test 3 Flashcards
respiratory abnormals -- UTIs (166 cards)
1
Q
cheyne stokes
A
crescendo decrescendo breathing pattern
2
Q
kussmaul
A
rapid and deep breathing pattern
3
Q
atelectasis
A
partial or total lung collapse d/t incomplete expansion of alveoli
4
Q
how to determine if chest pain or respiratory pain
A
have pt take a deep breath, if pain worsens, may be respiratory
5
Q
surfactant
A
chemical that decreases surface tension and helps keep alveoli air sacs open
5
Q
why does atelectasis occur
A
not breathing deeply enough
6
Q
nursing interventions for atelectasis
A
- fowlers position
- incentive spirometer
- TC&DB
- splint abd when coughing
medication to precent hypoventilation
7
Q
air trapping
A
obstruction of air exiting the lungs (seen in COPD)
7
Q
COPD
A
chronic obstructive pulmonary disease
8
Q
types of COPD
A
chronic bronchitis and
emphysema
9
Q
normal stimulus to breathe
A
HIGH CO2
- body increases breathing to get rid of CO2
10
Q
COPD pt O2 sat levels should be…
A
88-92%
do not give more than 2LPM
10
Q
abnormal stimulus to breathe
A
LOW O2
- hypoxic drive
- body unable to correct chronically acidic blood levels
11
Q
PA findings of COPD
A
- diminished BBS
- exertional dyspnea
- accessory muscle use
- clubbing of nails
- prolonged expirations
- barrel chest
- hyperresonance
12
Q
what does vaping cause in the lungs
A
popcorn pneumonia
13
Q
COPD nursing interventions
A
pursed lip breathing
- keep O2 less than 2L/min
13
Q
PA findings for asthma
A
- wheezing
- SOB
- dyspnea
- coughing esp at night
- chest tightness
- ⬇ tactile fremitus
- intermittent hyperinflation
- hyperresonance
13
Q
what does asthma do to air ways
A
swells walls
fill w. mucous
bronchoconstriction
14
Q
pneumonia
A
inflammation of the bronchioles and alveolar space d/t viral, bacterial, or fungal infection
15
Q
A
16
Q
exudate leads to
A
lung consolidation
17
Q
empyema
A
pus in the pleural cavity
18
Q
PA findings for pneumonia
A
- FEVER
- CRACKLES
- dyspnea and tachypnea
- chest pain (friction rub- pleurisy)
- diminished BS
- ⬆ tactile fremitus
- green sputum
18
Q
pleurisy
A
friction rub
19
acute bronchitis
inflammation of larger bronchial tubes, NOT alveolar air sacs
20
PA findings for acute bronchitis
- rhonchi
- cough
- fever
- SOB
21
tuberculosis
chronic infection caused by mycobacterium TB
22
PA findings for TB
- hemoptysis (bloody cough)
- night sweats
- weight loss
23
have to be on meds for how long for TB
8-18 months
24
pneumothorax
collapsed lung d/t air in the plerual space
25
blep
blister that ruptures
- commonly seen in tall, thin, caucasian boys
26
PA findings for pneumothorax
- chest pain
- SOB w/ tachypnea
- ↓ SpO2 → cyanosis
- diminished or absent BS
- crepitus *esp in tension
27
tension pneumothorax
EMERGENCY
air continuously enters but cannot leave
28
what gets crimped off in a tension pneumothorax
vena cava
29
what heart valve is under the highest pressure when closed
mitral
30
SA node pace
60-100 BPM
31
if AV node takes over what is the pase
40-60BPM
32
what artery pumps blood to the entire body
left anterior descending artery
33
S1
closure of AV valves as both ventricles begin to contract
34
S2
closure of both SL valves as ventricles begin to relax
35
systole=
ventricular contraction
36
diastole =
ventricular relaxation
37
which is longer diastole or systole
diastole
38
what is lost in tachycardia
diastole
39
P wave
atrial depolarization
40
QRS complex
ventricular depolarization and atrial repolarization
41
T wave
ventricular repolarization
42
ST segment
ventricular contraction
43
how to calculate pulse deficit
difference between apical and radial pulses at the same point in time
44
best way to listen to aortic murmur
sit up, lean forward, and exhale
45
best way to listen to a mitral murmur
lie on left side
46
normal pulse deficit
0
47
causes of a silent MI
DM neuropathy
heart transplant
48
risk factors of heart attack
- smoking
- DM
- obesity
- lack of exercise
- HTN
- high cholesterol
49
CABG
coronary artery bypass graft
50
TAVR
valve replacement
51
most common veins for use of CABG
mammary or saphenous
52
chest tube should drain
no more than 100ml/hr within first couple hours post surgery
53
fluid overload S&S
DVBS
Dyspnea (with crackles)
Venous distention
Bounding pulses
Sensorium decreased
54
what lab is high during HF
BNP
hormone from atria
55
left sided HF
backs up to lungs
- pulmonary edema
- hemoptysis
- orthopnea
- dyspnea
56
right sided HF
backs up into body
- JVD
- hepatomegaly
- ascites
- peripheral edema
57
left AND right HF
- oliguria (no pee)
- confusion and cheyne stokes
- slow cap refill
58
devise that can block off auricle to lower chance of blood pooling and clotting
watchman devise
59
often hear murmers where
erbs point using the bell of steth.
60
regurgitating valve
doesnt close tightly
61
stenosed valve
doesnt open all the way
62
S3 ken-tuck-y
caused by sudden tensing of ventricular wall, NOT VALVE, as blood enters atria
63
S4 ten-nes-see
atrial gallop
atrial walls contracting
indicates HTN, CAD, or MI
64
how to listen to S4
with pt on left side
65
when to do allen test
before sticking a radial artery
66
what is allen test for
ABGs and cardiac cath
checks to make sure blood flow via unlar artery is okay in case of radial artery spasm
67
how to do allen test
raise hand
make a fist
press arteries until looks pale
68
amplitude
pulse quality
69
pulsus alternans
strength of an arterial pulse alternates between strong and weak
- sign of HF
70
signs of decreased ARTERIAL blood flow
- cool to the touch
- sluggish cap refill
71
signs of decreased VENOUS blood flow
- redness
- warmth
- pain
- edema
72
brawny edema
form, hard, discolored, fibrosed, unable to displace
73
varicose veins
swollen twisted and painful
superficial veins
d/t faulty valves
74
varicose and spider veins can result in...
chronic venous insufficiency
- hemosiderin staining
- brawny edema
- stasis dermatitis
venous stasis ulcers
75
most common place for an ulcer to form
medial malleolus
76
Thrombophlebitis
clot in a superficial vein
77
worst potential outcome of DVT
pulmonary embolism
77
beurgers disease
arterial inflammation
78
#1 cause of PAD
diabetes
79
signs of ischemia
weak or absent pulses
intermittent claudication
thin, shiny, hairless skin
coolness of skin and pale or molting
dependent rubor
severe = necrosis or gangrene
80
raynaud phenomenon
vasospasm of small arteries of fingers
seen with cold temps
increased with autoimmune collagenous disease (Lupus and RA)
81
pts with what are likely to have raynaud phenomenon
RA and lupus
82
ABI is screening for what
peripheral arterial disease
83
ideal position for GI inspection
supine with knees slightly flexed
84
jaundice caused by
increased biliruben
85
when to ask about flatus
GI surgery specific assessment
86
what do IV fluids do
prevent electrolyte imbalance and dehydration
87
TPN after how many days NPO
2-5
88
bridle secures NG tube via what bone
vomer
89
PEG stands for...
percutaneous endoscopic gastrostomy
90
how does PEG tube in jejunum affect flow rate
decreased flow rate more continuously
91
salum sump
used for suction
92
dobhoff
used for feeding via NJ or NG
93
colostomy vs ileostomy drainage
ileostomy is more watery because its the ileum-- small intestine and water has not been reabsorbed yet
94
signs of small bowel mechanical obstruction
- paralytic ileus
- high pitched tinkling sounds when auscultating
- hyperactive then absent BS
- N/V to projectile vomiting
- emesis w feces
95
first action when pt has emesis w feces
make pt NPO for surgery
96
what is responsible for GERD
weak lower esophageal sphincter
97
most classic symptom of GERD
chronic, dry, unproductive cough
98
what treats GERD
PPIs and H2 blockers
99
hiatal hernia
part of stomach pases through hiatus in diaphragm
100
S&S of hiatal hernia
- epigastric pain relieved by sitting upright
- dysphagia
- may be asymptomatic
101
hematochezia
recent bleeding in the stool
- lower GI bleed
- currant jelly stools
102
hematemesis
recent bleeding in the vomit
- upper GI bleed
103
melena
old blood in stool
- black and tarry
104
occuult blood
not visible
- guaiac test (FOBT)
105
Kehr sign
referred shoulder pain if blood in peritoneal cavity irritates diaphragm
106
S&S hypovolemia
(low levels of fluid in body)
- BP plummets
- dizzy and weak
- diaphoresis
- tachycardia
107
appendicitis S&S
- low grade fever
- pain moves from periumbilical to RLQ
- Mcburney sign
- guarding
- anorexia
108
S&S of ruptured appendix
- sharp stabbing pain, then decreased pain
- rebound tenderness d/t rupture causing peritonitis
109
peritonitis
life threatening infection of membrane lining abdomen
110
what happens if the infection from peritonitis spreads to the blood
sepsis
111
what can cause peritonitis
rupture of organs or by an STI entering the pelvis
112
S&S of pancreatitis
epigastric tenderness
- knife like abdominal pain in LUQ
- N/V
- pyrexia
- fever
- shock
113
expected lab levels for pancreatitis
elevated serum amylase levels
damaged pancreas cells release amylase which enters the blood
114
grey turner sign
ecchymosis of flanks
- seen in pancreatitis
115
cullen sign
ecchymosis near umbilicus
- seen in pancreatitis
116
cholecystitis
inflammation of gallbladder often due to cholelithiasis
117
cholelithiasis
gallstones
118
S&S of cholecystitis
RUQ pain
murphy sign
anorexia
N/V
jaundice
119
murphy sign
cessation of inspiration from pain w/ RUQ palpation
120
S&S of intestinal parasites
- abd pain
- N/V/D
- gas and bloating
- fatigue
- weight loss
- loose stools (sometimes w mucus or blood)
120
S&S of spleen laceration or rupture
- LUQ pain
- Kehr sign
- abd pain radiates to left shoulder
- hypovolemic shock d/t blood loss
121
scientific name for worms
helminths
122
types of worms
round worms-- 11 subtypes
pinworms -- enterobiasis
123
enterobiasis
pinworms common in children
- severe rectal itching
124
test for pinworms
tape test to look for eggs
125
ave I&O for adults
1500-2000mL
126
oliguria
below average urine output
127
cause for polyuria
decreased insulin, causing increased glucose in blood, which pulls more fluid into the blood from cells and is excreted in the urine
128
urometer
box on a urine drainage bag used to measure exact urine output per hour
129
CBI
continuous bladder irrigation
130
CBI purpose
to prevent blood clots from blocking urethra
131
what to assess with CBI
- amount in
- quality
- amount out
132
where to directly percuss for CBI
over costovertebral area for kidney tenderness
133
where to percuss indirectly for CBI
over suprapubic are for bladder distention
134
what should never be irrigated
urostomy or ileal conduit
135
lower UTI
cystitis (ureters)
136
upper UTI
pyelonephritis (kidneys)
137
chronic renal failure
glomeruli fail to filter blood
137
S&S of cystitis
- dysuria
- urinary freq. & urgency
- cloudy urine odor
- confusion in older adults
- kidney = flank and fever pain
138
DVBS
signs of fluid overload in bloodstream
Dyspnea
Venous distention
Bounding pulses
Sensorium decreased
138
decreased kidney filtration leads to...
fluid overload
increased wastes (acidosis) (hyperventilation)
anemia
139
PA and lab findings for chronic renal failure
oliguria or anuria
fluid overload
- crackles with dyspnea
- edema
HTN
kyperkalemia
low calcium
high phosphate
decreased pH
decreased RBC and H&H (anemia)
140
levels of creatinine and BUN in chronic kidney failure
both increased
141
normals for creatinine and BUN
creatinine: 0.5 to 1.5
BUN: 7-18mg/dL
142
microalbuminuria
protein in urine
seen in kidney failure
143
what do pts on HDY require
anticoagulant
144
which type of HDY accesses the vena cava
temporary
- red and blue ports like a CVC
145
long term HDY
AV fistula
146
STEAL syndrome or vascular access steal syndrome (VASS)
decreased arterial blood flow to distal extremity that has the AV fistula
- tissue ischemia
- pallor,
- decreased pulses (MOST serious)
- decreased cap refill
147
what medicine to hold the morning of HDY
anti-HTN meds
148
common vital sign abnormal on pts on HDY
decreased BP
149
what to check daily for HDY pts
weight -- should be down after HDY
150
good indicators post-HDY
lower weight
decreased fluid volume
crackles disappear
bounding pulses come back to normal
151
renal calculi
nephrolithiasis
AKA: kidney stones
152
increased risk for kidney stones
family history and dehydration
153
S&S of kidney stones
- severe colic (back and side pain)
- moves around side and down into lower abd. and into groin
- N/V
- Dysuria
- Hematuria
154
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