RN Learning Systems Flashcards
Communication Dogs (You, Why, and I)
Dig for information, Tell the truth
NO YOU
NO Why?
Just I, and Clarify?
Disaster occurs… first 2 priorities.
- Follow facility plan 2. Clear departments of non-urgent clients.
3 key S/S of a MI
Sever epigastric and L arm pain + Diaphoresis
2 Contraindications for the Small pox Vaccine?
Infants Immunocompromised
Counter to nuclear/radiation terrorism
Potassium Iodide (Pima) Prevents thyroid gland from absorbing radiation, thus preventing cancer
Most important factor of hand hygiene?
Friction
Machine wigging out?
Restart or unplug/replug it.
Angry co-worker?
Address them like a patient, but DO NOT ease their workload. Otherwise, GIVE IT TO EM STRAIGHT!
Fresh Frozen Plasma. Function. What to monitor.
Rich in clotting factors used to treat acute clotting disorders. PT
3 Expected S/S: dissecting aortic aneurysm
Blood loss at the heart… Tachycardia (to make up for flow) Hypotension (blood loss) Back pain
3 Expected S/S: Fluid Volume Excess
Late S/S:
Jugular Vein Distention ↓ Hematocrit (↓ concentration b/c fluids) ↑ Heart Rate (make up for O2 flow)
Pitting Edema +3
CHF w/ mitral stenosis - Dyspnea is caused by…?
Fluid accumulation in the lungs (Heart can’t pump
The Heart
Excepted S/S: Right Sided Heart Failure
Peripheral Edema
Right side of heart is where venous return is.
Weakness r/in poor output. Because input backflows, it gets stuck in the periphery.
Expected S/S: Pericarditis
Dyspnea w/ a rapid RR
How often should a patient exercise….? for ANYTHNG, really.
3x a week
Expected S/S: MI 24 hrs ago
Ventricular Dysrhythmias
TX: Hemophilia
Replacement of missing factor
Expected S/S: Acute Angina Attack
Transient Abnormal PMI
Blunt chest trauma commonly damages this portion of the heart
Right Ventricle
2 Expected S/S: recent MI or CHF
Crackles, Frothy sputum
Post vein ligation, stripping, or any VENOUS op/issue. Position for the client.
Supine w/ legs elevated 15º
FX: Flaxseed Oil
Omega-3 Fatty Acids
INFO: How long does Epoetin Alfa (Epogen, Procrit) take to take effect?
2 - 4 weeks
Expected EKG S/S: Atrial Flutter
Drastically higher Atrial Rate (P) than Ventrical Rate (QRS)
3 Expected S/S: Aplastic Anemia
Pancytopenia (↓ of WBC, RBC, and platelets), fatigue, and pale mucous membranes
FX: Hemophilia
Poor blood clotting
TX: Malignant Melanoma
What do they look like?
What to assess before biopsies?
Surgical Excision
6mm bluish-red lesions
Regional lymph nodes
Secondary nutrient (next to protein) that aids in healing
Vitamin C
What do these look like:
Papules
Macules
Wheals
Vesicles
small, solid, elevated (up to 10mm, like acne)
flat, variable shapes (up to 10mm, like freckles)
transient elevated (like hives)
elevated, containing fluid (chicken pox/herpes)
FX: Biological Dressings
Promote healing
Wound healing types:
Primary Intention
Secondary Intetnion
Tertiary Closure
Surgical closure
Left open to close on own
Left open and closed surgically later
Post-burn healing, what to avoid for a year?
Exposure to the sun
ADFX: Sulfadiazine Cream (Silvadine) for burns
Leukopenia 2 - 3 days beginning TX
Sun protection: How often to reapply sunscreen and strength SPF to use.
q2hrs, after swimming
At LEAST 15
TX: Snake bite?!
Immobilize the limb below the level of the heart
S/S potential malignancy in a basal cell carcinoma of surrounding moles.
Ulceration of moles.
FX: Type 1 vs. Type 2 DM
1 - pancreas does NOT produce insulin
2 - cells are resistant to insulin
TX: Somogyi Effect
Monitor glucose @ night
Cause of Acromegaly
Overproduction of Somatotropin
3 Expected S/S of a Thyroid Storm
Fever, HTN, Abdominal Pain
Diabetes and Exercise:
What to wear
When to eat?
Requirement to NOT exercise?
Always wear a Medical Alert Identification tag when doing so.
Eat within an hour if during insulin peak time
If Blood Glucose is ↑250, don’t exercise
2 Key S/S: Diabetes Insipidus
Polydipsia (↑ thirst)
Polyuria (↑ urination) with low specific gravity
FX: Addison’s Disease
Diet:
Lack of cortisol production
↑ salt, carbohydrates, protein, ↓ potassium
Post-Operative, patient’s bowel sounds JUST return. What should first feeding be?
Water
Diverticulitis
Diet:
High fiber
Hepatitis A
Report:
Hepatitis B
Who gets the shot?
Anorexia - this occurs if liver releases toxins or it fails to detoxify an abnormal product
Infants and children
Shoulder pain post-laparoscopic procedures?
Caused by gas irritating the diaphram.
It will resolve in 1 - 2 days, but can be TX by mild analgesics and the recumbent position.
Pancreatitis:
Progression Amylase/Lipase levels
Amylase ↑ 3 - 6 hrs onset.
Peaks in 20 - 30 hrs, and returns to normal in 2 - 3 days.
Lipase stays elevated for 14 days longer than amylase.
Esophagoscopy:
Purpose
Determine how well the LES of esophagus works
Gamma-glutamyl Transferase (GGT)
Test used to determine possibility of alcohol use
Esophagogastroduodenoscopy
Purpose:
Visualization of Upper GI and cauterization of bleeding varices to prevent blood loss.
Balloon Tamponade for esophageal varices. How to react if pt becomes agitated, ↑ shallow RR?
Cut the tubing in front of the nose guard or sponge
2 Expected S/S: Bowel Perforation
Hypotension and Rigid Abdomen
Systemic Lupus Erythematosus (SLE)
3 Risk Factors:
How to TX wounds
Originates from what part of body:
Pregnancy, Infection, Sunlight
Apply moisturizer after bathing lesions in warm water
Connective Tissue
Expected S/S with Systemic Scleroderma
Finger contractures
Expected S/S: Kaposi Sarcoma
Reddish-purple lesions
Early & Late Lyme Disease (from ticks!)
S/S
Early S/S = progressive, circular rash
Late S/S = double vision, stiff/swollen joints
Expected S/S: Herpes Zoster
Unilateral, localized, nodular skin lesions
Most indiciative sign of a post-op infection?
Erythema at the site
Initial S/S: HIV vs. AIDS
HIV = flu-like symstomes (sore throat, fatigue, headache) AIDS = persistent fever, swollen glands, diarrhea, weight loss
Histamines
FX:
↑ mucous secretion
FX of… (besides infection, ofc…)
Neutrophils
Lymphocytes
Monocytes
Eosinophils
stress and inflammation
infection (also cancer/malnourishment)
several collagen disorders
hypersensitivty/allergic RX
Skeletal Traction: If the client slips down and the weights are on the floor?
Help the pt use the trapeze to pull self up in bed
Skeletal Cast
TX for itchyness?
Blow cool air on it
Rheumatoid vs. Osteoarthritis
Nodes with Osteo?
Systemic, Autoimmune, and Bilateral vs. Local
Heberden’s: distal, hard on bony swellings
Pulmonary Embolus
S/S
Tachycardia/pnea, Hypotension w/ rapidly dropping O2 Sat, post-fracture
Gout
Nodes?
Tophi
Alendronate Sodium
How to maximize absorption
Situp straight for 30 min
Eye surgery post-operative position
Prone w/ operated eye up
ADFX: Lasik Surgery (eye)
Halos and glaring when driving at night
Expected S/S: Autonomic Dysreflexia
A severe headache
Important piece of information regarding progression of neurological manifestations with an: Unruptured Arteriovenous Malformation (AVM)
Location of the AVM
TX: Swimmer’s Ear + External Otitis
Instill diluted alcohol in the ear after swimming
Goal of TX: Transient Ischemic Attack
Prevent a CVA
Intracranial Pressure
2 Sign’s that it is worsening
Widening blood pressure (160/65)
↓ pulse rate