page 41-50 Flashcards
Neomycin Sulfate
What is it?
Aminoglycoside
-reduces the amount of bacteria in the colon
Neomycin Sulfate
Why does this matter?
It’s given for the GI tract before surgery.
Neomycin Sulfate
How is it used in clients with hepatic encephalopathy?
It is used to treat this disease when ammonia levels are elevated in the liver.
Neuroleptic Malignant Syndrome
When does this syndrome occur?
It could occur any time a client is on anti-psychotic medication, most commonly when treatment begins or doses increased.
Neuroleptic Malignant Syndrome
What are the signs of N.M.S?
- Tachycardia
- EXTREME FEVER
- altered LOC
- seizures
- muscle rigidity
- ELEVATED LAB VALUES (WBC/LFT) liver function test
Neuroleptic Malignant Syndrome
What is the treatment?
Discontinue the medication.
Initiate safety & seizure precautions.
Give antipyretics to reduce fever.
NG Tube
What position should the client be in during NG Tube placement?
High Fowler’s with head tilted forward
NG Tube
The NG Tube goes from ____ to ____.
Nose to stomach
NG Tube
What is a Salem sump?
Double lumen of NG tube used to decompress the stomach
NG Tube
What are the measuring points for determining the length if insertion?
Nose to earlobe to xiphoid process
NG Tube
If the client starts to gag during placement should you continue the procedure?
YES, wait until client stops gagging/coughing, then continue to advance, offer water to help the tube go down.
NG Tube
What should be done before using the NG Tube for the first time?
X-ray, aspirate for gastric content (pH should be <4)
NG Tube
If the NG Tube is to suction, should you turn off the suction when medications are given PO?
Yes, for at least 30 mins
NG Tube
If a client vomits during the procedure should you keep going with the NG Tube?
Yes, wait for a few minutes then proceed.
Let the client know that they will feel better once the NG tube is in place.
Nitroglycerin
What is the action?
Systemic/coronary vasodilation
Nitroglycerin
What conditions are treated by nitroglycerin?
Angina, BP, CHF
Nitroglycerin
If nitroglycerin is given sublingually for angina pain and it is not relieved, what should you do?
Give an additional tablet in 5 mins.
You can give up to 3 tablets over 15 mins activate EMS after 1st dose.
Nitroglycerin
If nitroglycerin is given sublingually & the client complains of a stinging sensation, is that normal?
Yes, it means the tablet is fresh.
Nitroglycerin
What is the number one complaint when taking nitroglycerin?
Headache
Nitroglycerin
What are the common side effects?
- Hypotension
- TACHYCARDIA
- dizziness
- syncope
Nitroglycerin
If a client has on a transdermal ointment or nitroglycerin patch, should you rotate sites during application?
Yes, to prevent skin irritation
Nitroglycerin
DO NOT PLACE a nitroglycerin patch over a _______.
P a c e m a k e r
Nitroglycerin
You should take off the client’s nitroglycerin patch before having a _____ scan.
M R I
Nitroglycerin
Should a client take nitroglycerin prophylactically before sex?
Yes, to prevent chest pain
Nitroglycerin
If your male client is taking Viagra (Sildefanil), what should you tell him?
DON’T TAKE WITH NITROGLYCERIN
Nitroglycerin
IV Nitroglycerin & all IV dysrhythmics should be placed on an ______.
Infusion pump
Nitroglycerin
What is verapamil used for?
Blood pressure & angina
NSAIDs
What does it stand for?
Nonsteroidal Anti-Inflammatory Drugs
NSAIDs
What type of drugs are they?
Aspirin & Aspirin-like drugs
NSAIDs
What do they do?
Reduce pain & body temperature & inhibit platelet aggregation
NSAIDs
Clients should take NSAIDs with a full glass of ______ or _____ to prevent stomach irritation.
Water, milk
NSAIDs
Aspirin toxicity will cause _____ in the ears.
Tinnitus
NSAIDs
Teach clients to avoid ____ when taking NSAIDs to decrease stomach irritation.
Alcohol
NSAIDs
NSAIDs increase/decrease bleeding potential.
INCREASE
NSAIDs
How soon should a client stop taking NSAIDs before having surgery?
1 week
NSAIDs
Kids shouldn’t take NSAIDs when they have flu-like symptoms due to the risk of?
Reye’s syndrome
Nursing Mnemonics
𝐀.𝐃.𝐏.𝐈.𝐄
for the Nursing Process
𝐀ssessment 𝐃iagnosis 𝐏lanning 𝐈ntervention 𝐄valuation
Nursing Mnemonics
𝐇.𝐄.𝐋.𝐋.𝐏
for Pre-eclampsia Syndrome (Severe)
𝐇emolysis 𝐄levated 𝐋iver 𝐋ow 𝐏latelet count
Nursing Mnemonics
𝐋.𝐈.𝐎.𝐍
for Maternal Fetal Distress
𝐋eft side
𝐈nitiate Fluids
𝐎xygen via Face Mask
𝐍otify the doctor
Nursing Mnemonics
𝐏.𝐀.𝐋.𝐒.𝐘
for Cerebral Palsy Features
𝐏aresis *refers to a condition in which muscle movement has become weakened or impaired
𝐀taxia *describes a lack of muscle control or coordination of voluntary movements, such as walking or picking up objects
𝐋agging motor development
𝐒pasticity
𝐘oung
Nursing Mnemonics
𝐒.𝐌.𝐀.𝐑.𝐓
for Parkinson’s Disease
𝐒huffling gait 𝐌ask-like face 𝐀kinesia 𝐑igidity 𝐓remor
Nursing Mnemonics
𝐀.𝐒.𝐓.𝐇.𝐌.𝐀
for Asthma
𝐀drenergics (Beta 2 Agonists Albuterol) 𝐒teroids 𝐓heophylline 𝐇ydration (IV) 𝐌ask O2 𝐀nticholinergics
Nursing Mnemonics
'’𝐈t’s 𝐍ot 𝐌y 𝐓ime’’
Pre-term Labor Drugs
𝐈ndomethacin (NSAID)
𝐍ifedipine (CCB)
Magnesium Sulfate
𝐓erbutaline
Nursing Mnemonics
𝐌.𝐎.𝐍.𝐀
for (MI) Medications
𝐌orphine
𝐎xygen
𝐍itrogen
𝐀spirin
Nursing Mnemonics
𝐑.𝐍 (𝐑 then 𝐍)
for Drawing Mixed Insulins
Air into NPH
AIr into Regular
Draw up 𝐑egular, then
draw up 𝐍PH
Nursing Mnemonics
𝐒.𝐓.𝐑.𝐈.𝐏.𝐄
TB medications
𝐒𝐓reptomyciin 𝐑ifampin 𝐈soniazid 𝐏yrazinamide 𝐄thambutol
Nursing Mnemonics
To describe fetal heart rates, remember:
VEAL CHOP
Variable = Cord Compression
Early Deceleration = Head Compression
Accelerations = Oxygenation is OK
Late Decelerations = Placental Insufficiency (bad sign)
Organ Donation
What do you need to know?
Best with living donor, matched by blood &tissue, must be in writing, and can be changed before removal
Organ Donation
Can a nurse approach client or family about donation
NO, only authorized representative
Orthostatic Hypotension
What is it?
Systolic or diastolic BP drops more than 10 mm Hg & HR increases by 10-20 when client changes position (lying, sitting, standing)
BP down HR UP
Orthostatic Hypotension
How will client feel?
Dizzy, light-headed, unsteady
Orthostatic Hypotension
How to assess for orthostatic hypotension?
Check BP while client is lying down, sitting up, & standing.
Wait 5 minutes between measurements.
Orthostatic Hypotension
What is the treatment?
IV fluids for volume replacement
Osteoarthritis
What is osteoarthritis?
Degenerative disease of the joints
Osteoarthritis
Osteoarthritis is the ____ form of arthritis seen in the elderly.
NUMBER ONE
Osteoarthritis
Which joints in the body are most affected?
Weight-bearing joints
knees, hips, fingers, back
Osteoarthritis
What are the signs/symptoms of Osteoarthritis?
Limited joint mobility, joint pain, joint stiffness
Osteoarthritis
Is the pain from Osteoarthritis relieved by activity or rest?
Rest
Osteoarthritis
Hard nodes will develop on the joints of the fingers, creating deformities. What is this called?
Heberden’s nodes
Osteoarthritis
What is the primary medication given for pain?
NSAIDs
Osteoarthritis
_____ may be injected into the joints to treat Osteoarthritis.
Corticosteroids
Osteoarthritis
What surgery may be required?
Hip/Knee replacements
Otitis Media
This is an infection of the ____ ear.
Middle
Otitis Media
Why are children more prone to this?
because their Eustachian tubes are shorter than those of adults
Otitis Media
What are the signs?
- fever
- loss of appetite
- rolling head from side to side (promotes air drainage)
Otitis Media
What is the treatment?
Analgesics & antibiotics
Oxygen Delivery Systems
What is the range of the flow rate for nasal cannula?
1-6 lpm
Oxygen Delivery Systems
Why keep O2 flow rate below 6?
Nares & mucosa dry out when the rate is high
Oxygen Delivery Systems
What are the benefits of using nasal cannula?
Client can still drink, eat & talk
Oxygen Delivery Systems
How often should the nasal cannula be changed?
Every day
Oxygen Delivery Systems
What should be expected daily due to irritation?
skin on face, nares & ears
Oxygen Delivery Systems
What is the flow rate range for a simple mask?
6-10 lpm
Oxygen Delivery Systems
When applying the mask, what must be done?
Make sure it fits properly, covering mouth & nose
Oxygen Delivery Systems
Clients wearing a face mask may feel ____.
Claustrophobic
Oxygen Delivery Systems
What makes a Venturi mask different from a regular face mask?
It allows you to control how much room air you want to mix with oxygen.
Oxygen Delivery Systems
Always use a Venturi mask for clients with ______.
COPD
because you want the specific 02 concentration
Oxygen Delivery Systems
A partial rebreather mask looks like a face mask with a ________ attached to it.
Reservoir bag
Oxygen Delivery Systems
Like the other forms of oxygen delivery , the partial rebreather allows _____ to mix with ___.
Room air, pure oxugen
Oxygen Delivery Systems
The reservoir bag should be inflated when?
At all times (important point)
Oxygen Delivery Systems
The non-rebreather mask does not allow ____.
Room air to be inhaled.
Oxygen Delivery Systems
How would you assess to see if the oxygen delivery system is effective?
Pulse oximetry, client’s respiration rate & pattern,
ABG
Oxygen Delivery Systems
Do not use ____ for a moisturizer.
Petroleum jelly can set the client’s face on fire!
use a water soluble jelly.
Pacemakers
What do they do?
Conduct electrical activity & maintain HR
Pacemakers
If you were at a conference on pacemakers, what should you teach?
-Check pulse DAILY
-AVOID large magnetic fields
(MRI, industrial equipment)
-AVOID contact sports.
-Household appliances are okay.
-Report signs of dizziness, fatigue or SOB to M.D
Pancreatitis (Acute)
What is the number one cause of acute pancreatitis?
Alcohol abuse
Pancreatitis (Acute)
What are the symptoms?
- Abdominal pain
- N V
- Board-like abdomen
- skin discoloration (Cullen’s & Turner’s Sign)
Pancreatitis (Acute)
Does eating make the pain better or worse?
worse, especially fatty foods
Pancreatitis (Acute)
What liver enzymes are elevated with pancreatitis?
lipase & amylase
Pancreatitis (Acute)
What are the nursing interventions?
- Make client NPO
- NG Tube to decrease gastric distention
- IV fluids
- Antacids
- Teach client to stop drinking
Pancreatitis (Acute)
How do you treat the pain?
Demerol or hydromorphone
Pancreatitis (Acute)
Never give this for pain
Morphine
It was thought to cause spasms in the pancreatic duct & sphincter of Oddi.
Paracentesis
This is an invasive procedure. Make sure the client has _____.
Informed consent
Paracentesis
This procedure collects the fluid from where?
Peritoneal cavity of the abdomen
Paracentesis
What to do before the procedure?
- Measure the abdomen
- Weigh & take VS
- Have client void to empty bladder
Paracentesis
What position should the client be in during this procedure?
Sitting on edge of bed
Paracentesis
What do you do after procedure?
- Monitor VS
- measure fluid collected
- apply sterile dressing to insertion site & monitor bleeding
- Make sure urine is not bloody
Parkinson’s Disease
This disease is caused by depletion of _____?
Dopamine
Parkinson’s Disease
What are the signs of Parkinson’s Disease?
- Bradykinea
- tremors in hands & feet at rest
- rigidity
- shuffling steps
- loss of balance
Parkinson’s Disease
Is this disease process fast or slow?
Slow, progressive
Parkinson’s Disease
What are the nursing interventions?
- assess neuro status & swallowing ability
- safety assist with ambulation
- encourage fluids
- high calorie-high fiber meals with low protein diet
Parkinson’s Disease
What medications are prescribed?
Anti-Parkinson’s, Anti-cholinergics
Parkinson’s Disease
When taking anti-cholinergic, client should increase _______ to avoid ______.
Fiber , constipation
Parkinson’s Disease
What are other side effects of anti-cholinergics?
- blurred vision
- dry mouth
- photophobia
- tachycardia
Parkinson’s Disease
What medication will be given to replace dopamine?
Levodopa or Carbidopa-levodopa
Parkinson’s Disease
DO NOT TAKE dopamine replacement medications WITH ______, as they may cause a hypertensive crisis.
MAIOs
Parkinson’s Disease
Teach clients taking Parkinson’s Drugs to follow a _______ diet.
Low-protein diet
Parkinson’s Disease
What vitamin should be avoided in the diet?
B6
which blocks the medication’s effect.
Peptic Ulcer Disease
What bacteria is responsible for most peptic ulcers?
H. Pylori
Peptic Ulcer Disease
Where are most peptic ulcers found?
Gastric & duodenal
Peptic Ulcer Disease
When a client has ulcers, what will the vomit look like?
'’coffee ground’’
Peptic Ulcer Disease
When a client has ulcers, what will the stool look like?
'’Black tarry’’
Peptic Ulcer Disease
What medications should be AVOIDED?
NSAIDs
Peptic Ulcer Disease
Is Acetaminophen a NSAID?
NO
Peptic Ulcer Disease
Gastric
- Where are the ulcers?
- Does stomach acid increase?
- Where does the pain occur?
- WHEN does the pain occur?
- Stomach
- No, normal production
- Mid-epigastric region
- With meals or after eating ‘‘starve a gastric ulcer’’
Peptic Ulcer Disease
Duodenal
- Where are the ulcers?
- Does stomach acid increase?
- Where does the pain occur?
- WHEN does the pain occur?
- Duodenum
- Yes, increase production
- Mid-epigastric region
- On an empty stomach ‘‘feed a duodenal ulcer’’
Peptic Ulcer Disease
What type of medication will be given to decrease gastric acid production in duodenal ulcers?
H2 blockers & proton pump inhibitors
Peptic Ulcer Disease
What are medication examples of H2 blockers?
Ranitidine
Cimetidine
Peptic Ulcer Disease
What are medication examples of proton pump inhibitors?
Generic ending in ‘‘-zole’’
Esomeprazole
Pantoprazole
Omeprazole
Peptic Ulcer Disease
___ are prescribed to neutralize gastric acid.
Antacids
Peptic Ulcer Disease
What should you teach clients with ulcers to avoid?
Smoking & alcohol
Peripheral Arterial Disease (PAD)
PAD is an occlusive disease of the ____.
Lower extremities
Peripheral Arterial Disease (PAD)
Does the damage to surrounding tissue occur above or below the arterial occlusion?
Below
Peripheral Arterial Disease (PAD)
Would you feel a pulse in a leg with PAD?
No, it would be absent.
Peripheral Arterial Disease (PAD)
What would the leg look like?
Hairless, cool, pale, thick toenails
Peripheral Arterial Disease (PAD)
What is intermittent claudication?
Muscle pain from decreased blood supply, pain comes & goes
Peripheral Arterial Disease (PAD)
Teach client NOT to?
- Smoke
- wear tight clothes
- apply direct heat to legs
- exercise
- inspect skin daily
- take prescribed meds
Peripheral Arterial Disease (PAD)
What procedures improve PAD?
Bypass surgery, angioplasty
Peripheral Arterial Disease (PAD)
What does a leg with a venous occlusion look like?
- Brown/purple discoloration
- edema
- weeping fluid
Pheochromocytoma
A tumor that produces an excessive amount of ___ & ______.
Epinephrine, norepinephrine
Pheochromocytoma
Clients will experience:
- Sustained hypertension
- sweating
- weight loss
- hyperglycemia
- H/A
Pheochromocytoma
This is the problem with _____ gland.
Adrenal
Pheochromocytoma
Treatment:
Surgical removal of one or both adrenal glands.
Pheochromocytoma
What will the client need to take AFTER surgery?
Glucocorticoid replacement
Phlebitis
What is Phlebitis?
Inflammation of veins
Phlebitis
What does it look like?
Red, warm, painful area, streaks up the arm
Phlebitis
What is the treatment for this?
- Remove the IV
- Apply warm towel
- Assess for infection
Piaget’s Theory of Cognitive Development
What Age/Stage?
Child learns about reality by interacting with his-her environment
Piaget’s Theory of Cognitive Development
Birth to 2 years
Sensorimotor
Piaget’s Theory of Cognitive Development
What Age/Stage?
Moves on to pre-logical thinking; learns past, present, future. No abstract thinking yet.
Piaget’s Theory of Cognitive Development
2 to 7 years
Preoperational
Piaget’s Theory of Cognitive Development
What Age/Stage?
Moves to LOGICAL thinking; able to classify & sort facts. Abstract thinking available.
Understand death by 10 years old.
Piaget’s Theory of Cognitive Development
7 to 11 years
Concrete
Piaget’s Theory of Cognitive Development
What Age/Stage?
Able to think & learn as an adult; concrete & abstract reasoning
Piaget’s Theory of Cognitive Development
11 to adult
Formal
