med Surg test 3 Flashcards
what is gas exchange
the process in which o2 and. co2 is exchange in the body
o2 is transported from the lungs to the blood
co2 is transported from the blood to the lungs
what is oxygenation
the process where oxygen is getting to the body
hypoxia means
a decrease in o2 in the cellular tissues
hypoxemia mean
A decrease in o2 in the blood
what does ventilation means
the movement of air in the atmosphere to the alveoli
diffusion
the process of o2 and co2 moves to an area of higher concentration to a lower concentration
perfusion
blood flow to the tissues and organs
shunting
in adequate ventilation and adequate perfusion
-pulmonary embolisms
what is atelectasis
the collapse of the alveoli
-leads to pnemonia
-hold onto fluid
what are the causes of atelectasis
- obtructive
- in adequate activation of surfactant
3.compression
- not meeting o2 needs
what are the risk factors for atelectasis
- pre-op pts who are immobile, abdominal dissension
- anestia greater than 4 hrs
chronic lung disease
lung cancer
morbid obesity
smoking
plural effusions
Ng tube placements
what are the signs and symptoms of atelectasis
dyspnea
coughs
fever
leukocytes
diminished breathe sounds
sputum production
the use of accessory muscles often happen because of
significant respiratory distress
as the nurse what type of mangement should be done for atelectasis?
- use the incentive spirometry
- turns
- mobilization
- nebulazier and bronchidlators
5.CPT - splinting when coughing
what is the goal for the pt using an incentive spirometer? what are the risk if the person is below the goal
1000-1500
risk for pneumonia or atelectasis
as a nurse with o2 therapy what mangement practice should be meet? what are some safety tips?
- monitoring for decrease in o2
-mointer skin integrity - asses need for o2
do not use protrolleum items
what does a endotracheal tube? how long should it be used for?
ideal for short term use < 10 day
-sereves as a temporary airway
what gives you 100% fio2
trach
non rebreather mask
endo-tube
what does a tracheotomy ? how long should it be used for? what are some safety practice?
- long term use >21 days
-surgical opening made into the trachea for breathing
-avoid showers, sprays, and powders
what is COPD
- a chronic obstructive pulmonary disease
-NOT FULLY REVERSIBLE
-air flow limitation is progressive - the pt is breathing in 02 but holding onto c02
-this pt will have high levels of c02
what is the rule for chronic bronchitis
cough sputum for 3 months wishing 2 years in a row
what a the risk factors with copd
Smoking
- how many years?
- how many packs
packs* years =
environmental smoke( second hand smoke)
occupational dust and chemicals ( where you work the type of environment)
infections
APlhia 1 antitrpisin deficiency
what are the signs a symptoms of COPD
dysoena
use of assessor muscles
chronic coughs
sputum production
what is the criteria for COPD
FEV1 <80%
FEV1/FVC ration less than 70%
As a nurse what is the mangement of COPD
decreasing the smoking cessation
bronchodilators and MDI
-anticholingrics
-sympathomimetic
cortocsteriods
oxygen therapy
surgery
what does the assesment look like for COPD
are you having SOB, Cough secretions?
how do you breathe and what does the posture look like?
-promoting better eating habbits,excersie, preventing complications
what is asthma
AIR FLOW OBSTRUCTION
Acute inflammation
-airflow limitations
-inflatiomation
IGE mediated response to allergens
signs and symptoms of asthma?
coughs, WHEEZING
what are the bronchodilators drugs and actions
- Beta adrergic agonist - relives the bronchospasm
- Salmetrol, Albutrol - anticholingic- reduces the airway obstruction
aid in secretion clearance
-iprattropium - methylxanthines -maintance
-theophyline
Respiratory meds and actions
antihistamines- helps dry secretions
- DIPHENHYDRAMINE
- Loratadine
-cetrizine
GALUCOCORTOCOIDS- reduces inflammation
-Prednisone
-beclomethdsone
Mast cell stabilizers- helps treat inflammation
-cromoyln
ldukotrine modifiers- reduce inflammation
- montelukast
-
what is the normal lung compliance
0.1L/cm h20
what is tidal volume
volume of each breathe
minute ventilation
how much air is let out per min
vital capacity
MAX amount of air exhaled from the MAX air inhaled
residual volume
the volume of air remaining in the lungs after a maximum exhalation
what is OSA
a disorder that recurrent episodes of UPPER AIRWAY obstruction
OSA signs and symptoms
1.loud snoring
2.breathing cessation >10 secs
3. snort as the 02 drops
4. daytime sleepyness
5. insomnia
what does OSA result to
a decrease in 02 in the tissues and a increase in ca+
increased HR
risk factors for OSA
Males
Obesity around the neck
alterations in the upper airway
what are some education topic to teach to a OSA pt
- recommend the the flu and pneumonia vaccine
- quit smoing
- high protein,nutrient dense meals
- avoid sedative medications
- encourage frequent rest periods
bubbling in the seal chamber indicates
a leakage
what do nutrition do for the body
tissue maintenance/ development
physicsal activity
provides energy
growth
and organ function
what is digestion
the mechinal break down of enzymes
what is absorption
-occurs in the small instance
one state is transferred into another substance
Enternal nutrion
providing nutrient to the stomach via feeding tube
what are marconutrients
carbs
fats
protiens
what is elimination
the excretion of waster
what is a parental nutrion
providing nutrients to the body via iv
what are micronutrients
vitamens
minerals
what are the rules about diet orders
- ordered by the MD based of
1pt condition
procedure
ability to swallow
malnutrition risk factors
-hospilized pts
-medications
dental problems
illness
physical disability
what is a a appetite stimulant
magase
what are. the signs and symptoms of malnutrition
- decrees in focus
- decreases in the interest in food
- poor wound healing
what are enteral nutrition used for
- decompress the stomach
- provide feeding
- medications admisteration
Gastrostomy/ jejunosostmy
-prefreed for prolong use
-regurgitation is less likely to happen
- don’t flush with an iv
how to care for a nasogastric tube
keep head of bed elevated 30 degrees
asses residuals
monitor lung sound s
monitor skin
what are the types of care needed of a gastrostmy and jejunosmy
cleanse with soap and water
monitor for dumping syndrome
flush tube with attest 30ML water
sit upright for an hour after eating
parental nutrition is used for
pts who have minimal intake
inability to ingest food
prolonged nutrital needs
what type of technique is used for parental nutrient
asepsis
change bag every 24 hours
what is dysphasia risk factors
smoking
med
alcohol consumption
hiatal hernia
musculoskeletal diseases
Obesity risk factors
- lack of physical activity
2.unhealthy eating habbits
3.stress
4.gentics - medications
what are the manifestations of dysphagia
pain to swallow
hoarseness
regurgitation
heartburn
coughing
chocking
what are the signs and symptoms of obesity
BMI greater than 30
what are the risk factors of iron deficiency anemia
lack of energy
SOB
dizzy
light headed
chest pain
PICA
pallor
what type of education does a pt with anemia need
increase iron intake
types of iron supplements
PO- ferrous sulfate and ferrous gluconate
IV- iron sucrose
better absorbed on empty stomach and with vitamin c
the labs for iron
Ferritin
men -224-336
women 11-301
transferrin
215-380
less than 215 is hemolytic
greater than 380- IDA
what labs indicate malnutrition
albumin-3.5-5.4
cellular regulation
control the series of events through the cell cycle
cellular growth
an increase in the total mass of the cell
secular reproduction
process in which cells duplicate
what is a begin tumor
its non cancers
grows slowly and don’t speread
what is a malignant tumor
rapid growth
moveable
cancerous
what are the risk factors for solid tumors
espouser to viruses
exposure to sunlight, radiation, chemicals,
hormonal imbalance and immuncomprised
what is a solid tumor
abnormal mass of tissue that usually does not contain a cyst
can be either benign or malignant
what does solid tumors happen
error in DNA replication
primary treatment
to remove as much as possible tissue
what is diagnostic
sample to confirm diagnosis
palliative care
when cure isn’t possible, improves comfort
what does radiation therapy consist of
-used to interrupt cellular growth, relive symptoms
BPH is
an abnormal mass of tissue that usable does not contain cyst or liquid
-obstrcuted urethra
Bph risk factors
African Americans
smoking
alcohol
htn
diabetes
what are the signs and symptoms
increased urniation
nocturia
urgency
straining
recurrent uti
assessment for BPH
urinalysis
renal function test
bladder scan
medication
aplha adrenfic blockers - relax the smooth muscle
-doxasoin ( cardura) tamsulosin ( flomax)
reductase inhibtors- interfere with the conversion of testorone
-finsateride(proscar)
saw palmetto-
Gerd
back flow of the gastric or duodenal contents
due to the lower esophageal sphincter
Gerd signs and symptoms
pyrosis
dyspepsia
regurgitation
hypersalvation
esiohagitis
gerd risk factors
overweight
being pregnant
alcohol
weak muscle
hiatal hernia
smoking
GERD Management
avoid coffee, tobacco, alcohol, milk, foods with peppermint, carbonated drinks
avoid drinking and eating 2hrs before bed
maintain normal body weight
GERD MEDICATION
histamine 2 antagonist- reduce stomach acid
-famotide( Pepcid), Cimetide (tagamet)
bpi-inhibits the proton pumps
-prazole
antacids- neutralize the stomach acid
-carbonates
what is the job of a endoscopy
asses for motility, abnormal, inflammations , or infections
what is elimination
expulstion of waste matter from the body
diarrhea
frequency of bowel movement and liquidity
what is diarrhea patho, risk factors, and symptoms and assessments
- rapidly moved contents that hasnt be absorbed in timed
2.antibitiocs, bowel disesese, food intolerance, go infection, hyperthyroidism, chrons
3.water stool, impaired skin integrity around the rectum cramps and bloating
diarrhea medications
antidiarrheals-slowing down the movement
-lopermide(Imodium)
c-diff
bacteria that causes infection in the LARGE INSTINE
risk factor- antibiotic therapy, loss of gut flora, impaired immune system
Cliff symptoms
increased WBC
water diarrhea 10-15day
fever
stress incontince
pressure with laughing, sneezing, or lifting
how can u treat c-difff
vancomycin
probiotics
consitpation
decrease in the frequency of bowel sounds
medications for consitpation
1.osmatic stimulants- pulls waters from surround tissue
-magnism
2. stimulant laxatives - increase muscle contraction
-bisccodyl
3. Gi stimulant -incresse the motility
-metoclopramide(reglan)
enemas
consipation patho,risk,signs and symptoms
- slow movement
- frequent laxities,age, inaduqete food and fiber intake, medication
- straining, hard feces,
overflow
loss of small amounts of urine due to obstruction
urge
can’t stop urine flow long enough to reach the bathroom
functional
mobility or environmental barriers
spiral facture
a twist around the shaft bone
reflex
due to cns impairment
greenstick fracture
a fracture in which one bone is broken and the other is bent
transit
re erasable incontince
open fracture
invokes the skin and mucous membranes
depressed fracture
a inward fragment
commented
several fragments
NSAIDS
ibuprofen and naproxen
fever and inflammation
blocks cox 1and 2
SE-stomach ulcers, indigestion
what are salicylates meds for and drug
aspirin,bayer
fever and inflmation
inhibits cox 1and2
SE- bleeding, tinnitus
osteoporosis
reduction in bone density and change bone structure
risk - white women
asian women
poor diet low ca+ and vitamin d
lack of excersie
greater than 2.5
corticosteroids
prednisone
decrease inflmation and suppress immune system
SE- fluid retention, High BP, hyperglycemia
cox 2 inhibitors
stimulant the inflammatory response
Celebrex
SE_ stomach pain
