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Lab values > mark k lecture 2 > Flashcards

mark k lecture 2 Flashcards

1
Q

*How do you respond/treat to pts in denial?

A

Support = Loss
Confront = Abuse

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2
Q

Dependency

A

when they get the significant other to do things or make decisions for them
The abuser is dependent

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3
Q

Co-dependency

A

when the significant other derives self-esteem for doing things or making
decisions for the abuser
The significant other is the co-dependent

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4
Q

How do you treat dependency/codependency?

A

Dependent pts are “abusers” … Confront them
o Co-dependent pts have self-esteem issues … Teach pts how to set limits and enforce them
o Agree in advance on what requests are allowed then enforce
o Teach significant other to say no
o Work on self-esteem on the co-dependent person

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5
Q

Manipulation

A

Manipulation is when the abuser gets the significant other to do things or make decisions
that are not in the best interests of the significant other
o The nature of the act is dangerous and harmful to the significant other

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6
Q

Wernicke (Korsakoff) Syndrome

A
  • Wernicke is an encephalopathy
  • Korsakoff is a psychosis
  • Psychosis induced by Vitamin B1, thiamine deficiency
  • This is a situation the pt looses touch with reality due to vit B1 deficiency
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7
Q

Wernicke (Korsakoff) Syndrome primary S/Sx

A

are amnesia (memory loss) and confabulation (making up stories)
o Confabulation—The lies for this pts are just as real as reality

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8
Q

How do deal with a pt with Wernicke and Korsafoff who is confabulating

A

Redirect the pt to something he can do
o For instance, tell pt something along that line: “Why can we go watch TV to see what is
on the news today”

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9
Q

Characteristics of Wernicke and Korsafoff syndrome

A

1.Preventable … Take B1
2.Arrestable (stop it from getting worse) … Take B1
3.Irreversible (70%) … Will kill brain cells

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10
Q

Disulfiram

A

Antabuse and Revia

Antabuse—Alcohol deterrent
Revia—Antidote

Med that causes pts who drink symptoms of n/v, even
death

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11
Q

duration of Disulfiram

A

2 weeks

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12
Q

Onset of Disulfiram

A

2 weeks

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13
Q

Patient teaching on Disulfiram

A

o Teach pt to avoid all forms of EtOH. Not doing so may lead to symptoms of n/v, even
death
o Teach them to avoid the followings items as they contain alcohol … Mouth wash,
cologne, perfume, aftershave, elixir, most OTC liquid medicine, insect repellant, hand
sanitizer, vanilla extract (can’t have cupcake with unbaked icing)
o On the exam, do not pick the Red Wine vinaigrettes … It does not have alcohol in it

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14
Q

First thing you ask in an overdose nclex Q

A

Is it a upper or downer

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15
Q

List of uppers

A
  • Caffeine
  • Cocaine
  • PCP/LSD (psychedelics/hallucinogens)
  • Methamphetamines
  • Adderall
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16
Q

SS of uppers

A
  • Things go UP!
  • Euphoria, seizures, restlessness,
    irritability, hyperreflexia (3+, 4+),
    tachycardia, increased bowels
    (borborygmi), diarrhea
17
Q

SS of downers

A
  • Things go DOWN!
  • Lethargic, respiratory depression/arrest,
    constipated, etc.
18
Q

The highest priority to anticipate in an Upper is

A

suctioning due to seizures

19
Q

The highest priority to anticipate in a Downer

A

intubation/ventilation

20
Q

At birth, you should assume the baby is withdrawing or intoxicated?

A

Intoxicated within 24hours

21
Q

Every alcoholic goes through alcohol withdrawal approximately

A

24 hours after the person
stops drinking

22
Q

Delirium tremens occurs about

A

72 hours after the person stop drinking

23
Q

Nursing Care Plan Dt

A

NPO (seizures) or clear liquid diet
* Private room, near nursing station
* Restricted bed rest (Pt is not free to move
around as desired—no bathroom)
* Restraints (vest or 2-point lock letters)

Antihypertensive
Tranquillizer
Multivitamin containing B1

24
Q

Nursing Care Plan AW

A
  • Regular diet
  • Semiprivate room, anywhere on the unit
  • Pt is up ad lib (Pt is free to move around
    as desired)
  • No restraints

Antihypertensive
Tranquillizer
Multivitamin containing B1

24
Q

Aminoglycosides

A

Aminoglycosides are the big
guns of ABXs (antibiotics)—
use them when nothing else
works. Aminoglycosides are
unsafe at toxic levels and
safety then becomes an issue.

25
Q

Aminoglycosides used to treat

A

used to treat serious, resistant, life-threatening, Gram negatives infections

26
Q

“A Mean Old Mysin”

A

Aminoglycosides So, treat a mean old infection with a “Mean Old Mycin”

27
Q

examples of uses for Aminoglycosides

A

TB, septic peritonitis, fulminating pyelonephritis, septic shock, infection
from third degree wound covering >80% of the body

28
Q

All aminoglycosides end in

A

Mycin

29
Q

Azithromycin, Clarithromycin, Erythromycin … All have THRO in the middle

A

THRO them off the “Mean Old Mycin” list

30
Q

What are toxic effects?

A

Monitor hearing (#1), balance, tinnitus
(ringing of the ear, Cranial nerve 8 toxicity)

nephrotoxicity (Toxic to the kidneys)
o Therefore, monitor Creatinine

31
Q

Aminoglycosides Q_?

A

8

32
Q

route of Aminoglycosides

A

IM/IV can’t give PO bc they are not absorbed

33
Q

2 cases that Aminoglycosides are given PO

A

Hepatic encephalopathy where ammonia level gets too high (kills bacteria that makes ammonia)
Pre-op bowel surgery (drug sterilizes bowel)

34
Q

2 Aminoglycosides given for bowel sterilization

A

Neomycin Kanamycin

35
Q

“TAP” Levels

A

“TAP”—Trough, Administer, Peak
o Trough before drug administration
o Peak after drug administration
o Trough and Peak levels are drawn because of a drug’s narrow therapeutic window or
index
o Narrow therapeutic window or index means that there is a small difference in what works
and what kills

36
Q

The Trough is always drawn

A

30min after

37
Q

For the peak,

A

Peak SubL 5 to 10 minutes after drug is dissolved
o Peak IV 15 to 30 minutes after drug is finished (bag empty)
o Peak IM 30 to 60 minutes
o Peak SubQ Depends on insulin (See diabetes lecture)
o Peak for PO Not necessary, not tested

Lab values (12 decks)

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