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Fundamentals SEM3 > FINAL EXAM REVIEW > Flashcards

FINAL EXAM REVIEW Flashcards

bits and pieces of ATI to look over

1
Q

what are the 6 domains of cognitive functioning
ELSA LV

A

executive
language
social
attention
learning
visuospatial

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2
Q

define DEMENTIA

A

occurs when injury or physiological changes within the brain cause damage, making it difficult for signals to be sent to and from the brain

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3
Q

is dementia a normal part of aging?

A

no! it should never be an expected change with aging

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4
Q

types of dementia

A

vascular
Lewy body
frontotemporal
mixed

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5
Q

vascular dementia

A

changes in VASCULATURE of the brain (blood vessels and decreased oxygen)

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6
Q

Lewy body dementia

A

deposits= ALPHA-SYNULEIN

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7
Q

frontotemporal dementia

A

changes to FRONTAL lobe (behaviors)

changes to TEMPORAL lobe (changes to language and emotion)

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8
Q

mixed dementia

A

shows characteristics of one or more types

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9
Q

risk factors for dementia

A

advanced age
unhealthy diets
lack of physical exercise
HTN, DM, high cholesterol
air pollution

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10
Q

mild (or beginning) dementia

A

forget where they placed an item or a word
so memory loss is an early indication of dementia

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11
Q

role of nurse with dementia

A

decrease stimulus
don’t give lots of options of things
fall precautions
maintain independence
small, frequent meals

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12
Q

priority with dementia

A

safety

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13
Q

patho of Alzheimer’s

A

buildup of certain proteins in the brain

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14
Q

what are the two classic findings with Alzheimer’s?

A

Beta-amyloid plaques and neurofibrillary tangles

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15
Q

define neurofibrillary tangles

A

A cluster of the abnormal protein, tau, that forms within the neurons resulting in impaired oxygenation and nutrition to the neuron contributing to Alzheimer’s disease.

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16
Q

where does damage in the brain start for Alzheimer’s

A

hippocampus (vital for MEMORY formation!)

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17
Q

early-onset Alzheimer’s

A

familial
genetic

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18
Q

late-onset Alzheimer’s

A

aka sporadic

age 65 and older WITH other risk factors

genetics, sedentary lifestyle, unhealthy diet

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19
Q

risk factors for Alzheimer’s

A

APOE-e4 gene
advanced age
females
unhealthy lifestyle and diet choices
high stress
HTN
low education
obesity

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20
Q

labs and Dx for Alzheimer’s

A

sBPP
MSE
APP gene (down syndrome)

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21
Q

main difference in dementia/Alzheimer’s and delirium?

A

delirium has a new ONSET of confusion

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22
Q

what are some general things that can cause delirium?

A

advanced age
diseases
recreational drug use
systemic infection
TBIs

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23
Q

manifestations of delrium can be?

A

progressive or regressive

changes in LOC
disorientation
anxiety/agitation/depression
hallucinations/delusions

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24
Q

lab tests for delirium

A

assess for the underlying cause!

BMP/blood glucose/UA/drug screen/CT

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25
treatment for delirium
LOW STIMULUS benzos and antipsychotics TX underlying cause!
26
define multiple sclerosis
inflammation and Demyelination occur, leads to disrupted messages from the brain to the spinal cord
27
McDonald's criteria
dissemination in space (in multiple areas of NS) dissemination in time (different periods of time)
28
types of MS
remitting MS primary progressive MS secondary progressive MS clinically isolated syndrome
29
remitting MS
most prevalent type manifestations and remissions NO PROGESSION
30
primary progressive MS
NO RELAPES and it does progress
31
secondary progressive MS
progressive AND remissions
32
clinically isolating syndrome (MS)
manifestations of MS but doesn't meet diagnostic criteria
33
contributing factors to MS
autoimmune genetic environmental
34
pain with MS
trigeminal (pace in face or jaw) Lhermitte's sign (shock in back down to spine) MS hug (squeezing around the trunk) paroxysmal spasms (intermittent, painful spasms)
35
triggers to MS
stress sickness smoking sun
36
pharm for MS
IVIG interferon steroids muscle spasms cyclosporine
37
labs and dx for MS
CSF = oligoclonal bands MRI
38
electrical impulse through the heart
SA node AV node Bundle of His Bundle branches Purkinje fibers Send A Big Bounding Pulse
39
three layers of heart from inner to outermost
ENDOcardium = ENDOtheial tissue lines heart MYOcardium = MMMuscle that pumps the heart EPIcardium = protection
40
layers of pericardium
visceral = covers surface of heart parietal = lines the sac
41
blood flow through the heart
SVC/IVC RA tricuspid valve RV pulmonic valve pulmonary artery lungs pulmonary vein LA mitral valve LV aortic valve aorta
42
what do Arterioles do
Join arteries and capillaries.
43
what do venules do
Joins capillaries and veins.
44
what do capillaries do
permits gas exchange transfer nutrients removes waste
45
cardiac output
blood ejected from ONE ventricle of the heart in ONE minute L/min HR x SV
46
normal cardiac output
5-6 L/min
47
define preload
stretching of the ventricle
48
define afterload
the resistance the heart's left ventricle has to overcome to pump blood into the aorta
49
heart sound
S1 = normal (AV valves closing) LUB S2 = normal (semilunar valves closing) DUB S3 = ventricular gallop S4 = atrial gallop murmur = whooshing sound
50
what is NSR in an ECG criteria?
HR = 60-100 bpm reg rhythm (marched out = equal) one P wave to every QRS PR = 0.12-0.20 seconds QRS = 0.06-0.10 seconds
51
causes of sinus brady
high endurance athletes genetic MI sleep apnea eating disorders hypothyroidism vagus nerve stimulation
52
meds that cause LOW hr
beta blockers digoxin calcium channel blockers amiodarone chemo lithium
53
unstable sinus brady patient tx
IV atropine 1 mg every 3-5 mins DO NOT EXCEED 3 MG temporary pacemaker
54
causes of sinus tachy
FVD/FVE pain fever shock MI hyperthyroidism anxiety/stress atropine illicit drugs stimulants (caffine/nicotine)
55
unstable sinus tach patient tx
IV adenosine IV beta blockers cath ablation
56
A fib patho
SA node is not firing properly the atrias are quivering BLOOD CLOTS can form
57
ECG tracing for A Fib
HR withing normal range rate: irregular P waves are indiscernible
58
what to do before cardiovert or echo for A fib
TEE!! this sees if there are any clots in the LA
59
treatment of A fib
antiarrhythmic medications beta blockers, calcium channel, amiodarone, and digoxin ASSESS APICAL PULSE BEFORE! cardiovert cath ablation anticoagulants
60
CAD: disease processes
chronic stable angina unstable angina NSTEMI STEMI
61
STEMI is
abrupt disruption of blood flow to an area of the heart
62
NSTEMI is
similar symptoms to unstable angina (so chest pain that is at rest) BUT cardiac enzymes are elevated
63
main difference in symptoms of a heart attack from male vs. female
female MAY not have chest pain!! they will have fatigue and fainting
64
lab levels ELEVATED with CAD
LDL high, HDL low homocysteine is HIGH CRP is high
65
tests for MI
troponin I & T HIGHLY SENS to an MI and remain elevated days later CK-MB for heart muscle (detected about 4 hours post MI)
66
gold standard for evaluating CAD
cardiac cath or coronary angiogram
67
calcium channel blockers
Very Nice Drugs verapamil nifedipine diltiazem
68
types of heart failure
left sided right sided biventricular (both)
69
both left and right sided have what manifestations
JVD and SOB
70
manifestations of left sided HF
Left = Lungs dyspnea crackles in lungs pink frothy sputum
71
manifestations of right sided HF
Right = Rest of body ascites peripheral edema murmurs
72
blood test with HF
BNP!! can show is dyspnea is cardiac related too
73
other DX for HF
echo cardiac cath chest x-ray
74
education with HF
smoking cessation SODIUM only 2-3 g/day FLUID only 2 L/day monitor daily weight!!
75
types of cardiomyopathy
dilated hypertrophic restrictive arrhythmogenic
76
restrictive CM
stiffness of ventricles least common
77
arrhythmogenic CM
walls of ventricle replaced with fat = Vtach/Vfib
78
hypertrophic CM
hypertrophy or thickening of LV
79
dilated CM
most common dilation or stretching of ventricles impairs contraction of heart
80
surgical interventions for CM
LVAD
81
pericarditis
inflammation of the pericardium
82
There is approximately ____ mL f lubricating fluid contained between the two pericardial layers to prevent _____ and _____
50 mL inflammation and irritation
83
hallmark sign of pericarditis
pericardial friction rub
84
blood tests for pericarditis
high WBC high ESR & CRP troponin I & T
85
most useful Dx for pericarditis
echo!!! can show fluid accumulation w/in pericardial sac
86
pericardial effusion
Abnormal accumulation of fluid in the pericardial sac that surrounds the heart.
87
client education for pericarditis
don't do any exercise that would make HR go about 100 because that can cause more stress on heart
88
chronic medical condition associated with pericarditis?
renal disease
89
tx for pericardial effusion
Pericardiocentesis
90
In peripheral venous disease
veins are either damaged from infection or injury, occluded from a blood clot, or altered due to a congenital defect pooling of blood in veins
91
Peripheral artery disease (PAD)
atherosclerosis in arteries decreases blood flow in lower extremities
92
central feature of asthma
airway inflammation
93
most common phenotype of astha
allergic
94
least common type of asthma, usually found in adults
non-allergic
95
type of asthma that flares up when the client uses NSAIDs
aspirin-sensitive asthma
96
what could an ABG used for asthma?
hypoxemia and respiratory acidosis
97
treatments for asthma
SABAs: Albuterol LABAs: Symbicort steroids muscarinic (anti-cholinergic): ipratropium
98
what are some adverse effects of anti-cholinergics
EVERYTHING DRY urinary retention and dyspepsia
99
long lasting anti-cholinergic (muscarinic)
ipratropium/albuterol (DuoNeb)
100
define OSA
characterized by episodes of a partial or complete collapse of the airway and a decrease in blood oxygen saturation
101
greatest risk factor for OSA
obesity
102
symptoms of OSA
loud snoring accompanied cessation of breathing for 10 seconds or longer followed by loud snort that wakes the patient up
103
DX of OSA
polysomnographic test sleep study pretty much
104
treatment order for OSA
weight loss & avoid alcohol! positional therapy MAD CPAP BiPAP
105
COPD: two disease processes
emphysema chronic bronchitis
106
most important risk factor for COPD
smoking! so important to educate about smoking cessation
107
severe COPD may have?
barrel chest
108
what kinds of tests to do for COPD
pulmonary function tests
109
what is another med for COPD that is not in asthma
xanthines (Theophylline) usually used alongside a LABA, like salmeterol monitor level should be around 8-20 mcg/mL
110
CAP vs HAP
HAP = acquired in the hospital setting at least 48 hr after admission CAP = community setting (not a hospital) and diagnosed less than 48 hr after admission.
111
two client identifiers
name DOB
112
how to use a metered-dose inhaler!!!
finger on top of the inhaler tilt head back slightly put inhaler in mouth above tongue BREATHE IN WHILE YOU PRESS DOWN and breathe in deep and steady for 3-5 seconds remove and hold breathe for up to 10 seconds
113
AP role
ADLs, vitals (stable patients), I&Os, ambulation
114
LPN role
stable patients, meds (NOT IV push), wound care, data collection
115
enteral nutrition protocols
HOB above 30 degrees
116
restraints
MUST have an order monitor every 15 mints remove ASAP
117
treating low blood sugar
15/15 rule 15g of carbs and recheck in 15 mins

Fundamentals SEM3 (6 decks)

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