Random Mark K Flashcards
Underventilated ex
Emphysema Pneumonia Drowning PCA pump toxicity Too low setting
Prolonged suctioning or vomiting (lead to metabolic alkalosis)
Hyperemesis gravidum
Surgery w NG tube suction for 3 days
Lead to metabolic acidosis
Acute RF
infant diarrhea
3rd degree burns over 60% of body
Hyperemesis gravidum with dehydration
delirium tremens
severe form of alc withdrawal… manifesterd by AMS (global confusion) and sympathetic overdrive (autonomic hyperactivity)… which can lead to cardiovascular collapse
- benzos are common meds used to calm NS
i. e. lorazepam, diazepam, oxazepam, chlordiazepoxide
- benzos are common meds used to calm NS
- may also need IV fluids w vitamins and minerals to treat dehydration or bring electrolytes back to balance
meds for dts
anti-hypertensives
tranquilizers
multivitamin containing vit B1
what type of burns would you give pt aminoglycosides
infection from third degree wound covering > 80% of body
when would you use CCBs
treat A, AA, AAA
antihypertensive
antianginal drugs (decrease O2 demand)
antiatrialarrhythmia
**SE –> H/A and hypotension
examples of CCBs
- dipine
verapimil, cardizem (diltiazem) * diltiazem is given continuous IV drip
tx for supraventricular arrhythmias
atrial arrhythmias (super = above) adenocard (adenosine) beta blockers CCBs digoxin/digitalis, lanoxin (Another dig analog)
what to do if water seal of a chest tube breaks
clamp clamp, unclamp, place tube under water must be done in 15 seconds or less
cut the tube away
submerge the end of the tube under sterile water THE MOST IMPORTANT STEP
unclamp tube if it was initially clamped clamping the tube prevents air to get into the chest but does not allow anything from the chest to get out
what to do if drainage device (i.e. jackson pratt, emission, pneumovac, hemovac, etc) is knocked over?
ask pt to take a deep breath and set the device back up
NOT A MED EMERGENCY, no neet to call physician
what to do if chest tube gets pulled out?
- take a gloved hand and cover the opening first step
2. take a sterile vaseline gauze and tape 3 sides best step
what does it mean if the water seal chamber is continuously bubbling
BAD
indicates a break/leak in the system (find it and tape it)
what does it mean if suction control chamber is intermittently bubbling
BAD
suction pressure is too low, increase it at the wall until it is continuous
rules for clamping tubes
do not clamp for more than 15 seconds w/o order
use a rubber tooth (will not puncture tubing), double clamps
pediatric pt with congential heart defect
needs surgery now/soon to live
has a slowed/delayed growth and development (FTT)
shortened life expectancy
parents will experience
acute glomerularnephritis
inflammation and subsequent damage of glomeruli leading to hematuria, proteinuria and azotemia higher BUN’
urine output may be decreased in early stages
when should you notify healthcare provider for pt in labor for 16 hours
fetal HR above 160 for longer than 10 mins
variable decels report IMMEDIATELY **sharp and profound drops in the fetal HR unrelated to time of contractions are NON-REASSURING cord compression like prolapsed cord
gastrotomy
insert a tube through the abdomen and into the stomach
- provide route for tube feeding if needed for four weeks or longer and or to vent the stomach for air or drainage
- children may need if they are having a intestine transplant or after intestinal transplant
- if pt can’t tolerate NG
reasons for enteral feedings
stroke
cancer
critical illness/injury, which reduces energy/ability to eat
failure to thrive
serious illness, body in state of stress
neurologic/mov’t diorders that incr cal requirements
GI dysfunction or disease may require IV nutrition instead
enteral vs parenteral feeding
if you’re at risk for malnutrition and don’t have a functional GI system… may need parenteral feeding
** port of PICC
if you need supplementary nutrition = peripheral parenteral nutrition (PPN) –> all nutritional requirements through IV = TPN
late sign of incr ICP
babinski reflex
decorticate
decerebrate postures
seizures
nonstress test reactive
assesses fetal HR and movement, noninvasive procedure has no risk to mom/child
- nonreactive indicates fetus needs more monitoring and testing
- test occurs over 20 min period
- 2 or more accelerations
- accelerations are 15 b/min lasting 15 seconds
- measures FHR in response to fetal mov’t
examples of objective data
BP, HR, RR, O2 sat
gait and posture
uncoordinated or spontaneous body movements
hygiene and grooming
side effects of levothyroxine sodium for hypothyroidism
slight heat intolerance
weight loss
insomnia
tx for DI
desmopressin
thiazide diuretics
anti-inflammatories
pt at risk for fluid volume deficit bc client may be experiencing polyuria *may manifest as tachycardia, hypotension, thready pulse, hypernatremia
**hydrocortisone is short-actinhg corticosteroid and is indicated for ADRENAL INSUFFICIENCY
hyperthyrodism tx
methimazole
propylthiouracil
manifestations + tx of pheochromocytoma
type of neuroendocrine tumor that grows from cells called chromaffin cells
- cells produce hormones needed for the body and are found in the adrenal glands
** hypertension, H/A, sweating and s/s of panic attack life threatening
give antihypertensives (like prazosin which is an alpha-adrenergic blocker)
what medication should pt not take with phenytoin
calcium carbonate **can decrease the effects of phenytoin, decrease bioavailability
NO ANTACIDS
separate times by at least 2-3 hours
ace inhibitors uses and concerns
- manage HR and hypertension
MED MAY BE NEPHROTOXIC… need to watch creatinine and GFR
lugol’s solution purpose
to reduce the size of the thyroid and reduce bleeding
**given 10-14 days before surgery to decrease vascularity of thyroid
brown-sequard syndrome
incomplete spinal cord injury
- weakness/paralysis (hemi-paraplegia) on the ipsiolateral (same) and sensory loss (hemianesthesia) on the contralateral (opposite) side
when would you use a 24-hour urine sample to diagnose
pheochromocytoma
abnormal protein quantification in multiple myeloma
cystitis s/s
leukocyte esterase nitrite rbcs abnormal number of WBCs bacteria
when would you hear fine crackles
pulmonary edema
asthma
obstructive diseases
when would you hear coarse crackles
pulmonary edema
pneumonia
depressed cough reflex
when would you hear wheezes
asthma
bronchitis
chronic emphysema
when would you hear stridor
croup
epiglottis
any airway obstruction
** requires medical attention
emphysema s/s
hyperventilation, breathing fast, trying to blow off CO2
PINK PUFFER
- barrel chest
- thin weight loss
- SOB
- severe dyspnea
chronic bronchitis s/s
- mucus secretition
- chronic productive cough
BLUE BLOATERS
- cyanotic too much CO2, hypexemia
- peripheral edema
- rhonchi and wheezing
- chronic cough
COPD meds
bronchodilators first
corticosteroids second
buproprion
- asone
- inide
- olone
Pneumonia meds
antipyretics antibiotics antivirals bronchodilators cough suppressants mucolytic agents
status asthmaticus
life threatening asthma episode O2 HYDRATE NEBULIZATION SYSTEMIC CORTICOSTEROID
