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ABSN Cohort 19 > MedSurge Exam2 > Flashcards

MedSurge Exam2 Flashcards

1
Q

Reference Ranges

Na, K, Ca, Mg, P, Cl

A 
135 - 145
3.5 - 5
9 - 10.5
1 - 2
3.0 - 4.5
98 - 106
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2
Q

Reference Ranges

BUN, Creatinine, Blood, Urine Specific Gravity

A

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

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3
Q

Reference Ranges

WBC, RBC, Hgb, Hct

A

4k - 10k
4.6 - 5.5
13.5 - 15.5
39 - 49

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4
Q

Reference Ranges

T3, T4, HDL, LDL, ADH

A 
70 - 205
4 - 12
> 50
< 190
1 - 5
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5
Q

Cushings @ Plasma Cortisol

A

suggestive if Ø↑ in mornings and ↓ night

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6
Q

Salivary Cortisol and hypercorticoidism

A

suggestive if ↑<2.0 @ midnight

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7
Q

Urinary Cortisol and hypercorticoidism

A

sugg. if ↑10-100

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8
Q

Reference Range

Serum ACTH and direction Addisons/Cushings

A

25 - 200
↑ Addisons
↓ Cushings

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9
Q

VMA test Range and direction

A

↑2-7 sugg. pheochromocytoma

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10
Q

Fx on SIADH on Urine [Na, K, Cl, Osma]

A 
75 - 200
26 - 123
110 - 250
200 - 800
Low values is sugg.
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11
Q

Pain med re-assessment interval

A

30 - 60 minutes

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12
Q

Acute vs Chronic Pain

A

Temporary FoF S/S
vs
Ongoing >60mo ØFof byt depression, fatigue

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13
Q

Nonopiods

A

Mild - Moderate

Acetaminophen (toxic if >4 days), NSAIDS, salicylates (tinnitus, vertigo. ↓hearing)

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14
Q

Opiods

A

Moderate - Severe
Morphine, Fentanyl (Sublimaze)
(constipation, hypoTN, UTR, Resp Depression)

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15
Q

Phantom Pain? Feeling/meds

A

pins and needles/anti-depressants/spasmodics

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16
Q

Adjuvants

A

Boost nonopiods

Anti/convulsant (Tegretol), anxiety (Valium, Depressants (Elavil)

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17
Q

4 CAMS

A

Natural Products - supplements
Mind-body - imagery, meditation
Manipulative - chiropractice
Other - touch, reiki

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18
Q

6 Herbs

A

Ginkgo Biloba - memory/bleeding
Garlic - Chol and BP - bleeding
Glucosamine - inflammation, ØWarfarin
Ginseng - anti-aging, ØWarfarin
Saw Palmetto - prostatic hyperplasia, Øclotting
Aromatherapy - well-being, nausea and vomitting

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19
Q

Pain Perceptions 4

A

Addiction - compulsive use despite harm
Psuedoadditcion - anger w/ staff b/c undertx
Tolerance - rq. ↑ drug for fx
Physical Dependence - withdrawal

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20
Q

WHO Pain Relief Ladder

A
  1. Nonopiod (g/t adjuvant)
  2. Weak opiod (g/t nonopiod/adjuvant)
  3. Strong opiod (g/t nonopiod/adjuvant)
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21
Q

Benzodiazepines

A

reduce anxiety pre-surgery
Diazepam (Valium and Versed)
Adfx. CR

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22
Q

Antiemetics

A

Decrease post-anesthetic nausea/vomitting
Ondansetron (Zofran)
Adfx. Dry mouth, dizziness

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23
Q

Sedatives

A

General anesthesia
Pentobarbital (Nembutal)
Adfx Øgive if w/in 14 days MAOI

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24
Q

Neuromuscular Blocking Agents

A

Skeletal relaxation/Airway placement
Succinylcholine (Anectine)
Rq. mechanical ventilation b/c blocks all contraction

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25
Q

Phases of General. Anesthesia

A

Induction
Maintenance
Emergence

26
Q

Malignant Hyperthermia
Overdose Anesthetic
Unrecognized Hyperventilation
Intubation Problems

A

Hot contractions, iced NSS and Dantrolene (Dantrium)
Proper screening
Monitor equipment
Proper assistance, r/in sore throat/neck injury

27
Q

Epidural/Spinal blockade Interventions (3)

A

lower head
quiet environment
keep hydrated

28
Q

Types of Surgeries (4)

A

Emergency
Palliative
Elective
Radical

29
Q

Renal Failure

Fx on BUN/Creatinine

A

↑

30
Q

Type of assessment for BUN, Creatinine, Na, Ca, catecholamines, and proteins

A

24 hour

31
Q

Renal GRAM interventions have…?

4 followups

A

Iodine, so check seafood allergies, meds, history of asthma, and get an enema

32
Q

Hemodialysis Dos(5) and Don’ts(3)

A

Elevate, x3week, 3-5 hour sessions, 2 needles, continue held meds afterwards

Take BP, give IV, injection near access site.

33
Q

Hemodialysis vs. Peritodialysis

A

Running lines through veins, filling peritoneal cavity with hypertonic glucose solution to even out electrolytes.

B/c loss, gain… watch labs.

34
Q

Acute (4 phases) vs. Chronic Glomulonephritis (5 stages)

A

Acute - clogged, recovers
Chronic - progressive destruction

AKI - onset, oliguria, diuresis, recovery
CKD - 1 (90), 2 (60), 3 (30), 4 (15), 5 (<15)

35
Q

Reasons for pre, intra, post renal injury

A

pre - fluid leveles
intra - injury
post - obstruction

36
Q

S/S UTR

A

Protein, blood, etc. in urine
Low labs, High WBC/leukocyte esterase/nitrates
Lethargy, deep sighing, yawning, anemia, ↓turgor

37
Q

Renal Calculi Fx, tx, and 4 food groups to avoid

A 
↑ Ca absorption ↓ excretion
Treat w/ opiods q4h
Calcium phosphate - high animal protein
Calicum Oxalate - spinach and K stuff
Struvite - dairy, red mean, whole grain P stuff
Uric Acid - Poultry, fish, wine
38
Q

ADH fx if too high/low

A 
high = SIADH, retaining
low = polyuria, sugg. DI
39
Q

Water Deprivaiton Test

A

Don’t drink H2O

If [urine] ↑ then +

40
Q

VMA Testing

A

24 hour collection Vanillymandelic acid w/out K foods

41
Q

Clonidine Suppression Test

A

Catecholamines q3h before Clonidine (Catapres)

if BP Ø↓ +

42
Q

Fx SIADH

A

↑ urine specific gravity

↓ all labs b/c retention

43
Q

Phentolamine Blocking test

A

Phentolamine (Regitene) Ablocker administered

if BP ↑= 25, pheochromocytoma

44
Q

Cushings Syndrome

A

Hyperfx Adrenal Cortex r/in ↑ cortisol

45
Q

Dexamethasone Suppression TEst

A

Dexa PO. ATCH and Cortisone should drop.

No? + Cushings

46
Q

Fx DI

A

Sunken eyes, Tachy, HypoTN

↓ urine labs ↑ serum labs, osmo, and thirst

47
Q

Fx SIASH

A

↑ urine labs, ↑ serum labs

RESTRICT FLUIDS TO .5 - 1 L/day

48
Q

Cushings Fx on Labs

A

↑ Na

↓ K, Ca, Glucose

49
Q

Addisons Syndrome

A

Adrenal Insufficiency

↓ aldosterone and cortisol

50
Q

Addisons Fx on labs

A

↓ Na

↑ K, Ca, Glucose

51
Q

Hyperthyroidism Fx and Tx (3)

A 
Overdrive!
Reduce stimulation
Thionamides (Methimazole and PTU 1-2 years)
Propanolol (Inderal) to relieve S/S
Iodine Solutions - after meds
52
Q

Hypothyroidism Fx and Tx

A 
Cooldown!
Levothyroxin (Synthoid)
Replacement therapy q2-3wks
!!! fiber, calcium, iron, antacides.
TAKE ON EMPTY STOMACH
53
Q

Diabetes S/S (4)

A 
Hyperglycemia
Polyuria
Polydipsia
Polyphagia
Acetone/Fruity Breath
54
Q

Diabetes Expected Labs (4)

A

Casual > 200
Fasting > 126
2 hour > 200 w/ oral tolerance
Urinanalysis (glucose/ketones in urine)

55
Q

Type1 v Type 2 Diabetes

A

1 - genetic, younger, Ø beta cells

2 - behavioral, older, resistance,

56
Q

Kussmaul Respirations

A

b/c acid buildup to substitute energy production.

↑ rate and depth of respirations and fruity breath

57
Q

Glycogenesis
Glycogenolysis
Ketogenesis
Gluconeogenesis

A

glucose to glycogen
glycogen to glucose
fat to acid
protein to glucose

58
Q

Diabetic KetoAcidosis vs. Hyperglycemia-hyperosmolar state

A

DK- ↑ ketosis b/c ↓ insulin PH < 7.4

HHS- ↓ insulin, hydration. PH > 7.4

59
Q

Fx Hypoglycemia vs. Hyperglycemia

A

Cool clammy, anxious, Øresp change

Warm moist, stuporous, Kussmaul Resps.

60
Q

Mild, Moderate, Severe hypoglycemia and tx

A

hungry, irritable, eat sweet things
cold, clammy, rapid pulse, rapid absorbing carbs
dysphagia, unconscious - IM/SubQ glucagon

61
Q

Diabetes 2 drug alerts

A

Metformin r/in lactic acidosis
Actos, anti-diabetic.
NOT Actonel, which prevents calcium loss.

ABSN Cohort 19 (28 decks)

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