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Med Surg ATI > Med Surg Rem > Flashcards

Med Surg Rem Flashcards

1
Q

IBS Diet

A

No dairy, eggs, wheat

Increase fiber to 30-40 g/day

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2
Q

Seizure steps

A

Turn patient on side

Loosen restrictive clothing

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3
Q

Blood transfusion: circulatory overload s/s

A 
Dyspnea
Chest tightness
Tachycardia
Tachypnea 
Headache 
HTN
jugular vein distention 
Edema
Crackles
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4
Q

Blood transfusion: circulatory overload interventions

A 
O2
Vitals
Slow infusion 
Admin diuretics 
Notify provider
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5
Q

TPN Tubing

A

Change every 24 hrs

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6
Q

Glycosylated hemoglobin

A

HbA1c

Best indicator for past 120 days

Expected is 4-6%

Diabetics 6.5-8%

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7
Q

Chronic lymphatic leukemia s/s

A 
Chills
Fever
Night sweats
Swollen lymph nodes
Feeling full in belly
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8
Q

Glossectomy teaching

A

Frequent mouth cleanse

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9
Q

Glossectomy

A

Removal of part or all of tongue
Thickened liquids
Alternate communication
Elevating head to reduce edema

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10
Q

Chemo treatment teaching

A

Temp daily
No crowds
Avoid foods containing bacteria
Avoid drink at room temp longer than 1 hr
No gardening, changing litter box
Toothbrush in dishwasher or bleach solution

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11
Q

Thrombolytic therapy contraindications

A

Hemorrhagic stroke

Increase bleeding with anticoagulant

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12
Q

Lupus erythematosus s/s

A 
Fatigue/malaise
Slope is
Blurred vision 
Pleuritic pain
Anorexia
Depression
Joint pain, swelling, tenderness
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13
Q

Lupus erythematosus physical findings

A 
Fever
Anemia
Lymphadenopathy
Pericarditis (pleural friction rub)
Raynauds
Butterfly rash
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14
Q

Thyroid storm s/s

A 
Nervousness 
Irritability
Hyperactivity 
Heat intolerance 
Decreased weight
Increased appetite 
Insomnia
Amenorrhea
Increased stools and diarrhea
Warm, sweaty, flushed skin
Tremor
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15
Q

Nephrotic syndrome

A 
Fluid overload
Dysrhythmia
Crackles
SOB
Increased urine output
Hematuria (RBCs in urine) 
Lethargy, twitching, seizure
Dry skin and mucous membranes
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16
Q

Acute respiratory failure

A

Pulmonary embolism
Edema
Pneumonia

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17
Q

Pathophysiology: Parkinson’s

A

Overstimulation of basal ganglia by acetylcholine

Increase dopamine

Increase in acetylcholine

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18
Q

Loss of fluids with burn

A

Elevated Hct and Hgb

Low sodium

High potassium

Elevated BG

hypoxemia and metabolic acidosis

Low protein and albumin

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19
Q

Polycystic kidney disease nutrition

A

Restrict potassium , phosphate, magnesium

High protein

Possible TPN

20
Q

ACE inhibitors education

A

Can increase potassium levels

Dry cough

Notify- rash, decreased taste, swelling face or extremities

BP monitored for 2 hrs after initial dose

21
Q

Blood transfusion steps

A

Assess labs Hgb (less than 8) and Hct

Verify prescription

Obtain blood samples

Initiate large bore 20-g

Assess for history of reactions

Obtain product from blood bank

Confirm identity etc with 2nd nurse

Prime with .9% Na chloride

22
Q

Acute hemolytic reaction

A 
Chills 
Fever 
Low back pain 
Tachycardia
Flushing
Hypotension
Chest tightening 
Tachypnea
Nausea
Anxiety
Hemoglbonuria
23
Q

Febrile reaction blood transfusion

A 
Chills
Fever
Flushing
Headache
Anxiety

Use WBC Filter
Admin antipyretics

24
Q

Mild allergic reaction blood transfusion

A

Itching
Urticaria
Flushing

Admin diphenhydramine

25
Q

Anaphylactic reaction blood transfusion

A 
Wheezing
Dyspnea
Chest tightness
Cyanosis
Hypotension
Maintain airway
O2
IV fluids 
Antihistamines
Corticosteroids 
Vasopressors
26
Q

Septic shock blood transfusion

A 
Fever 
Nausea
Vomiting
Abdominal pain
Chills
Hypotension

Admin O2
Dopamine- vasopressor
Elevate feet!!!

27
Q

MI meds

A

Aspirin

Beta blockers

28
Q

MI labs

A

Myoglobin (0-85)
Creatinine kinase (25-200)
Troponin (0-0.4)

29
Q

Musculoskeletal trauma

A 
Crepitus
Deformity
Muscle spasms
Edema
Ecchymosis (bleeding to tissues)
30
Q

Hypovolemic shock s/s

A

Hypotension
Decreased urine output
Tachycardia
Slow cap refill

31
Q

Paralytic ileus

A 
Monitor bowel sounds 
Encourage ambulatory
Advance diet as tolerated
NG- empty stomach contents
Med- metoclopramide
32
Q

Wound dehiscence or evisceration intervention

A 
Call for help
Stay w client
Cover with sterile dressing 
Place supine with hips and knees bent
Monitor for shock
Notify provider
33
Q

Arterial venous fistula s/s

A 
Hypotension
Clotting
Headache
Muscle cramps
Bleeding
Disequilibrium syndrome
HYPOVOLEMIA
Tachycardia
34
Q

Urine specific gravity

A

1.002-1.030

35
Q

Mannitol

A

Osmotic diuretic

Treat cerebral edema

  • insert indwelling catheter to monitor I & O
  • monitor electrolytes and osmolality e/6 hr
36
Q

Pentobarbital

A

Decrease ICP

want ICP below 20 (10-15 norm)

37
Q

Phenytoin

A

Treat or prevent seizure

38
Q

Open head injury greatest risk

A

Infection

39
Q

Skull fracture greatest risk

A

Damage to brain tissue

Decreased O2

Alteration in neurological synaptic ability

40
Q

Head injuries with hemorrhage greatest risk

A

Cerebral spinal fluid leakage
Epidural
Subdues
Intracerebral

Collection of fluid or foreign objects

Risk for cerebral edema

Cerebral hypoxia

Brain herniation

41
Q

Pertussis

A

Droplet precautions

Gown
Mask

42
Q

Nursing intervention for hearing loss

A

Tympanogram
Otoscope
Electronystagmography
Caloric testing

43
Q

Continuous bladder irrigation complications

A

Catheter obstruction = bladder spasms and reduced outflow

Turn off and flush with 50 mL irrigation solution

Ambulate ASAP

44
Q

PUD: GI bleed

A

Avoid foods that cause distress

Monitor BP

Monitor tachycardia

Decrease environment stress

Encourage periods of rest

Smoking cessation and no alcohol

45
Q

Promoting wound healing

A

High calorie
High protein
High Vit C
Appropriate glycemic control

Med Surg ATI (6 decks)

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