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Capstone Round 3 > Cumulative Review 2 > Flashcards

Cumulative Review 2 Flashcards

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1
Q

3 Medications for:
Post-Partum Hemorrhage

OMM

A

Oxytocin (if contractions ↑ 90 seconds = tachysystole, d/c )
Methylergonovine - Ø give if HTN, SFX diarrhea
Misprostol - uterus contraction/ulcer prevention
IF for ulcers, do a pregnancy test first

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2
Q

FX: Uterine Atony

2 R/F

A

Non-firm (loss of tone)

Mag Sulate or retained placenta

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3
Q

S/S Mastitis
EDUCATION: hands, drying nipples, infant position, when to break suction.

Each feeding should... 2
What packs?
Pump OK?
Analgesic/Antibiotics ok?
Type of bra?
A 
Unilateral, pain, warm, tender boobs
Wash before feeding
Air dry
Proper for latch
Empty the breast, frequent on affected side
Ice/Warm
PUMP OK
Analgesics/Antibiotics OK
Well-fitted
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4
Q

FX: Post-Partum Depression

Length = Blues

A

Tearful insomnia
Feeling let down
Ø intervene

+10 days

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5
Q

S/S Post-Partum:
Depression
Psychosis
2 Nurse Roles:

A

Persistent sadness/mood swings Ø resolving w/ intervention
Attempting to harm self/infant
Monitor mom/baby and administer anti-depressants/anti-psychotics

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6
Q

APGAR

Scoring:

A 
0 - 10, 2 points each
A2, acrocyanosis = 1, pale blue = 0
P2, HR ↓100 = 1, Ø HR = 0
G2, reflex grimace = 1, Ø grimace = 0
A2, some flex = 1, Ø flex = 0
R2, weak cry = 1, Ø cry = 0
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7
Q

Normal Length and Wt Range for a Baby (kg and lbs)

A

Length: 45 - 65 cm
Wt: 2.5 - 4kg (5.5 - 8.8 lbs)

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8
Q

Infant Reflex end times
Sucking/Rooting/Moro
Babinski

A

4 months

1 year

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9
Q 
4 S/S Baby Hypoglycemia
Cry Type:
Skin Color
R/R
Muscle Tone
TX:
A

High pitched cry
↓ 40 RR
Cyanosis
Irritatble, twitching, flaccid muscle tone

↑ Breast feeding frequency

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10
Q 
Milk Storage Timings:
On table
Fridge
Freezer
Deep Freezer
A

8 hours
8 days
6 months
12 months

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11
Q

How to Thaw milk:
EDUCATION:
Re-usable milk?

A

Thaw in fridge for 24 hours
DO NOT refreeze
DO NOT save used portions.

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12
Q

Mix w/: Baby Formula

Fridge life

A

Tap water

48 hours

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13
Q

Barlow Test

A

Audible click w/ aduction/shorter flexion of leg

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14
Q

Ortonali Test

A

Reduces hip back into socket by manipulation of the joint

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15
Q

Baby Weights

When to double? Triple? Quadruple?

A

6 months
1 year
2 1/2 years

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16
Q

Average Diapers/day for a newborn

A

6 - 8

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17
Q 
Circumcision:
TX of crust
Use of petroleum jelly
Clean with...?
Diaper change q?
A

Leave crust, mucus fulm
Apply to prevent sticking to diaper
Warm trickling water
q4hrs

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18
Q

Circumcision:
When to bathe
What NOT to use to clean

A

NOT until healed

Moistened towelettes/alcohol

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19
Q 
Cord Care:
When is clamp removed
Keep diaper...?
Time to fall off
How to bathe
Watch for, REPORT?
A 
Before d/c
Dry and folded below
10 - 14 days
Sponge bath ONLY
Infection
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20
Q

Babies: 20 second apnea

A

Totaaally OK

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21
Q 
Pre-term Baby S/S
Weight
Lanugo
Creases
Grasp
Muscles
A 
Low, ↓ fat
ALOT of lanugo
NO creases
WEAK grasp
Hypotonic muscles
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22
Q

Pre-term Baby S/S
Affect
Sucking/Feeding
↑ R/F

A

Lethargic
Trouble with…
Necrotizing Entero Colitis

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23
Q

FX: Hyperbilirubemia in Children
Persistence length
TX

A

Jaundice in sclera/mucus membranes.
Birth - Day 7, 8+ = jaundice
Phototherapy

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24
Q 
Children Phototherapy 
Nurse Roles:
Eyes
Clothing
Genitals of male
Lotion use
Removal/Turning timings
A 
Cover eyes
Undress baby
COVER genitals
NO lotion/ointments as they can cause burns from absorbing heat
Remove q4hrs, turn q2hrs
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25
Children Phototherapy: Monitor...? Mucular Papular Rash? Complicaiton? 2 TX:
Temperature q4hrs OK Dehydration ↑ Feeds to promote excretion of bilirubin + supplement
26
``` S/S Post-Term Babies: Appearance: Skin texture: Hair/Nails: Feet: Fat: Vernix/Lanugo: ``` Glycemia?
``` Leathery Dry/Cracked Long Many creases Loss of fat Sparse vernix/lanugo ``` HYPOglycemia
27
Fibroids FX on contractions
Poor contractions
28
Cephalo Hematoma vs. Caput Seccededum
Cephalo - DOES NOT cross the suture line Resolves on own, but ↑ r/o jaundice Caput - CROSSES suture line Often due to vaccum assisted birth Resolves on own, but ↑ r/o jaundice
29
Mild - Sever Fever in Children vs. Vaccinations
Mild, low fever, congestion = OK! | Severe = Uhh... NOPE!
30
``` S/S Small for Gestational Age: Skin Abdomen Umbilical Cord Sutures ```
Loose, dry Sunken Thin, yellowish Wide
31
BRAT Diet: | Diet Contraindicated in...?
Bananas, Rice, Applesauce, Toast | diarrhea
32
Assault vs. Battery
Threatening vs. Doing it
33
``` Beneficence Autonomy Justice Fidelity Veracity ```
``` Do good Pt knows self Fair Loyalty to patient Honesty/truth ```
34
``` Repression Suppression Sublimation Displacement Reaction Formation ```
``` Unconscious forgetting Voluntary avoiding Convert into appropriate behavior Emotions towards one to another Feeling against, doing anyways ```
35
Disassociation Splitting Denial
Rape ALL GOOD or ALL BAD Refusing to accept truth
36
``` Levels of Anxiety Mild Moderate Severe Panic ```
perform better, figety ↑ HR/RR ↓ perception ↓↓ perception, tachycardia, impending doom HEART ATTACK
37
Stages of a Therapeutic Relationship Orientation Working Termination
Frequency, duration, confidentiality ▲behavior, dealing w/ problems Summarizing goals, reviewing memories, expressing feelings
38
Transference vs. Countertransference
Patient associates nurse w/ someone they know VS. nurse doing it
39
``` Behavioral Therapy Systematic Desensitization Aversion Therapy Operant Condition Biofeedback Guided Imagery Medication ```
↑ exposure until not afraid punishment rewards controlling body responses (breathing, like for OB pts)
40
S/S Electro Convulsive Therapy Pre-procedure Diet? How often/number of TX: 3 Nurse Roles:
Short term memory loss NPO 3x/week for 6 - 12 TX Ensure gag reflex works Position on side TX with Succinylcholine (Anectine) which is a muscle relaxant afterwards
41
Psychotic Disorders: Positive vs. Negative S/S (5As) ``` Affect Alogia Anergia Anhedonia Avolition ```
``` Positive = presence of extra things (behavior, speech, hallucinations) Negative = Missing something ``` ``` Affect (blunt) Alogia (speech poverty) Anergia (Ø energy) Anhedonia (Ø pleasure) Avolition (Ø motivation) ```
42
``` Personality Disorders: Antisocial Borderline Hsitrionic Narcissistic Schizotypical Schizoid ```
``` Asshole (no leading) All good/bad (watch for self-injury) flirtatious attention seeker Grandiose views of self Magical thinking Ø interest, emotional detachement ```
43
S/S Delirium vs. Dementia
Quick onset, temporary Electrolyte imabalances r/in confusion, ↑ ICP r/in restlesness, ↓ LoC Progresive, long term
44
Substance Abuse: Peak hours Delirium timing Medication for:
24 - 48 hours 2 - 3 days Benzodiazepines
45
FX: Disulfiram (Antebuse) | 2 Nurse Roles:
Causes people to get sick if they drink Ask when was last drink First a benzo... then a mood stabilizer
46
``` Substance Abuse medication FXs: Lorzepam (Ativan) Chlorodiazaproxide/Librium Carbamazapine (Tregratol)/Clonidine Propranolol Disulfiram ```
``` Anti-seizure Anti-anxiety Anti-seizure Decrease cravings Aversion Therapy ```
47
3 Key S/S Heroin | TX:
Pinpoint pupils Dental Caries Yawning/Insomnia Methadone
48
6 Key S/S Cocaine
Dilated pupils Hypotension Depression, fatigue, and apathy
49
FX: Benzos Abuse Monitor for (2) Antidote: Withdraw ↑ R/F?
Sedation Respiratory depression/↓ LoC Flumenazil (Romazicon) ↑ Seizure activity
50
FX: Cocaine/Amphetamine Abuse
Rush of euphoria which r/in HTN and tachycardia (could r/in DEATH)
51
FX: Opiods Antidote 3 S/S Withdrawal
Euphoria Naloxone Pupil Dilation, tremors, and N/V
52
``` S/S Anorexia: Menstruation Hair Temperature Weight Heart Rate ``` Nurse Role:
``` Amenorrhea Hair loss Low temperature Loss of 30% in 6 months Bradycardia ``` Reward for CALORIES consumed
53
S/S Bulemia: Weight Parotid Gland Teeth Nurse Role:
Normal/Slightly increased Swollen Messed up due to stomach acid Don't leave alone w/ meals
54
``` For Anxiety: Benzodiazepines (ex: Diazepam) Length of TX: 3 TX: 4 Examples: How to end: ```
Short term (long = addictions) DiaZEPAM, LoraZEPAM, ChlorDIAZEpoxide, ClonaZEPAM Taper off Alcohol withdrawal, seizures, insomnia
55
For Anxiety: Buspar (Busparone) Length of TX: R/T Sedation? What fruit to avoid:
Long term (not addicting) Does NOT sedate Grapefruit
56
FX: Benzodiazepines 3 SFX: ANTIDOTE:
Sedation Dizziness, drowsiness, ↓ RR Flumenazil
57
4 SFX: Tricyclic Antidepressants | REPORT SFX:
Orthostatic Hypotension Anticholinergic Sedation ↑ r/o seizures URINARY RETENTION
58
A.C.E. Inhibitor (-pril) mneumonic
Angioedema Coughing Excessive Potassium
59
Anticholinergic mneumonic
Can't see Can't pee Can't spit Can't SHIT
60
TX: SSRIs 4 Examples (SEFF) Time to take FX Monitor for...?
``` Depression Sertaline Escitalopram Fluoxetine Fluvoxamine ``` Serotonine Syndrome
61
``` S/S Serotonin Syndrome: Mental Sex Sleep Salt Teeth Weight ``` TX:
``` ↓ LoC, fever, tremors dysfunction insomnia HYPOnatremia Bruxism - grinding GAIN ``` Taper off the drug
62
What can't you eat with a MAOI (and an example med)
Tyramine (aged cheese, avocado, meats, figs, wine), r/in HTN crisis Phenelzine (Nardil)
63
3 TX: Atypical Antidepressant Example S/S for... Seizures, GI, Weight, Sleep, DICK?! Nurse Role:
Depression, smoking cessation, tobacco use Buproprion (Wellbutrin) ↑ risk of, distress, weight loss, insomnia, piaprism (PROLONGED ERECTION) TX anticholinergic FX
64
``` FX: Lithium Toxic level FX long term use: Diet: 3 ADFX: ```
``` Mood stabilizer ↑ 1.5 Thyroid dysfunction ↑ salt and water (diuretic) GI distress, FINE HAND TREMORS, weight gain ```
65
3 Contraindications: Lithium | 2 Monitors:
Anticholinergics, diuretics, NSAIDS | BUN (↑ 20) and CK (↑1.8) = BAD
66
``` French: Anti-epileptics When to TAKE: What not to DRINK: Monitor: 4 S/S ```
``` CAPHE VALET GA? Bedtime Grapefruit Liver FX Thrombocytopenia, pancreatitis, hepatotoxicity, GI FX ```
67
SFX Chlorpromazine and Haldol (1st Gen Antipsychotics) NEAA!
Every SFX in the world...? Agranulocytosis Anticholinergic Extrapyramidial NMS
68
2 SFX Risperadol and Clozapine | 2nd Gen Antipsychotics
Weight gain | Diabetes mellitus
69
``` Extrapyramidal SFX: Acute Dystonia Tardive Dyskenia Akathesis NMS ``` Medication to TX:
↓ muscle tone lip smacking pacing + aggitation Sudden high fever, dysrthymias, and ▲ LoC Benztropine
70
``` Key SFX 2nd Gen Antipsychotics 4 Examples Blood glucose and weight WBC Temperature Cholesterol and...? ```
Rispiridone, Aripripazole, Seroquel, Clozapine ``` ↑ glucose, ↑ weight Agranulocytosis FEVER Hypercholesterolemia Anticholinergics ```
71
FX: Methylphenidate, Atomoxetine TX: 1 SFX:
CNS stimulant ADHD Weight loss
72
4 EDUCATION: | Methylphenidate + Atomoxetine
Will loss weight Give with meal NO BAD THINGS NO OTC meds
73
Crises: Situational Maturational Adventitious TX:
Unexpected Natural (marriage, retirement) External disasters (hurricane) Stay with them (1-on-1)
74
S/S Autism: Eye contact 2 Speech Behavior
Delayed repetitive/delayed repetitive
75
Conduct Disorder
Defiant
76
3 R/F Suicide
Giving away stuff Saying everything's gonna be fine Putting in w/ roommate
77
4 S/S Child Abuse
Inconsistent stories Spiral Fractures Bulging fontanels + ↑ head circumference (shaking baby syndrome) Small round burns
78
Preservation Clang Association Confabulation Agoraphobia
repetition of words/ideas batch, match, latch, cratch Making up stuff to fill gaps in memory
79
``` Vital signs for babies/kids • HR • Temp • 5 years old temp • BP • RR ```
``` FAST Higher 98.6 ↓ 80/40 = OK HIGH ```
80
When do Anterior/Posterior Fontanels close
12 - 18 months | 6 - 8 weeks
81
How many teeth by 1 year How many deciduous How many permanent
6 - 8 20 32
82
Reflexes End Month: Sucking, Moro, Tonic Babinski
4 months | 1 year
83
``` Developmental Milestones: Length per month # teeth in a year Head lift Roll around sit unsupported stand ```
``` 1 inch 6 - 8 2 months 4 - 6 months 8 months 9 months ```
84
``` When can a kid... Bang blocks Stack 2 blocks Stack 6 - 7 blocks Tricycle Skip/hop on 1 foot Jump Rope ```
``` 9 months 15 months 2 years 3 years 4 years 5 years ```
85
``` Immunizations: When to give... Hep B (3) MMR Varicella ``` WHEN IN DOUBT?
birth, 1 - 2 months, 6 - 18 months 1 year 12 - 15 months DTaP
86
Meningitis Vaccines are for which type of people? 3
Teenagers Prison/Jail Military housing
87
DX: Meningitis Patient position: Precautions: Viral vs Bacterial Results Viral vs. Bacterial
Lumbar puncture Side lying knees bent Supine 4 - 8 hours post-procedure Standard vs droplet ``` V = clear B = cloudy ```
88
Brudenski and Kernig Sign
Pain and flexion of hips w/ neck flexion | Knee can't extend @ 90º lying down
89
Early Sign ICP
Restlessness
90
Putting PPE ON vs. Taking PPE OFF
Gown, mask, goggles, gloves | Gloves, goggles, gown, mask
91
``` 4 S/S Menningitis Head Mental Consciousness common ``` TX for kids
↑ circumferences seizure precautions ↓ (keep NPO to prevent aspiration) Flu-like EMLA cream!
92
Medication for Reye Syndrome
TYLENOL
93
Seizures: Tonic Clonic Absence TX meds?
Rigid Jerky back and forth (clown) Zoning Out CA PHE
94
Seizure TX (7)
Stay with them Lower to floor, on side Loosen restrictive clothing Patent airway (have O2/suction equipment nearby)
95
FX/TX: Strabismus
1 eye does it own thing | Patch the strong eye
96
``` Inhaler Education: Distance from mouth Breathing technique Head position Inhale speed Hold breath for...? ```
``` 2 - 4 cm Deep breath/exhaling Tilt back Slowly 10 seconds ```
97
Peak Flow Meters: How many times? When? Yellow/Red meaning?
3x in a row Same time each day Impending asthma attack/BAD, administer rescue medicaitons
98
Physiotherapy Education: When Administer before? Med order (2):
1 - 2 hrs before meals Bronchodilators before Albuterol then steroid
99
``` Nurse Role: Tonsillitus Frequent swallowing Milk/red liquids Juices Types of food ```
REPORT NO NO Soft bland only
100
2 S/S Epiglottis: 2 What NOT to use What to have nearby
Drooling/Aphasia Tongue depressor/throat culture Intubation supplies
101
DX: Cystic Fibrosis | 3 Nurse Roles
Chloride Sweat Test Pancreatic enzymes per meal Bronchodilator Fat soluble vitamins (ADEK)
102
Type of DZ: Cystic Fibrosis and Sickle Cell Anemia | Steatorea (S/S)
Autosomal Recessive | Foul smelling fatty stool
103
Nurse Role: Cyanotic Event
Knee to Chest (such as teterology of Fallot "T")
104
Polycythemia
↑ Hct in response to low O2
105
``` S/S of... VSD PDA Pulmonary Stenosis Coarctation of Aorta ```
Loud harsh murmur on L sternal border Machine hum murmur Narrow Systolic ejection murmur Bounding pulses proximal and decreased pulses distal
106
4 Dz of a Tetraology of Fallot
VSD Pulmonary Stenosis Overriding Aorta Right Ventricular Hypertrophy
107
``` FX of blood flow (♥ Disease) ASD, VSD, PDA Tetraology of Fallot Transposition of Great Vessels Coarctation of Aorta ```
↑ ↓ Mixed Obstructive
108
``` R/F Rheumatic Fever S/S... Type of nodules Joints Heart sounds 4 Key (RCCC) ``` TX
``` Strept Throat Subcutaneous Large painful swelling Muffled Rash, Corea (involuntary muscle movements), carditis, and chest pain ``` PCN
109
Medication for: Kawasaki (strawberry red stuff!) Vaccination EDucation 2 S/S: TX:
Aspirin in HIGH doses No live vaccines for 1 year ♥ and red eyes w/out drainage IV Immuneglobulin G
110
Medication for: Henophilia | ↑ r/o
``` Factor 8 (NOT PLATELETS) Bleeding (no razors, avoid IVs, etc.) ```
111
What 2 not to consume: Gastroenteritis
Fruit juices and caffeine
112
3 Nurse Role: Cleft Lip
Soft elbow restraints Petroleum jelly OK Cup for drinking
113
4 S/S: Pyloric Stenosis | TX:
Projectile vomiting Olive shaped mass RUQ Throwing up ↓ K Surgery
114
3 S/S: Hirschsprung Dz:TX: | Diet:
Ribbon stools, abdominal distension, ↓ motility Resection bowel r/in colostomy HIGH protein and calories LOW fiber
115
2 S/S: Intussusception | DX/TX:
Red jelly stool Telescoping of bowel Barium/Air enema
116
Lab ▲: Appendicitis C-Reactive Protein ESR WBC
↑ ↑ ↑
117
Euresis
Wetting bed at night (like nocturia)
118
Diaper rash on an infant indicates
a UTI
119
Hypospadias vs. Epispadious DO NOT WHAT THESE 2?
meatus below glans penis meatus above glans penis Circumcise them.
120
``` Lab ▲: Glomerulonephritis Sodium Creatinine BUN ASO (Anti-streptolysine) titer Urine (3) ```
``` ↑ ↑ ↑ + Cloudy, +protein, + blood ```
121
R/F/FX: Glomerulonephritis TX: Restrict 3 Monitor... Medications...
Inflammation of glomerulous Recent Strept infection Sodium, Potassium, Fluid Weight QD Diuretics
122
4 S/S: Nephrotic Syndrome | 3 Medications:
Weight gain, Edema, Ascites, Protein in urine | Steroids, Diuretics, Albumin
123
Lab ▲: Chronic Kidney Disease TX:
ALL UP except Calcium Restrict fluids, give Ca... but NOTHING ELSE
124
TX: Compartment Syndrome | S/S (5Ps)
Faciotomy (cutting to relieve pressure) | Pain, Pallor, Pulselessnessm Paresthesia, and Paralysis
125
2 Nurse Roles: Traction
Ø weights on floor | Check pin sites
126
2 S/S Dysplasia of the Hip
Uneven skin folds | 1 leg shorter
127
FX: Ortolani vs. Barlow Test
Relocate hip w/ pressure | DX by adducting and listening for a click
128
``` Hip Dysplasia/Pavlik Harness Education: Placement Baby powder? No. Diapers Assess Massage Avoid? ```
``` Over diaper NO Double Skin Skin under straps Lotions/powders ```
129
DX: Scoliosis
BEND OVER
130
2 Nurse Roles: Spina Bifida
Assess head circumference | Abducted Legs
131
2 S/S: Impetigo | 2 TX:
Honey crusts that're highly contagious | Topical antibiotic, remove crust w/ Barlow solution
132
``` 5 TX: Lice Belongings in... Bag for how long? Type of shampoo How to get eggs out Soak what? how long? ```
``` Hot water 7 - 14 days Commercial (Promethazine) Comb Brushes for 1 hour ```
133
3 S/S: Scabies | Medication:
Pencil marks, itchy, rashes between fingers | Permetherine cream ALL OVER BODY qWeek
134
Kirkland Formula of Fluid Replacement
4 mL/kg/% body burned is how much fluid to give in first 8 hours... then the rest over 16 hours
135
DX: Aids 2 Diet ▲s: Sarcoma r/t: Medications:
CD4 ↓ 200 HIGH calories HIGH protein Kaposi -Virs
136
Wilms Tumor
DON'T TOUCH
137
3 Counters to SIDS
Firm mattress Put on back Pacifier
138
Education: Neuroblastoma
CALL POSION CONTROL
139
Education: Chemo | What type of rinses
Water/Saline
140
ICP in kids vs adults
irritable vs restless
141
Stranger anxiety
6 - 18 months
142
TX: Lead Poisoning
Ipecac Syrup
143
3 Nurse Roles: TURP
Sterile technique w/ irrigation Ensure tubing is patent Notify surgeon if urine is bright red/has large clots
144
MOST effective form of Contraception
IUD
145
2nd trimester Pregnancy and Exercise for circulation amount of rest between sessions
Moderate OK! | Rest 10 minutes in between
146
Time it takes for Lithium to become FX
7 - 10 days
147
Thora vs. Paracentesis Patient position
Leaning Forward over table | High-Fowlers
148
3 Prego OK shots
Tetanus, Influenza, Hep B
149
Chemotherapy, how to N/V
↑ unsaturated fats in diet
150
Herpes 1 vs 2 locations
1 mouth | 2 genitalia
151
``` 4 S/S Dehydration Temperature Eyeballs BP Tongue ```
↑ Sunken ↓ Orthostatic Hypo Swollen

Capstone Round 3 (7 decks)

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