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Med surg > week 7 > Flashcards

week 7 Flashcards

1
Q

BP management during a stroke

A

you want to keep it around 160 to keep adequate CPP

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2
Q

who is most commonly effected by thermal burns

A
  1. kids
  2. older adults
  3. diabetics
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3
Q

priorities for a chemical burn

A
  1. remove cloths
    - chemical stay in the cloths
  2. rinse skin dont but dont use cold b/c youll cause vasoconstriction
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4
Q

what are the two types of smoke inhalation

A
  1. above glottis

2. below glottis

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5
Q

what does a below glottis injury indicate

A

longer exposure

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6
Q

what is the main complication for smoke inhalation injury

A

carbon monoxie poisoning

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7
Q

what are the main sources of smoke inhalation injuries

A

gas leak and old cars inside a garage

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8
Q

why cannot we let go when we recieve an electrical shock

A
  1. muscle contract

2. instant nerve damage

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9
Q

what is the iceberg effect

A

extensive deep tissue damage

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10
Q

what are the types of 2nd degree burns

A

superficial-the first part of the dermis

Deep-the whole dermis

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11
Q

how can you tell you have a deep second degree burn

A

youll see blisters, this is automatically considered a 2nd stage wound and requires a wound consult

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12
Q

3rd degree burn characteristics

A

you see open skin

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13
Q

rule of 9s

A

chest is 18, face 9, thigh 9 etc

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14
Q

priority for burns in the head neck or chest

A

ABC

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15
Q

priority for burns in the hands feet, joint, eyes

A

self care

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16
Q

priority for burns in the ears nose, butt, perinonium

A

infection

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17
Q

what is the emergent phase

A

the phase right after the burn, strong inflammatory process happening, lasts 72 hours

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18
Q

what do you do after intubation

A

bronchoscopy to see how bad the lung damage is

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19
Q

what happens when the chest is burnt

A

any skin that is burnt gets hard (feels leathery) therefore lung expansion becomes very hard

20
Q

Escharotomies

A

removal of skin from the chest wall

21
Q

facial edema

A

is expected after a burn b/c of the fluid replacement

22
Q

complications after burns

A

dysrhthias due to electrolyte imbalances

23
Q

how do you do fluid therapy for burns patients

A

two large bore IVs for >15% TBSA

24
Q

parkland (baxter) formula

A

kg x 4mL x Body % burned

give first half in 8 hours then the rest over 16 hours

25
Q

how do you treat 3rd spacing

A

albumin and lasix

26
Q

how do you prevent ear pressure ulcer

A

put a towel under the heal to keep ears floated

27
Q

what is given to all burns patients

A

tetanus

28
Q

what is the goal for acute phase

A

start ambulation and fix the fluid shift. Also watch for ileus (no gas, no BMs, no Bowel sounds)

29
Q

what are the main causes of sepsis

A
  1. UTI
  2. pneumonia
  3. pressure ulcers
30
Q

Vancomycin considerations

A

dont give faster then 1g/hr b/c you can cause acute tubular necrosis (ATN)
this applys for all -mycin drugs (the aminoglycosides)
-Contrast also puts patients at risk for ATN

31
Q

you suction a sepsis patient and get blood what does this indicate what should you do

A

DIC -> fresh frozen plasma

32
Q

what does low platelets indicate for burns patients

A

myelosuppression

33
Q

how do you diagnose DIC

A

all the clotting factors go up and D-Dimer is elevated

34
Q

how do you treat hyperkalemia in CKD

A

kaxelate with D5W and IV insulin. Try not to give lasixs b/c it can cause ATN. Give calcium gluconate, Bicarb and albuterol to move k+ into the cell

35
Q

3 phases of acute renal failure

A
  1. diuretic
  2. oliguric (less then 400 ml in 24 hours)
  3. anuric (less then 40mL in 24 hours)
36
Q

when do you give blood transfusions for CKD patients

A

during dialysis

37
Q

what is the normal urine output

A

0.5 ml/kg/hr

38
Q

how do you diagnose CKD

A

GFR < 60 for 3 months

but really we diagnose using the albumin-creatinine ratio

39
Q

how do you diagnose ESKF

A

GFR <15 (normal is 125+)

40
Q

when do you give epogen

A

HgB less then 7

41
Q

magnesium considerations

A

dont give faster then 1g/hr or youll cause heart block

42
Q

potassium considerations

A

dont give faster then 10 mEq /hr

43
Q

what drug do you give for infiltration

A

Regitine

44
Q

how is the albumin-creatinine ratio done

A

use the first void of the morning b/c any exercise will effect the ratio

45
Q

who cannot recieve a kidney transplant

A

cardiomegaly patients b/c the BP will be to low and the kidney will fail

46
Q

what drug should patients recieving a kidney be on

A

steriods prior to transplant and antibiotics in the bladder prior too

47
Q

urine output post transplant

A

should be very high, higher then normal. Needs to be replaced 1:1 ratio.

Med surg (35 decks)

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