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aa orgo > med surg test 2 part 7 > Flashcards

med surg test 2 part 7 Flashcards

1
Q

3 major concerns of post op period

A

infection
atelectasis
bleeding

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2
Q

What kind of fracture has the highest DVT risk

A

knee

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3
Q

If you see an area is swollen, the number 1 thing to assess is

A

pulse

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4
Q

if there are multiple fractures you watch out for

A

fat emboli

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5
Q

In a fracture, some degree of ___ is expected

A

swelling

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6
Q

When you help someone out of bed, help them on their __ side

A

strong

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7
Q

Osteomyletis Tx (2 things)

A 
3 months Abx
PICC line (they're going home with it)
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8
Q

Comminuted fracture, 2 complications

A

fat emboli

hemorrhage

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9
Q

4 substances that increase risk for osteoporosis

A

steroids
caffeine
alcohol
smoking

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10
Q

Normal BMD range

A

-1 to +1

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11
Q

2 diseases that increase risk for osteoporosis

A

CKD (kidney problem)

hyperparathyroidism

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12
Q

CKD patients are in a constant state of

A

acidosis

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13
Q

Biggest issue with prosthetics (like hip replacement) is

A

dislocation (so watch out for how you position them etc)

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14
Q

2 things that are a “gotcha” for hip fracture

A

external rotation

leg shortening

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15
Q

Hip fracture, biggest thing to check is

A

circulation

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16
Q

First thing you check for with hip fracture pt

A

mental status

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17
Q

Validate its a hip fracture with this test

A

x ray

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18
Q

If the person has been laying on the floor for a long time, or has other reason to suspect muscle damage, test for

A

CK

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19
Q

The complication of elevated CK (from muscle damage) is

A

renal problems

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20
Q

Total hip arthroplasty is aka

A

totally replacing the ball and socket

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21
Q

THA patient is not allowed to

A

lean forward more than 90 degrees

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22
Q

THA home modification

A

raised toilet seat

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23
Q

When fiber glass cast is drying, place it on

A

a soft pillow

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24
Q

because someone with a cast is at risk for DVT, they may need to go home on what meds

A

lovanox or aspirin

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25
Q

What do you teach the patient about the tingling feeling

A

elevate that tingling extremity

if that doesn’t work, call doctor

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26
Q

Between cast syndrome and DVT, first r/o

A

DVT

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27
Q

Main problem area for External Fixation Device is

A

perfusion

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28
Q

A type of traction that can be used for spine fracture

A

Garender-Willis Traction (screwed into head)

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29
Q

If they have C2 vertebrae damage, assess for

A

sensation everywhere form the neck down

constipation

urine retention

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30
Q

Halo traction is at risk for

A

falls because they can’t bend properly

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31
Q

Bucks traction is at risk for

A

heel ulcer

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32
Q

Bucks traction: when you’re moving the pt, start by

A

disconnecting the weights

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33
Q

If there’s a lot of gunk and you need a sample, first

A

clean away with NS

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34
Q

AVN

A

acute vascular necrosis

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35
Q

If someone is bleeding, which IV do you give

A

RL

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36
Q

complication of RL

A

alkalosis b/c lactate becomes bicarbonate

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37
Q

ketorolac

A

really effective NSAID

contraindicated in PUD

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38
Q

In compartment syndrome, check the urine for

A

myoglobin

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39
Q

What tests are you going to order for DVT pt

A

doppler ultrasound

fibrinogen test

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40
Q

High blood sugar inhibits

A

healing

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41
Q

after surgery, a stump should be

A

elevated

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42
Q

2 supplements needed for healing

A

vit c

protein

43
Q

fracture that occurs spontaneously as opposed to from a trauma

A

pathological

44
Q

Osteoporosis 3 Tx

A

weight bearing (walking)

calcium and vit D

Biphosphate

45
Q

Biphosphate is contraindicated in

A

GERD and other GI disease

46
Q

Osteoporosis labs, check for

A

calcium levels

47
Q

Causes of Dehydration: has to do with breathing pattern

A

hyperventilation

48
Q

Causes of Dehydration: has to do with diabetes type 1

A

DKA

49
Q

with dehydration, temp will be

A

increased

50
Q

dehydration, oxygen status will be

A

hypoxemic

51
Q

Dehydration Nursing Care: Administer supplemental __ as prescribed.

A

oxygen

52
Q

Dehydration Nursing Care: Initiate and maintain

A

IV access

53
Q

Dehydration Nursing Care: Place the client in shock position which is

A

on back with legs elevated

54
Q

Nursing Actions for Hypovolemic Shock: Administer

A

O2

55
Q

Nursing Actions for Hypovolemic Shock: Provide fluid replacement with the following:

A

Colloids

Crystalloids

56
Q

Nursing Actions for Hypovolemic Shock: administer what class of drugs

A

vasoconstrictors

57
Q

Hypervolemia can be caused by interstitial to plasma fluid shifts, which can be caused by

A

burns

58
Q

Hypervolemia can be caused by Water replacement without ___ replacement

A

electrolyte

59
Q

In hypervolemia, what test reveals possible pulmonary congestion

A

x ray

60
Q

In hypervolemia position pt in

A

semi-Fowler’s

61
Q

Pulmonary Edema, postion pt in

A

high-Fowler’s position to maximize ventilation

62
Q

Pulmonary Edema 2 meds that may be needed

A

morphine and diuretic

63
Q

Hyponatremia delays and slows the __ of __

A

depolarization of membranes

64
Q

Hyponatremia: Compensatory mechanisms include the renal excretion of sodium-free water.

A

pissing out sodium-free water.

65
Q

SIADH causes which electrolyte imbalance

A

hyponatremia

66
Q

Full compensation occurs when

A

the pH level of the blood returns to normal (7.35 to 7.45)

67
Q

If the pH level is not able to normalize, then it is referred to as

A

partial compensation

68
Q

RESpiRAtoRy AcidoSiS – skin

A

pale or cyanotic

69
Q

Respiratory acidosis and alkalosis can be treated with

A

O2

70
Q

DXA scans are done to estimate the

A

density of a client’s bone mass – usually in the hip or spine – and the presence/extent of osteoporosis.

71
Q

refers to the surgical removal of a diseased joint due to osteoarthritis, osteonecrosis, rheumatoid arthritis, trauma, or congenital anomalies

A

Arthroplasty

72
Q

Arthroplasty refers to the surgical removal of a diseased joint and

A

replacing it with prosthetics

73
Q

Goal of both hip and knee arthroplasty is to eliminate

A

pain

74
Q

Goal of both hip and knee arthroplasty is to restore

A

restore joint motions

75
Q

before arthroplasty, r/o

A

anemia, infection, or organ failure

76
Q

___ alfa may be prescribed preoperatively to increase Hgb.

A

Epoetin

77
Q

Contraindications of Arthroplasty: ___ impairment to the affected extremity

A

Arterial

78
Q

Arthroplasty: May use ___ or ___ anesthesia

A

spinal or general

79
Q

Arthroplasty: Components may or may not be ___ in place

A

cemented

80
Q

Knee arthroplasty: 3 postoperative complications

A

deep vein thrombosis, anemia, infection

81
Q

Arthroplasty: CPM machine may be prescribed to promote motion in the knee and prevent

A

prevent scar tissue formation

82
Q

When is CPM started

A

right after surgery

83
Q

CPM: The prescribed duration of its use should be followed, but it should be turned off during

A

meals

84
Q

Knee arthroplasty: avoid pillows

A

behind the knee

85
Q

Knee arthroplasty: To prevent pressure ulcers from developing on the heels,

A

place a small blanket or pillow slightly above the ankle area to keep heels off the bed

86
Q

Knee arthroplasty: A continuous peripheral nerve block is a

A

continuous infusion of local anesthetic directly into sciatic or femoral nerve

87
Q

Knee arthroplasty: Ice or cold therapy may be applied to

A

reduce swelling

88
Q

Hip arthroplasty: The client should not be turned to the

A

operative side, which could cause hip dislocation.

89
Q

Hip arthroplasty: ___ rotate a client’s toe

A

externally

90
Q

Knee arthroplasty – Dislocation is not common following total knee arthroplasty. Kneeling and deep-knee bends are, however,

A

limited indefinitely

91
Q

Lower extremity amputations are usually done due to

A

peripheral vascular disease as a result of arteriosclerosis

92
Q

Management of Traumatic Amputation: in an emergency, position the extremity

A

above the heart

93
Q

most common amputation technique used

A

Closed amputation

94
Q

Closed amputation: ___ __ is sutured over end of residual limb, closing site

A

Skin flap

95
Q

Open amputation: This technique is used when an

A

active infection is present

96
Q

Phantom limb pain occurs less frequently following ___ amputation

A

traumatic

97
Q

Nurses need to differentiate between phantom limb and __ pain

A

incisional (tesoro said you’re going to ask the client about the pain, how’s it feel?)

98
Q

Phantom limb pain may be treated with

A

beta blockers
antiepileptics
antidepressant

99
Q

Amputation may not heal if performed below the level of adequate

A

tissue perfusion

100
Q

Amputation: IF there’s infection and/or nonhealing of incision, than you position the stump

A

dependently to promote blood flow

101
Q

Residual limb must be shaped and ___ in preparation for prosthetic training.

A

shrunk

102
Q

Flexion contractures are more likely with the hip or __ joint following amputation due to improper positioning.

A

knee

103
Q

Flexion Contractures: Nursing action: have client lay

A

prone for 20 or 30 min

104
Q

Flexion Contractures: Nursing action: discourage

A

sitting in a chair to long

aa orgo (196 decks)

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