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PA > test 3 > Flashcards

test 3 Flashcards

respiratory abnormals -- UTIs

1
Q

cheyne stokes

A

crescendo decrescendo breathing pattern

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2
Q

kussmaul

A

rapid and deep breathing pattern

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3
Q

atelectasis

A

partial or total lung collapse d/t incomplete expansion of alveoli

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4
Q

how to determine if chest pain or respiratory pain

A

have pt take a deep breath, if pain worsens, may be respiratory

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5
Q

surfactant

A

chemical that decreases surface tension and helps keep alveoli air sacs open

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5
Q

why does atelectasis occur

A

not breathing deeply enough

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6
Q

nursing interventions for atelectasis

A
  • fowlers position
  • incentive spirometer
  • TC&DB
  • splint abd when coughing
    medication to precent hypoventilation
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7
Q

air trapping

A

obstruction of air exiting the lungs (seen in COPD)

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7
Q

COPD

A

chronic obstructive pulmonary disease

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8
Q

types of COPD

A

chronic bronchitis and
emphysema

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9
Q

normal stimulus to breathe

A

HIGH CO2
- body increases breathing to get rid of CO2

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10
Q

COPD pt O2 sat levels should be…

A

88-92%
do not give more than 2LPM

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10
Q

abnormal stimulus to breathe

A

LOW O2
- hypoxic drive
- body unable to correct chronically acidic blood levels

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11
Q

PA findings of COPD

A
  • diminished BBS
  • exertional dyspnea
  • accessory muscle use
  • clubbing of nails
  • prolonged expirations
  • barrel chest
  • hyperresonance
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12
Q

what does vaping cause in the lungs

A

popcorn pneumonia

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13
Q

COPD nursing interventions

A

pursed lip breathing
- keep O2 less than 2L/min

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13
Q

PA findings for asthma

A
  • wheezing
  • SOB
  • dyspnea
  • coughing esp at night
  • chest tightness
  • ⬇ tactile fremitus
  • intermittent hyperinflation
  • hyperresonance
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13
Q

what does asthma do to air ways

A

swells walls
fill w. mucous
bronchoconstriction

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14
Q

pneumonia

A

inflammation of the bronchioles and alveolar space d/t viral, bacterial, or fungal infection

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15
Q
A
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16
Q

exudate leads to

A

lung consolidation

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17
Q

empyema

A

pus in the pleural cavity

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18
Q

PA findings for pneumonia

A
  • FEVER
  • CRACKLES
  • dyspnea and tachypnea
  • chest pain (friction rub- pleurisy)
  • diminished BS
  • ⬆ tactile fremitus
  • green sputum
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18
Q

pleurisy

A

friction rub

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19
Q

acute bronchitis

A

inflammation of larger bronchial tubes, NOT alveolar air sacs

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20
Q

PA findings for acute bronchitis

A
  • rhonchi
  • cough
  • fever
  • SOB
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21
Q

tuberculosis

A

chronic infection caused by mycobacterium TB

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22
Q

PA findings for TB

A
  • hemoptysis (bloody cough)
  • night sweats
  • weight loss
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23
Q

have to be on meds for how long for TB

A

8-18 months

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24
Q

pneumothorax

A

collapsed lung d/t air in the plerual space

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25
Q

blep

A

blister that ruptures
- commonly seen in tall, thin, caucasian boys

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26
Q

PA findings for pneumothorax

A
  • chest pain
  • SOB w/ tachypnea
  • ↓ SpO2 → cyanosis
  • diminished or absent BS
  • crepitus *esp in tension
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27
Q

tension pneumothorax

A

EMERGENCY
air continuously enters but cannot leave

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28
Q

what gets crimped off in a tension pneumothorax

A

vena cava

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29
Q

what heart valve is under the highest pressure when closed

A

mitral

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30
Q

SA node pace

A

60-100 BPM

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31
Q

if AV node takes over what is the pase

A

40-60BPM

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32
Q

what artery pumps blood to the entire body

A

left anterior descending artery

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33
Q

S1

A

closure of AV valves as both ventricles begin to contract

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34
Q

S2

A

closure of both SL valves as ventricles begin to relax

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35
Q

systole=

A

ventricular contraction

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36
Q

diastole =

A

ventricular relaxation

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37
Q

which is longer diastole or systole

A

diastole

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38
Q

what is lost in tachycardia

A

diastole

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39
Q

P wave

A

atrial depolarization

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40
Q

QRS complex

A

ventricular depolarization and atrial repolarization

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41
Q

T wave

A

ventricular repolarization

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42
Q

ST segment

A

ventricular contraction

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43
Q

how to calculate pulse deficit

A

difference between apical and radial pulses at the same point in time

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44
Q

best way to listen to aortic murmur

A

sit up, lean forward, and exhale

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45
Q

best way to listen to a mitral murmur

A

lie on left side

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46
Q

normal pulse deficit

A

0

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47
Q

causes of a silent MI

A

DM neuropathy
heart transplant

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48
Q

risk factors of heart attack

A
  • smoking
  • DM
  • obesity
  • lack of exercise
  • HTN
  • high cholesterol
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49
Q

CABG

A

coronary artery bypass graft

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50
Q

TAVR

A

valve replacement

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51
Q

most common veins for use of CABG

A

mammary or saphenous

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52
Q

chest tube should drain

A

no more than 100ml/hr within first couple hours post surgery

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53
Q

fluid overload S&S

A

DVBS
Dyspnea (with crackles)
Venous distention
Bounding pulses
Sensorium decreased

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54
Q

what lab is high during HF

A

BNP
hormone from atria

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55
Q

left sided HF

A

backs up to lungs
- pulmonary edema
- hemoptysis
- orthopnea
- dyspnea

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56
Q

right sided HF

A

backs up into body
- JVD
- hepatomegaly
- ascites
- peripheral edema

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57
Q

left AND right HF

A
  • oliguria (no pee)
  • confusion and cheyne stokes
  • slow cap refill
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58
Q

devise that can block off auricle to lower chance of blood pooling and clotting

A

watchman devise

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59
Q

often hear murmers where

A

erbs point using the bell of steth.

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60
Q

regurgitating valve

A

doesnt close tightly

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61
Q

stenosed valve

A

doesnt open all the way

62
Q

S3 ken-tuck-y

A

caused by sudden tensing of ventricular wall, NOT VALVE, as blood enters atria

63
Q

S4 ten-nes-see

A

atrial gallop
atrial walls contracting
indicates HTN, CAD, or MI

64
Q

how to listen to S4

A

with pt on left side

65
Q

when to do allen test

A

before sticking a radial artery

66
Q

what is allen test for

A

ABGs and cardiac cath
checks to make sure blood flow via unlar artery is okay in case of radial artery spasm

67
Q

how to do allen test

A

raise hand
make a fist
press arteries until looks pale

68
Q

amplitude

A

pulse quality

69
Q

pulsus alternans

A

strength of an arterial pulse alternates between strong and weak
- sign of HF

70
Q

signs of decreased ARTERIAL blood flow

A
  • cool to the touch
  • sluggish cap refill
71
Q

signs of decreased VENOUS blood flow

A
  • redness
  • warmth
  • pain
  • edema
72
Q

brawny edema

A

form, hard, discolored, fibrosed, unable to displace

73
Q

varicose veins

A

swollen twisted and painful
superficial veins
d/t faulty valves

74
Q

varicose and spider veins can result in…

A

chronic venous insufficiency
- hemosiderin staining
- brawny edema
- stasis dermatitis
venous stasis ulcers

75
Q

most common place for an ulcer to form

A

medial malleolus

76
Q

Thrombophlebitis

A

clot in a superficial vein

77
Q

worst potential outcome of DVT

A

pulmonary embolism

77
Q

beurgers disease

A

arterial inflammation

78
Q

1 cause of PAD

A

diabetes

79
Q

signs of ischemia

A

weak or absent pulses
intermittent claudication
thin, shiny, hairless skin
coolness of skin and pale or molting
dependent rubor
severe = necrosis or gangrene

80
Q

raynaud phenomenon

A

vasospasm of small arteries of fingers
seen with cold temps
increased with autoimmune collagenous disease (Lupus and RA)

81
Q

pts with what are likely to have raynaud phenomenon

A

RA and lupus

82
Q

ABI is screening for what

A

peripheral arterial disease

83
Q

ideal position for GI inspection

A

supine with knees slightly flexed

84
Q

jaundice caused by

A

increased biliruben

85
Q

when to ask about flatus

A

GI surgery specific assessment

86
Q

what do IV fluids do

A

prevent electrolyte imbalance and dehydration

87
Q

TPN after how many days NPO

A

2-5

88
Q

bridle secures NG tube via what bone

A

vomer

89
Q

PEG stands for…

A

percutaneous endoscopic gastrostomy

90
Q

how does PEG tube in jejunum affect flow rate

A

decreased flow rate more continuously

91
Q

salum sump

A

used for suction

92
Q

dobhoff

A

used for feeding via NJ or NG

93
Q

colostomy vs ileostomy drainage

A

ileostomy is more watery because its the ileum– small intestine and water has not been reabsorbed yet

94
Q

signs of small bowel mechanical obstruction

A
  • paralytic ileus
  • high pitched tinkling sounds when auscultating
  • hyperactive then absent BS
  • N/V to projectile vomiting
  • emesis w feces
95
Q

first action when pt has emesis w feces

A

make pt NPO for surgery

96
Q

what is responsible for GERD

A

weak lower esophageal sphincter

97
Q

most classic symptom of GERD

A

chronic, dry, unproductive cough

98
Q

what treats GERD

A

PPIs and H2 blockers

99
Q

hiatal hernia

A

part of stomach pases through hiatus in diaphragm

100
Q

S&S of hiatal hernia

A
  • epigastric pain relieved by sitting upright
  • dysphagia
  • may be asymptomatic
101
Q

hematochezia

A

recent bleeding in the stool
- lower GI bleed
- currant jelly stools

102
Q

hematemesis

A

recent bleeding in the vomit
- upper GI bleed

103
Q

melena

A

old blood in stool
- black and tarry

104
Q

occuult blood

A

not visible
- guaiac test (FOBT)

105
Q

Kehr sign

A

referred shoulder pain if blood in peritoneal cavity irritates diaphragm

106
Q

S&S hypovolemia

A

(low levels of fluid in body)
- BP plummets
- dizzy and weak
- diaphoresis
- tachycardia

107
Q

appendicitis S&S

A
  • low grade fever
  • pain moves from periumbilical to RLQ
  • Mcburney sign
  • guarding
  • anorexia
108
Q

S&S of ruptured appendix

A
  • sharp stabbing pain, then decreased pain
  • rebound tenderness d/t rupture causing peritonitis
109
Q

peritonitis

A

life threatening infection of membrane lining abdomen

110
Q

what happens if the infection from peritonitis spreads to the blood

A

sepsis

111
Q

what can cause peritonitis

A

rupture of organs or by an STI entering the pelvis

112
Q

S&S of pancreatitis

A

epigastric tenderness
- knife like abdominal pain in LUQ
- N/V
- pyrexia
- fever
- shock

113
Q

expected lab levels for pancreatitis

A

elevated serum amylase levels
damaged pancreas cells release amylase which enters the blood

114
Q

grey turner sign

A

ecchymosis of flanks
- seen in pancreatitis

115
Q

cullen sign

A

ecchymosis near umbilicus
- seen in pancreatitis

116
Q

cholecystitis

A

inflammation of gallbladder often due to cholelithiasis

117
Q

cholelithiasis

A

gallstones

118
Q

S&S of cholecystitis

A

RUQ pain
murphy sign
anorexia
N/V
jaundice

119
Q

murphy sign

A

cessation of inspiration from pain w/ RUQ palpation

120
Q

S&S of intestinal parasites

A
  • abd pain
  • N/V/D
  • gas and bloating
  • fatigue
  • weight loss
  • loose stools (sometimes w mucus or blood)
120
Q

S&S of spleen laceration or rupture

A
  • LUQ pain
  • Kehr sign
  • abd pain radiates to left shoulder
  • hypovolemic shock d/t blood loss
121
Q

scientific name for worms

A

helminths

122
Q

types of worms

A

round worms– 11 subtypes
pinworms – enterobiasis

123
Q

enterobiasis

A

pinworms common in children
- severe rectal itching

124
Q

test for pinworms

A

tape test to look for eggs

125
Q

ave I&O for adults

A

1500-2000mL

126
Q

oliguria

A

below average urine output

127
Q

cause for polyuria

A

decreased insulin, causing increased glucose in blood, which pulls more fluid into the blood from cells and is excreted in the urine

128
Q

urometer

A

box on a urine drainage bag used to measure exact urine output per hour

129
Q

CBI

A

continuous bladder irrigation

130
Q

CBI purpose

A

to prevent blood clots from blocking urethra

131
Q

what to assess with CBI

A
  • amount in
  • quality
  • amount out
132
Q

where to directly percuss for CBI

A

over costovertebral area for kidney tenderness

133
Q

where to percuss indirectly for CBI

A

over suprapubic are for bladder distention

134
Q

what should never be irrigated

A

urostomy or ileal conduit

135
Q

lower UTI

A

cystitis (ureters)

136
Q

upper UTI

A

pyelonephritis (kidneys)

137
Q

chronic renal failure

A

glomeruli fail to filter blood

137
Q

S&S of cystitis

A
  • dysuria
  • urinary freq. & urgency
  • cloudy urine odor
  • confusion in older adults
  • kidney = flank and fever pain
138
Q

DVBS

A

signs of fluid overload in bloodstream
Dyspnea
Venous distention
Bounding pulses
Sensorium decreased

138
Q

decreased kidney filtration leads to…

A

fluid overload
increased wastes (acidosis) (hyperventilation)
anemia

139
Q

PA and lab findings for chronic renal failure

A

oliguria or anuria
fluid overload
- crackles with dyspnea
- edema
HTN
kyperkalemia
low calcium
high phosphate
decreased pH
decreased RBC and H&H (anemia)

140
Q

levels of creatinine and BUN in chronic kidney failure

A

both increased

141
Q

normals for creatinine and BUN

A

creatinine: 0.5 to 1.5
BUN: 7-18mg/dL

142
Q

microalbuminuria

A

protein in urine
seen in kidney failure

143
Q

what do pts on HDY require

A

anticoagulant

144
Q

which type of HDY accesses the vena cava

A

temporary
- red and blue ports like a CVC

145
Q

long term HDY

A

AV fistula

146
Q

STEAL syndrome or vascular access steal syndrome (VASS)

A

decreased arterial blood flow to distal extremity that has the AV fistula
- tissue ischemia
- pallor,
- decreased pulses (MOST serious)
- decreased cap refill

147
Q

what medicine to hold the morning of HDY

A

anti-HTN meds

148
Q

common vital sign abnormal on pts on HDY

A

decreased BP

149
Q

what to check daily for HDY pts

A

weight – should be down after HDY

150
Q

good indicators post-HDY

A

lower weight
decreased fluid volume
crackles disappear
bounding pulses come back to normal

151
Q

renal calculi

A

nephrolithiasis
AKA: kidney stones

152
Q

increased risk for kidney stones

A

family history and dehydration

153
Q

S&S of kidney stones

A
  • severe colic (back and side pain)
  • moves around side and down into lower abd. and into groin
  • N/V
  • Dysuria
  • Hematuria
154
Q
A
155
Q
A
156
Q
A

PA (10 decks)

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