Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations 2 > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

idiosyncratic effect

A

•an uncommon, unexpected, or individual drug response thought to result from a genetic predisposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

toxic effect

A

•a seriously adverse drug rxn caused by excessive dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

synergistic effect

A

•an increase in the effects of any or all of two or more drugs taken together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

adverse rxn/effect

A
  • any noxious, unintended, and undesired result of taking a drug in appropriate doses
  • NOT a side effect b/c side effects are harmless
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

drug tolerance

A

•pt requires increased dosage of medication to achieve intended therapeutic benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

addictive behavior

A

•pt continues to take medication despite harmful effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

physical drug dependence

A

•pt exhibits signs of withdrawal when a mediation is discontinued

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

drug reliance

A

•pt develops an intense craving for a drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

generic (nonproprietary) drug name

A
  • noncommercial name assigned to a drug by US adopted names
  • each drug has only ONE
  • syllables at end indicate class
  • Ex: acetaminophen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

enteral medication administration

A

•via GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

sublingual medication administration

A

•via mucosa under tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

transdermal medication administration

A

•via skin patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

parenteral medication administration

A

•via injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

preoperative period

A
  • begins when pt scheduled for surgery
  • ends at time of transfer to OR
  • time for pt and family teaching
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

inpatient surgical procedures

A
  • emergent- immediately
  • urgent- put on schedule ASAP
  • elective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

outpatient (ambulatory) surgery

A
  • most often elective
  • not acute
  • Ex: cataract removal, hernia repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

preoperative assessment

A
  • physical, emotional, and psychosocial status prior to surgery
  • Hx, meds, labs, allergies, anxiety, HTT
  • blood donations
  • discharge planning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

nurse role in informed consent

A
  • clarify info, but NOT give new info
  • witness pt signing form (must be done before pre-op meds)
  • ensure correct site is selected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

preoperative teaching

A 
•pain control
•breathing/spirometer
•ROM
•anti-embolism
•diet
•invasive devices
•anti-anxiety
*demonstrate and then have pt state understanding and demonstrate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

high RBC/hematocrit indicates…

A
  • high RBC production

* dehydration b/c blood is very concentrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

venous thrombo-embolism (VTE)

A
  • embolisms formed in venous blood due to venous stasis/pooling (legs/heart)
  • can develop DVT or pulmonary embolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

pts most at risk fro VTE

A
  • immobile
  • obese
  • > 40 y/o
  • hx of cancer
  • spinal injury
  • Hx of VTE, PE, varicose veins, edema
  • oral contraceptives
  • smoking
  • hx decreased cardiac output (pooling blood in heart)
  • hip fracture, total hip/knee surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

NPO prior to surgery

A

•6-8 hrs before general anesthesia
•3-4 hrs before local anesthesia
•goal is to prevent aspiration
*consult physician regarding regularly scheduled meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

hypothermia during surgery

A

•increases chance of surgical/wound infection
•alters metabolism of meds
*why need to give pt warm blanket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

prophylactic antimicrobials

A
  • given 1 hr prior to incision

* given to prevent surgical site infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

biggest concern of sedatives/opioids

A

•respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Intraoperative care

A

•while pt is in surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

holding area nurse

A

•monitors pt before surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

circulating nurse

A
  • coordinates all activities in OR
  • sets up/checks equipment
  • preps pt
  • documents care/events
  • counts sponges/instruments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

scrub nurse

A
  • sets up sterile field
  • drapes pt
  • hands sterile instruments
  • supplies surgeon
  • maintains sponge/equipment count
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

equipment/sponge counts

A

•performed 4 times

  1. ) before
  2. ) during
  3. ) beginning of 1st closure
  4. ) before final closure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

anesthesia

A
  • induced state of partial or fatal loss of sensation
  • with or w/o loss of consciousness
  • used to block nerve impulse, suppress reflex, relax muscle, achieve controlled unconsciousness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

general anesthesia

A
  • reversible loss of consciousness induced by inhibiting neuronal impulses in CNS
  • causes analgesia, amnesia, unconsciousness, and loss of reflexes/tone
  • used for major surgery or requiring major muscle rlx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

inhaled anesthetics

A
  • volatile gases/liquids dissolved in O2
  • most controllable method
  • few side effect
  • limited muscle rlxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

IV anesthetics

A
  • rapid
  • contraindicated w/ kidney/liver dz
  • increases resp. depression
  • Ex: propofol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

balanced anesthesia

A
  • combo of IV drugs and inhaled agents

* goal is sedation, amnesia, analgesia, immobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

adjuncts to general anesthetic agents

A
  • hypnotics
  • opioid analgesics
  • neuromuscular blocking agents (need other meds on board b/c will paralyze conscious pt)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

malignant hyperthermia

A
  • acute, life-threatening complication of drugs (anesthetics)
  • begins when skeletal muscle exposed to agent
  • causes increased Ca2+ levels in muscles
  • causes increased muscle metabolism
  • causes increase in serum Ca2+ and K+
  • leads to metabolic acidosis (not enough O2 to cells), cardiac dysrhythmias, high body temp
  • can occur during any point of anesthetic administration, maintenance, or recovery
  • may be genetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

clinical manifestation malignant hyperthermia

A
  • tachycardia/pnea
  • elevated body temp
  • muscle rigidity
  • skin mottling
  • cyanosis
  • myobloinuria (muscle protein in urine)
  • rise in tidal CO2 and decrease in O2 sat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

local anesthesia

A
  • loss of sensation w/o loss of consciousness
  • motor fxn may/may not be affected
  • topical, local infiltration, or regional
  • often supplemented w/ sedative, opioid analgesics, hypnotics
  • risk for aspiration low b/c cough/gag reflex intact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

regional anesthesia

A
  • blocks multiple peripheral nerves in specific body region
  • field
  • nerve
  • spinal
  • epidural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

field anesthesia

A

•series of injections around operative field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

nerve anesthesia

A

•injection into or around one nerve or group of nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

spinal anesthesia

A
  • injection into CSF in subarachnoid space

* abdominal, pelvic, hip, knee surgeries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

epidural anesthesia

A
  • injection into epidural space

* anorectal, vaginal, perinea, hip, lower extremity surgeries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

moderate (conscious) sedation

A
  • IV delivery of sedative, hypnotic, opioid drugs to reduce LOC for minor procedures w/o pt having discomfort
  • pt responds to verbal stimuli, retains reflexes, and is easily aroused
  • pt maintains airway
  • often used for burn debridement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

addressing malignant hyperthermia

A
  • stop procedure and remove from anesthesia
  • bag pt
  • give IV Dantrolene muscle relaxant given for malignant hyperthermia
  • may also have to give sodium bicarbonate
  • lavage organs with cold water (addresses high temp)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

which factor is of greatest concern for risk of infection during surgery

A

•diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

postoperative period

A

•begins w/ completion of surgery and transfer to PACU, ambulatory care unit, or ICU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

PACU recovery room

A
  • ongoing evaluation/stabilization of pt to anticipate, prevent, and manage complications after surgery
  • priorities include resp. and circulation (bleeding)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

circulating nurse AND anesthesia providers’ role post-op

A
  • transfer pt to PACU

* give PACU nurses verbal hand-off reports

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

function return after surgery

A
  1. touch
  2. movement
  3. pain
  4. warmth
  5. cold
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

readiness for discharge from PACU

A
  • pt goes home or post surgical unit
  • pt must take fluids orally and safely ambulate to bathroom w/ assistance
  • pt must have aldrete score of 8-10, stable VS, no bleeding, return of reflexes, moderate drainage, and UOP of at least 30 ml/hr
  • auscultation of bowel sounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

aldrete score

A
  • used to monitor recovery from anesthesia
  • scores from 0-2 in all areas
  • greater score -> better
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

5 areas to determine aldrete score

A
  1. ) activity
  2. ) consciousness
  3. ) respiration
  4. ) O2 saturation
  5. ) circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

emergy care of pt w/ opioid overdose

A
  • administer Narcan 1-2 mg IV every 2-3 min
  • repeat until 10 mg reached if needed
  • maintain open airway
  • O2 if hypoxia present
  • suction if vomiting
  • don’t leave pt alone
  • monitor every 10-15 min until stable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

post-operative complications

A
  • airway obstruction
  • hypoxia
  • hypovolemic schock (massive loss circulating blood)
  • paralytic ileus
  • wound dehiscence or evisceration
  • DVT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

hypoxemia

A
  • poor tissue perfusion
  • highest incidence 2nd post-op day
  • tx w/ airway maintenance, semi-fowlers, O2 therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

major components of fluid in body

A

1.) intracellular (ICF)- ⅔
2.) extracellular (ECF)- ⅓
•ECF includes intravascular and interstitial
•fluid can move b/t

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

electrolytes

A
  • minerals (salts) present in body fluids
  • regulate fluid balance and hormone production
  • strengthen skeletal structures
  • serve as catalysts for nerve responses, muscle ctx, and metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

fluid volume deficit (FVD)

A
  • fluid imbalance
  • hypovolemia and dehydration
  • tachy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

hypovolemia (isotonic FVD)

A
  • body loses fluid and electrolytes from ECF
  • intravascular fluid lost
  • can lead to hypovolemic shock
  • thready pulse b/c pumping blood faster
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

dehydration (osmolar FVD)

A

•water, but not electrolyte loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

compensatory mechanisms for FVD

A
  • SNS responses of thirst
  • ADH release
  • aldosterone release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

hemoconcentration

A

•decrease in the volume of plasma in relation to # of RBCs
•increase in concentration of circulating RBCs
•increases in Hct, Hgb, electrolytes, and urine specific gravity
*expected in endurance athletes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

FVD causes

A
  • GI losses (vomit, diarrhea, etc)
  • diaphoresis
  • renal loses
  • hemorrhage
  • third spacing- retaining fluid in interstitial spaces (ascites, burns)
  • altered fluid intake
  • hyperventilation
  • diabetes ketoacidosis
  • fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

FVD subjective

A
  • dizzy- poor perfusion to brain
  • weak
  • lethargic
  • fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

FVD objective

A
  • hyperthermia
  • syncope
  • tachycardia/pnea- compensate to maintain CO
  • thready pulse- vasoconstriction in periphery
  • hypotension
  • oliguria
  • confusion
  • diminished cap. refill
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

FVD laboratory

A
  • increased Hct
  • increased serum osmolarity
  • increased urine specific gravity and osmolarity
  • hypernaturia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

hypernatremia

A

•increased serum sodium or excessive water concentration in relation to sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

FVD tx

A
  • IV fluid replacement

* crystalloids or collide, depending on how fluid was lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

is it better to replace fluids via PO or IV

A
  • PO b/c normal body fxn

* If urgent, give IV b/c it’s fastest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

crystalloids

A 
•lactated ringers 
•normal saline
•isotonic
•used for dehydration situation
*best IV fluid replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

colloids

A
  • blood transfusions
  • larger molecules that help draw fluid into intravascular space
  • most often used for hemorrhage, massive wound, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

hypotensive postion

A
  • on back w/ legs elevated

* trendelenburg if crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

acceptable UOP

A

•greater than 30 mL/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

hypovolumetric shock

A
  • decreased oxygen to organ/pressure to organ
  • complication of FVD
  • tx w/ O2, fluids, vasoconstrictors (increase central flow first)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

fluid volume excess (FVE)

A
  • fluid imbalance
  • hypervolemia or over-hydration
  • tachy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

hypervolemia (isotonic FVE)

A
  • both water and sodium are retained in high proportions
  • blood volume increases
  • severe cases can lead to pulmonary edema, heart failure, and hyponatremia
  • bounding pulse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

over hydration (osmolar FVE)

A

•more water than electrolytes gained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

compensatory mechanism for FVE

A
  • release of natriuretic peptides -> increased excretion Na+/H2O from kidneys
  • decreased release of aldosterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

FVE risk factors

A
  • heart failure, increased glucocorticosteroids (-> fld retention)
  • kidney failure
  • fluid shifts (burns, IV fluid admin)
  • excessive Na+ intake
  • excessive fluid intake w/o electrolytes (athletes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

FVE subjective

A
  • confusion
  • SOB
  • lethargy
  • muscle weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

FVE objective

A
  • tachycardia/pnea
  • bounding pulse
  • hypertension
  • weight gain
  • crackles
  • edema
  • JVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

FVE labs

A
  • decreased Hct, serum osmolarity
  • decreased BUN, creatinine, electrolytes
  • respiratory alkalosis (dec. CO2/inc. pH)
  • chest x-ray showing pulm. congestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

FVE tx

A
  • limit fluid/Na+ intake
  • admin diuretics
  • admin O2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

hypotonic solution

A
  • osmolarity of less than 270 mOsm/L
  • fluid into cells (lyse)
  • 0.5% NS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

hypertonic ECF

A
  • osmolarity of greater than 300 mOsm/L
  • fluid out of cells (crenation)
  • 1.5% NS or 3% NS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

isotonic ECF

A
  • osmolarity of 270-300 mOsm/L

* 0.9% NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

aldosterone

A

•excreted by the cortex of the adrenal gland in response to low Na+ levels
•prevents sodium and water loss
*retain fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

anti-diuretic hormone (ADH)

A

•Produced in the posterior pituitary
•acts on kidneys to make kidneys reabsorb more water so that the body retains more fluid
*retain fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

natriuretic peptides (NPs)

A

•released in response to barorecptors in the heart or vascular system detecting increased blood volume
*LOSE fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

renin angiotension system

A
  • in response to low BP, blood volume, blood O2, and blood osmolarity kidneys excrete renin
  • renin catalyzes formation of angiotension I, which is converted to angiotension II (active form) by ACE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

angiotension II

A
  • vasoconstrictor
  • causes nephrons to contract, decreasing UOP
  • causes kidneys to release aldosterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

an ACE inhibitor would be classified as…

A
  • diuretic
  • lowers BP b/c blocks production of angiotension II
  • commonly used for mild HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

sodium

A

•major electrolyte found in ECF (intravascular), body fluids, and secretions
•essential for maintenance of acid-base and fluid balance, transport mechanisms, and nerve conduction
*imbalances cause NEURO problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

expected serum sodium levels

A

•135-145 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

hyponatremia

A

•serum Na+ level less than 136 mEq/L
•net gain of H2O or loss of Na-rich fluids
•delays/slows depolarization of membranes
•H2O moves from ECF to ICF (cerebral edema)
•Na+ loss via GI, renal, skin
•also caused by increased ECF H2O
*dehydrated OR over hydrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

hyponatremia s/s

A
  • serum Na+ level less than 136 mEq/L (BMP)
  • serum osmolarity less than 280 mOsm/kg
  • heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

hyponatremia tx

A 
•fld restriction
•loop diuretics and ACE inhibitors
•admin hypertonic sol. (3% NaCl)
•high Na+ food intake
*can't correct too quickly
101
Q

hypernatremia

A
  • serum Na+ level greater than 145 mEq/L
  • cells depleted of fld needed to fxn
  • causes hypertonicity of serum (water out of cells) -> dehydration
102
Q

hypernatremia s/s

A
  • serum Na+ level greater than 145 mEq/L
  • serum osmolarity greater than 300 mOsm/kg
  • Cushing syndrome
103
Q

hypernatremia tx

A
  • for fluid loss: admin hypotonic/isotonic fld

* for excess Na+: water intake and loop diuretics

104
Q

potassium

A

•major cation of ICF
•vital role in cell metabolism, nerve impulse transmission, cardic/lung fxn, etc
*imbalances cause CARDIAC problems

105
Q

expected K+ level

A

•3.5-5 mEq/L

106
Q

hypokalemia

A

•serum K+ below 3.5 mEq
•results from increased loss of K+ from body
•may be from from movement of K+ into cells (insulin high)
•Lasix (furosimide) cause K+ loss
*key s/s is fluttering chest

107
Q

hypokalemia s/s

A

•hypotension
•weak pulse
•confusion
•serum K+ below 3.5 mEq
•atrial blood gases reveal metabolic alkalosis (pH > 7.45)
*irregular EKG- inverted T waves (CARDIAC issues)

108
Q

hypokalemia tx

A
  • encourage K+ intake
  • admin K+ PO (best b/c absorbed better thru GI)
  • admin K+ IV (NEVER bolus)
109
Q

hyperkalemia

A
  • K+ Level of more than 5.0 mEq/L
  • results of increased K+ intake, movement of K+ out of cells, and inadequate renal excretion
  • causes include intake, tumor lysis, diabetes
  • can be caused by salt substitute -> K+ overdose
  • poses risk for cardiac arrhythmias and cardia arrest
110
Q

hyperkalemia s/s

A

•K+ Level of more than 5.0 mEq/L
•atrial blood gases reveal metabolic acidosis (pH < 7.45)
•oliguria/diarrhea
•irregular pulse
•irregular EKG shows vent. fibrillation, peaked T waves, widened QRS
*CARDIAC issues

111
Q

hyperkalemia tx

A
  • Decrease K+ intake
  • Administer Calcium Gluconate or Calcium Chloride
  • Administration if IVF along with D50 and insulin- K+ movement to ICF
  • Administer loop diuretics- K+ excretion
  • Administer Kayexalate (sodium polystyrene)- K+ excretion in stool
112
Q

calcium

A
  • electrolyte found in cells, bones, and teeth
  • essential for CV, nervous, and endocrine fxn
  • role in blood clotting and bone/teeth formation
  • important in depolarization of membranes
  • s/s involving SKELETAL MUSCLE
113
Q

expected Ca2+ levels

A

•9-10.5 mg/dL

114
Q

hypocalcemia

A
  • serum Ca2+ less than 9 mg/dL
  • bradycardia
  • hyperactive bowel sounds
  • hypotension
  • osteoporosis
  • muscle cramps (SPASMS)
  • risk of seizure/fall
  • Trousseau’s sign- wrist spasm with BP cuff
  • Chvostek’s sign- cheek muscle twitch when tap
115
Q

hypocalcemia tx

A
  • replace Ca2+ PO and IV

* admin vit. D

116
Q

hypercalcemia

A 
•serum Ca2+ greater than 10.5 mg/dL
•lethargy
•paresthesia 
•mscl WEAKNESS
•excitable tissues are less sensitive to normal stimuli, therefore it is harder for muscles to contract
•causes faster clotting time
*high risk for DVT
117
Q

hypercalcemia tx

A
  • stop intake of calcium and vitamin D
  • admin of isotonic sol to restore balance
  • discontinue thiazide diuretics
  • admin of Phosphorous, Lasix, calcium binders
  • dialysis
118
Q

expected phosphorus level

A
  • 3.0 - 4.5 mg/dL

* s/s involve SKELETAL MUSCLES

119
Q

hypophosphatemia

A
  • serum phos < 3.0 mg/dL
  • doesn’t affect body fxn except in chronic situations
  • RECIPROCATES Ca2+, so effects similar to HYPERCALCEMIA
  • risks include malnutrition, antacids, alcoholism, hyperglycemia, etc
  • muscle weakness
120
Q

hypophosphatemia tx

A
  • Discontinue antacids, calcium supplements
  • IV phosphorous only given when levels below 1 mg/dL
  • Increase intake of phosphorous rich foods (fish, chicken, beef, pork, organ meats, nuts, whole grains)
121
Q

hyperphosphatemia

A
  • serum phos >4.5 mg/dL
  • same as HYPOCALCEMIA in regards to s/s and tx
  • muscle spasms
  • hypoparatyroid/kidney dz
122
Q

magnesium

A

•electrolyte found mostly in bones
•small amt in cells and ECF
•important for skeletal muscle contraction, metabolism of carbohydrates, ATP formation, cell growth (preggo)
*s/s involve DTRs

123
Q

expected Mg2+ level

A

•1.3-2.1 mEq/L

124
Q

hypomagnesemia s/s

A
  • serum Mg2+ less than 1.3 mEq/L
  • occurs in conjunction w/ hypocalcemia
  • HYPERACTIVE DTRs (spasm)
  • tetany
  • seizures
  • psychosis
125
Q

hypomagnesemia tx

A
  • discontinue drugs that cause mag loss
  • IV replacement when loss is severe
  • Oral replacement (can cause diarrhea)
126
Q

hypermagnesemia

A 
•serum Mg2+ > 2.1 mEq/L
•renal dz
•lethargy
•HYPOACTIVE DTRs (weakness)
•coma
•bradycardia 
•hypotension
*use of laxatives poses major risk
127
Q

hypermagnesemia tx

A
  • discontinue oral and parenteral magnesium
  • give fluids free of mag
  • loop diuretics
  • calcium to reduce the cardiac side effects
128
Q

weight of 1 L water

A
  • 2.2 lbs

* 1 kg

129
Q

use of laxatives

A
  • hypermagnesemia

* hypokalemia

130
Q

mental status assessment

A
  • LOC

* orientation (x3)

131
Q

levels of consciousness

A
  • alert
  • lethargic- drowsy
  • stuporous- require stimulation to arouse
  • comatose- unconscious
132
Q

rapid neuro assessment

A
  • mental status
  • movement of extremities
  • pupil size/rxn to light
  • glasgow coma scale
133
Q

Glasgow Coma Scale

A
  • used to determine LOC and monitor changes following injury, tx, etc
  • Eye opening
  • Motor response
  • Verbal response
  • 15 = normal neuro function
  • 7 = coma
134
Q

what can pass thru BBB

A
  • glucose
  • O2
  • CO2
  • alcohol
  • anesthetics
  • water
135
Q

damage to cerebrum

A

•contralateral impact

136
Q

damage to cerebellum

A

•ipsilateral impact

137
Q

seizure

A

•abrupt, abnormal, excessive, and uncontrolled electrical discharge of neurons within the brain
•may cause alterations in LOC, motor/sensory ability, and/or behavior
•can be generalized (6 types), partial, or unclassified
*generalized involve BOTH hemispheres

138
Q

primary (idiopathic) epilepsy

A
  • chronic recurring abnormal brain electrical activity
  • dx based on hx and labs to rule out other causes
  • considered a syndrome
  • due to imbalance of nts (GABA)
139
Q

tonic-clonic seizure

A

•generalized
•used to be known as grand mal
•may (rarely) begin with aura (altered sense)
•begins for few sec w/ tonic episode and loc
•clonic episode follows tonic
•clonic phase followed by postictal phase
*lasts 2-5 min

140
Q

tonic episode

A
  • stiffening of muscles

* breathing may stop (cyanosis)

141
Q

clonic episode

A
  • rhythmic jerking of extremities
  • breathing may be irregular (cyanosis)
  • can have biting of tongue/cheek
142
Q

postictal phase

A
  • period of confusion, fatigue, agitation, and lethargy following a tonic-clonic seizure
  • lasts up to an hour
143
Q

tonic seizure

A
  • rare type of generalized seizure where only tonic phase is experienced
  • 30 sec -> several min
  • abrupt increase in muscle tone
  • autonomic changes (HR, RR)
  • loc
144
Q

clonic seizure

A
  • rare type of generalized seizure where only clonic phase is experienced
  • several minute duration
  • muscles ctx and rlxn
145
Q

absence seizure

A
  • generalized
  • most common in children
  • loc lasting few sec
  • blank staring
  • automatisms
  • return to baseline after seizure
146
Q

automastim

A
  • involuntary behavior
  • lip smacking
  • eye fluttering
  • picking at clothes
147
Q

myoclonic seizure

A
  • generalized
  • brief jerking/stiffening of extremities (sym/asym)
  • lasts for few seconds
148
Q

atonic (akinetic) seizure

A
  • generalized
  • few second period of muscle tone loss
  • followed by period of confusion (postictal)
  • frequently results in falling
  • most resistant to drug therapy
149
Q

partial (focal/local) seizure

A
  • begin in part of ONE cerebral hem.

* complex or simple

150
Q

complex partial seizure

A
  • automatisms
  • loc (black out) for 1-3 min
  • amnesia possible prior to and after seizure
  • temporal lobe usually involved
151
Q

simple partial seizure

A
  • consciousness maintained
  • unusual sensations (aura)
  • deja vu
  • autonomic abnormalities (HR, flushing, epigastric discomfort)
  • unilateral extremity movement
  • pain or offensive smell
152
Q

unclassified (idiopathic) seizure

A
  • occur fo no known reason

* account for ½ of all seizure activities

153
Q

seizure risks

A
  • genetics
  • febrile state
  • head trauma/cerebral edema/tumor
  • abrupt cessation of drugs/etoh
  • infection/toxins
  • metabolic disorder
  • hypoxia
  • fluid/electrolyte imbalances
154
Q

seizure triggers

A
  • increased physical activity
  • stress
  • hyperventilation
  • fatigue
  • excessive caffeine/etoh intake
  • flashing lights
  • chemical exposure
155
Q

seizure first aid

A 
•keep self/others calm
•ease pt to floor w/ soft under head
•turn pt on side (maintains airway)
•time seizure
•remove glasses, jewelry, etc
•do NOT restrain or put object in mouth
*call 911 if longer than 5 min, dyspnea, pain, etc
156
Q

nursing interventions during seizure

A
  • PRIORITY: keep pt from injury
  • maintain airway (be ready to suction)
  • ease pt to floor
  • turn pt on side
  • remove loose items
  • don’t retrain/put object in mouth
157
Q

nursing interventions post-seizure

A
  • keep pt on side
  • take VS
  • assess for injuries
  • perform neurological check
  • reorient/calm pt
  • place bed in lowest position and pad rails
  • maybe start IV or O2
  • try to ID trigger/aura
158
Q

status epilepticus

A

•potential seizure complication
•prolonged seizure activity occurring over 30-min time frame
•decreased O2
•inability brain to return to normal fxn
*require immediate tx to proven loss of brain fxn, organ failure, dysrhythmias, etc

159
Q

acute seizure

A
  • seizures occurring in greater intensity, number, or length than usual, or different clusters
  • tx w/ lorazepam (Ativan) or diazepam (Valium) to prevent progression into status epilepticus
160
Q

anticonvulsants (AEDs)

A

•tx to control seizures to some degree
•pt often requires combo for control
•doses adjusted to achieve therapeutic blood levels with least amount of side effects
•oral hygiene important when taking
*CANNOT be stopped abruptly
•educate pt on drug/food interactions (GF juice)

161
Q

vagal nerve stimulation (VNS)

A
  • surgical intervention for seizures
  • device implanted into left chest wall and connected to electrode on left vagus nerve
  • pt activates device w/ magnet when experiencing trigger/aura
  • device administers intermittent stimulation of brain via stimulation of vagal nerve at rate specific to pt needs
162
Q

excision of portion of brain

A
  • surgical intervention for seizure
  • removal/interruption of brain tissue causing seizure activity
  • mainly used for partial seizures
  • pt is awake/alert during operation
  • high risk procedure
163
Q

lorazepan (Ativan)

A
  • acute seizure tx to prevent progression into status epileptics
  • anti-anxiety, BZD, and anti-convulsant
  • give 4 mg over 2 min (slow IV push)
164
Q

diazepam (valium)

A
  • acute seizure tx to prevent progression into status epileptics
  • anti-convulsant, anti-anxiety, BZD, and skeletal muscle relaxer
  • give 4 mg over 2 min (slow IV push)
165
Q

phenytoin (Dilantin)

A

•acute seizure tx to prevent progression into status epileptics
•anti-convulsant and anti-dysrhythmic
•50 mg/min (IV pump w/ NS)- loading dose
•decreases effectiveness of warfarin and oral contraceptives
*can also be used as a maintenance therapy

166
Q

cerebral vascular accident (CVA)

A
  • disruption in the cerebral blood flow secondary to ischemia from thrombosis, hemorrhage, or embolism
  • aka: stroke, cerebral infarction, or brain attack
167
Q

hemorrhagic stroke

A
  • occur secondary to ruptured artery or aneurysm
  • prognosis poor b/c of amt ischemia and increased ICP caused by collection of blood
  • prognosis better if stroke caught early, bleeding ceased, and clot evacuated
168
Q

thrombotic stroke

A

•occurs secondary to development of blood clot on an atherosclerotic plaque in a cerebral artery
•clot gradually shuts off artery and causes ischemia distal to occlusion
•symptoms evolve over period of hrs-days (often preceded by TIA)
*occlusive

169
Q

embolic stroke

A

•occur secondary to embolus traveling from another part of body to cerebral artery
•brain blood distal to occlusion immediately shut off, causing loc to occur
*occlusive

170
Q

transient ischemic attack (TIA)

A
  • mini stroke (warning stroke)
  • caused by thrombotic clot but blockage is temporary
  • sx occur rapidly but last 1-5 minutes
  • warning signs almost same as stroke
  • usually no permanent damage
171
Q

reversible ischemic neurological deficit (RIND)

A
  • caused by thrombotic clot, but blockage temporary

* similar to TIA, but lasts longer (up to 24 hrs)

172
Q

sx left hem stroke consequences

A
  • language, math, and analytic thinking
  • expressive, receptive, global aphasia
  • agnosia- inability to recognize objects
  • alexia- reading diff.
  • agraphia- writing diff.
  • hemianopsia, hemiplegia, hemiparesis
173
Q

sx right hem stroke consequences

A
  • abnormalities in spatial perception, proprioception, and judgment/impulse control
  • hemianopsia, hemiplegia, hemiparesis
  • depth perception- overestimate
174
Q

risk for increased ICP

A

•blood from hemorrhage
•cerebral edema
•inflammation
*normal: 10-15 mmHg

175
Q

CVA nursing interventions

A
  • depends on sequelae (condition consequence of stroke)
  • monitor VS
  • assist w/ feeding
  • aid in ambulation
  • maintain safe environment
  • take measures to prevent DVT
  • seizure precautions
176
Q

thrombolytic meds

A

•given for CVA
•recombinant tissue plasminogen activator (rtPA, Retavase)
•admin within 3-4.5 hrs of onset of sx
•contraindicated if hemorrhagic stroke or pt on anticoagulants
*have to rule out hemorrhagic stroke w/ MRI before initiating

177
Q

antiplatelets

A
  • low dose ASA-acetylsalicylic acid (aspirin) given within 24-48 hrs. following a stroke to prevent further clot formation
  • Give within 4.5 hrs. of initial symptoms
178
Q

anticoagulates

A
  • controversial tx for CVA
  • high risk of intracerebral hemorrhage
  • Heparin, enoxaparin (Lovenox), warfarin (Coumadin)
179
Q

AEDs for stroke

A
  • phenytoin (Dilantin), gabapentin (Neurontin)
  • usally only if patient develops seizures
  • gabapentin may be given for paresthetic pain in affected extremity
180
Q

CVA surgical interventions

A
  • carotid artery angioplasty w/ stenting

* carotid endarterectomy- open artery by removing atherosclerotic plaque (common for TIA)

181
Q

CVA complications

A
  • dysphagia
  • aspiration
  • unilateral neglect
182
Q

homonymous hemianopsia

A
  • visual field loss on same side of both eyes
  • left: due to abrasion on right side of brain (has visual pathways for left hemifield of both eyes)
  • right: due to abrasion on left side of brain (has visual pathways for right hemifield of both eyes)
183
Q

consequences of increased ICP

A
  • hyperthermia b/c pressure on thalamus
  • widening of pulse pressure
  • decreasing HR
184
Q

FAST

A
  • facial drooping
  • arm weakness
  • slurred speech
  • time- call 911
185
Q

recombinant tissue plasminogen activator (rtPA)

A

•thrombolytic NZ (Activase)
•can be used to reverse ischemic stroke (thrombolitic/embolitic) if given w/ 3-4.5 hrs of initial sx
*only used for clot in brain (not used for DVT)

186
Q

anosognosia

A

•an inability to acknowledge the reality of the physical impairments resulting from stroke

187
Q

dysarthria

A

•slurred speech

188
Q

before angiogram

A
  • verify no iodine or shellfish allergy

* verify baseline creatinine/BUN level to make sure kidney fxn normal

189
Q

bone marrow

A

•responsible for production of RBCs, WBCs, and platelets

190
Q

erythropoiesis

A

•RBC production
•kidney releases (possibly in response to hypoxia) erythropoietin (GF)
•also need iron, B12, folic acid, copper, B6, cobalt, and nickel
*RCB last 120 days

191
Q

hematocrit

A

•percentage of packed RBCs per dL of blood

192
Q

anemia

A

•abnormally low RBCs, Hgb, and/or hematocrit
•results in diminished O2 carrying capacity and deliver to tissues/organs
*goal of tx is to restore/maintain adequate tissue oxygenation

193
Q

anemia causes

A
  • blood loss
  • inadequate RBC production (hypoproliferative)
  • increased RBC destruction (hemolytic)
  • Fe, folic acit, erythropoietin, and/or B12 deficiency
194
Q

iron-deficiency anemia

A

•due to inadequate intake, most common in children, adolescents, and preggo
•due to blood loss is common in older adults
*menstruating women can develop secondary to menorrhagia

195
Q

cardiac s/s anemia

A
  • tachycardia
  • orthostatic hypotension
  • palpations, murmors, gallops
  • angina
  • heart failure
196
Q

respiratory s/s anemia

A
  • dyspnea on exertion

* decreased O2 sat

197
Q

integumentary s/s anemia

A
  • pallor
  • cool to touch
  • cold intolerance
  • brittle nails
198
Q

musculoskeletal s/s anemia

A
  • weakness
  • malaise
  • fatigue
199
Q

neurologic s/s anemia

A
  • headache
  • somnolence
  • forgetfulness
  • dizziness
  • depression
200
Q

Hgb levels in anemic

A

•mild: 10-14 g/dL
•moderate: 8-10 g/dL
•severe: < 8 g/dL
* < 10 g/dL when clinical manifestations show

201
Q

types of anemia

A
  • sickle cell
  • G6PD deficiency
  • autoimmune hemolytic
  • vit B12 deficiency
  • folic acid deficiency
  • aplastic- exposure to myelotoxic agents (radiation, virus, etc)
202
Q

normal RBC levels

A

•m: 4.7-6.0 million/mm^3
•f: 4.2-5.4 million/mm^3
*4.5-6

203
Q

normal HCT levels

A
  • m: 50-57 ml/dL (50-54%)

* f: 37-48 ml/dL (37-48%)

204
Q

normal Hgb levels

A
  • m: 14-18 g/dL

* f: 12-16 g/dL

205
Q

screening for anemia

A
  • CBC w/ RBC indices
  • reticulocyte count
  • platelet count
  • morphology (wright stained blood smear)
  • serum ferritin, serum iron, and total iron binding capacity
  • bone-marrow aspiration/biopsy
206
Q

mean corpuscular volume (MCV)

A

•RBC indices that determines size of RBCs
•normocytic, microcytic, or macrocytic
•helps determine cause of anemia
*86-98

207
Q

mean corpuscular Hgb (MCH)

A

•RBC indices that determines amnt of Hgb per RBC
•normochromic or hypochromic
*27-32

208
Q

mean corpuscular Hgb concentration (MCHC)

A

•RBC indices that indicates Hgb amnt relative to size of cell
*32-36%

209
Q

normal MCV, MCH, MCHC

A
  • normocytic/normochromic anemia

* possible causes are acute blood loss and SCD

210
Q

decreased MCV, MCH, MCHC

A
  • microcytic/hypochromic anemia

* caused by Fe deficiency, chronic illness, or chronic blood loss

211
Q

increased MCV

A
  • macrocytic anemia

* caused by B12 deficiency or folic acid deficiency

212
Q

total iron binding capacity (TIBC)

A
  • indirect measurement of serum transferrin (Fe transporter)

* elevated level indicates Fe-deficiency anemia

213
Q

serum ferritin test

A

•indicates total iron stores in body

214
Q

serum iron study

A
  • measures amnt of Fe in blood

* low levels indicate Fe-deficiency anemia

215
Q

bone marrow aspiration/biopsy

A
  • used to diagnose aplastic anemia

* indicates bone marrow failure to produce RBCs, platelets, and/or RBCs

216
Q

hemochromatosis

A
  • too much Hgb

* causes iron overload

217
Q

polycythemia vera

A

•too many RBCs

218
Q

hemolytic anemia

A
  • due to excessive destruction of RBCs (or SCD)
  • splenomegaly and jaundice
  • followed by acceleration of erythropoises
  • response to trauma, infection, chemical exposure, autoimmune rxns
219
Q

hemolytic anemia tx

A
  • steriods
  • spenectomy
  • chemo
  • plasma exchange
  • immuno-suppressant agents
220
Q

iron-deficiency anemia (IDA)

A
  • chronic hypochromic, microcytic anemia caused by insufficient supply of Fe2+
  • impairs ability of RBCs to carry O2
  • high risk are females, elderly, blood loss pt, alcoholics
221
Q

s/s IDA

A
  • pallor
  • glossitis
  • cheilitis (inflammation of lips), stomatitis (inflammation of oral mucus membrane), mouth fissure
  • thin, febrile, brittle
  • weak
  • headache
  • dyspnea
222
Q

diagnostics of IDA

A
  • peripheral blood smear reveals microcytic/hypochromic RBCs
  • Hgb < 8 g/dL
  • Fe level 10 micrograms/dL
  • TIBC increase (trying to signal more iron to come)
  • occult blood-fecal and urine
  • GI endoscopy
223
Q

IDA tx

A
  • encourage intake
  • PO iron supplement (w/ OJ or vit C to absorb best)
  • Iron dextran- IM
  • transfusion packed RBCs
  • discontinue anti-acids, coffee, tea b/c impair Fe absorption
224
Q

Megaloblastic anemias

A
  • group of disorders caused by impaired DNA synthesis, resulting in defective and large RBCs (megaloblasts)
  • most are caused by Cobalamin (B12) and folic acid deficiencies
225
Q

pernicius anemia

A

•lack of intrinsic factor found in GI mucosa, which is necessary for B12 (extrinsic factor) absorption
•develops slowly (dx older)
•higher risk w/ GI tumors, GI issues, and/or hypothyroidism
*B12 deficiency

226
Q

s/s pernicius anemia

A
  • low Hgb, Hct, cobalamin, and RBC
  • weakness/fatigue
  • jaundice
  • glossitis (inflammed tongue)
  • memory/personality changes
  • depression/irritability
  • diminished senses/coordination
  • GI symptoms
  • positive schilling test
227
Q

Schilling test

A
  • measures urinary excretion of vitamin B12 for diagnosis of pernicious anemia and a variety of other malabsorption syndromes
  • give 2 doses B12 PO
  • collect 24 hr urine
228
Q

tx pernicious anemia

A

•parenteral/intranasal admin of B12
•Fe supp. to increase erythropoiesis
•encourage B12, and fortified cereal intake
*need lifelong tx

229
Q

folic acid deficiency anemia

A
  • megaloblastic anemia
  • decreased RBC, Hgb caused by impaired production r/t decreased folate level
  • higher risk if poor nutrition, malabsorption syndromes (Crohn’s), anticonvulsant/oral contraceptive use, alcoholism, anorexic
230
Q

s/s folic acid deficiency anemia

A
  • slow onset
  • thin, emaciated
  • electrolyte imbalance
  • serum folate < 4 ng/mL
231
Q

iron sources

A
  • red/organ meat
  • leafy greens
  • egg yolks
  • almonds
  • legumes
  • dried fruit
232
Q

B12 sources

A
  • meat/poultry
  • eggs
  • milk products
  • fortified cereals
233
Q

folic acid sources

A
  • beans/legumes
  • citrus fruits/juice
  • fortified bread, cereals, pasta, etc
234
Q

homologous blood transfusion

A

•blood from donor used

235
Q

autologous blood transfusion

A
  • pt blood collected in anticipation of future transfusion
  • donated 5 wks- 72 hrs prior to elective surgery
  • eliminates risk of alloimmunization (immune response to antigens)
236
Q

intraoperative blood salvage

A

•blood loss during surgeries recycled thru cell-saver machine and transfused intraoperative

237
Q

whole blood transfusion

A
  • massive blood loss

* pt needs O2-carrying capacity and vol. increase

238
Q

Packed RBC transfusion

A
  • whole blood with ⅔ of plasma removed
  • severe anemia
  • moderate blood loss
  • less danger of fluid overload
  • transfusion of choice
  • should not exceed 4 hrs transfusing
239
Q

platelet transfusion

A
  • concentrate of platelets suspended in small amnt of original plasma
  • bleeding from thrombocytopenia or abnormal platelet fxn
  • chemo-induced bone marrow failure
  • transfuse over 15-30 min
240
Q

fresh frozen plasma transfusion

A
  • anti coagulated clear liquid portion of blood separated from whole blood by centrifugation
  • used to reverse excessive anticoagulation
  • clotting factor deficiencies associated w/ hemorrhagic tendency
241
Q

admin blood products

A
  • ensure type and Rx order
  • cross match before getting from blood bank
  • verify blood and pt #
  • make sure no allergy, hx rxn, etc
  • use 20-gauge needle
  • infuse w/ NS (NOT meds)
  • remain w/ pt for first 15 min
242
Q

hemolytic transfusion rxn

A
  • during first 15 min, chills, fever, urticaria (rash), tach, pain/tight chest, SOB, cloudy urine
  • stop blood (keep NS)
243
Q

febrile transfusion rxn

A
  • during first 15 min, sudden fever/chills, headache, flushing, anxiety, muscle pain
  • give antipyretics (avoid aspirin)
244
Q

bacterial (sepsis) rxn

A
  • rapid onset of hypotension, fever, chills, vomit, diarrhea, and shock
  • tx: stop transfusion and treat septicemia (abx, IV fluid, vasopressors, steroids)
245
Q

allergic transfusion rxn

A
  • antihistamine admin 15-30 min prior to transfusion to preven
  • s/s: urticaria, edema of face, asthma attack, flushing/itching
  • tx: stop transfusion and KVO w/ NS
246
Q

circulatory overload transfusion rxn

A
  • higher risk if have renal/cardiac insufficiencies
  • s/s: cough, dyspnea, headache, hypertension, tach, JVD
  • tx: pt upright, O2 therapy, diuretics, morphine
247
Q

RBC count

A
  • m: 4.7-6.1 million/uL
  • f: 4.2-5.4 million/uL
  • decreased level indicates anemia
248
Q

WBC count

A
  • 5,000-10,000/uL
  • elevated evidence of infection
  • decreased evidence of immunosuppression
249
Q

pancytopenia

A

•low RBC, WBC, and platelets

Foundations 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions