Med Surg Tips

Question 1

Hypoglycemia Signs:

Answer 1

TIRED
Tachycardia

Irritability

Restlessness

Excessive hunger

Depression and diaphoresis

Question 2

Hypocalcaemia Signs and Symptoms:

Answer 2

CATS
Convulsions

Arrhythmias

Tetany

Stridor and spasms

Question 3

Hypokalemia Signs and Symptoms:

Answer 3

6 Ls
Lethargy

Leg cramps

Limp muscles

Low, shallow respirations

Lethal cardiac dysrhythmias

Lots of urine (polyuria)

Question 4

Hypoxia
early signs:
late signs:

Answer 4

Early: RAT
Restlessness
Anxiety
Tachycardia and tachypnea

Late: BED
Bradycardia
Extreme restlessness
Dyspnea

Question 5

What are the s/s of dumping syndrome?

Answer 5

(inability of pyloric sphincter to control the movement of food into the small intestine)

• Nausea, distention, cramping pains, and diarrhea within 15 min after eating.
• Weakness, dizziness, a rapid heartbeat, and hypoglycemia may occur.

Question 6

What are some nursing interventions/things to avoid dumping syndrome? (5)

Answer 6

• Small, frequent meals are indicated
• Consumption of protein and fat at each meal is indicated
• Avoid concentrated sugars
• Restrict lactose intake
• Consume liquids 1 hr before or after eating instead of with meals (a dry diet).

Question 7

A ___ fiber diet may prevent diverticulitis, but a ___ fiber diet is prescribed during acute diverticulitis

Answer 7

• High-fiber for prevention: produces stools that are easily passed and thus decreasing pressure within the colon
• Low-fiber: in order to reduce bowel stimulation

Question 8

What are some foods that will stimulate the gallbladder (things to avoid with cholecystitis)

Answer 8

fat intake should be limited, avoid coffee, broccoli, cauliflower, Brussel sprouts, cabbage, onions, legumes, an highly seasoned foods

Question 9

What is ARF? What causes it?

Answer 9

Acute Renal Failure: an abrupt decline in renal function

Causes: trauma, sepsis, poor perfusion, or meds

Question 10

What are some s/s of ARF? (4)

Answer 10

Hyponatremia, hyperkalemia, hypocalcemia, hyperphosphatemia

Question 11

What is pre-ESRD? Characterized by…

Answer 11

Pre-End Stage Renal Disease
diminished renal reserve/renal insufficiency
-predialysis condition characterized by an increase in serum creatinine

Question 12

What are the goals of nutritional therapy for ESRD?

Answer 12

• Help preserve remaining renal function by limiting the intake of protein** and phosphorus
• Control blood glucose levels and hypertension (both risk factors)
• Limit meat intake
• Limit dairy products
• Restrict sodium (to maintain BP)
• only take vitamin supplements when told to by Dr

Question 13

What are some high-phosphorous foods?

Answer 13

peanut butter, dried peas and beans, bran, cola, chocolate, beer, and some whole grains

Question 14

What is ESRD?

Answer 14

End Stage Renal Disease (aka chronic renal failure)

-occurs when the GFR is less than 25 mL/min, creatinine level steadily rises, or dialysis or transplantation is required

Question 15

What is the goal of nutritional therapy for ESRD? How do we achieve this goal?

Answer 15

to maintain appropriate fluid status, BP, and blood chemistries

• High protein, low phosphorus, low potassium, low sodium, fluid restrictions
• Calcium and vit D are nutrients of concern

Question 16

Why should protein be increased with ESRD? What else should you take due to the increased protein?

Answer 16

only once dialysis has begun because protein and amino acids are lost in the dialysate
-phosphate binders must be taken with all meals because high protein leads to an increase in phosphorus intake

Question 17

ESRD alters the metabolism of ___, ____, and ____ and leads to ____, _____, and _____

Answer 17

calcium, phosphorus, and magnesium

-hyperphosphatemia, hypocalcemia (bc phos foods are restricted and those foods usually have calcium), and hypermagnesium

Question 18

What is nephrotic syndrome?

Answer 18

results in serum proteins leaking into the urine

Question 19

What are the goals of nutritional therapy for nephrotic syndrome?

Answer 19

to minimize edema, replace lost nutrients, and minimize permanent renal damage
-sufficient protein and low sodium intake

Question 20

What is nephrolithiasis? How do you treat it?

Answer 20

kidney stones

increasing fluid consumption is the primary intervention for tx and prevention of renal calculi

Question 21

What increases your risk of nephrolithiasis formation?

Answer 21

excessive intake of protein, sodium, calcium, and oxalates (rhubarb, spinach, beets)

Question 22

What are the 4 Es of angina?

Answer 22

Exertion
Eating
Emotional Stress
Extreme Temperatures

Question 23

What is the treatment for CHF?

Answer 23

MADD DOG
Morphine
Aminophylline
Digoxin
Dopamine
Diuretics
Oxygen
Gasses: Monitor arterial blood gasses

Question 24

APE To MAn What are the locations?

Answer 24

Aortic: 2nd right intercostal space
Pulmonic: 2nd left intercostal space
Erb’s Point: 3rd left intercostal space
Tricuspid: 4th left intercostal space
Mitral or Apex:  5th left intercostal space