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Med Surg 2 Midterm Flashcards

1
Q

which meds are opioids

A

hydrocodone, codiene, morphine, fentanyl

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2
Q

which meds are non opioids

A

acetaminophen, ibuprofen

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3
Q

what is the most important thing for the nurse to assess prior to administering a opioid

A

respiratory depression

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4
Q

what are symptoms of opioid overdose

A

slow breathing, pin point pupils, respiratory distress, poor circulation

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5
Q

what is the antidote for opioid overdose

A

nalaxone

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6
Q

how would the nurse assess for pain

A

duration, intensity, quality

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7
Q

what type of pain assessment would be useful for a younger client or one that does not speak English

A

faces scale

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8
Q

what is the difference between acute and chronic pain

A

acute: less than 6 months
chronic: more than 6 months

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9
Q

what can happen when a person takes an opiate for an extended period of time

A

have tolerance

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10
Q

what is nociceptive pain

A

somatic and visceral

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11
Q

referred pain

A

pain in arm during heart attack

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12
Q

neuropathic pain

A

referred, nerve pain

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13
Q

phantom pain

A

pain where amputation was

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14
Q

how do NSAIDS work

A

anti inflammatory

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15
Q

who should determine the amount of pain a patient is in

A

patient

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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

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17
Q

what are common side effects of NSAIDS

A

GI BLEEDING!! N/V, headache, ulcer

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18
Q

what is a safety concern when giving opiates to an older adult

A

respiration

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19
Q

what documentation must the patient sign prior to performing any invasive procedure

A

informed consent form

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20
Q

why are food and fluids withheld prior to surgery

A

so aspiration doesn’t occur

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21
Q

what should the nurse do if the patients abdominal wound eviscerates

A

cover with saline wet gauze and call doctor

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22
Q

if a person develops a tolerance for opioids what should the nurse do

A

request a higher dose from doctor

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23
Q

what is an important safety measure when a patient has received pre op sedation

A

raise bed rails - respiration

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24
Q

what are symptoms of a pulmonary embolism

A

shortness of breath, decreased O2, chest pain

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25
Q

what is the priority for the nurse to maintain for a patient immediately post op

A

maintain airway

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26
Q

what is the job of a circulating nurse

A

doesn’t scrub - charts, gets stuff for surgeon

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27
Q

what is the job of a scrub nurse

A

hands instruments to surgeon

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28
Q

what is the job of an anesthesiologist

A

do anesthesia on patient and monitor

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29
Q

what is the earliest sign of hemorrhage

A

tachycardia

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30
Q

what are common anti emetics

A

promethazine, ondansetron

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31
Q

what are some interventions used to avoid venous stasis/ DVT

A

ambulation, TED hose

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32
Q

what are the different reasons for surgery and what do they mean

A

emergent: right away
urgent: within 24 hours
elective: choose to have it done - scheduled appointment

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33
Q

what aspects can increase the risks for surgical complications

A

age, severity of illness, smoker, diet, lifestyle

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34
Q

what is the priority before giving a post op patient fluids

A

check gag reflex

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35
Q

antidote for narcotics

A

nalaxone

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36
Q

antidote for benzodiazepines

A

flumazenil

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37
Q

what does metastasis mean

A

growing of cancer

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38
Q

what is the most common side effect of chemotherapy

A

nausea and vomiting

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39
Q

what class of medications would the nurse give for N/V

A

anti emetics

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40
Q

what is bone marrow suppression (aplastic anemia)

A

doesn’t produce enough blood cells

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41
Q

what are symptoms of bone marrow suppression

A

fatigue, dizzy, rash, bleeding, bruising

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42
Q

when caring for a patient that is receiving chemotherapy how should the nurse protect himself

A

wear chemo safety PPE

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43
Q

what type of room is required for a patient with radioactive implant

A

lead barrier wall - private room

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44
Q

most chemo and radiation is pregnancy category

A

D

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45
Q

which makes chemo at what risk

A

high risk

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46
Q

what is palliative care

A

relieve uncomfortable symptoms

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47
Q

what is extravasation

A

leaking of IV fluid into surrounding tissue

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48
Q

what are symptoms of extravasation

A

pain, swelling, erythema, blistering, tender

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49
Q

if a patient is taking antineoplastic meds what precautions should be taken with their secretions

A

sit to void, put toilet lid down, dispose of chemo waste

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50
Q

what are precautions to be taken for a patient that has a radioactive implant

A

time, distance, barrier

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51
Q

what is the best way to avoid the transmission of HIV

A

abstinence, use condom, avoid blood or body fluid contact

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52
Q

what is a common lung infection seen in AIDS patients

A

pneumocytosis pneumonia

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53
Q

how do antiretrovirals reduce the reproduction of the HIV virus

A

blocks different stages in life cycle

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54
Q

what is the first line of med for a severe allergic reaction

A

epinephrine

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55
Q

what should the nurse do if he suspects a hemolytic reaction to blood transfusion

A

stop transfusion

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56
Q

what are side effects of corticosteroids

A

moon face, hump neck, weight gain, hypertension, easy bruising

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57
Q

most common cause of UTI

A

bacteria

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58
Q

what are some common treatments for UTI

A

antibiotics, fluid intake

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59
Q

K+

A

3.5-5

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60
Q

symptoms of hyperkalemia

A

muscle twitch, cramping, v-fib, dysrythmias

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61
Q

symptoms of hypokalemia

A

weakness, lethargy, dysrythmias

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62
Q

Ca++

A

9-11

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63
Q

symptoms of hypercalcemia

A

N/V, lethargy, polyuria, thirst

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64
Q

symptoms of hypocalcemia

A

increased P, trosseau’s, chvosteks

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65
Q

treatment for hypercalcemia

A

lasix, dialysis, calcitonin

66
Q

treatment for hypocalcemia

A

Ca+ supplement, hydroxide, IV, Vitamin D

67
Q

Na+

68
Q

Creatinine

69
Q

what is the most common hereditary kidney disease

A

polycystic kidney disease

70
Q

nursing care of patient with renal calculi

A

strain the urine

71
Q

normal Specific gravity

A

1.010-1.030

72
Q

procedure for 24 hour creatinine clearance

A

pee 1st in toilet - collect rest for 24 hr in container - next day pee 1st in container

73
Q

UA normal

A

clear, straw-amber, 1,000-2,000/day

74
Q

normal Urine output per hour

75
Q

what condition would you expect to see with various abnormal urine results

A

renal failure

76
Q

abnormal urine

A

protein, glucose, ketones, nitrites

77
Q

fluid volume status - best indicator

A

daily weights

78
Q

symptoms of fluid overload

A

increased weight, edema, ascities, increase BP, JVD, crackles in lungs

79
Q

treatment of fluid overload

A

decrease NS, decrease fluid, diuretics, dialysis

80
Q

symptoms of dehydration

A

decreased BP, decreased weight, weak, dark urine, bad skin turgor

81
Q

treatment of dehydration

A

IV fluids, drink

82
Q

renal failure most common causes

A

infection, obstruction, hypertension, diabetes

83
Q

normal kidney function

A

excretes waste, electrolyte balance, fluid balance,

84
Q

symptoms of kidney failure

A

anemia, edema, electrolyte imbalance, increase BUN creatinine, metabolic acidosis

85
Q

what are causes of kidney failure

A

diabetic nephropathy, glomerulonephritis, nephritic syndrome

86
Q

pre-renal

A

before kidney

87
Q

intra-renal

88
Q

post-renal

A

after kidney

89
Q

what is sodium polystyrene sulfonate (kayexalate) used for

90
Q

types of dialysis

A

hemodialysis, peritoneal dialysis

91
Q

how would you check patency of AV fistula

A

feel the thrill

listen for the bruit

92
Q

osmotic

93
Q

potassium sparing

A

spironolactone

94
Q

loop

A

furosemide, bumetanicde

95
Q

thiazide

A

chlorothiazide

96
Q

carbonic anhydrase inhibitor

A

acetazolamide

97
Q

what would be a contraindication for carbonic anhydrase inhibitor

A

sulfa drugs, sulfonamides

98
Q

what types of diuretics are used for increased ICP or glaucoma

A

osmotic diuretic

99
Q

what is tress incontinence

A

incontinent when jump, laugh, sneeze

100
Q

what is ileal conduit

A

part of ileum attached to ureters - have a stoma to empty urine

101
Q

what is output is expected with ileal conduit

A

cloudy (mucus)

102
Q

what is the cause of polycystic kidney disease

103
Q

what is the most common cause of glomerulonephritis

104
Q

what main symptom would you see in nephritic syndrome

A

edema, ascites

105
Q

what should a patient avoid prior to an EEG

A

caffeine day before

106
Q

what does the hypothalamus do

A

regulates body temp

107
Q

what can happen inf anticonvulsants are discontinued abruptly

A

rebound seizures

108
Q

what are signs of increased ICP

A

headache, confusion, N/V

109
Q

what is treatment and nursing considerations for a patient that is seizing

A

keep safe, don’t hold down or put objects in mouth

110
Q

what is the first line medication for status epilepticus

A

diazepam (valium)

111
Q

if an ischemic stroke is suspected, how long is the treatment window

112
Q

which hematoma results from an arterial bleed

113
Q

which hematoma results from a venous bleed

114
Q

what is a concern if a post menopausal woman has vginal bleeding

A

endometrial cancer

115
Q

what is a common side effect of terazosin given for BPH

A

temporary loss of consciousness

orthostatic hypotension, dizzy, fainting

116
Q

what hormone lowers blood sugar

117
Q

what hormone increases blood sugar

118
Q

what hormone increases blood calcium

A

parathyroid hormone

119
Q

what hormone decreases blood calcium

A

calcitonin

120
Q

what hormone increases metabolism

A

thyroxine, T3

121
Q

what hromone causes decreases inflammation

122
Q

what hormone causes reabsorption in the kidneys and water follows

A

antidiuretic hormone

123
Q

what is a way to help avoid aspiration in a person receiving a continuous tube feeding

A

semi-fowlers position

124
Q

when codeine is used as an antitussive what are some teaching points for the patient

A

don’t drive or operate heavy machinery

125
Q

what constitutes a positive TB test

A

hard bump (induration)

126
Q

what does a negative test look like

127
Q

rifampin (commnoly given for TB) has what side effect

128
Q

albuterol inhaler how does it work

A

opens up airway

129
Q

side effects of albuterol

A

wheezing, chest tightness, trouble breathing

130
Q

contraindications for albuterol

A

hypertension, diabetes, seizures, hypokalemia

131
Q

what are modifiable and non-modifiable risk facts for CAD

A

modifiable - smoking, increased BP, exercise, diabetes

non-modifiable - age, gender, family history, race

132
Q

what common blood tests is used to monitor coagulation when a person is on warfarin

133
Q

what blood tests is used for a patient taking heparin

134
Q

where is the most common area to find peripheral edema

A

lower legs

135
Q

prior to giving digoxin what should be checked

A

apical pulse

136
Q

if apical is low, what should be done

A

don’t give digoxin

137
Q

prior to giving a beta blocker what should be checked

A

apical pulse

138
Q

if apical is low what should be done

A

don’t give beta blocker

139
Q

what is a common class of medication used to relieve fluid overload in CHF

140
Q

what is the most accurate way to monitor fluid balance

A

daily weights

141
Q

what is the electrical pathway through the heart

A

SA node - AV node - Bundle of HIS - R/L bundle branches

142
Q

which is known as the pacemaker of the heart

143
Q

if a patient has a history of rheumatic fever or valve disease/replacement what should be done before all dental work and every procedure

A

give prophylactic antibiotics

144
Q

what is pernicious anemia

A

anemia because of lack of B12

145
Q

what are side effects of iron supplement administration

A

constipation, black stool

146
Q

Hg

147
Q

Hct

148
Q

RBC

A

4-6 million

149
Q

WBC

A

5,000-10,000

150
Q

Platelet

A

150,000-450,000

151
Q

too many

152
Q

too few

153
Q

what symptoms would you see with too few platelets

154
Q

what symptoms would you see with too many WBC

155
Q

what symptoms would you see with low Hg & Hct

156
Q

what ethnic groups are most likely to have sickle cell anemia

A

African Americans

157
Q

what is the antidote for warfarin

158
Q

what is the antidote for heparin

A

protamine sulfate

159
Q

normal coagulation studies for heparin (PTT)

A

25-35 seconds to clot

160
Q

normal coagulation studies for warfarin (PT/INR)

A

2-3 is therapeutic

Med Surg 2 (8 decks)

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