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Med Surg 3 > Med Surg Final Review > Flashcards

Med Surg Final Review Flashcards

1
Q

CD4 Count

A

800-1400
Anything <200, you have AIDS
<800, immunosuppressed

Interventions for Aids
- blood spills should be cleaned with 1:10 bleach

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2
Q

Sickle Cell Anemia

A

2 triggers: dehydration and hypoxia

Hypoxia: painful in varied tissues

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3
Q

Causes of leukemia

A
  • radiation
  • Immature WBC
  • Infection
  • Low platelets
  • Decreased RBC
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4
Q

Anemia

A
  • pale
  • SOB
  • Pica

Pernicious anemia- intrinsic factor for B12 insufficient, seen in bypass patients and elderly

Iron deficiency anemia- could be due to hemorrhage or low iron

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5
Q

DIC

A

decrease in clotting factor

Give heparin, clotting factors, and plasma because it has clotting factors in it

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6
Q

If patient is in kidney failure what lab should we check?

A

Creatinine

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7
Q

Test that differentiates Hodgkins from non-hodgkins

A

Reed Sternberg

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8
Q

Bone Marrow Transplant

A

Give chemo first to kill off everything, wait 2-3 days, give stem cells IV. If patient rejects stem cells, will get peeling in hands and feet

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9
Q

Chemotherapy

A

Costic- give through central line- can be oral, intrathecal, or IV- if IV, dilute!!!! Lots of water!!!- most important lab to watch is platelets

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10
Q

Radiation

A

SE: fatigue, pathological fractures later on

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11
Q

Parkinsons

A

Starts as a tremor, moves to shuffle, then the face.
RISK FOR: falls and aspiration

SE to dopamine: involuntary movement, anxiety, psychological SE such as dementia, allergy

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12
Q

Allergic reactions

A

Happen within 20-30 minutes of exposure. Give Epi: 1.3-1.5mL of 1/1,000

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13
Q

Lupus

A

Can impact all systems so we can’t predict what it will effect in each patient.
Mostly seen in females
Diagnostic test: First ANA, then Anti-Smith test

Treatment: Goal: prevent further deterioration of the organ attacked. Give Aspirin, NSAIDs, anti-rheumatic medications

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14
Q

Guillian Bare

A

Diagnostic test: EMG and spinal tap

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15
Q

Myasthenia graves

A

Often see ptosis

Diagnose: give tensilon- 20 minutes later they will be fine Can also put ice on the eyes

Treatment: Tensilon

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16
Q

Multiple Sclerosis

A

Treat with IV steroids

3 things to check when giving steroids:

  • immunocompromised
  • taper down
  • blood glucose
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17
Q

Plasmaphoresis

A

Can do for antibody disorders. Take blood, remove antibodies and return blood to body.

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18
Q

Seizures

A

Grand mal- following seizure: check for injury, turn on side and let sleep

Epilepsy: will be on dilantin forever, should never take Coumadin

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19
Q

COPD

A

High H&H, High RBCs
Check blood gasses and pulmonary function
O2- 2-4L/min max

Postural drainage is involved in chest physiotherapy
Smoking increases mucous
PC: pneumonia

20
Q

Incentive spirometer used to prevent what?

A

Pneumonia

21
Q

TB

A

Night sweats

Diagnostics: has to be sputum

If you have a positive ID test, need to have 3 consecutive sputum negatives and then you go home

22
Q

OSHA

A

protective clothing, hobbies, smoking, dust

23
Q

Systemic IV

A

At risk for overload or air embolus

24
Q

Cytoxic vs. Anaphylactic allergic reaction

A

Blood transfusion- cytoxic

Anaphylactic- bee sting, food- can prevent death by wearing a medical bracelet.

25
Q

Transfusions

A

Plasma/albumin/platelets- special, shorter tubing

26
Q

Thyroid

A

If the thyroid is the problem, TSH is high because the thyroid is not putting T3 and T4

Graves disease- Hyperthyroidism, poppy eyes
Hypothyroidism- goiter, tired, always cold, weight gain

Goiter- can happen with either hyper or hypo

Thyroid storm- hyperthyroidism, high temp, drug of choice to treat is PTU and tapisol

27
Q

Adrenal Gland

A

Addison’s disease- hypo function. Give Salt and steroids. can be fatal without steroids (Addison’s crisis), Need more steroids with stressed. If they take too much steroids, could end up with cushings

Cushings disease- hyper function.

28
Q

parathyroid

A

Hypoparathyroidism–> hypocalcemia–> tetany–> notify provider and give Calcium gluconate

Hyperparathyroidism- at risk for kidney stones–> push fluids

29
Q

DI and SIADH

A

Diabetes Insipidus- Low specific gravity, peeing a lot so more electrolytes left inside the body- SG will be: 1.001-1.005

SIADH: Will have a high specific gravity. Not peeing enough so electrolytes are diluted in the body.

30
Q

Hypertension

A

Impacts cardiovascular and kidney the most. Should lose weight. Should be on a low fat, low sodium diet. Exercise: walking

Meds: ACE inhibitors, Lasix- depletes potassium so watch if also on digoxin

31
Q

Nitroglycerine

A

Vasodilator used to relieve angina. Give 1 every 5 minutes X3. If no relief, call 911, probably an MI.

32
Q

CAD

A

Caused by Increased fat in diet and low activity level. If the artery is totally plugged we can give a thrombolytic within the first 6 hours. If it is not totally plugged, we will give heparin and a stent.

Should be on a low fat diet to prevent CAD

33
Q

CHF

A

First sign of right sided HF- edema
First sign of left sided HF- dyspnea because fluid is backing up into lungs.

PC: pulmonary edema, LISTEN TO THE LUNGS and look for frothy pink sputum (also important to look for this in PEs)

Probably on Lasix, look at potassium and report any weight gain.

34
Q

Angina

A

Ischemia of the heart- sit them down and stop activity.

Stable angina- goes away with rest

Unstable angina- does not go away even with rest, can be a precursor to an MI

Ballooning and Stenting are good for both stable and unstable angina- also good for kidney carotids and PAD

35
Q

MI

A

means infarction- pain is unrelieved

Treat with MONA- Morphine, oxygen, nitroglycerine, and ***chewable aspirin. Also give beta blockers.

EKG can show an MI while it’s happening or it could not.

36
Q

Acute Coronary Syndrome (ACS)

A

Any condition brought on by a sudden reduction or blockage of blood flow to the heart.

Algorithm- Nitro X3, O2, aspirin, beta blocker

ST elevation is very significant in diagnosing ACS

Need to sit down, rest, and take nitro. If no relief, could be unstable and lead to an MI.

37
Q

Tissue Plaminogen Activator (TPA) (Thrombolytics)

A

Must be given within the first 6 hours of pain.

PC is a Pulmonary embolism (check for pink, frothy sputum), or stroke

38
Q

Heparin

A

Prevents further damage but does not bust clots

Check aPTT levels

Give at same time as warfarin until warfarin levels are sufficient, then d/c heaprin

Antidote: Protamine sulfate
Antidote to warfarin- vitamin K

39
Q

Infection of the heart

A

Named by location:
Pericarditis
Myocarditis
Endocarditis

At risk: IV drug users

Can lead to cardiomyopathies
Give antibiotics
Diagnose with echo

40
Q

Aortic regurgitation

A

first sign: blood goes back into the lungs, difficulty breathing

41
Q

Stenosis

A

A narrowing of the spinal canal
Often found in individuals with artificial valves
Need antibiotics

42
Q

Arterial problems (Reynauds and bergers)

A

PC: deep and round ulcer

Experience pain at rest

43
Q

Venous problems

A

PC- superficial and jagged edge ulcer- drainage

Pain with activity

44
Q

PAD

A

Experience intermittent pain usually experienced in the legs

Can be arterial blockage, think about CAD

45
Q

DVT

A

Leg care: don’t move the leg until you know the clot is stable. Even then, a physician or specially trained nurse should move patient.

Med Surg 3 (14 decks)

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