Med Surg Final Flashcards
What is the treatment for anthrax
antibiotics - penicillin, doxycycline, ciprofloxacin
antiemetics
promethazine, dexamethasone, ondansetron
emetics
syrup of ipecac, charcoal
How to check for placement of an NG tube
inject air, and listen for placement with stethescope
When do you hold tube feeding
100 mL or more
How should the head of the bed be for a tube feed person
semi fowlers
Post op abdominal surgery nursing care
splint incision, bowel sounds, gag reflex, bleeding, pain control
signs and symptoms of appendicitis
RLQ pain, guarding, rebound tenderness
Post op care for appendectomy
pain, bleeding, gag relfex
what complications to watch for post op appendectomy
infection - bleeding
with a gastrectomy or gastritis - what vitamin will be lacking and why
B12 - not enough intrinsic factor
what condition would not enough B12 cause
Pernicious Anemia
Treatment for pernicious anemia
B12 injections
symptoms of Pernicious anemia
confusion, anemic symptoms, sweating
gastric ulcer
open sore in stomach
GERD
stomach contents comes up into lower esophagus irritates it and causes heart burn
hiatal hernia
part of stomach pushes up through diaphragm
What is the most common cause of gastric and duodenal ulcers
H. pylori bacteria
What is the treatment for gastric and duodenal ulcers
antibiotics - antacids
If metronidazole (flagyl) is used what special instructions would you give the patient
don’t drink alcohol
What medications are used to treat GERD
Antacid - counteracts effects of stomach acid
PPI - decreases acid release in stomach
Antidiarrheal - reduces frequency and urgency of bowel movements
what is dumping syndrome
food goes down to intestines very fast
What is the cause of dumping syndrome
gastrectomy
symptoms of dumping syndrome
flushing, N/V, tachycardia, abdominal pain
cause of esophageal varices
cirrhosis -severe liver scarring
treatment of esophageal varices
vasoconstrictors
action of vasopressin
constriction of blood vessels
symptoms of esophageal varices
bloating, bleeding, melena, hand tremors
what type of effluent comes from each ostomy
ileostomy - liquid
colostomy - formed
symptoms of impaction
liquid stool, pain, urge to defecate, N/V, headache
treatment for diarrhea
BRAT diet, pedialyte, fluids, electrolytes
meds for diarrhea
loperamide, bismuth subsalicylate (pepto bismol)
treatment for constipation
fiber, exercise, fluids
meds for constipation
laxatives - senna - docusate sodium - psyllium - bisacodyl
what is crohn’s disease
chronic inflammation of digestive tract lining
surgical treatment for crohn’s disease
bowel resection
what is intussception
intestine telescopes itself
what is volvulos
intestine twists
what is diverticulitis
inflamed outpouches in the sigmoid colon
common cause of diverticulitis
constipation - eating seeds
symptoms of ulcerative colitis
abdominal cramps - pain - rectal bleeding - blood diarrhea
symptoms of irritable bowel syndrome
gas, bloating, constipation, diarrhea, depression, palpitations
treatment for Irritable bowel syndrome
increase fiber - small meals - stress management
when should an abdominal hernia be considered an emergency
when it doesn’t go back inside after lying down or with pressure
symptoms you should observe for emergency hernia
fever, chills, N/V, blood stool
what foods can people with celiac disease not have
gluten
what are normal functions of the liver
produces bile, metabolism, filters out toxins, gets rid of ammonia
symptoms with liver failure
jaundice, confusion, increased ammonia, increased PT
How are hepatitis A and E transmitted
fecal - oral
how are hepatitis B and C transmitted
blood and body flulids
melena
old blood in stool
hematochezia
new blood in stool
hematemesis
new blood in vomit
cause of pancreatitis
heavy alcohol use - gall stones
what meds would you give for pancreatitis
H2 blockers
typical labs ordered for pancreatitis
serum amylase 3X normal
what is the cause of gallbladder diseaese
gallstone stuck in biliary duct
symptoms of gallbladder disease
pain RUQ, N/V, fever, chills, jaundice
post op care for gallbladder disease
bleeding/ infection
tests for hearing acuity
weber test - tuning fork on head - same sound in both ears
rinne test - tuning fork behind ear on bone - in front of ear - air conduction twice as long as bone conduction
whisper test - whisper - see if they heard what you said
How would you document normal pupils
PERRLA - pupils equal round reactive to light accommodation
vision assessment
snellen chart
what do the numbers on a snellen chart mean
20/20 client sees at 20 ft what normal vision would see at 20 feet
20/100 client sees 20 ft normal 100 feet
what instructions would you give a patient after experiencing eye trauma
patch both eyes
visual disturbances with glaucoma
can’t see peripheral - only central vision
visual disturbances with macular degenereation
only peripheral - central blacked out
visual disturbances with retinal detachment (diabetic retinopathy
blurry with spots
visual disturbances with cataracts
blurry
cause of conjunctivitis
bacteria
treatment for conjunctivitis
antibiotics
nursing care for vision impaired
plate compare to clock - talk when entering room
nursing care of the hearing impaired
talk low pitch - slowly - clearly
otitis externa
painful infection of outer ear
symptoms of otitis externa
redness, warmth, pain itching, pressure
teaching for otitis externa
use ear plugs when swimming, don’t swim for 7-10 days
otitis media
inflammation of middle ear
what are symptoms of Meniere’s disease
vertigo, tinnitus, hearing loss
treatment of Meniere’s disease
diuretics, surgery, promethazine (antivertigo), not highly stimulating areas, carbonic anhydrase inhibitor
what is otosclerosis
new bone forms along stapes - stapes becomes immobile - hearing loss
meds that dilate pupil
mydriatic
meds that constrict the eye
miotics
cause of glaucoma
increased pressure
acute open angle glaucoma
no symptoms until vision loss has occurred
closed angle glaucoma
caused by sudden increase in pressure in eye
goal of meds and surgery in glaucoma
decrease pressure
what type of eyedrops are typically given for glaucoma
miotic - pilocarpine
what medications/ eye drops should be avoided
corticosteroids, antihistamines, anticholinergics (atropine), decongestants
procedure for adult ear drops
pull ear up and back
procedure for kids ear drops
pull ear down and back
procedure for eye drop administration
pull down lower eyelid and drop into lower conjunctiva
Right eye
OD
Left eye
OS
Right ear
AD
Left ear
AS
both eyes
OU
both ears
AU
what is the expected treatment for a severe allergic reaction
epinephrine
what should the nurse have on hand when a patient is undergoing allergy testing
epinephrine
what does histamine do
sympathetic nervous system - fight or flight
what is an autoimmune disease
your immune mistakes your body as foreign and starts destroying it
symptoms of hemolytic transfusion reaction
itching, redness, warmth, hives
nursing care for hemolytic transfusion reaction
stop immediately
check vitals
maintain IV access
call doctor
what vitamin is needed to absorb Calcium
vitamin D
what vitamin is needed to absorb Iron
Vitamin C
Name some corticosteroids
hydrocortisone, prednisone, methylprednisone
what are the side effects/health effects of corticosteroids
moon face, hump neck, weight gain, facial hair, increase blood sugar, osteoporosis, cataracts
what are special instructions would you give to a patient taking corticosteroids
don’t discontinue abruptly
how is HIV transmitted
blood and body fluids
how is it not transmitted
contact, hugging, shaking hands, sharing dishes, closed mouth kissing, mosquitos, ticks
how can HIV be prevented
abstinence - condoms - don’t inject drugs
what precautions would you use when caring for an HIV infected patient
cook produce completely - contact precautions
what are HIV meds
antiretroviral - zidovudine
what is the most common cuase of death
Aids - pneumonia
what teaching instructions would you give to AIDs patient regarding what to avoid
cook produce completely
nursing measures to administer topical meds
on skin
side effects of accutane
dry mouth, cracked lips, itchy, dry nose, nose bleeding
pregnancy category of accutane
category X
macule
flat colored spot
papule
solid raised lesion
vesicle
fluid filled blister < 1 cm
pustule
pus filled
bulla
fluid filled vesicle > 1 cm
wheal
red around - white in middle - hives
lichenification
caused by itching - thick leathery patches of skin
crust
scab
plaque
raised lesion > 1 cm scaly, crust
cyst
pouch of semi solid, solid, liquid fluid
fissure
split - crack in skin
ulceration
opened sore - dermis
erythema
red - dilation, infection
jaundice
yellow - liver gallbladder
cyanosis
blue - lungs
pallor
pale - anemia, lack of blood flow
what is herpes zoster
shingles
symptoms of herpes zoster
vesicles, bright red plaques, irritation, itching, fever, pain
treatment for herpes zoster
rest - anti viral - control nerve pain
symptoms of tinea infections
itching, stinging, blisters, red scaly rash
locations of tinea
pedis - foot
cruris - groin
capitis - scalp
corporis - body
complications of burns
ABC
Rule of 9’s what percentage does each body part represent
9%
what percentage does the palm represent
1%
symptoms of inhalation burns
cough, shortness of breath, hoarseness, headache, face - neck burn
if a patient has any injury to an extremity what should the nurse alwasy assess
6 P’s
pulse, pallor, paresthesia, pain, paralysis, poikilothermia
For osteoporosis, what medication stops the resorption of bone and increases the build up of bone
calcitonin
symptoms of gout
stiff joints - pain - redness
what lab test suggests the presence of gout
high uric acid - urine test
typical symptoms of rheumatoid arthritis
joint pain, fatigue, anemia, malaise
Aspirin are often used to treat rheumatoid arthritis. what is the main sign of salicylate (aspirin) toxicity
tinnitus - ringing in ears
symptoms of fat embolism
shortness of breath, tachycardia, hypoxia, confusion
care of client in traction
weights are hanging freely
cast care
don’t put anything in cast - don’t get wet
foods to avoid with gout
alcohol - red meats
management of client with bursitis
exercise - NSAIDS - RICE - rest, ice, compression, elevation
symptoms of osteoarhritis
pain, joints swelling, stiffness
what is osteomyelitis
inflammation of bone caused by infection
which bioterrorism agent can only be transferred between humans
small pox
morbidity and mortality of botulism is usually because of
respiratory distress
when is it acceptable to irrigate and lavage NG tube
when it’s clogged
which fluid to irrigate NG tube with
NS
symptoms of hemorrhagic shock
tachycardia, hypotension, weakness, decreased H & H, decreased LOC
Different colors- drainage from wounds
serous - clear
serosanguinous - pink
sanguinous - red (blood)
which skin lesions should be investigated for possible malignancy
Asymmetrical Border irregular Color Diameter Elevation - evolution black
which WBC is most common cause of leukemia
lymphocyte
symptoms of leukemia
decreased WBC
treatment of leukemia
chemotherapy - blood transfusion - stem cell transplant
care of client with lumbar puncture
flat on back - drink before and after
care of client with meningitis
droplet precautions
care of client experiencing a seizure
don’t restrain - keep safe - document
care of client with parkinsons
special silverware, no rugs on floor, no cords dragging on floor - easily fall
symptoms of intercranial pressure
headache, confusion, N/V, decreased LOC
care of someone with increased ICP
sedation - drain CSF
What is guillain barre syndrome
immune system attacks nerves - leads to weakness and eventually paralysis - need a blood transfusion
cause of multiple sclerosis
autoimmune
care of client with Bells Palsy
PT test, artificial tears, corticosteroids
care of client with spinal cord injury
keep still - move as a whole
Diet and care of client with iron deficiency anemia
orange juice (vitamin C) - fiber - ferrous sulfate
Treatment plan for a client with sickle cell anemia
blood transfusion
Normal levels of INR if patient is on Warfarin (Coumadin)
2-3
Normal INR if patient isn’t on Warfarin (Coumadin)
1-2
Normal PTT
25-35 sec
Reversal agent for Heparin
Protamine Sulfate
Methods of birth control for a female
condoms - hormonal birth control
which birth control is most effective
abstinence
symptosm of prostitis
urgency - frequency - low back pain
symptoms of BPH
increased urination - frequency - nocturia - weak urine stream
different types of shock
Hypovolemic: sudden loss of fluid Cardiogenic: HA - inflamed heart Obstruction: Obstruction in blood vessel Distributive: Anaphylactic: allergic Septic: infection Neurogenic: CNS damage
symptoms of shock
tachycardia - hypotension - tachypnea - weakness - pale - cool skin
symptoms of myocardial Infarction
angina - shortness of breath - dizzy - nausea
care of person with a heart aneurysm
maintain BP
what causes atherosclerosis
high BP - smoking - high alcohol
symptoms of right sided heart failure
ascites - JVD - edema
symptoms of left sided heart failure
crackles - pink frothy sputum - fatigue
when should clients with infective endocarditis take antibiotics
dental procedure - surgery
what is the history of a person diagnosed with rheumatic fever
strep
what instructions would you give a client on using an incentive spirometer
take a deep breath - make ball high for as long as possible
best time for postural drainage
before meal - on an empty stomach
symptoms of laryngeal cancer
hoarseness for over 2 weeks
care of client with thyroidectomy
thyroid replacement hormone
symptoms of type 1 diabetes
increased thirst, frequent urination, hunger, fatigue, blurred vision
what causes type 2 diabetes
kiet - lifestyle - exercise
symptoms of of hypoglycemia
confusion, dizzy, sweating, hungry
wymptoms of hyperglycemia
polyuria, polydipsia, fatigue, headache, fruit smelling breath
what is the function of the parathyroid gland
controls the body’s calcium levels
