Med Surg 2 Midterm Flashcards
1
Q
which meds are opioids
A
hydrocodone, codiene, morphine, fentanyl
2
Q
which meds are non opioids
A
acetaminophen, ibuprofen
3
Q
what is the most important thing for the nurse to assess prior to administering a opioid
A
respiratory depression
4
Q
what are symptoms of opioid overdose
A
slow breathing, pin point pupils, respiratory distress, poor circulation
5
Q
what is the antidote for opioid overdose
A
nalaxone
6
Q
how would the nurse assess for pain
A
duration, intensity, quality
7
Q
what type of pain assessment would be useful for a younger client or one that does not speak English
A
faces scale
8
Q
what is the difference between acute and chronic pain
A
acute: less than 6 months
chronic: more than 6 months
9
Q
what can happen when a person takes an opiate for an extended period of time
A
have tolerance
10
Q
what is nociceptive pain
A
somatic and visceral
11
Q
referred pain
A
pain in arm during heart attack
12
Q
neuropathic pain
A
referred, nerve pain
13
Q
phantom pain
A
pain where amputation was
14
Q
how do NSAIDS work
A
anti inflammatory
15
Q
who should determine the amount of pain a patient is in
A
patient
16
Q
what is a proper a pain assessment tool to use for a small child or someone mentally disabled
A
wong baker faces scale
17
Q
what are common side effects of NSAIDS
A
GI BLEEDING!! N/V, headache, ulcer
18
Q
what is a safety concern when giving opiates to an older adult
A
respiration
19
Q
what documentation must the patient sign prior to performing any invasive procedure
A
informed consent form
20
Q
why are food and fluids withheld prior to surgery
A
so aspiration doesn’t occur
21
Q
what should the nurse do if the patients abdominal wound eviscerates
A
cover with saline wet gauze and call doctor
22
Q
if a person develops a tolerance for opioids what should the nurse do
A
request a higher dose from doctor
23
Q
what is an important safety measure when a patient has received pre op sedation
A
raise bed rails - respiration
24
Q
what are symptoms of a pulmonary embolism
A
shortness of breath, decreased O2, chest pain
25
what is the priority for the nurse to maintain for a patient immediately post op
maintain airway
26
what is the job of a circulating nurse
doesn't scrub - charts, gets stuff for surgeon
27
what is the job of a scrub nurse
hands instruments to surgeon
28
what is the job of an anesthesiologist
do anesthesia on patient and monitor
29
what is the earliest sign of hemorrhage
tachycardia
30
what are common anti emetics
promethazine, ondansetron
31
what are some interventions used to avoid venous stasis/ DVT
ambulation, TED hose
32
what are the different reasons for surgery and what do they mean
emergent: right away
urgent: within 24 hours
elective: choose to have it done - scheduled appointment
33
what aspects can increase the risks for surgical complications
age, severity of illness, smoker, diet, lifestyle
34
what is the priority before giving a post op patient fluids
check gag reflex
35
antidote for narcotics
nalaxone
36
antidote for benzodiazepines
flumazenil
37
what does metastasis mean
growing of cancer
38
what is the most common side effect of chemotherapy
nausea and vomiting
39
what class of medications would the nurse give for N/V
anti emetics
40
what is bone marrow suppression (aplastic anemia)
doesn't produce enough blood cells
41
what are symptoms of bone marrow suppression
fatigue, dizzy, rash, bleeding, bruising
42
when caring for a patient that is receiving chemotherapy how should the nurse protect himself
wear chemo safety PPE
43
what type of room is required for a patient with radioactive implant
lead barrier wall - private room
44
most chemo and radiation is pregnancy category
D
45
which makes chemo at what risk
high risk
46
what is palliative care
relieve uncomfortable symptoms
47
what is extravasation
leaking of IV fluid into surrounding tissue
48
what are symptoms of extravasation
pain, swelling, erythema, blistering, tender
49
if a patient is taking antineoplastic meds what precautions should be taken with their secretions
sit to void, put toilet lid down, dispose of chemo waste
50
what are precautions to be taken for a patient that has a radioactive implant
time, distance, barrier
51
what is the best way to avoid the transmission of HIV
abstinence, use condom, avoid blood or body fluid contact
52
what is a common lung infection seen in AIDS patients
pneumocytosis pneumonia
53
how do antiretrovirals reduce the reproduction of the HIV virus
blocks different stages in life cycle
54
what is the first line of med for a severe allergic reaction
epinephrine
55
what should the nurse do if he suspects a hemolytic reaction to blood transfusion
stop transfusion
56
what are side effects of corticosteroids
moon face, hump neck, weight gain, hypertension, easy bruising
57
most common cause of UTI
bacteria
58
what are some common treatments for UTI
antibiotics, fluid intake
59
K+
3.5-5
60
symptoms of hyperkalemia
muscle twitch, cramping, v-fib, dysrythmias
61
symptoms of hypokalemia
weakness, lethargy, dysrythmias
62
Ca++
9-11
63
symptoms of hypercalcemia
N/V, lethargy, polyuria, thirst
64
symptoms of hypocalcemia
increased P, trosseau's, chvosteks
65
treatment for hypercalcemia
lasix, dialysis, calcitonin
66
treatment for hypocalcemia
Ca+ supplement, hydroxide, IV, Vitamin D
67
Na+
135-145
68
Creatinine
.5-1.5
69
what is the most common hereditary kidney disease
polycystic kidney disease
70
nursing care of patient with renal calculi
strain the urine
71
normal Specific gravity
1.010-1.030
72
procedure for 24 hour creatinine clearance
pee 1st in toilet - collect rest for 24 hr in container - next day pee 1st in container
73
UA normal
clear, straw-amber, 1,000-2,000/day
74
normal Urine output per hour
80 mL
75
what condition would you expect to see with various abnormal urine results
renal failure
76
abnormal urine
protein, glucose, ketones, nitrites
77
fluid volume status - best indicator
daily weights
78
symptoms of fluid overload
increased weight, edema, ascities, increase BP, JVD, crackles in lungs
79
treatment of fluid overload
decrease NS, decrease fluid, diuretics, dialysis
80
symptoms of dehydration
decreased BP, decreased weight, weak, dark urine, bad skin turgor
81
treatment of dehydration
IV fluids, drink
82
renal failure most common causes
infection, obstruction, hypertension, diabetes
83
normal kidney function
excretes waste, electrolyte balance, fluid balance,
84
symptoms of kidney failure
anemia, edema, electrolyte imbalance, increase BUN creatinine, metabolic acidosis
85
what are causes of kidney failure
diabetic nephropathy, glomerulonephritis, nephritic syndrome
86
pre-renal
before kidney
87
intra-renal
in kidney
88
post-renal
after kidney
89
what is sodium polystyrene sulfonate (kayexalate) used for
high K+
90
types of dialysis
hemodialysis, peritoneal dialysis
91
how would you check patency of AV fistula
feel the thrill
| listen for the bruit
92
osmotic
mannitol
93
potassium sparing
spironolactone
94
loop
furosemide, bumetanicde
95
thiazide
chlorothiazide
96
carbonic anhydrase inhibitor
acetazolamide
97
what would be a contraindication for carbonic anhydrase inhibitor
sulfa drugs, sulfonamides
98
what types of diuretics are used for increased ICP or glaucoma
osmotic diuretic
99
what is tress incontinence
incontinent when jump, laugh, sneeze
100
what is ileal conduit
part of ileum attached to ureters - have a stoma to empty urine
101
what is output is expected with ileal conduit
cloudy (mucus)
102
what is the cause of polycystic kidney disease
genetics
103
what is the most common cause of glomerulonephritis
strep
104
what main symptom would you see in nephritic syndrome
edema, ascites
105
what should a patient avoid prior to an EEG
caffeine day before
106
what does the hypothalamus do
regulates body temp
107
what can happen inf anticonvulsants are discontinued abruptly
rebound seizures
108
what are signs of increased ICP
headache, confusion, N/V
109
what is treatment and nursing considerations for a patient that is seizing
keep safe, don't hold down or put objects in mouth
110
what is the first line medication for status epilepticus
diazepam (valium)
111
if an ischemic stroke is suspected, how long is the treatment window
3 hours
112
which hematoma results from an arterial bleed
epidural
113
which hematoma results from a venous bleed
subdural
114
what is a concern if a post menopausal woman has vginal bleeding
endometrial cancer
115
what is a common side effect of terazosin given for BPH
temporary loss of consciousness
| orthostatic hypotension, dizzy, fainting
116
what hormone lowers blood sugar
insulin
117
what hormone increases blood sugar
glucagon
118
what hormone increases blood calcium
parathyroid hormone
119
what hormone decreases blood calcium
calcitonin
120
what hormone increases metabolism
thyroxine, T3
121
what hromone causes decreases inflammation
cortisol
122
what hormone causes reabsorption in the kidneys and water follows
antidiuretic hormone
123
what is a way to help avoid aspiration in a person receiving a continuous tube feeding
semi-fowlers position
124
when codeine is used as an antitussive what are some teaching points for the patient
don't drive or operate heavy machinery
125
what constitutes a positive TB test
hard bump (induration)
126
what does a negative test look like
no change
127
rifampin (commnoly given for TB) has what side effect
red urine
128
albuterol inhaler how does it work
opens up airway
129
side effects of albuterol
wheezing, chest tightness, trouble breathing
130
contraindications for albuterol
hypertension, diabetes, seizures, hypokalemia
131
what are modifiable and non-modifiable risk facts for CAD
modifiable - smoking, increased BP, exercise, diabetes
| non-modifiable - age, gender, family history, race
132
what common blood tests is used to monitor coagulation when a person is on warfarin
PT/INR
133
what blood tests is used for a patient taking heparin
PTT
134
where is the most common area to find peripheral edema
lower legs
135
prior to giving digoxin what should be checked
apical pulse
136
if apical is low, what should be done
don't give digoxin
137
prior to giving a beta blocker what should be checked
apical pulse
138
if apical is low what should be done
don't give beta blocker
139
what is a common class of medication used to relieve fluid overload in CHF
diuretics
140
what is the most accurate way to monitor fluid balance
daily weights
141
what is the electrical pathway through the heart
SA node - AV node - Bundle of HIS - R/L bundle branches
142
which is known as the pacemaker of the heart
SA node
143
if a patient has a history of rheumatic fever or valve disease/replacement what should be done before all dental work and every procedure
give prophylactic antibiotics
144
what is pernicious anemia
anemia because of lack of B12
145
what are side effects of iron supplement administration
constipation, black stool
146
Hg
12-18
147
Hct
38%-48%
148
RBC
4-6 million
149
WBC
5,000-10,000
150
Platelet
150,000-450,000
151
too many
osis
152
too few
penia
153
what symptoms would you see with too few platelets
bleeding
154
what symptoms would you see with too many WBC
infection
155
what symptoms would you see with low Hg & Hct
anemia
156
what ethnic groups are most likely to have sickle cell anemia
African Americans
157
what is the antidote for warfarin
Vitamin K
158
what is the antidote for heparin
protamine sulfate
159
normal coagulation studies for heparin (PTT)
25-35 seconds to clot
160
normal coagulation studies for warfarin (PT/INR)
2-3 is therapeutic
