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233 > Midterm Content > Flashcards

Midterm Content Flashcards

1
Q

What is the nurse’s role in obtaining consent?

A

Ask patient to sign and act as witness. Notify physician if patient doesn’t have information.

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2
Q

What 2 consents must be given?

A

Written and voluntary informed consent

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3
Q

How can patients present with vulnerability/anxiety?

A

repetitive questions, withdrawn, avoiding communication

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4
Q

How can the nurse address a vulnerable patient?

A

Empathy, listen well, psychosocial assessment

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5
Q

The use of pre op checklists is significant. Why?

A

Greatly reduces morbidity and mortality

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6
Q

By how much are deaths decreased when the WHO checklist is used?

A

Up to one third

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7
Q

Pre op nursing care

A

NPO, pre op scrub, prep bowel, fluid status, assessments, medications, patient education

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8
Q

Maintaining a patent airway in the PACU prevents

A

hypoxia and hypercapnia

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9
Q

When do respiratory complications occur post op?

A

w/i 48 hrs

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10
Q

most common respiratory complication post op

A

atelectasis. collapsed alveoli, X Ray confirmed

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11
Q

Pneumonia will present with

A

productive cough, dyspnea, crackles

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12
Q

PE will present with

A

dyspnea, pleuritic pain, fever, hemoptysis

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13
Q

What causes respiratory complications postoperatively? (6)

A

Pre existing conditions, anaesthetics, O2/trach tubes, aspiration, immobility, narcotics

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14
Q

How can respiratory complications be prevented? (4)

A

pre op teaching, post op assessment, adequate hydration, encouraging ambulation

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15
Q

Who (3) are most at risk for CV problems post op?

A

Elderly and those w cardiac hx

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16
Q

Thrombophlebitis/embolism happens when? Why? Mnfts?

A

POD 7-10.

Dehydration, pre rest, decreased circulation

Homan’s sign, calf pain

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17
Q

When will an MI most likely occur post op?

A

48 hrs PO.

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18
Q

Tx for blood loss

A

stop bleeding, plasma expanders, albumin, fluids, transfusion, coag factors

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19
Q

When does inflammation peak post op?

A
  1. up to 48 hrs.
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20
Q

How long are I&Os monitored for?

A

x 48 hrs

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21
Q

Why do we want to resume a normal diet ASAP? What must be in place?

A

promotes GI fx, assists wound healing.

BS and soft abdomen

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22
Q

Vomiting is preceded by

A

Nausea

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23
Q

5 Types of diarrhea

A

Secretory, osmotic, exudative, inflammatory, dysentry

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24
Q

Complications from diarrhea

A

cardiac dysrhythmias, low urine output, muscle weakness

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25
Q

Nursing care for those w diarrhea

A

assess and monitor, GI assessment, encourage bed rest, push fluids, bland foods, antidiarrheals, IV fluid therapy PRN

26
Q

Vomiting complications

A

fluid electrolyte imbalance, aspiration, increased ICP, wt. loss, Mallory-Weiss tear, dentition issues

27
Q

Hyperemesis Gravidarum is …

Due to…

A

severe debilitating nausea and vomiting in early pregnancy . Increased levels of HCG

28
Q

Hyperemesis Gravidarum usually is in what trimester?

A

First

29
Q

What is the safest antiemetic drug to use during pregnancy?

A

Dimenhydrinate

30
Q

What is the most effective antiemetic to use during pregnancy? What are the issues with it?

A

Ondansetron.

Not in a safe pregnancy category but benefit may outweigh the risk.

31
Q

What % of weight loss occurs to classify Hyperemesis Gravidarum?

A

> 5%

32
Q

When is sx indicated in PUD?

A

Intractable ulcers, hemorrhaging, perforation, obstruction

33
Q

What is used to treat NSAID induced ulcers?

A

H2RA (eg. Ranitidine)

34
Q

Non pharmacological interventions for PUD?

A

Decrease stress, rest, smoking cessation, diet modification

35
Q

Another name for Crohns is

A

Regional enteritis

36
Q

Where does pain occur in regional enteritis (Crohns)?

A

right lower quadrant and periumbilical

37
Q

Age that regional enteritis usually occurs

A

adolesence

38
Q

Where is pain found in ulcerative colitis?

A

left lower quadrant, rebound tenderness

39
Q

Complications of regional enteritis (6)

A 
obstruction
fluid electrolyte imbalance
malnutrition
fistula/abcess formation
retinitis/irititis/erythema nodosum
depression
40
Q

What would fluid and electrolyte imbalance in IBD present with?

A

narrowing pulse pressure
decreased urine output
tachycardia

41
Q

Why would metabolic acidosis occur in Regional enteritis?

A

Loss of HCO3 (buffer) due to diarrhea would decrease ph

42
Q

How does regional enteritis lead to third spacing?

A

Not absorbing enough nutrients to form albumin = decreased OP = fluid shift = 3rd spacing

43
Q

Ulcerative colitis complications (6)

A 
toxic megacolon
perforation
bleeding
depression
pyelonephritis/nephrolithiasis
malignant neoplasms
44
Q

Common presentations of IBD

A

diarrhea, abdominal pain, low grade fever, anorexia, joint disorders, skin lesions, ocular disorders

45
Q

Complications of hyperemesis gravadarum

A

elevated urine-specific gravity, ketonuria, hypokale- mia, hypochloremic metabolic alkalosis, and ketosis

46
Q

What potential side effects for fetus in HEG? How do we prevent this?

A

Wernicke’s encephalopathy. IV Thiamine

47
Q

Amount of anaesthetic to produce anaesthesia is what in elderly

A

Lower

48
Q

why is there more potent action in elderly for anaesthesia

A

less plasma proteins

lower met/excretion rate

49
Q

Why are elderly at risk for hypothermia when receiving an anaesthetic

A

impaired ability to increase metabolic rate and thermoregulate

50
Q

What is a side effect of Metoclopramide? When not to give?

A

Increases gastric emptying. When a patient doesn’t have BS/is fresh post op/NPO

51
Q

What NTs released in CTZ stimulation?

What drugs work on these NTs?

A

Dopamine and serotonin

Onsansetron, metoclopramide, procholorperazine

52
Q

Major side effect of dimenhydrinate?

A

Drowsiness

53
Q

What nausea pathway is innervated in HG?

A

CTZ

54
Q

What NT does dimenhydrinate block

A

histamine

55
Q

What NT does scopolamine block

A

Ach

56
Q

What NT does metoclopramide block

A

dopamine

57
Q

What NT does ondansetron block

A

serotonin

58
Q

What NT does prochlorperazine block

A

dopamine

59
Q

What 3 drugs work on the CTZ

A

metoclopramide, ondansetron, prochlorperazine

60
Q

What 2 drugs work viscerally

A

metoclopramide and ondansetron

61
Q

What 2 drugs work at higher CNS/Vestibular

A

dimenhydrinate and scopolamine

62
Q

Toxic mega colon is a complication of

A

Ulcerative colitis

233 (3 decks)

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