Med Surg Test 1 part 1 Flashcards
1
Q
Cxr
A
Chest x ray
2
Q
Peak flow meter measures
A
lung capacity
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.
4
Q
purpose of V/Q scan
A
look for pulmonary embolism (PE)
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.
6
Q
before an ABG test,
A
check that platelet levels are norma
do an Allen test
7
Q
Hypoventilation assessment findings
A
Diminished breath sounds,
decreased respiratory effort,
use of accessory muscles
8
Q
Hypoventilation interventions
A
Position q2h to promote ventilation/perfusion matching,
encourage slow deep breaths
9
Q
Impaired Gas Exchange interventions
A
evaluate ABG
suction as indicated
Not positioning
10
Q
the best way to determine need for O2 therapy
A
ABG
11
Q
CO2 narcosis
A
loss of sensitivity to high levels of CO2
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
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
14
Q
oral care: Avoid glycerin swabs or mouthwash containing
A
alcohol
15
Q
Weaning from a Tracheostomy Tube: gradually decrease
A
tube size
16
Q
Weaning from a Tracheostomy Tube: cuff is deflated when patient can manage
A
secretions
17
Q
patient that can NEVER be intubated
A
laryngectomy
18
Q
pink puffer
A
emphysema
19
Q
emphysema sputum
A
minimal
20
Q
chronic bronchitis sputum
A
excessive
21
Q
cor pulmonale is common in which COPD
A
chronic bronchitis
22
Q
Cor pulmonale
A
hypertrophy of right side of the heart with or without heart failure resulting from pulmonary hypertension
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.
24
Q
Goal for copd pt: eats over
A
50% of diet
25
2 very important questions to ask an asthma pt
have you ever taken steroids
| ever been intubated because of asthma
26
Peak expiratory flow rate
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
27
incentive spirometer
used to help patients improve the functioning of their lungs
28
ipratropium
Cholinergic antagonists
29
montelukast
Leukotriene antagonists
30
Immunomodulators
cromolyn
31
Stepwise approach for managing asthma: quick relief
short acting bronchodilator, up to 3 treatments at 20 minute intervals
course of systemic corticosteriods
32
Stepwise approach for managing asthma: step 2
symptoms 80%
Low dose inhaled steroids,
cromylyn,
leukotriene modifier,
course of systemic steroids
33
Stepwise approach for managing asthma: step 3
-daily symptoms with pef >60
low to medium dose inhaled steriods,
theophylline,
leukotriene modifier
34
Stepwise approach for managing asthma: step 4
symptoms or continual or frequent at night, pef
high dose inhaled steroids, steroids, long acting inhaled b agonists
35
status asthmaticus
Severe, life-threatening, acute episode of airway obstruction
Intensifies once it begins, often does not respond to common therapy
36
status asthmaticus Treatment
IV fluids,
potent systemic bronchodilator,
steroids,
epinephrine,
37
helpful eating pattern for someone with lower resp problem
4 to 6 smaller meals a day
38
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
Pleural effusion
39
An inflammation of the lung parenchyma usually associated with a marked increase in interstitial and alveolar fluid
Pneumonia
40
Pneumonia: the breath sounds over the area of consolidation will be
bronchial breath sounds
41
common adventitious sounds with pneumonia
Wheezing, rhonchi, crackles
42
Pleurisy
inflammation of the pleura
43
Virchow’s triad
Venous stasis
Endothelial injury
Hypercoagulable state
44
Pulmonary embolism symptoms
chest pain
Fast/irregular HR
Light headed
Fast breathing
45
Acute Respiratory Failure: ABG value: Pao2
less than 60
46
Acute Respiratory Failure: ABG value: Sao2
less than 90
47
Acute Respiratory Failure: ABG value: Paco2
greater than 50
48
Acute Respiratory Failure: ABG value: pH
less than 7.30
49
Raynaud’s Disease
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
50
Buerger’s Disease,
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
Acute coronary syndrome
Any condition brought on by a sudden reduction or blockage of blood flow to the heart.
52
total fat in diet should be less than
30%
53
major SE of statins
liver issues
54
men and women waist sizes
men less then 40 women 35
55
total cholesterol
less than 200 is desired
| over 240 is high
56
LDL level
less than 100 is desired
57
desired triglyceride
less than 150
58
Pt w/o CVD or DM and LDL 70-189 mg/dl and 10 year risk of CVD >=7.5%
Moderate or high intensity statin therapy
59
Pt 40-75 w DM and LDL 70-189 mg/dl w/o clinical atherosclerotic disease
Moderate statin therapy
60
treatment for Pt w clinical atherosclerotic disease
high intensity statin
61
Pt w LDL levels >= 190 mg/dl. Ie. Familial hypercholerterolemia
high intensity statin
62
HTN formula
CO times PVR
63
the best diuretic for uncomplicated HTN
thiazide
64
stage 2 SBP
over 160
65
stage 2 DBP
over 100
66
3 common causes of secondary HTN
Primary aldosteronism
Pheochromocytoma
Cushing’s syndrome
67
normal bun range
7 to 20
68
normal creatinine levels
0.7 to 1.3
69
severe PAD
blue limbs
white when you raise it
red when you lower it
70
The 6 P’s- Neurovascular assessment
```
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermy
```
71
PAD Diagnostic Assessments (3)
Ankle-brachial index (ABI)
Exercise tolerance testing
Plethysmography
72
Small arterioles and arteries constrict in response to cold, nicotine, caffeine or stress.
Raynaud’s Syndrome
73
good class of drug for Raynaud's
CCB
74
Inflammatory disease of small and medium-sized arteries AND veins of the extremities
Buerger’s Disease(thromboangitis obliterans)
75
Buerger’s Disease most common manifestation
pain
76
Digital ulcers (gangrene), and S & S of ischemia, cold sensitivity, color changes
Buerger’s
77
Buerger’s dx test
arteriogram
78
Aneurysm
permanent localized dilation of artery, enlarging artery to twice its normal diameter
79
May be caused by sudden tear in aortic intima, opening way for blood to enter aortic wall
Aortic Dissection
80
Aortic Dissection pain described as
tearing, ripping, stabbing
81
Aortic Dissection is life
threatening
82
Aortic Dissection- emergency treatment: reduce
BP
83
Unstable angina- pain lasts longer than
15 minutes
84
pain: Sudden, squeezing, vice like, substernal and may radiate
angina
85
pain: Sudden w/o precipitating factors, intense stabbing, viselike, elephant sitting on chest, substernal and may radiate
MI
86
pain: Sudden, sharp, stabbing, substernal
Pericarditis
87
pain: Variable, moderate ache, worse on inspiration, lung fields
Pleural pain
88
pain: Variable, squeezing, heartburn, substernal, may be relieved w antacids
GI
89
pain: Variable, in response to stress or fatigue, dull ache to sharp stabbing, may be associated w numbness in fingers. Not well located
anxiety
90
angina is relieved with
rest, ntg, o2
91
MI is relieved with
morphine
| O2
92
Pericarditis is relieved with
sitting upright/forward
anti inflammatory
93
Pt with chest pain: checks labs for
troponin
creatinine kinase
myoglobin
94
chest pain: position pt in
semi fowlers
95
drug given before Percutaneous Transluminal Coronary Angioplasty
Clopidogrel
96
MI common dysrrthymias
VF and VT
97
cardiogenic shock involves urine output less than
30ml
98
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,
the heart releases more BNP
99
Digoxin purpose
treat heart failure and heart rhythm problems
100
If HF patient is SOB, position in
High Fowler
101
Indications for Worsening or Recurrent Heart Failure
Cold symptoms
Excessive awakening at night to urinate
Development of dyspnea/angina at rest
edema
102
the main idea of right side HF
systemic congestion
103
the main idea of left side HF
decreased output
104
right side HF manifestations
JVD
Edema
Liver enlargement
Nocturia/polyuria
105
left side HF manifestations
Orthopnea
Oliguria
Weakness
Confusion
106
Drugs that Enhance Contractility
Digoxin
Inotropic drugs
Beta-adrenergic blockers
107
Digoxin (cardiac gyloside) effects on HR and Contractility
decrease HR
| Increase contractility
108
dig toxicity manifestations
cardiac
| N/V
109
Drugs Used to Reduce Afterload
ACE inhibitors
ARB
Human B-type natriuretic peptides
110
ARB
angiotensin blockers (sartan)
111
Pericarditis VS changes
decreased BP
| increase HR
112
S/S: Fever, chills, joint pain, anorexia, nausea, weight loss
Pericarditis
113
Pericarditis/endocarditis administer
antibiotics
| NSAIDS
114
Pericarditis: assess for
cardiac tamponade
| pulsus paradoxus
115
```
Manifestations:
Murmur
Heart failure
Arterial embolization
Splenic infarction
Neurologic changes
Petechiae
Splinter hemorrhages
```
Endocarditis
116
Endocarditis risk factors
Oral surgery
Skin rashes or lesions
Infections
Surgery or invasive procedures including IV placement
117
A fib pattern
irregularly irregular
118
A fib is associated with
atrial fibrosis and loss of muscle mass
119
Ventricular Dysrhythmias
More life-threatening than atrial dysrhythmias
Left ventricle pumps oxygenated blood through the body to perfuse vital organs and other tissues
120
Ventricular Tachycardia
repetitive firing of irritable ventricular ectopic focus, usually at 140-180 beats/min
121
Ventricular Fibrillation
result of electrical chaos in ventricles
122
Pacemakers
Complete heart block
2nd degree heart block with symptomatic brady
Bradycardia unrelated to drugs
123
wavy baseline with atrial electrical activity and irregular ventricular rhythm
A fib
124
ABG bicarb range
22 to 28
