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ABSN Cohort 19 > MedSurg Exam2 > Flashcards

MedSurg Exam2 Flashcards

1
Q

Xerosis

A

dry skin (common in older pts)

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2
Q

Urticaria

A

hives

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3
Q

Contamination

A

presence of organisms w/out infx

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4
Q

Infection

A

organisms grow/spread, Ø control by body’s immune sys.

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5
Q

Hirsutism

A

excessive growth of body hair or in ab. areas

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6
Q

Acute paronychia

A

inflammation of skin around nail

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7
Q

Lichenification

A

thick skin (caused by scratching r/t dry skin)

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8
Q

Diagnosing Skin (5)

A

C&S - reveals fungal, bacterial, viral
Wood’s light - colors show infx, lighter pts
Tzank Smear - reveals viral
Potassium Hydroxide (KOH) - reveals fungal (threads)
Biopsy

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9
Q

4 Biopsies and 2 reqs?

A 
Punch = 2 - 6 mm plug
Shave = raised area only w/ razor
Excisional = deep specimen, reqs. sutures
Incisional = cross-section through center lesion. reqs. sutures

Biopsies req. consent and local anesthesia

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10
Q

Assessment of Darker pts

A 
Pallor = ashe gray on mucous membranes
Cyanosis = lips, mouth, tongue for blue
Inflammation = palpation
Jaundice = hard palate
Bleeding = compare affected to unaffected. Also petechiae!
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11
Q

3 Phases of wound healing

A

Inflammatory
Proliferative
Maturation

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12
Q

Inflammatory Phase (3)

A

3 - 5 days when injury starts
WBC/macrophages migrate -> wound
S/S = edema, pain, erthyema, warmth

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13
Q

Proliferative/Fibroblastic (2)

A

2 - 4 weeks past 4th day

Epithelialization (tissue repair) takes place

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14
Q

Maturation Phase (3)

A

3 weeks after injury -> 1 year?
Collagen
Scar tissue becomes thinner/paler

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15
Q

Process of Wound Healing (3)

A

Depends for each wound.
1st - edges brought together
2nd - granulation/contraction
3rd - delayed closure, ↑% infx and scarring

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16
Q

Skin Risk Factors labs (3)

A

Albumin < 3.5 mg/dL
Prealbumin < 19.5 mg/dL
Lymphtocye < 1800/mm3

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17
Q

Skin Assessment Factors (7)

PCSE-CSL

A 
Presense of foreign bodies
Condition of surrounding tissue
Spreading
Extent of Tissue involvement
Color
Size
Location
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18
Q

Skin S/S Infx Present (5)

A 
Fever
Exudate
WBC > 10k
↑ CRP
↑ ESR
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19
Q

Cellulitis

A

Deep skin infx 2ndary to infx in open wound

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20
Q

MRSA

A

Mild folliculitis -> Extensive Furuncles

↑% incidence in communal environments

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21
Q

Herpes 1 and 2

A

1 - recurring sores last for 3 - 10 days
contagious first 3 - 5 days, tingling/burning lip!
2 - genital, lol.

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22
Q

Autoinoculation

A

transfer from 1 viral type to another part of body

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23
Q

Herpetic Whitlow

A

Occurs on fingertips of medical personnel

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24
Q

Herpes Zoster (shingles) (3)

A

Follows a dermatome (Cervial Nerve Ending)
Dormant active
Ø midline

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25
Q

Fungal Infx (2)

A

Dermatophyte - tinea, direct contact

Candida Albicans - vagina/mouth. In mouth, swish/swallow mystatin

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26
Q

Parasitic Infx (3)

A

Pediculosis - lice. S/S pruritis. c/w sprays, creams, changing bedding.
Scabies - S/S curved/linear ridges. Common w/ poor hygiene/living. Tx scabicides/laundry
Bedbugs - blood suckers. Tx topical antihistamines

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27
Q

Skin Lesion Configurations (9)

ACCCC - U DSL!

A 
annular - ringlike, raised borders
circinate - circular
circumscribed - well defined sharp borders
clustered
coalesced - merge w/ one another
diffuse - widespread
linear
serpiginous - wavy borders
universal - all body fx'ed.
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28
Q

Primary Lesions (7)

MP N/T VPTW

A 
Macule - color▲, Ø palpable
Papule - circumscribed < 1 cm
Nodule/Tumor - circumscribed, firm 2 cm
Vesicle - serous fluid filled, < 1 cm
Pustule - pus-filled
Tumor - solid mass > 2 cm
Wheal - irregular border
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29
Q

Secondary Lesions (5)

C-FUSE

A

Erosion - Lost epidermis, moist, Ø bleeding
Crust - dried blood
Scale - skin flakes
Fissue - linear crack
Ulcer - Lost epidermis AND dermis w/ bleeding

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30
Q

Skin Color ▲’s (4)

JPEC

A

Pallor - anemia/Ø blood flow
Cyanosis - hypoxia, thrombocytopenia, bruising
Jaundice - liver/RBC d/fx
Ertthema - inflammation/vasodilation

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31
Q

Abnormal Skin ABC’s

A 
A - asymmetry
B - Border irregularity
C - color
D - diameter
E - Evolving
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32
Q

Benign Tumors (4)

SKNC

A

Cysts - dent upon palpation
Seborrheic Keratoses - scaly patches
Keloids - scar overgrowth
Nevi - moles

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33
Q

Actinic Keratosis are…?

A

Pre-malignant

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34
Q

Basal vs. Squamous cell carcinomas

A

Basal - mostly by UV and outter skin.
Squamous - cancer in epidermis/can be metastatic.
On ear, lip, and external genitalia.

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35
Q

Melanomas !!!’s (2)

A

> 6mm have doc check

Highly metastatic

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36
Q

Advanced Surgical Skin Managment

A 
Crosurgery
Electrodesiccation
Excision
Moh's for Basal Cell Carcinomas
Wide Excisions
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37
Q

Dystrophic Nails reason

A

Clubbing b/c impaired gas exchange

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38
Q

Alopecia reasons (3)

A

Endocrine dz, ↓nutrition, male pattern baldness

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39
Q

Psoriasis

A

Autoimmune dz, 7x growth rate.

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40
Q

Psoriasis Big r/fs (4)

A

Infections - strep throat, candida, upper resp. infx
Seasons - warm weather
Hormones - puberty/menopause
Medications - Lithium, BBlockers, Anti-malarials, Indocin

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41
Q

3 Types Psoriasis

A

Vulgaris - silvery white scaly
Exfoliative - red severe inflammatory
Palmoplantar - browned hyperkaratotic

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42
Q

Psoriasis Big 4 Medications

A

Topical Corticosteroids
Topical Epidermopoiesis Suppresive Meds
Tar Preparations
Cytotoxic Meds

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43
Q

Topical Corticosteroid EFP

example, fx, precaution

A

Triamocinolone Acetonid (Kenalog)
↓ inflammatory response
Ø face skin, asses for thinning/hypopigmentation

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44
Q

Topical Epidermopoiesis Suppresive Meds EFP

A

Calcipotriene (Dovenex)
Mild - Moderate Psoriasis, ↓ epidermal development
TERATOGENIC and r/in hypercalcemia

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45
Q

Tar Preperations EFP

A

Anthralin (Drithocreme, Lasan)
ModeratePsoriasis, ↓ cell division/itching
STOP Creams, STARTs Cancer, stains and smells!

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46
Q

Cytotoxic Meds EFP

A

Methotraxate (Trexal)
Severe Psoriasis, ↓ epidermal turnover
TERATOGENIC, also r/in sore throat, fever, bleeding, fatigue

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47
Q

Photochemotherapy and Ultraviolet Light (PUVA)

A

Methoxsalen (Uvadex)
↓ cell proliferation
Report any extreme redness, swelling, long term aging fx.

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48
Q

Seborrheic Dermatitis

What? R/in 2? Tx 2? Report if 2?

A

Inflammation of areas w/ sebaceous glands.
R/in papulopustules (oily) and flakes (dry)

Topical Corticosteroids/Antiseborrheic Shampoos.
Exacerbations/remissions

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49
Q

Pruritis 4 Tx

A

Cool environment
Hygiene
Antihistamines
Topical Steroids

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50
Q

Braden Scale 7 Factors

SPAMMNF

A 
Sensory
Perception
Moisture
Activity
Mobility
Nutrition
Friction/Sheer
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51
Q

Pressure Ulcer 5 Stages

A 
1 - Intact, unblanchable redness
2- Non-intact w/ partial skin abrasian/blister
3 - full skin loss, subq visible
4 - full skin loss, bone/muscle visible
5 - eschar/slough
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52
Q 
UlCcer Assessment (like skin)
PCSE - CSL
A

Presence foreign body
Condition surrounding tissue
…

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53
Q

NonSurgical Ulcer Tx’s (4)

A

Dressing
Whirlpool
Drug
Nutrition

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54
Q

Future is Now Ulcer Tx (5)

A 
Electrical
Vaccum Assisted
Hyperbaric O2 (HBO)
Topical Growth
Skin Substitutes
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55
Q

Surgical Ulcer (2)

A

Debridement

Skin Grafting

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56
Q

S/S Organ Rejection

A

Tachycardia, fever, pain
AST/ALT values ↓ (liver)
Pigmentation/Diaphoresis

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57
Q

Hyper-Acute Transplant Rejeciton

A

Remove STAT

HLA Ø recognize object

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58
Q

Acute Transplant Rejection

A

1 - 3 months post-transplant

Tx immunosuppresants

59
Q

Chronic Rejection

A

Scarring impedes organ fx

60
Q

S/S Appendicitis

A

Pain epigastric/umbilical area that migrates to Mc.Burney’s Point (R). Rebound tenderness.

Appendectomy req.

61
Q

Paracentesis, Colonoscopy, and Thoracentesis Procedure.

A

Paracentesis - trocar catheter removes fluid (r/t liver cirrhosis)
Colonoscopy - camera up butt!
Thoracentesis - aspiration of fluid in pleural space

62
Q

Key findings of Abdomen Organ Trauma (3)

CMM

A

Cullens - bruising around umbulicus (GI bleed)
McBurney’s - tenderness LQ (appendicitis)
Murphy’s - R side pain, increases w/ inspiration (Choli/gallblader)

63
Q

Acute vs. Chronic Cholesystitis

A

Acute - Flatulence
Blumberg’s rebound tenderness
Steatorrhea fatty stools
R/in calculous (kidney stones)

Chronic - Pancreatitis
Jaundice & Icterus - yellow eyes
Pruritis - b/c bile salts in skin
R/in ↓motility, absorption

64
Q

GERD CM

Cause, 2K M

A

Relaxed lower esosphincter and backward flow of stomach content (reflux esophagitis)
Dyspepsia (heartburn)
Waterbrash (hypersalivation)

65
Q

GERD NonSurgical Management (4)

A

Diet Therapy
Education
Lifestyle changes (sleep head up, don’t strain, smoke)
Drug Therapy

66
Q

GERD Drug Therapies (4) and EFPs

A

Antacids - Tums, Maalox, Mylanta. neutralize Ph > 3. Fx is Short!
H2 Antagonists - Pepcid, Zantac, Tagamet. ↓ acid secretion.
PPI - Prevacid, Prilosec. long acting ↓ acid secretion. ↓Ca and Protein absorption
Prokinetics - Reglan. ↑ gastric emptying. Tardive dykensia

67
Q

Gastritis Cause and Tx

A 
Inflammation gastric mucosa (Acute/Chronic) b/c H. Pylori in Serum, Breath, and Stool
Triple Therapy (H2, PPI, Antibiotics)
68
Q

Cholecystitis

How to Dx and different lab S/S comparative (6)

A

S/S p eating fatty foods
Lab changes
↑ WBC, AST, ALT, serum albumin, amylase and lipase (if pancreas involved)

69
Q

Cirrhosis C3, labs S3 , assess S3

A

Extensive scarring of liver b/c inflammation
Laennec - alcohol
Postnecrotic - Viral Hep C or drugs
Biliary - biliary obstrx

↑ Labs ALT, AST, LDH

Ascites
↑ portal pressure
Hepatic encephalopathy

70
Q

Transjugular Intraheptatic Portosystemic Shunt Fx

A

Controsl long term ascites to ↓ variceal bleeding

71
Q

NonSurgical Tx for Excessive Volume Cirrhosis (3)

A

Drug Therapy - BBlocker (propranolol)
↓ bleeding
Gastric intubation - detect bleeding
Esophagogastric ballon tamponade - controls bleeding by putting pressure on wound. Protects airway!

72
Q

NO Liver Transplant is you have…? (5)

A 
♥ Dz
Alcohol abuse/dependence
Metastatic Cancer
Respiratory Issues
Refusal to follow up with Drug Therapy
73
Q

Labs associated w/ Liver d/fx

A 
↑ ALT, AST, LDH, alkaline phosphates, serum bilirubin, urobilinogen
↓ serum protein, albumin, Hgb, Hct, WBCs
Thrombocytopenia
↑ Creat. level = death close
↑ ammonia
74
Q

Peptic Ulcers C2, S0, T5

A

H.Pylori infx r/in lesion in stomach/duodenum
Pain relief
H. Pylori eradications
Ulcer Healing
Recurrence prevention
Education to avoid bedtime snacks, alcohol, and smoking

75
Q

Ulcer Complications (4)

A

Hemorrhage (vomiting blood)
Perforation <- life threatening!!!
Pyloric Obstructx r/in vomitting
Intractable dz - pt Ø manages and recurrence

76
Q

GI Bleed High vs. Low

A

Melena

Frank Hematochezia

77
Q

Labs for GI Bleeds (8)

A 
CBC
BUN
Electrolytes
PT/PTT
ABGs
Liver Enzymes (AST, ALT, ammonia)
Blood Glucose
H & H
78
Q

Dx for GI Bleeds

A

Type and Cross

Endoscopy

79
Q

Hiatal Hernia C1, Types2, Education?

A

Protrusion of stomach through hiatus in diaphragm
Sliding = most common
Rolling = intestinal torsion, reqs. surgical intervention
Regular GI stuff… head elevated, no eating late, smoking, alcohol, etc.

80
Q

Ulcerative Colitis C1, S4, T4 with EFØP

A

Inflammation of rectum/sigmoid colon

15 - 20 watery stools w/ blood/pus
LLQ pain
Pseudopolyps
B12 Ø absorption (pernicious anemia)

Drug Therapy
Salicylate compounds (5ASAs) 
Sulfasalzine ↓ inflammation
Corticosteroids
Prednisone ↓ exacerbations
Immunosuppresants
Humira ↓ immune response
Antidiarrheal drug
Lomotil, Imodium S/S tx
81
Q

ONLY TRUE CURE FOR UC (& 3 types)

A

Colectomy
Total permanent
Total continent
Total w/ stripping/ileoanal pouch

82
Q

Crohn’s Dz C1, S5, TØ

A

Inflammation/ulceration GI tract

Fistulas
5 watery stools w/ pus/musucs
RLQ paint
Steatorrhea - fatty stool
Req. B12 injection
83
Q

Labs betwwen UC and Crohns

5↓ 6↑

A

↓ HH, Albumin, K, Mg, Ca
↑ ESR, WBC, Cprotein, Platelets,

↑pANCA (UC only)
↑ Antiglycan antibodies (Crohns only)

84
Q

Diverticulitis C, S3, T

A

↑ pressure in intestinal lumen (usually asymptomatic)
Pain LLQ, ab. distension, low fever
Ø seeds n stuff

85
Q

Pancreatis Fx on 2 labs

A

serum amylase and lipase ↑

86
Q

Esophageal Varices C, S2, TØ (relation to exercise)

A

Distended esophageal veins r/in ↑ pressure
straining exercise ↑%
Bleeding (hemetemesis or melena) !!!
LIFE THREATENING EMERGENCY

87
Q

Bariatric/Cholecystectomy Precautions (4 ea)

A 
Bariatric
Notify if displacement
Monitor for leak
Ambulate asap
6 small meals
Cholcystectomy
Report ↑ drainage
Monitor drainage
Empty q8h
Clamp q1-2h tp assess food tolerance
88
Q

Labs r/t Enteral 3 and Parenteral 2 nutrition

A

Enteral - ↓Na, ↑K, and fluid overload

Parenteral - ↑Blood glucose, all electrolytes (Na/K imba common), ↑Ca

89
Q 
7 Labs r/t Nutrition
HH
Albumin Squad
C
TL
A

Hgb - anemia, hemorrhage, hemodilution/concentration
Hct - ↑ditto
Serum albumin (3.5 - 4.0 mg/dL) - reflects previous weeks.
Prealbumin (15 - 36 mg/dL) - most sensitive b/c 2 day HL (MOST ACCURATE)
Transferrin - iron-transport protein. ↑ sensitivity to protein status. HL 8 - 10 days
Cholesterol (160 - 220 mg/dL)) - ↓w/ malabsorption or malnutrition
Total Lymphocyte Count - TLC < 1500/mm3 = malnourishment which = ↓immune fx

90
Q

Nursing Interventions r/t restoral oral HP (3)

A

Hygiene q2h soft toothbrush
Ø toothetes/foam brushes b/c Ø bacteria control
Ø commerical mouthwash b/c alcohol and acidity

91
Q

Stomatitis C1, Types2, Tx2

A

Inflammation oral cavity
Primary - most common. includes cakers, herpes, and ulcers
Secondary - b/c opportunistic fungi, bacteria

Rinse mouth q2-3hours w/ baking soda/saline solution
SLS toothpaste

92
Q

Hep ABCDE

A

A - fecal self limiting. GI S/S.
B - blood sex and needles. Whitlows! Nausea, fatigue.
C - Continuation of B. Carrier! Asymptomatic for decades.
D - Must have B. Needle sharers.
E - waterborne, self limiting.

93
Q

Labs fx’ed by ALL Hepatitis

A

AST/ALT

94
Q

R/f for ↑% Cancer 4

Antigens of importance?!

A

↑Alpha-fetoprotein
HepB and C
Esophageal tumors
Cancer of Liver (most common in the WOOOORLD!)

Oncofetal antigens.

95
Q

Diarrhea Organism Cause and Diagnostics 2

A

C. Diff

Stool culture and C.Diff test (enzyme-linked immunosorbent assay ‘ELISA’ results w/in 2-6 hrs

96
Q

Jaundice main lab and r/t which organs 3.

A

↑Bilirubin b/c liver Ø excreting

Liver d/fx, cancer gall bladder, panceratiis

97
Q

Peritonitis and Perforation

Cause/Symptoms

A 
Peritonitis - acute inflammation of peritoneum
ab. pain and fetal position. ↓ GI
Perforation - ulcers
sudden sharp pain that spreads ↑ GI
SURGICAL EMERGENCY!!!
98
Q

4 Hernias S/S for 1st two.

2 Dx and 1 Tx?

A 
Sliding - eso up
♥burn,dysphagia, belching
Rolling - stomach up
Fullness, worse when recumbent
Inguinal (Femora) and Umbilical

Barium swallow, Endoscopy.
Nissen Fundoplication to prevent respiratory complication

99
Q

Cirrhosis Early2, Late2r, Other3 Assessment

A

↑ wieght, pain
Jaundice & liver issues
Neuro changes, fetor hepaticus (fruity/musty breath), asterixis (tremors in wrists, hands, fingers)

100
Q

Cirrhosis Lab changes ↑↓

7↑ 3↓ 1 Prolonged

A

↑ AST, ALT, ALP, LDH, bilirubin, ammonia, creatinine
↓ albumin, platelet, HH

Prolonged PT/INR

101
Q

Types Pancreatitis 3

A

Chronic - progressive destruction w/ remissions/exacerbations
Acute - life threatening by premature activation of enzymes (autodigestion)
Necrotizing Hemorrhagic - bleeding! r/in high fever

102
Q

Pancreatitis Assessment 5 and how to Dx

CT LABs

A 
Cullens - perumbilical bluish grey
Turners - Ecchymoses on flanks
LUQ pain
Ø bowel sounds
Ascites

CatScan with Contrast

103
Q

Pancreatis Labs

A

↑ amylase/lipase
↑ glucose
↑ liver enzymes
↓ calcium

104
Q

Pancreatitis Pt education (4)

PAIN

A

PERT
Antiemetics
Insulin therapy
NPO early

105
Q

Pancreatic Enzyme Replacement Therapy (PERT)

A

Administering enzymes w/ meals/glass of H2O.

Wipe lips after consuming.

106
Q

Lungs place in pH defense.

Response to Respiratory Acidosis/Respiratory Alkalosis

A

2nd behind chemical buffers
RAcid - ↑ RR/depth to ↓ CO2 and pH
RAlk - ↓RR/depth to ↑ CO2 and pH

107
Q

Smoking Calculations

A

(#years smoked) x (pks/day) = PACK years

108
Q

Early/Late findings in declining Respiratory status

A

Early - tachy, restlessness, pallor

Late - brady, confusion/stupor, cyanosis

109
Q

O2 Delivery Systems 7 (rates and key notes)

A

Nasal Cannula : 1 - 6 L. Fitting/Nasal patency
Simple Facemask : 5 - 8 L. Moisture r/in breakdown
Partial RBreather : 6 - 11 L. Deflation = ↓O2
Non RBreather : 80 - 95%. Suffocation if kinks.For unstable pts.
Venti Mask : 4 - 10 L. For chronic lung dz.
Tent/Collar : > 10L. For high humidity b/c thick secretions
T- Piece : > 10L. For tracheostomy and other procedures.

110
Q

COPD

2 R/F, 3 Labs, 3 ABG fx

A

Primarily smoking, Alpha 1 antitrypsin (AAT) deficiency (genetic)

↑Hct, sputum for infx, electrolytes

Hypoxemia for PaCO2 < 80mm
Hypercarbia for PaCO2 > 45mm during attack
Respiratory Acidosis

111
Q

COPD Dx 3 and 2 Medications

A

Chest X-Ray for hyperinflation (late)
PulseOx
AAT

Bronchodialtors and Anti-inflammatory

112
Q

Cystic Fibrosis C1, SØ, Dx2

A

Genetic dz b/c error in chloride transport in lungs.

Dx with sweat chloride analysis and genetic testing

113
Q

Cystic Fibrosis Interventions 4

A

Postural drainage
Ø mechanical ventilation
Heliox (50/50 oxy.helium
Avoid direct contact b/c Burkholderia Cepacia (IGGY)

114
Q

Emphysema and Chronic Bronchitis

A

Emphysema - loss in elasticity and hyperinflation. R/in dysnpea and ↑RR. Stretches alveoli and bullae.
Chronic Bronchitis - inflammation r/t tobacco smoke. ONLY airways, not alveoli. Thick mucus and congestion

115
Q

Sinusitis CST2 and Pharnygitis CSDx2

A

Frontal/Maxillary swelling b/c bacteroides. S/S similar to colds. Tx antibiotics, also Functional Endoscopic Sinus Surgery (FESS)

Sore throat b/c Strep. Dysphagia.
Rapid Antigen Test (RAT), results in 15 minutes.
C&S

116
Q

Upper Airway Infx
Retropharyngeal Abscess
Tonsilar Infx

A

Cause by Staph/MRSA
Kids < 2 yrs old
Usually unilateral

117
Q

3 Types of Pneumonia

A

Bacterial
Viral - most common
Atypical - look @ labs CRP and CBC

118
Q

Bronchoiolitis

A

Viral induced lower respiratory for kids

119
Q

Aspiration pneumonitis

A

Older folks and (Myconeum) babies

120
Q

Pneumonia Labs 5 and Dx 2

A 
Sputum C&S
CBC
ABG
Blood Culture
Electrolytes

Chest X-Ray
PulseIOx

121
Q

Pneumonia Tx 3

A

Antibiotics
Bronchodialators
Anti-inflammatories

122
Q 
Myobacterium Tuberculosis (TB)
Vector?
Level communicable?
3  S/S
Best Dx?
Other Dx?

Similar infx?

A

Airborne
High
Persistent cough, night sweats, heoptysis (spitting up blood)
Nucleic Acid Amplicification Test (NAAT) 2 hrs
QuantiFeron GOLD (blood test)
Acid-Fast Bacilli Smear/Culture

Miliary TB blood Dz

123
Q

TB Interventions

PIE!!!

A

Combined Drug Therapy
Pyrazinamide
Isonazids
Ethambutol

124
Q

Pulmonary Empyema

A

Collection of pus in pleural space

125
Q

Asthma
Is it like COPD?
Reason for S/S?
Age? Cause?

A

Reversible airflow obstruction (contrary to COPD)
Airway hyperresponsiveness
None, Unknown

126
Q

Asthma Classifications 4

A

Mild intermittent - < 2x a week
Mild persistent - > 2x a week but Ødaily
Moderate persistent - daily w/ exacerbations 2x a week
Severe persistent - continuous w/ exacerbations FML

127
Q

Bronchospams

…and Meds that trigger?

A

Narrowing of bronchial tubes b/c smooth muscle constriction in response to pollutants/viruses.

Airway hyperresponsiveness.
Triggered by Aspriin and NSAIDS b/c leukotrine

128
Q

Asthma 1 Lab 3 Fx and other lab

A

PaCO2

Hypoxemia - ↓ PaCO2 < 80mm
Hypocarbia - ↓ PaCO2 < 35mm early in attack
Hypercarbia - ↑ PaCO2 > 45mm later in attack (Administer 1L O2)

Eosinophils and IgE for allergic

129
Q

Asthma Dx 2

A

Pulmonary Function Test (Ø smoking 4 - 6 hrs before test)

Chest XRay

130
Q

Asthma Tx 3

A

Bronchodialators
Short/Long acting B2 Agonist
Cholinergic Agonists

131
Q

Peak Flow Meter
X used per day, X number times each use
Green, Yellow, Red Zones?

A

2x a day/3 times per use
Green = good control, 80% personal best
Yellow = Caution. Have rescue med.
Red = Med. Alert. Instruct to take med/seek med. attention

132
Q

3 Pulmonary Fx Tests

A

Forced Vital Capacity (FVC) - full in/exhalation
Forced Expiratory Volume in the 1st second (FEV1) - volume air blown out forcefully 1st second exhalation
Peak Expiratory Flow Rate (PEFR) - fastest airflow rate during exhalation
15 - 20% < expected value is seen in asthmatics
This % increases 12% when given bronchodialators

133
Q

Status Asthmaticus

A

Life threatening acute episode of asthma

134
Q

Inhaler Education 3

A

Inhale drug as long as possible
Spacer helps
Full inhalers sink to bottom

135
Q

Trach Education 2

A

Too large r/in hypoxia

Fenestrated vs. Non Fenestrated - fenestrated allows pt to speak

136
Q

Trach Interventions 5

A

Confirm breath sounds q2hrs
Assess site qShift
Keep pressure 14 - 20 mm
Equipment left @ bedside for first 72 hours

137
Q

Suctioning Complications 5 and follow-ups if(true)

A

Hypoxia, trauma, infx, vaginal stimulation, cardiac dysrhythmia (b/c hypoxia)

ANY? STOP IMMEDIATELY and 100% O2

138
Q

Chest Tube Nursing Focus and 3 Chamber of Secrets

A

Ensure Integrity of System
1 - collects fluid. tube must Ø touch liquid
2 - water seal prevents air from entering pt pleural space. 2 cm H2O. Add sterile H2O as needed.
3 - Suction control.

139
Q

Chest Tube Assessment 3

A

Drainage, Leaks, Crepitus (SubQ emphysema)

140
Q

Ranges:

BUN
Creatinine
Blood Glucose
Urine Specific Gravity

A

10 - 20
0.5 - 1.5
70 - 120
1.00 - 1.03

141
Q

Ranges:

Na
K
Ca
Mg
P
Cl
A 
135 - 145
3.5 - 5
9 - 10.5
1.3 - 2.1
3.0 - 4.5
98 - 106
142
Q

Ranges:

T3
T4
HDL
LDL

A

70 - 205
4 - 12
> 50
< 190

143
Q

Ranges:

WBC
RBC
HH
Platelets

A

4k - 10k
4.6 - 5.5
13.4 - 15.5 / 39 - 49
140 -400

144
Q

Ranges:

AST
ALt
ALP
Amylase
Bilirubin
Albumin
Ammonia
A 
5 - 40
8 - 20
30 - 120
56 - 90
0.1 - 1.0
3.5 - 5.0
15 - 110

ABSN Cohort 19 (28 decks)

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