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1
Q

DI

A

polyuria, polydipsia = dehydration d/t low ADH

< more urine
< low specific gravity

(the less urine the higher specific gravity)

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2
Q

SIADH

A

< low urine o/p, not thirsty and gaining weight

< less urine
< high specific gravity

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3
Q

DM2 diet:

A

restrict calories (1800) and have 6 small meals/day

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4
Q

Insulins: 4

onset
peak
duration

A
  1. rapid acting- humalog (lispro)- give during meal:
    < 15, 30, 3 hrs
2. Regular (short)- R rapid and run (fast/IV)
   > 1
   > 2
   > 4
3. NPH (intermid)- N (not so fast/not in bag) cloudy
   < 6
   < 8- 10
   < 12
4. Lantus (glargine)
   < duration 12-24 hrs
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5
Q

if you have more exercise, you will need ______ insulin?

A

less . Or have to eat snacks during game

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6
Q

S and S of hypoglycemic

Drunk and in shock

A

< stagger gait
< slurred speech
< poor judgemnt
< emotions: labile (laugh/cry), obnoxious

< shock:
– low BP, tachycardia, tachypnea, diaphoesis/cool/clammy/mottled

N: what to give
< fast acting metabolizing carb: juice, honey, candy, pop (only if they can swallow)
< plus protein

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7
Q

HA1C

A

best indicator for BS control

< glycolsated hemoglobin

< or = to 6
8 means out of control
7 need to be monitored

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8
Q

drug toxicities:

Lithium and lanoxen

A

lithium: anti- mania (BP)
< 0.6- 1.2 theraputic
< 2.0 = toxic

lanoxin (digoxin): A.fib/CHF
< adenosine, beta, CCB, dig
< 1.0-2.0 theraputic
> or = 2.0 = toxic

–> lith and lenox = go low 2.0

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9
Q

Billi, Aminophylline, Dilantin

A
  1. Bilirubin: waste prod from breakdown RBC
    < theraputic new born 10-20 normal for baby
    > or = to 20= toxic
    –> if baby 15 they are almost toxic. baby needs to come to hosp
  2. Aminophylline: relieves spasmMMM in airway (not bronchodilate.
    < 10-20 therapeutic
    > 20 = toxic
  3. Dilantin (phenytoin): seizures
    < 10-20 therapeutic
    > 20 = toxic

BAD high go 20

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10
Q

kernicterus

A

when bili gets up to 20 and gets through the blood/brain barrier

causes sterile encephalitis

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11
Q

pathological jaundice

A

yellow at birth = normal

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12
Q

physiologic jaundice

A

after 2-3 days baby becomes yellow. not normal

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13
Q

opisthotonus

A

position of baby from meningitis/ or bili in brain

= feet in ears
place on side

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14
Q

dumping syndrome

A

< gastric empty probs (surgery)

< right direction at the wrong rate

< Drunk, shock, acute abd distress

  • -> drunk: staggered gait, slurred speech, poor judgement, labile, cerebral impair d/t less blood to brain
  • -> shock: hypotension, cold/clammy/pale, tachycardia, tachypnea
  • -> acute abd distress: cramping, pain, borborygmic, diarrhea, bloat

tx: want stomach to empty slower
> HOB- flat, on side to eat
> fluids- low. not with meals, 1-2 hrs bfr/after meals
> carbs low, high protein

when everything is low, the stomach empties slow.

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15
Q

Hiatal Hernia

A

gastic empty probs. Regurgitate gas fluids up esophagus. above diaphram

> when you eat, food comes back up

> content moving in the wrong direction ans the correct rate

> GERD- when you lie down after you eat then its HH. NOT if its random

tx: want stomach to empty faster
> HOB during and after meals- high
> fluids with meal - high
> carbs high, protein high

when everything is high, stomach empties high

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16
Q

K+

A

do the same as prefix except for HR and urine OP

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17
Q

hyperK+

A 
agitation, 
tachypnea
bradycardia- tall T-waves
diarrhea/borborygmi
spastic and increased muscle tone 
decreased urine 
increased tendon reflex
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18
Q

hypoK+

A 
lethargy
tachycardia
polyuria
ileus, constipation, decreased BS
flaccidity and decreased muscle tendons reflex
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19
Q

u-wave

A

is a depression

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20
Q

obtunded

A

more comotose than lethargy

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21
Q

Ca+

A

does the opp as prefix

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22
Q

hyperCa+

A 
bradycardia
bradypnea
flaccid muscles, hypoactive reflex
constipation
lethargy
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23
Q

hypoCa+

A 
tachy
spastic muscles
increased reflexes
diarrhea
clonus
irritable, restless, agitated
seizure
Trusseaus/Chvosteks + signs
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24
Q

if close and you have hyperK+ and hypoCa+…

A

pick skeletal muscles, nerves or heart for Ca

and

everything else pick K+

If tie, dont pick Mg.

ex. If PT had diarrhea. could be hyperK+, hypoCa or hypoMg. Tie, so dont pick Mg. Not skeletal muscle so not Ca. Answer K+

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25
Mg
pick the opposite of prefix
26
Na+
dehydration and overload
27
hyperNa+
hypEr = dEhydration > hot flushed dry skin > DKA > HHNK
28
hypoNa+
hypO= Overload > lasix > fluid vol excess
29
the earliest sign of electrolyte imbalance is?
numb and tingle (parasthesia) then all muscle weakness (paresis) Circumoral parasthesia = numb and tingle around mouth.
30
treat hyperK+
fast: give D5W with regular insulin. > enters early/fast and drives K+ into the cells out of the blood. does not get rid of excess K+. temp. slow: Kayexalate. > PO or rectum. full of Na+. as this sits in your gut it puts NA+ into blood and swaps K+. Kayexalate is then excreted out of the bowels. > not PT has hyperNa+ = dehydrated = give fluids to correct prob > takes longer K-exit-late
31
hyperthyroid
Graves: run yourself into the grave ``` > skinny and weight loss > high BP > tachycardia > irritable, hyper... > hot intolerant > exopthalmos ```
32
3 ways to tx hyperthyroid:
1. radioactive iodine- > Pt by themselves for 24 hrs > careful with urine, flush 3 x 2. PTU propyltheouricil > used for Ca as well > Nurse- treat immunosuppress and watch WBCs 3. Thyroidectomy - most common ``` > total or sub Total--> need life long horm replacement > risk for hypocalcemia. hard to not take out parathyroid > parasthesia will happen first > + T and C sign ``` ``` Partial--> might be on horms > at risk for thyroid storm ** crisis. a) super high temp 105 b) extreme high BP 210/180 c) severe tachycardia 180 d) psycho delerium - can cause brain damage. EMERG ```
33
thyriod storm tx:
1. Get temp down and O2 up > ice packs/cooling blanket/O2 at 10L > no meds > stay with PT
34
post-thyroidectomy
first 12 hrs- 1. top priority is airway 2. hemorrhage 3. 12-48 hr window (now must know what type thyroidectomy) Total= tetany d/t hypocalcium- could cause larynx spasm and cut off airway Sub-total = Storm > 48hrs = infection (never pick infection in the first 72 hrs for anything)
35
hypothyroid
``` Myxedema > obese > flat, dull, boring > cold intolerance > decreased pulse > decreased grades ``` Tx: give synthroid Do not sedate these ppl. = myxedema coma (decreased mental status and hypothermia + others. EMERG). No zopiclone! NEVER hold synthroid
36
adrenal cortex under secretion
Addisons | Add-I-sone (steroids). if you are adding then its hypo.
37
cushing (over secretion)
S and S is same for steriods ``` > puffy moon face > hirsutism > big body small extrematies > buffalo hump > gynecomastia> > irritable > water/Na retention (losing K+) > striae > high glucose > bruise easy > immunocompromised ``` > acu-checks Q6hrs d/t steroids
38
cushing tx
adernalectomy bilateral would give you addisons = give steroids = look like cushing man
39
chilrens play toys
1. is it safe 2. is it feasible 3. is it age approp
40
infant to 6 months toys
mobile, soft book
41
6-9 months toys
object permanence N- cover/uncover jack-in-box, peekaboo, window books
42
9-12 months toys
vocalization talking toys/books/ see and say build tower with 3 blocks
43
1-3 years toys
``` toddlers push/pull toys gross motor skills - run, jump no finger dexterity- but can finger paint parallel play. beside not with ```
44
3-5 year toys
``` preschool work on fine motor finger dexterity balance- tricycles dance class cooperative play/intract highly imaginative/pretend ```
45
5-12 toys
Creative Collective Competative blank paper and colored pencils lego, stamps
46
adolescence
peer group association | unless fresh post-op not < 12 hrs, or immunocomp, or contagious disease
47
laminectomy
vertebra spine process removal to relieve nerve decompression S and S- Pain, parasthesia, paresis
48
spine compression location
Cervical- diaphram, breathing and arms Thoracic- cough mechanism and bowels (ab/gut muscles) > cough and BS Lumbar- bladder/ legs > OP/distension and function of legs
49
post-laminectomy
> log roll > no dangle- lying to standing. can walk > no sit for longer than 30 min. only for meals
50
post-lam complications:
cervical- pneumonia thoracic- pneumonia and ileus lumbar- urine retention and legs dont work
51
lam post-op teaching
> log roll > no drive 6 weeks and not heavy lift 6 weeks (<5 lbs) > no sit longer than 30min for 6 weeks Permanent restrict: > cannot bend at waist/ knees only > cervical- never lift above head > no horse back/bike rides...
52
All psych drugs cause:
low BP and weight changes (most increase). Prozac either
53
Phenothiazines
first gen- typical antipsychotic ZINE ``` > ZINE for zaney. crazy > N- risk for injury and safety issues > in small dose antiemetic > Major tranquilizers > ```
54
why do PTs need to report rheumatic fever
to start antibiotics bfr surgery or any dental to prevent reoccurance
55
if a PT has a temp of 105 (38.05) then
they need a private room until you know the cause
56
triage after natural disaster amputation 75% burns fx humerus BP 90/40, lathargic
red black green red
57
fluorouracil
cancer drug
58
what is time-out i surgery?
its when the staff verbalize the verification of the correct PT, procedure, site and implant.
59
immediate intervention for HHNK
correct dehydration with isotonic IV fluids
60
hep A symptoms
malaise dark colored urine jaundce
61
presbyopia
at age 40, the near point of focus gets farther away = normal
62
anomia
cannot name objects early alzheimers
63
apraxia
PT cannot perform purposeful movement
64
Myasthenia gravis
chronic autoimmune neuromuscular disease that causes weakness in the skeletal muscles, which are responsible for breathing and moving parts of the body, including the arms and legs
65
when do you not give baby MMR vaccine?
when baby is allergic to gelatin. MMr is grown in chicken embryos and manufactured with the use of gelatin.
66
isoniazid and rafampin
used to tx TB

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