Hesi Flashcards
Air precaution: PPE, diseases
N95, negative pressure room
Measles, chicken pox, rubeola, shingles, tuberculosis
Contact precaution: PPE, diseases
Gloves and gown
MRSA, C diff, shingella, E. coli, Hep A and E, skin and wound infection, “resistance”
Precaution for infectious diarrhea, C. diff, Rotavirus, Norovirus
Contact precaution (gloves and gown)
Wash hands with soap and water (no alcohol rub)
Live vaccines
MMR, Varicella, Rotavirus, Intranasal influenza
Donning steps
Gown, mask, goggles, gloves
Doffing steps
Gloves, goggles, gown, mask
Position after cardiac catheter
Leg straight for 2-6 hours
Prevent bleeding and promote circulation
SIADH S/S, labs, treatment
Water retention
S/S; FVO, swelling, bloating, edema
Labs; low sodium, low HCT, high urine concentration
Treatment; fluid restriction, diuretics, 3% NS if Na < 120
Diabetes Insipidus
Excessive water excretion
S/S; FVD, thirsty, polyuria, dehydration
Labs; high sodium, high HCT, diluted urine
Treatment; give fluid, desmopressin
Addison’s disease S/S, labs, treatment
Not enough steroids
Addisonian crisis; severely low BP
S/S; tan brown skin, lethargic, anorexia, kidney malfunction, cardiac problems, immunocompromised, increased for infection
Labs; decreased BS, FVD, decreased Na, increased K
Treatment; give steroids, check BS
Cushing’s disease S/S, labs, treatment
Too much steroids/aldosterone/cortisone
Pituitary tumor
S/S; buffalo hump, moon face, osteoporosis, wound won’t heal, extra hair growth, no periods, thin skin and bruising, immunocompromised, increased risk for infection
Labs; high BS, high Na, FVO, low K
Treatment; restrict fluid, prevent skin breakdown, check BS
Hyperthyroidism (Grave’s Disease)
S/S; fast metabolism, all symptoms are high, exophthalmos, high T3 and T4, decreased TSH
Treatment; give propylthiouracil, Radioactive iodine, thyroidectomy
Hypothyroidism S/S, treatment
S/S; all S/S is down, increased TSH
Treatment; get VS up, give levothyroxine at AM early
Hyperparathyroidism S/S
Increased Ca, decreased phosphorus
S/S; hypercalcemia = constipation, n/v, kidney failure, weaken bones, lethargy, fatigue
Hypoparathyroidism labs, S/S,
Decreased Ca, increased Phosphorus
S/S; hypocalcemia = Trousseau’s sign, Chvostek’s sign, tingling, numbness, seizures, cramps, abnormal heart beats
DKA treatment
0.9 NS
Regular insulin
Add dextrose when BS between 250 - 300
Assess K
Multiple Myeloma characteristics, risk for
Over production of calcium
Risk for hypercalcemia, bone fracture, high BUN and creatinine
Ulcerative colitis diet
High protein and low residue
Avoid high fiber
Polycythemia?
Increased RBC due to tissue hypoxia
Bipolar manic state interventions
decrease stimuli, finger food, no activities that requires focus
High pressure alarm ventilator meaning
Increased resistance
Low pressure alarm ventilator meaning
Disconnection, need immediate attention
ED Triag priority
Trauma, chest pain, respiratory destress, acute neuro
Disaster Triag priority
Red > yellow > green > black
Pneumothorax characteristics, S/S, treatment
Diminished/absent lung sounds on affected side
Tracheal deviation to unaffected side
Changes in LOC, decreased O2, increased HR, dyspnea
Chest tube
Intussusception stool characteristics
Currant jelly and olive shape
Hirschsprung disease
Ribbon like stool
Fail to pass meconium within 24 hours
No stool first 24 - 48 hours
DKA S/S
Hyperglycemia, dehydration, tachy, hypotension, polyuria, thirsty, lethargy, nausea, vomiting, metabolic acidosis, sweet/fruity breath, Kussmaul respiration (deep and rapid),
Hypocalcemia S/S, EKG
Tetany (muscle spasm), Chvostek’s sign (facial), Trousseau’s sign (wrist), prolonged QT
Hepatic Encephalopathy S/S, treatment
Asterixis (flapping tremor)
Lactulose (help excrete ammonia)
GBS S/S, treatment
Respiratory acidosis
IV immunoglobulins, plasmapheresis
Myasthenia Gravis cause, treatment
Not enough acetylcholine (muscle weakness = respiratory paralysis)
Pyridostigmine, neostigmine
V tach treatment
With pulse = stable V tach (amiodarone or synchronized cardioversion)
No pulse = unstable V tach (CPR, defibrillator, epinephrine)
Kawasaki disease S/S
Less than 5 years old
Strawberry tongue
Preeclampsia complication, treatment
HELLP syndrome (hemolysis, elevated liver enzymes, low platelets)
Bed rest and magnesium sulfate
Warfarin antidote
Vit K
Heparin antidote
Protamine sulfate
Benzodiazepine antidote
Flumazenil
Morphine antidote
Naloxone
Acetaminophen antidote
N-Acetylcysteine
Bradycardia treatment, causes
Atropine (only if patient has symptoms pale, cool, clammy)
Vagal maneuver, CCB and Beta blockers
V Fib EKG, treatment, causes
Squiggly line
Defibrillation (not synchronized) before CPR and drugs
Drugs; LAP (lidocaine, amiodarone, procainamide)
Untreated V tach, post MI
V Tach EKG, treatment, causes
WWWWW (tombstone pattern)
Early Defib (apply pads>call out clear>shock)
No pulse = Defib
With pulse = Cardioversion
Post MI, hypoxia, low K, low magnesium
A Fib EKG, treatment, causes
No P wave, uneven QRS
Cardioversion (after TTE clot check)
Digoxin (check apical pulse 60 sec., toxicity max 2.0, potassium lower than 3.5)
Anticoagulants
Valvular disease, heart failure, pulmonary hypertension, COPD, after heart surgery
A Flutter EKG, treatment, causes
Saw tooth pattern
Cardioversion (after TTE clot check)
Digoxin (check apical pulse 60 sec., toxicity max 2.0, potassium lower than 3.5)
Anticoagulants
Valvular disease, heart failure, pulmonary hypertension, COPD, after heart surgery
Supraventricular Tach EKG, caused, treatment
NNNNNNN Super fast pattern
Simulants, strenuous exercise, hypoxia, heart disease
Vagal maneuver
Adenosine (rapid push with flush NS, expect heart rate to stop)
Cardioversion
Torsades de Pointes EKG, causes, treatment
Tornado patterns
Post MI, hypoxia, low magnesium
Magnesium sulfate
Asystole EKG, treatment
Flat line (dead)
Epinephrine, atropine, CPR
No Defib needed
P wave =
Atrial rhythm
QRS wave =
Ventricular rhythm
Lack QRS complexes =
Asystole
Wide QRS complexes =
V Tach
Chaotic or unorganized waves =
Fibrillation
Chaotic and no P waves =
A Fib
Chaotic and no QRS complexes =
V Fib
Bizarre rhythm with QRS complexes =
V Tach
