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Block 2 Exam 2 > Treatment > Flashcards

Treatment Flashcards

1
Q

AKI

A

Underlying cause
Fluid balance
Sodium polystyrene sulfonate, sorbitol, IV insulin/D50 for hyperkalemia
IV bicarbonate
Dialysis

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2
Q

AKI and CKD

A

Fluid balance (prevent excess)
Adequate nutrition (increase protein and calcium and vitamin D)
Education
Activity with rest
Prevent complications

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3
Q

FVE

A

I/O, weights
Limit fluid
Oral hygiene

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4
Q

ESKD

A

RRT
Dialysis
Kidney transplant

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5
Q

ESRD diet

A

4-5 small meals
Low salt
Low potassium
Low phosphorus
High protein
Limit fluids

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6
Q

Types of RRT

A

HD, CRRT, PD, Hemofiltration, hemodiafiltration

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7
Q

Kidney transplant contraindications for living donor

A

HTN and DM

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8
Q

Kidney transplant requirements

A

No infection
Anti rejection meds
Psychosocial evaluation

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9
Q

Sinus Brady

A

Change meds
Pacemaker
Atropine

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10
Q

Sinus tachy

A

Vagal maneuver
Meds: BB, CCB, adenosine

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11
Q

A fib drugs and devices

A

BB
Warfarin
Amiodarone
Cardioversion, ablation, watchman

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12
Q

Adjunct with meds for arrhythmias

A

Pacemakers
Cardioversion
Defibrillation

6 minute walk test

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13
Q

Prevention CAD

A

Lower cholesterol with diet and meds
Exercise
Stop smoke
Manage HTN
Control DM

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14
Q

Angina goal

A

Decrease oxygen demand and increase the supply
Reduce and control risk factors

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15
Q

Angina meds

A

Nitro
BB, CCB
Antiplatelet/anticoagulants- aspirin, clopidogrel and ticlopidine, heparin, glycoprotein inhibitors
May also need PPI, H2 for GI upset

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16
Q

MI

A

MOAN: morphine, oxygen, aspirin (ASA), nitro (NTG)
BB, heparin

PCI for STEMI
Thrombolytic (“plase”) if no PCI

Inpatient: cardiac monitor, meds, ASA and clopidogrel, BB, ACE ARB

Goals include: improve respiratory and perfusion

Nursing: oxygen, elevate head, IO, pain, frequent assessment and evaluation

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17
Q

Mitral regurgitation

A

HF treatment (BB, ACE, ARB)

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18
Q

Mitral stenosis

A

Anticoagulant, BB, CCB, digoxin

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19
Q

Aortic regurgitation

A

ACE, CCB
Valvuloplasty, valve replacement

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20
Q

Aortic stenosis procedures

A

TAVR (valve replacement), percutaneous valvuloplasty

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21
Q

Nursing for valvular heart disorders

A

Daily weights, activity with rest
(Along with typical monitor and med stuff)

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22
Q

Nursing for valve surgery (plasty or replacement)

A

Monitor for HF and emboli
(Along with typical perioperative stuff like VS, anesthesia recovery, stability)
Anticoagulant, prevent endocarditis, echoes

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23
Q

Cardiomyopathy nursing

A

Low Na, fluid restriction
Meds
Exercise, pacemaker
Rest with legs down, O2

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24
Q

Heart infection prevention

A

Abx and oral hygiene
Immunization

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25
Q

Lower UTI prevention

A

Shower, hygiene, fluids, pee, vitamin C or cranberry juice

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26
Q

Lower UTI treatment

A

Fluids
Avoid coffee, tea, citrus, cola, alcohol
Abx and analgesics
Heat

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27
Q

UTI hospital protocol

A

If no void 4-6 hrs/symptomatic, scan
If scan >300 ml do straight cath
Repeat if not fix
Foley if still problem

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28
Q

Pyelonephritis

A

Usually outpatient
Abx and fluids

If chronic: strict IO and temp

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29
Q

Urolithiasis

A

Pain and infection control
ID location and type
Increase fluid - we want 2 L UOP
Strain all UOP

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30
Q

Urolithiasis surgical procedures

A

Ureteroscopy, ESWL (shockwave lithotripsy), percutaneous nephrolithotomy, chemolysis with percutaneous nephrostomy

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31
Q

Bladder cancer

A

Radiation, chemo
Surgery: transurethral resection “TURBT”, cystectomy with diversion

Non invasive: TURBT then IVT then surveillance; lifestyle

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32
Q

Neobadder nursing

A

F and lytes and nutrition
Prevent acidosis
Catheter care, bladder retraining

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33
Q

Cutaneous diversion nursing

A

Monitor urine volume hourly
Stoma and skin care
Fluids
Self care

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34
Q

BPH drugs and nursing

A

Alpha block (alfuzosin, tamsulosin, terazosin)
Anti androgen (finasteride, dutasteride)
Pain and spasm control
Catheter for acute/unable to void

35
Q

BPH surgical procedures

A

TUMT (transurethral microwave)
TUNA (transurethral ablation)

Resections: TURP, suprapubic, retropubic, transurethral incision

36
Q

BPH post TURP care

A

CBI (continuous bladder irrigation)
Pain control
Monitor for hemorrhage and infection
Early ambulating

37
Q

Prostate cancer

A

ADT hormonal therapy
Therapeutic vaccine
Radiation and chemo
Resection

38
Q

Post prostate surgery mgmt

A

Treat if transurethral resection syndrome
F and lyte
Manage complications: hemorrhage, infection, VTE, catheter
CBI

39
Q

CBI mgmt

A

Titration high when red til clear then slow
CBI infused - foley OP = UOP
Bring in a back up bag

40
Q

HF nursing and surgical options

A

Meds, lifestyle, O2
Surg: ICD (defibrillator device), valve repair, heart transplant

41
Q

HF meds

A

Diuretics
ACE, ARB, BB
Ivabradine
Hydralazine and isosorbide dinitrate
Digoxin

42
Q

Special considerations with treating HF older patient

A

Diuretics with BPH
Drugs with decreased renal
Atypical ss: fatigue, weak, somnolence

43
Q

HF nursing

A

Activity with rest - 30 minutes, wait 2 hours after eating, avoid extremes
Elevate head of bed
Relieve fluid overload - weight, IO, diuretics, fluid and sodium restriction
Treat comorbidities
Education- include teachings on vaccines and infection prevention

44
Q

Pulmonary edema

A

O2, NRB, CPAP, BiPAP
Diuretics, dilators (nitro)
Upright with dangly legs
IO

45
Q

Pericardial effusion and cardiac tamponade

A

Pericardiocentesis
Pericardiotomy

46
Q

Drugs for PAD

A

Phosphodiesterase inhibitor: cilostazol
Antiplatelets
Statins

47
Q

Surg for PAD

A

Balloon angioplasty
Stent
Atherectomy
Bypass graft

48
Q

PAD nursing

A

Monitor pulses frequently
ABI
Exercise and SET program

49
Q

Aneurysm management

A

Control HTN with BB, hydralazine, sodium nitroprusside for emergency
Surgery

50
Q

Abdominal aortic aneurysm

A

BB, CCB, ACE, ARB, diuretic
Stent, removal with graft

51
Q

DVT prevention

A

Early ambulation and leg exercises
TED hose and SCDs
Heparin, LMWH
Lifestyle: weight, smoke, exercise

52
Q

Pulmonary embolism drugs and surg

A

Unstable: thrombolytics, bypass surgery (rare)
Stable: heparin gtt, LMWH, apixaban

53
Q

Pulmonary embolism nursing

A

Monitor SpO2
Manage pain
Monitor complications

54
Q

Leg ulcers

A

Abx and analgesics
Compression therapy
Debridement
Silver dressing
Avoid heat
Gradually progress activity
Nutrition for healing- protein, vitamins A and C, iron, zinc

55
Q

Cardiomyopathy surgery

A

Assist devices (VAD, LVAD)
IAP (balloon pump)
Total artificial heart as last resort

Anti rejection drugs

56
Q

Angina surgical options

A

Reperfusion therapy (PCI, stents, CABG)

57
Q

Angina nursing

A

Rest, semi Fowler, assessment, meds, 2 L NC

58
Q

Angina teaching

A

Stop smoking, low fat high fiber, carry nitro always, maintain good BP and blood sugar

59
Q

Cholesterol drugs

A

Statins
Bile acid sequestrants
Nicotinic acids
Cholesterol absorption inhibitors
Omega 3 acid ethyl esters

60
Q

DM

A

Nutrition
Exercise
Monitor
Pharm
Education

61
Q

DM diet

A

50-60% carbs
20-30% fats
<10% saturated
<300 mg cholesterol
Non animal proteins
Increase fiber

62
Q

Lower glycemic index

A

Combined with fats or proteins
Raw or whole

63
Q

Somogyi

A

Insulin adjustment
Bedtime snack

64
Q

Dawn phenomenon

A

No carbs before bed
Insulin at bedtime

65
Q

HHS

A

Rehydrate with iso or hypo
Insulin with D5
Monitor f and lyte
Tele

66
Q

Diabetic nephropathy - drugs, diet, other

A

ACE, prevent UTI, low salt low protein diet, dialysis

67
Q

Insulin drip protocol

A

100 units/ 100 mL
140-180 glucose
Check glucose q1h
D5W driver

68
Q

Hypoglycemic mgmt

A

15-20 gram fast carb, 4-6 oz juice or soda, 3-4 glucose tabs
Recheck 15 minutes later
Retreat if necessary
Snack with carb and protein unless meal in 30-60 minutes
Intranasal glucagon

69
Q

Emergency hypoglycemia treatment

A

<55
IM or SC 1 mg glucagon
Fast carb and snack
25 to 50 mL D50 IV
Ketone and glucose test strip education

70
Q

SIADH

A

Furosemide, hypertonic IV if severe hyponatremia
IO, weights, monitor labs, neuro

71
Q

Hypothyroidism

A

Levothyroxine 75 to 150 mcg/day to start, then raise til labs are normal
Activity intolerance, monitor for myxedema and constipation and chest pain (angina)
Blankets but no heating pads
Infection prevention (can lead to myxedema)

72
Q

Hyperthyroidism

A

Small frequent
Cool environment
Monitor for storm, CV, resp, temp

73
Q

Calcium foods

A

Dairy
Seeds
Leafy greens
Almonds

74
Q

Hypercalcemic crisis

A

Rapid high vol iso 100-150 ml/hr
Calcitonin and mithramycin

75
Q

Hyperparathyroidism

A

Avoid high calcium diet, increase fluid to avoid stones
Monitor ss: stones, Ca crisis, apathy, fatigue, NVC, weak, HTN, arrhythmias
Education on fracture prevention
Increase exercise to move calcium into them bones

76
Q

Hypoparathyroidism

A

Diet: high Ca low phosph (no spinach or dairy)
Meds
If giving Ca with dig monitor arrhythmia
Monitor post neck surg for tetany, seizure, resp
Seizure precautions

77
Q

Thyroidectomy

A

Pre op: no caffeine, decrease stress to avoid storm

Post op: airway/breathing, tracheostomy tray, drains for OP, ss bleeding, ice chips then soft/liquid, monitor Ca and phosph

78
Q

Addison

A

Lifelong steroids
Restore circulation/increase BP via 3-4 L NS or D5, hydrocortisone + vasopressors, abx for chronic immune suppression
F and lytes, ortho hypo, fluids, IO

79
Q

Addison crisis

A

IVF, glucose, lytes (Na), steroids, vasopressors

80
Q

Cushing

A

Avoid injury, falls, infection, skin damage
Cardiac
Hypophysectomy/monitor Addison, radiation, taper steroids, insulin for hyperG

81
Q

Potassium foods

A

Fruits and vegetables
Legumes and whole grains
Milk and meat

82
Q

Phosphorus foods

A

Meat, dairy, beans

83
Q

Post PCI assessment

A

We want…
No chest pain
Normal VS
Normal neuro
Normal heart
Normal lung

Block 2 Exam 2 (6 decks)

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