week 4 midterm Flashcards
The nurse should instruct the client to take hydrochlorothiazide
early in the day to avoid nocturia.
If a client’s potassium level is above the expected reference range of 3.5-5.0 mEq/L..
nurse should obtain a 12-lead ECG to monitor for cardiac changes.
*dysrhythmia’s
adverse effects of ACE inhibitors
*treated with
angioedema (tongue/pharynx swelling)
cough
giant wheals
*subcutaneous epinephrine
Atenolol & considerations
Beta-Blocker
lowers blood pressure & heart rate
*adv effect = bradycardia (monitor pulse rate)
*contraindicated in asthma, COPD, & heart failure
*masks hypoglycemia
digoxin toxicity
vision changes (green halos)
n/v
abdominal pain
bradycardia
*call provider if heart rate is less than 60 bpm
spironolactone
potassium sparing diuretic — loss of sodium & water
adv effects = hyponatremia & hyperkalemia
carvedilol
*beta blocker = lowers heart rate and blood pressure
contraindicated in asthma
masks hypoglycemia
adv effect = bradycardia
s/s of left sided heart failure
hacking cough
frothy sputum
wheezing
weakness
fatigue
tramadol patch considerations
- new patch each morning
- hairless & rotate sites
- remove for 10 to 12 hr daily
client should limit cheese intake due to
high levels of fat & sodium
s/s of hypokalemia
muscle weakness
n/v
fatigue
full liquid diet includes
*skim milk
milk & milk products
test for digoxin toxicity
fab antibody fragments
applying nitro patches
*angina pain
in the morning & off at night
rotate areas
hairless sites
10 to 12 hrs w/o it
s/s of blood transfusion reactions
uticaria
fever / chills
bronchospasm
** take baseline temperature
teach a patient how to use albuterol
retain in the lungs for a min of 10 sec so the max amount of the dosage can be delivered properly to the airways.
To use the inhaler, the
1.client exhales normally just prior to releasing the medication
2. inhales deeply as the medication is released
3. then holds the medication in the lungs for approx 10 seconds prior to exhaling.
occupational therapist role
fine motor skills & coordination
- improving hand strength/movements - self-management of ADLs- eating, hygiene, and dressing.
- independent living skills - cooking & shopping.
combination drugs for TB
- Rifampin - orange urine
- Isoniazid - empty stomach & *liver
- Pyrazinamide - assess gout & drink water
- Ethambutol - ocular toxicity
pulmonary tuberculosis manifestations
*lethargy & fatigue
fever
night sweats
cough
ABC approach w lungs
auscultate lung fields to provide knowledge of which lung areas are most affected and would be the focus of the procedure.
chest pain of 6/10 and takes 1 sublingual nitro. Pain is now 2/10
admin another nitro
*can have a sip of water
to prevent vasoconstriction
WARMTH
keeping the environment WARM
Wearing gloves, warm clothes, and socks
exercising indoors
*extra socks
Intermittent claudication
ischemic pain that is precipitated by EXERCISE & RESOLVES W REST & is reproducible. (O2 demand exceeds supply)
**Initial reason clients who have PAD seek medical attention.
iron-rich diet
*red & organ meat
fish
poultry
grains
legumes
veggies
spinach
beef
when diet fails to improve the anemia
nurse should administer vitamin B12 injections to treat pernicious anemia — poor absorption
ABC w anemia
- O2 saturation
- hypotension
hgb
hct
thrombocytopenia teaching
*bleeding risk
soft tooth brush
electric razor
avoid dental work - tooth extraction
Lubricate lips with
water-soluble ointment.
central venous catheter risk & priority action
*air entering = highest risk
first action the nurse should take is to CLAMP the catheter
increase in venous hydrostatic pressure
develops when fluid accumulates in the veins, causes fluid to leak out into the tissues = edema.
treatment for venous insufficiency
Elastic or compression stockings
elevating legs
avoid crossing legs
s/s of chronic venous insufficiency
*varicose veins – lack of perfusion = priority
*shoes feel tighter at end of day
- edema
- heaviness in the legs
- prolonged capillary refill
- venous stasis ulcers (irregular, shallow w drainage on ankle
A client who has an elevated sodium level and is NPO requires
hypotonic IV solution, such as 0.45% sodium chloride or 0.225% sodium chloride.
s/s of infiltration
Edema
pallor
coolness around the insertion site
collection of fluid leaking into subcutaneous tissue
immune thrombocytopenic purpura (ITP)
*destruction of platelets by antibodies;
expect a platelet level below the expected reference range. (<150k)
history of allergic reactions to blood transfusions
administering an antihistamine such as diphenhydramine prior to the transfusion might prevent future reactions.
*slower rate over 2 to 4 hrs
s/s of fluid overload & heart failure
tachycardia / bounding pulse / HTN / tachypnea / increased central venous pressure / weakness / vision changes / altered LOC
ascites
CRACKLES
cough
dyspnea
edema
weight gain
JVD
pallor
increased urine output
patient has type A blood an recieved type O…next step?
administer as ordered
steps to take in a blood transfusion reaction
- stop infusion
- Request a prescription for an antipyretic medication
- Begin infusing 0.9% sodium chloride solution is correct
How to use an MDI
1) Inhale deeply and then exhale completely.
2) Place her lips firmly around the mouthpiece.
3) Breathe in deeply over 2 to 3 seconds while pushing down on the canister.
4) Hold her breath for 10 seconds.
5) Exhale slowly through pursed lips.
6) Wait 60 seconds between each puff
To decrease the risk for renal calculi
client would have to increase fluid intake of 3-4L daily.
Hypomagnesemia is associated with
alcohol use
*n/v/w/fatigue/tremors
Patients with COPD
- sitting up in the “tripod” position.
- O2 sat of 90% indicates adequate blood oxygen level w/o danger of suppressing the respiratory drive.
diagnosing COPD
*Bronchodilators b4 spirometry so that a baseline assessment of airway function can be determined.
Testing is repeated after bronchodilator use to determine whether the decrease in lung function is reversible.
all patients with PAD must maintain
aggressive lipid management
-statins
to reduce the risk for amputation in patients with Buerger’s disease
Absolute cessation of nicotine use is needed
new onset dyspnea with DVT
indicates pulmonary embolism – rapid O2 administration
aplastic anemia considerations
low WBC = risk for infection
avoid other sick patients
hypocalcemia s/s
tingling and numbness of the lips, tongue, fingers and feet,
muscle cramps,
twitching of the facial muscles
bone pain.
