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aa Orgo > Med Surg Test 1 part 1 > Flashcards

Med Surg Test 1 part 1 Flashcards

1
Q

Cxr

A

Chest x ray

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2
Q

Peak flow meter measures

A

lung capacity

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3
Q

V/q scan

A

nuclear medicine scan that uses radioactive material (radiopharmaceutical) to examine airflow (ventilation) and blood flow (perfusion) in the lungs.

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4
Q

purpose of V/Q scan

A

look for pulmonary embolism (PE)

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5
Q

gallium scan

A

look for swelling (inflammation), infection, or cancer in the body. It uses a radioactive material called gallium and is a type of nuclear medicine exam.

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6
Q

before an ABG test,

A

check that platelet levels are norma

do an Allen test

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7
Q

Hypoventilation assessment findings

A

Diminished breath sounds,

decreased respiratory effort,

use of accessory muscles

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8
Q

Hypoventilation interventions

A

Position q2h to promote ventilation/perfusion matching,

encourage slow deep breaths

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9
Q

Impaired Gas Exchange interventions

A

evaluate ABG

suction as indicated

Not positioning

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10
Q

the best way to determine need for O2 therapy

A

ABG

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11
Q

CO2 narcosis

A

loss of sensitivity to high levels of CO2

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12
Q

If a large volume of nitrogen in the lungs is replaced with oxygen, the oxygen may subsequently be absorbed into the blood, reducing the volume of the alveoli, resulting in

A

Absorption atelectasis

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13
Q

Tracheostomy indications

A 
Long term airway management
Upper airway obstruction
Upper airway bleeding
Inability to clear lower airway secretions
Long term mechanical ventilation
Sleep apnea
Laryngeal or tracheal fracture
Airway burns
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14
Q

oral care: Avoid glycerin swabs or mouthwash containing

A

alcohol

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15
Q

Weaning from a Tracheostomy Tube: gradually decrease

A

tube size

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16
Q

Weaning from a Tracheostomy Tube: cuff is deflated when patient can manage

A

secretions

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17
Q

patient that can NEVER be intubated

A

laryngectomy

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18
Q

pink puffer

A

emphysema

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19
Q

emphysema sputum

A

minimal

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20
Q

chronic bronchitis sputum

A

excessive

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21
Q

cor pulmonale is common in which COPD

A

chronic bronchitis

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22
Q

Cor pulmonale

A

hypertrophy of right side of the heart with or without heart failure resulting from pulmonary hypertension

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23
Q

In copd, pulmonary htn is caused by constriction of the

A

pulmonary vessels in response to alveolar hypoxia with acidosis further potentating the vasoconstriction.

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24
Q

Goal for copd pt: eats over

A

50% of diet

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25
Q

2 very important questions to ask an asthma pt

A

have you ever taken steroids

ever been intubated because of asthma

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26
Q

Peak expiratory flow rate

A

a person’s maximum speed of expiration, as measured with a peak flow meter, a small, hand-held device used to monitor a person’s ability to breathe out air

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27
Q

incentive spirometer

A

used to help patients improve the functioning of their lungs

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28
Q

ipratropium

A

Cholinergic antagonists

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29
Q

montelukast

A

Leukotriene antagonists

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30
Q

Immunomodulators

A

cromolyn

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31
Q

Stepwise approach for managing asthma: quick relief

A

short acting bronchodilator, up to 3 treatments at 20 minute intervals

course of systemic corticosteriods

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32
Q

Stepwise approach for managing asthma: step 2

symptoms 80%

A

Low dose inhaled steroids,

cromylyn,

leukotriene modifier,

course of systemic steroids

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33
Q

Stepwise approach for managing asthma: step 3

-daily symptoms with pef >60

A

low to medium dose inhaled steriods,

theophylline,

leukotriene modifier

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34
Q

Stepwise approach for managing asthma: step 4

symptoms or continual or frequent at night, pef

A

high dose inhaled steroids, steroids, long acting inhaled b agonists

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35
Q

status asthmaticus

A

Severe, life-threatening, acute episode of airway obstruction

Intensifies once it begins, often does not respond to common therapy

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36
Q

status asthmaticus Treatment

A

IV fluids,

potent systemic bronchodilator,

steroids,

epinephrine,

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37
Q

helpful eating pattern for someone with lower resp problem

A

4 to 6 smaller meals a day

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38
Q

An accumulation of fluid within the intrapleural space that may reflect and increase in pleural fluid formation or a decrease in its reabsorbtion from the intrapleural space or both

A

Pleural effusion

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39
Q

An inflammation of the lung parenchyma usually associated with a marked increase in interstitial and alveolar fluid

A

Pneumonia

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40
Q

Pneumonia: the breath sounds over the area of consolidation will be

A

bronchial breath sounds

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41
Q

common adventitious sounds with pneumonia

A

Wheezing, rhonchi, crackles

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42
Q

Pleurisy

A

inflammation of the pleura

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43
Q

Virchow’s triad

A

Venous stasis
Endothelial injury
Hypercoagulable state

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44
Q

Pulmonary embolism symptoms

A

chest pain

Fast/irregular HR

Light headed

Fast breathing

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45
Q

Acute Respiratory Failure: ABG value: Pao2

A

less than 60

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46
Q

Acute Respiratory Failure: ABG value: Sao2

A

less than 90

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47
Q

Acute Respiratory Failure: ABG value: Paco2

A

greater than 50

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48
Q

Acute Respiratory Failure: ABG value: pH

A

less than 7.30

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49
Q

Raynaud’s Disease

A

some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress. In Raynaud’s disease, smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas

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50
Q

Buerger’s Disease,

A

inflammation and thrombosis in small and medium-sized blood vessels, typically in the legs and leading to gangrene. It has been associated with smoking.

51
Q

Acute coronary syndrome

A

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

52
Q

total fat in diet should be less than

53
Q

major SE of statins

A

liver issues

54
Q

men and women waist sizes

A

men less then 40 women 35

55
Q

total cholesterol

A

less than 200 is desired

over 240 is high

56
Q

LDL level

A

less than 100 is desired

57
Q

desired triglyceride

A

less than 150

58
Q

Pt w/o CVD or DM and LDL 70-189 mg/dl and 10 year risk of CVD >=7.5%

A

Moderate or high intensity statin therapy

59
Q

Pt 40-75 w DM and LDL 70-189 mg/dl w/o clinical atherosclerotic disease

A

Moderate statin therapy

60
Q

treatment for Pt w clinical atherosclerotic disease

A

high intensity statin

61
Q

Pt w LDL levels >= 190 mg/dl. Ie. Familial hypercholerterolemia

A

high intensity statin

62
Q

HTN formula

A

CO times PVR

63
Q

the best diuretic for uncomplicated HTN

64
Q

stage 2 SBP

65
Q

stage 2 DBP

66
Q

3 common causes of secondary HTN

A

Primary aldosteronism
Pheochromocytoma
Cushing’s syndrome

67
Q

normal bun range

68
Q

normal creatinine levels

A

0.7 to 1.3

69
Q

severe PAD

A

blue limbs

white when you raise it

red when you lower it

70
Q

The 6 P’s- Neurovascular assessment

A 
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermy
71
Q

PAD Diagnostic Assessments (3)

A

Ankle-brachial index (ABI)
Exercise tolerance testing
Plethysmography

72
Q

Small arterioles and arteries constrict in response to cold, nicotine, caffeine or stress.

A

Raynaud’s Syndrome

73
Q

good class of drug for Raynaud’s

74
Q

Inflammatory disease of small and medium-sized arteries AND veins of the extremities

A

Buerger’s Disease(thromboangitis obliterans)

75
Q

Buerger’s Disease most common manifestation

76
Q

Digital ulcers (gangrene), and S & S of ischemia, cold sensitivity, color changes

A

Buerger’s

77
Q

Buerger’s dx test

A

arteriogram

78
Q

Aneurysm

A

permanent localized dilation of artery, enlarging artery to twice its normal diameter

79
Q

May be caused by sudden tear in aortic intima, opening way for blood to enter aortic wall

A

Aortic Dissection

80
Q

Aortic Dissection pain described as

A

tearing, ripping, stabbing

81
Q

Aortic Dissection is life

A

threatening

82
Q

Aortic Dissection- emergency treatment: reduce

83
Q

Unstable angina- pain lasts longer than

A

15 minutes

84
Q

pain: Sudden, squeezing, vice like, substernal and may radiate

85
Q

pain: Sudden w/o precipitating factors, intense stabbing, viselike, elephant sitting on chest, substernal and may radiate

86
Q

pain: Sudden, sharp, stabbing, substernal

A

Pericarditis

87
Q

pain: Variable, moderate ache, worse on inspiration, lung fields

A

Pleural pain

88
Q

pain: Variable, squeezing, heartburn, substernal, may be relieved w antacids

89
Q

pain: Variable, in response to stress or fatigue, dull ache to sharp stabbing, may be associated w numbness in fingers. Not well located

90
Q

angina is relieved with

A

rest, ntg, o2

91
Q

MI is relieved with

A

morphine

O2

92
Q

Pericarditis is relieved with

A

sitting upright/forward

anti inflammatory

93
Q

Pt with chest pain: checks labs for

A

troponin
creatinine kinase
myoglobin

94
Q

chest pain: position pt in

A

semi fowlers

95
Q

drug given before Percutaneous Transluminal Coronary Angioplasty

A

Clopidogrel

96
Q

MI common dysrrthymias

97
Q

cardiogenic shock involves urine output less than

98
Q

Normally, only a low amount of BNP is found in your blood. But if your heart has to work harder than usual over a long period of time, such as from heart failure,

A

the heart releases more BNP

99
Q

Digoxin purpose

A

treat heart failure and heart rhythm problems

100
Q

If HF patient is SOB, position in

A

High Fowler

101
Q

Indications for Worsening or Recurrent Heart Failure

A

Cold symptoms
Excessive awakening at night to urinate
Development of dyspnea/angina at rest
edema

102
Q

the main idea of right side HF

A

systemic congestion

103
Q

the main idea of left side HF

A

decreased output

104
Q

right side HF manifestations

A

JVD
Edema
Liver enlargement
Nocturia/polyuria

105
Q

left side HF manifestations

A

Orthopnea
Oliguria
Weakness
Confusion

106
Q

Drugs that Enhance Contractility

A

Digoxin
Inotropic drugs
Beta-adrenergic blockers

107
Q

Digoxin (cardiac gyloside) effects on HR and Contractility

A

decrease HR

Increase contractility

108
Q

dig toxicity manifestations

A

cardiac

N/V

109
Q

Drugs Used to Reduce Afterload

A

ACE inhibitors
ARB
Human B-type natriuretic peptides

110
Q

ARB

A

angiotensin blockers (sartan)

111
Q

Pericarditis VS changes

A

decreased BP

increase HR

112
Q

S/S: Fever, chills, joint pain, anorexia, nausea, weight loss

A

Pericarditis

113
Q

Pericarditis/endocarditis administer

A

antibiotics

NSAIDS

114
Q

Pericarditis: assess for

A

cardiac tamponade

pulsus paradoxus

115
Q 
Manifestations:
Murmur
Heart failure
Arterial embolization
Splenic infarction
Neurologic changes
Petechiae
Splinter hemorrhages
A

Endocarditis

116
Q

Endocarditis risk factors

A

Oral surgery
Skin rashes or lesions
Infections
Surgery or invasive procedures including IV placement

117
Q

A fib pattern

A

irregularly irregular

118
Q

A fib is associated with

A

atrial fibrosis and loss of muscle mass

119
Q

Ventricular Dysrhythmias

A

More life-threatening than atrial dysrhythmias

Left ventricle pumps oxygenated blood through the body to perfuse vital organs and other tissues

120
Q

Ventricular Tachycardia

A

repetitive firing of irritable ventricular ectopic focus, usually at 140-180 beats/min

121
Q

Ventricular Fibrillation

A

result of electrical chaos in ventricles

122
Q

Pacemakers

A

Complete heart block
2nd degree heart block with symptomatic brady
Bradycardia unrelated to drugs

123
Q

wavy baseline with atrial electrical activity and irregular ventricular rhythm

124
Q

ABG bicarb range

aa Orgo (196 decks)

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