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Block 4 Exam 3 > Tx/mgmt > Flashcards

Tx/mgmt Flashcards

1
Q

DI

A

Fluid deprivation test
Vasopressin

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2
Q

SIADH

A

Neuro assessments
Lasix
3% NS

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3
Q

Addison

A

IV fluids
IV hydrocortisone
Corticosteroids
Vasopressors
Recumbent/legs elevated
Abx if due to infection

(Must have supplemental steroids when undergoing stress)

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4
Q

Cushing (procedures and tests)

A

Dx 2/3 must be positive (serum cortisol, urine cortisol, low dose Dexamethasone suppression test)

Surgery if tumor
Adrenalectomy

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5
Q

DKA and HHS

A

IV fluids
IV insulin
Restore pH and lyte balance
Potassium

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6
Q

Components of hemodynamic monitoring system

A

Disposable flush system
Pressure bag (300 mm Hg, prevents clotting and backflow)
Transducer (to show electrical signal)
Amplifier/monitor

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7
Q

Nursing role with hemodynamic monitor

A

Ensure no air bubbles
Stopcock at phlebostatic axis
Zeroed out

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8
Q

What the heck does a CVP monitor do? What’s a normal value?
Where do you stick it?

A

Measures pressure at vena cava/R atrium and the preload at the right ventricle
Normal 2 to 6 mmHg
At subclavian vein

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9
Q

What the heck does a PAP monitor do?
What are some considerations?

A

Monitors pulmonary arterial pressure at the left ventricle
Don’t fill balloon with fluids - only fill with 1.5 mL air to measure PAWP (L vent preload) for 15 seconds max

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10
Q

Sinus bradycardia

A

Pacemaker
Underlying
Atropine, dopamine, Epi

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11
Q

Sinus tachycardia

A

Synchronized cardioversion
Vagal, cold stimulation
IV BB
CCB
Ablation if all else fails

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12
Q

Atrial flutter

A

Cardioversion
Catheter ablation
Drugs (see other f card)

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13
Q

Afib

A

Cardioversion
Ablation
Maze with cyoablation
LAAO (left arterial appendage occlusion with Watchman for stroke prevention)
Drugs (antiarrhythmics and antithrombics) - see other f card

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14
Q

V Tach

A

Cardioversion
Defibrillation if pulseless/unresponsive
Antiarrhythmics (see other f card)
ICD for long term tx

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15
Q

V fib

A

CPR, ACLS
Defibrillator
Epi, amiodarone

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16
Q

Asystole

A

CPR
IV access
Find cause (Hs and Ts)
Epi, atropine

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17
Q

PEA

A

CPR
Intubation
IV epinephrine
Underlying cause

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18
Q

Anemia

A

Underlying
PRBC
Diet
Iron, folate, B12
Immunosuppressive therapy

19
Q

Education for neutropenia to decrease infection risk

A

Mask
Avoid crowds
Healthy diet and lifestyle
No fresh fruit or flowers
Handwashing and overall hygiene
Notify provider if infection
IS/deep breathe

20
Q

Bleeding disorders

A

Platelet transfusion
Aminocaproic acid
Limit injury

21
Q

DIC

A

Underlying
Correct tissue ischemia
Fluid and lytes
Maintain BP (vasopressor)
Replace coagulation factors
Heparin, LMWH
Do not use aminocaproic acid
Avoid bleeding
Avoid increasing ICP

22
Q

Polycythemia Vera

A

Phlebotomy
Chemo to suppress bone marrow
Mgmt atherosclerosis
Meds (see other f card)

23
Q

Lupus

A

Prevent loss of organ function
Avoid sun
Prevent infections
Manage fatigue, impaired skin integrity, osteoporosis
Smoking cessation
Skin integrity

24
Q

Sickle cell

A

Stem cell
Hydroxyuria
Daily folic acid
Corticosteroids
Transfusions
Vax up to date
Pain mgmt
Fatigue management
Infection prevention
IVF, O2
Hydration, nutrition, rest and activity

25
Q

Hereditary hemochromatosis

A

Phlebotomy
Avoid iron and vitamin C supplements
Decrease ETOH

26
Q

AV block

A

IV atropine
Pacemaker

27
Q

Sick day rules for DM

A

Normal insulin/anti diabetic
Test BG and ketones q3-4h
Take additional insulin if needed
Soft foods 6-8x/day
Liquid q30-60m

28
Q

HF

A

Meds (see other f card)
Lifestyle
O2
ICD
Heart transplant
Bed rest when acute
30 minute of activity
Avoid extreme temp
Good HOB
Manage fluid volume, low salt

29
Q

Pulmonary edema

A

Nonrebreather
Furosemide and nitro
Dangle feet
I/O

POND: position/PVV, oxygen, nitro, diuretics

30
Q

Anaphylaxis

A

O2, intubation, CPR
Epi
IV Fluids
Take to ER
Monitor for rebound in 4-8 hours

31
Q

Postexposure prophylaxis for HC worker

A

ART within 72 hours
2-3 drugs for 28 days
HIV testing after 6 weeks, 12 weeks, and 6 months

32
Q

Hematologic assessment includes looking for…

A

Fatigue
Delayed clotting
Family history
Bruising and bleeding
Abdominal pain
Joint pain
Abnormal blood cell counts
Illness
Dyspnea
Diet low in B12, iron, folate
Skin discoloration (ruddy, pallor, bronze, rash, jaundice)
Swollen tongue
Occult blood

33
Q

Ascites assessment

A

Girth and weight daily
Look for striae, distended veins, umbilical hernia
Percuss for dullness
Monitor for f and l imbalances

34
Q

Ascites tx

A

Low sodium diet
Diuretics (spironolactone)
Bed rest
Paracentesis
Albumin
TIPS

35
Q

Hepatic encephalopathy assessment

A

EEG
LOC
Fluid, lyte, ammonia levels
Monitor for seizures and fetor hepaticus

36
Q

Hepatic encephalopathy mgmt

A

Underlying
Lactulose
IV glucose to decrease protein metabolism
Flumazenil
1.2 g protein/kg/day
Reduce ammonia via suction, enema, oral abx
Dc sedatives
Tx comps and infections
Rifaximin, neomycin, metronidazole to decrease ammonia forming bacteria in colon

37
Q

Esophageal varices

A

Shock tx, O2
IVF, lytes, volume expanders, blood products
Vasopressin, somatostatin/octreotide to decrease bleeding
Nitro with vasopressin
Propranolol and nadolol
Balloon tamponade
Endoscopic sclerotherapy
Banding ligation
TIPS
Surg - bypass, devasc and transaction

38
Q

HAV

A

Hygiene
Safe water
Vax
IG
Bed rest
Nutrition

39
Q

HBV

A

Antivirals ETV and TDF
Bed rest
Nutrition
Vax
Screen blood products

40
Q

HCV

A

Number one cause for liver transplant
Stop etoh
Antivirals
Avoid hepatotoxic meds
Needle safety

41
Q

Cirrhosis

A

IO
Small frequent
High calorie low sodium
1.2 g protein/kg/day
Vitamins
Skin
Prevent injury

42
Q

Cholelithiasis

A

ERCP
Low fat
Ursodeoxycholic acid 6-12 months
Chenodeoxycholic acid
Laparoscopic cholecystectomy

43
Q

Interventions for gb surg includes

A

Low Fowler
NG/NPO til bowel sounds
Progress to soft low fat/high carb
Biliary drainage system
Pain mgmt
Splinting, cough, db
Ambulation

44
Q

Pancreatitis

A

Pain mgmt (PCA)
Resp care
Biliary drainage
NPO, rest, NGT
Surg
Nutrition (low fat, low protein)
Skin
F and lytes, combat shock/MODS/pancreatic necrosis

Block 4 Exam 3 (4 decks)

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