FUNDAMENTALS/MANAGEMENT Flashcards

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1
Q

ISOtonic IVFs

A
  • NS (0.9% NaCl)
  • Lactated Ringers (LR) –> burns!!
  • D5W

used for: dehydration, blood loss, NPO pts, burns

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2
Q

HYPOtonic IVFs

A
  • 0.45% NS/NaCl
  • 0.33% NS/NaCl
  • D2.5W

used for: DI, DKA, HHNS, HyperNA

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3
Q

HYPERtonic IVFs

A
  • 1.5/3/5% NS/NaCl
  • D5NS
  • D5 LR
  • D10W

used for: SIADH, HypoNA, cerebral edema, hypoCL

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4
Q

hypoK

A
  • Cushing’s Disease
  • Vomiting
  • Suctioning
  • Alkalosis
  • Steroids, Diuertics, Laxatives
  • NPO
  • Too much IVF
  • Anorexia + Bulemia Nervosa
  • Prominent U waves!
  • Tx: IV K (bananas, avocados, potatoes, beans, milk) + K-wasting Diuretics + Cardiac Telemetry
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5
Q

hyperK

A
  • Addison’s Disease (hypoaldosteronism)
  • Burns
  • Acidosis / DKA
  • Renal Failure
  • ACE-Inhibitors, K-Sparing Diuretics
  • Tall, peaked T waves!
  • Tx: D5W with Regular Insulin, Kayexalate, Loop/Thiazide Diuretics, + NO K+
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6
Q

hypoNA

A
  • Addison’s Disease
  • ALL Diuretics (except osmotic)
  • TOO MUCH water
  • SIADH
  • Polyuria + Diarrhea
  • Suction
  • Vomiting
  • NPO
  • Sweating
  • Tx: give Na (salt), IVF (NS), NO water, Osmotic Diuretics (Mannitol)
    ** Increase Na SLOWLY –> cerebral edema (seizures)
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7
Q

hyperNA

A
  • Cushing’s Disease
  • TOO MUCH salt + hypertonic IVF
  • LITTLE water + Fluid Loss
  • Steroids
  • Osmotic Diuretics
  • DI, DKA, Dehydration
  • Burns
  • Tx: LR or water (NO NS), Loop Diuretics (-ide), STOP Na,
    ** Lower Na SLOWLY –> cerebral edema (seizures)
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8
Q

hypoCA

A

HIGH EVERYTHING!!
- hypoP + hypoPARATHYROIDism + LOW Vit. D
- Chvostek’s (cheek spasm) + Trousseau’s (BP cuff spasm) signs!!
- post-THYROIDECTOMY!
- Celiac Disease + Crohn’s Disease
- Alcohol
- Malabsorption + Malnutrition
- Renal Failure
- Bulemia Nervosa
- Pancreatitis
- Tx: give Ca and Vit. D

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9
Q

hyperCA

A

LOW EVERYTHING!!
- hyperP + hyperPARATHYROIDism + HIGH Vit. D
- DVT!
- Addison’s Disease
- Steroids
- Diuretics
- Immobility
- Bone Cancer
- Tx: NO Ca or Vit. D, IVF (NS), Loop Diuretics (-ide), + Dialysis (if really bad)

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10
Q

Assessments

A
  • ALL assessments: inspection, palpation, percussion, auscultate
  • GI assessment: (IAPP) inspection, auscultation, percussion, palpation
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11
Q

Contact Precautions

A

“SEWER” + VRE
- Skin infections
- Eye infections
- Wound infections
- Enteric (C. Diff) + E. Coli
- Rotavirus + RSV
- VRE
** gloves + gown!

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12
Q

Droplet Precautions

A

“PIMP DRE”
- Pertussis
- Influenza (flu)
- Meningitis, Mumps
- Pneumonia
- Diphtheria
- Rubela
- Epiglottitis
** surgical mask!
** pt wear mask when transporting
** private room (door can be open)

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13
Q

Airborne Precautions

A

“MTV” + Shingles
- Measles
- TB
- Varicella (chickenpox)
- Shingles
** N-95 mask!
** pt wear mask when transporting
** private NEGATIVE pressure room with door CLOSED!

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14
Q

Ear Drops

A
  • ages 0-3 = pinna down + back
  • ages 3+ = pinna up + back
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15
Q

Jewish / Judaism

A
  • KOSHER Diet = NO dairy + meat together!
  • NO pork, fish without scales
  • silverware WRAPPED!
  • belief in prolongation of life = do NOT remove life-support, NO autopsies, + NO cremations!
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16
Q

Jehovah’s Witness

A

NO BLOOD products!!
- except in EMERGENCY situations for CHILDREN!

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17
Q

Islam

A
  • NO pork, meat, alcohol, gelatin
  • Ramadan = refuses food from sun-up to sun-down
  • belief in HOB always above head at ALL times!
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18
Q

Buddhism

A
  • NO meat or alcohol
  • belief in NO pain meds!
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19
Q

Hinduism

A

NO beef or pork!

20
Q

Muslim

A

ONLY halal foods! = killed by a Muslim and prayed over!

21
Q

Mormons

A

NO coffee, tea, or alcohol!

22
Q

Seventh-Day Adventists

A

NO animal products, alcohol, or caffeine!

23
Q

Blood O-

A

universal DONOR = emergency blood!

24
Q

Blood AB+

A

universal RECIPIENT

25
Q

Adult Vaccines

A
  • ages 18-60 = “IT” –> Influenza (yearly) + TDap (every 10 yrs)
  • ages 60+ = “HIP” –> Herpes Zoster (Shingles), Influenza (yearly), + Pneumococcal (yearly)
26
Q

FIRE

A
  • RN Actions: RACE
    Rescue, Alarm, Confine, Extinguish
  • Fire Extinguisher Use: PASS
    Pull pin, Aim at base, Squeeze handle, Sweep side to side
27
Q

CPAP

A

for OSA / sleep apnea + COPD!

28
Q

Beneficence

A

to do GOOD

29
Q

Nonmaleficence

A

to do NO HARM

30
Q

Autonomy

A

pt makes their OWN DECISIONS (consent + advanced directives)

31
Q

Justice

A

fairness

32
Q

Veracity

A

truthfulness

33
Q

Fidelity

A

fulfills commitments, loyalty

34
Q

Assault

A

threat (not physical)

35
Q

Battery

A

physical contact without permission

36
Q

False imprisonment

A

preventing another from moving without consent

37
Q

Defamation

A

damaging someones good reputation
- Libel = written defamation
- Slander = oral defamation

38
Q

Negligence

A

CARELESS (on accident) mistake!

39
Q

Malpractice

A

PREVENTABLE (on purpose) action!

40
Q

NO Parent Consent needed IF:

A
  • pregnant
  • STIs
  • birth control/contraceptives
  • substance abuse
  • suicidal/homicidal
41
Q

Crutches

A
  • 3 point gait = both crutches and weak leg move together, then strong leg
  • swing through = both crutches move, then swing through weak leg, then strong leg
  • UP stairs: good leg, bad leg, crutch
  • DOWN stairs: crutch, bad leg, good leg
42
Q

Canes

A
  • hold on GOOD leg, move cane 6-10 inches, move BAD leg, move GOOD leg
  • measure length from top of cane to wrist crease
  • elbow flexed 15-30 degrees
  • about 4 inches from foot
  • UP stairs = good leg then cane with BAD leg
  • DOWN stairs = BAD leg with cane then good leg
43
Q

Walkers

A
  1. pick up walker
  2. put down walker
  3. walk to walker (BAD leg first)
44
Q

ACIDOSIS

A

LOW EVERYTHING + hyperK+
- metabolic acidosis = dehydration, diarrhea, burns, renal failure, HYPERK
- respiratory acidosis = COPD, pneumonia, hypoventilation

45
Q

ALKALOSIS

A

HIGH everything + hypoK+
- metabolic alkalosis = vomiting, hyperemesis gravidarum, suctioning, HIGH antacids, HYPOK
- respiratory alkalosis = PE, hyperventilation