final!! Flashcards
(373 cards)
1
Q
role of baroreceptors
A
they are signaled by a rise in BP and send signals to lower the bp
2
Q
stages of HTN
A
normal <120 and <80
elevated 120-129 and <80
stage 1 130-139 or 80-89
stage 2 140 or 90
3
Q
2 gerontological considerations for elderly and htn
A
higher systolic and more orthostatic hypotension
4
Q
hypotension s/s
A
change in loc/dizzy/ha/HIGH hr
5
Q
IV tx med for a HTN crisis
A
IV sodium nitroprusside
6
Q
major cause of CAD
A
artheroscleroisis - hardening
7
Q
goal of cholesterol med tx
A
cholesterol <200 / LDL < 100 / HDL >40
8
Q
what is chronic stable angina
A
myocardial ischemia - inadequate blood supply and diminished perfusion and O2
9
Q
s/s of chronic STABLE angina
A
pressure on chest radiating that is provoked by exertion
10
Q
3 tx for STABLE angina
A
sit up
O2
NTG
11
Q
what is ACS
A
when plaques rupture
12
Q
what is unstable angina + s/s
A
when someone has ACS but negative biomarkers - pain that is at rest and not relieved by NTG
13
Q
3 biomarkers for dx MI
A
troponin
myoglobin
CKMB
14
Q
tx for NSTEMI, meds and surgery
A
cardiac cath - statins and IV NTG
15
Q
tx for STEMI surgery and meds
A
emergency PCI + thrombolytics like alteplase
16
Q
3 nursing role for cardiac cath and pci
A
check for shellfish and iodine allergy
check site every 15 min after
bed rest amount depends on amt of damage
17
Q
what blood tests to monitor on heparin
A
CBC (wbc, rbc, hemoglobin) / aPTT / ACT
18
Q
2 pt teaching for a VTE
A
get OOB 4-6x day and ROM 2x day
19
Q
what is point of giving ace inhibitors after an mi
A
to prevent ventricular remodeling
20
Q
main cause of PAD
A
artherosclerosis due to high cholesterol
21
Q
4 ss of PAD
A
pallor
parasthesia
intermittent claudication
reactive hyperuremia
Pain is BETTER when legs down
22
Q
how to dx PAD
A
ankle brachial index- if low, can be PAD
23
Q
critical limb ischemia patient may have what tx
A
revascularization
24
Q
6 care for pt post revascularization
bedrest?
leg position?
positioning?
dressings?
skin?
heels?
A
oob and walking
legs extended and elevated
pillow under CALVES not heels
dry sterile dressing
gentle skin care
reverse trendelenberg
25
s/s of an aneurysm
sudden back or flank pain
26
2 ways to repair an aneurysm
OAR and endovascular graft
27
2 complications of an aneurysm
endoleak and aortic dissection
28
aortic dissection post op care
position?
medS?
monitoring?
priority?
semi fowlers
analgesics and sedatives
HR<60 and BP 100-120
control BP priority
29
raynauds
decreased blood flow to fingers - cold temp sensitivity
30
cause of VTE
virchows triad - venous stasis, endolethial damage, blood coag
31
4 preventions for VTE
compression
anticoags
rom 2x day
oob 4-6x day
32
s/s of DVT
red, swollen, tender, pain
33
ss of chronic venous insufficiency
dry flaky skin
34
venous ulcer s/s
red swollen and with drainage
35
pt teaching about food for chornic venous insuff.
meat, cheese, beans, green veg, citrus and fiber
36
priority care for venous ulcers
compression
37
normal ICP
5-15
38
6 ss of increased ICP
nuchal rigidity
dolls eyes
cushings triad
change in loc
decorticate/decerebrate
vomit without nausea
39
contraindication for increased icp
no LP
40
coma scale value for coma
<8
41
positioning and movement for inc ICP
30 deg, turn q 2 hours
42
2 meds for inc ICP
mannitol and hypertonic saline 3-5%
43
2 ss of basilar skull fracture
battles sign and racoon eyes
44
4 ss of bacterial meningitis
nuchal rigidity
fever
HA
pos brudinski and kernigs
45
3 labs for bacterial meningitis dx
low glucose
high protein
high wbc
46
what is a brain abcess caused from
infected tooth
47
viral encephalitis prevention
tick and mosquito prevention
48
embolic vs thrombolytic stroke ss
embolic is sudden s/s
49
r vs l stroke s/s
right:
spatial perceptual
rapid performance
impulsivity
50
nutrition for stroke pt 3
purred
fiber and fluids
NPO until dysphagia ruled out
51
2 tx for migraines + contraindication
sumatriptan to vasoconstrict and O2 - no opioids
52
triptan education
take at 1st sign of HA
53
3 meds for a tension HA
NSAIDS, aspirin, acetaminophen
54
med for status elipticus
lorazepam
55
what is PD
low dopamine and lewy bodies
56
4 ss of PD
bradykinesia
tremor
gait changes
rigidity
57
RN role in PD pt
monitor for dyskinesia
58
earliest ss of MS
vision problems
59
what is MG
autoimmune of NM junction which dec ACH
60
ss of MS
increased muscle weakness
61
dx MS
tensilon test - given anticholinesterase if + then MS
62
teaching about movement for MS pt
do activites in the AM
63
ALS is
loss of motor neurons
64
what is HD
dec ACH and dec gABA
65
how is HD passed
1 parent
66
what is chorea and what disease shows it
involuntary movement in HD
67
what is role of donepezil
temp memory improvement in AD
68
stroke priority action
TPA
69
sinusitis tx
amoxicillin
70
flu ss
clear lungs - if crackles then it is penumonia
71
2 contraindications for flu vaccine
guillian barre
acutely ill
72
cause of pharyngitis
strep
73
RN role for pharyngitis
strep test
74
sinusitis education to pt
leaning fwd can make pain worse
75
main ss of nasal fracture
flashes of light
76
RN role before nasal surgery
no NSAIDS or ASA
77
tx for candidiasis
swish and swallow niacin
78
laryngitis education***
limit use of voice
79
1st thing to do when doing trach care
sterile glvoes
80
dislodgement of trach rN role
call for help, hemostat then enter obtruator
81
fenestrated trach use*
promotes spontaneous breathing
82
RN role before a tracheostomy
assess reading and writing ability
83
what to tx dry mouth from radiation
pilocarpine
suck on candy
gum
84
4 ss of laryngitis
hoarsenss
tingling
loss of voice
clearing throat a lot
85
3 priorities for post op laryngectomy and neck dissection
semi fowlers
suctioning
deep breathe and coughing
86
how to know bacterial progression of rhinitis
cough?
87
priority for fracture
immobilization
88
priority for traction
skin care and assessment
89
tx for sprain
rice and then heat after 24-48 hours
90
position for post arthroplasty
ABDUCTION
91
priority for amputation prosthesis
monitor for bleeding
92
concern for post op fracture and prevention
flexion contracture - LIE on stomach 30 min 3-4x a day
93
biggest risk factor for osteoporosis
smoking
94
nutriton teaching for osteoporosis
seeds, cheese, yogurt (Ca) and sardines, fish, Oj (vit D)
95
positioning for after spine surgery
pillows under thighs and between legs
96
most important education for spine surgery discharge
go to PT
97
what is sjogrens
immune system disorder causing dry eyes and mouth
98
education for sjigrens
chew gum and hard candy to suck on
99
what is apgets
larg disorganized bones
100
first ss of pagets
pathologic fractures
101
labs found in pagets
high phosphate because high bone turnover
102
4 ss of pagets
loss of height, waddling gait, back pain
103
what is fibromyalgia
widespread bruning pain with multiple tender points
104
pt education for fibromyalgia
pt shoudl assist in care
105
ss of fibromyalgia
difficulty concentrating
106
education for exercise for fibromyalgia
low impact exercises
107
what is osteomalacia caused by
lack of vitamin D
108
labs for RA
inc ESR
antibodies present
positive RF
109
osteoarthritis vs RA
O: non inflammatory, non symmetrical, pain BETTER w rest
RA: inflammatory, symmetrical, pain not better w rest
110
gOUt education for nutrition
avoid high purine foods like fish meat asparagus
Sugary drinks and sweets. ...
High fructose corn syrup. ...
Alcohol. ...
Organ meats. ...
Game meats. ...
Certain seafood, including herring, scallops, mussels, codfish, tuna, trout and haddock.
Red meats, including beef, lamb pork and bacon.
Turkey.
111
RN role for AS
assess chest expansion and lung sounds
112
what to do if someone has reactive arthritis
screen for chlamydia
113
contraindications for pts with scleroderma
avoid glucose testing, small frequent meals, avoid cold, avoid stress**
114
fibromyalgia main ss
malaise and fatigue
115
how to treat mandible fracture pts
**
116
what is cataracts
degeneration of lens with opacity
117
ss cataracts 3
decreased vision , color perception, glare
118
what is retinopathy
disease of breakdown of retina form DM or HTN
119
retinopathy ss
wool spots, dot blot, severe vision loss
120
ss of retinal detachment 4
cobweb, curtain vision, floaters, light flashes
121
vision changes for MD
close up activites difficult, central vision loss
122
tx for MD
vitamins can slow progession
123
what is glaucoma
degenerative dx effecting the aqueous humor balance in the anterior chamber creating an increase in IOP and optic nerve atrophy.
124
vision changes with glaucoma
peripheral vision loss
125
POAG vs AACG s/s
AACG is sudden in onset and painful
126
what is normal IOP
10-21
127
7 ways to avoid increased IOP
bending
sneezing or coughing
lifting, constipation
vomitting
hyperflexion
tight clothing
sex
128
external and middle hear is what type of hearing
conductive
129
conductive HL can be caused by 6
obstruction, perforation, infection, otosclerosis, aging, acute otitis media
130
tx for otitis externa
moist heat
131
3 middle ear disorders
acute otitis meda, mastoiditis
132
tx for AOM
amoxicillin
133
post op priority from mastoidectomy 3
change cotton ball dressing, dont cough with mouth closed, ear dry for 6 weeks,
134
what is menieres
accumulation of endolymph in labyrinth
135
3ss of meieres
vertigo, tinnitus, hearing loss
136
test for menieres
glycerol test – if hearing improves = menieres
137
during menieres attack rn should
lower lights and give antiemetics
138
ss of labrynthitis
NO HL
139
tx for labyrnthitis
eply menauever
140
acoustic neuroma ss
unilateral HL
141
what is acitinic keratosis
flat, precancerous non malignant neoplasm
142
tx for follicultis
warm compress
143
tx for cellulitis
systemic abx like doxycycline
144
painful group of vesicles on erythmetous base
herpes simple
145
ss of herpes zoster and tx
shingles- burning along dermatomes
tx: analgesics
146
how to dx fungal infection
skin scraping
147
candidiasis teaching
keep mouth air and dry
148
3 education for topical abx
taper off
apply thin and rub in
only 2 weeks or less
149
what is bronchitis
viral infection of upper resp tract caused by smoking and other pollutants
150
how is a cough induced with bronchitis
Virus enters bronchial tubes -> smooth muscle reacts by contracting (bronchoconstriction) -> mucus cells produce extra mucus -> airway gets clogged -> body attempts to clear airway by inducing a COUGH
151
6 s.s of bronchitis
cough for 4-6 wks with clear phlegm
mild fever 99 -100
fatigue
wheezing
tightness in chest
almost no sob
152
med given for bronchitis
albuterol
153
4 ss of pertussis
cough fits
lightheadedness
vomitting
fainting
154
tx for pertussis
rest, nutrition, O2, erythromycin (abx)
155
pertussis is a ______ infection
bacterial
156
education 2 for pertussis
cough lasts long
contagious for 3 weeks after symptoms start
157
what is penumonia
- Infection of the alveoli because of pus that is unilateral or bilateral
- Caused by bacteria, virus or fungus
158
how does pneumonia occur
Aspiration of normal flora into nasopharynx or oropharynx -> inhalation of microbes present in the air -> hematogenous spread from other infection already in the system
159
how is O2 decreased with pneumonia
Immune system detects invader in the alveoli -> fluid and immune cells flood the alveoli causing inflammation + increased mucus production -> O2 and CO2 unable to exchange -> lung tissue hardens and swells (consolidation) -> O2 decreased in the blood (hypoxia and fatigue)
160
community vs hospital pneumonia
C: In pts who have not been in hospital or long term facility within 14 days of onset of symptoms
H:Occurs 48 hours or longer after hospitalization and not present on hospital admission
161
what is aspiration pneumonia
- Oral or gastric material entry into lower airway
162
4 risk factors for pneumonia
- Decreased LOC
- Depressed cough or gag reflex
- Difficulty swallowing
- Primary bacterial infection
163
ss of pneumonia 10
- Cough productive or nonproductive
- Green yellow or rust color sputum
- Fever 101 and up
- Chills
- Dyspnea
- Tachypnea
- Pleuritic chest pain
- crackles
- confusion
- stupor
164
tx for CAP
azithromycin, doxycycline, fluoroquinolone
165
HAP tx
fluorquinolones
166
education for nutrition for pneumonia
small frequent high calorie meals
167
How is TB spread
airborne not touching, sharing food, kissing
168
airborne precaution diseases
MMR TB varicella
169
education for TB
not everyone who gets it will have active TB
170
primary pnuemonia is
- Bacterial inhaled, inflammatory response occurs, immune response can fight it off
171
primary vs reactivation tb
- Primary TB – active disease within 2 years of infection
- Reactivation TB – disease occurs > 2 years after infection = infectious
172
latent tb means
infected but not active so noninfectious
173
pulmonary tb ss
dry cough that is then productive
fatigue, malaise, low grade fever, night sweats
174
when to do sputum sample for tb
Sputum test done THREE times collected FIRST thing in the MORNING
175
meds for active TB
Isonaiazid (INH) + rifampin (rifadin) + pyrazinamide (PZA) + ethambutol
176
educaton for isonaiazid
INH: hepatotoxicity
NO ALCOHOL
177
nurse role for INH med
monitor LFTs
178
pyrazinamide education
NOT for pregnant pts or liver disease history
179
latent tb meds given what and when
INH once daily or twice weekly with DOT for 6 months
180
why pertussis vaccine
to prevent whooping cough
181
penumothroax vs hemothorax
pneumo -air in pleural
hemo - blood in pleural
182
flail chest
fracture of two or more adjacent ribs in two or more places with a loss of chest wall stability
183
cardiac tamponade
pressure on heart from fluid or blood in the space between the heart muscle and outer covering of heart (pericardium)
184
what is blunt trauma
impact without breaking the skin
185
what happens when air enters pleural space
the suction force holding the pleural membranes together is destroyed and the pleural membranes (visceral pleural) separate
186
Patients will want to breathe shallowly secondary to pain, this increases risk for ___________ & ___________.
atelectasis and pneumothroax
187
what is key for pts to deep breathe
pain control
188
when should nurse intervene for pt who cant deep breathe
if there is a splint
189
what does it look like when someone has flail chest
affected portion draws in when they breathe when rest of chest expands
190
ss of pneumothrorax
dyspnea, anxiety, tachy, pleural pain, asymmetrical chest wall expansionn, dec breath sounds
191
what is spontaneous pneumothrorax
rupture of blebs that can occur in healthy or ill people
192
what is iatrogenic pneumothorax
happens from medical procedure
193
ss of small vs large pneumothorax
Small pneumothorax
*Mild tachycardia and dyspnea
Large pneumothorax
*Respiratory distress
*diminished or absent breath sounds over affected area, unilateral
194
assesssment of hemo thorax
decreased blood pressure, weak pulse, cool skin, irregular pulse, confusion
195
percussion for pneumo vs hemothorax
Percussion with pneumothorax is hyperresonant secondary to all the extra air in pleural space, percussion with hemothorax is dull secondary to blood in pleural space
196
emergency tx of pneumothorax
Cover wound with dressing secured on 3 sides
197
tension pneumothorax tx
needle decompression
198
site for chest tube
midaxillary
199
bed for chest tube and body position
30-60 deg, arm above head
200
flutter valve inspiration and expiration
During inspiration, the pressure in the chest decreases and the valve closes.
During expiration, intrathoracic pressure increases and the valve opens.
201
drainage bag should be ______ for flutter valve
vented to atmosphere
202
3 compartments of pleural drainage
1ST compartment or collection chamber
*Fluid stays in; air vents to 2ND compartment
2ND compartment or water-seal chamber
*Contains 2 cm of water; acts as one-way valve; air goes in, bubbles out, but can’t go back to patient
3RD compartment or suction control chamber
*Uses column of water to control suction from regulator
203
what to do if tidaling stops in pleural drainage
check for oclusion
204
what to encourage pt to do with chest tube
IS
deep breathe
ROM
205
where to keep chest tube
below chest
206
what to report for chest tube drainage
greater than 200 mL/hr in first hour and 100 mL/hr thereafter;
207
what gauze used for chest tube dressing
petroleum
208
3 complications of chest tube
Reexpansion pulmonary edema
Hypotension
Severe subcutaneous emphysema
209
thoracotomy
incision into chest
210
what is restrictive lung disease
chest wall and diaphragm can not move normally with respiration
211
what is interstitial lung disease
Diseases that cause irreversible scarring of the lung tissue, the scarring affects the lungs ability to breathe and allow for oxygen exchange in alveoli
212
what is vascular lung disease
any condition that affects the blood flow of the lungs
213
what is intrapulmonary restrictive lung disease
Something in the lungs or pleural space themselves is causing the problem
214
examples of intrapulmonary restrictive lung disease
Pleural Disorders: Pleurisy, Pleural effusion, Pneumothorax
Parenchymal (Lung) Disorder: Atelectasis, Pneumonia, Interstitial Lung Disease
215
what is extrapulmonary restricitve lung disease
Lung tissue is normal. Something has gone wrong somewhere else that is causing the problems.
216
what is atelectasis
collapsed, airless alveoli
217
2 causes of atelectasis
1) Mucus obstructing the small airways 2) Pores of Kohn and surfactant are unable to work properly because both require deep breaths to function as intended
218
2 tx for atelectasis
1) Cough 2) Deep Breath
219
physical teaching for atelectasis
get up and move and walk and turn
220
3 causes of pleurisy
Pneumonia, tuberculosis, chest trauma
221
hallmark of pleurisy
sharp pain that worsens with taking deep breath, breaths are rapid and shallow
222
physical exam finding for pleurisy
pleural friction rub possible-sounds like a squeaky door as pleura rub against one another
223
splinting for pleurisy
holding a pillow helps to cushion pleura so that lung expansion is a little less uncomfortable
224
effusion is
escape of fluid into a body cavity
225
4 causes of pleural effusion
increased pulmonary capillary pressure, decreased oncotic pressure, increased pleural membrane permeability, or lymph flow obstruction
226
types of pleural effusion
*Transudative—noninflammatory diseases ie right sided congestive heart failure
*Exudative—inflammatory diseases
Empyema—purulent fluid in pleural space
Antibiotics and/or drainage or other procedures
227
ss of pleural effusion
dyspnea
cough
sharp chest pain with inhalation
dull or dec breath sounds
emphyema
dull percussion
228
cause of pulm embolism
Blockage of pulmonary arteries by a thrombus, fat or air embolus
229
what are emboli
clots that are mobile and don’t stop moving until they are lodged in a narrow part of the circulatory system
230
what is typically affected with pulmonary embolism
lower lobes
231
primary culprit of pulm embolism
DVT
232
4 origins of VTE and DVT
deep veins of legs, femoral or iliac veins, right side of heart (atrial fibrillation) and pelvic veins
233
3 labs/dx for pulmonary embolism
high d dimer
spiral CT
V/Q scan
234
tx for pulm ebolism 3
anticoags, fibrinolytics, surgery
235
2 fibrinolytic meds and for what
pulm embolism
TPA, alteplase
236
early vs late signs of resp distress
237
indicators of impaired gas xchange
Hypoxemia
Abnormal breathing pattern
Abnormal arterial blood gases
Restlessness
Cyanosis
Dyspnea
Coughing
Nasal flaring
Hypercapnia
Hypoxia
Hypoxemia
Orthopnea
Use of accessory muscles
238
ss of pneumothorax
Sharp, stabbing chest pain that worsens when trying to breath in.
Shortness of breath.
Bluish skin caused by a lack of oxygen.
Fatigue.
Rapid breathing and heartbeat.
A dry, hacking cough.
239
ss of tension pneumo
240
dx test for pleural effusion
ultrasound, CT, radiograph
241
dx test for pulm embolism
CT pulmonary angiography
242
2 tx for pleural effusion
Treat underlying cause
Chemical pleurodesis
243
pre op chest surgery steps
Assess cardiopulmonary status
Diagnostic studies
Chest x-ray, ECG, PFTs, BUN, creatinine, glucose, electrolytes, coagulation studies, and CBC
Anesthesia consult
Smoking cessation
Teaching
Reassurance
244
post op chest surgery steps
Pain management
PCA, epidural, nerve blocks
Assess respiratory status
RR, effort, breath sounds, and sputum volume and color, chest tubes, and chest x-rays
Infection
Temperature
Incision
245
1st step in eR for chest pain
EKG
246
asthma is a _______disease
heterogeneous
247
who is more likely to have asthma
males before puberty
248
what is pathophys of asthma
inflammation in airways resulting in bronchoconstriction and vasodilation
249
astma mostly affects what type of breathing
expiratory
250
when someone is having asthma , nurse should
get help and prepare for mechanical ventilation
251
7 ss of asthma
Wheezing-expiratory
Cough
Dyspnea
Chest tightness
Prolonged Expiration
hyperventilation
night time awakenings
252
what occurs during asthma attack
Swelling + Excess Mucus + Bronchoconstriction =
Narrow airways that are very difficult to move air through. = WHEEZING
253
severe sign of astma
silent chest - no wheezing
254
silent chest can indicate
status asthmaticus
255
even when asthma is severe, the obstruction
can be reversed
256
what is used to measure air outflow
peak flow meter
257
with asthma there is ______, ______ and _____
hypercapnia, hypoxia, acute resp failure
258
MDI vs dry powder vs nebulizer
Metered-dose inhaler (MDI): This is the most common type of inhaler. A metered-dose inhaler uses a chemical to push the medicine into the lungs. It is held in front of or put into the mouth as the medicine is released in puffs.
Nebulizer: A nebulizer is a machine that sprays a fine, liquid mist of medicine. The medicine is delivered with a mouthpiece or mask. Nebulizers are often used by people who cannot use metered-dose inhalers, such as infants and young children, and people with severe asthma.
Dry powder or rotary inhaler: Dry powder is inhaled with these devices that are activated by your breath. They may be used by children and adults. It’s important to keep these inhalers dry so that the powder doesn't clump together.
259
what is copd
progressive inflammatory of airways, bronchioles, alveoli, pulm blood vessels - persistent airflow limitation during forced expiration with loss of elastic recoil
260
6 ss of COPD
chronic cough, activity intolerance, prolonged expiratory phase, wheezing, dyspnea, barrel chest
261
2 complications of COPD
pulmonary HTN, cor pulmonale (R HF)
262
what is pulmonary HTN
pulmonary vessel vasoconstriction due to alveolar hypoxia which increases pulm vascular resistence
263
how to know if COPD is getting worse
*Increased dyspnea, increased sputum volume, increased sputum purulence
*Malaise, insomnia, fatigue, depression, confusion, decreased exercise tolerance, wheezing, fever
264
explain spirometry
Pt given bronchodilator
FEV1 measured against FVC
FEV1/FVC ratio is <70% = COPD
The lower the FEV1 the worse the obstruction
265
gold 1-4 severity for COPD
4 is most severe
266
diff in asthma and copd meds
LABA can be given alone in COPD
267
how to decrease dyspnea with food 6
rest 30 min before eating
avoid exercise 1 hour before or after eating
use bronchodilators before meals
use O2
high cal, high protein, mod carb and fat reccomended
eat small meals
268
describe pursed lip breathing
in 2 , out 4
269
what meds to avoid with COPD
benzos
270
what is CF
Autosomal recessive, multisystem disease with altered transport of sodium and chloride ions in and out of epithelial cells with persistent chornic airway infection
271
4 early signs of CF
Meconium ileus in the newborn
Acute or persistent respiratory symptoms
Failure to thrive or malnutrition
Steatorrhea
272
gold standard for CF dx
SWEAT CHLORIDE TEST with pilocarpine - if value > 60 = CF+
273
what is bronchiectasis
Permanent, abnormal dilation of medium-sized bronchi due to inflammatory changes
274
ss of bronchiectasis
Cough with persistent production of thick, tenacious, purulent sputum
275
main dx test for bronchiectasis
CT scan
276
medication for bronchitis
inhaled corticosteroids like albuterol
277
med for pertussis
antibiotics - macrolides (azithromycin)
278
meds for CAP
macrolides (azithromycin) and doxycycline
279
med for HAP
respiratory fluroquinolones like levaquin
280
drug alert for isonaiazid
hepatotoxicity - measure LFTs
no alcohol
281
drug alert for pyrazinamide
none while pregnant or hx of liver disease
282
med for latent TB
isonaiazid 1 times dly with DOT for 6-9 months
283
4 meds for pulmonary embolism
fibrinolytics like tpa and alteplase to dissolve clots
heparin
warfarin
analgesics
284
which inhaler is not shaken
dry powder
285
which inhaler do you breathe slowly for
metered dose
286
3 rescue asthma meds
inhaled saba like albuterol
inhaled anticholinergics
corticosteroids
287
normal SE of asthma meds
shakiness, tachycardia, HA
288
advair is
salmeterol and fluticasone
289
simbiort is
bidenoside and formoterol
290
inhaled LABA name, MOA, class
B2 adrenergic agonist
bronchodilator
salmeterol
291
methylxanthines - name, SE, Education
theophylline
SE: toxicity
report signs of toxicity - nausea, vomitting, seizures, insomnia, avoid caffeine
292
anticholinergic - name, MOA, SE
ipatropium
blocks acetylcholine
and mucus production
Se: dry everything
293
leukotriene - name, MOA, class,
montelukast , antiinflammatory, blocks bronchoconstriction, inc HR and expands lungs
294
monoclonal antibodies name, class, moa
omalizumab, antiinflammatory, prevents igE attaching to mast cells
295
3 names of corticosteroids
prednisone, methylprednisolone, budesonide
296
inhaled corticosteroids class and SE
antiinflam , oral flush
297
oral corticosteroids SE
adrenal suppresion (weight gain, hyperglycemia, acne, osteoporosis)
298
cause of bronchiectasis
damaged airways and widened due to infection or other cause
299
early vs late signs of hypoxia
300
cause of CF
a defective gene that makes the body produce abnormally thick and sticky fluid, called mucus.
301
diet with CF
you need to eat a balanced diet consisting of fat, protein, dairy, fruits, and vegetables.
302
pulmonary embolism ss
dyspnea
teachycardia
chest pain
wheezing
303
what is interstitial lung disease
irreversible scaring of tissue
304
what is atelectasis
collapsed alveoli
305
what is a collapsed lung called
pneumothorax
306
tx for atelectasis
IS
307
what condition requires chemical pleurodesis
pleural effusion
308
tx for flail chest
surgery
309
tension pneumothorax percussion
dullness
310
tx for pneumo and hemothorax
benzos and analgesics
311
ss of PE 7
SOB
anxiety
pain with INSPIRATION
tachycardia
tachypnea
hypotension
petechaie
312
how to dx pulm embolism
high d dimer
313
what to do if client is hypoxic
get ABGs
314
low o2 in arterial blood is
hypoxemia
315
tx for CF
pancreatic enzymes before meals
316
COPD percussion
hyperressonance
317
how to dx COPD
spirometry- lower the FEv1 worse
318
5 ss of COPD
tripod
using accessory muscles
wheezing
intermittent cough
polycythemia
319
no tidaling means
occlusion check for one
320
when to report to hcp for chest tube
> 200 ml per hour in 1st hour and 100mL after
321
3 complications of chest tubes
pulmonary edema, hypotension, subq emphysema
322
compare fever with
bronchitis
penumonia
TB
bronchitis = low
pneumonia = high
TB = low
323
what disease has consolidation of the lungs
pneumonia
324
what color sputum for pneumonia
green and yellow
325
what disease has a dry unproductive cough
TB
326
restrictive lung disease means
problems with air getting in
327
hallmark symptom of pleurisy
sharp pain on inhalation
328
percussion and auscultation for
pneumonia
pleurisy
pleural effusion
pneumothorax
hemothorax
COPD
crackles and auscultation
pleural rub squeak on auscultation
dullness on percussion/ dec breath sounds
hyperres on percussion
dull on percussion
hyperes on percussion
329
how to dx status asthmaticus with peak flow meter
PEFR <300 and FEV1 <60%
330
how to know if epi is successfull
less difficulty on inspiration
331
3 main ss of COPD
hypoxia, hypercapnia, hypoventilation(inc CO2)
332
what disease cannot be given benzos or opioids
COPD
333
what indicates a postivie chloride test for CF
>60
334
what is blood in sputum called
hemoptysis
335
what med is given for bronchitis
albuterol
336
what med is given for pertussis
ABX like macrolides like azithromycin
337
what to monitor for when giving azithro or erythromycin
ECG and LFTs
338
3 education for dozycycline
tooth discoloration
not safe for pregnancy
wear sunscreen
339
normal SE of corticosteroids
hyperglycemia
340
3 normal SE of asthma meds
tachycardia, HA, shaky
341
calculating HR
300/large or 1500/small
342
tx for bradycardia
if ss/: atropine
if none: monitor
343
tx for tachycardia
vagal maneuver or beta blockers
344
premature atrial contraction
ss/ palpations
tx: remove stressors
345
PSVT
tx: rapid adenosine push
346
atrial flutter
tx: dofetilide/ibutilide
347
afib
tx: amiodarone, anticoags
348
vtach
tx:
if pulse: amiodarone
if no pulse: CPR/defib
349
torsades de pointes
tx: Mg
350
defibrilation function and sync
SYNC OFF , helps SA return to normal function
351
CV rn role and sync
SYNC ON and give anticoags before
352
implantable defib ed 5
4 days dry
avoid lifitng arm
if fires once, call HCP
you can travel
no mri
353
3 signs of worsening HF
wet warm skin
>3lbs in 2 days
dry hacking cough
354
HF lab
low ejection fraction
355
LHF vs RHF
Left has pulonary edema, crackles, dyspnea
356
3 ways to manage ADHF
imporve contractility with digoxin
decrease fluids with diuretics
decrease afterload(dec vasoconstriciton) with pressors
357
position for HF patient
high fowlers with feet dangling
358
cause of infective enocarditis and RN role
untreated strep , teach good dental hygiene
359
after TEE what is priority
assess gag reflex
blood samples before abx
360
teaching for pts with heart conditions to prevent endocarditis
prophylaxis abx
361
peak blood test drawn when
30 min after dose infuses
362
meds for pericarditis
corticosteroids and NSAIDS to control inflammation
363
positionign education for pericarditis
sit up
364
4 ss of cardiac tamponade
hypotension
muffled lung sounds
JVD
pulsus paradoxus
365
cause of rheumatic fever
immune response to previous strep
366
RN role for rheumatic fever
strep test
367
education for rheumatic fever
pencillin injections for life
368
stenosis vs regurgitation
stenosis: valve doesnt open properly
369
ss of mitral stenosis
pulmonary edema and dec CO
370
monitoring for mitral stenosis
*
371
mumur is not heard when
in mitral valve prolapse
372
tricupsid stenosis ss
venous congestion(right HF)
373
mechanical vs biological valves
mechanical last longer but have to take anticoags for life
