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NURS322 Final Flashcards

1
Q

3 Causing Factors for Dz in eye

A

injury
disease
aging

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2
Q

3 Eye Dz’s

A

Macular Degeneration
Cataracts
Glaucoma

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3
Q

Macular Degeneration
AKA?
Cure?
#1 Cause of…?

A

Age-related MD
NO CURE
Vision Loss > 60y/o

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4
Q

2 Types Macular Degeneration and Fx

A

Dry - most common, ■ retinal/capillary arteries r/in ischemic/necrotic macula
Wet - new growth of blood vessels w/ thin walls that leak. OCCURS @ any age

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5
Q

Macular Degeneration Nutritional Risk Factors (2)

A

↓ Carotene and Vitamin A

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6
Q

MD 3 S/S

A

↓ Depth perception, distorted, and blurred vision

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7
Q

Interventions for MD?

A

NONE

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8
Q

Snellen Test HowTo and

Interpretation

A

Pt stand 20 feet and cover 1 eye
example: 20/50 what pt can see @ 20, a healthy eye can @ 50 ft.
↑ second number, worse vision

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9
Q

MD 2 Diagnostic Tests

A

Opthalmoscopy and Visual Acuity (Snellen/Rosenbaum)

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10
Q

MD Education (4)

A

Eat antioxidants, carotene, VitA, B12
Get exams yearly
↓ ADL’s as dz progresses
Get assist services

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11
Q

Foods with… (3 ea)
Carotene
VitA (shares w/ Carotene)
B12

A

Carrots, sweet potato, dark leafies

Shellfish, liver, fish

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12
Q

Cataracts
▲ in…? and Fx?

3 Key S/S

A

Opacity of lens of eye r/in impaired vision

Diplopia - double vision
Photosensitivity
Ø red reflex

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13
Q

3 Types of Cataracts

A

Subscapular - back to front
Nuclear - center out
Cortical - outside (cortex) in

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14
Q

Key Risk Factors Cataracts (4)

A

UV exposure
Chronic Steroid Use
DM
Trauma

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15
Q

How to Diagnose Cataracts (2)

A

Looking at it &

Opthalmascope

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16
Q

Surgical removal of Cataracts contraindicated in…? (2)

A

Infection and bleeding

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17
Q

Cataract pts should report… (4)

A

Infection (yellow/green drainage)
Hemorrhage
Pain w/ nausea/vomiting
Sudden swelling, light, shapes

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18
Q

Time until vision returns post-cataract op

A

4 - 6 weeks

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19
Q

What to avoid post-eye op w/ 3 examples

A

IOP increasing actions (straining, tilting head back in shower, sex)

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20
Q

What is Glaucoma?
Education focuses on…?
S/S (2) Fx…?
IOP Reference Range

A

Disturbance of optic nerve (Leading cause of blindness)
Education on early detection >40 y/o
↓ drainage ↑ secretion fx IOP
10 - 21 mm/Hg

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21
Q

2 Types of Glaucoma and Fx’s

+Key S/S (3 ea)

A

Open-angle - most common, angle b2in iris/sclera opens
↓ aqueous outflow which ↑ IOP
↓ Periphery and accommodation (IOP > 21)
Angle-Closure/Closed-Angle - Suuden ↑ IOP b/c same angle closes
SUDDEN ↑ IOP w/ Halos and PAIN

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22
Q

Risk Factors (3) Glaucoma

A

Age, infx, tumors

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23
Q

Diagnostics (3) Glaucoma

A

Visual Acuity
Tonometry - IOP
Gonioscopy - drainage

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24
Q

Eye Drops How to (5)

A 
q12h
if > 1 drop at a time, wait 10 - 15 min b2in drops
Pull down bottom lid, drop
Push on punctum
Lay for 10 minutes
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25
Glaucoma Surgery Check IOP? Contraindication?
Check IOP 1 - 2 hours pre-op | Contraindicated in blindness
26
Glaucoma med: Pilocarpine Route, Type, and Fx (2)
DROP Miotic Constricts pupil and ↑ circulation
27
Glaucoma med: Diamox Route (2), Type, and Fx
DROP Betablocker/Carbonic Anhydrase Inhibtor ↓ IOP by ↓ aqueous humor PO Acetazolamide Pre-OP ↓ IOP pDilating pupils/eye paralysis to stop movement
28
Glaucoma med: Mannitol Route, Type, and Fx
IV Osmotic Diuretic in ER to quickly ↓ IOP
29
Glaucoma med: Predisolone Acetate Route, Type, and Fx
DROP Ocular Steroid ↓ inflammation
30
What to check if giving Acetazolamides?
Acetazolmaids are sulfa-based meds. | ASK ABOUT SULFA ALLERGIES BEFORE USING.
31
Middle Ear ▲ are b/c (3) and are caused by (3)
thickening TM ↓ sensory hairs in Organ of Corti ↓ ossicular bone movement Injury, Dz, Aging
32
Otitis Media, fx, how to tx (2)
Middle Ear Infx Inflammation of ossicles Antibiotics or surgery
33
Middle Ear 3 Key R/F
Reccurent colds, enlarged adenoids, ▲ air pressure
34
Otitis Media 3 S/S
▲ TM Feeling full Pain in ear
35
3 Inner Ear Dzs and Fx
Tinnitus - ringing, whirling, dizziness Labyrinthitis - infx labyrinth (2ndary Otitis Media) Meniere's - Tinnitus, Unilateral Sensorineural Hearing Loss, and Vertigo
36
Inner Ear 2 R/F
Viral/Bacterial Infx | Ototoxic Medications
37
Inner Ear Dz 4 Key S/S
Tinnitus Nausea/Vomitting Nystagmus - involuntary eye movement (regular when looking far though!) Poor Balance
38
Ear Diagnostic Procedures (4)
Tympanogram Otoscopy Electronystagomography (ENG) Caloric Testing
39
Tympanogram measures...?
TM/middle ear structure mobility w/ sound
40
Otoscopy is used to examine (3) Procedure for adults vs. children. Light reflexes R vs L
external canal, TM, and malleus (through TM) Adults: Up Back Children: Down Back Right 5:00, Left 7:00 (towards front basically)
41
ENG 3 steps | 2 pre-op notes (4 no no's and key device?)
Electrode eyes, stimulate ear with air/water Ask simple questions Keep bedrest/NPO until Ø vertigo FAST pre-op. No caffeine, alcohol, sedatives, or antihistamines Ø for pts with pacemaker
42
Caloric Testing
Diff. temp H2O in pt ear, watch eyes.
43
Ear care. Monitor...? Evaluate...? Encourage...?
Balance Home situation Rising slowly w/ assistive devices
44
4 Ototoxic medications > 5 days
Antibiotics Diuretics NSAIDs Chemtherapeutic Agents
45
How to reduce vertigo. Amigo! (5)
``` ↓ stimulation ↓ caffeine/alcohol ↓ Na intake ↑ assistive devices Monitor fluid intake ```
46
Eye: Floating spots are a key S/S of...?
Retinal Detachment
47
Smoking Fx on vertigo?
Ø
48
Middle Ear Dz on Light Reflex
They're gone
49
Ear Med: Meclizine Type, Tx for...? Contraindication? Warning?
Antihistamine Vertigo/inner ear problems Ø open-angle glaucoma It sedates
50
Ear Med: Droperidol (Inapsine) Type. Tx for...? 3 Warnings?
Antiemetic Nausea/Vomiting HypoTN, tachycardia, ▲ position quickly
51
Ear Med: Scopolamine (Transderm Scop) Type, Tx for...? 3 Warnings?
Anticholinergic Nausea/Vomiting r/t inner ear dz URT, sedation, ↑ IOP (care w/ open-angle)
52
Diuretics fx on Ear
↓ semicircular fluids
53
Ear Surgical Procedures (3)
Stapedectomy Choclear Implant Labyrinthectomy
54
What is a Stapedectomy? | Target pts, asses for? How is hearing post-op?
remove/replace stapes Pts with otosclerosis (fused bones) middle ear Facial nerve dmg Initially worse
55
What is a cochlear implant?
Implanted microphone behind ear that converts sound into impulses to auditory nerve
56
What is a Labyrinthectomy? | Post-Op fx? Expected finding?
Removal of labyrinth SEVERE nausea/vertigo post-op Hearing loss is EXPECTED in affected ear
57
4 MusculoSkeletal Diagnostic Procedures
Arthroscopy Nuclear Scans (bone, gallium, thallium) Dual X-Ray Absorptiometry Scans (DX) Electromyography (EMG)
58
What is an arthroscopy? 2 Contraindications? 3 Post-Op notes
Physical incision around joint for visualization Ø with inflammation or pt can't bend joint 40 degrees Provide ice Monitor site Notify ▲ swelling, pain, infx SWELLING IS NOT EXPECTED
59
``` What is an Electromyography (EMG)? EMG vs. Nerve conduction study? Detects 3 Dzs? Ø if pt is taking (2)? 3 Expectations? ```
Needling/shocking to detect muscle weakness Nerve conduction done with pads Neuromuscular, motor neuron, and peripheral nerve dz Pt taking anticoagulants/muscle relaxants Discomfort, flex while needle inserted (ease), bruising @ sites
60
BONE scans? Injection time. Detects...? (3) GALLIUM/THALLIUM scan r/t BONE SCAN. Injection Time. Detects+...? (3) How long does scan take? May require?
Entire skeletal system 2 - 3 hrs Fractures, tumors, Bone dz ↑ sensitivity 4 - 6 hrs Brain, liver, breast dz 30 - 60 minutes, may require sedation.
61
Assess before Bone scans?
Radioisotope Allergies
62
Bone scan post-op encourage?
Drinking fluids to excrete radioisotopes
63
What is Dual X-Ray Absorptiometry (DXA) WHY DO I LOVE IT?! (3) Pre-Assess for and remove...?
Estimates density of bone map (hip/spine) and presence of osteoporosis Non-invasive, Ø contrast, Ø sedation Metallic objects
64
Osteoclasts vs. Osteoblasts
Resorption vs. Formation
65
Bone density age peak range | ▲ r/t postmenopause?
18 - 30 y/o | ↑ LOSS b/c Ø estrogen
66
Prevention | 2 Foods to eat
Calcium - milk, beans Vitamin D - fish, egg yolks Ø carbonated beverages Sun 5 - 30 min/week ↑ Weight lifting
67
S/S Osteoporosis (5)
↓ height, ROM ↑ pain, hx fractures Kyphosis
68
Bone Labs (5) First 4 rule out...? (2) Last 2 rule out...? (1)
Ca, VitD, P Alkaline P - Rule out Paget's/Osteomalacia T3/T4 Serum proteins - Rule out Hyperthyroidism
69
7 Bone meds and Fx
``` Thyroid (calcitonine) ↓ bone resorption Teriparatide (Forte) - ↑ bone formation Estrogen Estrogen Agonists - ↓ osteoclast activity Ca - ↑ strong bones VitD - ↑ bone reformation BiPhosphates - ↓#osteoclasts ```
70
2 Bone Surgical Interventions
Arthroplasty - joint repair | Kyphoplasty - Vertebroplasty
71
Most Hip fractures are b/c?
OSTEOPOROSIS DAMMIT!!!
72
Timing of Physical Therapy for Osteopts?
q20-30m
73
> 3 glasses of wine a day and ↑↓ BMI r/in?
BONE LOSS
74
Bedfast pt Bone Education (4)
``` About... Skin breakdown Posture/Mechanics How to Log roll Heat/Back rubs for relaxation ```
75
Paget's Dz | Osteomalacia
abnormal bone destruction | soft bones
76
Open vs. Closed Fractures
Break skin surface vs. Ø break skin surface Open grades... 1 - minimal skin dmg 2 - skin/muscle contusions 3 - dmg to skin, muscle, nerves, blood vessles
77
``` Fracture types Complete Simple Comminuted Displaced Non-Discplaced Fatigue Compression ```
``` split in 2! 1 line multiple pieces fragments Ø aligned fragments aligned r/t athletics r/t loading for on bone (common osteoporosis) ```
78
``` Fracture types Oblique Spiral Impacted Greenstick ```
Ø90 degree angle twisting motion (physical abuse) 1 bone wedged into other 1 side Ø extend through whole bone (children)
79
5 Types of Immobilization Devices
``` Casts Traction Splints Internal External Fixation ```
80
Casts 3 lengths 3 types 2 material weight/dry time
short, long, leg walking, spica (congenital hip dysplasia in kids), body (encircle strunk) Plaster of Paris - heavy 24-72 hr dry Synthetic Fiberglass - light 30min dry
81
Moleskin
Used where casts rub against client skin
82
``` Cast Assess what? and time intervals? Ice time interval? Handle with...? (body part) Air quality (2) Wear what until completely dry? What to do if damage? ```
``` Neurologic checks Qhr (1st 24hr) then q4hr q24-48hrs palms warm dry air Gloves Record outline, date, and time of damage ```
83
Things to report r/t casts (5)
``` painful hotspots S/S infx SOB Breakdown Constipation ```
84
Traction 2 Classifications 2 Types Ensure what are in place? time interval?
Straight/running - line Balanced - slings w/ ropes Manual - pulling w/ hands Skin - w/ weights (Bucks/Bryants) Weights, q8-12hrs
85
Traction | Notify provider if...?
pain unrelieved by meds/repositioning
86
Pin care time interval | 2 types of meds given
1 - 2 times a day | Antibiotics and Opiods
87
What to assess for w/ pins (3)
infx loosening of pins tenting @ pinsite
88
Immobilizers are? | Key trait?
Splints and slings (Ø casts!) | Removable in case of swelling
89
Open Reduction (Internal Fixation)
Installation of pins inside body which can be removed later
90
6 Fracture Complications
``` Compartment Syndrome (ACS) Fat Embolisms DVT Osteomyelitis Avascular Necrosis Failure to Heal ```
91
Compartment Syndrome (ACS) 5Ps 2 Txs
Swelling in cast r/in ischemia/edema cycle (w/in 4 - 6 hrs) b/c ↓ circulation Pain, paralysis, parethesia, pallor, pulelessness Uni/Bivalve cuts Fasciotomy - cutting skin for pressure relief
92
Fat Embolism | 3 key S/S
> 70 - 80 y/o injury, fat travels from bone to lungs Dyspnea, ↓ LoC, cutaneous petechiae (pinpoint hemorrhages late sign)
93
DVT 3 Tx's
Early ambulation SCD stockings Anti-coagulants
94
Osteomylitis 3 S/S and diff. if chronic. 2 Diagnostic tools 4Txs
infx of bone r/in inflammation pain, fever, ↑WBCS S/S disappear if infx is CHRONIC Bone scans, cultures 3 mo Antibiotics Surgical debridement/antibiotic implantment Hyperbaric O2 Amputation
95
Avascular Necrosis | What is it common w/?
circulatory compromise b/c fracture | common w/ hip fractures
96
``` Failure to Heal 2 Types (+2 fixes for last one) ```
Ø healed in 6 monthers Malunion - improper healng Nonunion - just not healing Electrical stimulation and bone grafting
97
parasthesia
numbness/thingling
98
Angina
pain b/c ↓ blood flow to ♥
99
Myocardial Infarction. | Death ETA?
Ischemia/Necrosis of ♥ muscles b/c artery occlusion | Death ETA w/in 1 hr.
100
♥ Failure (HF) and 3 R/F
inefficient ♥ pumping b/c... ↓ output hypertrophy systemic congestion
101
Valvular ♥ Dz's
Abnormality in 1/4 or multiple ♥ valves
102
4 Types of ♥ inflammatory responses
Pericarditis Mycarditis Rheumatic Endocarditis Infective Endocarditis
103
HOW TO PREVENT ALL ♥ PROBLEMS?! (4)
Stay active Maintain ↓ cholesterol/BP Eat ↓ Na/Saturated Fats Stop smoking.
104
Angina Pectoris | 3 sensations
(aka chest pain) 1st s/s angina | squeezing, heavy pressure, constriction
105
3 Types of Angina and traits
Stable (exertional) - w/ stress (tx nitroglycerin if pain > 15 minutes) Unstable (preinfarction) - like above, but frequency and level ↑ over time Variant Angina (Prinzmetals) - r/t coronary artery spasms when resting
106
Risk Factors for Angina/MI (7)
``` post-menopausal ♀ HTN Tobacco use ↑Lipidemia +Meth/Cocaine Stresssed Old ```
107
2 Key S/S Angina/MI
Anxiety of impending doom | Crushing jaw to R arm pain
108
Angina/MI labs and time window before gone
Myoglobin
109
4 Angina/MI Diagnostics and what to ask before starting
ECG - evaluate PQRST Stress Test - evaluate tolerance to activity Thallium - assess ischemia/necrosis (cold spots) Catheterization (coronary angiogram) Iodine/Shellfish allergy (in contrast media)
110
is ♥ ischemia reversible?
NOPE
111
♥ Issue Monitoring Solve all (6)
``` q15min until stable.... then qHr ECG monitoring Urine output hourly O2 ( 2 - 4 L/min) IV access Energy Conservation ```
112
♥ Meds (3) and Fx
Nitroglycerin (Vasodilator) - ↓ preload/afterload, 2 doses/5 minutes Morphine (Analgesic) - pain r/in constipation Metoprolol (B■) - ↓ HTN, ↑ Survival Rate. Causes bradycardia/HypoHTN so Øgive if pulse
113
♥ Blood Thinners (4)
Streptovase/Activase (Thrombolytic Agents) - clot break Aspirin (Antiplatelet Agent) - watch for bleeding and PUD, Tinnitus = toxicity!!! Heparin (Anticoagulant) - ↓ clot growth/formation Glycoprotein IIb/IIa's
114
3 Platelet Labs to monitor when giving thinners and normal ranges
PT 11 - 14 PTT 25 - 35 seconds INR 0.8 - 1.2 ↑ time = bad!
115
Angina/MI Surgical Options (2)
``` Percuanteous Transluminal Coronary Angioplasty (PTCA) Bypass Graft (CABG) ```
116
Angina/MI complications that simply require O2 admin and provider notification
Acute MI - when Ø fixed by Nitro w/in 15 minutes Ischemic Mitral Regugitation - development of murmur Ventricular Aneurysm/Rupture - sudden chest pain and HypoHTN
117
HF/Cardiogenic Shock and proper reactions (3)
Serious pump failure (40% blockage) Intubation Ventilation Med. Administration
118
Dysrhythmias, med to give in reaction and what to prepare
Anti-dysrhymthmics and a Pacemaker
119
4 Classes of HF
1 - no S/S with activity 2 - S/S ordinary exertion 3 - S/S minimal exertion 4 - SITTING? DIE!!!
120
3 S/S Low-Output Failure (L or R?)
L ventricle pump inefficiency, this r/in... | Systolic HF -
121
R-sided HF key S/S
peripheral edema
122
LHF Risk factors (4)
HTN CAD MI Angina
123
RHF Risk Factors (2)
COPD | Pulmonary Fibrosis
124
HOutput-Failure Risk Factor
↑ metabolic needs ↑ fever ↑thyroidism
125
Cardiomyopathy Risk Factors (4)
Infection, Cancer Tx, Alcohol, FHx
126
S/S LHF (3)
Dyspnea Fatigue S3 Gallop
127
S/S RHF (3)
JVP, edema, weight gain
128
4 Types Cardiomyopathy
Dilated (most common) Hypertrophic Arrhythmogenic R Ventricle Restrictive
129
Key S/S Cardiomyopathy
Cardiomegaly (↑♥ size)
130
What 2 conditions mask presence of ♥ failure in older pts?
Lung Dz and Kidney Failure
131
HF Labs/Diagnostics and importance (6)
``` Human B-type HBNP ↓ 100 pg/mL = good 100 -300 = present HF > 300 = mild > 600 = moderate > 900 = severe Hemodynamic Monitoring - HF r/in ↑ acronyms (CVP, PAWP, PAP, CO) but ↓ SvO2 (venous o2 sat.) Ultrasound - Normal L pump 55 - 70% Normal R pump = 45 - 60% Transesophageal Echocardiography (TEE) - transduser in esophagus views ♥ Chest X-Rays ECGs ```
132
8 HF Meds (2 important fxs)
``` Diuretics ACE inhibitors Anticoagulants Vasodilators B■ Inotropics - ↑ caridac output (digoxin) Human B-peptides - ↑ Na loss/vasodialtion ```
133
What does a Ventricular Assist Device (VAD) do?
pumps ♥ for pt
134
Why is Pulmonary Edema dangerous
accumulation of fluid in alveoli/lungs r/in HF
135
2 Types Pulmonary Edema (PE) and causes
Noncardiac - b/c opiate OD, inhaled irritants, rapid IV | Neurogenic - b/c head injury
136
What to treat Acute Edema with?
``` HF meds (8 of them) Diuretics ACE inhibitors Anticoagulants Vasodilators B■ Inotropics - ↑ caridac output (digoxin) Human B-peptides - ↑ Na loss/vasodialtion ```
137
Pericardial Tamponade and 2 S/S | Counter Tx? and prep for...?
fluid accumulation in pericardial sac HypoTN and JVP Administer fluids to aocunter HypoHTN Prep for Pericardiocentesis
138
Valve stenosis vs insufficiency
valve narrowing / improper closure
139
Ventricular Heart Dz (VHF) 3 types Symptomatic when?
Degenerative - mechanical stress Rheumatic - gradual calcification/fibrotic ▲ Infective - Infx (commonly strep) Asymptomatic until late in Dz!
140
TricuspidS vs TricuspidI
D murmur w/ atrial dysrhythmia | S murmur w/ tachcardia/flutters
141
PulmonaryS vs PulmonaryI
S murmur w/ angina/cyanosis | D murmur w/ split S2
142
MitralS vs MitralI
D murmur w/ edema s/s | S murmur w/ edema s/s
143
AorticS vs AorticI
S murmur w/ narrowed pulse | S murmur w/ widened pulse
144
Valvular Dz 5 Surgical Interventions
``` Percutaneous Baloon Valvuloplasty - fuse balloon with commisures Repair Reconstructure Comissurotomy Annuloplasty Ring Insertion ```
145
How long does a Prosthetic Valve last?
10 - 15 years
146
R/F ♥ Inflammation (6)
``` Strep Infx IV drug use Valve replacement Overcrowding Being Poor ```
147
What is Pericarditis and key S/S (2)
inflammation pericaridum common w/ MI/Respiratory infx, S/S HF when leaning forward, Ø murmur
148
What is Myocarditis and key S/S (2)
inflammation myocardium S/S HF w/ murmur
149
Rheumatic Endocarditis and key S/S (4)
infx endocardium w/ strep r/t URinfx. S/S lesions, spasms, SOB, rash
150
What is Infective Endocarditis and key (2) S/S
infx endocardium w/ staph r/t druggies S/S fever/flus with spliner hemorrhages on nails
151
Inflammation Labs (3)
Culture - Ø administer med until post-culture!!! ↑ WBC ↑ ESR/CRP
152
Inflammation (2) Diagnostic Tools
ECG | Echocardiograph
153
NSAID fx on platelets?
lowers em'
154
Valve r/t weight gain?
L valves
155
Phantom pain meds (4) | and pain reduction action pts can do
B■ (propranolol) - dull/burning Antieleptics (gabapentin/carbamezepin) - sharp! Antispasmotics Antidepressants Press limb toward bed pillow
156
Inisional pain med?
Analgesics
157
Amputee prone position time? | What about legs?
q3-4hrs for 20 - 30 minutes unless otherwise | Contract glutes baby!
158
Stages HTN (5)
Normal 180 / >110
159
♥ Assessment Anatomical Landmarks (6)
Aortic area- 2nd ICS, R-sternal border Pulmonic area- 2nd ICS, L-sternal border Erb’s point- 3rd ICS, L-sternal border Tricuspid area- 5th ICS, L-sternal border Mitral area (apex)- 5th ICS, L-midclavicular line PMI at 5th ICS L-midclavicular line
160
``` Buergers Dz (what, s/s, tx) Raynauds Dz (what, s/s, tx) ```
Occlusive small arteries/veins First S/S claudification vasodilation Vasospasms aterioles UE and LE S/S pallor/cyanosis
161
``` Normal values: CK - MB Troponin I Troponin T Myoglobin ```
0%
162
Normal values: BUN Creatinine Blood Glucose
10 - 20 0.5 - 1.5 70 - 120
163
``` Normal Values: Na K CA Mg P Cl ```
``` 135 - 145 3.5 - 5 9 - 10.5 1.3 - 21. 3.0 - 4.5 98 - 106 ```
164
``` Normal Values: Urine Specific Gravity UNa UK UCl UOsmo ```
``` 1.00 - 1.03 75 - 200 26 - 123 110 - 250 200 - 800 ```
165
``` Normal Values: T3 T4 HDL LDL ADH ```
70 - 205 4 - 12 > 50
166
``` Normal Values: WBC RBC Hgb Hct ```
4k - 10k 4.6 - 5.5 13.5 - 15.5 39 - 49
167
``` Normal Values: Platelets PT PTT INR ```
140 - 400 11 - 14 23 - 35 0.8 - 1.2

ABSN Cohort 19 (28 decks)

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