Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing > Final Exam 2016 > Flashcards

Final Exam 2016 Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Pharmacology flashcards NCLEX-RN® flashcards Nursing Mental Health flashcards Nursing Fundamentals flashcards Nursing Safety & Infection flashcards Nursing Adult Health flashcards NCLEX-PN® flashcards Nursing Management of Care flashcards Nursing Pediatrics flashcards Nursing Maternity flashcards
1
Q

S/s liver disease/failure (RUQ)

A

Jaundice, pruritis(itchy), spider angiomas, red palms, anorexia, N/V, DULL right up quad pain, clay colored stool, fector hepaticus (sweet musty breath), portal HTN (ascites/varices), dark brown frothy urine, decrease u/o, hepatic encephalopathy, asterixis (liver flap), anasarca (fluid in skin), pleural effusion, leukopenia (NOTHING FRESH), K loss, confusion, male breasts, woman face hair, amenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prevent liver disease

A

Avoid raw shellfish, vent room, protect skin, limit meds, limit ETOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Interventions

A

Lotion, high calorie high carbs LOW PROTEIN, I&O, fluids, neuro: alarms, freq checks, elevate edema, pericentesis for ascites, respiratory: fowlers, arms out, conserve energy, nothing fresh, electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

High PT/INR means?

A

Coumadin or liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most specific serum test for liver used to monitor tx

A

ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Post liver biopsy

A

Bed rest 12 hrs, lay ON SITE (pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Portal HTN

A 
Comp liver disease
Ascites 
Peripheral edema 
Splenomegaly 
Increase venous pressure in portal circulation 
Varices 
HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ascites main s/s and intervention

A

Abd pain, impaired respiratory, low u/o, low K, bacterial peritonitis

NA restrict
Diuretics
Paracentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Varices

A

Comp portal HTN (liver disease)

Bleeding/shock for esophageal varices

Gastric

Internal hemorrhoids

Caput medusae (around umbilicus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Esophageal varices bleed tx

A

Caused from portal HTN
contributor: STRAINING, alcohol, coarse food

Stabilize and stop bleed (fluids, blood)

Tx w/ either sclerotherapy (heat), band ligation, balloon tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Endoscopy interventions

A

Return of gag reflex, LOC, bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Balloon tamponade care

A 
For bleeding esophageal varices 
Patency
Position via X-ray 
Saline lovage/NG suction 
Semi fowlers 
NPO 
Scissors at bedside
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Shunting

A

Used after bleeding varices episode

Shunts blood out of portal vein

TIPS (non surgical)

COMPLICATION = ammonia build up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hepatic encephalopathy

A

Life threat complication liver disease
Ammonia (normal 15-40)
Neurotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hepatic encephalopathy interventions

A 
Limit protein
Mental change 
Asterixis- Liver flap
Hyperreflexia 
Fector hepaticus (musty sweet breath)

TX WITH LACTULOSE (bm to get rid ammonia)
Antibiotics
Electrolytes
Neuro asses Q2hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hepatorenal syndrome

A

Life threat complication liver disease
Renal vasoconstrict –> renal fail
Liver transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Overall care liver disease

A 
Rest 
No etoh, ASA, NSAIDS
Manage s/s 
Prevent complication 
Diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Liver fail

A 
Jaundice 
Coagulation defects
Encephalopathy 
Portal HTN
Cerebral edema
Electrolyte disturb 
Cardio abnormal
Renal fail
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Key w/ hepatitis management

A

Rest and nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hep incubation phase

A

Most infectious
Flu-like (malaise, anorexia, low grade fever, N/V, arthralgia (joint aches))
RUQ pain

one month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Acute/icteric phase hep

A

No fever
Jaundice, pruritis, dark tea urine, clay stooo
Anicteric

2-4weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Convalescent/posticteric phase hep

A

Gradual improvement
Malaise, fatigue
REST
2-4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hep nutrition

A

High cal/card low fat/protein

Sm freq meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hep A

A

Fecal/oral, dirty water, raw shellfish
“Newsmaker”
Acute only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hep A diagnostics

A

Anti-HAV (antibody to hep A)
Anti-HAV IgM (immunoglobulin=acute hep)
Anti-HAV IgG= (G=gone, past infection, future immunity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Tx hep A

A

Vaccine prophylaxis

Immunoglobulin within 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hep B

A

Blood, body fluids, sex, needles ,perinatal
Lives on dry surface 7days
Carrier/infectious lifetime
HIV test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Chronic hep b

A

HBsAg positive 2x
Seen in very young
Interferon and antivirala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Hep c

A

Silent killer
Asymptomatic for yrs
No vaccine
Always infectious perinatal, percutaneous, permucosal
Symptoms usually jaundice/bruising/fatigue
HIV
antibody test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Colorectal cancer

A

Change in bowel pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Polyps

A

All abnormal need removed
Adenomatous/neoplastic linked cancer
Risk cancer increase w polyp size increase
Gradual/insidious onset (0 symptoms until advanced)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Polyp risk

A 
Genetics 
IBD
Age > 50
Increased red meat diet 
Lynch syndrome (born with hundreds polyps)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

S/S polyps/colorectal cancer

A 
Insidious/gradual
Non specific
Problems w/ bleed, obstruction, perforation, fistula 
Recent weight loss
Iron deficient anemia 
Rectal bleed
Abd tender 
Bowel change 
Hepatomegaly/ascites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Descending colon tumor s/s

A

Bleed and diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Ascending colon tumor

A

Detected later, presents as bowel obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Cancer detect

A 
Sigmoidoscopy Q5 years
Or
Colonoscopy Q10 yrs
Age 50+
Yearly feckless occult blood tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Colorectal cancer geriatrics

A

Fatigue
Iron deficient
Minor bowel change/bleed
Tenesmus (feeling to have to poop)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

colorectal cancer tx

A

Stage 1 hemicolectomy
Stage 2 resection w/ or w/o chemo
Stage 3 surgery and chemo
Stage 4 palliative

***bowel cleanse and antibiotics prior (ex miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Low anterior reception (LAR)

A

Preserves sphincter function

Tx colorectal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Chemo

A

Affects all systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Ostomy care

A

High fiber

Increase fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is celiac

A

Autoimmune genetic digestive disease
Malabsorption
Inflammation w/ gluten (wheat, barley, rye)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Celiac comp

A

Iron anemia, vit b/d deficient leading osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Celiac s/s

A 
Chronic diarrhea 
Steatorrhea (pale frothy floating poop) bc impaired fat absorb
Abd pain, distention, N/V, constipation 
Growth fail (lack energy/appetite) 
Bruising/anemia 
Tetany
Dehydration 
Hair thinning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Adult celiac s/s

A 
Iron anemia
Fatigue
Bone/joint pain 
Depression
Tingling hands/feet 
Seizures/migraines 
Canker sores in mouth 
Itchy dry skin rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Celiac tx

A 
Only 100% gluten free + steroids short term 
Vitamins 
Replace w/ corn & rice 
Low fat 
Compliance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Celiac crisis

A

Dehydration
Profuse watery diarrhea
Emotional disturb
Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Diverticulosis

A

Sacs in sigmoid no inflame or symptoms
Vague abd pain, bloating, flatulence, change bowel
Some bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Diverticulitis

A

Inflammation w/ infection
Acute LLQ pain, mass
Infection s/s: fever, leukocytosis
Abscess

Maybe asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Risk diverticular disease

A

Age
Low fiber/fluid
Low exercise
Congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Dx diverticular disease

A

Colonoscopy or rectal bleed
**Never colonoscopy w/ itis
Do CT scan with contrast **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Tx diverticulitis

A

NPO, rest, antibiotics, NG tube, IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Tx diverticulosis

A 
High fiber
Low fat/red meat 
Exercise/fluids
Weight reduction 
Stool soften 
No straining
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Acute pancreatitis

A 
Life threat 
Sudden severe deep piercing radiating Abd pain LUQ or midepigastrum 
Decreased bowel sounds 
Increase pain AFTER meals 
N/V (vomit doesn't help) 
Dyspnea, jaundice, cyanosis
S/S hypovolemic shock
Grey turners (flank ecchymosis)/Cullen's sign (peri umbilical ecchymosis)  
Hypocalcemia (chvosteks, trousseaus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Chronic pancreatitis

A

LUQ pain
Chronic heavy gnawing feelings not relieved by foods/antacids
Malabsorption: weight loss, jaundice & dark urine, steatorrhea (fatty stool), DM
Frothy urine/stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Acute pancreatitis complications

A 
Respiratory: effusion, ARDS (LUNG SOUNDS!!!!)
Cardiac: shock 
Hypocalcemia: tetany 
Infection 
Compartment syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Pancreatitis interventions

A 
Pain
NG auction 
NPO (maybe ppn)
Semi fowlers 
Antacids, PPI, H2RA
Slowly advance food (high carbs!) 
Education (no alcohol, diet) 
Pancreatic enzyme meds WITH meals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Two types of IBD

A

Chrons and Ulcerative colitis (UC)

Chronic inflammation; exacerbations &a remission

*no cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Diff btwn chrons and UC

A

Chrons- all layers bowl, anywhere in GI, skip lesions, recurrence

UC- inner layer GI, starts in rectum -> continuous, pseudopolyps, cured w surgery, cancer risk, toxic mega colon more common (perforation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Chrons s/s

A

Diarrhea
Abd pain
Weight loss (malabsorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

UC s/s

A

Bloody stool***
Anemia, weight loss, dehydration, diarrhea
Abd pain (lower cramping)
Tenesmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Toxic megacolon

A 
Complication UC 
SEVERE abd pain
Distention
Fever 
Severe bloody diarrhea

Tx
NPO, rest, NG tube, IVF, steroids, antibiotics if no cure 24hrs -> colectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Systemic complication IBD

A 
Finger clubbing
Erythema nodosum 
Aphthous ulcers 
Conjunctivitis 
Thromboembolism 
Gallstones 
Osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

IBD dx

A

Colonoscopy (never w/ exacerbation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Pharm tx IBD

A

5-ASA (reduce inflam)

Sensitive to sun w/ meds! Know bleeding s/s, orange skin/urine NORMAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

IBD diet

A

High calorie, high vitamin, high protein, low residue (no dairy)

67
Q

Mechanical bowel obstruction

A

Small intestine

Surgical, cancer, diverticular disease

68
Q

Non mechanical bowel obstruct

A 
Paralytic ileus (post op) 
Neuro or vascular
69
Q

Bowel Obstruction pathophysiology

A

Hyper bowel sounds above, absent below
Distention -> third spacing
Can lead to hypovolemic shock
Bowel ischemia -> necrosis -> perf-> septic shock

70
Q

Small bowel obstruction

A 
Rapid dehydration 
Intermittent pain 
Freq projectile vomit (orange, brown) 
Greatly increase distention
Borborygmi (loud bowel sounds) above obstruction 
Hypovolemia
71
Q

Large bowel obstruct

A 
Slow dehydration 
Persistent cramping pain 
Rare/gradual vomit
 increase distention
Borborygmi (loud bowel sounds) above obstruction 
Hypovolemia
72
Q

Obstruction dx

A

Ct

Abd X-ray

73
Q

Tx obstruction

A 
Must resolve in 24 hrs
NPO
NG tube
IVF 
I & O
Pain
74
Q

GERD s/s

A 
Pyrosis (burning in esophagus)
Dyspepsia (indigestion) 
Regurgitate 
Hyper salvation 
Dysphasia
Odynophagia (pain w swallow)
Globus sensation (lump in throat)
Non cardiac chest pain
75
Q

Esophagitis

A

Common comp GERD
inflammation esophagus
Ulcers -> structures/dysphasia

Tx with sucralfate*** to coat esophagus

76
Q

Barret’s esophagus

A

Lining lower esophagus changes
Precursor cancer
Freq heartburn, gnawing epigastric pain, bleed, perf

Tx: endoscopic ablation therapy

77
Q

GERD teaching

A 
Low fat, small freq meals
No caffeine, beer, milk, carbonation 
Don't drink/eat before bed
Normal body weight 
No tight clothes 
Elevate HOB

H2RB
Before meal PPI
Antacid
Prokinetic

78
Q

PPI side effect

A

Osteoporosis

79
Q

IBS s/s

A 
Alter bowel pattern 
Abd pain/distention 
Bloating
Constipation/diarrhea/both 
Excessive flatulence
  • no fluids with meals
80
Q

Cholecystitis

A 
Obstruction gallbladder from stones 
Emergency 
S/s:
Indigestion
Pain RUQ radiate shoulder
Abd rigidity 
Fever
Jaundice 
Increased labs
81
Q

Cholecystitis care

A 
NPO
rest
Fluids
NG tube 
Dressing
82
Q

Cholelithiasis

A 
Intolerance fatty food 
Severe pain (biliary colic) 
Obstructive jaundice 
Dark amber urine 
Clay stool

Tx
Surgery
ERCP
ESWL (shock wave)

83
Q

ERCP

A

Pt left side

Gag/cough reflex post procedure

84
Q

Peripheral artery disease

A 
Intermit claudication (pain/cramps)
Paresthesia
Pallor when legs up (no blood) 
Rubor when legs down (blood pooling) 
Rest pain
No periph pulses

Dx: ankle brachial index

85
Q

Percutaneous transluminal balloon angioplasty

A

Balloon tipped cath in stenotic vessel, inflates to compress plaque and stretch vessel –> stent

(PAD tx)

86
Q

Post surgical PAD nsg care

A

Avoid knee flexed position and prolonged sitting (cuts circulation)

ABI

pulses

87
Q

6 Ps of acute arterial ischemia

A 
Pain 
Pallor
Pulsessness
Paresthesia 
Poikilothermia (coldness) 
Paralysis (advanced stage)
  • caused from clot that cuts off blood supply
88
Q

Care for arterial embolism

A

SUPINE

89
Q

Venous leg ulcer

A 
Near medial malleolus 
Edema
Exudate 
Superficial IRREGULAR shape 
Red/yellow color
Pain worsens when dangling legs
90
Q

venous insufficiency

A 
Aching/crampy 
Present pulses
Stasis dermatitis 
Warm 
Thick/tough skin
Brown/leathery skin
91
Q

Arterial ulcer

A 
In feet areas 
Very painful or no pain 
Deep CIRCULAR shape 
Ulcer pale black 
No edema or drainage
92
Q

PQRST assessment for angina

A 
Pain 
Quality
Radiating
Severity
Timing
93
Q

Acute coronary syndrome

A

Is an MI just different types (stemi/nonstemi)

94
Q

Most cardiac specific biomarker

A

Troponin

95
Q

Tx ACS

A

Acute coronary syndrome (MI)

Oxygen, ASA, NTG, Morphine

“M-A-N-O”

PCI within 90 min

96
Q

1 complication MI

A

Dysrhythmias

97
Q

Post PCI care

A

SUPINE, leg straight, insertion site, pressure when sheath removed, distal extremity

98
Q

PDA

A

Patent ductus arteriosus

Widening pulse pressure
Bounding pulse
Acyanotic

99
Q

Aortic stenosis

A

Limit activity

Acyanotic

100
Q

Tetralogy of fallot

A

Pulmonary stenosis
Right ventricular hypertrophy
Ventrical septal defect
Overriding of aorta

Dx: cyanosis, Tet spells

101
Q

Tet spells

A

With activity that increases O2 demand

Tachypnea, tachycardia, irritable, crying, cyanosis, KNEE TO CHEST POSITION to compensate (calm the child down)

102
Q

Normal CO, MAP, and EF

A

CO: 5-7
MAP > 60
EF > 60

103
Q

Normal K

A

3.5-5

104
Q

Normal pH
Normal CO2
Normal bicarbonate

A

PH 7.35-7.45
CO2 35-45
Bicarbonate 22-26

105
Q

Left HF

A

PND

Pulmonary

106
Q

2 ACE inhibitor examples

A

Captopril
Lisinopril

HF !!!!!

107
Q

BB example

A

Metoprolol

108
Q

Digoxin and digoxin toxicity

A

Increase force contraction and slows conduction in HF

toxicity: nausea, blurred vision, halos, dysrhythmias

109
Q

HF symptom recognition teaching

A

FACES:

Fatigue
Activity limitation
Cough
Edema
SOB
110
Q

Reasons why went into HF exacerbation (acronym)

A

A3 I3 E

Arrhythmia
Angina
Anemia

Indiscretion of meds
Infarction
Infection

Endocrine

111
Q

Another name for ADHF

A

Pulmonary edema

112
Q

Early sx ADHF

A

Tachypnea

Decrease O2 sat

113
Q

“Donkey and cart up hill” interventions (3) for ADHF

A

Can either unload cart to get uphill (diuretics)
Have donkey go around hill (vasodilators)
Push donkey to go uphill (inotropes)

114
Q

Takotsubo

A

Stress related syndrome in women that mimics cardiomyopathy until cath

115
Q

Weird teaching about mouth to prevent IE

A

Prevent gum infections/tooth decay

Prophylactic antibiotics for dental cleanings

116
Q

IE s/s

A 
Flu
Murmur
HF
Splinter hemorrhages 
Petechiae
Olsers nodes 
Janeways lesion
117
Q

PTBV

A

Percutaneous transluminal balloon valvuloplasty

Cath lab
Balloon prevents stenosis in valve
Extremity CMS, pressure dressing

118
Q

INR range onnnnnn Coumadin

A

2.5-3.5

Takes longer to work

119
Q

Immediate post op for heart replacement

A

Lethal arrhythmias and rejection

120
Q

Cor pulmonale

A

From copd (pulmonary artery HTN) -> increase work of R side heart -> right sided HF

121
Q

S/s COPD

A

Weight loss
Chronic cough
Dyspnea
Sputum

122
Q

Bacterial pneumonia sputum color

A

Purulent

123
Q

HAP

A

More virulent pneumonia

Onset 48hrs or longer after admission

124
Q

IHI ventilator bundle

A 
Sedation vacation 
Chlorhexidine rinse 
Elevate HOB 
Ulcer prophylaxis 
DVT prophylactic
125
Q

S/s lung cancer

A 
Silent
Persist cough 
Sputum volume/blood
Pneumonitis sx 
Chest shoulder back pain 
Dyspnea wheezing strider
Systemic (late)
Bone/joint pain 
Weight loss
Anorexia 
Fatigue 
N/V
Hoarseness
126
Q

2 main issues w/ end stage lung cancer

A

Dyspnea (air hunger)

Pain

127
Q

TB manifestations

A

DRY cough -> productive
Fatigue, weight loss, night sweats, fever (flu like)

Dyspnea
Hemoptysis (cough blood)

128
Q

Tuberculin skin test

A

Screening if infected

PPD objected read 48-72 hrs

129
Q

Positive TB skin test

A

Redness NOT positive, hardness (induration) is

If it’s over 15 induration = low risk
5 = immunosuppressed, recent exposure
10 = immigrant, high risk setting, IV drug users

Doesn’t mean disease present (exposed or vaccinated)

Should have CXR***

130
Q

Dx TB

A

Sputum culture (8 weeks) (and H&P and CXR)

131
Q

Positive TB sputum smear infection time

A

2 weeks

Avoid public

132
Q

TB meds

A 
Rifampin
INH (causes hepatitis--> avoid alcohol)
133
Q

Main reason for TB tx fail and how to solve

A

Non-adherence

DOT (direct observed therapy)- watch them swallow meds

134
Q

ARDS

A

Severe dyspnea/hypoxemia UNRESPONSIVE to O2

Infiltrates on CXR

135
Q

ARDS tx

A 
O2 + PEEP (positive end expiratory pressure to open alveoli) 
Manage underlying cause 
Lateral rotation therapy
PRONE position (tummy) 
Nutrition
136
Q

Acute respiratory failure

A

50/50

o2 50
CO2 50

137
Q

When is trach tube consider for pt on vent

A

If on vent longer than 10-14 days (damage)

138
Q

Flail chest

A

Floating seg ribs from fractures

Paradoxical chest movement

139
Q

Croup s/s

A

Harsh barking cough
Hoarseness
Inspiratory strider

LTB most common type
(Epiglottitis = emergency!)

140
Q

Epiglottitis

A 
Type of croup: EMERGENT!
strider at rest
Cyanosis
Severe agitation
Retractions
CANT DRINK FLUIDS
141
Q

Croup (LTB) management

A 
Patent airway (home care usually)
Moist air 
Room temp oral fluids 
Cool mist 
Steroids
142
Q

Cardinal signs of Epiglottitis (4 D)

A

Drooling
Dysphasia
Dysphonia
Distressed inspiration

(Never examine epiglottis until intubation equipment available- NPO)

143
Q

Bronchiolitis

A

Commonly from RSV
Most common ped. Respiratory infection
No cough but trouble breathing s/s
CONTACT/droplet precautions

144
Q

Cystic fibrosis

A

Inherited
Mucus in bronchioles, intestine, pancreatic/bile ducts)
Increase Cl and Na in sweat !
No cure

145
Q

S/s cystic fibrosis

A 
Poor growth
Bulky greasy stool or STEATORRHEA (difficulty absorbing)
Freq colds/cough 
Thick sticky secretions
Cor pulmonale 
Diabetes
146
Q

Cystic fibrosis tx

A

Airway clearance therapy

Mucolytics

147
Q

Pancreatic enzyme capsule

A

WITH meals to breakdown high fat foods in CF

148
Q

Adrenal cortex

A

Cortisol (metabolism and stress)

Aldosterone (k/na for bp regulation)

149
Q

Addisons

A 
Adrenal cortex insufficiency 
Hyper pigment
Low Na, low glucose
High K 
Muscle weakness 
Neuro

Steroids (increase in times of stress)
** increase Na intake **

150
Q

Cushings

A 
Excessive ACTH (from pituitary to adrenal cortex->cortisol)
From long term steroids; can be hypothalamus, pituitary, or adrenal
High Na, high glucose
Low K
Moon face
Muscle atrophy(low K)
HTN
buffalo humo 
Facial hair
Na and water retention 
Thin fragile skin, acne 
Fat tummy 
Facial hair

Taped down steroids

151
Q

Primary hyper aldosteronism

A 
Excess aldosterone (adrenal cortex) 
Tumor 
HTN
Low k 
Low Ca (tetany, paresthesia, weakness, cramps, dysrhythmias)
High Na (sodium retention, K excretion)

K sparing diuretic
Na restrict, K supplements

152
Q

Adrenal medulla

A

Epi/norepi

Vasoconstrict; “fight or flight”

153
Q

Pheochromocytoma

A 
Adrenal medulla tumor 
EXCESSIVE catecholemines (epi/norepi) 
Pounding headache
Tachycardia 
HTN
Diaphoresis
Flushing
Hyperglycemia 
Tremor 
Anxious

Give antiHTN
Don’t palp abd

154
Q

Anterior pituitary

A

ACTH, TSH, GH

155
Q

Acromegaly

A 
Excess GH 
Sweat
Mood disorders
Enlarged hands/feet
Deep voice 
Thick facial features
Hyperglycemia 
Thick leathery skin 
Large lips
156
Q

Pituitary tumor

A

Gland bear face/eyes
Headache
Visual disturb
Hypo or hyper secretion s/s

Tx transphenoidal hypophysectomy

157
Q

Transphenoidal hypophysectomy

A

Removal of pituitary (secretes ADH so at risk for DI) need lifelong hormones
Neuro assess
CSF drainage
Nasal packing
HOB up
Avoid straining *** (sneeze, lift, blow nose)

158
Q

Posterior pituitary

A

ADH (water balance)and vasopressin

Low osmolality=more dilute

159
Q

SIADH

A 
Excess ADH 
increase H2O absorb, dilute Na (low osmality) 
Water retention low Na 
Weight gain
Muscle weakness 
Lethargy 
Low u/o 
Headache 
Confusion 
THIRST

Tx fluid restrict (<1000), diuretics, IV hypertonic

160
Q

DI

A 
Deficient ADH 
LARGE amounts dilute urine, increasing serum osmolality, hypernatremia
Low sp gravity (<1) 
Polydipsia 
Polyuria 
U/o > 20L
Weakness 
Dehydration

Tx fluid replace, vasopressin

161
Q

Dignostic for thyroid disease

A

TSH
high= hypoactive thyroid
Low= hyperactive

162
Q

Thyroid hormone needs what

A

Iodine (in salt)

163
Q

Goiter

A

Enlarged thyroid gland

Swallowing/airway problems

164
Q

Hashimoto’s thyroiditis

A

Autoimmune
High TSH
hypothyroid

Nursing (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions