S/S Flashcards
myasthenia gravis s/s?
myasthenia gravis s/s?
We see diplopia, ptosis, impaired speech, dysphagia, respiratory distress
Hyperparathyroidism
Back/joint pain and pathological fractures
Hypoparathyrodism
CATS: convulsions, arrythmias, tetany, spasms, stridor
Hypovolemia
Increased temp Rapid/weak pulse Increased respirations Decrease BP Anxiety Urine specific gravity >1.030
Hypervolemia
Fluid overload
Bounding pulse SOB Dyspnea Rales/crackles Peripheral edema HTN Urine specific gravity <1.010
If we suspect digoxin toxicity, what lab value should we check as a hidden sign
Magnesium could be low causing this!
When drawing up regular insulin with NPH, which order do you draw them up?
RN!!
Regular before NPH
Which disease should you avoid when you are pregnant?
German measles! AKA Rubella
S&S of Neuroleptic Malignant Syndrome
Think S&M
You get hot (hyperpyrexia) You get stiff (increased muscle tone) You get sweaty (diaphoresis) BP, Pulse and Resp inrease Start to drool!
What do we do as the nurse for neuroleptic malignant syndrome
Immediately withdraw anti-psychotic meds (like Haldol)
Control hyperthermia
Hydration
Give Dantroline and Bromocriptine
ICP vs Shock vital signs
ICP: High BP, low pulse, low respirations
Shock: Low BP, high pulse, high respirations
Diet of a premature infant?
What do they need more of ?
What supplements do they need?
100-200 kcal/kg/day
Need more sodium, calcium, and protein than full term infants
Supplements: Vitamin A, C, D, and iron. Sometimes Vitamin E. Vitamin K to prevent clotting problems
How many diapers for a full term infant
6-8 wet diapers and one stool daily
Diet of a full term infant
120 cal/kg/day
Human milk is ideal for first 0-12 months
IF using formula, should me for 12 months, before going to regular cows milk
Introducing a child to table foods: 1-4 months they can have what supplements?
Liquid vitamins only (A, C, D, and fluoride if indicated)
Introducing a child to table foods: 4-5 months they can have
Cereal (usually rice cereal first)
Strained fruits next
Introducing a child to table foods: 5-6 months
Strained veggies
Strained meat
Introducing a child to table foods: 7-9 months:
Chopped meat,
hard breads and “finger foods”,
baked potato and mashed potato
Diet for toddler through adolescent should be
High protein and high calcium
Allow the toddler to pick foods to avoid an argument (we just want them to eat! Anything!)
Diet for adolescent
Caloric, protein and calcium is high!
For adolescent girls that are menstruating, we need to increase their iron
Must have high minerals and high vitamins
Where do we get pulses for CPR in an adult and infant
Adult: Neck (sternoceidomastoid)
Infant: Arm (Brachial)
What is cor pulmonale?
What causes it?
Abnormal enlargement of the right side (right HF) of the heart as a result of disease of the lungs or the pulmonary blood vessels (left heart failure).
Choose Edema or JVD if its a choice
Additional calories needed for a pregnant woman, and then for a lactating woman
Extra 300/day for a pregnant woman
Extra 500/day for a lactating woman
Difference between Enteral nutrition and Parenteral nutrition
Enteral goes to the stomach via G-tube or something
Parenteral goes through the heart straight into the cells
What do we do if the Parenteral nutrition needs to be stopped immediately or the new feeding bag is not ready on the unit
Hang D10% so we can keep the patients sugars in check and they don’t suddenly go hypoglycemic
Anuria vs oliguria vs polyuria vs dysuria vs enuresis
Anuria = <100 ml in 24 hours (basically nothing) Oliguria = 100-400 ml in 24 hours Polyuria = >2000 ml in 24 hours (too much!) Dysuria = painful or difficult voiding Enuresis = bed wetting in a child over 5 (usually have small bladder and more common in males)
Kegel exercises
Used to strengthen muscles of pelvic floor
Tighten pelvic muscles for a count of 3, then relax for a count of 3. Do this lying down, sitting, and standing for a total of 45
Toilet training time schedule
Never begin before 18th month
2-3 years: bladder control reflex achieved
3 years: regular voiding habits establisted
4 years: independent bathroom activity
5 years: night time control expected
Neprolithiasis
Kidney stones
Uterolithiasis
Stones in the ureter
Causes of kidney/ureter stones
Obstruction and urinary stasis Hypercalcemia Dehydration Immobility Gout
What do we do as the nurse for kidney stones
Monitor I&O and temp
Avoid over hydration and under hydration
Strain the urine and check the PH
Give analgesics
Diet for prevention of stones
Low calcium
Low sodium
Low in oxylates (spinach, cola, tea, chocolate)
No vitamin D (increases calcium absorption)
Low organ meats
Drugs for stones
Broad spectrum antibiotics
Thiazide diuretics
Allopurinol
Vitamin B6 (pyridoxine)
Extracorporeal Shock wave therapy
Non-invasive treatment of the kidney using an acoustic pulse.
Teach patient to report fever, decreased UO and pain
Hematuria is expected but should clear within 24 hours
Cystitis
Inflammation of the bladder
Urinary frequency, burning on urination, cloudy/foul smelling odor
What do we do as nurses for cystitis
Get a clean catch for testing
Encourage 3000ml of fluid a day
Give cranberry juice / urinary acidifiers
Void every 2-3 hours
Teach females to void after intercourse and to wipe from front to back
Pyelonephritis
Inflammation of the kidney caused by a bacteria
Chills, fever, malaise, flank pain, urinary frequency, dysuria, CVA tenderness
What do we as nurses do for Pyelonephritis
Bedrest during the acute phase
Antibiotic therapy, antiseptics, analgesics
Encourage 3000ml/day
Continuous ambulatory peritoneal dialysis
Client performs self-dialysis 7 days a week 24 hours a day
Dialysis is warmed (using heat pad), then infused and then dwell time is 4-8 hours
Tubing and bag is disconnected or rolled up and worn under the clothing
After the dwell time, the fluid is drained back into the bag and then the process is repeated
What do we do as the nurse for sleep apnea syndrome
Avoid alcohol and meds that depress the upper airway
Talk about weight loss and diet
CPAP or BiPAP
Surgery
Low-flow O2
Position (fixing devices are used to prevent subluxation of the neck and tongue obstruction)
