FINAL COACHING Flashcards
CELLULITIS
- Bacterial infection –> ______ & ______
- commonly affects dermis and subcutaneous tissues
- usually affects lower extremities
T_____
R_____
S_____
H_____
- Hotness: ____ compress
- Antibiotic: _______
- MRSA: _______
- strep/staph
- tenderness, redness, swelling, hotness
- warm compress
- methicillin
- trimethoprim (bactrim)
Pathognomotic signs:
- hydrocephalus:
- Inc ICP:
- MG:
- Leptospirosis:
- Grave’s disease:
- leprosy:
- SLE:
- tetanus:
- diphtheria:
- pernicious anemia:
- kawasaki disease:
- measles:
- german measles:
- pneumonia:
- PTB:
- hydrocephalus: sun setting eyes
- Inc ICP: cushing’s triad
- MG: ptosis
- Leptospirosis: orange eyes
- Grave’s disease: exophthalmos
- leprosy: lionine facies
- SLE: butterfly rash
- tetanus: lock jaw
- diphtheria: pseudomembrane
- pernicious anemia: red beefy tongue
- kawasaki disease: strawberry tongue/rosie tongue
- measles: koplik’s spots
- german measles: forchheimer spots
- pneumonia: rusty sputum
- PTB: low grade afternoon fever
Pathognomotic signs:
- angina:
- abdominal aortic aneurysm:
- dengue:
- malaria:
- cirrhosis:
- pancreatitis:
- cholecystitis:
- thyphoid fever:
- cholera:
- gout:
- GBS:
- Parkinson’s:
- MS:
- Cataract:
- Glaucoma
- Retinal detachment:
- angina: levine’s sign
- abdominal aortic aneurysm: pulsating abdominal mass
- dengue: petichial rash
- malaria: chills
- cirrhosis: spider angiomas
- pancreatitis: cullen’s sign, grey turner’s sign
- cholecystitis: murphey’s sign
- thyphoid fever: rose spots
- cholera: rice watery stools
- gout: tophi
- GBS: ascending paralysis
- Parkinson’s: pill rolling tremor
- MS: charcot’s triad (nystagmus, intention tremor, scanning/staccato speech)
- Cataract: hazy/cloudy vision
- Glaucoma: tunnel vision
- Retinal detachment: curtain-like veil
POISON IVY
- Red rash: __ - __ hours after contact
> soap & water, before s/sx, can remove the chemicals
- usually treated with ________ ointment
- Fever and pus: ________
- Tx: _______: worst case scenario
- 12-17 hours after contact
- steroid oitnments
- antibiotic
- prednisone
Characteristic of Herpes Zoster?
Treatment?
- clustered skin vesicles, unilateral, itchy and painful
- Acyclovir
Pressure Ulcer Staging:
I:
II:
III:
IV:
Pressure Ulcer Staging:
I: skin intact - inflammation
II: ulcerations
III: muscles
IV: bones
Degree of burns:
Fluid Resuscitation in burn patients:
- Solution: plain LR
- Parkland Formula: ______
- First 8 hours: _____
8: ______
8: ______
- Parkland Formula: 4 ml x (wt in KG) x TBSA(%)
- First 8 hours: 50%
8: 25%
8: 25%
TBSA calculation
RA or OA?
- inflammatory?
- degenerative?
- kagagamit kaya nasira?
- autoimmune?
- systemic?
- wear and tear joint disorder?
- heberden’s bouchard’s?
- morning stiffness?
- swan neck deformity?
- swimming as exercise?
- ROM exercise?
- symmetrical joint disorder?
- assymetrical?
- direct injection of corticosteroids?
- NSAIDs or aspirin?
RA or OA?
- inflammatory? RA
- degenerative? OA
- kagagamit kaya nasira? OA
- autoimmune? RA
- systemic? RA
- wear and tear joint disorder? OA
- heberden’s, bouchard’s? OA
- morning stiffness? RA
- swan neck deformity? RA
- swimming as exercise? OA
- ROM exercise? RA
- symmetrical joint disorder? RA
- assymetrical? OA
- direct injection of corticosteroids? OA
- NSAIDs or aspirin? RA
Antidotes?
- morphine
- magnesium sulfate
- hyperkalemia
- beta adrenergc blockers
- calcium channel blockers
- acetaminophen poisoning
- lead poisoning
- heparin
- coumadin
- opiate addiction
- digitalis toxicity
- alcohol abuse
- mysthenic crisis
- cholinergic crisis
- diazepam
- hemosiderosis (iron overload)
- morphine = NALOXONE
- magnesium sulfate = CALCIUM GLUCONATE
- hyperkalemia = CALCIUM GLUCONATE
- beta adrenergc blockers = GLUCAGON
- calcium channel blockers = GLUCAGON
- acetaminophen poisoning = MUCOMYST (ACETYLCYSTEIN)
- lead poisoning = EDTA
- heparin = PROTAMINE SULFATE
- coumadin = VIT. K
- opiate addiction = MATHADONE
- digitalis toxicity = DIGIBIND
- alcohol abuse = DISULFIRAM
- mysthenic crisis = CHOLINERGIC
- cholinergic crisis = ANTI-CHOLINERGIC (ATROPINE)
- diazepam = FLUMAZENIL (ROMAZICON)
- hemosiderosis (iron overload) = DESFERAL (DEFEROXAMINE MESYLATE)
POSITIONING CHEAT SHEET (UDAN)
- after liver biopsy
- ptx with increased ICP
- after kidney biopsy
- after tonsillectomy
- after pantopaque (oil-based myelography)
- after metrizamide (water-based myelography)
- after UGI endoscopy
- during colonoscopy
- after incisional cholecystectomy
- patient with MI
- Patient with CHF
- ptx with supratentorial craniotomy
- ptx with infratentorial craniotomy
- during gastrostomy feeding
- during change of IV tubing
- after liver biopsy = RIGHT SIDE-LYING
- ptx with increased ICP = SEMI-FOWLER’S, HOB @15-30°, MAX 45
- after kidney biopsy = SUPINE
- after tonsillectomy = LATERAL
- after pantopaque (oil-based myelography) = FLAT/SUPINE
- after metrizamide (water-based myelography) = SEMI-FOWLER’S
- after UGI endoscopy = LATERAL/SIDE-LYING
- during colonoscopy LEFT LATERAL
- after incisional cholecystectomy = SEMI-FOWLERS
- patient with MI = SEMI-FOWLERS
- Patient with CHF = HIGH-FOWLERS
- ptx with supratentorial craniotomy = SEMI-FOWLERS
- ptx with infratentorial craniotomy = FLAT
- during gastrostomy feeding = SEMI-FOWLERS
- during change of IV tubing = TRENDELENBURG
The Change Process
- perceive the need for change.
- ***** Initiate a group interaction.
- Implement plan ONE STEP at a time – gradually.
- Evaluate over all results.
- perceive the need for change.
- identify problem!
- acceptance for need to change
- ***** Initiate a group interaction.
* key is the GROUP!!!!! (Do not confront staff indiv. –> always grp. unless isa lang na staff ang may problem, then confidentially. - Implement plan ONE STEP at a time – gradually.
- Evaluate over all results. [Go back to 2 aspects of directing: TECHNICAL vs INTERPERSONAL]
2 ASPECTS OF DIRECTING
- Technical: T.P.M.E.
- Interpersonal: A.B.S.
- Technical: T.P.M.E.
- Tasks, procedures, materials & equipments
- Interpersonal: A.B.S.
- Attitudes, beliefs, & styles of direction giving
ANSWERS:
Technical: Show, teach, demonstrate, supervise, do/perform with the nurse
Inetrpersonal: VERBALIZATION of feelings, Talk to……, Confront…….
4 POINTERS OF DELEGATION:
- Position
- Ward
- Capabilities of staff
- Condition of the ptx
-
Position – LICENSED OR UNLICENSED
- Unlicensed = simple tasks
- Licensed = what ward siya galing? Condition of the patient?
- Ward – SAAN GALING AT SAAN PUPUNTA?
- Capabilities of staff – depends on the POSITION and WARD of the staff
- Condition of the ptx
PRESUMPTIVE vs PROBABLE vs POSITIVE?
- braxton hicks
- breast changes
- (+) pregnancy test
- goodell’s sign
- FHT
- urinary changes
- Chloasma
- Ballotement
- (+) UTZ
- Melasma
- Nausea and Vomiting
- movement felt by examiner
- Chadwick’s sign
- thinning of the uterus
- Amenorrhea
- Quickening
- braxton hicks - PROBABLE
- breast changes PRESUMPTIVE
- (+) pregnancy test PROBABLE
- goodell’s sign PROBABLE
- FHT POSITIVE
- urinary changes PRESUMPTIVE
- Chloasma PRESUMPTIVE
- Ballotement PROBABLE
- (+) UTZ - POSITIVE
- Melasma PRESUMPTIVE
- Nausea and Vomiting PRESUMPTIVE
- movement felt by examiner POSITIVE
- Chadwick’s sign PROBABLE
- thinning of the uterus PROBABLE
- Amenorrhea PRESUMPTIVE
- Quickening PRESUMPTIVE
GTPAL
Gravida:
Term:
Preterm:
Abortion:
Living:
GTPAL
Gravida: # of pregnancies
Term: 37 wks and above (per preg)
Preterm: < 37 wks (per preg)
Abortion: < 20 wks (per preg)
Living: BUHAY (per head)
** PARA: have reached the age of viability (20 wks) and ARE DELIVERED
CERVICAL CANCER
I -
II -
III -
IV -
V -
C. U. R. E.
I - normal
II - Inflammation –> hospital, bawal IE
III - mild to moderate dysplasia –> bawal ang f word (sex)
IV - probably malignant
V - possibly malignant (maliit daliri, slimmest chance of living)
c = CHEMOTHERAPY
U = UPERA
R = RADIATION
E = EMOTIONAL SUPPORT
TYPES OF ABORTION
- Threatened
- Imminent
- Complete
- Incomplete
- Therapeutic
- Induced
SEE PICS