Reproductive and Final Flashcards
Chlamydia Treatment and most common symptom
One large dose of Azithromycin pain
What is it called when a doctor can give a drug to a sex partner?
Expedited partner therapy
Which STI do they treat in infants?
Gonorrhea
What is the most common s/s of gonorrhea?
Purulent drainage
Tx for Gonorrhea
You need at least two antibiotics azithromycin and IM ceftriaxone
Trichomoniasis most common s/s and treatment
Itchy PO metronidazole
What drug for STI do you need to not drink on?
Metronidazole
What is the sore in syphilis called?
Chancer
4 stages of syphilis and what happens in them
primary- chancer
Secondary-Rash flu like symptoms
Latent-no symptoms
Tertiary- organ damage
two things to remember about syphilis
contact precautions and transmit to fetus and have lots of problems.
2 risks for herpes outbreak
Sunburn and menstruation
One thing that can help with herps
sits bath
Stages of Herps and what happens
Prodromal-Tingle
Vesicular-Blister
ulcerative-Blister pops
final -Crusting
What STI is non reportable?
HPV
Mastaliga and One thing
Breast pain can be cyclic or not
Mastitis usually from
Breast infection staph
Fibroadenoma 3
Well delineated lumps can move found in 20 and 30 usually go away after menopause.
Fibrocystic changes 4
30-50 umbrella term one or more lumps, can get worse around period
When does annual breast exam start? one consideration
45 but earlier if risks
when does biennial breast screening start?
55
2 pathophys of benign prostatic hyperplasia
DHT and higher estrogen stimulates cell growth
4 things BPH can cause
UTI, kidney stones, retention, hydronephrosis
3 meds for BPH and what do they do?
5a reductase inhibitors- reduce size
alpha adrenergic receptor blockers
Erectogenics-ED
One nursing consideration for a BPH med and what is the med?
Orthostatic hypotension and alpha adrenergic receptor blockers.
TUIP vs TURR
sm incisions
Remove tissue
Causes of res acidosis 4
decreased respirations (asthma, drug over dose)
COPD
Pneumonia
Atelectisis
Causes of res Alk 4
Anxiety/fear, PE, mechanical vent
Symptoms of both resp alk and acid 3
Rapid breathing, Decreased BP N/V
Opposites What is Acid 3
Hypoventilation, shallow res, hyper kalemia,
3 signs of Ac and Ak that are not opposites
Acid- decreased BP and vasodilation, mm weakness, dysrhythmias
Alk- numbness and tingling, lethergy and confusion, tachy
Causes of plural effusion 4
Anything that causes permeability, build up of fluid, trauma, TB
Manifestations of a plural effusion that you don’t know 3
acidotic, empyema, inhale pain
COPD causes hyperplasia of goblet cells cause
increase mucus, decreased diameter of airway, difficulty secretions, decrease in cillia, alveolar walls and inflammation causes airway remodeling
What happens to diaphragm and blood with COPD
diaphragm flattens, polycythemia
3 things about asthma that you didnt know
aspirin and gerd can induce expirations may be longer
peak flow meter values
green-80-100
yellow 50-80
red 50 and below.
drug choice for step one
SABA
drug choice step two
Low dose ICS Inhaled cortico steroids with SABA
Drug choice step three
low dose ICS/LABA
Drug choice step four
med/high ICS/LABA
Anticholenergic name
Atrovent
Atrovent considerations 2
not for late asthma less than twice a week
LABA name
salmeterol, Foradil, servent
LABA considerations
for mod-severe
never use alone for asthma
What to use for moderate COPD
LABA- can be used alone and corticosteroids but not for long term
What is SABA Give example and when not to use?
Short Acting Beta 2 adrenergic agonist proair cardiac
What is SAMA give example and when not to use?
Short acting muscarinic antagonist Ipratropium narrow-angle glaucoma
3 things to know about corticosteroids
Oeteoporosis, take in am with food, not a rescue inhaler,
How is TB Spread
Through airborne droplets
What is a Ghon lesion?
calified TB granuloma
oliguria and value
Low urine output less than .5ml/kg/h
Anuria and value
No urine output less than 50ml/day
Normal urine value
0.5-1.0ml/kg/hr
Chloride level
97-107 mEq/L
Potassium level
3.5-4.5mEq/L
Calcium level
8.6-10.2 mg/dl
phosphate level
2.4-4.4g/dl
Plasma osmolality range
275-295.
3 isotonic solutions
0.9% lactated ringers and 5% dextrose(Special) D5W
2 hypotonic solutions
5%dextrose D5W(Special) 0.45 NAcl half normal saline
hypertonic solution 1 plus???
3 percent saline, dextrose 5 added to anything or dextrose 10 and up with water
Normal saline 4 things you would use it for that you don’t know
2
mild hyponatremia, metabolic acidosis, hyper ca+ can cause hyperchloremia.
when to use lactated ringers 3 things that go together and one other .
Burns, trauma, third spacing. Large gi or fistula drainage
Don’t administer lactated ringers to 3
Lactic acidosis, ph greater than 7.5, liver fail
5 percent dextrose 2 things to remember and one thing to use it for
dont use alone and not great for nutrition severe hypernatremia
when to use 1/2 strength when not to
hypernatremia, avoid liver disease burns trauma
Aldosterone and ADH do what what keeps what?
Aldosterone- keeps Na and H2O and lets go of K
ADH-keeps H2O
What electrolyte goes with Na?
Cl
Relationship between K and pH
K is acidic
Three things that can tx hyperk+
Insulin, dialysis, loops
Hypoca+ S/s
CATS Convulsions Arrhythmias Tetany Stridor/Spasms
Hyperca+ S/S 4
Stones, groans, moans, Sedative
phases of AKI
Oliguric, Diuresis, recovery
Olugaric urine number and specific gravity and what does that mean?
Less than 400ml/day 1.010 kidneys can’t concentrate urine.
Why is there an increase in urine output in the diuresis phase?
Because of the oncotic pressure from the o stage
What function is lacking in the Diuresis stage?
urine concentration
Normal BUN
Less than 20
What to know about Creatinine and AKI
May not show up until 50% is gone
Normal creatinine clearance level
less than 70
4 stages of shock names
initial, compensatory, progressive, refectory
how to calculate MAP
SABP+2DABP/3
what value of MAP indicated adequate tissue perfusion
60mmHg
Manifestations of anaphylaxis 2 you really need
incontinence, purritus (itch) uricaria(hives) angioedema, metallic taste, n/v/pain
steps for anaphylaxis four words and 7 steps
Stop-call-assess-prepare
stop, call. 02. saline flush. maybe start 2nd iv assess epi
What do biguanides do and give a name 3
Metformin primary is to decrease glucose production in the liver, enhance insulin sensitivity, improves glucose transfer
metformin can be used to blank age and blank
prevent DM in people younger than 60 with risk factors
two other things metformin can help with
weight loss and lower cholesterol
Metformin is contraindicated in people with 3 because?
Kidney disease, liver disease, heart failure, lactic acidosis
names of sulfonylureas 3
Glipizide, glimepiride, glyburide
what do sulfonylureas do 3
increase insulin production from pancreas, stimulate sustained insulin release, lower A1C
What to watch for with sulfonylureas 2
hypoglycemia, weight gain
meglitinide name and what does it do why is it better and when to take?
prandin stimulates rapis insulin release more rapidly absorbed than sulf (causes less hypo) and before meals
Normal Cerebral Perfusion Pressure
60 or 70mmHg-100mmHg
Decorticate positioning and what does it mean?
flexed and in (don’t forget about legs) and it means that there are problems with cervical spinal tract or cerebral hemisphere
Decerebrate positioning and what does it mean?
Extensor problems within midbrain or PONS
things the Glasgow coma scale assesses and when is it a problem
Eye opening, verbal response, Motor response. less than 8.
Cushings triad
Increase in systolic BP, decrease in pulse, decreased respirations.
Bacterial meningitis differences 5
Turbid, purulent, higher protein levels, glucose is decreased, neutrophils
Three things that can cause gerd?
Hiatal hernia smoking obesity
Manifestations of GERD 5
hyper salvation, respiratory, otolaryngologic-horseness, globus sensation, chocking
Treatment for GERD
PPI (Zoles) H2 receptor blockers (ines), cholinergic, prokinetic (Metoclopramide)
PUD 3 things
Erosion of GI mucosa from HCL and Pepsin. any point in GI tract, chronic
PUD etiologi 5
Acidic environment, H pylori, meds, lifestyle, stress
manifestations of perforation 5
Rigid board like ab, shallow fast respirations, shock. maybe febrile
Difference between Ulcerative and crohns? 1
UC-colon and rectom
Crohns and segment of GI
Crohns 3 things
Old cronies skip, inflam of all layers, long ulcerations that pen mucosa
one thing about UC
BLEEDING
What can develop with crohns?
Fistulas
Common symptoms of crohns 5
diarrhea usually not bloody, cramping. nutritional def, weight loss when sm in is involved, system symptoms.
UC manifestations 8
bloody diarrhea up to 20 times a day, ab pain. anemia, fever, rapid weight loss, tachy. dehydration. tenesmus
What is ammonia?
normal level?
Increased level shows, leads to blank and blank.
Toxic product of protein breakdown and is turned into urea and excreted through the kidneys.
15-45mcg/dl
shows liver dysfunction, leads to neuro problems and hepatic encephalopathy.
Hep A how do you get it? How do you prevent it? one more thing? Therapy?
I Ate it food, milk,water from f-o Vaccine no chronic None but can use immunoglob
Hep B how do you get it? How do you prevent it? one more thing? Therapy?
Blood or Body fluids
vaccine hand washing avoid fluids
Usually recover
Hep C how do you get it? How do you prevent it? one more thing? Therapy?
sex and blood and drugs
screening decrease risky behaviors
currently no vaccine
antivirals that block protein for replication
two things to remember about HIV and the liver
HIV meds are hepatotoxic and Hep C and HIV are a terrible combo,
cataracts loss of
general vision
Patho cataracts
change in lens fiber structure age and trauma
s/s 4 cataracts
deploplia, absent red reflex, decrease visual accuity, photo sensitivity
phacoemulsification
for cataracts break it up and suck it out
extracapsular
for cataracts incision take out without break up
symptoms of detachment 3
floaters, light flashes (photopsia) cobwebs
macular degeneration
irreversible central vision loss
Primary open angle glaucoma caused by s/s 2
Caused by clogged drainage channels gradual, tunnel vision
Accute angle closure glaucoma caused by s/s 3 and is a
pupil dilation or lens bulging pain, colored halos, blurred vision emergency
treatment of Glaucoma 3
miotic/cholinergic to constrict pupil hyperosmotic to draw fluid out surgery
6 ps of compartment syndrome
pain, pressure, paresthesia, pallor, paralysis, pulselessness
fat embo syn one s/s and time
Petechial rash usually 24-48 hours
Rhabdomyolysis
Damaged mm cells releases myoglobin in blood stream
Risks for osteoporosis 8 you don’t know
estrogen, excessive alcohol, corticosteroids, low testosterone, heparin, thyroid replacement, anti seizure meds, long acting sedatives.
3 s/s of OA
Crepitation, asymmetrical, localized
9 s/s hypothyroidism
prolonged DTR, hoarseness, thick cold skin, distended ab sensitivity to ops, barbs, anesthesia ,enlarged tongue, mm aches, joint pain
hyperthyroidism s/s 5
Like you just got done with a run, acropachy, exopthalmos, spino/meglo, vertigo.
RBC value
4.7-6.1 mil per microlt
Hgb value
12-18
Hct value
36-50%
WBC value
4,500-11,000
Platelets value
150,000-450,000 platelets per microlt
megaloblastic anemia
impaired DNA synthesis have large RBC so they can be destroyed easily
Pernicious anemia 3 + one s/s
absence of intrinsic factor, insidious onset, more neurological symptoms plus symptoms for anemia beefy red tongue.
What does the intrinsic factor do?
helps absorb vit b
Aplastic anemia risk for? 3
auto-immune that targets blood cell production Infection bleeding, shock
Acquired hemolytic anemia is and can cause 3
Normal RBC but external forces are causing damage jaundice, spleen and liver enlargement because of hyperactivity.
CAD risk factors 7
HTN, Smoking, hyperlipidemia, hyperhomocysteinemia, diabetes, infection, toxins
What causes angina?
02 demand on heart
What do beta blockers do?
improve contractility
What do calcium channel blockers do?
Arterial Dilator decrease afterload
What do nitrates do?
Help with preload venodialator
two signs of crisis HTN
Headache and nose bleed
HFrEF is blank during blank caused by blank the tissue is blank
reduced ejection, systolic, impaired contractility (MI) increased afterload (HTN) hypertrophied cant squeeze
HFpEF is blank during blank caused by blank
Preserved, diastole, can’t relax, thickens, no room for blood to come in.
SV?
Stroke volume is amount of blood pumped during systole
Skin with PAD 4
Thin, shinny, tight, hairless
