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Adult Health 2 > Final Exam 😍 test 1 > Flashcards

Final Exam 😍 test 1 Flashcards

1
Q

What is the purpose of giving LR?

A

To increase blood volume and increase urine output.

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2
Q

What should we monitor for when giving D5NS?

A

hypervolemia (volume overload/pulmonary edema
- D5NS is a hypertonic solution

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3
Q

Excessive use of LR can cause what?

A

-Metabolic Alkalosis

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4
Q

Avoid giving LR in what type of patients?

A

Pt in renal failure!

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5
Q

What type of pt can you not give hypotonic fluids to?

A
  • hypotensive pt
    -head injuries with increased ICP
  • pt w/ liver disease, trauma, or burns
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6
Q

What is our go-to IV gauge?

A

20!!
- good for IV fluids/UO

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7
Q

What gauge is preferred for blood?

A

18!!

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8
Q

Tubing should be changed every how many days?

A

4

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9
Q

Change IV bag how often?

A

24 hours!

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10
Q

Clotting of an IV cath can be do to what things?

A

-kinked IV tubing
-very slow infusion rate
-empty IV bag
-failure to flush line

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11
Q

What are s/s of hematoma?

A
  • ecchymosis
    -immediate swelling at site
    -blood leaking from insertion site
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12
Q

How do you treat a hematoma?

A
  • d/c and apply direct pressure
    -apply ice on/off 24 hours
    -elevate extremity
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13
Q

s/s of phlebitist?

A
  • pain
    -inflammation
    -swelling
    -warmth
    -tenderness along the vein (Red streak)
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14
Q

How do you treat phlebitis?

A
  • d/c IV
  • Apply warm/moist compress
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15
Q

What are s/s of infiltration?

A
  • coolness of skin
    -edema at or below the site
    -blanching/leaking at insertion site
    -discomfort at site
    -decrease in flow rate
    -coolness of skin
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16
Q

How do you treat infiltration?

A
  • Stop infusion –> d/c IV
  • warm compress to site
    -elevate extremity
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17
Q

What are signs of extravasation??

A

-pain/burning at site
-redness/blistering
-necrosis or sloughing

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18
Q

What position do we put pt in with fluid overload?

A

-High fowlers

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19
Q

What are s/s of fluid overload?

A
  • Increase in Bp/HR
  • bounding pulse
    -JVD
    -cough
  • weight gain
  • edema
    -intake >output
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20
Q

What position do we put pt who are having an air embolism?

A
  • left lateral Trendelenburg position
  • to trap in RA!!
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21
Q

What type of current is when the body becomes part of the circuit?

A

Alternating

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22
Q

What type of current is when the body receives a one directional blast?

A

Direct

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23
Q

What type of burn can cause immediate cardiac or pulmonary arrest?

A

Electrical

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24
Q

What should we NOT do with a superficial partial burn?

A

– don’t apply ice/submerge in ice water!!

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25
Q

What is the main thing you want to watch out for with burn edema?

A
  • compartment syndrome
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26
Q

What are the s/s of burn shock?

A
  • hypotension, tachycardia, AMS, decreased urinary output
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27
Q

What starts to happen in the post- burn shock phase?

A
  • volume increases, UO increases, BP normalizes
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28
Q

What tissue involvement is going on with superficial burn?

A

Epidermal

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29
Q

Wound characteristics for superficial burns?

A

-Mild erythema
-Dry/no blisters
-Blanches easily (blanchable)

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30
Q

What tissue is involved in superficial partial thickness burns?

A

entire epidermis and minimal damage to the dermis

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31
Q

Wound characteristics for superficial partial thickness burns?

A

-Closed or open/weeping blisters
-Pink/red
-Mild edema
-Blanches easily

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32
Q

What is the tissue Involvement with Deep Partial Thickness Burns?

A

Entire epidermis and deep layers of the dermis

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33
Q

What are some wound characteristics of Deep Partial Thickness Burns?

A

-Waxy appearance/ blisters
-Pink/red edges with white center
-Nonblanchable
-Decreased/absent capillary refill

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34
Q

What is the tissue involvement of a full thickness burn?

A

the entire epidermis and dermis is destroyed

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35
Q

What are the wound characteristics of a full thickness burn?

A

-Dry, leathery (eschar)
-Pale, white, brown, black, or charred
-No blanching

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36
Q

What do we suspect if a person has myoglobinuria?

A

Acute tubular Necrosis!!
Red/tea colored urine!

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37
Q

How do you prevent a paralytic ileus d/t a burn?

A

Enteral feeding!

38
Q

What ulcer is specific to burn pt?

A

Curling ulcer

39
Q

What is the main goal in the emergent/resuscitative phase?

A

-airway management

40
Q

what are the fluid and electrolyte changes in the emergent phase of a burn?

A

-decreased blood volume/UO
-hyperkalemia
-hyponatremia
-metabolic acidosis
- elevated H&H

41
Q

What is the main goal in the acute/intermediate phase?

A

Wound healing and infection prevention!

42
Q

What are the f/e changes in the acute phase?

A

-increase UO
-hemodilution
-hyponatremia/hypokalemia
- metabolic acidosis

43
Q

Somone just came in with a burn, and is now having a change in mental status, decreased urinary output, and a decline in respiratory function. What do we suspect?

A

Sepsis

44
Q

A person is spitting up black sputum what do we suspect and do to treat?

A
  • CO2 poisoning
  • Immediate administration of 100% o2 via mask; intubate/ventilation
45
Q

How do you treat an injury above the glottis?

A

-emergent intubation!!

46
Q

What can an injury above the glottis cause?

A

-edema
- which then leads to mechanical obstruction
- which then leads to respiratory failure

47
Q

How do we treat an injury below the glottis?

A
  • intubation/vent/O2
48
Q

What type of diet do we want burn pt to be on orally?

A

-High protein/high calorie

49
Q

Before we perform a dressing change on a burn pt, what do we need to do first?

A
  • premedicate at least 20 min prior to starting!
50
Q

Tell me all you know about that silvadene! :)

A
  • broad spectrum antibiotic
    -easily penetrates eschar
    -NOT FOR FACE
51
Q

Which topical antibiotic therapy is best for the face, but it has minimal eschar penetration?

A

-bacitracin

52
Q

How can we prevent hypertrophic scars?

A
  • ace wraps
    -pressure garments
    -hydrate, massage, and protect healing skin
53
Q

What does aldosterone do?

A
  • increases Na resorption
    -increases K excretion
54
Q

What is the most accurate indicator to determine F&E imbalances?

A

WEIGHT

55
Q

What does erythropoietin do?

A

-Stimulates/regulates RBC production

56
Q

What does pain at the CVA indicate?

A
  • kidney inflammation/infection
57
Q

What is the first sign you see with PKD? and then what follows??

A
  • HTN
    -Hematuria
    -lower back/flank
58
Q

What type of medicines do you give for PKD?

A
  • antihypertensives, antibiotics, pain medicines
59
Q

What causes pyelonephritis?

A
  • upwards spread of bacteria from bladder (untreated UTI!!/ Most common)
    -increased risk incompetent valve/obstruction to flow
    -hormonal changes and urinary retention associated w/ pregnancy
    -long-term use of an indwelling catheter
60
Q

How do we medically manage acute pyelonephritis?

A
  • antibiotics for 2 weeks (Ciprofloxacin, gentamicin)
  • FOLLOW UP 2 WEEKS LATER AND DO C/S!!
61
Q

What is the main symptom with pyelonephritis?

A
  • low back/flank pain
62
Q

What labs do we see with chronic pyelonephritis?

A
  • Low Cr clearance
  • High BUN, Cr
63
Q

What are some complications you can see with chronic pyelonephritis??

A

-ESRD
-HTN
-Renal Calculi

64
Q

How do you treat Chronic pyelonephritis?

A

LT antibiotics!

65
Q

Why does acute glomerulonephritis usually occur?

A

Secondary to strep infection

66
Q

What are some clinical manifestations of acute glomerulonephritis?

A

-hematuria/proteinuria
-hypoalbuminemia
- Cola colored urine
-periorbital/generalized edema
-HTN
-elevated BUN and Cr

67
Q

What kind of diet do we follow for acute glomerulonephritis?

A
  • low protein, low Na, restrict fluids
68
Q

What clinical manifestations do you see with chronic glomerulonephritis?

A
  • feet swelling at night
    -retinal change
    -yellow/grey skin
    -pericarditis
    -s/s of HF
69
Q

How do you diagnosis chronic glomerulonephritis?

A
  • UA- specific gravity fixed at 1.010
    -proteinuria
    GFR < 50
  • increased K
    -metabolic acidosis
    -anemia
    -hypoalbuminemia
  • increased phosphorus/ low calcium
70
Q

How do we medically manage chronic glomerulonephritis?

A
  • antihypertensives
    -na and water restriction
  • Diuretics
    -adequate calories; high value protein diet
71
Q

What are clinical manifestations of nephrotic syndrome?

A
  • MASSIVE proteinuria
  • frothy/foamy/ dark yellow urine
  • hypoalbuminemia
  • edema, soft-pitting
    -hyperlipidemia
72
Q

How do we diagnose nephrotic syndrom

A
  • proteinuria >3.5 g
    -WBC in urine
    -kidney biopsy
73
Q

What meds/diet do we want to be on for nephrotic syndrome?

A
  • loop diuretics, ACE inhibitors, Albumin
    -low sodium, protein, and fat diet
74
Q

What is nephrosclerosis often caused by?

A

-HTN AND DM

75
Q

What can cause pre-renal failure?

A

MI!!!

76
Q

What do we see in the initiation phase of ARF?

A
  • decrease in UO
  • high urine specific gravity
  • low urine Na
77
Q

What phase typically doesn’t respond to diuretics?

A
  • Oliguric
78
Q

What do you see in the oliguric phase?

A
  • Urine output falls below 400 ml/day
  • specific gravity fixed at 1.010
  • reduced GFR
79
Q

What happens in the diuresis phase?

A
  • occurs when cause has been corrected
    -gradual increase in UO, then high output
80
Q

What are you at risk for in the diuresis phase?

A

-DEHYDRATION

81
Q

What happens in the recovery stage?

A
  • labs return to normal –> GFR may permanently be reduced.
82
Q

What labs do you see with ARF?

A

-low sodium, calcium
- high phosphorus, potassium, elevated BUN, Cr.
-metabolic acidosis

83
Q

What clinical manifestations do you see with ARF?

A
  • Fluid volume overload (edema, pulmonary edema, JVD, SOB, HF, HTN)
84
Q

What drugs can you give for ARF?

A

-kayexalate
-50% dextrose, insulin IV
Loop diuretics - lasix, bumex
osmotic diuretics (mannitol)
Bicarb replacement (metabolic acidosis)

85
Q

What are the triad of symptoms for renal cancer?

A

-painless hematuria
-dull pain around kidney
-mass in flank area

86
Q

What drug can we give for renal cancer?

A

-interleukin-2

87
Q

What are we concerned about after kidney surgey?

A
  • hemorrhage/abdominal distention
    -monitor all drains seperatly!!!
    paralytic ileus
    infection
88
Q

What are some nursing interventions for kidney surgery?

A

-educate pt to splint incision with hands or pillow when coughing
- encourage cough and deep breathing q1 hour

89
Q

What is the normal Cr level?

A

-0.5-1.2

90
Q

NORMAL HAMBURGER BUN LEVEL?

A

10-20

91
Q

normal specific gravity level?

A

1.005-1.030

Adult Health 2 (5 decks)

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