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NCLEX > module 3 > Flashcards

module 3 Flashcards

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1
Q

pancreatitis

A

keeping the stomach empty and dry so that the pancreas stops releasing enzymes that are causing the pain in the first place

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2
Q

pancreatitis patho

A

endocrine: insulin
exocrine: digestive enzymes
causes: GB or alcohol
normally: eat - enzymes go to pancreatic duct - then to the intestine then activate
pancreatitis: obstruction - enzymes activate in the pancreas - auto digestion

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3
Q

BMI greater than 25 indicates

A

overweight or obese

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4
Q

DASH

A

diet appropriate to stop hypertension

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5
Q

pancreatitis s/s

A

s/s: pain that increases with eating, abdominal distension (ascites), swollen pancreas you can palpate
peritonitis- rigid board like abdomen, blood
grey turners- bruising flank cullens-bruising umbilicus
fever, n/a, jaundice, hypotension

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6
Q

orthopedics fractures s/s

A 
pain and tenderness
unnatural movement 
deformity
shortening of extremity
crepitus 
swelling  
discoloration 
worry about compartment syndrome **
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7
Q

fracture treatment

A

tx: immobilize adjacent joints and bone ends, support function above and below site, move as little as possible, splints help prevent fat emboli and muscle spasms, cover open function with sterile dressing
neuro vascular checks: pulse, color, movement, sensation, cap refill, temp

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8
Q

maternity s/s

A

presumptive: amenorrhea, nausea and vomiting, urinary frequency, breast tenderness
probable: + pregnancy test, goodell’s, chadwicks, hegar’s, uterine enlargement, pigmentation changes, braxton hicks
positive: FHR, ultrasound, fetal movement

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9
Q

Definitions : Gravidity

A

number of pregnancy

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10
Q

Definitions : Parity

A

number of pregnancy with 20 week fetus

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11
Q

Definitions : Viability

A

24 weeks gestation

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12
Q

Definitions : Naegele’s Rule

A

1st day of LMP + 7 DAYS - 3 MONTHS + 1 YEAR

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13
Q

TPAL

A

term, preterm, abortion, living children

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14
Q

clients with pancreatitis

A

keep stomach empty and dry

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15
Q

4 major functions of the liver

A

detoxify the body
helps your blood to clot
the liver helps to metabolize (break down) drugs
the liver synthesizes albumin

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16
Q

cirrhosis

A

liver cells are destroyed and are replaced with connective/scar tissue - alters the circulation within the liver- BP in the liver goes up (portal HTN)

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17
Q

if liver is sick…

A

decrease the dose of medications

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18
Q

enlarged spleen

A

immune system is involved

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19
Q

s/s of cirrhosis

A

firm, nodular liver, abdominal pain, spenaomegaly, decreease serum albumin, increase ALT & AST, anemia

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20
Q

when liver is sick

A

ammonia in the body increases

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21
Q

protein

A

breaks down to ammonia - liver converts ammonia to urea - kidneys excrete urea

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22
Q

hepatic coma
patho
s/s
treat

A

liver is impaired and cannot break down the ammonia so LOC goes down.
s/s: difficult to arouse, asterixis, decrease reflexes, EEG slow
tx: lactulose (decrease ammonia), decrease protein in diet, enemas

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23
Q

blackmore tube

A

balloon tamponade is for bleeding varices and it holds pressure on the bleed

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24
Q

peptic ulcers

patho, diagnosis, tx

A

common cause of gi bleeds
gastroscopy (EGD): npo pre and post procedure (when gag reflex returns), watching for pain, bleeding, trouble swallowing. upper GI: look at esophagus and stomach with dye. npo past midnight, no smoking, chewing gum, or mints
tx: anatacids- take on empty stomach, PPI (ZOLE), H2 (famotidine)

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25
Q

may appear malnourished, pain is usually half hour - 1 hour after meals; food does not help, but vomiting does, vomit blood

A

gastic ulcers

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26
Q

appear well nourished, night time pain is common and also occurs 2-3 hours after meals; food helps; blood in stools

A

duodenal ulcers

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27
Q

hiatal hernia
patho
s/s
tx

A

hole in diaphragm is too large so the stomach moves up into the thoracic cavity
s/s: heartburn, regurg, dysphagia
tx: small frequent meals, hob, sit up 1 hour after eating, surgery

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28
Q

dumping

A

stomach empties too quickly after eating and client experiences many s/s.
lay down on left side, no fluids with meals, small/frequent meals

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29
Q

what side to lay on

A

left side= leaves food in the stomach

right side= releases the food

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30
Q

ulcerative colitis vs. crohns

s/s

A

uc- ulcerative inflammatory bowel disease; in large intestine
crohns- aka regional enteritis; inflammation and erosion of the ileum, but can be found anywhere in the small or large intestines
s/s: diarrhea, rectal bleeding, dehydration, rebound tenderness, cramping, weight loss

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31
Q

coloscopy

A

clear liquid diet 12-24 hours pre procedure
NPO 6-8 hours pre procedure
avoid NSAIDS
polyethylene glycol
colon prep drank icy cold with no straw
POST: watch for perforation (pain and unusual discomfort)

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32
Q

mcburneys point

A

RLQ appendix

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33
Q

TPN

A

central line needed, filter needs, may have to start taking insulin, gradual discontinue to avoid hypoglycemia, check urine for glucose or ketones
only hung for 24 hours, change tubing with new bag

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34
Q

central line

A

position? tredelenberg to distend veins

if air gets in the line- left side, tredelenberg

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35
Q

with what type of fractures do you see fat embolisms or shock

A

long bones (Femur), pelvic fractures, crushing injuries

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36
Q

s/s of fat emboli

A

petechiae or rash over chest, conjunctival hemorrhage, snow storm on CXR

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37
Q

muscle becomes swollen and hard and the client reports severe pain that is not relieved with pain meds; pain is disproportionate to the injury could lead to amp

A

compartment syndrome

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38
Q

tx for compartment syndrome

A

if they have a cast, losen cast to restore circulatio

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39
Q

traction

A

never release it unless you have doc order

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40
Q

total hip replacement

client education

A

neuro checks, monitor drains, firm mattress, trapeze bar overhead
neutral rotation; limit flexion but want extension of the hips, isometric exercises , abduction
avoid crossing legs or beding over; 1 day post op you can walk or when doc says
walking/swimming/rocking; avoid flexion: low chairs, traveling long distances, sitting more than 30 mins, lefting heavy objects, stair climbing

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41
Q

how do you prevent contratures

A

extension!!!

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42
Q

what position would extend the hip or knee joints

A

prone

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43
Q

amputation

A

stump shaped cone, need a limb sock, massage stump

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44
Q

walker

A

you walk into a walker

45
Q

crutches

A

up with the good leg, and down with the bad leg

46
Q

canes

A

use on strong side of the body

47
Q

hormone that induces amenorrhea

A

progesterone

48
Q

softening of the cervix; second month

A

goodells

49
Q

bluish color of the vaginal mucosa and cervix; 4th week

A

chadwicks

50
Q

softening of the lower uterine segment; 2 or 3 month

A

hegars

51
Q

contractions which occur throughout pregnancy; moves blood through the placenta

A

braxton hicks

52
Q

mask of pregnancy

A

facial chloasma

53
Q

bleeding, cramping, backache think

A

miscarriage

54
Q

first trimester

A 
1-13 weeks 
expect weight gain 1-4 lbs
folic acid- prevents neural tube defects 
always take iron with vitamin C
do not let heart rate get above 140
55
Q

normal protein

A

40-45

increases to 60 first trimester

56
Q

danger signs and potential complication of maternity (8)

A

sudden gush of vaginal fluid, bleeding, abdominal pain, increase temps, persistent vomiting, edema, severe headache, no fetal movement

57
Q

doc visits the first 28 weeks

A

once a month

58
Q

doc visits 28-36 weeks

A

every 2 weeks or twice a month

59
Q

ultrasounds

A

drink water before to distend the bladder

ultrasound before a procedure we want them to void

60
Q

second trimester

A 
weel 14-26
increase to 300 calories a day 
general 1 pound weight gain 
NO n/v, NO urinary frequency, YES breast tenderness 
FHR 110-160
61
Q

kegel exercises

A

exercise frequently to strengthen the pubococcygeal muscles; helps stop urine flow and keeps uterus from falling out

62
Q

third trimester

A

27-40 weeks

no more than 1 pound a week

63
Q

2 or more pounds a week we worry about

A

preclampsia

64
Q

preclampsia

A

bp of 160/110
increased bp, proteinuria, edema
mag sulfate

65
Q

ruptured membranes think

A

prolapsed cord until proven otherwise

66
Q

when should client go to the hospital

A

contractions are 5 minutes apart or when the membrane ruptures

67
Q

non stress test

A

2 or more accelerations of 15 beats/ min or more without fetal movement
want reactive because this means accelerations are present

68
Q

biophysical profile test BPP

A

observation time is 30 mins by sonogram
parameters count 2; 10/10 is perfect
HR, muscle tone, movement, breathing and the amount of amniotic fluid around the baby

69
Q

contraction stress test

A

performed on high risk pregnancies
determines if the baby can handle the stress of uterine contraction
NEGATIVE stress test is good

70
Q

if blood flow decreases enough to cause hypoxia in the fetus, then the FHR will decrease from the baseline

A

deceleration

71
Q

true labor

A

regular contractions
pain increases
contractions increase in frequency and duration

72
Q

false labor

A

contractions irregular
discomfort is in abdomen
pain with change in activity decreases/goes away

73
Q

steroid that helps the fetal lungs mature

A

betamethasone

74
Q

epidural

A

lie on left side, legs flexed, prop up over the bedside

biggest complication hypotension

75
Q

oxytocin

A

one on one care
contraction rate 1 q 2-3 mins each lasting 60 seconds
if late decels occur turn off oxytocin

76
Q

tachycardia + postpartum think

A

hemorrhage

77
Q

post partum uterus

A

fundus is midline below umbilicus

78
Q

boggy uterus

A

massage the fundus until it is firm then check for bladder distension

79
Q

lochia

A

rubra: 3-4 days and dark red
serosa: 4-10 days and pinkish brown
alba: 10-28 days and whitish yellow

clots are ok as long as they are smaller than a nickel

80
Q

babies immediate care

A

erythromycin to kill gono or chlamydia

phytonadione which is vitamin k and promotes formation of clotting factors

81
Q

rh

A

rh+ blood from baby comes in contact with moms rh - blood
mom looks at babys blood as a foreign body and the mom produces antibodies against rh + blood.
first baby not affected. second baby will be. give mom rhogam within 72 hours after birth so she doesnt produce antibodies

82
Q

rhogam must be given

A

before the antibodies form

83
Q

3 rules for measuring abdominal girth

A

mark the abdomen so everyone measures the abdomen in the same place
measure the abdomen at the area of the umbilicus or belly button
measuring tape should be snug but not compress the skin

84
Q

what levels will be elevated for acute pancreatitis

A 
amylase
lipase
AST ALT
PT and PTT
glucose
85
Q

h2 receptors

A

end in dine

86
Q

with TNA check the urine for

A

ketones and glucose

87
Q

s/s of too much ammonia

A 
think SEDATIVE 
minor mental changes
motor problems
difficulty in awakening 
decreased reflexes 
handwriting changes
slow EEG 
asterixis 
GO INTO A COMA 
HEPATIC COMA OR HEPATIC ENCEPHALOPATHY
88
Q

should you give the liver client narcotics via IM route

A

no we are trying to prevent bleeding

89
Q

priority assessment post paracentesis to be assessed for what

A

FVD by looking at the BP and pulse

90
Q

immediately post tube feeding how would you place a client

A

right side HOB elevated

91
Q

position post liver biopsy

A

right side to apply pressure to the puncture site

92
Q

appendictis patient waiting to go to surgery what position should they be in

A

right side HOB elevated

93
Q

gastric ulcers vs. duodenal

A

G- pain after meals, looks malnourished, hematemesis
D- pain with empty stomach, looks nourished, blood in stool
BOTH - antacids provide relief, avoid caffeine, medication for one year

94
Q

what to monitor after an EGD

A

gag reflex, bleeding, swallowing, VS, pain

95
Q

only occurs in the large intestine

A

ulcerative colitis

96
Q

occurs anywhere in the body

A

crohns

97
Q

tx for ulcerative colitis

A

low fiber diet, antibiotics, steroids, total colectomy

98
Q

tx for crohns

A

try not to do surgery, low fiber diet, antibiotics, steriods

99
Q

no insoluble fiber for crohns disease

A

just know; foods with skins are not good

100
Q

with a potential leg fracture what 3 things should you do

A
  1. immobilize the bone ends and adjacent joints
  2. support the fracture above and below the site
  3. move the leg as little as possible
101
Q

before and after a splinting what do you need to do

A

a neurovascular check

pulse, color, movement, temp, sensation, cap refill

102
Q

increase pressure with limited space

A

compartment syndrome

103
Q

how do you know when a person develops compartment syndrome

A

pain that is not relieved with pain meds

104
Q

difference between skin and skeletal traction

A

skin is short term (skin assessment is important)
skeletal is long term (continuous traction, intact pins)
both decrease muscle spasms, relieve pain, and immobilize fracture

105
Q

term baby

A

38 weeks

106
Q

a pregnant client with a rigid abdomen and uterine tenderness

A

placental abruption

107
Q

if client has pre clampsia or eclampsia how long is she at risk for seizures after delivery

A

first 48 hours

108
Q

newborn rr

A

30-60

NCLEX (17 decks)

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