonary effects of prolonged bedrest

A

Decreased strength and endurance of ventilatory muscles, increased RR and work of breathing, pneumonia risk due to pooling of mucus

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8
Q

Gastrointestinal effects of prolonged bedrest

A

Decreased appetite and fluid intake, constipation due to decreased motility of small intestine in supine

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9
Q

Urinary effects of prolonged bedrest

A

Excretion of sodium in urine causing decreased blood volume, increased risk of UTI, trouble voiding

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10
Q

95% of pressure injuries occur where?

A

Heels, sacrum, ischial tuberosities, back of head,

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11
Q

Delirium

A

Can be Due to prolonged bedrest, meds, anesthesia. Can be hyperactive, hypoactive, or a mix

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12
Q

Blood pressure normal vs not

A

120/80. Stage 1 hypertension 140/90, stage 2 160/100

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13
Q

Hypervolemia

A

Fluid imbalance causing fatigue and SOB

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14
Q

Hypovolemia

A

Fatigue and elevated HR

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15
Q

Sodium

A

Fluid balance and muscle contractions

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16
Q

Hypernatremia

A

Too much sodium. Irritable, tachycardia, seizure, coma
Hold at >150

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17
Q

Hyponatremia

A

Too little sodium. Lethargy, seizure, coma.
Hold at <125

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18
Q

Potassium

A

Skeletal and cardiac muscle contractions

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19
Q

Hyperkalemia

A

Weakness, bradycardia, cardiac arrest, numbness/tingling, paralysis
Hold at >5.1

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20
Q

Hypokalemia

A

Weakness, cramps, cardiac arrest, arrhythmias
Hold at <3.2

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21
Q

Calcium

A

Bone and cell growth

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22
Q

Hypercalcemia

A

Arrhythmia, weakness, poor tolerance

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23
Q

Hypocalcemia

A

Anxiety, confusion, cramps
Hold at <6.0

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24
Q

Chloride

A

Associated with sodium for fluid balance

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25
Q

Hyperchloremia

A

Lethargy, tachycardia, weakness

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26
Q

Hypochloremia

A

Irritability, cramping, twitching

27
Q

CO2

A

Elevated= acidosis and elevated pH: lethargy
Decreased= alkalosis and decreased pH: confusion and dizziness

28
Q

Platelets

A

<5000= bed rest

29
Q

Hemoglobin

A

Binds and transports O2 in RBCs
High= clogging
Low= heart failure

30
Q

Hematocrit

A

Percentage of red blood cells in total blood
Assesses blood loss and fluid balance

31
Q

Tracheal

A

Over trachea, high pitched, 1:1

32
Q

Bronchial

A

Over manubrium, 1:2

33
Q

Bronchovesicular

A

Between scapulae, 1:1

34
Q

Vesicular

A

Most commonly heard, mostly hear inhale
3:1

35
Q

Stage 1

A

Skin intact, nonblanchable redness

36
Q

Stage 2

A

Pink, painful, partial. Through to dermis with no slough

37
Q

Stage 3

A

Through to subcutaneous, crater with or without undermining/tunneling, slough

38
Q

Stage 4

A

Through to bone, muscle, tendons. Includes slough or eschar

39
Q

Deep tissue

A

Discolored intact skin, mushy or boggy feel

40
Q

Unstageable

A

Full thickness loss covered by slough or eschar, tan green black brown

41
Q

Symptoms of arterial insufficiency

A

Ur or of dependency, elevations of pallor, weak or absent pulse, cool, hairless, shiny, intermittent claudication

42
Q

Tests for arterial insufficiency

A

Elevation- between 25- 60 sec. No pallor is is normal
Rubor- in 15-30 turns bright red
Pulses- 0-4. 0= absent, 2= normal
Cap refill- takes longer than 3 sec
Claudication- scale 0-4. Exercise should cease at 2

43
Q

Venous insufficiency symptoms

A

Peripheral edema, hemosideran staining, venous stasis ulcers (moist and irregular)

44
Q

Venous testing

A

Pitting edema- scale 0-4. 1 = 0-15 sec. 4 = >60 sec
Calf girth measurement
Venous fill time

45
Q

DVT presentation

A

Swelling and pain
Redness and warmth
Low fever
Dull ache

46
Q

Wells CPR for DVT

A

Cancer
Bedridden
Paralysis
Swelling of leg
Localized tenderness
Calf swelling
Pitting edema

47
Q

Hip precautions

A

No flexion past 90
No IR
No adduction
All for 3 months, but avoid combo for life
Causes dislocation

48
Q

Spine

A

No bending or twisting
No lifting more than 10 lbs
2-6 weeks

49
Q

Fractures

A

No precautions other than WB
A lot of the time is WBAT for bone regrowth

50
Q

Compartment syndrome

A

Swelling leads to occlusion of blood flow in compartment
Can lead to necrosis within 4-12 hours

51
Q

General anesthesia

A

Fully under and ventilated, complications are nausea and sore throat
Requires more monitoring

52
Q

Regional anesthesia

A

Spinal and epidural (stays in place) and nerve block
Numbed from waist down typically

53
Q

Abdominal surgery precautions

A

Log roll
Avoid extension/flexion
No lifting more than 10 lbs

54
Q

Complications for cardio thoracic surgery

A

Pulmonary: atelectasis, lung collapse, pneumonia
Bleeding, hemorrhaging, infection

55
Q

Interventions after thoracic or abdominal surgery

A

Coughing, breathing, splinting, ROM, positioning, mobility

56
Q

Sternal precautions

A

No pushing/pulling
Lifting >10 lbs
No full abduction arm
No full extension arm
No driving for 4 weeks
12 weeks for bony callus

57
Q

Palliative care

A

Holistic and life sustaining
See pt though to end of life or to transition to hospice

58
Q

Hospice

A

Focused on comfort
>6 months and signed into transition

59
Q

Full code

A

All life saving/sustaining measures

60
Q

DNI (limited code)

A

Do everything one can except for intubation

61
Q

DNR (no code)

A

No life saving or sustaining measures

62
Q

Advanced directive

A

Living will
States what pt wants at end of life
What kind of code? Etc

63
Q

Health care proxy

A

Designated person that will make healthcare decisions for you once you are unable to
If no one is designated then next of kin or court appointed guardian takes over

Acute (1 decks)

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