Final Blueprint (Josh) Flashcards
Possible TNM cancer staging.
T0 - T4
N0 - N3
M0 - M1
***T4 N3 M1 is worst dx you can have
Burns:
We want to promote adequate nutrition because BMR can increase by —
40 - 100 percent
Brachytherapy:
Limit visitors to no more than — a day and they must stay – away.
30 mins
6 feet
***no preggos or kids below 16
Preventing MRSA
Hand hygiene
Avoid close contact with those with infectious wounds
Avoid large crowds
Avoid contaminated surfaces
When should an amputation be elevated on pillow?
only after first 24 hrs
Normal Lactate Levels
0.5 - 1
***lactate greater than 1 is a sign of shock
Which burn injury BLANCHES?
Superficial (1st Degree)
Partial Thickness (2nd Degree) - Deep Dermal
With sepsis, what happens to glucose?
goes up
***more than 140 is a symptom of SIRS
Skin:
— are small, waxy nodules with superficial blood vessels and well-defined borders. If oral, will be found on lips.
Basal Cell Carcinomas
Burns:
Daily protein requirements are —
Daily caloric requirements are —
2-4 x’s normal
8000 cal per day
Treating MRSA - What meds?
Vanco
Linezolid
Examples of Airborne Precautions?
Droplet?
Contact?
Standard?
Airborne:
- TB, Measles, Chickenpox, Smallpox
Droplet:
- Mumps, Flu, Pertussis, Meneingitis, Smallpox, Plague
Contact:
- MRSA, C.diff, Pediculosis, Scabies, RSV, Smallpox, Plague
Standard:
- Antrax, Botulism
Why do we need to watch for infections closely with TPN?
bacteria like glucose
Dx criteria for SIRS:
- Temp
- HR
- RR
- WBC
Temp - greater than 38 (101) or less than 36 (98.6)
HR - greater than 90
RR - greater than 20 or PaCO2 less than 32
WBC - greater than 12000 or less than 4000 or more than 10 percent bands
Education regarding an EMG
Electromyography is a procedure that gives electrical shocks to nerves to study nerve conduction
- inspect needle insertion site for infectoin
- may have discomfort when electrical current is passed through
- doc may DC muscle relaxants several days prior to prevent drugs from affecting results
With the Parkland Formula, how much should the fluids be given within 24 hours?
50 percent in first 8 hrs
25 percent in next 8 hrs
25 percent in final 8 hrs
With Hypovolemic Shock, always — first.
replace volume
***NS or LR
Complication of Distributive Shock
DIC
UC vs Crohn’s:
— has bloody stools.
UC
– is the primary risk factor for Genital Warts.
HPV
In hypovolemic shock, elevate —
feet
***or keep HOB flat or less than 30 degrees
Cholecystitis Risk Factors - 4 f’s
Female
Forty
Fat
Fertile
Which topical ointment penetrates eschar and is used for electrical burns?
Mafenide Acetate
- **it’s painful, though
- **Silver Sulfadiazine is NOT painful but doesn’t penetrate
Nutrition education for Gout
Avoid proteins (organ and red meats)
Avoid starvation diets
Avoid dehydration
Increase fluids
Increase pH with alkaline foods (citrus fruits and juices, milk and dairy)
Low purines (gravy, meats, etc.)
What is the antifungal that can treat fungal infections of mouth?
Nystatin
Which skin graft is from a Human Cadaver?
Pig?
Self?
Homograft (Allograft)
Heterograft (Xenograft)
Autograft
Skin:
— is precancerous
Actinic Keratosis
Radiation:
How long should they avoid direct sun exposure?
1 year
With — shock, the actual volume of blood isn’t lost, but it isn’t going where it’s supposed to go.
Distributive
What meds are for Hypovolemic Shock?
Vasopressors
- NE, DA, Phenyleprhine
Which burn injury BLISTERS?
Partial Thickness (2nd Degree) – Superficial Dermal
Rule of 9’s:
How much is head?
Torso?
Arms?
Legs?
Head - 9 percent (4.5 on each side)
Torso - 36 percent (18 on each side)
Arms - 9 percent (4.5 on each side)
Legs - 18 percent (9 on each side)
Ewing’s Sarcoma is a cancer of the —. What will labs look like?
bone
Leukocytosis (WBC greater than 10000)
Anemia (RBC less than 4.2)
Which type of cancers are Tumor Lysis Syndrome seen in?
Leukemia
Lymphoma
Multiple Metastatic Conditions
PUD:
Epigastric pain that will radiate where?
back
**indicates perforation is imminent
With Acute Pancreatitis, what labs are decreased?
Calcium
Mag
Potassium
***Albumin can go either way
What is the progression with Sepsis?
Local infection leads to…
Systemic Infection (early Sepsis) leads to…
SIRS leads to…
Organ Failure (Severe Sepsis) leads to
MODS (Septic Shock) leads to….
DEATH
Skin:
— has scaly lesions with central ulceration and, if oral, will be found on base of tongue or tonsilar area.
Squamous Cell Carcinomas
What med to treat Syphillis?
Benzathine Penicillin-G IM
- 2.4 million Unit dose ONE TIME
- Late latent and Tertiary stage gets dose EACH WK FOR 3 WKS
Chronic Kidney Disease:
What is GFR in Stages 1 - 5
Stage 1 - GFR is 90 mL or more per min Stage 2 - GFR is 60 - 89 per min Stage 3 - GFR is 30 - 59 per min Stage 4 - GFR is 15 - 29 per min Stage 5 - GFR is less than 15
Which coral snake is dangerous?
Red touches yellow, dangerous fellow
Red touches black, friend to Jack
Burns:
What are the following during the first 24 hrs:
- HCT and Hgb
- Na
- K
What about 48-72 hrs?
First 24:
- H and H are elevated due to fluid loss and third spacing
- Na is decreased due to third spacing
- K is increased due to cell destruction
48-72 hrs:
- H and H are decreased due to fluid shifting back into vascular space
- Na remains decreased due to renal and would loss
- K is decreased due to renal loss and movement back into cells
— — — is a complication seen in after first cycle of chemo and is actually a sign that chemo is working.
Tumor Lysis Syndrome
RIFLE Classification:
Risk has Cr increased by – or GFR decreased by — with UOP less than normal for – hrs
Injury has Cr increased by – or GFR decreased by — with UOP less than normal for – hrs
Failure has Cr increased by – or GFR decreased by — with UOP less than normal for – hrs
Loss has complete loss of kidney function for —
ESKD has complete loss of kidney function for —
Risk - Cr (1.5) GFR (25 percent) UOP (6 hrs)
Injury - Cr (2) GFR (50 percent) UOP (12 hrs)
Failure - Cr (3) GFR (75 percent) UOP (24 hrs) or Anuria
Loss - 4 wks
ESKD - 3 mths
What do you do within 3 hrs of Severe Sepsis?
Draw lactate levels
Give antibiotics
Obtain blood cultures
Osteoporosis:
Which medication can cause DVT?
Raloxifene
**it’s an Estogen Agonist Antagonist
Vit D deficiency leads to —
Prevent with what?
Osteomalacia
- fish, butter, cheese, whole grains, cereal and milk
- sunlight
Hypovolemic shock will have — SVR.
increased
***compensatory measure
Cancer Complications:
Patient has SOB and persistent cough and noticable dilation of veins in upper chest as well as reddish face, palms, and mucous membranes.
What does she likely have?
Superior Vena Cava Syndrome
What is the Parkland Formula?
4 mL x TBSA x weight in kg
Which types of foods should a chemo client avoid?
- fresh fruits and veggies
- undercooked meats
- paprika
- Raw nuts
- Yogurt
Phantom Limb Pain:
Give — during first postop week to prevent PLP.
Give — for knifelike pain.
Give — for continuous, dull, burning pain.
Calcitonin IV
Gabapentin
Beta Blockers (Propanolol)