Final Review Flashcards
(254 cards)
1
Q
Preoperative steps
A
Teaching
Consent
Site marking
NPO
Psychosocial
2
Q
Preoperative history
A
Age
General health status
Review of systems
Medical hx (current medical problems and tx, allergies and sensitivities, hx of prostheses)
Surgical hx including past surgeries, anesthesia, and post surgical pain control
Social history (tobacco, alcohol, drugs, current medications, alternative therapies
Family history
Psychosocial status
Cultural or spiritual needs
3
Q
Post operative phase
A
Handoff
Airway
Vs
Fluids
LOC
I/O
Bowels
4
Q
Postoperative complications (8)
A
Fluid deficits
Shock
Hemorrhage
DVT
Constipation
Pain
Dehiscence
Evisceration
5
Q
Postoperative intervention
A
Teaching
Wound management
Pain management
Breathing exercises
6
Q
Purpose of isotonic fluids
A
Give to increase volume
7
Q
Examples of a isotonic fluids
A
0.9% normal saline
5% dextrose in water
5% dextrose in 0.225% water
Lactated Ringers
8
Q
Purpose of hypertonic fluids
A
Use cautiously to correct imbalance (can cause fluid overload)
9
Q
Examples of hypertonic fluids
A
Any saline over 0.9 %
Any dextrose over 5%, or 5% with any saline, or with Lactated Ringers
10
Q
Purpose of hypotonic fluids
A
Replace fluids in DKA when blood is hypertonic, not for hypovolemia
11
Q
Sodium limits
A
Na 136-145
12
Q
Low sodium intervention
A
Watch for seizure
Give diuretics
Restrict fluids
13
Q
High sodium interventions
A
Replace Na
Oral hydration
14
Q
Potassium range
A
3.5 - 5
15
Q
Low potassium interventions
A
ECG
K supplement
Slow infusion via pump
16
Q
High Potassium interventions (4)
A
Safety
Kayexalate
Insulin
Glucose
17
Q
Calcium range
A
9 - 10.5
18
Q
Low calcium interventions (3)
A
IV administration
Vitamin D (needed to absorb Ca)
Seizure/fall precautions
19
Q
High calcium interventions (5)
A
Stop diuretics
Stop vitamin D
Stop calcium
Rehydrate
Cardiac monitoring
20
Q
Magnesium range
A
1.3 - 2.1
21
Q
Low Magnesium interventions
A
Stop diuretics
Administer replacement
Monitor for Safety / LOC
22
Q
High magnesium interventions
A
Diuretics
Fluids
Lower Na level
Monitor EKG
23
Q
Chloride Range
A
99 - 106
24
Q
Low Chloride interventions
A
Hypertonic IV
I/O
Labs
Restrict water
25
High chloride interventions (4)
Hypotonic fluids
Limit Na
Monitor LOC
Monitor I/O
26
Phosphate range
3 - 4.5
27
Low phosphate interventions
Vs
Neuro signs
Avoid Phosphate binding antacids
28
High phosphate intervention
Monitor for signs of low calcium
29
Types of IV access (7)
Peripheral
Midline
PICC
Tunneled
Nontunneled
Ports
HD catheters
30
24-26 gauge catheters
Indication and flow rate
Preferred for infants and small children
Not ideal for viscous infusions
Expect blood transfusion to take longer
24 mL/hr
31
22 gauge catheter
Indication and flow rate
Adequate for most therapies
Blood can infuse without damage
38 mL/min
32
20 gauge (1 - 1.25 inch length) catheter
Indications and flow rate
Adequate for all therapies
Most providers of anesthesia prefer at least this large for surgery
65 mL/min
33
18 gauge catheter
Indications and flow rate
Preferred for surgery
Vein must be large enough to accommodate catheter
110 mL/min
34
14-16 gauge catheter
Indications and flow rate
For trauma and surgical patients requiring rapid fluid resuscitation
Needs to be in a vein that can accommodate
Over 200 mL/min
35
Midline catheter gauge, length
2 to 5 Fr, sometimes 18 to 22 gauge, double or single lumen
3 to 8 inches long
36
Midline catheter site
Above antecubital fossa in basilic vein
37
Advantages of midline catheter
Reduce patient discomfort by reducing # of attempts at vein puncture for infusion or lab draws
Possible when shorter peripheral iv catheters won’t work due to skin integrity or limited peripheral veins
38
Midline catheter indications
IV fluid or drug therapy for 6-14 days
39
Sign of CSF leak after nasal hypophysectomy
Yellow edge around nasal discharge
40
Indication of arterial ulcer
Lack of hair
Thickened toenails
Diminished pedal pulse
41
Position for surgery for nasogastric ulcer
Semi-Fowler because it localizes spilled stomach contents and is best for comfort and breathing
42
Sign of heart failure
Dypsnea on exertion
43
Foods high in calcium
Cream, milk
Cheese
Orange juice
Broccoli
White meat chicken
Spinach
44
Calcium level that stimulates release of parathyroid hormone
Low; Below 9 mg/dL
45
Priority intervention in sepsis
Antibiotics
46
Diagnose fever, redness, skin breakdown, inflammation, an area that is edematous with diffused borders
Cellulitis
47
How is vitamin B12 (cyanocobalamin) administered for patients with pernicious anemia?
Weekly or Monthly injection (patients with pernicious anemia lack intrinsic factor so can’t absorb vitamin B12)
48
Parathyroid d/o with n/v, weight loss, epigastric pain because of what electrolyte imbalance?
Hypercalcemia
49
Thyrotoxic crisis (thyroid storm) causes what symptoms (3)
Pyrexia
Tachycardia
Exaggerated sx of thyrotoxicosis
50
Causes of thyrotoxic crisis (thyroid storm)
Surgery
Infection
Ablation therapy
51
Bleeding precautions
Electric razors only
Soft bristle toothbrush
No contact sports
52
Interventions (5) when client on anticoagulant
1. Medical alert bracelet
2. Bleeding precautions
3. No estrogen therapy
4. Get routine prothrombin time (PTT)
5. Notify HCPs of anticoagulation
53
ST segment elevation emergency?
Yes. Called STEMI segment elevation myocardial infarction. Must go to cardiac catheterization lab for percutaneous coronary intervention within 90 minutes
54
Sharp pain with deep inspiration
Pericarditis or pleural effusion
55
Highest priority for patient with moderate substernal chest pain not relieved by rest and nitroglycerin
Get 12 lead electrocardiogram (ECG)
56
Intervention after PEG tube feeding
Elevate head of bed
57
Why early ambulation after surgery
Prevent blood from pooling in legs, thus preventing clots
58
Patient refuses hemoglobin, which may cause death if not given. What is best action by nurse
Notify HCP
59
Risk factors for women developing osteoporosis
Cigarette smoking
Familial disposition
Inadequate dietary calcium
60
Check for subcutaneous emphysema in patients with chest tube by_______?
Palpate around tube insertion site for crepitus
61
Sx of hypovolemia (4)?
Decreased urine
Hypotension
Dry mucous membranes
Poor skin turgor
62
Signs of pulmonary edema (4)
Crackles
Coughing
Orthopnea
Pulmonary interstitial edema
63
Left ventricular failure s/s
Dypsnea
Crackles
Frequent cough
No peripheral edema in left ventricular f.
No jugular vein distention in L ventricular failure
64
Right ventricular failure s/s
Pulmonary edema
Jugular vein distention
65
Dehydration s/s
Oliguria
Hypotension
Tenting skin turgor
66
Priority action if patient has hx of heart failure
O2 <90%: oxygenate
Crackles at bases of lungs: Diuretic
67
NG tube intervention before giving meds to prevent aspiration
Verify placement of tube
68
Teaching for client with intermittent claudification
Assess feet daily for injuries
69
Expected symptom for patient with varicose veins
Feeling of heaviness in legs
70
TSH range
0.3 - 5
71
T3 (age 20-50)
70 - 205
72
T3 over age 50
40 - 180
73
T4
4 - 12
(Females 5 - 12)
74
T4 over age 60
5 - 11
75
Free T4
0.8 - 2.8
76
What causes Heberden nodes?
Osteoarthritis
77
Deformities caused by rheumatoid arthritis (3)
Ulnar drift
Swan-neck deformity
Boutonnière deformity
78
Client consideration for rheumatoid arthritis
Comfort (minimize pain)
79
Patient has gastric ulcer causing metabolic alkalosis. Primary concern?
Electrolyte imbalance
80
Sign of functionality in water seal system
Fluid rises with inspiration and falls with expiration
81
Signs of hyperkalemia (high potassium)
Muscle weakness
Irregular heart rhythm
Hyperactive bowel tones
82
Hypertension sign
Severe pounding headache
83
Transurethral resection of prostate after care for urine
Indwelling urinary catheter for at least one day
84
First priority post thyroidectomy
Monitor for signs of respiratory obstruction
85
Patient just started transfusion of packed red blood cells reports chest pain, flank pain, difficulty breathing, & chills. What is happening?
Hemolytic reaction
86
Priority action if suspected anaphylaxis
Airway / oxygenation
87
Dark skinned client with grey tongue and lips
Cyanosis
88
Signs of cor pulmonale (R sided HF caused by pulmonary hypertension secondary to COPD)
Neck vein distension
Lower extremity edema
R upper quadrant abdominal tenderness
Elevated B-type natriuretic peptide (BNP)
Hepatomegaly causes R upper quad tenderness
High BNP caused by atrial enlargement
89
Decrease Dypsnea in patient with acute emphysema episode
Teach pursed lip breathing to prolong exhalation, which prevents bronchiolar collapse and air trapping
90
Left ventricular failure sign
Dypsnea on exertion
91
Left sided stroke sx
Slow performance and caution
Impaired speech/language aphasia
Awareness of deficit with depression and anxiety
92
Glaucoma teaching
Therapy needed for rest of life
93
Why low sodium diet if have HF
Decreased fluid retention
94
Besides sodium, most serious electrolyte depletion in older adults with diarrhea
Potassium
95
Intervention if serum ammonia elevated
Observe for increasing confusion
96
Hypoglycemia signs
Palpitations
Tachycardia
Nervousness
Cool moist skin
97
Hematocrit range
37-52%
98
Hemoglobin range
12-18
99
Sudden waking at night. With shortness of breath
Paroxysmal nocturnal dypsnea
100
After insertion of central venous catheter, client reports chest pain and dypsnea with decreased breath sounds on left side. Intervene
1. Admin prescribed oxygen
2. Activate Rapid Response Team
101
Polycythemia
Elevated hemoglobin and/or hematocrit
102
Signs of end stage kidney disease
Anemia from decreased production of erythropoietin by kidneys
Dypsnea caused by fluid overload
103
Labs showing renal impairment
Elevated creatinine
Elevated potassium
Elevated BUN
104
Med to withhold if diabetic patients getting CT with contrast
Metformin
105
Obstructive jaundice signs
Dark or tea colored urine
Yellow skin
Clay colored stool
106
Position after cardiac catheterization via femoral insertion site
Supine for 4 hours; avoid hip flexion
107
Evaluate epoetin response with what lab value?
Hemoglobin
108
Prothrombin Time (PT) range
11-12.5 seconds
109
INR range (no anticoagulant)
0.8-1.1
110
INR range (afib, dvt, pe)
2-3
111
INR range (prosthetic heart valve)
3-4 seconds
112
aPTT range
30-40 seconds
113
PTT range
60-70 seconds
114
Platelet range
150-400 x 10 to the third
115
Tunneled central venous catheter
Surgically implanted VAD used for long-term infusion therapy in which the catheter lies in a subcutaneous tunnel, separating the points where the catheter enters the vein from where it enters the skin
116
Nontunneled central venous catheter
Multi-lumen VAD inserted percutaneously through the subclavian or jugular vein
117
When to check peripheral iv
At least every shift
Every 4 hours if continuous infusion
Every 1-2 hrs if critically ill or cognitive deficits
More often if receiving vesicant meds
118
HANDS mnemonic for IV insertion
H hygiene: wash hands and skin of pt; use gloves
A antisepsis: prep with skin antiseptic w/back and forth motion for 30 seconds, allow to dry
N no-touch technique: do not touch after cleaning
D document: assessment of site, dressing, tubing; ensure date is clear for all infusion sites
S scrub the hub: scrub for at least 15 sec before accessing
119
Central venous therapy
Long flexible tube inserted in neck, chest, arm, or groin leading to vena cava (empties into heart)
Emergency or long term
120
IV access complications (4)
Infiltration
Extravasation
Phlebitis
Infection
121
Intervention for prevention of IV complications
Arm board
Stabilization
Site selection
Vesicant recognition
Check blood return
122
Shingles risk factors
Immunocompromised
Stress
Varicella
123
Shingles sequence of inflammatory response (6 phases)
1. Pain
2. Redness
3. Vesicles
4. Weeping
5. Crusting
6. Post-herpetic neuralgia
124
Shingles treatment
Acyclovir
125
Shingles nursing intervention (7)
1. Prevent spread
2. Monitor vesicles
3. Provide comfort
4. Administer meds
5. Compresses as needed
6. Support
7. Educate re: vaccine
126
Shingles restrictions
Contact
Avoid contact w/pregnant staff, visitors
127
Cellulitis risk factors
Diabetes mellitus
Malnutrition
Substance abuse
Obesity
Edema
Older adults
Recent surgery
128
Cellulitis sx
Red
Warm
Swelling
Fever
Tender
Diffuse borders
129
Cellulitis intervention
1. Rule out DVT by getting culture (before antibiotics
2. Outline border with pen
3. Moist dressing
4. Teach wound care
4. Teach s/s to report
130
Cellulitis treatment
Cephalexin, pain management
131
signs of acute Osteomyelitis
Fever
Swelling
Heat
Tender w/movement
132
Signs of chronic osteomyelitis
Ulcer
Bone surgery
Sinus tract
Abscess
133
Osteomyelitis treatment priority
Antibiotics (long course that will need to continue at home (teach patient, caregiver, or get VNA)
134
Osteomyelitis teaching
Antibiotic administration
Wound care
What to report
135
Osteomyelitis post op considerations
Amputation may be necessary (provide support)
Neurovascular assessment
Distal pulses
Capillary refill
Elevation
Wound care
136
Rheumatoid arthritis pathophysiology
Inflammatory autoimmune process that affects synovial joints
137
Rheumatoid arthritis cause
Environment or genetics
138
Rheumatoid arthritis symptoms
Weakness
Fatigue
Morning stiffness
May be disability
139
Rheumatoid arthritis diagnosis
Elevated ESR
Rheumatoid factors
Antinuclear antibody test (ANA)
X-ray & MRI changes
140
Rheumatoid arthritis treatment
NSAIDs
Biologics
Immunosuppressants
Prednisone
Promote mobility and self esteem
141
osteoarthritis patho
Deterioration of bone cartilage
142
Osteoarthritis cause
Wear and tear
143
Osteoarthritis sx
Joint pain and stiffness that is relieved by rest
144
Osteoarthritis diagnosis
Structural change on X ray
145
Osteoarthritis treatment
NSAIDs
Acetaminophen
Joint replacement
146
Gout patho
Recurrent error in purine metabolism
147
Gout cause
Urate crystals in joints
148
Gout sx
Pain, especially big toe
Tophi (enlarged joints from uric acid crystals)
149
Gout treatment
NSAIDs
Prednisone (taper)
Allopurinal (if chronic)
Colchicine (acute attack)
Avoid triggers (alcohol, high protein foods, seafood)
150
Joint replacement teaching
Expected post op exercises
151
Joint replacement monitoring
VS
LOC
Pain
Neurovascular signs
Incision
Bowels
152
Joint replacement complications
DVT
PE
Infection
Pain
Joint dislocation (shortening, pain at groin, internal rotation)
153
Joint replacement intervention
Remove foley within 24 hours to prevent UTI
Consider geriatric pain dosing
154
Pneumonia sx
Fever
Chills
Cough
Sputum
Tripod position
Crackles and/or decreased breath sounds
Dull percussion
Tachycardia
Tachypnea
155
Pneumonia diagnosis
Look at sputum
X-ray
CBC
ABG
156
Pneumonia treatment
O2
IS
Bronchodilators
Steroids
Antibiotics
Fluids
Rest
157
Pneumonia teaching
Vaccinations
What to report
158
COPD patho
Emphysema is hyperinflation of lung: obstructive
Chronic bronchitis is inflammation of lung
159
COPD risk factors
Smoking
Genetics
Occupational exposure
160
COPD sx
Wheezing
Fatigue
Hypoxia
Clubbing
Tripod position
Barrel chest
Shallow breathing
Increased work of breathing
Polycythemia (compensating w/ increased # of RBCs
161
COPD diagnosis
Chest X-ray
Sputum sample
PFT (pulmonary function test)
CBC
ABG
162
COPD treatment
Bronchodilator
Steroid
Expectorant
Anxiolytic / anxiety reduction
Antibiotics
Weight management
O2 sat monitoring
Smoking cessation
Positioning
163
Chest tubes indication and description
Allows for lungs to re-expand
3 chambers on system
Water seal stops bubbling when all air has passed out
164
Chest tube intervention
-Check for tracheal alignment and report deviation from midline
-Auscultation: report puffiness or crackling
-Do not strip or clamp chest tube
-Empty drainage chamber before drainage reaches tube
-If tube falls out of patient, cover with dry sterile gauze
-if tube disconnects from system, put in sterile water and keep below chest
165
Tracheostomy intervention
-Secure trach in place to prevent accidental decannulation
-preoxygenate before suctioning
-do not suction more than 10-15 sec
-humidify air
-support out of bed activity
-elevate head of bed after meals, speech eval as needed, small frequent meals
- support communication
- support psychosocial needs
166
Right sided Heart failure causes
Left ventricular failure
Right ventricular MI
Pulmonary hypertension
167
Right sided HF sx
Systemic congestion
Jugular vein distention
Enlarged liver and spleen
Edema
Weight gain
Polyuria at night
Distended abdomen
168
Left sided heart failure causes
Hypertension
Coronary artery disease
Valvular disease
169
Left sided HF sx
Fatigue
Weakness
Oliguria
Angina
Confusion
Dizziness
Pink sputum
Hacking cough (worse at night)
170
HF interventions
Reduce Na in diet -3g / day
Fluid restriction
Daily weight: 1 kg=1L
Diuretics
MWADS Meds/Weight/Active/Diet/Sx
Teach when to report
171
Angina characteristics
-Chest pain that occurs in familiar pattern with moderate to prolonged exertion
-doesn’t limit activity too much
-associated with/atherosclerosis
172
Angina treatment
Rest
Nitroglycerin (NTG)
Rarely requires aggressive treatment
173
Pulmonary Embolism patho
Inappropriate blood clot forms DVT in legs or pelvis, then breaks off
174
Pulmonary embolism risk factors
Immobilization
Cardiovascular arterial disease
Surgery
Pregnancy
Obesity
Older
Smoking
Heart failure
Stroke
Cancer
175
Pulmonary embolism sx
Anxiety
Impending doom
Dypsnea
Cough
Hemoptysis
Low PaCO2 on ABG
176
PaCO2 range
35-45
177
PE interventions
O2
Manage hypoxemia
Minimize anxiety
Control BP
Control bleeding/clot
178
Anemia patho
Iron deficiency caused by inadequate iron intake
179
Anemia s/s
Pallor
Cool
Fatigue
Shortness of breath
180
B12 deficiency patho
Caused by vegan diets, diverticula, tapeworm, deficiency in intrinsic factor (pernicious anemia)
181
B 12 deficiency s/s
Pallor
Jaundice
Glossitis
Paresthesia
182
Iron deficiency anemia treatment
Increase iron supplements, take with meals (cause tarry black stools)
183
B12 deficiency treatment
-Increase foods with B12
-SL better absorbed
-pernicious anemia, monthly IM injections
184
Folic acid deficiency causes
Anticonvulsants
Alcoholism
Oral contraceptives
185
Folic acid deficiency sx
Pallor, jaundice, fatigue
186
Folic acid deficiency treatment/prevention
Diet rich in folic acid
187
Aplastic anemia cause and treatment
Decreasing circulation RBCs, exposure to toxins;
Treat by cause, may get transfusion
188
Blood transfusion policy
1. 2 RNs verify
2. Hemolytic reaction from incompatible blood (apprehension, chest pain, hypotension
3. Allergic reaction: urticaria, itching, bronchospasm
4. Assess for fluid overload
5. Graft versus host disease reaction (occurs in immune suppressed patients)
189
Acute kidney injury
onset and course
Sudden onset
-Oliguric phase: 1-7 days; daily output 400 mL
-Diuretic phase 1-3 weeks; output increases as kidney recovers 1-3 L per day;
-Recovery phase up to 12 months
190
Acute kidney injury diagnosis
Decreased GFR (normal is >90mL/min
Increased Cr (norm is 0.5-1.2)
Increased BUN (norm is 10-20)
191
GFR range
>90
192
Creatinine range
0.5-1.2
193
BUN range
10-20
194
Acute kidney injury intervention
-I/O
-Daily weight
-Urine output
-Fluid restriction
-Monitor labs GFR, BUN, Creatinine
-Careful with nephrotoxic meds (Metformin)
-nutrition
-psychosocial support
- may need renal replacement therapy
195
Chronic kidney disease
onset and course
-Onset is gradual over years
-5 stages based on GFR:
— stage 1 >90
— stage 2 60-89
— stage 3 30-59
— stage 4 15-29
— stage 5 <15 (end stage)
-end stage requires dialysis and is anuric; little or no filtration
196
Chronic kidney disease diagnosis
Decreased GFR
Increased Creatinine
Increased BUN
Significant waste accumulation
197
Chronic kidney disease intervention
-Goal: improve cardiac Fx and manage fluid volume
-diet: low protein, low Na, low PO4, low K
-fluid restriction
Meds: loop diuretic, vit D, phosphate binders, iron support, erythropoietin support, avoid straining,
-AVOID Mg
-end stage requires dialysis
198
Diabetes Mellitus
def and type
-DM is a disorder of impaired nutrient metabolism
-T1: beta cells don’t produce insulin
-T2: result of insulin resistance
199
Hypoglycemia sx
Sweating, anxiety, hunger, neuro changes, dizziness
200
Hyperglycemia sx
Polyuria
Polydipsia
Polyphagia
Fruity breath
Dry mouth
Shortness of breath
201
DM patient ed.
Sick day rules
Medications
Insulin
Exercise
Possible complications
Foot care
Eye exams
202
Hypopituitary treatment
Replacement
203
Hyperpituitary treatment
Possibly from tumor,
hypophysectomy (surgery)
204
Hypothyroid complication (extreme)
Myxedema coma
205
Hyperthyroid complications
-Exopthalmos: eye bulges out of socket
-Graves disease : autoimmune disease
206
Graves’ disease / hyperthyroidism sx
Irritability
Muscle weakness
Sleeping problems
Tachycardia
Poor tolerance of heat
Diarrhea
Weight loss
207
GERD sx
Heartburn
Dyspepsia
Regurgitation
May be respiratory sx
208
GERD complications
Esophagitis
Dental carries
209
GERD
Diagnosis and treatment
-Diagnosis: EGD (upper endoscopy)
-treatment: PPIs (proton pump inhibitors), H2 receptor blockers
-avoid irritating foods
210
Hiatal hernia sx and treatment
-Same as GERD (heartburn, dyspepsia, regurgitation) treated with (PPI and H2 receptor blockers)
-may also need surgery to reduce intra abdominal pressure and reduce the hernia
211
Peptic Ulcer Disease (PUD) patho
Erosion of GI mucosa from HCl acid and pepsin;
May be gastric and/or duodenal
212
PUD risk factors
H.pylori
NSAIDs
Smoking
Caffeine
Stress
213
PUD complications
Hemorrhage
Perforation
Obstruction
Intractable disease
214
PUD upper GI bleed (Gastric) sx
Hematemisis
Malnourished
Sx occur after meals
Food makes worse
215
PUD Lower GI bleed (Duodenal)
Melena (passes through GI tract)
Patient tolerates meals; food alleviates
216
PUD treatment
Triple therapy
1. PPI
2. Antibiotics
3. EGD
217
Upper GI bleed treatment
NPO
Endoscopy
NGT (nasogastric tube)
IV fluids
PPI
Blood replacement
O2 support
218
Diverticulitis patho
Sacular dilations in colon mucosa
219
Diverticulitis risk factors
Constipation
Lack of dietary fiber
220
Diverticulitis complications
Inflammation
Abscess
221
Diverticulitis prevention
High fiber diet
Diet low in red meat and fat
222
Diverticulitis treatment
-Fluids
-Avoid alcohol
-If acute inflammation, avoid fiber, avoid laxatives, avoid enemas
-patient may need bowel rest and surgery with temporary ostomy ( teach ostomy care, importance of psyllium laxatives)
223
Cholecystitis patho
Inflammation of gall bladder
Possibly with stones (cholelithiasis)
224
Cholecystitis risk factors
Female
Pregnancy
Obesity
DM
Estrogen
Sedentary
Fatty foods
225
Cholecystitis sx
RUQ pain
Tachycardia
Jaundice
Fatty stools
Clay colored stools
Indigestion
226
Cholecystitis medicine
Ursodeozycholic acid
227
Cholecystitis diagnostic and procedure
ERCP
May need shockwave therapy to break stones
Surgery may be needed to remove gallbladder
228
Liver disease patho
Liver is body’s primary filter
Cirrhosis causes dysfunctional filtration
229
Liver disease sx
-if compensated cirrhosis, patient may not look sick
-first sx is fatigue, weak, poor po intake, weight loss, n/v, mild pain/discomfort, fever
-later signs caused by accumulation of waste and ammonia include jaundice
230
Seizure management (during seizure)
Safety is focus
Protect patient from injury
Don’t put things in patient’s mouth
Turn patient to side to prevent aspiration
Remove objects that may injure patient
Suction oral secretions without force
Loosen restrictive clothes
Guide movements, don’t restrain
Record time began and ended
231
Parkinson disease patho
Neurodegenerative d/o
232
Parkinson disease characteristics
T tremor at rest
R rigidity
A akinesia or bradykinesia
P postural changes
-also mask like facial expression
233
Parkinson meds
Aimed at correcting imbalance of neurotransmitters by CNS
- first line carbidopa-levodopa must be given on time and w/out protein
234
Parkinson intervention
Check airway
Check Swallowing
Teach energy conservation
Enable communication
Encourage independence
Refer to ancillary disciplines
235
Stroke: TIA def
Transischemic attack; often precursor to more serious attack
236
Stroke is emergency; intervention
F face (limp on one side?)
A arm (weak?)
S speech (abnormal difficulty?)
T time (get to stroke center ASAP)
237
Stroke risk factor
Smoking
Obesity
DM
High Cholesterol
238
Two types of stroke
-Ischemic (blockage prevents perfusion; thrombotic from atherosclerosis or embolic from clot reaching brain from elsewhere in body)
-Hemorrhagic (bleeding; sudden onset)
239
Stroke on right side of brain effects
Impulsive
impaired judgment
Paralyzed left side
240
Stroke on left side of brain effect
Impaired speech/language
Depression
Anxiety
Slow performance
Paralyzed right side
241
Dementia intervention
Safety
Communication
Promote independence
242
Dementia progression
-Sx may not be noticed at first stage
-Second stage: getting lost, wandering, disorientation, impaired ADLs
-final stage is total dependence
-
243
Dementia medication
Donepezil to slow cognitive decline
Memantine to improve memory skills
244
Cataracts sx
Blurry vision
245
Cataracts cause
Age
246
Cataract treatment
Surgery
247
Cataract post surgery teaching
Keep IOP (introcular pressure) low:
-no lifting, bending, stooping, coughing
248
Glaucoma patho
-Increased IOP leading to loss of peripheral vision;
249
Acute angle glaucoma vs
Primary angle glaucoma
-Acute angle is Emergency with sudden pain
-primary angle glaucoma is gradual
250
Glaucoma treatment and education
Drug therapy with eye drops
Teach eye administration and adherence to regimen
251
Macular degeneration
Central vision loss
Affects all ADLs and IADLs
Teach eye protection
252
Macular degeneration
253
Glaucoma
254
Retinopathy
