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Medical Surgical Nursing Lecture > Exam 1 > Flashcards

Exam 1 Flashcards

(57 cards)

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1
Q

What is PCA?

A

pt-controlled analgesic which allows the pt to control their own pain

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2
Q

How is PCA administered?

A
  1. it can only be pushed by pt (not by a fam member or dr)
  2. the patient must be alert and oriented x4
  3. the time restriction is set by physician (meds are only administered at a set time, even if the pt tried to push the button meds will only be released in a given set time)
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3
Q

What are the rapid acting insulins?

A
  1. asparrt (Novolog)
  2. lispro (Humalog)
  3. glulisine (Aspidra)
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4
Q

What is the short acting insulin?

A

regular (Novolin and Humulin R)

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5
Q

What are the long-acting insulin?

A
  1. glargine (Lantus)

2. detemir (Levemir)

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6
Q

What is the intermediate insulin?

A

NPH

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7
Q

What is the onset, duration, and peak of rapid-acting insulin?

A

onset: 10-30 mins
duration: 3-5 hr
peak: 30 mins- 1 hr

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8
Q

What is the onset, duration, and peak of short-acting insulin?

A

onset: 30min - 1 hr
duration: 5-8 hr
peak: 2-5 hr

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9
Q

What is the onset, duration, and peak of long-acting insulin?

A

onset: 0.8-4 hr
duration: 24+ hr
peak: no pronounced peak

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10
Q

What is the onset, duration, and peak intermediate insulin?

A

onset: 1.5-4 hr
duration: 12-18 hr
peak: 4-12 hr

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11
Q

Which type of insulin can be given IVP?

A

Regular

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12
Q

What are the nursing interventions for a patient who is vomiting?

A
  1. turn them to their side
  2. elevate HOB
  3. emesis bag or basin
  4. suction
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13
Q

What is ketamine (Ketalar)?

A

potent analgesic and amnesic; bronchodilator

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14
Q

Before administering Ketalar what should you know about the patient?

A

make sure the patient is not tachycardic or hypertensive

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15
Q

What are 2 side effects of taking Ketalar?

A

increase BP & HR

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16
Q

What type of drug is most commonly given to type II diabetics?

A

Metformin (glucophage)

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17
Q

What is a side effect of Metformin?

A

causes weight loss

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18
Q

Can a type II diabetic drink ETHOL?

A

No because alcohol increases the risk of hypoglycemia

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19
Q

What is the proper diet for a pt. with diverticulosis?

A

low fat (reduce red meats) and high fiber (fruits and vegetables)

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20
Q

What is the normal range of urine specific gravity?

A

1.003-1.030

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21
Q

What is the normal range of NA+?

A

135-145

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22
Q

What is the normal range of K+?

A

3.5-5.5

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23
Q

Of the electrolytes, which should be reported for diabetics?

Study These Flashcards
A

K+, NA+, Urine specific gravity, and glucose levels

24
Q

If Jill is in PACU, how should I assess the neurologic system?

Study These Flashcards
A
  1. LOC
  2. Orientation
  3. Sensory and motor status
  4. PERRLA
25
If patient says my body's cells are resisting insulin, is this a correct understanding of type II diabetes?
yes
26
What is important when teaching a newly diagnosed pt. with diabetes
1. teach the pt. to have their A1C monitored regularly 2. diet 3. exercise 4. enough supplies 5. keep simple carbs with the,
27
If a patient with type I refuses food after insulin, what is a nursing action?
Offer another option or meds that increase appetite, so ask before the insulin if they will eat
28
How do you assess for Type I?
1. polyuria 2. polyphagia 3. polydipsia 4. recurrent infxn 5. weight loss 6. weakness 7. fatigue 8. Kussmaul respirations 9. Fasting glucose 10. AIC
29
What are some nursing interventions for GERD?
1. Assess precipitating factors 2. Avoid caffeine 3. Avoid spicy foods 4. NO OJ 5. Cigarette smoking 6. No late snacking 7. Do not eat and drink together 8. Decrease high fat foods
30
Can LVNs teach patients?
No, only the RN
31
If I am busy putting an IV in my new admit, can I delegate to a UAP to check the blood glucose of my other patient?
No, that is not under a UAP's duties
32
If I am busy checking the blood glucose of my patient, can I delegate my patient to administer insulin when i am done so I can move faster.
No, that is not under a UAP's duties
33
If my patient has a peptic ulcer, should I palpate the abdomen for tenderness?
no, do not palpate may cause bleeding and/or perforation
34
If patient abdomen hardens, what is my next action?
notify the MD immediately
35
What should I do as an RN for a preop pt?
1. labs 2. allergies 3. history 4. code status 5. meds 6. Ht and WT 7. NPO (know last meal/ drink) 8. If they smoke or drink 9. Get consent form signed
36
How do you assess a pt with GERD?
1. They say they are experiencing heartburn 2. dypepsia 3. reguritation 4. respiratory problems (wheezing, coughing, dyspnea) 5. chest pain relieved with antacids
37
If a patient reports numbness, tingling in both legs, what is a nursing intervention?
1. manage blood glucose levels 2. meds (topical creams) 3. drug therapy
38
What is a diabetic diet?
1. follow my plate Carbs counting normal protein low fats (less than 200 mg/day)
39
If while inserting an NG tube, the patient begins to cough, O2 sat decreases, and the becomes cyanotic, what is your nursing action?
stop and remove the tube
40
While prepping the pt for surgery, he tells you his fam doesn't want him to have the surgery and he no longer wants to go through with it, what is your nursing role?
act as the advocate for the patient and tell the surgeon the patient changed his mind
41
What is the normal range for WBCs?
4.9-11.0 x 10^9/L
42
What is the normal range for glucose?
70-120 mg/dl
43
What are some teachings for a patient who is about to have mastectomy?
1. breathing techniques 2. arrival and length of surgery 3. what to expect during preop and postOp 4. Recovery 5. food and fluid restrictions 6. designated driver to drive them home
44
If during postOP and the patient begins to vomit what are the nursing interventions?
1. determine quantity, characteristics, and color of the vomitus 2. assess the abdomen for distention and auscultate 3. be ready to suction
45
How is GERD typically diagnosed?
diagnosis is usually based on SI/Sx and the patient's response to behavioral and drug therapies
46
What is the diet for a patient with UC?
High protein and low residue
47
What are some nursing interventions for patients with PUD?
Hemorrhage - maintain patency of NG tube Perforation - take VS and record them every 15-30 mins - stop all oral or NG drugs and feedings Obstruction - irrigate the NG tube with normal saline solution
48
After surgery, what may be placed for a postOP pt with PUD?
An NG tube may be placed to decompress the stomach the remaining portion of the stomach
49
What are some nursing interventions for those with IBS or IBD?
1. Pain control 2. fluid and electrolyte balance 3. If pt. is experiencing diarrhea, keep them dry and free of odor 4. increase fiber 5. use a bulk-forming agent
50
During postOp, a pt. vital signs alter, what is the nursing intervention?
after checking the vital signs, inspect the the surgical incision to determine if there is excessive bleeding
51
What is the normal value for AIC?
<6.5%
52
What is the normal range for fasting glucose?
<126 mg/dl
53
What is the normal range for random plasma glucose?
<200 mg/dl
54
What is the diabetes #1 cause of?
kidney failure
55
What is the Dawn phenomenon?
hyperglycemia in the am upon awakening; can be experienced by anyone
56
What is the Somogyi effect?
low blood sugar in the am (2-3am); if not on continuous insulin, the patient has to wake up between 2-3 to check levels
57
DKA
acid buildup in the blood due to a profound deficiency oxf insulin

Medical Surgical Nursing Lecture (4 decks)

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