final exam nurs 350 Flashcards by Chae Han

what are the causes of hypovolemia?

diarrhea, vomiting, suctioning, elderly, infection

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what are the signs and symptoms of hypo-volemia?

tinting of the skin, hypotension, dry mucous membranes, chapped lips

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what lab values do you watch out for hypovolemia?

increased lab values of hgb and hct

increased sodium

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what causes confusion in the elderly?

fluid imbalance, UTI, hormonal changes, and fever

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define community acquired pneumonia

occurs within the first 48 hours after hospitalization

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what are the signs and symptoms of pneumonia?

sudden onset of chills, rapidly rising fever and chest pain

pleuritic-type pain, fatigue, tachypnea, the use of accessory muscles for breathing, bradycardia or relative bradycardia, coughing, and purulent sputum

if pt is really ill then he has tachypnea, sob, and use of accessory muscles in respiration

FOR OLD PEOPLE: important to assess older adult patients for unusual behavior, altered mental status, dehydration, excessive fatigue, and concomitant heart failure

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what are the nursing interventions for pneumonia?

Removing secretions
high-humidity facemask
Chest physiotherapy
After each position change, the nurse encourages the patient to breathe deeply and cough
PROMOTE FLUID INTAKE
maintain nutrition

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Order of starting IVs and drawing labs

check for providers orders
gather supplies, examine skin
apply tourniquet
cleanse
insert
release tourniquet

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what do you do before giving an antibiotic to a patient?

grab a culture

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What does the nurse predict for order after assessing the patient?

Diagnosis–> planning–> intervention –> evaluation

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What are the two types of COPD? How do they present differently?

Bronchitis - productive cough, blue bloats, sob, cyanosis,

Emphysema - dry cough, pink puffers, hyperventilation, barrel chest

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What is the first line drug for an asthma attack?

albuterol (SABA) or LABA then give them steroids

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medications for COPD

bronchodilators, corticosteroids, theophylline, Phosphodiesterase-4 inhibitors

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interventions for copd

respiratory assessment; lung sounds, sputum, production, keep O2 stat
pursed lip diaphragmatic breathing
administer O2 as prescribed
administer SHORT acting ALBUTEROL (bronchodilator)
as needed inhalers
–> acute episodes is short acting
–> chronic episode is long acting
–> corticosteroids: decrease inflammation, decreased mucous production
*** rinse mouth after corticosteroids inhaler
stop smoking bruh
nutrition needs

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interventions for pneumonia

monitor lung sounds (coarse crackles, wheezes)
monitor ABG results
color of skin (cyanotic)
SUCTION
educating on incentive spirometer usage
stay hydrated

-medications include antipyretics, antibiotics, antivirals

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What are the labs for coumadin?

this is WARFARIN so check for INR

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labs for heparin?

aPTT and INR

how to manage afib

start them on anticoagulants bc they have risk of developing blood clots

signs and symptoms of pulmonary edema

PE is frothy pink sputum

COPD is coughing up gunk

first line drug for type 2 diabetics

metformin

Symptoms of peritonitis

fever, cloudy drainage, tachycardia

medications you hold before hemodialysis

-antihypertensives 
(ACES and ARBS) 
-beta blockers 
-ca cannel blockers ( dilatezem, biferdipine) 
-diuretics 
-dilators (nitrglyercine 
-antibiotics 
-digoxin 
-water soluble vitamins (B< C< folic acid)

risk factors of pulmonary embolism

atherosclerosis

- smoking

goal for hypertensive crisis

goal BP is reducing by 20-25% initially (within the first 4 hours) - then over next 6 hours keep reducing

modifiable risk factors for atherosclerosis

Hyperlipidemia Cigarette smoking, tobacco use Hypertension Diabetes Metabolic syndrome Obesity Physical inactivity

how do you recognize organ damage with hypertension

eye examination with an ophthalmoscope is particularly important because retinal blood vessel damage indicates similar damage elsewhere in the vascular system. The patient is questioned about blurred vision, spots in front of the eyes, and diminished visual acuity. The heart, nervous system, and kidneys are also carefully assessed. Any significant findings are promptly reported to determine whether additional diagnostic studies are required.

how do you manage urinary retention

The detrusor muscle after a while gets neurologically injured - they might have difficulty voiding or completely emptying bladder When catheter comes out - put pt on voiding schedule and scan bladder after they void (anything greater than 200mL have to straight cath to get out rest)

name conduction blocks

Conduction blocks - type 1 2 and 3 QRST without atrial conduction bc its getting conduction from other areas of the heart 1st degree - no symptoms really, don't typically treat 2nd degree - 3rd degree - medical emergency, if they LOC - call code start CPR (don't get EKG b4 lol)

position best for patients with copd

tripod position

renal cancer treatment

Treated with renal artery embolization

what labs will change for diabetes insipidus?

urinalysis

what are you looking for radical dissection?

airway problems

Addisonian crisis - causes of flare

the cold, stress, trauma, infection

what is pheochromocytoma?

adrenal medulla tumor

management of pre and post op of Pheochromocytoma

. Nursing Management - Preoperative 1. Reduce stressors to prevent thyroid storm 2. Teach how to support neck post operatively to insure adequate healing of incision site G. Nursing Management - postoperative 1. Bleeding at incision site 2. VS 3. Pain, swelling or pressure at surgical site may indicate hematoma formation 4. Tracheostomy set is kept at bedside if difficulty breathing develops from swelling or hematoma formation *NOTIFY SURGEON.

which medications to hold the day of dialysis

antihypertensives (ace and arbs) and anticoagulants (heparin, warfarin)

how do treat Dka

fluid replacement first then replacing electrolytes - monitor for hypokalemia and electrolytes) ekg

signs and symptoms of parathyroid injury

Monitor blood calcium levels -evidence of TETANY ( hyper irritability of nerves, spasms of hands and feet, muscle twitching). Notify surgeon, look for signs of layngospasym, infusion of calcium gluconate.

Radical neck dissection nursing interventions

MAINTAINING AIRWAY CLEARANCE After the endotracheal tube or airway has been removed and the effects of the anesthesia have worn off, the patient may be placed in the Fowler position to facilitate breathing and promote comfort.

what are the manifestations of diabetes inspidus

dry inside= diabetes inspidus | siadh= soaked