Set 4 Flashcards
Retinoblastoma
Retinal tumor common in children, typically under 2.
Signs:
-white glow of the pupil instead of red
-strabismus (misalignment of the eyes)
Characteristic of glaucoma
Fixed, mid dilated pupil
UAP role during blood transfusions
UAP can take vitals before transfusion and anytime AFTER the first 15 minutes of the transfusion. RN must do initial vital signs to monitor for reactions.
Suctioning and mechanical ventilation
Suction when REMOVING the catheter, not inserting.
Veracity
Duty to always tell the truth
Tetracycline administration
Used for acne
- Take on empty stomach but with full glass of water
- Avoid dairy or antacids
- Wear sunscreen
Trigeminal Neuralgia
Sudden sharp pain along trigeminal nerve. Nerve ends are around eyes, nose and mouth. Pain can be triggered by washing face, brushing teeth, chewing food, talking, yawning, etc.
Drug of choice is Carbamazepine. This is a seizure medication but is effective for neuropathic pain. Increased infection risk with use of carbamazepine!
Filgrastim
Used to increase neutrophil count in clients with malignancies (cancer growth) and undergoing chemotherapy
Aminoglycosides
gentamicin, tobramycin, amikacin
Used to treat serious infections. Huge risk for irreversible nephrotoxicity, so monitor renal values during administration
When to shock
Only provide defibrillator shock when pt is in Vfib or pulseless Vtach
Asystole
Flat line. No electrical activity present
Benztropine
Used to treat extrapyramidal side effects such as:
pseudoparkinsonism and dystonia (abnormal movement of face, neck and trunk)
Nephrotic syndrome
Caused by glomerular injury 4 classic manifestations: -proteinurea -hypoalbuminemia -edema -hyperlipidemia
Ankylosing spondylitis
Inflammatory disease affecting the spine. No known cause or cure. Characterised by stiffness and fusion of axial joints leading to restricted spinal mobility.
- sleep on your back with firm mattress to stretch out spine.
Insulin and IV push
Regular insulin is the only insulin allowed to be administered IV push!
Phenytoin therapeutic range
10-20
Eardrops in children administration
Pull DOWN AND BACK in children <3 years old
Up and back for all children >3.
Place children in supine or prone position with head turned to the side
Calcium gluconate
Antidote for magnesium toxicity.
Also used to treat sever hyperkalemia
BP during pregnancy
BP has a slight decrease during the first trimester and reaches the lowest point at 24-32 wks gestation then increases back to baseline during 3rd trimester.
An increase of BP >30 SBP or >15 DBP requires further assessment.
Herbal remedies that increase bleeding risk
G's! Ginko Garlic Ginseng Ginger
Desquamation
Peeling skin - normal finding in newborns
Fluid of choice for burn victims
Lactated Ringers
Sildenifil
Viagra - Vasodilator
Neonatal abstinence syndrome
Opioid withdrawal in newborns. Manifestations:
- Irritability, restlessness, high pitched cry
- Sweating, sneezing, nasal congestion
- poor feeding, vomiting, diarrhea
Signs of down syndrome (trisomy 21) in newborns
Floppy muscle tone
Cleft palate
Sign of early prenatal exposure to teratogenic agents: alcohol, cytomegalovirus, valproic acid
Hypothermia
Heart becomes prone to dysrhythmias - spontaneous V-fib could develop when moved or touched
ACE inhibitors and pregnancy
ACE inhibitors are the “prils”
CONTRAINDICATED in pregnancy
Albumin
3.5-5.0
Albumin is assessed to evaluate nutritional status
Preeclampsia
Development of HTN during pregnancy and proteinuria - must have both
Head tilt/chin lift maneuver
Do not use in pt with potential spine injury - use the JAW THRUST TECHNIQUE
Suctioning tracheostomy technique
- Preoxygenate with 100% oxygen
- Suction only while withdrawing the catheter!
- Use sterile technique
- Limit suctioning to <10 seconds
Acute pancreatitis
NPO!
-Use suction via nasogastric tube
Infectious MONOnucleosis
Caused by the Epstein-Barr virus (EBV)
Spleen rupture is a major complication. Watch for abdominal pain as that can indicate hepatomegaly and splenomegaly
Reye syndrome
Usually occurs after a viral infection such as the chicken pox or the flu, especially if they have been taking ASPIRIN.
Airborne precautions
N95!!! Varicella (chicken pox) Herpes Zoster (shingles) TB Measles
Ankylosing spondylitis characteristic
Early morning low back stiffness
Scleroderma
Thickening of the skin
Foods high in Vit K
Spinach, Broccoli, Liver
Avoid foods high in vit K with blood thinner therapy
Gonorrhea and Chlamydia
Lead to pelvic inflammatory disease and infertility
Neonates and cold stress
Unable to shiver
Dextromethorphan
Cough suppressant
Lead poisoning
Affects the neurological system and the kidneys
Adenosine
Treats supraventricular tachycardia
Torsades de pointes
“Twisting of the points”
Ventricular tachycardia characterized by QRS complexes that change size and shape in a characteristic twisting pattern.
Treatment: IV Magnesium
Pt with epilepsy and an aura
An aura is a sensory perception that occurs prior to having a seizure
Acetylcysteine
Bronchodilator used to help loosen secretions when given via nebulizer
Synchronize button when performing cardioversion
Very important that you push the synchronize button so it delivers the shock at the appropriate time.
Turn it off when the pt is pulseless
Thiamine deficiency
Results in Wernicke Encephalopathy
Thiamine deficiency occurs in pt’s with alcohol intoxication
Myelomeningocele
Type of spina bifida
Airborne precautions
Do not need to wear gown or googles/eye protection Infections that are airborne: TB Rubella (Measles) Herpes Zoster (shingles) Varicella Zoster (chicken pox)
Calcium and iron administration
Do not administer Calcium or antacids within 1 hour Iron! Decreases absorption
Bathing clients with MRSA
Use chlorhexidine solution in warm water or pre moistened cloths
Saw palmetto
Hawthorn Extract
St. John’s Wort
Saw Palmetto: Herbal supplement used to treat BPH
Hawthorn Extract: Herbal supplement for HF.
St. John’s Wort: Herbal supplement for depression
Caring for newly circumcised newborn
Clean with warm water (no soap, no alcohol-based wipes)
Lobes of the brain and what they control Frontal Parietal Temporal Occipital
Frontal: Behavior
Parietal: Sensory
Temporal: Hearing
Occipital: Vision
Signs of increased intracranial pressure
Bulging fontanelles
Sunset eyes
Increased head circumference
SSRI’s and MAOI’s
Do not take concurrently! Wait 2 weeks in between.
Major SSRI’s
Fluoxetine
Sertraline
Paroxetine
Citalopram
Growth hormone replacement therapy administration
Subcutaneous injection
Decerebrate posturing
Toes pointed downwards… indicates severe brain damage
Hepatitis A
Transmitted through fecal-oral route - WASH HANDS!
Kosher diet
No dairy or meat within 3 hours of each other
Lithium therapeutic index
0.6-1.2
>1.5 is considered toxic
Fifth disease
Viral infection common in school age children. Red rash on face. Infectious before symptoms appear, not infectious once rash appears. Usually lasts 7-10 days
Strabismus
Cross eye.
Treated by wearing patch over stronger eye
Warfarin
Does not begin to take effect until 48-72 hours then takes even longer to reach maximum effect. Heparin may be given at the start of warfarin therapy.f
Antidotes for warfarin and heparin
Warfarin = Vitamin K Heparin = Protamine Sulfate
Ventricular tachycardia
Pulse = treat with medications such as amiodarone
No Pulse = treat with cardioversion
Macular degeneration
Retinal detachment
Glaucoma
Macular degeneration is loss of central field of vision
Retinal detachment is seeing flashes of light
Glaucoma often causes tunnel vision (poor peripheral vision)
Testicular torsion
Emergency situation. Twisting of the spermatic cord leading to testicular ischemia and necrosis. Must be untwisted within 4-6 hours.
Manifestations: Edema and severe pain
IM injections in children
Do not use ventrogluteal site in children <3.
Vastus lateralis muscle preferred (anterolateral thigh)
Trismus
Inability to open the mouth due to a tonic contraction of the muscles used for chewing
Complete heart block
Same as 3rd degree heart block
Atria and ventricles contract independently
Addison’s disease skin
Bronze hyperpigmentation
Vitiligo (white patches)
Patchy/blotchy skin
Characteristics of cushing’s syndrome
Purple striae
hirsutism (increased body and facial hair)
Buffalo hump (supraclavicular fat pad)
Risk factors for preterm birth
INFECTION (UTI, periodontal disease, etc)
Cyanide poisoning
A bitter almond smell on patient’s breath is a classic sign.
Synchronization button when delivering shock
Delivers a shock on the R wave of the QRS complex. Do not turn on during Ventricular fibrillation as there is no QRS complex! Turn on during: -supraventricular vtach -Vtach with a pulse -Afib with rapid ventricular response
Allergy to latex
Can be manifested by lip swelling when in contact with bananas, kiwis, or latex balloons
Allergies to vaccine components
neomycin, gelatin, yeast
Latex allergies
Lithium toxicity
Therapeutic range: 0.6-1.2 >1.5 is considered toxic Ways to prevent lithium toxicity: Avoid sodium depletion Drink a lot of fluids
Percussing lungs
Hyperressonance is heard with pneumothorax and emphysema
Dullness is heard with a pleural effusion, pneumonia, or atelectasis
Stoma color
Pink! It should never be dusty or grey colored. That indicates inadequate oxygen
Testing creatinine clearance
24 hr urine collection
Urinalysis and culture and sensitivity tests
First AM void is preferred - more concentrated urine
Clean catch or midstream urine sample
Meningitis precautions
DROPLET precautions
Bedrest with HOB 10-30 degrees
High risk for seizures - seizure precautions
Status epilepticus
Prolonged seizure… longer than 5 minutes. Characterized by: dazed appearance, grunting, not responding. First intervention is to administer IV or rectal benzodiazepines (diazepam or lorazepam)
Proton Pump Inhibitors
PPI's -esomeprazole -omeprazole -pantoprazole Long term use decreases absorption of calcium and promotes osteoporosis
Dumping syndrome
After a partial gastrectomy... gastric contents empty too rapidly into the duodenum causing a fluid shift.... hypotension, tachycardia, sweating, pain, dizziness... To prevent: -Lay down after eating -Eat small frequent meals -Eat high protein and high fat meals -No fluids with meals -Avoid simple carbs
Primary cause of bladder cancer
Cigarette smoking or other tobacco use
Painless hematuria is the tell tale sign of bladder cancer
Hepatitis B transmission
Blood, semen, vaginal secretions
Duloxetine
SSRI
Has both antidepressant and pain-relieving effects
Fibromyalgia
Chronic pain with multiple tender points throughout the body
Ruptured appendix
Pain is relieved when ruptured, but full blown sepsis and peritonitis comes shortly after.
Codeine
Cough suppressant!
Filgrastim
Stimulates Neutrophil count
Normal bilirubin
0.2-1.2
Aphasia
Loss of ability to understand or express speech caused by brain damage
One TBSP in ML
1 TBSP = 15 mL
Lithium toxicity risk factors
Dehydration
Decreased renal function (in elderly)
Diet low in sodium
Drug-drug interactions with NSAIDS and thiazide diuretics
24 hr urine collection
Use a dark jug with powder to collect to protect the urine from light
Ace inhibitors and pregnancy
-prils
Do not take during pregnancy! Teratogenic
Addison’s disease
Not enough steroid hormones Symptoms: -weight loss -muscle weakness -low BP -hypoglycemia -hyperpigmented skin
Polycythemia vera
Too many RBCs are produced increasing blood viscosity.
Thrombus formation a big risk
Celiac disease… foods they can’t eat
BROW Barley Rye Oats Wheat
Levetiracetam
Treats and prevents seizures
MMR vaccine fun fact
You can administer within 6 days of exposure to MMR.
Recommended for children ages 12-15 mo
ACE-inhibitors
-prils
Can cause LIFE THREATENING angioedema
Lactase deficiency
Lactose intolerant
NSAIDS
Indomethacin and meloxicam are also NSAIDS.
NSAIDS increase bleeding risk!
Fat embolism
Defining characteristic is a fat embolism
Statin’s adverse reaction
Myopathy - Muscle aches and weakness
BNP
Elevated in HF!
>100
Meningitis
DROPLET precautions
Glaucoma vs macular degeneration vs cataract
Glaucoma: Tunnel Vision
Macular degeneration: Loss of central vision
Cataract: Blurry vision
Desmopressin
Synthetic form of ADH. Used to retain fluid
Flumazenil
Antidote to reverse sedative effects of benzodiazepines
Benzotropine
Treats extrapyramidal effects of antipsychotics
Chronic CHF
Symptoms of both Right and Left HF!
Amnioinfusion
Relieves VARIABLE decelerations
Mannitol
DIURETIC
Preterm labor risks
Infection such as UTI or periodontal disease History of spontaneous preterm birth Previous cervical surgery Tobacco or drug use <17 or >35 Maternal undernutrition
Asterixis
Flapping tremor of the hand seen in encephalopathy
Meningocele
Type of Spina bifida
-Sac like protrusion coming from the spine containing CSF and meninges
Hemophilia
BLEEDING DISORDER
Codeine
Cough SUPPRESSANT
-You don’t want to suppress a cough when you want to get rid of secretions
Hemorrhagic stroke
Blood vessel bursts in the brain causing bleeding into the brain
