Adult Health 1 Exam 1 Flashcards Preview

Adult Health > Adult Health 1 Exam 1 > Flashcards

Flashcards in Adult Health 1 Exam 1 Deck (40):
1

Penecillins

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

2

probenecid

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

3

Oxacillin sodium
Nafcillin sodium
Cloxacillin sodium
Dicloxacillin sodium

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

4

Ampicillim

rash

5

Gentamicin sulfate
Tobramycin sulfate (Nebcin)
Amikacin sulfate

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

6

Cephalosporins

superinfection
thrombophlebitis

7

Aztreonam (azactam)

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

8

Macrolides:
Clarithromycin (Biaxin)
Azithromycin (Zithromax)
Erythromycin

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

9

Fluoroquinolones
CIpro

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

10

Clindamycin

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

11

Bronchial breath sounds are heard

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

12

Early signs of cerebral hypoxia

restlessness and irritability

13

Chronic Bronchitis

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

14

Chronic Bronchitis Assessment

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

15

Chronic bronchitis and Emphysema nursing interventions

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

16

Emphysema

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

17

Emphesema assessment

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

18

COPD is characterized by

bronchospasm and dyspnea

19

Dietary supplements for COPD

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

20

Suctioning key points

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

Surgery and smoking

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

Meds that increase surgical risk

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

Liver disease and surgery

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

24

s/sx shock and hemorrhage

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

25

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

q2h

26

post op vitals schedule

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

27

cardiac asthma manifests with

expiratory wheezes

28

fine crackles early in inspiration indicate

bronchitis or pneumonia

29

wheezes indicate

partial obstruction

30

meds for OSA

modafinil (provigil) t oreduce daytime sleepiness
Protriptyline (Triptil) at bedtime to increase respiratory drive and improve upper airway muscle tone

31

Hyperthyroidism: Graves Disease/ Goiter

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

T3 and T4 values that indicate hyperthyroidism

T3 > 220 ng/dL
T4 > 12 mcg/dL

33

Hyperthyroidism caused by anterior pituitary

will have elevated TSH and T3/T4
primary hyperthyroidism has normal or low TSH

34

Thyroid storm

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

35

Primary Nursing intervention for thyroid storm

maintain airway and adequate aeration

36

Antithyroid drugs used to treat thyroid storm

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

37

Hyperthyroidism recommended diet

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

38

Post op thyroidectomy

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

signs/Sx laryngeal edema

hoarseness or inability to speak clearly

40

Thyroidectomy post op assessments

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