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NUR 103 > Unit 4 > Flashcards

Unit 4 Flashcards

1
Q

what do you hold before a patient is seen by dialysis?

A

hold blood thinners

hold Antihypertensives.

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2
Q

what considerations do you want to do with a fistula?

A

ensure there is no bleeding
monitor Vitals
listen for the thrill
feel for the bruit

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3
Q

what are some other considerations for dialysis patients?

A

daily weights

Labs

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4
Q

what are some post Dialysis considerations ?

A 
monitor vitals 
check for bleeding 
LOC
N/V
HA
muscle cramps. 
measure urine if any.
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5
Q

what are some dietary considerations for dialysis patients?

A

Restrict fluid salt sodium
Low protein
Low potassium
Limit phos—take pills that bind to it

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6
Q

what should you never do w/ dialysis patient?

A

Never take BP or any sticks in fistula arm

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7
Q

elevated BUN and Elevated creatine is associated with what?

A

Dialysis LAB findings.

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8
Q

what are some complications for dialysis patients ?

A

Edema
HTN
Bleeding from fistula

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9
Q

Ensuring there is no bleed, feeling for a thrill and listening for bruit, checking the perfusion below
These are examples of care for what?

A

AV Fistula Care

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10
Q

A patient initally showing up to the ER with s/s of pancreatitis will be put on what (nutrition wise) ?

A

NPO

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11
Q

how can a pancreatitis patient receive nutrition?

A

NG tube

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12
Q

what diet are pancreatitis patients on Once PO intake resumes?

A

low protein

High Fat

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13
Q

what enzyme will break down food for pancreatitis?

A

Pancreatic Enzyme

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14
Q

bruised and purple flanks are finding’s of what?

A

Turner Sign

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15
Q

purplish discoloration around the belly button are findings of what?

A

Cullen Sign

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16
Q

complications of pancreatitis are ?

A 
N/v
sweating 
JUANDICE 
Weakness
HEMORRHAGE
turner sign 
cullen sign 
Peritonitis
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17
Q

Excruciating Abd pain in epigastrium or LUQ

pain increasing with eating radiating to flank are findings of what?

A

Pancreatitis

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18
Q

a Liver Biopsy is a definitive diagnosis of?

A

Cirrhosis

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19
Q

what are some other way to diagnose cirrhosis?

A

Lab will show liver injury

AST / ALT

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20
Q

what are some findings for Cirrhosis

A 
Anorexia
Nausea
Weight loss
Ascites
Bruising
Cramping
Dull RUQ pain
GI bleeding
Itching
Jaundice—yellow skin
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21
Q

A condition that collects fluid in your abdomen causing difficulties breathing is what ?

A

Ascites

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22
Q

complications associated with cirrhosis include?

A 
Clotting defects
Portal HTN
esophageal varices 
Hepatic encephalopathy 
hepatorenal syndrome
ascites
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23
Q

Decreased LOC, confusion changes in handwriting , asterixis, bad breath from the body are indications of?

A

Hepatic Encephalopathy

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24
Q

this condition is caused by elevated ammonia
s/s conclude of irritability , hyperventilation, can cause death or coma
is what condition

A

Hepatorenal Syndrome

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25
Q

what are some teaching with cirrhosis ?

A 
avoid acetaminophen 
avoid forceful coughing/straining
later liver cirrhosis is irreversible 
fluid and sodium restrictions 
leading cause is excessive alcohol ingestion.
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26
Q 
tight red skin over inflamed  joints 
more common in men
extreme pain at joint site 
common in big toe 
are finding of what ?
A

GOUT

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27
Q

what do you want to avoid with GOUT

A

Aspirin

Alcohol

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28
Q

what are some ttmt for gout

A 
NSAIDS
Steroids 
allurinol
colchicine 
dietary management of weight 
increase water intake
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29
Q

this medication is given to reduce uric acid production

A

Allurinol

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30
Q

this medication is given to interrupt the cycle of crystal formation but does not affect

A

Colchicine

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31
Q

what are some teaching with Gout ?

A 
common in men than women 
Caused by High protein Diet 
genetics 
caused by excessive alcohol
drink cherry juice 
avoid red meat anything high in purine 
weight control 
Associated with kidney stone, diuretics and other drug therapy.
32
Q

this medications prevents an attack of gouty arthritis and neuropathy ?

A

Zyloprim

33
Q

Zyloprim considerations

A

avoid alcohol
can take up 2-6 weeks to be effective
Alkaline diet do decrease stone formation.

34
Q 
Anchovies 
Sardines 
Sweet bread
Liver
Red meats
Kidneys 
are example of what diet and should be avoided for what disease?
A

Purines

Gout

35
Q

Nursing care for leukemia ?

A 
Monitor for infection
monitor temp 
NO flowers or fruit baskets
NO deli trays
Neutropenic precaution 
monitor for abnormal bleeding d/t low platelet count
diet 
monitor renal function
Emotional  support 
pain management 
education
36
Q

what are some ttmts for leukemia ?

A

 Slowing growth of the abnormal blood cells
 Maintain normal level of RBC, hemoglobin, platelets
 Manage symptoms
 Chemotherapy
 Antineoplastic agents (anticancer drugs prevent or inhibit the maturation and proliferation of neoplasms)
 Radiation
 Bone marrow transplant
 Biologics
 No rectal temps

37
Q

what should you NEVER do with leukemia patients?

A

RECTAL TEMP

38
Q

sickle cells travel through small blood vessels, they can get stuck and clog the blood flow. This causes pain that can start suddenly, be mild to severe this is a sign of what?

A

sickle cell crisis

39
Q

what are some findings of the expected findings of sickle cell anemia ?

A 
	Decreased RBC and HGB
	Elevated bili
	Skeletal x-ray may show joint and bone deformities-uneven bone growth
	Hypoxia
	Usually in a lot of pain
40
Q

complication of sickle cell include ?

A

Hand and foot syndrome
Jaundice due to increased bili
Cholelithiasis
Enlarged spleen or liver r/t retained cells and debris
Hypoxia
Stroke is common at a young age d/t blood clots
Chronic pain

41
Q

what are teachings to a sickle cell patient ?

A 
drink plenty of water to reduce pain 
do not get to hot or to cold
avoid High altitudes 
Avoid extreme exercise 
walk slowly
Folic acid Diet
No smoking, drugs or alcohol
Adequate rest 
no cold therapy for sore joints
ONLY hot therapy
no physical activities
42
Q

s/s include bleeding
swollen painful joint=bleeding into the joins
bleeding into muscle=swollen painful muscles
what are these symptoms of?

A

Hemophilia

43
Q

what is a major complication with hemophilia ?

A 
Inter cranial bleeding
Convulsions 
brain damage
fatal bleeding into lungs 
fatal bleeding into neck causing obstruction of AIRWAY
44
Q

what are some signs of ICB?

A

stroke like symptoms

45
Q

how should you treat hemophilia ?

A 
elevate injured part, apply ice packs
control pain
observe for any other bleeding
stool softeners
Demporessin 
analgesics and corticosteroids 
Psychological support
46
Q

what should you never give to hemophilia patients?

A

NO enemas
NO Aspirin
NO Safety Razors

47
Q

Headache
Projectile vomiting
decreased loc, irritability, restlness are findings of what?

A

ICP

48
Q

whta are the early signs of ICP?

A

decreased LOC
Irritability
Restlessness

49
Q

what is a classic sign of ICP

A

Projectile vomiting

50
Q

what are some nursing care for ICP?

A

monitor Resp and other vitals

Keep HOB elevated

51
Q

should you trendelenburg a ICP patient?

A

NOOOOOOO

52
Q

primary prevention of head injury?

A

education

53
Q

screening for a head injury is what kind of prevention?

A

secondary

54
Q

treating the head injury is what prevention?

A

Tertiary

55
Q

this dx cannot be seen, there will be no abnormalities detected on brain scan, it will look normal
what is this?

A

Concussion

56
Q

the Glasgow coma scale measures what?

A

LOC

57
Q 
dilation of pupil on one side 
stroke symptoms 
weakness
Confusion 
headache
lethargy
are symptoms of ?
A

subdural hematoma

58
Q

Unconsciousness at time of injury
Brief lucid interaction
decreased loc, HA n/v dilation of one pupil on affected side are s/s of ?

A

epidural hematoma

59
Q

which is hematoma is more serious and fatal?

A

Epidural hematoma

60
Q

what are some complications of hematomas?

A 
brain herniation 
diabetes insipidus 
acute hydrocephalus
labile vital signs
ptsd
Cognitive and personality changes
61
Q

48 pulse
29 respirations
220/70 bp
what does this bp represent ?

A

Crushing Triad

62
Q

what is crushing triad is a medical emergency ?

A

yes,
Bradycardia
Irregular respirations
Arterial hypertension (rising systolic while diastolic remains stable

63
Q

Below normal body temp (<97)
Mild: vigorous shivering, feeling cols, skin is cold to the touch, slurred speech
Worsening: loss of coordination, shivering is replaced with muscle rigidity, loss of consciousness, death like appearance
Some pts react different: some my become dizzy, get chills, SOB
this is a sign of what ?

A

Hypothermia

64
Q

Above the normal body temp (>100)
Drink plenty of fluids, limit exertion, sit in shade
Limit outdoor activity, stay indoors if weather is too hot, do outside activities closer to night time, use air conditioning
Immediately place person in shade, cold water SPRINKLED on them, fan
At hospital: remove clothing, wipe skin with cool cloth, ice packs to groin and under arms, cooling blanket, infuse cold fluids
this is indicating what?

A

Hyperthermia

65
Q

what should you do if the rectal body temp reaches 102.2 ?

A

stop all interventions

66
Q

what are some frost bite interventions

A

warm the core FIRST
DO NOT rub or massage frost bite
NO alcohol or sedatives!!
Warming extremities first can cause refreezing and this can cause more damage than prolonged freezing.
Separate skin areas (fingers/toes) with sterile bandages, and elevate to level of the heart
try to keep them from being out in the cold again

67
Q

what does a high BUN indicate?

A

dehydration, poor kidney function, or an increased breakdown of proteins such as that which would occur with excessive burns, exercising, or low carb dieting.

68
Q

what does a low BUN indicate?

A

liver damage excessive hydration or protein deficiency

69
Q

7-20 are normal values of what?

A

BUN

Evaluate the kidneys

70
Q

0.8-1.2

are normal values of what ?

A

Creatine

evaluate the kidney dysfunction.

71
Q

Male: 14-18
Female: 12-16
are normal values of what?

A

Hemoglobin

72
Q

Male: 42%-52%
Female: 37%-47%
normal values of what lab?

A

Hematocrit

73
Q

150,000-400,000

is a normal count for what?

A

Platelets

74
Q

5,000-10,000

is a normal count for what?

A

WBC

75
Q

Glomerular filtration Rate does what?

A

overall in depth lab of how well the kidneys are filtering.

NUR 103 (3 decks)

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