Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Med-Surg II > Study Guide Flashcards > Flashcards

Study Guide Flashcards

1
Q

What to do when physician removes chest tube

A

Tell pt to perform valsalva maneuver and bear down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When to contact physician for chest tubes

A

Bubbling increases over time
Bubbling returns after having stopped
Output more than 100-150mL/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

K normal range

A

3.5-5.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Calcium normal range

A

8.5-10.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Magnesium normal range

A

1.5-2.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Atelectasis

A

Alveolar collapse due to obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

S/Sx of Atelectasis

A

Increased work of breathing - dyspnea
Decreased breath sounds
Crackles
Hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tx for atelectasis

A

Remove secretions
Frequent turning, early ambulation, lung volume expansion (incentive spirometer), deep breathing, coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Surgical/procedural tx for atelectasis

A

Endotracheal intubation, mechanical ventilations = last resort
Thoracentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pneumonia patho

A

Movement of WBC’s into alveoli leads to perfusion issues
Development of thick sputum leads to ventilation issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Community-Acquired Pneumonia

A

Pt that have not been hospitalized/lived in long-term care within 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hospital-Acquired Pneumonia

A

Begins 48 hours+ after hospital admission
Ex. Ventilator-associated pneumonia (VAP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tx for bacterial pneumonia

A

Abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Aspiration pneumonia

A

Entry of material from mouth into trachea/lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Necrotizing pneumonia

A

Rare complication
Lung tissue turns into thick/ liquid mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Opportunistic pneumonia

A

Occurs in immunocompromised pts
- Malnutrition, HIV, chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risk factors for pneumonia

A

Smoking, COPD, immobility, depressed cough, NGT/other drains, old age, aspiration risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is pneumonia dx

A

S/sx, CXR, blood cx, sputum cx, bronchoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

S/sx of pneumonia

A

Cough, fever, chills
Dyspnea, tachypnea, chest pain
Confusion - elderly
Coarse crackles, purulent sputum - vocal fremitus
Elevated RR
Decreased SpO2
Elevated WBC, + sputum culture
Respiratory acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Infection goal of care

A

Remove bacteria and clear purulent drainage/sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Nursing interventions to promote airway clearance

A

Oxygen therapy - continuous SpO2 (humidified)
Hydration
Chest PT (physiotherapy)
- Inventive spirometer, cough and deep breath (IS/CDB)
NT (nasotracheal) suction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Nursing interventions for infection (lung infection/pneumonia)

A

Sputum culture
Abx administration
- Should be working by 48-72h
- Not for viral infections, but could be used for secondary bacterial infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Medications for pneumonia

A

Antipyretics
Cough suppressants
Mucolytics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Long-term interventions for pneumonia

A

Pneumococcal vaccine
Oral abx - once pt is stable
Assess for aspiration risk - NG/OG tube = increased risk
Prevent hospital acquired infection
Teach abx adherence
Follow up with PCP in 6-8 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
**Post thoracentesis nursing interventions**
Monitor HR and BP Monitor for pneumothorax
26
**Tension (spontaneous) pneumothorax**
Accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart
27
**Iatrogenic pneumothorax**
Traumatic pneumothorax secondary to an invasive procedure or surgery
28
**S/SX of closed pneumothorax**
Sudden pain Tachypnea, air hunger, accessory muscle use Absent breath sounds Tracheal shift Hypotension Jugulovenous distention (JVD) - thoracic pressure Hypoxemia - can lead to cyanosis
29
**Tx for closed pneumothorax**
Cover with vent dressing Chest tube
30
**Tx and interventions for ineffective airway clearance**
IS/CDB Suctioning Bronchoscopy Positioning - "good" lung down so "bad" lung can drain Monitory for s/sx of pneumonia
31
**How is TB contracted**
Through air, person to person Mostly effects immunocompromised
32
**S/x of tuberculosis**
High fever, chills, flu-like symptoms Extrapulmonary TB (outside of lungs)
33
**BCG vaccine**
Bacillus Calmette–Guérin Recommended for infants born in countries with high prevalence of TB - Africa, Asia, Eastern Europe
34
**BCG vaccine side effects**
Swollen lymph nodes Fever (mild) Headache Injection site reactions
35
**TB precautions**
Airborne isolation with HEPA filter Pt must wear surgical mask outside of room
36
**Rifampin nursing considerations**
Tx for TB Orange urine/secretions Liver failure - AE Decreases hormonal birth control effectiveness
37
**Risk factors for pulmonary embolism (PE)**
**DVT** Immobility, Surgery Obesity, Smoking HF, A fib Pregnancy Clotting disorders Fx of long bones
38
**Risk factors for head and neck cancer**
Tobacco, ETOH, environmental exposure, HPV, over 50 men
39
**Dx for head and neck cancer**
Laryngoscopy with biopsy of tumor CT/MRI Barium swallow Pharyngoscopy and laryngoscopy
40
**Head and neck cancer tx**
Surgery - first line - Stage 1&2: Partial laryngectomy - Stage 3&4: Total laryngectomy Radical neck dissection Radiation therapy
41
**Radical neck dissection**
Removal of: All cervical lymph nodes Sternocleidomastoid muscle Internal jugular vein Spinal accessory muscle - Tx for severe head/neck cancers
42
**Normal amount of drainage from JP drain**
80-120 mL in first 24 hours
43
**Central venous pressure**
Measures the amount of blood returning to the right atrium - Decreased if blood volume is decreased Normal range: 2-8, 8-12(?)
44
**Guillan Barre**
Autoimmune disorder that destroys myelin on nerve cells
45
**Causes of Guillan Barre**
Viral infection: Flu, mycoplasma, HIV/Epstein Barr, campylobacter (GI bug)
46
**Guillan Barre s/sx**
Paresthesia of hands/feet **Weakness of respiratory muscles** Can progress to blindness and dysphagia No change in cognitive status
47
**Guillan Barre dx**
Lumbar puncture or electromyelogram
48
**Tx of Guillan Barre**
No tx - supportive measures until myelin regenerates **IVIG and plasmapheresis** - reduces s/sx length **Monitor respiratory status** PT/OT for mobility
49
**Primary concerns for Guillan Barre**
Altered breathing pattern - Decrease in ventilation Impaired swallowing - nutrition Physical mobility Autonomic dysfunction - controls bradycardic responses, rapid changes in VS
50
**First symptoms of Guillan Barre**
Can't feel middle finger Feet feel funny Can no longer lift 20lb box Falling
51
**Hypersensitivity Reaction Type 1**
Allergic response. IgE mediated Histamine release, itchy eyes, runny nose, rashes, edema, **anaphylaxis**
52
**Hypersensitivity Reaction Type 1 examples**
Nasal allergic rhinitis or hay fever Hives, atopic eczema, or erythema Angioedema Asthma Anaphylaxis
53
**Passive immunity**
Receiving antibodies rather than making them - Ex. Globulin injection, mother’s breast milk
54
**Anaphylaxis s/sx**
Tingling hands, flushing, oral swelling Warm sensation, nasal congestion, periorbital swelling, difficulty swallowing, wheals
55
Anaphylactic shock s/sx
Bronchospasm Laryngeal edema Dyspnea Hypotension Cyanosis
56
**Anaphylaxis tx**
Epinephrine Supplemental O2 with cooled water Advanced airway IV antihistamines Corticosteroids
57
**Anaphylaxis tx**
Epinephrine Supplemental O2 with cooled water Advanced airway IV antihistamines Corticosteroids
58
**Atopic reactions**
Most common type 1 hypersensitivity AKA seasonal/environmental allergies Ex. Hay fever
59
**Atopic reaction s/sx**
Allergic rhinitis Atopic dermatitis Urticaria - hives Angioedema
60
**Atopic dermatitis**
Type 1 hypersensitivity
61
**Atopic dermatitis tx**
Avoid cause Topical corticosteroid creams NSAID's Skin moisturizer
62
**Parkinson's disease**
Slow, progressive neurologic movement disorder due to decreased dopamine levels - Unknown cause
63
**Parkinson's risk factors**
Increased incidence with age More common in men 3:2 Well water, pesticides, rural residence
64
**Parkinson's characteristics**
Tremor Rigidity Bradykinesia, akinesia Postural instability Hypokinetic dysarthria (speech abnormalities)
65
**Dx of Parkinson's**
4 symptoms + responds to pharm therapy Presence of **Lewy bodies**: protein deposits in the brain
66
**Parkinson's tx**
Levadopa/carbidopa Deep brain stimulator Ablation: destruction of affected part of brain
67
**Multiple sclerosis**
Demyelinating disease of the CNS T cells enter brain and cause inflammation, destroying myelin Caused by virus
68
**Risk factors for multiple sclerosis**
Smoking Vit D deficiency Epstein Barr exposure Women 30-35 yrs
69
**Multiple sclerosis cause**
Unknown May be triggered by virus or northern climate
70
**What can multiple sclerosis lead to**
Chronic inflammation Demyelination of nerves Scarring of CNS
71
**Multiple sclerosis s/sx**
Initial: Poor coordination, loss of balance, double vision Motor changes, sensory changes, cerebellar changes (nystagmus), changes in bowel/bladder/sexual function, cognitive changes, emotional changes
72
**Multiple sclerosis drugs**
Muscle relaxants: Benzos, Baclofen, Dantrolene CNS stimulants - for fatigue Antiseizure drugs Tricyclic antidepressants
73
**Multiple sclerosis complications**
Urine retention - bladder training, avoid fluids at night, catheterization Constipation - stool softeners, activity, high fiber/fluid diet
74
**Myasthenia Gravis patho**
Antibodies attack acetylcholine receptors in nerve junctions When nerves receive a signal they release ACH to stimulate muscle response If there are no receptors, no signals get sent Leads to weakness of voluntary muscles
75
**Myasthenia Gravis s/sx**
Facial/eyelid droop Flat affect Dysphonia Peek sign - after closing eyes the eyes open slightly to show sclera May progress to respiratory failure
76
**Pharmacological tx for Myasthenia Gravis**
Pyridostigmine bromide IVIG - immune therapy Plasmapheresis Prednisone
77
**How does Pyridostigmine bromide work**
Inhibits ACH breakdown Reduces symptoms of MG
78
**Purpose of plasmaphersesis in myasthenia gravis tx**
To remove antibodies to ACH
79
**Pyridostigmine bromide AE**
Abdominal pain, diarrhea
80
**Prednisone use for myasthenia gravis and AE**
Decreases overall immune response AE: Leukopenia and hepatotoxicity
81
**Surgical tx for myasthenia gravis**
Thymectomy: Reduces T cell production
82
**Myasthenic crisis**
Exacerbation of MG symptoms D/t **extremely low ACH** at neuromuscular junction from **stressful event** (URI, change in meds)
83
**S/sx of Myasthenic crisis**
Extreme weakness Double vision Drooping eyelids
84
**Huntington's disease**
Chronic progressive hereditary disease Results in choreiform (jerking or writhing) movements and dementia - Death after 10-20 yrs of dx
85
**Huntington's disease patho**
Premature death of cells in the striatum of the: Basal ganglia – leads to poor movement control Cerebral cortex – defects in thinking, memory and judgement Cerebellum – defects in coordination
86
**Huntington's disease s/sx**
Motor dysfunction: jerky movements Cognitive impairments: attention deficits Behavioral changes: apathy, blunt affect Facial ticks Slurred speech **Impaired swallowing** Disorganized gait
87
**Huntington's disease dx**
Family hx S/sx CAG repeats: polymorphic nucleotide repeats present in the androgen receptor gene
88
**Huntington's disease meds**
Benzos - control jerky movement SSRI's - psych symptoms Antipsychotics - for late disease
89
**HIV Patho**
It is a retrovirus: attacks T cells and reproduces Decrease in immune function (opportunistic infections)
90
**How is HIV transmitted**
Body fluids: Blood, semen, vaginal secretions, amniotic fluid, breast milk
91
**What populations are at risk for HIV**
Injection drug users Sex with HIV+ HIV infected blood or organ transplant Needlesticks - healthcare workers
92
**How to prevent HIV**
Condoms, dental dams, female condoms Treat addictive disorders/mental health diagnoses 1 sexual partner Early testing No sharing blood contaminated items - razors, toothbrush **Pre-exposure prophylaxis** - antiretroviral therapies
93
**Tx for healthcare worker exposed to HIV**
Post-exposure prophylaxis (PEP) 2-3 antiretroviral regimen taken within 72 hours of exposure Taken for 28 days
94
**Pneumocystis pneumonia**
PCP Serious lung infection that affects people with weakened immune systems
95
**Active TB tx**
Four drug regimen: Isoniazid, rifampin, pyrazinamide, and ethambutol - Airborne precautions
96
Empyema Question
Answer: Pneumonia

Med-Surg II (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions