random 2 Flashcards
DI
polyuria, polydipsia = dehydration d/t low ADH
< more urine
< low specific gravity
(the less urine the higher specific gravity)
SIADH
< low urine o/p, not thirsty and gaining weight
< less urine
< high specific gravity
DM2 diet:
restrict calories (1800) and have 6 small meals/day
Insulins: 4
onset
peak
duration
- 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
if you have more exercise, you will need ______ insulin?
less . Or have to eat snacks during game
S and S of hypoglycemic
Drunk and in shock
< 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
HA1C
best indicator for BS control
< glycolsated hemoglobin
< or = to 6
8 means out of control
7 need to be monitored
drug toxicities:
Lithium and lanoxen
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
Billi, Aminophylline, Dilantin
- 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 - Aminophylline: relieves spasmMMM in airway (not bronchodilate.
< 10-20 therapeutic
> 20 = toxic - Dilantin (phenytoin): seizures
< 10-20 therapeutic
> 20 = toxic
BAD high go 20
kernicterus
when bili gets up to 20 and gets through the blood/brain barrier
causes sterile encephalitis
pathological jaundice
yellow at birth = normal
physiologic jaundice
after 2-3 days baby becomes yellow. not normal
opisthotonus
position of baby from meningitis/ or bili in brain
= feet in ears
place on side
dumping syndrome
< 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.
Hiatal Hernia
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
K+
do the same as prefix except for HR and urine OP
hyperK+
agitation, tachypnea bradycardia- tall T-waves diarrhea/borborygmi spastic and increased muscle tone decreased urine increased tendon reflex
hypoK+
lethargy tachycardia polyuria ileus, constipation, decreased BS flaccidity and decreased muscle tendons reflex
u-wave
is a depression
obtunded
more comotose than lethargy
Ca+
does the opp as prefix
hyperCa+
bradycardia bradypnea flaccid muscles, hypoactive reflex constipation lethargy
hypoCa+
tachy spastic muscles increased reflexes diarrhea clonus irritable, restless, agitated seizure Trusseaus/Chvosteks + signs
if close and you have hyperK+ and hypoCa+…
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+
Mg
pick the opposite of prefix
Na+
dehydration and overload
hyperNa+
hypEr = dEhydration
> hot flushed dry skin
DKA
HHNK
hypoNa+
hypO= Overload
> lasix
fluid vol excess
the earliest sign of electrolyte imbalance is?
numb and tingle (parasthesia)
then all muscle weakness (paresis)
Circumoral parasthesia = numb and tingle around mouth.
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
hyperthyroid
Graves: run yourself into the grave
> skinny and weight loss > high BP > tachycardia > irritable, hyper... > hot intolerant > exopthalmos
3 ways to tx hyperthyroid:
- radioactive iodine-
> Pt by themselves for 24 hrs
> careful with urine, flush 3 x - PTU propyltheouricil
> used for Ca as well
> Nurse- treat immunosuppress and watch WBCs - 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
thyriod storm tx:
- Get temp down and O2 up
> ice packs/cooling blanket/O2 at 10L
> no meds
> stay with PT
post-thyroidectomy
first 12 hrs-
- top priority is airway
- hemorrhage
- 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)
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
adrenal cortex under secretion
Addisons
Add-I-sone (steroids). if you are adding then its hypo.
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
cushing tx
adernalectomy
bilateral would give you addisons = give steroids = look like cushing man
chilrens play toys
- is it safe
- is it feasible
- is it age approp
infant to 6 months toys
mobile, soft book
6-9 months toys
object permanence
N- cover/uncover
jack-in-box, peekaboo, window books
9-12 months toys
vocalization
talking toys/books/ see and say
build tower with 3 blocks
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
3-5 year toys
preschool work on fine motor finger dexterity balance- tricycles dance class cooperative play/intract highly imaginative/pretend
5-12 toys
Creative
Collective
Competative
blank paper and colored pencils
lego, stamps
adolescence
peer group association
unless fresh post-op not < 12 hrs, or immunocomp, or contagious disease
laminectomy
vertebra spine process removal to relieve nerve decompression
S and S- Pain, parasthesia, paresis
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
post-laminectomy
> log roll
no dangle- lying to standing. can walk
no sit for longer than 30 min. only for meals
post-lam complications:
cervical- pneumonia
thoracic- pneumonia and ileus
lumbar- urine retention and legs dont work
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…
All psych drugs cause:
low BP and weight changes (most increase). Prozac either
Phenothiazines
first gen- typical antipsychotic ZINE
> ZINE for zaney. crazy > N- risk for injury and safety issues > in small dose antiemetic > Major tranquilizers >
why do PTs need to report rheumatic fever
to start antibiotics bfr surgery or any dental to prevent reoccurance
if a PT has a temp of 105 (38.05) then
they need a private room until you know the cause
triage after natural disaster
amputation
75% burns
fx humerus
BP 90/40, lathargic
red
black
green
red
fluorouracil
cancer drug
what is time-out i surgery?
its when the staff verbalize the verification of the correct PT, procedure, site and implant.
immediate intervention for HHNK
correct dehydration with isotonic IV fluids
hep A symptoms
malaise
dark colored urine
jaundce
presbyopia
at age 40, the near point of focus gets farther away = normal
anomia
cannot name objects
early alzheimers
apraxia
PT cannot perform purposeful movement
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
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.
isoniazid and rafampin
used to tx TB
