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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
Q

Mg

A

pick the opposite of prefix

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26
Q

Na+

A

dehydration and overload

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27
Q

hyperNa+

A

hypEr = dEhydration

> hot flushed dry skin
DKA
HHNK

28
Q

hypoNa+

A

hypO= Overload

> lasix
fluid vol excess

29
Q

the earliest sign of electrolyte imbalance is?

A

numb and tingle (parasthesia)
then all muscle weakness (paresis)

Circumoral parasthesia = numb and tingle around mouth.

30
Q

treat hyperK+

A

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
Q

hyperthyroid

A

Graves: run yourself into the grave

> skinny and weight loss
> high BP
> tachycardia
> irritable, hyper...
> hot intolerant 
> exopthalmos
32
Q

3 ways to tx hyperthyroid:

A
  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
Q

thyriod storm tx:

A
  1. Get temp down and O2 up
    > ice packs/cooling blanket/O2 at 10L
    > no meds
    > stay with PT
34
Q

post-thyroidectomy

A

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
Q

hypothyroid

A 
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
Q

adrenal cortex under secretion

A

Addisons

Add-I-sone (steroids). if you are adding then its hypo.

37
Q

cushing (over secretion)

A

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
Q

cushing tx

A

adernalectomy

bilateral would give you addisons = give steroids = look like cushing man

39
Q

chilrens play toys

A
  1. is it safe
  2. is it feasible
  3. is it age approp
40
Q

infant to 6 months toys

A

mobile, soft book

41
Q

6-9 months toys

A

object permanence
N- cover/uncover
jack-in-box, peekaboo, window books

42
Q

9-12 months toys

A

vocalization
talking toys/books/ see and say
build tower with 3 blocks

43
Q

1-3 years toys

A 
toddlers
push/pull toys
gross motor skills -  run, jump
no finger dexterity- but can finger paint
parallel play. beside not with
44
Q

3-5 year toys

A 
preschool
work on fine motor finger dexterity 
balance- tricycles 
dance class
cooperative play/intract 
highly imaginative/pretend
45
Q

5-12 toys

A

Creative
Collective
Competative

blank paper and colored pencils
lego, stamps

46
Q

adolescence

A

peer group association

unless fresh post-op not < 12 hrs, or immunocomp, or contagious disease

47
Q

laminectomy

A

vertebra spine process removal to relieve nerve decompression

S and S- Pain, parasthesia, paresis

48
Q

spine compression location

A

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
Q

post-laminectomy

A

> log roll
no dangle- lying to standing. can walk
no sit for longer than 30 min. only for meals

50
Q

post-lam complications:

A

cervical- pneumonia
thoracic- pneumonia and ileus
lumbar- urine retention and legs dont work

51
Q

lam post-op teaching

A

> 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
Q

All psych drugs cause:

A

low BP and weight changes (most increase). Prozac either

53
Q

Phenothiazines

A

first gen- typical antipsychotic ZINE

> ZINE for zaney. crazy
> N- risk for injury and safety issues
> in small dose antiemetic
> Major tranquilizers 
>
54
Q

why do PTs need to report rheumatic fever

A

to start antibiotics bfr surgery or any dental to prevent reoccurance

55
Q

if a PT has a temp of 105 (38.05) then

A

they need a private room until you know the cause

56
Q

triage after natural disaster

amputation

75% burns

fx humerus

BP 90/40, lathargic

A

red

black

green

red

57
Q

fluorouracil

A

cancer drug

58
Q

what is time-out i surgery?

A

its when the staff verbalize the verification of the correct PT, procedure, site and implant.

59
Q

immediate intervention for HHNK

A

correct dehydration with isotonic IV fluids

60
Q

hep A symptoms

A

malaise
dark colored urine
jaundce

61
Q

presbyopia

A

at age 40, the near point of focus gets farther away = normal

62
Q

anomia

A

cannot name objects

early alzheimers

63
Q

apraxia

A

PT cannot perform purposeful movement

64
Q

Myasthenia gravis

A

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
Q

when do you not give baby MMR vaccine?

A

when baby is allergic to gelatin.

MMr is grown in chicken embryos and manufactured with the use of gelatin.

66
Q

isoniazid and rafampin

A

used to tx TB

Random NCLEX (6 decks)

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