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Final Flashcards

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1
Q

What does Hypovolemia mean?

A

Hypo= low
volemia=volume
(fluid volume deficit)

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2
Q

What are some s/s of Hypovolemia?

A

skin tenting
dry, scaly skin
dry mucus membranes
altered LOC
oliguria
wt loss
↑ HR
↑RR
↓BP
low grade fever
hypotension
thirst
sluggish

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3
Q

What are some abnormal labs linked to Hypovolemia?

A

↑BUN/creatinine
↑HCT
↑glucose
↑Protein
↑Osmolarity

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4
Q

What does Hemoconcentration mean?

A

In the body:
Solutes > fluids = ↑ labs

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5
Q

What does Hypervolemia mean?

A

Hyper= high
volemia= volume
(Fluid overload)

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6
Q

What are some s/s of Hypervolemia?

A

↑BP
↑HR
Distended neck veins (JVD)
Crackles
SOB
Wheezing
Edema
↑ urine output
Skin is pale/cool
Altered LOC
↑ motility
Hepatomegaly
Paresthesia

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7
Q

What are some abnormal labs linked to Hypervolemia?

A

BMP (basic metabolic panel)

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8
Q

What does Hemodilution mean?

A

In the body:
Solutes < fluids = ↓labs

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9
Q

What is Hypokalemia?

A

Hypo= low
K= potassium
Emia= blood
(low potassium in blood)

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10
Q

What are the s/s of Hypokalemia?

A

SUCTION
Skeletal muscle WEAKNESS
U wave ↓
Constipation
Toxicity
Irregular weak pulse
Orthostatic hypotension
Numbness

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11
Q

What is the Tx for Hypokalemia?

A

1st = oral supplement
2nd = IV potassium (dilute- it burns, and give slowly)

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12
Q

What is Hyperkalemia?

A

Hyper= high
K= potassium
Emia= blood
(high potassium in blood)

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13
Q

What are the s/s of Hyperkalemia?

A

(numb/tingling-early sign)
1st tachycardia -> bradycardia

MURDER
Muscle cramps
Urine abnormalities
Respiratory distress
Decreased cardiac function
EKG changes
Reflexes

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14
Q

What is the Tx for Hyperkalemia?

A

C BIG KD (see big kid)
Calcium glucontae
Bicarbonate
Insulin
Glucose
Kayexalate
Diuretics (last resort-Dialysis)

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15
Q

What is Hyponatremia?

A

Hypo= low
Na= sodium
Emia= blood
(low sodium in blood)

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16
Q

What are the two types of Hyponatremia?

A

Hyponatremia Hypovolemia
Hyponatremia Hypervolemia

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17
Q

Where salt goes…

A

…fluid goes
…water follows

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18
Q

What are the s/s of Hyponatremia?

A

SALT LOSS
Stupor
Anorexia
Lethargy
Tachycardia
Limp muscle
Orthostatic hypotension
Seizures
Stomach cramping

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19
Q

What is the Tx for Hyponatremia?

A

IV fluids (hypertonic solution- salt>fluid)
seizure precautions
SIADH = fluid restriction
airway protection (NPO- aspiration)

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20
Q

What is Hypomagnesemia?

A

Hypo= low
Mag= magnesium
Emia= blood
(low magnesium in blood)

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21
Q

What are the s/s of Hypomagnesemia?

A

(EVERYTHING IS HIGH)
↑ DTR’s
↑ HR
↑ BP
Shallow respirations
Twitches
Tetany
Irritability
TROUSSEAU’S
CHVOSTEK’S

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22
Q

What is Trousseau’s?

A

lower arm spasm- bp cuff inflating

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23
Q

What is Chvostek’s?

A

light touch of face- cheeky smile reaction

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24
Q

What is the Tx for Hypomagnesemia?

A

Magnesium sulfate IV or PO
Seizure precaution
Increase intake of magnesium rich foods

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25
What assessments should be done for the GI?
Current Problems Patient hx Nutrition Family hx Abdominal assessment
26
What should occur during an abdominal assessment?
INSPECTION -pt empty bladder -lie supine w/ knees bent -inspect symmetry, coloration, distention, pressure injuries -contour, symmetry -abdominal movements (rise and fall) AUSCULTATION -hypo or hyperactive bowel sounds (PERCUSSION- provider only) PALPATE -size and location or organs and masses
27
What are GI changes related to aging?
GASTRIC MUCOSA ATROPHY -anemia -B 12 deficiency -Gastritis CALCIFICATION, PANCREATIC VESSELS -↓ lipase production -↓ fat absorption - Steatorrhea ↓ HEPATIC CELLS -poor filtration -drug toxicity
28
What is Crohn's?
Inflammation of GI tract (anus to mouth) Transmural Patches (cobblestone) Diarrhea (NO BLOOD)
29
What are the s/s of Crohn's?
(abscess/fistulas-↑ infection risk/sepsis) -Diarrhea/steatorrhea -Abdominal pain -Wt loss -Nutritional deficiencies -Fatigue
30
What is the Tx for Crohn's?
NO CURE- drug therapy -Medication. (azathioprine, mercaptopurine, methotrexate & corticosteroids) -Daily wt -3000 calories daily -No caffeine/alcohol
31
What are abnormal labs for Crohn's?
WBC urinalysis infection ↑ C-reactive protien ↑ ESR ↓ albumin ↓ folic acid ↓ vitamin B12 ↓ potassium ↓ magnesium (fluid/electrolyte imbalance)
32
What is Ulcerative colitis?
Chronic inflammation/ulceration of rectum and large intestine (starts at rectum and works up) mucosa/submucosa continuous inflamed areas BLOODY diarrhea
33
What are the s/s of Ulcerative colitis?
(toxic megacolon, rupture bowel, dehydration-↑ risk hemorrhage/shock) -diarrhea BLOODY -abdominal pain -wt loss -deficiencies -fatigue
34
What is the Tx for Ulcerative colitis?
NO CURE- drug/nutritional therapy -physical/emotional rest -record everything about stool -daily wt -medications (amino-salicylates, glucocorticoids, antidiarrheal, immunomodulators) -no caffeine, carbonated drinks, alcohol -no lactose, raw veggies, high fiber -surgery - ostomy
35
What are abnormal labs for Ulcerative colitis?
↓ H&H ↑ WBC ↑ C-reactive protein ↑ ESR ↓ sodium ↓ potassium ↓ chloride ↓ albumin
36
What is IBS?
Irritable Bowel Syndrome -GI disorder -chronic/recurrent -diarrhea -constipation -abdominal pain/bloating
37
What are preventions for IBS?
-Increase fiber (30-40g/day) -8-10 glasses water/day -Chew slowly -Bulk-forming laxatives/anti-diarrheal -Probiotics -Stress management -Regular exercise (promotes elimination)
38
What are the types of Bowel Obstructions?
mechanical and nonmechanical
39
What are the risks for Bowl obstruction?
-reduced/blocked flow -abdominal pain/cramping/distention -vomiting/diarrhea -dehydration -obstipation
40
What are complications of a Bowel Obstruction?
Fluid & electrolyte imbalance Acid-base imbalance -Metabolic Alkalosis (SBO- ↓ hydrochloric acid) -Metabolic Acidosis (LBO- ↓ alkaline fluids)
41
What is Dumping syndrome?
Rapid emptying of food contents into the small intestine
42
What are the two types of Dumping syndrome?
Early stage -30min after eating Late stage -90min after eating -insulin release
43
What are the s/s of early Dumping syndrome?
-vertigo -tachycardia -syncope -sweating -pallor -palpitations -desire to lie down
44
What are the s/s of late Dumping syndrome?
-dizziness -lightheadedness -palpitations -diaphoresis -confusion
45
What is the Tx for Dumping syndrome?
(nutrition changes, eliminating fluids w/ meals) -high protein/fat, low carb diet -several small meals through day -no milk, sweets, sugar -liquid between meals only
46
What is the care for a colostomy/ileostomy?
skin protection pouch care nutrition drug therapy symptoms to watch for
47
What is included in skin protection for a colostomy/ileostomy?
-use of a skin barrier (protects from contact with ostomy contents) -watch skin for irritants or redness
48
What is included in pouch care for a colostomy/ileostomy?
-empty pouch 1/3 or 1/2 full -change during inactive times -change entire system every 3-7 days -cleanse peri-stoma skin meticulously -waffler 1/8" larger than the stoma
49
What is included in nutrition for a colostomy/ileostomy?
-chew food thoroughly -low fiber, high protein diet -no high fiber/gassy foods -no hard to digest foods (seeds/nuts) -↑ fluid intake (3000mL/day)
50
What is included in drug therapy for a colostomy/ileostomy?
-NO enteric coated/capsule meds -NO laxatives/enemas
51
What symptoms should be watched for for a colostomy/ileostomy?
-↑ or ↓ drainage -stoma swelling -abdominal cramping/distention -ostomy contents stop draining
52
What assessments of colostomy/ileostomy mean?
Good -red "beefy" (after surgery) -pink (long term) -moist and shiny Bad -cold -discoloration(pale, gray, purple, dusky)
53
What is a common complication of a colostomy/ileostomy?
-sexual dysfunction -urinary incontinence
54
What is HTN?
Hyper= high Tension= pressure (chronic high blood pressure) "silent killer"
55
What is the Tx for HTN?
THIAZIDE DIURETICS -↓ lidibo -hyperglycemia -no gout LOOD DIURETIC -dehydration -orthostatic hypotension -↑ potassium intake POTASSIUM SPARING(spironolactone) -hyperkalemia CALCIUM CHANNEL BLOCKER -effective for African Americans -for older adults -NO grapefruit -hold if BP ↓90 ACE INHIBITOR -dry cough -angieoedema -not as effective in African Americans ARB'S -hyperkalemia (no potassium foods) -not as effective in African Americans -interaction w/ -zole meds BETA BLOCKERS -fatigue -weakness -depression -↓ libido -orthostatic hypotension -hyperglycemia
56
What is PAD?
Peripheral Arterial Disease (manifestation of atherosclerosis)
57
What are the s/s of PAD?
Pain: intermittent claudication/rest pain Pulse: poor/absent Edema: no (no blood) Temp: cool (no blood) Color: pale, hairless, thin, dry, scaly wounds: red, round, regular, Gangrene: yes (lack of blood) Position: dAngle arteries (A)
58
What is the Tx for PAD?
Exercise -gradually/slowly (no for rest pain, ulcers, and gangrene Positioning -dAngle -dependent position Promote vasodilation -no smoking -warmth -avoid cold -no heat pads -stay hydrated -medications(vasodilation/antiplatelets)
59
What is PVD?
Peripheral Venous Disease
60
What are the s/s of PVD?
Pain: dull/constant Pulse: can't palpate due to edema Edema: yes (blood is pooling) Temp: warm (blood is warm) Color: stasis dermatitis (brown/yellow) Wounds: venous stasis ulcers, irregular Gangrene: no (too much blood) Position: eleVate
61
What is the Tx of PVD?
-eleVate -medications (aspirin/statins) -surgery (angioplasty, bypass, endarterectomy) -compression/ted hose
62
What is HF?
heart can't pump enough blood to meet the needs of the body (HTN, CAD, valvular disease)
63
What are the two types of HF?
right sided HF left sided HF
64
What is right sided HF?
Right Retains fluid Right=Rest of body peripheral edema
65
What are the s/s of right sided HF?
SWELLING Swelling of legs, hands Wt gain Edema (pitting) Large neck veins (JVD) Lethargy Irregular HR Nocturne Girth (ascites)
66
What is left sided HF?
Left=Lungs pulmonary fluid congestion (COPD)
67
What are the s/s of left sided HF?
DROWNING Dyspnea Rales Orthopnea Weakness Nocturnal dyspnea Increased HR Nagging cough Gaining wt
68
What are the two types of left sided HF?
systolic diastolic
69
What is systolic HF?
weak heart (can't empty) ↓EF
70
What is diastolic HF?
stiff heart (can't fill) normal EF
71
Normal levels of cholesterol and triglycerides?
Cholesterol <200 Triglycerides <150
72
What is the Dash diet?
Whole grains (6-8) fruits/veggies (4-5) low fat dairy (2-3) nuts/seeds (4-5) fats/oils (2-3) sweets/added sugar (5/wk)
73
What are the abnormal lung sounds?
Crackles Wheeze Rhonchi Stridor Pleural Friction Rub
74
What is Crackles?
Crackles=Crazy fluid -lower lobes filled w/ fluid -pulmonary edema -diuretics
75
What is Wheeze?
Wheeze=Whistle -narrow airways "bronchoconstriction" -asthma/COPD (expiration) -AIM
76
What is Rhonchi?
Ronchi=Rumble -bronchi (bronchitis) -snoring sound -↑fluids/percussion
77
What is Stridor?
Stridor=Squeak -blockage (emergency -remove obstruction
78
What is Plural Friction Rub?
Plural Friction Rub=Fruity Pebbles -inhalation/exhalation -pneumonia - antibiotics
79
Prednisone
anti-inflammatory -hyperglycemia -↓ bone density -immune suppression -THRUSH -GI bleeding -No stop suddenly -no live vaccine
80
Ipatropium
anticholinergic DRIES EVERYTHING UP -no for glaucoma/peanut allergies -no swallow- crush
81
What are general respiratory complications?
-high fowlers -change position for lung expansion -purse lip breathing -fan on nose/mouth -O2
82
Allopurinol
alloPurinol= Prevents gout -IV dilute 30-60min -w/ food ↓ GI upset -stop if rash
83
Colchicine
Colchicine= aCute attacks -w/ food prevent GI upset -NO grapefruit -Rnhabdomylosis -4-7days
84
6 P's?
Pain Pallor Pulselessness Paralysis Parasthesia Poikilothermia
85
Hep A
water/fecal vaccine hand hygiene
86
Hep B
bodily fluid vaccine hand hygiene
87
Hep C
bodily fluid hand hygiene
88

NSG 121 (6 decks)

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