Med Surg Rem Flashcards by Ashley Shores

IBS Diet

No dairy, eggs, wheat

Increase fiber to 30-40 g/day

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Seizure steps

Turn patient on side

Loosen restrictive clothing

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Blood transfusion: circulatory overload s/s

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

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Blood transfusion: circulatory overload interventions

O2
Vitals
Slow infusion 
Admin diuretics 
Notify provider

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TPN Tubing

Change every 24 hrs

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Glycosylated hemoglobin

HbA1c

Best indicator for past 120 days

Expected is 4-6%

Diabetics 6.5-8%

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Chronic lymphatic leukemia s/s

Chills
Fever
Night sweats
Swollen lymph nodes
Feeling full in belly

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Glossectomy teaching

Frequent mouth cleanse

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Glossectomy

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

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Chemo treatment teaching

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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Thrombolytic therapy contraindications

Hemorrhagic stroke

Increase bleeding with anticoagulant

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Lupus erythematosus s/s

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

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Lupus erythematosus physical findings

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

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Thyroid storm s/s

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

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Nephrotic syndrome

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

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Acute respiratory failure

Pulmonary embolism
Edema
Pneumonia

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Pathophysiology: Parkinson’s

Overstimulation of basal ganglia by acetylcholine

Increase dopamine

Increase in acetylcholine

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Loss of fluids with burn

Elevated Hct and Hgb

Low sodium

High potassium

Elevated BG

hypoxemia and metabolic acidosis

Low protein and albumin

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Polycystic kidney disease nutrition

Restrict potassium , phosphate, magnesium

High protein

Possible TPN

ACE inhibitors education

Can increase potassium levels

Dry cough

Notify- rash, decreased taste, swelling face or extremities

BP monitored for 2 hrs after initial dose

Blood transfusion steps

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

Acute hemolytic reaction

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

Febrile reaction blood transfusion

Chills
Fever
Flushing
Headache
Anxiety

Use WBC Filter
Admin antipyretics

Mild allergic reaction blood transfusion

Itching
Urticaria
Flushing

Admin diphenhydramine

Anaphylactic reaction blood transfusion

``` Wheezing Dyspnea Chest tightness Cyanosis Hypotension ``` ``` Maintain airway O2 IV fluids Antihistamines Corticosteroids Vasopressors ```

Septic shock blood transfusion

``` Fever Nausea Vomiting Abdominal pain Chills Hypotension ``` Admin O2 Dopamine- vasopressor Elevate feet!!!

MI meds

Aspirin | Beta blockers

MI labs

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

Musculoskeletal trauma

``` Crepitus Deformity Muscle spasms Edema Ecchymosis (bleeding to tissues) ```

Hypovolemic shock s/s

Hypotension Decreased urine output Tachycardia Slow cap refill

Paralytic ileus

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

Wound dehiscence or evisceration intervention

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

Arterial venous fistula s/s

``` Hypotension Clotting Headache Muscle cramps Bleeding Disequilibrium syndrome HYPOVOLEMIA Tachycardia ```

Urine specific gravity

1.002-1.030

Mannitol

Osmotic diuretic Treat cerebral edema * insert indwelling catheter to monitor I & O * monitor electrolytes and osmolality e/6 hr

Pentobarbital

Decrease ICP want ICP below 20 (10-15 norm)

Phenytoin

Treat or prevent seizure

Open head injury greatest risk

Infection

Skull fracture greatest risk

Damage to brain tissue Decreased O2 Alteration in neurological synaptic ability

Head injuries with hemorrhage greatest risk

Cerebral spinal fluid leakage Epidural Subdues Intracerebral Collection of fluid or foreign objects Risk for cerebral edema Cerebral hypoxia Brain herniation

Pertussis

Droplet precautions Gown Mask

Nursing intervention for hearing loss

Tympanogram Otoscope Electronystagmography Caloric testing

Continuous bladder irrigation complications

Catheter obstruction = bladder spasms and reduced outflow Turn off and flush with 50 mL irrigation solution Ambulate ASAP

PUD: GI bleed

Avoid foods that cause distress Monitor BP Monitor tachycardia Decrease environment stress Encourage periods of rest Smoking cessation and no alcohol

Promoting wound healing

High calorie High protein High Vit C Appropriate glycemic control