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NUR 103 > Unit 4 > Flashcards

Unit 4 Flashcards

1
Q

Vibration in a fistula

A

Thrill

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2
Q

Soft swishing in a fistula

A

bruit

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3
Q

Things to monitor for after dialysis

A 
ensure fistula is not bleeding
monitor vitals
LOC
N/V
HA
muscle cramps
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4
Q

Medicines to withold before dialysis

A

Blood thinners and antihypertensives

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5
Q

Dietary considerations for kidney disease patients

A

Restrict fluid, sodium, phos

low protein and potassium

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6
Q

What labs are elevated in kidney disease patients

A

BUN and creatinine

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7
Q

What do you always need to ask a kidney disease patient?

A

If they produce urine and you NEED to measure it

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8
Q

AV fistula care

A
  • ensure its not bleeding
  • feel for thrill and listen for bruit
  • check perfusion below fistula
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9
Q

Nutrition for pancreatitis patients

A
  • Pt may be NPO to give pancrease a break
  • low protein, high fat once PO diet resumes
  • Enzymes WILL be given EVERY time they eat.
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10
Q

Sign of hemorrhage in pancreatitis. Flanks are going to be bruised and purple.

A

Turners sign

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11
Q

Sign of hemorrhage in pancreatitis. Purplish discoloration around belly botton.

A

Cullen sign

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12
Q

What is the most accurate way to diagnose cirrhosis of the liver?

A

Liver biopsy

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13
Q

Patient dispays the following:

	Anorexia
	Nausea
	Weight loss
	Ascites
	Bruising
	Cramping
	Dull RUQ pain
	GI bleeding
	Itching
	Jaundice

What do you suspect the dx to be?

A

Cirrhosis

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14
Q

this is a result of portal HTN, enlarged blood vessels in the esophagus with thin walls that may tear easily and cause severe bleeding and death THIS IS AN EMERGENCY CALL 911

A

esophageal varices

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15
Q

this is caused by liver scarring obstructs blood flow in the portal vein causing pressure to build in the surrounding vessels

A

portal HTN

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16
Q

S/S are decreaed LOC, confusion, changes in handwriting, asterixis (flapping hand tremor), bad breath from the body

A

hepatic encehalopathy

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17
Q

Flapping hand tremor

A

asterixis

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18
Q

caused by elevated ammonia. S/S: confusion, asterix, fector hepaticus (foul breath from body not dentition), irritability, hyperventilation. Can cause coma and death

A

hepatorenal syndrome

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19
Q

accumulation of fluid in the peritoneal cavity. Causes difficulty breathing

A

ascites

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20
Q

Cirrhosis patients should avoid taking what for a headache?

A

tylenol or anything with acetaminophen

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21
Q

Cirrhosis patients are on what kinf od dietary restrictions

A

FLuid and sodium

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22
Q

Tight red skin over inflamed joints
occurs more in med
extreme pain at joint site; most common in big toe

A

Gout

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23
Q

Gout patients can take any NSAID except…

A

Apsirin

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24
Q

Cirrhosis patients will probably be taking stool softeners becuase

A

they have to avoid coughing and straining

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25
Q

Things that can cause gout

A

high protein diet
genetics
excessive alcohol
High purine foods

26
Q

High purine foods

A 
anchovies
sardines
sweet breads
liver
red meat
kidneys
27
Q

How long might it take to see imprivement when taking zyliprim?

28
Q

How should allopurinol be taken?

A

with food or milk to avoid GI irritation

29
Q

Should NSAIDs be taken with zyliprim? why or why not?

A

yes bc zyliprim is for prevention of actue gout attacks not the tx of them

30
Q

What kind of precautions should a leukemia pt be on?

A

neutropenic

31
Q

What is common among pts diagnosed with sickle cell even young patients

32
Q

Things to avoid with leukemia patients

A 
deli trays
flowers
rectal temps
high altitudes
drugs and alcohol
extreme exercise
cold therapy
33
Q

What should you encourage sickle cell patients to do?

A

drink plenty of water

34
Q

Diet for sickle cell patients

A

folic acid: to help body make new cells

sufficient protein: to build up RBC

35
Q

S/S of intercranial bleeding

A

Stroke s/s

36
Q

What NSAID should hemophillia pts avoid

37
Q

A hemophillia pt has a swollen painful joint…what do you suspect

A

bleeding into the joints

38
Q

A hemophillia pt has swollen painful muscles

A

bleeding into muscle

39
Q

Drug used to stimulate clotting factors for hemophilia pts

A

desmopressin

40
Q

Before any dental or invasive procedure, what should you ensure to do for a hemophilia pt?

A

prophylactic factor tx

41
Q

If a hemophilia pt has a hx of constipation what should you and should you not do?

A

NO enemas or suppositories!!

YES stool softeners

42
Q 
Pt displays:
headache
projectile vomiting
decreased LOC
irritability
restlessness

What do you suspect?

A

Increased intracranial pressure

43
Q

Early S/S of increased intracranial pressure

A

decreased LOC
irritability
restlessness

44
Q

Can a concussion be seen on a brain scan?

A

NO!

It will look normal!

45
Q

Pt presents with stroke symptoms, weakness, confusion, headache, lethargy, and dialation of pupil on one side
what so you suspect?

A

subdural hematoma

46
Q

Pt was unconsciousness at time of injury, breif lucid interactions followed by decreasing LOC, HA, N/V, dialation of one pupil (on affected side)
what do you suspect?

A

epidural hematoma

47
Q

What is most concerning:
subdural hematoma
epidural hematoma?

48
Q

S/S of crushing triad

A

Bradycardia
Irregular respirations
Arterial hypertension

49
Q

rising systolic while diastolic remains stabe

A

arterial hypertension

50
Q

body temp less than 97

vigorous shivering, feeling cols, skin is cold to the touch, slurred speech

A

mild hypothermia

51
Q

body temp less than 97

loss of coordination, shivering is replaced with muscle rigidity, loss of consciousness, death like appearance

A

worsening hypothermia

52
Q

Tx and interventions for hyperthermia

A

 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
 When rectal temp reaches 102.2 what do you do???

53
Q

Frostbite interventions

A

 Do not rub/massage frost bite!!
 Warm the core first!!
 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
 No alcohol no sedatives

54
Q

Hemoglobin

A

Male: 14-18
Female: 12-16

55
Q

Hematocrit

A

Male: 42%-52%
Female: 37%-47%

56
Q

platelet count

A

150,000-400,000

57
Q

WBC count

A

5,000-10,000

58
Q

High BUN

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.

59
Q

Low BUN

A

liver damage excessive hydration or protein deficiency

Creatinine 0.8-1.2; evaluates kidney dysfunction

60
Q

GFR measures

A

how well the kidneys are functioning

61
Q

BUN levels

A

7-20

evaluates how well the kidneys function

62
Q

Creatinine

A

0.8-1.2

evaluates kidney dysfunction

NUR 103 (5 decks)

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