Term 3 Cumulative Flashcards
*Care of the client after biopsy of prostate for possible cancer
.
Care of the client receiving isoniazid
first line drug for active TB and for prophylaxis.
may cause peripheral neuropathy, and hepatitis.
do not administer with: aged cheese processed meats and fish bananas dried fruits yeast products soy sauce red wine
take on empty stomach
administer vitamin B5 as prescribed to reduce risk of neurotoxicity.
Care of the client with HHNS
BS >600. put on fluids and focus on hydration. start with 0.9 then 0.45, check sugar, then 5% dextrose
Care of the client with leukemia
neutropenic precautions.
Indications for a carotid endarterectomy
surgical removal of part of the inner lining of an artery, together with any obstructive deposits, most often carried out on the carotid artery or on vessels supplying the legs
Care of the client with an abdominal aneurysm
observe signs: gnawing feeling in abdomen, flank or back pain, pulsating abdominal mass, bruit, and elevated BP
monitor vitals q15mins, check pain often, focus on lowering BP, surgical intervention:
resection.. excision of the aneurysm and the placement of a synthetic graft
Monitoring Labs for the cancer client
CBC
WBC
RBC
Platelets
Care of the pregnant client with AIDS.
do not breastfeed
can transfer disease during childbirth
Care of the client receiving allogenic bone marrow transplant
With this type of BMT, the transplant comes from a donor. Often family members are found to be the best match. High doses of chemotherapy with or without radiation are administered, then the bone marrow is transplanted to “rescue” the host. This type is most commonly used in leukemia patients.
BMT allows for large doses of chemotherapy (with or without radiation) to be administered to clients where tumours are resistant to the standard doses of treatment. Once these treatments are complete, a bone marrow transplant is used to replace the client’s bone marrow.
The Goal of a BMT is to cure a client’s malignant or nonmalignant disease.
Care of the client with an abdominal aortic aneurysm
monitor s/s.
take antihypertensives to lower BP
Care of the client with pulmonary edema
relax
high fowlers
levothyroxine
Synthetic Thyroxine (T4). Thyroid hormone replacement
Care of the client undergoing radiation treatment
body fluids will be contaminated and should be disposed of appropriately
Dietary education for the client with Cushing’s
eat foods high in calcium and vitamin D.
no alcohol or caffeine
Care of the client with Hashimoto’s thyroiditis
is hypothyroidism believed to be autoimmune in origin. It is of the type of autoimmune disorders known as organ specific because the body builds up antibodies against thyroid tissue only.
Client education about the spread of TB
airborne/droplet
anti tubercular therapy: rifampin, isoniazid, pyrazinadmide, streptomycin and ethambutol. 2-3 weeks continuous meds
encourage fluid intake
proper handwashing
cover mouth when coughing/sneezing
Give example of the 4 different types of immunity
Active natural: client gets disease. body makes antibodies
active artificial: client receives immunization
Passive natural: mother to child
Passive artificial: client received immunoglobulin containing someone else antibodies
Care of the client with thrombocytopenia
safety precautions. watch for bruising. check pt, ptt, INR
Care of the client with breast cancer
can metastasize to the bone
will have orange peel skin, dimpling, nipple discharge
meds:
tamoxifen, raloxifine, lupron
dexamethasone
Synthetic Adrenocortical Steroid. Anti-inflammatory, Diagnostic aid, Immunosuppressant.
spironolactone
Aldosterone antagonist, antihypertensive, diagnostic aid for primary hyperaldosteronism, diuretic (potassium sparing diuretic)
methimazole
Thioimidazole derivative. Antithyroid
Care of the client with Addison’s disease
treat with IV fluid
hydrocortisone
flonuet
low sodium. high potassium.
dysrhythmias
muscle weakness
bronze skin pigmentation
Care of the client with hypoparathyroidism
MONITOR CALCIUM LEVELS
Describe how vaccines affect the immune system
when a client receives an immunization, they get dead antigens and the body will make antibodies from it
Priority of care for the client receiving external radiation therapy
patient will be fatigued. will need periods of rest.
monitor: skin blanching mucositis, xerostomia difficulty swallowing gastroenteritis CBC
do not wash off the x tattoos
Discuss the drug therapy for the HIV infected client
HAART therapy.
includes: enfuvirtide (fuzeon) maraviroc (selzentry) delavirdine (descriptor) interferon
used in combination with other antiretroviral meds to reduce medication resistance, adverse effects, and dosages.
Care of the client with hypothyroidism, including diet
Give Levothyroxine
everything is low and slow. Provide diet with fiber. lotion skin. allow rest periods. eat smaller more frequent meals.
Care of the client with hemolytic anemia
premature destruction (lysis) of RBC’s
monitor for hypoxemia.
Corticosteroid hormones and splenectomy may also be of benefit.
Client education; Care of the client pre/post cardiac catheterization
most definitive but most invasive test in the diagnosis of heart disease.
client is strapped to a table the cath lab and the table is turned during the procedure
local analgesic injected at the insertion site
client may have mild sedative but most be able to report any chest pain, pressure, or other symptoms.
informed consent
NPO 8 hr prior to procedure
report iodine/shellfish allergies
PTU
Thiourea Derivative. Antithyroid
Discuss the complications of immobility
risk for DVT
Care of the client receiving nitroglycerin for angina
nitro given sublingualy. if still having pain, repeat q5mins 3 times. No more than 3 pills. Call emergency services.
Care of the client with diabetic ketoacidosis
severe hyperglycemia >300
kussmaul respirations
fruity breath
type 1
increase in ketones in urine
asses:
airway
blood glucose level
vitals q15mins
administer:
IV fluids 0.9 then 0.45. check BG. then dextrose solution
Care of the client having MI
Monitor vitals q15 minutes until stable, then every hour
monitor continous cardiac monitoring
monitor hourly output
administer o2
administer meds: vasodilators like nitrostat, analgesics such as morphine to help control pain. streptase or activase.
Care of the client with hypothyroidism
increase activities gradually
apply anti embolism stockings and elevate the legs to promote venous return
encourage to turn cough and deep breath
provide meticulous skin care
administer levothyroxine
Care of the client with Grave’s Disease
see hyperthyroid
Care of the client using nasal prongs for oxygen delivery
Perform a respiratory assessment along with a complete set of vital signs, including oxygen saturation indicated via pulse oximetry. After assessing your patient, also document the patient’s skin color, level of consciousness, and other signs and any manifestations of hypoxia.
perform a skin assessment where the oxygen-delivery device comes into contact with the patient’s skin. Inspect the nose, the ears, and under the chin for redness, irritation, and skin breakdown. To help prevent irritation and skin breakdown, consider padding pressure areas when initiating oxygen therapy. Keeping the patient’s skin clean and dry can also help reduce the risk of skin irritation and breakdown
Care for the client receiving Furosemide
MUST MONITOR POTASSIUM LEVELS AND ENSURE CLIENT IS RECEIVING ADEQUATE FLUID INTAKE
glipizide
Sulfonylurea. Antidiabeti
insulin
Rapid-Acting: This insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with longer-acting insulin.
Short-Acting: Covers insulin needs for meals eaten within 30-60 minutes.
Intermediate Acting: Covers insulin needs for about half the day or overnight. This type of insulin is often combined with a rapid or short-acting type.
Long-Acting: Insulin needs for about one full day. This type is often combined, when needed, with rapid or short acting insulin.
Care of the client receiving morphine sulfate
monitor respiratory rate
erythropoietin
RBCs usually given for anemi
Care of the client with hypertension
encourage weight loss encourage low sodium diet, low fat, low cholesterol exercise program alcohol and smoking cessation administer antihypertensives increase fiber with verapamil and stay away from grapefruit juice change positions slowly monitor for angioedema
List chronic complications of diabetes mellitus
DKA and HHS
Care of the client with left-sided heart failure
s/s: pulmonary edema, dyspnea, cough, fatigue, cool pale skin, s3 heart sounds, pink frothy sputum
Education for the client undergoing chemotherapy (Neutropenia, pancytopenia, anemia)
encourage them to avoid crowds while undergoing chemotherapy
monitor fatigue, pallor, dizziness, and SOB
provider can provide epstein alfa and ferrous sulfate
monitor hgb values
nitroglycerin
Nitrate. Antianginal, antihypertensive, vasodilator.
clopidogrel
Thienopyridine derivative. Platelet aggregation inhibito
heparin
Glycosaminoglycan. Anticoagulan
Care for the client having sickle cell crisis
administer pain medications
RBC transfusions may occur in the crisis
Care of the client with atelectasis
the collapse of lung tissue.
s/s:
diminished breath sounds at the bases
usually requires chest tube insertion
Care of the client with diabetes insipidus
low ADH
provide fluids because they are giving them out frequently
treatment is vasopressin and DDAVP. Given for it’s side effects of retaining urine.
BP low. HR high. Low urine specific gravity
complications: dehydration and hypovolemia
Care of the client with chronic emphysema
treatment: avoid tobacco use bronchodilators and antibiotics flu vaccine pneumovax low oxygen flow
nursing: position high fowlers deep breath, turn, cough provide chest physiotherapy avoid irritants: smoke, allergens, chemicals increase fluid intake
ferrous sulfate
trace Element, mineral. Antianemic, nutritional supplement.
Care of the client who is HIV positive
treatment includes: antiretroviral agents, immunomodulatory agents, supportive therapy.
use standard precautions
use gloves for all contact with blood
always wash hands
maintain confidentiality
Care of the client with Addisonian crisis
risk factors include stress abrupt steroid withdrawal infection pregnancy dehydration
digoxin
Digitalis glycoside. Antiarrhythmic, cardiotoni
Care of the client following a thyroidectomy
keep in high fowlers position assess back of neck for bleeding ensure suction equipment is ready check for laryngeal nerve damage administer meds for pain watch for hypocalcemia
warfarin sodium
Coumarin derivative. Anticoagulant
Care of the client receiving blood or platelet transfusion
safety blood precautions. double check all information. watch patient for 15 minutes while starting transfusion. monitor vitals.
Indication for percutaneous transluminal coronary angioplasty (PTCA)
minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle.
Next, a long narrow tube called a diagnostic catheter is advanced through the introducer over the guide wire, into the blood vessel.
Care of the client with SIADH
high ADH
Holding onto fluid
administer declomycin
monitor for hypervolemia, pulmonary edema (crackles), cerebral edema (change in LOC)
weight gain
low sodium serum
high urine specific gravity because retaining of water. low urine output.
strptomycin
Aminoglycoside. Antibiotic.
Care of the client with a tracheostomy
ALWAYS MONITOR AIRWAY
Care of the client following surgery for laryngeal cancer (radical neck dissection)
- figure out which alternate communication will be used post surgery
- keep HOB elevated to reduce edema
- report leakage from suture line, swallowing difficulty, or coughing when oral intake is resumed
- will be required to try to speak q2 hours
Assessment of the client with peripheral artery disease
subjective:
durning, cramping, and pain in legs
numbness or during pain primary in the feet
pain relieved by resting in dependent position
objective: decreased cap refill non palpable pulses loss of hair on lower calf, ankle, and foot dry, scaly, mottled skin thick toenails cold and cyanotic extremity pallor of extremity with elevation dependent rubor muscle atrophy ulcers and possible gangrene of toes
Care of the client with lung cancer; complications
superior vena cava syndrom is the #1 complication. s/s: facial edema nosebleeds peripheral edema dyspnea late LOC
will use bronchodilators and corticosteroids
chest tube to be expected
Care of the client prescribed warfarin sodium
place on bleeding precautions and make safety important
Care of the client receiving erythropoietin
stimulates production of RBCs, given for anemia.
Interpreting a TB skin test
SHOULD HAVE A WHEEL AFTER ADMINISTRATION. POSITIVE IF THE SKIN SURROUNDING TURNS RED.
Care of the client taking digoxin
ALWAYS CHECK BP AND BPM PRIOR TO ADMINISTRATION.
Care of the client with AID; priority complication
client is immunocompromised.
neutropenic precautions and also nutrition. high calories.
rest as much as possible.
Care of the client with diabetes
type 1 insulin dependence
type 2 insulin resistance
monitor class signs (3 P’s)
Care of the client with hyperthyroidism
clinical syndrome caused by excessive circulating thyroid hormone. Thyroid hormone exaggerates normal body functions and produces a hyper metabolic state and increased sympathetic nervous system
client will receive PTU, thionamides, methimazole, inderal, and Lugols solution
encourage periods of rest
increase protein, calories
provide eye protection
report 1 degree increase in temp immediately
avoid palpitation of the thyroid
adminsister antithyroid medications
Discuss the side effects of dexamethasone
.
Care of the client undergoing angiography
Must ask for allergies to shellfish/iodine. consent form is signed.
common bronchdilators
advair
dulera
symbicort
Care and risk factors for the client with melanoma
skin cancer
excision biopsy
s/s: red, white, blue color over a brown or black irregular, notched margin. irregular surface. may ulcerate
lymphadenopathy in metastasis.
Care of the client receiving propylthiouracil
.
Care of the client with myxedema
maintain airway continuous ecg monitoring warming the client with blankets monitoring body temp and BP administer large doses of levothyroxine IV monitor I and O treat hypoglycemia with glucose administer corticosteroids watch for infection
Know lab ranges: Ca, WBC, plt, RBC, BUN, Cr, Na, K, HgbA1c, glucose, HCT, hgb, CD4, T-cell count, liver function tests
CA 9.5-10.0 WBC 5000-10000 PLT 150,000-400000 CREATININE SODIUM 98-136 HBGA1C GOOD RANGE IS 4-6% GLUCOSE 70-110 HCT HBG CD4 T CELL
HAART
Enfuvirtide/Fuzeon: Infusion inhibitors. Blocks the fusion of HIV with the host cell
Maraviroc/Selzentry: Entry inhibitors Zidovudine/Retrovir: Nucleoside reverse transcriptase inhibitors (NRTI’s). Interfere with the virus’s ability to convert RNA into DNA. Delavirdine/Rescriptor and Efavirenz/Sustiva: Non-nucleoside Reverse Transcriptase inhibitors (NNRTI’s). Inhibit viral replication. Atazanavir/Reyataz, Nelfinavir/Viracept, Saquinavir/Invirase, and Indinavir/Crixivan: Protease inhibitors. Inhibit and enzyme needed for the virus to replicate. Raltegravir/Isentress: Integrase Inhibitors Interleukin/Interferon: antineoplastic medication. Immunostimulant that enhances the immune response and reduces the production of cancer cells.
furosemide
Sulfonamide. Antihypertensive, diuretic
Care of the client with aplastic anemia
will be on neutropenic precautions
Care of the client with thrombophlebitis/DVT
tx: lovenox, warfarin, regular heparin. thrombolytic therapy: activase. platelet inhibitors: abciximac (ReoPro), eptifibatide (integrilin.
monitor: aPTT, platelet counts, protamine sulfate (heparin antidote) is available, PT and INR receiving warfarin. bleeding precautions.
ensure vitamin K (warfarin antidote) is available. observe signs of bleeding. Bed rest with elevation of the affected arm or leg.
administer meds as prescribed. measure limb circumference daily. monitor SOB and chest pain. apply warm, moist soaks over affected areas. apply anti embolism stockings.
tamoxifen
Nonsteroidal antiestrogen agent, partial estrogen agonist
Care of the client receiving streptomycin
Aminoglycoside. Antibiotic.
Care of the client prescribed methimazole
treats hyperthyroidism
isoniazid
Acid Derivativexs. Antibiotic, Antitubercular.
Care of the client following bronchoscopy
client goes to PACU check LOC, and for gag reflex return once gag reflex returns, can give ice provide oral hygiene monitor vitals encourage deep cough and breath
Care of the client receiving Lugol’s solution
Antihyperthyroid agent—In hyperthyroid patients, strong iodine produces rapid remission of symptoms by inhibiting the release of thyroid hormone into the circulation.
Prior to and following administration of radioactive isotopes and in radiation emergencies, strong iodine protects the thyroid gland by blocking the thyroidal uptake of radioactive isotopes of iodine.
Client education for the client taking spironolactone
teaching client to avoid extra potassium intake. monitor I and O.
Care of the client taking ferrous sulfate
monitor iron levels
Caring for the client prescribed clopidogrel
PLAVIX.
platelet aggregation inhibitor
