Part 1 Flashcards
What is Redman syndrome?
-Flushing of the neck face upper body arms and back along with tachycardia hypotension and urticaria
-Can lead to anaphylactic reaction if the IV infusion rate is not slow down to run greater than one hour
Divalproex
-an anticonvulsant that helps control seizures and treats the manic phase of bipolar disorder
When should hydrochlorothiazide be taken and why?
-Early in the day to avoid nocturia
What med is administered prior to a surgical repair of a detached retina?
-mydriatic meds (pupil dilating) such as phenylephrine (vasoconstrictor/decongestant)
Adverse effect of bevacizumba that should be reported
Severe bleeding from nose, bleeds, vaginal, bleeding, G.I., bleeding, intracranial, bleeding, and pulmonary bleeding, which may be caused from the development of thrombocytopenia and other blood disorders
Complication of Amphotericin B
Nephrotoxicity
Antidote for acetaminophen
-acetylcysteine
-Converts toxic metabolite to non-toxic form
Antidote for benzodiazepine receptor agonists
-flumazenil
Muscarinic poisoning antidote
-atropine
Dietary considerations for ferrous sulfate
Should not be taken with dairy products due to risk of interference with absorption of carbonyl iron
-Should be taken in between meals
What is leuprolide
-treats cancer of the prostate hormonally. It antagonizes the androgens that androgen dependent neoplasms require
What is cyclophosphamide
treats leukemia, multiple Myeloma, lymphomas and head over your breast and lung cancer
What is finasteride
Treats, benign, prostatic hypertrophy and also helps reduce the risk of prostate cancer
Zidovudine Complication
Severe myelosuppression that results in anemia, agranulocytosis and thrombocytopenia is a life-threatening adverse reaction. This drug must be used cautiously and clients already experiencing myelosuppression, and the client must be monitored with CBC performed every few weeks for early detection of marrow failure, which may lead to aplastic anemia.
What is clopidogrel
-inhibits platelet aggregation and can cause bleeding
-Client should report taking this medication to providers to determine whether to discontinue the medication prior to elective procedures to reduce the risk for bleeding
ESR
Measurement of inflammation
Ventricular fibrillation
-Chaotic, electrical activity in the heart, with ineffective pumping, and no cardiac output
Diabetes insipidus
-an endocrine disorder of the posterior lobe of the pituitary gland that results in decrease production of antidiuretic hormone
depth of mild edema
Less than 1/4 inch or 6.2 mm
Depth of Moderate edema
-1/2 inch or more
Severe edema depth
1 inch or more
ECG hypokalemia
long QT interval
ECG hyperkalemia characteristics
-Peaked T waves
Pediculosis capitis
-Head lice and it’s nits are cemented to the hair shaft. The Nits are silvery to white in color, similar to dandruff. They are typically seen on hair on the back of the head near the nape of the neck. A papular rash might be present at the nape of the neck secondary to scratching.
Impetigo Contagiosa
-a reddish macular that ruptures easily leaving exudate that forms a honey colored crust
Folliculitis
-infection of the hair follicles that look like a small red or white bumps around the hair follicles
Tinea capitis
-ringworm, causing scaly patches on the scalp with alopecia
Hirschsprung’s disease
-aganglionic megacon characterized by an area of the large intestine without nerve innervation. The child will probably require two surgeries over and 18 to 24 month Before normal bowel function is obtained. The initial surgery creates an ostomy which relieves the obstructed area and allows the bow distal to the ostomy to rest
Subinvolution of the uterus
When the uterus does not return to its normal size after childbirth
What is a good L/S ratio
2:1 to indicate fetal lung maturity
(Measures ratio of two substances in amniotic fluid)
Cullens sign
A blue discoloration similar to ecchymosis around the umbilicus
-indicates hematoperitonerm a common clinical manifestation of a ruptured ectopic pregnancy
What is hydrops fetalis
-most severe form of Rh incompatibility can be prevented by administration of RH immunoglobulin
Regular insulin
-regular rapid (short acting) run (Iv)
Onset: 1 hour
Peak: 2 hours
Duration: 4 hours
NPH
-not in the bag not so fast not clear (cloudy)
Onset:6 hours
Peak: 8 to 10 hours
Duration: 12 hours
Humalog
Lispro, Aspart (fastest)
Onset: 15 minutes
Peak: 30 minutes
Duration: three hours
Administer with meals, do not mix with other insulins
Lantus
Glargine or determir
Long acting
Slow absorption
No peak
Duration 12 to 24 hours
Cannot mix this insulin with any others
Premixed Insulin 70/30
Humulin, 7030
70% is NPH 30% is REGULAR
Onset: 30 minutes
Peak: two hours
Duration: 16 hours
Premixed Insulin 70/30
Humulin, 7030
70% is NPH 30% is REGULAR
Onset: 30 minutes
Peak: two hours
Duration: 16 hours
What is the therapeutic and toxic levels for Aminophylline
Therapeutic level: 10 to 20
Toxic level equal to, or greater than 20
What is the therapeutic and toxic levels for Bilirubin in a newborn
Therapeutic: 10 to 20
Toxic: greater than 20
Kernicterus
-bilirubin in the CSF
Opisthotonos/ what position should child be placed in
Position of slight extension in neck seen in patient’s with kernicterus (bad sign)
-should be placed on their side
Hiatal hernia
Regurgitation of acid into esophagus because upper stomach herniates upward and through the diaphragm
-2 chamber stomach
-empties backward in the correct rate
-“direction issue”
-GERD effects when lying down after eating
Dumping syndrome
-Postop gastric surgery, complication in which group gastric contents, dump to quickly into the duodenum
-right direction at the incorrect rate
-“speed issue”
-cerebral impairment “drunk”
-shock “pale, cold, clammy”
-acute abdominal distress (cramping, N/V, hyperactive bowels (borborygmi)
Treatment for hiatal hernia
“Want stomach to empty faster to reduce reflux”
HIGHiatal hernia
- HOB during & 1 hour after meals HIGH
-amount of fluids with meals- HIGH
-carbs content of meals- HIGH
Treatment for dumping syndrome
“When everything is low the stomach empties slow”
-HOB during and 1 hour after meals LOW
-amount of fluids w meals LOW
-carbs content in meals LOW
Whatever amount of carbs (high or low) protein is
Opposite
Kalemias do the 1._______ as the prefix expect for 2.____
1.same as
2. Heart rate and urine output
Calcemias and Magnesemias do the 1._______ of the prefix. No expections
-opposite
Hypocalcemia 2 signs of neuromuscular irritability
Chvosteks sign: cheek tap= facial spasm
Trousseaus sign: BP cuff= carpal (hand) spasm
If a symptom involves nerve or skeletal muscle pick 1. _______ . For any other symptom pick 2. ______ (generally anything affecting 3. _______)
- Calcium.
- Potassium.
- Blood pressure
hypErnatermia
=dEhydration (dry skin, threads pulse, rapid HR)
hypOnatremia
=overload (crackles, distended neck veins)
The earliest sign of any electrolyte imbalance is _____ and ______
Numbness & tingling (paresthesias)
Universal signs/symptoms of electrolyte in balance is
Muscle weakness (paresis)
Not more than _____ of K+ per liter of IV fluid
40mEq
Give 1.______ & 2.______ to decrease K+ (most dangerous electrolyte imbalance due to can stop heart)
- D5W
- Regular Insulin (not permanent solution)
“K exits early”
Kayexalate
-full of sodium can be an enema
- K+ exits
-not as quick, more of a permanent solution
“K exits late”
DI is
Polyuria polydipsia leading to dehydration due to low ADH
SIADH
opposite of DI
-oliguria
-not thirsty bc retaining water
Type 1 Diabtetes
-Insulin dependent
-Juvenile onset
-ketosis prone
Type 2 Diabetes
-non insulin dependent
-adult onset
-nonketosis prone
When should Lispro be administered?
With meals
The thyroid regulates
Metabolism
Is exophthalmus (bulging eyes) found in hyper or hypo thyroidism
Hyper
Graves’ disease
You were going to run yourself into the grave
Hyperthyroidism
The localized point of tenderness in appendicitis is called
McBurney’s point
Name of the sign that is characterized by right lower quadrant abdominal pain upon palpation of the left side of the lower abdomen (rebound tenderness
Rovsing sign
Appendicitis
Names of calcium channel blockers
Dipine
*cardizem & verapamil **
What does a normal sinus rhythm EKG look like
-There is a P-wave before every QRX and QRX are followed by a T-wave for every single complex
- peaks of P waves are equally distant from each other
What does ventricular fibrillation look like on an EKG?
-Chaotic, squiggly line
-No pattern
What does ventricular tachycardia look like on an EKG?
-70s wallpaper designs
-Sharp and jagged peaks
-Has a pattern
QRS depolarization=
Ventricular
P wave means
Atrial
Sawtooth in an a EKG means
Flutter
Chaotic is the word used to describe what in an EKG
Fibrillation
Ventricular tachycardia on an EKG shows
Wide bizarre QRS’s
Premature ventricular contractions (PVC)
-periodic wide bizarre QRSs
-One piece of tachycardia
When should you be concerned about PVCs?
-More than six per minute
-6 in a row
-PVC falls on T wave of previous beat
would reach a moderate level of priority
What are the lethal arrhythmias?
-Asystole and ventricular fibrillation
For ventricular use
Lidocaine
Atrial Treatment
ABCDs
Adenocard (adenosine) *push less then 8 secs SLAM this flush
Betablockers
Calcium Channel Blockers
Digitalis/Digoxin (lanoxin)
How do you treat V fib?
Defib by shocking
How do you treat asystole?
Epinephrine and atropine in that order
How do you treat asystole?
Epinephrine and atropine in that order
What do apical chest tubes removed?
-Air because they are high
What do basilar chest tubes remove?
- blood because they’re at the base of the lung
What do you do if the water seal breaks
-First Clamp it and cut tube away from device
-Best submerge the tube underwater than unclamp
What should you do if a chest tube is pulled out
First-cover with a gloved hand
Best- cover the hole with a Vaseline gauze put a dry sterile dressing on top place tape on three sides
Intermittent bubbling in the water seal is
Good
Continuous bubbling in the water seal is
Bad
Must cover hole
Continuous bubbling in the water seal is
Bad
Must cover hole
-If something is sealed, it should not have continuous bubbling
Intermittent bubbling in the suction control chamber is
Bad
If there is continuous bubbling in the suction control chamber, it is
Good
Never clamp a tube for longer then ___ without a doctors order
15 seconds
Rubber tipped double clamps
TRouBLe congenital heart deficits
T starts w letter T (expect for Left Ventricular Hyperplasmic syndrome)
R-L Right to left Shunt
B blue
Trouble or no trouble CHD kids will have two things
- Murmurs
- Echocardiogram
4 defects in tetralogy of fallot are
-Varied Pictures Of A Ranch
Ventricular defect
Pulmonary stenosis
Overriding aorta
Right hypertrophy
4 defects in tetralogy of fallot are
-Varied Pictures Of A Ranch
Ventricular defect
Pulmonary stenosis
Overriding aorta
Right hypertrophy
Hep A
Anus
-anything w a vowel comes from the bowel
Hep B
-spread by blood
Contact isolation
-anything enteric (from the bowel)
-fecal oral
-c diff, hep A, staph infections, RSV (transmitted by droplet but in contact precaution), herpes
-private room preferred or cohort illnesses, gloves, gown, dedicated equipment
Droplet isolation
-all meningitis, H flu (can cause epiglottitis)
-private room preferred
-mask
-gloves
Airborne precaution
-measles, mumps, rubella, TB (droplet spread but airborne precaution) and varicella (chicken pox)
-private room
-mask (N95 for TB)
-gloves
-pt wear mask when leaving
Order of PPE
take of in alphabetical order
gloves, goggles, gown, mask
Put on reverse but mask is second
gown, mask, goggles, gloves
