med surg final Flashcards by Eire Bradley

What does RANDI stand for?

no sharp razors
no aspirin
small needles
decrease needle sticks
protect from injury

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what are causes of renal failure?

polycystic kidney disease
diabetes
hypertension

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What should be monitored during a liver biopsy?

Monitor ammonia levels, PT-INR, PTT, and bleeding precautions.

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What to do if ammonia levels are high?

Give lactulose to lower ammonia levels.

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What position should a patient be in during and after a liver biopsy?

Laying on the right side during the procedure and on the left side afterward for pressure.

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How often should vitals be monitored post-liver biopsy?

Q15x4, Q30x2, and Q1hourx4.

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What are the signs of shock vs hemorrhage?

Shock: High WBC and Lactic Acid. Hemorrhage: Tachycardia and Hypotension.

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What are the three causes of chronic kidney disease (CKD)?

Polycystic kidney disease, diabetes, and hypertension.

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What are the common symptoms of benign prostatic hyperplasia (BPH)?

Urinary retention, nocturia, hesitancy, and weakened stream.

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What predisposes urinary retention to urinary tract infections (UTIs)?

Urinary retention can cause urine to back up into the bladder.

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What are common causes of UTI in the elderly?

Confusion, immobility, and decreased fluid intake.

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What are the signs of a medication allergy?

Fever, chills, hives, and tachycardia. STOP the infusion and notify the HCP.

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What is TURP?

Transurethral resection of the prostate. Notify HCP for fever and inability to urinate.

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What type of foley is used during TURP?

Continuous bladder irrigation (CBI) foley, which is a 3-way foley.

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What is the expected urine output for a patient with CBI?

Output should be higher than intake, ideally 30cc/hr.

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What are the complications to monitor for after TURP?

Fever, retention, hemorrhage, and shock. Call the HCP if these occur.

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What are the preventive measures for UTIs?

Increase fluid intake, wear cotton underwear, loose-fitting clothes, and complete antibiotics as prescribed.

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What is a complication of peritoneal dialysis?

Peritonitis. Teach the patient to look for particles in the lines and ensure the dialysis is warmed.

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What are the signs and symptoms of peritonitis?

Fever, chills, elevated WBC, rigid abdomen, and rebound tenderness.

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What screenings are important for cancer prevention?

Mammograms, colonoscopies, and prostate-specific antigen (PSA) tests.

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What are the types of hepatitis?

Food and waterborne: A and E; Blood serum: B.

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What is the platelet count if someone has thrombocytopenia?

Thrombocytopenia is defined as a platelet count <150,000.

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What are the guidelines for giving blood?

Give blood within 4 hours, hang within 30 minutes, use a 16, 18 or 20 gauge needle, get baseline vitals, and flush the IV.

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What are the different blood transfusion complications?

Hemolytic, febrile, and allergic reactions.

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What is the best way to prevent blood transfusion reactions?

Cross match and have two nurses verify.

What should be discussed after a prostatectomy?

Discuss potential sexual dysfunction.

What are the rules of delegation in nursing?

TAPE: Teaching, Assessment, Predictability, and Evaluation.

Who performs the first dressing change post-surgery?

The surgeon performs the first dressing change.

What are the signs of bleeding issues in cirrhosis?

Low PT-INR, ecchymosis, and petechiae.

What should be assessed in a patient with an AV fistula?

Assess blood flow by feeling and listening to it.

What should be avoided in the arm with an AV fistula?

No IVs and no blood pressure measurements in that arm.

What are the clinical manifestations of elevated ammonia levels?

Confusion, seizures, unstable gait, and asterixis (liver flaps).

What diet should a patient with inflammatory bowel disease (IBD) follow?

A high-fiber diet to flush out the bowels.

What are the dietary recommendations for peptic ulcer disease (PUD)?

Small meals and sitting up after eating.

When does pain occur with gastric vs duodenal ulcers?

Gastric ulcer pain occurs right after eating; duodenal ulcer pain occurs 2 hours after eating.

What are the clinical manifestations of anemia?

Low RBC, dyspnea, pale skin, and weakness.

What is the best intervention for a patient with anemia?

A blood transfusion to stabilize hemoglobin and hematocrit.

How to prioritize patient care?

Consider acute vs chronic conditions, ABCs, and predictability.

What is the difference between ulcerative colitis (UC) and Crohn's disease?

UC typically has 10-20 bloody stools.

Which electrolyte is most critical in the human body?

Potassium.

What is the difference between acute and chronic conditions?

Acute conditions have a sudden onset; chronic conditions last 4-6 months.

What can RNs do that LPNs cannot?

RNs can perform initial assessments and the nursing process (ADPIE); LPNs cannot. IV Meds

What are the sick day rules for a patient with type 1 diabetes?

Take insulin, drink liquids if unable to eat solids, and monitor for ketones and blood sugar.

What are the causes of hypoglycemia?

Too much insulin, not eating, or strenuous activity.

What is the treatment for hypoglycemia?

Orange juice, milk, and crackers. Check blood sugar post-treatment.

What to give a patient who is comatose or unresponsive?

Administer dextrose fluids.

What should be checked in a diabetic patient with decreased sensation in the feet?

Check for injuries on the feet.

What IV fluid is appropriate for a patient with elevated glucose levels?

Normal saline (NS) or lactated Ringer's (LR).

What are the differences between DKA and HHS?

DKA is type 1 diabetes with Kussmaul's respirations, ketones in urine, and fruity breath; HHS is type 2 diabetes without these symptoms.

How to assess a patient's readiness to learn?

Avoid probing questions, giving false hope, and instilling fear.

What are the normal and elevated HbA1C levels?

Normal <5.5, diabetic normal <7, elevated for diabetic patients >8.

What three things are affected by thyroid function?

Metabolism, movement, and mental function.

What are the clinical manifestations of hypothyroidism?

Constipation, weight gain, bradycardia, and cold intolerance.

What should be monitored after a thyroidectomy?

Monitor for thyroid storm and calcium levels.

What are the signs of calcium depression?

Chvostek's sign and Trousseau's sign.

What should be checked at the back of the neck after surgery?

Check for bleeding and sit the patient up.

What can SIADH cause?

Hyponatremia, which predisposes patients to seizures.

What are the clinical manifestations of Cushing's syndrome?

Moon face, buffalo hump, purple striae, and pruitism

What defines AIDS?

CD4 count <200 or presence of an opportunistic infection.

What are the precautions for HIV?

Standard precautions until coughing or airborne precautions are necessary.

What is the pre-operative testing for females?

Pregnancy test.

What increases the risk of bleeding post-surgery?

Check PT-INR, smoking, and alcohol consumption.

What labs will be elevated with pancreatitis?

lipase, amylase