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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
Hypoglycemia Medication
Glucagon
26
Acute Pancreatitis Labs
Amylase and Lipase
27
Acute Pancreatitis Teaching
Diet, wound care, assistance with ADL's, Avoid alcohol, Low fat diet
28
Renal Stent removal care
Monitor BP (HTN), bruit over site, decreased renal fx (oliguria) elevated BUN, creatinine. Angioplasty/Surgery? infection control
29
Cushing's Syndrome Causes
Hypercortisolism, excess production of cortisol
30
Acute Renal Failure Phases
PreRenal Failure: HoTN, HypoVolemia. IntraRenal Failure: glomerulonephritis, kidney structure, ATN. PostRenal Failure: Obstruction, low urine output
31
Acute Renal Failure Diet
High Carb, Low/Restricted Protein 3+ Urine Ketones
32
PreRenal phase s/s
Hypovolemia (hemorrhage, GI fluid loss, burns)
33
IntraRenal Phase s/s
ATN ischemic prolonged prerenal state, sepsis,
34
Post Renal phase
Ureteric obstruction, bladder outflow obstruction
35
First Responder Emergency Situations
4 phases: Preparedness (disaster plan) Mitigation (Organization, identify hazards) Emergency Response (Coordinate response & meet needs) Recovery (Rebuilding community)
36
Priority for Fractures
Stabilization of extremity
37
Abx injury & s/s of spleen and/or liver damage
Spleen - major hemorrhage, shock, abx pain, distention. LUQ pain. Hypovolemia. Liver: 7-9 rib fracture, RUQ tenderness
38
Priority for Chest Trauma & Fractured ribs
Assess RR, O2, RR fxn, suction, stabilize thoracic cage, deep breathing exercise, intubation/mechanical ventilation if necessary
39
chemical burns to eye interventions
Flush w/ h2O or NS for 15 min.
40
Burns interventions
First 24 hrs replace fluids than infection
41
Burn Electrolyte imbalance
Initial fluid shift, elevated hct/hgb, hyponatremia, hyperkalemia. Once fluid immobilized hct/hgb decrease hypokalemic
42
Burn Electrolyte continued
WBC increase than decrease, Glucose elevated, ABG's slight hypoxemia/metabolic acidosis, low protein and albumin
43
HIV
#1 blood transfusion, sharing needles, sex T4 <200 is Aids
44
HIV interventions
Patient education on spreading disease, preventing infection, tx pain & discomfort. PT specific equipment
45
Pneumocystitis Carinii Outcomes
PT may present with respiratory distress, mild chest pain, sputum, fever, cough, dyspnea, tachypnea and tachycardia
46
Pneumocystitis Carinii Diagnosis
Chest x-ray, pulmonary fxn tests, induced sputum test, bronchoscopy
47
Health Care needle stick. What to do?
Squeeze out blood asap, report, blood sample tested
48
STD patient teaching
Use condoms, notify sexual partners
49
Who Can't Donate
HIV, Hepatitis, viruses, blood transfusions
50
Organ rejection tx
lifelong anti rejection Sandimmune
51
Priority nursing dx for transplants
Tissue perfusion to organ, risk for infection
52
Liver transplant indication
cirrhosis, liver failure, **alcohol/drug abuse is contraindicated
53
Heart Transplant interventions
Bleeding, Chest tube drainage, CO, pulmonary artery and central venous pressures, I&O's rhythm for dyshythmias
54
RBC's
Male: 4.7 - 6.1 million cells/mcL Female: 4.2 - 5.4 million cells/McL
55
WBC's
4,500 - 10,000 cells/McL
56
Platelets
150,000 - 400,000 McL
57
Cancer complications from Tx
Infection, anorexia-cachexia syndrome, paraneoplastic syndrome, toxicity, neutropenia, superior vena cava syndrome, tumor lysis
58
Superior Vena Cava Syndrome Manifestations
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
Tumor Lysis Syndrome manifestations
high K+, low Ca+, high Phosphate, uricemia, fatigue, weakness, memory loss, altered mental, muscle cramps, HoTN, dysrhythmias, cardiac arrest
60
Spinal Shock interventions
Airway support, fluids, Atropine for bradycardia, vasopressors for BP support.
61
Cardiogenic Causes
Pump failure due to MI, HF, cardiomyopathy, dysrhythmias, valvular rupture, stenosis
62
Hypovolemic shock cause
hemorrhage, dehydration, trauma, surgery, DM, DI, burns, ascites, peritonitis
63
Hypovolemic monitoring/manifestations
primary prevention, monitor fluid deficits, assist w/fluid replacement. Restore intravascular volume correct underlying cause.
64
tx for distributive shock
fluids, I&O, V.S., IV, PA and arterial catheters, daily wts, O2, antimicrobials, corticosteroids, norepinephrine, dopamine
65
Distributive Shock Complications
Anaphylactic reaction, microvascular thrombosis,
66
s/s of bowel obstruction
Pain, cramping increasing w/progression, Vomiting feces, visible peristaltic waves & hyperactive, high pitched tinkling sounds. later BS cease
67
Bowel obstruction interventions
Nasogastric or intestinal low suction, surgery? IV fluids NPO, pain/nausea meds
68
Biological warfare
anthrax, smallpox, plague (more of a threat)
69
Chemical warfare
nerve agents, cyanide, vesicant and pulmonary agents (more apparent)
70
Triage
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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