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Flashcards in FINAL EXAM Deck (182):
1

depolarization of atria

P

2

depolarization of ventricles

QRS

3

repolarization of ventricles

ST

4

de and repolarization of ventricles

QR interval

5

Impulse travel through AVN

PR segment

6

Atrial depolarization and travel time

PR interval

7

Slow repolarization of the Purkrnje fibers

U waev

8

Total ventricular activity

QT interval

9

occurs when the heart contracts to pump blood out

systole

10

occurs when the heart relaxes after contraction

diastole

11

angiotension ii is a what

vasoconstriction

12

MONABATH- used for MI

Morphine
Oxygen
Nitroglycerin
ASA

Beta-blockers
ACE-I
Thrombolytics
Heparin

13

treating congestive heart failure

Upright position
Nitrates
Lasix- urinate less pressure in body
Oxygen
Ace I
Digoxin

Fluids - decrease
Afterload- decrease
Sodium restriction
Test - ABGs

14

ABG (partial blood gases)

ph 7.35-7.45
PCO2-35-45

HCO3- 22-26

PaO2- >80

15

anaerobic metabolism is what

breakdown of glucose without oxygen

16

what is the by product of anaerobic metabolism

lactic acid

17

normal wbc count

4,000-12,000

18

normal platelet range

150,000 to 350,000

19

Controls the reabsorption of water by the kidneys

ADH

20

synthesized by cells in the nuclei of the hypothalamus and then transported to the posterior pituitary gland, where it is stored.

adh

21

adh levels are controlled by

extracellular fluid (ECF) volume and osmolality

22

adh pulls the water out of the cells to give to other places so it makes the urine

concentrated

23

less than 400 ml in a 24 hour period

oliguria

24

Not enough ADH or kidney/tubules are not responding; Deficiency of ADH or a decreased renal response to ADH

diabetes ins

25

how much urine do diabetes in excrete per day

3-20L a day

26

dehydration can be measured by

osmolarity and severity

27

one of the markers used to measure dehydration

Serum sodium marker of osmolarity

28

(130-150 mEq/L)

isonatremic

29

(< 130 mEq/L)

hyponatremic

30

(>150 mEq/L)

hypernatremic

31

sodium in the blood is = to the sodium I am losing

isotonic

32

more sodium than water is lost. Because the serum sodium is low, intravascular water shifts to the extravascular space, exaggerating intravascular volume depletion for a given amount of total body water loss. 

hyponatremic

33

Relatively less sodium than water is lost. dehydration occurs when the lost fluid contains less sodium than the blood (loss of hypotonic fluid).

hypernatremic

34

severe hyponatremia

intractable seizures

35

hypernatremia dehydration

cerebral edema- more water than sodium so swelling occurs

36

holding onto fluid

SI ADH - concentrated

37

Urine osmolarity will be concentrated because its not mixing
Serum osmolarity be diluted because its mixing-hyponatremic

SI ADH

38

which occurs because of a defect in the synthesis or release of ADH
Inflammatory, autoimmune, vascular disease

neurogenic DI

39

kidneys do not respond to ADH

nephrogenic DI

40

Complaints of intense thirst
Craving for ice water
Polyuria

DI

41

treatment for DI

DDAVP

42

The syndrome of inappropriate ADH (SIADH) results from a failure of the negative feedback system that regulates the release and inhibition of ADH.

SIADH

43

INCREASE ADH
DECREASE URINE
HYPERTENSION
INCREASE HR
DILUTIONAL HYPONATREMIA
URINE OSMOLARITY HIGH
SERUM OSMOLARITY LOW

SIADH

44

INCREASE URINE
DECREASE ADH
HYPOTENSION
DECREASE HR
DECREASE OSMOLARITY
DILUTIONAL HYPERNATREMIA
SERUM OSMOLARITY HIGH
URINE OSMOLARITY LOW

DI ADH

45

Lung tumors
Chest lesions
CNS disorders
Tumors, particularly bronchogenic carcinomas and cancers of the lymphoid tissue, prostate, and pancreas
Positive-pressure ventilation

SI ADH

46

treatment for SIADH

give them fluids
diuretic-lasix

47

Break of a bone in the base of the skull

basilar skull fracture

48

bruising behind the ears
bruising around the eyes
blood behind the ear drum.

basilar skull fracture

49

how to test for cerebral spinal fluid

halo test
check for glucose -csf has glucose in it

50

what should you not do if your patient has a basilar skull fracture

insert a nasogastric tube; tube can go through the skull and go up to the brain

51

170-171

look at

52

The greater the concentration of the substance dissolved

the higher the osmolality

53

acute failure of the circulatory system to supply the peripheral tissues and organs of the body with an adequate blood supply, resulting in cellular hypoxia

circulatory shock; not enough oxygen/nutritents; inflammatory mechanism

54

hypotension and hypoperfusion are present

shock

55

why is anaerobic not good for a patient experiencing shock

lactic acid is produced and there is not oxygen in the cells;

56

lactic acid level greater than WHAT is not good

2

57

sodium potassium pump

NA outside the cell
K inside the cell

58

when the na/k pump isn't working properly, the sodium ends up inside the cell. what follows sodium?

water; edema.. lots of fluid

59

compensatory mechanisms for shock

raas system (LOOK UPP)
sympathetic nervous system

60

receptor that works with epiphinerphine and norephinerphine

adrenergic receptors

61

(vasoconstriction)located arteries

alpha cells in adrenergic

62

Increase HR and myocardial contraction

B1 cells

63

Vasodilatation skeletal muscle

B2 cells

64

why do you not want to give a beta blocker to a person with asthma

beta blocker vasoconstricts so it constricts the airways

65

20-1

look over

66

internal hemorrhage
third-space losses

hypovolemic shock

67

the passage of black, tarry stools. Hematochezia is the passage of fresh blood per anus, usually in or with stools.

melena

68

black tarry stool indicative of

high gi bleed; a low GI bleed it'll be red

69

biggest shock states we see in burns

hypovolemia

70

S3

adult- not good it means heart failure
child-normal

71

Necrosis of >40% of the left ventricle

cardiogenic shock

72

3 I's of a myocardial infarction

inverted T wave- ischemia
ST elevation- injury
abnormal Q- infarction

73

blood ejected with each beat

stroke volume

74

amount of blood thats ejected from heart in 1 minute

cardiac output

75

Tachycardia
Hypotension- bum left ventricle
SBP < 90 or 30mm Hg less than the baseline
UA output < 30mL/hr
Cold, clammy skin, PPP
Agitation, restlessness, or confusion- LOC
Pulmonary congestion
Tachypnea
Continuing chest discomfort

cardiogenic shock

76

amount of stretch on ventricle at the end of diastole / filling

preload

77

what would you give to treat a patient in cardiogenic shock

lasix and nitroglycerin (vasodilation)

78

most frequent cause of obstructive struck whats the second

pulmonary embolism ; cardiac tamponde

79

blood clot in the lungs

pulmonary embolism

80

a pressure on the heart that keeps it from filling which decreases blood pressure

cardiac tamponde

81

total collapsed lung

tension pneumothorax

82

partial collapsed lung

atelectasis

83

#1 cause of thrombus formation

DVT in lower extremities

84

cardiac tamponade becks triad

JVD
Hypotension
Muffled heart sounds

85

someone who is in septic shock you will see what

SIRS- Systemic Inflammatory Response Syndrome

86

– Temperature >38⁰C (100.4⁰F) or <36⁰C (96.8⁰F)
– Heart Rate >90
– Respiratory Rate >20 or PaCO2
– White Blood Cell (WBC) Count >12,000 or <4,000 or >10% bands

SIRS requirement

87

treatment for SIRS

steroid; can mask their symptoms

88

what sepsis

2 characteristics of SIRS and the infection

89

what is severe sepsis

sepsis and hypotension

90

when do you know your patient is in septic shock

severe sepsis and MODS (blood pressure doesn't respond to fluid anymore)

91

treatment for septic shock

vasopressor- levafed

92

what does qSOFA measure (SEPSIS)

respiratory rate
altered mental status
low blood pressure

93

heart rate

60-100 beats per minute

94

respiratory breaths

12-20

95

legal pulmonary injury; white lungs

Acute Lung Injury/Acute Respiratory Distress Syndrome (ALI/ARDS)

96

test for ARDS

ground glass - stiff lungs

97

the amount of gas reaching the alveoli

ventilation

98

the blood flow reaching the alveoli

perfusion

99

what is the initial problem in DIC
Disseminated Intravascular Coagulation

clotting- give heparin (break down clots from occurring)

100

complicated condition that can occur when someone has severe sepsis or septic shock.

DIC
Disseminated Intravascular Coagulation

101

what test is for a DVT ?

D dimer; Deep vein thrombosis (DVT) Pulmonary embolism (PE)

102

inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse

erectile dysfunction

103

What symptom will the patient exhibit if they become toxic from the medication?

blue halo

104

involuntary, prolonged (>4 hours), abnormal and painful erection that continues beyond, or is unrelated to, sexual stimulation.

priapism

105

is a component of metabolic syndrome

erectile dysfunction ; cardiovascular disease

106

why should patients with cardiac history not take viagra or clialis

blood pressure will drop -nitroglycerin will drop blood pressure too

107

stores and transport sperm

epididymitis

108

muscle pain

myalgia

109

infection of the testes.

orchitis

110

Painful urination
Dribbling
Frequency
Urosepsis

prostatitis

111

what can cause prostatitis on the health care end

inserting foley catheter but not sterile

112

scrotal cancer is associated with

chimney sweeps

113

BPH is what kind of renal problems

post renal

114

Solitary, painless, firm, fixed lesion with poorly defined borders.

BRCA

115

2 causative factors of ovarian cancer

talc powder and western diet- high fat diet

116

how to test for ovarian cancer/breast cancer

CA-125 >65-70 means a malignant tumor

117

non modifiable of breast cancer

Obesity
Physical inactivity
Caffeine
ETOH
Cigarette smoking
Birth control pills

118

mature into new osteocytes

osteoblasts

119

mature, permanent bone cells

osteocytes

120

reabsorb old osteocytes

osteoclasts

121

Important regulators of calcium and phosphate levels in the blood.

parathyroid hormone

122

what 2 have a reverse relationship

calcium and phosphate

123

hypocalcemia sign

chvosteks or trousseaus

124

who do you expect to have hypocalcemia

multiple myeloma -affected by calcium

125

what is vitamin D

a steroid hormone

126

attaches bone to bone

ligament

127

injury, or bruise, that results from direct trauma and is usually caused by striking a body part against a hard object.

contusion

128

difference between contusion and hematoma

The pain and swelling of a hematoma take longer to subside than those accompanying a contusion.

129

joint ligaments or capsule surrounding the joint, resembles a strain, but the pain and swelling subside more slowly.

sprain

130

stretching or partial tear in a muscle or a muscle–tendon unit.

strain

131

how to treat sprain or strain

Rest
Ice
Compression
Elevation

132

bone is broken and it is protruding through the skin

compound or open

133

occurs due to the migration of fat particles from the bone marrow at the time of trauma or during reaming of the intramedullary canal; causes the release of inflammatory mediators with endothetial lung damage and hypoxia

fat embolism syndrome

134

short of breath
confusion- LOC

fat embolism syndrome

135

treatment for fat embolism

statin and heparin

136

Fever
Swelling, warmth and redness over the area of the infection
Pain in the area of the infection
Fatigue

osteomyelitis

137

can cause no symptoms or signs with people who are immunosuppressed, old, or young

osetomyelitis

138

immune symptom is low with this drug

steroids - causes sugar to increase

139

osteoporosis risk factors

Alc use
Corticosteroid use
Calcium low
Estrogen low
Smoking
Sedentary lifestyle - no physical activity

140

First manifestations
Skeletal fractures
Dowager hump
Pain

osteoporosis

141

buffalo hump is for

cushing syndrome- high cortisol levels

142

osteoporosis treatment

calcium (kale) - can cause constipation / renal stones
vitamin D
exercise
prevent falls
stop smoking
good nutrition

143

Disorder of the bone remodeling; body absorbs old bone but makes bad new bone

Paget Disease

144

causative factor for paget disease

osteoblasts

145

treatment for paget disease

biphosphonates and calcium, vit D

146

body’s immune system –mistakenly attacks the joints.

rheumatoid arthritis

147

how are the joints affected in rheumatoid arthritis

symmetrically

148

rheumatoid arthritis genetic marker

Human Leukocyte Antigen (HLA)

149

Rheumatoid Arthritis: Blood Test

Erythrocyte Sedimentation Rate (ESR)

150

Morning stiffness for 30 minutes or longer
More than one joint is affected
Small joints (wrists, certain joints of the hands and feet) are affected
The same joints on both sides of the body are affected
Along with pain, many people experience fatigue, loss of appetite and a low-grade fever.

rheumatoid arthritis

151

Nonsteroidal anti-inflammatory drugs NSAIDs
Corticosteroid medications
Disease-Modifying Antirheumatic Drugs DMARDs
JAK inhibitors
Surgery

medications for rheumatoid arth

152

Red meat and organ meats (liver, tongue and sweetbreads)
Shellfish such as shrimp and lobster
Refined carbohydrates (white bread, white rice, pasta, sugar)
Processed foods (chips, snack foods, frozen dinners)
Sugary beverages

gout

153

#1 shock state for burns

hypovolemia

154

which degree of burn hurts

second degree

155

burn patients could have burns on the inside so what should you be caution of

their airway

156

how much fluid and how fast they need it

parkland

157

rapid breakdown of muscle that causes the release of intracellular contents including myoglobin(protein), into the extracellular space and bloodstream.

Rhabdomyolysis

158

Rhabdomyolysis triad

Myalgias
Weakness
darkened urine

159

autonomic dysreflexia can cause

pressure ulcers

160

difference between Purpura and Petechiae

Petechiae is smaller

161

Most common invasive cancer

More on fair skin persons with history of tanning

basal cell carcinoma

162

multiple myeloma test

UA; bence jones proteins

163

acute lymphobastic leukemia

lymph system
sudden onset
seen more in children

164

acute myeloid leukemia

bone marrow
in adults

165

chronic lymph leuk

adult
poor prognosis
lymph system
HALLMARK SIGN-high wbc count

166

chronic myeloid leukemia

philadelphia chromosome

167

hodgekins lymphoma

reed sternberg

168

hypocalcemia cats

convulsions
arrythmias
tetany
spasms

169

if they are taking viagra you cannot give

nitrates -bp will go down

170

if they are taking viagra you cannot give

nitrates -bp will go down

171

guys with epididymitis younger than 35 is caused by

stds

172

older than 35

bacteria-e.coli or sudamonas

173

where should you get vitamin d

fish liver or radiated milk

174

can leave the bone marrow and go into the blood stream and might not show up until days later

fat embolism

175

related to obstructive shock

cardiac tamponade

176

foods high in potassium

avocado
banana
potatoes
spinach
beans
citrus juices
fish

177

foods high in phosphorus

meat
fast food
cheese
seeds
milk
canned foods
cola

178

GFR normal kidneys

60 or above

179

GFR kidney disease

15-60

180

kidney failure

less than 15

181

peaked t waves

hyperkalemia

182

u wave

hypocalcemia