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Adult Health > Adult Health 1 Exam 1 > Flashcards

Adult Health 1 Exam 1 Flashcards

1
Q

Penecillins

A

Phlebitis at IV site
superinfection
oral penecillin G should be taken on an empty stomach

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2
Q

probenecid

A

Probenecid decreases renal excretion, thereby resulting in an increased blood level of the penecillin

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3
Q

Oxacillin sodium
Nafcillin sodium
Cloxacillin sodium
Dicloxacillin sodium

A

superinfection (sore mouth, vaginal discharge, diarrhea, cough)

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4
Q

Ampicillim

A

rash

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5
Q

Gentamicin sulfate
Tobramycin sulfate (Nebcin)
Amikacin sulfate

A 
used on gram negative bacteria
neuromuscular blockade
nephrotoxicity
ototoxicity
superinfection
peak, trough, renal function studies
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6
Q

Cephalosporins

A

superinfection

thrombophlebitis

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7
Q

Aztreonam (azactam)

A 
Pseudomonas aeruginosa+many otherwise reistent organisms
most effective against gram neg
phlebitis
pseudomembraneous colitis
CNS changes
EEG changes
HA, diplopia
Hypotension
assess motor sensory function and cardiac rhythm
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8
Q

Macrolides:
Clarithromycin (Biaxin)
Azithromycin (Zithromax)
Erythromycin

A

pseudomembranous colitis
phlebitis: vescicant
superinfections
space MAOI 14 days before start and end of Biaxin

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9
Q

Fluoroquinolones

CIpro

A 
superinfections
CNS disturbances
Vescicant
Monitor liver, renal, blood counts
many drug interactions
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10
Q

Clindamycin

A 
used in PCN and erythromycin allergies
agranulocytosis
pseudomembranos colitis
superinfections
liver, renal, blood studies
reprot diarrhea immediately
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11
Q

Bronchial breath sounds are heard

A

over areas of density or consolidation. Sound waves are easily transmitted over consolidated tissue

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12
Q

Early signs of cerebral hypoxia

A

restlessness and irritability

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13
Q

Chronic Bronchitis

A

chronic sputum with cough production on a daily basis for a min of 3 months in each of 2 consecutive years.
chronic hypoxemia, cor pulmonale
increase in mucus, cilia produciton
increase in bronchila wall thickness which obstructs airflow
reduced responsiveness of respiratory center to hypoexemic stimuli

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14
Q

Chronic Bronchitis Assessment

A 
right sided heart failure
distended neck veins
crackles
expiratory wheezes
generalized cyanosis
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15
Q

Chronic bronchitis and Emphysema nursing interventions

A

lowest FIo2 possible to prevent CO2 retention
monitor for s/sx of fluid overload
maintain PaO2 55-60
baselines ABGs
Teach pursed lip breathing and diaphragmatic breathing
teach tripod position
administer bronchodilator and anti inflammatory agents

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16
Q

Emphysema

A

reduced gas exchange surface area
increased air trapping (increased AP diameter)
Decreased capillary network
increased work, increased o2 consumption

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17
Q

Emphesema assessment

A 
barrel chest
pursed lip breathers
distant, quiet breath sounds
wheezes
pulmonary blebs on radiograph
18
Q

COPD is characterized by

A

bronchospasm and dyspnea

19
Q

Dietary supplements for COPD

A

Vit C
Mg and Calcium (role in muscle contraction and relaxation)
Mg and Phosphate r/t role in bone density to avoid osteoporosis

20
Q

Suctioning key points

A

apply suction only when wd catheter (and gently rotate the catheter while wd)
never suction for more than 10-15 seconds and pass the catheter only 3 or fewer times
Oxygenate before and after suctioning

21
Q

Surgery and smoking

A

it is recommended to quit smoking 2 days prior to surgery, but research shows that to actually decrease post op complications r/t smoking, cessation for 8 weeks prior to surgery is best

22
Q

Meds that increase surgical risk

A

anticoags
tranquilizers (risk for hypotension)
heroin (decrease CNS response)
antibiotics (erythromycin/anesthesia incompatibility)
diuretics (may precipitate electrolyte imbalance)
steriods (potential for cardiovascular collapse if dc abruptly, therefore, a bolus may be given before and after surgery
OTC herbs
Vit E (increase bleeding time)
MAOIs (NArdil)
ASA (platelet aggregation decreased)

23
Q

Liver disease and surgery

A

liver disease impairs the liver’s ability to detoxify meds used during surgery, to produce prothrombin, or to metabolize nutrients for wound healing

24
Q

s/sx shock and hemorrhage

A 
hypotension
narrow pulse pressure
rapid, weak pulse
cold, moist skin
increased capillary filling time
25
Q

how often should clients turn, cough, and deep breathe?

A

q2h

26
Q

post op vitals schedule

A

q 15 mins for first hour
q30 mins next 2 hours
temp is measured q4hrs for first 24 hrs post op

27
Q

cardiac asthma manifests with

A

expiratory wheezes

28
Q

fine crackles early in inspiration indicate

A

bronchitis or pneumonia

29
Q

wheezes indicate

A

partial obstruction

30
Q

meds for OSA

A

modafinil (provigil) t oreduce daytime sleepiness

Protriptyline (Triptil) at bedtime to increase respiratory drive and improve upper airway muscle tone

31
Q

Hyperthyroidism: Graves Disease/ Goiter

A

either hypersecretion of thyroid or Anterior pituitary
thyroid storm
acceleration of body processes: weight loss, increased appetite, diarrhea, heat intolerance, tachycardia, palpitations, increased BP, diaphoresis, wet or moist skin, nervousness, insomnia, exophalamus

32
Q

T3 and T4 values that indicate hyperthyroidism

A

T3 > 220 ng/dL

T4 > 12 mcg/dL

33
Q

Hyperthyroidism caused by anterior pituitary

A

will have elevated TSH and T3/T4

primary hyperthyroidism has normal or low TSH

34
Q

Thyroid storm

A

life threatening event caused by Graves disease, childbirth, CHF, DKA, infection, PE, emotional distress, trauma, surgery
Sx: fever, tachycardia, agitation, anxiety and HTN

35
Q

Primary Nursing intervention for thyroid storm

A

maintain airway and adequate aeration

36
Q

Antithyroid drugs used to treat thyroid storm

A

PTU and Tapazole block synthesis of T3/T4; Propranolol (Inderal) may be given to decrease excessive SNS.

37
Q

Hyperthyroidism recommended diet

A

high calorie, high protein, low caffeine, low fiber if diarrhea present

38
Q

Post op thyroidectomy

A

be prepared for possibility of laryngeal edema. Put a tracheostomy set at the bedside along with O2 and a suction machine. calcium gluconate should be easily accessible

39
Q

signs/Sx laryngeal edema

A

hoarseness or inability to speak clearly

40
Q

Thyroidectomy post op assessments

A

bleeding
irregular breathing
frequent swallowing
do not hyperextend neck
laryngeal edema (hoarseness and inability to speak clearly)
Monitor Troussea and Chvostek signs as removal of parathyroid may lead to tetany
keep drainage devices compressed and empty

Adult Health (18 decks)

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