FINAL Flashcards
(197 cards)
1
Q
Risk factors for impaired thermoregulation
A
age (elderly or really young)
obesity
cognitive impairment
working environments
2
Q
first thing to do if someone is suffering from hypo/hyperthermia
A
get them out of that cold or hot environment immediately
3
Q
what to do for a patient suffering from hyperthermia in order
A
- remove clothes
- mist them with water
3 fans
4
Q
How to treat frostbite
A
warm blankets warm IV fluids warm humidified oxygen DO NOT RUB Loosley dress with sterile dry gauze and separate fingers
5
Q
The patient is suffering from: projectile vomiting decreased LOC headache confusion has unequal pupils
what do you suspect?
A
Increased intracranial pressure
6
Q
Components of the glasgow coma scale
A
eye response
motor response
verbal response
7
Q
risk factors for CAD
A
Increased LDL Low HDL smoking HTN Obesity sedentary lifestyle excessive alcohol age genetics
8
Q
Pt presents with decreased urine output Fluid volume overload HTN hyperkalemia what do you suspect?
A
renal disease
9
Q
S/S of renal disease
A
decreased urine output
fluid volume overload
HTN
hyperkalemia
10
Q
S/S of increased intracranial pressure
A
projectile vomiting irritability decreased LOC headache confusion unequal pupils
11
Q
Dietary considerations for RENAL FAILUREpatients
A
restrict potassium foods
Phos needs to be restricted but they usually get pills for that
12
Q
Can a patient with CAD have orange juice or potato chips?
A
NO
13
Q
Diarrhea
abd pain
bloody stool are all S/S of what?
A
Crohn disease, ulcerative colitis, and diverticulitis
14
Q
If a pt with crohn’s disease, ulcerative colitis, and diverticulitis have diarrhea, abd pain, and/or bloody stools should they still call the doc?
A
YES
15
Q
What kind of diet should a patient with diverticulosis be on?
A
high fiber to prevent diverticulitis
16
Q
What kind of diet should a patient with diverticulitis be on?
A
low fiber
17
Q
A patient with Crohn’s, ulcerative colitis, or diverticulitis should decrease what during flare ups?
A
fiber
18
Q
Dehydration peritonitis anemia sepsis electrolyte imbalance malnutrition and ruptured bowel are all complications of what?
A
crohn’s, ulcerative colitis, and diverticulitis
19
Q
patient has a ridgid or board like abdomen what do you suspect?
A
peritonitis
20
Q
patient has fatigue, weakness, dry mucous membranes, dehydration, orthostatic hypotension, and presents to the ER with ShOB what do you suspect?
A
anemia
21
Q
S/S of anemia
A
weakness fatigue dry mucous membranes dehydration orthostatic hypotension pale skin always cold
22
Q
S/S of sepsis
A
changes in LOC
fever
vital sign changes (BP drops)
decreased urine output
23
Q
What can trigger sickle cell crisis
A
strenuous exercise infection surgery smoking drugs dehydration anything that increases need for oxygen
24
Q
treatment and interventions for sickle cell crisis
A
teach light exercise: walking or yoga ensure they drink plenty of water esp before exercise warm compresses never cold admin oxygen pain management
25
If a sickle cell pt is in labor what should you have ready??
oxygen and IV fluids
26
S/S of leukemia
bleeding
infection
anemia
effects all blood cells
27
Interventions for leukemia
neutropenic precautions
teach pt and family no fresh flowers, fruits, veggies, no deli meats
stay away from sick people
avoid large crowds
no rectal temps, soft toothbrush or washcloth, fall precautions, use an electric razor, no safety razor, no flossing
premedicate with antibiotic to go to dentist
28
S/S of cirrhosis
clay colored stools
decreased LOC
jaundice
RUQ pain
29
complications from Cirrhosis
esophageal varices
clotting defects
encephalopathy
ascites
30
S/S of Hep B
fatuige
nausea
vomiting
can be asymptomatic
31
Can someone with an active hep infection receive the Hep B vaccine
NO
32
Why would someone need to take lactulose?
Cirrhosis and/or high ammonia level
33
side effects of lactulose?
dehydration
| low potassium
34
Desired effect of lactulose?
bowel movement
35
Nursing considerations for lasix
```
strict I&O
daily weights
check potassium
give in morning
check BP do not give if low
increase potassium in the diet
```
36
Side effects of lasix
```
blurred vision
dizziness
polyuria
hypotension
FVD
hypokalemia
```
37
If a pt's apical pulse is less than 60 should you give the patient their digoxin?
NO
38
sign of digoxin toxicity
halos around lights
39
When does a pregnant woman get rhogam?
when she is Rh neg at 28 wks and after birth
| after anything that could have meant contact with Rh positive blood
40
sign of carbon monoxide poisoning
cherry red mucous membranes
41
priority for burn patients, what to monitor for?
airway!
| Monitor for wheezing, stridor, black around mouth or nose
42
How many times should a patient use an incentive spirometer in an hour
10
43
WBC count
5,000-10,000
44
Hgb
M: 14-18
F: 12-16
45
Plt count
150,000-400,000
46
Normal potassium levels
3.5-5.3
47
S/s of hyperkalemia
```
bradycardia or other arrhythmias
nausea
intestinal cramping
diarrhea
anxiety
muscle weakness
numbness or prickly sensations
flaccid paralysis
```
48
S/S of hypokalemia
```
Weak, rapid irregular pulse
low BP
anorexia
nausea
vomiting
decreased DTR
fatigue
muscular weak cramps
numbness
abd distention
peristalsis ileus
```
49
Sodium levels
135-145
50
```
artichoke
avocados
bananas
cantaloupe
cassava
dried fruits
grapefruit
honey dew
jack fruit
kiwi
kohlrabi
lima beans
mango
meats
milk
dried peas and beans
nuts
oranges/orange juice
papaya
peaches
pears
plantains
pomegranate
potatoes (white and sweet)
prunes/prune juice
pumpkin
rhubarb
salt substitute
spinach
sunflower seeds
Swiss chard
tomatoes/tomato juice
vegetable juice
winter squash
```
potassium rich foods
51
potassium-rich foods
```
artichoke
avocados
bananas
cantaloupe
cassava
dried fruits
grapefruit
honey dew
jack fruit
kiwi
kohlrabi
lima beans
mango
meats
milk
dried peas and beans
nuts
oranges/orange juice
papaya
peaches
pears
plantains
pomegranate
potatoes (white and sweet)
prunes/prune juice
pumpkin
rhubarb
salt substitute
spinach
sunflower seeds
Swiss chard
tomatoes/tomato juice
vegetable juice
winter squash
```
52
Order to don PPE
```
handwashing
gown
mask
eyewear
hair cover
shoe cover
gloves
```
53
when taking off PPE
```
remove gloves
gown
eye wear
mask
hair covering
shoe covering
handwashing
```
54
warfarin antidote
vitamin K
55
heparin antidote
protamine sulfate
56
what to do to prevent an air embolism?
when starting an IV tell them to hold their breath and be still
57
Common abuse in older adults and children
malnutrition
58
Tylenol antidote
acetelysine
59
medications containing tylenol
Lortab, Percocet, hydrocodone, Vicodin
60
what labs to watch for someone taking tylenol
blood sugar
| liver enzymes
61
what can you not have when taking xanax?
grape fruit juice
62
when should you give xanax?
at bed time
63
how long should you take xanax?
it is for short term use
64
how should you adjust xanax?
half a dose in the morning and half a dose at night
65
angina that occurs with moderate exertion in a pattern that is familiar to the patient. pain is predictable and lasts only a few minutes. can usually be relieved by resting and nitro
stable angina
66
angina that increases unpredictably in frequency or that occurs with less exertion, at rest, or during sleep. not relieved by rest or medication.
unstable angina
67
what kind of angina is more likely to lead to a heart attack?
unstable angina
68
who shouldn't be taking aspirin?
those under 18
| anyone with asthma
69
what kinds of foods should be avoided when taking aspirin?
foods that acidify urine
70
foods that acidify urine
```
cheeses
corn
cranberries
eggs
fish
grains (breads and cereals)
lentils
meats
nuts (Brazil, filberts, walnuts)
pasta
plums
poultry
prunes
rice
```
71
what kinds of foods are these
```
cheeses
corn
cranberries
eggs
fish
grains (breads and cereals)
lentils
meats
nuts (Brazil, filberts, walnuts)
pasta
plums
poultry
prunes
rice
```
foods that acidify urine
72
```
patient presents with
lack of energy
flat affect
appear depressed
loss of interest in hobbies
```
avolition
73
what kinds of patients might present with avolition?
older clients
patients with terminal illness'
schizophrenic
behavioral health patients
74
barriers to healthcare
language
economics
geography
75
who should not be taking benedryl
children under 4
mothers who are breastfeeding
those with acute angle glaucoma
76
Who is at risk for Wernicke's encephalopathy?
alcoholics
77
What does an alcoholic's diet need to be high in to prevent Wernicke's encephalopathy
Thiamine
78
high thiamine foods
cereal (whole grain and enriched)
meats (esp pork)
fresh veggies (loss is variable during cooking)
79
should an alcoholics' thiamine levels be checked if they look healthy?
yes
80
What is a red tipped thermometer used for?
rectal use
81
how long after eating, drinking, or smoking should you check a patients temp?
30 mins
82
What can cause a stroke?
lack of oxygen to the brain due to ischemia due or a brain hemorrhage
83
a lack of oxygen to the brain due to ischemia due or a brain hemorrhage can cause a what?
stroke
84
FAST for a stroke
Facial features
arm weakness
Speech
Time to call 911
85
patient presents with
weakness, change in facial features, speech, paralysis, dizziness, trouble walking, severe headache with no known cause, lack of balance and coordination, sudden confusion, sudden trouble seeing in one eye or both
What do you suspect?
stroke
86
S/S of a stroke
weakness, change in facial features, speech, paralysis, dizziness, trouble walking, severe headache with no known cause, lack of balance and coordination, sudden confusion, sudden trouble seeing in one eye or both
87
if the stroke is on the stoke is on the left side of the brain then what side is affected
right side
88
if the stroke is on the right side of the body then what side is affected?
left side
89
when a patient presents to the ER with a stroke you should monitor their face for what?
symmetry and asymmetry
90
What stage of Alzheimer's is this?
| forgetfulness
forgetfulness of glasses or wallet, no memory problems
stage 2 of Alzheimer's
91
stage 1 of Alzheimer's
no apparent manifestations
92
the following is what stage of Alzheimer's
mild cognitive decline
(inability to plan, decreased attention, unable to remember names, difficulty in social or work situations)
Alzheimer's stage 3
93
The following is what stage of Alzheimer's
mild to moderate cognitive decline
(withdrawn, obvious memory loss, limited knowledge, difficulty performing task planning or organizing, depression and social withdrawal)
Alzheimer's stage 4
94
the following is what stage of alzheimer's
moderate cognitive decline
(inability to recall important details such as address, telephone, schools, assistance with adls become necessary, disorientation and confusion as to time and place)
Alzheimer's stage 5
95
the following is what stage of alzheimer's
moderate to severe cognitive decline (late-stage)
(loss of awareness to recent events, can recall the name but not hx, significant personality changes, wandering behavior, x1 w/adls, the normal sleep cycle is disrupted, increased episode of incontinence
Alzheimer's stage 6
96
The following is what stage of alzheimer's
severe cognitive decline
(inability to respond to environment, speak, control movement is lost, unrecognizable speech, incontinence, inability to eat w/o assistance and impaired swallowing, ataxia)
Alzheimer's stage 7
97
positive S/S of schizophrenia
hallucinations and delusions
98
negative symptoms of schizophrenia
apathy, flat affect, anhedonia
99
how often should circulation be checked or the patient be allowed to stretch when they are in restraints?
every 2 hr
100
What should happen before applying restraints
all less restrictive methods should be exhausted
101
how should you release restraints?
one arm at a time
102
how often should a new order be required for restraints
within 24 hrs
103
where should soft restrains be fastened to?
side rails
104
how does the body respond to stress
lower immune system, interfere with sleep patterns, hard to concentrate, raises BP
105
Know the correct way to count respirations
you better not tell that patient you're counting their respirations mary. 12-20 resp
106
PT/Coumadin/Warfarin
10-13 sec
107
APTT/Heparin
25-35
108
INR for no anticoag tx
0.9-1.1
109
INR for pt receiving anticoag tx
2.5-3.5
110
peripheral pulse sites
```
temporal
carotid
brachial
radial
femoral
popliteal
```
111
is the apical pulse a peripheral pulse
NO
112
what can make getting a peripheral pulse difficult?
low perfusion
113
if you're allergic to amoxicillin then you can't take what?
penicillin
114
if you're allergic to penicillin then you can't take what?
amoxicillin
115
How can nitro be given
sublingual
IV
Transdermal
116
How many times can nitro be given sublingually before calling 911
3
| once every 5 min
117
patient presents with:
chest pain, ShOB, dizziness, nausea, sweating, left arm pain and jaw pain
what do you suspect?
classic MI
118
classic S/S of MI
chest pain, ShOB, dizziness, nausea, sweating, left arm pain and jaw pain
119
patient presents with
heartburn, epigastric pain, fatigue, abd pain
what do you suspect
non-classic MI
120
who is more likely to die from a heart attack?
a woman
121
how do women present with heart attacks
fatigue
shoulder blade discomfort
ShOB
Epigastric pain
122
What are some major injuries that a pt might sustain in a MVC?
head trauma, paralysis, ICP, fracture amputations
123
What is the priority after an MVC
check the perfusion
124
bipolar/mood stabilizer. prevents/decreases incidences of acute manic episodes
Lithium
125
side effects of lithium
lack of coordination
dizziness
drowsiness
126
S/S of lithium toxicity
```
vomiting
diarrhea
slurred speech
lightheadedness
decreased LOC
decreased coordination
drowsiness
muscle weakness
tremor or twitching
```
127
when should you call the doc when taking lithium?
fever
vomiting
diarrhea
128
what are mistaken perceptions of reality?
illusions
129
Who might present with illusions
schizophrenic patients
130
early stage hypoxia
```
restlessness
tachycardia
tachypnea
dyspnea
increased agitation
anxiety
diaphoresis
retractions
headache
```
131
late-stage hypoxia
```
restlessness
stupor
dyspnea
decreased respirations
bradycardia
cyanosis
```
132
hgb male
14-18
133
hgb female
12-16
134
increased hgb indicates what
chronic hypoxia
135
decreased hgb indicates what?
anemia or blood loss
136
what are hallucinations?
are false sensory perceptions that can affect all 5 senses
137
most common hallucinations
auditory and visual hallucinations
138
what kinds of patients present with hallucinations
schizophrenia
139
normal blood sugar ranges
70-100
140
if a patient's blood sugar is below 70 what do you do?
give OJ sugared candy, peanut butter crackers, glucose tabs, milk
141
if pts blood sugar is above 100 what do you do?
give insulin
insulin drip
more fluids or IV fluids
142
an eating disorder that causes lack of appetite
anorexia
143
most common eating disorder
obesity
144
caloric dysfunction
overeating obesity
145
an eating disorder where the patient is afraid to eat because of fear of gaining weight
anorexia nervosa
146
an eating disorder that consists of binge eating and self-induced vomiting or laxatives
bulimia nervosa
147
what drug is used to decrease the severity of HF and used to increase cardiac output
digoxin
148
what should you check before giving digoxin
the apical pulse
149
why should you withhold Dig
low BP
| pulseless than 60
150
where is the apical pulse
fifth inner midclavicular space
151
S/S of dig toxicity
```
vomiting
abd pain
green halos around objects
anorexia
nausea
arrhythmias
visual disturbances
```
152
random blood glucose test
70-100
153
glucose tolerance test
140-199 pre-diabetes
| over 200 indicates diabeties
154
fasting glucose
100-125 prediabetes
| 126 or higher is diabetes
155
Ha1C
normal less than 5.7
prediabeties 5.7-6.4
higher than 6.4 is diabetes
156
s/s of hypoglycemia
faintness, hunger, sweating, irritability, trembling, low urine output, lethargy, cool clammy skin
157
```
patient present with
irritable
mood swings
isolation
feeling hopeless
suicidal ideations
PMS
```
what do you suspect
depression
158
what is the most important thing to ask a depressed patient?
if they have had suicidal or homicidal thoughts
159
who is most at risk for depression
older adult patients
160
PMDD mostly affects women when?
the second half of their menstrual cycle
161
is dementia a disease?
NO a symptom
162
S/S of dementia
```
short term memory loss
long term memory
misplaced items
agitation
repeat of questions
delusions
hallucinations
aphasia
unable to communicate needs
```
163
causes of dementia
medications
chronic alcoholism
neurological infections
head injuries
164
can dementia be reversed if r/t head trauma
no
165
can dementia be reversed if r/t medications
yes
166
what are delusions?
fixed false beliefs that cannot be changed by logic or factual proof
167
how may delusions present
patients my exhibit delusions of grandeur, persecution, or guilt
168
s/s of colon cancer
blood, black or black tarry stools, if closer to anal opening brighter red
169
testing or screening for colon cancer
guiac or occult blood stool
colonoscopy w/ biopsy
sigmoidoscopy w/ biopsy
170
guiac testing my give a false positive if
the pt has had red meat within 3 days
171
what is the goal of cognitive-behavioral therapy?
trying to change mindset of thinking of themselves to more positive thinking
172
what is a priority consideration of COPD patients
do not turn their O2 above 2L
173
what is the normal O2 levels for a CPOD patient
88-92%
174
a medication used to decrease positive symptoms of schizophrenia?
clozapine
175
side effects of clozapine
seizures
drowsiness
orthostatic hypotension
176
What is a high-priority side effect of clozapine?
neuroleptic malignant syndrome
fever
respiratory distress
tachycardia
177
an increase of neutrophils indicates?
infection
178
an increase of basophils can indicate?
hyperthyroidism,
bone marrow disorder,
ulcerative colitis
179
an increase of lymphocytes indicates?
viral infection
chronic bacterial infection
leukemia
180
an increase of eosinophils indicates?
allergic response
| some leukemias
181
an increase of Monocytes indicates?
chronic inflammatory disorders
| some leukemias
182
a test used to break down white blood cell count is?
CBC w/ differential
183
a low fat, low cholesterol diet is needed for a patient with?
CVD/CAD
184
what risk factors can be controlled with CAD/CVD?
```
diabetes mellitus
hypertension
elevated serum levels
elevated LDL
excessive alcohol use
obesity
sedentary lifestyle
emotional stress
tobacco use
second-hand smoking
```
185
what cannot be controlled with CAD/CVD
Age
ethnicity
gender
genetics
186
when do you start to see the therapeutic effects when on medications for CAD/CVD?
4-6 weeks
187
other than medications what are some other therapeutic measures for CAD/CVD?
Smoking cessation
exercise
diet (what kind?)
188
what kind of medications are used for CAD/CVD?
```
anti-platelet
nitrates
ace inhibitors
calcium channel blockers
beta-blockers
anti-ischemic agents
statins
```
189
an antidepressant used to help with smoking cessation and cessation of bedwetting is what?
Bupropion (Wellbutrin)
190
what are the positive effects of Wellbutrin?
fewer withdrawal symptoms
| helps improve depression
191
what are the negative effects of Wellbutrin?
Suicidal thoughts
| possibly uncontrolled behaviors
192
who needs to be cautious when taking beta-blockers?
elderly
pregnant women
breastfeeding women
193
who should avoid Benadryl?
children >4 y.o
Acute angle gluacoma patients
breastfeeding women
194
what are some side effects of Benadryl?
```
urinary retention
photosensitivity
tinnitus
dry mouth
Drowsiness
```
195
LACK OF MOTIVATION AND ENERGY
| US CURRENTLY IS?
AVOLITION
196
```
cheeses
corn
cranberries
eggs
fish
grains (bread and cereals)
lentils
meats
nuts (Brazil, filberts, walnuts)
pasta
plums
poultry
prunes
rice
```
foods that acidify urine.
197
what foods should be avoided when on Aspirin?
Foods that Acidify Urine.
