OTHER Flashcards
What position is preferred for thoracentesis?
The patient should be sitting up, leaning over a bedside table with arms rested, feet supported on the ground, or stool so the needle can be inserted appropriately
Supine is ok is unable to sit.
Some manifestations of MI
- Denial
- Hypotension
- Orthopnea (dyspnea when lying flat)
What is hemoptysis?
Coughing up small amounts of blood from the lungs
What are 3 manifestations of Nephrotic syndrome?
- Proteinuria (renal glomerular damage)
- Hypoalbuminemia (protein from the bloodstream is being lost in the urine; there is decreased protein in the bloodstream)
- Edema ( from hypoalbuminemia causing decreased oncotic pressure in the vasculature)
What lung sounds would you expect to hear with a pneumothorax?
Diminished breath sounds.
NO adventitious sounds
How do you determine if a client has infectious pulmonary TB?
Sputum culture
How does Superior Vena Cava Syndrome present?
Caused obstruction of blood flow to and from the superior vena cava resulting in venous congestion (puffiness in the face/ neck) and jugular-venous distension.
Frequent clinical features of venous congestion include blurred vision, hoarse voice, stridor, dyspnea, and nasal congestion.
What kind of diet is appropriate for patients with kidney disease / ESRD?
a diet low in potassium, phosphorus, and sodium
* green beans, cabbage, lettuce, peppers, grapes, blueberries, cooked summer squash, cooked turnip greens, pineapple, and raspberries
Signs of lithium toxicity and how to prevent
Signs and symptoms
* nausea, vomiting, lethargy, confusion, delirium, coma, seizures, and hypotension
Prevent by
* maintaining adequate fluid and salt intake
What are some main roles of calcium?
- promote blood clotting
- increase bone density
- promote healthy dentition
- maintain neuromuscular health
What are the targets for DKA treatment? What is the treatment?
Targets
* Aim to lower blood glucose by 50 to 75 mg/dL per hour (2.775 to 4.165 mmol/L/hr)
Treatment
* by giving a regular insulin bolus at 0.1 unit/kg followed by a continuous infusion at 0.1 unit/kg/hr until acidosis resolves
* monitor for hypoglycemia and hypokalemia
What is the triad of symptoms for pre-eclampsia?
PRE-
* Proteinuria
* Rising BP
* Edema
Worsening pre-eclampsia may include: visual disturbance, severe headache, epigastric pain, or decreased fetal movements
What is tympany? What is happening if the patient presents with it?
A hollow drum like sound over an area filled with gas or air.
* heard with ascites over the top of the abdomen where the intestines float
* & a pneumothorax where the chest cavity contains freeair
What is ptosis?
Ptosis is drooping of the eyelid.
* Ptosis may be congenital or acquired
* may be a clinical feature of neurological conditions such as myasthenia gravis or multiple sclerosis
What would a patients electrolytes look like with hyperparathyroidism?
What manifestations may this cause?
Hypercalcemia
* nephrolithiasis, polyuria, confusion, constipation, and shortened QT interval
* manage with loop diuretics
Hypophosphatemia
* Ca and Ph have an inverse relationship
What are manifestations of appendicitis?
PAINS
* Pain RLQ
* Anorexia
* Increased temperature & WBC
* Nausea and vomiting
* Signs (McBurneys point, Psoas)
Monitor for rupture/perforation!
* sudden relief of pain is BAD
Cranial nerves
What is hemoglobinuria a sign of? What is it?
Red or brown tinged urine is a classic manifestation of a hemolytic reaction (incompatible blood)
* The hemolysis causes the body to spill hemoglobin in the urine
Heat stroke treatment and signs
vs heat exhaustion
q23
qid11018
What is dumping syndrome?
Common complication following gastric bypass surgery
* it is a rapid emptying of food contents into the small intestine, which shifts fluid into the gut, causing abdominal distention
* the client should lie down after meals to mitigate symptoms because this will slow gastric emptying
* avoid drinking with meals because this accelerates gastric emptying
Symptoms
* colicky abdominal pain, diarrhea, nausea, and tachycardia
What is hemophilia?
Hemophilia is a genetic disorder that causes a factor VIII deficiency. Factor VIII is produced by the liver and is necessary for the formation of thromboplastin in phase I of blood coagulation. Bleeding is commonly found in the joints (termed hemarthrosis), which causes joint stiffness, aches, and a decreased range of motion. Hematuria is also a clinical feature that may be evident (either grossly or by microscopy that would be shown on a urine analysis). Epistaxis is a feature as well if trauma to the nose occurs.
Bleeding is commonly found in the joints that manifest as joint stiffness, limited range of motion, and swelling
✓ A client with hemophilia should be educated to avoid contact sports, the manifestations of bleeding, and adherence to follow-up care
✓ Clients with hemophilia should avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) because they inhibit platelet function
What is pediculosis?
also known as head lice
* requires contact precautions until 24 hours after initiation of effective therapy.
What is Buergers disease?
The small blood vessels of the feet and hands become blocked with blood clots. Over time, skin tissue is damaged or destroyed. Open, painful sores develop on the toes and fingers.
This impediment is caused by inflammation and is significantly worsened by smoking
What is a slit lamp examination?
What do you do for a patient with hypema?
- elevate HOB to 30+ degrees to prevent increased intraocular pressure
- apply eye patch to prevent injury
*
Differentiate warm and cold compress use
Warm compress
*
Cold compress
* fractures to reduce swelling
What is atelectasis?
The collapse of part or all of a lung, is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the lung. BIG risk factor…
* rib fractures because the client does not fully expand the chest
What is Guillain-Barré syndrome?
Guillain-Barré syndrome (GBS) is a rare acute inflammatory disorder that affects the axons and/or myelin of the PNS resulting in ascending muscle weakness or paralysis.
* monitor for respiratory distress
What is urolithiasis?
Urolithiasis is the presence of calculi (stones) in the urinary tract
Typical signs/symptoms
* hematuria (blood in urine),
* renal colic (unilateral pain spasms in flank),
* severe radiating pain, which can cause nausea/vomiting, sweating, and elevated blood pressure.
* may experience dysuria & increased urinary frequency.
(not kidney stones = nephrolithiasis)
What is trichomoniasis?
Trichomoniasis is primarily transmitted through sexual contact, including vaginal, oral, or anal sex with an infected partner.
* produces malodorous, thin, yellow discharge
* genital redness, burning, itching
* painful urination
What does CK-MB measure? When is its peak?
CK-MB, or creatine kinase myocardial muscle, levels measure muscle cell death especially after an MI.
Post cardiac muscle damage CK-MB:
* begin elevating in 3 to 6 hours
* peak elevation at 18 hours
* levels begin to decrease witihin 48-72 hours
What is scleroderma?
A progressive multisystem autoimmune disorder that causes fibrosis to the connective tissue.
False inflammation causes:
* thickening of the skin
* joint pain
* contractures
* vasospasm in the fingers
* dysphagia
* renal insufficiency
* pulmonary hypertension
Diphtheria:
1. How does it present?
2. How do you prevent it?
3. What bacteria causes the infection?
4. How does it spread?
Presentation
* a thick, gray coating in the throat and nose, making it difficult to breathe and swallow.
* The toxin can also damage the heart, nervous system, and other organs.
Prevention
* vaccination at 2 months and booster after 10 years
Cause
* a serious bacterial infection caused by the bacterium Corynebacterium diphtheria
Infection control
* It is spread through respiratory droplets or contact with skin lesions of infected individuals.
What diet is required for patients with Cystic fibrosis?
The diet should be rich in vitamins, fat, and protein.
Because a client with CF often excretes high amounts of sodium, dietary items rich in sodium are usually not restricted.
Hearing loss is divided into sensorineural or conductive.
Conductive hearing loss is caused by obstruction. Causes of this type of hearing loss include cerumen, foreign body, water, edema, infection, or tumor. This type of hearing loss may be reversible.
Impairments of the nerve fibers cause sensorineural hearing loss. Causes of this type of hearing loss include prolonged exposure to noise, ototoxic substances (aminoglycosides), diabetes mellitus, and presbycusis (age-related hearing loss). This type of hearing loss is often not reversible.
