Missed Question Flashcards
Cataracts symptoms
Blurred vision
Reduce ability to distinguish among different colors
When should live vaccine be avoided
Pregnancy
Treatment with immunoglobulin such as in Kawasaki disease
And immunosuppressed
Complications of tetralogy of falot
Seizure
Loss of consciousness or death from anoxia
Drugs interactions with Nsaid 1st generation of cox 1 and cox2
Anticoagulant Glucocorticoids Alcohol Ace inhibitors Angiotensin receptors inhibitors
Intravenous pyelogram
Bowel preparation
NPO after midnight
Iodine sensitivity
Caring for cast
Neurovascular check every hour for 24hrs
Elevation to reduce swelling
Ice in the first 24 hours
Complications
Itching
Compartment syndrome
Digoxin
Hypokalemia increases digoxin toxicity
Chiari malformation complications
Result in hydrocephalus Infant Bulging fontanels Head enlargement Dilated scalp veins Frontal protrusion Irritability High pitched cry and seizure
Childhood Headache Ataxia Papilledema Strabismus Irritability confusion lethargic incoherent
Muscle spasticity weakness and atrophy
Nursing intervention
Place kid on side or knee chest Allow children to squat Oxygen at 100% face mask Morphine or just iv fluid to treat cyanotic episodes Daily weight High calorie formula
Presbycusis
Difficulty hearing high frequency sounds
What are possible complications of shocks
Organ failure
Multiple organ failure
Disseminated intravascular coagulation due to body overuse of clotting factors which fails to clot blood and result in bleeding
Seizure precautions
Raise side rails and pad hard objects Swim with supervision Use protective headwear/ padding for sports or physical activity Wear a medical alert bracelet Set driving restrictions for teens
Symptoms of autonomic dysreflexia
Goose flesh below the level of injury Profuse sweating above the level of injury Flushing of the skin Nasal congestion Nausea Headache High blood pressure
Cytoscopy
Informed consent
Bowel prep
NPO
Post procedure Monitor Abdominal distention Urinary frequency Fever
Complications
Perforation of urinary track or bladder as demonstrated by pelvic pain
Signs of poor perfusion
Hypotension Tachycardia Weak thready or absent peripheral pulse Capillary refill greater than 3srconds Cool clammy pale skin Decreased level of consciousness Oliguria Diaphoresis
Insulin type
Onset
Peak
Duration
Fastest Insulin humalog O: 15 minutes P: 30 minutes D: 2-3hours
Fast: regular insulin
O: 30 minutes
P: 1-2 hours
D: 2-4 hours
Slow: NPH insulin
O: 1 hours
P: 2-4 hours
D: 10-24hrs
Slowest: insulin glargine
O: 1-2 hours
P: none
D: 24hrs
Signs and symptoms of fluid overload
Rapid bounding pulse Jugular vein distension Hypertension Dyspnea Crackles Peripheral edema Urine specific gravity les than 1.01 Decreased hemoglobin hematocrit bun because of hemodilution
Type of diets
Low purine diet = restrict meats anchovies beer wine
Low residual/ low fiber= reduce intake of canned fruit, refined carbohydrates, fruits, vegetables
Food that are high in refined carbohydrates are usually low in fiber
Clinical manifestations of CF
Salty skin because of loss of chlorine salt
Infertility
Delayed puberty
Increased risk for miscarriage
Méconium ileus Steatorrhea fatty and smelly stool Wheezes Atelectasis Pneumothorax Poor absorption of vitamin adek Poor absorption of protein and fats Hyperglycemia Barrel chest appearance Clubbing
Teaching for kawasaki disease
Sign of aspirin toxicity
Follow up visit with cardiology within a week and 4-6 weeks later
Avoid MMR and varicella for 11 months after treatment with IVIG
Exercise stress test
Avoid caffeine/caffeinated beverages
Npo or only eat light meal
Comfortable clothing/footwear
Pharmaceutical stress test
Induced with Dobutamine
BRAT vs CRAM
BRAT = not good for diarrhea banana rice
CRAM = good for diarrhea
Frontal lobe functions
Controls affect, judgment and emotions
Dysfuntion results in symptoms such as emotional lability changes in personality inattentiveness, flat affect and inappropriate behavior
Therapeutic action of Terbutaline
Terbutaline is a beta 2 adrenergic antagonist
A bronchodilator used in acute asthma attack, chronic bronchitis , and emphysema
In labor terbutaline injections is used labor to prevent preterm labor and slow contraction
Monitor patients with tractions
Monitor for muscle spasms (weight might be heavier)
Pain monitoring
Pin site care
Priority in hypertensive crisis
High risk for rupture of cerebral blood vessels leading to a stroke
Symptoms of kawasaki disease
Acute phase Unresolved fever after 5 days Conjunctiva Strawberry tongue Reddened and crackled lips Rash on body and genital parts Irritability Cervical lymphadenopathy
Subacute phase Acute symptoms clear Thrombocytosis Dilated coronary arteries Skin peeling on fingers and toes Arthritis affecting the large weight bearing joints Convalescent phase Most symptoms resolve but abnormal lab values can persist Anemia thrombocytosis elevated ALT High WBC Low albumin High wbc urine
Symptoms of salicylism
Early sign = tinnitius, headache
Long term sign = nausea, vomiting, diaphoresis
autonomic dysreflexia causes
Seen above T6 level Noxious stimulus below the level of injury Full bladder Enema/bowel movement Rectal examination
Enema
Indications: abdominal distension
Bowel preparation
Soften hardened stool
Contraindications: rectal surgery
Colon surgery
Acute MI
Appendicitis
Complications
Hyperphosphatemia
Perforation
Sepsis
Positioning after hip arthroplasty
Keeping legs abducted while in bed or sitting in chair
Prevention of hip flexion greater than 90
Avoid sitting in low chairs and install raised toilet seat
Use two pillows or abductions pillows between legs when sleeping
Fifth disease
Contagious during prodromal phase
Once rash appears, no longer contagious
Ecg section explanation
P wave= atrial depolarization
QRS = ventricular depolarization
ST = early ventricular repolarization
T wave =ventricular repolarization
Post surgery complications
Hemorrhage Atelectasis/pneumonia VTE Paralytic ileus SSI Dehiscence Evisceration Urinary retention Neurocognitive complications Psychosocial complications
Symptoms of ventricular septum defect
Heart murmur Tachycardia Retractions Cool extremities Wheezing
Antidote for Warfarin
Vitamin K and fresh frozen plasma
Diet for patient with liver disease
Low protein and high carbohydrates because the liver can no longer metabolize protein which can result in accumulation of ammonia in the body
High carbohydrate tomeet caloric and metabolic needs
Kawasaki disease
Mucocutaneous lymph node syndrome or infantile polyarteritis affects mucous membranes lymph nodes walls of the blood vessels and the heart
It can cause inflammation or the arteries especially the coronary arteries of the heart which can result in aneurysm and myocardial infarction in the child
To avoid cardiac complications from
Kawasaki disease treatment IVIG and aspirin should be started in 10 days
Cullen’s sign
Redness around the belly button
The aorta large vessel coming directly from the heart within the abdomen can tear during trauma often resulting in a sudden emergency
Clinical manifestations of DI
Increased serum sodium and osmolality Weight loss Dehydration Hypotension Tachycardia
Multiple sclerosis
Limit
Demyelination of white matter
Cranial nerves alteration
Interventions
Bowel/bladder training
ROM exercises
Coordination exercise
Medications: muscle relaxant
Tramadol
Pharmaceutical action
And side effects
Centrally acting analgesic
Block reuptake of NE and Serotonin
Side effects Sedation Dizziness headaches Seizure Nausea Urinary retention
Symptoms of fat embolism
Dyspnea Tachycardia Petechia on chest Low grade fever Hypotension
Signs of skull fracture
Bleeding from the wound near location of trauma
Eyes
Ears
And nose
Ideal conditions for optimal vaginal delivery
Lie- longitudinal
Présentation- céphalique/ vertex (head first)
Attitude- flexion of head and extremities
Position- loa and ROA
Compare contrast gromerulonephritis
Both are autoimmune disease
Glomerulonephritis can be caused by untreated strep throat or lupus and nephrotic syndrome causes are unknown but DM is a risk factor
Glomerulonephritis symptoms are hematuria, proteinuria
Nephrotic syndrome has massive protein in urine, low albumin in blood and edema
Hypoalbulmin trigger the liver to make more albumin and hence more lipids. So hypoalbumiemia is often followed by hyperlipidemia
Food cross reactivity with latex
Apple Avocado Banana Carrot Celery Chestnut Kiwi Melon Papaya Raw potatoes Tomato
Causes of Diabetes Insipidus
Head trauma
Pituitary tumor
CNS infection
End of childhood reflexes
Moro reflexes ends around 4-6 months
Babinski around 2 years
Stepping reflex ends around 2months
Sucking reflex ends 4 months
Isometric
Contract relax muscle without moving affected part
Symptoms of abstinence syndrome
Sudden withdrawal from opioid Nausea Vomiting Anorexia Abdominal cramps Tremors Fever
Clinical manifestations of peritonitis
Cloudy dialysate Rebond tenderness Diffuse abdominal pain Vomiting Diarrhea Hyperactive bowel sounds Fever
Physiologic responses noted during acute pain in neonate
Change in Vital signs
Oxygenation
Dilated pupils
Increased muscle tone
What medications should not be taken with milk
Ferrous sulfate
Tetracycline
Doxycycline
Ciprofloxacin
Transesopheal echocardiography
NPO hours before
Gag reflex before client resume oral intake
Monitor for respiratory depression
Offering throat lozenges for dry tongue
Symptoms for tetralogy of falot
Pulmonary stenosis
Ventricular septic defect
Overriding aorta
Hyperatrophy of the right ventricle
Cyanosis at birth
Murmur
Blue spells or tet spells from hypoxia May occur with crying or feeding
Signs of low cardiac output
Low BP High HR SOB Low urine output Unrelieved chest pain
Four markers that indicate child readiness to toilet train
Awareness of urge to void or stool
Interest inand motivation to use toilet
Being dry for at least 2 hours during the day
Ability to pull pants up and down
Monitoring schedule after cardiac catherization
Monitor for 7 hours
4x 15 minutes
4x 30 minutes
4 x 1 hour
Complications after thyrodectomy
Hypocalcemia
Assess patient for signs and symptoms of thyrodectomy
Positive trousseau sign
Positive chevosek sign
Numbness and tingling of the lips or fingertips
Muscle twitching
Muscle spasms
Treatment of hydrocephalus
Ventriloperitoneal shunt
Complications of vp shunt
Infection and malfunction
Malfunctions lead to increased ICP which manifestations are Loss of consciousness Decreased HR Increased BP Decreased RR Headache Blurred vision
Late signs of ICP is the cushing triad
Hypertension with widened pulse pressure
Bradycardia And abnormal respirations
Food rich in potassium
Oranges Bananas Tomatoes Potatoes Squash Dark leafy vegetables
Complications of ventricular septal defect
Excess fluid in lungs leading to congestive heart failure Clinical finding of CHF Impaired myocardial function Pulmonary congestion Systemic venous congestion
Signs/symptoms of air embolism
Dyspnea
Continuous coughing
Chest pain
Nursing interventions
Trendelenburg position
Inspect integrity of the CVAD
Changing dressing and cleansing insertion site with chlohexedine
Care of patients with Tracheostomy
Suction no longer than 10s
Hyperoxygenate prior to and immediately
Acute complications: bleeding Infection Air leak Subcutaneous emphysema Tube displacement
Chronic complications altered body image
Tracheal necrosis
Tracheal stenosis
FAST
Facial droop
Arm weakness
Speech difficulties
Time
What is ketogenic diet
Diet use to reduce fever activity
Avoid carbohydrates and glucose
Consume high fats and proteins
Encourage additional vitamin and supplements
Erickson 8 stages of development
Infant to 18 months: trust vs mistrust
18 months to 3 years : autonomy vs shame and doubt
3 years to 5 years: initiative vs guilt
5 to 13 years: industry vs inferiority
13-21 years: identity vs role confusion
21-39 years : intimacy vs. Isolation
40 -65 years: generativity vs stagnation
65 and older: Ego integrity vs Despair
Drugs not to take with grapefruit
Statin Nifedipine Buspirone Budesonide Amiodarone
Additional complications of dehydration
DVT due to hemo concentration related to blood viscosity
How can you differentiate type of stroke?
Characteristics of ischemic stroke
Slow progression of symptoms
Weakness on right side
Asymetrical smile or facia movement
Side effects of glucocorticoids
Effect on blood sugar = hyperglycemia
Effect on electrolytes imbalance
Hypernatremia
Hypokalemia
Infection
Bone loss
Headache
