Medsurg 3 part 6 Flashcards
btwn RA OA SLE which are systemic and which are local
RA and SLE are systemic
OA is local
btwn RA OA SLE which have risk for infection
RA and SLE
SLE has 3 top causes of death
pneumonia
sepsis
kidney failure
SLE can cause inflammation of
vessels
steroids can cause hyper___
gylcemia
btwn RA OA SLE which is non-inflammatory
OA
btwn RA OA SLE which has bone spurs
OA
OA exercise recommendation
exercise but stop when it hurts
C-reactive protein test: Is there an inflammatory response? If so, the dx is
RA or SLE
if ESR is elevated the dx is
RA or SLE
btwn RA OA SLE which one needs immediate care to prevent skin breakdown
RA
OA exercise goal
joint mobility (i.e. swimming, ti chi)
OA can’t be cured but
joints can be improved
OA patient that has stiffness in the morning gets
heat for 20 minutes
OA patient that has pain after walking gets
cold for 20 minutes
Acetaminophen shouldn’t be given in excess of
4 gm in 24 h
COX inhibitors have certain ___ risks
cardiac
viscosupplementation can be given __ times
6 times
defining characteristic of RA
symmetric
A patient has RA and their personality changes. It could be cause by
vasculitis in the brain
Pericarditis involves chest pain that’s relieved by
sitting forward
Abnormal CRP and ESR doesn’t definitively mean
you have RA
Splenomegaly risk
risk for bleeding if they fall
with pleuritis you will hear pleural rub and
crackles
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
RA
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
CK
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
A
Hepatitis risk factor: Unprotected sex with infected individual
B
Hepatitis risk factor: Infants born to infected mothers
B
Hepatitis risk factor: Contact with infected blood
B
Hepatitis risk factor: Drug abuse
B C
Hepatitis risk factor: Sexual contact
C
When do hep B symptoms occur
(wide range) 25 to 180 days after exposure
What is the incubation period for hep C
7 weeks
