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1. Health Alterations > Final > Flashcards

Final Flashcards

1
Q

Anaphylaxis- intraop

A
  • SS: HoTN, tachycardia, bronchospasm, pulmonary edema

- Tx= recognize SS, maintain airway, 100% O2, epinephrine IV, maintain BP with fluids or meds, Benadryl IV

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2
Q

malignant hyperthermia - intraop

A

-SS early: tachycardia, rising BP, tachypnea, muscle rigidity
-SS late- increased temp, increased metabolic rate, HoTN, muscle rigidity, cyanosis
Tx- stop procedure, 100% O2, cool PT
Med- dantrolene sodium, diuretics, bicarb

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3
Q

metabolic syndrome

A
  • cluster of 5 components:
    1. elevated glucose levels
    2. abdominal obesity
    3. increased triglycerides
    4. Decreased HDLs
    5. HTN
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4
Q

T1DM 3 Ps

A
  • polydipsia, polyuria, polyphagia (hungry)
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5
Q

3 methods of diagnosis for DM

A
  1. fasting plasma glucose level > 126 mg/dl
  2. random or casual plasma glucose measurement ≥ 200 mg/dl + SS ( 3 Ps or others)
  3. Two-hour OGTT level≥ 200 mg/dl using glucose load of 75 g
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6
Q

rapid acting insulin

A
  • basal, bolus-
  • Lispro , aspart, glulisine
  • injected 0 -15 minutes before meal
  • onset : 15 min
  • Peak: 60-90 min
  • Duration- 3-4 hrs
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7
Q

Short-acting bolus insulin

A
  • reg
  • injected 30-45 min before meal
  • Action: 30-60 min
  • 2-3 hrs
  • duration: 3-6 hrs
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8
Q

intermediate acting insulin

A
  • NPH or Lente
  • injected 1 or 2 X a day
  • onset : 2-4 hrs
  • peak: 4-10
  • duration: 10-16
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9
Q

long-acting basal

A
  • Lantus or Levimir
  • injected once a day at bedtime or in morning
  • released steadily and continuously
  • onset: 1-2 hrs
  • no peak action
  • duration: 24 + hrs
  • cannot be mixes with any other insulin
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10
Q

Storage of insulin

A
  • do not heat/freeze
  • in-use vial may be left at room temp up to 4 weeks
  • extra insulin should be refridgerated
  • avoid exposure to direct sunlight
  • prefilled syringes stable for 30 days when refridgerated
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11
Q

sulfonylureas

A
  • T2DM
  • increase insulin production in the pancreas
  • 10% experience decreased effectiveness after prolonged use
  • ex. Glipizide, Glimepiride
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12
Q

Meglitinides

A
  • increase insulin production from pancreas
  • taken 30 min before meal , don’t take if meal skipped
  • ex. Repaglinide, Nateglinide
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13
Q

Biguanides

A
  • reduce glucose production by liver
  • enhance insulin sensitivity at tissues
  • improve glucose transport into cells
  • do not promote weight gain
  • Metformin: hold 24 hrs before/after use of IV contrast
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14
Q

a-glucosidase inhibitors

A
  • starch blockers
  • slow down absorption of carbs in sm intestine
  • Acarbose, Miglitol
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15
Q

Meds that impact BGM

A
  1. B-adrenergic blockers- mask SS of hypoglycemia or prolong effects
  2. thiazide/loop diuretics- potentiate hyperglycemia by inducing K+
  3. corticosteroids- can potentiate hyperglycemia
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16
Q

Hypoglycemia

A 
-BGM < 70
CMs:
-confusion, irritability, pale and diaphoretic
-weakness
-tremors
-hunger
-visual disturbances
-unTreated: Loss of C. seizures, coma, death
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17
Q

at first sign of hypoglycemia, the nurse should

A
  • Check BGM

- if <70 start treatment

18
Q

Hypoglycemia Rule of 15

A
  • 15 g of simple carbs
  • recheck BGM 15 min after tx
  • repeat 15 g carbs X2 until BGM > 70
  • Call EMS if not responding after 3X
  • follow up with longer acting carbs to avoid rebound hyperglycemia
  • check BGM again after 45 minutes after Tx
19
Q

thyroid blood levels , hyperthyroidism

A

decreased TSH + increased T3 and T4

20
Q

thyroid blood levels, hypothyroidism

A

increased TSH + increased T3 and T4

21
Q

hyperthyroidism CM

A

-graves, goiter
- increased metabolic rate
- weight loss, nervousness, sleep disturbances
- hair loss
-poor intolerance to heat
-excessive perspiration
- exopthalmos
-tachycardia
Tx- antithyroid, iodine, B adrenergic blockers

22
Q

signs of hypoglycemia

A
  • Chovsteks

- Trousseau’s

23
Q

hypothyroidism SS

A
  • congenital:cretinism
  • acquired: Hashimoto’s-autoimmune
  • SS: weight gain, fatigue, lethargy, forgetfulness, irritability, HAs, constipation, menstrual disorders, numbness, tingling in arms & legs, intolerance to cold
24
Q

hypothyroidism Physical Exam

A
  • swollen eyelids & lips
  • dry thick skin
  • goiter
  • bruising
  • thin, coarse hair
  • hoarseness
  • non-pitting edema
  • facial edema/ myexedema
  • bradycardia
  • dyspnea
  • pallor
  • anemia
25
Q

Aldosterone regulates….

A

Sodium!

26
Q

Anti diuretic hormone regulates….

A

Water !

27
Q

Sickle cell crisis

A 
HOPS
Hydration
Oxygen
Pain management
Support
28
Q

thrombocytopenia

A
  • platelet < 150k
  • other labs
  • Bone marrow aspiration
  • ITP positive antigen
29
Q

Blood therapy reaction plan

A
  • STOP TRANSFUSION
  • IV access
  • ABCs
  • frequent VS
  • Call MD
  • Notify blood bank/save bag
  • 24 hour urine-why? evaluate hemolysis
30
Q

SS local inflammation

A 
FIRE
Feeling pain
Induration
Redness
Edema
31
Q

cortisol

A
  • from adrenal gland

- helps body control inflammation

32
Q

IgG

A

viruses, bacteria, fungi

33
Q

IgM

A

ABO/blood type

34
Q

IgA

A

breast milk

35
Q

IgE

A

allergic reactions and parasitic

36
Q

IgD

A

Assists in differentiation of B-cells

37
Q

HIV SS

A
  • frequent persistent infections
  • fever
  • night sweats
  • swollen lymph nodes
  • fatigue
  • weight loss
  • peds: lymphadenopathy, hepatosplenomegaly, oral candidiasis, chronic recurrent diarrhea, failure to thrive, developmental delay
38
Q

stages of cancer developmetn

A
  1. initiation- taken over
  2. promotion-mutated cell proliferating
  3. Progression- now have SS of disease process (fatigue, anorexia, weight loss)
39
Q

TNM classification

A

anatomic extent of disease is based on 3 parameters:

  1. Tumor size and invasiveness (T)
  2. Spread to lymph nodes (N)
  3. Metastasis (M)
40
Q

7 warning signs of cancer

A 
CAUTION
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge from any body orifice
Thickening or a lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
41
Q

TB SS

A
  • cough
  • night sweats
  • chest pain & tightness
  • fatigue
  • anorexia
  • weight loss
  • low-grade fever
42
Q

TB confirm DG

A

Sputum culture AFB

1. Health Alterations (11 decks)

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