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Med Surg 1 > EXAM 1 REVIEW MAIN POINTS > Flashcards

EXAM 1 REVIEW MAIN POINTS Flashcards

1
Q

fluid volume deficit (hypovolemia)
onset

A

rapid

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2
Q

fluid volume deficit (hypovolemia)
severity

A

depends on degree of fluid loss

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3
Q

fluid volume deficit (hypovolemia)
clinical cues
first signs

A

increased pulse
increased respiratory

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4
Q

fluid volume deficit (hypovolemia)
clinical cues
late sign

A

decreased BP

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5
Q

fluid volume deficit (hypovolemia)
nursing management

A

monitor
- VS
- mental status
- I&O
- daily weights

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6
Q

fluid volume deficit (hypovolemia)
nursing management
cautions

A

be careful when giving fluids to not push patient into fluid volume overload so make sure to monitor

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7
Q

fluid volume deficit (hypovolemia)
nursing management
monitor for fluid volume overload

A

lung sounds
respiratory rate
heart rate
pulse ox

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8
Q

fluid volume deficit (hypovolemia)
nursing management
maintain what priority

A

patent airway

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9
Q

fluid volume excess (hypervolemia)
nursing management

A

monitor
- VS
- mental status
- I&O
- daily weights

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10
Q

fluid volume excess (hypervolemia)
nursing management
cautions

A

could go too far
diuresis/restrict too much

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11
Q

sodium normal

A

135-145

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12
Q

sodium main _______ cation

A

ECF

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13
Q

a gain or loss in sodium usually equals

A

gain or loss in water

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14
Q

hyponatremia
number

A

less than 135

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15
Q

hyponatremia
clinical effects

A

neurological changes

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16
Q

hypernatremia
number

A

greater than 145

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17
Q

hypernatremia
clinical effects

A

neurological symptoms

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18
Q

potassium number

A

3.5-5

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19
Q

hypokalemia
number

A

less than 3.5

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20
Q

hypokalemia
causes

A

GI losses, medications, alterations of acid base balance, alkalosis, hyperaldosteronism, poor diet intake, starvation, diuretics, dig tox

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21
Q

hypokalemia
manifestations

A

dysrhythmias

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22
Q

hypokalemia
medical management

A

administer K over an hour IVPB
NEVER IV PUSH

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23
Q

hypokalemia
nursing management

A

monitor ECG and ABG
IV assessment

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24
Q

hypokalemia
clinical profile
GI

A

anorexia, N/V, decreased bowel movement, abdominal distension

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25
Q

hypokalemia
clinical profile
CV

A

flat T wave, dysrhythmias

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26
Q

LOW POTASSIUM

A

LOW T WAVES

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27
Q

hyperkalemia
number

A

larger than 5

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28
Q

hyperkalemia
causes

A

impaired renal function, metabolic acidosis, crush injury, burns, stored PRBC, ACE and NSAIDS

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29
Q

hyperkalemia
manifestations

A

cardiac changes and dysthymia’s

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30
Q

hyperkalemia
medical management

A

monitor ECG

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31
Q

hyperkalemia
clinical profile
CV

A

tachy to brady to asystole
peaked T wave
wide QRS to sine wave

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32
Q

HIGH POTASSIUM

A

HIGH T WAVE

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33
Q

hyperkalemia
clinical profile
muscle

A

muscle weakness

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34
Q

hyperkalemia
therapy

A

shifter:
- NaHCO3
- insulin
- glucose
neutralizer:
- calcium
remover:
- diuretic
- kayexolate
- dialysis

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35
Q

hypocalcemia
number

A

less than 8.6

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36
Q

hypocalcemia
causes

A

alkalosis

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37
Q

hypocalcemia
manifesations

A

hyperactive DTR, trousseau, chovostek, seizures, abnormal clotting, increase neuromuscular excitability

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38
Q

hypocalcemia
clinical profile
CNS

A

anxiety, irritability, seizures

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39
Q

hypocalcemia
clinical profile
pulmonary

A

cardiopulmonary arrest

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40
Q

hypocalcemia
nursing management

A

severe hypocal is life threatening

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41
Q

hypercalcemia
number

A

larger than 10.2

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42
Q

hypercalcemia
manifestations

A

muscle weakness, ECG changes, dysrhythmias, decrease in neuromuscular excitability

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43
Q

hypercalcemia
clinical profile
CNS

A

depression

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44
Q

hypercalcemia
clinical profile
CV

A

heart block
arrthymias
arrest

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45
Q

hypercalcemia
clinical profile
pulmonary

A

bronchospasm

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46
Q

hypomagnesium
number

A

less than 1.3

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47
Q

hypomagnesium
mainfesations

A

neuromuscular excitability, ECG changes

48
Q

hypomagnesium
nursing management

A

often accompanied by hypocalcemia

49
Q

hypermagnesium
number

A

larger than 2.3

50
Q

hypermagnesium
manifestations

A

lower BP, depressed respirations, ECG changes, decreased neuromuscular excitability

51
Q

hypotonic
avoid

A

brain injuries

52
Q

IV assessment of allergies

A

latex and medications

53
Q

infiltration
how to avoid

A

ongoing close monitoring

54
Q

infiltration
what to do

A

IV stopped
catheter disoncontinoued

55
Q

infiltration
new site

A

started proximal to infiltration

56
Q

extravasation
medications

A

chemo, vasopressors, potassium, calcium

57
Q

extravasation
initial manifestations

A

pain, burning, redness

58
Q

extravasation
later manifesations

A

blister, inflammation, necrosis

59
Q

extravasation
increase risk patients

A

elderly, comatose, anesthesia, diabetes, peripheral vascular, cardiovascular

60
Q

extravasation
what to do

A

stop infusion
notify MD
leave IV in

61
Q

extravasation
new site

A

new extremity

62
Q

phlebitis
types

A

chemical
mechanical
bacterial

63
Q

phlebitis
symptoms

A

redness, swelling, pain, tenderness at site and along vein

64
Q

phlebitis
what to do for new IV

A

discontinuous IV
restart in another site

65
Q

phlebitis
treatment

A

warm moist compress to affected site

66
Q

phlebitis
what is key

A

prevention

67
Q

clotting or obstruction
what to do

A

discontinue
new site

68
Q

clotting or obstruction
what not to do

A

do not raise infusion site or solution container
do not aspirate clot

69
Q

cough is a symptom of

A

bronchospasm

70
Q

chest pain

A

bronchospasm, PE

71
Q

wheezing

A

PE

72
Q

crackles

A

fluid volume overload, PE

73
Q

hemoptysis

A

PE, bronchospasm, fluid volume overload

74
Q

FVC

A

forced vital capacity
max forced expiratory
(unable to assess on COPD)

75
Q

FEV1

A

forced expiratory volume
volume of air exhaled in 1 second
if unable to do=airway obstruction

76
Q

arterial blood gas

A

accurate measurement of oxygen in blood

77
Q

sputum is obtained

A

in the morning before the patient ate or drank

78
Q

imaging studies
assess for what prior

A

allergies to contrast, shellfish
monitor BUN and creatinine

79
Q

MRI

A

remove metal

80
Q

broncoscopy

A

postprocedure monitoring

81
Q

oxygen toxicity main symptom

A

substernal discomfort

82
Q

venturi mask

A

most reliable and accurate/precise

83
Q

care of patient with trache
gold standard

A

bilateral breath sounds followed by xray

84
Q

care of patient with trache
monitor/check cuff pressure every

A

6-8 hours

85
Q

prevention of complications in postop

A

improving gas exchange
improving airway clearance
relieving pain
promoting mobility and shoulder exercises
maintain fluid and nutrition

86
Q

most common cause of upper respiratory tract disorders are

A

viruses

87
Q

epistaxis
treatment

A

topical vasoconstrictors
packing of nasal cavity

88
Q

laryngeal obstruction

A

use of ACEI
history of NG tube

89
Q

laryngeal cancer
early symptoms

A

hoarseness, persistent cough, weight loss

90
Q

laryngeal cancer
later symptoms

A

dysphagia
dyspnea
persistent hoarsness

91
Q

care of patient post op laryngectomy
pre and post op care

A

self care of airway
methods of communication
pain control medications
nutritional support

92
Q

care of patient post op laryngectomy
nursing assessment

A

airway patency
montior for hemorrhage and repertory distress
airway obstruction

93
Q

care of patient post op laryngectomy
nursing assessment
prevention of aspiration

A

elevate head of bead
gastric residual
rehab for swallowing
diet adjustment

94
Q

care of patient post op laryngectomy
disturbed body image

A

realistic goals
involving client in self care
communication methods

95
Q

allergy

A

hypersensitive reaction to an allergen initiated by an imununologic mechanisms that is usually mediated by IgE antibodies

96
Q

patients at risk for allergies

A

peanuts, shellfish, penicillin, sulfa antibiotics, contrast, NSAIDS, stings, latex, ACEI

97
Q

severe allergic reaction/anaphylaxis

A

abrupt onset
progress to bronchospasm
laryngeal edema
severe dyspnea
cyanosis
hypotension
cardiac arrest

98
Q

allergic reaction
medical and nursing management strategies

A

treat respiratory problems
o2
intubation and CPR
epi 1:1000 subq

99
Q

atelectasis
prevention

A

early mobilization
deep breathing
pain meds
incentive spiro
suction
positioning

100
Q

pneumonia
risk factors

A

long term care
compromised defense mechanisms
immunosupresion
smoking
prolonged immobility
depressed cough reflex
supine position
transmission from healthcare providers

101
Q

pneumonia
manifestations elderly

A

mental status
fatigue

102
Q

pneumonia
interventions

A

hydration (2-3L)
humidification
cough and deep breath
provide nutritional enriched foods

103
Q

PPD placed

A

intradermally forearm

104
Q

PPD
exposure in healthy patient

A

10mm

105
Q

PPD exposure in immunocompsorimsed

A

5mm

106
Q

tuberculosis
patient education

A

follow drug regimen

107
Q

pulmonary emboli
risk factors

A

venous status
heart disease
trauma
postop/partum
diabetes
COPD

108
Q

pulmonary emboli
preventive

A

leg exercises
ambulation
SCD
subq heparin

109
Q

pulmonary emboli
emergency

A

VOMIT

110
Q

pulmonary emboli
anticoagulant therapy

A

prevent reoccurrence

111
Q

pulmonary emboli
thrombolytic

A

high risk of bleeding

112
Q

tension pneumothorax
Signs and symptoms

A

weak and rapid pulse
pallor
JVD
anxiety
assymetrical chest wall movement
shortness of breath
dercreased/abseent breath sounds over lung
trachea deviation

113
Q

COPD
bronchitis

A

blue bloater

dusky to cyanotic
recurrent cough
increased sputum
hypoxemia
respiratory acidosis
increased H&H
increase RR
dyspnea
Digital clubing
use of accessory musclesC

114
Q

COPD
emphysema

A

smoking or recurrent inflamations
pink puffer

increased co2 retention, no cyanosis, purse lip breathing, ineffective cough, bronchi collapse on expiration, orthopenic, barrel chest

115
Q

COPD
diagnostic tests

A

pulmonary function: FEV1
sputum samples
oxygenation assessment
- ABGS: resp acidosis
pulse ox 88-92

116
Q

COPD
treatment strategies

A

airway management
oxygen therapy
patient education
- smoking
- vaccinations

Med Surg 1 (47 decks)

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