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NUR 325 > exam 3 > Flashcards

exam 3 Flashcards

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1
Q

interstitial fluid

A

fluid between cells

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2
Q

intravascular fluid

A

plasma

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3
Q

osmosis

A

movement of water down a concentration gradient, from region of low to high

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4
Q

diffusion

A

from high to low

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5
Q

osmotic pressure

A

amount of pressure needed to prevent movement of water across membrane

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6
Q

colloids

A

increase osmotic pressure, makes it easier for fluid to move from interstitial to plasma

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7
Q

3 primary colloids

A

albumin, globulin, fibrinogen

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8
Q

hydrostatic pressure

A

fluid pushing against cell membrane, generated by blood pressure, push water into interstitial space

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9
Q

oncotic pressure

A

pulls tissue space to vascular space

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10
Q

intracellular electrolytes

A

potassium +
magnesium +
phosphorous -e

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11
Q

extracellular electrolytes

A

sodium +
Chloride -
bicarbonate-
calcium +

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12
Q

sodium lab

A

136-145p

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13
Q

potassium lab

A

3.5-5

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14
Q

magnesium lab

A

1.3-2.1

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15
Q

phosphate

A

3-4.5

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16
Q

hyponatremia

A

gi, renal, skin loss
excess hypotonic fluid,
Signs: confusion, weakness, seizures

treatment: replace slowly, PO/IV. normal saline, fluid restriction,

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17
Q

sodium bicarbonate

A

MOA: provides bicarbonate ion which neutralizes ion concentrations to raise blood and urinary PH, increases sodium in plasma

indication: metabolic acidosis

adverse effects: edema, cerebral hemorrhage,electrolyte abnormalities,

nursing: cardiac, ABG, electrolytes

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18
Q

hypernatremia

A

over 145
caused by: iv fluid, tube feed, excess intake,
symtoms: LOC, confusion, seizure, coma, thirst, crampst

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19
Q

treatment of hypernatremia

A

if due to water loss add water, if excess sodium is cause remove sodium

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20
Q

potassium

A

intracellular cation, regulates electrical status, diet, kidneys source of K loss

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21
Q

hypokalemia

A

renal or gi loss, acid base disorders

symtoms: cardiac rhythm disturbance, cramps, weakness, decreased bile motility

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22
Q

potassium chloride

A

indications: prevent or treat K + depletions when diet is insufficient, assess for n/v, may cause gi issues

MUST BE DILUTED/SLOW

contraindications: renal failure, ask about dialysis

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23
Q

hyperkalemia

A

> 5
decreased output, burn, crush injuries, sepsis, potassium sparing diuretics

sings: cardiac, muscle weakness, cramps
abd pain. d/v

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24
Q

kayexalate/sodium polystyrene sulfonate

A

class: cation exchange resins
indication: treat hyperkalemia
MOA: binds to potassium in digestive track and replaces it with sodium ions

only for use in people with normal bowel function

adverse reactions: constipation, diarrhea, n/v, hypokalemia
intestinal obstruction

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25
D50 and insulin
shifts potassium to cell temporarily, 10 units insulin, 1 ampule D50
26
magnesium function/levels
helps stabilize cardiac muscle cells, blocks movement of K out of them stabilizes smooth muscle hypomagnesemia = <1.3 hypermagnesemia= >2.1
27
hypomagnesemia
<1.3 causes: diuresis, renal loss, limited intake, alcohol, pancreatitis, hyperglycemia signs: hyperative reflexes, confusion, cramps\, tremors oral or IV
28
magnesium sulfate and magnesium oxide
MOA: replaces mag indication: hypomagm prevent/treat pre-eclampsia seizures, treat cardiac rhythm disturbances adverse rxn: hypermag, confusion, sluggish, slow movement, SOA
29
hypermagnesemia
>2.1 causes: increased intake/renal failure symptoms: lethargy, weakness, decreased reflexes, low pulse and BP treatment: stop replacing
30
calcium levels and function
hypocalcemia <9 hypercalcemia>10.5 hormones released by thyroid and parathyroid are controllers of amount of calcium =99% calcium in bone role in enzyme reactions, membrane potentials, hormone release, cardiac contractility, blood clotting
31
hypocalcemia
<9 unable to mobilize from bone, could be caused by increased renal lost increased neuromuscular excitability, muscle cramps, tetany, hyperactive reflexes, prolonged QT that can lead to fatal arrhythmia chvosteks sign, trousseaus sign
32
chvosteks sign
ipsilateral twitching in response to tapping of facial nerve
33
trousseaus sign
carpal spasm upon inflation of bp cuff to 20 mm above systolic for 3 minutes
34
hypercalcemia >10.5
caused by hyperparathyroidism, cancer fatigue, lethargy, confusion, weakness
35
hypercalcemia treatment
hydration, increase urine output
36
phosphorous levels and function
role in bone formation, atp formation hypophosphatemia <3 hyperphosphatemia >4.5 calcium and phosphate work together.. low calcium=high phosphate
37
hypophosphatemia
decreased absorption, antacid OD, diarrhea tremor, confusion, seizure, bone pain
38
hyperphosphatemia
caused by kidney failure, laxatives, trauma asymtomatic treat the cause!
39
types of white blood cells
never let monkeys eat bananas neutrophils lymphocytes monocytes eosinophils basophils
40
granulocytes
neutrophils, eosinophils, basophils (majority neutrophils)
41
agranulocytes
lymophocytes (majority) monocytes
42
neutrophil
WBC first to arrive for inflammation, increase in acute bacterial infections and trauma
43
lymphocyte
WBC, primary immune response, increase with chronic bacterial infection and acute viral infection
44
monocytes
WBC, phagocytocis, increase with bacterial infection and cancer
45
eosinophils
WBC, increase with allergic rxn or parasites
46
basophils
WBC, increase with allergic rxn
47
hemoglobin
amount of hemoglobin in blood (oxygen carrying capacity low: bleeding, cancer, kidney/liver disease, b12 deficiency high: polycethemia, copd, high altitude, heavy smoking
48
hematocrit
percent of blood made up of packed red blood cells low: anemia, bleeding, fluid imbalance high: copd, dehydration, congenital heart disease, shock
49
leukocytosis
increased wbc
50
leukopenia
decreased wbc neutropenia-decreased neutrophils
51
filgrastim
hematopoietic agent leukocyte growth factor MOA: promotes proliferation and differentiation indication: leukopenia, neutropenia, bone marrow trasnplants adverse effect: bone pain, leukocytosis
52
pegfilgrastim
long acting MOA: increase neutrophil production effects: bone pain
53
mononucleosis
b lymphocyte infection, epstein barr patho:atypical lymphocytes proliferate 4-8 week incubation hepatitis, high WBC
54
myelodysplastic syndrome
disorder characterized by change in quality or quantity of bone marrow elements clinical: anemia, infection, bleeding, bruising
55
leukemia
malignant neoplasm of cells leukemic cells: immature and unregulated, circulate blood, infiltrate spleen and lymph nodes classified according to cell type
56
acute leukemia
fast onset chrmost childhood, diagnosed based on blood and bone marrow tissue, immature WBC
57
chronic leukemia
discovered with routine exam relatively mature cells are incompetent fatigue, weight loss, anorexia
58
leukemia treatment
chemo, stem cell transplant allogenic-donor syngenic-identical twin autologous-pt own
59
hodgkin disease
rubbery enlargement of single or group of nodes, reed stenberg cell-tumor cell diagnosis: blood analysis, lymph node biopsy, treatment: chemo, radiation, stem cell transplant
60
non hodkin disease
spreads to liver, spleen, bone marrow quickly lymph node enlargement
61
multiple myeloma
plasma cell (b cell) cancer bone pain/fractures, impaired RBC and WBC production skeletal pain, hypercalcemia diagnosed: lab tests, bone marrow exam treatment: corticosteroids, chemo, stem cell, hydration
62
implantation fungal transmission
tineas
63
64
taking antibiotics fungal transmission
candidasis
65
dermatophytes
fungi that cause superficial skin infections
66
tinea pedis
dry scaling foot lesions wear shower shoes treat with topical antifungals
67
tinea capitis
scalp/eyebrows/lashes scaly hair loss, PO antifungals
68
tinea versicolor
upper chest, back, arms risk: hot, sweaty bleached skin from yeast topical antifungals
69
thrush/yeast candidiasis
risk is being immunosuppressed, antibiotic use white lesions in mouth, beefy red on skin topical anti-fungal
70
systemic fungal infections
require po/iv antifungals affect internal organs, lungs, meninges
71
melasma
dark molecules on face avoid sun, use bleach creams/tretinoin
72
vitiligo
abnormal melanin production, no treatment, unknown cause
73
herpes zoster shingles
lies dormant after chicken pox, reactivated prodrome:burning, tingling, rash that crusts over treat with anti virals
74
impetigo
organisms in nose, staph and strep acute and contagious topical antibacterial
75
furuncle and carbuncle
furuncle:bacterial infection of hair follicle, carbuncle is painful deep swelling caused by bacteria treatment: I and D, antibiotics
76
cellulitis
bacterial skin infection staph or strep, not contagious red/warm/painful antibiotics
77
MRSA
staph bacteria, painful boil purulent drainage, fever, abcess, can affect bloodstream antibiotics
78
actinic keratosis
benign lesions damage from sun, rough
79
solar lentigos
age spots, benign lesions
80
basal cell
most common, least malignant translucent shiny nodule, ulcer with shiny border
81
squamous cell
2nd most common, can metastasize increased with sun exposure red scaly, irregular border
82
melanoma
rare, high metastasis rate dark spot, fam hx, can form in eyes and under nails ABCDE
83
eczema
itching, rash, ooze treatment: lotion/cream cortisone
84
psoriasis
over active immune syste, skin cells grow too quick, keep moist, steroid cream
85
polyenes
nystatin, Amphotericin B
86
pyrimidine
flucytosine
87
azoles
fluconazole
88
misc agent
grisefulvin
89
nystatin
class: polyene indication: topical candida, thrush, vag, skin side effects: skin irritation, n/v/d., poor GI absorption
90
amphotericin B
polyene indication: systemic mycoses moa:binds ergosterol in fungal cell membranes and destroys cell wall high alert drug, diluted and infused slowly, monitor bun and creatinine, cardiac monitor, every other day for several months pre treat with diphenhydramine, tylenol, or aspirin
91
flucytosine
pyrimidine moa: inhibits fungal dna synthesis indications: lower dose amphotericin b
92
azoles
MOA: interrupts cell wall integrity by interfering with synthesis of ergosterol indications: superficial and non serious systematic SE: redness, itching, gi upset, liver toxicity take with food, separate from antacids
93
fluconazole/diflucan
completely absorbed orally, narrow spectrum, many drug interactions (CYP450 pathway) do not mix iv with other meds, monitor if on warfarin, monitor for hypoglycemia if on sulfonureas. increases haldol and dilantin levels
94
grisefulvin
moa: inhibits fungal mitosis, binds to keratin bone marrow suppression, rash, cns change, anorexia, n/v/d indications: resistant dermatophyte infection of scalp/skin/nails

NUR 325 (6 decks)

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