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Medsurge 2 Final > Final Study guide > Flashcards

Final Study guide Flashcards

1
Q

Meaning of Compensation

A

Body’s counterbalance of acid base disturbance.

Compensation causes PH 7.35 - 7.45

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2
Q

Acidosis

A

PH < 7.35

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3
Q

Alkalosis

A

PH > 7.45

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4
Q

Respiratory Acidosis

A

Lung disease, narcotics, airway obstruction, neuro disease < 7.35 PaCO2 > 45 Bicarb > 26

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5
Q

Respiratory Aklalosis

A

Hyperventilation, Anxiety, mechanical ventilation >7.45 PaCO2 < 35

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6
Q

Metabolic Acidosis

A

DKA, Renal Failure, hypoxia (shock,cardiac arrest) < 7.35 low bicarb < 22 PaCO2 < 35

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7
Q

Metabolic Alkalosis

A

> 7.45, Bicarb > 26 PaCO2 >45, Vomiting, gastric suction, hypokalemia

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8
Q

Hypernatremia

A

> 145 Restless, thirst, Increased Urine specific gravity, deep tendon reflexes

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9
Q

Hyponatremia

A

< 135 Headache, Dry mucosa, Dehydrated, GI

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10
Q

Hyperkalemia

A

> 5 dysrhythmias, muscle weakness, paralysis including respiratory system

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11
Q

Hypokalemia

A

<3.5 Fatigue, dysrhythmias, GI, numbness, tingling, muscle spasms

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12
Q

Hypercalcemia

A

> 10.5 GI pain, polyuria, bone pain, manic

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13
Q

Hypocalcemia

A

<8.5 tinnitus, depression, impaired memory, seizures, dyspnea & stridor, Prolonged QT, Tetany (hand)

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14
Q

Stroke risk factors

A

High BP, A-Fib, High Cholesterol, DM, smoking, alcohol, obesity, atherosclerosis, age, gender, race, family hx.

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15
Q

SA Node Fx

A

Pacemaker, 60-100 bpm to AV Node

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16
Q

AV node

A

Slows impulses, allowing ventricles time to fill. Synchronizing atrial/ventricular activity, if SA fails AV 40-60 bpm

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17
Q

Pericardiocentesis Interventions

A

Monitor pericarial effusion & cardiac tamponade. Assess EKG, chest tube insertion site

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18
Q

Pulmonary edema Interventions

A

O2, diuretics, pharmacologic preload/afterload reduction, hemodynamic monitoring, Beta2 blocker (albuterol)

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19
Q

ARDS manifestations

A

Rapid onset 12-24 hrs, does not respond to O2, Paradoxical breathing, patchy infiltrates on xray

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20
Q

Increased ICP interventions & s/s

A

Restlessness, pupil dilation (1), confusion, LOC, decorticate posturing. Maintain Airway, Mannitol, hyperventilate, Avoid corticosteroids

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21
Q

Guillain Barre s/s, complications, care

A

Muscle weakness, diminished reflexes, nerves. Monitor RR, BP, HR. Maintain Airway, anti coags

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22
Q

Diabetes s/s, labs

A

A1C < 6.5, Polydipsia, polyphagia, polyuria

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23
Q

DKA s/s, care, complications

A

Metabolic Acidosis, ketones in urine and protein

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24
Q

Glucophage (Metformin)

A

Discontinue and begin after renal fxn returns

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25
Q

Hypoglycemia Medication

A

Glucagon

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26
Q

Acute Pancreatitis Labs

A

Amylase and Lipase

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27
Q

Acute Pancreatitis Teaching

A

Diet, wound care, assistance with ADL’s, Avoid alcohol, Low fat diet

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28
Q

Renal Stent removal care

A

Monitor BP (HTN), bruit over site, decreased renal fx (oliguria) elevated BUN, creatinine. Angioplasty/Surgery? infection control

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29
Q

Cushing’s Syndrome Causes

A

Hypercortisolism, excess production of cortisol

30
Q

Acute Renal Failure Phases

A

PreRenal Failure: HoTN, HypoVolemia. IntraRenal Failure: glomerulonephritis, kidney structure, ATN. PostRenal Failure: Obstruction, low urine output

31
Q

Acute Renal Failure Diet

A

High Carb, Low/Restricted Protein 3+ Urine Ketones

32
Q

PreRenal phase s/s

A

Hypovolemia (hemorrhage, GI fluid loss, burns)

33
Q

IntraRenal Phase s/s

A

ATN ischemic prolonged prerenal state, sepsis,

34
Q

Post Renal phase

A

Ureteric obstruction, bladder outflow obstruction

35
Q

First Responder Emergency Situations

A

4 phases: Preparedness (disaster plan) Mitigation (Organization, identify hazards) Emergency Response (Coordinate response & meet needs) Recovery (Rebuilding community)

36
Q

Priority for Fractures

A

Stabilization of extremity

37
Q

Abx injury & s/s of spleen and/or liver damage

A

Spleen - major hemorrhage, shock, abx pain, distention. LUQ pain. Hypovolemia. Liver: 7-9 rib fracture, RUQ tenderness

38
Q

Priority for Chest Trauma & Fractured ribs

A

Assess RR, O2, RR fxn, suction, stabilize thoracic cage, deep breathing exercise, intubation/mechanical ventilation if necessary

39
Q

chemical burns to eye interventions

A

Flush w/ h2O or NS for 15 min.

40
Q

Burns interventions

A

First 24 hrs replace fluids than infection

41
Q

Burn Electrolyte imbalance

A

Initial fluid shift, elevated hct/hgb, hyponatremia, hyperkalemia. Once fluid immobilized hct/hgb decrease hypokalemic

42
Q

Burn Electrolyte continued

A

WBC increase than decrease, Glucose elevated, ABG’s slight hypoxemia/metabolic acidosis, low protein and albumin

43
Q

HIV

A

1 blood transfusion, sharing needles, sex T4 <200 is Aids

44
Q

HIV interventions

A

Patient education on spreading disease, preventing infection, tx pain & discomfort. PT specific equipment

45
Q

Pneumocystitis Carinii Outcomes

A

PT may present with respiratory distress, mild chest pain, sputum, fever, cough, dyspnea, tachypnea and tachycardia

46
Q

Pneumocystitis Carinii Diagnosis

A

Chest x-ray, pulmonary fxn tests, induced sputum test, bronchoscopy

47
Q

Health Care needle stick. What to do?

A

Squeeze out blood asap, report, blood sample tested

48
Q

STD patient teaching

A

Use condoms, notify sexual partners

49
Q

Who Can’t Donate

A

HIV, Hepatitis, viruses, blood transfusions

50
Q

Organ rejection tx

A

lifelong anti rejection Sandimmune

51
Q

Priority nursing dx for transplants

A

Tissue perfusion to organ, risk for infection

52
Q

Liver transplant indication

A

cirrhosis, liver failure, **alcohol/drug abuse is contraindicated

53
Q

Heart Transplant interventions

A

Bleeding, Chest tube drainage, CO, pulmonary artery and central venous pressures, I&O’s rhythm for dyshythmias

54
Q

RBC’s

A

Male: 4.7 - 6.1 million cells/mcL
Female: 4.2 - 5.4 million cells/McL

55
Q

WBC’s

A

4,500 - 10,000 cells/McL

56
Q

Platelets

A

150,000 - 400,000 McL

57
Q

Cancer complications from Tx

A

Infection, anorexia-cachexia syndrome, paraneoplastic syndrome, toxicity, neutropenia, superior vena cava syndrome, tumor lysis

58
Q

Superior Vena Cava Syndrome Manifestations

A

dyspnea, cough, hoarseness, chest pain, face swelling, cyanosis, distention of Jugular, temporal, arm veins, prominent vein patterns on chest, tachycardia, increased ICP (visual disturbance, HA, dizzy, altered LOC)

59
Q

Tumor Lysis Syndrome manifestations

A

high K+, low Ca+, high Phosphate, uricemia, fatigue, weakness, memory loss, altered mental, muscle cramps, HoTN, dysrhythmias, cardiac arrest

60
Q

Spinal Shock interventions

A

Airway support, fluids, Atropine for bradycardia, vasopressors for BP support.

61
Q

Cardiogenic Causes

A

Pump failure due to MI, HF, cardiomyopathy, dysrhythmias, valvular rupture, stenosis

62
Q

Hypovolemic shock cause

A

hemorrhage, dehydration, trauma, surgery, DM, DI, burns, ascites, peritonitis

63
Q

Hypovolemic monitoring/manifestations

A

primary prevention, monitor fluid deficits, assist w/fluid replacement. Restore intravascular volume correct underlying cause.

64
Q

tx for distributive shock

A

fluids, I&O, V.S., IV, PA and arterial catheters, daily wts, O2, antimicrobials, corticosteroids, norepinephrine, dopamine

65
Q

Distributive Shock Complications

A

Anaphylactic reaction, microvascular thrombosis,

66
Q

s/s of bowel obstruction

A

Pain, cramping increasing w/progression, Vomiting feces, visible peristaltic waves & hyperactive, high pitched tinkling sounds. later BS cease

67
Q

Bowel obstruction interventions

A

Nasogastric or intestinal low suction, surgery? IV fluids NPO, pain/nausea meds

68
Q

Biological warfare

A

anthrax, smallpox, plague (more of a threat)

69
Q

Chemical warfare

A

nerve agents, cyanide, vesicant and pulmonary agents (more apparent)

70
Q

Triage

A

Red: Immediate attention can survive with interventions. Yellow delayed,injured & need attention but will survive, Green - minor injury first aid, Black survival unlikely

Medsurge 2 Final (1 decks)

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