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Med surg > Med surg final > Flashcards

Med surg final Flashcards

1
Q

What is the most common kidney stone?

A

Calcium Stone

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2
Q

What stone is more common in women and is caused by bacteria produced in urease?

A

Struvite Stone

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3
Q

Which stone is predominate in men and is caused by high uric acid levels or diets high in purines (animal protein)?

A

Uric Acid stone

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4
Q

What stone is rare and is cause by an autosomal recessive genetic disorder that affects the absorption of cystine?

A

Cystine stone

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5
Q

What are some risk factors for kidney stones?

A

Genetics
Diet
Medical conditions
medications
Lifestyle

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6
Q

What is the gold standard diagnostic test for kidney stones?

A

Non-contrast CT

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7
Q

What diagnostic test is used when a patient is pregnant?

A

Ultrasound

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8
Q

What does a urinalysis detect?

A

hematuria
crystalluria
infection
pH levels

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9
Q

What is a treatment option for a stone <4mm?

A

It will pass on its own and should strain the urine to capture the stone for analysis

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10
Q

What should the nurse encourage the patient to do?

A

Drink at least 2-3 L of fluids a day

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11
Q

What is another intervention that can help a patient pass the stone?

A

Ambulation

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12
Q

What is a least invasive surgical treatment for kidney stones?

A

ESWL lithotripsy

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13
Q

How does Lithotripsy remove a stone?

A

Uses shock waves to break the stone making it easier to pass

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14
Q

Normal GFR

A

90-120

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15
Q

Stage 1

A

90

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16
Q

Stage 2

A

60-89

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17
Q

Stage 3a

A

45-59

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18
Q

Stage 3b

A

30-44

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19
Q

Stage 4

A

15-29

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20
Q

Stage 5

A

<15

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21
Q

What is the leading cause of CKD?

A

Diabetes Mellitus

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22
Q

what is the second leading cause of CKD?

A

Hypertension

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23
Q

Other causes of ckd

A

Nephrotoxic medication
glomerulonephritis
polycystic kidney disease

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24
Q

What electrolytes would you monitor with CKD?

A

Hyperkalemia
hyponatremia
hypocalcemia
hyperphosphatemia

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25
Q

What is the cause for anemia for CKD?

A

Lack of erythropoietin (decreased RBC production)

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26
Q

Uremic syndrome

A

Accumulation of waste products in the blood due to severely impaired kidney function

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27
Q

Symptoms of Uremic syndrome

A

pruritis
oliguria

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28
Q

What is the most common cause of PUD?

A

H. Pylori

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29
Q

What are the risk factors for PUD?

A

H Pylori
NSAIDS
Alcohol
Smoking
Coffee
Stress

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30
Q

What are 3 complications if PUD is left untreated?

A

Gi Bleeding
Perforation
Gastric Outlet obstruction

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31
Q

What is the expected outcome for PUD

A

Pain management
Self care and management of disease
Follow up and compliance with medication
Be free of complications

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32
Q

Patient Education pud

A

Avoid foods that cause epigastric distress
Adequate rest
avoid cigarettes
reduce alcohol consumption
Avoid OTC unless approved by provider

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33
Q

What is IBS?

A

Chronic abdominal pain and altered bowel patterns

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34
Q

what are the 4 types of IBS?

A

IBS-C
IBS-D
IBS-M
IBS-U

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35
Q

What are the causes of IBS?

A

Altered GI Motility
Gut-Brain axis
psychosocial factors
Altered gut microbiota

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36
Q

Risk factors IBS

A

Family History
History of GI infection
Diet intolerance

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37
Q

Assessment for IBS

A

Patient history on symptoms and patterns

How long has this occurred?

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38
Q

Prevention of flare- ups

A

Dietary changes
Food Diary

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39
Q

Crohn’s disease

A

Inflammatory process that affects the whole GI from mouth to anus

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40
Q

Characteristics of Crohn’s

A

Skip lesions which means it can be mixed in with healthy segments and affects the entire thickness of the GI wall

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41
Q

Crohn’s stool

A

Diarrhea that is not bloody

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42
Q

Crohn’s Pain

A

Cramps found in the LRQ

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43
Q

Complications of Crohn’s

A

Fistula
strictures
Perforation
Increased risk of cancer

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44
Q

Dietary Recommendation for Crohn’s

A

High calorie
Low fiber
Avoid caffeine, alcohol, lactose
Small frequent meals
Should keep a food diary
May need nutritional support (enteral or parenteral)

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45
Q

Ulcerative Colitis

A

Inflammation limited to the mucosa and constant lesions of inflammation throughout the rectum and colon

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46
Q

Ulcerative colitis stool

A

tenesmus and bloody diarrhea

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47
Q

Complication of UC

A

Toxic megacolon
Perforation
High incidence of colorectal cancer in 10 years

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48
Q

UC pain

A

Severe constant pain

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49
Q

What are non modifiable risk factors for CAD?

A

Age
Gender
Family history

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50
Q

What are modifiable risk factors of CAD?

A

HTN
Hyperlipidemia
Smoking
DM
Obesity
Alcohol consumption

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51
Q

What is the golden standard diagnostic testing for CAD?

A

CTA

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52
Q

Interventions for CAD?

A

Non invasive first (dietary changes, exercise, stop smoking)
Then medications (Aspirin or statins)

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53
Q

Stable Angina

A

Occurs in a pattern usually during exercise or stress

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54
Q

What is the treatment for Stable angina?

A

Nitroglycerin or rest

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55
Q

Unstable angina

A

Chest pain that occurs at rest, does not follow a pattern and does not go away easily with medication

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56
Q

What is the treatment for unstable angina?

A

Aspirin and nitroglycerin

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57
Q

Prinzmetal angina (Vasospastic)

A

Occurs at rest

58
Q

What is the treatment for Prinzmetal?

A

Nitrates and or CCB

59
Q

Microvascular angina

A

More common in women and is triggered by daily activities such as shopping or work

60
Q

What is the treatment for microvascular angina?

A

Nitroglycerin

61
Q

What is the most common cause of myocarditis?

A

Viral infection

62
Q

What is the golden standard diagnostic testing for myocarditis?

A

Endomyocardial biopsy

63
Q

What is the least invasive diagnostic for myocarditis?

A

Echocardiogram

64
Q

Ace inhibitor MOA for myocarditis

A

Reduce the workload

65
Q

Diruetics MOA for myocarditis

A

Reduce preload

66
Q

Digoxin MOA for Myocarditis

A

Improve contractility

67
Q

Clinical manifestation of myocarditis

A

SOB with exertion
Chest pain

68
Q

What is the most common cause of pericarditis?

A

Coxsackvirus A and B

69
Q

What is the golden standard diagnostic testing for pericarditis?

A

ECG (ST elevations)

70
Q

Positioning Intervention for pericarditis

A

Sitting up and leaning forward helps relieve pain

71
Q

What is a hallmark clinical assessment finding for pericarditis?

A

Pericardial Friction rub

72
Q

Clinical manifestation of pericarditis

A

Severe sharp chest pain that can radiate to neck, arm or left shoulder

Worst with inspiration and laying flat

73
Q

Risk Factors for Infective Endocarditis

A

Poor dental hygiene
IV drug use
Heart defects
Valve issues

74
Q

IV drug users and infective endocarditis

A

sharing of needles and non sterile technique can introduce bacteria into the blood stream

75
Q

What is the golden standard diagnostic test for infective endocarditis?

A

Blood cultures

76
Q

Complications of Infective endocarditis

A

HF
Stroke
Regurgitation
sepsis
arrhythmia

77
Q

What does the P wave represent?

A

Atrial depolarization

78
Q

What does the QRS represent?

A

Ventricular depolarization

79
Q

What does the T wave represent?

A

Ventricular repolarization

80
Q

What are the primary risk factors for HF?

A

HTN
CAD

81
Q

Complications of heart failure

A

Pleural Effusion
Hepatomegaly
Cardiorenal Syndrome
Anemia

82
Q

What is the MOA of Anticoagulants in HF?

A

Prevent Clots

83
Q

What is the MOA of Diuretics in HF?

A

Reduces Preload

84
Q

What is the MOA of Ace inhibitors in HF?

A

Decreases the after load to improve Cardiac output

85
Q

Lifestyle modifications for HF

A

Weight Management
Diet (sodium restriction)
Regular exercise

86
Q

Tension Pneumothorax

A

Life threatening condition where air enters the pleural space and cannot escape

87
Q

Assessment findings of tension Pneumothorax

A

Tracheal deviation to the UNAFFECTED side

88
Q

Clinical Manifestation of tension pneumothorax

A

Sudden onset of chest pain
dyspnea
tachypnea
decreased or absent breath sounds
HYPERRESONNANCE on percussion
Asymmetrical chest movement

89
Q

Priority Intervention for Tension Pneumothorax

A

Emergency Needle Decompression followed by chest tube insertion

90
Q

Primary Spontaneous Pneumothorax

A

Occurs without an apparent cause and in the absence of significant lung disease often in tall thin individuals

91
Q

Secondary Spontaneous Pneumothorax

A

Occurs with patient who have a preexisting lung disease such as COPD

92
Q

Priority intervention with spontaneous pneumothorax

A

Observation
Oxygen therapy
Needle aspiration or chest tube insertion for severe cases

93
Q

Hemothorax

A

Accumulation of blood in the pleural space

94
Q

Causes of Hemothorax

A

Traumatic
Iatrogenic (medical procedure)
Non-traumatic (bleeding disorders)

95
Q

Clinical manifestation of Hemothorax

A

Dyspnea
Tachypnea
Diminished or absent breath sounds
hypotension
Tachycardia
DULLNESS to percussion on the affected side

96
Q

Priority intervention of Hemothorax

A

Chest tube insertion
Autotransfusion
Surgical intervention

97
Q

Clinical Manifestation of PE

A

Dyspnea
Tachypnea
Chest pain (unilateral)
Hemoptysis
Crackles
Wheezing
Diminished breath sounds on affected side

98
Q

What is the golden standard for diagnostic test for PE?

A

Spiral CT with an IV injection contrast media (CT angiogram)

99
Q

Priority intervention for PE

A

Oxygen therapy
Anticoagulant Therapy
Cardiopulmonary support

100
Q

Risk factors for PE

A

Immobility
surgery within last 3 months
History of VTE
Cancer
obesity
Oral contraceptives
hormone therapy
smoking
prolonged air travel
HF
Pregnancy
Clotting disorders

101
Q

Most Common Causes of PE

A

Arise from DVT in the legs

102
Q

What do you do when the Chest tube is disconnected from the drainage system?

A

Place the distal end of the tubing in a container with sterile water

103
Q

What do you do when the chest tube becomes dislodged from the patient?

A

Cover the incision with petroleum and gauze and tape it on Three sides

104
Q

What is the indication for a thoracentesis?

A

Pleural effusion
Empyema
hemothorax
Pneumothorax
drainage to analyze fluids

105
Q

How do you confirm placement for a thoracentesis?

A

Ultrasound or chest X-ray

106
Q

Encephalitis

A

Acute inflammation of the brain due to viral causes

107
Q

Primary cause for encephalitis

A

Viral
CMV
MMR
Chicken pox

108
Q

Clinical Manifestation of Encephalitis

A

Fever
Headache
nausea
vomiting
Tremors
seizures
personality changes
photophobia
Nuchal Rigidity

109
Q

Diagnostic Test for Encephalitis

A

Lumbar Puncture and CSF analysis

110
Q

Treatment for encephalitis

A

Antiviral Therapy
Symptom management
Fever management
Corticosteroids
Supportive care
Immunisuppressive therapy

111
Q

Nursing Management of Encephalitis

A

HOB 30 degrees to promote reduced ICP
Seizure precautions
Keep environment quiet and dim

112
Q

Bacterial Meningitis

A

Bacterial replication in the subarachnoid space triggers inflammatory response which leads to production of CSF and increased intracranial pressure and edema of the brain tissues

113
Q

Clinical Manifestation Meningitis

A

Fever
Severe headache
Nuchal rigidity
Nausea
photophobia
Petechial rash

114
Q

What is the Brudzinski sign?

A

Involuntary lifting of the legs when the neck is flexed

115
Q

What is the Kernig’s sign?

A

Resistance and pain when attempting to extend the knee with the hips flexed

116
Q

What is the diagnostic testing for Bacteria meningitis?

A

Lumbar puncture and CSF analysis
CT scan/ MRI
Blood cultures

117
Q

Treatment for Bacteria Meningitis

A

Antibiotics Broad spectrum (ceftriaxone or Vancomycin)
Dexamethasone
Supportive care (hydration, fever, pain, Monitoring complications)

118
Q

Bacterial Meningitis CSF findings

A

Elevated WBC
Decreased Glucose
Increased Protein
Cloudy or purulent appearance

119
Q

Viral Meningitis

A

Virus enters the bloodstream throgh common entry ports and enter into the bloodstream and cause inflammation of the meninges.

120
Q

Clinical Manifestations of Viral Meningitis

A

Symptoms are less milder and is self- limiting and resolve in 7-10 days

Headache
Fever
Nuchal rigidity
Photophobia
Nausea and Vomiting

121
Q

Diagnostic Test for viral meningitis

A

Lumbar puncture and CSF analysis
VIral Cultures and PCR
Blood test
CT scan/MRI

122
Q

CSF analysis for Viral meningitis

A

Clear and colorless
Increased WBC
Normal or slightly elevated protein levels
NORMAL glucose levels

123
Q

Treatment for Viral Meningitis

A

Self Limiting
Supportive care (hydration, pain relief)
Acyclovir (HSV or VZV)
Rest

124
Q

Complete Fractures

A

The bone is broken completely through with 2 or more distinct pieces

125
Q

Incomplete Fracture

A

A fracture in which the bone is not broken all the way through

126
Q

Closed Fracture

A

Fracture where the skin remains in tact and the bone does not break skin

127
Q

Open Fracture

A

Fracture where the bone breaks through the skin, creating an open wound

128
Q

Comminuted fracture

A

Bone is shattered into 3 or more pieces

129
Q

Segmental Fracture

A

Fracture that creates 2 or more bone fragments that separated from the main body of the bone

130
Q

Avulsion fracture

A

Fragment of bone is pulled off by a tendon or ligament due to a sudden contraction or stretch

131
Q

Displaced fracture

A

The bone ends are out of normal alignment

132
Q

Non displaced Fracture

A

The bone ends retain their normal position even though the bone is broken

133
Q

Closed Reduction

A

Manual realignment of the bone fragment without surgical intervention

134
Q

Open Reduction

A

Surgical realignment of bone fragments using internal fixation

135
Q

Cast and splints

A

Used to immobilize fraction and allow healing

136
Q

External fixation

A

Pins or screws are placed in the bone and connected to a stabilizing frame outside the body

137
Q

InSurgical interventionInternal fixation

A

Metal rods, plates, screws are inserted to hold bone fragments in place

138
Q

Bone Grafting

A

May be necessary in case of bone loss of poor healing

139
Q

Rehab

A

Physical therapy
Weight-bearing exercise

140
Q

Nursing Management

A

-Assess for circulation
-Monitor for compartment syndrome (pain, Pallor, paresthesia, paralysis and pulselessness)
-Pain management
-Prevent complications (infection and fat embolism syndrome)

Med surg (2 decks)

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