midterm med surge Flashcards
Maslow stages
self actualization esteem love/belonging safety physiological
IV fluids
isotonic
hypertonic
hypotonic
Evidence based practice
Evaluation of quality Applicability of existing research Patient preferences Costs Clinical expertise Clinical setting
levels of research
One
Two
Three
Four
cultural sensitivity
knowledge, awareness, and acceptance of other cultures
which IV fluid has the same osmolarity as blood
9% percent saline
a pt has new crackles. What does this indicate?
indicates fluid volume overload
potassium levels
3.5 to 5 mEq/L
sodium
135 to 145 mEq/L
calcium
8.4 to 10.2
magnesium
1.6 to 2.6 mEq/L
s/s of hypocalcemia are after a thyroidectomy
tachycardia, fever, or sudden change in mental status
why is calcium gluconate used?
for magnesium sulfate toxicity
chevostic sign
indicative of hypocalcemia
the face twitches when tapped
truseau sign
spasms of the hand and wrist
if the IV pump is beeping and it says blockage
kinks
roller clamps, obstructuction and oclusion
parenteral nutrition
intravenous administration of nutrition
hypodermoclysis, who is it used for?
infusing fluid into sub-Q into dehydrated pt.’s
what is the difference between a macro drip and a micro drip
the tubing
what are the interventions for a evisceration
notify the provider
cover it
pt has abdominal surgery and is screaming for help
put them back in bed
call for help
call doctor, normal saline
SA node rate
60 to 100
AV node rate
40 to 60 beats per minute
ventricular rate
20 to 40
complications of hypertension are..?
Atherosclerosis Coronary artery disease Myocardial infarction Heart failure Stroke Kidney/eye damage
Interventions for aortic regurgitation
Digitalis
Diuretics
Vasodilators
Valve replacement
what is the antidote for heparin?
protamine sulfate
how do you care for a patient with peripheral vascular disease (PVD)
elevate their legs
side effects of statins
weakness, tiredness, and muscle pain
why are loose teeth the greatest risk for a nurse?
pt can aspirate them blocking the airway which results in the pt choking
high pitch tinkling is associated with what?
bowel obstruction
how do you check placement of NG tube prior to use. Check by
aspirate contents and checking the Ph.
must be acidic
What is gavage?
irrigation in a NG tube
temporary intervention
non vented NG tube.
What suction should it be on?
low-intermittent suction
What is the cause of C-diff?
antibiotics
a pt would benefit from parenteral nutrition if the pt has?
Esophageal cancer
NPO because of esophageal varices or
Severe burns on the face and chest
Which anemia is vitamin b12 required?
pernicious anemia
patients that need vitamin b12 are ?
pt’s undergoing/undergone gastrectomy
GERD leads to changes to the epithelial cells of the esophagus which leads to barrettes which is?
pre-cancerous
What is the major cause of peptic ulcers?
H.pylori
what foods must be eliminated from the diet of a patient that has celiac disease?
wheat
If someone has a diverticulosis diagnosis. What do not cause infection?
nuts, seeds, and hulls
the main goal for a acetaminophen overdose is to maintain what?
functional ability of the liver
What does a decreased amount of bile in the T-Tube indicate?
a sign of impending rejection of a newly transplanted liver
level 1 evidence
Strongest evidence
Systematic reviews of randomized controlled trials
True experimental studies: Factors that could falsely change results controlled as possible
level 2 evidence based practice
At least one well-designed randomized controlled trial
level 3 evidence based practice
Evidence obtained from quasi-experimental research studies
Factors that could falsely change the results are not controlled
Less predictive of effectiveness
level 4 evidenced based practice
Evidence obtained from quasi-experimental research studies
Factors that could falsely change the results are not controlled
Less predictive of effectiveness
level 1 resources
Joanna Briggs Institute’s Evidence-Based Resources and Cochrane Reviews
Which I V fluid is hypertonic? 5% dextrose in 0.9% sodium chloride Normal saline 0.33% sodium chloride Lactated Ringer’s solution
Correct Answer: 1
there is precipitate in piggy back IV line. What do you do? What is happening?
the meds may not be compatible
stop it and alert someone
who is at the highest risk for death related to cardiovascular disease?
the elderly
thrombophlebitis therapeutic measures
Warfarin (coumadin)
Monitor appropriate lab values
Bedrest (elevate extremity above heart level)
What are the therapeutic measures for a DVT?
compression socks
blood thinners
ambulation every two hours
what are the 6 P’s of PVD
pain paresthesia( decreased sensation) pallor pulselessness paralysis poikilothermia (assumes temperature of the environment)
what are the s/s peripheral vascular disease?
numbness, tingling, or weakness
what are some complications of a DVT?
Chronic venous insufficiency
Varicose veins
Recurrent D V T
data collection for thrombophlebitis
contrast venography
MRI
CT scan
pericarditis s/s
chest pain, cough, edema, low-grade fever, and pericardial friction rub
pericarditis therapeutic measures
treat underlying causes
Anti-inflammatory medication, corticosteroids, pericardiocentesis, and percardiectomy
What are the complications of aortic stenosis?
Heart failure
Arrhythmias
Emboli
who is at risk for DVT?
hospitalized patients who are immobile after surgery
what is dilated cardiomyopathy ?
Size of the heart chambers increase
The wall of the heart become thin
Cardiac output is reduced
what is angina?
chest pain due to not enough blood or oxygen
causes of ineffective endocarditis
Most commonly bacteria but possibly fungi or other organisms.
Entry of organism into bloodstream
interventions and rationales for a nursing diagnosis of decreased cardiac output related to post op cardiac surgery
Closely monitor fluid intake, including IV lines. Maintain fluid restriction if ordered.
Place on a cardiac monitor; monitor for dysrhythmias, especially atrial fibrillation.
what are the safety measures for coumadin use?
monitor INR and monitor for bleeding (teach patient to report bleeding)
a non pharmacological intervention
call the HCP
the nurse needs to administer a hypertensive med. The pt’s blood pressure is 70/38. What do you do?
call the physician
do not hold unless she instructs it.
what medication will be prescribed for stage 1 hypertension?
Thiazide-like diuretic
ACE inhibitors
Calcium channel blockers
hypertensive emergency
systolic bp higher than 180 mm Hg or diastolic BP higher than 120 occurs
follow up time frames for different blood pressures
For those with normal B P • 3 to 5 years For those over the age of 39 or with increased risk • Annually
under inspection
what is brown discoloration and
purple skin?
may be seen in the presence of venous flow problems.
what test do you perform if potassium level is out of range
EKG
interventions for pulse deficit
Contact The HCP
criteria for a heart donor
no hypertension diabetes absent of malignant diseases no active infections no significant cardiac disease
dissecting aortic aneurysm
created when blood separates the layers of the artery wall forming a cavity between them.
foods high in potassium
banana’s, potatoes, citrus fruit, cooked spinach
pink frothy sputum is an indicator of
pulmonary edema
Contact Healthcare Provider
bnp high level indicates
heart failure
symptoms of digoxin toxicity
abdominal pain, anorexia, nausea, vomiting, visual changes, and bradycardia
increase in potassium can cause
ventricular fibrillation
common cause of a PVC is
caffeine
V-FIB =
D-Fib
pt has a pacemaker placed what should you do?
take radial pulse for 1 minute
main treatment of buergers disease
smoking cessation
sudden back or flank pain are classic symptoms of a…?
abdominal aortic aneurism
needs to be reported immediately because it can rupture
a pt has had a vascular surgery. When a neuro vascular check is done the extremity is cool to the touch and dusty in color. What should you do?
notify the physician
Buerger’s disease
occlusive disease of the median and small arteries and veins.
peripheral arterial disease (PAD)
a chronic disorder in which partial or total arterial occlusion deprives the lower extremities of oxygen and nutrients
Raynaud’s
the vasospasm of the arterioles and arteries of the upper and lower extremities.
females who smoke and take birth control are at a higher risk for a…?
MI
5% dextrose in 0.9% sodium chloride
is isotonic
Normal saline
hypotonic
0.33% sodium chloride
hypotonic
Lactated Ringer’s solution
isotonic
