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Flashcards in FINAL Deck (197)
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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
  1. remove clothes
  2. 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
Q

If a sickle cell pt is in labor what should you have ready??

A

oxygen and IV fluids

26
Q

S/S of leukemia

A

bleeding
infection
anemia
effects all blood cells

27
Q

Interventions for leukemia

A

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
Q

S/S of cirrhosis

A

clay colored stools
decreased LOC
jaundice
RUQ pain

29
Q

complications from Cirrhosis

A

esophageal varices
clotting defects
encephalopathy
ascites

30
Q

S/S of Hep B

A

fatuige
nausea
vomiting
can be asymptomatic

31
Q

Can someone with an active hep infection receive the Hep B vaccine

A

NO

32
Q

Why would someone need to take lactulose?

A

Cirrhosis and/or high ammonia level

33
Q

side effects of lactulose?

A

dehydration

low potassium

34
Q

Desired effect of lactulose?

A

bowel movement

35
Q

Nursing considerations for lasix

A
strict I&O
daily weights
check potassium
give in morning
check BP do not give if low
increase potassium in the diet
36
Q

Side effects of lasix

A
blurred vision
dizziness
polyuria
hypotension
FVD
hypokalemia
37
Q

If a pt’s apical pulse is less than 60 should you give the patient their digoxin?

A

NO

38
Q

sign of digoxin toxicity

A

halos around lights

39
Q

When does a pregnant woman get rhogam?

A

when she is Rh neg at 28 wks and after birth

after anything that could have meant contact with Rh positive blood

40
Q

sign of carbon monoxide poisoning

A

cherry red mucous membranes

41
Q

priority for burn patients, what to monitor for?

A

airway!

Monitor for wheezing, stridor, black around mouth or nose

42
Q

How many times should a patient use an incentive spirometer in an hour

A

10

43
Q

WBC count

A

5,000-10,000

44
Q

Hgb

A

M: 14-18
F: 12-16

45
Q

Plt count

A

150,000-400,000

46
Q

Normal potassium levels

A

3.5-5.3

47
Q

S/s of hyperkalemia

A
bradycardia or other arrhythmias
nausea
intestinal cramping
diarrhea
anxiety
muscle weakness
numbness or prickly sensations
flaccid paralysis
48
Q

S/S of hypokalemia

A
Weak, rapid irregular pulse
low BP
anorexia
nausea
vomiting 
decreased DTR
fatigue
muscular weak cramps
numbness
abd distention
peristalsis ileus
49
Q

Sodium levels

A

135-145

50
Q
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
A

potassium rich foods

51
Q

potassium-rich foods

A
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
Q

Order to don PPE

A
handwashing
gown
mask
eyewear
hair cover
shoe cover
gloves
53
Q

when taking off PPE

A
remove gloves
gown
eye wear
mask
hair covering
shoe covering
handwashing
54
Q

warfarin antidote

A

vitamin K

55
Q

heparin antidote

A

protamine sulfate

56
Q

what to do to prevent an air embolism?

A

when starting an IV tell them to hold their breath and be still

57
Q

Common abuse in older adults and children

A

malnutrition

58
Q

Tylenol antidote

A

acetelysine

59
Q

medications containing tylenol

A

Lortab, Percocet, hydrocodone, Vicodin

60
Q

what labs to watch for someone taking tylenol

A

blood sugar

liver enzymes

61
Q

what can you not have when taking xanax?

A

grape fruit juice

62
Q

when should you give xanax?

A

at bed time

63
Q

how long should you take xanax?

A

it is for short term use

64
Q

how should you adjust xanax?

A

half a dose in the morning and half a dose at night

65
Q

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

A

stable angina

66
Q

angina that increases unpredictably in frequency or that occurs with less exertion, at rest, or during sleep. not relieved by rest or medication.

A

unstable angina

67
Q

what kind of angina is more likely to lead to a heart attack?

A

unstable angina

68
Q

who shouldn’t be taking aspirin?

A

those under 18

anyone with asthma

69
Q

what kinds of foods should be avoided when taking aspirin?

A

foods that acidify urine

70
Q

foods that acidify urine

A
cheeses
corn
cranberries
eggs
fish
grains (breads and cereals)
lentils
meats
nuts (Brazil, filberts, walnuts)
pasta
plums
poultry
prunes
rice
71
Q

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
A

foods that acidify urine

72
Q
patient presents with 
lack of energy
flat affect
appear depressed
loss of interest in hobbies
A

avolition

73
Q

what kinds of patients might present with avolition?

A

older clients
patients with terminal illness’
schizophrenic
behavioral health patients

74
Q

barriers to healthcare

A

language
economics
geography

75
Q

who should not be taking benedryl

A

children under 4
mothers who are breastfeeding
those with acute angle glaucoma

76
Q

Who is at risk for Wernicke’s encephalopathy?

A

alcoholics

77
Q

What does an alcoholic’s diet need to be high in to prevent Wernicke’s encephalopathy

A

Thiamine

78
Q

high thiamine foods

A

cereal (whole grain and enriched)
meats (esp pork)
fresh veggies (loss is variable during cooking)

79
Q

should an alcoholics’ thiamine levels be checked if they look healthy?

A

yes

80
Q

What is a red tipped thermometer used for?

A

rectal use

81
Q

how long after eating, drinking, or smoking should you check a patients temp?

A

30 mins

82
Q

What can cause a stroke?

A

lack of oxygen to the brain due to ischemia due or a brain hemorrhage

83
Q

a lack of oxygen to the brain due to ischemia due or a brain hemorrhage can cause a what?

A

stroke

84
Q

FAST for a stroke

A

Facial features
arm weakness
Speech
Time to call 911

85
Q

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?

A

stroke

86
Q

S/S of a stroke

A

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
Q

if the stroke is on the stoke is on the left side of the brain then what side is affected

A

right side

88
Q

if the stroke is on the right side of the body then what side is affected?

A

left side

89
Q

when a patient presents to the ER with a stroke you should monitor their face for what?

A

symmetry and asymmetry

90
Q

What stage of Alzheimer’s is this?

forgetfulness
forgetfulness of glasses or wallet, no memory problems

A

stage 2 of Alzheimer’s

91
Q

stage 1 of Alzheimer’s

A

no apparent manifestations

92
Q

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)

A

Alzheimer’s stage 3

93
Q

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)

A

Alzheimer’s stage 4

94
Q

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)

A

Alzheimer’s stage 5

95
Q

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

A

Alzheimer’s stage 6

96
Q

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)

A

Alzheimer’s stage 7

97
Q

positive S/S of schizophrenia

A

hallucinations and delusions

98
Q

negative symptoms of schizophrenia

A

apathy, flat affect, anhedonia

99
Q

how often should circulation be checked or the patient be allowed to stretch when they are in restraints?

A

every 2 hr

100
Q

What should happen before applying restraints

A

all less restrictive methods should be exhausted

101
Q

how should you release restraints?

A

one arm at a time

102
Q

how often should a new order be required for restraints

A

within 24 hrs

103
Q

where should soft restrains be fastened to?

A

side rails

104
Q

how does the body respond to stress

A

lower immune system, interfere with sleep patterns, hard to concentrate, raises BP

105
Q

Know the correct way to count respirations

A

you better not tell that patient you’re counting their respirations mary. 12-20 resp

106
Q

PT/Coumadin/Warfarin

A

10-13 sec

107
Q

APTT/Heparin

A

25-35

108
Q

INR for no anticoag tx

A

0.9-1.1

109
Q

INR for pt receiving anticoag tx

A

2.5-3.5

110
Q

peripheral pulse sites

A
temporal
carotid
brachial
radial
femoral
popliteal
111
Q

is the apical pulse a peripheral pulse

A

NO

112
Q

what can make getting a peripheral pulse difficult?

A

low perfusion

113
Q

if you’re allergic to amoxicillin then you can’t take what?

A

penicillin

114
Q

if you’re allergic to penicillin then you can’t take what?

A

amoxicillin

115
Q

How can nitro be given

A

sublingual
IV
Transdermal

116
Q

How many times can nitro be given sublingually before calling 911

A

3

once every 5 min

117
Q

patient presents with:
chest pain, ShOB, dizziness, nausea, sweating, left arm pain and jaw pain
what do you suspect?

A

classic MI

118
Q

classic S/S of MI

A

chest pain, ShOB, dizziness, nausea, sweating, left arm pain and jaw pain

119
Q

patient presents with
heartburn, epigastric pain, fatigue, abd pain
what do you suspect

A

non-classic MI

120
Q

who is more likely to die from a heart attack?

A

a woman

121
Q

how do women present with heart attacks

A

fatigue
shoulder blade discomfort
ShOB
Epigastric pain

122
Q

What are some major injuries that a pt might sustain in a MVC?

A

head trauma, paralysis, ICP, fracture amputations

123
Q

What is the priority after an MVC

A

check the perfusion

124
Q

bipolar/mood stabilizer. prevents/decreases incidences of acute manic episodes

A

Lithium

125
Q

side effects of lithium

A

lack of coordination
dizziness
drowsiness

126
Q

S/S of lithium toxicity

A
vomiting
diarrhea
slurred speech
lightheadedness
decreased LOC
decreased coordination
drowsiness
muscle weakness
tremor or twitching
127
Q

when should you call the doc when taking lithium?

A

fever
vomiting
diarrhea

128
Q

what are mistaken perceptions of reality?

A

illusions

129
Q

Who might present with illusions

A

schizophrenic patients

130
Q

early stage hypoxia

A
restlessness
tachycardia
tachypnea
dyspnea
increased agitation
anxiety
diaphoresis
retractions
headache
131
Q

late-stage hypoxia

A
restlessness
stupor
dyspnea
decreased respirations
bradycardia
cyanosis
132
Q

hgb male

A

14-18

133
Q

hgb female

A

12-16

134
Q

increased hgb indicates what

A

chronic hypoxia

135
Q

decreased hgb indicates what?

A

anemia or blood loss

136
Q

what are hallucinations?

A

are false sensory perceptions that can affect all 5 senses

137
Q

most common hallucinations

A

auditory and visual hallucinations

138
Q

what kinds of patients present with hallucinations

A

schizophrenia

139
Q

normal blood sugar ranges

A

70-100

140
Q

if a patient’s blood sugar is below 70 what do you do?

A

give OJ sugared candy, peanut butter crackers, glucose tabs, milk

141
Q

if pts blood sugar is above 100 what do you do?

A

give insulin
insulin drip
more fluids or IV fluids

142
Q

an eating disorder that causes lack of appetite

A

anorexia

143
Q

most common eating disorder

A

obesity

144
Q

caloric dysfunction

A

overeating obesity

145
Q

an eating disorder where the patient is afraid to eat because of fear of gaining weight

A

anorexia nervosa

146
Q

an eating disorder that consists of binge eating and self-induced vomiting or laxatives

A

bulimia nervosa

147
Q

what drug is used to decrease the severity of HF and used to increase cardiac output

A

digoxin

148
Q

what should you check before giving digoxin

A

the apical pulse

149
Q

why should you withhold Dig

A

low BP

pulseless than 60

150
Q

where is the apical pulse

A

fifth inner midclavicular space

151
Q

S/S of dig toxicity

A
vomiting
abd pain
green halos around objects
anorexia
nausea
arrhythmias
visual disturbances
152
Q

random blood glucose test

A

70-100

153
Q

glucose tolerance test

A

140-199 pre-diabetes

over 200 indicates diabeties

154
Q

fasting glucose

A

100-125 prediabetes

126 or higher is diabetes

155
Q

Ha1C

A

normal less than 5.7
prediabeties 5.7-6.4
higher than 6.4 is diabetes

156
Q

s/s of hypoglycemia

A

faintness, hunger, sweating, irritability, trembling, low urine output, lethargy, cool clammy skin

157
Q
patient present with 
irritable
mood swings
isolation
feeling hopeless
suicidal ideations
PMS

what do you suspect

A

depression

158
Q

what is the most important thing to ask a depressed patient?

A

if they have had suicidal or homicidal thoughts

159
Q

who is most at risk for depression

A

older adult patients

160
Q

PMDD mostly affects women when?

A

the second half of their menstrual cycle

161
Q

is dementia a disease?

A

NO a symptom

162
Q

S/S of dementia

A
short term memory loss
long term memory
misplaced items
agitation
repeat of questions
delusions 
hallucinations
aphasia 
unable to communicate needs
163
Q

causes of dementia

A

medications
chronic alcoholism
neurological infections
head injuries

164
Q

can dementia be reversed if r/t head trauma

A

no

165
Q

can dementia be reversed if r/t medications

A

yes

166
Q

what are delusions?

A

fixed false beliefs that cannot be changed by logic or factual proof

167
Q

how may delusions present

A

patients my exhibit delusions of grandeur, persecution, or guilt

168
Q

s/s of colon cancer

A

blood, black or black tarry stools, if closer to anal opening brighter red

169
Q

testing or screening for colon cancer

A

guiac or occult blood stool
colonoscopy w/ biopsy
sigmoidoscopy w/ biopsy

170
Q

guiac testing my give a false positive if

A

the pt has had red meat within 3 days

171
Q

what is the goal of cognitive-behavioral therapy?

A

trying to change mindset of thinking of themselves to more positive thinking

172
Q

what is a priority consideration of COPD patients

A

do not turn their O2 above 2L

173
Q

what is the normal O2 levels for a CPOD patient

A

88-92%

174
Q

a medication used to decrease positive symptoms of schizophrenia?

A

clozapine

175
Q

side effects of clozapine

A

seizures
drowsiness
orthostatic hypotension

176
Q

What is a high-priority side effect of clozapine?

A

neuroleptic malignant syndrome
fever
respiratory distress
tachycardia

177
Q

an increase of neutrophils indicates?

A

infection

178
Q

an increase of basophils can indicate?

A

hyperthyroidism,
bone marrow disorder,
ulcerative colitis

179
Q

an increase of lymphocytes indicates?

A

viral infection
chronic bacterial infection
leukemia

180
Q

an increase of eosinophils indicates?

A

allergic response

some leukemias

181
Q

an increase of Monocytes indicates?

A

chronic inflammatory disorders

some leukemias

182
Q

a test used to break down white blood cell count is?

A

CBC w/ differential

183
Q

a low fat, low cholesterol diet is needed for a patient with?

A

CVD/CAD

184
Q

what risk factors can be controlled with CAD/CVD?

A
diabetes mellitus
hypertension
elevated serum levels 
elevated LDL
excessive alcohol use
obesity
sedentary lifestyle
emotional stress
tobacco use 
second-hand smoking
185
Q

what cannot be controlled with CAD/CVD

A

Age
ethnicity
gender
genetics

186
Q

when do you start to see the therapeutic effects when on medications for CAD/CVD?

A

4-6 weeks

187
Q

other than medications what are some other therapeutic measures for CAD/CVD?

A

Smoking cessation
exercise
diet (what kind?)

188
Q

what kind of medications are used for CAD/CVD?

A
anti-platelet 
nitrates
ace inhibitors
calcium channel blockers
beta-blockers
anti-ischemic agents
statins
189
Q

an antidepressant used to help with smoking cessation and cessation of bedwetting is what?

A

Bupropion (Wellbutrin)

190
Q

what are the positive effects of Wellbutrin?

A

fewer withdrawal symptoms

helps improve depression

191
Q

what are the negative effects of Wellbutrin?

A

Suicidal thoughts

possibly uncontrolled behaviors

192
Q

who needs to be cautious when taking beta-blockers?

A

elderly
pregnant women
breastfeeding women

193
Q

who should avoid Benadryl?

A

children >4 y.o
Acute angle gluacoma patients
breastfeeding women

194
Q

what are some side effects of Benadryl?

A
urinary retention
photosensitivity 
tinnitus
dry mouth
Drowsiness
195
Q

LACK OF MOTIVATION AND ENERGY

US CURRENTLY IS?

A

AVOLITION

196
Q
cheeses
corn
cranberries
eggs
fish
grains (bread and cereals)
lentils
meats
nuts (Brazil, filberts, walnuts)
pasta
plums
poultry
prunes
rice
A

foods that acidify urine.

197
Q

what foods should be avoided when on Aspirin?

A

Foods that Acidify Urine.