Study Guide Flashcards
Pre-Diabetic Blood Sugars
100-125 mg/dl; Nurses must teach about lifestyle changes to lower blood glucose. Oral hypoglycemic is an option at this point
How is blood sugar treatment effectiveness evaluated?
Hemoglobin A1C, glycosylated hemoglobin
What are normal blood sugars?
70-99 mg/dl
What blood sugars will a patient with hypoglycemia present? Why is this important?
Below 70 mg/dl. Hypoglycemia is more of an emergency than hyperglycemia, hypoglycemic patients should receive priority with nursing care
What is diabetes insipidus?
Related to lack of ADH; patient will have extremely high urinary output, causing patient to use restroom multiple times a day
What are symptoms of Cushings?
Hyperglycemia, elevated blood pressure, mood swings, gastric ulcers and decreased immunity
What is the onset of Humalog/lispro insulin?
Starts working in as early as 5-15 minutes
What does predinisone require tapering?
Glucocorticoid drug; should be tapered down if needed to stop medication to avoid adrenal insufficient crisis which can lead to circulatory collapse
What is the treatment for diabetes insipidus?
Synthetic form of ADH such as desmopressin or vasopressin
What is myxedema?
Group of symptoms associated with hypothyroidism, includes fatigue, weakness, muscle cramps, cold intolerance
What is Addison’s Disease?
Refers to primary adrenal insufficiency; leads to symptoms such as syncope, weakness, fatigue, and darkness of skin
What therapy is used to treat hyperthyroidism?
Iodine 131
What is seen with primary hypothyroidism diagnosis?
Low levels of T3 and T4, high levels of TSH
What is important patient education regarding migraines?
Choose a quiet and dark place when the headache begins
What should a nurse do if a patient is presenting a tonic clonic seizure?
Ensure patient safety, assess patient for injury, observe and note details of seizure and after seizure
What is status epilepticus?
Seizures that last greater than 20 minutes, medical emergency; nurses must give one of the abortive medications like gaba potentiator drugs such as Ativan or Valium IV
What is an adverse effect of overmedication of antiparkinson drugs?
Uncontrolled head movements (bobbing), must report to provider
What is necessary for a patient presenting with uncontrolled tonic clonic seizures?
Padded side rails, must be placed on oxygen mask, must have suction tubing available in the room
What is decorticate posturing?
Type of abnormal posturing which can take place in response to stimulation with internal rotation, adduction, and flexion of the arms
What is mannitol?
Osmotic diuretic which can be given to patients that require their intercranial pressure to be lowered; ICP must be monitored
What should nurses implement first with increased ICP?
Keep head of bed elevated to 30 degrees to improve drainage
What is suspected of clear drainage discharge with head injury?
Clear drainage from the nose or ears must be checked for glucose content, indicative of leaking CSF
What is the main concern with concussions?
Risk of epidural hematoma; sleeping should be avoided because this is an epidural bleeding and they may not wake up
What should patients at risk of increased ICP avoid?
Suctioning unless extremely necessary, coughing or bearing down if constipated will also increase ICP
LOC deterioration
REQUIRES IMMEDIATE ACTION, pt is deteriorating
Why is viral load checked when patients are started on antiretroviral therapy?
Providers can see the effectiveness of the therapy
What should be watched with antibiotic IV?
Pt complains of shortness of breath and itching, discontinue immediately
What cross sensitivity is possible with penicillin allergies?
Cephalosporin, question if doctor prescribes for patient with penicillin allergy
What do nurses check with insulin IV administration?
Patient potassium levels, potassium is shifted inside the cell
What are signs and symptoms of Parkinson’s disease?
Stooped posture, slow, shuffling, propulsive gait, slow , monotonous speech, tremors/pill-rolling tremor of fingers, muscle rigidity, bradykinesia/akinesia, masklike expression, difficulty chewing and swallowing, drooling, dryarthria, progressive difficulty with ADLs, mood swings, cognitive impairment
What medications are used to treat Parkinson’s?
dopaminergics (levodopa) to increase dopamine levels, dopamine agonists (bromocriptine [parlodel], ropinirole [requip], and pramipexole [mirapex]) to activate release of dopamine anticholinergics (benztropine [cogentin], trihexyphenidyl [artane]) to control tremors and rigidity COMT inhibitors (entacapone [comtan]) to decrease breakdown of levodopa to make dopamine more available in the brain antivirals (amantadine [symmetrel]) to stimulate release of dopamine, prevent reuptake
Glasgow Coma Scale
Eye opening 4-1
spontaneous, sound, pain, does not occur
Verbal 5-1
coherent/oriented, incoherent/disoriented, spoken words/inappropriate, sounds without words, does not occur
Motor 6-1
follows commands, local reaction to pain, general withdrawal to pain, decorticate posture, decerebrate posture, does not occur
CDC definition of AIDS
Characterized by life-threatening opportunistic infections, end stage of HIV infection; without treatment, death occurs within 5 years
Difference between HIV and AIDS
HIV is retrovirus transmitted through blood and body fluids; AIDS is end stage infection of HIV; all people who have AIDS have HIV but not all people who have HIV have AIDS
How is HIV transmitted?
Unprotected sex, multiple sex partners, occupational exposure, perinatal exposure, blood transfusions, IV drug use with a contaminated needle
Rifampin
Antibiotic; can interfere with oral contraceptives, may turn urine and other secretions orange; patient should report yellowing of skin, pain or swelling of joints, loss or appetite or malaise immediately
HIV initial infection
Viremia for 2-3 weeks; large viral levels in blood make transmission more likely, followed by prolonged period of low viral load
HIV acute infection
Flu-like symptoms (fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and joint pain, diarrhea, or a diffuse rash accompanies seroconversion); occurs 2-4 weeks after infection, lasts 1-2 weeks
HIV asymptomatic infection
Fatigue, headache, low-grade fever, night sweats, PGL, and other symptoms; most are unaware of infected status, median interval of 11 years between infection and diagnosis of AIDS
HIV symptomatic infection
CD4+ T cells drop to 200 to 500 cells/μL, viral load increases, symptoms seen in earlier phases become worse, other problems develop, HIV advances to a more active state
Mean arterial pressure
systolic + 2(diastolic)/3
What is direct observation therapy for patients receiving TB treatment?
Watching patient take medication to ensure medication adherence
Addison’s disease
Adrenocortical insufficiency, caused by damage or dysfunction of the adrenal cortex; primary addison’s is caused by idiopathic autoimmune dysfunction, tuberculosis, histoplasmosis, adrenalectomy, cancer; secondary addison’s is caused by steroid withdrawal, hypophysectomy, pituitary neoplasm
What patient teaching is initiated with induction phase of TB therapy?
Complete treatment for TB; four medication regimen includes isoniazid (nydrazid), rifampin (rifadin), pyrazinamide, and ethambutol hydrochloride (myambutol)
Clinical manifestations of Addison’s disease
Weight loss, craving for salt, hyperpigmentation, weakness and fatigue, nausea and vomiting, dizziness with orthostatic hypotension, severe hypotension, dehydration, hyponatremia, hyperkalemia, hypoglycemia, hypercalcemia
