Medsurg 3 part 6 Flashcards by Richard smith

btwn RA OA SLE which are systemic and which are local

RA and SLE are systemic

OA is local

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btwn RA OA SLE which have risk for infection

RA and SLE

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SLE has 3 top causes of death

pneumonia
sepsis
kidney failure

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SLE can cause inflammation of

vessels

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steroids can cause hyper___

gylcemia

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btwn RA OA SLE which is non-inflammatory

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btwn RA OA SLE which has bone spurs

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OA exercise recommendation

exercise but stop when it hurts

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C-reactive protein test: Is there an inflammatory response? If so, the dx is

RA or SLE

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if ESR is elevated the dx is

RA or SLE

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btwn RA OA SLE which one needs immediate care to prevent skin breakdown

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OA exercise goal

joint mobility (i.e. swimming, ti chi)

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OA can’t be cured but

joints can be improved

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OA patient that has stiffness in the morning gets

heat for 20 minutes

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OA patient that has pain after walking gets

cold for 20 minutes

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Acetaminophen shouldn’t be given in excess of

4 gm in 24 h

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COX inhibitors have certain ___ risks

cardiac

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viscosupplementation can be given __ times

6 times

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defining characteristic of RA

symmetric

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A patient has RA and their personality changes. It could be cause by

vasculitis in the brain

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Pericarditis involves chest pain that’s relieved by

sitting forward

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Abnormal CRP and ESR doesn’t definitively mean

you have RA

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Splenomegaly risk

risk for bleeding if they fall

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with pleuritis you will hear pleural rub and

crackles

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Mitral valve disease: listen for

murmur

S3 indicates

fluid overload

The key with DMARDS is to

use them ASAP

which disease gets a low dose of steroids

which disease gets a high dose of steroids

SLE

stomatitis aka

mouth sores

Mobility recommendation during exacerbation of RA

put on bed rest No exercise, except range of motion

Most people don't get fungal infections, but you might get one if you have

SLE

With SLE testing, are you looking for CK or CKMB

The steroid dose for SLE is around

40 to 60 mg (very high)

Urine output goal should be

50 ml (not 30 ml)

best indicator of nutrition

weight history

the first test you do because it's quick and easy

x ray

Between upper and lower GI series, which do you do first

lower

Which tests do you do last

the ones that require anesthesia

subclavian catheter puts you at risk for

pneumonia

Between PEG and PEJ, which gives residual

PEG

When you test an NG tube by putting it in water

there shouldn't be bubbles

Esophageal varices are common in ppl with

cirrhosis of the liver

Esophageal varices: do not use __ __ because you could rupture the varices

NG tube

Esophageal varices: you don't want the patient to __ or ___

vomit or gag (causes rupture)

Biggest risk of a pt with stricture

aspiration

What GI condition can be a trigger for asthma

GERD

what kind of ulcer has pain when the pt eats

gastric

what kind of ulcer has pain a couple hours after they eat

duodenal

The number 1 tx of GERD is

PPIs (decrease acid)

One food that shouldn't be given to GERD pt because it increases acid

chocolate

GERD position

raise the entire HOB (not just a pillow underneath)

With gastritis, in addition to the same drugs as GERD you will need

abx

The first thing you do with a vomiting pt

make them NPO

WBC in a pt with peritonitis

decreased

Milk stimulates a lot of

acid production

If you suspect bleeding, the pt may look fine on the outside, but you should check the

H and H

risk for shock if the systolic pressure is below

100

obvious sign of obstruction

distention

pancreatitis has a risk for h___

hemorrhage

obstruction is ___ danger

imminent

with obstruction you need to take the vitals because there's a risk for

shock

PUD drug regimen must include

abx

if pt has h/o arthritis, you can assume they are on NSAIDs and therefore have

risk for bleeding

what complication do you suspect in pt that's bleeding

hypovolemia

After someone has had a procedure, you need an order to start

feeding

Start discharge teaching by asking

about the patient about HERSELF

with the billroth procedures, watch out for malabsorption of

B12

3 signs of dumping syndrome

dizzy BM right after eating BM frequently

Dumping syndrome: exercise

don't walk right after eating

adhesions are aka

scar tissue

portal hypertension. think ____

varices

CEA is a test for

cancer

If someone was outside the country test for

parasites and ova

Gastroenteritis: medication do's and dont's

do give antiemetic don't give anti diarrhea

vomit smells like feces

small intestine block

too many enemas can cause what kind of electrolyte problem

hyponatremia

inflammation causes what kind of fluid imbalance

hypOvolemia

liver cirrhosis pt might not be allowed to get

pain meds

2 people who might get gallstones

someone that ate a lot of fat and then went on a diet someone that's pregnant

gallstones: feces is

chalky white

the biggest issue in ascites is

breathing

With elevated bilirubin, urine will be

dark and frothy

With portal htn you need to be worried about

decrease CO

before and after paracentesis

weigh the patient

Treat hepatic encephalopathy with

lactulose (to decrease ammonia)

first sign of hepatic encephalopathy

confusion

very high ___ puts you at risk for pancreatitis

triglycerides

Hepatitis risk factor: Close personal contact with an infected individual

Hepatitis risk factor: Unprotected sex with infected individual

Hepatitis risk factor: Infants born to infected mothers

Hepatitis risk factor: Contact with infected blood

Hepatitis risk factor: Drug abuse

B C

Hepatitis risk factor: Sexual contact

When do hep B symptoms occur

(wide range) 25 to 180 days after exposure

What is the incubation period for hep C

7 weeks